(I) Case
Jack, now 82 years old, had always led a very active and optimistic life. In his seventies, the family legacy of bad hips, and a history of pole-vaulting into a sawdust heap in college, finally caught up with him. Like his father before him, he struggled along with canes, but finally the constant discomfort became so intense, he decided to choose hip replacement. The first hospitalization was a totally new experience, and at times the pain and adversity were discouraging. After a few weeks of rehab, all was well, and eight months later, he decided to have the second hip also replaced.
(II) Q & A
Q: What seems to be the problem?
A: 1. I suffered severe low back pain when I tried to lift a box this morning.
2. I fell down this morning and bumped my head. I have a splitting headache right now.
3. I twisted my right ankle yesterday when I was playing basketball.
4. I have a tiff neck and constantly feel pain.
5. I sprained my ankle. My joint is red, swollen and painful.
6. I have numbness and tingling in my hands and fingers.
7. I have cramps in my legs.
Q: Is the pain slight, moderate, or strong?
A: 1. That is very painful.
2. The pain is very bad when you press here.
3. I have sudden and severe pain in one joint at a time.
4. The pain is slight, but won’t go away.
When severe arthritis pain and loss of function interfere with your quality of life and do not respond to medications, physical therapy, and other treatments, you may want to think about joint replacement surgery. Hip and knee joints are the most commonly replaced joints.
Here are a few points to keep in mind as you think about surgery:
l Surgery helps most when a single joint is causing most of your problem.
l To make the most of a new joint after surgery, you will need to do regular exercises and work with a physical therapist for several weeks or months.
l The chance of success is better if you are in good shape. Regular exercise and weight control are important both before and after the surgery.
l Artificial joints do not last forever. You may need to replace the joint again in 10 to 20 years.
(IV) What does the nurse say?
You generally stay in the hospital for four or five days. This is a time of closely supervised physical therapy and learning how to live with and protect your new hip.
You can be out of bed the next day and begin progressive weight bearing using a walker, crutches, and finally, a cane. Strengthening exercises concentrate on the muscles of your leg and hip.
To avoid dislocating the new joint, you should not bend forward beyond 90 degrees, internally rotate your leg, or cross your legs.
You will be shown safe way to sit, get out of a chair, bend over, climb stairs, and so forth.
(V) Lifestyle Changes
Unfortunately, some restrictions on your lifestyle are the price you pay for now having pain free activities of daily living. Your new hip will have a satisfactory range of motion for normal activities, but not the extended range of motion of a normal hip. It is subject to wear and tear, which can be accelerated by vigorous work or recreation
Nonstressful recreation – golf, swimming, bowling, even bicycle riding (don’t fall off) – is okay, but tennis, skiing, horseback riding, and demanding physical work can increase the risk of displacement, component loosening, and premature joint wear.
Fractured neck of femur
Herniated disc
Sciatica
Low back ain
Ligament injury
Arthritis
Backache
Numbness
Swollen joint
Rehabilitation
Chiropractic treatment
Hip joint replacement
Muscle strain
Tendonitis
Frozen shoulder / Adhesive capsulitis
l A strain is different from a sprain.
A strain can occur when you overwork or overstretch a muscle. The pain and tenderness that results is a sign that muscle fibers have been torn.
If you tear or overstretch a ligament (the tough, fibrous band that connects bones at a joint), the injury is called a sprain.
(VII) Dialogues
P: The patient fell down from a tree. He complains about a stabbing pain in the right lower arm, shin bone and the front of his foot and toes.
N: X-rays show that his calf bone and thigh bone have been dislocated. Besides, his metatarsus is fractured, and his shin bone has been broken into two fragments.
P: Is Surgery necessary right now to correct his dislocation and set his broken bones?
N: Certainly. We’ll perform the surgery immediately after a short meeting with the orthopedists.
P: When will he be able to walk after the surgery?
N: What’s wrong with him?
P: Fractures and dislocations. They resulted from a sport accident. Swelling around the injury is the main sign.
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