Arthroscopic Knee Surgery

A couple of weeks ago, I had arthroscopic knee surgery because of a fall more than a dozen years ago. It was partially exploratory to determine the next step as well as to “clean it up.” The next two weeks will determine my options, but total knee replacement is not necessary.

In order to go through this surgery, I had to get a second opinion and while the second doctor determined that surgery is necessary, it was his opinion that a total knee replacement should be considered “just in case” I might need one down the road. On the other hand, my world-renowned knee specialist said you never replace anything that’s in good condition and basically, other than my knee cap, my knee is in very good condition. But the most important lesson in this is to prevent falls in the first place and to prevent arthritis from creeping in.

Fitness expert Sonia Gow, in a previous post, shared her expertise about why people fall. She mentioned that falls are not a normal part of aging.

Did you know that falls are a leading cause of hospital admissions for people over 65? For those over 65, one in three will experience a fall each year. According to the Centers for Disease Control and Prevention, 20 to 30 percent of the falls result in injuries such as lacerations, hip fractures, and head traumas with hospital bills averaging nearly $18,000 per patient.

According to Mary Tinetti, M.D., professor of internal medicine at the Yale School of Medicine, the more chronic health conditions you have, the more likely you are to suffer a fall.

  • Diabetes can worsen vision and desensitize nerves in the feet.
  • Depression can increase risk of falling.
  • Many medications cause dizziness and affect balance, especially sleep aids.

Other diseases causing a higher rate of falls include:

  • Circulatory disease
  • Chronic obstructive pulmonary disease
  • Arthritis

Yoga and tai chi which has slow, rhythmic movements can help you with your balance. Don’t forget to strengthen your arms too since you can use them to steady yourself. Find a personal trainer or borrow/buy a DVD to help you.

Spinal Research Foundation

Spinal Research Foundation

This is a continuation of information from a seminar I attended called, “Osteoporosis: Taking Steps Towards Bone Health” sponsored by the Virginia Spine Institute and the Spinal Research Foundation. The presenter was Christopher R. Good, MD. Osteoporosis is a serious disease where bone mineral density is reduced. It is a myth that bone loss is not serious. It is a progressive disease and irreversible. Even a minor trauma can cause a debilitating fracture.

What action can you take if you are at risk for osteoporosis? Sure, you can take medication, but there are side effects to prescription medication. Calcium is a must and is best accomplished through fresh fruits and vegetables as well as dairy products. In addition, you can protect yourself by the following:

  • Calcium and Vitamin D supplementation
  • Fall prevention
  • Hip protectors
  • Balance and exercise programs

There are so many choices for calcium. Check to see that your calcium has Vitamin D added. You can check the absorption rate of your calcium with the vinegar test. Personally, I take coral calcium and if you do the vinegar test, this particular one does not fizz and dissolve immediately. It takes awhile, but it also contains enzymes which help with absorption and digestion. This is particularly important for those with digestive problems.

How much calcium do you need? Here is a guide.

  • Under 50 years of age: Calcium 1000 mg/day, Vitamin D 200 IU/day
  • 50 and older: Calcium 1200 mg/day, Vitamin D 400 IU/day
  • 70 and older: Calcium 1200 mg/day, Vitamin D 600 IU/day

There are so many more areas of discussion, but if you have the following warning signs, see  your medical practitioner right away.

  • Persistent, unexplained back pain
  • Loss of height
  • Can no longer stand upright
  • Spinal deformities

One of the tests that might be recommended is the bone density test or DEXA scan. According to the spring 2009 issue of the Journal of the Spinal Research Foundation, osteoporosis is classified by a t-score value of greater than -2.5 and osteopenia is classified by scores in the range of -1 to -2.5. The journal states:

Physical activity has been found to have a significant influence on reducing the effects of osteoporosis. As stress of force is placed on the bone (possibly through exercise), osteocytes are activated which will increase bone mass over time. Conversely, decreased load will result in decreased bone mass over time. Research has shown that greater loads and lower repetitions result in greater gains in bone mass, however, any type and amount of loading and resistance has been found to be effective. Physical activity, especially an exercise program involving weight bearing and resisted exercise, has been shown to be effective in preventing the onset of osteoporosis, as well as reversing the effects, if present. Individuals diagnosed with osteoporosis must be cautious when beginning an exercise program. As the disease progresses, certain exercises and positions are contraindicated due to the risk of injury, or more specifically, fracture. Physical therapists are specially trained in exercise prescription and will be able to develop an exercise program that is safe and effective in preventing or treating the effects of osteoporosis. In addition to strengthening, a physical therapist will also address other key topics   associated with osteoporosis. These will most likely include posture, balance, strength, flexibility and nutrition.

If you have the symptoms as discussed in Part 1 of this two-part series, be sure see your medical practitioner as soon as possible. Osteoporosis is a progressive and irreversible disease.

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Spinal Research Foundation

Spinal Research Foundation

Last week I attended a seminar called “Osteoporosis: Taking Steps Towards Bone Health” sponsored by the Virginia Spine Institute and the Spinal Research Foundation. The presenter was Christopher R. Good, MD. Osteoporosis is a serious disease where bone mineral density is reduced. It is a myth that bone loss is not serious. It is a progressive disease and irreversible. Even a minor trauma can cause a debilitating fracture. As a person with osteopenia (pre-osteoporosis), “irreversible” scared me.  Currently there is medication being developed to grow bone, but Dr. Good was not aware of when that might become available.

The number of people affected is staggering: 1 in 2 women and 1 in 4 men over age 50 will have an osteoporosis related fracture in their lifetime. There are 1.5 million fractures annually in the following categories:

  • Vertebral fractures: 700,000+
  • Hip fractures: 300,000+
  • Wrist fractures: 200,000+
  • Other fractures: 300,000+

Not only is the disease itself a problem, the costs associated with the disease are very high. Most patients with hip fractures are hospitalized for a week. One in four adults who lived independently before the hip fracture has to stay in a nursing home for at least a year after their injury. One in five hip fracture patients dies within a year of injury. I recall my father passing away within a few days of his hip fracture surgery, although he was never tested for bone density so it remains unknown as to whether or not he had osteoporosis. But mother’s osteoporosis showed prominently with the dowager’s hump.

If you fall in any of the following categories, it behooves you to take note. The risk factors are:

  • Female
  • Thin or small frame
  • Low body weight
  • Smoking
  • Advanced age
  • History of fragility fracture
  • Family history — primary relative with osteoporosis or fragility fracture
  • Post menopausal — women can lose up to 20% of their bone mass in 5 to 7 years
  • Amenorrhea
  • Eating disorders
  • Diet low in calcium
  • Certain medications
  • Low testosterone in men
  • Inactive lifestyle
  • Excessive alcohol consumption
  • Ethnicity — Hispanic, Caucasian, Asian-American women

What action can you take if you are at risk for osteoporosis? Sure, you can take medication, but there are side effects to prescription medication. Part 2 will discuss your options.

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Fitness: Strong Quadriceps

Clip Art Graphic of a Red Guy CharacterOne of the exercises I was taught by my physical therapist was a quadriceps (quads) muscle strengthener. With my feet about 1.5 feet from the wall, I put a small ball (16″) between my knees and I slide down the wall until I am almost in a seated position, making sure that my knees do not go over my toes. I then hold for a few seconds while squeezing the ball between my knees, then slowly slide back up. You don’t necessarily need a ball for this exercise, but it gives my knees greater support.

According to Prevention (11/2008), lower body strength translates into good balance, flexibility, and endurance. As you get older, those are the key attributes to reducing your risk of falls and injuries, particularly hip fractures, which often quickly lead to declining health. They state that up to 20% of hip fracture patients die within one year because of complications from the trauma. I know I would not want to be part of that statistic.

According to Robert N. Butler, MD, president of the International Longevity Center-USA, “Having weak thigh muscles is the number one predictor of frailty in old age.” What a great piece of information to know. I believe most of us want to remain independent until we depart this life.

For quicker recovery from sore muscles and joint support, consider a regimen of glucosamine/chondroitan. There are many over-the-counter brands, some with an additional ingredient, MSM, which some believe helps pain and inflammation. As in all dietary supplements, know your source and remember, this is not medication. Do not expect instant results. Your body needs time to absorb over a period ot time. Here is one to check out which I take called Naturflex. Here’s to strong quads!

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