Re:Vacation, ROM, anti-inflammatories/supplements (long)

[Guest guest]

Hi Rog, a and Sundog,

> Re vacation: Am I nuts for planning a 5-day Cabo getaway next week?

Why not? So long as your husband really DOES do the grunt work as

promised, and you get to go swimming (if permitted by your OS) and

relax. My physio actually prescribed walking barefoot in the sand as a

good way to focus on putting my weight in the right places (heel

first, then toe, making sure I wasn't just walking on the outside edge

of the ball of my foot). I figure that if many of us could survive a

9-hour flight from Europe at 2 weeks post-op, you can manage a 5-hour

flight to Cabo. Just try and get an aisle seat so you can stretch out

your leg, and get up and walk around at least once an hour. Tip: Take

your cane, and request a wheelchair for your arrivals. That way, you

won't be stuck standing in long line-ups at immigration, and your

husband can probably skip them too, to accompany you. Of course, you

want to make sure your extended health insurance would cover

medivacking you to Vancouver in case of emergency, but I doubt that

will be necessary.

For those hippies whose spouses are thinking that a week in the

sun might kickstart a return to normal marital relations, it's a good

idea, but if the patient is less that 6 weeks post-op, just remember

the " no bending more than 90 degrees " rule! Personally, my thigh was

just too painful or sensitive until about 8 weeks post-op to tolerate

anything (even a small child) resting weight on it for more than a

minute or two.

Re limited ROM: I have the same problem at 5 months post-op, but

it IS slowly improving. I wasn't super fit beforehand, but had been

walking and attending mild fitness classes. My physio says that my

brain is still thinking that I can't move any further without damaging

something, so it tries to protect me by forcing me to stop. But he has

ways of wearing down its resistance, and if I stretch for long enough,

I can bend a little more. Also, he has me do lots of repetitions,

starting with something easy, then introducing something harder, and

the repetitious aspect is to " retrain my brain " to accept my new

abilities. It's important to find a really knowledgeable and

experienced physio who is willing to spend the time to figure out

which of your muscles are the problems, and how you can stretch them out.

Here's an example of what gave me a major breakthrough, although I

wouldn't advise trying this until the physio says it's OK:

1.) Lie on your back with knees bent, a 1kg. medecine ball (or cushion

tied around a can of soup) between your knees (they should be about 10

inches apart), hands lying by your sides. Tighten the abs and glutes

(buttocks), then lift your lower back into the " bridge " position,

resting on your shoulders. Keeping the weight firmly between your

legs, drop the knees first to one side, then to the other (it's not

necessary to drop them to the floor, just a few inches or as far as

you feel comfortably in control of the movement). Return knees to the

centre. Lower your bottom to the ground. Repeat 30 times (or stop at

fewer reps, if the pain starts to get worse instead of better).

2.) Same starting position, tighten abs and glutes, make a bridge,

then lift the foot of your resurfed leg a few inches off the floor,

and drop your knees in the opposite direction as far as it feels

comfortable (this may only be an inch or two at first). E.g, if you

lift your right foot, drop knees to the left. If you feel more than a

little stretching pain, don't push yourself any further. Return knees

to the centre and lower bottom to starting position. Repeat 30 times.

3.) Same starting position, tighten abs and glutes, make a bridge then

lift the foot of your " good " leg a few inches, and drop your knees in

the opposite direction. Continue as in set #2, 30 reps. This was the

hardest for me. At first I couldn't even get my foot off the floor at

all, and once I finally did, with a supreme effort (which involved

some pressing on my arms), I certainly couldn't move my knees anywhere

while holding the weight between them. So I practiced a bit with my

knees bent but leaving my bottom on the ground (not making the

bridge), in which position I was able to lift my foot a bit, and then

when I tried the bridge I was finally able to do the exercise. Now I

can lift my foot up a few inches quite easily.

Important! If you feel a lot of pain the day after trying this

exercise, take the day off, and just walk but don't do other hip

exercises for a day or two. Personally, I find that 20 reps is usually

all I have time for most days, but even that much is making a

difference in freeing up those tight muscles. For you exercise

keeners, I don't think doing more than 30 reps of each is a good idea,

especially at first, as one's muscles might " seize up " in rebellion if

you overdo it, and cause muscle spasms and pain.

Someone mentioned they could see by looking at their legs the

areas where their muscles were not working. I also had the hanging

flesh on one side (the inner thigh) where my muscles had atrophied

from lack of use while my hip was locked into a position of very

limited movement. It's still not quite back to normal, but has firmed

up somewhat since my physio started working on my ROM.

Re anti-inflammatories: Some OS's think that glucosamine also

acts as an anti-inflammatory, so hopefully some research will be done

on glucosamine and chondroitin to see if taking them does more harm

than good in the long term. Recently I read several reports that cod

liver oil was good for keeping the joints well lubricated, so I

started taking it yesterday, and I'll see if it makes a difference. I

also heard that taking an Omega 3/6/9 supplement might be a good

preventative measure to help protect against osteoarthritis. Anyone

else have any experience using any of the these supplements?

Best wishes, n

rBHR Oct.17/03 McMinn