Does it matter where I do my rehabilitation therapy after hip replacement surgery?

DEAR DOCTOR K: I'm having hip replacement surgery next month. I know I'll need rehabilitation afterward, but does it matter where I do it?

DEAR READER: It's been routine after hip replacement surgery to have extensive physical therapy. This rehabilitation therapy, or "rehab," usually consists of a series of outpatient appointments with a physical therapist, as well as exercises to do at home. The goal of rehab is to improve the strength, stamina and balance of walking.

Does psoriasis affect body parts other than the skin?

DEAR DOCTOR K: My doctor thinks my arthritis and heart disease are connected to my psoriasis. Is this possible? I thought psoriasis was a skin condition.

DEAR READER: Psoriasis (pronounced so-RYE-uh-sis) is named for an ancient Greek word meaning an itchy or scaly condition. It is classified as a skin disease, but psoriasis is the result of an immune system abnormality that can cause problems throughout the body.

I have chronic pain that interferes with my sleep. What can I do?

DEAR DOCTOR K: I have chronic pain from arthritis. Lately it's so bad that I can't get a good night's sleep. What can I do?

DEAR READER: Chronic pain and insomnia are, unfortunately, a common combination. What's more, chronic pain puts you in double jeopardy: First the pain robs you of restful sleep, then losing restorative sleep makes you more fatigued, which makes you more sensitive to pain.

What types of joints are available for a knee replacement?

DEAR DOCTOR K: I am going to have my knee replaced. What types of artificial knee joints are available?

DEAR READER: The knee is a joint formed by the bottom end of the thigh bone and the top ends of two bones of the lower leg. When the ends of the bones that form the joint become damaged, they can be removed and replaced. That's total knee replacement, and it is major surgery.

Any advice to help me stay independent in spite of my arthritis?

DEAR DOCTOR K: Age and arthritis have done a number on my hands. I'd like to continue cooking, eating and dressing independently, but it's getting harder. Any advice?

DEAR READER: Many years ago I had a patient who taught me the importance of what I'm about to tell you. She was in her late 70s, retired, widowed and lived alone. She had been extremely independent all of her life. However, with age her dexterity and fine motor skills had diminished. In addition, the combination of arthritis and a small stroke had made cooking and grooming difficult.

Does the weather affect arthritis symptoms?

DEAR DOCTOR K: I swear my arthritis pain gets worse on cold, wet days. My husband is skeptical. Is it possible that the weather could affect my symptoms?

DEAR READER: I hear from my patients all the time that the weather affects their arthritis symptoms. But is it true? If so, how does that work? And is there any scientific evidence to explain it?

Could hypnotherapy help relieve my chronic pain?

DEAR DOCTOR K: I am in near-constant pain because of arthritis. My doctor suggested that I try hypnotherapy. My first reaction was that it sounds like hokum, but now I'm wondering if it could help. What do you think?

DEAR READER: Hypnotherapy may in fact help with pain management. These days it is used to treat many mental and physical health problems. I spoke to my colleague Dr. Max Shapiro, a psychologist with Harvard-affiliated Massachusetts General Hospital. He explained that hypnotherapy is most effective in treating problems that require stronger control over the body's responses. Pain is a good example; insomnia is another.

Would I be better off with hip resurfacing or a hip replacement?

DEAR DOCTOR K: My hip has bad arthritis, and my doctor says I need either a hip replacement or something called "hip resurfacing." Which one is best?

DEAR READER: I once had to ask myself that same question, when my right hip became so painful from arthritis that something needed to be done. Let me first explain what each type of surgery is, and then how to think about the choice between them.