Osteoarthritis post #30

The past eight days I’ve discussed factors that you can contribute, either positive or negative, to your total joint surgery.  I recommend that you work with your doctor and surgeon to get the best results from your surgery. 

A few final thoughts—don’t compare your journey with another person’s journey.

Each person is an individual and our chronic health issues can complicate dealing with arthritis.

The American Academy of Orthopaedic Surgeons (AAOS) gives more information about preparing for total joint surgery at

http://orthoinfo.aaos.org/topic.cfm?topic=A00220

Keep abreast of the best, most accurate information from the Arthritis foundation at the www.arthritis.org

Some of you may want to get involved at the Arthritis Foundation.  They welcome new members and volunteers. 

Regional offices of the Arthritis foundation around the country which can be found at http://www.arthritis.org/chaptermap.php 

Memorial Day

Memorial Day

We honor those brave men and women who serve (and have served) in the military.  We say thank you for all your work and dedication to our great country.  As we see the Statue of Liberty, we say thank you to those who protect our freedoms.

The second significance of Memorial Day for many families: it is a pilgrimage to the cemetery to place flowers on the graves of departed loved ones.  Peggy, Kim & I visited the cemetery where our loved ones were laid to rest.  It made us feel good to place fresh flowers at the gravesite; we honored and remembered those who contributed so much to our lives. 

Osteoarthritis post #29

If you deal with diabetes or hypoglycemia, can you keep your blood sugar within a normal range?  Researchers found that people dealing with either high (hyperglycemia) or low blood sugar (hypoglycemia) get better results from total joint surgery if their blood sugar levels are controlled.  A study published in 2009 reviewed  17 years of total joint surgery patients (over 1 million patients) looking at whether good control of blood sugar helped decrease complications.  Their conclusion:  “regardless of diabetes type, patients with uncontrolled diabetes mellitus exhibited significantly increased odds of surgical and systemic complications, higher mortality and increased length of stay during the index hospitalization following the lower extremity total joint arthroplasty.”  (Interpretation, uncontrolled blood sugars increase a person’s risk of a longer stay in the hospital, and complications which include wound infection, stroke, postoperative bleeding, and even death.)  This information can be found at http://www.ncbi.nlm.nih.gov/pubmed/19571084.  Talk with your doctor to make a plan for better control of your blood sugar. 

Osteoarthritis post #28

Prepare yourself mentally

The American Academy of Orthopaedic Surgeons (AAOS) held their 2011 annual meeting.  One speaker shared that “strong mental and emotional health (of patients) can set the stage for success…Individuals who recognize within themselves the ability to ensure that things will be okay consistently report less pain and disability for a given disease or impairment.”  More details on this can be found at http://www6.aaos.org/news/Pemr/releases/release.cfm?releasenum=971

Interesting, our mental health impacts our coping with disease and and treatments, including surgery. 

Osteoarthritis post #27

Stop smoking

The 2011 annual meeting of the American Academy of Orthopaedic Surgeons (AAOS) reported a study that confirms that smoking raises a patient’s risk of complications after total joint surgery.  “Current smokers had 41% higher odds of site infections than those who had never smoked before.  Current smokers also had significantly higher odds of pneumonia (53%), stroke (161%) and one-year mortality (63%) compared to never smokers.  Find this information at http://www6.aaos.org/news/Pemr/releases/release.cfm?releasenum=971  Enough said. 

   

Osteoarthritis post #26

Think about the quality of your bones (osteoporosis)

Osteoporosis affects approximately 10 million Americans.  Bone is living tissue and our body continually builds new and breaks down old, worn-out bone.

The quality of your bone may dictate to your doctor what type implant to put in your joint.  Strong, healthy bone is always the best situation.  It takes time to build strong bone; if your surgery is scheduled in the near future, there’s not time to change bone quality.  However, if a total joint is being considered months or a few years in the future, there may be ways to improve the quality of your bone.  Talk to your surgeon and family doctor about treating your osteoporosis and making your bone stronger. 

More information about osteoporosis can be found at the National Osteoporosis Foundation at http://www.nof.org/aboutosteoporosis

Osteoarthritis post #25

Consider your teeth and gums

Do you have gingivitis or periodontal disease?  The infection and inflammation of gum disease needs to be treated by a dentist before a total joint surgery.  The infection present in gingivitis could cause an infection problem in the new total joint site.  This teeth cleaning and treatment needs to be done and time for healing needs to be allowed before a total joint replacement.  The American Academy of Orthopaedic Surgeons (AAOS) gives information at  http://orthoinfo.aaos.org/topic.cfm?topic=A00220   

Also ask your surgeon about teeth cleaning procedures for after your total joint replacements.  Many surgeons recommend a prophylactic (preventive antibiotic) before teeth cleaning after total joint replacements

Osteoarthritis post #24

Avoid infection anywhere in your body and if it develops, contact your surgeon

Do you have an ingrown, sore, reddened great toenail beginning to hurt and throb?  Do you have a poison ivy rash that’s weeping and itchy?  If your surgery is scheduled for a few days from now, please contact your surgeon for the best outcome.  He will likely say let’s postpone surgery until we get this infection/skin problem cleared up and he work with you to get the best outcome on your surgery.  If you develop a “fever, cold, or other illness in the week before surgery, notify your surgeon”.  More information can be found at http://orthoinfo.aaos.org/topic.cfm?topic=A00220

Osteoarthritis post #23

Protect your skin

You may think your flower beds need to be weed-free before your total joint surgery.  That’s fine.  However, you want your skin intact and infection free.  Your skin is an important defense against infection and you don’t want scratches, scrapes or infection which might compromise your skin’s healing and the results of your total joint surgery.  In the weeks prior to surgery and forever after surgery, you want to protect your skin.   

Osteoarthritis post #22

Eat healthy

In the weeks prior to surgery and after surgery, it’s especially important to eat healthy and give your body the building blocks of nutrition it needs to heal.  Put some color on your plate (and I don’t mean ketchup and mustard).  Red color can be tomatoes and radishes.  Yellow/orange can be carrots and yellow peppers.  Purple can be grapes and eggplant.  Green color comes in many foods—from lettuce to green beans, celery to spinach.  Add color to your plates by eating fruits and vegetables.  The experts recommend a balanced, healthy diet.  This includes lean proteins, fresh fruits and vegetables, complex carbohydrates (whole wheat pastas, brown rice, and whole grain breads) and healthy oils.  If you are a person who has a special diet because of chronic health issues, talk to your dietitian and/or doctor about your best plan for eating healthy.  Unless your surgeon tells you to diet for weight loss, the weeks surrounding your total joint procedure are not the best time to diet.  More information about eating healthy after surgery from the experts at Mayo Clinic at http://www.mayoclinic.org/news2010-mchi/5701.html

Osteoarthritis post #21

We’re almost finished talking about osteoarthritis.  We will finish this series by asking this question:  what can you do to prepare your body for surgery?

Actually there are several things you can do to maximize your good results from total joint surgery.  As always, work with your doctor.  If you have questions about any of these topics, discuss them with your surgeon to get his opinion and follow his directions. 

Eat healthy

Protect your skin

Avoid infection anywhere in your body

Consider your teeth and gums

Think about the quality of your bones (osteoporosis)

Stop smoking

Prepare yourself mentally

If you deal with diabetes or hypoglycemia, can you keep your blood sugar within a normal range?

Osteoarthritis post #20

Finding an orthopaedic surgeon is an important step in preparing for surgery.  Consider these details:

Get a recommendation from your family doctor or other medical staff.  The question to ask is:

“who would you have perform a total joint surgery on yourself or your loved one?”

Ask friends and family their recommendations.  However, keep in mind no one can please everyone.  Even the best, kindest, most wonderful surgeon will be challenged to please some people.  And some people like to tell their ‘horror stories’.   So be prepared, but you may get some good information. 

Look for board certification.  Doctors put time and effort into becoming board certified:  that’s the stamp of excellence showing knowledge and skill.  For young fresh-out-of-school surgeons, are they a part of a group whose surgeons are board certified?  Surgeons must finish all training and practice for a  

for a specific time frame before taking the board examination.  If they have joined a group of surgeons who are board certified, that says the established members of the group have confidence in the ‘new guy’. 

Look at a surgeon and facility (hospital) where a large number of total joints are performed.  Numbers matter; surgeons and hospitals who do a lot of total joints have the best results.  Statistics show that. 

Osteoarthritis post #19

Surgery

When does a person seriously consider surgery for his arthritis?  When pain takes the pleasure out of life,

when a person can’t sleep because he’s hurting, when a person can’t climb stairs, get up off a chair, off the toilet, or off the floor without pain. 

People get serious about total joint surgery when pain medicines don’t work anymore. 

The most common two total joint procedures are total hip and total knee replacement. 

Check out this Total hip animation at the Arthritis Foundation website at http://www.arthritis.org/joint-surgery.php

Is Hip Replacement surgery for you?  The American Academy of Orthopaedic Surgeons website gives information at http://orthoinfo.aaos.org/topic.cfm?topic=A00377

If knee problems are your concern, the Arthritis Foundation shows an animation of total knee surgery at http://www.arthritis.org/joint-surgery.php

Is total knee replacement surgery for you?  The American Academy of Orthopaedic Surgeons website gives information at http://orthoinfo.aaos.org/topic.cfm?topic=A00389