Episode 59 Transcript
Welcome back to The Hip Replacement Podcast. In the last episode, we talked about travel long after a hip replacement surgery, like years later. So, for example, like me, I'm more than 12 years past one surgery and 11 years past another surgery, and we were talking about that situation. So, I still have some things I need to address long after a hip replacement, like stiffness from sitting too long. making sure I stay hydrated, in increasing my activity when I'm done traveling so I can get back to where I was before I started traveling because stiffness sets in even years later. The hip replacement is the gift that keeps on giving years and years later. That's something they don't tell people when they're getting a hip replacement surgery.
But anyway, today we're going to talk about travel soon after a hip replacement surgery. So, not the situation where it's a year, 5 years, 10 years later, but where it's a day, a few days, a week, maybe a month. So, soon after hip replacement surgery. Not sure why people would want to do that, but they still do it. So, we're going to talk about it because it's an issue. Some people have to travel. Some people want to travel. So let's talk about that. And again, I'm talking about a few days, maybe a few weeks, maybe even a month after surgery.
And the big question, the high-level question is, should you be doing this at all? Should you be going at all wherever you're going to go? And there's a broad spectrum of approaches. All right. On one side, people may take the approach of, well, it's my life. I'm gonna live it the way I want to and I'm gonna go down in a blaze of glory doing whatever I want to do. That's on one side of the spectrum. But on the other side of the spectrum, there are people who are just going to follow the doctor's instructions. They're going to be conservative and they're going to focus on their long-term recovery and they're going to put off everything they have to put off so that they can have recovery and to do the things that they want to do later.
And only you can decide where you are on the spectrum. Okay? There's opposing sides, opposing viewpoints. Maybe you're on one side or the other. Maybe you're in the middle. Only you can decide that. But with the surgery comes the risk. I'm sure your surgeon talked about the risks or someone in their organization talked about the risks with you. But those risks don't stop when the surgery's done.
All right? So, you got to consider these things. I believe the best approach is to mitigate the risk as much as possible. When you're recovering, you're in a familiar environment, maybe like your home. You can control the movements. You can go at your speed. You know where everything is. There's no outside influences, no strangers, no distractions. You can stay on your schedule and your medical team is nearby. All of those things are important to your recovery. When you travel shortly after the recovery, all that stuff goes out the window.
But again, you might have a good reason to travel. It's important to talk about your risk tolerance because in order to be on the same page, we need to address risk tolerance. Yeah. Risk tolerance. So, if we're going to have a conversation about something that involves risk, like traveling after a hip replacement surgery or whatever it is, you have to understand what your risk tolerance is and what the other person's risk tolerance is. Because if you're asking someone if they would do this or if you're asking for someone for their advice, someone like your surgeon or a friend or a family member, it's important to understand their perspective on things. And that perspective is really their risk tolerance.
So let me give you my risk tolerance regarding physical health and the possibility of physical harm. So we have some perspective, so we have a gauge. Okay? So on a scale of one to 10 with one being not risky and 10 being very risky, I live my life generally somewhere between the four and the six range. I'm pretty conservative, but I do take small risks if the payout is big. I prefer not to take too much risk though. I plan for the long term rather than like some immediate short-term thrill. That's just the way I do it. It's not right for everybody. I have great friends who are great risktakers that I'd love to pay attention to and watch and hear what they're doing because it's very exciting, but it's not for me.
So, just to gauge this, let me give you some examples of where different activities would fall. So, skydiving 10 out of 10 on the risk scale. Bull riding nine out of 10. Driving a motorcycle eight or nine out of 10. Scuba diving with sharks, eight or nine out of 10, maybe a ten.
All these things I probably wouldn't do.
But on the other end, some things that are low on the risk scale, going for a walk, two, maybe riding a bike, maybe a four or five, depending upon how fast you're riding or where you're riding. Water slides, three or four. Ice skating, five or a six. You kind of get it. Riskier activities are higher on the risk scale. Lower risk activities are lower on the risk scale. This is my scale. You may have a different scale.
For example, you may say, you may think that motorcycle riding is a two. Fine. Not a problem. Everyone's going to have their own. But this is mine. I'm just sharing with you so that we can have a conversation and you know where I'm coming from. I'm not saying that these risky activities are bad. I'm just gauging my perspective. I think all of these activities are awesome. I really do. I wish I had the gall to go and do more of them. But I'm thinking long term. I want another 50 years of great life and I don't want to have to worry about an injury because I wanted to spike up my excitement for an hour or so. Okay, that's just who I am.
Maybe you're a little bit different. I'm simply not going to do some of those activities. And there's nothing wrong with that. You may love those activities. Some people say taking risks is really about living their life to the fullest. And I agree with that for sure.
But there's other ways to do that. For example, I would go and do an endurance event to push myself to push my body's limits farther than it's been before. That's how I experience living my life to the fullest rather than maybe taking a lifechanging or a life-ending decision or activity. All right, that's the way I look at it. I'd rather push myself than risk my life. Okay, you may do it differently. Doesn't matter. To each their own. Everyone's going to do it a little bit differently. But consider the size of the risk.
If you fall or dislocate the hip, you put yourself months behind in your recovery. You risk infection, other health issues, having to go through another surgery. So, these are all things to consider if you're going to travel shortly after surgery and you're taken out of your normal environment away from your surgeon. What if you're far from home or wherever your surgeon is and you fall and somehow damage your hip because it was brand new and the bone was not healed yet, you're probably not going to be able to go back to your surgeon for a repair. You're not going to be able to go back to that same surgeon who originally did your hip because they're far away and you may need something now.
You can't get on their schedule. They're far away. They may have a packed schedule. They may be on vacation. It may be the weekend. Whatever it is, if you need an immediate repair to that hip, you may get whatever surgeon is available on that day in that hospital or that emergency room. That to me seems a little too uncertain and something I don't want to have to face. Again, I'm facing that every day now, but that risk is so small because I'm so far out from surgery. The bones healed. Okay. What I'm talking about is it's so soon after surgery that the risk is high that something could go wrong.
And if you're out of your normal environment, that brings a whole lot more uncertainty into the equation. So, regarding travel soon after a hip replacement, some people have a decision to make because maybe there's an event coming up or some trip that's coming up that can't be moved.
Maybe it's a trip with friends. Maybe it's a wedding, a graduation, a business event. Like I said, some type of vacation with friends that's been on the schedule for a long time. People have all kinds of reasons to travel. So, we're not going to debate the reasons to travel, okay? Some reasons may be good, some reasons may be bad. We're not judging here. It doesn't matter. What we're talking about here is you're going to travel, what do you do about it?
But if it's any of these things and you have the possibility to do something different, maybe consider either one of two things. Delaying the surgery or delaying the event. But some events, like I said, can't be delayed. An anniversary, a wedding, unless it's your wedding. So maybe push that surgery back a week or two if you can.
But if you have to travel, again, the reason doesn't matter. If you absolutely positively have to travel, then here's 10 things to consider. But before we get into these 10 things, it's make sure you get with your surgeon and get his or her thoughts and recommendations for your travel. The exact timing and precautions definitely should come from your surgeon because the recommendations would vary based on the surgical approach, your health or your physical condition, your recovery progress, timing of the trip, how soon after your surgery, length of the trip, and what exactly does the trip entail. Is it a four-hour drive or is it an eight hour plane ride and then a 21-day cruise where you're on and off the boat on smaller boats? Those are different.
All right. So, traveling shortly after a hip replacement is much more complicated because you're combining a lot of factors. A lot of people will play it down and the doctors will tell you'll be fine and you may read on social media that you'll do fine, you'll do great. It was easy for me. Okay, maybe not. So, you're combining recent major surgery, your limited mobility, and probably prolonged sitting if we're talking about travel.
Okay, 10 things to consider. Number one, whether you should be traveling at all. This is the first question. It's not how do I make the trip more comfortable. It's has my surgeon cleared me to take this trip. Does the surgeon think it's okay to take this trip? But again, you really have to understand the risk tolerance to have a clear understanding of where they're coming from. How important or necessary is this trip? Can you delay it? Is there any way to not go to change something about it? Change your surgery date or change your trip date? And also, can you physically do it? What's this trip all about? Are you going to be cramped up in an airplane for four or eight hours or something worse?
So, consider not how to take the trip, but whether you should be taking the trip at all. Often we want to rationalize our decisions. Say it won't be that bad. I'll be okay. I'll take my medications.
But if you just had your surgery, odds are that you had this trip planned before the surgery and you're not going to understand the condition your body is going to be in until it's too late. And that trip is only a day or two away. So, if you're planning before your surgery that you're going to go on this trip a week later, maybe pause a little bit and take that trip before the surgery or push it out. Do yourself a favor. Yeah, maybe the timing of the trip could be moved or the surgery changed. I would seriously consider those because you may come out of surgery and feel moderately okay for a few days because they give you some pretty strong drugs during surgery and then that stuff wears off and then you're taking whatever medication they prescribe to you which may not work as well. There may be lapses. There may be some times where the pain medication is not working as well because it's not kicked in yet. You may forget to take it. You may get busy. So be careful with that.
Consider whether or not you should be taking that trip at all and push it out or push the surgery out if possible. Number two, consider the increased risk of blood clots, recent surgery, and long periods of immobility of not moving up and not getting around, not moving your body. These are both risk factors for vein issues, for deep vein issues, and that makes blood clots a very serious travel concern. So be careful if you're not as mobile as you should be. Be very careful. Really consider this trip.
You may need to walk regularly. Perform your ankle pumps, your whatever exercises they gave you at the surgery center or hospital just to keep your blood flowing. Remember to stay hydrated and continue taking whatever medication, maybe blood thinning medication that the doctors gave you exactly as directed. It's easy to get distracted when you're traveling and get off schedule, but you've got to stay on schedule with any medication that they give you. And maybe there's the possibility of wearing compression stockings. I know a lot of people wear them after hip replacement surgery. I wore them for several weeks after my surgery. They went all the way up to my hips. They were very sexy, I might add. So, consider wearing those.
If your surgeon told you to wear those, yeah, on the trip, put some pants over them, and maybe some additional medication. But make sure you have this discussion with your doctor about the medication, the stockings, the compression stockings, or anything else regarding the trip.
Next one. Protecting. What about protecting the hip during sitting, turning, or transfers as you're moving and shifting around. Maybe you're getting into a low car. I found that difficult. Maybe you're squeezing into an airplane row or twisting while standing. And that can place um a lot of strain because you're in an awkward position on the plane. If you have your private plane, that would probably be easier to travel. But if you don't have your private plane, like most of us, and you have to get on a commercial airline, sometimes we put ourselves in compromising positions by having to get out of the row or when we're getting into the row, having to move around people. those put a lot of stress on the muscles in the legs and the hips and the back. So, you have to be very careful with that.
And depending on the surgical approach and the surgeon's instructions, you may still have serious restrictions involving deep hip flexes or movements, crossing your legs, pivoting or rotating on the operated leg. And even if you pivot on the non-operated leg, you're leaving that other leg behind. You're leaving your surgery leg possibly in a compromised position. So consider the movements that you would normally make. And if you're distracted by the travel, you may put yourself in more risk than you would normally think you're in. The danger may not just be sitting itself. Okay, you may be able to sit there just fine, but when you're distracted by the travel, maybe you're rushed, you're twisting, you're doing some movements you don't normally do. Those may cause issues for you. I think it's a little risky.
What about swelling? Number four, what about the swelling and pain during the journey or the travel or the trip? That operated leg may swell a lot when it hangs down for several hours. So, if you're sitting in a chair, you may have a lot of swelling. If you're not able to elevate the leg, you're going to have swelling. And the pain and that stiffness and the heaviness can also increase because the hip remains in one position or a very similar position. Do the best you can with scheduling movement breaks. I mean, set a watch maybe and move every 15 or 20 or 30 minutes. Do your best to make sure you have adequate leg room. If you're getting on a flight, now is the perfect time to pay extra to get extra leg room. Now is not the time to go cheap. Get all the leg room that you can get.
You definitely when you get to wherever you're going. And if you can, even while you're traveling, maybe you want to ice your hip and your leg after you get there. Maybe if you can while you're traveling. And definitely schedule some time to elevate the leg because you want to get rid of as much of that inflammation as possible. And if you're driving, just know that the road trip may need to take a lot longer than normal or a lot longer than anticipated because you're going to have to stop. It's best if you stop and get out, I don't know, every 30 minutes, every hour so that you can move around and not be so stagnant. get your blood flowing a little bit.
So, these should be scheduled stops for as part of your recovery plan and not just like optional sightseeing breaks. All right? Or just restroom breaks. You should be getting up more than whenever you would need to use the restroom.
Number five, wound care and infection concerns. During the first few weeks, that incision is still healing. It's not closed up yet. You should consider whether the wound is closed and dry, whether the dressing or the bandage needs to be changed, and whether appropriate supplies are available during your trip. Do you have extra? Should you be changing that? I had a bandage or a dressing for two weeks after my surgeries and then the incision took six weeks to heal and I will tell you there was no way I was going anywhere without that being sealed. I guess if there was an emergency I would have gone somewhere but barring that I wasn't going to take an optional trip with that incision not being fully healed yet.
Number six, medication timing and actual transportation. You got to watch stay on top of your medications. Make before you leave to go on your trip, make sure the medications actually work for you, that you have plenty of them, and that you know how to get more if necessary. After my first surgery, I stayed in the hospital one night. I came home and about 10 o'clock at night, I took the medication exactly as prescribed. But about 10 o'clock at night, I was in agonizing pain and I was taking a medication, but it simply wasn't working for me. That medication was not working for me. So, we called the surgeon's number and another doctor called us back and got us another prescription. And my wife ran out in the middle of the night to get the different drug, the different painkiller that actually worked.
And it was probably two or three in the morning before my pain calmed down and I was able to go to sleep. And that worked because I was at home and the pharmacy was just a few miles away that was open all night long. If you're traveling, you may not have that situation. So, make sure you have the pain medication that actually works for you and that you take it and that you have plenty of it and know how to get more. Oh, and also a simple thing, make sure it's accessible rather than buried in your checked bag or under four or five suitcases in the back of a vehicle. Make sure you can actually access the pain medication.
Consider whether or not that same pain medication that you rely on could cause drowsiness or constipation or dizziness, diarrhea, nausea during your trip because nausea in a car or diarrhea on a plane don't sound that fun. And trying to get up in a hurry to make it to the restroom from a tight spot when you have very low mobility is going to be difficult and you may do more harm than good.
Number seven, what about mobility aids or walking assistance devices and that luggage that you have to take with you? If you're soon after surgery, you probably should be using some type of walking assistance device like a walker or cane or crutches. And if you should be using them, you should be using them. Even if you feel self-conscious in an airport or at a rest stop if you're getting out of the car to go use the restroom or something like that, we may feel too proud or too embarrassed to use those things and rationalize that we don't need them for such a short walk.
But if your surgery was pretty recent, weeks, months, that bone is still healing. So, you're putting all that pressure and movement on a bone that's not healed, and you might be stiff from sitting a while. So, this is kind of a recipe for disaster. And also consider being on uneven or unfamiliar surfaces or pavement or moving walkways or escalators or crowded aisles. Somebody could bump you or you bump into somebody. There's a lot of times when we travel where we need to be mobile like in an airport. Have you seen some of the sizes of these airports?
Some of the walks might be a lot longer than you expect. And if you don't have that walking assistance device with you may get into that walk and realize that you're in trouble because you have a lot longer to go and the pain just hit you. So, it's not the time to be proud. It's not the time to be embarrassed. It's the time to do what's best for your body and for your recovery. So, use the walking assistance device. All right? Better yet, use the airport wheelchair assistance if it's available. They'll wheel you around wherever you need to go. It may take some patience to wait for them, but it may be well worth your time.
And also watch out for your bags. If you're carrying, you're not carrying anything at this point, but if you have luggage that you're bringing with you, whether you're dragging it, be careful dragging that stuff behind you. All right? because you're doing kind of a twisting motion while you're trying to stay balanced, while you're trying not to limp, while you're trying to make progress. So, several things to consider, the suitcases, the long distances, your mobility in airports or train stations or cruise ship terminals.
Number eight, a lot of times we don't consider this beforehand, but fatigue can really sneak up on you and you may have limited access to help. Early recovery can be absolutely exhausting. So before your surgery, you may be in pain, but you may still have a lot of energy. After surgery, you may be wiped out for days, weeks, maybe even months. So, if you're planning something big, a big trip, you have to take that into consideration that you might not have the energy to actually go and enjoy or get by how you think it's going to go because you simply may be wiped out. Movements or your mobility that seemed kind of manageable before the surgery may be like absolutely overwhelming after the surgery. Especially after several hours of sitting or walking or standing in lines or navigating unfamiliar areas trying to find restrooms, trying to find a place to eat, a place to sit.
Also consider who's available to help. Who's going with you? And are they going to be able to take care of themselves and you? Their luggage and your luggage, their food and your food, their medications and your medications, their whatever and your whatever. So, you definitely need somebody with you to handle all of these things and also unexpected issues or problems that come up. You're basically going to need an assistant.
Also, you need to be aware of where you could possibly get medical help at your destination and carry information about your new hip with you. I have a card, like a little card, like a little business card that goes inside my wallet. I have one for each of my hips and I carry that around. I've never had to pull it out and use it for anything, but I still have it. So, make sure you have something on you that you can reference or give to somebody so that they understand what's going on.
Also, consider, I didn't put this down as a specific issue here, but consider where you're going. If you're going far, do they speak the same language as you? How would you communicate with somebody if you're going somewhere and they don't speak the same language or they're low staff? Is it a holiday season? Maybe they don't have the resources, the doctors, the surgical people to help you if you really need help and you're going to be laid up somewhere. So consider the remoteness of where you're going.
Number nine, what are you going to do when you get there? What's the plan? Are you going to be sitting around? Are you going to be walking? Will you have access to ice? Will you be able to continue with your physical therapy exercises when you're actually there? Will you be able to maintain your schedule? or is it gonna be go try to do different things and you're putting a lot of stress on your body just by itself because you're doing a lot of things never mind your new hip or will you be able to take time to take care of your hip and maybe it's just a short trip maybe it's just a 4-hour drive and you're coming home that's easy but if you're getting on a plane or you're going somewhere and you got bags and you're being in a hotel that's a different kind of trip that's a different kind of travel a lot more risk in that situation.
Number 10, what kind of travel is it? Will it be difficult to maneuver? Is there going to be tight spaces? Are the restrooms going to be small? I don't know about you, I'm not that big of a guy, but I have noticed that over the last 10, 20 years, the restrooms on airplanes have gotten much smaller. I would not want to have mobility issues trying to use a restroom on an airplane. So that is something to consider whether or not you should even get on the plane depending upon how long it is.
Is the travel going to be difficult? Are you able to relax? Can you elevate your leg? If you're sitting on a plane, there's nowhere to elevate your leg unless you buy an expensive ticket, which is always an option, which maybe in this case, if you don't normally fly business class or first class, maybe this is the time to do it. That way, you can elevate a lot better.
A lot of things to consider when travel soon after a hip replacement. And we just went over 10 things, but this could be a very long conversation. A long trip after a hip replacement is not just about the transportation itself, not about the time it takes to get there. You're taking your ability to recover with you. So this day or this week or this two week travel period where you're going to be gone away from your normal environment, those are weeks where you could be getting a lot done, which even includes being patient. You could get a lot done with physical therapy exercises that you may not be able to do while you're on your trip or you may simply not do because you're busy or tired or you just can't work it in.
So, you need to be taking your ability to recover with you so you don't set yourself behind so you don't cause yourself any unnecessary pain or hardship. Everything that you would need to help you should go with you. All your medications, if you're using anything for physical therapy, if you're having any guidance, take that with you. If you can't do that, if you cannot continue with your recovery while you're on your trip, maybe consider delaying the trip or doing the trip before your surgery.
So, I recommend considering these things and then minimum travel for as long as possible, maybe even several months, 3 to 6 months if possible. No flights, no trains, no boats, no car rides, or car rides when necessary, but nothing with distance. Like it's not the time to drive 10 12 hours. Everyone has to make their own decision.
But in that short period after surgery, that is the time your body needs to rest and recover. And putting undue stress on it by travel, by changing environments, by doing a lot of different unnecessary movements may not be the best for your long-term recovery. And maybe a good approach is this. Travel or move a distance in an emergency situation only. Like when your life is in danger, things like hurricanes or fires or floods. Everything else is really voluntary, isn't it? And if it's voluntary, you control it before you actually go on it. You can control the timing of that.
You can control if you go or not. You have more control over your recovery than you think you do. And maybe delaying the trip or going on it earlier is part of the recovery. It may be important to you to go on this trip or attend this event, but really consider if attending the event is worth your long-term health, your mobility, and your recovery from this major surgery. Limited travel immediately after surgery. Talk with your surgeon. Get their input.
But if you do have to go, mitigate as much as you possibly can so that you can still be in recovery mode. It may not be the best recovery mode that you can be in, but it'll still be some type of recovery mode. Again, if possible, take that vacation before the surgery or push the surgery farther out or the vacation farther out so you can have less pain and take less risk on the trip. And if you're on a trip with less pain and less risk, you'll enjoy it a lot more. You may have all the reasons in the world to travel, but consider if those reasons are worth the risk and worth your recovery. Timing could be everything. One or two weeks after surgery is much different than six months after surgery. You may enjoy the experience more. You may take less risk. You may have a better recovery long term. A lot of things to consider before taking that trip, that voluntary trip, that optional trip within a few days, weeks, or even just a few months after your surgery. I hope this was helpful.
Thanks so much for tuning in to The Hip Replacement Podcast, and until next time, I wish you the best recovery possible. Take care.
