Medical, Preparation, Sentence Mitigation

BOTTOM BUNK: IN PRISON AFTER A HIP, KNEE REPLACEMENT or OTHER SURGERY IS A MUST.

NO TOP BUNK AND PHYSICIAN DOCUMENTED IN YOUR PSR. DON’T DO ANYTHING TO INJURE YOURSELF.

You do not want an upper bunk if you had a major joint replacement or have an unstable gait or are older. This includes a history of back, shoulder, and foot pain treatment—pathology or surgery, ringing in your ears (Tinnitus), or other medical conditions. If you are unsure, call me. – Dr. Blatstein (Marc), 240.888.7778.

I’m Dr. Marc Blatstein. I’ve been where you are and am here to help you on your journey. With work, I got my license reinstated and my career back.

Preparation for release (at least considering it) before your PSI is a start in the right direction. You may do something completely different, but having a Plan, Daily Routine and an idea as to what to expect on your first day is a good start.
• Prison is Temporary.

  • For those of you who have had bone-on-bone pain, you have had this for a long time and have been through conservative treatments; you may be a surgical candidate.
  • No one wakes up one morning and wants to be cut open and have surgery, but at this point, it’s your only option.
  • I know because I, too, had a hip replacement, and I did everything I could to avoid it.
  • There are different types of arthritis, but mostly, these result in bone-on-bone disease.

Osteoarthritis?

Osteoarthritis (OA) is a painful condition characterized by joint degeneration. It primarily impacts the cartilage and has implications for the surrounding structures, including tendons, ligaments, and bones. OA happens when the cartilage that lines your joints is worn down or damaged, and your bones rub together when you use that joint.OA stands as the most prevalent joint disease worldwide.

Osteoarthritis (OA) mainly occurs in individuals over the age of 50. However, it can also develop in younger people due to injury (fractures, dislocations, or tendon/ligament damage), abnormal joint formation in the womb, or childhood. Additionally, being overweight can increase stress on the joints, especially the knees, and raise the risk of osteoarthritis – but do not let this stop you from getting treatment, including surgery. There are two types,

  • Primary osteoarthritis is the most common form of osteoarthritis, which develops in joints over time. It’s similar to car tires wearing down or everyday wear and tear.
  • Secondary osteoarthritis happens when something directly damages one of your joints enough to cause injuries or trauma, damaging the cartilage, which is the protective shock absorber covering the bone in the joint.
  • Other causes:

Osteoarthritis vs Rheumatoid Arthritis?

Unlike OA, rheumatoid arthritis is a chronic disease of the immune system that causes inflammation in the joint when tissues lining the joints are recognized as foreign. Sometimes, both rheumatoid arthritis and OA can be seen in the same joint.

Joints most commonly affected by arthritis?

All surgeries have complications; don’t make life more difficult for yourself.

In Prison.

Recognize that you’re going into a place where you have no control. 

You do not want an upper bunk if you have muscle weakness, an unstable gait due to degenerative joint disease, sciatica (or neuritis), are older, or have other medical conditions that could contribute to an unstable equilibrium.

Your Presentence Report should provide documentation from your surgeon, family practitioner, internal medicine doctor, or other physician stating that a top bunk is out of the question and Why!

You do not want to fall because getting medical care inside is not like you are used to. Expect not to have specialty care provided, and even if you have that second opinion (after 2-3 years) – your facility’s Clinical Director (CD) is Not Obligated to follow those recommendations. This is one more reason why a comprehensive Presentence Report is essential. Consider it similar to Insurance; you hope you don’t need it until you do.

CAVEAT. You’ve done everything to get all your medical care before you surrender.

You Need The Surgery – But Your Sentencing Day Is Coming

All is not lost. Strategic Planning begins with you, your surgeon, and your attorney. Get your medical records written so the judge, court, and BOP will all act as your advocates. Make sure your Presentence Report reflects all of the medical records, including all the conservative care you’ve done and the surgical planning your orthopedic surgeon plans on doing – and why, without it, your quality of life will be severely affected. [That is, if this is an Ortho Case].

Then, preplan with counsel before the Presentation Interview that your First placement request is to a specific FMC to get your procedure, then your second designation to where you’d like to spend the rest of your sentence, supported with “reasons” why you’ve picked this facility. The reasons may be based on available programming, medical care, location, etc.

Hip Replacement Fracture Post-OP.

These fractures are very painful, and you can’t walk or stand. You’ll need to go to the emergency room. Doctors will check your leg and may take x-rays or a CT scan. They might admit you to the hospital or send you to another one that treats this injury. They may test your head and heart to see if you’re hurt elsewhere.

A periprosthetic hip fracture refers to a broken bone around a hip replacement. This can occur during the surgery or as a result of a fall or accident. The fracture typically occurs in the thigh bone near the metal stem; in some cases, the bone near the hip socket may also break.

On the outside. When you have fractures that cause intense pain and make it impossible to walk or stand, it’s crucial to seek urgent medical care at the emergency room. There, doctors will carefully assess your leg, possibly performing X-rays or a CT scan to get a detailed view of the injury.

Depending on the severity of the fractures, they may decide to admit you to the hospital or transfer you to a specialized medical center for further treatment. In addition to focusing on your leg, medical professionals may conduct tests to check for any potential injuries to your head or heart.

But you are in Prison and may not be seen by a specialist for weeks, months, or possibly years. Prevention is most important.

What tests are done to diagnose osteoarthritis?

  • In Prison, there are No Guarantees Regarding a Specialist’s Second Opinion, Diagnostic Testing, or getting the ordered tests requested by their Specialists.’ 
  • Not all medical care is guaranteed in prison – in a timely fashion.

On the outside. 

  • You might need blood tests to rule out other conditions or issues that cause similar symptoms.

Knee Replacement – Then Total Dislocation.

As in all joint replacement procedures, pain comes from bone rubbing on bone, and there are only so many conservative ways to treat this pathology. Eventually, the patient decides that they are ready to take the next step.

  • In the knee, bone on bone looks like this representation:
  • What causes a knee replacement implant to fail?
  • The primary causes of knee implant failure are wear and loosening, infection, instability, leg fractures, or stiffness.

The Total Knee Replacement

All Revision surgical procedures are more complicated, which is another reason to know your limitations.

Total Knee Dislocation

Prosthetic Knee Implant Dislocation Left,

Correction by Orthopedic Knee Specialists,  Right X-ray.

Please keep in mind that the care you get on the outside with pain medication, steroids, anesthesia, CT, and MRI Scans is done quickly. A trip to the operating room, recovery, physical therapy, medications by mouth, and IV then follows all.

But in prison, any type of medical care is likely not to be comparable to what you are used to (Become familiar with the Admin. Remedy Process), and don’t injure yourself.

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