Help my dad walk again!

January 14, 2006 10:17 AM

My dad fractured his hip. Need to hear about people's experiences with rehab and recovery.

My dad, age 67, fractured his hip on Tuesday. Surgery to put pins in place was Wednesday evening. Thursday and Friday were a drug-induced blur for him. They did get him up in a walker the day after surgery, and he's been doing physical therapy twice/day since then. He's still in the hospital. They say the break was a bit complicated-- if it doesn't heal properly they will have to do a hip replacement.

Anyone out there with personal experience, or seen someone else go through it? He is 2000 miles away (with my mother and my two sisters), but I hear he's in a good deal of pain and discomfort. He's anxious to come home, but we may try to convince him to go to rehab from the hospital, if that's what's best. As of now, we don't even know when he'll be discharged.

FWIW, he's 67 with no other medical conditions, although he's led a pretty sendentary life, doesn't exercise regularly, is a bit overweight. Also, believe it or not, he's a doctor, which complicates things in the sense that he thinks he knows what's best for him-- and is trying to paint a rosy picture for everyone (e.g., he thinks he's going back to work in a week or so!) Also, this makes his doctors (who are also his friends and colleagues) reluctant to tell him what to do. He really wants to get back to normal and is pushing to be discharged as early as possible, to go home and try to get by on his own, etc. Leaving this up to my dad, my indeed make things worse, be more of a burden on my sisters and mother, etc. I'd like to talk this through with him, knowing the pros and cons of going home vs. rehab, of staying in the hospital longer vs. coming home, of how long he should expect to be out of work, etc.

posted by picklebird to health & fitness (5 comments total)

My situation wasn't quite the same, but my father recently had to have surgery on his leg that left him in a full-leg cast for several weeks. He lives by himself, with no family nearby, so the alternative to rehab was having family members put their lives on hold to go tend to him, and as much as he disliked the idea of rehab, he disliked the idea of relying on and inconveniencing family even more.

So he was in the hospital for several weeks, then rehab for a full month, I think. After getting out of rehab, he got a once-a-day home health worker to come in and deal with bathing him, getting him dressed, etc. until the cast came off, then a physical therapist a couple times a week once he was in the leg brace. Now he's doing outpatient PT, since his doctor cleared him to drive.

In reality, we all managed to get out there to visit, so it's not like we all ignored him and let the professionals deal with all of it, but it was a huge point of pride with him that he not burden us. (This may have been different if my mother were still alive though; I can see not wanting your kids or sister or sisters-in-law tending to you in that way, but the wife/caregiver line may be more blurred.)

Can you appeal to some aspect of his personality (pride, independence, perfectionism, whatever) to get him to see that your sisters and mothers may not be his best caregiving choice? And even if he won't agree to rehab, maybe trying to get nurses or physical therapists to visit the house could take some of the burden off your family.

Also, my father was the same way with the "I'll be fine in two weeks" spiel. As annoying as it can be, I think that attitude also helped him recover faster -- he was goddamned determined not to be reliant on anyone longer than was necessary.
posted by occhiblu at 11:32 AM on January 14, 2006

My own experience with having both hip joints completely replaced (both ball and socket parts of the joints) in 1994 due to bilateral avascular necrosis suggests that your dad should scale back his expectations of recovery considerably. I was in my early 40's, not my late sixties, and had both hips done, 1 week apart. I was up bearing weight within a day of each surgery, but the recovery process was more than 5 months in my case, and it was about a year before I really begin to walk anywhere without resort to canes. Part of my problem was that I wound up getting an older version of the procedure than is generally done now, and had about 18" of surgical wounds to heal on each side, at the same time.

About 6 years later, one of my femur head prosthesis broke, and I had to have a revision on one side. That time around, I was off work about 2 months. It's no picnic, but 80 year old women have hip replacements, and return to active life, on a fairly routine basis.

But the key to success is going through the rehab without setbacks. You have to pay attention to range of motion restrictions, and move carefully as you learn to use the new joints, especially while the muscles and tendons around the joint heal and adapt. For "Type A" personalities, the whole process is a huge lesson in the limits of the body, and in patience. Baby steps, all over again, indeed.

At the moment, it sounds like your dad has not yet gone through as extensive a procedure as a total hip replacement, but he has sustained significant surgical trauma, and has continuing risks of post-surgical complications, on top of risks stemming from various healing outcomes. He needs to respect his body, and take the best care of himself possible for next couple of months, to give himself the best long term prognosis possible. Probably, this is especially tough for an experienced M.D.

But it's his turn to be the patient. His only choice now is whether he'll be a good one, or a more extensive, higher risk case for his surgical team.
posted by paulsc at 2:28 PM on January 14, 2006

I've written about my experiences in my blog, so in the interests of laziness, I'll just link here.

first broken hip
second broken hip.
posted by adamrice at 2:50 PM on January 14, 2006

(I'm a physician with a fair amount of experience caring for people after repair of hip fractures.) The rehab experience is highly variable and hard to predict. The most important predictive factor is the person's prior condition. Since your father has no other medical conditions, he'll likely do well, particularly if he had a normal gait before the fracture.

In general, more physical activity is better, within the limits prescribed by his orthopedist and physical therapist. Don't be afraid to gripe at your dad about listening to them. The biggest danger right now is for him to get too ambitious and fall.
posted by neuron at 10:46 PM on January 14, 2006

These are all great responses-- just what I was looking for. It's all a little sobering, but good to know. Thanks.
posted by picklebird at 12:20 PM on January 16, 2006