The heart is one of the most important organs in the human body. The function of the heart is to pump blood. The human heart has four chambers. Each chamber has its own valve to make sure blood flows in the right direction. Before leaving the heart, the aortic valve is the final one amongst the four valves through which the blood flows. The aortic valve’s task is to pump blood that is rich in oxygen into the largest blood vessel in your body, referred to as the aorta.
The aortic valve has leaflets which open and closes during each
heartbeat. In some heart diseases, the valve does not open or close properly
disrupting the blood flow to the body. This may lead to the valve leaking and
is called valvular regurgitation.
Another form of valve disease is valvular stenosis that commonly affects the aortic valve. This condition occurs due to calcium build-up on the leaflets leading to the stiffing of the valve. The severity of aortic stenosis increases with age and can be classified as mild, moderate, and severe. The stiffing of the valve prevents it from opening fully which reduces or blocks the blood flow from the heart to the rest of the body.
Your heart needs to work more than normal to supply blood to the entire body when the flow of blood through the aortic valve gets lessened or stops completely due to blockage. Eventually, this extra work limits the amount of blood it can pump, and this can cause symptoms as well as possibly weaken your heart muscle.
Calcium deposition in the valve, defects present in the heart from birth and strep throat infection (rheumatic fever) are a few of the causes of aortic stenosis.
Some people with aortic valve stenosis may not experience any
symptoms for many years.
Signs and symptoms of aortic valve stenosis may include:
·Abnormal heart sound (heart murmur) heard through a stethoscope
·Chest pain (angina) or tightness with activity
·Feeling faint or dizzy or fainting with activity
·Shortness of breath, especially when you have been active
·Fatigue, especially during times of increased activity
·Heart palpitations — sensations of a rapid, fluttering heartbeat
·Not eating enough (mainly in children with aortic valve stenosis)
·Not gaining enough weight (mainly in children with aortic valve stenosis)
If you have the above symptoms, don’t worry. Visit your doctor
Angioplasties are increasingly recommended for uncomplicated cases with minimum blockages as they are less invasive and require shorter recovery time. However, as with any surgery, there are quite a few precautions that one must undertake to ensure a complication-free recovery. This handy primer is a supportive document to your cardiologist’s advice. In case of any doubts, consult your cardiologist. For your ease, let us break down the recovery period into what one can expect at the hospital after the procedure, the actual recovery, and general precautions.
What to expect at the hospital after the procedure: 1. In the case of groin catheterization, one will need to lie straight with unbent legs while the groin sheath is in place. In some situations, a sheet may be placed across your legs to help you keep them straight.
2. You are advised to stay lying in a flat position for at least 6 hours post sheath removal. This is to prevent hemorrhage. If you are uncomfortable, you can have your head elevated after 2 hours.
3. Moving out of bed will depend on the nature of your recovery and the nursing staff’s advice.
4. It is best to avoid consuming anything other than clear liquids while the sheath is in place. This will help prevent nausea. Remember to stick to a heart-healthy diet once the cardiologist gives the all-clear sign to resume solid food.
5. In case you experience chest pain, swelling, pain at the insertion site or bleeding; call your cardiologist immediately.
6. In case you have had a stent placed in your heart after your angioplasty, you will be required to take certain medicines to reduce the chances of blood clot formation.
7. In the case of arm catheterization, a specialized bandage will be placed to ensure proper healing.
During the recovery period: 1. In case your angioplasty was done without you undergoing a heart attack prior to it, you can be back in the driver’s seat just after 2 days. If you have had a heart attack though, you will need to wait till your cardiologist gives you the green signal. 2. Even though an angioplasty is less invasive, it is still a major procedure so take care and rest to avoid all strenuous activities. Avoid lifting heavy objects (more than 5 kg) preferably till 1 week after the procedure. 3. Getting enough rest does not mean that one can turn into a couch potato though. Regular exercises recommended by the doctor will not only speed up your recovery but also will help in preventing further cardiac incidences. Your diet will also play a major role in your recovery. Consuming a heart-healthy diet that is low in sodium and fats is crucial to your long-term wellbeing.
Do’s: 1. Don’t be in a hurry to resume your routine activities after your angioplasty and stent implantation. Resume them gradually to avoid strain. 2. One major point to remember is that angioplasty won’t cure your disease. It only serves to keep your arteries open. To truly prevent future incidence, you will need to change your lifestyle and diet. 3. Ensure that your diet mainly consists of fruits, vegetables, whole grains, nuts, etc. to decrease your heart disease risk. 4. Reduce and control your salt consumption as well as sugar intake. 5. Most importantly, do NOT skip or neglect your medication. Consume your prescribed medicines such as blood-thinners, lipid-lowering medicines, such as statins or anti-hypertensive as recommended by your cardiologist, depending on your condition. 6. Exercise regularly and maintain a healthy body weight. 7. Do follow-up regularly with your cardiologist. 8. Always carry a stent implantation card with you to avoid unforeseen problems.
Don’t: 1) Stop smoking immediately. Consume alcohol only if your cardiologist says it is ok to do so. 2) Avoid taking on too much stress.
Now that you are on the journey towards healing, here’s wishing you a happy and complication-free recovery period! Get well soon!
Pain in any part of our body can be severely restricting. More so when
the pain prevents us from leading our normal lives and carrying out our favorite
activities, like the pain experienced by those who have chronic hip pain
whether due to trauma or arthritis. The most unfortunate part about this pain
is that it severely hampers the patient’s mobility; leaving them confined to
their rooms or at the mercy of a cane or walker.
Total Hip Replacement or Total Hip Replacement is most and often the best option for patients in this situation. But how does one come to the realization that surgery is required or what is an orthopedic surgeon looking for before recommending surgery?
More often than not, these symptoms are:
Chronic hip pain that hinders daily activities and is unabated by non-invasive therapies like weight reduction, physical therapy and painkillers. Lack of sleep due to pain is also an indicator that a Total Hip Replacement is required.
If the stiffness of the hip prevents the patient from going about their daily lives.
Inability to stand on the affected leg without support for even a minute.
The patient can no longer walk short distances.
Pain that is beginning to affect the patient mentally as well as physically
The patient is experiencing severe side effects of pain-killers.
Last but not the least, the doctor has determined that non-invasive or conservative treatments are no longer effective or helpful.
Is a hip replacement
safe and successful and what restrictions will that place on the patient?
A large majority of Total Hip Replacement Surgery are successful with most patients experiencing significant relief from their symptoms. While there are some risks like infection and blood clots associated with Total Hip Replacement, they are easily preventable. Overall, the procedure is one of the safest surgeries to undergo, with millions of patients getting their hips replaced every year. The evolving technology and surgeon skills are also improving the procedure every day. New and improved implant design also reduces the chances of dislocation. As to post-surgery restrictions, patients who decide to undergo a Total Hip Replacement should adapt a few permanent changes to their posture for the maximum benefit and in order to prevent any negative effect to the hip implant.
For preventing such incidents, certain movements or activities need to
be avoided. They are:
Forward Bending: Avoiding bending one’s knees beyond 90 degrees is a crucial thing to keep in mind. Postures where the knee is not below one’s hip joints can lead to complications and difficulties.
As with anything surgery related, any doubts related to one’s
condition should be cleared with one’s surgeon.
How do I convince my
loved ones to undergo a hip replacement?
The possibility of undergoing a major surgery can be quite
intimidating to anyone especially elderly patients. Convincing them requires patience
and time. While the final decision rests in their hands, here are some things
that may help you in helping them make the right choice.
Firstly, have a sit-down conversation with your loved one and their orthopedic doctor to fully understand the procedure, the risks and expected results. Encourage your loved one to get their doubts cleared by the doctor no matter how insignificant they may seem.
Have a heart to heart conversation with them about how the procedure can help get rid of the chronic pain.
Take them to meet other people who have undergone Total Hip Replacement recently, preferably those who have been operated on by their orthopedic surgeon. This will help them see how the procedure has helped these patients.
Describe to them how people undergoing Total Hip Replacement can not only get relief from their pain but also regain their normal movements like navigating stairs and sit on the floor with folded legs.
Discuss how current technology and expert surgeon availability means that they can undergo the procedure both successfully and with fewer chances of side effects.
Alleviate their fears by providing them encouragement and assuring them that you will be with them every step of the way.
Explain to them how keeping a positive attitude with regard to the operation will help them come through the procedure with much better outcomes.
If they are worried about the physical therapy that will follow, then convince them that it will strengthen the muscles supporting the hip and allow them to recover faster.
The idea of undergoing surgery can be immensely daunting, even if the
patient is already in significant pain. Coupled with the thought of physical
therapy and recovery period, it is quite understandable for patients to refuse
surgery or put it off until it’s too late. But the thing to know here is that
beyond the surgery, physical therapy, and recovery, lies the light at the end
of the tunnel. A light that is not only the promise of a pain-free life but
also one in which the patient can regain their old life back.
By far the second most common form of joint surgery, after total knee replacement is total hip replacement or to put it medically, total hip Arthroplasty. It is also not only one of the most successful joint surgeries performed today but, also one of the most effective in reducing the pain and resulting side effects of having damaged hip joints. While this can seem like a daunting process for both patients and their families, the hip is an important joint that helps us conduct the most basic activities of our daily lives like walking, jumping, running etc. When the joint is diseased, whether due to osteoarthritis or injury, it reduces the patient’s ability to be mobile. However, truth be told, there is little cause for worry when it comes to total hip replacement surgery. The rate of complications is low and with proper care, the patient can soon regain mobility. That aside, the reliable pain relief and sizable functional improvement that arthritis patients experience post-surgery make it extremely beneficial for those suffering from intense pain and restrictive movement. Around 3 lakh Total Hip Replacement procedures are carried out globally every year. Still concerned? Here’s some information to help you make this decision.
There is no difference between hip replacement and total hip replacement.
Depending on the components of the hip joint that are going to be replaced, the procedure can be called as either total hip replacement surgery or partial hip replacement surgery. As you must already have learned from your orthopedic surgeon, the hip joint is a ball and socket joint, which means a ball-like structure, in this case, the head of your thigh bone or femur fits in a socket or the pelvic bone or acetabulum, to form a joint. With Total Hip Replacement orthopedic ball and the socket is replaced, while partial hip replacement only requires the ball or the head of the femur to be replaced.
Now both surgeries are called hip replacement surgeries, differing only in technicality, but Total Hip Replacement surgery is most common as partial replacement is considered sub-optimal and less recommended. Another point to be noted is that bilateral hip replacement is not the same as Total Hip Replacement. The former requires surgery on the hip joint of both legs while Total Hip Replacement simply requires replacement of the ball and socket components of any one leg.
Anyone with significant joint damage is a candidate for total hip replacement
Living with hip pain can be a challenge for anyone, young or old. Whether it is through arthritis or trauma, a hip injury can result in intense pain while carrying out regular activities. Even resting may not bring relief as the hip may be stiff and painful. While medicines, lifestyle modifications, and walking aids may help to a large extent, in severe cases, surgery is the best option.
Since 1960, advances in joint replacement operative techniques and technology have greatly improved the efficacy of total hip replacement.
Getting a Total Hip Replacement is the best option in case of significant pain and mobility reduction.
Every patient is different and their need for surgery may depend on various factors. That being said, any patient suffering from chronic hip pain which is hindering their daily activities and for whom other non-invasive methods of pain reduction have proved to be ineffective can be considered as a candidate for Total Hip Replacement.
Total Hip Replacement is recommended if:
The patient is in significant pain. If the hip pain is preventing the patient from conducting their daily activities, interfering with their sleep and rest and restricts their hip and knee movements, then surgery may be the best way out. Ditto, if the patient requires walking aids to move or cannot stand on their aching leg even for a minute without support.
Painkillers no longer work: In some situations, the pain may no longer be controlled by the use of painkillers or the patient starts to experience severe side-effects from said painkillers.
Increased stiffness: Stiffness in the hip joint that prevents one from going about one’s daily life may require the use of Total Hip Replacement for long-term relief.
Doctor’s recommendation: If less invasive and conservative treatment efforts fail, then a doctor will recommend a Total Hip Replacement.
The situation is becoming unbearable: Severe pain can be physically, mentally, and emotionally traumatizing, especially for the elderly. If the patient feels that they can no longer live with the pain, then Total Hip Replacement is by far the best option to help them heal.
Here’s what one can expect from a Total Hip Replacement surgery
Total Hip Replacement involves the following steps:
The damaged ball of the hip joint is taken out and replaced with a metallic stem and is placed into the femur’s hollow centre. The stem could either be cemented or “press-fit” into the bone.
A metal or ceramic ball then replaces the worn out femoral head which was removed. This artificial ball is positioned on the stem’s upper part.
The cartilage surface of the socket which is damaged gets replaced with a metallic socket. In order to hold the new socket in place, screws or cement is used.
Finally, a metallic or plastic spacer is positioned between the new implants to permit a smooth gliding surface for frictionless movement of the joint.
How soon you can be discharged depends on your doctor As much as you would like to go home and get back on your feet, Total Hip Replacement surgery will require you to stay at the hospital for a few days. The length of your stay and discharge will depend on your doctor’s recommendation.
One can expect to be walking freely within 6 weeks post-surgery Independent walking may not be possible immediately after the surgery. However, post-physical therapy, most Total Hip Replacement patients can find themselves walking with a walker or on crutches on a levelled surface. They can even navigate through stairs in both ways. Most patients require the walker for 2 weeks maximum. Getting back to walking depends on your recovery rate, though free and easy movement will be regained fairly soon after the pain decreases. Resumption of normal activities, including driving, can be achieved well within 6 weeks post-surgery. Normal recreation can be resumed 12 weeks post-surgery and one can be expected to be completely back to one’s normal routine within 6 months post-surgery.
Physiotherapy is an important part of the recovery process Physiotherapy is extremely important post- Total Hip Replacement. The therapist will not only assist you with the exercises taught in the hospital but will also ensure that you can walk safely in your house. A physiotherapist will also help you keep a check on post-surgery dos and don’ts and be the ones assessing your need for a walker. Once the patient is moving freely at home, the physiotherapy sessions will be shifted to a clinic to further increase the strength of the muscles around the joint.
Patients will require around-the-clock care for at least 6 weeks post-surgery In the initial days after surgery, most patients will be fatigued from the after-effects of anesthesia and painkillers and may require help with their daily activities. This phase may last for up to 6 weeks. So if you or your loved ones live alone, it is best to arrange for care during the recovery period.
Expect to be on painkillers for at least 4 weeks Pain is an unfortunate side effect of any surgery and one does need to take painkillers to control it. Total Hip Replacement patients mostly require painkillers in the initial 2 to 4 weeks post-surgery, post which they can sit down with their surgeon to discuss further pain relief strategies. A large majority of patients can expect excellent pain control after 4 to 6 weeks.
So, as you can see, undergoing a Total Hip Replacement procedure is nothing to worry about. With a good surgeon and the availability of excellent implants, a hip arthritis patient can easily regain their mobility and previous quality of life within months.
Dr. Harish Bhende, an Arthroplasty Surgeon with 20 years of practice explains what a hip replacement surgery is, the difference between an original and artificial hip, and some pointers to keep in mind before opting for the procedure.