Chris Ha, DO, RMSK

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Chris Ha, DO, RMSK

Chris Ha, DO, RMSK

@ChrisHaDO

Musculoskeletal doc @MayoClinic Arizona. Regenerative medicine, longevity, lifestyle med. Tweets mine.

Scottsdale, AZ Katılım Mart 2009
1.4K Takip Edilen1.3K Takipçiler
Chris Ha, DO, RMSK
Chris Ha, DO, RMSK@ChrisHaDO·
Rooting for all you #newdocs starting #residency this week! #Internyear can be stressful. My best tip comes from @JamesClear: Aim to be 1% better each day. Follow up on that patient. Read a bit each night. Lock in your system. After 365 days, you’ll be 37x better.
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jon
jon@jonmichaelsr·
Muscle tear in lower leg. No Spring marathon this year. 15 wks of 18 wk build completed. I felt great until I didn’t. Choosing to see the bigger picture. 15 weeks of work completed. Set new 5k PR (19:04). Still 🧱. And I have much bigger goals than this Spring marathon. Onward.
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Chris Ha, DO, RMSK retweetledi
Howard Luks MD
Howard Luks MD@hjluks·
Osteoarthritis is poorly understood... and often managed even more poorly. Osteoarthritis is the gradual loss of cartilage or cushioning on the ends of our bones. The cartilage cushions the forces of weight bearing and provides a near frictionless interface between the bones of our joints. Inflammation often follows the loss of cartilage. Knees with more inflammation and swelling have more pain than dry knees. Cartilage breakdown can begin for many reasons. Contrary to popular thought, cartilage does have complex repair mechanisms in place. But genetics, prior trauma, or surgery can upset those processes. When these processes go awry, cartilage loss can result. The severity of the arthritis is based on how it impacts your life--- not necessarily by the appearance of your X-ray. I know people who run on bone-on-bone arthritis... yet I know others who are crippled by far more mild osteoarthritis. Therefore, I usually do not allow the X-ray's appearance alone to define the severity. Why? Because remaining active with an arthritic joint will often enable you to keep that joint longer than someone who is far more sedentary. This is the reason why telling people to stop moving, stop exercising, or even stop running after they're diagnosed with osteoarthritis is poor advice. Our overall health and well-being also affect the onset and progression of osteoarthritis. People with big bellies, type 2 diabetes, pre-diabetes, fatty liver, and so on have a high degree of systemic inflammation. Osteoarthritis is more common in this group; it is typically associated with more swelling and pain, and it will progress faster. Those inflammatory mediators make their way into our joint fluid. A complex series of interactions with macrophages and other cells in our joints can initiate or accelerate the arthritic process and increase the amount of inflammation (and pain) in our joints. Our joints are not as fragile as you might think. Even after they've become arthritic, our joints will treat us better if we treat our whole body better and maintain our mobility and strength. A recent paper on GLP-1 medications in the management of people with obesity and osteoarthritis shows that pain scores drop significantly over time and that improvement is sustained. Interestingly, the pain can improve before the dramatic weight loss. GLP1 medications are well known for their ability to "fix" metabolic dysfunction and improve metabolic health. There's still much more to learn about osteoarthritis. But one thing is sure: the healthier and more active you are with your arthritic joint, the longer you are likely to keep that natural joint. Genetics should have been listed in the graphic... my bad.
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Chris Ha, DO, RMSK
Chris Ha, DO, RMSK@ChrisHaDO·
@BStulberg FWIW: here’s the study on the UPF; she could have added more context. tinyurl.com/ysfsnkcb “A higher consumption of UPF (>4 servings daily) was independently associated with a 62% relatively increased hazard for ACM. For each additional serving of UPF, ACM increased by 18%”
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Brad Stulberg
Brad Stulberg@BStulberg·
This statement from Dr. Casey Means is full of so many falsehoods I don't even know where to start. Here is a small sampling, with my responses in bold. “I did not learn that for each additional serving of ultra-processed food we eat, early mortality increases by 18%." I've easily had 1000 bags of chips in my life. If this is true, it means my mortality risk has increased by 18,000 percent. That seems unlikely. "I certainly did not learn that medical error and medications are the third-leading cause of death in the US." This is a lie. The third leading cause of death in the US is accidents, and the majority of those accidents are car accidents and falls. Medical errors are, of course, a real cause for concern but they are not the third leading cause of death in the US. "I didn’t learn that 95% of the people who created the recent USDA food guidelines for America had significant conflicts of interest with the food industry." Nobody gets sick from following the USDA guidelines, which are to eat around 2000 calories, focus on nutrient dense food, and limit sugar-sweetened beverages. There is an entire nutrition grift to demonize the guidelines but the guidelines are pretty solid! The problem is nobody follows them, for all sorts of reasons. "I didn’t learn that professional organizations that we get out practice guidelines from, like the American Diabetes Association and the American Academy of Pediatrics, have taken tens of millions of dollars from Coke, Cadbury, processed food companies and vaccine manufacturers like Moderna." This is why the scientific community requires conflict of interest statements. (Unlike in Dr. Means current work, where she is selling a continuous glucose monitor to healthy people and telling them to stress out and obsess over their blood sugar.) "I didn’t learn that just five nights of sleep deprivation can induce full-blown pre-diabetes." Running a marathon can induce full-blown kidney disease. So what? The body normalizes after. All sorts of things can lead to all sorts of effects. This is more fear-mongering. "I didn’t learn that if you address these root causes that all lead to metabolic dysfunction and help patients change their food and lifestyle patterns … we could reverse the chronic disease crisis in America, save millions of lives and trillions of dollars in healthcare costs per year." This is surprising. I learned this at the University of Michigan and nearly everyone I know who recently attended medical or public health school learned this too. We also learned the solution is not medical devices, shunning modern vaccine technology for no good reason other than unfounded tribal fear, or cold plunging and taking supplements. The solution is to improve social determinants of health across the population. Everyone knows this. But it's hard to do. Listen, ultra-processed foods generally aren't good for you (with some exceptions, such as Coca-Cola at mile 22 of a hard marathon) and physical activity and sleep are both really good for you! But the amount of wild claims, us vs. the "establishment" boogeyman thinking, and of course, contrarian thinking on everything, and sewing vaccine skepticism are all just signs of a grifter who wants to sell their product. It's sad but impossible not to see.
MAHA PAC🗽@MAHA_PAC

Dr. Casey Means: “I learned virtually nothing at Stanford Medical School about the tens of thousands of scientific papers that elucidate the root causes of why American health is plummeting.” “I did not learn that for each additional serving of ultra-processed food we eat, early mortality increases by 18%. This now makes up 67% of the foods our kids are eating. I took zero nutrition courses in medical school. I didn’t learn that 82% of independently-funded studies show harm from processed food, while 93% of industry-sponsored studies reflect no harm. I didn’t learn that 95% of the people who created the recent USDA food guidelines for America had significant conflicts of interest with the food industry. I did not learn that one billion pounds of synthetic pesticides are being sprayed on our foods every single year. 99% of the farmland in the United States is sprayed with synthetic pesticides, many from China and Germany, and these invisible, tasteless chemicals are strongly linked to autism, ADHD, sex hormone disruption, thyroid disease, sperm dysfunction, Alzheimer’s, dementia, birth defects, cancer, obesity, liver dysfunction, female infertility and more. I did not learn that the eight billion tons of plastic that have been produced just in the last 100 years … are being broken down into microplastics that are now filling our food, our water, and we are now even inhaling them in our air, and that very recent research … tells us that now about 0.5% of our brains by weight are plastic. I didn’t learn that there are more than 80,000 toxins that have entered our food, water, air, and homes by industry, many of which are banned in Europe, and they are known to alter our gene expression, alter our microbiome composition and the lining of our gut, and disrupt our hormones. I didn’t learn that heavy metals like aluminum and lead are present in our food, our baby formula, personal care products, our soil, and many of the mandated medications like vaccines, and that these metals are neurotoxic and inflammatory. I didn’t learn that the average American walks a paltry 3,500 steps per day even though we know, based on science and top journals, that simply walking 7,000 steps a day slashes by 40-60% our risk of Alzheimer’s, dementia, type 2 diabetes, cancer, and obesity. I certainly did not learn that medical error and medications are the third-leading cause of death in the US. I didn’t learn that just five nights of sleep deprivation can induce full-blown pre-diabetes. I learned nothing about sleep, and we’re getting about 20% less sleep on average than we were 100 years ago. I didn’t learn that American children are getting less time outdoors now than a maximum security prisoner, and on average, adults spend 93% of their time indoors, even though we know from the science that separation from sunlight destroys our circadian biology, and circadian biology dictated our cellular biology. I didn’t learn that professional organizations that we get out practice guidelines from, like the American Diabetes Association and the American Academy of Pediatrics, have taken tens of millions of dollars from Coke, Cadbury, processed food companies and vaccine manufacturers like Moderna. I didn’t learn that if you address these root causes that all lead to metabolic dysfunction and help patients change their food and lifestyle patterns … we could reverse the chronic disease crisis in America, save millions of lives and trillions of dollars in healthcare costs per year. This is a spiritual crisis. We are choosing death over life, we are choosing darkness over light. We need a return to courage. We need a return to common sense and intuition. We need a return to awe for the sheer miraculousness of our lives. We need all hands on deck.” Source: Sen. Ron Johnson’s Roundtable on “American Health and Nutrition: A Second Opinion”

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Chris Ha, DO, RMSK
Chris Ha, DO, RMSK@ChrisHaDO·
Lot of truths in here! Thanks for sharing @hjluks. #tenniselbow
Howard Luks MD@hjluks

Orthopedic Truths: Tennis Elbow Stupid name Most people who have it don't play tennis. Nearly every person will get it. The most common cause of lateral elbow/upper forearm pain. It will resolve almost everyone on its own. Without "treatment". But it might take 6-12 months. Yep, 6-12 months. It may not resolve in some people. Some people have minimal symptoms. Some have severe pain. Some people deal with pain well. Some don't. Most people are in our office because they're afraid of hurting themselves or they have a fear of the unknown. If you tell them the proper story about tennis elbow, most are relieved and will go on to live their active lives without needing anything. The pain when lifting with your palm facing down is real. It also will amaze you how often the outside of your elbow contacts doors, etc. Lift with your palm up... no pain. The examination is straightforward. The diagnosis is straightforward. MRI imaging isn't needed. It always says, "partial thickness tears.... yada, yada, yada...." MRI findings are rarely a reason to have surgery. Basically... there's very little reason to operate on these at all. Besides... there are plenty of surgeries described to manage this... most involve releasing/removing the offending tendon-- the ECRB... so why would a tear need to be "fixed" 😂 It can be super annoying... I'll agree to that. It's worse in people who lift a lot for work. Some people might insist that something be done. That's fine... But far, far, far too many are offered injections as a first-line treatment. Steroid injections are not kind to tendons. They're not kind to the lateral ligaments, either. If not appropriately placed, steroids dissolve the fat under your skin. That pale dimple with veins running through it is unsightly. Tendons really don't like steroid injections. A steroid injection might feel great for a few weeks or months... but the pain often returns. Not in everyone, though. So... it might have worked for you. But it made many others worse. PRP injections, anyone?? Maybe It won't cause harm. You should never pay > $500-1000. It could work... Then again... so do placebos I'm not calling PRP injections placebos... But, you know, maybe??? Physical therapy? Meh... But anything that distracts you while nature runs its course is valuable. Braces? Meh... That damn placebo effect again Try it... no harm, no foul. Red light, laser, blue/purple pulsed lights... whatever. Shockwave therapy... maybe. Hard to find... and it hurts... but it might help. This very common yet annoying ailment is so prevalent. Most everyone is going to get it. Carry on... No need to rest or stop activities unless the pain is too spicy. Everyone on IG has a cure: save your money, and if you can move on, wait it out. As usual... it's always far more complex than most people think.

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Chris Ha, DO, RMSK
Chris Ha, DO, RMSK@ChrisHaDO·
@DrTimothyTiu Love when the peer to peer is due by 5pm today and you call them 6 times with no response and then they send over the denial at 3:30pm with 1.5 hrs to spare
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Timothy Tiu, MD, FAAPMR
Timothy Tiu, MD, FAAPMR@DrTimothyTiu·
Insurance: we won't pay for your patient's procedure unless you document x y z Me: I did that Insurance: sucks Me: I need to speak to someone Insurance: ok we will call you between 8am and 5pm. Me: today? Insurance: yes. Maybe tomorrow. Or next week, so just be ready.
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Chris Ha, DO, RMSK
Chris Ha, DO, RMSK@ChrisHaDO·
@AyooshPareekMD @jxnlco Agree with @AyooshPareekMD. I’m hopeful you saw a clinician to help to rule out carpal tunnel, ulnar neuropathy, and other potential progressive neurologic conditions. These things can be insidious and don’t always show up on routine tests!
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jason liu
jason liu@jxnlco·
In 2020 I lost my hands. ability to code, hold my phone, or even tie my shoes Unable to work, and I was a depressed about potentially losing my ability to make a living doing what I love. jxnl.co/writing/2024/0… This is the first of that story, and largely why im consulting vs founding a company or at a fast paced startup.
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Erek Latzka MD, RMSK
Erek Latzka MD, RMSK@ErekLatzkaMD·
30 yo 🏋️(no hx steroid use) with acute onset of superior/lateral shoulder pain, that began during a dumbbell overhead press. Exam with shoulder abduction weakness > ER and extension weakness (w pain inhibition). (-) Hawkins/Neers. (+) empty can & cross arm abduction.
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Anthony DiGiorgio, DO, MHA
Anthony DiGiorgio, DO, MHA@DrDiGiorgio·
This post has been getting quite the attention. Want to know why your office visit doesn't run on time? Take a seat... this may take a while... Healthcare consolidation means doctors are no longer owner/operators of their own small business, able to cater to their patients' needs. They can't even set the prices they want. With the physician fee schedule being imposed on us by CMS, we are beholden to the price assigned to our CPT codes. For your beloved pediatrician, those E&M CPT codes reimburse very very poorly. Sure, some clinics can negotiate better rates with insurance companies, but for the most part it's a fraction of what is needed to run a small business. Econ 101 tells us that price caps cause shortages. Here it is in action. The price cap set on E&M codes means that doctors can no longer generate enough revenue off of professional fees to run their E&M-based practice. Additionally, they have more and more regulatory burdens that increase the price of running a practice (mandated EHR uptake, quality metrics, etc) while reimbursement declines. That's not all. The large hospital conglomerates have rules written in their favor, giving a competitive advantage. They get to charge more for those E&M visits due to "facility fees." They get to be tax-exempt entities. They get massive discounts on drug purchases that they can resell for profit. They get "economies of scale" in operating EHR & quality metrics. They can absorb the cost of a financially underperforming clinic by ensuring they capture downstream revenue from referrals, imaging and labs. It doesn't take a policy expert to see that the small, independent practice has no chance of surviving. So they sell out. The physicians become employees of a system which tells them how many patients they must see. They say they can't see patients in that small of a time frame, but the corporation doesn't care. It plans on replacing them with NPs or PAs soon anyway. The other option is they open a concierge clinic. They stop taking government funds and get away from the price caps. They charge what they feel is needed to give the patients the attention they deserve. So, what can you, healthcare policy expert and consumer of healthcare goods, do for the situation? Take your business to a practice which runs on time. If you have to pay for it, pay for it. That's the beauty of the free market. You're free to take your business to a concierge practice or cash-pay clinic. Nobody is forcing you to go to the practice which is chronically late. And if your answer is: "but healthcare is a RIGHT! It should be free!!" Just remember, you'll get what you pay for. @anish_koka @DrBrian4Health @cscla @DutchRojas @LighthouseDPC
Shawn F. Gremminger@sgremminger

I'm at the pediatrician office for a well child visit with my daughter. Appointment was 9:20. Vitals taken and paperwork filled out, but still waiting to see a doctor. Reason #30584 of why healthcare in the US sucks. Why can every other sector keep appts, but physicians can't?

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Chris Ha, DO, RMSK
Chris Ha, DO, RMSK@ChrisHaDO·
@TheDrROBO I just tried this on a patient recently and had good results! Thanks for sharing!
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Robby Bowers DO, PhD
Robby Bowers DO, PhD@TheDrROBO·
I’ve had great results with HVI (1 cc steroid, 4 cc ropi, 15 cc saline) for midportion and insertional Achilles tendinopathy. This is now my go to treatment as it quickly calms symptoms. I frequently combine this with shockwave and results have been 👌. pubmed.ncbi.nlm.nih.gov/28530451/
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Chris Ha, DO, RMSK
Chris Ha, DO, RMSK@ChrisHaDO·
@FitFounder Great info! I point all my patients with back pain to the McGill Big 3. Many will ask how to stay active despite the back pain and I recommend cycling, swimming, and other low impact exercises. Yoga, tai chi as well for balance and flexibility.
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Dan Go
Dan Go@CoachDanGo·
In my mid 20's to early 30's I dealt with chronic low back pain. I went to a Chiropractor who told me I'd have to live with the pain & get adjustments for the rest of my life. I said screw that, searched for a solution, and fixed my back. Here's how I did it:
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Chris Ha, DO, RMSK
Chris Ha, DO, RMSK@ChrisHaDO·
I had a Vietnamese patient in clinic a month ago. We shared stories common to our heritage. Today she came back for follow-up, with an awesome surprise. A whole batch of homemade eggrolls. 😵 She said she was so grateful to have a doctor who is Vietnamese. 🙏 Made my day!
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Chris Ha, DO, RMSK
Chris Ha, DO, RMSK@ChrisHaDO·
Congrats future docs on #MatchDay2024! As you prep for the next chapter, reflect on: Who helped get you here? What principles led you along the way? When did you feel most alive? Where do you see your mission field? But most importantly: start with WHY. Let this guide you!
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Dianna H. Nguyen, DO, PhD
Dianna H. Nguyen, DO, PhD@DiannaHNguyen1·
Feeling blessed! 🙏 Speechless. So excited for this next phase with the @UTHPMR family!!! Forever grateful to everyone who's helped me get to this point. ❤️🥰❤️ CONGRATS to all #Match2024 @TCOM_UNTHSC
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