Monday, October 26, 2015

Monday, October 19, 2015

Monday Meet the TOCA Team: Samuel M. Harmsen, MD!


Dr. Samuel Harmsen is thrilled to be joining the outstanding physicians at The Orthopedic Clinic Association. He is fellowship trained in shoulder and elbow surgery with advanced training in complex shoulder and elbow reconstruction. Dr. Harmsen specializes in the treatment of all shoulder and elbow conditions including sports related, reconstructive, and traumatic injury. He performs arthroscopic and open surgical techniques and is uniquely skilled with reverse shoulder replacement and revision shoulder surgery. He also treats general orthopaedic trauma of the upper and lower extremities.
Dr. Harmsen was born and raised in Salt Lake City, Utah. He attended the University of Utah majoring in Japanese and Asian Studies, interrupting his studies to serve a two-year mission for his church in Japan. Prior to medical school he enjoyed several years of ski instructing at one of his favorite ski resorts, Deer Valley, UT.
Dr. Harmsen has had the opportunity to train under some of the world’s most renowned leaders in shoulder and elbow surgery. Following orthopaedic residency, he completed a complex shoulder and elbow fellowship at the San Francisco Shoulder, Elbow and Hand Clinic under Drs. Tom Norris and James Kelly. After fellowship, he extended his training by spending time with Dr. Laurent LaFosse in Annecy, France, and Dr. Pascal Boileau in Nice, France. This specialty training has helped him gain unique skills in advanced shoulder and elbow arthroscopy and reconstruction that are not widely available in Arizona.
Dr. Harmsen is very active in orthopedic research, having published and presented at a number of local, national, and international meetings. His primary area of interest is shoulder surgery, particularly in clinical results with shoulder arthroplasty. Dr. Harmsen plans to establish the Arizona Shoulder and Elbow Institute and, together with TOCA, develop a center of excellence within Arizona for shoulder and elbow research, education, and patient care.
Dr. Harmsen likes to create a professional but relaxed clinical atmosphere where everyone feels comfortable and able to ask questions freely. He wants you to leave each visit confident and encouraged. His clinical approach is centered around each patient’s individual concerns and goals. He believes that clear communication, patient education, and patient participation are vital to the success of any treatment, whether operative or non-operative.
To schedule an appointment with Dr. Harmsen please call 602-277-6211. To learn more visit: www.tocamd.com

602-277-6211
www.tocamd.com

Tuesday, October 13, 2015

Hand Surgery and Breast Cancer Patients - Dr. Josh Vella

Hand Surgery and Breast Cancer Patients - Dr. Josh Vella

One of the more troublesome issues surrounding breast cancer surgery and lymph node dissection is the development of lymphedema in the arm. Traditionally these patients have been warned against having blood pressures taken, IV’s placed and surgery performed on the same side as lymph node dissection. However, recent research suggests that surgery is safe in patients who have previously had mastectomy and lymph node dissection.
A 2007 article studied 25 women who previously had mastectomy and lymph node dissection. Four of these women had a history of lymphedema. All of these patients underwent hand surgery on the same side as their lymph node dissection. There was no increased risk of infection in this group. Only 2 had a temporary worsening of their lymphedema. Of the women who never experienced lymphedema in the past, none of them developed it after hand surgery.
Another study in 1995 studied 15 women who had lymph node dissection and hand surgery. Seven of these women had a history of lymphedema. All of these women had hand surgery and none of them developed any symptoms of lymphedema after surgery.
While there is a perception, mainly among breast care nurses and breast surgeons, that hand surgery should not be performed after lymph node dissection, literature supports that it is safe. These articles suggest that hand surgery after lymph node dissection does not increase risk of developing lymphedema after surgery. Hand surgery is safe for women who have had mastectomy and lymph node dissection.
My hands helping your hands.
Josh C. Vella, M.D.

Breast J. Hershko: Safety of Elective Hand Surgery following axillary Lymph node Dissection. 2007;13(3):287-90
Ann Surg Onc. Dawson:Elective Hand Surgery in Breast Cancer patient with prior ipsilateral axillary dissection. 1995; Mar;2(2): 132-7
Ann R Coll Surg Eng: Fulford: Hand Surgery after Axillary Lymph Node clearance. 2010; Oct:92(7):573-

RECOVERY. RESULTS. RELIEF.

602-277-6211
www.tocamd.com