Paul Szmal: Good morning, it's 8.38, it's FLX Morning Tuesday, it's time to get healthy with UR Medicine, Finger Lakes Health, and Kim is off today, so Caroline Scott, who we just met the last time or a time before, is here. Good morning to you.
Caroline Scott: Good morning.
Paul Szmal: I don't know this for sure, but I think you would be only the third person to do this in 20 plus years. Laura and Kim and you, I think, are the only ones that have ever been the co-hosts of the Finger Lakes Health Matters segment, so welcome.
Caroline Scott: Why, thank you, and I think you might be correct about that.
Paul Szmal: Now, I know you don't want to talk a whole lot about yourself, but just a little bit. Just tell us where you're from and what brought you to Finger Lakes Health.
Caroline Scott: Well, I actually am from New Jersey, a little town called Frenchtown, and my husband and I are in the process of transitioning up here. I have deep connections to the Finger Lakes through my grandparents and family, especially Kuka Lake, so this opportunity came about at Finger Lakes Health, and I didn't want to say no, because as you said, you know, so anyway, here I am. It's not about me today, but yes, I'm thrilled to be migrating up this way.
Paul Szmal: So we've been talking about the 100th anniversary events at Soldiers and Sailors Hospital, and people can still show their support by joining the Centennial Circle.
Caroline Scott: They absolutely can. We're wrapping up the Centennial Celebration, and you know, we're getting close to year end, which I cannot believe 2025 is upon us, but yes, people can still join the Centennial Circle.
Paul Szmal: Now, of course, we have the three holiday tree events going on at Geneva General, at Soldiers and Sailors, and at Huntington Living Center, a combination of trees and lights and cones and support, whichever one you like, and part of the idea is you can do something in honor of somebody, a cone or an ornament, and you can have a message on it in honor of a person who's passed or an event or an occasion, and it's a great way to support these facilities.
Caroline Scott: It is, and new this year at Geneva General, we've got an ornament that has a beautiful illustration of the hospital on it, and there is a limited number, and that is yours to keep.
Paul Szmal: All right, now we love our old friends, and we love meeting new ones, so we have a first time provider today, so introduce our guest today.
Caroline Scott: We do. I have to say I'm a little nervous doing this, but anyway, I am very pleased to introduce orthopedic surgeon Dr. Alexander Akoto, who is one of our newest specialists to join Finger Lakes Health, so welcome. Dr. Akoto, welcome.
Dr. Alexander Akoto: Thank you so much to be here. It's great to have you here.
Paul Szmal: So tell us a little bit about you. You come to UR Medicine Finger Lakes Health by way of the U of R, Howard University in D.C., and the University of Michigan.
Dr. Alexander Akoto: That's right, that's right. So I'm originally from the Philadelphia area, but I've had kind of a circuitous route to get here, as you pointed out. I did my medical school in Washington, D.C. at Howard University, as you said, and then my orthopedic surgery residency at the University of Michigan, so I lived in Ann Arbor, Michigan for five years, and then I came to the area originally a year ago to do my spine surgery training at the University of Rochester. So I came here with my wife, and we absolutely loved the area, and I was fortunate enough to find a position that would allow me to stay here, so now we're here.
Paul Szmal: So tell us a little bit about orthopedics, the study of musculoskeletal disorders.
Dr. Alexander Akoto: That's right. Orthopedic surgery is muscles and bones and tendons and ligaments, so it's a specialty that's about allowing people to get back to the movement, the activities that they enjoy doing and that make their life meaningful. So I got into orthopedics because some of the procedures and some of the problems that we're able to address can really be life-changing for people. You talk about hip replacement or knee replacement, that's really, really life-changing surgery. So that was a big draw for me.
Paul Szmal: The part that amazes me the most is the recovery times. I mean, we're having people go home same day for all kinds of procedures and a couple of days where it used to be maybe two weeks or a month or something in a hospital bed.
Dr. Alexander Akoto: Yeah, and it's been sort of a slow and steady incremental change. Twenty years ago, I just talked about hip replacements and knee replacements, twenty years ago, you could be in the hospital for a week afterwards and now exactly we're in certain patients and in certain cases, we're getting people out later the same day. And that's been the result of not just surgical techniques but also improving pain control. The anesthesia that you get before the surgery, the combination of medications that you get the surgery has all been really, really completely changed what we're able to do.
Paul Szmal: And the other thing is safety, of course.
Dr. Alexander Akoto: So as we've gotten more and more experienced with these surgeries, part of the reason that we would previously have people stay in the hospital for such a long period of time is because we had to monitor them for complications. But as the surgeries have gotten safer and safer, the risk of sending somebody home has dramatically decreased.
Paul Szmal: There's always been and there'll always be the people who are just a little leery of having bionic parts inside of their body. But I had this experience with friends, and I'm sure you see it all the time. People have it done and they go, why did I wait to get this done? So talk about that person who's reluctant to have something artificial be put inside them.
Dr. Alexander Akoto: Yeah. Well, you know, and this is just sort of focusing on, again, hip replacements, knee replacements because it's so common. And I think that's what people are often familiar with. You know, what we tend to say is when you know, you know, right? When your joints are giving you so much trouble that you're not able to do the things that you want to do, then maybe it's time for the surgery. And what you just said is a very common way to feel. And that doesn't mean that you necessarily waited too long. If you have a hip replacement or a knee replacement and you, you know, weeks to months later, you are saying to yourself, why did I wait so long to do this? It was probably exactly the right time to do it.
Paul Szmal: Well, what happens is if you have chronic pain that's with you for a long time, sometimes you kind of get used to it.
Dr. Alexander Akoto: Exactly. And so you don't realize until after and a couple of days later, all of a sudden, wait, that doesn't hurt anymore at all.
Paul Szmal: Yeah.
Dr. Alexander Akoto: And people, you know, people are very smart and good at adapting. And so often people come up with all kinds of ways of compensating for the pain and the difficulty doing things that they've developed. Right. And so often after surgery that helps with pain the way a lot of orthopedic surgeries do. And they'll notice, oh, I've been, you know, I have, I've not been laying on this side or I've, you know, been leaning on my shopping cart when I go to the grocery store or, you know, I've been only carrying so much weight in my bag because I know if I put 10 pounds in there, I can't, I can't do it. So, you know, I definitely have heard from patients after surgeries that it's, it's almost a liberating experience. There's so much more they can do afterwards that they didn't even realize they were missing out on.
Paul Szmal: Is a big part of the recovery, the mental part, the, the, that, that you're a little leery and a little afraid to put full weight. It's like I talk about this when we talk about recovering from sports injuries, the first time you have to put your full weight on that reconstructed knee or something. Is that a big part of it with joint replacements is, is telling the patient, you trust yourself, you can walk on it, you can put weight on it, it's not going to snap.
Dr. Alexander Akoto: Yeah. And, and, and I think that one of the things that we've learned is that the faster you start mobilizing somebody after surgery, the more encouraging you are getting them up the day, you know, hours after the surgery is over, the more encouraging you are about getting them up and getting them moving, the easier it is to overcome that, that kind of initial barrier because, you know, a lot of the, you know, when you're immediately out of the surgery, you know, you wake up the afternoon after your surgery is over, you're still feeling pretty good. Right. You know, I think a lot of people have had the experience of undergoing some sort of anesthetic and when you're first waking up, you may be a little bit groggy, but also, you know, you're waking up before all the pain control has worn off. And so, and so that's a great opportunity to show somebody what they can do now. And so, you know, the day after the surgery, when they're a little bit more painful, they can think back to the, you know, the evening after their operation and they can say, well, you know, actually, I was able to walk around, so I know I can do this. And then that, I think, helps with kind of pushing forward the recovery process.
Paul Szmal: Do these replacement joints have to be maintained at all or adjusted or anything over time or is it one and done?
Dr. Alexander Akoto: No, no. The hope is that it's one and done. You know, the hope is that these implants will last at least 20, 25 years. You know, that's not always the case. Sometimes they're, you know, in a small subset of patients, you know, 1% or something like that, secondary surgeries are needed. But no, it's not, it's not, it's, the hope is that we do it and you never have to worry about it.
Paul Szmal: What are some of the spinal surgeries, or especially to you, what are some of the common spinal disorders that you deal with?
Dr. Alexander Akoto: Yeah. So we deal with, you know, as the most typical spine disorders are degenerative disorders. So we were just, we've just been talking about hip and knee replacements. You know, that's as you get older and you develop arthritis and the cartilage of the joint wears out, it starts to become more and more painful. Similar things happen around the spine, right? As you get older, you develop essentially arthritis of your spine. You know, the discs in the front of your spine, the intervertebral discs start to get worn out. They start to become more and more painful. You also have actually fluid-filled joints in your spine in the back, you know, that are just sort of like a hip or a knee joint. They've got cartilage in them, they've got joint fluid. Those can also develop arthritis, bone spurs. And so the, on aggregate, what happens is that that arthritis of your spine can start to cause compression of the nerves, you know, your spinal cord, the nerve roots that supply your arms, your legs. And so a lot of spine surgery is focused on taking pressure off those nerves to help people restore function.
Paul Szmal: We always like to talk about prevention. What are some things we can do for spine and bone and joint health?
Dr. Alexander Akoto: Yeah. So with your spine, the thing that I always emphasize to people, so first of all, there's a lot of people with back pain, as kind of everybody knows. Like a third of American adults have had back pain in the last year. So, and often back pain is kind of the early, early in the process of the sort of degenerative changes that we see over the course of people's lives. So the biggest thing, the thing that I always emphasize when I talk to patients who have back pain and who have early degenerative changes is keeping the muscles that help support your spine really strong. Because even in people who are very active, you know, people who do a lot of, you know, cardiovascular, they run, they bike, these kinds of things, often doing the kind of exercises that keep the muscles that help support your spine, you know, your core muscles, the muscles of your abdomen, the muscles directly around your spine, the exercises that keep those muscles really strong are specific and not things that people necessarily do. And that helps a lot, helps a lot with pain itself, and it also helps to take some pressure, the pressure off your spine and allow it to have the support that kind of prevent degeneration.
You asked also about bone health. So physical activity is something that we always recommend, you know, the more you're using your bones, the more healthy they're going to be in the long term. For everybody, combating against, you know, osteoporosis, osteopoeia, right, the process of your bones losing their strength over the course of your lifetime, which happens to everybody, is something that we all have to take seriously and think about, right? Because we all know as you get older, as you get into your 70s and 80s and 90s, you know, if your bones aren't strong, all it takes is a fall to send you into a knockout situation.
Paul Szmal: All right, Dr. Alexander Akoto with UR Medicine Finger Lakes Health. You work out of the Finger Lakes Surgery Center?
Dr. Alexander Akoto: I work out of Geneva General Hospital.
Paul Szmal: Okay, okay. All right, well thanks for your time. Great to meet you.
Dr. Alexander Akoto: Absolutely. I know we'll talk again.
Paul Szmal: Caroline, thank you.
Caroline Scott: Great to have you here.
Paul Szmal: Thank you for having me. And we'll do it again in two weeks and get healthy with UR Medicine Finger Lakes Health. It's 8 52 now.
