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Any Advice: Cruise, Work, Covid, Hip Replacement ?

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I know this might reach a wider audience in the Ask a Cruise Question thread, but I value the information I have learned from the Viking crowd, so here goes. Long standing arthritis in my hip which was just a minor inconvenience has suddenly become much more problematic. While I am coping as is, medical advice indicates that ultimately, hip replacement surgery will be needed. On the one hand, this time when we are unable to cruise seems like a great time to do it. On the other hand, going into a hospital right now at 67 for what is essentially elective surgery seems questionable. The surgeon is doing surgery again, but only on patients willing to go home the same day of surgery. That adds an extra degree of worry for this patient!

 

As the bookkeeper for a florist, there are certain times of year when missing work is much more problematic than others (think Valentine's Day, Mother's Day, etc.), so that impacts my options. And now the cruise part. We are booked on an April 2021 cruise in the eastern Mediterranean (10 days) with final payment coming up the end of September. Of course, there is no way to know if cruising will resume by then. I am trying to decide whether to move that forward to April of 2022. That would give me more than a year until our next booked river cruise in October 2021.

 

How much time should I allow between the scheduling of the surgery and a cruise? Of course, I know that might vary from person to person. There are also the small percentage of people who have complications, but since we have insurance I am only worrying about the more common outcomes. We have missed two cruises from covid already so I am really anxious to go again. 

 

Sorry for the long post of interest to a very small audience, but I would appreciate advice from anyone with experience.

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The Mrs (age 60) had hip replacement surgery on 26JUN - same day procedure which is the standard for our Kaiser managed care in California. Her recovery has been fairly quick because she prepped by swimming/pool walking for a few months prior and was back to the pool after 4 weeks. She is not the average but shows with a little planning you can manage the recovery. I'd say April is reasonable and a good cruise goal. We have January Windstar Tahiti reservations that we are hoping but not losing sleep if it goes away. 

 

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Personally, if I could stand the hip pain, I'd wait for the vaccine (maybe Jan?) before I did anything.  So let's say you had surgery in Feb.  That would give you 2 months to recover before your cruise.  I'd talk to my doctor and see what he/she recommends about recovery.  Just my 2 cents.

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My husband had a full hip replacement, done on an outpatient basis, in June of 2019.  His recovery was very quick, which his surgeon attributes to the fact that he was in great shape before the procedure, and also because he went through the front (anterior) instead of the back.  (When the incision is in the front, there's no need to cut through the muscles; you can go in between them to get to where you need to be.  With the posterior procedure, the surgeon is cutting the gluteus maximus, which ends up requiring more time for rehab, since the muscle has to heal.)

 

The outpatient recommendation surprised us, but we were very happy to come home late that evening, after a 9:00 a.m. surgery. He slept in a recliner for the first two weeks, which was more comfortable for him than lying flat in bed, but was mobile from just a very few hours after surgery, with a walker.  Upon arriving home that evening, he climbed one flight of stairs from our lower level to our first level, under his own power.  Yes, I was pretty nervous about the whole idea, but when we actually experienced it, it was just fine.  (They wouldn't have released him to go home that evening if there were any complications whatsoever; that was understood up front.)

 

He did everything the doctor ordered, and was back to full mobility, no pain or movement restrictions, within 8 weeks.  We didn't have a cruise scheduled, but he could easily have taken one and participated in all of the normal activities and tours, including extended walking or hiking.

 

So, rehab time I think depends on your general level of fitness, as well as the type of procedure the surgeon uses.  That's worth understanding before you make your final timing decision.  (My cousin, on the other hand, had the posterior version about a year before my husband's procedure, and she also did great, but her full recovery time was about twice as long.)

 

In terms of Covid risk, from what I've observed in going into hospital settings for routine medical care, I wouldn't personally be concerned about scheduling the procedure now, but that's a very personal decision.  I was nervous about my first visit to a medical facility setting back in late May, and ended up being blown away with the safety protocols and how safe I felt.  That has remained true the few additional times one of us has had a visit across this summer.  But again, that's something that's completely dependent on how you feel when you go into the medical facility there.   I noticed you're in Maryland, and we're in Virginia, but our healthcare is all oriented to the Baltimore area.  Happy to discuss our experience in more detail if that would help.  My email is aungrl at gmail.  

 

(My husband was 62 at the time of the surgery, so a little bit on the young side, but lots of hip stress from years of athletics.)

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I had a posterior hip replacement when I was 59 and an anterior replacement at 65.  Do NOT have the posterior.  It was awful and almost a six month recovery.  The anterior was a breeze, much less painful, mobility the same day and about a 2 month recovery.  But you MUST do the PT and exercises religiously.  After 2 months I went sailing on my own boat, swimming off the deck and climbing a vertical ladder to get back on - much more difficult to do then anything on a cruise.  I would not go home the same day however.  Too many potential complications but then I live an hour away from any hospital.  I had a girlfriend who had hers done at end of June in Florida.  One overnight, PT and a 2 month recovery also.  Good luck.  You will say - I should have done this sooner.

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2 hours ago, aungrl said:

My husband had a full hip replacement, done on an outpatient basis, in June of 2019.  His recovery was very quick, which his surgeon attributes to the fact that he was in great shape before the procedure, and also because he went through the front (anterior) instead of the back.  (When the incision is in the front, there's no need to cut through the muscles; you can go in between them to get to where you need to be.  With the posterior procedure, the surgeon is cutting the gluteus maximus, which ends up requiring more time for rehab, since the muscle has to heal.)

 

The outpatient recommendation surprised us, but we were very happy to come home late that evening, after a 9:00 a.m. surgery. He slept in a recliner for the first two weeks, which was more comfortable for him than lying flat in bed, but was mobile from just a very few hours after surgery, with a walker.  Upon arriving home that evening, he climbed one flight of stairs from our lower level to our first level, under his own power.  Yes, I was pretty nervous about the whole idea, but when we actually experienced it, it was just fine.  (They wouldn't have released him to go home that evening if there were any complications whatsoever; that was understood up front.)

 

He did everything the doctor ordered, and was back to full mobility, no pain or movement restrictions, within 8 weeks.  We didn't have a cruise scheduled, but he could easily have taken one and participated in all of the normal activities and tours, including extended walking or hiking.

 

So, rehab time I think depends on your general level of fitness, as well as the type of procedure the surgeon uses.  That's worth understanding before you make your final timing decision.  (My cousin, on the other hand, had the posterior version about a year before my husband's procedure, and she also did great, but her full recovery time was about twice as long.)

 

In terms of Covid risk, from what I've observed in going into hospital settings for routine medical care, I wouldn't personally be concerned about scheduling the procedure now, but that's a very personal decision.  I was nervous about my first visit to a medical facility setting back in late May, and ended up being blown away with the safety protocols and how safe I felt.  That has remained true the few additional times one of us has had a visit across this summer.  But again, that's something that's completely dependent on how you feel when you go into the medical facility there.   I noticed you're in Maryland, and we're in Virginia, but our healthcare is all oriented to the Baltimore area.  Happy to discuss our experience in more detail if that would help.  My email is aungrl at gmail.  

 

(My husband was 62 at the time of the surgery, so a little bit on the young side, but lots of hip stress from years of athletics.)

aungrl,

 

Thanks so much for the detailed reply. I will follow up with an email, for a few additional questions.

Joanne

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7 minutes ago, TayanaLorna said:

  You will say - I should have done this sooner.

 

I have heard this from the doctor and multiple patients. I do believe it, but it doesn't make me any more excited about going through it!

 

I will certainly talk to the doctor again about the anterior/posterior approach. I met him a month ago, and he talked about it but I didn't know how important it might be so I don't remember what he said.

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I had both hips done and the choice of anterior or posterior was based on my surgeon's experience as well as my physical status at the time.  I'm overweight and they chose posterior.  Second one in 2018 I went home the same afternoon!  My recovery on both was pretty good and I returned to work after 6 weeks.... I could have gone back sooner but chose to be cautious.  I went on a cruise to Alaska 3 months after my last surgery and I did fine.  I wasn't leaping over rocks and logs on shore but really was quite comfortable!  Good luck and I also "Wished I had done it sooner"!!

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I have had 4 hip replacements.  My first pair were anterior and posterior.  My recovery times for each were virtually identical, I was back at work in 2 weeks.....however, my recovery is NOT normal, average is about 6 weeks.  The biggest problem after surgery is the utter exhaustion that hits mid afternoon, and it took me 2-3 months to not crawl under my lab bench at work and take a nap!  Just be aware that not everyone is eligible for an anterior surgery, my second hip was funky enough that my surgeon wanted better visualization.  Most hips these days are done outpatient, to minimize the problem of picking up a hospital microbe.  
 

My second 2 7 years later (my first pair got infected), I had my second hip rereplaced in late Nov. and in Feb. easily went to Mexico.  By then, I was able to get around fairly easily but still had some residual weaknesses from multiple surgeries over a short time.  I could have easily done a cruise then.  Ironically, my last surgery was a 6 hour surgery and I was in the hospital a whopping 20 hours.  

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I have had both hips replaced - one posterior and one anterior (minimally invasive).  I did well with the first but had many positional restrictions and about six weeks to be fully back to normal.  The second six years later was minimally invasive and a totally different experience,  Home the same day with NO restrictions.  I took Tylenol for a couple of days for incisional discomfort but nothing stronger.  I was playing golf at two weeks and on an African Safari at week six. I didn't need PT and nine years later am still doing well with both.  I echo the comment "wish I had done it sooner". Whatever you decide I wish you well and a full and painless recovery!  If you wish more details don't hesitate to email me - pafield2000 at gmail dot com.  

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I had my right hip replaced in 2016. I did not have any complications, and was on a plane less than 4 weeks later (as a passenger), with the surgeon's consent.

As far as the choice of anterior or posterior, I did not form an opinion ahead of time but I did a little research to learn about the techniques. I spent a GREAT deal of time finding the best orthopedic surgeon in our area - Reno, NV - and selected an internationally-known orthopedist who is also a leading researcher. He is the team doctor for the UNR sports department, too.

His preferred technique was a modified posterior approach, which he performs in such a way that the muscles are not damaged. The operation was quick, and I was in the hospital overnight (remember it was 2016). My recovery, including PT, was easy: no pain, but it took a lot of time getting used to the fact that I didn't have to baby the joint, just walk (sit, stand, bend over) normally.

As to risk of infection in the hospital, I can only say that you have to decide for yourself how your hospital is doing on that front.

Having said all that, my advice on timing is to do it sooner rather than later. Every day it will continue to get worse - after the surgery, every day will get better! I rarely think about my hip nowadays - except when I go thru airport security.

Good Luck!

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Given the modern techniques used, it is doable if all goes well. If it would be a load off your mind and not push you to make decisions you might not ordinarily make, then delay. I had five of my seven cervical disks removed 11 years ago and went overseas two months later. It pushed me to work my hardest to recover. It was great for my sanity!

 

I would use a doctor who specializes in this procedure and has done thousands. Make sure the hospital has a good safety rating. https://www.hospitalsafetygrade.org/  As to when I would do it, a lot depends on the COVID situation in your city. I would check what extra safety procedures the hospital out-patient department is observing. If the positivity rate is below one in your city, I would go for it.

Best of luck!

RB

 

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I read all the replies and am amazed that people did so well with the posterior entry.  Surgery technique certainly improves over time.  There is also another technique called Anterior Lateral where entry is along the side of the hip.  It can be performed for people not eligible for anterior (large boned, overweight, previous replacement).  It is major surgery and you are right to approach with caution.  Don't be afraid to interview your surgeon, have her describe the technique in detail, ask him what are potential complications and what his complication rate is.  And as suggested before do it sooner rather then later.  Hip pain causes us to adjust how we walk and stand thereby stressing other muscles and bones potentially causing other problems.  Success to you.

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Thanks everyone for your input. My fears are easing from all the information offered here. The training video the surgeon requires of patients was very factual and informative, but lacking in the emotional support I think I needed. From what I have heard, I think I would feel most comfortable scheduling the surgery 3-4 months before a cruise, which should be more than what I need. 

 

I have a personal connection of sorts to the surgeon who will be my doctor. He is well regarded, and focuses on minimally invasive hip and knee replacements. My godson worked with him for twelve years. I know  three people who have had successful surgeries with him, and also two nurses I know well have given thumbs up.  Generally, I believe the Baltimore metro area has better than average health care facilities, so I do have confidence in that part of the equation. 

 

Now, if only I knew how the future of cruising was going to work out, maybe I could start to make my plans!

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5 minutes ago, lackcreativity said:

Now, if only I knew how the future of cruising was going to work out, maybe I could start to make my plans!

It looks like you have the surgeon sorted out properly. If you go ahead now you will be ready for the holidays - and regardless of what happens with cruising, you will be prepared whenever they re-start.

Good luck!

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1 hour ago, What was that? said:

It looks like you have the surgeon sorted out properly. If you go ahead now you will be ready for the holidays - and regardless of what happens with cruising, you will be prepared whenever they re-start.

Good luck!

That sounds like a good plan, except first I have to teach someone else at work how to do payroll before I go. Just in case I'm not back in two weeks!

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Wow, from someone who is heading towards knee replacement I am amazed that you can be in for a hip operation as a day patient! I know surgery has moved forward considerably but I didn't think so far.  I am 67 and muy surgeon appears to be more reluctant to do knee surgery so young (and here is me thinking I am past it)! I believe it is more risky and wondered if my American 'cousins' have any views or reassurance about their experiences or knowledge of knee surgery advancements and a bit of reassurance to a scaredy cat. Our cruise, first on viking, is January February but I don't expect to be sailing, I have an upcoming appointment with my Consultant and a bit of expert knowledge might help me with my questions and come to an informed decision. I would really appreciate your response. Apologies if I am turning this into an episode of ER but you good Viking folk are always so helpful.

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49 minutes ago, tine-tine said:

Wow, from someone who is heading towards knee replacement I am amazed that you can be in for a hip operation as a day patient! I know surgery has moved forward considerably but I didn't think so far.  I am 67 and muy surgeon appears to be more reluctant to do knee surgery so young (and here is me thinking I am past it)! I believe it is more risky and wondered if my American 'cousins' have any views or reassurance about their experiences or knowledge of knee surgery advancements and a bit of reassurance to a scaredy cat. Our cruise, first on viking, is January February but I don't expect to be sailing, I have an upcoming appointment with my Consultant and a bit of expert knowledge might help me with my questions and come to an informed decision. I would really appreciate your response. Apologies if I am turning this into an episode of ER but you good Viking folk are always so helpful.

Don't worry about taking  the discussion in a slightly different direction. Anyone who enters a thread with "Hip Replacement" in the title should know where they are headed.

 

I have heard that hip replacement surgery is generally an easier surgery than the knee, and when I asked my surgeon that question he said that was 100% true. I don't think he said that just to make this nervous patient feel better. One of my friends had that same doctor do her knee replacement surgery maybe three years ago. They kept her in the hospital overnight. Her recovery was a bit hard, but she still says it was 100% worth it and she wishes she had done it sooner. I think she was about 64 at the time. Maybe it's like childbirth. It's hard to go through that, but you forget about it afterwards because you are so pleased with the outcome!

 

 

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3 hours ago, tine-tine said:

Wow, from someone who is heading towards knee replacement I am amazed that you can be in for a hip operation as a day patient! I know surgery has moved forward considerably but I didn't think so far.  I am 67 and muy surgeon appears to be more reluctant to do knee surgery so young (and here is me thinking I am past it)! I believe it is more risky and wondered if my American 'cousins' have any views or reassurance about their experiences or knowledge of knee surgery advancements and a bit of reassurance to a scaredy cat. Our cruise, first on viking, is January February but I don't expect to be sailing, I have an upcoming appointment with my Consultant and a bit of expert knowledge might help me with my questions and come to an informed decision. I would really appreciate your response. Apologies if I am turning this into an episode of ER but you good Viking folk are always so helpful.

Who knew running all those years would wear knees out?  And yes, techniques are changing due to lots of reasons.  In April I had bilateral femoral arthroplasty.  Ha, in my world that would be both knees replaced.  Surgery ended at 3:30pm, at least that's when I woke up, and at 5:00pm was put in our car for a trip home with a prescription for pain meds.  That was on Friday.  The following Monday morning I had my first therapy session.  Was it fun? HeXX no!  Two at once is rough.  But then I don't have to think about doing the other one.  Still a bit tender but going to the gym and getting around better.  Most people say it takes at least 6 months to feel normal.  Would I go on a cruise today? You bet.  Would I evaluate my participation in certain excursions, absolutely.  Better to be realistic than to have a bad day for you and your fellow travelers.  🍸

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5 hours ago, Jim Avery said:

 Most people say it takes at least 6 months to feel normal.  Would I go on a cruise today? You bet.  Would I evaluate my participation in certain excursions, absolutely.  Better to be realistic than to have a bad day for you and your fellow travelers.  🍸

In the months/years before your surgery, did you still cruise, even if you had to limit your activities? I currently cannot do what I did six months ago, but I still argue with myself that if I used the elevator, not the stairs, and took enough ibuprofen, I could go on our cruise in April (if it goes). 

 

What made you decide it was time to get your surgery done?

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I've had 2 knee and 1 hip (3 times, not a normal reaction) replacements. I had my first knee replacement at 49. I'm 62 now. Hips, are by far easier than knees. Both Anterior and Posterior hip surgeries are better than the knees. Although, I have a couple of friends who have had robotic knee surgery and were up and around in 3 days. 

It does take about 6 months for the knees to feel "regular" again.

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10 hours ago, tine-tine said:

Wow, from someone who is heading towards knee replacement I am amazed that you can be in for a hip operation as a day patient! I know surgery has moved forward considerably but I didn't think so far.  I am 67 and muy surgeon appears to be more reluctant to do knee surgery so young (and here is me thinking I am past it)! I believe it is more risky and wondered if my American 'cousins' have any views or reassurance about their experiences or knowledge of knee surgery advancements and a bit of reassurance to a scaredy cat. Our cruise, first on viking, is January February but I don't expect to be sailing, I have an upcoming appointment with my Consultant and a bit of expert knowledge might help me with my questions and come to an informed decision. I would really appreciate your response. Apologies if I am turning this into an episode of ER but you good Viking folk are always so helpful.

I had my knee replacement surgery in 2013 (I was 57) - best surgery I ever did - I was in agony for a few years.  I had definitely waited too long before having surgery so getting it @ 67 is not too young.  It was important to do PT beforehand to strengthen the muscles around the knee - I stayed overnight, had to do stairs before I left the hospital - came home and went up the stairs in the house to sleep every night.  Went to PT for a while after surgery - my sciatica was bad right after surgery but the PT worked it all out.  My surgeon was very conservative and I did not go under using general anesthesia, instead I got a sedative and an epidural - made recovery from surgery much easier.  It's important to do the PT - It took a while to recover but I walk two miles per day, do Zumba and I keep active.  Now the left knee is going but I still do as much as possible.  Yes, I need to make a decision about surgery but I'm not there yet.  

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2 hours ago, lackcreativity said:

In the months/years before your surgery, did you still cruise, even if you had to limit your activities? I currently cannot do what I did six months ago, but I still argue with myself that if I used the elevator, not the stairs, and took enough ibuprofen, I could go on our cruise in April (if it goes). 

 

What made you decide it was time to get your surgery done?

Yes, including two world cruises on Viking.  The tell was the last WC that ended this last January 4th.  On the Inaugural WC we had lifeboat/safety drill every 30 days.  On the last one it was every segment.  The last segment or two I had to walk down the stairs backwards.  (Can't use the elevators).  I also felt weird dressed for the gym having to take the elevator to the gym.  Too much Ibuprofen has it's own bad sides....  Heck getting older.😎

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Thank you all for your reassurance, what an inspiring bunch you are. You have somewhat reassured me and what I believed to be the case that it is better to get the surgery earlier as I would have thought the younger you are the fitter you are more likely to be and the chance of a better recovery greater plus I want to be able to walk and do all the things other 'young' people do now not when my body has fallen apart and I can't be bothered any longer. Cruising for me is an expedition as we always go in January/February to the Caribbean mainly to get a bit of sunshine and to escape our Scottish Winter storms, that involves at many segments of travel and it is always a worry booking in advance as you dont know how fit or able for cruising you will be at the the of making the reservation. 

 

I love that such a complicated operation as the knee allows you to be discharged the next day, who would have thought and I have heard the robotic surgery is supposed to be a much speedier recovery, hopefully that may be available when my time comes.

 

There is nothing quite like personal experience so I am indebted to all your sound knowledge and advice.🙏🏴󠁧󠁢󠁳󠁣󠁴󠁿❤️

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16 hours ago, SM77 said:

I had my knee replacement surgery in 2013 (I was 57) - best surgery I ever did - I was in agony for a few years.  I had definitely waited too long before having surgery so getting it @ 67 is not too young.  It was important to do PT beforehand to strengthen the muscles around the knee - I stayed overnight, had to do stairs before I left the hospital - came home and went up the stairs in the house to sleep every night.  Went to PT for a while after surgery - my sciatica was bad right after surgery but the PT worked it all out.  My surgeon was very conservative and I did not go under using general anesthesia, instead I got a sedative and an epidural - made recovery from surgery much easier.  It's important to do the PT - It took a while to recover but I walk two miles per day, do Zumba and I keep active.  Now the left knee is going but I still do as much as possible.  Yes, I need to make a decision about surgery but I'm not there yet.  

My niece just graduated with her Doctor of Physical Therapy degree, and this post made me happy. Her favorite thing to do is to work with patients right after surgery. 
 

Well done being a good patient! You’re reaping the benefits! 

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