Our Head of Business Operations, Jon Keating, is recovering from a hip replacement operation that took place between Christmas and new year.
Having declared himself his very own case study, Jon’s been chronicling his journey from his very first consultation to the time of writing.
Now, three months into his rehab, he has written this third blog contemplating how much more our sector could do to support people on a similar journey. Prehab4Surgery anyone?
As a sector specialising in physical activity – can we do more to help people prepare for surgery? Yes 100%. I’ve mentioned it before, but helping pre-surgery patients lose some weight (only if they need to do, of course), will help with mobility on crutches and not make climbing the stairs or taking a little walk feel like a marathon.
Encouraging and helping people to build upper body strength, certainly for the first week post-surgery, has to be critical too. When you’re on crutches you’re using your upper body for almost every movement, so the stronger we can help patients become, the better. Finally, flexibility, core strength and balance have been key post-surgery. I’m so pleased I did a lot of Pilates, among other things, in the build up to surgery (thanks to Life Leisure Cheadle and Tatton House Studio) – again important areas that we could promote more for pre-op patients.
Part of the Greater Manchester Combined Authority Live Well policy is proactive care. Hip and knee replacements are commonplace these days and the examples I’ve cited above really demonstrate the opportunities we have to help pre-op patients with proactive care. So, we need to forge those connections with hospitals and their waiting lists even more and be that extra support network to help individuals be ready for surgery as much as we can.
Here’s a thought. I waited around three months from initial surgeon consultation to surgery date (I know I’ve been lucky in that respect). Whilst I do have gym membership, if I didn’t, could there be an opportunity – much like Prehab4 Cancer – to give membership to those waiting for surgery? Discuss!
How to fund memberships would be open to debate, I know. But I look at all the kit I have been given – crutches, grabbers, sock applicators, raised toilet seats and more, and realise this is easily worth a few hundred pounds. A six-month membership for people waiting for hip or knee surgery would make such a huge difference.
Here’s how it could work:
Membership for three- or four-months pre-surgery. Freezing membership for a month when the op takes place, then two- or three-months post-surgery for rehab.
This would truly be proactive care, helping our health colleagues and more importantly supporting the individuals to regain an active lifestyle and return to normal life, pain free, sooner rather than later.
A big part of our role is to create behaviour change, and maybe such an offer would create this for those that could and would be willing to benefit from it. (And that’s another challenge, I know!)
Having been given the green light to forge ahead with my rehab, that’s where my efforts and energy have been focused. Sometimes I admit pushing way too much.
Despite staying as active as I’ve been able to, I’ve still managed to gain around 6kg (that’s nearly a stone in old money) in weight. I’ve actually managed to wear through the feet of my crutches and needed replacements. As a Man United fan (not something I should shout about too much at this time) I went for some red ones!
As an avid, former competitive swimmer, getting back in the pool has been amazing. I did one session of hydrotherapy as an NHS patient, (it comes as standard for private patients). My physio recommended that going to one session to be taught the exercises would be of huge benefit. It certainly was, but £67 for the privilege? Definitely, my most expensive swim ever!
I’ve since continued to get into the small pool sessions at Cheadle and Hazel Grove (not quite the warmth of a true hydro pool), but beneficial, nonetheless. But my real point here is that if we are in a space of breaking down inequalities, £67 for a hydro pool session doesn’t sit comfortably with me.
Those that can afford it recover and rehab more quickly. But we need to be working more collaboratively with colleagues in health care to inform people of the sessions at Cheadle, Hazel Grove and many other venues across GM that are more affordable – around £5 rather than £67. I will caveat that, however, and add that it would be without qualified physios supporting you.
I was around four weeks into my recovery when I started feeling OK to start walking crutch-free around the house. I have a Garmin watch and for those that are familiar with them, my Garmin badges have really helped to motivate me. Time to walk (15 hours in a month), Active Month (20 x 20 minutes), Monthly Gains (4 hours of strength training), which kept me up with my physio exercises. However, during one of our sessions my physio told me I needed to get a ‘bit braver’, I was too reliant on the crutches – hence the replacement feet, no doubt!
It is of course, a mental thing; the hip is strong enough to fully weight bear from day one. Trusting the new hip to be able to do that is another matter for the little chimps inside my head stopping me from believing it. That’s why the pool sessions were so positive. The competitive nature in my own head has meant I continue to ask the physio whether I’m ahead or behind in terms of rehab. It’s always nice to hear ‘you’re definitely ahead’. The Garmin insights have been horrible to read. My Vo2 max has plummeted by 10, my resting heart has increased, weight gain, poor sleep, and de-training! But the positive is I’m back exercising now. In the last few days, I’ve managed a 2k swim and 20 minutes on the exercise bike.
But a big one for me has been getting back to rugby coaching, just being out again and supporting the development of a great bunch of lads. That’s been hugely rewarding from a social and mental health perspective. I have made some mistakes along the way, I took a trip to the pub to watch the 6 Nations Rugby Union for the day. Bad mistake and I suffered for it the following day (and I don’t just mean with a headache!)
By pushing too hard I gave myself what can only be described as a feeling of a really bad groin strain. At the time of writing, I’m due to return to the physio, where I hope to be given the green light to do more and hopefully be able to tie up my own shoelaces again!
I guess this is where the real work begins. Losing weight, regaining fitness and being able to do a tumble turn whilst swimming again. Let the journey begin!
But in the meantime, a huge thank you for all those that have helped me through this journey and the support given by my employers. A special mention to my partner, Emily, for her patience throughout! I’m not the easiest patient to deal with. Thank you.
If you’re about to embark on a journey of this kind, or you know someone who is, I can only say it does get better quickly. But there is so much you can do to prepare.
As I said earlier, physically, lose weight, build upper body and core strength, and build up your cardiovascular fitness too.
Practically, get the home ready. Place all those things you need above waist height, do some batch cooking and freeze some. Where possible, create a support network and if you don’t have one be honest about that with health care professionals. Get some Skechers slip-ins!
Post surgery, think about having some books to read, or other interests to keep you busy (like writing a blog 😊). Look at what’s available locally to support your rehab – pools sessions, local walking groups etc. Most importantly stick with the rehab, do the exercises and get walking as soon as possible.
Finally, I have expressed to my physio that I’d like to get running again, something I didn’t think was going to be possible. But looks like it will, so I’ve been encouraged to download the couch to 5k app.
I can’t use it yet, but I can’t wait until the day dawns that I can.
