PHILIPPA’S TOP TIPS ON JOINT REPLACEMENTS

Our GP walks you through what to expect before and after the operation

◆ Joint replacements are major surgeries to replace a joint with an ar tificial one, most commonly the knee or hip, with the aim of reducing pain. They can be per formed on other joints such as the shoulder, wrist, ankle and elbow.

◆ Surgery is carried out if the joint is damaged or worn, leading to pain even when resting. Mobility may be reduced and treatments such as painkillers, physiotherapy and/or joint injections become ineffective.

◆ Common reasons for joint replacement surger y are osteoar thritis, where the joint is worn over time; hip fractures; or conditions such as rheumatoid ar thritis or gout.

◆ Prehabilitation is what you can do before you go into hospital to try and help your recovery – even before surgery.

◆ Staying as active as you can before surgery is impor tant. If you can, go on exercising – perhaps walking or swimming.

◆ A physiotherapist may give you exercises to help strengthen the muscles around the joint to be replaced, which can help your recovery.

◆ You may be asked to go in for a pre-operative assessment where you meet an anaesthetist and have any tests required.

◆ The length of your hospital stay will depend on the surgery you have.

◆ In hospital the team will help you mobilise as early as possible, perhaps star ting by getting out of bed and sitting in the chair. Mobilising is vital after any surger y; it helps ever ything from bowels to improving your breathing.

◆ You will be given advice and exercises to strengthen the muscles around the joint, and you should continue at home.

◆ Depending on which joint is replaced, you may need a walking aid such as a frame or crutches at first.

◆ Healing and recovery take time – keep doing your exercises!

QMy daughter has started taking the pill for contraception but she seems to be taking it very differently to how I took it! I used to take the pill for 3 weeks on and then have a week off, during which I got my period and then started the whole thing again. She says she has been told she can take it for 9 weeks at a time and then have only 4 days off, or even just keep taking it – but when will she get her period? The leaflet inside the box doesn’t say to take for so long but she insists her GP did. What is going on? A

It sounds as if you are talking about the combined contraceptive pill – which contains both oestrogen and progesterone and was traditionally prescribed as being taken for 3 weeks on and 1 week of f.

There are other types of contraception such as the progesterone-only pill, or mini-pill, which are taken daily without a break, but I am going to talk about the combined pill here.

During the break on the combined pill you don’t have a true period; rather it is a withdrawal bleed from the medication. Over time, though, it has become apparent through research that this is not the only way to take the oral combined contraceptive pill. Your daughter’s doctor is likely to have been talking

Studies have shown other safe ways to take the combined pill

about tailored pill-taking, which are other ways of taking the pill. Options include tricycling, which means taking 3 packets of the pill together (9 weeks) before a 7-day break, resulting in 5 bleeds a year instead of 13. Or you can back-to-back the packets of the pill continuously, without a break. You may still have a bleed at some point and if you bleed for more than 4 days in a row, you are advised to stop the pill for 4 days before star ting again. In fact, in any method you can have a 4-day break instead of 7 days – so there are various options about how you take the combined oral contraceptive pill!