The roller coaster begins...

Please don't get hung up on the approach. Your surgeon will use the approach and the implant that is most appropriate for you own medical situation. And despite all the hype you read, recovery from anterior is no faster or easier. Trust your surgeon. Sounds like you already have respect for him.
He said it would be great if I could take two weeks off and do nothing but really take it easy, mentally and physically, but I didn't *have* to.
You will need time off. The recommended time off is 10-12 weeks and then a Phased return to work. You may not need the full time. But part of this recovery is the Energy drain for THRs. It's real and you just can't fight it.

BTW - my first THR was posterior approach. No complaints!
 
Posterior approach here as well. There are minor nuances from surgeon to surgeon but the goal is always the same: a new hip that gets you back into the game. I recommend you schedule the max time off you can afford. I planned 6 but it took 14, mostly due to how bad my hip was before surgery. You don’t know how your body will respond. But it will be much less difficult to go back earlier than to negotiate more time off. I was lucky I had such an understanding boss. It could have otherwise been a nightmare.
So glad you have a date! Just keep those panic demons at bay. ❤️
 
Posterior approach. I live alone and had no help after day 9. Yet despite those "limitations," I cared for my home and animals. By week 3 I was driving. Surround yourself with assistive devices: long-handled shoehorn, a grabber in every room of the house, one of those devices that helps you get your pants up and socks on. A long-handled brush to use on your lower legs and feet in the shower. Good shower shoes with traction. Grab bars. Elevated toilet seat. A car "cane" you attach to the side of your car door so you can ease yourself in and out with strong support. All these I got in advance from Amazon and practiced with preop. Lots of YouTube videos showing you how.

Now the piece de resistance for me was a pair of Activity poles. Like Nordic poles, but the bottoms are cane-like. Fabulous support...no limp with them! Good core work, shoulders, upper arms. Nobody notices the difference between them and standard walking poles. They know I had hip replacement, but when I went from the walker to them, people said, "Wow! You're back to serious exercise!" Not. But they don't know that and meanwhile I'm training myself not to limp.

Go with the surgeon whose had a great deal of experience and you trust. The more experienced they are, the more they tend to prefer posterior because it lets them "see better." I really liked the idea of my surgeon having a "better view."

So try not to panic, tho I also did preop. Maybe try seeing the postop precautions as an athletic challenge?

Good luck! Keep us posted!
 
Hey - quick update. I have been on an "Internet diet" for a week to give my brain a rest and to give me a chance to build up my own self-reassurance abilities. It's been a good mental workout for sure and I feel much more grounded. Realized that I could spend my days panicking and worrying and reading every single story out there but that would have exactly zero impact on the outcome of the surgery and would make my pre-op days needlessly miserable.

I've done the same thing with other surgeries - holy cow, when I had a lumbar discectomy surgery twenty years ago, I was an absolute mess for months. Granted, I was also in a huge amount of sciatica pain and the idea of "back surgery" was freaking me right out, but did any of the frantic internet searching change the successful outcome? Nope. Did it give me any more control or predict a single thing? Nope.

The dread and fear are still there, but the volume is much, much lower.

I told my hockey team that I'd be having the surgery and they all seemed...relieved! They've seen me trying to play this season and I guess I looked much, much worse than I thought I did. A few of them work for medical device companies so they wanted to know which "brand" I was getting, LOL.

Not a single, "oh my gosh, I guess you won't be playing anymore!"

And one of them told me her husband had a THR and is playing again, so another IRL example.

But you know, I also realized that as much as I miss playing hockey as hard as I can, I also REALLY, REALLY miss just being able to go on a long walk without a second thought. I am hoping that by spring, I will be able to take a "victory walk" and see all the migrating warblers we get around here and just freaking enjoy being able to get up and go.

My MiL, unfortunately, did not get scheduled before Christmas as she'd been told, so she's feeling extremely low, especially because she has to go for a new pre-op appointment and it takes every ounce of her energy/courage to travel now. Still, she's scheduled in mid-January, a week before me, I think, so I'm really, really hoping she'll wake up and experience tremendous relief. My wife and I are both a little concerned that the hospital or insurance won't cover a stay in a rehab facility because it is "outpatient." Which is technically true, but my FiL cannot physically take care of her at home and no way can she take care of herself, so I've suggested they start looking into this to be sure there aren't any surprises.

Anyway, I was wondering, for those of you who had muscle twinges with your hip arthritis - were those different/healed after surgery? I get pings/friendly reminders from my IT band, hamstring and sometimes even my calf. My knee, once in a rare while, buckles in. I would imagine that once a new hip is in place and those muscles no longer have to repeatedly figure out what range of motion they can do, the little pings and twinges and ouches will resolve, but I'm wondering if any of you noticed that as well or if those resolved in PT or over time or....?

Thank you again for all the encouragement and helpful replies. Happy Holidays!
 
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Hi @thepuckhead !
Glad to see you found real examples of successful surgery.

I hope they can get things scheduled for your MIL soon.

Over a few yrs I had lumbar pain, groin pain, pain that would snake its way toward my right knee. I also had metatarsal pain on top of both of my feet by the end of the day. Sometimes cervical pain.

All of it was the hip.

As soon as I woke up and stood on the new hip the demon arthritis pain was gone.

There was bruising, swelling and some nerve zaps as the leg healed initally.

Be ready for the first couple of days at home as the long acting pain meds injected as part of surgery wear off.

Staying ahead of the pain w meds is important. Ice and elevating helps w this too.

Everything is now gone pain wise.

I still have numbness on my outer thigh but it does not affect leg movement or strength.
 
@thepuckhead So glad you came to the eventual realization we all did: we needed the surgery and, having done our due diligence, there was nothing more we could do except let the professionals do their jobs.

I also love that you've come to appreciate the idea of being able to do the simple pleasures of life again. I went from walking at least 3 miles a day to not being able to do the short walk down to the end of the street because I couldn't make it back without struggling and tears. I was doing that again within a couple of weeks or so with my walker for safety. You will have those zings and zaps after surgery for a short while but not that awful pain in the joint. You might even trade those for some new ones! LOL. It's all part of the process of healing and your body going "how wonderful I don't have to compensate for that anymore! Let's get back to business!"

I sure hope that you get some of those issues with your MIL settled. It's an added stress that you don't need and would be nice to have resolved soon. Just a little over a month now and you'll be looking at all of this in the rear view mirror! Happy Holidays.
 
@thepuckhead re MIL, my surgeon told me that Medicare will allow a same day surgery hippie to stay longer if he deems it medically necessary, but he isn't allowed to schedule someone to stay, then send them home early.
My sister had a problem after her THR, and went to rehab for (I think)5 days afterwards, and Medicare paid. Medicare also paid for transport to the facility. But it wouldn't have paid to transport her to her home, if she had opted out of the rehab place.
Check if Medicare has limits on how long MIL's rehab stay can be before it becomes out of pocket.

Good luck to both y'all hippies!
 
@thepuckhead Also re: your MIL -- she should check with her surgeon and maybe with the social worker at the hospital. There are a lot of different aspects to yes or no to post hip replacement rehab stays. A lot could depend on the kind(s) of insurance she has, how old she is, other medical conditions she might have, plus what help is available at home. When I had both my hips replaced in the same surgical session (Bilateral THR) I had HMO insurance and was told no when I asked about rehab. I was 64yo at the time, generally healthy and did have good help at home. The reason given for the "no" was ... I was not sick enough to warrant rehab. Also she would need a true rehab facility not just a nursing home ... she will need PT and OT to work with her and make sure she can get around OK once she is discharged home. And many nursing homes just don't have the staff to do those things.

As for the post op twinges and pangs ... yes but different from the ones before surgery. Afterwards the bone-on-bone pain was totally gone. But the incision pain was there and there were lots of muscle odd twinges as muscles and tendons got rehabbed back into proper working order. I'd limped on 2 bad hips for several years so it took a while for every thing to straighten out and get back to proper functioning. After hip replacement most folks have a swollen leg (aka log leg) that lasts for a week or 2. This does subside and is greatly helped with elevating the leg and applying ice!

Happy Holidays to you and your family! :xmas-wave-smiley-emoticon:
:xmas-snowball-fight-smiley-emoticon::xmas-snowball-fight-smiley-emoticon:
 
@thepuckhead — I had my THR last year at age 50. While not a hockey player, I was very active —mostly boxing, muay Thai and kettlebells and other weight training. My pain started in my left hip with similar shooting pain “catches” which eventually lead to other issues including lower back pain. If I took a walk (a limping walk) for longer than a half mile, my lower back started to lock up and i was miserable. I could box fine, but kicking was certainly limited and moving faster than a geriatric cat was out of the question.

I chose a surgeon from the leading sports medicine practice who not only has done several professional athletes with knee and hip surgery, but also two family member/friends. He only does the posterior approach (calls it a “mini posterior” because the incision is only about 5 inches long) and has done thousands. I explained my concerns and similar to others, he also said that basically after 3 months, assuming all went well, there would be no restrictions (other than maybe hardcore yoga, which is not a risk that I would be doing that anyway!). And as to the approach, again echoing others, it’s better to choose based on the surgeon, as opposed to the approach. Better a near-perfect posterior than a sloppy anterior.

It’s been just over a year and it was a great decision. So much so that I’m doing my other hip in a month. I’m just tired of the pain sitting, standing and moving (ha!) and with the surgery, I will (likely) be pain free for decades before I have to worry about replacing. All I can say Is that while surgery is never fun to deal with, the outcome of hip surgery (which is one of the most “routine“ surgeries around) is night and day. If you want to stay active while you’re still “young,” do the surgery now while you have strong muscles to help you recover. Best of luck!
 
Hello! Cheat day on my internet diet.

It is sooooo helpful to hear all of your thoughts. Thank you all for taking the time. It makes a big difference.

I am doing pretty well mentally now. Still bouts of anxiety, but what I find helpful is playing kind of a game show with myself. Name That Fear. Last week's flavor of the day was....*drumroll*...leg length differential. What if I end up with a noticeable lld that results in a permanent limp? What if I have to wear lifts in my shoes/skates forever and develop low back problems and problems I might develop now anyway because of my little waddle penguin walk?

Well. Hello there, fear of the moment. Have a seat. I'd say have some coffee, but I don't want you any more worked up. I believe you come from the general family of "fear of the surgery not working" don't you?

So. What did the surgeon say about chances of a permanent limp? That, when you do thousands of surgeries you do end up, by the reality of statistics, having a few cases that don't heal correctly. I believe the exact number he quoted was 2-4 cases. Of thousands. Good odds, those.

LLD: of course they try everything they can to make sure it doesn't happen. It can, though most people don't notice a difference less than an inch. It's your lucky day, fear, because it's cheat day and now I'm going to google....*sound of frantic typing*....hmmmm. I see stories of people noticing a helluva difference at 4mm, and some studies suggesting this is a common problem, so maybe this isn't reassuring but....

Do I have any control at all over lld if it happens? Am I going to be awake during the surgery to helpfully "remind" him that they need to be the same length (because I'm sure he doesn't know that). Nope and nope. No choice but to trust that the team doesn't want it to happen anymore than I do and will use their experience to do everything possible to prevent it.

Yeah, I know, fear of the moment, it's not a guarantee. But all I can do is hope it doesn't happen. I think you're also related to the big, big family of fear of optimism/hope. You know why you fear optimism/hope? Because you don't think you can handle bad news or disappointment. Because you're afraid you'll have to take any bad news or disappointment or catastrophe with a stiff upper lip or a smile and pretend it doesn't impact you. But guess what? How you handle any bad news or disappointment is entirely up to you.

Another thing I've found helpful is the idea of being a VIP of the surgeon's team, not a passive "victim." I mean, I'll certainly be really passive (or I'd better be) during the surgery, but in terms of preparing mentally and doing anything I can to help make the surgery a success, I can be much, much more than a scared patient. That's really empowering to think about.

I've scheduled a "spa day" a week before the surgery for a haircut and brow wax and also having lunch with friends, one of whom had a hip replacement surgery herself and tells me she wishes she had done it sooner and she will give me no small amount of grief if I chicken out. Her husband also had a THR and he didn't believe that it would be so "easy" even after watching his wife recover smoothly. His also went very well but he still won't admit she was right. :loll:

Have also noticed that when I have a good day (not much pain), I don't think 'maybe I don't need surgery.' I think, 'this is how you're SUPPOSED to feel- actually, you're supposed to not even think about your hip at all and that's what you'll experience once you recover. Also, you won't ever experience it if you don't have the surgery, so...'

And @Merrimay - thank you for this list! I am going shopping this week for sure!
A long-handled brush to use on your lower legs and feet in the shower. Good shower shoes with traction. Grab bars. Elevated toilet seat. A car "cane" you attach to the side of your car door so you can ease yourself in and out with strong support. All these I got in advance from Amazon and practiced with preop. Lots of YouTube videos showing you how.


MiL update: she had her pre-op physical and that went well. She will have a social worker in the hospital visit (think it's protocol) and it is abundantly clear that my FiL cannot take care of her on his own. He had his own health crisis (COPD crash - spent a week in ICU) last September and she needs help with any physical movement, including going to the bathroom. Her pain is so horrific that any moving at all ends in screams and tears and that takes a huge toll emotionally on my FiL. They made that clear at her pre-op, so hoping the hospital/surgeon makes similar recommendations to the insurance. Poor woman has to make another trip for a COVID test prior to the surgery. Can't do an at-home, can't do a drive through. Has to be in the clinic. Ugh. Trying to remind her that it will be the last time she has to move before surgery and she has two weeks to go, but she's in too much pain to take much comfort in that. So we're just hoping time flies until Friday the 13th.

Thank you for this space to ramble and think and read. Until next cheat day...onward! In a little over 3 weeks, both my MiL and I will be starting our journey to freedom and confidence.
 
@thepuckhead Just a couple of comments on your post. LLD - nearly every person coming out of THR surgery feels like there is LLD. In almost every case, this feeling just fades. Give it a good 3-4 months to allow your body to balance again.

You say you are going to be awake during surgery. Have you discussed this at length with your surgeon? This surgery is very "noisy" and there will be a lot of activity going on. A spinal with sedation is absolutely ideal. Just a suggestion.
 
@thepuckhead... I had MIS posterior surgery almost 6 weeks ago. I retired from recreational hockey a year ago due to hip... what position do you play? Thinking right wing, tough in the corners, able to free up a loose puck for a feed pass into the slot for your center to make a quick release shot into the top right corner, or maybe bar down?... sound familiar? :loll: I think the responses have covered most of what you've asked about, but from one puckhead to another will say this:

- Anterior/Posterior? Whatever feels right to you. #1 as all have said is skill of surgeon. If he/she does 100+ a year and reputable (we can't all go to the hospital for special surgery in NY after all haha) than you will be fine. Both are done minimally invasive and tissue sparing. Days of old school posterior pretty much gone in the US..
- At this point I'm walking w/ some biking and elliptical and doing PT, way slower recovery than I'd like to be going as dictated by my hip which has very limited ROM. I made the mistake of letting this go too long and continuing with hockey.... I agree with Bonesmart and Dr Google first 4-6 weeks the chill, bone/tissue healing phase.
- Love hockey but wont go back.. even the nicest gentle 'we are all cool' skate will have a knuckle head who will not know how to control their body even in a non-checking environment. All about risk reward...You mentioned wanting to do a pain free long walk... that's where my head is at... Don't live in fear, but a cracked femur from pick up hockey = I'm out! I'm content with a slow return to tip top fitness which will take all of 2023. You tube dude video (think we saw same one) I think went back too fast @12 weeks.

- Deconditioning: I had a bad few months going into surgery. Haven't had a proper workout since summer. You seem to be doing better and will aid in recovery... the single biggest gift you can give yourself is prehab if you are physically able... Many here, including me, could not do this......I'd give your body 6 solid months of rehab before considering going back..
 
@thepuckhead Oh those hips can be tricksy! One day they feel "OK" and the next the pain is off the charts. And just before surgery they up this game playing to test you. But you know you need to get this done.

Here's the link to the article in our library about LLDs: https://bonesmart.org/forum/threads/leg-length-differential-lld.6173/

Another tip: GET NEW SHOES! Old ones -- especially the "favorite" ones -- can have worn patterns in the soles and heels that can make you walk in the old limping pattern ... and that is NOT good for new hips!

It is good to hear your MIL is getting good support!

Happy New year to you and your family :happy-new-years-toast-smiley-emoticon:
 
You say you are going to be awake during surgery. Have you discussed this at length with your surgeon? This surgery is very "noisy" and there will be a lot of activity going on. A spinal with sedation is absolutely ideal. Just a suggestion.
Hi, Jaycey! I won't be awake - I will have a spinal and "light" sedation. I asked whether I'd hear anything such as "please pass the bone saw" and was assured I wouldn't. That's actually one fear I don't have - mainly because I did wake up during one "minor" procedure (a uterine artery embolization) and, even though I could feel my blood vessels spasm, I just thought it was a very strange feeling and I asked what one of the monitors was and the surgeon said, "could you give her a little more, please?" And back to nighty nights!
Here's the link to the article in our library about LLDs: https://bonesmart.org/forum/threads/leg-length-differential-lld.6173/

Oh, thank you! That helps a lot. Makes sense that the lld would likely be perceived rather than actual due to compensation. I do limp and I know one of the first things I'm going to need to sort out after surgery is learning how to walk again, so good to know this is one thing to be aware of. And new shoes? I think I can handle adding those to a shopping spree!

@Charlie33 - how nice to meet another puckhead! I'm so sorry your hip took you out of hockey, but I get it. I'm still playing and it SUCKS not to be able to go all in. I get the fall risk/reward completely. I have seen enough freaky falls in my "career" to know how those can end your skating days but quick. I saw one person fall just by catching an edge wrong and *snap* went her hamstring. Ouuuuucccch. Two surgeries later and she's planning to get back out there. We are kind of a crazy sort.

And you're right - I play mostly wing. I do love to dig for pucks on the boards but my patented, favorite move is to lie in wait when I'm weakside, waiting for the D to fling the puck around the boards so I can scoop it up and put a shot in right over the goalie's shoulder. I maybe *should* pass to the center, but my centers tend to be puckhogs and are right on top of me any time the puck comes close so no sense in passing. ;) I've also played some goalie, though really that's just ugliness best avoided.

I don't know how many "tube dudes" are out there documenting a return to hockey after THR, LOL, so I bet we did watch the same guy. He did say he overdid and came back too soon and had some unnecessary pain because of that. Even though I know I *can* play after 12 weeks, I'm not treating that as a deadline. When I've read that significant bone growth hasn't happened until about 3 months and the capsule regen can take up to 6 (general guidelines), I'm quite fine waiting and seeing what my body feels like. I would like to see how I feel at 3 months and then maybe try a public skate just to see how it goes, but again, I'm not committing to hard and fast deadlines at all.

Like you, I just want to get back to fully being active, confident and free to NOT think about my hip. That means taking it easy for as long as it takes and listening to my body and my PT for probably longer than I'd like to, but I'm not out to prove anything to anyone. It sounds great that you're able to get back to some cycling and elliptical at 6 weeks. That's very encouraging. Hopefully next year we'll be toasting how far we've come on this journey. Cheers!
 
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I won't be awake - I will have a spinal and "light" sedation.
Great! They will watch you throughout the procedure and keep you nice and comfy.
 
If anyone has stock in Walgreens medical supplies? You're welcome - I'm responsible for the sudden rise in stock, LOL. Did my shopping last weekend for all the goodies. Sticks galore, slippers, fancy ice machine. Guess what the anxiety kicked up in response? OMG, now I have to stay home 24-7 peering out the windows so that nobody steals them when delivered! Yeeeeeeeeeessssshhhhh.

But luckily, I received something far more onerous to take my mind off of delivery thieves. The dreaded leave of absence paperwork. Um, apparently fax machines still exist just to torment people already stressed out about a medical event. Yes, I, apparently, need to track down a fax machine somewhere and send in my personal medical information that I just got from my employer. It is a good thing I *can* walk because, yeah, I wanna go to Office Depot and try to print and fax....:skep:

My MiL got some wonderful news - no COVID test appointment needed. The hospital no longer requires a COVID test for procedures scheduled after today. Hoooray! Only 4 days until her surgery. :yes!:
 
@thepuckhead :oyvey: Ouch! The dreaded paperwork strikes again! I am sorry you have to deal with antiquated methods of delivering data to the (hopefully) right recipient. Sigh, wouldn't it be loverly if everything was easy?!

Yup gathering needed stuff can be a hassle but you will appreciate having it all when you need the stuff. And watching out for porch pirates does add an extra dimension of intrigue, doesn't it?

So glad to hear your MIL doesn't need the COVID test!
 
Paperwork done. Pre-op done. All good to get checked off the list, though each concrete step makes the anxiety raise its head. Yep. Really happening. Not as easy to stay on my "internet diet" right now, LOL.

Despite knowing that nobody can give me a 100% guarantee, I still keep hoping for child like reassurances from random strangers. It's a little embarrassing. Like today, I asked the pre-op physician, whom I've never met but I scheduled with b/c my primary care doc is booked for months, for reassurance that I would be OK. Yes, I literally asked her that. I felt about two years old. She said she was sure it would go well and then I couldn't help myself and asked "isn't it amazing that these days you can play hockey after a THR?" And she said, "I think that's interesting...but I'll defer to the orthopedist on that one..."

And three....two...one...oh my god, both surgeons I saw are greatly exaggerating what I'll be able to do after this. My primary care doc had the same super skeptical look when I asked her about hockey after THR and same result: feeling really skeptical and sad and down.

And, to make things even better, I decide to watch Tube Dude's hockey after THR vids again (telling myself I wanted to get a better idea of what recovery is like) and immediately hear the "if you want to play hockey, you have to get the anterior approach."

This morning, at the gym, I was getting nostalgic for, I kid you not, the leg press machine. I thought, "I only have a handful of times before I'll never be able to lift weights again and end up hobbled."

I think what also triggered all this is that I saw the paperwork formalizing the 8-12 week leave justification and my mind immediately thought "12 weeks of pain and incapacitation."

No amount of internet searching or assurances from anyone will predict how my recovery will go and you'd think I'd have figured that out by now, LOL!

Oh, and I realized I never told my surgeon that I have mild scoliosis and now I'm worried that this might increase my risk of dislocation or screw up my leg length.

Also, I am a heavy, heavy side sleeper (left side, of course). Terrified of rolling over out of 40+ years of habit and waking up with the new hip popped right out.

Also, terrified that I will be doing my business in the bathroom and the reaching to wipe will pop it out, too. Have toilet aid (thank goodness for forums like this where I can post this stuff) but have never used one. Seems kind of gross, but if the worst happens and the hip dislocates, could it please not be during THAT particular routine?

Can't believe it's only 2 days until my MiL has her surgery. Fingers crossed for big, big relief for her right when she wakes up.

Going for my "joint camp" (not that kind of joint, LOL) next week where I will meet the PT and NP, I think, plus get a tour of the surgical center. My wife is going with me so that, again, a second, more rational brain than mine is taking in the information. I will be making a list of questions for them, too. Like, "IS MY SURGEON LYING TO ME???" (j/k - I know better!)

Back on the internet diet...cheers, all!
 
@thepuckhead Oh I know those anxieties and questions and worries! The thing to keep in mind is that everyone you come in contact with at the hospital who is involved with your care is a professional! The surgeon and surgical team do these procedures nearly every working day and they ALL have your best interest and wellbeing as their #1 priority.

"IS MY SURGEON LYING TO ME???" No. Not about the need for surgery or his skills and experience. Though he may not know first hand what the recuperation will be like for you. He can give you the text book explanation but unless he's actually had a hip replacement ... And every patient is different as is their experience going through hip replacement. It will NOT be 12 weeks of disability ... it will be 12 weeks of getting better and better. In my experience (and I did both hips at once) the first 2-3 weeks are the hardest then things get better day by day. I think the hardest part for you will be being patient and allowing your body to heal before diving back into your usual way of doing things. By that I mean ya gotta slow down!

As for the sleeping concerns ... that is a problem for EVERYONE who gets a joint replaced! You'll probably have to sleep on your back for a while and then cautiously try sleeping on your side. At first it will probably feel like you are sleeping on a brick (IMO internal swelling takes quite a while to go away and that, more than having an implant, is what causes the "brick" feeling). That does go away ... eventually.

And dislocations are actually quite rare. As long as you follow your surgeon's recommendations and do things slowly at first you should be fine!
 
@thepuckhead glad to see things moving along for you!

The surgical teams have seen it all. They really are amazingly efficient.

I thought that I would need many more aids than I actually did.

These are the ones I used
Several lightweight ice packs.
Elevation wedge pillow
Meds filled and on hand
Night lights
The leg lifter for the log leg phase.
Good grabbers. I still use mine
Extra towels in the bathroom.
Shower grab bars 2

I had a pico negative pressure dressing and wanted it to stay dry so I did not take a standing shower right away. I was able to sit on the edge of the tub.
 
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