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Most Patients Wait Too Long for Knee Replacement

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According to a recent study, the majority of people who are experiencing knee pain from osteoarthritis wait too long to have knee replacement surgery. The statistics revealed up to 90 percent should have scheduled it sooner. On the other hand, 25 percent may be scheduled too soon for knee replacement.

When the patient waits too long, the surgery is often not as successful because the person has lost more function. Since they usually aren’t as active with the level of pain they’re experiencing, they may gain weight and suffer from depression along with other health issues.

This isn’t to say that the patient experiences no improvement if they wait too long to have knee replacement surgery. They will likely see some improvement, but it lags behind the average.

For those who get the surgery too soon, they may face more complications and end up with major costs without a lot of benefit. Another concern is that knee replacements wear out, and those patients will likely face a second replacement down the road. That surgery is often more difficult and doesn’t have as positive of an outcome.

To determine the best time to have knee replacement surgery, the researchers used several factors to create an algorithm for their test subjects. This included age, amount of pain and stability of the knee. They would consider how wiggly the knee felt based on if the tendons were loose. They also looked at the grinding and clicking sounds that come with knee issues.

The Cost of Knee Replacement

The average cost in the US for knee replacement surgery runs between $12,000 and $70,000, depending on the area of the country where you live. This has become a popular surgery in recent years, and that trend doesn’t appear to be changing. According to the American Academy of Orthopedic Surgeons, the rate of surgery for knee replacement will increase by 189 percent by 2030.

It is not only the elderly or senior citizens that are getting this type of surgery. Statistics show that is has increased for people between the age of 45 and 64 by three times while those over 65 doubled.

While there are proponents of the idea of using an objective measure for when it’s time for knee replacement surgery, many believe it wouldn’t be effective because the decision involves subjective factors, such as pain. Other considerations for the right time for the surgery is the lifestyle and schedule of the patient. They may be taking care of a spouse and not able to take time off to recover from surgery.

A recent study showed that nearly 20 percent of patients who had the surgery weren’t happy with how it turned out. In some cases, it was because the results didn’t live up to the expectations of the patient.

While knee replacement is obviously a growing trend, every person should discuss the option with their doctor and make a decision based on what’s right for them. They shouldn’t be pressured into a surgery they aren’t ready for and should understand the risks.

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Defective EpiPens Increase Risk of Death

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The US Food and Drug Administration announced that certain EpiPens may fail to work correctly for allergic reactions. This includes the Ep
iPen 0.3 mg and EpiPen Jr 0.15 mg and generic versions of the products.

EpiPen Malfunction

According to the FDA, the EpiPens may delay injection of the epinephrine being given for a severe allergic reaction. They may also activate too soon if the safety release is removed from the side. The correct way to remove the blue safety release is to pull it straight up with one hand while holding the pen with the other. If the person attempts to hold it and remove the release with the same hand, it may activate the medicine.

The blue safety release may already be partially raised on some of the EpiPens. This would allow the device to activate before it should, which means the person wouldn’t receive the medication for the reaction.

Another issue with the devices is that some may fail to slide out of the carrier. Other user errors could cause the EpiPens not to work correctly. The FDA recommended that patients review the instructions that come with the EpiPen periodically to ensure they know what to do in an emergency.

Pharmacists should inspect the EpiPens before they are distributed to the patient. If a patient has a device and they are having an issue with it, they can contact the manufacturer at 800-796-9526 for a replacement at no cost to them.

What EpiPens Do

EpiPens contain epinephrine, which is a medication designed to open the airways in the lungs and narrow blood vessels. It works by injection to take effect immediately.

The medication can stop wheezing, bring up severely low blood pressure and stop hives and itching as well as other symptoms of an allergic reaction. The reactions may be caused by an allergy to foods, drugs, insect bites or stings and even anaphylaxis caused by exercise. It can be given by the person suffering from the reaction and is generally kept on hand for anyone with a history of severe reactions to allergens.

The EpiPen Auto-Injector is designed for people who weigh at least 66 pounds. The EpiPen Jr Auto—Injector is prescribed for those who weight at least 33 pounds but no more than 66 pounds.

It’s important to contact a doctor after using the EpiPen even if the symptoms of the allergic reaction wear off. The EpiPen only lasts for about 30 minutes, and the person may start to have a reaction again.

Anyone who has an EpiPen should review the information and make sure they understand how it works. If they don’t, they can ask their pharmacist or doctor for information. They should also check the device to see if it is working correctly. If not, it should be replaced. It can be life-threatening to rely on the EpiPen when a person is having an episode and not have it work correctly or fail to dispense the medication at all.

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Health Concerns Over Vaping Limit Juul’s Expansion in Global Markets

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In 2019, a mysterious lung illness was linked to vaping, and several people died while thousands were diagnosed and treated. JUUL, one of the manufacturers of vaping devices, has seen more restrictions in the US because of the situation. To continue to be successful, JUUL has looked at expanding globally where fewer restrictions make it easier for vaping devices to gain new users.

Going Global

JUUL has looked at moving into several global markets in the past year. Following the strategy employed by cigarette companies, JUUL saw potential to win new consumers around the world with its vaping devices, especially after flavored devices were banned in the US.

While the company began its plan for expansion, many of these plans have been thwarted. JUUL was removed from the China market just four days after entry. Other markets that have proven fruitless include Thailand, India, Singapore, Philippines, Laos and Cambodia. JUUL has also delayed a launch in the Netherlands and stopped sales in Israel.

It appeared that South Korea would be a legitimate market for the manufacturer with a third of the men smoking and many consumers interested in the latest in Western technology and goods. JUUL started out with fast growth in the country and soon became a top brand for vaping products.

Two issues plagued JUUL in this lucrative market. First, a tax on e-liquid products made vaping devices expensive. Second, the amount of nicotine allowed in these devices is just one percent, which is less than the three and five percent that had been allowed in JUUL’s products in the US. A warning from the South Korea government about damage to the lungs from vaping products add to the problems for the vaping manufacturer.

Vaping Illness Casts Black Cloud on JUUL

Even though JUUL products aren’t linked to the lung illness, it has had an adverse effect on the company’s ability to enter global markets. Sales dropped dramatically in South Korea as the entire vaping industry was hard hit with a reduction of 90 percent in sales in the fourth quarter of 2019.

While JUUL products began to be sold in India in 2018, an official launch was planned for late 2019. India banned all e-cigarettes in the country before the launch could happen. In Indonesia, JUUL became quite popular with the younger crowd. While JUUL tried to make its products appeal as devices to help smokers stop smoking, the real use for the product came from those who both smoked and vaped as well as those who had never smoked.

While JUUL pulled out of Indonesia, many people are concerned that sales will just move online. Experts say that it’s already a flourishing market.

The illnesses in the US that were linked to vaping has led to concern around the world. Many countries that before were quite lenient with vaping have now taken action to limit or even ban the products. JUUL’s strategy to expand around the world has been delayed at least if not completed altered.

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Vaping Could Increase Health Risk with COVID-19

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The US Centers for Disease Control and Prevention has issued recommendations for those who are elderly and people who are high-risk for dealing with COVID-19. Another group who may be at risk for this disease is anyone who smokes or vapes.

Vaping Illnesses

Vaping has already been tied to a serious lung illness with many cases diagnosed and treated from the summer of 2019. Like the vaping illness, COVID-19 attacks the lungs, which could leave those who are smoking or vaping even more susceptible.

The illness tied to vaping results in permanent damage to the lungs. Many of patients have gone to the emergency room and even been put on ventilators to help with breathing because of the severity of the situation. Several have died from the disease. Those who vape may also suffer more serious effects of any illness, including flu. The issue becomes even more frightening with COVID-19.

When a person vapes, it impacts their lungs. The lungs have more difficulty clearing out foreign substances and working at normal capacity. Some experts are wondering if vaping has contributed to the number of younger people being hospitalized for the virus. A study done in China shows that people who smoke have a 14 times greater chance of developing a severe case of COVID-19 than someone who doesn’t. These same people have a 14 percent higher chance of getting pneumonia.

Along with people who smoke and vape, anyone abusing drugs could also be at an increased risk. Many of these drugs have a negative effect on the respiratory system. Opioids slow down the breathing rate, which makes it more difficult to get enough air and to send enough oxygen to the organs. Opioid misuse is already linked to an increased death rate in people who are diagnosed with respiratory issues. For many drug users, they double their risk because they also smoke or vape.

Fatalities with Vapers

With the vaping illness, many people went to the emergency room because they couldn’t breathe. The most serious cases would be put on a ventilator, and many died from the disease. The issues are similar with COVID-19. It can start with a cough and fever, but it can quickly lead to shortness of breath and pneumonia. Doctors are concerned with the need for ventilators for those who have underlying conditions or are at a higher risk. Thousands of people have already died from this virus, and vapers and smokers most likely will end up with a higher fatality rate if they are exposed.

While there were some similarities on cases involving the vaping-related lung disease, no single cause was found. Many experts and agencies recommended that people stop vaping or at least not buy vaping products from off the street because they might not know what ingredients were included. With the virus running rampant throughout the US, most experts would agree to stop vaping regardless of what products are being used.

The single best thing that anyone can do to avoid complications with the virus is to reduce their risk. That means stop smoking or vaping.

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