https://www.sandiegohealthdirectory.com/kb en-us Varicose veins are enlarged veins that can be flesh colored, dark purple or blue. They often look like cords and appear twisted and bulging. They are swollen and raised above the surface of the skin. https://www.sandiegohealthdirectory.com/kb/link.php?action=detail&id=128 Wed, 28 Jun 2006 08:11:36 GMT https://www.sandiegohealthdirectory.com/kb/link.php?action=detail&id=128
They are swollen and raised above the surface of the skin. Varicose veins are commonly found on the backs of the calves or on the inside of the leg. During pregnancy, varicose veins called hemorrhoids can form in the vagina or around the anus.

Spider veins are similar to varicose veins, but they are smaller. They are often red or blue and are closer to the surface of the skin than varicose veins. They can look like tree branches or spider webs with their short jagged lines. Spider veins can be found on the legs and face. They can cover either a very small or very large area of skin.

The heart pumps blood filled with oxygen and nutrients to the whole body. Arteries carry blood from the heart towards the body parts. Veins carry oxygen-poor blood from the body back to the heart.

The squeezing of leg muscles pumps blood back to the heart from the lower body. Veins have valves that act as one-way flaps. These valves prevent the blood from flowing backwards as it moves up the legs. If the one-way valves become weak, blood can leak back into the vein and collect there. This problem is called venous insufficiency. Pooled blood enlarges the vein and it becomes varicose. The backup of blood can also cause spider veins. Hormone changes, inherited factors, and exposure to the sun can also cause spider veins.

About 50 to 55% of American women and 40 to 45% of American men suffer from some form of vein problem. Varicose veins affect 1 out of 2 people age 50 and older.

Many factors increase a person's chances of developing varicose or spider veins. These include:
1. Increasing Age.
2. Having family members with vein problems or being born with weak vein valves.
3. Hormonal changes. These occur during puberty, pregnancy, and menopause.
4. Taking birth control pills and other medicines containing estrogen and progesterone also increase the risk of varicose or spider veins.
5. Pregnancy.
a. During pregnancy there is a huge increase in the amount of blood in the body. This can cause veins to enlarge. The expanding uterus also puts pressure on the veins. Varicose veins usually improve within 3 months after delivery. A growing number of abnormal veins usually appear with each additional pregnancy.
6. Obesity, leg injury, prolonged standing and other things that weaken vein valves.
7. Sun exposure, which can cause spider veins on the cheeks or nose of a fair-skinned person.

The force of gravity, the pressure of body weight, and the task of carrying blood from the bottom of the body up to the heart make legs the primary location for varicose and spider veins. Compared with other veins in the body, leg veins have the toughest job of carrying blood back to the heart. They endure the most pressure. This pressure can be stronger than the veins' one-way valves.

Spider veins usually do not need medical treatment. But varicose veins usually enlarge and worsen over time. Severe varicose veins can cause health problems. These include:
1. Severe venous insufficiency. This severe pooling of blood in the veins slows the return of blood to the heart. This condition can cause blood clots and severe infections. Blood clots can be very dangerous because they can move from leg veins and travel to the lungs.
2. Blood clots in the lungs are life-threatening because they can block the heart and lungs from functioning.
3. Sores or skin ulcers can occur on skin tissue around varicose veins.
4. Ongoing irritation, swelling and painful rashes of the legs.

Some common symptoms of varicose veins include:
1. Aching pain.
2. Easily tired legs
3. Leg heaviness.
4. Swelling in the legs.
5. Darkening of the skin - in severe cases.
6. Numbness in the legs.
7. Itching or irritated rash in the legs.

Not all varicose and spider veins can be prevented. But some things can reduce your chances of getting new varicose and spider veins. These same things can help ease discomfort from the ones you already have:
1. Wear Sunscreen to protect your skin from the sun and to limit spider veins on the face.
2. Exercise regularly to improve your leg strength, circulation, and vein strength. Focus on exercises that work your legs, such as walking or running.
3. Control your weight to avoid placing too much pressure on your legs.
4. Do not cross your legs when sitting.
5. Elevate your legs when resting as much as possible.
6. Do not stand or sit for long periods of time. If you must stand for a long time, shift your weight from one leg to the other every few minutes. If you must sit for long periods of time, stand up and move around or take a short walk every 30 minutes.
7. Wear elastic support stockings and avoid tight clothing that constricts your waist, groin, or legs.
8. Eat a low-salt diet rich in high-fiber foods. Eating fiber reduces the chances of constipation, which can contribute, to varicose veins. High fiber foods include fresh fruits and vegetables and whole grains, like bran. Eating too much salt can cause you to retain water or swell.

Remember these important questions when deciding whether to see your doctor:
Has the varicose vein become swollen, red, or very tender or warm to the touch?
If yes, see your doctor.
If no, are there sores or a rash on the leg or near the ankle with the varicose vein, or do you think there may be circulation problems in your feet?
If yes, see your doctor.
If no, continue to follow the self-care tips above.

Besides a physical exam, your doctor can take x-rays or ultrasound pictures of the vein to find the cause and severity of the problem. You may want to speak with a doctor who specializes in vein diseases or phlebology. Talk to your doctor about what treatment options are best for your condition and lifestyle. Not all cases of varicose veins are the same.

Some available treatments include:
A. Sclerotherapy
This is the most common treatment for both spider veins and varicose veins. The doctor injects a solution into the vein that causes the vein walls to swell, stick together, and seal shut. This stops the flow of blood and the vein turns into scar tissue. In a few weeks, the vein should fade. The same vein may need to be treated more than once.

This treatment is very effective if done the right way. Most patients can expect a 50% to 90% improvement. Microsclerotherapy uses special solutions and injection techniques that increase the success rate for removal of spider veins. Sclerotherapy does not require anesthesia, and can be done in the doctor's office.

Possible side effects include:
1. Temporary stinging or painful cramps where the injection was made.
2. Temporary red raised patches of skin where the injection was made.
3. Temporary small skin sores where the injection was made.
4. Temporary bruises where the injection was made.
5. Spots around the treated vein that usually disappears.
6. Brown lines around the treated vein that usually disappear.
7. Groups of fine red blood vessels around the treated vein that usually disappear.

The treated vein can also become inflamed or develop lumps of clotted blood. This is not dangerous. Applying heat and taking aspirin or antibiotics can relieve inflammation. Lumps of coagulated blood can be drained.

B. Laser surgery
New technology in laser treatments can effectively treat spider veins in the legs. Laser surgery sends very strong bursts of light onto the vein. This can makes the vein slowly fade and disappear. Lasers are very direct and accurate. So the proper laser controlled by a skilled doctor will usually only damage the area being treated. Most skin types and colors can be safely treated with lasers.

Laser surgery is more appealing to some patients because it does not use needles or incisions. Still, when the laser hits the skin, the patient feels a heat sensation that can be quite painful. Cooling helps reduce the pain. Laser treatments last for 15 to 20 minutes. Depending on the severity of the veins, two to five treatments are generally needed to remove spider veins in the legs. Patients can return to normal activity right after treatment, just as with sclerotherapy. For spider veins larger than 3 mm, laser therapy is not very practical.

Possible side effects of laser surgery include:
1. Redness or swelling of the skin right after the treatment that disappears within a few days.
2. Discolored skin that will disappear within one to two months.
3. Rarely burns and scars result from poorly performed laser surgery.

C. Endovenous Techniques (radio-frequency and laser) – These methods for treating the deeper varicose veins of the legs (the saphenous veins) have been a huge breakthrough. They have replaced surgery for the vast majority of patients with severe varicose veins. This technique is not very invasive and can be done in a doctor’s office.
The doctor puts a very small tube called a catheter into the vein. Once inside, the catheter sends out radiofrequency or laser energy that shrinks and seals the vein wall. Healthy veins around the closed vein restore the normal flow of blood. As this happens, symptoms from the varicose vein improve. Veins on the surface of the skin that are connected to the treated varicose vein will also usually shrink after treatment. When needed, these connected varicose veins can be treated with sclerotherapy or other techniques.

Possible side effect is slight bruising.

Surgery is used mostly to treat very large varicose veins. Types of surgery for varicose veins include:

A. Surgical Ligation and Stripping - With this treatment, problematic veins are tied shut and completely removed from the leg. Removing the veins does not affect the circulation of blood in the leg. Veins deeper in the leg take care of the larger volumes of blood. Most varicose veins removed by surgery are surface veins and collect blood only from the skin. This surgery requires either local or general anesthesia and must be done in an operating room on an outpatient basis.

Possible side effects: Serious side effects or problems from this surgery are uncommon.
1. With general anesthesia, a risk of heart and breathing problems.
2. Bleeding and congestion of blood can be a problem. But the collected blood usually settles on its own and does not require any further treatment.
3. Wound infection, inflammation, swelling and redness.
4. Permanent scars.
5. Damage of nerve tissue around the treated vein. It is hard to avoid harming small nerve branches when veins are removed. This damage can cause numbness, burning, or a change in sensation around the surgical scar.
6. A deep vein blood clot. These clots can travel to the lungs and heart. Injections of heparin, a medicine that reduces blood clotting reduces the chance of these dangerous blood clots. But, heparin also can increase the normal amount of bleeding and bruising after surgery.
7. Significant pain in the leg and recovery time of one to four weeks depending on the extent of surgery is typical after surgery.

B. Ambulatory Phlebectomy – With this surgery, a special light source marks the location of the vein. Tiny cuts are made in the skin, and surgical hooks pull the vein out of the leg. This surgery requires local or regional anesthesia. The vein usually is removed in one treatment. Very large varicose veins can be removed with this treatment while leaving only very small scars. Patients can return to normal activity the day after treatment.

Possible Side Effects:
Slight bruising.
Temporary numbness.

C. Endoscopic vein surgery – With this surgery, a small video camera is used to see inside the veins. Then varicose veins are removed through small cuts. People who have this surgery must have some kind of anesthesia including epidural, spinal, or general anesthesia. Patients can return to normal activity within a few weeks.

Current treatments for varicose veins and spider veins have very high success rates compared to traditional surgical treatments. Over a period of years, however, more abnormal veins can develop. The major reason for this is that there is no cure for weak vein valves. So with time, pressure gradually builds up in the leg veins. Ultrasound can be used to keep track of how badly the valves are leaking - venous insufficiency.

Ongoing treatment can help keep this problem under control.

The single most important thing a person can do to slow down the development of new varicose veins is to wear graduated compression support stockings as much as possible during the day.

For More Information...
Contact the National Women’s Health Information Center (NWHIC) at 1-800-994-9662. ]]> Severe obesity is a chronic condition that is difficult to treat through diet and exercise alone. Gastrointestinal surgery is an option for people who are severely obese and cannot lose weight by traditional means or who suffer from serious obesity-related health problems. https://www.sandiegohealthdirectory.com/kb/link.php?action=detail&id=72 Fri, 16 Jun 2006 04:02:54 GMT https://www.sandiegohealthdirectory.com/kb/link.php?action=detail&id=72
You may be a candidate for surgery if you have:

A body mass index (BMI) of 40 or more—about 100 pounds overweight for men and 80 pounds for women.

A BMI between 35 and 39.9 and a serious obesity-related health problem such as type 2 diabetes, heart disease, or severe sleep apnea (when breathing stops for short periods during sleep)

An understanding of the operation and the lifestyle changes you will need to make.
Normally, as food moves along the digestive tract, digestive juices and enzymes digest and absorb calories and nutrients. After we chew and swallow our food, it moves down the esophagus to the stomach, where a strong acid continues the digestive process. The stomach can hold about 3 pints of food at one time. When the stomach contents move to the duodenum, the first segment of the small intestine, bile and pancreatic juice speed up digestion. Most of the iron and calcium in the foods we eat is absorbed in the duodenum. The jejunum and ileum, the remaining two segments of the nearly 20 feet of small intestine, complete the absorption of almost all calories and nutrients. The food particles that cannot be digested in the small intestine are stored in the large intestine until eliminated.

Gastrointestinal surgery for obesity, also called bariatric surgery, alters the digestive process. The operations can be divided into three types: restrictive, malabsorptive, and combined restrictive/malabsorptive. Restrictive operations limit food intake by creating a narrow passage from the upper part of the stomach into the larger lower part, reducing the amount of food the stomach can hold and slowing the passage of food through the stomach. Malabsorptive operations do not limit food intake, but instead exclude most of the small intestine from the digestive tract so fewer calories and nutrients are absorbed.

Malabsorptive operations, also called intestinal bypasses, are no longer recommended because they result in severe nutritional deficiencies. Combined operations use stomach restriction and a partial bypass of the small intestine.

There are several types of restrictive and combined operations. Each one has its own benefits and risks.

Restrictive Operations
Purely restrictive operations only limit food intake and do not interfere with the normal digestive process. To perform the operation, doctors create a small pouch at the top of the stomach where food enters from the esophagus. At first, the pouch holds about 1 ounce of food and later may stretch to 2-3 ounces. The lower outlet of the pouch is usually about 1/2 inch in diameter or smaller. This small outlet delays the emptying of food from the pouch into the larger part of the stomach and causes a feeling of fullness.

After the operation, patients can no longer eat large amounts of food at one time. Most patients can eat about ½ to 1 cup of food without discomfort or nausea, but the food has to be soft, moist, and well chewed. Patients who undergo restrictive procedures generally are not able to eat as much as those who have combined operations.

Purely restrictive operations for obesity include adjustable gastric banding (AGB) and vertical banded gastroplasty (VBG).

Adjustable gastric banding. In this procedure, a hollow band made of silicone rubber is placed around the stomach near its upper end, creating a small pouch and a narrow passage into the rest of the stomach (figure 2). The band is then inflated with a salt solution through a tube that connects the band to an access port placed under the skin. It can be tightened or loosened over time to change the size of the passage by increasing or decreasing the amount of salt solution.

Vertical banded gastroplasty. VBG uses both a band and staples to create a small stomach pouch. Once the most common restrictive operation, VBG is not often used today.

Advantages: Restrictive operations are easier to perform and are generally safer than malabsorptive operations. AGB is usually done via laparoscopy, which uses smaller incisions, creates less tissue damage, and involves shorter operating time and hospital stays than open procedures. (See below for more information on laparoscopy.) Restrictive operations can be reversed if necessary, and result in few nutritional deficiencies.

Disadvantages: Patients who undergo restrictive operations generally lose less weight than patients who have malabsorptive operations, and are less likely to maintain weight loss over the long term. Patients generally lose about half of their excess body weight in the first year after restrictive procedures. However, in the first 3 to 5 years after VBG patients may regain some of the weight they lost. By 10 years, as few as 20 percent of patients have kept the weight off. (Although there is less information about long-term results with AGB, there is some evidence that weight loss results are better than with VBG.) Some patients regain weight by eating high-calorie soft foods that easily pass through the opening to the stomach. Others are unable to change their eating habits and do not lose much weight to begin with. Successful results depend on the patient’s willingness to adopt a long-term plan of healthy eating and regular physical activity.

Risks: One of the most common risks of restrictive operations is vomiting, which occurs when the patient eats too much or the narrow passage into the larger part of the stomach is blocked. Another is slippage or wearing away of the band. A common risk of AGB is breaks in the tubing between the band and the access port. This can cause the salt solution to leak, requiring another operation to repair. Some patients experience infections and bleeding, but this is much less common than other risks. Between 15 and 20 percent of VBG patients may have to undergo a second operation for a problem related to the procedure. Although restrictive operations are the safest of the bariatric procedures, they still carry risk—in less than 1 percent of all cases, complications can result in death.

Combined Restrictive/Malabsorptive Operations

Combined operations are the most common bariatric procedures. They restrict both food intake and the amount of calories and nutrients the body absorbs.

Roux-en-Y gastric bypass (RGB). This operation is the most common and successful combined procedure in the United States. First, the surgeon creates a small stomach pouch to restrict food intake. Next, a Y-shaped section of the small intestine is attached to the pouch to allow food to bypass the lower stomach, the duodenum (the first segment of the small intestine), and the first portion of the jejunum (the second segment of the small intestine). This reduces the amount of calories and nutrients the body absorbs. Rarely, a cholecystectomy (gall bladder removal) is performed to avoid the gallstones that may result from rapid weight loss. More commonly, patients take medication after the operation to dissolve gallstones. (See WIN’s fact sheet Dieting and Gallstones for more information

Biliopancreatic diversion (BPD). In this more complicated combined operation, the lower portion of the stomach is removed. The small pouch that remains is connected directly to the final segment of the small intestine, completely bypassing the duodenum and the jejunum. Although this procedure leads to weight loss, it is used less often than other types of operations because of the high risk for nutritional deficiencies. A variation of BPD includes a “duodenal switch” (see figure 6), which leaves a larger portion of the stomach intact, including the pyloric valve that regulates the release of stomach contents into the small intestine. It also keeps a small part of the duodenum in the digestive pathway. The larger stomach allows patients to eat more after the surgery than patients who have other types of procedures.

Advantages: Most patients lose weight quickly and continue to lose for 18 to 24 months after the procedure. With the Roux-en-Y gastric bypass, many patients maintain a weight loss of 60 to 70 percent of their excess weight for 10 years or more. With BPD, most studies report an average weight loss of 75 to 80 percent of excess weight. Because combined operations result in greater weight loss than restrictive operations, they may also be more effective in improving the health problems associated with severe obesity, such as hypertension (high blood pressure), sleep apnea, type 2 diabetes, and osteoarthritis.

Disadvantages: Combined procedures are more difficult to perform than the restrictive procedures. They are also more likely to result in long-term nutritional deficiencies. This is because the operation causes food to bypass the duodenum and jejunum, where most iron and calcium are absorbed. Menstruating women may develop anemia because not enough vitamin B12 and iron are absorbed. Decreased absorption of calcium may also bring on osteoporosis and related bone diseases. Patients must take nutritional supplements that usually prevent these deficiencies. Patients who have the biliopancreatic diversion procedure must also take fat-soluble (dissolved by fat) vitamins A, D, E, and K supplements, and require life-long use of special foods and medications.

RGB and BPD operations may also cause “dumping syndrome,” an unpleasant reaction that can occur after a meal high in simple carbohydrates, which contain sugars that are rapidly absorbed by the body. Stomach contents move too quickly through the small intestine, causing symptoms such as nausea, bloating, abdominal pain, weakness, sweating, faintness, and sometimes diarrhea after eating. Because the duodenal switch operation keeps the pyloric valve intact, it may reduce the likelihood of dumping syndrome.

Risks: In addition to risks associated with restrictive procedures such as infection, combined operations are more likely to lead to complications. The risk of death associated with these types of procedures is lower for the gastric bypass (less than 1 percent of patients) than for the biliopancreatic diversion with duodenal switch (2.5 to 5 percent). Combined operations carry a greater risk than restrictive operations for abdominal hernias (up to 28 percent), which require a follow-up operation to correct. The risk of hernia, however, is lower (about 3 percent) when laparoscopic techniques are used.

In laparoscopy, the surgeon makes one or more small incisions through which slender surgical instruments are passed. This technique eliminates the need for a large incision and creates less tissue damage. Patients who are super-obese (more than 350 pounds) or have had previous abdominal operations may not be good candidates for laparoscopy, however. Adjustable gastric banding is routinely performed via laparoscopy.

This technique is often used for Roux-en-Y gastric bypass, and although less common, biliopancreatirc diversion can also be performed laparoscopically. The small incisions result in less blood loss, shorter hospitalization, a faster recovery, and fewer complications than open operations. However, combined laparoscopic procedures are more difficult to perform than open procedures and can create serious problems if done incorrectly.

With rates of overweight among youth on the rise, bariatric surgery is sometimes considered as a treatment option for adolescents who are severely overweight. However, there are many concerns about the long-term effects of this type of operation on adolescents’ developing bodies and minds. Experts in pediatric overweight and bariatric surgery recommend that surgical treatment only be considered when adolescents have tried for at least 6 months to lose weight and have not been successful. Candidates should be severely overweight (BMI of 40 or more), have reached their adult height (usually 13 or older for girls, 15 or older for boys), and have serious weight-related health problems such as type 2 diabetes or heart disease. In addition, potential patients and their parents should be evaluated to see how emotionally prepared they are for the operation and the lifestyle changes they will need to make. Patients should also be referred to a team of experts in adolescent medicine and bariatric surgery who are qualified to meet their unique needs.

Bariatric procedures cost from $20,000 to $35,000. Medical insurance coverage varies by state and insurance provider. If you are considering bariatric surgery, contact your regional Medicare or Medicaid office or insurance plan to find out if the procedure is covered.

Bariatric surgery may be the next step for people who remain severely obese after trying nonsurgical approaches, or for people who have an obesity-related disease. Surgery to produce weight loss is a serious undertaking. Anyone thinking about undergoing this type of operation should understand what it involves. Answers to the following questions may help you decide whether weight-loss surgery is right for you.

Are you:
Unlikely to lose weight or keep weight off long-term with nonsurgical measures?
Well informed about the surgical procedure and the effects of treatment?
Determined to lose weight and improve your health?
Aware of how your life may change after the operation (adjustment to the side effects of the operation, including the need to chew food well and inability to eat large meals)?
Aware of the potential for serious complications, dietary restrictions, and occasional failures?
Committed to lifelong medical follow-up and vitamin/mineral supplementation?

Remember: There are no guarantees for any method, including surgery, to produce and maintain weight loss. Success is possible only with maximum cooperation and commitment to behavioral change and medical follow-up—and this cooperation and commitment must be carried out for the rest of your life.

In 2003, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health (NIH) formed a partnership with researchers called the Longitudinal Assessment of Bariatric Surgery, or LABS. LABS researchers are experts in bariatric surgery, obesity research, internal medicine, behavioral science, and related fields. Their mission is to plan and conduct studies that will lead to better understanding of bariatric surgery and its impact on the health and well being of patients with extreme obesity. For more information on LABS, visit www.niddklabs.org.

Notes:
Malabsorptive operations, also called intestinal bypasses, are no longer recommended because they result in severe nutritional deficiencies.

Because combined operations result in greater weight loss than restrictive operations, they may also be more effective in improving the health problems associated with severe obesity, such as hypertension (high blood pressure), sleep apnea, type 2 diabetes, and osteoarthritis.]]> Hip replacement surgery removes damaged or diseased parts of a hip joint and replaces them with new, man-made parts. https://www.sandiegohealthdirectory.com/kb/link.php?action=detail&id=61 Thu, 15 Jun 2006 03:21:05 GMT https://www.sandiegohealthdirectory.com/kb/link.php?action=detail&id=61
Relieve pain
1. Help the hip joint work better
2. Improve walking and other movements.

Who Should Have Hip Replacement Surgery?
The most common reason for hip replacement is osteoarthritis in the hip joint. Your doctor might also suggest this surgery if you have:
1. Rheumatoid arthritis (a disease that causes joint pain, stiffness, and swelling)
2. Osteonecrosis (a disease that causes the bone in joints to die)
3. Injury of the hip joint
4. Bone tumors that break down the hip joint.

Your doctor will likely suggest other treatments first, including:
1. Walking aids, such as a cane
2. An exercise program
3. Physical therapy
4. Medications.

These treatments may decrease hip pain and improve function. Sometimes the pain remains and makes daily activities hard to do. In this case, your doctor may order an x ray to look at the damage to the joint. If the x ray shows damage and your hip joint hurts, you may need a hip replacement.

Healthy, active people often have very good results after hip replacement surgery. But your doctor may not suggest this surgery if you have:
1. A disease that causes severe muscle weakness
2. Parkinson’s disease
3. A high risk of infection
4. Poor health.

How Should I Prepare for Surgery?

To prepare for surgery, you can.
a. Learn what to expect before, during, and after surgery
b. Ask the doctor for booklets about the surgery
c. Ask someone to drive you to and from the hospital
d. Arrange for someone to help you for a week or two after coming home from the hospital
e. Put things you need in one place at home (for instance, put the remote control, radio, telephone, medicine, tissues, and wastebasket next to your chair or bed)
f. Place items you use every day at arm level to avoid reaching up or bending down
g. Stock up on food
h. Make and freeze meals.

What Should I Do After Surgery?
Soon after surgery, you will meet a respiratory therapist and a physical therapist. The respiratory therapist may ask you to breathe deeply, cough, or blow into a device to check your lungs. Deep breathing helps to keep fluid out of your lungs after surgery.

The physical therapist will teach you how to sit up, bend over, and walk with your new hip. The therapist will also teach you simple exercises to help you get better. In some cases, within 1 to 2 days after surgery, you may be able to sit on the edge of the bed, stand, and even walk with help.

Most people spend 10 days or less in the hospital after hip replacement surgery. To be completely well takes about 3 to 6 months, based on:
1. The type of surgery
2. Your health
3. How quickly exercises help.
After you go home, be sure to follow the doctor’s instructions. Tips for getting better quickly are:
a. Work with a physical therapist.
b. Wear an apron to carry things around the house. This leaves your hands and arms free for balance or to use crutches.
c. Use a long-handled “reacher” to turn on lights or grab things you need. Your nurse at the hospital may give you one or tell you where to buy one.

What Problems Can Happen After Hip Replacement Surgery?
The most common problem soon after hip replacement surgery is hip dislocation. Because man-made hips are smaller than normal ones, the ball can come out of the socket. This can happen if you are in certain positions, such as pulling the knees up to the chest.

Sometimes, a person’s body reacts to the man-made joint. If that happens, there is usually inflammation (or swelling), and then special cells might eat away some of the bone, causing the joint to loosen. To treat this problem, your doctor may suggest medicines or surgery to replace the joint. Most people (more than 90 percent) who have hip joints replaced do not need more surgery. Researchers are trying out joints made of different materials that last longer and cause less inflammation.

Less common problems after surgery are:
1. Infection
2. Blood clots
3. Bone growth past the normal edges of the bone.
4. Risks of problems after hip replacement surgery are much lower than they used to be.

Will Exercise Help After a Total Hip Replacement?
Exercise can reduce joint pain and stiffness. It can increase muscle strength and joint range of motion (how much you can move the joint). Most physical therapists begin with exercises that:
1. Increase range of motion
2. Make muscles strong.

Your doctor or physical therapist will decide when you can do harder exercises. Your doctor may say not to jog or play basketball or tennis. These can damage or loosen the new hip joint.

Exercise goals after hip replacement surgery are to:
1. Increase muscle strength
2. Increase your blood circulation and overall fitness
3. Avoid injuring the new joint.

The types of exercise that may help you meet these goals are:
1. Walking
2. Bicycling (on a bike machine)
3. Swimming
4. Cross-country skiing.

What Research Is Being Done on Hip Replacement Surgery?

To improve hip replacement surgery, researchers are studying:
1. Which patients are more likely to do well after a hip replacement
2. New ways to do hip replacement surgery
3. How to make better man-made hip joints
4. Ways to keep the body from rejecting the man-made hip joints
5. How to improve recovery programs used after surgery. ]]> Psychologists investigating consciousness during operations to reveal techniques to identify wakefulness. https://www.sandiegohealthdirectory.com/kb/link.php?action=detail&id=7 Fri, 03 Feb 2006 14:39:34 GMT https://www.sandiegohealthdirectory.com/kb/link.php?action=detail&id=7
Psychologists investigating consciousness during operations to reveal techniques to identify wakefulness

It is the stuff of nightmares - you are under anaesthetic during an operation but you are fully conscious. Aware of every incision -yet unable to communicate that fact.

Now a leading Professor of Clinical Psychology at the University of Leicester is to reveal his views and findings on awareness in anaesthesia during his inaugural lecture on Tuesday 24 January.

Professor Michael Wang, of the School of Psychology at the University of Leicester, will give the lecture, Dissecting Consciousness on the Operating Theatre Table, at 5.30pm in Lecture Theatre 1, Ken Edwards Building. He said:

"My research has important implications for understanding the human psyche from a clinical point of view, by casting light on how some types of psychological disturbance may be caused, not just in the operating theatre, but in other circumstances as well."

"Psychologists have made, and continue to make, significant contributions to the study and practice of anaesthesia. Moreover the induction of general anaesthesia provides opportunity to investigate the nature of consciousness using experimental methods and systematic observation in the operating theatre."

Professor Wang said episodes of full awareness with explicit recall during operations with general anaesthesia are more common than many realise. He added:

"The common reason for failure to identify intra-operative awareness is the paralyzing effects of muscle relaxants. Contrary to traditional belief there are no reliable clinical signs to enable the identification of wakefulness."
Studies conducted by Prof Wang and Dr Ian Russell (Hull Royal Infirmary) have made use of the isolated forearm technique to determine levels of consciousness during general anaesthesia, which allows communication despite the muscle paralysis.

The isolated forearm technique simply involves applying a tourniquet to the forearm just before the paralysing drug is administered. This allows the patients to move his/her hand when asked to if he/she is sufficiently conscious to do so. The technique has been pioneered by Dr Russell and Prof Wang.

"Often patients will demonstrate high levels of consciousness during an operation but without conscious recall afterwards. This is because many anaesthetic drugs interfere with memory. I and colleagues have also investigated benzodiazepine sedation as another clinical circumstance in which there may be dissociation between unconscious and conscious recall. There is an intriguing literature in which patients have developed psychological disturbance following operations with general anaesthesia in which the patient has no conscious recall, but the nature of the disturbance is indicative of inadequate anaesthesia. Experimental studies that attempt to investigate the mechanisms by which this may occur are reviewed."


Biography

Prof Wang was born in Sheffield, Yorkshire. After attending Rowlinson School he went to Manchester University for both undergraduate and postgraduate clinical training in the late 1970s. He then spent eight years working as an NHS Clinical Psychologist at Withington Hospital initially treating patients with substance misuse followed by work with general and acute psychiatric patients. During this time he completed a part-time PhD which investigated the aetiology of phobias in alcohol-dependent patients. In 1988 he was appointed Clinical Co-Director and Honorary NHS Consultant on the integrated Clinical Psychology Course at the University of Hull. In 1997 he became Head of Department, and then in 2000 was made Honorary Clinical Professor in the Postgraduate Medical Institute, University of Hull. He was awarded the Fellowship of the British Psychological Society in 1999 in recognition of his research into psychological aspects of anaesthesia and his contributions to clinical psychology training.

Prof Wang has a commitment to his profession as well as to training, and in 2001 began a three-year stint in the Chair role of the Division of Clinical Psychology of the British Psychological Society. He is a registered clinical psychologist, neuropsychologist, health psychologist and cognitive-behavioural psychotherapist.

Prof Wang was appointed Professor of Clinical Psychology, Head of Clinical Section and Course Director at the University in May 2005.

Research Topic

Prof Wang has a longstanding research interest in psychological aspects of anaesthesia and in particular, the problem of anaesthetic awareness, which he is pursuing in Leicester alongside colleagues in the Academic Department of Anaesthesia, in addition to his work as Director of the Postgraduate Clinical Psychology Training Course.

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