clichay

Hello! I'm not a nurse but the wife of a hip joint replacement patient (3 years ago, actually). I was going to suggest using your seat, as well, but the reason I'm replying is to suggest that you have a look at a site called Hip Universe Support Group. http://groups.msn.com/hipuniversesupportgroup/welcome1.msnw To post a question, you will have to get yourself a Hotmail account then apply to join but all you have to say is that you will be having the hip surgery and have questions. There have been quite a few members recently who have had PAOs or other hip surgeries other than straight THRs and they might have helpful info for you. I might add that I have been a member for 2 and a half years and I think it is a good group.

For the Americans here, we do not have socialized medicine in Canada. That would mean that the government owned and operated the medical system. It doesn't. We have a single payer system and that payer is the government and the money comes from our income taxes. Most doctors are in private practice, singly or in groups; the rest are employed by clinics or hospitals. Hospitals are nearly all non-profit corporations. Non-hospital medical labs are privately owned. Physiotherapy clinics may be private or hospital based. Nursing homes are usually privately operated, but some are municipal. We all have a health card which is presented when we require care and the bill is sent to the provincial insurer, which here in Ontario is the Ontario Health Insurance Plan (OHIP). OHIP does have set amount for services and that it what it pays but then so do your HMOs. The plan covers all medically necessary services, part of long term care in a nursing home, drugs for hospital patients, seniors and those with very high drug costs and some medical devices . As for the cost, as I mentioned above, it comes out of taxes. I think the latest known cost for the whole country is about $2,800 per person. The $300 amount mentioned in an earlier post is a special "health" tax. The Ontario government had promised during an election campaign not to raise the income tax but found, once it was in office, that it was going to run a large deficit. Since it had promised not to it couldn't raise the income tax rates so it instituted the "health'' tax instead. Same difference!

There was a series called "Nurse" about 25 years ago, starring Michael Learned who had played the mother in "The Waltons". The series and the star were both excellent; in fact she won an Emmy for it. Unfortunately, it seems that the series was too intelligent because it was cancelled after a year.

One does not need to recline when sitting after a hip joint replacement, one needs to keep the knees lower than the hip. The easiest way to do that is to sit in a chair high enough that the knee naturally falls below the hip. The seats of chairs can be raised with padding and cushions, or the whole chair can be raised on a platform. And chairs should have arms to make it easier to stand up without bending forward which is how most of us get out of a chair. Recliners can be used quite safely if it is high enough or can be put on a platform AND if there is a mechanism for raising the back and lowering the leg rest without using the body; a few members of our support group have slept in their recliners because it was the only was they could get comfortable. It would be wonderful if you, or your hospitals, supplied the URLs of some useful web sites for those of your patients who use the Internet or who have relatives who do, and not only post-op but pre-op too. I have been appalled at the number of people who come to our support group without adequate information. I hope that I am not violating any rules in giving you the following URLs. http://groups.msn.com/hipuniversesupportgroup/welcome1.msnw (This is the support group in which I participate. Anyone can read it but you have to join to post) http://www.totaljoints.info/total_joint_home_page.htm (This is a Swedish site in somewhat quirky English run by a retired orthopedist) http://hipuniverse.homestead.com/ (This is the Mother Ship, as they put it, which is the permanent repository of helpful information for the support group) http://www.activejoints.com/ (run by a hip joint replacement patient) http://members.tripod.com/totallyhip1/index1.htm (general information run by a "hippie" - also includes a support group component) There are also support groups for resurfacing patients and those who have developmental hip dysplasia but I don't know the URLs. And thank you, Cheerfuldoer, my husband had an uneventful recovery from his surgery after a somewhat rocky start (he had muscle spasms which restricted his walking for a couple of days). He also had restrictions for 12 weeks instead of 6 weeks which I confess got a little frayed toward the end but he was driving by 5 weeks.

I went to the trouble of registering so I could reply to this post but I am not a nurse. My husband had a hip replacement a year ago and I am an active participant in 2 hip joint replacement support groups. Patients may be restricted to about 70 degrees for a couple of days but move to 90 degrees thereafter. Usually the 90 degree restriction lasts from 6 to 12 weeks; for my husband it was 12 weeks because he was older. There are 2 other restrictions as well. First, do not twist the body - move the whole body instead. Second, do not cross the operated leg over the center line of the body - no leg crossing at ankle or knee, even if you could. Also, if the femoral component is uncemented, there may be limited weight bearing for about 6 weeks although many surgeons are confident enough to allow immediate weight bearing. If it is cemented, usually weight bearing is allowed immediately, or as tolerated (code for "if it doesn't hurt too much"). A personal comment. Many THJ replacement patients live alone or a alone for much of the day; too much limitation is impractical and will probably be ignored. And the restrictions get rather tattered toward the end of 12 weeks.