St. Charles is sad to announce beloved former CEO Jim Lussier passed away Friday, Jan. 31. He will be deeply missed.

Lussier — a long-time caregiver and volunteer for the organization in addition to being CEO — passed away peacefully Friday, Jan. 31 at St. Charles Bend surrounded by his loved ones. He was 82 years old.

Hired by Sister Catherine Hellman in 1970, Jim was a beloved figure at St. Charles for more than 50 years, often spotted even in his retirement walking the hospital halls, working out in the caregiver gym or having coffee in the cafeteria while wearing his signature red beret. He had a twinkle in his eye and a smile on his face for every caregiver, patient or family member he passed along the way.

"Jim loved St. Charles like no one else," said Dr. Steve Gordon, president and CEO. "He has been an unwavering ally and champion for this organization. His passion for St. Charles came through in every conversation and I will personally miss him and the guidance he's provided. I'd like to thank Jim for creating a foundation of love and compassion that this organization still embraces and stands for today."

Every year, Jim would visit patients in the hospital on Christmas Eve dressed as an elf with a friend dressed as Santa, bringing cheer to those who couldn't be home for the holidays. After retiring from the organization in 2004, Jim served faithfully on the St. Charles Foundation Board of Directors helping to raise funds for the health system he loved so dearly. He was a prominent figure in recent years at the Heaven Can Wait 5K where he cheered every participant across the finish line.

In addition to his many contributions to St. Charles, Jim is a well-known community figure who was deeply involved in Rotary, City Club, the University of Oregon alumni association and was a proud founder of Volunteers in Medicine. When the new St. Charles ICU Tower opened in 2019, community members and family foundations came together to raise funds in Jim's honor. The tower is named for him – a fact he loved to share when visiting with staff.

Telling the story of his history with St. Charles a few years ago, Jim shared that in his first role as personnel director in 1970 he was tasked with overseeing the construction of the current St. Charles Bend hospital on a site east of Bend, which at the time was considered the outskirts of town. During his 38 years of employment with the organization, including 15 as CEO, Jim also oversaw the merger between St. Charles and Central Oregon District Hospital in Redmond, along with many other monumental changes in technology and medical services.

But he was always most proud of the St. Charles culture of caring.

"My proudest moment was the development of our caregivers," he said. "Our nurses are unbelievably caring. Sister Catherine wanted, as I did, staff that were dedicated to healing and health care and we built a culture around that."

Details regarding a memorial service and how best to share condolences will be shared once they are available. If you wish to make a donation to St. Charles Foundation in honor of Jim, you can do so here.

Michael Hartke, MBA
Executive Vice President, Chief Operating Officer

Michael Hartke has comprehensive responsibility for all organizational operations including all service lines, clinics, hospitals and ancillary services. He holds a bachelor’s degree from Northern Illinois University and a Master of Business Administration degree from Kellogg Graduate School of Management at Northwestern University in Chicago.

Michael has 25 years of health care leadership experience, including 10 years as chief operating officer of Northwest Community Healthcare, a division of Endeavor Health, in Arlington Heights, Ill.

I’ve spent time meeting with many local business leaders in recent weeks and have been hearing many positive comments about our region, our community and how most local businesses produce goods and services closely tied to our quality of life. We have incredible local restaurants, recreational activities and so much more that make Central Oregon a place we are proud to call home.

These conversations have also led me to think more critically about the role St. Charles plays — not only as the largest provider of health care in the region, but as the largest employer. What benefit do our friends and neighbors receive simply by St. Charles continuing to exist as a nonprofit organization that is locally owned and where every dollar goes back into our people, programs and places?

We recently asked East Slope Economics, a Bend-based firm, to produce a report on the health system’s economic impact. Here are just a few highlights that I think are worth calling out:

• Of the approximately 7,400 jobs directly and indirectly supported by St. Charles, 41% are health care clinicians or directly support clinicians. The rest work in information services, educational instruction, food preparation, community and social services, administration and other areas.
• The vast majority of the nearly 5,000 folks directly employed by St. Charles live in Central Oregon. They account for nearly 4.7% of total employment in Deschutes County and around 3.5% of total employment in Crook and Jefferson counties. Roughly one in 20 jobs are St. Charles jobs – which means if you go a movie, a busy restaurant or a concert there is a high likelihood someone – or many people – in the crowd work for St. Charles.
• Our average wage is more than $109,000 — 75% higher than the average wage in Deschutes County. In addition to our caregivers’ local spending at area businesses, we contribute an estimated $40 million in annual income taxes to the state of Oregon.
• The economic impact of those 5,000 jobs is nearly $871 million. Meanwhile, the economic impact of St. Charles’ business spending is around $202 million, and the impact of our caregivers’ spending is about $377 million.
• Add it all up and you have a total economic impact of approximately $1.45 billion — yes, billion. That’s roughly 5% of total economic output from the entire region.

It’s important to note that our economic impact doesn’t end with direct spending and jobs. There’s a ripple effect: Providing access to quality care and critical services leads to improved health outcomes for Central Oregonians, which leads to things like decreased spending on health services and increased workforce productivity.

Having this information has been helpful as I’ve also been listening to and learning from other local business operators over the past few weeks. In addition to the pride they feel in our region, I also hear concerns that Oregon has developed a reputation as a state that is unfriendly to business. These concerns were echoed and substantiated by Oregon Business & Industry in a recent and comprehensive report. This year CNBC gave Oregon an “F” for business friendliness. 

These are concerns that we at St. Charles share. Our long-term sustainability relies on the same trends supporting, or hindering, all local businesses. Our vitality is intimately linked with our region’s overall vibrancy.

My big takeaway from East Slope’s findings and listening to the voice of our local businesses? Our health system is an essential engine for a lot of good in Central Oregon — good that starts in our clinics and hospitals and stretches out to the far edges of the region, touching every individual, business and organization along the way. To maintain it, it’s imperative that our region adopts a renewed and thoughtful approach to continued economic development.

Sincerely,
Steve 

For Erin Mackie, caring for the people of Crook County has always been a family affair.

Her mother, Kim Crofcheck, ran the Prineville Medical Clinic for 10 years — from 1997 to 2007, before it was a St. Charles facility — managing the practices of eight different doctors. And her grandfather, Thomas Matheson, was a family practice physician in town for four decades.

“I remember they used to do after-hours physicals for the community and we were always helping out with those and checking people in, giving them their paperwork, stuff like that,” Mackie said. “It was just a volunteer, small-town thing, but being there and seeing what they were doing for the community was really cool.”

When it was time for her to go off to college, Mackie thought she wanted to work in the health care industry, but she didn’t want to do clinical work. She ended up studying business management and eventually moved back to Central Oregon, where she has worked for St. Charles for the past seven years, first in operations for the health system’s professional development department and then doing policy work for the Quality team.

She lived and worked in Bend, and didn’t think she’d ever move back home. But last year, a position became available there: Manager of St. Charles’ Prineville Family Care Clinic — the same job her mom held a generation ago.

“I said, ‘OK, let’s put our house in Bend on the market and see what happens.’ It sold in 48 hours,” Mackie said. “I looked at my husband and said, ‘Maybe we’re moving to Prineville.’”

Kim Crofcheck was thrilled, of course. She moved to Prineville when she was 6 years old, attended Lewis & Clark College in Portland and managed a medical clinic in Salem for 10 years before moving back to her hometown in 1997. Community health care work runs deep in the family, she said.

“My dad’s a doctor. My mom was a lab tech who did research on childhood leukemia. My brother’s a doctor. My uncle’s a doctor. Everyone’s in medicine,” she said. “I thought, ‘I’m going to do something different.’ So I got degrees in business and Spanish.”

After leaving the Prineville clinic in 2007, Crofcheck got her teaching degree and became a Spanish instructor at Crook County High School, where she still works. These days, she’s busy building the school’s business program.

“She’s just one of those people who always wants to learn and do things, and my grandfather was all about education, too. That’s just something that has been big in our family — growing and developing,” said Mackie, whose father Dan and sister Sarah are teachers. “I didn’t think I’d ever be in a management position and back in Prineville, but I think within the context of my family, it’s important that I take this next step.”

She’s ready for the job, according to someone who should know: Her mother.

“I loved that job because every day is different. There’s always something that needs your attention and needs to be fixed,” Crofcheck said. “That’s Erin’s personality. She and I are similar that way. So I encouraged her to go after it. I told her health care and education are two places where you can make a significant difference and give back to your community. And I told her, ‘You’ll be fine.’”

Nine months after accepting the position, Mackie is more than fine, actually. She distinctly remembers how much her mom loved the job, and she’s starting to see why.

“I’m really enjoying this, and it’s nice to be back in the community,” she said. “The older you get, the more you understand that your family and the place you grew up is as important as anything else in life.”

In 2024, St. Charles Foundation awarded nearly $90,000 in scholarships to 28 individuals pursuing health care careers, helping St. Charles caregivers and community members pursue secondary education and training in nursing, pharmacy, phlebotomy, Medical Assistant training and more.

Jordan Machtelinckx, who currently serves as a tech in the Emergency Department at St. Charles Bend, received a $5,250 scholarship to pursue a Bachelor of Science of Nursing degree through a new accelerated BSN program in Bend through Oregon Health & Sciences University. He is the first recipient of the new Dr. Lowery-North Nursing Scholarship and Education Fund, which was established in honor of Dr. Doug Lowery-North who practiced emergency medicine for three decades and served as a flight surgeon in the Air National Guard.  

Machtelinckx says the scholarship makes a meaningful impact on his life. “It makes a huge difference and eases the stress, allowing me to focus on the education,” said Machtelinckx. The 33-year-old Bend resident also volunteers with Deschutes County Search and Rescue and has a long history of being involved in wilderness medicine. He hopes to continue to work at St. Charles after graduating from the program later this year.

St. Charles Foundation director Jenny O’Bryan says funding scholarships is a way to help fuel health care careers and give St. Charles caregivers an opportunity to expand and grow in their professions.

“Through this scholarship program, Foundation donors are helping community members pursue their dreams while also growing our health care workforce. It’s a wonderful program worth celebrating,” said O’Bryan.   

The scholarship fund is one of many ways the Foundation helps support the health of Central Oregonians. Learn more about the efforts of the St. Charles Foundation: https://foundation.stcharleshealthcare.org/.  

About St. Charles Foundation

The mission of St. Charles Foundation is to support St. Charles Health System in the delivery and advancement of world-class health care in Central Oregon and achieve its strategic goals. Philanthropic donations fund innovation in programming, building expansions and initiatives that improve the patient experience. The St. Charles Foundation works with the community to develop and steward philanthropic resources to fund programs and capital projects that improve health, prevent disease, enhance quality of life and provide the highest quality care possible for all St. Charles patients now and in the future.

Today St. Charles Health System announced the recipients of a variety of Community Benefit grants, awarding more than $155,000 to 29 organizations in Central Oregon. The grants were awarded to provide basic needs, to support local diversity, equity and inclusion initiatives, to sponsor local events and as part of St. Charles’ Priority Grant to increase a sense of belonging and reduce loneliness and isolation.

Local nonprofit Prevention Intervention Recovery Services by SriPonya received $15,000 to help support a new drop-in space in Madras for youth. It’s a one of the many ways the organization is working to help students develop life skills and resilience to avoid drug and alcohol addiction.

PIRS President John Charles says that the grant from St. Charles aimed at reducing loneliness and increasing belonging will make a big difference in the organization’s ability to open the new space, which is set to open within the month in downtown Madras.

“We will have food, computers and support to help students succeed and be their authentic selves,” said Charles. The group also hosts a sports program in Warm Springs and Prineville as well as numerous programs, workshops and other efforts for youth and adults across the Tri-County region – all in support of prevention, intervention and recovery. “We are coming in with our sleeves rolled up and we are here to help and really want to serve,” said Charles.

Applications are open now through Feb. 28 for the next round of grants from the Community Benefit team at St. Charles. Organizations can learn more and apply on the website.

Five nurses from St. Charles Health System recently earned DAISY Awards for Extraordinary Nurses, recognizing the outstanding, compassionate nursing care they provide patients and families every day. The nurses, who represent all four St. Charles hospitals in Bend, Redmond, Madras and Prineville, were recognized with a ceremony on their respective units and presented with a certificate, a pin and a "healer's touch" sculpture by their hospital’s chief nursing officer. The honorees are:

The nurses earning DAISY awards are:

• Ryan Armand-Priefer, a patient care nurse at St. Charles Bend, was recognized for exemplifying the highest standards of nursing care and compassion and demonstrating extraordinary dedication and kindness while providing excellent medical care.

• Andrew Baca, a nurse at St. Charles Redmond, was recognized by a fellow caregiver for "consistently demonstrating his selflessness, his compassion and above and beyond effort to go out of his way to help. Andrew truly is a team player who excels in so many ways."

• Sadie Larson Robinson, a Nurse Navigator for Cancer Services, was recognized for compassionate treatment and support, and truly caring for her patients. She was specifically recognized for going over and above to help a patient rearrange their first chemotherapy treatment so that their spouse could also attend.

• Megan McPhetridge, a wound care nurse at St. Charles Prineville, was recognized for providing awesome, compassionate care to a wound ostomy patient and putting them at ease, as well as providing an effective treatment plan that fit the patient's needs.

• Jennifer Wienert, a house supervisor at St. Charles Madras, was recognized for going above and beyond her job responsibilities and during her personal time to anonymously assist a patient with personal matters, including volunteering to care for a patient’s dog.

About the DAISY Awards:

The DAISY Foundation is a not-for-profit organization that was established in memory of J. Patrick Barnes by members of his family. Patrick died at the age of 33 in late 1999 from complications of Idiopathic Thrombocytopenic Purpura (ITP), a little known but not uncommon auto-immune disease. (DAISY is an acronym for Diseases Attacking the Immune System.) The care Patrick and his family received from nurses while he was ill inspired this unique means of thanking nurses for making a profound difference in the lives of their patients and patient families.

This is one initiative of The DAISY Foundation to express gratitude to the nursing profession. Additionally, DAISY offers J. Patrick Barnes Grants for Nursing Research and Evidence-Based Practice Projects, The DAISY Faculty Award to honor inspiring faculty members in schools and colleges of nursing and The DAISY in Training Award for nursing students. More information is available at http://DAISYfoundation.org.

When it comes to injuries that affect our bones, muscles, and ligaments, three common terms are often used: strains, sprains, and fractures. While they may sound similar, these injuries are distinct in their nature and require different approaches for treatment and recovery. Whether you’re an athlete, a fitness enthusiast, or simply going about your daily activities, knowing the difference between strains, sprains, and fractures can be invaluable in understanding how to respond to injuries and promote healing. In this blog, we will delve into the definitions of each injury, their causes, symptoms, and the best practices for managing and treating them effectively.

Strain

A strain is when damage occurs to muscles and tendons as a result of a joint being pulled or stretched too far. Tendons are fibrous cords that attach muscles to the bones and allow our joints to move and be stable. Strains are most commonly seen in the lower back or leg muscles, but can also occur in the wrist, ankle, and other parts of the body where major muscles and tendons are present. Listed below are common strain injuries.

• Hamstring strain: This occurs when the muscles at the back of the thigh (hamstrings) are stretched or torn, often seen in sports that involve sprinting or jumping.
• Groin strain: Groin strains affect the muscles in the inner thigh or groin area and are common in sports that require sudden changes in direction or kicking movements.
• Calf strain: The calf muscles, located at the back of the lower leg, can be strained during activities that involve quick acceleration or intense calf contractions.
• Quadriceps strain: The quadriceps are the muscles at the front of the thigh, and a strain in this area can occur during activities like running, jumping, or kicking.
• Back strain: This involves the muscles and tendons in the lower back and can happen due to improper lifting techniques, sudden movements, or poor posture.
• Shoulder strain: The shoulder muscles and tendons can be strained from repetitive overhead movements or sudden, forceful actions.
• Rotator cuff strain: The rotator cuff is a group of muscles and tendons in the shoulder joint, and strain in this area is common among athletes and individuals who perform repetitive arm movements.
• Wrist strain: Wrist strains can occur from repetitive use or sudden impact, often seen in activities like typing, weightlifting, or playing racquet sports.
• Ankle strain: The ligaments around the ankle can be strained during activities that involve sudden changes in direction or rolling of the foot.
• Groin adductor strain: This involves the muscles on the inner side of the thigh, and it is common in sports that require lateral movements and sudden stops.

Pain, swelling, and muscle spasms are all usual symptoms of a strain, but they can usually be treated at home.

The RICE method is a widely recognized first-aid technique used to manage strains effectively. RICE stands for Rest, Ice, Compression, and Elevation. When you experience a strain, it is essential to promptly initiate the RICE method to alleviate pain, reduce swelling, and promote healing so you can get back to normal activities.

• Rest involves avoiding any activity that exacerbates the strain, allowing the affected area time to recover.
• Applying an ice pack to the injured area in short intervals helps to constrict blood vessels, decrease inflammation, and numb the pain.
• Compression with an elastic bandage provides support and reduces swelling.
• Lastly, elevating the injured limb above heart level helps to minimize swelling by aiding fluid drainage.

Remember, the RICE method is most effective when used within the first 48 hours after a strain occurs. If the pain persists or the strain is severe, seeking medical attention is crucial.

Sprain

Similar to a strain, a sprain occurs when ligaments are stretched beyond their limit – or even torn. Ligaments are tough bands of fibrous tissue that connect two bones together in your joints. The most common location for a sprain is your ankle, but sprains are also commonly seen in the knee and wrist. Symptoms of a sprain are similar to that of a strain with swelling and pain, but a sprain will also usually bring bruising with it. The majority of all ankle sprains will heal without any need for surgery. Even a complete ligament tear can heal naturally if given the appropriate rest. Rest and protection of the joint are the initial recommendations for a soft tissue injury. Once swelling is reduced, range of motion, strength, and flexibility will be reintroduced through various exercises dictated by your healthcare provider.

Some common sprain injuries include:

• Ankle sprain: The most common type of ankle injury, a sprained ankle, occurs when the ligaments around the ankle joint are stretched or torn, often due to rolling or twisting the foot.
• Wrist sprain: This type of sprain is a common injury that can result from a fall on an outstretched hand, causing the ligaments in the wrist to stretch or tear.
• Knee sprain: The knee joint is susceptible to sprains, especially the medial collateral ligament (MCL) and the anterior cruciate ligament (ACL).
• Thumb sprain: A thumb sprain can occur when the thumb is forcefully bent backward, stretching or tearing the ligaments supporting the thumb joint.
• Elbow sprain: Elbow sprains typically affect the ligaments on the inner (medial) or outer (lateral) side of the elbow and often result from repetitive overuse or sudden impact.
• Shoulder sprain: Shoulder sprains can happen when the ligaments in the shoulder joint are stretched or torn due to traumatic events or excessive force.
• Hip sprain: Although less common, the hip joint can experience sprains, particularly during high-impact activities or accidents.
• Finger sprain: A finger sprain occurs when the ligaments supporting the finger joints are injured, usually from hyperextension or impact.
• Back sprain: The ligaments supporting the spine can be sprained due to lifting heavy objects or sudden movements.
• Neck sprain: Neck sprains, also known as whiplash injuries, happen when the neck undergoes rapid back-and-forth movements, such as in car accidents.

Mild to moderate sprains can often be treated with the RICE method (Rest, Ice, Compression, and Elevation), anti-inflammatory medication and appropriate pain management. However, severe sprains may require medical evaluation and possibly imaging to assess the extent of the injury.

Fracture

Unlike strains and sprains, a fracture is when a bone is cracked or broken. The joints and ligaments may also be damaged when a fracture occurs. Symptoms of a fractured bone include sudden and severe pain, swelling, and bruising, and the inability to bear weight or move the injured part of your body. You may not require surgery if the joint remains stable and the fracture is minor. If the fracture is out of place or your joint is unstable, your orthopedic surgeon may need to do surgery. Listed below are common types of bone fractures.

• Closed fracture: Also known as a simple fracture, this type of fracture does not break the skin. The bone may be broken, but the surrounding skin remains intact, reducing the risk of infection compared to open fractures.
• Open fracture: An open fracture, also called a compound fracture, is one where the broken bone pierces through the skin, leading to an external wound. This type of serious injury poses a higher risk of infection and requires immediate medical attention in an emergency room to prevent complications.
• Greenstick fracture: Typically seen in children whose bones are more flexible, a greenstick fracture is an incomplete break, where the bone bends and cracks but doesn’t completely separate. It resembles the way a green branch of a tree would bend but not break completely.
• Comminuted fracture: In a comminuted fracture, the bone is shattered into three or more fragments. This type of fracture can be challenging to treat and may require surgery to realign and stabilize the bone fragments.
• Transverse fracture: A transverse fracture occurs when the fracture line is perpendicular to the long axis of the bone. It often results from a direct blow or impact on the bone.
• Oblique fracture: An oblique fracture has a diagonal fracture line across the bone. These fractures can be unstable and may require surgical intervention for proper alignment and healing.
• Spiral fracture: Spiral fractures have a twisting pattern along the bone. They commonly occur due to rotational forces applied to the bone during a fall or accident.
• Stress fracture: A stress fracture, also known as a hairline fracture, results from repetitive stress on a bone over time, often seen in athletes and people who engage in high-impact activities. Unlike other fractures, stress fractures may not be immediately noticeable and can develop gradually.
• Avulsion fracture: In an avulsion fracture, a small fragment of bone is pulled away from the main bone due to the force of a tendon or ligament pulling on it. This type of fracture is common in sports injuries.
• Compression fracture: Compression fractures typically occur in the vertebrae and result from the spine being compressed, often seen in conditions like osteoporosis or high-energy trauma.
• Pathological fracture: A pathological fracture occurs when a bone is weakened by an underlying medical condition, such as cancer or osteoporosis. These fractures can happen with minimal force and require specialized treatment.

It is important to have your injuries evaluated and treated by an orthopedic surgeon for an accurate diagnosis to ensure proper healing and avoid complications. Your surgeon will help create a treatment plan for you, as the approach for each injury type varies. It may involve casting, splinting, orthopedic surgery, physical therapy, or other interventions to support bone healing and recovery.

The knee is a complex joint with many different components. Bones, tendons, ligaments, and cartilage all work together to allow the joint to move and bend smoothly. It is also one of the largest joints in your body, making it vulnerable to a variety of injuries. Knee pain can be debilitating and impact your ability to do even the simplest everyday activities. Some of the most common knee injuries include overuse injuries, degenerative conditions, dislocations, sprains, fractures, and ligament tears.

Knee ligament sprains and tears are the most common knee injury, often seen in individuals who participate in sports from football to soccer to skiing. Each year in the United States approximately 75,000 people will experience an MCL injury and up to 200,000 will experience an ACL injury.

The anatomy of the knee

The knee is a hinge joint created by the femur (thighbone) and the tibia (shinbone). The patella (kneecap) is the third bone present that covers and protects the joint. In addition to these bones, cartilage, ligaments, and tendons are all present within the knee to help the joint function properly.  

Ligaments are the tissues that connect bones to other bones. There are four main ligaments in your knee that hold the bones of the joint together and provide stability:

• Anterior cruciate ligament (ACL)
• Lateral collateral ligament (LCL)
• Medial collateral ligament (MCL)
• Posterior cruciate ligament (PCL)

There are collateral and cruciate ligaments. Collateral ligaments (lateral collateral ligament and medial collateral ligament) are found on each side of your knee and control sideways movement, while cruciate ligaments (anterior cruciate ligament and posterior cruciate ligament) are found inside your knee joint and control backward and forward movement.

Understanding ligaments

Your ligaments are made up of fibrous soft tissues that hold your bones and joints together. Picture your ligaments as strong ropes – a small cut in the rope will make it less stable as all of the fibers become loose. This is similar to a tear in one of your ligaments, which occurs when the fibers are partially or fully torn away from each other. As the tissues in your ligaments expand and retract to stabilize your joints, the fibers can tear from certain unnatural movements like a fall or collision.

What is an ACL tear?

The ACL is located inside of the knee joint and connects the top front of the tibia (shinbone) to the bottom back of the femur (thighbone). Together, the ACL and PCL cross each other to form an “X” inside of your knee. The ACL prevents the tibia from sliding too far forward relative to the femur and is important for rotational stability. ACL injuries often occur during sports activities that involve frequent pivoting or cutting, like football, soccer, and basketball. Quickly changing direction or landing from a jump incorrectly can also result in an ACL injury.

What is a MCL tear?

The MCL is located on the inner side of your knee (connecting the bottom of the femur to the top of the tibia) and works to control sideways motion. Injuries to the MCL are usually caused by contact injuries to the outside of the joint that push the knee inward. Football, hockey, and other high contact sports are often responsible for MCL injuries.

It is not always the case, but ACL injuries are generally more complex to treat than MCL injuries, which sometimes heal on their own.

ACL and MCL injury symptoms

Injured ligaments are rated on a scale of one to three. Grade 1 means mild damage where the ligament has been slightly stretched, Grade 2 means a stretch to the point where the ligament is loose (partial tear), and Grade 3 means the ligament has been torn into two pieces.

ACL tear symptoms

• Pain and tenderness with swelling
• A “popping” noise or feeling of the knee giving out
• Difficulty and discomfort while walking
• Loss of full range of motion

MCL tear symptoms

• Pain and swelling specifically on the sides of the knee
• Instability or feeling of the knee giving out

In both cases, you are likely to experience pain and a significant instability of the injured knee. You may still be able to bear weight after a torn ACL, or you may not be able to depending on the severity of your injury. Most people are still able to walk and bear weight after an MCL tear.

ACL and MCL diagnosis

Most ligament injuries can be diagnosed through a physical examination of the knee where your doctor will compare the structure of your injured knee to your non-injured knee. Your doctor may or may not order an x-ray or MRI in order to determine whether the injury is associated with a broken bone or to get a better picture of the soft tissue ligaments.

ACL and MCL treatment

A MCL injury rarely requires surgery and, in time, will heal on their own given proper care. Icing, bracing, and physical therapy are all typical in an MCL tear treatment plan. Icing your injury is extremely important to the healing process and should be done for 15 to 20 minutes at a time with at least one hour between icing sessions.

It is important for your knee to be protected from the same sideways force that caused the injury, so your doctor may recommend a brace or even crutches to support the knee. You may need to adjust your daily activities to avoid bearing weight or risky movements. Strengthening exercises and physical therapy can help to restore function and strengthen the muscles that support the knee joint.

Your doctor may recommend nonsurgical treatment like bracing or physical therapy for an ACL injury, but a torn ACL will not repair itself. Sometimes patients who are elderly or who have a very low activity level and still have overall stability of the knee will not require surgery and can manage their injury with other treatment.

Surgical treatment of a torn ACL usually involves arthroscopy, where a small camera is inserted into the knee through a small incision and connected to a video monitor in the operating room. Your surgeon will use the camera to repair the damaged ACL with tissue from another part of the body – generally a tendon from the knee or hamstring, or from a cadaver. Choosing to use your own tissue or a cadaveric tissue graft is something you should discuss with your orthopedic surgeon, as there are pros and cons to each option. After the torn ACL is replaced with new tissue, it will develop into a ligament over time.

ACL and MCL recovery process

Once your range of motion returns to normal and you are able to walk and bear weight without a limp, your doctor will usually allow a gradual and progressive return to activities. This might look like starting with jogging and slowly progressing to sprinting over time. You may need to continue to wear a knee brace during physical activity depending on the severity of your injury.

ACL reconstruction surgery has a very high success rate. Your ACL rehabilitation plan is likely to include physical therapy, starting with a focus on returning motion to the joint and followed by strengthening exercises to protect your new ligament. After these steps have taken place, then you will follow a functional return to your normal physical activities. Generally, patients may return to sports when there is no longer any pain or swelling, typically a 4-6 month range. Recovery after surgery varies from patient to patient. Recovery time takes at least six months to fully incorporate the new ACL into your body.

ACL and MCL injuries are extremely common and often quite painful. The best thing you can do for a speedy recovery is to visit your doctor immediately following a knee injury to develop a treatment plan that works for you and your lifestyle.

What is a brain aneurysm?

A brain aneurysm is a bulge that forms in the wall of a weakened artery in the brain. If an aneurysm ruptures, blood spills into the space between the skull and the brain, causing a serious type of stroke known as a subarachnoid hemorrhage (SAH). Thinning of the arterial wall can occur gradually over time, and aneurysms most commonly develop at the base of arterial branches of the brain as the arteries are their weakest at these points. A ruptured aneurysm requires prompt medical treatment as it can quickly become life-threatening. However, not all brain aneurysms rupture and in some cases may be treated to prevent any rupturing in the future. These are often detected during tests for other conditions. Speak with your doctor to determine the best treatment plan for your specific needs.

Facts about aneurysms

Aneurysms vary in size. A small aneurysm is between 1/8 inch to almost 1 inch. It’s estimated that 50-80% of small aneurysms will not rupture. An aneurysm that is greater than 1 inch is considered a “giant” aneurysm, which is at a much higher risk of rupturing and can be difficult to treat.

• An estimated 6.5 million people in the United States have an unruptured brain aneurysm, or 1 in 50 people.

• Women are more likely than men to have a brain aneurysm (3:2 ratio).

• Brain aneurysms are most prevalent in people ages 35 to 60, but can occur in children as well. Most aneurysms develop after the age of 40.

• Women, particularly those over the age of 55, have a higher risk of brain aneurysm rupture than men (about 1.5 times the risk).

What symptoms should you look out for?

Brain aneurysms that have not ruptured typically have little to no symptoms. These aneurysms are most often smaller in size, and most are found incidentally when tests are being done to screen for other conditions.

If a small aneurysm grows larger and begins to press on nerves in the brain, such symptoms may be experienced.

• Blurred or double vision
• A drooping eyelid
• A dilated pupil
• Pain above and behind one eye
• Weakness and/or numbness

If you experience these symptoms, seek immediate medical attention.

Ruptured brain aneurysms are much more dangerous and not all of the symptoms listed below may be present at once. When an aneurysm ruptures, bleeding in the space around the brain usually occurs causing sudden symptoms. These sudden symptoms may include the following.

• Sudden and severe headache, often described as “the worst headache of my life”

• Nausea/vomiting

• Stiff neck

• Blurred or double vision

• Sensitivity to light

• Seizure

• Drooping eyelid

• A dilated pupil

• Pain above and behind the eye

• Loss of consciousness

• Confusion

• Weakness and/or numbness

If you experience any of the above symptoms of a ruptured aneurysm, call 911.

Causes and risk factors

Although the causes of a brain aneurysm are unknown, many other factors may increase your risk. Brain aneurysms are more common in female adults. Other common risk factors include:

• Drug abuse
• Hypertension
• Older Age
• Cigarette smoking
• Excessive alcohol consumption
• Head trauma from an injury

Complications

When a brain aneurysm ruptures, the pressure inside of the skull increases and the bleeding can cause irritation to the lining of the brain, damaging cells. When your skull experiences that amount of pressure, the blood and oxygen levels to your brain are disrupted causing loss of consciousness or even death.

Other complications that can develop after a brain aneurysm rupture include:

• Subarachnoid hemorrhage (SAH): A life-threatening type of stroke caused by bleeding in the brain.
• Hydrocephalus: Confusion, lethargy, and loss of consciousness caused by increased pressure in the skull that forces the brain to shift and herniate.
• Vasospasm: This occurs 5-10 days after the rupture when the walls of the artery begin to spasm and narrow, reducing blood flow to the part of the brain, causing a secondary stroke.