28 December, 2013

Rehabilitation after hip replacement

Philosophy and techniques for a rapid recovery

The aim of rehabilitation after a Total Hip Replacement (THR) is for a rapid return to normal life and minimise risks of surgery. It is essential to mobilise after surgery - the sooner the better! Shay Zayontz's rehabilitation methodology complements the minimally invasive surgical techniques employed. It allows for a safe and rapid return to function.

Firstly, it is essential to understand that there is pain after surgery and that this is normal. Often, the pain can be controlled using simple, common-sense techniques.

The first, is don't overdo it. In the initial few days after surgery, you only need to be up and walking no more than 5 minutes at a time; you can then sit (e.g. for your meal) and then get back into bed and elevate your leg. Over the next few days, this can be gradually increased. When you first return home, start slowly and slowly build up, as comfortable. Whilst many people will be able to walk for 10-20 minutes within the first 2 weeks, it is not essential. If you go on long walk, make sure you have a good, long rest (2 hours) afterwards. You may also choose to "ice" the hip when resting.

You should take regular Panadol Osteo (2 tablets, three times a day); this is generally safe and well tolerated. You may also receive Naprosyn SR - this is an anti inflammatory (NSAIDS) which is taken once a day. Although labelled an anti inflammatory, it is just another pain killer - therefore, if you don't feel you need it for pain, don't take it! You will also be prescribed medication that prevents NSAIDS from causing ulcers (e.g. Nexium, Pariet, Losec etc.). You will need to take this for as long as you take Naprosyn SR.

As an extra pain killer to be taken if needed, you will be given some Endone. This is a narcotic drug with several side effects including: constipation, drowsiness, dizziness and difficulty concentrating. Being a narcotic, it can also be addictive and it LOWERS your pain threshold (making you more sensitive to pain). It often needs to be used in the first week or two after surgery, but should only be used sparingly.

In summary, the best management for pain after surgery is to rest the limb, ice it and use simple (low side effects) analgesics.

Your rehab will be guided by the physio and nurses on the ward. Walking is the most important exercise; the other exercises used are to help you achieve that. Do not be over vigorous with the exercises. It is preferable to walk in short bursts (as explained above).

It is important to be able to return to normal activities as soon as possible. In general, urinary catheters are not used; if used, they are removed within 3 hours of surgery. (This minimises infection as well as reducing other complications of urinary catheters.) You will be expected to walk to the toilet after that - no bottles or bed pans.

The day after surgery, you should have a shower in the morning and then dress in normal DAYTIME clothes - no hospital gowns, pyjamas, dressing gowns etc. If you normally wear make up or jewellery, you should wear that as well. The nurses will help you.

All meals should be eaten sitting in a chair. You should not have any meals (including morning and afternoon tea) whilst in bed. The nursing staff will help you with getting in and out of bed.

The above techniques will allow you achieve independence quickly, making you more confident when you go home. As a patient, you are in control; your recovery is dependent on what you put into it.


Posted by Shay Zayontz



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