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Knee tab a2, b2,These instructions are designed to inform you about Total Knee Replacement. Initial instructions are to be fol owed before the surgery, during your stay in the hospital and after surgery when you are at home. The success of the Total Knee Replacement surgery requires active participation of the patient. For a long-term successful result, understanding and adherence to these guidelines are imperative. The joint replacement program at Integrity Orthopedics has been careful y planned in the sincere hope that your new artificial joint wil serve you for lasting pain relief and improved mobility. By the time you return home, you wil be familiar with precautions and exercises, which protect your new knee and encourage stability and healing. Your surgeon, physical therapists, and nurses wil instruct and assist you in learning these precautions and exercises. 1. Please arrange a pre-operative appointment with you family physician and if necessary your cardiologist for medical and or cardiac clearance for your upcoming surgery. Please have your physician fax us your clearance when ready. The fax number is (708) 429-3422. 2. The hospital wil cal you the approximately 7-10 days prior to the surgery, for you to have your pre-operative testing. They wil also cal you the night before surgery with any instructions regarding medications, eating, drinking, and the time you are to come into the hospital the day of surgery. 3. You should contact your insurance company with the date of the surgery to find out whether you require a precertification or a second opinion. Record the date of your conversation and the name of the person your spoke with as a reference. Our office wil also confirm this with your insurance company. 1. 10-14 Post-op to check wound and remove sutures/staples. 5. Then, every year for fol ow-up with x-rays 6. As need, for any problems or complications or as instructed by Dr. Weber. PRE-OPERATIVE INSTRUCTIONS/BEFORE SURGERY 1.
Stop al aspirin and/or anti-inflammatory medications like Ibuprofen, Advil, Aleve, aspirin (including Empirin), Daypro, Indocin, Lodine, Relafen, Vioxx, Celebrex, 10 days before your surgery. For pain you may take Tylenol, Darvocet N-100, or your doctor wil prescribe you another medication. 2. If you are taking any blood thinning medicine, speak to your medical doctor a bout their use before surgery. You wil need to be off this medication at least 7-10 days prior to surgery. Ask your medical doctor for the appropriate coverage. 3. Continue to take al of your regular medications like pil s for high blood 4. Take a multivitamin/multimineral daily. 5. Report any infections immediately, especial y urine or teeth. 6. Be sure to arrange for added assistance for when you go home. 7. Do not eat or drink ANYTHING after midnight the night before surgery. Your surgeon or medical doctor may instruct you to take your regular medications with a sip of water. 8. Remove the fol owing: makeup, nail polish, hairpins, jewelry, hairpieces, dentures, eyeglasses, contact lenses, and hearing aids before surgery. Take a shower with antibacterial soap the night before surgery. POST-OPERATIVE INSTRUCTIONS/IN THE HOSPITAL T he knee replacement we insert al ows ful weight bearing immediately. We have found the earlier we begin your therapy and activity, the better your a. Your regular medications you took before the operation b. Intravenous antibiotics for the first 48 hours. c. Pain medications by either injections, continuous pump, or pil s a. Aft er surgery you may need to receive a blood transfusion, this blood wil be supplied by the blood bank. We can assure you this blood has been tested and is safe for use. If you ca nnot receive or do not wish to receive blood transfusions, please inform us so we may ma ke the necessary arrangements to treat you post-operatively. b. Blood samples wil be drawn from you frequently so your surgeon can determine if you ed a blood transfusion or any adjustment in your medications c. Use the special breathing exercises to clear your lungs to prevent pneumonia. d. Do bedside exercises as directed by your surgeon and or physical therapist. e. Ph ysical therapy wil start early in your hospital stay. Your surgeon and physical therapist wil l discuss your goals. When these are satisfactorily met, you wil be able to go home. f. Safety is important in al aspects for your activities. If you have any questions concerning any precautions ask you knowledgeable nursing staff, physical therapist or your surgeon. 1. Discharge from the hospital can be expected on the third post-operative day. 2. You may walk as tolerated with the assistance of a cane/crutches/walker for 3 to 6 weeks. A general rule is to us a cane until the limp is gone. This prevents you from using poor mechanics to compensate for weakness in your operative leg. 3. Staples, if you have them, wil be removed from the skin in 10-14 days. Before the staples are removed, the incision must stay clean and dry. Be alert for certain warning signs. If there is increased pain, drainage from the incision site, redness around the incision, or fever (temperature greater than 101.5 degrees), report this immediately to the doctors office. 4. You may shower two weeks from the time of surgery. You may swim; use a Jacuzzi, or whirlpool 4 weeks from the time of surgery. 5. Driving an automobile is not recommended until you are one-month post surgery so that the control of the extremity is regained. Patients who have surgery on the left knee can sometimes drive sooner. 6. Fol ow al instructions give by your physical therapist. You wil be given information 7. You wil be placed on a blood thinner (Coumadin) for 3 weeks after surgery. Your doctor wil control the dosage. Blood values wil be checked on Monday and Thursday. If there is any change in dosage, our office wil notify you. 8. You wil be given a prescription for pain pil s to be taken by mouth as needed. 9. It is recommended to take vitamin C (1000 mg) and a multivitamin daily for 6 weeks. 10. Maximum recovery is attained in 3-6 months. 11. See attached forms for home exercises you wil need to do twice a day. 1. Joint replacements can become infected at any time after surgery from the first post-operative day to many years down the line. If at any time (even years after surgery), an infection develops such as strep throat or pneumonia, notify your primary physician. Antibiotics should be administered promptly to prevent the rare occurrence of distant infection localized to the 2. If you are going to undergo a dental procedure or certain medical procedures like a colonoscopy, sigmoidoscopy, you should pre-medicate with oral 3. See your physician to treat al suspected urinary tract infections. 4. Look for signs of infection in the knee including pain, redness, swel ing, or 5. Your new joint replacement may trigger airport security alarms. Please contact the office if you need a certificate that verifies your surgery. 6. A wel -implanted prosthesis, and a compliant patient, usual y lasts for many years. Strenuous use and obesity have the potential to shorten the life of the implant. It should be emphasized that total knee replacements are not done to al ow the patient to return to unlimited activities. Fitness may be maintained by “low impact” sports such as swimming, or bicycling. Golfing and bowling are usual y possible, and even moderate ski ng in some individuals. Jogging is not recommended. Doubles tennis is preferred to PLEASE FEE L FREE TO CONTACT OUR OFFICE AT ANY TIME FOR ANY AND ALL QUESTIONS REGARDING YOUR SURGERY AND NEW JOINT REPLACEMENT. WE LOOK
Seizure Characteristics in Pallister–Killian SyndromeMeghan S. Candee,1* John C. Carey,2 Ian D. Krantz,3 and Francis M. Filloux11Division of Pediatric Neurology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah2Division of Medical Genetics, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah; Intermountain Healthcare,Salt Lak