preparation for surgery

January 21, 2004

Recently somebody posted a message, which unfortunately I can't find

now, about why they thought their surgery was so succesful - 1)being

a good surgeon, and 2)the 6 months of getting fit etc leading up to

the surgery. I don't know much about my surgeon, who is called Mr

jain, although he gave me good answers to my questions. He suggested

that my recovery may be slower than average due to scar tissue from

previous surgery as a child (CDH). I am really interested to know, as

I ahve about 6 months now to wait for my surgery, what I can do

physically to maximise my muscle strength and range of movement etc

over the next 6 months, rather than sitting and waiting for it to

happen. I do hydrotherapy once a week, and try to go swimming also

once a week. I walk with a stick and my gait is crap now - noticeable

limp. Any suggestions?

Jen

January 22, 2004

--- I am really interested to know, as

> I ahve about 6 months now to wait for my surgery, what I can do

> physically to maximise my muscle strength and range of movement etc

> over the next 6 months, rather than sitting and waiting for it to

> happen. I do hydrotherapy once a week, and try to go swimming also

> once a week. I walk with a stick and my gait is crap now -

noticeable

> limp. Any suggestions?

> Jen

Hi Jen. Just about anything you can do to make you stronger will

make it better. I joined a gym, and worked on all the machines that

didn't cause excrutiating pain - but many were painful. My doc told

me that I really couldn't damage much in my hip, as long as I went at

a slow enough pace, so the pain was just something to tolerate. I

did everything below the waist - thighs (don't remember the name of

the muscles), adductors and abductors, leg presses, flexibility

stuff. By the time I went in, my legs were like rocks. (I'm still 30

pounds overweight, so don't imagine me as some kind of a body

builder. Just a middleaged housewife with " flab of steel " as we like

to call it.) At that time, I also used a cane most of the time, and

my limp was horrible.

Don't get me wrong - it hurt to do the exercises. But wimping out

is not my style, and altho it never really got easier, per se, I was

able to keep increasing the weight limits on the machines. And I

swear it made an incredible difference in how fast I healed (3 weeks

to no walking aids) Also, working on your arms is great- if you have

to use crutches after your op, your shoulders and arms will do better

being in good condition. Some docs have you use a trapeze in bed to

help you move around post-op, so working on biceps will make your

life easier afterward. Another excellent area is the back of your

arms, which are needed to help push you up out of a chair without

using your legs. Practice that now - try pushing yourself up in the

air (maintain hold on the chair arms and just hang there - let your

self up and down) Practice pushing yourself out of a chair not using

your bad leg at all - hold it up the air. It'll strengthen the other

leg and work on your arms all at once.

Exercising will make you feel better (I had to pop an ibuprofen or

two after working out), and makes you feel more in control over the

situation. What you're doing now is excellent - many folks swear by

any kind of water-work (I don't have any available to me, so that

wasn't an option) and the swimming, well, you can't beat that! Keep

it up.

Perhaps some other folks on the board will write in with some

exercises they feel are good, too.

Good luck to you as you wait.

Lois

Dr Gross 8/6/03

January 22, 2004

Thanks Lois,

Your support means a lot, and I'm going to explore options for going

to the gym. My only fear is that any movements I do weightbearing on

my bad leg cause my hip to make an audible crunching noise, which my

physio told me to avoid (largely I think cos she hated the noise of

it!). Have you experienced this? Its kind of like a ratchet, clunk,

clunk, clunk sound! Its not particularly associated with pain, so i

could work through it - just don't know if i should or not.

Jen

> --- I am really interested to know, as

> > I ahve about 6 months now to wait for my surgery, what I can do

> > physically to maximise my muscle strength and range of movement

etc

> > over the next 6 months, rather than sitting and waiting for it to

> > happen. I do hydrotherapy once a week, and try to go swimming

also

> > once a week. I walk with a stick and my gait is crap now -

> noticeable

> > limp. Any suggestions?

> > Jen

>

> Hi Jen. Just about anything you can do to make you stronger will

> make it better. I joined a gym, and worked on all the machines

that

> didn't cause excrutiating pain - but many were painful. My doc

told

> me that I really couldn't damage much in my hip, as long as I went

at

> a slow enough pace, so the pain was just something to tolerate. I

> did everything below the waist - thighs (don't remember the name of

> the muscles), adductors and abductors, leg presses, flexibility

> stuff. By the time I went in, my legs were like rocks. (I'm still

30

> pounds overweight, so don't imagine me as some kind of a body

> builder. Just a middleaged housewife with " flab of steel " as we

like

> to call it.) At that time, I also used a cane most of the time, and

> my limp was horrible.

> Don't get me wrong - it hurt to do the exercises. But wimping out

> is not my style, and altho it never really got easier, per se, I

was

> able to keep increasing the weight limits on the machines. And I

> swear it made an incredible difference in how fast I healed (3

weeks

> to no walking aids) Also, working on your arms is great- if you

have

> to use crutches after your op, your shoulders and arms will do

better

> being in good condition. Some docs have you use a trapeze in bed to

> help you move around post-op, so working on biceps will make your

> life easier afterward. Another excellent area is the back of your

> arms, which are needed to help push you up out of a chair without

> using your legs. Practice that now - try pushing yourself up in the

> air (maintain hold on the chair arms and just hang there - let your

> self up and down) Practice pushing yourself out of a chair not

using

> your bad leg at all - hold it up the air. It'll strengthen the

other

> leg and work on your arms all at once.

>

> Exercising will make you feel better (I had to pop an ibuprofen or

> two after working out), and makes you feel more in control over the

> situation. What you're doing now is excellent - many folks swear

by

> any kind of water-work (I don't have any available to me, so that

> wasn't an option) and the swimming, well, you can't beat that!

Keep

> it up.

>

> Perhaps some other folks on the board will write in with some

> exercises they feel are good, too.

>

> Good luck to you as you wait.

> Lois

> Dr Gross 8/6/03

January 23, 2004

Hi All!

I stopped doing lower body resistance machines about 6 months ago partly

because of the pain, but also because I already had couple of cysts. I was

afraid that anything that hurt that much had to be damaging what bone I have

left. Does anybone know if this was a reasonable precaution? I've continued to

do the upper body machines, but I've lost considerable strength in my legs, as

well as having put on an extra 10-15 pounds. Anyone have any experience with

cysts getting worse (or not) with exercise? Lois, did you have bone cysts when

your Dr. told you you wouldn't damage anything by exercising slowly?

Also, has anyone had any experience with insurance coverage for a THR

following a resurfacing. My husband is concerned that if for some reason the

resurfacing should fail, that insurance wouldn't pay for the revision(s) of a

first surgery that was investigational. We're willing to pay for the surgery

in Belgium if our last appeal for coverage under the investigational portocol in

the US is denied, but I think he's having nightmares of an endless cascade of

expenses down the road. Anyone have any experience with this scenerio?

Thanks for your help.

RPh, 54

Surfacehippy wannabe

Re: preparation for surgery

Thanks Lois,

Your support means a lot, and I'm going to explore options for going

to the gym. My only fear is that any movements I do weightbearing on

my bad leg cause my hip to make an audible crunching noise, which my

physio told me to avoid (largely I think cos she hated the noise of

it!). Have you experienced this? Its kind of like a ratchet, clunk,

clunk, clunk sound! Its not particularly associated with pain, so i

could work through it - just don't know if i should or not.

Jen

> --- I am really interested to know, as

> > I ahve about 6 months now to wait for my surgery, what I can do

> > physically to maximise my muscle strength and range of movement

etc

> > over the next 6 months, rather than sitting and waiting for it to

> > happen. I do hydrotherapy once a week, and try to go swimming

also

> > once a week. I walk with a stick and my gait is crap now -

> noticeable

> > limp. Any suggestions?

> > Jen

>

> Hi Jen. Just about anything you can do to make you stronger will

> make it better. I joined a gym, and worked on all the machines

that

> didn't cause excrutiating pain - but many were painful. My doc

told

> me that I really couldn't damage much in my hip, as long as I went

at

> a slow enough pace, so the pain was just something to tolerate. I

> did everything below the waist - thighs (don't remember the name of

> the muscles), adductors and abductors, leg presses, flexibility

> stuff. By the time I went in, my legs were like rocks. (I'm still

30

> pounds overweight, so don't imagine me as some kind of a body

> builder. Just a middleaged housewife with " flab of steel " as we

like

> to call it.) At that time, I also used a cane most of the time, and

> my limp was horrible.

> Don't get me wrong - it hurt to do the exercises. But wimping out

> is not my style, and altho it never really got easier, per se, I

was

> able to keep increasing the weight limits on the machines. And I

> swear it made an incredible difference in how fast I healed (3

weeks

> to no walking aids) Also, working on your arms is great- if you

have

> to use crutches after your op, your shoulders and arms will do

better

> being in good condition. Some docs have you use a trapeze in bed to

> help you move around post-op, so working on biceps will make your

> life easier afterward. Another excellent area is the back of your

> arms, which are needed to help push you up out of a chair without

> using your legs. Practice that now - try pushing yourself up in the

> air (maintain hold on the chair arms and just hang there - let your

> self up and down) Practice pushing yourself out of a chair not

using

> your bad leg at all - hold it up the air. It'll strengthen the

other

> leg and work on your arms all at once.

>

> Exercising will make you feel better (I had to pop an ibuprofen or

> two after working out), and makes you feel more in control over the

> situation. What you're doing now is excellent - many folks swear

by

> any kind of water-work (I don't have any available to me, so that

> wasn't an option) and the swimming, well, you can't beat that!

Keep

> it up.

>

> Perhaps some other folks on the board will write in with some

> exercises they feel are good, too.

>

> Good luck to you as you wait.

> Lois

> Dr Gross 8/6/03

------------------------------------------------------------------------------

January 25, 2004

> Thanks Lois,

> Your support means a lot, and I'm going to explore options for

going

> to the gym. My only fear is that any movements I do weightbearing

on

> my bad leg cause my hip to make an audible crunching noise, which

my

> physio told me to avoid (largely I think cos she hated the noise of

> it!). Have you experienced this? Its kind of like a ratchet, clunk,

> clunk, clunk sound! Its not particularly associated with pain, so i

> could work through it - just don't know if i should or not.

> Jen

>

You should ask your doctor if you can do further damage by doing the

exercises. I did not do weightbearing things- strictly machines

where I sat down or laid upon. I did the ellyptical machine - for

some reason that did not hurt, altho walking was agony. I was able to

keep it up (the ellyptical machine) until the last month or so - it

began to hurt to do that, so I stuck to the strictly non-weight-

beaing after that. It's amazing how well you can work muscle groups

without being weight bearing. I also did my best to maintain my

range of motion. Even if it hurt, I forced the leg to keep doing

what I had always been able to do, like crossing right ankle over

left knee (like to put socks on.

Before surgery, I did not have the kinds of noises that you describe,

altho they're not uncommon after surgery! So I can't really tell

you anything about how to handle that - the best route is your

doctor, and perhaps others on this board that may have experienced

the same thing.

Lois

Gross 8/6/03

January 27, 2004

Maintaining range of movement is something I am desparately trying to

do.UNfortunately I am really starting to notice that things like

putting my right sock on and shaving my right leg are becoming hard -

its not so much painful I just can't do it. I know there are easier

ways (I'm an Occupational therapist by training) like using a sock

aid or " helping hand " reacher, I just have a feeling at the moment

htat I should be maintaining as much range as possible, so I'm

refusing to take the easy way out (something to do with being an

Aries I think!)

You also mentioned an ellyptical exerciser - I have one of them but

wasn't sure whether it was ok as it is still weight-bearing. I tend

to use it for 5 minutes first thing in the morning to get me loosened

up, but haven't persevered much further as I wasn't sure if it was a

good idea. I guess you've answered that one.

Still wondering about the clunking,if anyone has any experience of

this PRE-surgery?

Cheers,

Jen

> You should ask your doctor if you can do further damage by doing

the

> exercises. I did not do weightbearing things- strictly machines

> where I sat down or laid upon. I did the ellyptical machine - for

> some reason that did not hurt, altho walking was agony. I was able

to

> keep it up (the ellyptical machine) until the last month or so - it

> began to hurt to do that, so I stuck to the strictly non-weight-

> beaing after that. It's amazing how well you can work muscle

groups

> without being weight bearing. I also did my best to maintain my

> range of motion. Even if it hurt, I forced the leg to keep doing

> what I had always been able to do, like crossing right ankle over

> left knee (like to put socks on.

> Before surgery, I did not have the kinds of noises that you

describe,

> altho they're not uncommon after surgery! So I can't really tell

> you anything about how to handle that - the best route is your

> doctor, and perhaps others on this board that may have experienced

> the same thing.

>

> Lois

> Gross 8/6/03

January 27, 2004