Record of Kris Stewart Knee Replacement may2012

kp.org is tied to my krisstewar@gmail.com

Got to see my Kaiser Surgeon - Dr. Arnold A. Yashar and he wanted xrays
From 10july2012_KneeUpdate
2 metal knees now -

looks much better than before:
From KneeXray_17may2012

12 june 2012 - update on steristripes
Orthopedic Allied Health/nurse Visit with MARZENA CEBULA RN
Tuesday June 12, 2012 11:00 AM
ORTHOPEDICS (SAN MARCOS OUTPATIENT MED CTR U-SAMU)
Phone: 866-459-2912
Vitals Pulse: 84 Temperature: 97.6 Temp source: Tympanic Respiration: 20
Patient instructions PATIENT EDUCATION:TKR: Your staples have just been removed. It will be ok to shower tomorrow if you feel safe. For at least the first shower it is good to have another person present. You may feel weak and tired after your first shower, this is expected. Taking your shower before doing any exercise is best. A walk-in shower is preferred for safety reasons. We still do not want you to soak for 2 weeks in bodies of water such as bath tubs, pools, spas, or ocean water. Continue with you range of motion, extension exercises, and physical therapy appointments. Continue to do your ankle pumps as these help prevent blood clots and improve your circulation. Try and resume a normal heel / toe gait with bending of the knee as you walk. This will help prevent future hip/back problems associated with limping and not bending the knee. Using a walker helps you get better extension of the leg because you can take longer strikes. After your steri strips fall off you can start scar massage of your incision. You can massage your scar to breakdown the scar bed and desensitize the wound. It also helps with the appearance of your scar formation. Recommend Cocoa Butter made by Palmers. In your preoperative packet is the dental antibiotic protocol. You can make 3 copies of this form. It is a good idea to keep one copy in your wallet for traveling, give one copy to your current dentist and keep a copy at home. Now your dentist will call or fax in your antibiotic prescription to Kaiser. We would like you to wait 3 months from your surgery date to go to the dentist even for a cleaning, unless you need emergency dental care. When you go to the airport or to a courthouse you may set off the metal detectors. You will possibly be taken to secondary and screened with a wand. Just tell the airport security you have had a total hip replacement and allow extra time. Remember for a refill of your medication call the number on the bottle 2 days before you run out so it can be refilled for you. The bottles may show no refills because the physicians keep track of usage and weaning of medications if appropriate. The medication will be ready at the pharmacy you selected unless you received a phone call to discuss the refill. You may have swelling of the affected leg after your surgery and this can be normal. Ice and elevation when lying down will help with swelling. Signs and symptoms of blood clot in your leg may be pain when doing foot pumps, pain in leg when walking, redness, warmth to leg, and / or increased swelling that does not diminish with icing and elevation. Signs and symptoms of pulmonary embolism may include chest pain/shortness of breath and this is considered a medical emergency. Signs and symptoms of infection are temperature greater than 101.5 degrees F, redness around the incision, increasing pain to the incision area, and a white pus-like drainage that has a foul odor. Call clinic @ toll free # 1-866-459-2912 for any questions or concerns, Monday through Friday 8am-5pm. After hours (nights, weekends or holidays) you may call KP-On Call at 1-888-576-6225 or go to Urgent Care or ER for symptoms of infection or pain out of control. COMMENTS: has physical therapy

08June2012 - Staples removed at San Marcos Ortho
Orthopedic Allied Health/nurse Visit with LINDA T POWRIE RN
Friday June 08, 2012 9:45 AM
ORTHOPEDICS (SAN MARCOS OUTPATIENT MED CTR U-SAMU)
Phone: 866-459-2912
Vitals Blood Pressure: 125/74 Pulse: 80 Temperature: 97.2 Temp source: Tympanic Respiration: 16
Patient instructions TKR: Your staples have just been removed. It will be ok to shower tomorrow if you feel safe. For at least the first shower it is good to have another person present. You may feel weak and tired after your first shower, this is expected. Taking your shower before doing any exercise is best. A walk-in shower is preferred for safety reasons. We still do not want you to soak for 2 weeks in bodies of water such as bath tubs, pools, spas, or ocean water. Continue with you range of motion, extension exercises, and physical therapy appointments. Continue to do your ankle pumps as these help prevent blood clots and improve your circulation. Try and resume a normal heel / toe gait with bending of the knee as you walk. This will help prevent future hip/back problems associated with limping and not bending the knee. Using a walker helps you get better extension of the leg because you can take longer strikes. After your steri strips fall off you can start scar massage of your incision. You can massage your scar to breakdown the scar bed and desensitize the wound. It also helps with the appearance of your scar formation. Recommend Cocoa Butter made by Palmers. In your preoperative packet is the dental antibiotic protocol. You can make 3 copies of this form. It is a good idea to keep one copy in your wallet for traveling, give one copy to your current dentist and keep a copy at home. Now your dentist will call or fax in your antibiotic prescription to Kaiser. We would like you to wait 3 months from your surgery date to go to the dentist even for a cleaning, unless you need emergency dental care. When you go to the airport or to a courthouse you may set off the metal detectors. You will possibly be taken to secondary and screened with a wand. Just tell the airport security you have had a total hip replacement and allow extra time. Remember for a refill of your medication call the number on the bottle 2 days before you run out so it can be refilled for you. The bottles may show no refills because the physicians keep track of usage and weaning of medications if appropriate. The medication will be ready at the pharmacy you selected unless you received a phone call to discuss the refill. You may have swelling of the affected leg after your surgery and this can be normal. Ice and elevation when lying down will help with swelling. Signs and symptoms of blood clot in your leg may be pain when doing foot pumps, pain in leg when walking, redness, warmth to leg, and / or increased swelling that does not diminish with icing and elevation. Signs and symptoms of pulmonary embolism may include chest pain/shortness of breath and this is considered a medical emergency. Signs and symptoms of infection are temperature greater than 101.5 degrees F, redness around the incision, increasing pain to the incision area, and a white pus-like drainage that has a foul odor. Call clinic @ toll free # 1-866-459-2912 for any questions or concerns, Monday through Friday 8am-5pm. After hours (nights, weekends or holidays) you may call KP-On Call at 1-888-576-6225 or go to Urgent Care or ER for symptoms of infection or pain out of control.

07june2012 - Physical Therapy - San marcos David Farris 858.502.1350

01june2012 - PT David Farris - Osteoarthritis of Knee

23may2012 - Stress Test 5pm at Zion
no coffee for 24 hours before. talk about pain!

22may2012 - CCM Healthy Bones - Amalia Louisa Bruning - Vamdever - OSTEOPOROSIS (SIGNIFICANT THINNING OF BONE) COUNSELING, OSTEOPOROSIS
HEALTHY BONES PATIENT INSTRUCTIONS - ABNORMAL BONE DENSITY SCAN Today we reviewed the results of your DXA scan, a bone density screening test for osteoporosis (bone loss). Early bone loss is called osteopenia. More advanced bone loss is called osteoporosis Bone loss is measured by T-score. Bone (calcium) loss is a silent process until there is a fracture (broken bone), so most people have no noticeable symptoms of this condition. T-Scores of -2.5 or less indicate a low bone density consistent with the diagnosis of osteoporosis (25% loss), and are associated with a high risk of fracture. DXA SCAN RESULTS: Your bone density T-score results are: -2.7 in your L leg. / which has been in a knee brace for the past year. Repeat DXA / 18- 24 months
1) LABORATORY TESTING: Go to the laboratory and CHECK-IN
Orders Placed This Encounter
* CALCIUM
* TOTAL PROTEIN, SERUM
* VITAMIN D, 25-HYDROXY
* ALBUMIN, SERUM
* TSH
* LIPID PANEL
2) PHARMACY: Go to the pharmacy and CHECK-IN to pick up your prescription if you have one. -Also, be sure you have a supply of Calcium with Vitamin D, and take it twice a day -A multivitamin is also recommended daily
3) REFERRALS: Maxon, Kimberly Ann (M.D.), MEDICAL DOCTOR / repeat DXA 18-4 months
ADDITIONAL BONE HEALTH ADVICE
*Walking and other forms of weight-bearing exercise stimulate your bones to rebuild, so be sure to do as much exercise as you can, within any limitations you may have.
* Do not smoke. Smoking increases the loss of calcium from your bones. Please call 1-888-883-7867 for get a STRATEGY to stop smoking or call the telephone support line at 1-800-No-Butts.
* If you use glasses, hearing aids, or mobility devices such as a can or walker, be certain to use them to reduce your risk of falls.
* Put up safety bars in your shower or tub
* Remove throw rugs and other fall-risk obstacles from your home
* Keep your home well lit, and use night-lights to reduce the risk of falling in the dark
* Limit alcohol use to less than one drink a day to reduce bone loss and risk of falls
* Please continue to maintain good oral hygiene and continue your routine
to see your dentist for your preventive dental care.
Thank you for your time attention in helping us care for your bone health! You may call us at 619-589-3305 if you have any questions or concerns about today's visit. Amalia ( Amy) Bruning PA-C, CCD Healthy Bones Program Complete Care Management 619-589-3305 option #1 Routine orders Name Type CALCIUM Lab TOTAL PROTEIN, SERUM Lab VITAMIN D, 25-HYDROXY Lab ALBUMIN, SERUM Lab TSH (THYROID STIMULATING HORMONE) Lab LIPID PANEL Lab ALT (ALANINE AMINOTRANSFERASE), SERUM Lab

17may2012 arnold abraham yashar md / garfield spec care center
Diagnosis: Oa Lower Leg
Phone: 866-459-2912
Vitals Blood Pressure: 112/68 Pulse: 88 Temperature: 96.5 Temp source: Tympanic Height: 5' 9" (175.3 cm) Weight: 165 lb (74.844 kg)
Patient instructions
Our records indicate that you are due for a Dexa scan, (this test is an x-ray which helps screen for or monitor bone density.) We have placed the order for you and would like you to call our radiology department at (866) 628-2006, (8:15am to 4:45pm,) in 2 days to schedule this exam. Thank you.

11may2012 - cardiology san marcos
the tech questions who took the EKG test? they must have misread it. got me walking incline and heart rate up and everything was fine. whew!

11may2012 - orthopedics - MRSA test (staphylococcus aureus test)
stick a Qtip up my nose ... very strange sensation

What is osteoarthritis? (you will need a Kaiser Online login for this)
Kaiser Health Online
Summary

Osteoarthritis is a painful problem with the joints. Healthy joints help your body move, bend, and twist. Knees glide up and down stairs without creaking or crunching. Hips move you along on a walk without a complaint. But when you have arthritis, such simple, everyday movements can hurt. Using the stairs can be painful
l. Walking a few steps, opening a door, and even combing your hair can be hard.
The simplest way to describe arthritis is that it's wear and tear on the cartilage of your joints. Your joints have cushioning inside them called cartilage. This tissue is firm, thick, and slippery. It covers and protects the ends of bones where they meet to form a joint.
With arthritis, there are changes in the cartilage that cause it to break down. When it breaks down, the bones rub together and cause damage and pain. Experts don't know why this breakdown in cartilage happens. But aging, joint injury, being overweight, and genetics may be a part of the reason.

What are the symptoms?
Pain: Your joints may ache, or the pain may feel burning or sharp.
Stiffness: Getting up in the morning can be hard. Your joints may feel stiff and creaky for a short time, until you get moving.
Muscle weakness: The muscles around the joint may get weaker. This happens a lot with arthritis in the knee.
Swelling: Arthritis can cause swelling in your joints, making them feel tender and sore.
Deformed joints: Joints can start to look like they are the wrong shape, especially as arthritis gets worse.
Reduced range of motion and loss of use of the joint: As your arthritis gets worse, you may not be able to fully bend, flex, or extend your joints. Or you may not be able to use them at all.
Cracking and creaking: Your joints may make crunching, creaking sounds.

How is osteoarthritis diagnosed?
Your doctor will check that your pain is not caused by another problem. He or she will ask questions about your symptoms, such as:
Is the pain burning, aching, or sharp?
Are your joints stiff in the morning? If yes, how long does the stiffness last?
Do you have any joint swelling?
If your joints are tender and swollen and the muscles are weak, this will also help your doctor confirm whether you have arthritis. You may also have X-rays to check your joints for damage. Your doctor may want to do blood tests or other tests to see if there are other causes for your pain.

How is it treated?
There are many treatments for arthritis, but what works for someone else may not help you. Work with your doctor to find what is best for you. Often a mix of things helps the most.
Your treatment may include:
Using pain medicine. If your pain is mild, over-the-counter pain medicines such as acetaminophen (for example, Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs) may help. Commonly used NSAIDs include ibuprofen (such as Advil and Motrin), naproxen (such as Aleve), and aspirin (such as Bayer and Bufferin). But if these don't get rid of your pain, you may need a stronger prescription medicine. Having shots of medicine in the joint also helps some people.
Using heat or ice on the painful joint. Heat may help you loosen up before an activity. Ice is a good pain reliever after activity or exercise. Your doctor may give you gels or creams that you can rub on the joint to make it stop hurting. Losing weight, if you're overweight. Losing weight may be one of the best things you can do for your arthritis. It helps take some of the stress off of your joints. Exercising to strengthen your muscles. Having stronger thigh muscles, for example, can help reduce stress on your knees. Swimming, biking, and walking are good activities. But make sure you talk to your doctor about what kind of activity is best for you. You may also get help from a physical therapist.
Having surgery. If the pain in your hip or knee does not get better with treatment, you may decide to have surgery to replace the joint.
There are also some things you can do at home to help relieve your symptoms. For example, there are devices and tools that can take the stress and weight off of your joints and make it easier for you to hold objects, open and close things, and walk. Doorknob covers, tape, braces, splints, and canes may help.
You might also try changing activities or the way you do things to reduce the stress on the joint that hurts and allow you to move better. For example, walk instead of jog. Or use a sewing machine to make a quilt instead of making it by hand.