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How Would Abnormal Range Results Negatively Impact The Bone After Bilateral Knee Replacement?
Question:
Dear Sir/Madam,
My Mom has Undergone Bilateral Knee Replacement on 30th March 2018.
My mother is Currently taking following prescribed medications.
CAP Maxgalin 75 mg 1-0-0 for pain After food 10 days
Tab TRAMADOL 50MG 1-0-1 for pain After food 10 days
Tab Neksium 40 MG 1-0-0 for Acidity before food
Tab LIVOGEN-Z 1-0-0 10 days iron supplement food 10 days
cap pregaba-nt 75 mg 0-0-1 for for pain 10 days
Tab Lasilactone 1-0-1 for pain 7 days
tab Ecosprin 150 mg 0-1-0 6 Weeks blood thinner
tab xykaa Extend 1GM 1-1-1 10 days for Pain
We have done basic Helath Checkup attached the results for the same following results are more than the normal range.Could you please give input if any of the results require any immediate attention.What can be done
to make those under normal range and whether any of the results listed would have any negative impact on Knee replacement which might indicate the infection etc.
Do you recommend contacting any other Specialist based upon the result
25-OH VITAMIN D (TOTAL) C.L.I.A ng/ml
Reference Range :-
20.86
DEFICIENCY : <20 ng/ml
INSUFFICIENCY : 20-<30 ng/ml
SUFFICIENCY : 30-100 ng/ml
TOXICITY : >100 ng/ml
Vitamin
TEST NAME TECHNOLOGY VALUE UNITS
HIGH SENSITIVITY C-REACTIVE PROTEIN (HS-CRP) IMMUNOTURBIDIMETRY mg/L
Reference Range :-
9.3
Adult : <=3.0 mg/L
HEMOGLOBIN 8.9 g/dL 12.0-15.0
HEMATOCRIT(PCV) 30.1 % 36.0-46.0
MEAN CORP.HEMO.CONC(MCHC) 29.6 g/dL 31.5-34.5
RED CELL DISTRIBUTION WIDTH - SD(RDW-SD) 53.1 fL 39.0-46.0
RED CELL DISTRIBUTION WIDTH (RDW-CV) 16.2 % 11.6-14.0
PLATELET DISTRIBUTION WIDTH(PDW) 9.4 fL 9.6-15.2
MEAN PLATELET VOLUME(MPV) 9.6 fL 6.5-12
PLATELET COUNT 485 X 10³ / μL 150-400
TEST NAME TECHNOLOGY VALUE UNITS NORMAL RANGE
ALKALINE PHOSPHATASE PHOTOMETRY 131 U/l 42 - 98
GAMMA GLUTAMYL TRANSFERASE (GGT) PHOTOMETRY 68.1 U/l < 38
TEST NAME TECHNOLOGY VALUE UNITS NORMAL RANGE
BLOOD UREA NITROGEN (BUN) PHOTOMETRY 5.87 mg/dl 7 - 25
TEST NAME TECHNOLOGY UNITS
HbA1c - (HPLC - NGSP Certified)
Dear Sir/Madam,
My Mom has Undergone Bilateral Knee Replacement on 30th March 2018.
My mother is Currently taking following prescribed medications.
CAP Maxgalin 75 mg 1-0-0 for pain After food 10 days
Tab TRAMADOL 50MG 1-0-1 for pain After food 10 days
Tab Neksium 40 MG 1-0-0 for Acidity before food
Tab LIVOGEN-Z 1-0-0 10 days iron supplement food 10 days
cap pregaba-nt 75 mg 0-0-1 for for pain 10 days
Tab Lasilactone 1-0-1 for pain 7 days
tab Ecosprin 150 mg 0-1-0 6 Weeks blood thinner
tab xykaa Extend 1GM 1-1-1 10 days for Pain
We have done basic Helath Checkup attached the results for the same following results are more than the normal range.Could you please give input if any of the results require any immediate attention.What can be done
to make those under normal range and whether any of the results listed would have any negative impact on Knee replacement which might indicate the infection etc.
Do you recommend contacting any other Specialist based upon the result
25-OH VITAMIN D (TOTAL) C.L.I.A ng/ml
Reference Range :-
20.86
DEFICIENCY : <20 ng/ml
INSUFFICIENCY : 20-<30 ng/ml
SUFFICIENCY : 30-100 ng/ml
TOXICITY : >100 ng/ml
Vitamin
TEST NAME TECHNOLOGY VALUE UNITS
HIGH SENSITIVITY C-REACTIVE PROTEIN (HS-CRP) IMMUNOTURBIDIMETRY mg/L
Reference Range :-
9.3
Adult : <=3.0 mg/L
HEMOGLOBIN 8.9 g/dL 12.0-15.0
HEMATOCRIT(PCV) 30.1 % 36.0-46.0
MEAN CORP.HEMO.CONC(MCHC) 29.6 g/dL 31.5-34.5
RED CELL DISTRIBUTION WIDTH - SD(RDW-SD) 53.1 fL 39.0-46.0
RED CELL DISTRIBUTION WIDTH (RDW-CV) 16.2 % 11.6-14.0
PLATELET DISTRIBUTION WIDTH(PDW) 9.4 fL 9.6-15.2
MEAN PLATELET VOLUME(MPV) 9.6 fL 6.5-12
PLATELET COUNT 485 X 10³ / μL 150-400
TEST NAME TECHNOLOGY VALUE UNITS NORMAL RANGE
ALKALINE PHOSPHATASE PHOTOMETRY 131 U/l 42 - 98
GAMMA GLUTAMYL TRANSFERASE (GGT) PHOTOMETRY 68.1 U/l < 38
TEST NAME TECHNOLOGY VALUE UNITS NORMAL RANGE
BLOOD UREA NITROGEN (BUN) PHOTOMETRY 5.87 mg/dl 7 - 25
TEST NAME TECHNOLOGY UNITS
HbA1c - (HPLC - NGSP Certified)
Brief Answer:
Answers
Detailed Answer:
Hi,
Your mother has diabetes, iron deficiency anemia, possible liver and/or gall bladder disorder (could be stone) as well as borderline Vitamin D deficiency.
There are also raised inflammatory makers as CRP and ESR are raised, suggesting some infection. This could be due to infection from surgery or could be fun the abdomen liver or gall bladder.
She needs to be treated for anemia with iron supplements.
She needs Vitamin D and Calcium supplements.
She needs ultrasound scan of abdomen to look for liver or gall bladder problems.
Also close watch of the knee operation sites to rule out infection.
I hope I have answered your query. I will be available to answer your follow up queries.
Regards,
Dr. Aashish Raghu
Orthopedic Surgeon
Answers
Detailed Answer:
Hi,
Your mother has diabetes, iron deficiency anemia, possible liver and/or gall bladder disorder (could be stone) as well as borderline Vitamin D deficiency.
There are also raised inflammatory makers as CRP and ESR are raised, suggesting some infection. This could be due to infection from surgery or could be fun the abdomen liver or gall bladder.
She needs to be treated for anemia with iron supplements.
She needs Vitamin D and Calcium supplements.
She needs ultrasound scan of abdomen to look for liver or gall bladder problems.
Also close watch of the knee operation sites to rule out infection.
I hope I have answered your query. I will be available to answer your follow up queries.
Regards,
Dr. Aashish Raghu
Orthopedic Surgeon
Above answer was peer-reviewed by :
Dr. Prasad
Thankypu very much for your quick reply.My mother is already taking Iron supplements as suggeted by doctor till 10 days post surgery,
Could you please give input on this.
as per your experience after Knee replacement Surgery elevated levels in ALKALINE PHOSPHATASE(Related to Liver) and HIGH SENSITIVITY C-REACTIVE PROTEIN (HS-CRP) ,LIPOPROTEIN (A) [LP(A)] are common due to surgery Stress and medications given post surgery?.
Or we need to to take immediate attention or wait till 2 moths post surgery and repeat the test once again to take appropriate action if same results are shown.
whether ultrasound scan of abdomen to look for liver or gall bladder problem is recommended at this point of time or wait till 2 months and do the test based upon the results?
Could you please give input on this.
as per your experience after Knee replacement Surgery elevated levels in ALKALINE PHOSPHATASE(Related to Liver) and HIGH SENSITIVITY C-REACTIVE PROTEIN (HS-CRP) ,LIPOPROTEIN (A) [LP(A)] are common due to surgery Stress and medications given post surgery?.
Or we need to to take immediate attention or wait till 2 moths post surgery and repeat the test once again to take appropriate action if same results are shown.
whether ultrasound scan of abdomen to look for liver or gall bladder problem is recommended at this point of time or wait till 2 months and do the test based upon the results?
Brief Answer:
Not urgent
Detailed Answer:
Hello,
There doesn't appear to be anything urgent. You can get the ultrasound scan once she is better.
Yes, CRP can be elevated after surgery but she's to be monitored. Even any infection anywhere else in the body can cause this. Alkaline phosphatase elevated usually in gallbladder problems.
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. Aashish Raghu
Orthopedic Surgeon
Not urgent
Detailed Answer:
Hello,
There doesn't appear to be anything urgent. You can get the ultrasound scan once she is better.
Yes, CRP can be elevated after surgery but she's to be monitored. Even any infection anywhere else in the body can cause this. Alkaline phosphatase elevated usually in gallbladder problems.
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. Aashish Raghu
Orthopedic Surgeon
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Thanks for your Suggestion.We will Do Ultrasound Test of abdomen and post the results as suggest by you to rule out Gall bladder/Liver problem.
Brief Answer:
Follow up
Detailed Answer:
Hello,
Not a problem.
Hope I have answered your query. Do follow up with me regarding her progress.
Regards,
Dr. Aashish Raghu
Orthopedic Surgeon
Follow up
Detailed Answer:
Hello,
Not a problem.
Hope I have answered your query. Do follow up with me regarding her progress.
Regards,
Dr. Aashish Raghu
Orthopedic Surgeon
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Dear Sir,
from Past 4-5 days My Mother is not able to sleep during night and is waking up intermittently causing sleep disturbance.Could you please let me know if any of the existing medication is causing this issue or what are the home remedies or medications for making Sleep proper during night
from Past 4-5 days My Mother is not able to sleep during night and is waking up intermittently causing sleep disturbance.Could you please let me know if any of the existing medication is causing this issue or what are the home remedies or medications for making Sleep proper during night
Brief Answer:
Electrolytes
Detailed Answer:
Hello,
I'd suggest doing serum electrolytes to look for any disturbance.
Avoid eating protein-rich food at night. She can have rice and carbs at night. Banana is good.
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. Aashish Raghu
Orthopedic Surgeon
Electrolytes
Detailed Answer:
Hello,
I'd suggest doing serum electrolytes to look for any disturbance.
Avoid eating protein-rich food at night. She can have rice and carbs at night. Banana is good.
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. Aashish Raghu
Orthopedic Surgeon
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Attached the Serum Electrolytes report.
Results are are under the normal range for Serum Electrolytes(Sodium,Pottasium and Chloride) But for Serum Creatinine results are slightly on Lower side 0.46 for the ref range 0.60 - 1.00.
Please let me know if anything needs to be checked
Results are are under the normal range for Serum Electrolytes(Sodium,Pottasium and Chloride) But for Serum Creatinine results are slightly on Lower side 0.46 for the ref range 0.60 - 1.00.
Please let me know if anything needs to be checked
Brief Answer:
Anxiety
Detailed Answer:
Hello,
I'm glad to see that the reports are within normal range.
Usually after surgery there may be stress. If she seems well oriented and responding to commands and conversation normally, then nothing to worry.
You can give Tab. Anxit 0.5mg at night for a few days for the stress and anxiety to reduce so that she can sleep normally.
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. Aashish Raghu
Orthopedic Surgeon
Anxiety
Detailed Answer:
Hello,
I'm glad to see that the reports are within normal range.
Usually after surgery there may be stress. If she seems well oriented and responding to commands and conversation normally, then nothing to worry.
You can give Tab. Anxit 0.5mg at night for a few days for the stress and anxiety to reduce so that she can sleep normally.
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. Aashish Raghu
Orthopedic Surgeon
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Thanks for letting me know the Tablets related to Anxiety Tab.Anxit 0.5mg.
Could you please let me know if this should be taken during Night or Morning with or without food?.
Also wanted to check if Tab TRAMADOL and Tab pregaba-nt 75 mg would cause any Sleep Disturbance do we have alternative medicines for this which does not cause any Sleep disturbance. ?
Could you please let me know if this should be taken during Night or Morning with or without food?.
Also wanted to check if Tab TRAMADOL and Tab pregaba-nt 75 mg would cause any Sleep Disturbance do we have alternative medicines for this which does not cause any Sleep disturbance. ?
Brief Answer:
Alternative not required right now
Detailed Answer:
Hello,
Tablet Anxit us to be taken once at night after food.
Pregaba and Tramadol are known to cause drowsiness so definitely does to prevent sleep from happening.
her main concern is anxiety associated with the surgery which is a new stress for her. Hence, Anxit being an anti-anxiety drug will help her.
Hope I have answered your query.
Regards,
Dr. Aashish Raghu
Orthopedic Surgeon
Alternative not required right now
Detailed Answer:
Hello,
Tablet Anxit us to be taken once at night after food.
Pregaba and Tramadol are known to cause drowsiness so definitely does to prevent sleep from happening.
her main concern is anxiety associated with the surgery which is a new stress for her. Hence, Anxit being an anti-anxiety drug will help her.
Hope I have answered your query.
Regards,
Dr. Aashish Raghu
Orthopedic Surgeon
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Yogesh D
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