Empowering Communities: A Heart Health Collaboration with the American Heart Association and Wellstar Congregational Health Network

There are more than 1 million hip and knee replacement surgeries performed in the United States each year, primarily for patients experiencing debilitating arthritis pain in those joints. That number is expected to grow considerably as the population ages and looks to maintain an active lifestyle. However, despite being one of the most common elective orthopedic procedures performed today, many patients whose quality of life could benefit from such a surgery are often hesitant because they know friends or family members who have had a total joint replacement with a poor outcome. That is why helping patients understand what to expect during and after surgery, and how to optimize their health prior to the surgery, is crucial to any successful joint replacement procedure.

Before undergoing total joint replacement surgery, it is vital for a patient to be as medically optimized and strong as possible. This means working on range of motion exercises for the affected joint and doing light strengthening exercises on a consistent basis in order to increase joint and muscle movement, reduce stiffness and pain, and maintain flexibility. In addition, encouraging patients to practice good diabetic control, stop the use of nicotine products and optimize their weight by making healthy lifestyle choices also helps to reduce the risk of infection after surgery and improve patient satisfaction and recovery. These are incredibly important factors for patients to discuss with their surgeon when considering joint replacement surgery in order to increase the likelihood of having a complication-free surgery.

Prior to surgery, patients should be able to meet with their surgeon and care team to discuss the procedure in detail and have all their questions answered regarding post-operative complications, mobility, pain management and the impact on their lifestyle and daily activities. Finding a surgeon who prioritizes sitting with patients and taking the time to answer their questions ahead of surgery is imperative. Further, meeting with the anesthesia care team and participating in instructional classes related to hip and knee replacement helps patients feel at ease with undergoing the surgery and managing the recovery process.

Patients are often concerned about the hospital stay, including what will happen the day of surgery and after the surgery. Thanks to advancements in surgical techniques, many hip and knee replacement surgeries can now be performed as outpatient procedures. This allows patients to go home on the same day as their surgery, often with the support of home health and physical therapy services. For those who have more complex medical problems, an overnight stay is typically recommended.

Pain control techniques have vastly improved in recent years, and surgeons and anesthesiologists now work together to use a variety of methods to treat patients’ pain. These include nerve blocks, medications infiltrated around the actual hip or knee joint and medications administered after surgery that target multiple pain receptors and help keep pain manageable. At Wellstar Orthopedics & Sports Medicine, we ensure that patients are up and walking within a couple of hours of surgery with an assistive device. Most patients no longer require a blood transfusion due to better anesthesia techniques as well as medications that now slow blood loss during surgery, which also contributes to a faster recovery.

After surgery, patients can expect to need a walker for anywhere from a few days to several weeks. Most patients don’t need an assistive device by three to four weeks after surgery, but this does vary. Patients often return to driving around three to four weeks after surgery. In my practice, we typically close the incision with sutures underneath the skin, eliminating the need for patients to return to the office for suture or staple removal. In addition, the bandages we use are waterproof, making it easy for patients to shower after surgery. The total recovery time following joint replacement surgery is usually two to three months. Most patients benefit from attending weekly physical therapy sessions during this time to assist with regaining full joint range of motion, increasing strength throughout the lower extremity and regaining independence with functional activities such as ascending and descending stairs and getting up from a couch.

For those who are interested in doing their homework prior to surgery, there are excellent resources available to patients on both the American Academy of Orthopedic Surgery and American Association of Hip and Knee Surgeons websites. But the most important step for patients as they prepare for joint replacement surgery is to consider choosing a surgeon who has additional fellowship training in hip and knee replacement, is willing to answer their questions and proactively share what to expect, and who they ultimately trust to perform the surgery. Taking the time to find a surgical team that is committed to enhancing patients’ well-being and helping them achieve the best possible outcome will increase the odds of a successful joint replacement.

Dr. Scott Miller, a Wellstar urologist and expert in robotic and laparoscopic surgery, joined Dr. Bruce Feinberg on 95.5 WSB’s The Weekly Checkup. Together, they tackled common questions about urology, prostate health, incontinence and more.

Does dark urine mean I have a medical problem?

There’s no normal color for urine, Dr. Miller explained. Most of the time, expect urine to be “fairly diluted, almost like water or very pale yellow.”

Urine color may be different in the morning after a night’s sleep without hydration. Some prescription and over-the-counter medicines, like multivitamins, can also affect urine color. Any red in urine could indicate the presence of blood. That’s a sign to call your primary care provider or urologist.

Should I be worried about bubbles in my urine?

That depends, according to Dr. Miller.

“If bubbles form simply because of the way your urine stream hits the water—causing a little turbulence—there’s no need for concern,” he said. “But if you actually feel the bubbles or air passing as you urinate, that’s different. It could indicate a bladder infection or an abnormal connection between the urinary and GI (gastrointestinal) tract.”

In that case, Dr. Miller said a doctor would likely order tests to determine the cause and recommend appropriate treatment.

Do women need urologists?

Yes. Urologists specialize in treating the kidneys and the bladder in both women and men, in addition to addressing prostate health in men.

“Anyone with a urologic issue should see a urologist,” Dr. Miller said. He noted that women are more likely than men to experience conditions like kidney stones and urinary tract infections, making specialized care essential.

Is bladder leakage inevitable with aging?

Dr. Miller noted that bladder control issues are common, but they can be an avoidable part of aging.

“Some females assume bladder control is a natural consequence of childbirth or aging,” he said. “But in reality, these are all treatable issues and sometimes very simple fixes.”

Dr. Miller said that both women and men can benefit from treatments that may include medications, lifestyle changes and minimally invasive procedures. He encourages those experiencing bladder control concerns to talk with their primary care doctor or urologist rather than assume it’s something they must live with.

What about erectile dysfunction? Is it unavoidable with aging?

Erectile dysfunction (ED) can occur at any age, Dr. Miller said. But it is more common as men get older.

“ED isn’t necessarily a direct result of aging. … For instance, testosterone levels naturally decline with age, which can contribute to ED. But that’s not necessarily the cause of the erectile function,” he said.

Underlying health conditions, such as heart disease, are sometimes related to ED and are more common as people age.

People with other diseases, such as diabetes, may also experience erectile dysfunction, he explained.

At any age, patients should see a doctor as soon as they start having erectile dysfunction, Dr. Miller said. Doctors can test and rule out other causes. Early treatment for erectile dysfunction is often more successful than when patients delay seeing a doctor.

Is vasectomy safe? Is it reversible?

Not only is vasectomy safe, but it’s also the “most effective form of permanent birth control,” Dr. Miller assured listeners. The outpatient procedure is performed in a doctor’s office, and recovery is quick.

Some men worry that a vasectomy might affect their sexual function or desire, but that’s not true, Dr. Miller added. Vasectomy doesn’t affect the testicles, where testosterone, the male hormone, is produced or the delivery of the hormone to the bloodstream.

Dr. Miller said that when patients ask if vasectomy is reversible, he cautions that while vasectomy reversal is possible, it is a complex procedure with no guarantees. The patient’s age, how much time has passed since the vasectomy and the partner’s fertility all influence the chances of achieving pregnancy.

“So, never count on it,” he said. “But there are other ways to achieve pregnancy, even in someone who has had a vasectomy, including retrieving sperm directly from the testicle” then attempting in-vitro fertilization.

If I have prostate cancer, does that mean I need surgery?

Advances in prostate cancer detection and treatment have changed considerably in how doctors treat the disease, Dr. Miller said.

“Up to 40% of all prostate cancers we diagnose are at least initially candidates for active surveillance,” he said. Of those, 40 to 50% will, over three to five years, require treatment. Even in those cases, he added doctors “have a lot of ‘runway.’”

“It’s like landing a commuter jet on a 747 runway. We don’t need to start at the very beginning of the runway to safely land before the runway runs out,” he said.

For some patients, that may eventually mean they are candidates for laparoscopic surgery to remove the prostate gland or parts of it that are cancerous.

Advances in diagnostic tools, such as MRIs, genetic testing and genomic testing, have also revolutionized the detection and treatment of prostate cancer, according to Dr. Miller. Genetic testing can help determine a person’s risk of developing prostate cancer, while genomic testing reveals the molecular makeup of tumors and helps guide treatment decisions between doctors and patients.

Can I change my diet to prevent kidney stones?

Dr. Miller recommends two dietary habits to help prevent kidney stones: drinking plenty of fluids and limiting sodium intake—not only table salt, but also foods high in sodium, including diet and snack foods. He advised that when you have a meal high in sodium, counter its effects by drinking extra water.

In general, “most of the things in your diet will have very little effect on your chance of having kidney stones,” Dr. Miller said.

Because calcium is one of the chemicals that makes up kidney stones, Dr. Miller said many people ask if they should avoid calcium to prevent kidney stones. In most cases, the answer is no. Women especially need adequate calcium in their diets to support bone health and reduce their risk of osteoporosis.

Find a urologist at Wellstar

Do you have questions or concerns about your urinary health? Wellstar’s expert urologists are ready to help. Visit wellstar.org/urology to learn more or schedule an appointment.

MARIETTA, Ga. (Feb. 20, 2025) – Wellstar Health System announced today the launch of residency programs at two more of its hospitals: Wellstar Paulding Medical Center in Hiram and West Georgia Medical Center in LaGrange.

Including its partnership with Augusta University’s Medical College of Georgia (MCG) at Wellstar MCG Health, Wellstar will now operate seven teaching hospitals in the state. In addition to Wellstar Paulding and Wellstar West Georgia, four other Wellstar hospitals—Wellstar Kennestone, Wellstar Cobb, Wellstar Douglas and Wellstar Spalding Medical Centers—are already designated as teaching hospitals.

Known as Graduate Medical Education (GME), the Paulding and West Georgia residency training programs will create 60 new physician positions—30 in each hospital. Both programs will focus on internal medicine with an emphasis on rural primary care.

In the last decade, Wellstar has grown its GME program from 14 trainees in 2016 to nearly 300 today, many of whom have remained with Wellstar and in Georgia.

Through Wellstar’s partnership with Augusta University’s Medical College of Georgia, Wellstar MCG Health Medical Center is the primary clinical training site for more than 500 GME positions. The new residency slots mean Wellstar will soon support more than 860 physicians in training.

Wellstar executives said one of their goals is to help fill an increasingly dire need for physicians in rural areas.

“We know that doctors are more likely to stay in communities where they train,” said Wellstar President and CEO Candice L. Saunders. “Because of that, we’ve committed significant resources to training physicians who care for people in rural areas where the need is much greater for highly skilled clinicians.”

“We must all work together to ensure students who graduate from medical schools in Georgia can remain in our state for residency and beyond,” said Augusta University President Russell T. Keen. “Programs like these are an essential part of ensuring a healthier future for our state. I am thankful to our educational partners at Wellstar for their vision and investment and I look forward to finding new ways to ensure our partnership continues to positively impact the lives of the people of Georgia.”

Later this year another hospital that serves rural areas, Wellstar Spalding in Griffin, will graduate its first class of resident physicians. The 10 graduates will be offered positions within the healthcare system. Wellstar is also pursuing a Rural Track Program (RTP) designation, which would allow for additional physician trainees to be based at Wellstar Kennestone but practice at rural hospitals across the state.

“Besides improving the health and wellness of Georgia’s rural communities, we’re also helping to make them stronger economically,” said Dr. Val Akopov, senior vice president of Wellstar Medical Group. “These new physicians and their families live and work in these small towns, which positively enhances our shared vision for our state.”

“Now with 304 students per class, Medical College of Georgia is among the top five largest medical school class sizes in the nation but is a net exporter of medical students,” said MCG Dean Dr. David Hess. “Growth in undergraduate medical education is only one part of addressing our nation’s and state’s growing physician shortage. We must also invest in GME—Georgia is one of the fastest growing and most populous states yet we still rank 40th in residents per capita. Statewide growth and expansion of residency slots is certainly a step in the right direction.”

Wellstar is also investing in its current educational portfolio through the expansion of its medical libraries, capital improvements to its Center for Healthcare Simulation, the construction of a new Anatomical Skills and Research Lab and new medical technologies to assist patients at the bedside.