Healthwise Maui

Q: Is there anything I can do to delay the need for knee replacement surgery?

Dr. Warren “Vic” Ayers, orthopedic surgeon & joint specialist, Maui Memorial Outpatient Clinic: Joint pain can have a major impact on people’s quality of life, limiting their ability to exercise, enjoy activities and even work. While knee replacement can take care of the problem, there are also many nonsurgical options you can try that may help you postpone the need for surgery or even avoid it altogether.

Physical therapy and proper exercise can help you strengthen the muscles that support and protect the injured joint, building them up to serve almost like shock absorbers for your knee. Wearing a knee brace can give you extra support during exercise and physical activity. Since obesity is also a major contributor to joint pain, losing weight can also make a huge difference and extend the “life” of your knee. Even losing 10 or 15 pounds can help take the pressure off.

For temporary relief, injections of a corticosteroid directly into the knee can reduce swelling, while injections of hyaluronic acid can help lubricate the joint. Finally, medications like ibuprofen can reduce inflammation and ease pain.

If these nonsurgical treatments don’t help, or if pain returns over time, a partial or total knee replacement can provide lasting results, eliminating pain and restoring mobility.

Q: What role does stress play in cancer risk and treatment?

Dr. Derrick Beech, surgical oncologist, Maui Memorial Outpatient Clinic: Although it is difficult to measure a direct link between stress and the development of cancer, stress has undoubtedly been linked to increased risk for several types of cancer. The balance between our spiritual, emotional and physical selves can be altered by excessive stress, resulting in a weakening of the immune system and increase in cancer risk. Also, there are several unhealthy ways that many people deal with stress, such as overeating, using tobacco products or consuming alcohol — all of which have been shown to increase cancer risk.

Q: At what age should my daughter start seeing a gynecologist?

Dr. Christy Takemoto, OB-GYN, Maui Lani Physicians & Surgeons: The American College of Obstetricians and Gynecologists recommends that girls first see a gynecologist between the ages of 13 and 15. This initial exam usually will not include a pelvic exam, unless you are having problems that need to be addressed. This appointment is meant to educate patients and to establish a relationship with them. Topics that may be addressed include talking about their period, cramps associated with their period, acne, weight issues, sex and the prevention of sexually transmitted diseases, healthy habits, and the use of alcohol, drugs and smoking. Pap testing does not start until age 21. This checks for abnormal changes that can occur in the cervix. STD screening is indicated once sexual activity begins, although this can be done with a urine test. While your daughter could potentially see her pediatrician as a teen, this is a great time for her to find a gynecologist that she likes, and to start building a relationship, so that she is comfortable talking about concerns and asking questions as she gets older.

* Physicians, providers and administrative staff who practice at Maui Health System hospitals and clinics answer questions from the public in “Healthwise Maui,” which appears on Thursdays. Maui Health System operates Maui Memorial Medical Center, Maui Memorial Medical Center Outpatient Clinic, Kula Hospital & Clinic and Lana’i Community Hospital and accepts all patients.

To submit a question, go to the website at mauihealthsystem.org/contact.