DEAR MAYO CLINIC: For my kids, the best part of back-to-school shopping is picking out a new backpack. While I want them to have backpacks they like, I also want to make sure they have features that support their backs. What should I look for?

ANSWER: The backpack is as much a part of school life as homework, pencils and recess. Kids use backpacks to carry everything they need during the day and make a fashion statement. Unfortunately, the excess weight of supplies stuffed into an improperly worn backpack may lead to sore joints and muscles.

As a new school year begins, follow these tips to help kids take a load off to keep their backs healthy:

Limit the weight.

Students of all ages seem to carry heavier loads in their backpacks. They often tote a day's worth of textbooks, a change of clothing for after-school activities, school projects and lunch. As a result, many parents have heard their school-age children complaining of back pain.

Overall, adults and children shouldn't carry more than 15% of their body weight in a backpack. For a 60-pound child, that means a pack weighing less than 9 pounds.

Even when worn properly, your student may need to lean forward to compensate for extra backpack weight. This can affect the natural curve in the lower back. Extra weight also can cause a rounding of the shoulders and an increased curve of the upper back. As a result, children may experience back, shoulder and neck pain.

Adjust them properly.

When worn properly, backpacks are the best way to carry things, especially for long periods of time.

Backpacks should be worn using both straps. Slinging a backpack over one shoulder can cause a person to lean to one side to compensate for the uneven weight, causing a curve in the spine. Over time, this can lead to lower and upper back pain, strained shoulders and neck, and even functional scoliosis (curvature of the spine). Teenage girls are especially susceptible to scoliosis.

Tighten the straps so the pack sits high on your child's back with the top of the pack about even with the shoulder blades. It also should be snug, so it doesn't sway side to side while walking.

When properly worn, the back and abdominal muscles support a backpack. These are the strongest muscles in the body, stabilizing the trunk and holding the body in proper postural alignment. Improper backpack use presents some dangers to young, still-growing joints and muscles.

Look for key pack features.

Urge your children to look past the color or design when selecting a backpack. These features can make a significant difference in how they feel while wearing the pack at school:

• Wide straps
  Wide, padded straps won't dig into the shoulders, and they're more comfortable. Narrow straps can hinder circulation, causing numbness or tingling in the arms, which may lead to weakness in the hands over time.
• Multiple sections
  Select a backpack with many pockets and sections to keep children organized. This also helps distribute the weight more evenly across the pack.
• Waist belt
  Tightening the waist belt helps to evenly distribute the weight of the backpack and support children's abdominal muscles.
• Lightweight when empty
  Consider the weight of the backpack when it's empty so your children don't have additional weight beyond books and supplies. For example, a canvas backpack will be lighter than leather.
• Reflective material
  If your children walk or bike to school, look for a backpack with reflective strips that make them more noticeable to drivers. You also can add strips of reflective tape at home.

Encourage your children to wear their backpacks properly. To help keep them light, they should make frequent stops at their lockers throughout the day to avoid carrying all their books at once. And leave nonessentials at home.

If they're in pain or have discomfort, talk with their primary care clinicians before a problem becomes serious.

Michelle Rein, M.D., Family Medicine, Mayo Clinic Health System, Caledonia, Minnesota

The post Mayo Clinic Q&A: Are backpacks hurting your kids’ backs? appeared first on Mayo Clinic News Network.

When Dr. Sam Sayed relocated to Rochester, Minnesota, for residency, he brought his nonprofit with him through the support of a Mayo Clinic Community Contributions grant. 

When Dr. Sam Sayed was in elementary school, his older sister, Dayna, took him and his brother to the shoe store where she worked. She offered to buy any sneakers they wanted. 

For two boys growing up in poverty, this was a pivotal moment.

"We were discount-store or hand-me-down kids — we had never gotten to do anything like that," says Dr. Sayed, an emergency medicine resident at Mayo Clinic in Rochester, Minnesota. "We can still recall the shoes and how they made us feel. We want other kids to feel that too." 

Nearly 30 years later, Dr. Sayed helped give 56 Rochester Boys & Girls Club members that same gift. He applied for a Mayo Clinic Community Contributions grant through his nonprofit, Dayna's Footprints, funding an Aug. 13 event that let the kids pick their dream kicks at a local shoe store. 

"They were joyous — one kid said, 'This is the best day of my life,'" says Dr. Sayed. "One boy picked a pair based on his favorite soccer player, Cristiano Ronaldo. As soon as he picked them up, he did the classic Ronaldo celebration — run to the corner and do a 360 — over and over."

Watch: Emergency medicine resident brings Mayo's mission to youth with new shoes

Journalists: Broadcast-quality b-roll and sound bites are in the downloads at the end of the post. Please courtesy: "Mayo Clinic News Network." Name supers/CG: Sam Sayed, M.D./Emergency Medicine Resident/Mayo Clinic; Sammy Arab, M.B.B.S./Research Fellow/Mayo Clinic

Their excitement reflected the day's deeper meaning — both for the kids and the many Mayo volunteers who made the event possible. 

"I know what it's like to show up in worn-out shoes and pretend you don't notice the comments," says Dr. Sammy Arab, a postdoctoral research fellow at Mayo and the event lead for Dayna's Footprints in Rochester. "We’re not just handing out shoes. We're giving kids dignity. We're telling them they matter." 

A purpose-driven mission

For Dr. Sayed, this isn't simply a passion project — it's a way to honor his sister's legacy. 

Not long after Dayna bought him his Nike Slants, she was tragically killed in a drive-by shooting. 

"We lost her, but we didn't lose her spirit," Dr. Sayed says.  

In 2018, he and his brother, Sharif, raised money to provide shoes for a family at their former school, inspired by what Dayna had done for them. They ended up helping 53 kids.

This compelled them to start Dayna's Footprints. After Dr. Sayed joined Mayo, they expanded to Rochester — a full-circle moment, since Dayna was born in Minneapolis.

This has given him a special way to fulfill his mission as a physician. 

"I don't want to wait for a patient to show up in the Emergency Department on their worst day. I want to know the community I serve," says Dr. Sayed. "At Mayo Clinic, it's about treating the patient in every facet of life. Before they show up and after they leave, Mayo cares." 

His perspective exemplifies Mayo Clinic's commitment to patients — past, present and future. 

"Mayo Clinic is about looking ahead — and with these kids, we're trying to intervene early," says Dr. Sayed. "We're treating them before they ever come here. We're giving them the confidence to believe they can overcome the circumstances they were born into." 

The post Emergency medicine resident brings Mayo’s mission to youth with new shoes  appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC: I have two sons, ages 5 and 11. My eldest is always excited to start school and have new adventures. My younger son will begin kindergarten this year. Although he went to child care part-time, my younger son has begun to express concern about being away from me all day and is showing increased anxiety as we talk about school. How can I help him be less anxious?

ANSWER: Getting ready for a new school year can be exciting for children, parents and caregivers. It may also be a major cause of anxiety or stress. 

Most people get nervous when they face change. Whether kids are heading off to elementary, middle or high school, or even college, leaving the safety and familiarity of home can prompt feelings of fear. 

One of the most helpful things you can do is reassure your son that what he's feeling is normal. Separation anxiety happens to many people of all ages. Then, as much as possible, help him gradually gain exposure to, and get comfortable with, going to school. 

Talking through fears

Try to gain a sense of what it is about school that makes your son nervous. Is he concerned about making new friends? Is he concerned about the teachers? Is he worried about the classwork? Is there something new that may be causing anxiety, like riding a bus? Sometimes, just being able to talk about those details and put the nervousness into words can help a child who is feeling anxious. 

Continuing to show love, support and warmth can go a long way. Share with your son an experience you had when you were anxious about facing something new. Talk to him about how you handled the situation. Ask your older child to share some experiences and how he overcame his fears. Doing this will let your younger child know that he is not alone in the situation, that it is OK to be nervous, and he can get through it. 

Preparing ahead of time

To help your son prepare for school, talk to him about what his school day might be like. You could also visit the school to meet his teachers, take a tour of his classroom, see the playground, or even locate the bus stop. If your son is nervous about getting on the school bus, call the transportation department to see if he can meet the bus driver early. 

Another idea is to find social opportunities with other incoming kindergarten students. Reach out to parents of children in your neighborhood who will be going to school for the first time. Then, plan a social gathering at a local playground. 

A week or two before school starts, develop a routine. Begin to wake up early and get ready on time. Also, consider practicing some schoolwork. You can get your older child involved in sharing his thoughts about what was the best part of school when he was that age. 

Spending time apart

Begin by spending some time away from your son. Maybe it's having your child go to a friend's home for an hour. Then, slowly increase the time away from your son so that he has an opportunity to feel comfortable being with others for longer periods of time. 

All of these steps will help him know what to expect, prepare him gradually for what school will be like, and ease the transition. This approach is based on one of the core principles of treating anxiety. That is, when you are frightened of something that is not dangerous, you need to have practice dealing with the source of your fear until it becomes routine or boring. You cannot be talked out of anxiety. You need exposure to, and experience in, dealing with the situation. 

If your child is resistant to the attempts you are making, or if his anxiety doesn't decrease even after you've taken these steps, talk with your pediatrician or primary care clinician about seeing a healthcare professional who can help. Books on coaching for anxiety can also be a resource. Anxiety is a normal part of life that can't be completely eliminated, but many successful strategies can reduce anxiety and how often it causes problems.

Stephen Whiteside, Ph.D., Psychology, Mayo Clinic, Rochester, Minnesota 

The post Mayo Clinic Q&A: Strategies for calming back-to-school anxiety  appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC: We have a new fitness facility nearby. The pool schedule shows a number of aqua exercise classes. I'd like to try a water fitness class to add variety to my regular fitness routine, but can I really get a good workout in water?

ANSWER: Regular exercise provides a wide range of benefits, including weight management, improved cardiovascular health and sleep quality. But for many people, common forms of exercise, such as walking, running and weight training, are a struggle due to pain, weakness, mobility issues or fear of falling.

Aquatic exercise is an excellent way to focus on fitness in a gravity-reduced environment. Here's why:

• Buoyancy. When standing waist-deep in water, buoyancy reduces your body weight by 50%, making this form of exercise very low impact. This significantly reduces the stress on your weight-bearing joints and bones. 
• Support. Water provides support for people with balance problems. The constant movement of water during a workout also challenges a person's balance. The more waves there are, the harder it is to balance and exercise.
• Resistance. Water's viscosity slows movement and provides resistance, making aquatic exercise a great, resistance-training workout. With less joint stress, people find they can work out longer and do more repetitions.

All these benefits make water exercise an effective option for anyone recovering from a sports injury to regain range of motion, strength and endurance.   

But these benefits also mean you can get a good, overall workout that improves strength, cardio and flexibility. As with any exercise, check with your healthcare team before starting a new routine. 

Five things to know before jumping into the pool

1. Aquatic exercise is versatile.

Aquatic exercise offers a variety of options and techniques for almost all levels of physical ability. These range from basic, such as walking in the water, to more high-level aerobic activities, such as deep-water running or swimming. 

Standing exercises often are performed in water that's waist to chest deep, and they typically focus on improving range of motion/flexibility, balance and strength. Resistance training can be amplified by simply increasing the speed and range of movement or adding equipment that increases drag, such as webbed mitts, paddles, noodles or bands.

2. You don’t need to know how to swim.

Having a basic knowledge of swimming or water safety is a good idea for anyone who's around water, but aquatic exercise doesn't necessarily involve swimming. The shallow end of any pool or lake will do, since for many of the movements, you only need to be able to stand in the water.

3. Water temperature is important.

Aquatic exercise in lower water temperatures (82-88 F) is generally best for higher-level intensity exercise or people who are prone to overheating, such as those who are pregnant, obese or have multiple sclerosis. Aquatic exercise in warmer temperatures (84-92 F) is better for people with arthritis, fibromyalgia or pain, as well as those who are frail.

4. Be aware of your abilities.

With the increased ease of exercise in water, people often can tolerate longer exercise sessions. As a result, these sessions can be more intense, with larger ranges of motion, which creates the potential of overstressing your body. You may be more fatigued than expected following an aquatic exercise session.

5. Consider group exercises to mix it up.

Group aquatic exercise classes are a great way to socialize, build connections, find support, increase accountability and stay motivated to continue exercising. Classes often are led by instructors who have special training in exercising in an aquatic environment. The instructors are able to offer suggestions for adjusting exercises for individual participants, if needed.

Beyond the basics

Amping up your water workout on your own or in a class may include resistance equipment such as:

• Foam dumbbells. Lightweight on land, they provide resistance underwater through flotation. They come in a variety of resistance options.
• Water weights. Strap-on ankle or wrist weights increase resistance during arm and leg exercises.
• Hand paddles and resistance gloves. They enhance strength training.
• Buoyancy belt. Helps keep your head above water in the deep end while leaving your hands free. You can run, lift weights and do other workouts using your hands without having to tread water.

People often enjoy working out more in water than on land. When they're not in pain or afraid of falling and are having fun, it encourages them to exercise more consistently. You can even get in a good workout without getting your hair wet.

Kimberly Olsen, Physical Therapy, Mayo Clinic Health System, Mankato, Minnesota

The post Mayo Clinic Q and A: Water fitness — why aqua exercise works wonders appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC: We just moved to an area with a lot of opportunities for water recreation and are so excited about our first summer on the water. But we want to make sure everyone stays safe. Can you give us some pointers for water safety?

ANSWER: Nothing beats a day at the lake, river, beach or pool for fun, fitness, fishing and relaxation. While spending time on and around the water this summer, these tips can ensure that everyone is safe, has fun and enjoys the time together.

Learn to swim

Every year in the U.S., about 4,000 people die by drowning. Children, men and nonwhite people are at the highest risk. 

Learning to swim is one of the most important ways to stay safe on the water. The American Academy of Pediatrics supports swimming lessons for most children ages 4 and older. Lessons for children ages 1 to 4 could be appropriate, depending on how often they're exposed to water. Even infants can be introduced to the water. Check to see what classes are available in your area.

Swimmers of all ages may be more familiar with pools than rivers and may not know what to do if caught in a current. Stay calm, float on your back, and when you come to a calmer area, flip over and swim diagonally toward shore with the flow of the current.

Keep these safety tips in mind too:

• Don't swim alone.
• Supervise children when they're swimming, and stay close enough to reach out to a child at any time.
• Before diving into a body of water, know the water depth and if there are any underwater obstacles.
• Keep pool gates closed at all times, and consider an alarm to alert you if the gate is opened.

Wear a personal floatation device

Even expert swimmers can get into trouble during an emergency. It's important to be sure everyone in a watercraft wears a U.S. Coast Guard-approved personal flotation device. While boating or swimming, remember that arm floaties and inflatable toys aren't a substitute and tend to give kids and families a false sense of security. 

Excellent, comfortable, easy-to-put-on models of personal flotation devices are available, so there's really no excuse not to wear one.

Stay safe while boating, no matter your craft

One of the most popular and fun activities of summer is spending time on the water. Boating creates lifelong memories and gives us the opportunity to unplug, spend time together, learn new skills and explore new areas. 

Whether your craft is a power boat, fishing boat, pontoon, personal watercraft, canoe or kayak, you should remember these basic safety rules as you head out for a day on the water:

• Be a weather watcher. Summer weather can change quickly. Check the forecast before heading out and check again frequently while on the water. If you do get caught in a storm, navigate to the shore as quickly as possible.
• Tell someone the details of your trip. Tell your trip plan to a friend who's staying ashore. Share details about who's on the boat, where you'll be and how long you'll be gone.
• Always operate your boat at a safe speed. Waterways can become crowded during the summer. Slow down, stay alert and steer clear of larger vessels. Be sure to follow speed limits in "no wake" areas.
• Respect buoys and other navigational aids. They've been put in place to ensure your safety and the safety of other boaters and swimmers. If you're not familiar with them, the U.S. Coast Guard has a handy water navigation system guide.
• Leave alcohol on shore. The risk of drowning or injury significantly increases when alcohol or drugs are involved. More than 70% of water recreation deaths are related to alcohol use.

Be sun savvy

The sun's rays can be intense on the open water. Protect everyone with hats, sunglasses and sunscreen. Look for water-resistant, broad-spectrum sunscreen with a sun protection factor (SPF) of at least 30. Apply sunscreen generously and reapply every two hours, or more often if you're swimming or sweating.

Drink plenty of water

Even when surrounded by water, it's possible to become dehydrated. Sitting in the sun can increase your body's temperature. Pack plenty of water for each person, and drink some water every 15 to 20 minutes to remain properly hydrated.

Jason Wray-Raabolle, M.D., Family Medicine, Mayo Clinic Health System, Owatonna, Minnesota

The post Mayo Clinic Q&A: Tips for summer water safety appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC: This is kind of embarrassing, but, for a while, I’ve been leaking urine. Can something be done to fix this incontinence problem?

ANSWER: You don’t have to live with this issue. The three main types of urinary incontinence are:

• Stress incontinence — due to leakage with activities, such as lifting, climbing stairs or strenuous activity.
• Urge incontinence — related to leakage associated with the feeling or urge to urinate.
• Mixed incontinence — a combination of stress and urge incontinence.

Incontinence can be treated with behavioral changes, exercises, medications, nerve stimulation and injections. Surgical options are also available.  

Stress incontinence in men

Up to 10% of men may experience stress incontinence after prostate surgery due to multiple factors related to the patient's anatomy, prostate cancer and the surgery performed. Ultimately, this leads to a weakened sphincter muscle and laxity of the pelvic floor. The sphincter muscles control the release of urine, and the urethra is the small tube that empties the bladder. 

A prostatectomy procedure removes some of the control provided by the prostate and bladder, making the patient reliant solely on the external sphincter muscle.

Normally, the sphincter remains closed as the bladder fills with urine until you can reach a restroom. The weakened muscles and relaxed pelvic floor have trouble holding urine, so any movement that exerts a force on the abdominal and pelvic muscles puts pressure on the bladder and can cause leakage. This force could be sneezing, bending over, lifting or even laughing.

Postsurgery stress incontinence symptoms may resolve on their own with time and pelvic physical therapy. Usually, patients can see continued improvement for 12 months after surgery and try nonsurgical treatments, such as physical therapy, before considering surgical treatment options, such as male urethral slings and artificial urinary sphincters.

Male urethral slings

Male urethral slings are indicated for men with mild to moderate stress urinary incontinence, which is defined as using one to four pads per day. The surgeon uses a synthetic mesh material to create a sling, or hammock, to support and pull the urethra and pelvic floor back toward their original locations. Some slings also provide compression support for the sphincter muscles.

A cystoscopy test will be needed before the surgery to confirm that the sphincter muscles are working.

Male urethral slings are performed as an outpatient procedure, and patients can go home the same day. Heavy lifting and strenuous exercise are restricted for about six weeks. Patients need to be careful when climbing ladders and squatting for about three months after surgery because significant hip flexing can loosen the sling.

About 80% of men with male urethral slings see an improvement in their symptoms after surgery, with the majority of them no longer needing pads after surgery.

Artificial urinary sphincters

This surgical procedure is more invasive than male urethral slings and appropriate for men with severe stress incontinence, which is defined as using more than four pads per day. It's also a good option for patients who have damage to sphincter muscles from radiation therapy or a failed male urethral sling.

The placement of artificial urinary sphincters has multiple components. A small cuff is placed around the urethra, replacing the sphincter muscle's function. Tubes connect the cuff to a pressure-regulating balloon placed in the lower pelvic region and a pump in the scrotum. The pump is manually operated to open the cuff on the urethra and allow urine to be released from the body.

Some patients can go home the same day as surgery, while others will require an overnight hospital stay to recover.

After surgery, the artificial urinary sphincter isn't activated for about a month while the body heals. During this time, heavy lifting and exercise are restricted. Patients return to the clinic and are taught how to properly use the device. With proper training and consistent use, artificial urinary sphincters are effective at treating symptoms of severe stress urinary incontinence in men.

Talk with your healthcare team if you're experiencing urinary incontinence symptoms or are concerned about your prostate or urinary health.

David Yang, M.D., Urology, Mayo Clinic Health System, Mankato, Minnesota

The post Mayo Clinic Q&A: Why some men experience urinary leaks — or incontinence appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC: I've taken up running again and decided to enter a half-marathon. I know I have to push myself to get ready for the race, but I don't want to overdo it. What should I watch out for as I train?

ANSWER: We're surrounded by warning signs — on the roads, at work, and on packaging and equipment. Your body sends warning signs, too. As your race date nears, it's tempting to pull out all the stops. But that makes this a prime time to watch for warning signs of overtraining.

Overtraining or overuse injuries are any muscle, joint or bony injuries, such as tendinitis or a stress fracture, that result from repetitive trauma. Overuse injuries typically occur because of training or technique errors.

Runners are tenacious athletes. Pulling back and slowing down may be tough, but while some overtraining issues can be resolved with simple rest, others may evolve into more significant problems.

How overtraining and overuse injuries occur

Going too fast, exercising for too long or simply doing too much of one type of activity can strain your muscles and lead to an overuse injury. Improper technique also takes a toll on your body. For example, if you use poor form while running or doing strength-training exercises, you may overload certain areas of the body, which can cause an overuse injury.

Thankfully, most overuse injuries are avoidable. Try these suggestions to prevent them:

• Use proper form and gear.
  Whether you're starting a new activity or have been playing a sport for a long time, taking lessons can help ensure you're using the correct technique. Talk with an expert about proper form, equipment and gear fit to help ensure success.
• Pace yourself.
  Rely on your training program, which should spread your aerobic activity throughout the week. Take time to warm up before physical activity and cool down afterward.
• Gradually increase your activity level.
  When changing the intensity or duration of physical activity, do so gradually. Try not to increase anything by more than about 10% per week. Your body needs time to adapt to the new stress.
• Mix up your routine.
  Instead of focusing on one type of exercise, build variety into your training program. Doing a variety of low-impact activities prevents overuse injuries and allows your body to use different muscle groups.

Overtraining signs and what to do 

It can be hard to know when you’re pushing through your training for continuous improvement and when you’re moving into overtraining. Your feet and legs take a pounding as you run mile after mile, so watch for these issues: 

• Callous blistering and broken toenails are common overtraining problems. 
• Early morning pain on the sole of your foot can be a sign of plantar fasciitis. 
• Tendinitis can leave you with pain in the back of your ankle or in the front of your shins, also called shin splints.

Typically, these can be treated with rest and medication to relieve pain and inflammation. Slow down your training. Return to the level you were at before the problem or consider cross-training with low- or no-impact exercise, such as a stationary bike, elliptical or swimming. Take an extra day off. These symptoms can be short-term if you treat them early and appropriately.

If pain continues despite rest or gets worse, it could indicate a bone issue, which is potentially serious. Stress reactions or stress fractures are common in the mid-foot, mid-shin or, most concerning, high up in your leg by your hip. Pain that doesn't go away is a symptom, so consult your healthcare team.

What to do if you suspect an overuse injury

Tell your healthcare practitioner if you've recently changed your workout technique, intensity, duration, frequency or types of exercises. Identifying the cause of your overuse injury will help you correct the problem and avoid repeating it. You can seek further guidance by talking with specialists such as sports medicine physicians, athletic trainers and physical therapists.

Once your injury has healed, ask a specialist to check that you've completely regained strength, motion, flexibility and balance before beginning the activity again. Pay special attention to proper technique to avoid future injuries.

Staying strong

Don't allow an overuse injury to prevent you from being physically active. By working with a specialist, listening to your body and pacing yourself, you can avoid this common setback and safely increase your activity level.

Knowing you worked hard to prepare will add to your feeling of accomplishment on race day, but don’t overdo it. You’re almost there. Take care of yourself so you can keep going strong all the way to the finish line.

Corey Wencl, Sports Medicine, Mayo Clinic Health System, La Crosse, Wisconsin

The post Mayo Clinic Q and A: Signs of overtraining appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC: I know there's a knee replacement in my not too distant future. I'm wondering if there are new techniques or technologies that will give me a good outcome?

ANSWER: Not so long ago, undergoing a total hip or knee replacement and recovery was a grueling and often painful ordeal. While these are still major surgeries, new techniques and technologies are redefining them — and improving people's outcomes. 

Robotic-assisted joint replacement technology has revolutionized hip and knee surgeries. This technology allows the surgeon to:

• Perform enhanced, three-dimensional preoperative planning and modeling to ensure there's no impingement or pinching of tissues, and to refine implant sizing and positioning for a high degree of accuracy.
• Prepare the bone and insert the implants with an unprecedented level of precision.
• Produce personalized, patient-specific joint replacements.  

In addition, major advances have been made in anesthesia used for total joint replacement surgery in the past decade. With these advances, patients recover more quickly and get up and move sooner after surgery with less pain, nausea and vomiting.

Another rapidly advancing technology in orthopedic surgery is 3D printing, which allows the designing and creation of custom implants to address challenging problems, including deformities, bone loss, and unusual hip or knee anatomy. 

This promising technology needs more long-term data before it becomes widely used. Mayo Clinic is at the forefront of 3D printing and has been integral in advancing its clinical applications.

If a total hip or knee replacement is in your future, here's what you can expect.

Hip replacements 

Any patient who is a candidate for a "conventional" total hip replacement is a candidate for a robotic-assisted total hip replacement.

Hip replacements are no longer a one-technique-fits-all approach. With a "360 degree" approach, your surgeon can tailor the surgery to you, choosing from direct anterior, posterior or anterolateral approaches. The surgeon will discuss these options with you during your pre-op consultation.

The surgeon also will review with you the entire surgical experience in detail. You'll also have a standardized patient education session with a specialty nurse and pre-op evaluation by a physical therapist. These sessions will set you up for success beginning immediately after surgery.

When it comes to recovery and rehabilitation:

• For most patients, total hip replacement surgery is either a same-day surgery or a one-night hospital stay.
• Patients can walk and navigate stairs right after surgery.
• The majority of patients will follow a self-directed physical therapy plan at home — no need to go to an outpatient physical therapy facility.
  

Knee replacements

As with hip replacements, any patient who is a candidate for a conventional total knee replacement is a candidate for robotic-assisted total knee replacement. You'll also take part in a comprehensive education experience and physical therapy assessment to review the technique your surgeon will use during surgery.

Like hip replacements, total knee replacements typically are same-day surgeries or may involve a one-night hospital stay.

Once you've awakened from the anesthesia, you can walk and navigate stairs. Within one week after surgery, you'll begin meeting with a physical therapist who specializes in working with knee-replacement patients. For best results with strength and range of motion, you'll also be assigned daily exercises to do at home to supplement your physical therapy sessions at an outpatient facility.

The excellent news for total hip and knee replacement patients is that the techniques and technologies for these surgeries continue to evolve. They have the primary goals of reducing pain, enhancing function, and getting patients back to their day-to-day activities and those they love to do.

Brandon Bukowski, M.D., Orthopedic Surgery, Mayo Clinic Health System, Mankato, Minnesota

The post Mayo Clinic Q&A: It’s a new era for knee replacements and other joint surgeries appeared first on Mayo Clinic News Network.

Craig Scherer takes a deep breath and a bold step into his second chance at life

Lung disease is a condition that affects millions of people worldwide. Some of those diseases, like chronic obstructive pulmonary disease, or COPD, are among the top leading causes of death globally.

COPD alone affects over 16 million people, like Arizona resident Craig Scherer. Craig got treatments to manage his condition, but there's no cure. The disease is progressive, meaning it gets worse over time, making it harder and harder for a person to breathe.

Craig's disease progressed until treatments no longer worked, leaving him gasping for air and facing death. Doctors said his only hope for survival was a lung transplant. 

Craig turned to Mayo Clinic in Phoenix, where doctors just launched a new multidisciplinary, specialized lung transplant program. Craig became the new program's first patient, and today he is breathing easy.

Watch: Breathing easy thanks to the gift of life and Mayo Clinic's new lung transplant program in Arizona

Journalists: Broadcast-quality video (2:43) is in the downloads at the end of this post. Please courtesy: "Mayo Clinic News Network." Read the script.

It was love at first sight for Craig and Nanci Scherer.

They met at a little league game in the spring of 1992. Eight months later, they were married. This year, Craig and Nanci celebrated their 32nd anniversary. 

Their smiles today are just as radiant as on their wedding day.

Happiness turns to heartache

The couple raised four children. Their family grew to include 14 grandchildren and six great-grandchildren. They planned for retirement and looked forward to the day when they could travel and enjoy their future together.

But when Craig turned 60, life took a sharp turn. He was diagnosed with chronic obstructive pulmonary disease. COPD is a progressive disease that causes damage to the lungs, making it hard to breathe. Treatments can help manage the disease, but there's no cure. As the disease continues its silent assault, quality of life often slowly slips away. 

"I couldn't do things, and even if I could do things, I didn't have the strength to do it or the stamina because my lungs would wear out," says Craig.

Craig's COPD continued to get worse. Eventually he couldn't breathe, walk or even talk. "It was silent at our house. We didn't talk because he couldn't talk. He didn't have the oxygen," says Nanci. "We lived in silence and isolation."

Last hope for survival

Eventually, Craig reached end-stage lung disease. Treatments no longer worked and his health continued to decline. Craig was left with only one last hope for survival, a lung transplant. Craig and Nanci turned to Mayo Clinic in Arizona.

"We see this with patients, when there are no other options, no medical interventions you can do at that point," says Dr. Jonathan D'Cunha, surgical director of the Mayo Clinic Lung Transplant Program in Arizona transplant center

For six years, Dr. D'Cunha had been working on building a multidisciplinary team of medical and surgical experts to create a new lung transplant program at Mayo Clinic in Arizona. 

The transplant center is the largest in the country, performing more adult solid organ transplants than any other center in the U.S. The addition of the lung transplant program establishes Mayo Clinic in Arizona as a comprehensive transplant destination medical center.

The program will provide transplantation for the full range of patients with end-stage lung disease. "This is the beginning of a remarkable new era for lung transplantation in Arizona," says Dr. D'Cunha. "We are excited and honored to offer patients and families renewed hope and a second chance at life through Mayo's unrivaled expertise in comprehensive adult organ transplant care."

Craig became the new program's first patient to receive a lung transplant.

Giving the gift of life

On May 30, 2025, Dr. D'Cunha led a team of surgeons in performing Craig's lung transplant. The surgery was a success, and soon after, Craig was slowly starting to breathe with his new lungs. 

"It is surreal to be able to breathe and not gasp for air when I talk," says Craig, who was up and walking within days of surgery. "I told the doctors when I got here that I will do whatever it takes. I'm 100% committed. If you want me to walk six times a day, I'll walk seven," says Craig.

"He did phenomenal," says Dr. D'Cunha. "His optimism and energy he brought with him is absolutely critical because the stronger you are going into these big operations, the better you are on the other side.

"I'm very proud of Craig. He always amazing me throughout the journey of transplant," says Ashraf Omar, M.B., B.Ch., medical director of the transplant program. "He is a special person. Motivation is the cornerstone of his success."

A fighter's farewell

Two and a half weeks after his transplant, Craig was heading home. The transplant team bid him farewell with a victory celebration with pom-poms waving and confetti raining down.

Watch: Craig crosses the finish line of his journey with a breathtaking victory celebration from Mayo's transplant team.

A few days later, on June 23, Craig returned to Mayo to join his transplant team for a news conference announcing the official launch of the lung transplant program.

It was also Craig's 67th birthday.

In honor of his organ donor and the donor family, Craig used his new lungs to blow out the candles on his birthday cake.

Watch: Craig's heartfelt moment in honor of the gift of life

Craig and Nanci are back at home and looking forward to beginning the next chapter of their story. 

"I have a lot of life left to live in me. Everything is a motivator — my wife, my kids, my grandkids, my health," says Craig. "Before, I had no quality of life and couldn't do anything. Now, there's nothing I can't accomplish." 

Related stories:

• Mayo Clinic in Arizona announces launch of new lung transplant program offering hope and restored function to patients facing advanced lung disease
• Lung Transplant Program
• Breathing easier with COPD

The post (VIDEO) Breathing easy thanks to the gift of life and new Mayo Clinic Lung Transplant Program in Arizona appeared first on Mayo Clinic News Network.

ROCHESTER, Minn. — You likely are accustomed to encountering a range of menus in daily life, but there is one that may be new to you: a dopamine menu. Dr. Robert Wilfahrt, a family medicine physician at Mayo Clinic and an expert in attention-deficit/hyperactivity disorder, or ADHD, explains.

“A dopamine menu is a rebranding of what psychologists or healthcare professionals previously called behavioral activation — ways to get yourself to do what’s best for you, instead of what you feel like doing in the moment,” Dr. Wilfahrt says.

In this case, the best route to getting that tough task done is to step away from it for a minute, do something else that feeds you energy and then dive back into the task.

The purpose? To stimulate dopamine — a hormone and neurotransmitter in the brain involved in mood, attention, reward and motivation. It’s also known as the “feel-good hormone.” Dopamine comes in many forms — reaching for your phone to doomscroll social media is an easy and convenient way to get a bit of a lift, but that’s not the only option. What other accessible activities can bring you joy and a happy brain break?

Examples of healthy “dopamenu” activities include:

• Going for a brief walk.
• Jamming out to your favorite song.
• Making a cup of tea.
• Petting your dog or cat.
• Lighting a candle.
• Reaching out to a friend or family member.

“The idea is to break up what you’re doing,” says Dr. Wilfahrt. And if the selected menu item is purposeful, you can feel a sense of reward for small progresses.

When are dopamine menus most useful? If we’re not necessarily enthusiastic about the task we’ve been assigned, we struggle to maintain attention or interest. We then risk not meeting the expectation or obligation. We feel bad about it, get flooded with remorse and have an even tougher time completing the task due to that sense of anxiety.

“It can become a vicious cycle,” says Dr. Wilfahrt. “It can be easy to become avoidant when we’re in these sort of doom loops.”

So how can you stop this cycle? Brainstorm. Make a mental or physical list of things you can do to get recentered.

Dr. Wilfahrt says the more recently rebranded concept tends to be targeted to people with ADHD, but anyone would benefit:

“It’s not a bad idea for anybody to know how to best manage energy. Sitting still to labor over one idea isn’t healthy for anyone.”

And while activities on your dopamine menu are meant to be enjoyable, don’t forget to go back to the hard task. A journey to the dopamine menu is meant to provide a burst of enthusiasm, not to be something that sucks you in. Consider setting a timer — perhaps for an unusual interval like 13 minutes and 17 seconds. Enjoy the boost and get back to the (real) to-do list.

For more healthy living tips, visit Mayo Clinic Press and MayoClinic.org.

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

Media contact:

• Sharon Theimer, Mayo Clinic Communications, newsbureau@mayo.edu

The post Dopamine menus: Give your brain some space appeared first on Mayo Clinic News Network.