HEALTHWISE MAUI
Q: How do I know if it’s time for joint replacement surgery?
Dr. Vic Ayers, Orthopedic Surgeon & Maui Memorial Chief of Staff, Pacific Permanente Group: Joint replacement surgery can significantly reduce pain and improve quality of life. But is it better to replace a joint sooner or keep trying non-invasive therapies in the hopes of postponing surgery a little longer? Ultimately, the decision is up to you, but several factors must be considered before moving ahead.
First and foremost, think about how joint pain impacts your daily life. Is it limiting your activities? Making it hard to do the things you enjoy or even get around the house? Is pain affecting your sleep? If your pain level is constant and severe, and you experience pain not only with movement but also at rest, that’s a sign it may be time for joint replacement.
Second, have you exhausted all your non-surgical options? These can include over-the-counter or prescription medications, injections, physical therapy, exercise to strengthen supporting muscles, weight loss to reduce stress on the joint, and assistive devices like a brace.
If you’ve tried other treatments and they’re no longer helping, or if medication is causing unwanted side effects, surgery is likely the next step. If you want to move ahead with joint replacement, you also need to make sure that you’re physically and mentally ready for surgery. Talk with your doctor about any underlying health issues you may need to address before surgery, such as losing weight or adjusting certain medications. You also need to consider the recovery process and ensure you’re prepared to take time off to recover at home for several weeks. Have a support system in place and be ready to commit to post-surgery rehabilitation and physical therapy.
Finally, if you’re younger than 60, your doctor may advise you to wait. While joint surgery can be done on people of all ages, there’s some evidence that artificial joints wear out faster in younger and more physically active patients. That means waiting may mean you’ll benefit more from your new joint over the long run.
Joint pain can seriously impact your life, and joint replacement surgery can be a solution. Each case is different, so talk with your doctor about whether you’re a good candidate.
If you’re considering surgery and want to learn more about how best to prepare for the procedure and recover for optimal outcomes, Maui Memorial Medical Center Outpatient Clinic offers free informational sessions every month. Call (808) 4425700 to reserve a seat or visit mauihealth.org/totaljoint for more information.
Q: Will my period affect my diabetes?
Barbara Satterfield, RN, Diabetes Program Manager, Maui Health: Actually, it can! Some women find that their glucose levels fluctuate with different stages of their menstrual cycle. This is due to changes in the hormones estrogen and progesterone, which can cause a temporary resistance to insulin. In many cases, blood sugar levels rise in the days before a woman’s period. During the period itself, blood sugar levels may be high—or sometimes they can drop. Of course, menopause can cause changes in how your body responds to insulin as well.
If you notice that your glucose levels seem to fluctuate around your period, try keeping a diary to determine whether it follows a regular pattern. This can help you plan ahead so you’re not surprised by sudden changes. You may need to take more insulin or be extra careful about your carbohydrate intake around these times. If you’re finding it difficult to keep your blood sugar levels consistent, talk with your doctor about how to better manage your insulin dosage around your menstrual cycle. Visit mauihealth.org/diabetes for more health tips.
Physicians, providers and administrative staff who practice at Maui Health hospitals and clinics answer questions from the public in Healthwise Maui, which appears on Thursdays. Maui Health operates Maui Memorial Medical Center, Maui Memorial Medical Center Outpatient Clinic, Kula Hospital & Clinic and Lana‘i Community Hospital and accepts all patients. To submit a question, go to the website at mauihealth. org/healthwise.