Maggie McKay (Host): Ultrasounds are used in several different fields. So today we're going to talk with Dr. Drew Nowakowski, physician at Falcon Health Center Primary Care Center, about innovative care and explore ultrasound treatments.

Welcome to Health Matters, insights from WCH Medical Experts, a podcast from Wood County Hospital. I'm your host, Maggie McKay. Thank you so much for being here, Dr. Nowakowski.

Drew Nowakowski, DO: Yeah, thank you so much for having me. I appreciate it.

Host: So to start off with, what is ultrasound-guided treatment exactly?

Drew Nowakowski, DO: Yeah. That's a very generic term for what we do. We use it in my field extensively not only from a diagnostic standpoint, but a therapeutic standpoint as well. So most people are familiar with getting ultrasounds of their babies when they're pregnant or when they have to see a heart doctor. But not a lot of people are aware that we also use it from an orthopedic standpoint as well. And so, it's been a growing field over the past 10 to 20 years now to where it can really help us treat not only chronic pain and injuries and things like that, but we can also use it when it comes to treating certain things, whether that be injections and things like that. So, it really helps us to kind of refine kind of diagnosis what we do in the office and kind of helps cut down on costs and things like that as well too.

Host: And talk a little bit about musculoskeletal.

Drew Nowakowski, DO: A lot of the patients I see vary from weekend warriors to NCAA athletes to middle-aged people and older age people. And whether or not it's an injury or just chronic muscle aches and pains that they have, we're able to not only do a physical exam in the office, but we're able to use the ultrasound on that injured area to look at the soft tissue and things like that to see if there's any injury to the muscles or ligaments or tendons. And we can give you a rough idea in terms of severity-wise, kind of what you're dealing with, whether that be a rotator cuff tear or a simple strain to one of your muscles. And so, it helps me not only from a treatment standpoint, but it provides significant information relatively quickly and in a timely fashion to the patient.

So from that standpoint, we can really effectively and efficiently come up with a good treatment plan and we don't have to wait long amounts of time to be getting additional imaging such as CTs and MRIs, which during this day and age of medicine, you're always waiting on insurance to approve certain things. So, we're at the point now where we can really use this at the same time of visit to look at these injuries a little bit closer and get some pictures and determine potentially what we need to do next.

Host: And why isn't it widely offered in our area?

Drew Nowakowski, DO: It requires a pretty significant amount of extensive training. So, anyone can throw an ultrasound on an injured area and get some pictures. But the real use of that is knowing exactly what you're looking at and how to convey what you're looking at to the patient. Half the battle is interpreting what you're seeing, and the other half is being able to perform unique procedures with it as well too.

Again, not only are we able to use it to diagnose things, but from a treatment perspective, we're able to use it to help with guided injections, whether that be steroids or your own blood into those injured areas. So we can. Really pinpoint that needle into the exact pathologic area and help from a treatment perspective that way.

Host: Okay. Wait, go back to you use your own blood and put it where?

Drew Nowakowski, DO: Into injured areas. So, we use something called platelet-rich plasma. So, we use your own cells in your body, specifically your platelets, and inject it into damaged tissue and things like that. So, we're able to spin down your own blood, isolate the platelets, and we use the ultrasound to find that damaged tissue. And we're able to introduce the needle into that damaged tissue to reintroduce your own cells to help heal that tissue up. That's kind of the newer age of medicine that we're approaching. And again, ultrasound, it started with ultrasound and it's really progressed to the point where we're able to use some of these other newer minimally invasive techniques to provide accurate treatment.

Host: That is amazing. I've heard of that in facials, doctor, but not in injuries. That's amazing. What are the benefits to the patient in using ultrasound-guided treatments versus other common practices?

Drew Nowakowski, DO: Commonly again, 30 years ago, you know, if you had an ache or a pain and you needed something more invasive, such as an injection done. Traditionally, the doctor would just poke you with a needle where it hurt. And so, didn't really know what you were poking, you were just kind of introducing it into the area that bothered you and you hoped it worked. And so, problems with that are, you know, you may not be getting the needle in the right spot. Number two, it can be pretty uncomfortable for the patient. So if you're sticking it into a tendon or muscle and it's not going into the correct space as they're pushing that medicine in, it can hurt a good bit and be uncomfortable. And at the same time, you might not get the best relief. So with ultrasound, you're able to specifically guide that needle into the right spot and maximize treatment that way

Host: And in closing, is there anything else you'd like to add?

Drew Nowakowski, DO: In terms of ultrasound and things like that, it's a relatively cheap and easy imaging study that's covered by insurance. So, it's not something that we ever have to get preauthorized through your insurance or anything like that. And in terms of diagnosis and things like that, I've been doing this for, six, seven years with thousands of patients, so we're able to accurately see things and with confidence, let patients know what they got going on. So in terms of evaluating things, I wouldn't say it's the gold standard for everything. There are certain imaging studies that sometimes we need to get in addition to ultrasound, but I think the advantage to seeing patients in our office and utilizing ultrasound is that it makes it a very good quality visit because you're not only leaving with a good exam, good diagnosis, but you're also seeing the images in real time and seeing what you've been living with from a pain perspective. And it really helps people realize, "I'm not just making up, there's something going on here." you can physically see the pictures and all that.

And so, it's really cool to see patients see those things in the office and you see their eyes kind of light up, because they're actually seeing what's wrong with them on the screen and it kind of makes more sense to them. And I think in terms of compliance and things like that, patients are definitely, I find, more compliant to go through the treatments and varying things that need to be done when they specifically see kind of the pathology that they're dealing with.

Host: That's so wild to be able to see that, and that the patient gets to see it is, you know, an extra bonus,

Drew Nowakowski, DO: Absolutely.

Host: Well, thank you so much for being here. This has been fascinating and thank you for sharing your expertise.

Drew Nowakowski, DO: Yeah, I appreciate it. Thank you so much for having me.

Host: Again, that's Dr. Drew Nowakowski. If you'd like to make an appointment with Dr. Nowakowski, call 419-372-2271, that's 419-372-2271, or visit falconhealth. og for more information. And if you found this podcast helpful, please share it on your social channels and check out our entire podcast library for topics of interest to you. I'm Maggie McKay. Thanks for listening. This is Health Matters, insights from WCH Medical Experts, a podcast from Wood County Hospital.