bi-lateral hip replacement - exercise

[cathd]

Hi all
Fantastic to find this site! I am scheduled to have bilateral hip replacement on 13 September. I am 47 and have had hip problems all my life due to congenitally dislocated hips (clicky hips not picked up as a baby). Despite having hip problems I have had a pretty active lifestyle. My physical activity was horse riding till about 3 years ago when the pain got too great. Now I do dog agility with a Heading dog and care for my goats and my partners horse. When I went for my pre assessment they gave me so much material about what I CAN"T do post operatively that I started feeling pretty depressed and wondering if the surgery was going to turn me into an old woman. It's been fantastic therefore to hear what some people are doing with their new hips. I'm really interested in any advice on exercises to help get fit for surgery and what people have found good afterwards. Esp. anyone who has had both hips done at once.
thanks

Cath

 

[ripanco]

Cath,

Find a different surgeon!!!! You absolutely should not have to give up the things you love! I had simultaneous bilateral THR 2 yrs ago and now I show my horse in eventing and hunter/jumper shows, I show my Siberian Huskies in conformation and skijor with them. I also mnt bike, ski, kayak, run, rollerblade and what ever I want. I have absolutely no retrictions at all.

I did go into my surgery in fantastic physical condition which made a huge difference in my recovery. I was home in 2 days and forgetting to use my crutches in 6 days. When I found out I needed both hips done, I cut back on my cardio and stretching, and concentrated on strength training. I did total body workouts. You will need a strong core and upper body to help you get along without your legs for a bit, and you need strong muscles around your hips to help hold the new joints tight. So start lifting!!

Getting back on a horse without hurting is the most wonderful thing that has happened to me in years....hope you can too!

Andrea

 

[Josephine]

This gal needs a gold medal for positive reinforcement on this site!!

 

[cathd]

Hi Andrea

Thanks for your encouragement - it's great. Actually though it is not the surgeon that is the problem. When I saw him he said horse riding and dog agility would be ok and was reassuring that my hips would function much better than they are now. Also my nephew who is a young Dr says his reputation is great and has people traveling from overseas to get him for their surgery. The problem is the physio and occupational therapists and possibly our NZ health system. In New Zealand we have a good free public health system that most people use. Unfortunately the public health system is not very responsive to individual needs and all the literature I got when I went for my pre-op was so negative and seemed to be targeted to people who never intend to get out of their high chair with arms on both sides again! There was no suggestion of getting fit for the surgery and it sounded like I will need to sleep with a pillow between my legs for the rest of my life? With our health system neither I nor the surgeon have any control over selecting the physio.

I see this surgery as a real opportunity and I want to get the most out of my new hips and esp. want to make them strong. Did you use any particular equipment. I understand I might not be able to drive for 6 weeks and have been thinking maybe I should buy a crosstrainer that I could use at home. Is there anything you would avoid. Any web sites with exercises? My health is good, my weight and blood pressure are good/low but I am not as fit and strong as I'd like.

Also it was amazing (and brilliant) to hear how quickly you were able to get around. I have had people looking horrified that I am getting both done at once and the physio literature didn't even cover that scenario.

Thanks again

Cath

 

[Josephine]

Here are some website for you to look at but I must say that few of them have the information you are looking for. Also I would be circumspect about taking everything on the internet as factual.

https://www.benedictine.org/surgery/hip-life-after-surgery.html

https://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=274

https://www.ehealthmd.com/library/totalhipreplacement/THR_whatis.html

 

[cathd]

Hi Josephine

Thanks for the web sites - they will be useful.

best regards

Cath

 

[ripanco]

Josephine....geez, I am blushing!!!

Cath,

Ok, sounds like you have a good surgeon, that is great. The skill of your surgeon is a big factor in how well your new hips will serve you. It is too bad about the follow up care, but the good thing about that is you can do it yourself too. I would suggest buying a stability ball along with a few sets of free weights (5-20 lbs). You can get a kickass workout with this minimal amount of equipment. Check out this site for an extensive series of exercises for your whole body: Sissel.com . DH and I did buy balls from them and they are by far better than the cheaper WalMart ones, but any ball is better than none. Start using it right away to get some muscle tone. Then make a 20-30 min workout 2-4x/week a regular part of your life. Also, if you have access to a pool, I found that to be my very best friend both before and after surgery. I used an Aquajogger for pool running as well as doing leg exercise in the shallow end. There is a good book called "Heal Your Hips" by Robert Klapper, MD that covers pool therapy. Then just start walking, lots! That will progress into more vigoruos activites as you feel stronger. I was back in the show ring with my Siberians at just 6 weeks.

You will need to sleep on your back for a few weeks, but I found if I used lots of pillows under my knees and ankles so that I was not flat, it was bearable. Once you can start on your side again, you will need a pillow between your knees, but not forever. I found that a smaller, beadfilled column shaped pillow was far better and less cumbersome than a regular sleeping pillow.

I was very fortunate to have an outstanding support crew at home between by most wonderul hubby and son who was home from college. You will be pretty flat on your back for at least the first week, even tho you must get up and walk around and do your leg exercises every day a few times. You will be very tired so plan on lots of naps. I found a recliner was the most wonderful place to nap.

As far as driving, most likely you will be physicaly able to much sooner than advised, but I believe that is for liablility issuse. You will not be as fast with the brake so if you were in an accident you could be held libel.

The great thing about this surgery is that the horrible grinding pain is gone immediatly and the surgical pain is easy to control with the wonderful drugs they give you. Then you just keep getting better and better for the next year with minor ups and downs, until all the hip pain is only a distant memory and your life is yours again. It will take work and determination on your part, but the more you put into your preperation and recovery, the better you long term results will be. And having both hips done at the same time was a fantastic way to go for me. One surgery, one recovery and no leg length issues! Stay postive!

Andrea

 

[cathd]

Hi Andrea

Thanks for taking time and giving me so much information. It is great to feel like I have a bit more control of the process and to be doing something constructive.

I read on one of you other posts that you have a mare that was quite green that you are competing on. It sounds like you are doing very well. My last horse was young and green when I got him and I felt so proud every time we achieved something, even learning to float. Since reading you posts I am getting really excited about the thought of getting on a horse again – especially without pain! In fact I have started looking up horses for sale. So I have moved pretty quickly from being terrified of the surgery to just wanting to get it over so I can get on with my life.

Thanks again and I hope your mare is still going well.

Cath

 

[ripanco]

Hi Cath,

Ohhh, horse shopping is so much fun!! Not sure how it is in your neck of the world, but it is a buyers market here in the US right now. Lots of really nice horses availbable very reasonably. I am in complete agreement with you on how wonderful it feels to bring a green youngster along. Every time you get one of those ah-ha moments! I am really proud of Willow, she is just becoming the most awsome horse I could ever imagine owning. And she too 'floats'. One gentleman at our barn remarked how much fun we are to watch cause "she floats and you grin". She has that natural floating trot you see in warmbloods, and now she is light on the bit and collected. She also just sails over fences. She is so smooth, I never feel afraid with her. She does have her redhead mare side too, just to keep me on my toes. She can have meltdowns when the work is too hard for her, but we are learning to trust each other so those are happening much less often now. I have tried foxhunting with her and so far that is waaaaaay too far out of her realm! We may be eventually able to work it out, but for now, I am not pushing that.

I am so glad to hear you have gotten such a positve outlook on your surgery. I think that is so very important. I truly feel like I have been given a whole new life and I love it!

BTW, in your first post you said you did agility with a heading dog, was that a typo for herding? If not, what is a heading dog? I have been involved with dogs, showing, racing, breeding all the time I did not have a horse (30 yrs) and did a little agility a few years back, but my Siberians are NOT reliable off leash. I also raised and milked goats for about 10 yrs. I had Sannens and Toggs.

So keep us all up to date!

Andrea

 

[cathd]

Hi Andrea
It is so interesting to hear from you. We obviously are interested in, and having many of the same experiences but different because we live on opposite sides of the world. Here horse prices seem really high. When I bought my first horse about 20 years ago there were heaps of great horses that came from big farms. They are crossbreds which we call stationbreds. Farmers on the big stations would leave a stallions running on the hills with mares. They then brought in the young horses when they are 2 or 3 and used them to do stock work for a while then sold them on. Unfortunately motorbikes have taken over on most farms so stationbreds are in short supply & all the prices have gone up. Thoroughbreds are the cheapest horses as we have lots of ex or failed races horses about. I’ve had a couple of these over the years but I’m looking for something quieter for my return to riding! Eventing is very big here but I am way too cowardly for that. I do love to watch and think you are so brave competing. It is an awesome test of horse and rider. I love to hear how its going.
Heading dog wasn’t a typo. They are a NZ farm dog – not a breed that you can register with the kennel club. They probably originated from the Border Collie but are quite different from them now. This web site will tell you a bit more and has some pictures. https://www.cariboosheepandwool.ca/david_hutchings.htm They are great little dogs. I am so slow at agility that I do a huge lead out and have to send her on. She is only 2yrs but is so good that despite my lack of speed we sometimes get ribbons! This year our National Dog Agility Champion was a Heading dog. What do people use on sheep farms there – Australian Shepherd?? Dog agility is my big post op worry – how long till I get back into it and making sure I don’t get carried away and damage my new hips.
I think Siberian Huskies are the most gorgeous looking dogs but have heard they can be challenging to handle. The top NZ Obedience dog has been a Husky Border Collie cross which was cool looking and obedient! There a few around in obedience circles now and the owners call them Si-borgs. This is probably sacrilege to a Siberian Husky breeder?
And the goats – I’ve only got two – mother and daughter and they are Sannen/Toggenberg crosses. I have milked the mother and even had a go at making cheese. Did you sell your milk or just use it yourself?
Gosh I have gone on here – always dangerous to get me started on animals. Be great to hear your news
Catherine

 

[pt109]

You'll do fine after the surgery as long as you stay within your limits and don't overdo at first. Lots of websites list the home exercises you can do, and you should do them several times each day. You will see a difference each day and it does get easier. I did my own exercises at home and by the time I got to PT, six weeks later, I was doing great - no cane, no walker. Recovery from this surgery is partly mental, partly physical. Your attitude will help a great deal. Stay positive and enjoy the fact that the grinding pain is gone and you're on your way to recovery. I'm three months out and doing everything and anything I want - pain free. It is WONDERFUL.

 

[cathd]

Great to hear that you are doing so well three months down the track. I do have a positive attitude but really really hate hospitals (even a blood test) so as you can imagine the thought of the actual surgery is very scary. Hearing how well you are doing helps remind my why I'm going through it!
Cath

 

[pt109]

I understand. Hospitals can be scary places. But, just try and keep in mind that everyone you will deal with is there to help you get better This surgery will change your life in wonderful ways. Not having to put up with the grinding pain anymore is simply wonderful. I did not find the pain unmanageable and I found the nurses very proactive in making sure that I took my pain meds regularly so that I could be up and about. Each day, you will feel a little stronger and one day you will wake up and realize that you are back to walking normally and without pain. After ypu recover, you will wonder why you waited so long! Good things are ahead for you.

PT109

 

[Cptn.Jeff]

Hi Catherine,
I just had my first hip done and the second one will be in January. I'm feeling so much better now after surgery 9 days ago. It takes getting use to like most things but I'm so glad I had it done. I have had this sence childhood and with my back surgerys my hips have taken a beating. I can't wait to have both my hips working well so I can get back to life, witch I enjoy with all my heart. You will do just fine. Thank positive......
Good luck,
Jeff

 

[Josephine]

Great to hear that you are doing so well three months down the track. I do have a positive attitude but really really hate hospitals (even a blood test) so as you can imagine the thought of the actual surgery is very scary. Hearing how well you are doing helps remind my why I'm going through it!
Cath

I'll say again to anyone/everyone reading this and I shall probably say it again, but I am eager to put people's mind at rest about this issue.

Everyone is scared of
1. going into hospital
2. having blood tests (some people)
3. putting themselves into the hands of strangers
4. having surgery
5. being a wuss when it hurts
6. of not KNOWING what's going to happen, when, how and why

I could go on but that list is sufficient for now.

In other words, don't be afraid of being afraid/anxious. Look at it this way - you'd be a bit odd if you actually enjoyed the prospect, now wouldn't you?!

Now to return you to your normal programming .......

 

[cathd]

Thanks for all your positive words PT109, Jeff and Josephine . Good to think that 9 days post surgery you are feeling well enough to be on the computer Jeff - soon you'll be playing with you little child. Hope things are still going well for you too PT109.

I'm just looking forward to being on the recovery side of all this too.

 

[ripanco]

Hi Catherine and All,

Catherine, I loved your email and the link to the Heading Dogs! Very cool, they look like they can do the job! Learning something new everyday . Thanks for all the info on the horses in NZ too. I hope you can find just the right partner for your riding comeback.

If you are like me, your dislike of hospitals will help you get the heck out of it faster. This was my first serious surgery, and while I was anxious to get it over with and back to my life, I was more than a little aprehensive too. The thought of having to stay there any longer than absolutely nessecary encouraged me to work even harder pre-op to get in the best shape possible, mental as well as physical. I spent a lot of time preparing my home to make getting around easier too. I even practiced getting in and out of bed and chairs. We had a great hip class at our hospital to show you how to manage post op...if you have access to one, take it, it helped a lot.

I was awake thru most of my surgery, dozing off now and then, but mostly aware of what was going on. Had some interesting conversations with the anethesiologists. So I was pretty awake and aware on the way to recovery. I kept myself completely postive about the next few days and was ready to tackle my PT as soon as they showed up. At first my OS said I would have to stay at least 3 days, especially with both hips done. However, after the first day, my PT talked to him and told him I was ready to go!!!! So he came to my room to let me know they were going to spring me the next morning. I was so happy! I really love my home, my family and animals and I knew I would recover and rest so much better there. I hate the way they wake you up at all hours to take vitals or blood. It is impossible to get a good night sleep in a hospital if you ask me. Both my PT and OS understood that I would indeed work hard at my therapy and that I had a super home support group, so they saw no reason to hold me hostage any longer!

I did drive my home health PT crazy. She was a really nice person, but she was use to working with older, more sendentary patients. Since home health was not expecting me home so early, they had to scramble to get someone out to us. By the time I had my first visit from the PT (4 days), I was outside walking without crutches when she pulled into the driveway. She was absolutely beside herself when she realized I was her patient, hustled me into the house and into my recliner. She started me off with some exercises that I had been doing from day 1 that were now very easy for me, but she kept insisting that I only do my leg lifts a few inches!! LOL. She ended up calling the hospital to 'tell' on me, but my OS told her that it was fine to let me go at my own pace. Poor lady, I am sure I gave her a few more grey hairs!!!

When you do get into your recovery phase, if you can get to a pool, that is a great place to rehab. I was allowed back into the pool as soon as my sutures were removed (8 days). I used Tegamet on the incisions for a few weeks longer. You can get a gentle but very effective workout in the water.

Another very important part of my recovery was seeing a 'gait specialist" therapist. They mostly train runners and other athletes to improve the mechanics of their strides, but it worked wonders for me. I actually had to relearn how to walk normally after years of compensating for the pain. When my surgeon watched me walk at my 2 yr check up, he was thrilled at how normal my gait is with absolutly no limp or irregular stride. I told him about the gait specialist and he is thinking maybe that may be a good thing for all his patients to do!

Ok, time to get off this computer and go ride my Willow!! Just think, Cath, by this time next year you may be riding like you never had hip problems! If you keep your hips strong and tight, you probably will be fine doing agility too.

andrea

 

[Swright]

Cathd,

You are the age I'll be when I get my THR, what type of hip is your surgeon going to use?

I've read about people going back to running, skiing, dancing even hockey.

The choice is to possibley wear out the replacement earlier with the high impact activity.

Not sure if horse back riding is high impact...

So much is not known about the longevity of THR's. What I was told by a surgeon is "these are the best years of your life, why wait" I don't know about being the "best" I've known people much older than 47 who have incredible lives, but I do know that each year that goes by without being able to truly enjoy my life is a year GONE...

I hope this surgery gives you back life to the degree you can truly embrace and enjoy it!!!

 

[Josephine]

So much is not known about the longevity of THR's.

That is so untrue, Swright. I have been working closely in this area since the early sixties when I worked with the first surgeon ever to undertake them routinely. I say this so you will know that I know what I'm talking about.

According to a UK Government study carried out in 1998, 40,000 hip replacements were carried out in the NHS alone. Quite possible a similar number - by the same surgeons - in the private sector. Of these a very tiny number - tiny number - have problems with wear. I can tell you that the rig testing on prostheses far exceeds any rig tests done on cars, seat belts, etc. (A rig is set up to put a unit though the extremities of it's functional movements for 24hrs a day often for weeks and months at a time - what be equivalent to running a marathon that long!.)

I know patients who had their THR done in 1975 and are still absolutely fine. The prostheses are just fine, believe me. More significant are the complications from loosening and infection which are more attributable to poor technique than design problems in the prostheses. This issue is much overplayed by firms seeking to convince potential customers that their product is better that their rival's because ... because ... because. Usual marketing stuff.

Believe me, surgeons who use a particular item will not use it lightly. They have to live with the consequences of their work for the rest of their lives (not just their working lives) so their choices are carefully calculated. Trust your surgeon. He knows what he's talking about when he says this or that prosthesis is ok.

And I, too, have known patients go back to their former lifestyle with no problems. And horse riding is definitely low impact - unless you take a fall, of course!!

 

[pt109]

When I was in the hospital, there were several other patients who were in to have revisions of first hip replacements that had been done over 25 years ago! And, those initial replacements were less sophisticated than the ones doctors are now using. My surgeon told me that I could return to a normal, active life and I have. I ride a bike, walk three miles a day and use cardio at the gym. I'm 62 and feeling GREAT three month out from surgery. I'm counting on my new hip lasting a long, long time and my surgeon agrees. The only activity he has suggested I not do is run.

You are going to do fine and you will be so glad you had the replacements. You have a community of hip replacement advocates around you who are living proof of the miracle this surgery is!