Physiotherapy for Hip Replacement

I went to an assessment for Physiotherapy at the Reh-Fit Center in Winnipeg last week. It was a good experience and I will be going for my first group session on Tuesday. She took a thorough history and is aware that I do have asthma,  high blood pressure issues and that I do not have equal strength on both sides. I have a bit of a wonky gait from "before" but apparently everyone with severe enough issues to need a joint replacement has gait issues, so that is something else that will automatically be addressed! Yipee😊! She checked my incision which is not fully healed and said we will continue to keep an eye on it too. She sent me home with a new and improved list of exercises.

About a year ago the government started doing an overhaul of health care services. One of the cuts was the post-hip and knee surgery outpatient aftercare. The departments were closed. The physio departments remained in the hospitals for inpatient care but staff layoffs occurred.

Since that time the health authority has continued to support the pre-hab clinic. They are giving education prior to surgery to have people as ready as possible for surgery and have the best outcomes. I will post a link at the bottom of this post for more information about the hip/ knee clinic. They have a lot of very good videos about joint replacement but I would draw your attention to a video of the exercises they recommend doing during for the time you are waiting for surgery. I think it would have benefited me to have started them years ago!

http://www.wrha.mb.ca/prog/hipknee/index.php



The physiotherapy and occupational therapists in the hospital assess if you are safe to leave for home before discharge and they review a few of the exercises that were to have been practiced before the surgery. You are to exercise at home but the set they give you is not looking at your specific needs nor does it show how to increase and changes the exercises as you grow stronger.
They give you a prescription for further private physiotherapy but then it is in your hands.

Many people do not have a insurance beyond that of our Canadian public health care system. I have very minimal work-related health insurance.  Physio for me is largely an out of pocket expense.

Many others have been in the same situations. I am youngish for a hip replacement and many seniors older than me live on limited incomes and will not have as much help as they need to get as full a recovery as possible.

The Reh-Fit center is very conveniently located about a mile from my home and is a lovely space with great resources and highly trained staff. I have known several people who have been referred there post heart attacks and they can't say enough good things about the services. It has a charitable status and a fantastic reputation but is at a higher cost than many other places around the city.

The Reh-Fit Centre is more than a fitness centre. We provide an environment to help individuals achieve and maintain health and wellness. We offer individual and group options for exercise, nutrition, and education through a team of certified health and fitness professionals. Expert guidance from professional personnel, innovative health enhancement programs, and the integration of medical, rehabilitative, and fitness services all are delivered in a clean, service-oriented environment.

                                                                                     http://www.reh-fit.com/about-us/

The Reh-Fit Centre has been offering post hip and knee replacement programming for members who are 6 months or more post surgery for a few years now. I noticed several months ago, after the withdrawal of our hospital-based rehab, that they were offering a knee replacement program for the immediate post-surgery period but not for hips. After I got home from the hospital an ad popped up in my social media feed about the new hip program so I called them up.

They launched the new program in mid-May!  They do not require membership and they enroll people between 1 and 2 weeks post surgery. I just plain old got lucky with this one! They do an initial assessment by a physiotherapist for about $70 (possibly covered by your private medical coverage) and then you can continue with weekly group sessions with a physiotherapist, a kinesiologist and possibly a volunteer. The groups can be up to 10 people, last an hour and all this for only $20 a visit.
After they feel you are no longer benefitting from this program they will encourage you toward other programs to help with your continued improvement.

We will see how this all goes tomorrow!

My Hip Replacement Surgery

The surgery was 19 days ago and I have had a chance to relax and reflect on the experience. I am home and my new hip is amazing and working very well. The pain is so much less than before the surgery and I am feeling better all the time.

I was pretty tense beforehand.. let's call it panicked.
I  had bad, life-threatening experiences in the hospital as a kid.
It was also very much on my mind that my hip surgery was occurring at 10 years to the day from when I was admitted to the hospital, hemorrhaging and with a pulmonary embolism in my lungs - and my life changed forever.

I kept thinking I can still change my mind - this is an elective procedure. The fact is that  I can not imagine living the rest of my life in the kind of pain and disability that I have been experiencing. I have fought too hard to regain my independence to have it slowly disappear on me once again.

They try to have patients well prepared for hip surgery. Patients have gone to these Regional health authority hip and knee clinic orientation meeting, met with appropriate therapists from the center and have an appointment with their surgeon. We received a 50 something page booklet to read that should answer most questions.

The week before surgery patients went to the hospital where they are having your surgery and have meetings with the anesthesiologist, physiotherapist, occupational therapist and a nurse. Blood pressure is checked and they do one last x-ray of the knee or hip. You get another booklet outlining what time you personally need to be at the hospital when you are last allowed to eat or take medications, a map of the place and a list of what you should or should not pack for your stay. There is a caregiver pamphlet with where to park and what the person accompanying the patient needs to do.

I have a LOT of allergies and because of past experience, I was concerned about that aspect of the surgery and was not feeling as prepared as we could be.  It did indeed turn into a problem with me trying to convince people of the severity of the reactions I can have to medication. Fortunately, the pain management nurse at the hospital actually contacted my allergists' office and got a written report about what medications I can have. I can say without a doubt that woman made a huge difference in the safe and successful management of my care.
There were still a lot of problems with pain management and even greater problems with finding a way to send me home with something for pain relief.

Lilacs and early summer flowers are not my friends. I have severe allergy-induced asthma,  I have wound up at the doctor or in the emergency at least 5 times during that last two weeks of May  This is a bad time for surgery. I wound up having three asthma attacks while in the hospital and one of them was probably the scariest close call I can remember. I am sure that besides the seasonal allergies I was reacting to some of the sanitation chemicals used to clean in the hospital and I suspect just the effect of the surgery on a body as well as the effects of the pain medication on breathing added up to a horrible mix of conditions.

The days blurred together with pain, narcotics, sponge baths and nurses coming in and out. Meals were ummm nourishing. The staff was all very kind and nice to me.

My family were there for me and kept me company and helped in any way they could.

I got along well with my roommate who had a knee replacement and I feel lucky to have shared this experience with her and shared her company.

Physiotherapists came each day to make sure I was starting to move a bit and getting me standing as soon as possible. They have to make sure you can get in and out of bed safely, stand up and use a bathroom and if needed make sure you can safely go up the number of stairs required so you can get into your home upon discharge.

My hospital bed.

The Walker.

My poor leg.

I just have to share the view from my second-floor hospital window. Talk about patriotic!

It was actually very soothing and meditative to lie in bed and watch the flag moving in the breeze.

My recovery now continues at home. I am doing the hospital based exercises and trying to move around the best I can.  Next, I will be starting a brand new post-surgery rehab program at a facility called the Reh-Fit Center.

My goal is to be Leading a Healthy Life!

Don't Stop Believin - Video

When I put a music video up on Leading a Healthy Life it is almost always because something in the song - tune or lyrics, is looping in my head and has meaning for me in the moment. I scheduled a video, Ooh-oo Child to be posted here while I was in the hospital.  I knew I would find it comforting and I did indeed listen to it on a somewhat tearful hospital afternoon. I asked my roommate if any songs would comfort her.  We were both feeling kind of miserable.

The first one to come to Lorri's mind was "Don't Stop Believing" by Journey.
Heres to you Lorri. I'm wishing you well.

"Don't Stop Believin'"

Just a small town girl
Livin' in a lonely world
She took the midnight train goin' anywhere

Just a city boy
Born and raised in South Detroit
He took the midnight train goin' anywhere

A singer in a smokey room
The smell of wine and cheap perfume
For a smile they can share the night
It goes on and on, and on, and on

Strangers waiting
Up and down the boulevard
Their shadows searching in the night

Streetlights people
Livin' just to find emotion
Hidin' somewhere in the night

Workin' hard to get my fill
Everybody wants a thrill
Payin' anything to roll the dice just one more time

Some will win, some will lose
Some were born to sing the blues
Oh, the movie never ends
It goes on and on, and on, and on

Strangers waiting
Up and down the boulevard
Their shadows searching in the night

Streetlights people
Livin' just to find emotion
Hidin' somewhere in the night

Don't stop believin'
Hold on to that feelin'
Streetlight people

Don't stop believin'
Hold on
Streetlight people

Don't stop believin'
Hold on to that feelin'
Streetlight people

Staples are Gone!

I got the staples from my hip replacement out yesterday.  

I just couldn't make myself look under that bandage but Bob, my husband, was with me and counted them as they came out. 30! It was uncomfortable but over quickly. I am so glad to not be sitting down on those sharp little bits anymore. It is pretty darn tender there, between the tiny holes from the staples prongs and the incision site, but it is healing really well. Two more days and I can remove the dressing and have a shower! Yes! I do want to have a shower from a hygienic point because sponge baths only go so far but I am really very sore all over and would love to have a hot shower to relax some of my other stiff muscles especially in my neck and back.

After the Technician removed the staples I got to speak to the Surgeon. I am doing well in all ways. We reviewed my movement, looked for swelling in my leg and talked about how medications were going at home. I asked him to fill in a form for work and he says return to work at 3 months and at this time anyway, he is not in favour of an earlier return on modified duty. He stressed the importance of walking a little bit at a time but frequently. I asked him again about my knees and If I should go back to my sports medicine / orthopedic doctor. I told him my left knee was at that moment hurting more than the surgical hip. He said we should do x rays of hip and both knees at the follow-up appointment I will have with him in 6 weeks.

It was actually quite the little hike around in the hospital for me and my walker to get to the Orthopedic Clinic. I got home beyond tired and laid down for hours. I sure don't have a lot of stamina back yet.

I am happy that I am indeed making progress!