Hip Replacement?

[CobraIV]

I know this is an EMS fourm but I just have an orthopaedic type thought. I work as a CNA on a rehab floor. The closest thing to a hospital. You think rehab floor CNA, Cleans,Nasty,Asses. You think old crusty people who :censored::censored::censored::censored: themselfs and wear dipers. Thats what I thought atleast when I first started. It's alittle more diffrent then that. I see alot of things from knee replacements,vents,hospice, fluff and buffs , strokes all sorts of patients. Young & old.

Today was no diffrent. I have this patient, shes 85 years old alert and oriented history of arthritis in her knees and back. You tranfer her from chair to bed and see cracks like a floor board. The lady looks like Mrs.Clause very nice and pleasent but her bottom half is big and wide. She can't stand for more then a mintute. She tends to hunch over when she stands. Now how can a women like this take care of herself?

To get to the point, the lady has been in the rehab center for more then 4 months. She has now decided to go through hip replacement surgery in the hopes of being able to walk again. I understand the pain and arthritis is no fun and a replacement is sometimes nessacery for some patients but for a 85 year old lady who wont even walk into the bathroom, who rather stays in bed then go to physical therapy. Whats the point of going through surgrey?


Any thoughts?


Sorry if I am wrong for posting this. I see a lot of emt's drop off hip replacement patients.The stretcher to bed transfers don't always go that smooth.

 

[firetender]

To get to the point...a 85 year old lady who wont even walk into the bathroom, who rather stays in bed then go to physical therapy. Whats the point of going through surgrey?

You're asking us to render a judgment on someone's choice to go through painful surgery. Just because we move patients from here to there does NOT mean we're qualified to make a call on this. I see no tie in to EMS; perhaps you could find something solid for us to consider, directly relatable to the work.

 

[Melclin]

Maybe it is pointless. Maybe she wants to give it shot. More importantly, how are we to know? What exactly is your point in asking us?

How is this appropriate for "Advanced Medical Discussion"? This is more of a lounge type thing I would have thought.

 

[usalsfyre]

Medical ethics scenario more than anything else, but I'll have to say I'm surprised she found a surgeon.

It simply speaks to the unrealistic expectations patients have about modern medicine. They've been told we work miracles so often that they think EVERYONE will be a miracle.

 

[LondonMedic]

I wouldn't want to be paying into her health insurance policy.

It's clearly rubbish, she'll liked get some minor symptom improvement and a tiny bit more mobility at the cost of a large peri-operative risk.

Immsurprised she found a surgeon, an anaesthetist and a hospital willing to share that risk with her but I guess that's the beauty of the American health system.

 

[Martyn]

Immsurprised she found a surgeon, an anaesthetist and a hospital willing to share that risk with her but I guess that's the beauty of the American health system.

It's all money, money, money over here

 

[Jay]

To get to the point, the lady has been in the rehab center for more then 4 months. She has now decided to go through hip replacement surgery in the hopes of being able to walk again. I understand the pain and arthritis is no fun and a replacement is sometimes nessacery for some patients but for a 85 year old lady who wont even walk into the bathroom, who rather stays in bed then go to physical therapy. Whats the point of going through surgrey?

I will share with you a personal story that you may or may not know about me. Back in 2004 I was in a bad MVA and over time found out that I needed spinal surgery as all of the other, more conservative treatments did not help. I had to give up the martial arts which were one of my favorite hobbies and over time gained more weight than I would have liked to. Flash forward a few years, I had the surgery and after almost two months I was feeling greater than I have felt in years. Remember that therapy and exercise were no longer an option for me since unlike musculoskeletal injuries the spinal nerves themselves were damaged and impinged. Since I waited such a long time, aside from the weight gain, I was told that it would takes weeks or months, maybe even a year or so to get the feeling back to parts of my leg and that some feeling will never return. Well, last November I was hit by a driver illegally crossing a median to make a u-turn in the rain, he was driving an F-350 which is a fairly large truck and I hydroplaned at a decent rate of speed for almost a hundred feet totaling out into a parked car. There was a decent impact as axles broke off my vehicle. I knew then and there while waiting for EMS to arrive that the nerve pain was back and that the disc(s) re-ruptured. Bottom line was that I had two herniations, a large rupture and muscle injury just to add the cherry to the top and I am seeing my neurosurgeon again in two weeks to reschedule surgery.

Here is what I am getting at:

1. Muscle injuries may take a week to two or three to heal when in a side-impact collision but the key factor is that muscles heal amazingly well compared to other bodily systems.

2. Other systems such as nerve and bone-specific sub-systems can take a much longer time to heal or may never heal absent of surgery.

3. During the duration that it takes for some areas of the body to improve or to try different therapies; other areas of the body may suffer, e.g. weight gain.

4. By the time certain issues are treated such as something that a surgeon needs to resolve that has no chance of healing on its own, the body can be totally out of whack, not just from weight gain or atrophy of muscles but suppose medications were being used such as anti-seizure to control the nerves from "misfiring" or anti-spasmodic, the body has to readjust itself into a homeostatic condition after the medications are terminated.

Bottom line that I know now from first hand experience is that this poor-soul is almost half a century older than myself and went through what sounds to be an amazing ordeal. Suppose that she needs the surgery to correct core orthopaedic functionality in order to gain the muscle functionality so that she can do adequate therapy and lose weight as well as strengthen core muscles needed for recovery. That is why therapy is a must after orthopaedic surgery. Perhaps she will need to go through such a chain of events so that she can really enjoy the remaining time she has. This may or may not be the logic of her physicians and surgeons who albeit know a hell of a lot more than we do, at least they get paid a lot more. As for nurses [to whom I love to pick on] that is a different story altogether.

Try not to over-think things so much and be well. Best of luck!

 

[mycrofft]

Sounds like seeking medical advice.

:unsure:.....

 

[Akulahawk]

Simply put, this could be exactly what she needs or it could be something that ultimately kills her. She could be choosing to be relatively immobile because of the arthritic pain or she could end up being relatively immobile because of the post-op stiffness/pain... Perhaps she thinks the post-op pain will be a relief from the arthritic pain and therefore will have a better quality of painful life.

Who knows... among us what the answer is.

 

[Bryan]

Hmm physical therapy is really essential in this kind of scenario one of my friend have had the same problem and after replacement physical therapy really help him......