Wednesday, July 27, 2016

Survey Monkey...

...just emailed request for review of Capital Cardiology Associates.  Maybe the group is utilizing a survey company to try to improve conditions for their patients.  I complied.

Friday, July 15, 2016

Report report: 2 yr. TKR FU

  I went to Ortho NY for two-year follow-up visit with Dr. C. for the TKR of my left knee.  Also a three-year check of my right TKR.  After negotiating the wrap-around line of patients at the receptionist window, I went to the X-ray room for fast and efficient pics of both knees, one recumbent of both, and then three views  of each knee while standing.
    Dr. C. introduced me  to an observer who was shadowing him, a student, at Buffalo.  I suppose somebody has to be learning the profession.  Replacement orthopedists will be in great demand; the present generation of the aggressive physically fit will see to that. While Dr. C. is fairly young, a year or so older than my youngest child, he has performed thousands and thousands of surgical procedures.  He is acclaimed for his expertise which derives from experience, so anyone aspiring to be  a skilled surgeon has a long and grueling road ahead. That student looked so young.
     The examination comprises measuring the degree of flexion of the knee, from  0 to 116 or so, with the right knee slightly better. He checks the lateral  movements as well, looks for any indications of loosening. Checks how I walk, asks if I have any problem climbing stairs. I say no problem, don't tell him about my 100 steps a day, wanting to preserve my status as sane.   All looks good. He is very pleased with how the scars look---almost invisible, he says.
    More innovations in technology:  previously the doctor would ask you if you wanted to see your X-rays and if you did, would have you go to the viewer outside the room to look at  the pics.  This time, there was a viewer in the examining room.  Behold your films.  They look like the pictures you can see on the computer sites, your anatomy now a graphic illustration.    Fortunately, my X-ray pictures now look like the "after" pictures, with the leg structures completely straight. Before my first surgery, my legs were so bowed that I couldn't even stand with my knees together.
   Dr. C. pointed out the different components of the knee replacement.  Titanium here, at the tibia, and the femur. The patella, in the center of course, is the area of the problematic. It's plastic he says, a much better plastic than before, but it will eventually be absorbed into the surrounding bone.  Inevitably, but the plastic lasts much longer now, up to 20 years. "How does it get absorbed into the bone?" I asked, "Does it liquefy?"   He said no, it breaks into tiny little particles.  It used to be, he said, that they didn't know why the knee replacements were failing. The immune system tries to ward off the particle invasion, and inflammation results.  Once they figured that out, they worked on developing a better plastic, still not perfect though.
  He asked if I was happy with my knees, how they felt, if they were better than before.  I told him they were pain free, had had no pain at all in left TKR, that I had postponed the surgery for a long time because I dreaded the long and painful results that I had heard and read about.  He said the people who have the worst results are the ones who post their stories; those who have good outcomes don't comment. I said in my experience  I'd found that no one wants to hear about a good outcome.  He said, "Tell them anyway."