Exercising is typically very painful for patients preparing for hip surgery. However, a moderate program of exercises targeting the hip area will be beneficial in hastening post-operatively recovery. Some exercise to try include:
1) Glut squeezes – Lying on back, isolate and squeeze butt muscles.
2) Heel slides – Lying on back, bend the knee and slide the foot towards body and back down again.
3) Side leg slide – Lying on back with legs together, move one leg out to the side and back or spread both legs out and in (similar to making snow angels).

Standing hip exercises are usually difficult for hip patients to do, as most cannot tolerate weight bearing on the affected leg. Quite a few exercise machines target the hip muscles.

Access to a heated pool is beneficial in that you will be able to get good, aerobic exercise without causing too much discomfort to your hip. Swimming or even walking and moving the body against the resistance of the water are beneficial to increase your endurance.

For women: Plan ahead for your last haircut and/or color, as you will have a long period when it may be difficult to get out and get a trim. Likewise, have your legs waxed or shave before surgery if you follow those grooming habits. After surgery, you can tape a razor to a long handled wooden spoon for shaving without breaking precautions. You may not be able to reach your feet for quite a while after surgery. You may want to have a pedicure prior to surgery.

It is very important to sleep well before the surgery. Many people find that the anxiety about their upcoming surgery and increased pain caused by ceasing NSAIDs immediately prior to surgery keeps them awake. If you have trouble sleeping you many want to take a sleeping aid like Tylenol PM or Benadryl (diphenhydramine). Tylenol can help with pain control in lieu of NSAIDs. Check with Dr Swanson or his staff before adding any medications.

Dental Appointments
You should do any pending dental work well in advance of surgery. Dental work, even cleaning, can be a potential risk of infection afterwards. The American Dental Association and the American Academy of Orthopedic Surgeons recommends dentists use antibiotics prophylactically for two years following hip replacement surgery to prevent oral bacteria from entering the blood stream and coating the hip implant. After two years, the implant is surrounded by new bone or fibrous tissue, and the risk of infection is reduced. Patients with diabetes, inflammatory arthritis, using steroids or immunosuppressant medication, or anyone else prone to infection should plan on using prophylactic antibiotics before dental work for the rest of their lives. Check with Dr. Swanson if you are unsure. American Association of Orthopedic Surgeons recommendation on post-op dental care.

Avoid Blood Thinning Agents
Do not take any aspirin or anti-inflammatory medications for 10 days prior to surgery. This includes Advil, Aleve, Motrin, Mobic, Voltaren, Relafen, Daypro, etc. All of these items thin the blood and may cause excessive bleeding during surgery. Vitamin E may also thin your blood and should be discontinued prior to surgery. Any herbal supplementation should be discussed with Dr Swanson’s staff. Many herbs are known to thin the blood.

The following list of supplements and foods associated with blood thinning.
Vitamin E – ask your doctor what amount you may take *
Vitamin C- ask your doctor what amount you may take*
Omega 3 Fatty Acids (oil supplements made from the fat of salmon, sardines, mackerel and herring) like EPA Eicosapentanoic
Acid) and DHA (docosahexanoic acid) **
Flaxseed oil (also known as linseed oil) in a supplemental dose like 1 or more Tablespoons per day**
Systemic oral enzymes that clean up the blood and make it less likely to clot***
St. John’s Wort*
Ginko Biloba*
Tree ear or wood ear or mo-er ear fungus-all names for a Chinese mushroom also known as Auricularia pollytricha, a rubbery
brown species cultivated on logs. A common ingredient of Chinese soups and stir-fries, it has a crunchy texture and no taste.**
Coumadin, persantine, aspirin and other blood thinners, as well as all routinely taken medications — ask your doctor which ones you need
to stop before surgery.
* Cedar-Sinai Institute for Joint Replacement
** Natural Health, Natural Medicine, by Andrew Weil, M.D.
*** The Aspirin Alternative,- by Michael Loes, M.D.
**** A Prescription for Nutritional Healing, by James F. Balch, M.D.

Recommendations For Nutrition Before Surgery
Eliminate processed foods from the diet as far in advance of surgery as possible. Processed foods overwork the body. Drink at least 8 glasses of water per day. Eat protein foods like meat, chicken and fish and if desired, take protein supplements in the form of amino acids and protein powders. Rice protein powder is a sugar-free protein that is highly digestible, rarely causes indigestion or allergies like milk and soy protein powders and stirs up easily in water. Protein is needed for mending wounds and growing new tissue. Get plenty of it in your body before surgery. Have plenty of fiber in the diet to keep the colon clean. An ounce or two of pure Aloe Vera juice night and morning keeps the digestive tract clean. Acidophilus supplements promote a healthy environment in the digestive tract. Take any supplements your doctor recommends and check with him on the above recommendations.

Dealing with Fear and Anxiety
It is perfectly normal and perfectly appropriate to feel fear and anxiety prior to surgery. Avoid caffeine and stimulants. Make you sure you sleep each night even if it requires taking sleeping aids. It is not helpful to lie awake and worry, exhausting your body and mind. Many people find that once they stop taking their NSAID medication, they are acutely aware of just how bad their condition is and feel a renewed commitment to ending the pain. It helps to be intellectually convinced of your decision. Examine for yourself if there is convincing evidence that you have made a wise selection of prosthetic type and surgeon and then act with conviction.

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