Your Questions, Our Answers
Q. My friend was up and walking shortly after his knee replacement. Will I be able to do the same when I have my knee replaced?
A: Yes, you will be up and moving right after your joint replacement. A physical therapist will have you walking the same afternoon as your surgery. At OHSU orthopaedics, we use rapid recovery protocols, so getting moving quickly is important. The other key is reducing or avoiding the use of opiates. Instead, we use a variety of other medications to reduce swelling and pain. By following these two methods, data show people have fewer problems and get back to their normal lives quicker. Many joint replacement patients go home the same day as the surgery with an at-home exercise plan. Knee patients start physical therapy about a week after surgery. Most of the healing happens within three months, however, you may continue to improve for up to a year after surgery.
Q. Our daughter was born with a strawberry birthmark. Should we see a doctor about it and when?
A: Early treatment is key. The sooner we treat these birthmarks (hemangiomas), the better the results. Though we don’t know what causes them, these red birthmarks usually need treatment, especially when on the face or neck. They can grow a lot in the first six months of life and cause lasting changes in the skin. With early treatment, we can keep hemangiomas from getting bigger and make them fade faster. Unfortunately, I often see babies after the birthmark has grown significantly, because parents didn’t know how important it is to seek early treatment. Though the color will fade over time, the skin is never normal where the hemangioma grew. As soon as you discover the birthmark, plan to meet with a pediatric dermatologist or an ear, nose and throat specialist for guidance. At OHSU Doernbecher, we have both types of specialists working together in the Hemangioma and Vascular Birthmarks Clinic.
Coming soon to Tuality Healthcare, we will have pediatric ENT specialists performing outpatient surgery with a pediatric team of nurses, anesthesiologists and surgeons.
Q. I’ve started having hot flashes and I’m miserable! Is there anything I can do?
A: Yes, there are medical and lifestyle options to improve hot flashes. About 80 percent of women have hot flashes and night sweats in the four years or so before menopause, and some women will have these symptoms long after their periods have stopped. Each woman has to decide how much intervention she needs for daily comfort and function. For some, loose clothing, exercise and a fan at the ready are enough. For others, we can prescribe estrogen therapy, which will stop hot flashes within about three weeks. There are some other prescription alternatives that can also help. Other common symptoms of menopause include sleep and mood disturbance, vaginal dryness and low libido. Just know that you don’t need to suffer. If any of these symptoms are negatively impacting your life, speak to your health care provider. At OHSU, we have the Menopause and Sexual Medicine program to address multiple issues.
Q. Who should see a preventive cardiologist?
A: Heart disease is the leading cause of death and certain people are more at risk than others. A preventive cardiologist can identify your risk for a heart attack and suggest the right plan for managing that risk. Some people have risk factors at a younger age, but any man over 55 and woman over 60 will benefit from an expert evaluation to avoid a cardiac event. Also, anybody who has already survived one heart attack or stroke should be seen to help avoid a second one. Preventive visits include a review of family history, blood tests, nutrition advice and, in some cases, imaging tests. Preventive cardiology is a specialized service not available everywhere. OHSU Center for Preventive Cardiology is accepting new patients.
Q. I got a notice that I’m due for a cervical cancer screening. Why do I need that?
A: We recommend that women over 21 get tested periodically for cervical cancer because it is a type of cancer that doesn’t have symptoms until the disease is advanced. Importantly, it is a type of cancer that we can prevent. We can reliably catch precancers with swab tests – Pap and HPV – and resolve them with less traumatic treatment than if the disease progresses. Current guidelines recommend that women ages 21-29 get a Pap test every three years. Women ages 30-64 should get the same, or a co-test of Pap/HPV every five years. HPV is very common in the population now, and we know it is a driver for causing cervical cancer. If you have a positive HPV status, your provider will follow you more closely and may recommend additional testing.
Q. As a parent, what should I know about vaping among children and teens?
A: Recent reports show a worrying increase in vaping among youth, with about one-fifth of high schoolers now vaping. By law, vaping (using a device to breathe in flavored products that usually contain nicotine) is restricted to people over 18 years old, but that hasn’t stopped curious teens. Youth, and even parents, often view vaping as having no health consequences and as safer than cigarettes. However, vaped nicotine can be addictive, especially for teens, whose brains are still developing. The aerosols also contain toxins, such as metals and formaldehyde, which may have as-yet unknown effects. Vaping fluids come in delicious-sounding flavors such as mango and crème brulee, avoiding the tobacco smell, making it easier to avoid detection by parents and teachers. One popular type of vaping device (Juul) looks like a thumb drive, not a cigarette. Parents should inform children about how unhealthy and addictive vaping is and that it is not harmless.