Medical & HealthNews and debate about medical and health issues as they relate to aircrews and aviation. Any information gleaned from this forum MUST be backed up by consulting your state-registered health professional or AME.
I'm up for one of these soon, degenerative osteoarthritis from years of leg length discrepancy from an accident 35 years ago. Getting to the point where I can't walk without a lot of pain and am off to buy a cane tomorrow.
Been putting it off as long as I can but can't go on like this as it hurts even at rest now and pain killers are making no difference, cartilage nearly all gone at last x-ray. Keeping as fit as I can with swimming and cycling which don't hurt much, but have had to give up karate which was keeping me strong and flexible and forcing me not to favour the "good" leg but can't even get through the warm-ups now.
I looked at getting a hip resurfacing done my surgeon has advised against it in my case.
As a self employed instructor I need to get back to work soon as I can.
Surgeon says minimum 6 weeks before driving and flying which is going to be a huge financial hit as well as very very boring.
Anyone else had this done, is six weeks realistic? My GP advises even longer...!
Some seem to walk out the door post op and others struggle for a bit. Think it depends on how much muscle you have lost. Which implant you get and what they use to fix it there are different methods of gluing, strapping and pinning. They each have different characteristics and it could very well be that the most aggressive one which will take the most time to recover from will give you most life out of the joint and will also allow for a second one when it wears out.
Thats from an ex engineer that used to dable in bio engineering so in the grand scale of things pretty clueless.
The biggest thing in the Uk is to get them out the door ASAP to reduce the chance of secondary infections it appeared to me.
I had to have this op 2 years ago. Like you, I struggled on for years in pain - although I bought the cane sooner!
I think I was advised that about 6 weeks was required before driving etc, but I seem to recall that I was actually behind the wheel before that. What the legal requirements are for your flying situation are, I suggest, worth investigating (as a retired ATCO I didn't have that problem). What made a big difference in my case was the support I received from the local health service. They provided me with advice & a comprehensive exercise plan which proved invaluable (I've still got it, might be able to scan it for you if necessary). My sister had the operation at about the same time (with a different health authority) and received nothing like that. A friend of ours had the op in the USA and was shown the door with no advice.
The operation (my first, after a lifetime of near perfect health) was no problem. Afterwards, I attacked the problem of walking again with a determination which is unusual for me. As soon as I was on my feet I was doing the exercises - rather tedious for someone as unathletic as me, but worth it. I can only say, go for it - the pain relief is magical. BUT, do check what type of replacement they are proposing. Mine was ceramic. There are a lot of problems surfacing with metal ones...
You might be required to notify both your equivalent of the driver's licence department and almost certainly your CAA since you will be hospitalised. I suspect your CAA will then class you temporarily unfit. Your AME will notice the scarring at your next medical so you can't very well fudge the thing. You should expect to be in hospital for ten days and in bed for four ie: a bedpan job although the physiotherapists may briefly have you up on a zimmer frame on day one and daily thereafter. Six weeks would, in my experience, be a minimum. If you start getting into cars and climbing into aircraft, you run the serious risk of dislocating your hip. That is extremely painful, will require an ambulance job to hospital and will probably put you back to square one. I don't think your own body is going to want to let you do that. You are likely to need raised toilet seats and if you live in a house with stairs, you'll probably have to go up them on hands and knees for a while. If you give it time you are very likely to be able to get back to karate but if you don't sleep with a pillow between your legs for a month or whatever your surgeon tells you to do, you may regret matters mightily. It's major surgery and recovery should be treated with respect. You will have to learn how to walk all over again. Practice balance exercises with a frame once you get strong enough in the operated hip. Your goal should be to eventually balance on one foot for a minute. I have no medical qualifications but have been to Birmingham. Good luck-it will come right if you work at it and respect your limitations - like instructing?
Hi Clare, My wife went through this four years ago, she had a double hip replacement and regained her medical 10-11 weeks later if I recall correctly. The uk caa advised 12 weeks prior to the op. Good luck with yours and hope your recovery is equally speedy.
As I remember, one of the reasons for the length of recuperation time is that you mustn't be in a position where your bottom is below you knees for some weeks after the operation. This is why you might need raised toilet seats, special cushions on an armchair and no driving position possibilities. I would have thought that your hospital or surgeon would have given you a proper fact sheet print out with all of his sort of information on it. I used a metal bar stool in the walk in shower. If you only have a bathtub shower you might want to have a look at medical supply shops to see what's available to help you wash. Your NHS equivalent might fund the rental of this post operative care equipment. Would you get paid for sitting on a bar stool briefing students?
There wouldn't be any students or any business at all if I have to take more than a month off, I will have no choice but to close down. When you are the boss there are no such thngs as sick pay and there are no people who can fill in my job as CFI witout a fortune being spent on CASA approvals.
Living in the sticks with a husband away more than he is home and a set of boisterous dogs, it really looks like this op will be impossible for me and I'll just have to struggle through. If I can't drive I can't get to hospital or wherever you have to go for physio etc.
I was never told any of these horror stories by my GP, my sports doc, physio, podiatrist or the surgeon, that I would basically be a helpless invalid for months. As someone who has never been able to ask for help and who has always been very fit, strong and active I think the effect on my mental health being stranded at home alone and helpless would be far worse than the arthirits.
These were all the reasons I wanted a resurfacing and NOT a THR. Maybe it's time to look for another surgeon until I can find one that will do it, though many of them seem to be moving away from it, it's OK for them on their massive salaries!
My AME is also my GP and a pilot so she is well clued up on physical limitations and flying.
Hello Clare Prop, I got both of my hips changed within 1 week about 4 years ago, I was 54 by this time. After 2 weeks in hospital and 2 weeks at a special rehabilitation hospital I went back home and 4 weeks later I was the first time on my motorcycle. Of course it will be different case by case and I was physically very fit, otherwise the docs would never change both hips within this short period. During the reha I have seen people in the age 70+ with only one side changed and much more problems to recover then I did. Regarding the medical it was a no brainer, 3 month after the the ops I was checked by the AME and could return to flying. Today I have not a single problem. Go for it!
Thanks, that sounds less terrible! But three months away from work means I have to close my business, decades of work down the drain, let the staff go etc. And I was defiantely told six weeks, not twelve so it's worrying that it has taken people double that time to get their medical back. Both GP/AME and surgeon well aware of what I do for a living and never, ever indicated it would take that long....maybe because I have always been, until having to give up karate training, very fit and strong.
I suppose what I am trying to work out is, do I keep going like this in a lot of pain for another ten years and get it done when I retire, or do I get it done now and take a financial hit I may not be able to recover from in the current economic climate.
Clare in the grand scale of things whats more important your health and wel being or the buisness.
And I suspect you might be suprised if you started looking for tempory cover its the intial panic that you have to find some thats the worst bit. Once you start putting feelers out I am sure someone suitable will turn up. And you won't be away for the whole period just grounded for it.
In the UK at least you can still be in charge supervising but be medically unfit. You need to speak to your NAA its not as if you are going to be grounded for more than 6 months or for that matter you won't be able to at least visit and do the ground CFI stuff.
The problem your going hit is that it will get worse and eventually they will pull your medical and then you won't have any time to plan what your going to do.
At least now you can set everything in place before you go under the knife.
I know little of Australia climatology or holiday cycles but if I were in South Africa for such a procedure, I'd probably try and have it done in the first week in December and then have as recuperation time the whole slack period over Christmas and New Year. The recovery is not uncomfortable, unlike tummy ticks where you have to wear a body stocking in the heat. Can't see that a hip resurface would involve much less time out of the loop and if you go for a hip resurface when you should be having a replacement then I think the future could hold problems. Ship in a couple of fresh young instructors to work for you on experience for board and lodging basis. Buy lots of beer and sit on a high throne chair and dictate such that the kids do it your way?
Just to come back regarding my 12 weeks recovery: After 8 weeks I was given the ok for driving a car respectively my motorcycle (which is a heavy piece of iron). The restriction for not flying until 12 weeks after the surgery was not only the point regarding walking . The AME wanted me to be fully recovered for ALL duties as pilot, specially the task regarding an evacuation.
Please think as well what might happen if you continue without the treatment. In my case, the AME would withdraw my medical due to the year-long strong medication I had to take on a daily base, just to be able to survive without pain. One more thing: You are now on the point of no return and the pain will go into a spiral dive if you are allready considering to get a cane....
You have only one side to change, that might give you the chance to recover faster. Talk to your doctor and tell him about the situation.
Germany, Switzerland and Austria abound in specialised recuperation hospitals where one goes to recover and rehabilitate from major surgery. As far as I know either none or very few such facilities exist in the UK either privately or on the National Health System. They may well not do so in Australia either. A friend of mine recently had a radical prostatectomy in Germany. He was involved with a medical rehabilitation Klinic for nearly six weeks after he was discharged from hospital. This was a proper medical establishment, licensed and regulated, not a glorified fat farm. The twin shames of the British NHS are diagnosis and post operative care. Both are constrained by money and facilities and a continental implementation of both aspects of medicine would save the NHS millions every year and relieve patients of much suffering. Of course it might also ensure that many lived longer because of early diagnosis and better care so that would work to the detriment of the welfare state so perhaps there's a deal on somewhere? Two weeks in a special rehabilitation hospital was priceless adjunctive medicine.
I've only just found this thread, but here are my experiences, for what it's worth....
I had a bilateral TKR (two knees replaced) just under four weeks ago. I was told it would be tough having both done together, but I was out of hospital in four days and bending my knees further by then than I'd been told I'd ever be able to bend them again. I ditched the crutches indoors within a week (apart from stairs), and now only use one out of doors. I can climb into a car normally, and I plan to ask next week if I can drive - I too was told six weeks, but I can't think of a single good reason why.
Ok, two knees is different from one hip. Also, everyone is different. I was pretty fit, and I exercised like mad from the start, right after the anaesthetic wore off in fact, and I think this made a lot of difference. I was up and walking with a frame the day after the op. The physios couldn't believe my progress, but they were used to people who lay about and moaned.
I still get very tired, and I wouldn't like to try flying yet - in fact, I haven't even considered it due to lack of work and money problems. However, lack of stamina has always been a problem for me, so this is nothing new. And it is less than four weeks!
The point I'm making is that everyone is different, and what you get told may have nothing to do with how things work out. I know quite a few people who've driven in less than six weeks; there are no absolutes in this. I can't make the decision for you, but maybe this will help a bit.