Friday, November 30, 2007

Hip and knee replacements

Many people with osteoarthritis face the prospect of a hip or knee replacement sometime in their life. This major surgery is life changing and can add years of productivity and quality of life.

First, why a replacement?
As the knee or hip wears down, the pain can become unbearable. As it becomes harder to walk, activity levels go down. As activity levels go down, physical fitness can become affected and – importantly – it can the psychosocial aspect of life. Someone who can’t leave the home can become socially isolated, leading to depression and other issues. The older the person, the worse it can be.

What is involved in a replacement?
You can have a total replacement or a partial replacement. A total replacement is exactly what it says – the entire joint is replaced with a manmade device and attached to the bones. The implant is made of the socket, ball, and stem. A partial replacement involves only removing parts of the joint. Which one and which brand of replacement someone receives depends on many issues, including the extent of damage to the joint, the condition of the bones to which the joint must be attached, availability of the implant, and the surgeon’s experience.

This is a major surgery with all the accompanying surgical risks. People who are overweight may be told they need to lose weight first. The reason is very clear – the weight can cause problems with anesthesia and recovery, as well as the burden placed on the new joint. Those who smoke should stop smoking – this can greatly affect how someone recovers from anesthetic and there have been studies that show that smokers have a harder time healing.

What can be expected after surgery?
After a replacement, patients go either to a rehabilitation center or home, depending on how the home is set up and if there is help available. Physiotherapy is a large component of proper healing following a replacement so compliance with the physiotherapy program is vital

How long does an implant last?
The length of time an implant lasts depends on many issues and lifestyle factors. These include if someone is overweight, participates in impact-loading activities (running, for example), lifts heavy weights frequently, and so on.

What about complications?
Yes, there can be complications following hip or knee replacements. Occasionally, the hardware breaks or becomes loose, requiring a revision surgery. As well, the bone surrounding the replacement can weaken or break, causing problems. If pain or clicking noises begin, this should be investigated to prevent worsening of the problem.

Hip and knee replacements can literally re-open the world for people; technology can be a wonderful thing.

News for Today:

Montreal health experts want 60-second AIDS test available in province
New HIV-AIDS drug approved for Canadian market
Panel Seeks Warning to Prevent Pediatric Use of Sleep Drug
Ibuprofen associated with slower lung function decline in children with cystic fibrosis
Health Canada issues health alert for Axcil, Desirin
Identifying patients at high risk for total hip replacement
U.S. obesity rates level off: CDC
Cases of mumps continue to rise in Alberta
Night shift-cancer link gaining acceptance
Long-term improvement seen with hip replacement

Thursday, November 29, 2007

Holistic medicine

Holistic health, often thought of as just a type of alternative medicine, is beginning to gain recognition in Western medicine. It makes sense if you think about it and it’s a shame that it is taking so long for the concept of holistic health to make inroads in our healthcare.

Look at two of today’s news stories: High blood pressure could worsen Alzheimer's: study and Depression linked to brittle bones in women. Blood pressure and Alzheimer’s disease, and depression and osteoporosis. How many other diseases and health problems have we heard of that are related? Diabetes and high blood pressure is just one example of many.

In my opinion, it only makes sense that one part of the body affects another – for better or worse.

Traditionally, our medical approach is to treat the symptoms of an illness and then to try to get rid of the illness. This can be done by surgery (removing or repairing the problem) or treatment. While this approach may work much of the time, is it taking care of the whole problem? Holistic medicine encourages using all the resources available to you – be it psychology, acupuncture, massage, or any other field of so-called alternative medicine that is appropriate.

I often wonder, why is Western medicine so afraid of the older ones from elsewhere.

News for Today:

High blood pressure could worsen Alzheimer's: study
HIV infections rising among gay men in developed countries
Drug maker accepts FDA's new Tamiflu warning
System of simplified, standardized dosing instructions for prescription drug labels proposed
Heavy keyboard use won't trigger carpal tunnel woe
Depression linked to brittle bones in women

Wednesday, November 28, 2007

Dementia screening - is it time?

The article, Dementia screening in primary care: Is it time? was interesting to me. We are hearing more and more about dementia and Alzheimer’s disease, and the social, emotional, physical, and financial toll that the disease takes.

Some people feel that screening for dementia would catch a significant number of people who could slip through the cracks. However, currently there are no methods for across-the-board screening. In this article, it is argued that such screening could, in fact, have detrimental effects. It says, “Harms include possible stigma, loss of long term care insurance, emotional dislocation for both the individual and family, and resources’ shifting from other health problems.”

It’s a tough one. It’s a sad and frustrating situation when an elderly person does slip through the cracks when dementia develops and doesn’t receive the care he or she needs. There has to be a way to identify the people at risk without causing a whole new problem, as could be with overall screening.

News for Today:

Women happier when babies delivered by midwives: Statscan survey
Surgery allows amputees to 'feel' in missing hand
Dementia screening in primary care: Is it time?
Hospital superbugs now in nursing homes and the community
High-trauma fractures in older adults linked to osteoporosis, increased risk of another fracture
Factors identified to help predict risk of hip fracture in postmenopausal women
Another complication for gastric bypass patients
PET/CT brings new hope to patients with deadly form of breast cancer
PET imaging may improve lung cancer diagnosis
Freezing bone cancer tumors reduces pain, Mayo Clinic study shows

Tuesday, November 27, 2007

Good and bad cholesterol?

We often hear about good cholesterol and bad cholesterol, such as when we read articles like Not enough 'good' cholesterol makes it harder to recover from stroke. Unfortunately, many people don’t understand what bad or good cholesterol are and what the difference is between the two.

First, what is cholesterol? Cholesterol is a fat-like substance that is produced by our liver and ingested through food. We need cholesterol as a building block for healthy cells walls and tissues, among other things. However, cholesterol can also be dangerous as it can build up and block blood flow.

The so-called good cholesterol, the one we need to keep healthy is called high-density lipoprotein (HDL) and the so-called bad cholesterol is called low-density lipoprotein (LDL). A trick to remember which is which – you want the good cholesterol to be high so HDL; you want the bad cholesterol to be low, so LDL.

The American Heart Association has this great section, What Your Cholesterol Levels Mean to help you understand the numbers and what numbers you want to see when your blood is tested.

Since it’s known that high LDL can contribute to heart disease and stroke, everyone – particularly those with heart disease in the family – should know their baseline cholesterol levels. The earlier you know your levels, the earlier you can begin working on prevention. If your levels are normal, your goal is to keep it normal; if your levels are too high for LDL, then your goals are lower your numbers.

News for Today:

Trained patients show improved cholesterol levels
Too little milk, exercise, sunshine hurting kids
Mental health hotlines help American farmers
City women more likely to have denser breasts, study suggests
High-glycemic index carbohydrates associated with risk for developing type 2 diabetes in women
Patient knowledge of heart risk profile may help improve cholesterol management
Not enough 'good' cholesterol makes it harder to recover from stroke
Attitudes toward mammography differ across ethnicities, cultures, backgrounds

Monday, November 26, 2007

News stories

What are the important health news stories of 2007 and the upcoming year? I’d like to hear what you have to say. I’ve written about different kinds of cancers, high blood pressure, heart disease, strokes, and many other commonly discussed issues. I’ve also tackled issues like mental illness, addiction, and suicide – the last one being something that has affected me personally.

Of course, the news isn’t going to report a lot on issues that aren’t popular, that don’t raise too many eyebrows. If a disease, disorder, or disability is a concern, it’s up to us to raise the awareness because no-one else will. The more noise we make, the more news gets made.

So, how do we do that? Take suicide for example. I wrote a post earlier this year about suicide and I called it Suicide, not a disease, so no walkathons, ribbons, or research race. I also wrote: Quebec has one of the highest young male suicide rates in the country. Young men are one of the highest risk groups for suicide. In a youth suicide report published by the Canadian Task Force on Preventative Health Care, it says: “Suicide has accounted for about 2% of annual deaths in Canada since the late 1970s. Eighty percent of all suicides in 1991 involved men. The male:female ratio for suicide risk was 3.8 to 1. In both males and females, the greatest increase between 1960 and 1991 occurred in the 15- to 19-year age group, with a four-and-a-half-fold increase for males, and a three-fold increase for females.”

Where are the hue and outcry that so many lives are being lost?

What do other people feel are important health issues? I will look for information and news on the different topics suggested.

News for Today:

FDA mulls psych warning for 2 flu drugs
Montreal doctor exploring link between football and ALS
Cryoablation continues to show good results for kidney cancer patients
'Mismatched' prostate cancer treatment more common than expected
Non-Caucasians at higher risk for severe metastatic breast cancer pain