Which Type Of Joint?

You may have hoped this would be easy-you just order up a new knee or hip, and in it goes. But it’s not quite that simple. You and your doctor need to consider if you will have a cemented or uncemented joint and what type of knee prosthesis to use.

Cemented. Cemented is just like it sounds. Remember that tube of cement you used as a child to glue model airplanes together? It’s not the same glue, of course, but the idea is the same: The new joint is actually glued to the bone. Your joint heals quickly, but about half the time, it will loosen or become unglued in 10 to 20 years. When this happens, you may need more surgery to reglue the joint, a procedure called a revision. Revisions are more complicated than the original surgery, as more bone must be cut away and the surgery takes longer.

Generally, the cemented joints are recommended for people over 65. One reason is that bones have grown thinner in many older people, and for these people a cemented joint may work better. But this is hardly a fIxed rule. If you’re a healthy, active 70-year-old, for instance, you probably have stronger bones than a sedentary person 20 years younger who already has osteoporosis, or thinning of the bones. (Osteoporosis is linked to a lack of calcium and vitamin D. lt can be hereditary and is most common in postmenopausal women who do not take supplemental estrogen, although some men suffer osteoporosis as well.)

Uncemented. With uncemented joints, your existing bone actually grows right into the bumpy, sandpapery material of your new joint. It produces a tighter bond, but because it isn’t initially fastened as tightly as cemented joints,

it takes longer to heal. You should be prepared to spend more recovery time, perhaps three or more months on crutches, and postpone dancing that jig at your nephew’s wedding.

Full or partial. Knees are complicated apparatuses, so surgeons have developed two options for knee replacements. Your knee has two compartments, inside and outside. A total (bicondylar) knee prosthesis replaces both compartments. It has two parts: the femoral part, a metal unit that fits on top of your femur bone, and a tibial part, a metal “tray” on a stem that’s fastened to your tibia. After this procedure, you’ll walk freely but be able to bend your new knee only 90 to 110 degrees, less than the 140 degrees of a natural knee.

A unicompartmental (unicondylar) knee prosthesis replaces only one compartment of the knee, either the inside or the outside one. An obvious benefit is that it’s less extensive surgery and allows more knee flexibility than a total replacement. Doctors may recommend this for young, active people who will be more likely to wear out their prosthesis, thus minimizing the amount of later surgery they may need.

A Look At Other Procedures

Here’s a rundown of other procedures your doctor may recommend.

Osteotomy. In Greek, this means bone cutting, and that’s exactly what it is. Bone near a damaged joint, often the knee, is cut away and the rest of the bones are realigned, sometimes by removing or adding wedges of bone. Osteotomy particularly helps people with osteoarthritis whose cartilage has eroded unevenly, resulting in joints that don’t line up right. This procedure can straighten out slight abnormalities that may have caused you to be a bit bow-legged or knock-kneed, for example. Good candidates are people with mild arthritis in just one compartment of the knee and those who are too young or otherwise not ready for joint replacement. Some researchers recommend an osteotomy for people who want to continue sports that involve running or jumping or a job that requires bending or lifting. In about six weeks, you’ll be 80 percent recovered, and after six months, fully recovered. Of 34 men aged 60 and under who had osteotomies, 28 of them were happy with the surgery, and most could continue their previous activities, such as skiing and bicycling. After an average of seven years, 8 of the 34 required a second operation, mosdy joint replacement.

Resection. This is a fancy word for removal of all or part of a bone, generally in the hands, wrists, elbows, ankles or toes. It can relieve pain in the feet, for example, when body weight is distributed unevenly and dislocated parts of the bones bear the brunt of the burden with each step. Usually people with rheumatoid arthritis can benefit from resection; recovery can take several weeks.

Arthrodesis. In this procedure, two bones are fused, or fastened together, permanently. This is used for unstable, painful joints that can’t usually be replaced, such as in the wrists, feet, ankles, and thumbs, and occasionally for joints in the back or neck. In the knee, for example, the femur and tibia would be joined so that they basically become one bone. After arthrodesis, the joint cannot be moved, but it’s more stable and you’ll no longer feel pain. For several months after surgery, you’ll have to wear a brace. That can place additional strain on adjoining joints, and once in a while joints become unfused. Arthrodesis is seldom chosen unless a joint replacement is impossible.

The Nitty Gritty Of Surgery

You and your doctor have determined that surgery is the best option for you. Now you need to find answers to some specific questions.

Who does it? The person who operates on you will generally be an orthopedic surgeon. Or sometimes you may need a hand surgeon who has also been trained in either orthopedic or plastic surgery. As with most things in life, practice makes perfect, so feel free to ask how often the doctor has done this operation. Often, a surgeon at a teaching hospital or joint center will have more procedures under his belt. And while your surgeon’s skill is important, it’s also crucial that you feel comfortable asking questions.

Select the hospital. Your options may be limited by where your chosen orthopedic surgeon operates, where you live, or where your health plan will allow you to go. If you have the luxury, however, you’ll want to choose a hospital with a good general reputation that’s also known for orthopedics.

What to expect afterward. Ask your doctor specifically what you’ll be able to do after your successful surgery. It’s crucial to tell the doctor exactly what activities you most enjoy or what your work involves, because the surgeon may use different techniques, depending on your goals. Whether or not you consider your procedure a success will partly depend on the expectations you carry into surgery. So if you want to be able to polevault after surgery, and it leaves you only able to walk and swim free of pain, you may be disappointed. But if you know ahead of time that pole-vaulting isn’t realistic, you’re more likely to be happy with the activities you can do.

Consider a second opinion. Your insurance mayor may not pay for your visit to another doctor, but many people feel that it’s a wise investment before you undertake a costly medical procedure. You need to make sure you’re making the choice that’s right for you.

Get the specifics. Take a notepad with a list of questions for your doctor. You’ll want to know:

Are there any alternatives to this type of surgery?
What’s involved in this operation? How long will it take? . How long will I stay in the hospital?
How much time is required for rehabilitation? Will I need physical therapy? In the hospital or at home?
Will I need crutches or a walker while I recover?
How much time will I have to take off from work?
How many times have you done this procedure?
What is the cost? (You’ll have to ask your health insurance representative how much is covered by your insurance. )
Is a blood transfusion necessary? Can I donate my own blood in advance?
What after-surgery care will I need? Will I need home nursing, a physical therapist, an occupational therapist, or a nutritionist?

Things To Do Before You Leave Home

You’ve weighed your options, discussed the procedure with your doctor, and your surgery date is reserved. Ready to go, right?

A little forethought can make things a whole lot easier during your hospital stay and when you come home. And sometimes it can help prevent some unpleasant surprises. Here’s a checklist.

Catch up on paperwork. This includes arranging for deposits of income and paying bills that will become due during your hospital stay and your first few weeks of recovery. And, not to borrow trouble, but if you’re like most of us, you’ll go into any operation with an easier mind if you’ve asked your lawyer to draw up a power of attorney and update your will if necessary.

Visit your dentist. You should have any necessary dental work done well before the operation. Bacteria from even a minor infection elsewhere in the body, like the mouth, can get into your bloodstream and travel to the joint. One thing you don’t want is to have your new joint get infected, and this can happen if unfriendly bacteria start swimming around in your bloodstream. (If you need dental work after your joint replacement, your doctor may prescribe preventive antibiotics in advance for safety’s sake. Be sure to check with your doctor before any dental work.)

Assess your surroundings. Look around at your home or office as though you’re seeing it during your recovery period. If you’ll be using crutches or a walker, how easy will it be to get around? Tidy up and move obstacles out of the way. If your bedroom is upstairs, consider lining up some helpers to set up a temporary downstairs bedroom and make it cheerful. Your friends will be just as happy to hold your hand in the living room.

Go shopping. Stock up on grocery staples and house-hold items now. Prepare and freeze meals ahead of time. Now’s the time to indulge in that novel you’ve been wanting to read or borrow stacks of videos from your neighbor. Your local library, besides lending books, probably also lends videos; update your library card and check things out ahead of time. If you have a computer and modem, often you can search the library catalogs and request titles you want and even renew items over the modem.

Pack with care. Be choosy about what to take with you to the hospital. Pack comfy pajamas and robe but not your favorites (there’s a chance they’ll get stained), nonslip slippers, an inexpensive watch or clock, magazines, and phone numbers of friends and relatives. Leave your valuables at home, but don’t forget a favorite photo. A small inexpensive tape player with headphones can fill your mind with music.

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Should you be using a nebuliser to treat your respiratory illness? Let’s find out. A nebuliser is equipment that transforms liquid into globules of aerosol that can be inhaled. This device uses oxygen, air that is compressed and even ultrasonic power. This ruptures the solution and discharges droplets of aerosol straight to the lungs. However, the use of this device has seen a decline in recent years. Despite this fact, they are favoured by some patients and can be greatly useful in certain conditions.

You can find a broad variety of this device in the market. Jet nebulisers are managed by compressed air while the ultrasonic ones by vibrating crystals. The first one consumes huge amount of the drug while expiration. The other variety is being widely used.

The rate of flow of gas has to touch a minimum of 6 litres per minute in order to deliver tiny adequate particles in about 5-10 minutes. The ultrasonic variety is relatively smaller and does not produce much noise.

The device is not so efficient with many producing only about 10% of the dosage that is suggested. A huge amount of the drug remains glued to the internal parts of the equipment or is misused while exhalation. The productiveness of the delivery of the medication is based on the kind and quantity of nebuliser chamber and the rate of flow. There are chambers with a container and various systems of valve that enhances the productiveness of the delivery of the drug.

The use of nebulisers for Respiratory illness:

Undoubtedly, nebulisers can help in curing most of your respiratory problems. Those problems can be anything, COPD, cystic fibrosis and many other clinical conditions.

However, the device is no more used for treating serious asthmatic patients as laid down by the British Guideline. Despite this fact, it is increasingly used for treating severe asthma attacks. The Guideline states that there is not enough evidence to recommend the use of the equipment in case of acute asthma. In case the device is used in emergency conditions, there is a risk of desaturation of oxygen. Hence the device should be driven by oxygen with a heavy flow regulator connected to the cylinder. This will ensure the much needed rate of flow which stands at 6L per minute.

Can COPD be cured by a Nebuliser?

Patients suffering from COPD have bronchoconstriction that is not reversible. But most of them show reversibility with increased dosage of bronchodilator.

The emanating liquefied vapour from the device changes the viscosity of the mucus and aids expectoration. Hence nebulisers driven by air are used most of the times while treating serious conditions of exacerbations and COPD.

While using the device in the treatment of COPD the following points should be taken into account:

1. Hand-held nebulisers are superior
2. Treat patients with the device with upsetting breathlessness in spite of treatment with inhalers.
3. Find out if the patient is able to use the device before prescribing one.
4. The patient is to use a mouthpiece or a face mask whenever it’s possible.
5. Individuals having problems with hand-held inhalers may also experience problems using the device.

How to Maintain a Nebuliser?

The device has to be cleaned on a regular basis. The face mask and mouthpiece has to be washed thoroughly in warm water. Leave the different parts to dry overnight. Before you use the device, you should run it for some time and then add the drug.

All in all, this device has generally proven to be useful for most of the patients who are suffering from minor respiratory issues. Consult with your physician and see what he says.

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It can be extremely difficult to have sound sleep when you have a large tummy and you are always conscious of not hurting the baby in your womb. You may order any sleeping pill any time if you are a regular insomniac but that option strikes out if you are pregnant. To top it all, lack of quality sleep makes you more prone to frequent depression, illnesses, and colds, when you are expecting.

With various other guidelines that mom-to-bes’ are inundated with, a thing as simple as sleeping also has its do’s and don’ts for pregnant women. Explained below is how various sleep positions affect you and your baby:

Sleeping on your stomach – During the initial pregnancy stages, breasts are usually tenders. As you reach the third trimester, your belly and breasts are a lot larger than before. Although it isn’t very dangerous to sleep on your stomach, still it is not recommended as it can be very uncomfortable.

Sleeping on your back – The weight of your increasing uterus immediately begins to pure pressure on your back muscles, primary blood vessels, and intestines. This can lead to disrupted blood circulation, blood pressure issues, backache, indigestion, and haemorrhoids.

Sleeping on your side – When you lie on your left side, it enhances the flow of blood and nutrients towards your baby. This also makes it easy for your kidneys to discard any wastes or fruits from your body. Consequently, swelling in your hands, feet, and legs are bound to be minimal. Although there’s no real benefit of sleeping on your right side but it still isn’t harmful. So, you can switch sides in between and be comfortable while drifting off to slumber. Side positions are good for the health of both the mother as well as the baby and also ensure that you sleep tight to wake up all fresh in the morning.

For additional comfort, it is a good idea to use a pillow to support your belly or you may even put one in between your knees. Here are a few special pillows that you can use in pregnancy:

Small Pillows – Using a small pillow in between the bent knees reduces the pressure on lower back and makes it even easier to sleep on your sides. You can even tuck one behind your back, which makes it easy for you to maintain your side positions without any trouble.

Wedge Pillows – These wedge-shaped pillows are placed below your belly as you sleep on your side. This takes the pressure off your neck and back. It also aligns your back and stops any rolling forward. For those who experience shortening of breath or heartburn due to pregnancy, wedge pillows can be a good solution as it elevates their head more than the chest, preventing and relieving these problems.

Body Pillows – These full-length pillows support as well as realign the back, hips, neck, and belly. These pillows are loved by many would-be-mothers as they not only support the back but also structures around the belly.

Finally, don’t stay anxious all night worrying about the comfort of your baby. Your baby floats in a weightless environment without feeling any discomfort even when you are tossing and turning all night. So, just relax and have a good sleep!

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Unlike how many people take it to be an option; stretching should actually be a part of your daily routine. Beginning with warm ups and ending with cool downs have its own set of benefits. Foremost being, it prevents injuries and muscle pulls and prepares the body for the exercise regimen. Stretching also improves flexibility. There are different types of stretches that have been created, keeping different training programs in mind. Some of them have been described below along with the fitness program with which they should be combined:

1. Static Stretching – This stretching is a cool down stretch where you have to stretch your body to its maximum distance and hold it there for half a minute. It is done by staying in one place and does not involve any quick movements. All that you can feel during this stretch is a mild pull throughout the body.

2. Passive Stretching – This is similar to the above stretch with the difference that it requires a partner who provides the stretch. One example is the hamstring stretch where you stand with the wall supporting your back and your partner lifts your leg in a stretch. This stretches the hamstrings and is one that is popularly used by all sports people.

3. Isolated Active Stretch – Trainers and massage therapists use this from of stretch. They hold the position and remain there with the assistance of only the muscles. One example would be the air kick where you kick your leg up in the air and hold it for a count of 30 seconds. It increases elasticity of the muscles and also improves blood circulation.

4. Ballistic Stretching – This encourages a part of the body to be exercised to go ballistic, or in other words, beyond its range. These stretches can cause injury if you are not used to them and should be performed under the supervision of a personal trainer.

5. Dynamic stretching – When your swing your hands and legs in a controlled manner so that they reach their maximum limit of motion, you perform a dynamic stretch. The stretch begins slowly and as your get used to the motion, you increase the speed.

6. Isometric Stretching – This is a kind of stretch where you resist stretching after the muscle has been stretched, creating a pull. So, there are two movements in the opposite directions. You can do this with the help of a partner and ask him to hold your leg high while you oppose it.

All these stretches and a few more increase the flexibility of the body and prepare it for the actual exercise without having to buy any pills, no matter what your age may be. They also increase the flexibility of joints and you will find that the ligaments and tendons are stronger than ever.

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One minute you’re innocently going about doing your routine work, the next minute you know you are relentlessly searching for that mud cake that was kept in the refrigerator. What really happened? You were taken over by the demons of food cravings that make losing weight seem almost like impossibility in your situation.

Like millions of other people, you almost always choose to brush off that faint voice at the back of your head, which is saying “This is loaded with calories. Don’t eat it!” Almost each one of us has these cravings and at that time, the answer to keep a check on them goes a lot beyond willpower.

Scientifically speaking, it is actually the feel-good brain chemicals like dopamine that fuel these cravings. And once you eat what you were pining for, these chemicals are released to create a sense of euphoria that your brain wants, time and again.

Natural as this cycle might be, it is detrimental for weight watchers like you who’re unable to resist and succumb to these urges and add on more unsightly pounds to your waistline. So, if you’re a worried weight watcher who is desperately trying to develop a resistance for these calorie-laden delights, here are a few things you MUST ask yourself when that insatiable urge tries to win you over:

1.Do I Feel Stressed?

Norman Pecoraro, a researcher with University of California, who studies stress physiology, explains that cortisol is a hormone that is released by the body when we’re stressed. This hormone suggests your brain to look for rewards and is usually satisfied (or eases out stress) by comfort foods that are loaded with fat and sugar. When you look for potato chips, french fries or any such food to ease out your negative emotions, like sadness or anger after an argument or fight with someone, you are subconsciously establishing a connection in your brain between comfort foods and stress.

In order to combat these negative emotions, it’s important that you find out ways for yourself that can help you relax instead of just grabbing the next bag of chips:

Listen to Music – Have an upbeat playlist ready with you at all times. Listen to it when the craving strikes. The songs provide an emotional release as well as the much-needed distraction.

Pause for the Cause – Wait it out. The intensity of cravings is known to subside after the initial 10 minutes have passed.

Know What’s the Distraction that Will Work For You – Every time you feel any negative feelings and you want to just gorge on food, ask this “I’m feeling _____ because ____.” This will help you find the distraction that will work best for you in that situation. For example, if you’re feeling lonely, taking a walk alone wouldn’t be of any help. If you’re stressed out because of a fight with your mom, call a close friend and let it all out. In short, look for an outlet that will help you release your nervous energy.

2. Am I Eating Less Than Usual?

You might think that by eliminating carbohydrates or any other food group completely, you’re reducing your calorie intake substantially. But the truth is, by cutting out any particular food group completely or by reducing your calorie intake to less than 1,000 calories daily, you’re only getting your body ready for the main craving mode. “Restrained eaters” thereby end up having 1-2 BMI points (or 10-20 pounds) higher than regular eaters.

Exercise Your Leeway Safely – Even if you do feel like surrendering to your cravings sometimes, don’t forget about portion control. Instead of eating the whole chocolate pie all by yourself, settle for only a bite of it.

Don’t Eat around Other Stuff to Avoid Your Specific Food Craving – If milkshake is what you seek, having yoghurt instead won’t be of any help. Trying to satisfy your specific craving by bingeing on other random food stuff may make you consume more calories than if you’ve just had that food item in a limited portion.

It may seem like a real pain initially to curb your food cravings but as you move along; it will become a habit and wouldn’t seem like too much of an effort anymore. It’s also a good idea to not stack fat-laden stuff, like mayonnaise, ice creams or cheese at home. If you don’t have time to cook, instead of going out to have a subway or any other restaurants that you “think” serve healthy food, try sticking to best home delivery diet food package services that serve fresh food at your doorstep at an affordable price.

Also, instead of fad diets, my personal recommendation would be to try this popular weight loss plan, which also focuses on bringing about behavioral changes in you instead of just guiding you about exercises or diet that’s good for you.
Always know that it’s not just the willpower and knowledge of what to do or eat that’s going to help you in your weight loss endeavors. Behavioral changes play a very subtle and crucial role in helping you stick to that lifestyle and keep off your lost weight for the long haul. Now you know why you always end up gaining weight whenever you get off a regime suggested by fad diets.

Your Turn

What do you crave for the most? How do you fight your cravings? Share it all with us in the comments section.

Rebecca Williams loves writing about meal delivery programs and review popular weight loss programs that are both healthy and easy on the pocket. She’s an avid reader and a nature lover. In her free time, she loves to spend time with her plants or go for a walk in the woods and spend time with children. She’s a contributor to Health Care Information, which is a great website that offers tips and advice for healthy living enthusiasts. She lives in Melbourne, Australia.

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