
Thank God.
Because they can't make
easy to pick up.
It's an awesome organization.
You guys have probably, you probably have done that, but you get teams of four and you pour like, it's powder.
One's different.
Forms and you pour it into a funnel and then it goes into a bag you seal the bag and that actually becomes a meal and they ship it It's really doesn't
It's a great program.
Anyway, so John and I are there and Okay, let's get going.
So Johnny's pouring the stuff in and then the other one and it's all going on the floor because there's no bag under that it's a John but bag So that's the analogy to yesterday.
He's making coffee and he's got the
thing on there the creak thing
is at least twice.
This is twice.
This is twice.
The receptacle is
us.
Yeah, I guess,
That's the direction it goes.
a lot
This is true.
That is very good.
Most people know that.
Yes, yeah, coming since I'm not maybe I usually give people a spiel, you know, it's it's either drive with your left foot You take it off you put on a shoe.
It's it is a broad device.
It is that's the hazard you
so I got
Traditionally, you push one of those at a time.
Yeah.
Yeah.
That's how that goes.
Crazy.
you, Doc.
His place is to be.
He's being efficient.
Thank you.
wrong with
You know,
Totally agree.
Totally agree.
Can you explain?
No, sprained ankles.
And can you do me a favor?
Because we've used this or the media uses this term.
all the time, and I don't know what it means.
I'm not sure anybody knows what it means other than the people that do it.
A high ankle sprain, which puts people on the bench for like a month.
What is a high, because in my era, did you ever hear of the term high ankle sprain, Jim?
Back in our day,
you know,
So, to answer that question, quick comment on ankle sprain.
Yeah.
So people, that is an overly used term.
Yes.
Everyone, it's widely under-traded.
It's the most common sports injury, most common ankle sprain.
Right.
Significantly under-traded.
People go, oh, it's no big deal.
Put some dirt on it.
Here's
advantage.
Yes.
That is not true.
Commonly, it is a complete tearing of ligaments.
What we call an ankle sprain is a low ankle sprain in actuality.
A high ankle sprain is above the ankle.
If you look at an x-ray, there's two bones in our leg.
tibia and fibula.
There's a bunch of stuff in between them.
It is not air.
There's a bunch of ligaments.
A high ankle sprain is a tearing of those ligaments.
I never knew that.
So it's a high.
So people grab their skin.
People kind of grab right below their knee.
And so it is an injury that is above the ankle.
People will get a little device between their bones called a tightrope.
You'll hear people say, oh, he had a high ankle sprain.
He got the tightrope surgery.
And that is a treatment of all of those ligaments above the ankle.
Sendysmosis.
Wow, so it's
what you
I
Yes, that's where we are.
You're a specialist.
Yes, we all
Everyone there is fellowship trained subspecialty orthopedics.
No, no, it's the most common sports injury.
Right.
Is it sprained ankle?
Is it sprained ankle?
Various degrees right there are mild by definition.
So if you get an MRI after sprained ankle, it is not normal like it is an injury to your ligaments It's a mild sprain.
It's a tearing or it's a or it's a greater tear or it's a full tear That is those are the grades of an I never knew that and so that's
is that's right Yeah, that's right.
Yeah, but if it's a severe sprain Lots of literature says that you can be back to high-intensity sports with an ankle brace like three weeks It'll sometimes.
Oh,
really help?
Yeah, ultimately.
Yes.
Okay.
Oh, yeah.
Yeah, it provides a little external support when you are still recovering.
the whole industry.
Like you don't give it out like you're used to.
Yes.
Okay.
And just talk about because that became very serious addiction actually led to heroin with some people.
When you took the opiates away, they still needed something and that
caused more problems.
I'm just wondering what your comment is.
I mean, you're a young doctor, but I think back in the day, they gave it out a lot more liberal than you do.
Absolutely.
And I saw the
So yeah, so as you noted there has been a lot more research research in multimodal pain management has exploded and so there is a lot of research to show that it is good for people to do pain medications of different modalities and so this strong anti-inflammatory plus this nerve medicine plus this opioid and You take it for a short amount of time in the immediately post injury post surgery period and then you go to other pain medications
And we do blocks around surgeries.
And the goal is to minimize opioids.
You decrease their side effects.
You still give people excellent pain relief.
So it is the pain management is much different than it
a
And you know, you always used to be the boy, you go to the dentist and you don't get Percocet or whatever, whatever.
And none of that, it's like three Tylenol and two Advil or so.
And I always said, well, the worst thing you can do is mixed medicines.
You can't do that.
But that's the way they do it now,
correct?
Yeah, multimodal.
That's right.
Yeah.
So you gotta be one of the younger doctors there.
You know what?
I don't think I am, but I love that you say that.
I will take that to the
People.
Do you
Green?
Is it Dr. Green?
No.
So which one?
Who's Dr. Green?
At Titletown?
Yeah.
We got Shepit.
He's sports guy, Lichti.
Oh, maybe he's a
Kevin Borst.
He doesn't consider doctors
Fellowship trained so fellowship is optional
So, to be a practicing physician, you go to college, then you go to four years of medical school.
After medical school, you are a doctor.
You're called doctor now.
You're not able to independently treat patients.
To do that, you have to go to residency.
Residency is long and hard, and it's... Like hell week?
Yeah,
saying.
Boy, they work, you guys.
And then following that, you know, that's like Grey's Anatomy and all that.
Those are residents.
And then following that, you can be done.
You are an independent practicing physician.
You can do one year in orthopedics.
It's one year of subspecialty training.
That is what fellowship is.
It's optional.
Orthopedics has exploded.
Many medical fields have exploded.
It is hard to keep up with the innovations and the different techniques and instrumentation and research.
You kind of can't be good at every single thing.
And so at this point now 90% of orthopedic graduates do a fellowship.
And that makes you subspecialty trained in your field.
And so Bellin, the hires only subspecialty trained orthopedic surgeons.
So it gives you a bit of confidence if whoever you're talking to there, they are going to know what they're talking about.
Yeah.
I love that.
You don't know him
It's great.
Yeah.
Yeah.
This is great radio.
That looks like a friendly gentleman that I don't personally know.
Yeah.
I see.
I notice.
notice the
The other ankle.
Any questions for our doctor?
No, no, none at all.
I'm good.
absolute
I love it.
That's a big reason that I'm there, right?
So huge investment.
So they expect, I mean, like, I do mean this genuinely, they expect excellence.
Like if you are one of the orthopedic surgeons there, you are expected to be excellent with that.
a lot of resources are sort of entrusted to you, like these facilities, like these facilities, the imaging facilities, the rehabilitation facilities.
And so it is state of the art, the imaging is excellent, the rehab upstairs is
That's what we talked to Mark about right after, because I had never seen that before.
And with what you talk about the difference in maybe 20 years or 10 years or whatever, where these athletes or anybody, when they're in the rehab, you videotape so much.
to see if they're doing the techniques right and everything.
And that's amazing what you guys have upstairs there, isn't
it?
It's amazing.
There's a basketball court.
There's turf.
There is the multidirectional cameras that you're talking about, the force plates that you step on.
after this.
Who'd
besides the wind, it's, is the sun out or not?
The sun's out.
It's like, oh, it's a beautiful day.
No, it's still cold, but it's Dr. David Ruda.
Go ahead.
Bell and sports medicine.
I talk all the time about how fortunate we are to live in Green Bay with our healthcare systems.
I mean, all three of you guys are doing a good job.
We also, besides the equipment and, you know, fishing and the other reasons some of you guys come here.
What was it?
I mean, you probably could have gone a lot of places as my guess, because most of you doctors can.
Yeah, so the reason that I am here, quite honestly, so I love, I love this city, I love it, is everything that I hoped it would be, my wife loves it.
The thing that initially drew me here was the position, was working for Bellin, that it is, in short, it's kind of the culture.
And so there is the expectation, and then there's the delivery.
The expectation, like I said a moment ago, the expectation really is,
Excellence and so everyone there like you're expected to be very good.
You're expected to know your stuff with that They give you resources to say you have a high work Ethic and you have a high standard use these high quality this high quality machinery to help these people So that is not present everywhere.
You're not always entrusted with that.
That is huge for surgeons who value that
As business gets more competitive and you want to get the best employees because that's really that is besides the equipment everything you bet
And I just interviewed our mayor yesterday about a show that I have coming up.
But the Packers did a good job when they remodeled their facility and people came in and were like, this is awesome.
And municipalities need to do that like a better police station, you know, because people want to come to work out rooms, that kind of stuff.
So I'm glad, Belin, I mean, they're pretty smart what they did.
Not only did they get you good equipment, but you talked about the culture to attract some of your buddies.
Absolutely.
So it is like I said, the culture of excellence and then the delivery.
is if you have an urgent problem, it's going to be taken care of.
It's not just for athletes.
It is across the street from Lambeau.
So there's a strong relationship with athleticism.
I get that.
That is true.
We are good at...
Athletes, that is true.
However, we take care of a whole lot of non-athletes there.
There's the walk-in clinic there.
You have a problem.
You literally walk in.
It is called a walk-in clinic.
There's no appointment.
You just walk in.
If you need to see a doc, you will be seen.
If not, if you just need some initial rehabilitation, you get that.
And so people, we are involved with high schools locally.
And so it is this culture of...
of high standards, the physical therapy, they are awesome.
They're an academic, the physical therapists are academic there, which means that they're part of a training program.
You have to be pretty good to do that.
You can't kind of fudge your discipline and then be a training institution.
I mean?
So they're gentle on the patient, which is nice, but they're very hard on themselves.
And so if you send your postoperative patients to the physical therapist there,
It's they're just top-notch.
I get asked one question when you
talk about the food we're talking ankles But foot I would think that's got to be a hard one because I've known so many athletes and just going back to the athletic part where they'll break something in their foot and They do whatever they can and then it'll break again or their foot injuries are tough I mean it's ended careers.
Yes, and what people would think it would be a seemingly minor
Totally agree.
So the reason for that is it's hard to compensate
So if you've got a little something with your shoulder, you move your elbow differently.
If you've got a little something with your elbow, you move your shoulder differently.
If you've got a problem with your foot, it is hard to compensate.
You walk different.
And athletes are extremely high-performing people.
They just do stuff just a little differently, and then they get new injuries.
Todd, Dr. Ruta brought in
work.
His
used?
I'm coming in to see it.
It's amazing.
He
an
Yeah, ankle replacement, ankle fracture, lots of broken bones.
And these are just for the listeners.
These are all X-rays.
This could not be more hip or compliant.
Right.
It's healing.
That's visible healing is what that is.
Do you guys use an
Oh yes.
Dewalt drill.
And so you use a drill.
And then you tap.
Sometimes you have to tap.
Sometimes they're self-tapping screws in that they make their own threads.
And then you put in screws with threads.
That screw looks like it's from a hardware store.
You know what I mean?
That's a screw.
That is a screw.
Yeah, some of them are headless.
Some of them are partially threaded and fully threaded.
Do
put a rebar in.
They typically do.
So many of these implants can come out if they're bothersome, but they do not have to.
Once the bones heal, they're not doing anything.
So you can take them out if they're problematic.
Yes.
stay in there.
They stay in.
Yeah.
Most of them are titanium now.
And the bone likes titanium and they just stay in there.
If they don't bother you, you don't bother it.
the
Yeah, for the normal person.
I see a lot of post-traumatic arthritis.
So lots of us get hip in the arthritis and we just sort of develop it.
It's just built into us sometimes.
Ankle arthritis is very largely post-traumatic.
So you have ankle sprains when you're a younger athlete.
You pull off a little piece of bone here and there and then you fast forward 50 years.
That's post-traumatic arthritis.
Or you have an ankle fracture that becomes arthritis after injury.
And so I see a lot of arthritis.
in the ankles and feet, and then I see deformity.
I mean, I come to your
care of me for everything.
Could
Not, not usually.
usually.
Okay, let's get back on
Yes.
Is there a correlation there?
Yeah, there's a strong correlation.
And so the way to explain that is kind of the hip fracture for a lot of us, not for all of us.
For a lot of us as we age is sometimes an indicator of decline.
And so it is not that this hip fracture
It's the cause to mortality.
It's an indicator of decline, and so they have this big surgery, and then they have a big recovery.
All right.
And it is difficult to recover from
Thank you so
much
Tim?
How many 22?
Wow, do
ever have screws put in you?
I had screws in my heel.
Yeah, I got a fake hip.
I got hip replacement I got a kid.
He's tendon reconstruction.
I got
good thing.
I got some good metal.
That's good stuff.
I've
it in
It is.
they
Okay.
Tim Cote here in the House Fox Valley Veterans Council.
They take Memorial Day very seriously.
In fact, not just Memorial Day, they take the whole weekend very, very seriously.
I've been to all their events.
It's incredible.
Based in Appleton Tim go ahead and give a little schedule what you got going on brother.
Sure.
Thanks First thing we got coming up is Saturday morning at the out of gamey County courthouse at 10 o'clock.
We're gonna do our Memorial for the 50th anniversary the end of the Vietnam War So we do maintain a list of all those who have died for the nation of their country from the Civil War on So we'll be reading the names from the Vietnam War era during that ceremony.
It's a very
Poignant short ceremony.
There's no speeches.
the area for the fox live entrance of the names you're reading?
Oh, so that's just out of gamey County, right?
So let's just be out of gamey County because we do out of gamey County I asked us to put it on
of
Yeah, we got about roughly 60, 65 who perished.
That's incredible.
Yeah.
Wow.
Yeah.
So what we'll do is we'll have everyone line up what bagpipes playing some really cool kind of somber haunting
Yeah.
Well, we won't have the bell this time.
So we won't have the bell because that's a Navy thing.
So we kind of move it around for different.
Oh, I didn't know that.
Yeah.
So we try to move it and have a different theme.
So this theme is just is the Vietnam era theme and
Participants, anybody can show up.
Participants can show up.
We'll give them a carnation as we read the names.
They'll walk towards, we'll have like a banner with the names on there that looks like the wall.
And as the names are being read, they can lay a carnation down at the banner.
And then at the end, we'll have a 21 gun salute and taps played.
So it's just, it's very, uh, um, pregnant ceremony.
Um, it gets right to the heart of what we're doing, which is Memorial Day for those who have died for their country.
Um, and it's fairly short.
So, you know, if you, if you're trying to get something in for that long weekend and you know, and people want to go up north and do all of those stuff, but they have to remember why we have this weekend.
Yeah, I just say that all the time when he gives a ton of talks in Memorial Day and sort of die.
It's important that you as a dad take your kids to this and they'll enjoy the day more and it becomes a tradition.
And so many of these things are in the morning.
I don't know what time, what time is
this?
It's at
times.
Behind the
so a couple other things going on.
Yeah, you can get it done and and boom you're you're
to go right and you paid your
there's no wasted time like I said it's not speeches you don't have to worry about a politician talking or anything else yeah no don't need to worry about it
Award that valedictorian because he went too long on the speech.
Oh principles like you know you give that back So his metal they took his metal back after that.
Wow Yeah, I went too long crappy.
Yeah, that was a Wow, I don't know was it well, you'd love to pull our title to us politicians We get up there.
We go off script because you sports guys do that a lot
that's Saturday morning
No.
Yep, Saturday morning.
That's tomorrow.
And then what else is
county?
So the Scarlet Guard is going to be going to cemeteries in the out of game area and they're going to be laying wreaths on there and then Monday we'll be taking the Wall of Honor and
which is all those who have died in out of gamey county uh further service from the civil war on and we've created a very large memorial that you can that's draped over 18 wheeler truck uh donated by great northern corporation and fast signs is the one who made the um
made the tarp force and they hang it on there.
And then that's always the last, that's the last vehicle in the procession.
And it's really cool.
a great company.
Yeah, G&C is a great company.
They have a, the tractor has photos of veterans in the area.
And so like even they even took one of my photos, which is really cool and smoke the cigar on Saddam Hussein's pals.
I have
Yeah,
Oh, I got tons of them.
I
That's awesome.
And then, you know fast signs made it and they and they hang it Which is actually a very delicate process because you're not allowed to step on top of those 18-wheeler truck trailers Yeah, where do we witness that tell me so that's in starting in downtown Appleton, okay?
And it goes down College Avenue and jigs and jags to Riverside Cemetery
is Monday or that
Monday
had they were part they were part of the black hats the iron brigade
iron brigade.
Yeah, I We don't talk a lot about
Yeah, the iron brigade is probably the most famous Union unit
It was famous, obviously, that they called Diane Brigitte because it stood, it stood a significant charge.
It got very famous in Chancellors Farrell and Gettysburg, most casualties.
And they also called them the black hats they wore, these black.
Kind of almost like top hats at the Civil War is fascinating.
I know if you love you always
very tragic But
was but very needed obviously.
I had a friend in law school African-American and we were having a constitutional
discussion over the Stars and Bars and the Rebel flag and whether it should be allowed or not allowed.
And he was the only African-American kid in that class and the professor, he sat right next to me.
We both had played football and he was sitting right next to me and the professor said, well, Eric, what do you think about that?
And he goes, that just tells me someone's dumb enough to stand up there and go, look at me, I'm 0-1.
I mean
Well, you know, I love the Civil War one because it's I think it's a time when
when everything from privates to general officers and politicians wrote long detailed letters to their folks at home.
And so you have that encapsulated.
And you can read these letters.
I mean, from what you would think would be uneducated folks, they're writing home and they're talking about, you know, the food, the medical care, how boring it is, along with the tragedy and everything else.
But I loved it because for so many years, I thought it was a great teaching point.
to the world on how a country could heal itself over a tragic sin that we had been committing and then a tragic event to stop that sin and the wounds that were opened and the history that was required to fix that.
And I remember being in Europe and people talking about, they couldn't believe that there was all of this battle.
replaying the battles and people being Southern supporters and people being Northern supporters.
And, you know, that was a time when we were, I would say getting along a lot better in our country, but I used to use that to the Europeans as a great example of how free speech works and how it heals.
And that both sides could talk in kind of honor.
I mean, clearly, you know, there was a sin that we were fixing in that war, right?
Just an unpardonable sin of slavery.
But you know,
There's still your brothers and sisters in the country, right?
And we had to we had to heal and I thought we were doing that very well and I think we've kind of tried to reopen some of those wounds again, but
Yeah, that's kind of a good point.
When I talk to people, I don't want to take their lovely three-day weekend or four-day weekend away from them, right?
All I just tell them is you just need to do something to commemorate why you're having this weekend, right?
That's kind of why I like that.
ceremony on Saturday because it's, I mean, it's a half an hour long.
It doesn't take a huge commitment, but it's powerful.
The point is, it's one
hour.
Yeah.
And, you know, I think there's tons of stuff going on.
It actually can be challenging for groups like us, because we're all competing against each other to get people to come
I mean,
Right.
You
this You're
It's a free ticket Friday and a shot to win a four pack of Brewer's tickets for the game Tuesday, May 27th, the brew crew taken on Boston.
The keyword this morning is radio R A D I O radio.
If you haven't done so already, I don't know why you haven't, but download the Civic Media app and the Apple or Google Store, choose WISS or WGBW, use that text button, send the keyword radio right now to be entered in the statewide contest.
Again, it's radio.
You've got to
9 o'clock this morning to a text in the word radio for your shot to win.
And again, you help out Jim and John when it comes to the contest within Civic Media.
So
Tim, I want to think that, and this is all great with the ceremonies and all these things, but.
What have you done like individually behind the scenes that you know people probably don't know about to help Families who have who have lost someone and I know that's a big part of your job And I know you guys try to stay fairly very private in regards to you know the people that you help So I'm not asking for names or anything like that But some of the things that you guys do that maybe people don't think about Especially this time of year that we could do for those gold star families
Are you asking kind of like what the council does?
Well,
28 years.
Yeah.
I mean, you know, the first and most important thing is there to be there for them.
So for example, we had a member of the council, a couple, a veteran couple, and the wife had died from
breast cancer, and we had actually helped them earlier.
They were a struggling couple trying to be entrepreneurs, and we had helped them in our assistance program.
And they'd grown their business and everything else, and then tragically, you know, mother of two children and a veteran and very young couple, and she succumbed to breast cancer.
The most important thing for us was to be there for the husband and the kids, just be there.
Physically and emotionally for them, you know, we can assist with funeral services and things like that which can become very expensive Sometimes we are able to relate With our veterans that other people can't and I'm not saying that you know You have to be a veteran to do that because you don't have to be but there are sometimes that veterans
they just want to talk to somebody who shared their own experience.
And sometimes it helps that you have shared that experience, you know, just to be there.
And so they understand just to be a listening ear, to be there.
And also, you know, sometimes it also gives you a little bit of validity to, hey, okay, let's tragedies happen.
Let's pull our bootstraps up.
Let's keep going.
And
Let's talk about Memorial Day where I was gonna be in everything like that.
And he said, yeah, I'm gonna go put a wreath and a flag on my buddy.
Well, okay, that's gonna be just because he committed suicide, but that war killed him.
I agree with
him.
Yeah, I mean, it can be.
He's a casualty of war
Yeah.
No, I mean, you know, I mean, there are lots of soldiers who come back with the mental scars and
You know you face them pretty you can face them pretty pretty nasty stuff and everybody can deal with it in their own way On top of that you're taking whatever baggage you had with you when you went in and you're also having baggage when you come out So it's not just the service, you know, it's the person as a whole and everybody is individual But yeah, you know some of that stuff can just
can really haunt some people.
And that's tough when that occurs.
It's tough to heal somebody in that way because it's not something we can point to.
It's not a virus we can give an inoculation to.
It's not a bone we can mend.
It's a haunting thing that's bouncing around in their noggin.
And how do you erase that or how do you get them to deal with it in a really healthy way?
And it's different for everybody.
I mean, that's the thing that we found.
There's no one way to treat it.
And so every person is so different.
And to be understanding, to be there for them, to listen to them and also try to lift them.
And however way that is, whether that means you're kicking them in the ass a few times or whether that means you're holding them up.
you know, giving them some confidence when nobody else is, however that, you know, can work, that that's, that's what we got to do for veterans.
And you said it's good.
It's not great in terms of knowing what they should know and showing the respect they should show.
I don't know that you said exactly that, but this is my question.
How are we doing?
You're very plugged into this.
How are we doing in our educational system to making sure this stuff is learned?
Like is it being?
You know, I don't feel overly competent because I'm not in the history classes listening to it.
I get to go talk to schools
that's really cool.
My take is that, you know, war has always been like one of the favorite things for history because it's so dramatic.
It's got so much action.
You know, it's like drama on TV, real life, right?
But it's also...
I mean, there's lots of other great things in history other than people killing each other.
And so sometimes I think that even though that's been a focus over years, I think nowadays there may be a tendency not to dwell on those areas because violence is traumatic to people.
I mean, I've had teachers say that, well, I don't want to get any triggers on these 13 or 14 year old students learning about battles and wars.
Okay.
know.
You know, I mean, there's got to be a video game.
You know, I think if we teach it, you know, we teach it one, the purpose, we teach the reasons, we teach the mistakes and why we got in or how we got out.
But more importantly than anything, the people that we asked to sacrifice is the most important thing to talk about because they have put their trust in their government hands to serve their nation.
And there are people.
They're from Appleton.
10 a.m.
out of Gamy County Courthouse.
Fantastic event.
Thank you.
Thanks
Council.
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