# hips xrays ?



## Orchid (Sep 1, 2011)

So finally I went to hospital to have some hips xrays and now waiting for the results. My doctors are worried about this and I also. I am not supposed to have any surgery ever , due to my endstage heartfailure and my pulmonary hypertension , as anesthesia is very bad for my heart at this stage. I might not wake up after surgery as in eternal sleep.
Anyone know anything about hips to avoid surgery ?


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## moore2me (Sep 2, 2011)

Hi Orchid,

We haven't talked for a while - you just can't stay out of trouble can you?
I looked up a medical search engine called "PubMed" and searched the medical journals which are usually the most recent information. I entered the terms "non surgical hip procedures" and "non surgical hip treatment for osteoarthritis". I got several hits on medical journals that just included the titles, the summaries, and the conclusions. The best way to get a full copy of the articles is to go thru your doctor, or go thru your medical school library, or call one of the head researchers in each paper and ask them for a copy of their important article. There were more articles, but I just stopped at ones that were a year or two old, were in english, and I could sort of understand. I am not a doctor, but I can talk to you a little more about them if you have specific questions.

http://www.ncbi.nlm.nih.gov/books/NBK3827/#pubmedhelp.How_do_I_search_by_j

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http://www.ncbi.nlm.nih.gov/pubmed/21729315

BMC Musculoskelet Disord. 2011 Jul 5;12:149. (BioMed Central Musculoskeletal Disorders)

*Decision quality instrument for treatment of hip and knee osteoarthritis: a psychometric evaluation.*
Abstract - A high quality decision requires that patients who meet clinical criteria for surgery are informed about the options (including non-surgical alternatives) and receive treatments that match their goals . . .

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http://www.ncbi.nlm.nih.gov/pubmed/19689824
BMC Musculoskelet Disord. 2009 Aug 19;10:104.
*A comparison of Kneipp hydrotherapy with conventional physiotherapy in the treatment of osteoarthritis of the hip or knee: protocol of a prospective randomised controlled clinical trial.*

BACKGROUND: 
The increasing age of the population, especially in the western world, means that the prevalence of osteoarthritis is also increasing, with corresponding socioeconomic consequences. Although there is no curative intervention at present, in accordance with US and European guidelines, pharmacotherapeutic and non-pharmacological approaches aim at pain control and the reduction of functional restriction.It has been established that hydrotherapy for osteoarthritis of the hip or knee joint using serial cold and warm water stimulation not only improves the range of movement but also reduces pain significantly and increases quality of life over a period of up to three months. Weight reduction is important for patients with osteoarthritis of the hip or knee. In addition, conventional physiotherapy and exercise therapy have both been shown, at a high level of evidence, to be cost-effective and to have long-term benefits for pain relief, movement in the affected joint, and patient quality of life.

CONCLUSION: 
This study methodology has been conceived according to the standards of the CONSORT recommendations. The results will contribute to establishing hydrotherapy as a non-invasive, non-interventional, reasonably priced, therapeutic option with few side effects, in the concomitant treatment of osteoarthritis of the hip or knee.

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http://www.ncbi.nlm.nih.gov/pubmed/21684382
Lancet. 2011 Jun 18;377(9783):2115-26.
*Osteoarthritis: an update with relevance for clinical practice.*
Bijlsma JW, Berenbaum F, Lafeber FP.

Source
Department of Rheumatology and Clinical Immunology, University Medical Centre Utrecht, Utrecht, Netherlands. [email protected]
Abstract
Osteoarthritis is thought to be the most prevalent chronic joint disease. The incidence of osteoarthritis is rising because of the ageing population and the epidemic of obesity. Pain and loss of function are the main clinical features that lead to treatment, including non-pharmacological, pharmacological, and surgical approaches. Clinicians recognise that the diagnosis of osteoarthritis is established late in the disease process, maybe too late to expect much help from disease-modifying drugs. Despite efforts over the past decades to develop markers of disease, still-imaging procedures and biochemical marker analyses need to be improved and possibly extended with more specific and sensitive methods to reliably describe disease processes, to diagnose the disease at an early stage, to classify patients according to their prognosis, and to follow the course of disease and treatment effectiveness. In the coming years, a better definition of osteoarthritis is expected by delineating different phenotypes of the disease. Treatment targeted more specifically at these phenotypes might lead to improved outcomes.


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http://www.ncbi.nlm.nih.gov/pubmed/21542914
BMC Musculoskelet Disord. 2011 May 4;12:88.
*Non-surgical treatment of hip osteoarthritis. Hip school, with or without the addition of manual therapy, in comparison to a minimal control intervention: protocol for a three-armed randomized clinical trial.
*
Abstract
BACKGROUND: 
Hip osteoarthritis is a common and chronic condition resulting in pain, functional disability and reduced quality of life. In the early stages of the disease, a combination of non-pharmacological and pharmacological treatment is recommended. There is evidence from several trials that exercise therapy is effective. In addition, single trials suggest that patient education in the form of a hip school is a promising intervention and that manual therapy is superior to exercise.

DISCUSSION: 
To our knowledge this is the first randomized clinical trial comparing a patient education program with or without the addition of manual therapy to a minimal intervention for patients with hip osteoarthritis.
TRIAL REGISTRATION: 
ClinicalTrials NCT01039337

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Cochrane Database Syst Rev. 2010 Jan 20;(1):CD003132.
*Therapeutic ultrasound for osteoarthritis of the knee or hip*

Abstract
BACKGROUND: 
Osteoarthritis is the most common form of joint disease and the leading cause of pain and physical disability in the elderly. Therapeutic ultrasound is one of several physical therapy modalities suggested for the management of pain and loss of function due to osteoarthritis (OA). beneficial for patients with osteoarthritis of the knee. Because of the low quality of the evidence, we are uncertain about the magnitude of the effects on pain relief and function, however. Therapeutic ultrasound is widely used for its potential benefits on both knee pain and function, which may be clinically relevant. Appropriately designed trials of adequate power are therefore warranted.


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## Orchid (Sep 2, 2011)

Great thanks for the reply on my question as soon as I feel up to it I will start reading the articles you posted . I am feeling tired now.
More trouble my diuretics where increased as I have been gaining water weight and getting less air so far lost 7 lbs in water here at home in 3 days time . After one week I get put back on my usual dosage of diuretics I have a combination of two of those. My hips have been giving me trouble for many years just got worse and worse etc. My water issue is in the organs so I feel full like a balloon. I am on fluid restriction 1.5 liters daily which is not much like 6 cups for 1 day.
Greetings Orchid. :goodbye:


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## moore2me (Sep 4, 2011)

Hi Violet,

I hope you're feeling better today. I was reading your note about your fluid intake restrictions and that's not much! Can you supplement it with fruit or veggies that have more juice (like fresh bell peppers, watermelon, melons, oranges, tomatoes, etc.)?

I found another article for you that has a different viewpoint on the medical procedure(s) that they may be suggesting for you. I just depends on the details. Again, I am not a doctor, but I it really would be in your best interest to have someone look into the details very, very closely. Read on . . .

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http://www.thedailybeast.com/newswe...-tests-procedures-do-more-harm-than-good.html
From Newsweek Magazine  The Daily Beast / Science

*One Word Can Save Your Life: No!*
Aug 14, 2011 10:00 AM EDT. Contributors include - Dr. Stephen Smith, Professor emeritus of family medicine at Brown University School of Medicine, Dr. James Goodwin, Geriatrician at the University of Texas Medical Branch, Dr. Michael Lauer, cardiologist at the National Heart, Lung, and Blood Institute, Dr. Rita Redberg, professor of medicine at the University of California, San Francisco, and editor of_ the Archives of Internal Medicine_, John McEvoy, a heart specialist at Johns Hopkins Medical, Nortin Hadler, Professor of medicine at the University of North Carolina, _Rethinking Aging  Overtreatment in the Elderly_.

*New research shows how some common tests and procedures arent just expensive, but can do more harm than good. Actually, there are many areas of medicine where not testing, not imaging, and not treating actually result in better health outcomes.*

**(Violet - M2Ms comment  the above article is about 5 type written pages long. I have summarized part of it for brevity, but suggest you look at the original if possible for better details.) *

When the following medical tests are used right, patients lives can be saved. But when the tests are used or prescribed inappropriately, people can be hurt or even die. *The point of this article is that it is best to say no to these inappropriate tests and perhaps save your life or save yourself physical harm and pain. Plus, one wrong test can lead to another, and another and a continued session of bads*. The authors further states that Medicare could save both money and lives if it stopped paying for some common treatments.

In fact, for many otherwise healthy people, tests often lead to more tests, which can lead to interventions based on a possible problem that may have gone away on its own or ultimately proved harmless. Patients can easily be fooled when a screening test detects, or an intervention treats, an abnormality, and their health improves, says cardiologist Michael Lauer of the National Heart, Lung, and Blood Institute. In fact, says Lauer, that abnormality may not have been the cause of the problem or a threat to future health: All youve done is misclassify someone with no disease as having disease.

*The problem tests, use of drugs, and/or surgeries depend on the situation in which they are used. Some of them include:*

1. PSA blood test for prostate cancer; 

2. An annual electrocardiogram to screen for heart irregularities, since neither test has been shown to save lives;

3. Screening mammograms prior to age 50 (or even later in cases). However, screening tests like mammograms can lead to early treatment of breast cancer, especially for women with hereditary risk or a strong family history of breast camcer;

4. Back surgeries and procedures. Evidence shows that most back problems (including disc issues) resolve spontaneously - with no medical intervention within 6 weeks. A little rest, then mild exercise, pain relief, and inflammation control works best. Moving around helps most people with back pain recover. However, for cancer patients who report back pain a different approach is needed - MRIs can prove invaluable for spotting tumors that have metastasized to the bones, allowing doctors to intervene before its too late;

5. Antibiotics for sinus infections;

6. In cases of mild chest pain using invasive procedures like angioplasty to crush plaque blockages, insert stents, or perform a bypass when drugs (like statins, aspirin, beta blockers) or a healthy diet, or exercise would have resulted in just an effective (and less traumatic) result on the patient;
. 
It turns out that the big blockages that show up on CT scans and other imaging, and that were long assumed to cause heart attacks, usually dontbut treating them can. Thats because when you disrupt these blockages through surgery, you spray a whole lot of debris down into the tiny blood vessels, which can trigger a heart attack or stroke, says Nortin Hadler, a professor of medicine at the University of North Carolina, whose book on overtreatment in the elderly, Rethinking Aging, will be published next month. Many of the 500,000 elective angioplasties (at least $50,000 each) performed every year are done on patients who could benefit more from drugs, exercise, and healthy eating.

New technology has sometimes made the problem more acute. Where once arterial blockages were detected by chest X-ray, now doctors can use cardiac CT angiography, which shows the heart and coronary arteries in dramatic 3-D. When it was introduced a decade ago to screen for cardiovascular disease, it seemed almost miraculous: a 2005 cover of Time trumpeted that it could stop a heart attack before it happens. Difficult as it is to believe, however, there can be such a thing as too much information, especially from new imaging technology. Our imaging and diagnostic tests are so good, we can see things we couldnt see before, says Lauer of the National Heart, Lung, and Blood Institute. But our ability to understand what were seeing and to know if we should intervene hasnt kept up.

In a recent study, John McEvoy, a heart specialist at Johns Hopkins Medical Institutions, and colleagues found that 1,000 low-risk patients who had CT angiography had no fewer heart attacks or deaths over the next 18 months than 1,000 patients who did not undergo the screening. But they did have more drugs, tests, and invasive procedures such as stenting, all of which carry a risk of side effects, surgical complications, and even death. The CT itself has a potential side effect: by exposing patients to high levels of radiation, it raises the risk of cancer. Low-risk patients without symptoms dont benefit from CT angiography, says McEvoy, though high-risk patients with heart disease might.

*The list of problem tests, drugs, and/or surgeries that in certain situations are having mixed or in some case negative results continue:*

7. Screening colonoscopies in patients age 75 or older who have had a normal colon test within the last 10 years;

8. Drugs for mild to moderate depression may not work, however the same drugs are appropriate for severe depression;

9. Drugs called PPIs (proton pump inhibitors) work for reflux or gastric diseases (ulcers) but do not work for stomachaches. Unfortunately, at least half, and possibly 70 percent, of the 113 million U.S. prescriptions for PPIs each year are for common stomachaches. The problem is - PPIs can cause bone fractures, severe and hard-to-treat bacterial infections, and pneumonia;

10. Statins, common cholesterol-reducing drugs, may also not benefit some people who are taking them. Statins are proved to help people with both heart disease and high cholesterol, but not those with just high cholesterol. The drugs are nevertheless widely prescribed to patients who fit the latter description, despite adverse effects, such as severe muscle disease in up to 20 percent of patients;

11. Similarly, cardiac resynchronization therapy, a special pacemaker that causes the right and left ventricles to beat in sync, can save the life of a patient with congestive heart failure whose ventricles are at least 150 milliseconds out of sync. Yet patients with a mistiming of 120-150 milliseconds are receiving the devices. The surgery is dangerous and there are problems with pacemakers in themselves. Also infection is possible;

12. Arthroscopic knee surgery for osteoarthritis is performed about 650,000 times a year; studies show that it, too, is no more effective than placebo treatment.

(The above is a short list of the tests, drugs, and procedures that patients should consider saying no to.)

*In summary, Many doctors dont seem to be getting the message about useless and harmful health care. The truth is . . . Were killing more people than were saving with these procedures, says UTs Goodwin. Its as simple as that.
*


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## Orchid (Sep 5, 2011)

hello
thanks for the reply , I do eat fruits and veg daily but very watery things like grapes count towards the 1.5 ltr
Waiting for the hip results supposed to call my housedoctor GP wednesday and if the results are not in yet , then its friday as thursday is his free day.
In the mornings I put out a small tray with small cups and glasses 100 or 150 ml adding up to 1500 ml my coffee is demi tasse , small size teacup etc
on hot days some ice cubes. No soups which I do miss in cold weather.
The thing about fluid restrictiction I find weird some small lady half my size has same 1.5 ltr I mean my body is way bigger and what about those 8 glasses of water not getting those with this dismal low amount of fluid. I did talk about this with my doctors but indeed is same for everybody with the heart failure.
Greetings Orchid


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## Orchid (Sep 6, 2011)

so far so good now I have lost 8.5 lbs in water weight my form is less balloon like
and I am able to eat without feeling full after just a few bites getting a bit more air too , waiting for tomorrow for the hip results
will keep you posted , greetings Orchid


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## moore2me (Sep 6, 2011)

Orchid said:


> so far so good now I have lost 8.5 lbs in water weight my form is less balloon like
> and I am able to eat without feeling full after just a few bites getting a bit more air too , waiting for tomorrow for the hip results
> will keep you posted , greetings Orchid



I am glad to hear you are doing better and have lost some weight (probably water weight). I hope the results of your hip exam is good too.

I have a few comments and questions about your previous post about your water restrictions. . . .* First about no soup? Why can't you take some of your daily allotment of water and/or fluid or veggies with fluid and use them to make soup.* Before you start to cook or boil the mixture -* measure the volume*. This way if you cook it for 30 minutes or an hour at a simmer or so, you can go back and add the water that escaped in the evaporating steam *by rechecking the volume.* It would be easier tho, if you used a tightly closed pot and didn't let much of the steam get out in the first place. Also watch out for premade soup mixes as many are too salty.

You could also add meats or other veggies that are not part of your water allotment to your soup pot. Sounds do able to me. I might even cook the meat in a pressure cooker to make it more soup like. If you don't do pressure cookers, use a crockpot or long time on stove at low temp.

Some nice pixs for you. 

View attachment Chrysanthemum (640x480) (400x300) (325x244).jpg


View attachment Tulips (325x244).jpg


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## Orchid (Sep 7, 2011)

hello
got my hip xrays results today there is some osteoarthritis/artrose but no need for surgery , I may be getting some injections but only after my GP talks to my cardiologist about this , because of my heart meds etc 
I will make some small amount of soup tomorrow in the worlds smallest soup pan 
it measures 1 cup with some head space so it does not boil over.
We had our first autumn/fall storm last night , lots of rain.
I can do my usual diuretics dosage now , my GP said as I lost the 8.5 lbs in water 
if I start gaining again I must call him , thanks for all your help , 
greetings Orchid


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## Yakatori (Sep 7, 2011)

On fluid-restriction, is something like just water-alone counted against the limited intake? That's sounds...just...really difficult and counter-intuitive. 

But at least as things seems like they're moving in the right direction, really try to hang-in there with the Dr.'s advice


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## Orchid (Sep 7, 2011)

Hello
Fluid restriction for severe heart failure is indeed very difficult to get used too
The restriction is for all fluids throughout the day and night including watery fruits like grapes citrus etc.
The 1.5 ltrs is 6 cups so in my case this is what I drink

3 x 1/4 cup water for the meds I take
1/4 cup nightstand water for when I wake up thirsty at night

breakfast 3/4 cup tea and 1/4 cup juice

midmorning small coffee 1/4 cup

lunch 3/4 cup tomato juice or buttermilk or water or fruit juice

afternoon 3/4 cup tea 

1/4 cup water while I am cooking dinner

dinner 3/4 cup water , small after dinner coffee 1/4 cup

evening 1/2 cup juice , 1/2 cup water or tea or hot cocoa


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## moore2me (Sep 7, 2011)

Orchid said:


> Hello
> Fluid restriction for severe heart failure is indeed very difficult to get used too
> The restriction is for all fluids throughout the day and night including watery fruits like grapes citrus etc.
> The 1.5 ltrs is 6 cups so in my case this is what I drink
> ...




Violet, 

Here's a recipe that may work with your restrictions. You like tomatoes? Take about three large ones (or 4 small) and plunge in boiling water for about 2 minutes or so. Then plunge in cold water and skins should easily peel off. Then cut skin 'maters into bite size pieces. (Note: If you don't have fresh tomatoes, you can use canned - diced or whole tomatoes and follow the rest of the steps below.)

Add a cup or so of extra water to the 'maters and start the mix boiling in a quart pot. Light boil for about 15 minutes. Measure liquid at end time and stop at one cup. *This one cup will be substituted for your 1/4 cup for breakfast and your 3/4 cup liquid for lunch.

*(If you're over one cup, either continue to reduce liquid by boiling or freeze extra in ice cube tray and use for next soup batch.) 

Now take your quart pot with one cup of cooked tomato sauce in it and add a couple of tablespoons butter, a little salt, and a little sugar. And for the grand finale, take a couple of slices of white bread and tear the bread into bite size pieces and blend them into the tomato mixture. Consume while warm. (My granny made this all the time.)
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You could also use this tomato base to make vegetable soup. Use the same one cup of condensed cooked down tomatoes. Add one cooked and cubed irish potato. Add either a half can of drained veg-all or cook a half cup of frozen mixed veggies in a separate pot. Drain the veggies well and discard liquid. Now add meat of your choice. I like to use ground sirlion fried with a little onion and garlic. Drain the fat with paper towels and add meat to soup. Sometimes I also add some canned kidney beans too. Season with salt, pepper, and hot sauce. (You can make a double batch and freeze half. Be careful to divide the liquid into one cup before adding the meat and veggies.) Hubby and I both like this vegetable soup.

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Your hip doctor sounds like a good man/woman. Ask him about the article on the hip school if you can or send him the source. There may be other things you can do too. More good luck to you 'My lady.

Deborah :bow:


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