Chapter 32 – Post-Surgery Timeline And Checklist: Seven Days And Beyond
Hip Replacement Book
Some Days I Was ‘Sisy’ – I generally noticed progress each day, but there were some days where I felt like Sisyphus where I almost got to the top, only to slide back down. Of course the next day I would roll up recovery mountain again.
“Two men looked out from prison bars,
One saw the mud, the other saw stars.”
Ready To Jail Break – When you are recovering from surgery, you might feel as though you are trapped in a prison cell. Someone is always watching you, you can look at the window but not really enjoy as much as you want. When you want food someone must cook for you. Your freedom feels very limited.
“I did not have sexual relations with that woman.”
Conjugal Visits – Many patients wonder when they can resume sex (assuming they had any before the operation). Various online forums and hospitals offer an array of opinions as to when you can safely rekindle your romantic relationships. Most sites indicate to wait several weeks before resuming sexual intercourse. My physician told me I could resume when I felt comfortable. Later he commented that a seven day waiting period was not what he had in mind. I asked him if he meant it could have been a shorter period of time.
You can read more about sex after surgery here.
Tearing Up The Streets – After a week, my healing was fast-tracking. I was now tearing up the neighborhood with my crutches. I thought I should get those bicycle streamers back out so everyone would know has fast I was trekking. In my mind, thousands would line the streets chanting my name and admiring my progress. Well, actually… a couple of neighbors honked at me and showed me the modified, ‘You are #1’ hand gesture, because I was walking, very slowly, in the center of the road.
Hip Tip – Don’t Hit The Road Jack: When you are performing your rehab, be sure to stay on level ground. Do not walk on anything too soft, too hard, too angled, too rocky, too wet or too dangerous. Ideally, there is a nice, flat, level dirt path that can serve you.
Ideally a nice soft path, as long as it isn’t too muddy, was my rehab trail of choice
Faster Than A Speeding Snail – I was told by many people I was healing rapidly, but it wasn’t fast enough. I was still on crutches and had bought a cane. I tried the cane in the house, but I didn’t like the support it provided and didn’t think it would be as good as walking sticks.
Ichabod Cane – Now Ichabod always enforced strict rules. But few people know that he created guidelines for how to use a cane. Here is how to use your cane:
> Sizing Your Cane – The top of your cane should reach to the crease in your wrist when you stand up straight. You should also allow your elbow to slightly bend, ideally at 15-20 degrees while standing. Cane length is usually about one half your height, in inches, wearing shoes.
> Positioning Your Cane – Hold the cane in the hand of your good leg. No, not on your operated side. Why is this? When you stride with your left foot, you swing with your right hand; when you stride with your right foot, you swing with your left hand. By having a cane in the hand opposite your injury allows you to replicate your natural arm movement. Additionally, this gives your hand an opportunity to absorb some of your weight when you walk.
> Walking With Your Cane – When you walk, the cane and your injured leg swing and strike the ground at the same time. To start, position your cane about one small stride ahead and step off on your injured leg. Finish the step with your normal leg. Don’t try and look classy or coordinated, because you won’t.
> Climbing Stairs With Your Cane – To climb stairs, grasp the handrail and step up on your good leg first, while keeping your cane in the hand opposite the injured leg. Next step up with your injured side. To come down stairs, place your cane securely on the step, followed by your injured leg. Finally move your good side, which carries your body weight.
Advanced Caning – No, this isn’t what they do in Thailand to people who litter. Advanced caning is what I call walking sticks. A couple of years ago, my wife and I had purchased hiking sticks with built in ‘shock absorbers.’ We used the poles every time we went for an outdoors hike. I was now ready to use the sticks in place of my crutches and saw the sticks as advanced canes. I took two bright yellow, glow-in-the-dark tennis balls (I thought the bright yellow, the same color as my ‘fall risk’ socks in the hospital, would signal to everyone that I was still a danger) and put them on my poles. I was off and running, well, err, walking, anyway.
A Walk On The Wild Side – At about six weeks after my surgery I was doing a morning walk of 1.2 miles with two crutches and what used to take 40 minutes had been reduced to 28 minutes. I would take a second walk at noon using just one crutch. I would take a third walk in late afternoon using just walking sticks. I could walk around the house, slowly with a limp, with no crutches and easily get in/out of car.
Let’s See That Play Again In Slow Motion – My walks were so slow I saw nature in moments I hadn’t previously witnessed. I remember coming back from a warm day walk and proclaiming to my wife that she would be surprised at how many ants were crossing the pavement at any given time. She just nodded and said, “Don’t worry, sweetie, you will get faster.”
The Long Hike – There is a nice wooded park near my home. It has tall trees, irregular terrain and the trail winds so it is always interesting. About 10 weeks after my surgery, on a Saturday morning my wife and I went for the ‘round the park’ trail which is about four miles. We both used hiking sticks to ease the pressure on our knees and my hips. After we completed this long hike, I felt OK. But when I got home, my hip was really sore; not painful, just sore. I resigned myself to more pool time and less trail walking for the near future.
Hip Tip – Tennis Balls Are For The Dogs: After I had graduated to the walking sticks, I added yellow tennis balls to the base of each. This was so the rubber end caps wouldn’t wear so fast. I was on my neighborhood route and was coming up to an empty corner lot. I could see a shorter woman approaching the corner of the same lot and it look like she was walking at least two dogs. I couldn’t tell as the weeds were high in the lot and dogs must have been small as well. She was walking at a leisurely pace. Once she arrived at the corner she turned and started towards me. Her three Yorkies also saw me and soon broke into a full trot towards me, dragging the five foot woman behind. The lady had the wind in her hair, a slightly crazed look in her eyes as her trusty steeds barked and rushed furiously towards me. It look as if it was a scene from a diminutive Ben Hur movie.
As she got close enough to me she said, “They love tennis balls.”
Got Twitch? At my six week office visit, my doctor gave me permission to swim. I bought a pass to my local YMCA as they had a daily slot set aside called ‘Rehab Swim.’ I soon discovered there were some swimmers with fast twitch, others with slow twitch and me with no twitch. I asked the pool manager if they could install a sundial so I could time my laps.
Hip Tip – Everybody Jump Into The Pool – Except You: I was being very careful with my new hip when I first when swimming. I knew the first rule of being around a pool, is not to dive in. Got it. But the second rule, for hip replacement patients is to not jump in. I was at the deep end and ‘gently’ jumped in. Who knew that the bottom of the deep end was slightly curved at the bottom? My good leg hit the sloping pools side with a mild impact. I am lucky my operated leg was sticking out more towards the pool or I could of had a painful experience.
Swim Speed Proportional To Aquatic Environment? After my first week I was complaining (what else is a spouse for?) about how slow I was in the pool. About a week later my wife asked how the swimming was going, if I was finding it easier to swim and, after a thoughtful pause, asked if there were any cute women in the pool. Because I like to tease her I quickly replied, “Well, at first there were a lot nice elderly women in those full length swim suits with leggings and ruffles. Then the next time there were 40-ish women in one-piece snug fitting swim suits. The following time there were many 30-ish women in one-piece suits with a high hip cut and a low neckline. I really appreciated the high cut on the hip so I could remember what a normal hip looks like. Yesterday there were 20-something woman in the pool swimming in their bikinis. And today, there were college girls in the pool swimming with only a thong and no top. Of course I have to honestly say I didn’t really notice any women, babe, but my swim times have really improved.” My wife quit asking me about the pool after that conversation.
Resistance Is Futile – I tried aqua jogging interspersed with lap swimming. Even though I was very gentle with how my feet would hit the pool, my hip was very sore afterwards. I also didn’t find enough resistance in chest deep water to feeling challenged aerobically. I tried three more times and then resorted to swimming only.
Scotty: “I’m giving her all she’s got, Captain!”
James T. Kirk: “All she’s got isn’t good enough!
What else do you have?”
Star Trek TV Series
These Are The Voyages Of The ‘Starfish’ Enterprise – Over the next few weeks, after starting at the plunging anchor level, I would advance from oyster speed to starfish speed to jelly fish speed to upstream-swimming guppy speed. I was ready to sew on those four merit badges to my swim trunks so I could be the Eddie Rickenbacker of swimmers. The rehab lifeguard was so impressed as he was forced to witness the painfully slow monotony of my progress that he commented my lap speed was improving. I replied back, “If that is too exciting, I can swim more slowly if you would like.”
Ever Wonder How A Lifeguard Passing Time? After a month of swimming during the allotted rehab swim period I asked the lifeguard how she stays awake. She told me she imagines, like a horse race, the swimmers competing against each other. I imagine my horse race name is ‘Two-legged Turtle.’ I can hear her doing the call, “Two-legged Turtle is almost out of the gate, Two-legged Turtle is almost out of the gate, Two-legged Turtle is almost out of the gate, Two-legged Turtle is now out of the gate.”
“The man who is swimming against the stream
knows the strength of it.”
Swim Like A Seal – The pool lifeguard enjoys giving me grief about my swimming technique. At about the four month mark he said, “You are swimming like a seal.” I couldn’t tell if he was joking or just noticing that I was slowly improving. The next day I told him I had to look up his comment on YouTube.com to see what he really meant. I said I found the video about which he was referring, “It is off the coast of South Africa and a seal is swimming around and a great white shark comes from under the water, takes a bite of the seal and throws the seal 10 feet in the air.” He laughed and said, “No, I meant Navy Seal.”
Don’t Push It – I don’t push off the wall on lap turns for a couple of reasons: I am swimming exercise my hip, not for gliding and second, I don’t want any extra forcible stress on my hip.
Kicking It – I used the same four regular sized kickboards bounded with a Velcro strap as I did in my prehab to create resistance. I found the kickboard exercises to be very beneficial.
Take Note – I found an underwater writing tablet for six dollars MyHipReplacementSurgery.com and told my wife that when I was swimming I would have thoughts and then write down the notes. She laughed at me and asked if I was taking notes for this book. I was, but I told her that, “I am taking notes like, ‘You are wonderful, you can do it, you are special, you are kind.’” She rolled her eyes as you are now doing.
Biking & Rehab
Hell On Wheels – I wanted something more than walking around the block and my doctor had cleared me for stationary bike riding at my six week follow-up. Even though my wife has a stationary bike so she could ‘spin.’ I had watched her “spinning” at our local gym and it just looked so wimpy. Besides, I was ready to terrorize the neighborhood at a faster pace and feel real wind in my hair. I wanted to be outdoors, working out on a ‘real’ bike and I thought I could even feel like a bad-ass motorcycle biker, so I took my mountain bike to the shop and had it tuned.
Born To Be Wild – Steppenwolf
(as a bonus, the term ‘Heavy Metal’ came from the above lyrics)
Hill On Wheels – I soon realized just how hilly of an area my neighborhood was. I found half my time was pedaling up gradual hills and straining my hip, and the other half coasting down while applying brakes. My hip was just not getting a work-out and my rebel bike riding efforts were not really producing the results I had envisioned. I put away my perceived biker-gang leather jacket (nylon windbreaker) and skull protector helmet and opted for watching NetFlix on my iPad as I did my ‘spinning’ regimen with an electric fan blowing my hair. Maybe I could find YouTube.com footage of the Sturgis Motorcycle Rally, Daytona, Laconia or Myrtle Beach motorcycle rallies and at least feel like a biker.
Work To Do – Isley Brothers
Avoiding Work – A common question asked is, “When can I return to work?” To your surprise, you might find your spouse constantly telling you how much you have improved after just a couple of weeks at home, politely reminding you of how valuable you are at work and how much your fellow employees miss and need you. Typically, if you work at a desk, you may return after approximately one month. If your type of work is more rigorous, you might require up to three months of recovery before you can return to full duty. Warehouse type work may require three months of recovery, while heavy labor jobs can take up to six months before you can fully perform work.
Don’t Plan On Dressing Up – Gathering all your clothes, then putting them on is a slow and tedious project. It is hard to bend over to put pants on as well as shoes and socks.
Who Needs Socks Anyways – I wasn’t all that limber prior to surgery so it is no surprise that even after three months it was still difficult to get a sock on my operated side. Flip-flops were the shoe of choice for most of my travels.
I’m A Traveling Man
See The World – You can travel when you feel comfortable. For most people this will be at least six weeks. To prevent blood clots you get up to stretch or walk at least once an hour. Remember if your travel involves an airplane ride, those seats can be hard on your hip.
“Sir, Raise Your Arms And Step Away From The Bag.” When the security officer shouted that command, I immediately raised my arms and distanced myself from my mother-in-law. I would shortly learn that wasn’t such a funny move. Of course that was a fictitious cheap shot at my mother-in-law, but I just had to get within a couple of thousand shots of making the score even.
Hip Tip – TSA Magnet: You may fall into the ‘high risk’ category at airports by setting off the security checkpoint equipment. I did. The TSA is probably tired of manually screening all the hips and knees that set off the alarm. I also carried a card from my doctor indicating I had an implant, but that really doesn’t pass for a ‘get out of jail free’ card. Interestingly enough, On my return trip I was given a card identifying me as an ‘implant.’ Things went a bit faster, but still was screened. A passenger can request to be screened by TSA imaging technology if it is in use and available at the checkpoint. Overall, and as a word of caution, plan on allowing an extra five to 15 minutes when going through security – depending on how funny you think you are.
Alrighty… that concludes Chapter 32.