Because almost all of us have to work within our lifetime, and because that work-span can often exceed 40 years, it is beneficial to know what to do if you should have an on-the-job injury. We may go years without an injury happening to us, but when it does, it is in the best interest not only for ourselves, but also our family to be somewhat informed.

The first important thing to know is that you should always notify your supervisor immediately after an injury occurs. Along with this, make sure that you fill out the proper paperwork. Although you have sixty days to fill out your workers compensation paperwork, it is always good to do it immediately. If not, over time the circumstances surrounding your injury may become more vague thus increasing the chance that you may not get all of the benefits that you are entitled to. Along with this, even though you may believe that what occurred was quite minor, conditions often can and do change. A sprain may worsen overnight, or, a cut may become infected or any number of conditions may arise.

Secondly, seek out a provider, or encourage your employer to offer you a provider highly skilled in occupational medicine. Providers in occupational medicine can vary greatly. Often, providers can range from a mid-level, all the way up to a board certified and residency trained occupational medicine physician. Think of it like this, would you go to an optometrist for a toothache? Of course not, therefore you should try (and you have the right) to see an Occupational Medicine physician for your work-related injury. The reasons for this are numerous, but the most important is that they are the most skilled in identifying what your condition is and how to treat it. In most cases you will feel better, much faster!

Finally, when choosing a qualified provider, take a look at where they work. Are they a part of a multi-care specialty group? This is extremely important because often we may need other forms of specialists for second opinions or referrals. At Saltzer Medical Group we not only have a board certified and residency trained occupational physician (Dr. Howard Shoemaker), but we also offer Orthopedics, Ophthalmology and rehab services, just to name a few specialties. When your providers are a part of a multi-specialty group, communication between providers about you and your condition becomes much easier and thorough which can only benefit the person who is most important, you.

“Ok, you have some varicose veins, but… Do you have venous reflux?”

This question is more important that many people realize. Venous reflux is a common medical problem where the blood traveling in the leg veins “refluxes” or, slides back down the leg veins instead of going upwards, back to the heart. This condition is a result of the ever present force of gravity while we are standing and the fact that age, previous blood clots, pregnancy, and other conditions cause the small valves in the vein to malfunction and allow the blood to slip back downwards, towards the feet. This de-oxygenated blood then pools in the lower leg veins and creates several problems over time. One of the earliest manifestations is varicose veins, which sometimes may be noted as a painful throbbing sensation, because of the pressure of the “old” blood which is pooling in them. Other problems then result over time, such as discoloration of the skin, increased swelling of the surrounding tissue (edema), and ultimately, skin breakdown and chronic sores called venous stasis ulcers. The goal is to prevent these later changes from occurring and treat the reflux early, since it only worsens over time.

So, whenever a provider is examining a patient who has complained of varicose veins, the most important question is whether those veins are the result of venous reflux (bad vein valves). The reason this is so important, is that if the reflux, which is the actual cause of the problem, is not treated, then treated problem veins will recur. We encounter many patients who have previously been treated in a med spa or shopping mall facility where laser or sclerotherapy treatment was performed, but the patients find that their problem veins recur in a few years time. Many of these patients are found to have venous reflux on a comprehensive ultrasound evaluation. Here, at Saltzer vein clinic, patients who are suspected of having venous reflux are screened by a Registered Vascular Ultrasound Technician to find whether or not they have venous reflux. If they do, the underlying reflux is treated with a catheter inserted into the vein using laser or radiofrequency energy. If they do not have reflux, they are usually treated by injecting a sclerosant chemical into the veins or by use of a cutaneous laser for these veins.

As mentioned above, if the patient does have venous reflux, almost all insurers and medicare programs consider this a medical problem and it is covered as such. The patient who chooses Saltzer Vein Clinic benefits from our expertise in treating all sizes of varicose veins as well as the causes of venous reflux and late effects of reflux, such as venous ulcers. Not only do patients benefit from our high tech, comfortable, American College of Radiology approved imaging facility, they also receive care from a board certified surgeon and phycisian assistant. We have invested much more into these resources than most of our competitors. We have multiple options for treatment, all the way from ultrasound guided injection, different laser treatments, radiofrequency treatment, to actual surgery. As you can imagine, having all of these options available means we can tailor the best treatment for each individual patient, instead of “pushing” our patients to be treated with limited options. Just like home or car repair, having the right tool for the job at hand makes all the difference. Now that you know how much we have invested into these resources, you would likely conclude that we charge more than some of the smaller shops in the area. Our costs are cheaper than any of the area vein treatment facilities and I encourage patients to call around and prove this for themselves.

Please visit our website, www.saltzervein.com for more detailed information. Thank you.

Steven W. Williams, M.D., F.A.C.S.

RICE = Rest, Ice, Compression, Elevate

The RICE method often helps with many types of joint and muscle injuries. The method will ease pain and help speed recovery. The RICE method is very helpfully if you use it right away after an injury.

REST - For most injuries, rest the area until the pain decreases. However, For simple sore muscles gentle stretching will reduce stiffness more quickly.

ICE - Ice is the most effective treatment for reducing inflammation, pain and swelling of injured muscles, joints and connective tissue. The cold helps keep blood and fluid from building up in the injured area, reducing pain and swelling. For the first 48 hours post-injury, ice for 20 to 30 minutes every 2 hours. More than 30 minutes doesn’t help heal the injury any faster, you can cause damage to the tissue.

COMPRESSION – Between icings, wrap the injured area with an elastic bandage to help control swelling and provide support. Begin wrapping at the farthest point away from the body and wrap towards the heart. The wrap should be snug, but not cutting off circulation to the extremity. So, if the extremity becomes cold, blue, or tingle, re-wrap!

ELEVATE – Raising the injured area for the first 24hours above your heart will allow gravity to help reduce swelling and draining excess fluid. The less swelling present, the faster an injury will heal.

Dr. Howard Shoemaker is now with Saltzer Medical Group in both Meridain and Nampa, Idaho! I can’t tell you what a relief this is for me personnally as well as professionally.

I first started working with Dr. Shoemaker and his nurse Lynda some four years ago. That was when I discovered that I had a passion for this line of work. Through Dr. Shoemakers indirect influence and Lynda’s direct influence, I made the decision to go back to school (after 20+ years) to obtain an Associates Degree in Health Sciences. I felt that through this degree and a certification as a Medical Assistant I would be able to give more of myself to the area of work comp and the injured worker. I can’t begin to tell you how they both have influenced me; both professionally and spiritually and how good it is to be a part of his Occupational Medicine team again.

Dr. Shoemaker has over thrity years of experience in the world of Occupational Medicine. His willingness to treat injured workers and to assist them in their rehabilitation process is commendable. Dr. Shoemaker prides himself on his specific protocols which help him to return the injured worker back to a full duty status sooner.

I value Dr. Shoemakers’ experience and the knowlege that both he and Lynda posses and am truely blessed to be a part of the Occupational Medicine team here at Saltzer Medical Group. If you have experienced a work related injury, I would not hesitate to recommend Dr. Shoemaker and his staff to you. So if the occasion should arise, we would be glad to see you and to help serve your needs as a work comp patient.

Saltzer Medical Group is ramping up their Workman Compensation program, with the return of Dr. Howard Shoemaker.

I worked with Dr. Shoemaker as his nurse for several years and when he decided to return to the Treasure Valley, he called me and requested that I come back to work with him. Of course it didn’t take long to answer him.

I’ve been at Saltzer Medical Group for just a few weeks and have met so many nice people. I wanted to get to know as many people as I could before I started woking in the clinic.So far everyone has been great to work with. Saltzer seems to have picked the cream of the crop of employees. The public is so fortunate.

I am looking forward to working with Dr. Shoemaker again and working as a team. Most importantly working with the public and giving them the best care that they deserve.

Dr. Howard Shoemaker is Saltzer Medical Group’s newest expert in the field of Occupational Health. He is Board Certified with 30 years of Occupational / Preventative Medicine.

Dr. Shoemaker obtained his Doctor of Medicine at the University of Miami School of Medicine followed by his Masters of Health Sciences at the University of Colorado. Additionally, Dr. Shoemaker is a Medical Review Officer.

Dr. Shoemaker has extensive experience in all forms of Occupational Medicine which includes 14 years in Hospital based Medical Programs, 15 years as the in-house Medical Director of a major telecommunications company in Colorado and 4 years in Idaho / Oregon with Medical groups. Dr. Shoemaker has extensive experience as a consultant to all types of industries ranging from Preventative to Injury treatment perspectives.

Satzer Medical Group has invited Dr. Shoemaker to start on April 15, 2008. I’ve spoken with Dr. Shoemaker and he’s really excited to start servicing the community.