Hip Rehab + New Pacemaker

Hi all,

I am posting for my aunt who is in the hospital recovering from surgery after a hip fracture. The day after surgery the PT came to get her out of bed for the first time and she fainted at the sitting up position. After a day of monitoring her heart a cardiologist recommended a pacemaker. Her surgery for that was two days ago. I am getting a LOT of conflicting information on how the new pacemaker will affect her rehab for her hip (left hip and pacemaker on the left side). I've been told everything from "no change in the process at all" to "can't use a walker"! She will transfer soon to a skilled nursing care facility for up to a month for her rehab and I would like to get all the information I can on how her new pacemaker impacts her physical therapy. I appreciate any information you all can provide.

Many thanks in advance.


5 Comments

Post surgical hip & PM surgery

by harley63 - 2008-05-29 10:05:07

Helen~

As BABlocker posted above, your Aunt will have limitations with her left arm for a while. You did not mention her age or if there are any other health problems that might slow the recovery process. How old is she and was she in reasonably good shape prior to the hip surgery? Here are some questions to ask if you do not already know: Ask the Cardio MD: “What can she do and not do with her left arm and for how long is the restriction?” Ask the Ortho MD: “How much weight can she put on the left leg, full amount, partial, or as much as possible?” The physical & occupational therapist are going to need this information to formulate her therapy program. The therapist will take into consideration the left arm limitations/restrictions when they see her during therapy sessions.

The limitations of the left arm are the biggest concern. Once that is provided in detail, then you can map out the therapy that your Aunt will/should receive following hip surgery. I will be happy to assist you with more questions or will attempt to explain the rehab recovery phase of hip surgery in private post, if you need further assistance.

Hope that she continues to recovery nicely. Keep us posted.
Harley63


Follow up: Hip Surgery + New PM

by HelenJ - 2008-05-29 11:05:23

Thanks for your comments -- I really appreciate it!

My aunt will be 80 in August but until this incident with her hip fracture has been independent and mobile without assistance. Currently she also suffers from Type II diabetes and intermittent low blood pressure. (The latter is causing major dizziness when she sits up to start her PT.)

Her Orthopedic Surgeon said she could put full weight on her left leg immediately but shouldn't use a walker, but didn't say for how long. The Medical Director at the receiving rehab facility said her Cardiologist would provide the rehab instructions and any limitations. The Cardiologist said there wouldn't be much impact at all and deferred to the Internist. The Internist said she shouldn't raise her left arm above her head (didn't say for how long) but did say she could put pressure on her let arm when using a walker! Now you see the reason for my post! :-)

After speaking with the Director of Rehab at the facility to which she is transferring (in a couple of days) I feel better about the care they will give and understanding her new pacemaker. I just wish I could get the same answer from at least two of her three doctors!

I appreciate reading all of the posts here and gaining a much more "real world view" of living with a pacemaker.

Much appreciation!

Rehab

by BABlocker - 2008-05-29 11:05:35

Helen,
Your aunt's physical limits will, in the first week, be governed by the pain level...I would imagine the weight bearing that goes with using a walker would be somewhat painful.

After that, I can't see why she can't use a walker. The restrictions many of us have experienced involves keeping our arms at shoulder length or below for 6 weeks after surgery to allow the leads to scar into the heart muscle. During that time, it is important to move the shoulder joint without raising her arm above the shoulder level, to prevent her shoulder to "freeze", which could cause immobility later on.

The physical therapists at the rehab facility will be well versed and trained to deal with your aunt's needs, factoring in her recent PM surgery in the treatment plan.

Hope this helps...

Hip and PM recovery

by roy haycock - 2008-05-30 01:05:11

Last year I had a total left hip replacement in March, followed by a prostate op' in May, followed by a new PM ( the third ) in September, all of which were very successful and did not result in any problems of movement or recovery and I am nearly 70.
Keep in contact with the medic's and they will ensure all is well and will deal with any problems should they arise.
With best wishes for a speedy recovery foryour aunt

Additional rehab information...

by harley63 - 2008-05-30 10:05:19

HelenJ~

It's hard to remember that each MD is speaking from their specialty view point. Hence the passing the buck run around that appears to be happening. The length of time on not raising the left arm will depend on how she recovers. Everyone heals at a different rate. With the added diagnosis of diabetes, the healing process of the incision might take a bit longer. It will be a wait and watch situation. Once her pacemaker is "happy" in it's new home and the incision looks well healed, some of the limitations will be lifted.

Drawing on my years as a Rehab nurse… I’d recommend that you stay is close communication with the Medical Director at the receiving rehab facility, the therapy team and the charge nurse. They will be able to provide you with the progress that your Aunt is making.

Another concern is to take a look at the medications that she is taking. Ask questions about how they will work together or against each other and the side effects. With a history of low blood pressure, there maybe something that she is taking that drops her pressure lower. The dosage may need to be decreased or discontinued altogether.

Please take my suggestions just as that.. suggestions. I am not a doctor. Just a nurse. My suggestions are what I would begin with if your Aunt was my patient and I needed to be her advocate.

Wishing her a speedy recovery.
Harley63

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