The 5 Dos and Don’ts of Managing Joint Health

As a board-certified gastroenterologist, I am often tasked with the responsibility of breaking bad news in the form of relaying a newfound colorectal (colon) cancer diagnosis. I don’t take this obligation lightly as I know my next discussion with the patient will greatly impact their life.

Colon cancer is a malignant tumor originating from the colon or rectum. Often there are no signs, but colon cancer can present with rectal bleeding, weight loss, abdominal pain, change in bowel patterns and loss of appetite. Unlike many other cancers, however, most colon cancers can be diagnosed early and even prevented with the appropriate screening.

The Problem: Colon Cancer is Common and Rising

Colon cancer is very common. It is the third most common cancer worldwide and ranks second in cancer-related death. The number of cases increases as we get older. Unfortunately, we are also seeing a rise in numbers among younger adults under the age of 50.

This increase cannot be explained through hereditary factors as most early onset colon cancers are sporadic, meaning not linked to passed-down genetics. To add insult to injury, we are seeing an overall trend of rising colon cancer mortality among this younger group.

The Answer: Screening

Colon cancer screening has shown to improve survival from colon cancer by catching it early. Some screening tools can even prevent colon cancer by removing the precursor to cancer. There are multiple screening tests available, including stool-based tests that look for blood or abnormal DNA, and specialized imaging tests that allow doctors to visualize your colon from the outside.

One of the highest recommended screening tools is a colonoscopy. Colonoscopy involves direct examination of the colon with biopsy or removal of abnormal colon tissue. Unlike the other screening tests, a colonoscopy can prevent colon cancer with removal of polyps. Polyps are benign tissue but can develop into cancer over time if left untreated. Studies have shown that colonoscopy and removal of polyps significantly reduce the long-term incidence of colon cancer.

I encourage you to speak with your primary care provider about colon cancer screening. Taking this simple step could save your life.

Learn more about colon cancer prevention at Wellstar by visiting wellstar.org/cleancolons. To make an appointment with Dr. Renelus, call (470) 610-0145.

Pregnancy is a time of excitement and change. But it also puts added strain on the heart. In fact, cardiovascular conditions are one of the leading causes of maternal complications worldwide. Some women can develop heart conditions during pregnancy that can lead to serious complications if not recognized early. Knowing the risks and being proactive about your heart health can help prevent a life-threatening problem.

Here’s what every expectant mom should know about heart health during pregnancy.

1. High blood pressure can be silent—and dangerous.

Some women develop high blood pressure during pregnancy, even if they’ve never had it before. High blood pressure can lead to preeclampsia. It’s a condition that can cause organ damage and, in severe cases, seizures. When high blood pressure isn’t treated, it can increase the risk of stroke or heart failure. Checking your blood pressure regularly can help catch problems early.

What to do about high blood pressure

If you have a history of high blood pressure, heart disease or a family history of cardiovascular issues, tell your care team. Preconception counseling is essential if you have a known heart condition. Your physician may recommend that you monitor your blood pressure at home and report any sudden swelling, headaches or vision changes immediately.

2. Heart failure can happen—even in healthy moms.

A rare but serious condition called peripartum cardiomyopathy (PPCM) weakens the heart, usually in the last month of pregnancy or the months following delivery. If you have shortness of breath, swelling or often feel extremely tired, don’t ignore those signs.

What to do if you have shortness of breath or a racing heart

Talk to your provider immediately if everyday activities leave you exhausted or struggling to breathe. Other concerning symptoms include persistent coughing, swelling in your legs or feet and dizziness. Don’t ignore symptoms like chest pain, shortness of breath, severe fatigue or a racing heartbeat. These could signal a serious heart problem—seek help right away.

3. Pre-existing heart conditions and hypertensive disorders require extra care.

If you’ve ever had heart disease, a heart defect or high blood pressure—including hypertension or hypertensive disorders—pregnancy can increase your risks. Even women without symptoms before pregnancy may need extra monitoring.

What to do if you have a pre-existing heart condition

Talk with your provider early about a care plan. High-risk pregnancies may require specialist support, like a maternal-fetal medicine physician or cardiologist. If you’ve been diagnosed with a heart condition before pregnancy, ask your provider how it may affect labor and delivery. If something doesn’t feel right, speak up. You know your body best, and your concerns deserve attention.

4. Blood clots are more common during pregnancy.

Pregnancy increases the risk of thromboembolism, a serious condition where blood clots can travel to the lungs and cause a pulmonary embolism. The risk is even higher for women with a history of clotting disorders, obesity or limited mobility.

What to do to prevent blood clots

To reduce your risk of blood clots, stay active, stay hydrated and watch for warning signs like leg swelling, redness or pain. If you notice these, call your provider right away. If you’re on bed rest, ask your provider about ways to improve circulation. Learn the signs of deep vein thrombosis and pulmonary embolism.

5. A racing heartbeat may be abnormal.

You can expect some changes in heart rhythm during pregnancy, but arrhythmias (irregular heartbeats) can be a sign of something more serious. Hormone changes, increased blood volume and underlying conditions like thyroid disorders can all contribute to an irregular heartbeat.

What to do about a racing heart

If your heart races often, feels like it’s skipping beats or you feel dizzy or faint, let your provider know immediately. Keep track of when these symptoms happen and whether they occur at specific times, such as during physical activities or when your stress levels are high.

6. Postpartum recovery still puts stress on the heart.

The risk of heart complications doesn’t end at delivery. Many serious conditions, including heart failure or high blood pressure, can develop in the weeks or months after childbirth. Postpartum heart issues can be life-threatening if you don’t address them.

What to do during the postpartum period

Keep all postpartum checkups, even if you feel fine. Watch for new symptoms like chest pain, shortness of breath or extreme fatigue. If you had high blood pressure during pregnancy, continue monitoring it after delivery. Be aware that cardiovascular complications can develop up to a year postpartum, and follow-up care is so important for your long-term health.

7. Your hospital choice matters

For women at high risk, delivering in a hospital with access to specialized prenatal tests, genetic testing like amniocentesis, fetal evaluations and emergency cardiac care can make all the difference. Not all hospitals have the same level of maternal heart care, so it’s important to plan ahead. Choose a hospital that is equipped to handle pregnancy-related cardiac emergencies.

Wellstar provides specialized care for mothers and babies close to home, including:

• Wellstar Acworth Health Park: Perinatal cardiology
• Wellstar Avalon Health Park: Perinatal cardiology
• Wellstar Cherokee Health Park: Perinatal cardiology
• Wellstar Children’s Hospital of Georgia: Level IV NICU
• Wellstar Cobb Medical Center: Emergency cardiac care, level III NICU, maternal-fetal medicine, medical genetics, perinatal cardiology
• Wellstar Douglas Medical Center: Emergency cardiac care, maternal-fetal medicine
• Wellstar East Cobb Health Park: Perinatal cardiology
• Wellstar Kennestone Regional Medical Center: Emergency cardiac care, Level III NICU, maternal-fetal medicine, medical genetics, perinatal cardiology
• Wellstar MCG Health Medical Center: Cardio-obstetrics, emergency cardiac care, maternal-fetal medicine, medical genetics
• Wellstar North Fulton Medical Center: Emergency cardiac care, medical genetics
• Wellstar Paulding Medical Center: Emergency cardiac care, medical genetics, perinatal cardiology
• Wellstar Spalding Medical Center: Maternal-fetal medicine
• Wellstar Vinings Health Park: Perinatal cardiology
• Wellstar West Georgia Medical Center: Emergency cardiac care

What to do about your hospital choice

If you are high-risk, consider hospitals with advanced cardiac care and those that have expertise in pregnancy-related heart conditions. Talk to your care team well in advance about your birth plan, especially if you have a heart condition. If possible, tour the hospital beforehand and ask about its capabilities in managing pregnancy-related heart complications.

8. Mental health and stress impact heart health.

Anxiety and stress can affect your heart. If you’re feeling overwhelmed, talk to someone. Your mental health is just as important as your physical health. Depression, anxiety and even post-traumatic stress disorder are common in pregnancy and postpartum, and they can impact heart health.

What to do to keep your mental health in check

Access mental health resources and practice stress management techniques to help you manage your mental health. Simple practices like deep breathing, mindfulness and connecting with loved ones can help lower stress levels. Remember, you are empowered to take control of your health—talk with your provider or a support person and get the help you need.

Take Action for a Healthier Pregnancy.

Eat well, stay active and avoid smoking or alcohol. These efforts can protect your heart and your baby’s health. Small, consistent changes—like reducing salt intake or walking daily—can make a difference.

Regular prenatal visits are just as important. Remember, knowledge is power. Stay informed, speak up when something feels off and choose a hospital that meets your needs. These simple steps can help you take control of your heart health and reduce the risk for you and your baby.

Find an OB/GYN or perinatal cardiologist and learn about labor and delivery at Wellstar.

Hand surgery is a unique and intricate field that combines the precision of microsurgery with the compassion required to treat patients of all ages. My journey into this specialized area of medicine comes from a deep passion for helping individuals regain function and improve their quality of life. This article explores my dedication to pediatric hand surgery and minimally invasive adult hand surgery, including arthroscopy and ultrasound-guided procedures such as carpal tunnel and trigger finger release.

The Beginnings of a Passion

From an early age, I was fascinated by the complexity of machines, computers and tools. Until high school, I was convinced that I should become an engineer. However, in the last month of high school I shadowed an orthopedic surgeon and told myself, “I’ll go to medical school if I can do that!” During my medical training, I was fortunate to be able to help many patients in the emergency department to return to their lives and work by treating their hand injuries. I became enamored with the hand’s intricate network of bones, tendons, nerves and muscles that allow for an incredible range of motion and dexterity. Also, in treating children during residency, I wanted to learn more about the growing hand and how I could help children gain the most function. This fascination led me to direct my career in medicine toward a particular focus on hand surgery and pediatric orthopedics.

Pediatric Hand Surgery: A Delicate Balance

Pediatric hand surgery is a particularly rewarding aspect of my practice. Children with congenital hand differences or traumatic injuries require specialized care that addresses both their physical and emotional needs. The challenge lies in the delicate balance of performing intricate surgeries on tiny, developing hands while ensuring minimal disruption to their growth and development.

One of the most fulfilling aspects of pediatric hand surgery is witnessing the resilience and adaptability of young patients. Their ability to recover and adapt to new circumstances is truly remarkable. Whether it is correcting a congenital anomaly like syndactyly (webbed fingers) or repairing a traumatic injury, the goal is always to restore function and enable these children to lead active, fulfilling lives. My favorite pediatric hand surgery is the index pollicization, in which I convert the index finger into a thumb for children who are born without a thumb.

Minimally Invasive Techniques: The Future of Hand Surgery

In recent years, minimally invasive techniques have revolutionized the field of hand surgery. These approaches offer many benefits, including reduced pain, faster recovery times and smaller scars. My practice has increasingly incorporated these techniques, particularly arthroscopy and ultrasound-guided procedures, to provide the best possible outcomes for my patients.

Arthroscopy: Precision Through Small Incisions

Arthroscopy is a minimally invasive surgical technique that involves the use of a small camera, called an arthroscope, to visualize the inside of a joint. This allows for precise diagnosis and treatment of various hand conditions without the need for large incisions. In my practice, arthroscopy works well for conditions such as wrist ligament injuries, ganglion cysts and early-stage arthritis.

The advantages of arthroscopy are myriad. Patients experience less postoperative pain, shorter hospital stays and quicker return to daily activities. Additionally, the smaller incisions result in less scarring, which is particularly important for hand surgery, where stiffness can lead to delayed recovery since tissues must stretch to recover.

Ultrasound-Guided Procedures: Real-Time Precision

Ultrasound-guided procedures have also become a cornerstone of my practice. This technique involves using ultrasound imaging to guide the placement of needles or surgical instruments in real-time. It is particularly useful for conditions such as carpal tunnel syndrome and trigger finger, where precise targeting of the affected area is crucial.

For carpal tunnel syndrome, ultrasound guidance allows for accurate placement of the needle during corticosteroid injections or for the release of the transverse carpal ligament. This results in effective symptom relief with minimal discomfort for the patient. Similarly, for trigger finger, ultrasound guidance ensures precise release of the constricted tendon sheath, leading to improved outcomes and faster recovery.

The Human Connection: Building Trust and Empathy

While the technical aspects of hand surgery are undoubtedly important, the human connection is equally vital. Building trust and empathy with my patients is at the core of my practice. Each patient comes with their own unique story, and understanding their concerns and goals is essential for providing personalized care.

In pediatric hand surgery, this often involves working closely with both the child and their family. Explaining the surgical procedure in a way that is understandable and reassuring helps to alleviate anxiety and build confidence in the treatment plan. For adult patients, particularly those undergoing minimally invasive procedures, clear communication about the benefits and expectations of the surgery is crucial for informed decision-making.

Continuing Education and Innovation

The field of hand surgery is constantly evolving, with new techniques and technologies emerging regularly. Staying at the forefront of these advancements is a priority for me. I am committed to continuous education and regularly attend conferences, workshops and training sessions to refine my skills and learn about the latest developments in hand surgery.

Innovation is also a key aspect of my practice. I actively participate in research studies and collaborate with colleagues to explore innovative approaches and improve existing techniques. This commitment to innovation ensures that my patients receive the most advanced and effective treatments available.

Conclusion: A Lifelong Commitment

My passion for pediatric hand surgery and minimally invasive adult hand surgery comes from my desire to make a meaningful difference in the lives of my patients. The ability to restore function, alleviate pain and improve quality of life is incredibly rewarding. As I continue this journey, I remain dedicated to providing compassionate, cutting-edge care to all my patients, young and old.

Hand surgery is more than just a profession for me; it is a lifelong commitment to excellence, empathy and innovation. Each day brings new challenges and opportunities to gain experience and grow, and I am grateful for the privilege of being able to help my patients achieve their best outcomes.