Derek L. Hill, D.O.

Fellowship-Trained Orthopedic Surgeon and Specialist

Tips For a Successful Hip Replacement Surgery

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375x321_the_hipAccording to the National Hospital Discharge Survey, approximately 332,000 people in America have a total hip replacement each year. If your chronic hip pain has gotten you and your doctor talking about hip replacement surgery, there are a few things to consider before taking this critical step.

Lose Weight (Heavy Patients)

A hip prosthesis can only comfortably support a person of normal weight. If you are heavy, it is advisable to lose weight before your surgery. Most surgeons will not perform hip replacement surgery on any patient whose BMI is in the high 30s.

Research Your Surgeon Carefully

Once you and your doctor have decided the best course of action for you is hip replacement surgery, ask which surgeon he recommends. Then, do some of your own research. If you know someone who has had the surgery, talk with them and get an idea of their experience.

An experienced surgeon will have performed at least 100 hip replacement surgeries and does at least 30 replacements per year. Don’t be too timid to ask the hard questions. After all, this is your body that the surgeon will be working on.

See a Physical Therapist Before Your Surgery

It is a good idea to visit with a physical therapist before your surgery. She will get an idea of your current function so she is better equipped to help you afterward. Also, this “prehab” will help to strengthen the muscles in your hips and legs, which will lessen your recovery time. Furthermore, it will improve your circulation, which may help to prevent potentially-dangerous blood clots.

Stick with Your Physical Therapy

While it may seem like a common sense piece of advice, you would be surprised how many patients skimp on their physical therapy and refuse to do their at-home exercises. You may be worn out and in pain but this is the time to stick with your physical therapy and continue to exercise at home so you will experience your fullest recovery possible.

Avoid Drug Dependency

Some patients have an understandable concern about possible prescription drug dependency and even addiction. To avoid this potential risk, take your medications only as prescribed and pay close attention to how your body feels as you recover. You may not need as much of the medication as you begin to heal. If, at any point, you believe you are developing a habit, discuss this with your doctor immediately.

Hip replacement surgery can be intimidating but if you follow these tips, the process will go more smoothly. Within a few months, you should feel significant pain relief and an increase in mobility as you get back to your regular enjoyed activities.

Written by: Jaime Heidel, Rust Built, Marketing Services

Tips For a Successful Total Knee Replacement

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knee-replacementFor many people, total knee replacement surgery is a welcome alternative to what may have been years of knee pain, limited mobility, and an all-around decrease in quality of life. But knee replacement is a major surgery, only to be used as a remedy after all other non-surgical options have been exhausted, and may involve a good amount of post-surgery rehabilitation. And ultimately, a great deal of the success of the surgery is in our hands.

So what are some things we can do to make sure we do everything we can to support the process? Here are some pre-surgery tips from WebMd:

(for the complete list see the article “Knee and Hip Replacement for OA: The Facts” on www.WebMD.com)

Ask questions

Learn as much about the procedure and rehabilitation as possible. Be specific.

Get in shape

Upper body strength is extremely important if crutches or a walker will be used after the surgery. Allina Health has a list of suggested exercises, complete with diagrams. (http://www.allinahealth.org/ac/patiented.nsf/page/knee_exercises)

Quit smoking

Smoking can slow down wound healing and recovery time.

Rehab exercises

Find out about the rehab exercises, and if possible start doing them before the surgery.

Prepare your home and arrange for post-op help

If your bedroom’s on the second floor, a first floor sleeping arrangement might be a good idea. Make sure all trip hazards such as throw rugs are put away, and hallways are clear and able to accommodate crutches or a walker. Ask a neighbor for help walking the dog, or better yet, find someone who could stay with you for a while after the surgery.

Healthline offers the following post-operative advice for a successful recovery & rehab:

  1. Follow the doctor’s and physical therapist’s orders; take medicine as prescribed, go to all follow-up appointments and physical therapy sessions, do the recommended exercises.
  2. Avoid unnecessary stress on the knee.
  3. If compression stockings are recommended, wear them as directed and for as long as directed. They can help prevent blood clots.
  4. Avoid alcohol and smoking. The alcohol can interact badly with certain medicines, and smoking, as mentioned earlier, can slow down the healing process.
  5. Stay positive. The recovery process may be stressful and even painful at times. According to Healthline, some experts believe that as much as 50% of a successful knee replacement is due to the patient’s attitude and willingness to do what’s required during rehab.

To read the entire Healthline article, go to http://www.healthline.com/health-slideshow/total-knee-replacement-surgery-success#12.

Written by: Tricia Doane, Rust Built, Marketing Services

Hip Fracture Cause & Recovery

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PixmacPreview000087901002A hip fracture, which is often the result of osteoporosis, is a serious femoral fracture that occurs at the proximal end of the femur near the hip. This type of fracture is serious, especially for adults over 65, resulting in life-threatening complications. Your bones tend to weaken (osteoporosis) as you get older, which is why older people are more susceptible to hip fractures. Younger people can also suffer from hip fractures, but the cause is usually the result of car or cycling accidents.

There are signs and symptoms of a hip fracture to look for. These may include the inability to move after a fall, severe hip or groin pain, inability to bear weight on the leg of your injured hip, stiffness/bruising/swelling surrounding your hip area and shortness of the leg of your injured hip.

Not all hip fractures are readily visible on an x-ray, therefore an MRI is the next test option. In cases where the patient cannot afford an MRI or cannot fit in the scanner, a CT may be substituted. MRI sensitivity for fractures usually are greater than a CT. Once a fracture is identified it is determined if the patient will require orthopedic surgery. If an operation is necessary a full pre-operative general investigation including blood labs, ECG and a chest x-ray will be obtained. The surgery is a stress on the patient, especially if elderly due to the prolonged immobilization.

According to Mayo Clinic Staff (2012), “A hip fracture almost always requires surgical repair or replacement, followed by months of physical therapy. Taking steps to maintain bone density and prevent falls can help prevent hip fracture.” Occupational therapy and/or physical therapy is a very important process in rehabilitation, as it has been known to increase daily function for a healthy recovery. About 2% of hip surgery recipients experience a deep or superficial wound infection. If the infection is superficial it could lead to a deep infection including the healing bone. It could also contaminate the implants, which requires implant removal once the infection has been treated and clears up.

Medical Disclaimer: Always talk to a medical consultant before starting a new exercise routine, returning to exercise after injury or surgery, or if you have any health care-related questions.

Written by: Jamacia Taylor, Rust Built, Marketing Services

Treat Your Osteoarthritis Hip & Knee Pain Naturally

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woman walkingAccording to the Journal of Arthritis and Rheumatology, an estimated 27 million adults are living with osteoarthritis. Nearly 50% of seniors aged 65 and older struggle with arthritis. In osteoarthritis, the cartilage that acts as a cushion between your bones wears away, causing them to rub together painfully.

Oftentimes, the symptoms come on over the course of years, beginning as stiffness, limited mobility, and discomfort. Over time, you may lose the ability to rotate, flex or extend your knee or hip.

The most common conventional treatments for osteoarthritis are NSAID pain relievers and surgical knee or hip replacement. Habitual use of NSAID pain relievers can result in the development of stomach ulcers. Knee and hip replacement, while effective, could be risky and entail a long and difficult recovery time.

Treating your osteoarthritis hip and knee pain naturally can help avoid these risks.

Natural Treatments for Osteoarthritis

Physical Therapy

According to a study published in Physical Therapy Magazine, physical therapy has been shown to have a positive impact in reducing the risk of disability associated with osteoarthritis. Clinically-treated osteoarthritis patients achieved nearly twice as much improvement in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores than patients who only exercised at home. Physical therapy helps provide pain relief, increase mobility, and preserve function.

Weight Management

The Journal of the American Academy of Orthopedic Surgeons (JAAOS) conducted a study, which revealed that approximately one half of cases of osteoarthritis of the knee could be eliminated if obesity was no longer a risk factor. Obesity creates a significant increase in adipose tissue, a multifunctional organ that increases inflammatory signals. When you reduce your weight, you reduce your risk for needing knee or hip replacement.

Regular Exercise

Exercise can help reduce inflammation and increase mobility. Gentle stretching, yoga, water exercises, and walking are good low-impact ways to ease your osteoarthritis symptoms without furthering discomfort.

Massage

Regular massage can help reduce the discomfort in your hip and knee. Massage encourages lymphatic drainage, which helps detoxify your body. This helps reduce overall inflammation and improves your circulation. This natural practice also gives you a relaxed feeling of well-being.

Apply Heat/Ice

Heat and ice therapy can help reduce pain and inflammation as well as help improve your circulation. When pain is accompanied by swelling, use ice 20 minutes on and 20 minutes off. Once discomfort decreases, gently exercise the area. Afterward, apply heat; 20 minutes on and 20 minutes off.

Dietary Changes

A junk-food diet increases inflammation and can worsen your symptoms over time. Instead, slowly wean yourself off these foods and increase your intake of anti-inflammatory foods such as organic vegetables, fruit, nuts, seeds, poultry, fish, coconut oil, avocado, and walnut.

Supplements

A study published by The Lancet hailed glucosamine as a “disease-modifying agent” in osteoarthritis. This is because it acts as a building block for mucopolysaccharides (MPSs), which are the major components of cartilage.

The Journal of Orthopedic Research showed that N-acetylcysteine (NAC) can help ease osteoarthritis by preventing cellular death and cartilage degeneration. NAC contains high levels of sulfur, which helps fight free radical damage.

Vitamin C has also been shown to help ease osteoarthritis symptoms naturally because of its strong antioxidant content and its ability to help build collagen.

If you’re struggling with the pain of osteoarthritis, turn to these natural remedies. They may help greatly improve your quality of life.

Resources:
http://www.ncbi.nlm.nih.gov/pubmed/16305269
http://www.ncbi.nlm.nih.gov/pubmed/11214126
http://www.ncbi.nlm.nih.gov/pubmed/19725096

Written by: Jaime Heidel, Rust Built, Marketing Services

The Importance of Physical Therapy Post-Surgery

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physical-therapyIf you’re about to have orthopedic surgery, it’s important to consider the physical therapy you will need afterward. Without it, you may not heal as quickly or as completely as you should. Although you’ll be that much closer to recovery when you finally have the surgery, it is not the last step. Physical therapy helps you regain your mobility, activity, and strength while reducing your pain. It also helps to prevent potentially-dangerous bed sores and blood clots.

Do Some Preparation Before Your Surgery

Talk with Your Surgeon

A few weeks before your surgery, talk with your surgeon. Find out what you can expect from the procedure and what type of temporary pain and loss of mobility you will endure. Ask your surgeon if he can recommend a physical therapist for you. This way, you can meet with him or her to measure your current level of strength and range of motion as a baseline. Establishing a rapport with a physical therapist ahead of time can help you learn more about the process and how he or she can help you reach your post-surgery goals.

Call Your Insurance Company

Call your insurance company before your surgery. This way, you can find out how many sessions of physical therapy they will cover. (After all, you don’t want to find out mid-way through your 10th session that your plan only pays for 5.)

How Physical Therapy Helps Your Recovery after Surgery

  • Relieves pain without medication
  • Improves your strength, flexibility, and range of motion
  • Boosts your endurance and stamina
  • Breaks up scar tissue
  • Prevents stroke*

* According to studies, patients who have had kidney or blood pressure problems may be at increased risk for a stroke due to the formation of blood clots. Gentle manipulation exercises help improve your circulation and reduce this risk.

What You Can Expect During a Physical Therapy Session

Limb manipulation

Your physical therapist will gently manipulate the limb near the site of the surgery to improve range of motion and encourage strength and flexibility.

Strengthening and flexibility exercises

Where applicable, your physical therapist may have you use exercise equipment or a pool to further your rehabilitation.

Balance and coordination training

Depending on the type of surgery you have, you may also benefit from balance and coordination training to retrain your senses and regain your independence.

Massage

Massage helps reduce inflammation, relieve pain, improve circulation, and speed your total recovery.

Alternating hot and cold therapy

Hot and cold therapy helps reduce inflammation and swelling, while improving circulation so your body can better heal itself.

Electrotherapy

Electrotherapy with a TENS unit can help override the pain signals sent to your brain during the course of your rehabilitation.

Exercise instruction to be used at home

When you work with a physical therapist, he or she will give you a feeling of empowerment by giving you safe exercises to continue your therapy at home.

If You’re Tempted to Skip Physical Therapy

When you’re tired and recovering from surgery, it can sometimes be tempting to skip physical therapy but that’s highly inadvisable. Without this added step, scar tissue will form along the injury site and could cause permanent loss of range of motion.

A physical therapist won’t just help you exercise, he or she give you a thorough and supported education about which exercises will work best for your individual needs and why.

Don’t risk another injury by skipping physical therapy. Start your physical therapy as soon as possible after the surgery and stick with it. The work will be well worth it in the end.

Written by: Jaime Heidel, Rust Built, Marketing Services

Home Health Recovery After Total Hip Replacement Surgery

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375x321_the_hipAccording to WebMD, “Total Hip replacement surgery is a procedure in which a doctor surgically removes a painful hip joint with arthritis and replaces it with an artificial joint, often made from metal and plastic components. It is usually done when all other treatment options have failed to provide adequate pain relief. The procedure should relieve a painful hip joint, making walking easier.”

Recovery after total hip replacement surgery requires strict adherence to your doctor and physical therapist to avoid a setback. Within 24 hours following hip replacement surgery, as long as there are no complications, you will begin physical therapy to help you start walking again with the use of a walker, crutches, or a cane. Physical therapy will last anywhere from weeks to months after surgery depending on age, pain perception, motivation, and the healing rate we each have.

Much of your healing will take place at home, in conjunction with regular doctor visits and rehab appointments. Have your caregiver set up your home before you return home from surgery to aid you in a successful recovery.

Listed below are a few common things to do in preparation to help make life easier at home after total hip replacement surgery:

• Limit your use of stair climbing to a minimum. If you must use the stairs, plan in advance so that you only go up and down once or twice a day.
• Sit in a firm, straight-back chair. Avoid using a recliner.
• To help prevent falls, remove all throw rugs, keep floors clean and rooms clutter free.
• Use an elevated toilet seat. This will help keep you from bending too far at the hips.
• Keep all enthusiastic pets away until you have healed completely.
• Use walking aids (i.e. a walker, crutches, or cane). Discuss in advance with the doctor to see what he or she recommends.
• Purchase a bench to put in the shower or have one installed.
• Attend regular physical therapy sessions to aid your recovery.
Consult with your doctor before returning to such activities such as driving, sexual activity, and exercise.

Reference: http://www.webmd.com/osteoarthritis/guide/hip-replacement-surgery

Written by: Jamacia Taylor,Rust Built, Marketing Services

Rotator Cuff Repair: 7 Insider Secrets For The Fastest Recovery

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physical-therapyFollow these tips to ensure a speedy recovery from your rotator cuff repair surgery.

Work With Specialists – Who you work with matters. Choose the best professionals you can (based on your insurance coverage and geographic access). And by best I mean those professionals that are:

  • Experts in rotator cuff repair surgery
  • Experts in rotator cuff repair rehabilitation

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How to Feel Good About Your Recovery

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recovery from surgeryIsn’t it a common practice to let our thoughts run away with us? So how does one feel good about their recovery from surgery? For example, when we are at work we fantasize about being on vacation.  But, when we are on vacation we worry about all the work piling up in our office.  Our minds can get the best of us in just about any situation.  I’m willing to bet that these nagging thoughts are working over time throughout our recovery when we have plenty of time to think.

Feel good about your recovery by implementing a few practices that will help you stay in the moment.  Learn to stay positive and enjoy even the most challenging times in your life.

Here are 5 steps to help you feel good about your recovery from surgery:

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