23.03.15 23:46:42

Hello! I would like to write about my stay with the baby in the pediatric surgery of MONIKA. We were hospitalized at the beginning of April 2015 with a diagnosis of cryptorchidism. I’ll tell you right away how it ended: on the third day the child’s temperature rose and we were sent home. We’ll go again. 1) How we arrived (we arrived at 10:30): first go to the pediatric surgery, without the child with documents. There they check the tests, issue a visa and send you to the emergency department. In the first window, documents and analyzes are checked again. In another room, the child is examined, the temperature is checked and sent into the corridor to wait (there are lines everywhere, it is better to take something to eat and drink with you). Then your name is shouted out from the third office and a mourner comes. The nurse told us to quickly follow her into the car with our things. And we were taken in a gazelle with documents, things and other things to building 15. Dad can take you to the 6th floor hall. What I didn’t like: discharge after 12, and admission of new patients before 12. As a result, I have more than once seen unhappy parents with children waiting for a long time for hospitalization. And there were no free beds. Outerwear should be given to accompanying persons, but many leave it so that they can go out to the store. 2) Regarding the conditions of stay: Quite clean. Freshly renovated. They wash it every day. Chambers for 4-5 people (4 children and 4 mothers, respectively). Mostly mothers and children on one bed with one pillow. But there are cots for very small children. My child is 1.7. We weren't supposed to have a games room. Quite decent. Lots of toys: rides, cars, dolls, Legos, etc. There is a TV set with Masha and the Bear discs. Experienced mothers immediately warned us that we shouldn’t go to the playroom, it’s a breeding ground for all sorts of infections. We walked. Because it is impossible to stop my hurricane. And there’s nothing to do other than play. A corridor with doors and everything. On the ground floor there is a pharmacy and some machines with tea and coffee. Everyone runs by agreement with the nurses at Dixie across the street. They swear at everyone that they are carrying trunks with them. What would it be like without them? They seem to provide pots there. Teapots are possible. Each room has a toilet, sink, refrigerator and trash can. One closet for everyone. Everyone has a bedside table and a chair. There is one shower per floor. There was no hot water. There is a laundry room and there is also a bathroom there. We washed in it. You can dry your clothes only in this “laundry room”. 3) Meals: breakfast, lunch and dinner. I didn't think it was completely terrible. For breakfast, porridge or omelet, casserole, pasta, bread. Lunch: soup, main course, and thin porridge. Dinner: side dish and cutlet or something similar. Sometimes they give fruit. Kefir, Ryazhenka. You won't remain hungry. What I liked: there is always at least some choice. I took us 2 plates and 2 cups and asked for different food. At least my child ate something. There are two IKEA high chairs. Eating is allowed only in the dining room. But as with everything, of course there are exceptions. I took cottage cheese with me, boiled several sausages in advance, and prepared porridge. And fed the cub. In the dining room there is a microwave in free access and hot water. Water in the kettle. Plates, cups, table. Your own devices. 4) Length of stay: Almost immediately after our check-in, our doctor (surgeon) came to see us. He examined me, signed some papers and said that we were preparing for an operation tomorrow and from 6 in the morning not to drink or eat. This is the worst thing! It's hot in the room. The child constantly asks for a drink. We just wet our lips and cried. Then he figured out what he could look for in other people’s bedside tables and went around the wards to beg. Well, horror! At about 10-11 o'clock we were informed that there would be no operation. Breakfast was over by then. This is where our feeding came in handy. The next day, the same thing: don’t drink, don’t eat... That’s when our temperature jumped. It’s disgusting... But it was even more offensive for my roommate, who was also preparing with her daughter and was starving. At 11 they were told that the operation was postponed, eat. They managed to eat 3-4 spoons and drink water when the doctor came running and said that a place had become available and they would be operated on. But when he learned that they had eaten, he naturally did not take them. Thus, you can lie there for a week, or even two. They don't operate on weekends. Not always on Fridays either (washing day). Many emergency children are brought in. Children from the age of 5 (seemingly) are without parents. And the mothers present in the ward should help these children. It's impossible to visit. But everyone arrives and sees each other in the lobby near the elevators. 5) Daily routine: breakfast at 9. Detour at 10-10. 30. At 13 lunch. From 14-16 quiet time. It seems like dinner at 6 p.m. Evening round around 22. All rounds are very conditional in time +/- an hour. The staff is sane. No one ever yelled at us or said anything nasty - that’s not bad. An ultrasound was done as if by chance. No lines or waiting, they just came to the dining room for us and they told us to go to the ultrasound room. We came and did it without any problems. Very nice and sincere doctor there. Found our lost egg and calmed the always crying mother. I can't say anything particularly bad. It was just difficult for me and my baby due to his hyperactivity and our joint inability to cope with hospitals. Waiting for surgery is, of course, hard. I can advise you to immediately be patient (they will operate quickly - it will be a pleasant surprise). Stock up on kipferon, viferon, influferon and other antiviral support drugs. Good luck to all of us and our children!

Why do people who have undergone knee replacement have such different reviews? The fact is that when it comes to the hip joint, everything is relatively simple, and the results are almost always positive.

• Types of endoprostheses
• Endoprosthesis replacement surgery
• Rehabilitation period after endoprosthetics

But it is difficult to replace a knee, and complications often occur:

• infection of the endoprosthesis area,
• dislocation of the prosthesis,
• rupture of the patellar ligament,
• thrombosis of the veins of the leg,
• fracture of the femur.

For the sake of truth, it should be said that these cases are isolated, but they took place 10 years ago, and today there are much fewer complaining patients. All complications have anatomical and biochemical features. Today, the design of the endoprosthesis itself and the technology of the operation minimize the percentage of subsequent complications. But even the most successful work of a surgeon requires competent rehabilitation during the recovery period.

Types of endoprostheses

Endoprostheses for large joints, including the knee, are becoming more accessible. Thanks to frequent operations. This artificial product is placed in the body to replace a worn out or damaged organ. Complex endoprostheses made of high-quality materials, which have undergone numerous tests, trials and studies, are more expensive than their Chinese counterparts.

When the entire knee joint is replaced, it is called total arthroplasty. Sometimes a partial replacement of a department is enough. The materials from which the prosthesis is made depend on the manufacturer: durable plastic, metal alloy, ceramics. It is fixed to the bone using acrylic bone cement. The surgeon determines which type of endoprosthesis is right for you, since there are more than 150 models of implants on the market.

Modern implants take into account all the nuances and features of the knee structure and do not represent, as before, just a hinge. Recent studies have shown that male and female knees are different, so gender is also taken into account when designing. When choosing a model, the patient’s age, weight, general condition, degree of activity, and cost are important. Some clinics make custom prostheses.

Endoprosthesis replacement surgery

Usually implantation lasts 2-3 hours. Prevention of infectious complications is mandatory. Before installing the endoprosthesis, the destroyed parts of the knee joint, the back of the kneecap are removed and the axis of the leg is aligned. If necessary, the surgeon can restore the integrity of the knee ligaments.

Today, high-quality prostheses allow you to bend your leg up to 155 degrees. People wrote in reviews that after the operation, before discharge, they already bent their knee 75 degrees. But there is still a rehabilitation period ahead, which is no less important than the prosthetics itself. Often, when you come across reviews about complications after knee replacement surgery, it becomes clear that a big mistake was made in the postoperative period.

It is worth mentioning that spinal anesthesia is given before the operation. Judging by what eyewitnesses say, the sound accompanying this whole thing is not very pleasant to bear, therefore, if the anesthesiologist does not mind, you can ask for “sleep”. It takes courage to undergo surgery, but determination and patience are required during recovery.

Rehabilitation period after endoprosthetics

All patients who have undergone knee replacement write about how effective the recovery measures are. For some it takes 2 months, for others six months. But the result is almost always positive. The main thing is to work tirelessly on your renewed knee.

You should start fighting for recovery on the very first day. The main stage is the exercises that need to be done in the morning, afternoon, and evening:

• raising a straight leg;
• bending the knee with support on the bed;
• bending the knee while sitting without support;
• bending the knee while sitting with support from the healthy leg;
• straightening the knee joint;
• ankle rotation. Working calf muscles help normalize blood circulation.

The set of exercises and their duration are determined by the doctor individually for each person. Some were impressed by a special device for passive flexion and extension of the knee, the use of which is called mechanotherapy. In mechanotherapy, specially designed mechanisms and devices are used for physical exercises.

It is very important to learn to walk with the help of a walker or crutches. This way you can feel like a truly complete person. Try to take care of yourself, without outside help. Move the walker or crutches close to the body and step on the heel of the operated leg, and then on the entire foot, after which you can tear the big toe of the healthy leg off the floor. Over time, patients switch to a cane.

A new knee, new steps, new movements, a new life - this is what awaits the persistent and obedient patient. As for the effect of joint replacement, one thing is clear - everything is good, which brings relief to the patient.

Not every person knows that gonarthrosis is the same well-known arthrosis of the knee joint. The disease is characterized by chronic degenerative damage to the knee joints, where not only the interarticular cartilage tissues are destroyed, but also the bone structures, if the disease is allowed to develop to its extreme stages. Knee problems can occur in one or both of them.

The knee joint is a very complex mechanism, consisting of many small components, with the coordinated work of which, a person moves from place to place at different speeds, squats, stands up, and so on. It is this area of ​​the body that bears the load of the entire human body. Excess weight can be the main cause of the development of a disease such as arthrosis. The initial manifestations of gonarthrosis are invisible, as there is a gradual thinning of the layer of cartilage tissue. With the initial degree of arthrosis of the knee joint, a person almost does not feel any changes occurring in the lower extremities. This phenomenon may begin to cause concern only a couple of years after the onset of the disease, if measures are not taken in time to prevent its progression.

It is mistakenly believed that arthrosis of the knee joint does not threaten young people - they simply do not notice it. An unhealthy lifestyle (smoking and alcohol), frequent injuries, sprains, excessive stress on the body, wearing high heels, strict diets, which provoke a vitamin deficiency in the body, will certainly lead to the development of the disease.

The main symptoms of arthrosis of the knee joint

You should not lose sight of the manifestations of the first signs of such an unpleasant disease as arthrosis of the knee joint, if you do not want to subsequently lose the ability to move freely or resort to a more radical method of treating arthrosis of the knee joint - surgery.

The main symptoms of articular deformity, both knee and hip, are:

Having noted the above, do not delay until later - get examined and begin treatment for arthrosis of the knee joint in order to restore the regeneration of cartilage tissue throughout the body in the initial stages of the disease or slow down its destructive process.

Common degrees of arthrosis of the knee joint

There are three degrees of the disease:

I degree is the initial stage of the disease. Almost not felt by the patient. Occasionally, minor pain occurs when walking or running quickly; sometimes the knee areas become swollen for a short period of time. In a state of rest, nothing bothers you. During the examination, X-ray images already show a certain change - the thickness of the interarticular space has been reduced.

II degree – the inflammatory process is gaining strength. Long-term pain increases, even with little physical activity. Pain relief is achieved by taking painkillers. When bending and extending the leg, limited movement appears, the patient already hears clicks and crunching of the interarticular joints. With the initial degree of detection of arthrosis of the knee joint, a slight deformation occurs, and therefore there is a moderate limitation of motor functions. The load on the legs is not distributed evenly. In places where the cartilage has already disappeared, osteophytes (bone growths) appear, which causes severe pain. X-ray images clearly show the growth of bone inclusions along the edges of the articulation, the interarticular gap becomes thinner.

III degree – characterized by incessant pain. Changes in a person's gait and the appearance of the knee are visible to the naked eye. The patient can hardly bend or straighten his legs. An X-ray image shows an absolute absence of cartilage tissue, a huge amount of pathological bone structure in the joint and destruction of the main interarticular joints. This degree of the knee joint is the most severe; often the only option to help the patient is endoprosthetics.

Treatment for the first stage of the disease

Let us dwell in more detail on the first stage, since it is easier to prevent the disease than to treat advanced arthrosis of the knee joint.

Diagnosis of arthrosis

An orthopedist with extensive experience in medical practice may suspect grade 1 arthrosis of the knee joint based on an external examination and the presenting symptoms. He can receive confirmation of the preliminary diagnosis thanks to a simple x-ray, which shows a slight narrowing of the joint space, which has arisen due to the beginning of thinning of the cartilage tissue. There is no need to undergo more expensive diagnostic procedures, such as computed tomography or MSCT.

The disease can be either bilateral - bilateral arthrosis, or unilateral, for example - arthrosis of the left (right) knee joint or arthrosis of the right knee joint.

Drug treatment

With arthrosis of the 1st degree, you can even begin treatment of the knee joint with home remedies - ointments, creams, medications - chondoprotectors, but to achieve maximum results it will be necessary to resort to clinical help - physiotherapy, manual therapy, the use of intra-articular injections, non-steroidal anti-inflammatory drugs.

Before starting treatment for arthrosis of this degree of the knee joint, it is necessary to seek the advice of an orthopedist, because the objectives of treatment include:

• body weight correction,
• correctly selected drug treatment that is suitable for you,
• a set of physical therapy exercises,
• a certain type of massage,
• physical therapy or manual therapy.

The doctor will tell you how to adhere to the diet correctly so as not to cause more damage to the cartilage tissues of the body and at the same time lose weight, which will reduce the load on the patient’s lower limbs.

Taking chondoprotectors helps relieve joint pain, restore (that is, regenerate) cartilage tissue, and strengthen interarticular cartilage. This type of drug contains glucosamine and chondroitin sulfate, which affect cartilage tissue. The most well-known drugs are: Dona, Chondrolon, Teraflex, Structum, Chondroxide (in the form of tablets and ointments). To achieve the best results, it is recommended to undergo several courses of treatment with chondoprotectors, in combination with physiotherapy and therapeutic exercises.

Therapeutic exercise

An individual set of physical therapy exercises is the most important process in the treatment of early-stage arthrosis. As noted above, nutrition of cartilage tissue occurs precisely at the moment of movement of the joint. That is, the best regeneration will occur when taking chondoprotectors and exercising, as blood circulation in the tissues improves, thereby achieving rapid delivery of necessary nutrients throughout the body. Gymnastics will also help strengthen the leg muscles, so the load will also fall on the muscle tissue. After physical therapy exercises, massage is performed to achieve better results from manual therapy.

Practical advice from the best chiropractor Vitaly Demyanovich Gitt.

Physiotherapy

Physiotherapeutic treatment for arthrosis may include:

• magnetic therapy – applied locally, stimulates regenerative processes, improves blood circulation in the joints,
• electrophoresis – medications are administered locally, which facilitates their direct delivery to the affected area, thereby accelerating the recovery process,
• Ultrasound influence – helps to improve the functioning of cellular metabolism.

Conclusion

You should not resort to all of the above treatment methods on your own for early-stage arthrosis. It may be excessive or insufficient, which can lead to further development of the disease. If you follow the recommendations of the attending physician, the dynamics will be monitored and, in accordance with its results, the doctor can make adjustments to the treatment plan and thereby relieve you of the disease or slow down the development process.

Knee replacement: rehabilitation after surgery, complications

Endoprosthetics is a surgical operation in which a person’s damaged or destroyed joint is replaced with an artificial analogue.

Replacement of joints with artificial implants is indicated for patients for whom a complex of conservative treatment has not brought results, and the damaged joint cannot function normally.

As a rule, prosthetics are performed against the background of severe forms of arthrosis or after a serious injury to the joint. The cartilage pad that exists between the bones of the joint wears out, preventing the knee from working normally.

There are several other causes of osteoarthritis:

• rheumatism,
• metabolic disorders,
• infections.

The purpose of the operation is to reduce pain and restore the functionality of the joint. The structure of the prosthesis closely follows the natural architecture of the joint. Modern dentures are made of metal and ceramics; they last up to 20 years; after they become obsolete, they are replaced with new ones.

To fully resume your normal lifestyle after knee or hip replacement, it is not enough to undergo a total surgical intervention.

After the operation, rehabilitation is necessary.

The first day after endoprosthetics

If endoprosthetics was successful and there are no contraindications, then within a few hours after surgery the patient can sit down. You can hang your legs off the bed and get up only on the second day.

You need to be prepared for the fact that the rehabilitation period will take at least three months. This time is purely individual and depends on the age, weight and general condition of the patient.

To prevent a blood clot, the patient should wear special stockings or use an elastic bandage.

For a quick recovery, you must follow all medical recommendations and do a set of exercises that are designed specifically for people after knee replacement.

In order to get out of bed correctly for the first time after surgery, it is important to know the following rules:

• you need to stand on the side of the healthy limb,
• before getting out of bed, the leg should be extended forward and not bent,
• When lifting, you need to rely only on crutches and your healthy leg. For the first time, it is best to carry out the procedure together with a doctor, and stand up, leaning on another person,
• the floor should not be slippery to avoid burning and damage to the operated limb.

The patient should take the first steps as carefully as possible. Do not put any weight on the operated leg; it is lightly touched to the floor. The load on the joint should increase gradually, every day.

After knee replacement, the person remains in hospital for several more days to exclude unexpected changes in condition.

At this time, doctors monitor the patient’s general well-being and teach him the necessary set of gymnastic exercises, which the person will then do independently at home.

In addition to independent exercises, doctors prescribe the patient a course of therapeutic and preventive exercises - exercise therapy.

Exercises after knee replacement

Only if you perform daily special exercises will the normal functioning of the knee be restored and complications excluded. After the operation, a person must take painkillers for several days; gymnastics is carried out after the doctor’s permission.

Later, any gymnastics is performed without taking painkillers. These medications reduce sensation levels, which can lead to unexpected knee damage.

Gymnastics complex:

1. Flex and straighten the ankle joint. Each exercise is repeated five times, then the number increases to 20 times as recovery progresses.
2. Tighten the anterior thigh muscles and keep them toned for 2-5 seconds. Do the same with the back muscles of the thigh,
3. Hold your gluteal muscles tense for about 5 seconds,
4. In a lying position, raise your straight legs at an angle of 45 degrees and hold them for about 5 seconds,
5. Move your hips to the side several times
6. Move the straightened prosthetic leg back.

It should be noted that all procedures are necessary for the restoration of the knee joint to take place in a short time. Exercise therapy is a procedure that is also initially characterized by pain and discomfort; it is important to strictly follow the doctor’s recommendations and perform the exercises.

Sometimes exercise can cause swelling in the operated leg, which can be relieved with a cold compress. During the recovery period at home, it is best to supplement therapeutic exercises with physical activity:

1. cycling,
2. swimming,
3. massage.

All this stimulates the muscles and enriches the blood with oxygen, which promotes successful tissue healing and prevents various complications after knee replacement.

At the same time, the prosthetic limb should not be subjected to heavy loads.

Contraindications

After knee replacement and a rehabilitation period, most people return to a normal lifestyle. It is important to follow some rules that will help you successfully recover and extend the life of the endoprosthesis.

After surgery, doctors advise you to gradually carry out your usual activities. Can:

1. drive a car,
2. do a little work at home,
3. walk up the stairs.

Despite the fact that quick recovery requires gymnastic exercises, exercise therapy and walking, doctors prohibit the following types of physical activity:

• jumping,
• aerobics
• some sports: tennis, skiing, etc.

Any type of knee or hip replacement does not involve lifting heavy objects.

Pain is completely normal after knee replacement. In the period after surgery, you should not abuse painkillers. The pain is relieved by a compress or relaxing massage.

It is important to remember that developing the knee joint is the best way to get used to the prosthesis.

The leg will not hurt when the body gets used to its condition and muscle activity is restored.

Rehabilitation and complications

Each person’s body has its own characteristics, and it is possible that complications may arise after joint replacement.

Sometimes after replacement the joint is also unstable and additional surgery is necessary to correct the situation. After surgery, the wound may become infected and the patient is prescribed antibiotics.

For six weeks after surgery, there is a risk of swelling and blood clots, so you will need to wear special stockings and take blood thinners.

Rehabilitation after knee replacement includes exercise therapy, this helps normalize blood circulation in the legs, and a special massage relieves swelling.

After surgery, there is a possibility of a fracture or crack in the bone near the implanted implant. During the healing period, scar tissue appears, which can cause limitations in joint mobility; it is removed surgically.

The kneecap may become dislodged; it can only be put back in place through surgery. There is also a risk of deformation of the artificial implant itself.

For some time, the postoperative scar and adjacent skin will have reduced sensitivity and numbness.

The rehabilitation period and knee replacement are serious processes, so it is important to follow all medical recommendations and responsibly perform the necessary exercises at home or in a sanatorium.

The prosthesis makes it possible to lead a normal lifestyle. However, there are still certain motor limitations.

Many sanatoriums offer rehabilitation procedures after endoprosthetics. But not all courses have a set of equipment, so it is important to carefully choose a place where total restoration of the condition will be ensured.

Many patients prefer to visit sanatoriums abroad. Such sanatoriums offer patients a full range of services, they have modern equipment, and the medical staff has the entire base of necessary skills.

The cost of services that provide total limb restoration in a sanatorium is quite moderate, which is why such establishments are traditionally popular and in demand.

Disability and rehabilitation after knee replacement

For diseases that destroy joints and bone tissue, patients are entitled to disability benefits. To obtain it, you need to collect all the necessary documentation, photographs, as well as a medical certificate stating that the person cannot perform full independent movement.

Rehabilitation after knee replacement may also result in disability status if the patient is unable to move at the level necessary to perform activities.

Social assistance is provided for 1 year. To extend payments, after this period you need to undergo a second examination procedure, providing documents to a special commission on disability.