Tag Archives: physiatrist

Meet Ashot Kotcharian, MD: Interventional Pain Management Physician

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This is a continuing series of interviews we do with our physicians here at SOA. Dr Ashot Kotcharian is a Board Certified/Fellowship Trained Physical Medicine & Rehabilitation Physician with a specialty in Interventional Spine and Sports Medicine. Dr Kotcharian has a strong background in interventional therapies for spine disease, complex pain syndromes, peripheral joint disease, and sports injuries. He served a most distinguished career in medicine as Assistant Professor of PM&R at Johns Hopkins University School of Medicine. Learn more about what motivates him and how he spends his time when not at work.

What inspired you to become a physician? What inspired me to become a physician is the legacy of my great grandfather. He was my namesake. Although I have no memory of him I grew up hearing so much about him. Before me he was the only physician in our family history. I grew up listening to stories of his work and all the good he did treating those who were ill.  I knew early on that just like my namesake I too wanted to have a career that can result in good to others and help those who are ill. One of my younger sisters was born with epilepsy and has a learning disability. As a young boy I witnessed how much my parents cared for her. From city to city, hospital-to-hospital, my parents searched for the best medical treatment available. Seeing her go from one hospital to another, I wondered why nobody could help her become better. I watched my parent’s worried faces and how hard they tried to get answers and care for my sister. Once they were able to get her the care she needed and the doctors were able to get her seizures under better control the relief and joy it brought was immeasurable. This is what I wanted to do with my life.  I wanted to be able to take away peoples pain, fear and confusion and give them hope and relief.

Why orthopedics? While on my journey through medical school and residency training what I found myself enjoying the most was anatomy and musculoskeletal medicine. I learned how crucial good understanding and knowledge of anatomy can be in diagnosing nerve injuries, ligament tears, or radiculopathies. I developed a greater interest in diagnosing and treating patients who presented with muscle and tendon injuries, repetitive stress injuries, as well as back and radicular pain to name a few.

What do you love most about your job? I love how in this field the convergence of good anatomical knowledge, physical exam skill, and history taking can often lead to diagnosis without a need for invasive tests.  I get a satisfaction out of being able to arrive at the solution simply from what the patient told me and what I find on my physical exam. I get a satisfaction from knowing that I was able to treat disabling pain be it from back, muscle or tendon injury, without the need of invasive surgery.

What is your biggest challenge? Helping my patients through difficult diagnoses where treatment options are few and without a “cure” can definitely be challenging.  I would also say that being able to convey the importance of daily exercise, stretching, as well as proper posture is another big one.  While I have a lot of skills and tools with which to help stop pain, its what the patient is able to do on their own at home and in their daily life that can really keep the pain from coming back. If I weren’t an orthopedic physician I’d be either a martial art instructor or a university professor. Although, to be honest, this is a difficult question, because I can’t see myself doing anything else. I truly love what I do and I am very passionate about it.

Your proudest moment? My proudest moment is completing my fellowship training.  As I looked back at my journey through medical school, residency, and fellowship I knew I was becoming the person I wanted to be and the person I wanted my sister and great-grandfather to be proud of.

Where is the most interesting place you’ve travelled?  Why? It would have to be Rome.  The layers and layers of ancient history, the architecture, the people, and the food were truly amazing.

Any hobbies?  Activities? One of my biggest passions outside of medicine is martial arts, exercise, and mindfulness meditation. I have been a student of martial art since I was just a kid. Most of my studying and training has been in Taekwondo and I have earned a rank of 2nd degree black belt. I have also studied some techniques of hapkido, karate, kungfu, and Brazilian jujutsu while attending a mixed martial arts school. What I love most about martial arts is the respect, the discipline, the mindfulness, and the physical exercise.

What’s your next adventure? I don’t really know. I am pretty happy exploring the Gulf Coast for now.

Your guilty pleasure food? Oh gosh, too many probably.  Hamburgers, Chinese food, fried chicken, pizza, oh now you’re making me hungry!

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Sarasota Orthopedic Associates has three locations and offers same day/next day appointments when needed.  For more information on Dr Kotcharian or any of our physicians click here.

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COMMON HARMFUL MYTHS ABOUT PHYSICAL THERAPY

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October is NATIONAL PHYSICAL THERAPY MONTH so what better time to honor our awesome physical therapy staff for their skills and dedication to help our patients get back on their feet, back to work, back in the game, and back to life. Physical Therapy is often times misconstrued as a regimen of pain, or only for injuries, or even “why bother, I can do it myself”.   So let’s take a look at dispelling some common misconceptions.

First of all, Physical Therapy may be prescribed for a number of reasons: post-surgical rehabilitation, sports injury rehabilitation, joint replacement therapy, or to relieve the discomfort of a long term health condition such as arthritis. Rehabilitation of major joints and muscle groups allow you to move better and relieve pain. It even helps improve and restore physical function and fitness levels. The ultimate goal is to make daily tasks and activities easier for you to perform.

So why shouldn’t you do the therapy on your own? Bottom line, you could do more harm. A Physical Therapy regimen is certainly one to be practiced on your own as prescribed, however, that does not mean a single visit.  Typically, a physical therapist assesses your condition and creates an individualized treatment plan to help restore your physical and vocational function specific to you.  The ultimate goal is for you to return safely and efficiently to your previous level of activity.  This requires on-going monitoring by the professional guidance of a licensed Physical Therapist, and possibly increased therapy and/or additional exercises.

We’ve heard many a patient say “I thought surgery was my only option”. While that may ultimately be the case for some people, many an injury or condition has been successfully treated with physical therapy as an alternative to surgery.  For example, a rotator cuff tear or knee arthritis does not necessarily translate into a surgical procedure. Specific muscle strengthening therapies may help support the shoulder or knee and provide relief from discomfort as well as a return to normal activity. A recent patient survey showed 79% of those patients said physical therapy has helped them avoid surgery.

Another myth is that “physical therapy can be performed by any health care professional”. Physical Therapists are licensed professionals with years of education and extensive training. After an undergraduate degree, as many as three additional years of education in their respective field are required to become licensed. There are even specialties like orthopedics, geriatrics, pediatrics, oncology, sports and women’s health certifications within the field.

Sarasota Orthopedic Associates provides Physical and Occupational Therapy in our three locations of Sarasota, Lakewood Ranch, and Venice. We offer same day appointments and accept most insurances.

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GETTING TO KNOW YOU – Paul Lento, MD

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Last week we featured Dr Michael Gordon. This week, we asked the same questions of Paul Lento, MD, a triple board certified Physical Medicine & Rehabilitation physician here at SOA.

What inspired you to become a physician?

Not so much “what” but “who”.  My father had a pretty strong influence on my decision. He often talked that I should choose a career to help improve people’s lives but was also challenging. I thought medicine would be the best avenue to achieve both of these goals.

Why Physical Medicine and Rehabilitation (PM&R)?

While I was a General Medical Officer in the Navy taking care of Marines, I realized most of the personnel I saw had non-surgical orthopedic injuries, which often improved with a good rehabilitation program. PM&R focuses on several non-surgical options while treating the entire person, not just one body part.

What do you love most about your job?

Probably learning about the interesting things my patients have done in life. I have seen patients who have played professional tennis to those who taught Vivien Leigh how to talk with a southern drawl. One patient of mine was a bomber pilot in WWII.  Truly amazing people.

(Editorial Note: For the “younger” folks, Vivien Leigh was best known for her two Academy Award winning roles from classic movies as Scarlet O’Hara in “Gone With The Wind” and Blanche DuBois in “Streetcar Named Desire”.)

What is your biggest challenge?

Explaining to patients that I’m not an orthopedic physician. People look at me like I must be from another planet. The specialty of PM&R is very small and not well-known but I chose it as I think it has a lot to offer patients.

If I weren’t an orthopedic physician I’d be a _____________.

Fishing boat captain or a bartender on a beach in St. Barths.  Who knows, maybe combine the two when I retire?

Your proudest moment?

The times when I see my kids being kind to other people.

Where is the most interesting place you’ve travelled?  Why?

While I’ve been to different countries, I would have to say Salt Lake City during the 2002 Winter Olympics. I saw and met people from all over the world. It was like circling the globe in two weeks without having to leave the U.S.

Any hobbies?  Activities?

I love to fish. I would try to fish in any body of water if given the chance. It’s one of the reasons I moved to Florida.

What’s your next adventure?

I may explore Italy in the next year or two if I can get away.

Your guilty pleasure food?

Having lived in both Chicago and Philadelphia, I would have to say deep dish pizza and soft pretzels.

Paul Lento, MD is triple board certified and a Castle Connelly “Top Doc”.  You may read his medical biography by visiting our website here. To make an appointment with Dr Lento, call 941-951-2663. Sarasota Orthopedic Associates has 13 physicians across 4 locations (Sarasota, Lakewood Ranch, Venice, and Bradenton) and we offer same day appointments when needed. Our commitment is to get our patients back on their feet, back to work, back in the game, and back to life.

SHOULD MY CHILD PLAY THE SAME SPORT ALL YEAR LONG?

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Ahhh!!! Florida, with its beautiful warm sunny days and virtually endless opportunities for sporting events, is a hotbed for the development of youth sports.  Here in the Sarasota/Bradenton area, there are numerous opportunities for the young athlete to participate in sports year round.  Too often, however, young athletes are playing only one sport all year long without the potential for rest or recovery.

Unfortunately, sports medicine specialists now understand that this is not a healthy strategy. In fact, young athletes who play or perform a single sport greater than eight months out of the year are at a significantly increased risk of experiencing an injury compared to the other youths who participate in different sports.  In a recent sports medicine article, youth athletes who focus on a specific specialization of sport program are twice as likely to get injured compared to their friends who participated in self-directed unstructured free play.

There are a few theories as to why this may occur. Playing only one sport may overload developing structures causing overuse injuries.  Additionally, proper development of other diverse muscle skills which occur during regular free play or from participating in array of different sports may not occur when a child only plays one sport.

Based on these theories, it is recommended that young athletes be given time away from their specific sport so that they can participate in free unstructured play with their peers.  Parents and educators should provide opportunities for free play as well so that our young athletes can improve their motor development in general during the growing years which can reduce injury rates and encourage life-long activity free of injury.

Paul H. Lento, MDDr Lento is Fellowship Trained and Triple Board Certified in Physical Medicine.  He is a nationally recognized Sports Physician having served as team physician for major sporting events such as Winter Olympics and major city marathons. Locally he is team physician for Lakewood Ranch High and Booker High Schools. He holds the distinction being named a Castle Connelly Top Doc and sees patients at Sarasota Orthopedic Associates.  Learn more HERE.

USING ULTRASOUND TECHNOLOGY TO DETECT CAUSES OF PAIN

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Musculoskeletal Ultrasound (US) is a non-invasive office-based diagnostic test that uses non-painful ultrasound waves that creates images of various structures in the body. These images help elucidate the various causes of orthopedic pain such as tendon tears, muscle contusions, and even early stress fractures of bone.

Unlike x-rays, which use harmful ionizing radiation, US is completely safe even in patients with pacemakers and other types of surgical hardware who may not be able to receive an MRI. Patients also do not need to worry about getting into a narrow tube, which can cause some patients to become extremely claustrophobic.  In fact, in a comparative study, patients preferred getting a diagnostic US compared to undergoing MRI scans.

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Since US can be used while a patient is moving, it is a great diagnostic test to determine causes of pops, snaps, or clicks occurring about joints, muscles or tendons. Additionally, it can not only help identify the underlying problem causing the pain, but it can also help guide a therapeutic injections.  When performed under US-guidance these procedures have been shown to be less painful and more effective in treating various orthopedic conditions compared to more traditional procedures.

 Dr Paul Lento, a non-operative board certified sports medicine specialist at Sarasota Orthopedic Associates, has been performing Musculoskeletal US since 2003 and has published book chapters and journal articles on the topic.  Additionally, while lecturing nationally and internationally, he has trained several hundred physicians on Musculoskeletal US.  He is fellowship trained and certified as a Registered Musculoskeletal Sonographer (RMSK) and has been using non-surgical treatments for various musculoskeletal conditions since 2000.   Here at SOA, our doctors strive to provide the latest strategies, which help get our patients back on their feet, back to work, back in the game, and back to life.