Who's behind the scenes?

           This post is a huge thank you to everyone in the medical field patients probably take for granted.  Dr. Greenwald did a great job on my surgery, he put in the time (most likely a couple all nighters in med school) to sharpen his skills to make him the best surgeon he can be.  But he did not do it alone, he had a staff, nurses, someone filling out paperwork, someone prepping rooms, the list goes on.  And there is one thing that I didn’t even think of about my surgery.

            That one aspect about my surgery that I didn’t think of was the tools and equipment that he used during the operation.  I was under the assumption that all his tools were sterilized or cleaned very well, and then used for the next patient.  That isn’t the case.  Dr. Greenwald probably (if I was a betting man I would put money on this) used a UCL instrument set.

            When I asked him about the tools he used, I asked him questions like, did someone sell you this or that instrument/medical tool just for this procedure?  I was way off in my thinking.  It was much more simple than that.  Dr. Greenwald has a business relationship with a company called Arthrex.  Arthrex is a company whose mission is to help surgeons treat their patients better.  They most likely gave my doctor, and many others, peace of mind knowing that their product would be in the operating room when they needed it and it would the right tools for the job.

            Arthrex is a big “behind the scenes” teammate of orthopedic surgeons.  They are a world leading medical device company who strives to be a pioneer and leader in their field.  They are making a complex job easier to do for professionals.  This company was behind the scenes of my surgery and they definitely made a difference to me, they deserve a thank you as well.

A UCL instrument Kit used by many doctors.

            Arthrex works with doctors to deliver the best quality products that will ultimately affect one of there millions of patients, like me.  In my case, a UCL instrument kit has screws, drill bits, and other very useful pieces of equipment that doctors use.  Dr Greenwald used them all to perfection.  Until next time, laugh often, with everyone, but never at someone.

Riley Banach

Check out their website http://www.arthrex.com/

An answer to pain or injury

            On Thursday morning March 7^th, I was sitting in Dr. Clark’s office waiting to hear what my MRI results from a week earlier had shown.  At this point I knew my arm was weak but had been getting better slowly.  I still could not open a door, but I just figured I had a minor sprain or a big bruise and with ice and pain meds it, my pain would be fixed.  That was not the case at all.

            Dr. Clark is the UNI athletics team doctor, athletes who have major injuries competing for the panthers see him.  Looking back I am glad that he presented the news of my injury the way he did.  He walked in and told me his thoughts about my arm, and my athletic trainer Troy’s, had been true, complete tears of major ligaments with specific bodily functions.  I translated the medical language as “really screwed up.”  What made me glad the way Dr. Clark presented this news was how he showed me that rehab or surgery could only strengthen my arm more.  That is what I was most concerned about, because at the time I couldn’t even open a door with my left arm.

            Now comparing this to what my Dad did in college has really made me think about the old saying that everyone has heard from a coach (or elementary school playground teacher, Mean Gibbins ahh I mean Mrs. Gibbins, who hated every form of fun I had), “pain or injury?  While wrestling for Iowa my Dad won 3 NCAA titles, became the first wrestler in Iowa history to make the finals four times, and then won a gold medal in the 1984 Olympics.

            His senior year he defeated his rival from Iowa State, Mike Mann in the finals.  Earlier in the year however, my dad tore his ACL in his right knee.  He said the pain felt like it was on fire and he had no idea what he had done.  My dad actually tore his ligament at midlands, an annual tournament held at Northwestern University.  He continued to wrestle and reached the finals before talking to his trainers and coach, Dan Gable.  After hearing this story a few times, the doctors first told my dad he was to have surgery and was not going to be able to compete for the rest of the year.  Gable and my Dad had other ideas.

            My dad was, and in lifting respects still is, an incredible athlete.  Growing up he had two brothers he would wrestle, lift, and play other sports with.  His twin, my uncle, Lou won 2 NCAA titles for Iowa and a gold medal at the same Olympics too.  My dad still had a huge gas tank of endurance in wrestling, an upper body second to none, and one strong leg that he planned to use that to his advantage.  Over the next few weeks and months of rest and rehab strength came back.  People walk on torn ACLs all the time, but few wrestle on one.

            My dad changed the way he wrestled; he led with his left foot instead of his right from that point in the year on.  He had success with it too, in march he won his third NCAA title.  He was disciplined, focused, and mentally put the injury out of his mind.  It didn’t affect him.  In my case however, I basically tore the same ligament he did, but in my elbow.  Instantly I lost all strength in that arm.  I was more stunned than anything.

            Wrestling requires hand-to-hand combat before enforcing your offence upon your opponent.  My arms are major factors in wrestling and are used a lot in practice and a match.  With my left one at no strength I would have stood no chance.  What also scared me was watching a teammate.  Aaron McMurphy, a redshirt freshman that year had dislocated his elbow and tore the same ligament earlier in the year.  Two months later, right after I tore mine, he came back to wrestle.

            It didn’t go very well for him, I saw him try to wrestle at the level our room had set.  I loved his attitude and drive, but he could not compete because his arm wasn’t one hundred percent.  He tried to come back too fast and he hurt it again.  He had rehabbed it, but the fact of the matter was he still had a torn UCL and couldn’t wrestle.  After seeing that I told myself I needed surgery.  I was basically in the same boat as he was.

            Which made me clearly define in my mind what an injury is and the difference from an injury to pain.  An injury, to me, is a condition of the body beyond one’s control.  It prevents an individual from doing something they wish to do, like an everyday task or a specific action.  An injury is not a full impairment to an activity if it can be fixed or healed.  Pain is discomfort while performing any activity of your choice, an individual can push through pain.  An injury can’t be ignored.

            My dad dealt with the pain.  He told me surgery was the road I should take.  I couldn’t wrestle with one arm, I had surgery and took six months off.  Currently I am back on the mat and excited for the upcoming season.  Time is flying by and so is this year, our first tournament is less than 3 weeks away.  Tomorrow, Monday, is a work day, and I can’t wait for the opportunity.

Until next time, laugh often, with everyone, but never at someone.

Riley Banach

My Dad, and Dr. Greenwald (and yes, that is my Dad's Gold Medal)

The best medicine #4, Celebrity Jeopardy

            Hello again blog readers.   I have been crazy busy with two tests and a quiz this past week.  I have another test next week as well, so this weekend I will be busy studying for that.  In the mean time I want you to get your weekend started off right.  Here is the best medicine number four post.  Click play and enjoy, this is one of my favorite SNL games.

The best medicine #3, Happy Birthday Mom!!!!!

 

Happy Birthday to my Mom!!!!!!

           Today is my Mom’s birthday.  This is a post about the best medicine out there in the world, laughter.  I love my mom, this is a story about my first year of high school wrestling and an incident which made me question whether or not my Mom was cheering for me, or against me . . .

            Here is a little background on the match, I am the last JV match of the night before varsity comes.  It is my freshman year of high school, and I all of a sudden on the other mat there is a pin.  Which means I am on center stage so to speak.  Parents are there, and some are still filing in.  The gym is getting a little quiet waiting for varsity to start.

            As the match goes underway I give up a stalling call early in the match, for whatever reason I wasn’t focused in the opening minute of the match.  The second and third period I came firing back and build my lead to something to the tune of 20-8, if you know anything about wrestling, the match is basically over.

            So after the last takedown I cut him, I let him go and gave him a point.  The score is 20-9 now.  There are fifteen seconds left.  I have the win, I have “checked out” mentally.  In the second row behind the score table with ten seconds left is where my mom is sitting.  She has been watching the whole time, and knows I am going to win, with ten seconds left, I hear “quit stalling,” come from her direction.  A few moments after words, the referee calls me for stalling and awards my opponent another point and I won 20-10.  Thanks Mom!!!!!!!!

Had to add this one, a big thank you to my sister in this one!!!!

            My mom has always been there for me, I love her.  Later in high school I said that in an interview, that scored me a ton of points in the brownie category.  I hope she has an awesome birthday!!!!  I get to see her tomorrow.

Until next time, laugh hard, laugh with everyone but never at someone.

Riley

I pray you never go through this . . .

            Playing sports has brought me a ton of great opportunities throughout my life.  I have met a ton of cool people, had a blast in high school competing, and I was blessed enough to be able to zero in on wrestling in college for the University of Northern Iowa.  I have wrestled since 7^th grade straight, baseball and football also worked their way into my schedule when time allowed.  My favorite sport has always been wrestling though.

            This post is about a recent experience in college wrestling that seemed very negative and disheartening when it happened, however everything happens in life for a reason, this is just one little stop on life’s long journey.  I know some of these dates by heart because of all the forms I needed to fill out, on February 20^th, 2013 thirty minutes into wrestling practice, I hurt my elbow.  It hyper-extended the wrong direction; my hand was to the left of my elbow, if that makes sense.  Long story short, I later found out I had torn my ulnar collateral ligament, or UCL for short.

            When the UCL is torn, the recommendation is either a long rehab period or Tommy John surgery based on the severity of the tear.  My tear was bad, and after talking with my family and doctors whom we knew, I elected to get surgery.  Tommy John surgery is common in baseball pitchers who continually stress their arms.  In a split second I had the same injury as two million pitches would cause.

This is what was revealed to me after my MRI, this is the ligament on the inside of your elbow.

            On March 15^th, I was to be put on the operating table.  The man who would perform the surgery on me was Dr. Tom Greenwald.  I knew of Tom from an early age and into high school, I was in the same grade as his middle son and two years younger than his oldest, and two years older than his youngest.  I always knew he was smart and a hard worker.  My trainer at UNI recommended him, and in the back of my mind I thought, he’s like the top of the line, does he even have time for me?  I knew he was the Iowa State University sports team doctor, I thought he might be too busy for me.  I was wrong, and really glad I was.

            He told me to try and watch the surgery online the day before, I got a short way into the video before I got sick and turned it off.  That told me, it takes a different kind of strength to be an orthopedic surgeon.  Dr. Greenwald was great, he came into my prep room and talked with me and my Dad.  He explained everything, made me feel really relaxed, and confident about what was about to happen.

            So, this is the part you’re probably waiting for.  The beginning is like you’re going in for a physical.  I had to change clothes and wear a medical gown.  Take my height and weight, blood pressure, pulse, etc.  When the doctor’s assistants got the green light I was wheeled from the prep room to the operating room.  Long white hallways led me to the operating room.  I didn’t know what to really expect, but the operating room was a little smaller than I was expecting.  I don’t know why I thought it’d be bigger because it was my first time ever being in one.

            When I got there, the team attending to me was getting tools ready for the doctor and giving me the anesthetic medicine to knock me out.  I am really scared of needles, I thought I would faint from the little prick, but I didn’t feel a thing.  Which meant she did her job great as far as I’m concerned.  She made a difference to me.  When I got the first dose of medicine she told me to count from ten to one, I it made one with no problem.  In the mean time I continued to have a conversation with her.

            This was something that I don’t think she had seen before.  I processed an entire dose of anesthetic like it was nothing.  A few minutes later Dr. Greenwald walked in, and I talked with him for a bit.  I remember him marking my arm with his little sharpie and then receiving a nerve blocker followed by more anesthetic.  I looked up at the light and slowly fell asleep.  The operation began shortly thereafter.

             My palmaris longus tendon was taken out of my left arm.  It is a “spare tire” tendon that doesn’t have a major function.  You body just has it, it is meaningful to doctors to use as grafts.  When mine was successfully “harvested,” the next step was to go attack my UCL.  Yes, my arm was opened up, what Dr. Greenwald saw, confirmed what the MRI had said, a complete and total rupture (medical terms for really badly hurt).  A few drilled holes in my bone, and guiding in the graft to through the holes and that was it.

My palmaris longus was used to create a stabilize the tendon.

            I came to later find out my metabolism was the reason I needed so much anesthetic, it was still there even though I had not wrestled in about three weeks.  I just didn’t lose it.  When I woke up, it felt like 5 minutes had gone by, the kind of sleep where you think you fell asleep in class.  My first thought was I woke up during the surgery.  I was a little scared, I tried to sit up, I looked at my arm and then it all came back to me.  It was over; I made it so to speak.  My left arm was in a brace at ninety degrees.  I did feel a lot of pain in my arm, but that wasn’t my main concern.

            I felt like I had a huge headache, I wanted to be awake, but I couldn’t.  My vision was blurry, really blurry.  When I was taken back to the prep room where my Dad was waiting for me it was slowly getting better.  I just wanted to keep my eyes shut, but I didn’t want to sleep.  When my dad said hi to me I looked over at him, I couldn’t see him.  I knew he was there, but honest to god I could not definitively make him out.  It was an all-bright red (his shirt) torso, and a black chair he was sitting on.

            At this time I was telling myself to stop feeling sorry for myself and get up and get out of there to feel better.  The medicine still in me had other plans, I did walk, but then sat right away.  Got up, but sat back down.  I have a great Dad for putting up with most of this, I was a specticale.  The nurses helped me put my clothes on.  Obscure shapes slowly came into focus.  The lights where not so big and I was slowly taking control back.  The way medicines made me feel was abnormal, my body wanted to do one thing, and I didn’t want to do that.  I didn’t have a choice in the matter.

            The team that Dr. Greenwald had did great.  I followed his rehab plan for me all summer, on September 15^th, 6 months after surgery, I stepped back on the mat and had a great workout.  Dr. Greenwald made a difference to me that day, he has given me the chance to do what I love for one more year.  I am not the only one he has made a meaningful difference too since he has started practicing, there are many others who I know will probably say the same thing that I have too.  To me, he’s got a good team of people around him to make him successful.  I can’t give him enough thanks.

            The last part of my day when I got home was cool.  My dog, Charlie, helped me through until bed.  He was so excited to see me, even though I had been gone for a long time.  Whenever I come home, he goes crazy because he has missed me.  He sat on my lap and kinda looked at me, expecting me to say something.  I think he knew I was really tired, but it was so early in the night.  When I said “bed,” he jumped off my lap and led me upstairs and stayed by my side all night.  When I woke up, I felt normal again.

My dog, Charlie.

Recap and tips from my surgery:

• ·      I was given an extra anesthetic to knock me out, this is just my case, everyone is different.  I am a student athlete, and I wasn’t out of shape.  I had worked out every day up to my surgery, some days twice.  One tip, don’t work out a few days before surgery, my thinking is the less anesthetic you’re given the better you’ll feel after surgery.  I know I won’t if there is a next time.
• ·      After doing a little research, the feelings I had after surgery are the same as 0.35 blood alcohol level, I learned I never want to drink to excess.  I was not in control of my body, I didn’t like that, I am assuming others don’t either.
• ·      I don’t know everything there is to know about the next few weeks after surgery, but the patient will most likely be prescribed some pain-killers.  One stronger than the other.  Dr. Greenwald told my Dad how to give me the medicine, but when my Dad told me to take medicine the next morning, I didn’t know what to take.  I had two pills, I took one of each.  Morale of this story, ask questions.  I had holes drilled into my bone, don’t add a stomach ache to that pain.
• ·      Never assume anything about a doctor or how busy they might be.  Everything I thought I knew about Dr. Greenwald was wrong, he was motivated to make a difference, and believe me, he did.  Later I came to find out, he had performed other procedures on a few of my friends and former teammates from high school.

·      Until next time, laugh hard, laugh with everyone, but never at someone.

Riley

The best medicine dose #2, People's Champs

            This video that I am posting today was a ton of fun.  I am in it, I helped with the music, and yes I have pants on.  They are just zebra stripped spandex and really short.  This is our talent show put on by the UNI athletic department, the name of the even is "Panther's got Talent."  In 2012, the wrestling team finished 2nd to women's basketball.  We did our thing, they did Michael Jackson's thriller.  This year, the Panther Train incorporated running over thriller as a joke, however that was not enough in the judges mind.  The four judges this year gave the award to track and field.

            Both the wrestling and track and field videos are on youtube if you search "Panthers Got Talent 2013."  (If you hit filter and sort by view count you will see that Wrestling is up to over 10,500 views while track and field is only sitting at 3,500, the people have spoken)  7,000 people chose to click our video who probably saw the track and field link, but didn't watch it.  I like the fact there is a huge gap that 7,000 other people see, that a few judges missed.  But I'm over it, here is the link to the video, enjoy!

Hi, I work for . . .

Chris Roberts and his son, Leo.

            In a follow up from my first post, this is the Man whom I have looked up to growing up, sometimes not by choice.  Chris Robert's father Jay and my Dad became very close friends while my Dad was attending the University of Iowa in the early 80s.  Chris, and his older sister Josie, grew up watching my Dad and his twin brother, Lou, wrestle.  But the family grew closer, Jay welcomed my Dad and Uncle Lou into his home like they were family.

            That bond we share as a family is incredible, fun, and one tight as a family.  When Chris was growing up, my Dad and Uncle would play and rough house with Chris.  When I was growing up and going to get togethers, the most common was the NCAA wrestling championships, I wrestled and played with Chris a lot.  Since Chris has had children of his own, I am now playing with his kids in all sorts of ways.  From tag to jet ski rides to sports, we do it all.

            I look up to Chris, I have since I first met him.  When I was a freshman in high school he was working for a pharmaceutical company called Eli Lilly.  The night I got on the phone with him after finding out about where medicine came from, he placed answered all my questions like it common knowledge.  He did it so smoothly and with ease, he is a professional salesman.

            Last spring I received an assignment in Marty Hansen's personal selling class.  I had to write a paper over an interview with a sales person.  I had no trouble selecting Chris.  I got an A on the paper, but that wasn't what I was concerned about.  I wanted to learn everything there was to know about a pharmaceutical sales rep.  The interview was great, the paper was easy, but what I learned is priceless.

            Chris gave me all sorts of advice, like what they look for in the interviewing process, what kind of company to work for, what he sees others doing, interacting with gatekeepers, and keeping a great reputation that nurses, doctors, and physicians all respect.

            Everyday Chris' goal is to have one appointment on the books with a doctor to explain a medicine he represents.  The current medicine that Chris represents is humalog infulin and tradjenta for diabetes.  From there he visits other offices and hospitals in his territory to see if any doctors need samples or more of the products that he has previously had prescribed by doctors at that location.

            There are many common challenges that Chris faces, one is not being able to do his job.  A doctor or physician may get caught up with a patient when Chris is suppose to see the medical expert.  That is tough and something he cannot control.  The next challenge is how his job is evolving.  With new health care laws in place, the way medicine is promoted may change.  With that Chris has a plan, he wants to be able to adapt to change at the drop of a hat.  He is ready for the future and whatever it may hold.

            Chris is motivated by many things, a sales job has its highs and lows.  Chris always makes the highs last a long time and the lows short.  The best moments of his job is when a nurse or doctor inform him that they took a chance on his medicine for a patient, and it worked.  It was the difference and it changed a life for someone.  He makes a difference in the health world, it is small, but he does it every week.  That is why I want to try my hand at the field, I want to know what it feels like to make a meaningful difference someday for a complete stranger.

            Laughter is always the best medicine you can never have too much of, laugh with everyone, but never at someone.  Until next time, have a good one.

Riley Banach

Where Passions Begin

        Emotions that words can’t describe are created when the fire of a passion is lit inside someone for the first time.  Questions start racing into someone’s mind, puzzle pieces start to fall into place, excitement is in every breath taken, a thirst for more has begun, it is almost like an addiction.  The brain cannot turn it off once it has begun.  Gabrielle is right on, I do plan on my profession being intertwined in the medical sales world.  This post is about how my passion arose on a wintery night during my freshman year of high school.

            Growing up I played three sports, football, wrestling, and baseball.  One for every season, as I transitioned into high school, I continued all three.  After football was over I joined the wrestling team.  Two months into the season after our first meet, I found out what the common wrestling skin diseases were.  Needless to say I found out the hard way what these skin diseases were when I got one.

            When my wrestling coaches found out I had a skin disease, they sent me to the nurse who sent me to the doctor.  The doctor confirmed that I had in fact contracted a skin disease.  Which was the same diagnosis of all the people before her, she just had the power to.  Anyhow, my doctor sent me with a prescription to the pharmacy, and that is where the ball got rolling.

            As my dad and I pulled into the Hy-vee that night we noticed the store was busier than normal.  A blizzard had everyone stocking up on groceries in case the snow became too much.  My dad had to get a few things himself for us at the store, and being a freshman in high school he trusted me to pick up my medication myself.

            As I waited in line I noticed the pharmacists behind the counter continue to go in and out of rows with shelves upon shelves of medicine.  Like a library but the books were boxes.  They had something for the three people in front of me without fail, so when I came up I told them what I needed, and within minutes it was taken out of a box, placed in an orange container and packaged up for me.

            It was then I asked the pharmacist helping me, where did all that medicine come from?  He looked at me puzzled, and said, “do you mean who made them? or who represents and sells them?”  The second part of that phrase was the little force needed to start an avalanche of thoughts, questions, and new ideas.  Since I was the last one at the counter that day, I talked this poor guy’s ear off.

            From what I gathered, at one point in time, a company produced each box of medicine.  There are tons of companies out there dedicated to producing medicine for specific purposes.  A sales person then represents each type of medicine, their title is called a pharmaceutical sales rep, and they explain what their product does to doctors.  What I gathered from that was every box, every container of medicine I saw that night had a sales person behind it, promoting it to doctors.  There were easily ten rows of medicine, with shelves as high as arm’s reach and about as long as a typical high school classroom.

            By now my dad had gathered the three or four items he needed and realized that I was still at the pharmacy counter clearly keeping the worker form leaving.  Where the worker left off in our talk, I continued with my dad all the way home.  At the same time I may have been responsible for making my dad’s bald spot a couple hairs bigger that night.  A lot of questions he didn’t know the answer too and he became a little frustrated.

            When we got home though, I told my mom what I had talked about at the pharmacy.  She looked at my dad said, “why don’t you call Chris and have him answer some of these questions?”  My dad had a light bulb go off.  Chris, the man my mom was talking about, is a pharmaceutical sales rep.  This was a huge piece to the puzzle that was taking shape in my mind.

            Chris Roberts was the right man to go to.  He explained to me what a typical day is like for him, the kinds of drugs he represents and a typical patient who uses them.  He went onto explain the best part of his job was hearing how a patient’s life changed because of medicine that their doctor recommended that Chris promoted to the doctor.  In college I was fortunate enough to get an assignment to interview a salesperson I had to know personally.  In that interview with him he went more in-depth on what he did, he was more than happy to help.

            Pharmaceutical sales reps have a tough job.  They are rewarded for working hard and sticking to their plan and have a reputable career.  Chris sets goals every week and he tracks himself on how he is doing.  There will be other posts to stay tuned for, I will go more into detail about Chris’s job, my experience in the health care world, and topics I plan to have discussions with other interested people.  Until next time, laugh with everyone, laugh hard,

but never at someone, have a great week.

Riley Banach

A pharmaceutical sales rep at work.

A pharmacist hard at work, like the one who helped me.