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Following through with the recommended PT can make all the difference with your long term result.
I made sure DH went to his recommended PT after shoulder surgery, none of that "I can do it at home."
The shoulder isn't 100% (and no one said it would be), but he can play racquetball and lift weights with it.
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Following through with the recommended PT can make all the difference with your long term result.
The operative word here is "appropriate/recommended" PT determined by someone who knows the anatomy of the joint and who also knows what surgical approach was used. If for some reason the patient doesn't trust their orthopedist its easy enough to research range of motion PT on the web. You can eliminate the more bizarre recommendations pretty quickly.
Just got a note from the neighbor who had one hip replaced Dec 1, 2017 and no walking and did not go to rehab for PT and then surgeon ordered the 2nd hip be replaced and I think that was Jan 8, 2018 or thereabouts and this time surgeon ordered PT to come to her home 3 times per week. And so her message tonight she is totally not walking and the same as she was before hip replacements...she's been on a rollater before and now still after two replacements. Says home PT will end Friday this week, and then she's approved to go out to PT at a therapy location.
I still believe the surgeon failed her by no PT help after first replacement, as he sent her home with paper instructions on what to do. The right thing, I believe, rehab was in order at a rehab facility before she got home from the first replacement. She's been thru Hail with these surgeries and no better, maybe even worse. Says she has appt with surgeon March 1. How can this surgeon sleep?
I still believe the surgeon failed her by no PT help after first replacement, as he sent her home with paper instructions on what to do. The right thing, I believe, rehab was in order at a rehab facility before she got home from the first replacement. She's been thru Hail with these surgeries and no better, maybe even worse. Says she has appt with surgeon March 1. How can this surgeon sleep?
It should go without saying that neither you, nor anyone else on this board (with the exception of bluedevilz) is qualified to judge the physician's actions in this case. You might even have some valid points regarding your neighbor, but your need to search for that "A-ha, told you so" moment that indicates a doctor did something wrong clouds your posts on this forum. Lest you think I'm being overly critical, let me add that you strike me as a good hearted person who is engaged with others around her, and that's a good thing. During your absence from the boards last year, I looked up your posting history to see where you had gone to, and was glad to see you return.
The surgeon can sleep at night because he knows bad outcomes happen, and if he doesn't find a way to mentally and emotionally deal with that reality early in his career, he would go insane. He sleeps at night knowing that he will be able to offer good outcomes and relief to the vast and overwhelming majority of his patients, and when that doesn't happen, it's usually attributable to many other factors aside from him doing something wrong. As long as for every 1 person who doesn't do well, he has many more than that coming in post op saying "Thank You", he will continue to do what he does.
Last edited by Texas Ag 93; 02-08-2018 at 06:21 AM..
If you take a look at the exercises prescribed for therapy after hip replacement, http://grpt.ca/handouts/Patient-Exer...nt-Surgery.pdf they start with simple range of motion. You really don't need assistance from a PT to do them. I can't imagine why you would need to be in a facility, or even need professional guidance to accomplish them. They go over all that at your pre-op visit and make sure you know what to do the first few days. They send you home with a paper to remind you of what to do and how often.
I can see why a doctor might put off full PT until after the second surgery. As the exercises progress, you have to be able to shift your weight to the hip that hasn't been operated on in order to exercise the one that has. If that hip is itself so bad that surgery is required in just a few weeks, I would think completing the exercises would be impossible due to pain and range of motion limitations.
More importantly, attempting to complete the exercises by putting the weight on a bad hip could cause the patient to fall. Such a fall (or an attempt to catch oneself) after recent surgery on the other hip would likely be catastrophic.
The goals for PT on a hip replacement at 6 weeks include being able to walk several blocks with a cane. It doesn't strike me as odd that a patient with double replacement needs a rollator just four weeks out. Indeed, even at 9 weeks they still want you to use support as needed to prevent limping. It isn't until you reach 12 weeks, that you should be able walk without a limp unaided. Full recovery takes one year. Of course, all of this assumes patient compliance and reasonable fitness before surgery.
The Mayo Clinic guidelines for the first followup appointment following hip replacement say "six to twelve weeks." It sounds like your friend's appointment is right in the middle of that recommendation. Keep in mind, during that time, the therapist will be sending reports to the doctor and is always free to call them or alert the patient to call the doctor if an issue arises.
Your friend sounds likes she's right on track and the doctor sounds like he's sticking to an accepted standard of care. There is no issue here.
This woman was NOT walking going into the first replacement, MORE reason I would believe to get into progressive rehab. Many older people especially have to go to rehabs as many don't have help at home...she lives alone.
I've been thru a replacement and my outcome was good considering, BUT I was also walking pretty good when I went into it all.
While in my recent staph mess and in 3 rehabs, there were many older folks going thru rehab, Medicare I believe allows for 21 days in a facility rehab. This neighbor is 79 and again has not walked for I don't know how long. I've always seen her rolling around on rollater. She expected to be walking and I certainly thought that would be the case too. I've been on a lot of replacement forums and never heard a story like the one she is reporting. And I've heard from many with a lot of complications which I live with too 7 yrs post op.
My neighbor even asked the visiting nurse "why she isn't walking" and the nurse was stymied...those were her words..she did these replacements with the goal of WALKING.
If you take a look at the exercises prescribed for therapy after hip replacement, http://grpt.ca/handouts/Patient-Exer...nt-Surgery.pdf they start with simple range of motion. You really don't need assistance from a PT to do them. I can't imagine why you would need to be in a facility, or even need professional guidance to accomplish them. They go over all that at your pre-op visit and make sure you know what to do the first few days. They send you home with a paper to remind you of what to do and how often.
I can see why a doctor might put off full PT until after the second surgery. As the exercises progress, you have to be able to shift your weight to the hip that hasn't been operated on in order to exercise the one that has. If that hip is itself so bad that surgery is required in just a few weeks, I would think completing the exercises would be impossible due to pain and range of motion limitations.
More importantly, attempting to complete the exercises by putting the weight on a bad hip could cause the patient to fall. Such a fall (or an attempt to catch oneself) after recent surgery on the other hip would likely be catastrophic.
The goals for PT on a hip replacement at 6 weeks include being able to walk several blocks with a cane. It doesn't strike me as odd that a patient with double replacement needs a rollator just four weeks out. Indeed, even at 9 weeks they still want you to use support as needed to prevent limping. It isn't until you reach 12 weeks, that you should be able walk without a limp unaided. Full recovery takes one year. Of course, all of this assumes patient compliance and reasonable fitness before surgery.
The Mayo Clinic guidelines for the first followup appointment following hip replacement say "six to twelve weeks." It sounds like your friend's appointment is right in the middle of that recommendation. Keep in mind, during that time, the therapist will be sending reports to the doctor and is always free to call them or alert the patient to call the doctor if an issue arises.
Your friend sounds likes she's right on track and the doctor sounds like he's sticking to an accepted standard of care. There is no issue here.
An obviously knowledgeable contribution to this thread...thank you!
If you take a look at the exercises prescribed for therapy after hip replacement, http://grpt.ca/handouts/Patient-Exer...nt-Surgery.pdf they start with simple range of motion. You really don't need assistance from a PT to do them. I can't imagine why you would need to be in a facility, or even need professional guidance to accomplish them. They go over all that at your pre-op visit and make sure you know what to do the first few days. They send you home with a paper to remind you of what to do and how often.
I can see why a doctor might put off full PT until after the second surgery. As the exercises progress, you have to be able to shift your weight to the hip that hasn't been operated on in order to exercise the one that has. If that hip is itself so bad that surgery is required in just a few weeks, I would think completing the exercises would be impossible due to pain and range of motion limitations.
More importantly, attempting to complete the exercises by putting the weight on a bad hip could cause the patient to fall. Such a fall (or an attempt to catch oneself) after recent surgery on the other hip would likely be catastrophic.
The goals for PT on a hip replacement at 6 weeks include being able to walk several blocks with a cane. It doesn't strike me as odd that a patient with double replacement needs a rollator just four weeks out. Indeed, even at 9 weeks they still want you to use support as needed to prevent limping. It isn't until you reach 12 weeks, that you should be able walk without a limp unaided. Full recovery takes one year. Of course, all of this assumes patient compliance and reasonable fitness before surgery.
The Mayo Clinic guidelines for the first followup appointment following hip replacement say "six to twelve weeks." It sounds like your friend's appointment is right in the middle of that recommendation. Keep in mind, during that time, the therapist will be sending reports to the doctor and is always free to call them or alert the patient to call the doctor if an issue arises.
Your friend sounds likes she's right on track and the doctor sounds like he's sticking to an accepted standard of care. There is no issue here.
You think she's on the "right track" NOT walking after 2 hips being replaced and headed to 3 months post op? Guess we'll agree to disagree on this one. All the standard care I've seen and I've had a replacement is for quite a few to get good PT therapy program.
You think she's on the "right track" NOT walking after 2 hips being replaced and headed to 3 months post op? Guess we'll agree to disagree on this one. All the standard care I've seen and I've had a replacement is for quite a few to get good PT therapy program.
In your first post, you stated that her dates of surgery were December 1 and January 19. Today is February 8. She is not "headed to three months post op." Tomorrow she will be just three weeks post op from the second surgery.
From the PT link I posted earlier:
Goals: By the end of week 3
• Move your leg in and out of bed by yourself (start with a strap)
• Move on and off a raised chair, bed and toilet without help
• Walk at home using a walker, cane or crutches
• Use the stairs safely with cane or crutches
You stated she is walking with the aid of the rollator, so your own words indicate she has met that important goal. They've released her to outside PT, so she's probably met the other goals as well.
In your first post, you stated that her dates of surgery were December 1 and January 19. Today is February 8. She is not "headed to three months post op." Tomorrow she will be just three weeks post op from the second surgery.
From the PT link I posted earlier:
Goals: By the end of week 3
• Move your leg in and out of bed by yourself (start with a strap)
• Move on and off a raised chair, bed and toilet without help
• Walk at home using a walker, cane or crutches
• Use the stairs safely with cane or crutches
You stated she is walking with the aid of the rollator, so your own words indicate she has met that important goal. They've released her to outside PT, so she's probably met the other goals as well.
Did you go thru a hip replacement?
The goal and this starts the morning after replacements, is to get the patient up and walking.
If this surgeon has "other" plans it will be very interesting to see where she is say at 6 months post op. Walking?????
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