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A question for the medical professionals

Maggot

"For we wrestle not against flesh and blood"
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Minuteman
  • Jul 27, 2007
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    Virginia
    I have an arthritic hip, no cartilage left after an injury and it aches like a bitch. 600 mg of Ibuprofen in the morning helps. I take it with a big bowl of oatmeal and then some kefir or yogurt to line my stomach but lately have noticed that it seems to just sit there and irritate the stomach lining. Im wondering if the pills are not disolving and if crushing them to would alleviate the problem. I Googled it and it seems ok, though some recommend taking liquid Motrin, but I have a stockpile of tabs I bought when this bullshit hit. So is it ok to crush them or could there be side effects?
     
    Crushing wont hurt As far as medication absorption, probably wont help with that feeling either.

    best advice I ever got was to wash it down with 8-10 oz of water.
    wait 5 min, then eat to “pad” your stomach.

    Idea is the pills dont sit, the move through and absorb. Your gut slows down a bit when food is in it, keeping the tabs there longer.

    This is how I do it and seems to work just dandy.
    Or go get a new hip....
     
    Crushing wont hurt As far as medication absorption, probably wont help with that feeling either.

    best advice I ever got was to wash it down with 8-10 oz of water.
    wait 5 min, then eat to “pad” your stomach.

    Idea is the pills dont sit, the move through and absorb. Your gut slows down a bit when food is in it, keeping the tabs there longer.

    This is how I do it and seems to work just dandy.
    Or go get a new hip....

    I was supposed to get the new hip in March/April but then the China Virus happened. I need to get back on it.
     
    Ibuprofen is very hard on the body.
    I am not medically inclined in any fashion.
    I was diagnosed with osteoarthritis about 15 years ago. The doctor recommended that I begin taking glucosamine and chondroitin.
    I take the triple strength (2 tablets) every day.
    I don't know how much it has helped, but I can say that my joints are still working.
    Red Ginseng is claimed to be an anti-inflammatory, it will also increase your energy levels.
    Omega 3 fish oils also provide lube for your joints.
    If you can reduce your Ibuprofen intake by taking the supplements, i would highly encourage it.
     
    I have an arthritic hip, no cartilage left after an injury and it aches like a bitch. 600 mg of Ibuprofen in the morning helps. I take it with a big bowl of oatmeal and then some kefir or yogurt to line my stomach but lately have noticed that it seems to just sit there and irritate the stomach lining. Im wondering if the pills are not disolving and if crushing them to would alleviate the problem. I Googled it and it seems ok, though some recommend taking liquid Motrin, but I have a stockpile of tabs I bought when this bullshit hit. So is it ok to crush them or could there be side effects?
    I'm not a medical professional, just an honorary one like my law degree 🤣 🤣 , nor do play one on TV, nor did I sleep at HI Express. Be careful with those NSAIDS!!! I had been using Aleve (per advice of back doctor since ibuprofen apparently isn't compatible with the spinal shot). Dad also took ibuprofen and and then Naproxin Sodium (Aleve). You need to be very careful with them as they cause kidney damage - especially Naproxin Sodium.

    My neprhologist, Mayo Clinic Rochester educated, has told me under no uncertain terms....you will never take Naproxin Sodium again, and I'd prefer you never take ibuprofen again (I've had to break that promise twice with some bad tendinosis in my Achilles). I'm now only able to take Tylenol or Aspirin. What happens is these NSAIDS clog up the filter in the kidney. I was actually at stage 2 kidney disease (Dad basically died with stage 4) and my great doctor back in FL (before I moved to AL) called and laid the law down and said I had to go to specialist or I could die. Fortunately I picked the best doctor I have here in 'Bama. Long story short, by stopping all NSAIDS and cleaning up my diet for 2 years (I now can drink occasional beer and have occasional bacon) I've almost completely reversed damage which is almost unheard of. My nephrologist says that he won't be surprised if Naproxin Sodium is banned due to the direct traceability of damage and that ibuprofen may indeed go back to prescription (if nephrologists get their way).

    My advice is to go get that hip fixed if it's financially within your reach and go make sure your kidneys are still functioning properly.
     
    Ibuprofen is very hard on the body.

    I was diagnosed with osteoarthritis about 15 years ago. The doctor recommended that I begin taking glucosamine and chondroitin.
    I take the triple strength (2 tablets) every day.

    If you can reduce your Ibuprofen intake by taking the supplements, i would highly encourage it.

    @fdkay any chance you could expound a bit on the ibuprofen issues?

    I am also taking glucosamine/chondroiton and doing PT/rehab from Achilles rupture surgery, and am having knee joint issues from some of the exercises (I don't believe there's much cushioning left in the 60+ year old knees) I have been taking ibuprofen and tylenol as well as icing for the pain.

    I may have to look at fish oil as well for the knee joints. Growing old, even with its maladies, beats the hell out of the alternative. :LOL:

    Looks like I need to do more research on NSAIDS too. DAMN!
     
    @DIBBS. My doc said glucosomine/chondroitin is fine to take. I didn't ask about turmeric but I think it too can be hard on you in massive doses. Glucosomine doesn't digest for me (the pills) and I may try the more expensive ones by quonol. Fish oil helps too; but you have to worry about mercury. Krill oil is probably better.

    When my dog got arthritis, they wanted him on Glucosomine, fish oil, and turmeric - and I did CBD tincture which seemed to work as well. Sadly he wouldn't do the fish oil...even on salmon. He'd eat around the fish oil on the salmon!!!!! Nuts!!
     
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    I'm not a doctor, but I do wonder if eating "a big bowl of oatmeal and then some kefir or yogurt" is causing a slow-moving gut bomb to form in your stomach. Maybe take the pills with some food, but a smaller amount?
     
    @fdkay any chance you could expound a bit on the ibuprofen issues?

    I am also taking glucosamine/chondroiton and doing PT/rehab from Achilles rupture surgery, and am having knee joint issues from some of the exercises (I don't believe there's much cushioning left in the 60+ year old knees) I have been taking ibuprofen and tylenol as well as icing for the pain.

    I may have to look at fish oil as well for the knee joints. Growing old, even with its maladies, beats the hell out of the alternative. :LOL:

    Looks like I need to do more research on NSAIDS too. DAMN!
    Ibuprofen is not as bad as tylenol when it comes to your liver, but it can be very hard on your stomach.
     
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    For several of the above.

    Yeah it can be bad shit. Years ago on a buddy's recommendation I started taking Aleve. Pretty soon I started noting my shit was hard and black. Fortunately an old friend said "Stop taking that stuff now it can kill you." So I did and looked into it, apparently it had burned a hole in my stomach wall and caused bleeding. Reading the package (who reads instructions?) it warns, can lead to bleeding and hemorrhaging, even to death. Fuck...this is an over the counter drug.

    I quit and finally got my stomach straightened out and controlled the arthritis with several of the herbs and supplements ya'll mentioned. Then I fell on the hip and destroyed all the cartilage and they dont get the job done. The Ibu helps but at a cost. I guess its time for the knife...scares the shit out of me but Ive heard nothing but great reports and have one of the best surgeons around.
     
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    For several of the above.

    Yeah it can be bad shit. Years ago on a buddy's recommendation I started taking Aleve. Pretty soon I started noting my shit was hard and black. Fortunately an old friend said "Stop taking that stuff now it can kill you." So I did and looked into it, apparently it had burned a hole in my stomach wall and caused bleeding. Reading the package (who reads instructions?) it warns, can lead to bleeding and hemorrhaging, even to death. Fuck...this is an over the counter drug.

    I quit and finally got my stomach straightened out and controlled the arthritis with several of the herbs and supplements ya'll mentioned. Then I fell on the hip and destroyed all the cartilage and they dont get the job done. The Ibu helps but at a cost. I guess its time for the knife...scares the shit out of me but Ive heard nothing but great reports and have one of the best surgeons around.
    alieve can eat a hole in your stomach. i found out when blood came pouring out of my butthole.
     
    Yes, Tylenol can damage the liver as stated; but, fortunately, the liver can repair itself. Basically my rule now is...don't take anything but BP pill and stupid thyroid pill and obviously the allergy pill.
     
    if IB or aspirin were "created today" they would both be prescription.

    they are grand fathered in because they are considered a DESI- drug...around long enough that we know the effects but pretty strong to put it in laymen terms

    the effects of both stay in your your system several hours after the pain/fever reducing effect stops working

    this causes you to need more dosing for pain/fever which causes a build up in certain organs

    tylenol is still used and suggested because it has very limited adverse effects with other scrips and pain/fever reducers

    most likely the IB is cooking your stomach lining or the beginning of the intestinal tract, causing discomfort

    daily medication that is causing this discomfort pain is considered chronic and should be looked at by a professional

    crushing any medication (that is not a chewable or deliberately labeled crushable) is a big nono

    for OTC drugs (very general terms) the FDA has guidelines for "DT" disintegration time

    this is the time which the actual pill/capsuel/tablet is required to physically breakdown in you stomach

    then there is the time it is absorbed "dissolves" into solution called buffer that mimics the PH of the stomach)

    if you crush/chew break in half the total surface area is now greater and could mess with the absorption

    once the drug is your stomach solution it is being absorbed etc, if it breaks down too fast from crushing the stomach acids start destroying the drug before it gets absorbed and you dont get the full dose

    the next step is to look for timed released or enteric coated (like the 81mg aspirin)

    those products have a more robust outer coating that is dissolved lower in the digestive tract where the PH is more acidic

    this saves the stomach lining but being that it takes longer to dissolve in-turn taking more time to be absorbed by the body you will not take on of those enteric coated time released products in you have a splitting headache

    it wont hurt to try a different dosing method like the liquid, its the same active raw material so there wont be any different side effects (unless your allergic to the color/dye or something strange)

    but as suggested before, if its really killing your stomach you should have it looked at

    as with heart burn, fighting it with tums works for awhile after a while the lining gets beat to shit and you need real medication

    this is all very very general information, the real info gets boring

    i manufacture OTC drugs for a living..
     
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    I guess its time for the knife...scares the shit out of me but Ive heard nothing but great reports and have one of the best surgeons around.

    A buddy of mine has suffered from arthritis since a young age (I met him in 7th grade and he was already moving stiffly at that point), and finally had to have his hip replaced last October. He got back on his mountain bike in late March and is making huge improvements each week, and looks better than he has since his college years.

    My dad waited as long as he could to have his hip done, but by that point he tore up his back and knees trying to compensate. This doesn't seem to have been the best approach.
     
    As said above, don't crush the tabs. And as a medical professional, call your doctor and get that replacement scheduled. A new hip is the best thing you can do for yourself!!!!! With the new implants and new techniques, you will be up and running in a matter of weeks PAIN FREE!
     
    As said above, don't crush the tabs. And as a medical professional, call your doctor and get that replacement scheduled. A new hip is the best thing you can do for yourself!!!!! With the new implants and new techniques, you will be up and running in a matter of weeks PAIN FREE!
    Thats what Ive heard from several people. One guy said that in 6 weeks you'll wonder which hip it was.

    Just called and scheduled an appointment. Fuck this pain.
     
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    You guys need to be careful with the aspirin as it has two effects: pain reliever and anti-coagulant (anti-clotting). The pain relief is temporary. The anti-coagulant properties are much longer lasting. This is the reason for the taking a 81 mg daily dose of aspirin for those it is prescribed for. It acts upon the platelets and prevents them from being able to clot for the entire lifespan of the individual platelets affected, which is 7 days. Not every platelet affected is a new one, so there's that, but in reality the effect of aspirin is days, with it trailing off as the platelets die off and are replaced.

    Think about it like this: if an 81mg aspirin can effectively thin the blood for a heart patient or someone with a risk of thrombosis (the efficacy of this can be argued, not here, don't care), then consider the effects of high daily doses of aspirin upon one's ability to clot when its needed. Bigger dose = more platelets impacted. This is also why they suggest that aspirin may lead to a stroke risk as well - pop a vein in your head and it doesn't clot off, that's bad news. Had an older (not old) woman come into the ER who had fallen and hit her head on some concrete stairs. Imaging showed a subdural bleed, OTC meds complicate everything. She was a retired nurse and knew the math of what was occurring. I don't think I will ever forget that.
     
    I require daily dosages of Ibuprofen. I was medically advised to avoid Advil. They are both injurious in some ways, but based on my other meds intake, the Ibuprofen is the lesser of the two evils. In my situtation, it's a matter of protecting my liver.

    There are 16 pills in my morning dosage. 7 more in late evening. 3 more at bedtime. There are also three inhalation meds throughout the day.

    Ibuprofen is rather a bit down on my list of pharmacological concerns.

    Meds like mine require a larger fluid intake in order to properly distribute through the system. Always take significant amounts of fluids with meds. Caffeine will speed uptake of meds that need to have effect sooner. Be careful with fluids containing high acidic or alkaline levels; they can attack medicinal coatings and reregulate release rates. Generally, wait an hour or two after taking time release meds before assimilating things like Grapefruit juice.

    because I have CHF and COPD, I am compelled to take special care with my fluid intake. There can be too much, and there can be too little; and the correct level is in a more narrow band than for most other folks.

    Missing that mark puts me in the hospital for roughly 3 days every time.

    Greg
     
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    Switch to Celebrex. . It’s an NSAID with a different mechanism of action and doesn’t cause the acid reflux / upset stomach that your typical NSAIDS do

    you’ll have to ask you PCP for it because it’s not OTC.
     
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    I require daily dosages of Ibuprofen. I was medically advised to avoid Advil. They are both injurious in some ways, but based on my other meds intake, the Ibuprofen is the lesser of the two evils.

    There are 16 pills in my morning dosage. 7 more in late evening. 3 more at bedtime. There are also three inhalation meds throughout the day.

    Ibuprofen is rather ia bit down on my list of pharmacological concerns.

    Greg


    not knowing all the info from your doctors

    but ibuprofen and advil are the exact same drug/ raw material

    the active ingredient in advil is ibuprophen

    advil is just brand

    actually most of the off brand names like walgreens ibuprofen CVS etc buy raw material from the same suppliers

    the off brands that have "compare to" on the label have to go through certain testing (potency, size, shape, taste, etc)

    one of the easiest way to get a "compare to" to pass testing is buying the exact same raw material

    i buy APAP (tylenol raw material) from one of the facilities that supply the Tylenol brand
     
    @brianf

    good info. Certainly seems logical.
    I will however stand beside the best way to take ibuprofen i mentioned, if Being taken.

    i knew about some meds not being crushable, but never learned in pharmacology about some of the stuff you explained.

    working neuro for 3.5 yrs, we crushed almost everything to go down an NG or PEG tube.
    There were a few non-nos, but motrin certainly wasnt mentioned.
    For sure doesnt mean they were right telling us it was ok....... 🧐

    either way, best idea is to get that thing fixed.

    One of our ortho guys did a hip the other day for a bad femoral Neck fracture.
    lady was out of bed the next day and taking steps with a walker day 2 post op.
    she was even older than you @Maggot!!!!
     
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    @brianf

    good info. Certainly seems logical.
    I will however stand beside the best way to take ibuprofen i mentioned, if Being taken.

    i knew about some meds not being crushable, but never learned in pharmacology about some of the stuff you explained.

    working neuro for 3.5 yrs, we crushed almost everything to go down an NG or PEG tube.
    There were a few non-nos, but motrin certainly wasnt mentioned.
    For sure doesnt mean they were right telling us it was ok....... 🧐

    either way, best idea is to get that thing fixed.

    One of our ortho guys did a hip the other day for a bad femoral Neck fracture.
    lady was out of bed the next day and taking steps with a walker day 2 post op.
    she was even older than you @Maggot!!!!


    thanks,

    thats why i was saying very laymen terms

    under medical supervision and especially with other more concerning issues/triage crushed meds are the least of the worries...im talking long term headaches your talking a whole different animal pretty far up the food chain

    i think we are all in agreement...get a new hip lol
     
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    I'm not a medical professional, just an honorary one like my law degree 🤣 🤣 , nor do play one on TV, nor did I sleep at HI Express. Be careful with those NSAIDS!!! I had been using Aleve (per advice of back doctor since ibuprofen apparently isn't compatible with the spinal shot). Dad also took ibuprofen and and then Naproxin Sodium (Aleve). You need to be very careful with them as they cause kidney damage - especially Naproxin Sodium.

    My neprhologist, Mayo Clinic Rochester educated, has told me under no uncertain terms....you will never take Naproxin Sodium again, and I'd prefer you never take ibuprofen again (I've had to break that promise twice with some bad tendinosis in my Achilles). I'm now only able to take Tylenol or Aspirin. What happens is these NSAIDS clog up the filter in the kidney. I was actually at stage 2 kidney disease (Dad basically died with stage 4) and my great doctor back in FL (before I moved to AL) called and laid the law down and said I had to go to specialist or I could die. Fortunately I picked the best doctor I have here in 'Bama. Long story short, by stopping all NSAIDS and cleaning up my diet for 2 years (I now can drink occasional beer and have occasional bacon) I've almost completely reversed damage which is almost unheard of. My nephrologist says that he won't be surprised if Naproxin Sodium is banned due to the direct traceability of damage and that ibuprofen may indeed go back to prescription (if nephrologists get their way).

    My advice is to go get that hip fixed if it's financially within your reach and go make sure your kidneys are still functioning properly.

    Kidneys issues are only part of the issues with NSAID's. The likelihood of Cardiac events even in young people go off the charts with NSAIDS. MY wife has studied this for years and she and a colleague wrote a white paper on it. Further research came out 8 years later stating the exact same high risk of a cardiac event in all patients - even worse for those with existing cardiac issues.
     
    What you’re after is a selective COX 2 inhibitor. Like Celebrex. If you want to stay on an NSAID but not have the GI symtptoms that’s your best bet. I do anesthesia for a living.
     
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    Any non selective COX inhibitor can cause GI symptoms, including ulcers. They typically don’t cause lower GI bleeds. Usually gastric ulcers. Bright red blood out of your ass is typically something else. Like a blown roid or tumor
     
    interesting....

    black stools generally signify bleeding high up in the GI system (acid plus blood plus enough time to interact).....

    red bloody stools are usually from lower on the GI system and / or the ano-rectal region.

    Sometimes profound bleeding from high up can come out bloody red but that usually represents a more of a profound / significant volume and rate of bleeding
     
    Exactly. An nsaid induced gastric ulcer is most likely going to cause black stool as the blood is broken down while it traverses the GI track.
     
    interesting....

    black stools generally signify bleeding high up in the GI system (acid plus blood plus enough time to interact).....

    red bloody stools are usually from lower on the GI system and / or the ano-rectal region.

    Sometimes profound bleeding from high up can come out bloody red but that usually represents a more of a profound / significant volume and rate of bleeding
    the hole may have been in the upper intestines. i didn't get scoped.
    they gave me stuff to coat my insides and some anti-acids and it stopped.
     
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    Thanks for all the great advice. I will immediately look into Cox2/Celebrex.
     
    I have a lot of joint pain from fighting......I just drink a lot now!(y)
     
    Here's my experience with OTC NSAID's. February 11th of this year I had my annual physical, I'll be 68 the 29th of May, and passed again with flying colors. I'm still not prescribed any medications whatsoever! However, I had been taking a daily dose of 81mg of aspirin for the last 8 years. When I hit 65 I started taking 600mg of ibuprofen, whenever I hit it really hard here on the homestead, to deal with nagging aches and pains when needed.

    February 19th I had emergency brain surgery due to a spontaneous subdural hematoma. Afterwards, my fantastic neurosurgeon said I had only 2 hours left on the clock.

    No more NSAID's for me.
     
    I avoid ANY medications, although, if you have heart condition, nitro does work very well to help in critical situation.

    I use vodka as a blood thiner, pain killer and general purpose relaxer and organic inside and outside anticeptic.

    I eat raw sauerkraut, fresh garlic, oily fish and beef for vitamins.

    So far, it seems to work.
     
    Never ask a surgeon if you need an operation.
    That is straight up wisdom. But when it is time, get multiple opinions and then get it done.

    Doctors can be interviewed like its a job. Because it is, and you are the contracting employer.
     
    Didn't feel like filtering through all the above, but my doc told me to use the gel caps. She said tablets may or may not dissolve depending on your digestive tract.
     
    ...ibuprofen and Advil are the exact same drug/ raw material

    the active ingredient in Advil is ibuprofen...

    Correct you are, and I retract my statement about Ibuprofen.

    It was a brain fart on my part; I meant that I am advised to take Tylenol/Acetaminophen.

    Put together 74 years and all those meds, and sometimes some things get crossed up a bit.

    Greg (74 as of last Friday)
     
    I avoid ANY medications, although, if you have heart condition, nitro does work very well to help in critical situation.

    I use vodka as a blood thiner, pain killer and general purpose relaxer and organic inside and outside anticeptic.

    I eat raw sauerkraut, fresh garlic, oily fish and beef for vitamins.

    So far, it seems to work.
    You probably rip some stupendous farts
     
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    You probably rip some stupendous farts
    Nope, I've never had this, but I'm sure you are extremely well familiar with this condition.
    ______________________________________________________________________________

    And a question for Greg Langelius:

    Why did you like fdkay's reply reg. my post? Do you have "rip farts" conditions, same as fdkay? Trust me, I do not care if you or fddkay do have it.
     
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    Its possible the drug is fine and crushing would make it dissolve into your system quicker, There's no harm in trying that as i have done it(Other drugs) so many times. You issue might be a slow digestive system.
     
    Nope, I've never had this, but I'm sure you are extremely well familiar with this condition.
    ______________________________________________________________________________

    And a question for Greg Langelius:

    Why did you like fdkay's reply reg. my post? Do you have "rip farts" conditions, same as fdkay? Trust me, I do not care if you or fddkay do have it.
    I have been known to release epic olfactory nuclear bombs.
     
    Ask your doc for meloxicam

    I was just given a script for Celebrex but I heard from a buddy that hte meloxicam is good. Ill give the Clebrex a cautious try.
    I avoid ANY medications, although, if you have heart condition, nitro does work very well to help in critical situation.

    I use vodka as a blood thiner, pain killer and general purpose relaxer and organic inside and outside anticeptic.

    I eat raw sauerkraut, fresh garlic, oily fish and beef for vitamins.

    So far, it seems to work.

    Yea, alcohol can help but not if youve got to work and be clear headed. Doesnt really fo much for a hip with no cartilige.
    That is straight up wisdom. But when it is time, get multiple opinions and then get it done.

    Doctors can be interviewed like its a job. Because it is, and you are the contracting employer.

    Going to see about getting the operation scheduled next friday. A orthopedic surgeon who does only sholders and nerves told me the guy Im going to "Is the one Id go to if it were for me or my wife. One of the best in the business."
    Didn't feel like filtering through all the above, but my doc told me to use the gel caps. She said tablets may or may not dissolve depending on your digestive tract.

    I think the Celebrex is a gel cap. I hope that makes a difference.


    Thanks for al the posit eve comments and advice
     
    If you are not taking a good acid blocker - you need to be on one if you are taking chronic NSAID's/COX-2 inhibitors. Several OTC PPI's are available. Zegerid is my personal favorite, but Prilosec/Nexium/Prevacid will do what you need it to do.

    Celebrex, being a COX-2 inhibitor will tend to cause less stomach irritation but still can. But it works. Meloxicam is another good choice. Though it is an NSAID just like Ibuprofen, it has a much longer half-life, so you avoid the peaks and valleys of Ibuprofen

    Good luck with the hip surgery.
     
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    I had a hip replacement a couple years ago, I smashed the crap out of the ball and socket in a ski mountaineering accident long ago and lost cartilage over time like it sounds you did too. For me it hurt like a motherfucker for a week after surgery then got better over the course of a month or so. Now it is great it feels amazing to not have the chronic pain you get grinding bone on bone. The only thing I gave up is running. The reason being you have to realize it won’t last forever if you beat the shit out of it. Consider what you value. So I switched to mountain biking, and I still do ski mountaineering though not at the same level. Elk hunting again without pain. Except the normal pain which is good.
     
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    My Wife Celia had her hips replaced in the 2000's. Both hip joints were described by the surgeon as 'rubble'.

    A normally 2 hour surgery on the second one ended up taking over 8 hours. There were complications to this day that put her on a walker/roller shortly after the surgery.

    She has the most magnificent mobility scooter money can buy, with a suspension and everything. We're talking $K's. I have to disassemble it into components before I can get it in and out of the back of the van. Worth every dollar and second; sometimes she leaves me puffin' in the dust...

    I'm getting to the point (cardiopulmonary) where I may absolutely need one myself. We had a folder for Celia sometime back and that worked great for me. Right now, I get by with the store scooters. I can handle stores for about 20 min on my own; after that, I need to ride. Aside from the COPD/CHF, I'm physically fine, just pretty underweight. The only actual issue would be the transporting of the two of them.

    Acid Blockers? ROFL!

    I take 4 Prilosec each day.

    Greg
     
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