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Whether it’s shoulder, knee or hip joint replacement, aftercare is vitally important. Early motion after joint replacement helps achieve the best possible function. And motion is typically started 48 hours post surgery.

According to University of Washington, arthritic joints are stiff. One of the major goals of total joint replacement surgery is to relieve much of this stiffness. However, following surgery, scar tissue will tend to recur and limit movement unless motion is started immediately. This early motion is facilitated by the complete surgical release of the tight tissues so that after surgery the patient has only to maintain the range of motion achieved at the operation.

All new joint patients need to have a regular exercise program to maintain their fitness and the health of the muscles around their joints. With both their orthopedic and primary care physicians’ permission, they should be on a regular exercise program 3 to 4 times per week lasting 20 to 30 minutes.

General Tips from Texas Health Resources

• Patients should take antibiotics one hour before having dental work or other invasive procedures for their lifetime. Patients are recommended to take antibiotics before, during, and immediately after any elective procedures in order to prevent infection of the replaced joint
• Although the risks are very low for postoperative infections, it is important to realize that the risk remains. A prosthetic join could possibly attract the bacteria from an infection located in another part of the patient’s body. A fever is reason to call the doctor.
• Occasionally, antibiotics may be needed. Superficial scratches may be treated with topical antibiotic ointment. Patients should notify their doctor if the area becomes painful or reddened.
• Patients are given an implant card by their surgeon that states they had a joint replacement. They should carry the card with them, as they may set off security alarms at airports, malls, etc. Also when traveling, patients should stop and change positions hourly to prevent the joint from tightening.
• Patients should visit their surgeon yearly unless otherwise recommended. Routine initial, mid-term and long-term follow up is a valuable part of joint replacement care.

According to the Mayo Clinic, patients usually require some assistance with self-care, activities of daily living, shopping and driving for approximately six weeks after surgery. Patients usually go home after this surgery, especially if there are people at home who can provide the necessary assistance, or if such assistance can be arranged through an agency. In the absence of home support, a convalescent facility may provide a safe environment for recovery.

Recovery of comfort and function after joint replacement continues for many months after the surgery. Improvement in some activities may be evident as early as six weeks. With persistent effort, patients make progress for as long as a year after surgery.

Future activities are generally limited to those that do not risk injuring the replaced joint. Sports that involve running or contact are avoided, in favor of leisure sports, such as golf, and swimming.

Swimming is the ideal form of exercise, since the sport improves muscle strength and endurance without exerting any pressure or stress on the replaced joint.

See you at the pool!

Although the fall weather has been gloriously moderate, one can be certain that cold weather is on the way. It is important to remember that the cold temperatures of winter are especially dangerous for older adults. Seniors may not be able to feel that they are getting too cold, or they may set their thermostats low to save on heating costs.

A drop in body temperature is called hypothermia (hi-po-ther-mee-uh), and it can be deadly if not treated quickly. Hypothermia can happen anywhere, not just outside and not just in northern states. In fact, some older people can have a mild form of hypothermia if the temperature in their home is too cool.

When you think about being cold, you probably think of shivering. That is one way the body stays warm when it gets cold. But, shivering alone does not mean you have hypothermia.

So how do you know if someone has hypothermia? According to the National Institute on Aging, look for the “umbles” – stumbles, mumbles, fumbles, and grumbles. These may be clues that the cold is a problem.

Check for:

• Confusion or sleepiness
• Slowed, slurred speech, or shallow breathing
• Weak pulse
• Change in behavior or in the way a person looks
• A lot of shivering or no shivering; stiffness in the arms or legs
• Poor control over body movements or slow reactions

According to gericarefinder.com, during each cold weather month, many seniors die from hypothermia.

Wearing more clothes and proper cold-weather attire are necessary for aging adults. Indoors, many seniors may require an extra blanket or thicker socks.

To prevent hypothermia (very low body temperature), a dangerous and potentially life-threatening condition, ), read these tips offered by the National Institute on Aging:

• Ask your doctor if you have any health conditions or take any medications that make it hard for your body to stay warm. At increased risk are older people who take certain medications, drink alcohol, lack proper nutrition and have conditions such as arthritis, stroke, Alzheimer’s disease and Parkinson’s disease.
• Set your thermostat above 65 degrees; older people are at higher risk of becoming ill during the cold winter months.
• Try to stay away from cold places. Changes in your body that come with aging can make it harder to feel when you are getting cold. It also may be harder for your body to warm itself.
• Wear several layers of loose clothing indoors and out. The layers will trap warm air between them. Tight clothing can keep your blood from flowing freely, which can lead to loss of body heat. Hypothermia can occur in bed, so wear warm clothing to bed and use blankets.
• Ask friends or neighbors to look in once or twice a day if you live alone. Your area may offer a telephone check-in or personal visit service.
• Use alcohol moderately, if at all. Avoid alcohol altogether near bedtime.
• Eat hot foods and drink hot liquids to raise your body temperature and keep warm.
• Keep aware of the daily weather forecast and be sure to dress warmly enough, with hat and gloves, if you must go out. In extremely low temperatures with wind-chill factors, weather forecasters may suggest staying inside.
• Make sure you eat enough food to keep up your weight. If you don’t eat well, you might have less fat under your skin, and fat can help protect you by keeping heat in your body. Also, drink 10 glasses of water or other non-alcoholic liquids daily.

And remember, spring will eventually come. Promise.

Ah-choo! With cooler weather on the way, the cold season revs up, and there’s nothing as miserable as a bad head cold. How about this statistic from healthline.com: Americans “catch” an estimated one billion colds every year. Most adults suffer from two to four colds per year.

The common cold causes a runny nose, nasal congestion, sneezing, coughing, and, in some cases, coughing and a sore throat. Colds can occur at any time during the year but are most common in the fall and winter months.

A head cold really is a viral infection which settles in the mucus membranes of the nose. A cold is usually harmless, although it can be quite uncomfortable. Typically it resolves on its own after around ten days. Some people experience a mild fever and watery eyes, and people may complain of feeling unwell.

The mucus which drains from the nose is typically clear in color. Some people with a head cold find that they cough and experience hoarseness because of mucus dripping down their throats.

No vaccine has been developed for the common cold which can be caused by many different viruses, but there are some common-sense precautions to slow the spread of autumn viruses:

• Wash your hands. Clean your hands thoroughly and often. Carry a bottle of alcohol-based hand rub containing at least 60 percent alcohol for times when soap and water aren’t available. These gels kill most germs.
• Scrub your stuff. Keep kitchen and bathroom countertops clean, especially when someone nearby has a cold.
• Use tissues. Always sneeze and cough into tissues. Discard used tissues right away, and then wash your hands thoroughly.
• Don’t share. Use your own glass or disposable cups when you or someone else is sick.
• Steer clear of colds. Avoid close contact with anyone who has a cold.

Drinking lots of fluids, especially warm fluids, can help as can staying in a warm and slightly humid environment. Avoiding dairy is advised, because this tends to  increase mucus production. Rest, many people think, helps a cold resolve more quickly.

If a head cold is persistent, a doctor can prescribe decongestants and pain management medications. Saline rinses or sprays in the nose can also help to flush out the mucus and increase comfort. However, patients should be aware that prolonged use of decongestant sprays can lead to an inflammation of the mucus membranes in the nose.

Sometimes a head cold can become a sinus infection. A head cold can also lead to an ear infection. While these infections sometimes can resolve on their own, medical treatment may be necessary especially if the condition becomes especially painful.

Web MD mentions more worrisome situations and complications when it comes to colds. It’s a good idea to consult the doctor for any of these conditions:

• Asthma and Colds  – Living with asthma is no easy task, and a cold can make breathing more difficult.
• Heart Disease and Colds – Catching a cold for someone with heart disease poses a greater danger, because the cold makes it difficult to take in oxygen efficiently.
• Diabetes and Colds – For those with diabetes, a common cold makes it difficult to keep blood glucose levels balanced.

It’s sneaky and it’s subtle. It’s referred to as “…the silent thief of sight.” “It” is glaucoma. Most types of glaucoma cause no pain and produce no symptoms. What glaucoma does do, however, is cause damage to the optic nerve. The main function of the optic nerve is sending electrical transmissions to the brain. Damage to it can lead to serious problems with vision that eventually lead to blindness.

Glaucoma is caused by increased pressure in the eye. This pressure is from a buildup of fluid, called aqueous humor, in the front of the eye. The elevated pressure is often extremely subtle with no symptoms until the disease has already caused significant damage.

In the U.S., approximately 2.2 million people age 40 and older have glaucoma, and of these, as many as 120,000 are blind, according to the American Health Assistance Foundation. An estimated 3.3 million of Americans could have glaucoma by the year 2020.

Glaucoma is a leading cause of blindness among African Americans and Hispanics in the U.S. Three times as many African Americans have glaucoma than Caucasians, and four times as many are blind. Between the ages of 45 and 64, glaucoma is fifteen times more likely to cause blindness in African Americans than in Caucasians.

Because people may not know they have glaucoma, a simple and painless glaucoma test, performed by an ophthalmologist, is vital. These tests allow the doctor to measure pressure in the eye, examine the optic nerve, check the visual field and determine the fluid drainage angle in the eye.

According to seniormag.com, there are actually two major types of glaucoma – open angle and closed angle. Typically open angle glaucoma has no symptoms in its early stages and vision remains normal. As the optic nerve becomes more damaged, blank spots begin to appear in one’s vision, but such spots can be unnoticeable at first. If the optic nerve is significantly damaged, these spots become large. If all the optic nerve fibers die, blindness results.

Some eyes are formed with the iris too close to the drainage angle. In these eyes, which are often small and farsighted, the iris can be sucked into the drainage angle and block it completely. This is called closed-angle glaucoma. Since the fluid cannot exit the eye, pressure inside the eye builds rapidly and causes an acute closed-angle attack. Symptoms that occur suddenly can include blurry vision, halos around lights, eye pain, nausea and vomiting. Medical attention should be immediate.

Early detection is key

Early detection through eye exams, visual field tests and optic nerve imaging, and management through medications and laser treatments (to relieve eye pressure) are keys to preventing optic nerve damage and blindness from glaucoma.

Be aware

• Everyone older than age 60 is at increased risk.
• For certain population groups such as African-Americans, the risk is much higher, and they should have eye pressure monitored before age 30. Hispanic, Asian and Japanese Americans also face an increased risk. The reasons for these differences aren’t clear.
• If there’s a family history of glaucoma, there is a much greater risk of developing it. A form of juvenile open-angle glaucoma has been clearly linked to genetic abnormalities.
• Diabetes increases the risk of developing glaucoma. A history of high blood pressure, heart disease, or hypothyroidism can increase risk as well.
• Severe eye injuries can result in increased eye pressure. Injury can also dislocate the lens, closing the drainage angle. Other risk factors include retinal detachment, eye tumors or eye inflammations.
• Being nearsighted, which generally means that objects in the distance look fuzzy without glasses or contacts, increases the risk of developing glaucoma.
• Using corticosteroids for prolonged periods of time appears to increase the risk of getting secondary glaucoma. This is especially true if someone uses corticosteroid eye drops.

The commercial, “I’ve fallen and I can’t get up,” is no joke. For seniors, falling rarely just happens but rather results from multiple causes that occur over time. As people age, their muscles and bones can weaken, balance can be affected, and certain medications and medical conditions can make falling and fractures more likely. Seniors who are also more prone to diseases like osteoporosis are more susceptible to experiencing a fall.

According to SeniorAdvice.com, every year more than 1.6 million older adults go to the emergency department for fall related injuries. Falls are the main cause of fractures, loss of independence, hospital admissions and death.

Hip fractures are the most common and serious type fall related injuries. After such a fall, only half of older adults hospitalized with hip fractures can return home and live on their own. About 80 percent of hip fractures occur in women. Women lose bone density at a faster rate than men do. The drop in estrogen levels that occurs with menopause accelerates bone loss, increasing the risk of hip fractures as a woman moves beyond menopause. However, men also can develop dangerously low levels of bone density.

The fear of falling causes older adults to avoid physical activities, such as walking and exercise. But the truth is physical activity can help prevent falls. Some seniors who are concerned with falling go to physical therapy which can help improve balance, maintain physical health and prevent falls.

Bone fractures in senior citizens are not only traumatic but can lead to more serious problems later on, but there are some ways to decrease the probability of falling by following some simple guidelines.

Preventive Measures from the National Institute on Aging:

• The doctor can perform a bone mineral density test that measures bone strength. Some medications can increase bone strength which can prevent likelihood for falling.
• Take part in healthy amounts of physical activity which will improve balance, muscle tone, joint flexibility, or even slow osteoporosis.
• Test vision and hearing since defects in sensory functioning can make one less stable overall.
• Be aware of the side effects of medications which can affect balance and coordination.
• Limit the amount of alcohol consumed which can also affect balance and coordination.
• Use a cane or walking stick if needed, and always be careful when walking on unstable or slippery surfaces
• Wear the right footwear that has rubber soles or low heels.
• Hold the handrails when going up and down stairs and only hold items in one hand so that you can keep a hand on the rail at all times
• Use good judgment – stay away from situations that could cause a fall such as a freshly washed floor, trying to reach something that is too high.
• Research home monitoring systems that will allow for access to help after experiencing a fracture
• Install good lighting with light switch access both at the top and bottom of staircases.
• Keep areas where you walk clear.
• Be sure that carpets are firmly fixed to the floor or apply no-slip strips to slippier surfaces such as wood and tile.
• Install handrails on both sides of the stairs or inside the bathroom.
• Place non-skid mats and strips on surfaces that get wet within the bathroom.
• Keep night lights for easy navigation in the dark in hallways, near the bed, and in the bathroom.
• Keep a telephone near the bed.
• Keep electric cords and wires near the wall and out of paths of travel.
• Tack down carpets and rugs firmly to the floor.
• Be careful!

Giving up driving can be a tremendous blow to an older person. There’s the practical side: how to run errands, get to the doctor, visit friends, etc., and then there’s the emotional side: driving is a key symbol of independence.

Agreeing to forgo driving is in many ways also an agreement to give up one’s independence. It is very tough. Most seniors will drive as long as they can, and many times, it is up to the adult children to decide when driving has become unsafe.

Remember, the issue is safety – both the senior’s and other people. If a person can’t make decisions quickly enough or has difficulty seeing, then it is time to stop driving.

What about driver’s licenses? According to SeniorAdvice.com, many seniors will argue they can still drive, because the DMV is still giving them a license. The DMV, however, only sees them for a short period of time and often there is no road test. There is little basis for determining whether they are adequate drivers in a real world environment, so a license doesn’t really mean that much.

Study after study shows that the mere fact a person is older is not an indicator as to whether they can drive. Just because someone is 65 does not mean they should lose their license automatically. The only exception is once a person reaches the age of 80, because people older than 80 get into as many accidents as teenagers.

People age differently. For that reason, it is not possible to set one age when everyone should stop driving. So, how does one know when to stop?

The website HelpGuide.org tells about unsafe driving warning signs:

• Problems on the road. Abrupt lane changes, braking, or acceleration. Failing to use the turn signal, or keeping the signal on without changing lanes. Drifting into other lanes. Driving on the wrong side of the road or in the shoulder.
• Trouble with reflexes. Trouble reading signs or navigating directions to get somewhere. Range-of-motion issues (looking over the shoulder, moving the hands or feet). Trouble moving from the gas to the brake pedal, or confusing the two pedals. Slow reaction to changes in the driving environment.
• Increased anxiety and anger in the car. Feeling more nervous or fearful while driving or feeling exhausted after driving. Frustration or anger at other drivers but oblivious to the frustration of other drivers, not understanding why they are honking. Reluctance from friends or relatives to be in the car with the senior driving
• Trouble with memory or handling change. Getting lost more often. Missing highway exits or backing up after missing an exit. Trouble paying attention to signals, road signs, pavement markings, or pedestrians.
• Close calls and increased citations. More frequent “close calls” (i.e., almost crashing), or dents and scrapes on the car or on fences, mailboxes, garage doors, and curbs. Increased traffic tickets or “warnings” by traffic or law enforcement officers.

If some of the descriptions above are apt, it may be time to think about whether or not a senior is still a safe driver.

Some helpful websites are www.seniordrivers.org and www.granddriver.info