Ankle replacement can offer return to mobility

  • Stock PhotoAnkle replacement requires a long and arduous recovery.

    Stock PhotoAnkle replacement requires a long and arduous recovery.

 
By Dr. Eve Glazier and Dr. Elizabeth Ko
Updated 11/21/2021 10:00 AM

We heard from a reader in Southern California in response to a column about full ankle replacement, which is a complex surgery with a long and rigorous recovery:

"By my late 70s, my often-injured right ankle had crippled me to the point of limited and painful walking, but thankfully the total ankle replacement you wrote about had become a viable procedure," he wrote. "It took about eight months of therapy to fully recover, but I now have mobility and almost no pain."

 

We agree with his reminder to fully vet any surgeon you plan to work with. And we will echo our recent column that it's crucial for older adults to make sure they are strong and healthy enough to undergo -- and to recover from -- a surgical procedure.

No honey for infants: In response to a column about medical-grade honey, which is honey that has been specially processed and sterilized for use on the skin in burn and wound care, we heard from several readers. They asked us to make clear that babies younger than 1 year old, whose guts and immune systems are still developing, should never be given honey.

The reason is that ingesting honey puts them at risk of developing infant botulism. This is a rare but serious gastrointestinal condition caused by exposure to C. botulinum spores, and which has been associated with honey. Don't offer honey of any kind, not even a taste, to infants younger than 1.

Also regarding medical-grade honey, several readers have asked if a prescription is required. The answer is no, you don't need a prescription. Medical-grade honey is available over-the-counter at many large chain and drugstores, and through online retail sites. We can't offer recommendations regarding specific brands, but pharmacists at the stores you visit may be able to offer guidance.

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Omega-3s: We've written about the health benefits of omega-3 fatty acids. In response to our suggestion that food-based sources are preferable to supplements, a reader had a question: "How much sardines or other fish do we need to consume to get our omega-3s?" he asked. "I would also like to ask about tilapia and flounder. Do they contain the omega-3s we need to consume?"

For adults between the ages of 19 and 55-plus, the adequate intake of omega-3 fatty acids is between 1.1 grams per week for women, and 1.6 grams per week for men. This can be achieved by eating fatty fish -- such as salmon, mackerel, tuna, herring and sardines -- two to three times per week.

Mackerel is high in the nutrient, at 2.6 grams per 3.5 ounces. Sardines weigh in a 1.5 grams for the same serving. Tilapia and flounder, which are lean fish, have about .2 grams of omega-3s per serving.

The nutrient is also available in seeds and nuts, such as walnuts and flaxseed, and in plant oils such as flaxseed oil, soybean oil and canola oil.

A long haul: We heard from a reader who is eight months into her recovery from COVID-19. This ongoing illness, which affects up to one-quarter of COVID patients, has come to be known as long-haul COVID.

                                                                                                                                                                                                                       
 

"I would like to know if there's a study that I could join regarding the long-haulers' COVID symptoms," she wrote. "Yesterday was my first day back at work with the use of oxygen, due to my oxygen levels and heart rate. Is there is anywhere I can volunteer?"

The National Institutes of Health has launched a study into the lingering form of this illness, in which symptoms persist for weeks and months. You can find more information at recovercovid.org. You can also find clinical trials that are still in the process of recruiting at clinicaltrials.gov; use the search phrase "long covid."

• Dr. Eve Glazier is an internist and associate professor of medicine at UCLA Health. Dr. Elizabeth Ko is an internist and assistant professor of medicine at UCLA Health. Send your questions to askthedoctors@mednet.ucla.edu.

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