Knee Replacement Surgery Advice

knee replacement surgery


Working in collaboration with joint care experts who have pioneered in specialized knee replacement procedures and orthopedic specialists of national and international repute, Texas Medical Concierge offers a comprehensive program with personalized care, excellent outcomes and superior satisfaction.  We describe here, in a nutshell, the most important aspects of post-operative care after you have undergone a successful knee replacement surgery. Access to information about knee replacement surgery and a strong support network plays an important role in bringing you back on your feet!

Pre- Surgery Advice

Before the knee replacement surgery, the joints adjacent to the diseased knee (i.e. hip and ankle joints) are carefully examined. Since the nearby joint may become more painful if it is abnormal, it is not advisable to replace a knee joint that is adjacent to a severely damaged joint. In this case, the knee replacement surgery may not yield major improvement in function of the leg. Thus, critical examination prior to surgery is crucial to ensure optimal outcome and recovery from the surgery.

Post-Operative Care

Continuous Passive Motion

Your physical therapist (PT) will acquaint you with a continuous passive motion (CPM) machine. The machine is attached to the operated leg and it keeps your knee in motion. The goal is to improve circulation of blood in the knee, prevent stiffness and the buildup of scar tissuethat can result from being immobile. The machine constantly moves the knee through various degrees of range of motion for hours while you relax.

Elastic stockings:

Wearing a compression stocking (tight pressure stockings) will put pressure on your legs after your surgery. This helps blood flow through your blood vessels to help prevent blood clots. Formation of blood clots in your leg veins blocks the blood flow, called as deep vein thrombosis. These clots can further enter heart or brain blood vessels resulting in a cardiac arrest or stroke, respectively.

Physical therapy:

A physical therapist will help you with simple exercises such as knee bending, sit-stand-sit exercises, straight leg raises, and heel slides. You may also be asked to do leg stretching, squatting, and ankle bending and stretching. You may need to begin a walking program, or use an exercise bicycle. These exercises not only help your knee heal but they also assist in strengthening the bones and muscles around your knee joint.

Place Ice:

To control the swelling, pain and redness around your prosthetic knee(s), you may put crushed ice in a plastic bag and cover it with a towel. Place this over your knee for 15 to 20 minutes every hour as long as you need it. Maintaining an elevated position for your leg also aids in relieving the pain. (Note of caution: Do not sleep with the ice pack on your knee as doing this may cause frostbite!)

Assistive Equipment to help you walk:

It is vital to familiarize yourself with the supportive equipment and accessories that will assist you to walk after the knee replacement surgery. These include a shoe lift, knee brace, crutch, cane, and a walker, to name a few. Learn how to choose and use the crutch, a cane or a walker from an expert and avoid placing excessive stress on your “new” knee.

Medical treatment & Medication:

The replaced joints may be at risk for infection by bacteria and other microorganism introduced by any invasive procedures such as surgery, dental or gum procedures, urological and endoscopic procedures, as well as from infections elsewhere in the body. If you have undergone a joint replacement surgery, you should alert your doctors and dentists regarding the artificial joint. This will help your doctor to typically prescribe antibiotics before, during, and immediately after any elective procedures, in order to prevent infection of the replaced joint.

If you’ve stayed on your exercise and rehab schedule you should notice a dramatic improvement in your knee after 4-6 weeks of the knee replacement surgery. In three months time, you will be walking on the road to recovery. As time goes on, pain should subside and, mostly, after a year you should feel at or very near 100 percent. Of course, every person is different and recovery periods can vary, depending on a number of factors.

At Texas Medical Concierge, taking care of YOU is our priority. Our membership benefits for Jasmine, Lotus and Orchid comprises of advising you on the best physicians and institutes to suit your needs. Through our Orchid Membership, we deliver services such as, personalized appointment scheduling (along with Appointment reminders), preferential appointments with super specialty doctors, to name a few. Following a knee replacement surgery, we encourage you to stay in touch with your medical team and have periodical check-ups to ensure that the knee is continuing to work properly.

Fixing broken Hips


If you are thinking about having a hip joint replacement surgery, the health care specialists Texas Medical Concierge will help you understand every stage of the surgical process. This includes what you should expect and how you can prepare for the surgery. At Texas Medical Concierge, we believe in providing the best pre-operative and post-operative support to the individuals we serve.

Preparing for hip joint replacement surgery includes observing certain important precautions for the first six weeks to prevent dislocation of your hip. Even though the surgery may relieve your hip pain, your body needs time to heal from the operation. You will be limited in your mobility and the following checklist is provided to help you through the recovery process.

Note to Yourself

  • You should NOT bend your hip (hip flexion) beyond 90°.
  • You should NOT attempt to bring your legs or knees together, i.e. do NOT sit straight up in bed or cross your legs or ankles while sitting or even bring your operative leg up towards your chest.
  • While sleeping, it is advisable to keep a pillow between your legs to ensure that you keep your legs apart.
  • Do NOT try to rotate your operative legs.
  • Always use a reacher to pick objects off the floor. Do NOT bend over.

At Home

  • Avoid slippery areas and remove the rugs and mats to prevent you from tripping over.
  • Safety-proof the house (including the bathroom) for clutter so that you get enough space to move around using your walker.
  • Prepare yourself well in advance if you expect to be left alone in the house. Keep food items and dressing garments within your reach. Stretching or bending is NOT advisable.

Activities to Avoid

  • Do NOT drive until your doctor permits you to.
  • Avoid low chairs and sitting continuously for long hours. While sitting on a chair, always remember that your hips should be higher than your knees (Use a pillow to sit on if you are comfortable). When getting up from a chair, slide your body towards the edge of the chair and take support from the arms of the chair to stand up.
  • Avoid air travel as the pressure changes in high altitude and the immobility in flight may cause adverse effects to your hip joint. Also, while going through security your artificial joint may cause the highly sensitive metal detectors to send off an alarm. Ensure that you carry a medical alert card to show at the airport screener.

Self Care for your New Hip

  • Ice packs around the swelling will help to control the pain.
  • It is advisable to use a heating pad/warm towel on the operative leg before starting the prescribed exercises.
  • Wear appropriate non-skid footwear.
  • Regular exercises to restore your normal hip motion and strength are crucial during your recovery phase. Your orthopedic surgeon or physical therapist may recommend a 20-30 minute exercise regimen to follow for 2-3 times in a day depending upon your status.

We have listed the points with the hopes that you enjoy your new hip while you safely resume your daily routines. Being an active participant in the journey to wellness will ensure that you have a successful outcome.


Happy Festival Diet Plan

Top ten glycemic ingredients in Foods

Diabetes Picture



It’s that time of the year again! With Diwali around the corner, the wedding season soon to follow, and Christmas and New Years eve tagging along- ‘tis the season to make merry! Amidst all the mind boggling, mouth-watering assortment of delicacies, it is a difficult time for the gut and the tummy. We dedicate this blog to the people with diabetes. In this blog, we answer the crucial question, “How do we allow the diabetic people to celebrate festivals, and life, with the rest of society, without harming themselves?”  There must be a way out for such people to escape this cruel situation.

One of the problems associated with a life-long health issue like diabetes is that of food choices. We know the loss of the luxury of eating whatever and whenever is a pinch that you feel the most!! But then, your health comes first and taste buds can certainly take a back seat. Here’s the thing with diabetes. You have to make a conscious choice of foods for EVERY meal in order to maintain your blood sugar levels near normal.

So, there are a couple of concepts that you need to understand.

  1. Glycemic Index

The glycemic index (GI) is a ranking of foods and beverages (containing carbohydrates) using a scale from 0 to 100 according to how they affect our blood sugar levels in a span of 2 – 3 hours after having food. Glucose is accorded the highest value of 100 and the glycemic index all other foods are expressed as a ratio of this value.

  1. Insulin Spikes

Speaking from experience, after eating a hearty meal at a lavish Chinese buffet, I was convinced that I couldn’t move an inch. I thought to myself that I will certainly not be hungry for the next couple of days after this sumptuous meal. And then to my surprise, two hours later I’m starving again! So, this rollercoaster ride can be explained with the help of the term “insulin spikes”!  The thousands of calories of rice, noodle and dumplings that I consumed only hours ago didn’t look much like a sugar cube, but upon digestion, sends me down a sugar thrill ride. The human body is programmed to control the abnormal rapid rise in blood glucose that occurs after eating a carb-rich meal. It is the job of the insulin (a hormone secreted by our pancreas to control sugar levels) to lower the sugar levels in the blood. Thus, a huge insulin spike is the body’s answer to drive away the sugar from the blood. The thing that happens is that insulin does a fantastic job but overdoes its job in the process; insulin lowers blood sugar a little more than necessary. With the lower levels of sugar in our blood, we tend to starve again even though we just ate! We begin to crave for more sugar. This is how the vicious cycle goes on and on.

So, in order to eat a balanced meal, you should have a good mix of low-glycemic index foods, medium glycemic index foods and perhaps one small serving of a high-glycemic index food if you are especially drawn to it. It follows that high-glycemic foods CAUSE insulin spikes and low-glycemic foods do NOT!! If you have diabetes, you cannot afford to experience repeated insulin spikes with each meal.

So, how do you make a choice of the most ideal foods?? Not everyone can be a nutritionist-on-the-go and hence we have a list of foods compiled for your ready reference. These foods are arranged in a descending order and the glycemic index of a normal size serving is stated for each food.

A low glycemic index is not a licence to indulge indiscriminately, though! Eat only until you feel ~90% full but choose small servings of each kind of food.


Top Ten High-Glycemic Foods Top Ten Medium Glycemic Food Top Ten Low-Glycemic Foods
Baked potato (without skin) [98] Raw Banana [70] Hummus (chickpea salad dip) [6]
Cornflakes, Tapioca [93] Basmati (long grained) white rice, Whole wheat bread,  Uppitu (roasted semolina and onions in water) [69] Peanuts [7]
Appam (thin pancake made from fermented rice flour batter with tender coconut) eaten with Bengal gram curry & Pongal (rice and roasted green dal, pressure cooked) [90] Pita bread [69] Whole milk (full fat) [11]
White rice, white bread [89] Raw pineapple, raisins [66] Peanuts [13]
Rice porridge [88] Icecream, dates, sweet corn [62] Canned soya beans [14]
Honey, Brown rice [87] Condensed, sweetened milk [61] Raw carrots [16]
Muesli [86] Papaya [60] Kidney beans (rajmah) [19]
Millet, Ragi, Pretzels [84] Roti/Chapati (Indian bread) [59] Barley, cherries, lentils, peas [22]
Pancake [80] Honey, kiwi [58] Plum [24]
Gatorade (beverage) [79] Lychee, apricot [57] Cashewnuts, Grapefruit, yam [25]


Diabetes Pic 2

Bon Appetit!!

Yoga is the journey….INWARD!

In Conversation with Dr. Naveen Visweswaraiah- Lifestyle Interventionist at Texas Medical Concierge

dr. naveen's interview

Yoga becomes a transformative journey of rediscovery that makes lasting happiness possible-by taking YOU on an inward path. Yoga, derived from the Sanskrit root “yuj”, meaning “to yoke” or “to bind”, is most commonly interpreted to signify “union”. Yoga’s roots can be traced back to the Indus Valley Civilization between 3000- 1500 BCE.

All of us go non-stop from the beginning of the day to the very end. No time to stop and think about what we’re experiencing or to just settle our mind. The constant beeping of our phones and iPads, or horns honking at traffic signals, or even the continuous chattering around us fill our mind with incessant disturbance. 

{Be Still}

The quieter you become, the more you can hear ~ Ram Dass.

In conversation with Dr. Naveen K Visweswaraiah, India’s first qualified Yoga & Naturopathy physician who leads the field with 20 years of research,; academic and clinical experience, we learn about coming back to the yoga mat every day. We have to train ourselves to take  time everyday to just be alone with our thoughts and focus internally. Consider this as an investment in your wellbeing and your sacred time with yourself.

Listen to Dr. Naveen explain the nuances of Mind-Body Interventions and how they are designed to enhance the mind’s positive impact on the body. We will soon do a Q&A with Dr. Naveen describing his journey so far. So stay tuned on that one!

Happy listening :)

With Love, Texas Medical Concierge

Psychological & Mental Health Services brought to you by Texas Medical Services

brain fitness coach

Mental and behavioural problems are taking centre stage amongst health problems the world over. The burden of illness resulting from psychiatric and behavioral disorders is enormous. The overall DALYs burden for neuropsychiatric disorders is projected to increase to 15% by the year 2020!

Research has advanced the understanding of psychiatric disorders and made major contributions towards identifying treatments to address these disorders. The helplessness of the past has been replaced by considerable hope since conditions like schizophrenia, that once were treated in restricted access institutions are being treated in general hospitals, in primary care services and through interventions at home. Effective treatments for depressive disorders are available, yet there are millions of people affected by depression where suffering and disability is prolonged because their condition goes undetected, or is often not adequately treated. Early treatment is essential for better recovery from ailments such as depression. Strengthening the mental and behavioural health of the workforce is a critically important component of our overall efforts at Texas Medical Concierge. We have therefore developed testing and diagnostic procedures for mental healthcare.

A la carte services offered at Texas Medical Concierge are as follows,

  • Psychological and neuro-cognitive testing -

Neuro-Cognitive Testing or Mental Status Testing is done to check a person’s thinking ability and to determine if any problems are getting better or worse. Neuro-cognitive assessment is typically useful during the course of recovery from a brain injury while developing rehabilitation goals for the patient.


  • Psychiatric evaluation by psychiatrist-

Psychiatrists perform a full range of medical laboratory and psychological tests which, combined with interviews/discussions with patients to determine a complete a picture of a patient’s physical and mental state. The medical and psychological data are further evaluated and a diagnosis or a treatment plan is developed for the patient. Psychiatrists at Texas Medical Concierge come with years of clinical training and experience which allows them to understand the complex relationship between emotional and other medical illnesses.


  • Psycho-social evaluation, family systems assessment and collateral contacts by social worker-

A psychosocial assessment is an evaluation of a patient’s mental, physical, and emotional health. It takes into account not only the physical health of the patient, but also the patient’s perception of self and his or her ability to function in the community. Usually, psycho-social evaluation takes the form of a series of questions asked by trained health care professionals.

Other data sources, such as interviews with collateral contacts (teachers, family members, service providers, institutional care givers) may be essential in completing a satisfactory assessment. Family assessment focuses on the participation of the whole family.

A comprehensive family assessment gathered from the family’s experiences assists in maintaining the well being of the family and map out treatment goal for any member (if required).Depending on the context of the treatment, we at Texas Medical Concierge, can draw up a treatment plan with milestones that help the patient recognize when he or she is making progress.


  • Genetic  testing-

Genetic testing can be performed at Texas Medical Concierge to assess familial inheritance of neurodegenerative diseases like Alzheimer’s disease, Parkinson’s disease and Huntington’s disease.  The results of a genetic testing can determine whether a person has an inherited disposition to a certain disease before symptoms start, since these conditions manifest as structural changes in the brain that also result in cognitive and psychological deficits.At Texas Medical Concierge, a doctor or a genetic counselor who knows about the diseases in your family will provide you a realistic scenario about your risks and what you might learn from genetic testing.


  • Pharmacist review of medication history-

Medication review services are provided by Texas Medical Concierge through an individualized, in-person appointment with the pharmacist to gather all pertinent information about the patient’s medications. Medication has review has numerous potential benefits for the patients. These include:

  • Improving the current and future management of the patient’s medical condition
  • Increase communication between patients and pharmacists
  • Promotes safe and effective medication use
  • Reduction in adverse effects related to medicines
  • Empowers patients and the care-givers to be actively involved in the treatment plan
  • Reduction in unwanted or unused medicines


  • Specialty consultations as needed including psychopharmacological, neurology, addiction, anxiety, trauma, eating disorders, vocational, family systems- marital-

Texas Medical Concierge is a comprehensive health centre for the treatment of behavioral health issues ranging from eating disorders to post-traumatic stress disorder, substance abuse and neurologic disorders. The treatment program offered at Texas Medical Concierge includes the following;

  • Psychologist consult
  • Social work consult
  • Psychological testing
  • Psychologist therapy
  • Social work therapy

For individuals suffering with behavioral health issues and addiction, recovery may sometimes require around-the-clock care in a safe, secure and structured setting. At Texas Medical Concierge, we provide a comprehensive treatment program of mental health services that is solution-focused and success-oriented. We provide exceptional behavioural and neurobehavioral health programs and services that increase the mental, physical, and spiritual well-being and functioning of the individuals we serve.