Monday, January 22, 2007

Sore Groin Sore Glut

If your butt, groin and thigh muscles hurt like mine, it's likely the adductor muscles need attention.




There's five of them. They extend from the pelvis to the thigh bone and the pelvis to the knee.





The adductors main function is to pull the legs together.



I find the lateral extension difficult to do, however I'm doing it better now than I did six weeks ago.

There are two lateral extensions in the Hip and Knee Clinic booklet. If you are just starting the program I recommend you do those as much as you can prior to surgery.

Wednesday, January 17, 2007

Six Week Check Up

My six-week check-up didn’t start well. My surgeon took expectation to this letter to the editor of the Edmonton Journal.

“ Let's not get carried away with the Hip and Knee Program. The current protocol is myopically focused on systemic, non patient outcomes. Twenty weeks from pre-operation to surgery does not account for 12 weeks of ( post op) patient convalescence. I am four weeks into convalescence. I haven't seen a physiotherapist since I left hospital December 15th. The protocol of the new hip and knee centre should recognize patient outcomes don't end when the hospital door closes behind you.”

I had several issues going into the consultation. It took some time to resolve them.




Five things I learned at my six week consultation.

  • Rehab is a home based patient directed process for 6-8 weeks. (It takes that time for the healing process to take hold)
  • Physiotherapy will not be prescribed during this period.
  • My operative leg is longer, than it used to be, longer than my non operative leg. (This is considered a normal outcome of total hip replacement. It can be mediated with a shoe insert. I over used my non operative leg, in the initial rehab period. My right knee swelled. My right hamstring over stretched. I had more pain than I expected.





  • My operative leg adductor muscles are very weak
  • Physiotherapystarts, January 24th.

I need it

My surgeon and I intend to have lunch to compare notes.

I 'll let you know how we do.

Editorial disclousre, the first draft of this post was written January 17th 2007.It was completed February, 1. The healing process is longer and more painful than anticipated, preempting regular postings. My intention is to create a chronology of this process, by event date, not posting date. Hopefully, it will help future hip replacement patients.

Tuesday, January 09, 2007

SHUT OUT

Twenty weeks to get a new hip, or knee, is the goal of the new Orthopedic Centre planned for Royal Alexandria Hospital, in Edmonton. The Edmonton Journal has editorially embraced the protocol.

(Note: the link may not be live, as Journal does not 'permalink' its’ stories)

Prematurely, I say! I got my new hip in 12 weeks. That is impressive. I am quite pleased; I got in and out that quickly.

There is a problem. The current program is, myopically, focused, on the front end of the process. Twenty weeks from pre-operation to surgery is fine. Then what? The surgeon is done. The patient is not.

Capital Health, may want to talk to some patients. Patient feedback could prove enlightening. Six hundred orthopedic surgeries, a month, are performed, at the Misericordia and the Royal Alexandria hospitals. That is a massive database of patient experience begging to be tapped!


Hip Flex 24 hours after sugergy

Here is a summary of my post operation experience. Support from the Hip and Knee Clinic is sparse. My two-week post operation appointment was a perfunctory, fifteen-minute, visit to remove stitches. I expected a physiotherapy assessment of my progress, then.

I entered the program active, healthy and determined to shorten the rehab cycle, as much as possible. My pre operation preparation has morphed into a self administered, home based, convalescence, bereft of professional guidance. Program sponsored physiotherapy has been denied. I will launch my own post operation exercise plan, shortly. Watch for it.



Rail Walking 24 Hours after Surgery

Contrary to my current experience, all orthopedic patients need a professionally designed, personally managed, four week, postoperative rehab program. It should include; a progressive exercise plan, physiotherapy, and a dietary advice, recipes even!

Eating the right food, in appropriate portions, provides the energy to heal. I found it hard to eat, for two weeks. It took that long for the operational drugs to depart my system.

There's an important soical interaction component to convalescence. It is acceptable to be shut in, for two weeks. After that, there's a keen desire to 'get out' and socialize. Social interaction is a panacea a key element in the healing process.

The proposed new Hip and Knee Centre could be just the place to facilitate post operation interaction. It could become a 'patient experience ' laboratory. Information gathered could be catalogued and "paid forward". Use patient wisdom to benefit patients. That will only happen when "convalescence" is recognized as a key component of the process. Currently it isn't!

What is your experience? Let's talk.


Thursday, January 04, 2007

24 HOURS POST OP

This is day 22 of recovery. It is proceeding well. Here's a clip from physiotherapy, 24 hours after surgery. Thanks to therapist Sherry Rioux for helping me through the exercises.