Preparing for Knee Surgery: What to Expect

 Preparing for Knee Surgery: What to Expect

Preparation for knee surgery is crucial to ensure the best possible outcomes and minimise risks. It helps patients understand the procedure, mentally and physically prepare for the surgery, and optimise their overall health and well-being before undergoing the operation. 

Proper preparation involves medical evaluations, addressing any pre-existing health conditions, following pre-surgery instructions, and planning for post-surgery recovery. This preparation enhances the effectiveness of the surgery, reduces the risk of complications, and promotes a smoother recovery process.

Pre-Surgery Evaluation

Before undergoing knee surgery, patients typically undergo a pre-surgery evaluation to assess their overall health and determine the best course of action. This evaluation involves several key components to ensure the safety and success of the procedure.

Initial Consultation with the Orthopaedic Surgeon

The first step in the pre-surgery evaluation is an initial consultation with the orthopaedic surgeon. During this appointment, the surgeon will discuss the patient's symptoms, medical history, and treatment goals. They will also review any previous imaging studies, such as X-rays or MRIs, to evaluate the extent of the knee problem. This consultation provides an opportunity for the patient to ask questions, express concerns, and gain a better understanding of the proposed surgical procedure.

Medical History Review and Physical Examination

Following the initial consultation, the orthopaedic surgeon will conduct a thorough review of the patient's medical history and perform a comprehensive physical examination. This includes assessing the range of motion, stability, and strength of the affected knee, as well as evaluating any other joints or areas of concern. 

The surgeon will also inquire about any pre-existing medical conditions, allergies, medications, or previous surgeries that may impact the surgical procedure or recovery process. Additionally, they will assess the patient's overall health status, including factors such as smoking history, alcohol consumption, and exercise habits, which can influence surgical outcomes.

Diagnostic Tests (e.g., MRI, X-rays)

Diagnostic tests like MRI and X-rays are essential in the pre-surgery evaluation for knee procedures. X-rays assess bone structures, while MRI provides detailed images of soft tissues like ligaments and knee cartilage. These tests help orthopaedic surgeons accurately diagnose knee issues, guiding treatment decisions and surgical planning for optimal outcomes.

Physical Preparation

Preparing physically for knee surgery is essential to optimise outcomes and facilitate a smooth recovery process.

Medication Management

Patients may need to make adjustments to their current medications leading up to surgery. This may involve temporarily discontinuing certain medications that could interfere with the surgical procedure or recovery process, such as blood thinners or nonsteroidal anti-inflammatory drugs (NSAIDs). Patients must follow their knee surgeon's instructions regarding medication management and inform them of all medications they are currently taking, including prescription drugs, over-the-counter medications, and supplements.

Lifestyle Modifications

Making lifestyle modifications can help improve overall health and prepare the body for surgery. This may include adopting a healthy diet rich in nutrients to support healing and immune function, as well as maintaining a healthy weight to reduce stress on the knee joint. Regular exercise can also strengthen muscles around the knee, improve flexibility, and enhance cardiovascular fitness, which can aid in the recovery process. Patients should discuss any lifestyle changes with their healthcare provider to ensure they are safe and appropriate.

Pre-surgery Physiotherapy

Participating in pre-surgery physiotherapy can help prepare the knee joint and surrounding muscles for the surgical procedure. Physiotherapy exercises may focus on strengthening muscles, improving range of motion, and reducing pain and inflammation in the affected knee. 

Physiotherapists can also provide education on post-surgery exercises and techniques to optimise recovery. Engaging in pre-surgery physiotherapy can improve surgical outcomes, shorten recovery time, and enhance overall functional outcomes following knee surgery.

Mental and Emotional Preparation

Preparing mentally and emotionally for knee surgery is just as important as physical preparation, as it can significantly impact the overall experience and recovery process.

Understanding the Purpose and Potential Outcomes of the Surgery

Patients should take the time to educate themselves about the purpose and potential outcomes of the surgery. This involves discussing the procedure in detail with their orthopaedic surgeon, understanding the goals of the surgery, and having realistic expectations about the results. Knowing what to expect can help alleviate fears and uncertainties, empowering patients to approach the surgery with confidence and optimism.

Addressing Concerns and Anxieties

It's normal for patients to experience concerns and anxieties leading up to knee surgery. Whether it's fear of the unknown, worries about pain or complications, or concerns about the recovery process, addressing these emotions is essential for mental and emotional preparation. 

Patients should feel comfortable discussing their concerns with their healthcare team, including their orthopaedic surgeon, nurses, and support staff. Seeking support from friends, family members, or support groups can also provide reassurance and encouragement during this time. Additionally, practising relaxation techniques, such as deep breathing exercises or mindfulness meditation, can help manage stress and promote a sense of calmness and emotional well-being.

Pre-Surgery Instructions

Adhering to pre-surgery instructions regarding fasting guidelines and medication protocols can help minimise risks and optimise outcomes for knee surgery. Following these guidelines is essential for ensuring the safety and success of the surgical procedure, as well as promoting a smooth recovery process afterwards.

Fasting Guidelines Before Surgery

Patients are typically instructed to refrain from eating or drinking anything, including water, for a certain period before the scheduled surgery. This fasting period helps reduce the risk of complications related to anaesthesia, such as aspiration pneumonia. Following fasting guidelines is essential to ensure the stomach is empty during surgery, minimising the likelihood of regurgitation and aspiration of stomach contents into the lungs.

Medication Protocols

Patients may receive specific instructions regarding the use of medications before surgery, particularly concerning pain relievers and blood thinners. Some medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and aspirin, can increase the risk of bleeding during surgery and may need to be temporarily discontinued before the procedure. 

Patients should follow their surgeon's recommendations regarding medication management closely, including any adjustments to dosage or timing of medications. It's important to communicate with the healthcare team about all medications being taken, including prescription drugs, over-the-counter medications, and supplements, to ensure a safe surgical experience.

Instructions Regarding Hygiene and Skin Preparation

Patients are advised to shower with antibacterial soap and remove jewellery and nail polish to maintain cleanliness. Specific skin preparation may include using antiseptic wipes to cleanse the surgical site, reducing the risk of infection. Following these instructions diligently is vital for a safe and successful outcome.

Planning for Recovery

Planning for recovery is an essential aspect of preparing for knee surgery, ensuring a smooth transition from the surgical procedure to post-operative care.

Arranging Transportation

Patients should arrange for transportation to and from the surgical facility on the day of the procedure, as they may not be able to drive themselves home following surgery due to the effects of anaesthesia and potential discomfort. Having a designated driver or arranging for transportation services in advance helps ensure a safe and stress-free journey to and from the hospital or outpatient surgical centre.

Preparing the Home Environment

Before undergoing knee surgery, patients should take steps to prepare their home environment for post-operative comfort and convenience. This may include setting up a designated recovery area with essential items within reach, such as pillows, blankets, medications, and assistive devices like crutches or walkers. Clearing pathways and removing obstacles to mobility can also help minimise the risk of falls and ensure a safe recovery environment.

Coordination of Post-surgery Care

Planning for recovery also involves coordinating post-surgery care and rehabilitation appointments with healthcare providers. This may include scheduling follow-up visits with the orthopaedic surgeon, physiotherapy sessions, and any necessary medical consultations or imaging studies. Patients should communicate with their healthcare team to ensure a comprehensive and coordinated approach to post-operative care, addressing any concerns or questions along the way.

Communication with the Healthcare Team

Open communication with the healthcare team is essential when preparing for knee surgery, ensuring that patients feel informed, supported, and confident in their treatment plans.

Open Communication

Patients should maintain open lines of communication with their knee surgeon and medical team throughout the pre-surgery process. This includes discussing any concerns or questions about the procedure, recovery expectations, and potential risks or complications. 

Clear communication allows patients to fully understand their treatment options and make informed decisions about their care. Additionally, patients should inform their healthcare team about any relevant medical history, allergies, or medications they are taking to ensure a comprehensive approach to their treatment.

Addressing Concerns

Before surgery, patients may have last-minute questions or concerns that they wish to discuss with their healthcare team. Whether it's clarifying instructions, addressing anxiety about the procedure, or discussing post-operative care plans, patients should feel comfortable voicing their concerns and seeking clarification from their surgeon or medical team. Addressing these concerns can help alleviate anxiety and ensure that patients feel confident and prepared for their upcoming knee surgery.

Bottom Line

Adhering to pre-surgery instructions and actively engaging in the recovery process are crucial for ensuring the best outcomes post-knee surgery. By following guidelines meticulously, patients minimise surgical risks and create an optimal environment for recovery. 

Active participation, including pre-surgery physiotherapy and lifestyle adjustments, accelerates healing and strengthens the knee. Moreover, mental readiness and open communication with healthcare providers foster confidence and empowerment throughout the journey. By embracing these steps, patients pave the way for a smoother recovery and a return to optimal knee health and function.

Recognising Chronic Shoulder Discomfort

 Shoulder pain is a widespread issue affecting people of various ages and backgrounds in Singapore. In today's fast-paced world, people engaging in repetitive or strenuous activities may be more susceptible to shoulder discomfort. Occupations that involve repetitive overhead movements, such as those in construction or sports, can contribute to the development of shoulder pain. Additionally, the ageing process may bring about wear and tear on the joints, increasing the risk of shoulder-related problems. This discomfort can vary widely in its nature and duration, creating a need to distinguish between acute and chronic shoulder pain.

Difference Between Acute and Chronic Shoulder Pain

Acute shoulder pain typically arises suddenly and is often associated with a specific incident or injury. This type of pain can result from trauma, such as a fall or sudden impact, causing immediate discomfort and restricted mobility. Acute shoulder injuries may involve sprains, strains, dislocations, or fractures.

Chronic shoulder pain, on the other hand, persists over an extended period, ranging from weeks to months or even years. Unlike acute pain, chronic shoulder discomfort may not have a clear, singular cause and can be influenced by various factors, such as repetitive stress, overuse, or underlying medical conditions. 

Common Injuries Contributing to Shoulder Pain

A. Rotator Cuff Injuries

The rotator cuff is a group of muscles and tendons that surround the shoulder joint, providing stability and enabling a wide range of motion. Composing the supraspinatus, infraspinatus, teres minor, and subscapularis muscles, the rotator cuff plays a pivotal role in lifting, rotating, and moving the arm.

Causes

Rotator cuff injuries can arise from various factors, with the most common being:

• Trauma: A sudden impact or force on the shoulder, such as a fall or collision.

• Overuse: Repetitive overhead motions or excessive strain on the shoulder, common in activities like pitching, swimming, or weightlifting.

• Age-related degeneration: Gradual wear and tear of the tendons due to ageing, making them more susceptible to injuries.

Symptoms

• Pain: Persistent pain, particularly when lifting or rotating the arm.

• Weakness: Difficulty in lifting or holding objects, indicating muscle weakness.

• Limited Range of Motion: Reduced ability to move the arm freely, especially overhead.

• Crepitus: A crackling or popping sensation during shoulder movement.

• Sleep Disturbances: Discomfort that may disrupt sleep, especially when lying on the affected shoulder.

B. Frozen Shoulder (adhesive capsulitis)

Frozen shoulder, clinically known as adhesive capsulitis, is a condition characterised by the gradual onset of pain and stiffness in the shoulder joint. This disorder primarily affects the capsule, a connective tissue surrounding the shoulder joint, leading to inflammation and the formation of adhesions. This results in restricted movement and persistent pain, impacting daily activities.

Factors Leading to Frozen Shoulders

• Inflammatory Response: The exact cause of frozen shoulders is not always clear, but inflammation within the shoulder joint is a common trigger. This inflammation can result from various factors, including trauma, surgery, or systemic conditions such as diabetes.

• Immobility or Lack of Use: Prolonged immobility or limited use of the shoulder joint, often due to injury, surgery, or prolonged periods of inactivity, can contribute to the development of adhesive capsulitis.

• Systemic Diseases: Certain medical conditions, such as diabetes, autoimmune diseases, or cardiovascular disorders, have been linked to an increased risk of developing frozen shoulders.

• Age and Gender: People between the ages of 40 and 60, and women more frequently than men, are more susceptible to developing frozen shoulders.

• Previous Shoulder Trauma: Any history of shoulder injury, surgery, or trauma can increase the risk of developing adhesive capsulitis.

C. Shoulder Impingement Syndrome

Shoulder impingement syndrome is a common orthopaedic condition that occurs when the tendons of the rotator cuff muscles become compressed or irritated as they pass through the subacromial space. This space is located beneath the acromion, the bony prominence of the shoulder blade. The impingement typically occurs during shoulder movements, leading to irritation, inflammation, and discomfort.

Activities and Conditions Contributing to Impingement

• Overhead Activities: Repetitive overhead activities, such as reaching, lifting, or throwing, can contribute to impingement syndrome. Athletes involved in sports like swimming, baseball, or weightlifting may be particularly susceptible.

• Poor Posture: Maintaining poor posture, especially with rounded shoulders or a forward head position, alters the alignment of the shoulder joint. This misalignment increases the risk of impingement during routine movements.

• Muscle Imbalances: Weakness or imbalance in the muscles surrounding the shoulder, especially the rotator cuff muscles, can lead to abnormal joint mechanics and impingement.

• Bone Spurs: Over time, the development of bone spurs on the acromion can reduce the available space for the rotator cuff tendons, contributing to impingement.

• Trauma or Injury: Previous shoulder injuries or trauma, such as dislocations or fractures, can alter the joint's anatomy and contribute to impingement.

• Ageing: As people age, natural wear and tear on the shoulder joint can lead to changes in the structures, increasing the risk of impingement.

D. Labral tears

The labrum is a ring of cartilage that surrounds the socket of the shoulder joint, enhancing its stability and providing support for the shoulder's range of motion. It acts as a cushion and helps keep the humeral head securely within the socket during movements.

Causes and consequences of labral tears

• Trauma: Acute injuries, such as dislocations or heavy falls on the outstretched arm, can cause labral tears. Trauma-related labral tears are often seen in athletes involved in contact sports.

• Repetitive Overuse: Continuous overhead activities, common in sports like baseball, swimming, or weightlifting, can lead to gradual wear and tear of the labrum, eventually resulting in tears.

• Anatomical Variations: Some people may have structural abnormalities in the shoulder joint, making them more susceptible to labral tears.

• Age-Related Changes: Over time, the labrum may degenerate as part of the natural ageing process, making it more prone to tears.

• Instability: People with shoulder instability, where the joint is overly loose, are at an increased risk of labral tears.

Conclusion

Common injuries leading to chronic shoulder pain encompass rotator cuff injuries, frozen shoulder (adhesive capsulitis), shoulder impingement syndrome, and labral tears. These shoulder pain conditions can arise from a combination of factors, such as traumatic incidents, overuse, and underlying anatomical issues. Recognising the distinctive characteristics of each injury is crucial for accurate diagnosis and tailored treatment. Encouraging people experiencing shoulder pain in Singapore to seek timely medical attention is vital for early diagnosis and intervention. Timely care can prevent the progression of acute injuries into chronic conditions, preserving shoulder function and minimising long-term discomfort. 

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HIV Symptoms: How to know when to get HIV test

HIV Symptoms: How to know when to get HIV test

 

I.                     What is HIV?

II.                   Who is at risk for HIV?

III.                 Early Symptoms of HIV

IV.                When to see a doctor?

V.                  Importance of getting tested

VI.                Conclusion – It’s not too late for an HIV test

Have you noticed your immune system weakening lately? You know that you have a healthy body but lately you get sick so easily and you are experiencing muscle and joint pains. What if I tell you that those are signs of viral infection? Once viruses enter the body, it multiplies inside the body’s healthy cells which is why your immune system weakens. Actually, even though you feel fine, your body is still home to the infection. That’s why it’s important for everyone to take good care of themselves. In this article, we’ll discuss one of the dangerous viral infections that you need to protect yourself from, including its initial symptoms for you to know when to get an HIV test.

 

What is HIV?

Human immunodeficiency virus, also known as HIV, targets the immune system of the body. It is a infectious disease that spreads by several ways, including:

 

By having sex – The most common way of HIV transmission is through genital secretions. There’s a high possibility for you to get infected if your infected partner whose body fluid, semen or vaginal discharge enter your body.

 

By sharing needles – The blood of an infected person can also bring harm to you. You run a high risk of contracting HIV and other infectious diseases like hepatitis if you share infected injection needles and syringes.

 

From blood transfusions – HIV can also be transmitted through blood transfusions. That's why it’s important to screen the blood supply for HIV to prevent the disease from being passed to other people.

 

During pregnancy – When an infected woman gets pregnant, she can possibly pass the virus to her baby during her pregnancy. However, she can lower the risk of transmission by getting treatment for the infection.

 

Who is at risk for HIV?

HIV isn’t a disease that you’ll get from aging. Aside from having it caused by a genetic factor, it is a viral infection that you may get unexpectedly. But the most common cause of transmission is through sexual contact so if you’re someone who engages in unprotected sex or has multiple sexual partners, consider yourself as someone who is at risk of contracting the HIV virus. Being sexually active with someone who is HIV-positive makes you a potential HIV carrier too.

 

Early symptoms of HIV

These early symptoms are often referred to as primary HIV infection or acute retroviral syndrome. HIV carriers don't experience the same symptoms. But people who are infected usually experience the following:

• fever

• headache

• muscle aches and joint pain

• sore throats and mouth sores

• skin rash

• night sweats

• swollen lymph nodes

• diarrhea

 

The early symptoms might occur within 2 to 4 weeks of contracting the virus. Your body's immune system fights back at this point. They usually last a week or two before disappearing.

When to see a doctor?

Since HIV signs and symptoms are similar to those of other viral infections, it’s normal for a person to not immediately recognize their HIV infection. And the mere presence of these signs does not necessarily mean you have HIV infection. That’s why it’s important to get tested even if you are symptom-free but believe you may have come into touch with the virus.

 

Early diagnosis is key. You can’t rely on the symptoms alone to know if you have contracted the virus or not. It’s better to seek your health care provider as soon as possible. Isn't it more believable if the doctor will be the one to tell you that you have or haven’t been infected with HIV? If you’re really HIV positive it’ll be good coz you found it out before it gets worse. The sooner you find out your HIV, the sooner you can begin your treatment.

 

Importance of getting tested

HIV is a disease that cannot be cured but with the help of HIV treatment (called antiretroviral therapy or ART), people with HIV can remain healthy for many years. Without treatment, your HIV will get worse over time and eventually weakens the immune system. This leads to Acquired Immunodeficiency Syndrome (AIDS) which is a life-threatening condition. Seeking medical care right away benefits you and your partner as it prevents the progression of HIV to AIDS. Taking an HIV test also prevents transmission to others through other ways. Once you’re aware that you are HIV positive you’ll probably be more careful about the injections you used and you wouldn’t dare to let other people use it. Same with donating blood of course you shouldn’t do it anymore.

 

In fact, you can take an HIV test even if you don’t have symptoms or you are not exposed to someone who has it. It can be part of your monthly health check-up. It’s one way to take care of yourself especially if you’re sexually active. Do it for yourself. It’s your body and nobody will protect it aside from you. 

It’s not too late for an HIV test

Once HIV has weakened your immune system, you are more likely to have its symptoms that a healthy body wouldn’t be able to resist. It's important to be aware of the early warning signs of HIV transmission so you can start your treatment right away. HIV can be controlled and prevented from progressing to AIDS by early detection and immediate treatment. So if you want to make sure you’re safe from the danger it brings, consult your doctor for an HIV test.