Taking on Hip Replacement Surgery… One Exercise at a Time: Q&A with Bob Caplan
Thursday, June 28, 2018

For 75-year-old Center for Health & Fitness (CHF) member Bob Caplan, hip arthritis threatened to derail two important life goals: adventure travel and hiking with friends and family. To get back on the trail, Bob followed medical recommendations and in Jan. 2018, had total hip replacement surgery. Months before, Bob read that the better one’s physical condition, the more successful the surgery. To maximize his readiness for surgery, he sought special training from CHF trainer Jason Bautista.

CHF recently interviewed Bob about his experience.

When you first agreed to surgery, what questions ran through your mind?

One could reasonably be worried something might go wrong. I suppose I wasn’t worried because I have many friends who have undergone similar procedures and continue, in their 60s and 70s, to participate in extreme sports such as white-water rafting and rock climbing. My friends’ experiences increased my confidence. Still, nothing is risk free. My family had discussed the risks and benefits, the likelihood they applied to me and whether they were acceptable to all of us. Whatever the outcome, we’d all be affected.

During surgery, all control would be in the hands of my medical team.  Having a trainer help me prepare for surgery certainly gave me a sense of responsibility and control. Six months before my surgery, I began going to my health provider’s physical therapist and working out with Jason here at CHF. The therapist and Jason worked to provide collaborative training.

Prior to your surgery, what type of physical condition were you in?

I’ve been a CHF member and come in regularly for the past 10 years, so I was in decent shape in terms of strength, aerobics and balance. But due to the arthritis in my hips, I was losing related flexibility and my hiking stride began to decrease. My wife and I hike with a group of friends every Tuesday in Palos Verdes and I couldn’t keep up.

What did getting in shape mean for you?

Being in shape could increase the odds of a successful surgery, recovery and a return to adventure travel and hiking.

Before surgery, I’d asked the surgeon how I should interpret risks of the surgery: 1 percent risk of blood clot, heart attack, getting an infection, etc. Added up, it looked like a 12 percent risk!  He told me these risks were averages that included people who were poor candidates for surgery. CHF pre-surgery training was an important factor in his judgment that my risks were extremely low.

How did the surgery impact you mentally?

Some studies suggest the better one’s mental health before surgery, the better the surgical outcome. I knew that social support has a positive effect on mental health in the same way that loneliness has a bad effect. The network of friends I’ve made at CHF has been, both before and after surgery, like family, a terrific source of support. My experience at CHF has made me realize that coming to the gym has been an important social as well as physical part of my daily life.

What’s been your biggest challenge?

For a long time, I was unbelievably stiff after sitting even a short time. Loosening up would take a minute or more of walking. Eventually, the stiffness disappeared after a few strides, and then altogether. Perhaps from disuse, I found my body lacked the strength to walk fast and perhaps my brain forgot how. My exercises have built up strength, pace and form. I’ve returned to walking with my regular group of hikers.

How did your workouts at CHF prepare you for surgery?

Jason’s first step was to listen to what I wanted to accomplish and why. He used that information to lay out an evidence-based plan for reaching my goals. Jason understood what muscles would be most affected by my surgery, and helped me with effective types of strengthening exercises and a program for following them. Jason’s never-miss-a-chance encouragements were as valuable as his technical knowledge and ability to give guidance.

How did you stay positive?

I viewed training for my surgery the way I view training for a wilderness trip. A couple of years ago, a group of us went for a long canoe trip in the Boundary Waters of Minnesota and needed to carry 40-pound canoes between lakes (portages), some quite challenging. Each one required several trips because the trip required many days’ supplies. To prepare physically, I talked to CHF trainers about what muscles I needed to strengthen and what machines I could use to mimic lifting and carrying the canoe.

As with wilderness travel, part of my preparation would be so others – the doctors, my family – could depend on me. That attitude gave me something to do, something useful and positive.

After surgery, what was the healing process like?

In about five months, I was free of symptoms and walking 3.5 miles per hour or faster.

From day one, I spent little time in bed except to sleep. If I had to draw a line describing my improvement, it would have a few peaks, an occasional valley for a day or two and some long plateaus where not much seemed to improve.

In the first few weeks of recovery, I needed a walker or cane. Walking was slow, but not too challenging. Getting in and out of bed was another story, one where CHF training played a role. Getting into and out of bed involved key muscles affected by the surgery, and it hurt less if done correctly. Jason had had me work on my core, a set of muscles the surgery would not effect, but these strengthening exercises allowed me to tighten my body so I could swivel on and off the bed with little or no pain. And once out of bed, it was the aerobic workouts Jason provided that allowed me to be up and around, dining, socializing and playing board games with my family within a day or two of surgery.

What have you been up to since your surgery?

In addition to hiking with my regular fast group weekly, I’m working out five days a week at CHF and doing a bit of ocean swimming.  I find I’m lifting heavier weights than in the year before surgery! And adventure travel has re-entered my life. My wife and I recently spent a month snorkeling and hiking with friends in Papua, Indonesia. If that sounds risky, my surgeon thought the trip was a reasonable activity. I followed his advice – no falls allowed! I was risk aversive to a T.

What’s next?

Eastern Europe and Southern France look tempting, some canyon exploration in Utah’s Escalante. As for day-to-day, CHF is my health anchor, my basecamp.