FAQ Category: General

Some people do have problems healing after surgery, patients with psychiatric illnesses included. What may happen in the case of patients with illnesses like schizophrenia, is that they are unable to care for themselves or they may not understand the importance of follow-up care, dressing changes, or taking medications properly.

Often, people with psychiatric illnesses do not have the family or community support that they need, so they can’t access the service they require.

Someone who has a mental illness can heal following surgery just as well as someone without, but they may need extra help and consideration from the healthcare professionals and the health services available.

An arthroscopy is a procedure that allows a surgeon to see inside certain parts of the body without making big incisions or performing general surgery.

To do an arthroscopy, the surgeon makes a very small incision, less than half an inch long. Through the incision, the surgeon inserts a tool that has a camera on the other end, which will send back images from inside the joint.

Certain procedures, like repairs, can also be done. Other tiny incisions would be made for the surgeon to insert the instruments and, by watching through the camera, the repairs can be done.

The concept of functional fitness (FF) could apply to any age but especially to older adults. By virtue of the aging process, muscle strength declines as does cardiopulmonary endurance and flexibility.

FF refers to the ability to perform activities of daily living (ADLs). This could be walking, climbing stairs, or getting up and down from a toilet or chair. Reaching for objects, performing house or yard work, and carrying groceries or other heavy objects are other examples of ADLs.

Balance, flexibility, and agility are needed for FF. Strength in both the upper and lower body are also important. All of these things combined together help prevent falls that can be deadly for an older adult.

Experts are studying ways older adults can maintain and/or improve FF. Various types of exercise have been compared. For example, one study of 113 adults ages 67 to 79 included aerobic, resistance, balance, flexibility, and Tai Chi exercises.

They found that only specific aerobic exercise improved cardiorespiratory function. But all the other types of exercise actually provided cross-training. Adults who include aerobic exercise plus one other type (resistance, balance, Tai Chi) should do well in getting the components needed for FF.

You aren’t alone in recognizing the challenge of maintaining fitness throughout the aging process. Many seniors notice decreases in balance, strength, flexibility, and endurance. Many times, their daily physical activities are limited by deficiencies in one or more of these areas.

Exercise does seem to be the key in preventing declines in physical fitness. Quality of life is directly linked to health. Any problems with muscular strength, coordination, or balance can result in falls, fractures, and/or disability.

But finding one exercise to fit everyone and accomplish all these goals isn’t realistic. However, it does appear that choosing one form of aerobic exercise combined with a second type of activity may be all that’s required.

A recent study comparing five types of exercise showed that resistance training, balance training, and Tai Chi all had crossover effects. This means improvements were measured in muscle strength, balance, and agility when doing any one of the exercise types.

It seems a well-rounded exercise program really only requires two types of exercise for overall fitness. Seniors can choose from several forms of exercise that challenge the heart such as brisk walking, swimming, or riding a stationary bike. Adding yoga, Tai Chi, or strength training on alternate days will enhance upper and lower body fitness as well as balance and agility.

Marfan syndrome is a genetic disorder of connective tissue. It was named after Dr. Antoine Marfan a French pediatrician who first described it in 1899.

The elastic fibers that make up the aorta in the heart, ligaments in the joints, and other supportive structures are affected most often. Without a strong network of connective tissue, support and stability of joints and tissues are compromised.

People with Marfan syndrome often have long limbs, long thin fingers, and are very tall.They are prone to abnormalities of the cardiovascular system. The heart valves and aorta are affected most often. The disorder may also affect many other structures and organs. This includes the lungs, eyes, sac around the spinal cord, and hard palate.

It was once thought that President Lincoln had Marfan Sydrome. More recent studies show this probably wasn’t so.

Insomnia, while not a danger itself, can cause certain situations to be dangerous. For example, if someone is not sleeping well has a job where he or she must be driving for long periods of time, sleepiness due to insomnia could cause them to fall asleep at the wheel. This danger crosses over to working with dangerous machinery, or caring for other people, for example.

Insomnia can cause depression or anxiety, and other health issues. Lack of sleep can cause some disorders or diseases to get worse.

Many times, medical specialties overlap with each other and much of medicine is team work. For example, if a patient with diabetes has to have surgery, the medical care of diabetes is just as important as the surgery itself. The same thing happens with psychiatric illnesses.

If your brother will allow you or your parents, it may be a good idea to go to his surgeon’s appointments with him in order that you can help explain the situation and your concerns to the doctor. You can also help by enlisting the help of community services, for example. With that sort of help, your brother’s chances at a successful recovery may be better than if he is left on his own.

As well, your brother’s psychiatrist should know about the upcoming surgery so preparations can be made and contact be made between the surgeon and the psychiatrist.

When someone is having a plaster cast applied, it is done in stages. The limb is first covered with a type of “sock” and then wrapped with cotton. A splint is usually put next to the limb to keep the limb straight and the plaster product is dipped in water and then the wet plaster is wrapped around the limb and splint.

When the plaster comes in contact with the water, a chemical reaction occurs and heat is generated. As the plaster is wrapped around the limb, this heat is retained between the layers as the plaster remains wet. Once the plaster dries, the temperature drops and the plaster feels cold to touch.

Both types of casting agents have their pros and cons – which one is chosen depends on the injury, the doctor, the patient, and cost. Generally, a plaster cast is less expensive than a fiberglass cast, for example.

The advantage of plaster is that it can be molded to the limb’s shape and any splint that is used to support it. Fiberglass must be fit after the swelling of the limb has gone down. Both should not get wet – the plaster because it will cause the cast to become misshapen and the fiberglass because there is cotton between the cast and the skin.

Anyone can be considered as a tissue donor. After your death, there is a careful process by which the tissues are examined and determined useful for transplantation.

A licensed physician makes the first decision. A lengthy questionnaire is answered by the family. The donor is examined and/or the autopsy report is reviewed.

Certain diseases, illnesses, and conditions may keep some donor tissue from being used. For example, musculoskeletal tissue won’t be used from anyone with a connective tissue disease or auto-immune system dysfunction.

Likewise, exposure to toxic substances, the presence of rheumatoid arthritis, or bone disease makes the tissue ineligible for use. The donor’s blood is screened for any infectious diseases. There can’t be any antibodies for hepatitis or HIV.

From there the collection and storage process for the donor’s tissue is reviewed carefully. Proper temperature control and sterilization techniques must be used. Many advances and improvements have been made in these procedures making it possible to store some tissue for up to 10 years.

There are several organizations willing to help individuals make this decision and complete the necessary paperwork ahead of time. For more information, you can contact The Living Bank. This organization is an independent non-profit public interest foundation. They can help you become an organ or tissue donor.

Diabetic neuropathy can affect both the sensory and motor control of the foot. Without the ability to sense pain and/or increased pressure, you are at increased risk for foot ulcers. Protection of the feet at all times is of utmost importance.

Exercise is a key factor in controlling diabetes. Any type of exercise is helpful. But when orthopedic or neurologic problems occur, certain types of exercise may be better than others.

For example, biking and stair climbing put less pressure on the feet compared with walking. Always hold on to a railing when walking up and down stairs. Studies show that a recumbent bike may be the best choice when limiting forces on the foot.

With a few modifications, walking may still be an option. Good shoes can make a difference. You’ll want footwear that provides good arch support. Newer shoes reduce the amount of pressure placed on the forefoot, arch, and heel. The more worn the shoe is, the more pressure is placed on the foot.

Using a cane or walking stick may help if you should trip, stumble, or lose your balance for any reason. Stay alert to any uneven areas, cracks in the sidewalk, tree roots, or other things that can trip you up. If walking seems out of the question, consider swimming or other exercises in the pool as alternative but still excellent choices.

Osteopetrosis is a hardening of the bones that occurs at various ages depending on the type of osteopetrosis present. The benign form is the most common type and causes frequent, repeated fractures that don’t heal well. Anyone with genetic mutations causing this condition can develop these symptoms.

As you’ve mentioned, degenerative arthritis can occur. Fractures leading to deformities cause imbalances and problems with joint alignment. Uneven load bearing and weight distribution can lead to wear and tear on the joint. Joint replacements can be done but there are special steps the surgeon must take to prevent fractures and other complications.

For example, pin and screw holes can be predrilled. Special locking plates and special nails (pins) can be used to improve fixation and load bearing. Joint implants with a shorter femoral stem may be used.

Computer-assisted fluoroscopy is advised to guide the surgeon. Fluoroscopy is a special X-ray imaging that allows the surgeon to see the bones and joints during the operation.

You should expect a longer surgical time than the patient without osteopetrosis. Extra time may also be needed for healing and rehab. Patients must be followed closely by the therapist and the surgeon. Careful planning before surgery by the health care team can help prevent problems and complications during and after the procedure.

Marble bone disease is also known by its medical name: osteopetrosis. It was first described and named by a German radiologist in 1904. Sometimes it is referred to by the radiologist’s name: Albers-Schönberg disease.

Osteopetrosis is a hardening and overgrowth of bone. It can affect any bone but seems to especially target the bones of the skull and extremities (arms and legs).

A lack of hydrochloric acid needed by bone cells to break down and dissolve old bone cells is the underlying pathology. An inherited genetic mutation results in one of three forms of osteopetrosis. The most common type is called benign osteopetrosis.

Many people with benign osteopetrosis do not have any symptoms. Those who do are usually diagnosed after a series of bone fractures that don’t heal well. In some cases, overgrowth of the cranial (skull) bones puts pressure on the nerves to the face, eyes, and ears. Pain and loss of hearing or vision can occur.

It is not clear which CAMS affect bone healing and just how much. Most studies have been done in the laboratory, not in humans. Laboratory studies suggest that Omega-3 fatty acids may help heal cartilage and bone. Black cohosh may stimulate cells that make new bone. Aloe vera may prevent arthritis and help bone growth. In animals, chrondroitin may help healing of bone. Boron may also help with bone healing.

It is recommended that you discuss options with your orthopedist.

Traditionally, studies – particularly for medications – have been done in men. This is due to a few factors, the most important being that of safety. Women who are not yet menopausal may become pregnant and any medication tests may prove to be harmful to the baby.

Another issue was that, until not too long ago, scientists believed that if a treatment worked in a man, it should work in a woman. Through the years, we have learned that this isn’t true. For this reason, researchers are now making an effort to study for various treatments and therapies. For example, a recent study looked at women and neck strength. The researchers in that particular study wanted to see how strong a woman’s neck is and how this can affect the development of neck problems, such as pain and weakness.

A schwannoma is a benign, or non-cancerous, tumor that affects the peripheral nerves, or the nerves towards the outside of the body, like in the arms, legs, and so on.

Because the tumor is benign and usually very slow growing, your sister’s doctor may have good reasons for wanting to wait; they could range from availability to perform the surgery to your sister’s health and whether she can have surgery. Only her doctor can explain his approach to her treatment.

If your sister isn’t satisfied, or would like to see if someone may operate sooner, she would be advised to get a second opinion.

A schwannoma is a tumor that stays on the outside of the nerve and doesn’t invade. However, as the tumor grows, it can push on to the nerve, either pushing it to the side, or crowding it against a body part, like a bone. When this happens, this can cause damage and pain.

The use of non-traditional healing practices for conditions such as arthritis is called complementary and alternative medicine (CAM). In some circles, this has become complementary and integrative medicine (CIM).

CAM is more likely to divide treatment into two different camps: traditional and non-traditional. CIM is a blend of both together. With CIM, medical doctors are part of a team of specialists that can also include practitioners of a variety of CAM techniques.

Studies of CAM methods are in their infancy stages. Not much is known about the use of CAM for individual conditions such as arthritis. There is some evidence that acupuncture, relaxation, and biofeedback may be helpful when used along with medical care for arthritis.

Cognitive-behavioral therapy and stress management are also effective when used together with presription drugs and other traditional treatment. Other types of CAM may not help but they won’t hurt. The real concern is for possible drug interactions between some herbal remedies and conventional arthritis treatments.

It might be best if you could convince your mother to use both allopathic (traditional) medical care along with CAM. Perhaps explain the idea of integrating the two together for the best results. Finding a doctor who is comfortable supervising both types of treatment might help.

Nearly half of people in the United States are using Complementary Alternative Medicine (CAM) of one sort or another. Over half of those using complementary therapies or medications did not tell their doctor. While many CAM treatments are beneficial,
not all of them are safe, particularly when surgery is needed.

For example, chondroitin, gingko biloba, ginseng, and garlic supplements may lead to an increase in bleeding so should be stopped before surgery.

Echinacea should be stopped 2-3 weeks before surgery. It can slow the clearance from your body of certain medications. It may also affect allergic reactions, and cause suppression of the immune system. This could affect healing and fighting infection.

Glucosamine should also be stopped 2-3 weeks prior to surgery as it may cause low blood sugar, fainting, and delayed recovery after anesthesia.

Especially in the case of surgery, your surgeon should know about everything you are taking so that your care can be managed safely and appropriately.

In June of 2007, the Food and Drug Administration (FDA) approved the first drug for the treatment of fibromyalgia syndrome (FMS). Pregabalin (Lyrica) is an anti-seizure medication that has been shown to reduce the painful symptoms of FMS by as much as 50 per cent.

Off-label use of pregabalin was first approved for the management of diabetic neuropathy and neuralgia (nerve pain) from shingles. It appears to work by reducing the release of substance P and glutamate. These are neurotransmitters or nerve messengers that play an important role in signaling pain to the brain.

Amitriptyline is a tricyclic antidepressant (TCA). It provides pain relief, sleep, and an overall sense of well-being in patients with FMS. Amitriptyline and other TCAs seem to work well for many people with FMS. But studies have shown that over time, their effectiveness may decrease.

If your symptoms are under control with amitriptyline, there may be no need to switch medications. But if you find that your symptoms are less well-managed over time, then it may be a good idea to consider something else.

Discuss this and all other options with your primary care physician or specialist who is helping you manage your FMS. Drug therapy should always be combined with a wide range of other nondrug treatment.

Yoga, meditation, and other forms of relaxation have been shown to help. Exercise has some of the same benefits of the anti-depressants used to treat FMS. Proper nutrition and stress management are key elements in the management of FMS.