Injured and Avoiding the Flu? Get to OrthoNow

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Flu season is in full swing.  If you work in an office or you have kids in school, chances are very good that if you haven’t had the flu this year, you know someone who has. 

That’s why TSAOG wants to remind everyone about the availability of OrthoNow, San Antonio’s urgent care solution designed specifically for orthopaedic injuries.  If you have a musculoskeletal injury (like a sprain, muscle tear, or broken bone), get to OrthoNow to avoid the increased exposure to infectious disease you’ll find at a generalized urgent care clinic or at the ER.

The OrthoNow walk-in clinic from The San Antonio Orthopaedic Group is available at our Central location (400 Concord Plaza Dr, Ste 300, San Antonio, TX 78216) Monday through Friday from 11:30am-7:30pm and Saturdays from 9am-1pm.

We treat patients of all ages for a wide variety of urgent orthopedic conditions, including:

  • Sprains and Strains
  • Fractures / Broken Bones
  • Slip and Fall Injuries
  • Worker’s Comp Injuries
  • Minor Dislocations
  • Sports Injuries
  • Painful or Swollen Joints
  • Ligament and Tendon Damage
  • Acute Muscle Pain

Since OrthoNow only treats orthopedic injuries, you get specialty care from the very beginning, including an accurate diagnosis and treatment plan, access to imaging and casting/bracing, and expedited follow-up care with one of TSAOG’s board-certified surgeons.  Best of all, OrthoNow bills to your insurance as a specialty office visit, so you can avoid those costly ER copays!

Broken bones aren’t contagious.  That’s why when injuries happen, you should get to OrthoNow! Call 210.804.5424 to be seen today.

Providing specialty urgent care without the souvenir germs is one more way TSAOG makes your health our mission.

TSAOG Says No to Phone Tag, Adds Scheduling Resources

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Well, San Antonio, you talked and TSAOG listened!  Last year, our patients told us that they were frustrated with our scheduling process, often being put on hold or forwarded to voicemail when they called to schedule an appointment with one of our physicians.  That frustrated us too!

Beginning November 15th, 2012, TSAOG engaged additional scheduling resources to ensure that all scheduling calls (during normal business hours) are answered the first time, eliminating the need to leave a message and putting an end to the inevitable game of phone tag that follows.  This means that anytime you call us to schedule an appointment at 210.281.9595, you will get a live person on the phone to help you.  

So far, patient feedback has been FANTASTIC!  According to Carrie Miller, our Director of Scheduling, the new schedulers answered 2,500 calls and scheduled 900 appointments in the last month alone!

In addition to improving your phone scheduling experience, TSAOG is working to expand our web scheduling capability for your convenience. Right now, you can request an appointment with any of TSAOG’s physicians by sending a secure message to our Scheduling department through the Patient Portal.  In the future, we hope to expand that system even more to allow patients to actually schedule themselves online!  

Listening to your concerns and working hard to improve your healthcare experience is one more way TSAOG makes your health our mission.


Dr. David Schroder Discusses the “Get Around” Knee on Great Day SA

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TSAOG’s Dr. David T. Schroder appeared on KENS 5’s Great Day SA on December 10th, 2012 to discuss the “Get Around” knee implant for total knee replacement.

Dr. David T. Schroder is a board-certified orthopaedic surgeon, with fellowship training in adult reconstruction and joint replacement. He treats patients aged 11 years and up for all orthopaedic conditions.  His special interests include complex joint replacement of the shoulder, hip, and knee and arthritis care.  To schedule an appointment with Dr. Schroder, please call 210.281.9595.


Dr. Alan Hibberd on Painless Total Joint Replacement

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Total joint replacements, often considered miracles of modern medicine, have changed the lives of millions of patients by decreasing their joint pain and increasing their motion and mobility.  Prior to their development over 50 years ago, patients with degenerative and inflammatory joint diseases were forced to live out their lives with pain and debility.

Over the years orthopedic surgeons around the world have advanced the science of joint replacements by improving materials, surgical techniques and rehabilitation protocols.  With these advancements, patients receiving joint replacements can now expect new joints to last, in many cases, up to 20 years or more.

The most recent advances in joint replacement have been in perioperative pain management.  In the past, surgical pain was considered the chief complaint among those undergoing total hip and total knee replacements and often this pain would be an impediment to them having a second or subsequent joint replacement performed.   In the past, the postoperative pain from their joint replacement  has contributed to slower recovery and rehabilitation as well as delays in discharge from the hospital.

With our new approaches, however, postoperative pain should rarely be a concern.  In our practice, pain management is an integral part of the total joint replacement process.  Our goal is to eliminate as much pain as possible so that you as a patient can be free to pursue your physical therapy and work rapidly toward restoration of mobility.

Total joint procedures replace the diseased joints, but it is the surrounding muscles and tendons that make them work.  It is easier to prevent pain from occurring than to try to eliminate it once it is established.  Thus, our goal is to minimize the pain producers even before the procedures have started.  I personally employ multiple methods including anti-inflammatory drugs, nerve blocks, and local infusions, which are used to block the nerves at the site of incision.  Our goal is to minimize narcotic use, which is often associated with confusion, poor balance, and lethargy – all of which can impede the healing process.  Some other side effects of narcotic use include vomiting and constipation, which can also be major impediments to recovery following a joint replacement.  In the postoperative period, patients manage their own pain with the use of a pain pump, which allows them to control the amount of narcotics they require, within the confines of safety.

Using these advances in pain management for joint replacement patients, we have significantly diminished the psychological and physiological effects of pain.   We eliminate the fear associated with total joint replacements and allow the patient to pursue an aggressive rehabilitation program.  This helps to restore the patient’s function and speeds them on their way to recovery.

Most patients utilizing our protocols are up and active the next day following surgery.  They are ambulating on the floor with the aid of a physical therapist in a day or two and are usually ready for discharge by the third day.  Physical therapy is continued at home along with additional methods to control any discomfort.

Are total joint replacements totally pain free? Unfortunately, we cannot make that a reality at this time.  However, with our pain management protocols, we do everything possible to minimize your discomfort and speed your recovery so that you can enjoy all the benefits of these wonderful procedures.

Dr. Alan E. Hibberd is a board-certified orthopaedic surgeon with The San Antonio Orthopaedic Group.  He treats all orthopaedic conditions, with the exception of the spine, for patients aged 16 years and up.  His special interests include total hip replacement and total knee replacement.  To schedule an appointment with Dr. Hibberd, call 210.281.9595.

Orthopaedics VS Orthopedics

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Orthopaedic…orthopedic…?  We’ve all seen it spelled both ways, so which one is right?

Well, even though the computer spell checker seems to disagree, both spellings are technically correct.  Orthopaedics is the original British form of the word and Orthopedics is a more Americanized version.

The word “Orthopaedics” comes from the Greek words “orthos” – meaning straight – and “paideion” – meaning children.  It was coined by French physician Nicholas Andry when he published Orthopaedia: or the Art of Correcting and Preventing Deformities in Children in 1741.  While this may seem a limited definition of orthopaedics by today’s standards, it makes sense given that the specialty originally focused largely on correcting childhood musculoskeletal deformities like polio and scoliosis.

Today, the specialty of orthopaedics has evolved to handle the diagnosis and treatment of all conditions and injuries of the musculoskeletal system, so if you have a bone or muscle problem, it falls under our umbrella!

Though the orthopaedic specialty has advanced greatly over time and will continue to do so, TSAOG has chosen to use the original spelling in order to show our continuing commitment to our profession: past, present and future.

Evolving with our specialty while providing the same quality of care you’ve come to expect from us since 1947 is one more way TSAOG makes your health our mission.

Dr. Alan Hibberd with a Word of Christmas Caution

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Though the Christmas season is a joyous and wonderful time, it can also be a dangerous time.  We need to remember to be especially cautious to avoid injury during this time of year.

Each holiday season in the US, there are more than 6,000 people who present to emergency rooms with fall related injuries.  Thousands more are injured with bruises and sprains, but they manage these at home.  If there is ice or snow on the ground, step carefully, wear proper footwear, and remember to salt your sidewalks for safety.  If you have elderly relatives visiting your home, be sure to clear walking paths of objects that could cause someone to trip and fall.

Falls while hanging house lights or decorating a tall tree can also be a problem.  Always use a secure ladder and never stand on a stool or piece of furniture hang these high decorations.  For outside lights, you may even want to consider hiring a professional.

Cuts, eye injuries and choking hazards from Christmas decorations can also be a big problem, so watch out for your little ones!

Finally, candle-related fires result in over 100 deaths and 1,000 injuries each season so be very careful that your candles are not left burning unattended or in close proximity to a flammable object.  Also, be sure to check your electric hookups to make sure that they are wired correctly and not overloaded.

Be especially cautious during this holiday season and have a wonderful Christmas.

Dr. Alan E. Hibberd is a board-certified orthopaedic surgeon with The San Antonio Orthopaedic Group.  He treats all orthopaedic conditions, with the exception of the spine, for patients aged 16 years and up.  He has a special interest in reconstructive surgery, including total hip replacement and total knee replacement.  To schedule an appointment with Dr. Hibberd, call 210.281.9595.

Dr. Ronald Connor on Holiday Ladder Safety

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The holidays are here and so are holiday injuries.

Every orthopaedic surgeon has heard too many tales of injuries occurring at this time of year.

I will never forget treating a gentleman who fell from a ladder while putting up holiday lights at his home. He sustained fractures of both wrists and a fracture of one elbow. All three fractures required surgical treatment.

Whether you are putting up lights or taking them down this holiday season, please consider these tips regarding ladder safety:

  • Be aware of electrical hazards overhead.

  • Always maintain three points of contact on the ladder – either two feet and one hand or two hands and one foot.

  • Never try to move a ladder while a person or equipment is on the ladder.

  • An extension ladder or straight ladder should extend three feet above the point of support.

  • The proper angle for setting up a ladder is to place the base of the ladder one fourth of the working length of the ladder from the wall or other vertical surface.

  • The ladder should be placed on a stable and level surface. Do not place the base of the ladder on any unstable base to obtain additional height. 

Here’s wishing you a great – and safe – holiday season!

Dr. Ronald W. Connor is a board-certified orthopaedic surgeon with The San Antonio Orthopaedic Group.  He treats all orthopaedic conditions, with the exception of the spine, for patients aged 14 years and up.  He has a special interest in total knee replacement and shoulder and knee arthroscopy. To schedule an appointment with Dr. Connor, call 210.281.9595.

TSAOG Customer Survey Highlights – November 2012

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When our patients have something nice to say about us, we like to brag about it!

Please enjoy some of the highlights from our November Customer Survey:

  • Dr. Bergfeld was amazing. I really loved her caring nature and how she empathized with my pain.”

  • “The facility was great, the staff was great and the Dr. was great. One of the best Dr. visits I’ve ever had.” (Dr. Balldin)

  • “The doctor was very thorough and kind” (Dr. Hennessy)

  • “I have already referred Dr. Brown and Dr. Connor to friends and family.”

  • Dr Burkhart and his staff are extremely professional and thoughtful about treatment plans. I trust his opinion and advice. His staff is always very polite and caring. They know who we are and are very personable.”

  • “I never saw a frown on anyone’s face and the physician was calling patients into rooms when his staff was busy. I love this practice and being a nurse myself I’ve seen it all. Thank you for the care you provide.” (Dr. Drukker)

  • Dr. Galindo gave me his complete attention, answered questions, and I did not feel rushed in any way. Also, my wait time in the waiting room was very brief as well as in the patient room. I am very satisfied with my visit.”

  • “Very down to earth pleasant and professional all questions answered I have been very impressed by Dr. Garcia

  • “[I liked] the convenience of having the physician’s offices, therapy services and MRI facility all in one building just minutes from my job.”

  • “Pleasant and efficient doctor and staff” (Dr. Hibberd)

  • Doctor Jacobs is a pleasure to meet with and speak to. I enjoy his manner and approach.”

  • Dr. Kaiser is awesome! Not only is he a great surgeon, he is attentive and helpful during each office visit!”

  • “Thank y’all for what you do! I’ve been to multiple doctors in multiple states as my husband and I have moved in the military 14 times in 26 yrs. It has always been so hard to get established in a short time before having to leave again. As a Professional Patient I can honestly say that your group is the BEST I’ve seen ANYWHERE! You are a big part of the reason that we decided to retire here in San Antonio! Thank you!”

  • “As always staff very friendly, wait is usually very, very minimal, the best I’ve EVER experienced.” (Dr. Pace)

  • “Waiting area is clean and spacious I liked the professionalism and thoroughness of my doctor – Dr. Alexander Rowland. When I returned for a second visit he was very familiar with my medical concerns – I didn’t have to explain them again to him; I really appreciated that.”

  • “I have the best Dr. in Dr. Brad Tolin. His staff is A1 and Linda and Irene are both the very best at what they do. I would never go anywhere else. I have sent other people to see them as well and they are very happy with the Orthopedic Group. Thank you all for the finest care every patient wishes for. You are the best!”

  • Dr. Viroslav was very understanding of my condition and offered solutions to help manage my problem knees.”

  • “[I liked] the concern that is shown by PA and doctor to find out what is going on and what the best treatment would be for me.” (Dr. Taber)

  • Dr. Ochoa wasn’t even scheduled to see me today, I was in there for an injection with a PA, but Dr. Ochoa came in the room to check on me and the progress with my knee. Very professional!”

  • Dr. Ursone is very personable and gives his full attention to his patients. He is a very confident and competent doctor. I am extremely happy with the care I have received from him.”

  • Dr Bell was very informative and attentive to my concerns and left me with a sense of reassurance. I went to him as a second opinion and the quality of my appointment was like night and day. It was that good!”

  • “I have a strong sense of confidence in Dr. Brenman. I appreciate his direct and concise delivery of information. Very reassuring.”

  • “I really enjoy my visits to this office. The Dr and staff are very efficient and are concerned about the patient.” (Dr. Marx)

  • “Thank you Dr Woodbury for being the one Dr out of 3 that took the time to explain what is going on with my arm and gave me a possible solution to fix it. I just wish I would have met you a month ago.”

  • “[I liked] the kindness, consideration and professionalism shown by everyone.” (Dr. Gonzalez)

We encourage you to review and rate your experience at TSAOG. The next time you visit us, please take the time to fill out our customer survey and you may see one of your comments online the next month!



Dr. Josh Bell on Whether Drinking Soda Can Worsen Your Arthritis

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Over 70 million adults (1 in 3) in the United States are affected by arthritis. There are 3 basic types of arthritis: rheumatologic (inflammatory) arthritis, post-traumatic arthritis, and osteoarthiritis.  Inflammatory arthritis, like rheumatoid arthritis, is a condition in which the body sends inflammatory factors to the joint which destroys the joint over time.  Post-traumatic arthritis occurs after an injury in which there was damage to the joint which accelerates the breakdown of the joint.  The most common type of arthritis is osteoarthritis, which primarily affects middle aged and older adults and is often referred to as “wear and tear” arthritis.

There are many factors that contribute to osteoarthritis and some are out your control.  These factors include genes (whether or not your parents have arthritis) and gender (women have more knee arthritis).  Factors that you can influence include weight, activity level and diet.  A recent study presented at the American College of Rheumatology Annual Meeting in Washington, D.C. showed that an increased consumption of sugary carbonated drinks in men with osteoarthritis worsened their arthritis.  This finding did not occur in women in the same study.  While the association of sodas to worsening arthritis in the study was not entirely conclusive, it is an interesting finding.  What this suggests is that there are things that you can do to improve function and lessen your pain from arthritis.

What can you do to reduce arthritis pain and improve function?

  • Maintaining a proper body weight is very important in protecting your joints and reducing pain.  As you walk or run, the force that your knee experiences, is several times more than your body weight.  If you are carrying extra weight, that amount is multiplied in load across the knee.  You can imagine how sore your knees are after carrying a 50lb box throughout the day.  That is the same effect that your knee experiences if you are 50lbs overweight. 
  • Engage in regular exercise and stretching.  Proper strength and flexibility of the joints can reduce pain and improve function even in patients with established arthritis.
  • Modify your daily activities.  If you perform physically demanding work with arthritis, it is reasonable that an adjustment to the amount of physically demanding work may improve your symptoms.
  • Use tools to aid in movement.  A brace or cane may help to relieve the load on your joints and improve function.
  • Reduce soda consumption???   While it remains to be seen if soda intake can be definitively shown to accelerate arthritis in men, there is no question that it can contribute to weight gain, which has been clearly shown to effect arthritis pain.  If you’d rather be safe than sorry, it’s probably not a bad idea to cut back on sodas if you suffer from arthritis.

If you are unable to control arthritis symptoms on your own, there are excellent non-operative options available to improve your symptoms such as medications, injections (such as viscosupplementation) and physical therapy.  As an orthopaedic surgeon, these are some of the things I use commonly to relieve arthritis pain and improve function.  For those patients who have not improved after non-operative options have been exhausted, surgery is a great option to reduce pain and improve function. Advances in surgical techniques and technology allow for quick recoveries after arthroscopic surgery and total joint replacement alike.

S. Josh Bell, M.D.Dr. S. Josh Bell is an orthopaedic surgeon, with additional subspecialty certification in orthopaedic sports medicine.  He treats all orthopaedic conditions, with the exception of the spine, for patients aged 11 years and up.  His special interests include total joint replacement of the hip and knee and arthroscopic surgery. To schedule an appointment with Dr. Bell, please call 210.281.9595. 

Dr. Deborah Bergfeld on the Benefits of Exercise as You Age

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The benefits of exercise are undeniable for people of all ages.  However, more and more research supports the need for continued exercise as we age.

The physical benefits of exercise have long been touted, but new research even seems to support that continued exercise later in life has the added benefit of slowing cognitive decline and memory loss.  In a recent study out of the United Kingdom, persons over the age of 70 were studied. The group who reported the most physical activity tended to have larger brains and less brain atrophy.  In another study, 120 older adults without dementia began an exercise routine that included walking at a moderate pace for 30-45 minutes 3-4 times per week versus non-aerobic, stretching exercises. A year later, MRI brain scans showed an area involved in memory, the hippocampus, was larger in the walking group.

If such evidence about the cognitive benefits of exercise as we age is not enough, there are plenty of other reasons to exercise. 

Improved heart and lung function are long recognized benefits of aerobic exercise.

Exercise, particularly resistance training (weight training), has been shown to combat age related muscle loss.  Battling this muscle loss has translated to improved function. In a study of nursing home residents, mostly in their 80’s to 90’s, resistance training for 10 weeks increased walking speed, improved stair climbing ability, and decreased symptoms of depression.

Numerous forms of exercise have proven effective for treatment of osteoporosis with many studies showing an increase in bone density for the exercise group.  At best, managing osteoporosis with medication alone can only maintain current bone mass and prevent further loss, with far greater side effects.

Even if you find that resistance training or aerobic exercise does not appeal to you, numerous studies have found that the practice of Tai Chi can promote health benefits including improved strength and balance, lower blood pressure, improved arthritis pain, and stress reduction.

If you find that a pain complaint or injury is preventing you from exercise, no matter what your age, I encourage you to consult a physician to get on the road to a more active, fulfilling life.

Dr. Deborah A. Bergfeld is no longer in practice with The San Antonio Orthopaedic Group.  To schedule an appointment with another physical medicine & rehabilitation physician, please call 210.281.9595.



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