Dec 282009

Don’t ask for a new hip unless you really need one.  Part Six and last in a series.

After a total hip replacement, rehabilitation must become a top priority and probably an obsession.

The surgeon can remove your old hip and give you a brand new replacement, but he cannot rehabilitate you.  No one can.  Others can instruct and guide you, but you must do this work yourself.  And you must expect much of it to be tough and painful.  The ultimate success of the operation depends on what you do in self-managing and self-motivating your rehabilitation.

They do get you started, of course.  I was helped out of bed to sit in a chair the day following surgery.  I was helped to take a couple of weak steps using a sturdy walker.  The next day I took a few more cautious steps.  I began doing simple exercises in the bed like pumping my ankles.  Any movement was considered good, except for a few that were strictly forbidden due to the risk of dislocating the new hip.  But most any movement was also painful.  I quickly learned to get new pain medication started before exercising.

In the rehabilitation hospital there was a more intensive program of physical and occupational therapy.  I was given lessons in “bathing” myself on the side of the bed, using various aids.  I was shown how to dress myself as much as I was able.  I spent hours in group classes where we learned and began to practice the exercises that would someday let me walk again.  At first all exercises were tentative and gentle, gradually increasing in effort.  The  routines were somewhat individualized to our needs and abilities.  Since I had been strong and active before surgery, I tended to be ahead of the curve.  There was camaraderie among participants in these classes.  We cheered each other on and compared notes on our surgeons and surgeries.

At home I had an excellent physical therapist who visited three times a week.  She was competent and very friendly, but tough as well.  After six or eight visits she told me she had taken me as far as she could, and I was on my own.

The tricky thing about rehab for me is to find the right balance.  I cannot count the times I have over-done it, hurt myself, and had to lay off for days.  You have to push yourself enough, but not too much.  I am always pushing too much.  My surgeon told me the most important exercise is the standing hip abduction.  You lean against a wall on your good side, and move your leg on the operated side straight out, and back, and out, etc.  As you get stronger you can add resistance using ankle weights.  I purchased an ankle weight set with individual 1-pound inserts that goes up to 20 pounds.  The surgeon had told me to work up to 10 pounds and no more.  When I got to 10 pounds I was ready to put on more, but I could not find them anywhere.  Knowing my tendencies, my wife had hidden them away and refused to reveal their whereabouts.

Your progression toward walking again is from walker to crutches, to crutch, to cane, and then to free walking.  Actually there’s a progression with the free walking also.  You linp at first and then very gradually the limp goes away.  At four months past my hip replacement, I sometimes limp just a little, but not much.  I have walked as much as a mile without stopping.  I am riding my bicycle on a training stand in the basement.  I am swimming laps.  I have six months before a backpacking trip in the high Sierras I want to do if I can, averaging about eight miles a day with a heavy pack.  I may be able to get ready for this, or I may not.  We’ll see.  I’ll let you know.

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  2 Responses to “Hip Replacement – Rehabilitation”

  1. I am looking for a plugin that will let a person sign up and then get an email automatically when there is a new post. This reminds me to keep looking as I know this exists somewhere.

  2. I had meant to ask you if you were going to be ready for your hike. You were telling me on facebook you going to have the surgery and you had a hike planned and hoped to be ready for it in time. I was going to ask but you explained everything above in your article. Enjoy the articles and if not too much trouble drop me an e-mail when you update so I can come back and read.

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