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Joint Replacement and Diabetes

Joint replacement and diabetes

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People who have diabetes may be at greater risk after joint surgery. Over twenty-five million Americans have either type 1 or type 2 diabetes, and this can cause problems in the nervous, vascular and immune systems.

Diabetes and joint replacement

About eight percent of people who have joint replacement surgeries have diabetes. While diabetes is potentially connected to poorer outcomes from surgery, the prognosis is related to how well the diabetes is controlled.

How does it work?

The diabetic needs to control her blood sugar levels. Part of how a diabetes patient manages the disorder is through taking insulin. In addition, she needs to watch her weight and stay fit through proper diet and exercise. When this is done properly, all of her outcomes will be more positive. A person who has diabetes can live a completely normal and healthy life. Conversely, if poorly managed, there can be negative consequences, such as morbidity or even mortality.

People who have diabetes may be at a very high risk for greatly increased blood sugar levels after joint surgery. They are also at greater risk for developing complications and infections. These outcomes may mean longer hospitalizations and potentially a second round of surgery.

The key to preventing this is efficient glucose level management, as is in most health situations for diabetics. If glucose levels are generally not well-managed, the diabetic must get it under control before a joint replacement. If it’s generally well-manages, taking it up a notch will get you the best case scenario results.

Other issues

One of the issues that can affect any diabetic is wound healing. Even if the patient does not encounter complications or infection, it can take longer for a wound to heal. This can also lead to infection, as the site of the incision is exposed for a longer period of time.

New studies

A new study, put out together by researchers at the Hospital for Special Surgery in New York and the Ochsner Health System in New Orleans, found that after surgery, patients who’d had insulin-dependent diabetes had critically-spiked blood sugar levels. This study took a different spin than previous research that addressed this issue. It compared diabetics who take insulin and diabetics who don’t. It found that the more severe cases of diabetes have a much higher risk for acutely higher glucose levels after surgery.

Results and recommendations

Some doctors will not recommend joint surgery for patients who need it if their diabetes is not well-managed. Even if a patient needs the surgery, the doctor may decide that the risks are too great.

If someone feels that the operation will improve her life, he will need to start a new program of proper diet and exercise to make it happen.

If the diabetic is in good health and can undergo the surgery, she’ll need excellent post-operative care to help the recovery process. The Alameda Center offers top-level care for patients who undergo joint replacement surgery. Our staff of doctors, nurses and other staff will give your loved one exceptional services to heal fast and well.

Lung Function and Pulmonary Rehabilitation

Pulmonary Rehabilitation

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Lung function diseases affect millions of Americans and are a leading cause of death. However, prevention and cure are possible in many cases. Many people with breathing trouble attend pulmonary rehabilitation programs to find a better way.

What are lung diseases?

There are several lung diseases that affect how a person breathes. The most widespread ones are COPD, or Chronic Obstructive Pulmonary Disease, and pulmonary fibrosis. COPD includes chronic bronchitis and emphysema. These are diseases that make it hard to breathe and generally worsen over time. However, when treated properly, they can be highly manageable.

Pulmonary rehabilitation

Pulmonary rehabilitation is a combination of education, awareness and exercise that teaches someone how to effectively manage a pulmonary disease. It takes place in a group, so people dealing with the same problems can meet, connect and support each other. The groups tend to be small so patients feel comfortable and can get to know one another.

The first element is education. An educator, usually a respiratory therapist, will give over all the information the patient’s need about this disease. They’ll discuss physiology, symptoms, medication and more. She usually offers nutritional counseling as well. Extra weight can exacerbate breathing issues, and low weight can decrease the body’s ability to fight disease and infection. Even more, it can be hard to prepare nutritious food when you feel shortness of breath. The program explains how to prepare food without getting stressed out.

There’s also an emotional counseling component, because people dealing with these types of diseases are more prone to anxiety or other emotional fallouts.

The last element, exercise is an important part of the program, because many COPD patients don’t exercise at all; they fear its effect on their breathing. However, doing the right exercises will make someone feel more fit and help him breathe better. It will increase his lung function and make it easier for him to work out without experiencing severe shortness of breath. It come cases it can even decrease the need for hospital visits.

Finally, there’s a maintenance aspect to the program. Each program takes place over a few sessions, but participants often need a way to keep up with the agenda. Participants often come back for refresher classes or one-time sessions.

Meeting the patient’s needs

While the general rehab takes place in a group setting, each member has his own regimen. A team of doctors, nurses, respiratory therapists, exercise therapists, nutritionists and other staff members will work with each patient to create a plan to fit his specific needs. The program is done on an outpatient basis, with meetings at a facility. Some of the plan may require follow-up at home.

At the Alameda Center, we offer pulmonary rehabilitation at our premier facility in Perth Amboy, New Jersey. We have a large, experienced staff of doctors, nurses, therapists and nutritionists who provide excellent pulmonary rehabilitation services. We would be happy to arrange a meeting to hear about your needs and explain how our programs work.

Osteoarthritis and Joints

osteoarthritis and joints

Although arthritis usually strikes older people, osteoarthritis can affect anyone at any age. The reason it’s usually associated with older people is that they have put in more time on their bones due to their age. But a if a younger person pushed his body excessively, he is also at risk for osteoarthritis and all of its complications.

Osteoarthritis: What is it?

Joint bones are cushioned by cartilage, a soft tissue that provides some “grease” between the bones so they don’t rub against each other but manage together smoothly. When there’s tremendous wear and tear on the joints, the cartilage wears away slowly, and the bones don’t have the smooth cushion to act as a softener between the bones.

What are the symptoms?

Unfortunately, the symptoms of osteoarthritis are usually very pronounced, the most noticeable being pain. The area may feel tender to the touch. Other symptoms include a grating sensation at the joint, stiffness, and less flexibility.

These begin to happen as the disease builds. If it gets to the point when all of the cartilage degenerates, the bones begin to rub against each other, which can become tremendously painful and incapacitating.

Why does it happen?

Osteoarthritis is a disease of the joints, and it takes places when there is excessive wear and tear on the joints. It’s more likely to occur in the older population, particularly if someone is overweight. The extra weight tends to overwhelm the joints, which cannot carry the burden.

It can also happen to athletes who put in grueling hours and overstress their joints. While exercise is obviously extremely beneficial physically and important to stay healthy and fit, strenuous workouts can cause unwanted outcomes. Overstressing the joints when you’re young can bring on osteoarthritis more quickly.

Can cartilage regrow?

Cartilage may regrow, but due to its makeup, it doesn’t regenerate as easily as other kinds of body tissue. If there’s a weight problem, the mass weighs down the joints. The cartilage begins to sag outside of the joint, and any regrowth only occurs outside of the joint. So no one should count on ruining their joints and imagining that the body will simply repair itself.

When to see a doctor

As with most health issues, patients usually wait until the pain is unbearable before they seek help. But this is a mistake. When the problem is diagnosed early enough, the patient may be able to make changes to his lifestyle that can slow down or turn around the condition. If he stops stressing the joints, the cartilage can regrow sufficiently. And if he loses weight, it will take the ease off of the bones. However, this doesn’t happen in most cases, where the damage is difficult to reverse.

By the time the pain become agonizing, it may be too late to arrest the decline. When the cartilage thins out too much, it hardens into a protective layer around the bones. The bones then become susceptible to breakage. At this stage, often the only solution is a bone replacement.

How to slow it down

If you are showing any signs of osteoarthritis, see a doctor. Interestingly, while excessive exercise is detrimental for joints, healthy amounts of exercise are great for keeping bones and joints in good health.

If you need to recover from a knee or hip replacement or other procedures related to osteoarthritis, Alameda Center has premium services to help you get back on your feet. We have a large and modern facility with a caring, experienced and knowledgeable staff.

Occupational Therapy and Stroke

Occupational Therapy for stroke rehab at Alameda Center

Photo by Elien Dumon on Unsplash

Stroke victims often become impaired to some degree, and occupational therapy is usually required to get the patient back to a healthy mode of living. While each patient has a different story, most stroke victims will need to re-learn some skills for daily living. The occupational therapist is the address.

How does occupational therapy help?

The purpose of occupational therapy is to help people learn tasks for daily living. According to the American Occupational Therapy Association, “occupational therapists and occupational therapy assistants help people across the lifespan participate in the things they want and need to do through the therapeutic use of everyday activities (occupations).”

Occupational therapists work with all sorts of people who need to learn these tasks for different reasons – children who have not been able to master these tasks, people who have physical and mental limitations, and adults who need to re-learn tasks for due to various circumstances. Stroke victims often have impairment of their physical, cognitive and emotional capabilities, and occupational therapy can help.

Therapists work with patients for varying amounts of time depending on the deficiency. It usually lasts at least a few months, but more often it’s for an extended period of time.

What kinds of tasks are taught?

These are some of the ways an occupational therapist can attend to a stroke victim:

  • They train them in activities of daily living (ADLs). Stroke victims often have to re-learn normal tasks such as  dressing, bathing and feeding themselves, in addition to other activities.
  • They help them overcome general cognitive and physical impairment as well as overall weakness.
  • They counsel them as to how to re-enter the workplace and the home, making recommendations for adjustments to enable the patient to resume normal function.

Since each patient presents differently, the approach and recommendations will vary.

How does occupational therapy work?

Therapists use various modalities to help the patient regain lost functions. The basic idea is to reprogram the brain to know how to perform the functions that it previously knew how to do but lost.

One part of the process is breaking down each complex activity into parts. The occupational therapist then teaches the patient one part at a time, until he learns the whole activity. Because the brain is “re-learning,” it takes baby steps.

The occupational therapist also assesses where an aid might be handy. Since one side’s functioning may be compromised, the patient might need a device to compensate for the loss in the other side. The OT has access to a large range of aids and can teach the patient how to use them.

Because each case is so individual, there is no one solution under the overarching title of occupational therapy. The therapist will sit with the patient and develop a plan to help each one overcome his challenges. While some of it employs physical movement to train the muscles, a good portion is talking. The therapist asks and evaluates, and together they address problems with ideas for living.

At the Alameda Center, we have qualified and experienced occupational therapists to work with stroke patients. We offer premium services to help stroke victims reclaim their lives and get back to a regular living situation. Call us today to see how we can help you. 

 

Knee Replacement Surgery

Knee replacement surgery at Alameda center

Knee replacement surgery at Alameda center

Knee replacement surgery is indicated when someone has irreversible damage to his knee. In younger people, this generally happens due to a tear in one of the ligaments. In older people, this might happen due to deterioration, fracture or arthritis.

How does it work?

The knee is made up of three bones as well as many muscles and ligaments. Unlike the shoulder and hip joints, the knee has somewhat restricted movement. This makes it more like the ankle and elbow joints, which are made to move only in certain ways. Because of this, movements that are beyond the joint’s capabilities can put undue stress on the knee. Most knee trouble in younger people are due to sports injuries. Players often push their physical abilities to the max. While a hardy, young body can handle that, sometimes it’s just too much. A sports injury can put a player out in the hospital for surgery, and that can at times result in a knee replacement.

What happens in the younger set?

In most cases, if a young, healthy person complains of knee pain, it’s most likely to come from the knee cap. Sometimes a workup will show no issues at all. In these cases, rest and potentially physical therapy will help him back on the road to recovery.

When there is a problem, it’s often a torn ligament. The anterior cruciate ligament is a main ligament on the inside of the kneecap that can become disturbed via injury. If not treated, it can cause more damage and pain.

Soccer, Football, skiing, baseball and hockey are all good examples of sports where a player might move the wrong way and damage his knee. While this is more likely to happen at the professional level, a player at any level can cause himself damage. In rare occurrences, anyone can slip or make a wrong move, even off the field, and land himself in the hospital.

What happens in the older set?

Older people are more prone to knee injuries and knee replacements for several reasons. One is that they simply have used their knees more, and all human parts deteriorate over time. Another main cause is arthritis. To keep the knee in shape, there are many treatment options before a patient gets to the surgery level. An important remedy is weight loss, as weight puts undue pressure on the knee that it can’t support for a long time. If a person ages without losing weight, he puts his knees at risk. Therapy and medications can often put a knee back in function, and if necessary, a brace can support the knee and give it a longer life.

If a person experiences knee pain, steroids can help with inflammation. Doctors will often prescribe lubricants that “grease” the joint, reducing the friction and clearing up the pain.

When knee replacement surgery is called for

When the pain gets too strong or function decreases, and alternative methods are helping, you may be in for a knee replacement. There are two options for the surgery.

The first option is a partial knee replacement, where usually either the inside or the outside portion of the knee is replaced. This is usually prescribed for someone younger, who may have only partial arthritic knee damage. There’s a higher likelihood of success for a partial replacement to fix the problem.

The second option is a total knee replacement. This is called for when there’s too much damage, and a partial replacement won’t solve the problem. The knee is replaced with matching pieces that are constructed from metal and strong plastic.

After knee replacement surgery, the patient must rest up and decrease physical activity until healed. He may go through a therapy regimen to regain functionality.

At the Alameda Center, we offer a range of rehab options for patients who have had knee replacement surgery. We provide premium short term rehab, as a bridge for patients to move from hospital to home, as well as longer term care options for patients to fully heal. Our doctors and therapists work with the patient to  create a holistic treatment plan, and our supportive staff is there every step of the way.

 

Vision Evaluations for Patients Receiving Neurological Care

Neurological care in Newark

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Vision experts have come out with a recommendation for patients who have suffered from TBI’s, or Traumatic brain injuries, and are receiving neurological care. Doctors are encouraging patients who may have neurological damage to have their vision evaluated post-injury. This new recommendation was put out jointly by the College of Optometrists in Vision Development (COVD) and the Neuro-Optometric Rehabilitation Association (NORA). It’s aimed at doctors treating victims of all neurological injuries as well as those who have suffered from illnesses that can damage brain function, such as meningitis, stroke, brain tumor or Aneurism.

Brain Injury and Neurological care

The president of NORA, Dr. Susan Daniel, explained the recommendations. Several studies show that 50% of people who have brain injuries also suffer from vision problems. These can include blurry eyesight, reading problems, issues with light, and challenges with completing tasks related to seeing well. One study actually shows a 90% rate of people who have these problems. She goes on to say that stroke sufferers have vision issues about two-thirds of the time, including difficulty with eye movement, peripheral vision, and visual perception.

Dr. Christine Allison, President of the COVD, agrees. She notes that after a TBI, neurologists generally check for any abnormalities, but vision often goes by unchecked and unnoticed. Sometimes, issues related to proper eyesight won’t show up immediately, and may not for several weeks. Even if checked at a first evaluation and the patient “passes” his checkup, he may not realize that a problem could manifest later. Therefore the doctor needs to perform a follow-up evaluation at a later date.

Why it’s important

The eyes are connected to the central nervous system, which is why eyesight maybe get damaged when there’s a brain injury or other injury or illness that requires neurological care. If such an injury damages other physical functions, it’s usually very obvious – moving certain body parts, for example. If a TBI victim has a slurred gait or inability to move his arms, everyone will notice. With vision, only the patient himself will notice it, and he may not be objective about it. In fact, he may try to convince himself that it’s not really there, or in his damaged state, may not even realize it’s not normal.

That’s why it’s important for someone, in this case the treating doctor, to check for disturbances. Poor eyesight may cause a whole number of problems for the subject, including motor issues and reading issues. These can in turn create greater problems such as attention issues, difficulties with memory, poor work function, and weak physical performance. Doctors who are trained to provide neurological care can test for many of the red flags that show vision disturbance. They can treat the root problem sooner, before its turns into a larger issue.

Improving outcomes

Both Allison and Daniel encourage a comprehensive, team-based approach to vision testing and analysis post injury. A patient needs proper neurological care that comprises specialized doctors, different therapists, nurses, and rehab staff. With the right recipe, post injury patients have a higher likelihood of proper diagnosis and treatment.

At the Alameda Center, we provide all the elements you need for proper evaluation and treatment. We create a multidisciplinary team and plan for every patient with the relevant doctors, therapists and staff. We look forward to providing premium service for TBI patients and others that need neurological care in the Newark area and across New Jersey.