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Sex After a Hip Replacement (Page 1)

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:( I am 42 years old and had a hip replacement of the right hip. My doctor said that my husband and I can now have sex. I ask him how, I meant what restrictions did I need to use now and later. He replied very carefully. I was going to get back to the subject with him but there was so much going on I didn't. I have searched the internet night after night for books on intimacy after a hip replacement but I cannot find a thing. I assume there must be people out there with the same fears as me. I want to be able to resume a fullfilling sex life both for myself and my husband but I don't want to pop a hip doing it. Does anyone out there know where I can buy books on the subject?
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First Helper lillle
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replied August 15th, 2005
Experienced User
Can you just call your doctor back and ask him? This would save your time of trying to find an answer through books and the internet.
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replied August 15th, 2005
Thank you for your reply. I suppose I could call my doctor and ask him but he didn't seem to take it to seriously the first time. Besides the fact is that my doctor is over two hours away and to get him on the phone you have to first run your question past two other people to see if they can answer it. I really was hoping for something with a understanding of the fears that my husband and I are faceing right now. My physical therapists tells me that it is completley normal for him to be afraid of hurting me, but she had no suggestions. I think that with the number of hip replacements growing all the time this is an issue that should be adressed somewhere. I must have fifty booklets on hip replacements and the healing process but not one talks about intamacy.
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replied January 22nd, 2012
I started with hip replacements at age 20 and have had 6 surgeries, including revisions, as of a few weeks ago. I remember getting a detailed pamphlet way back with my first few replacements, but no one says a word now. Just use you 90 degree precaution and you will be OK. I had 4 kids after my original replacements and never had a problem. Would be happy to chat with you privately if you want.
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replied February 4th, 2012
Kemcr-

i too had my initial THR in my early 20's and am now in my early 40's about ready to have a revision. i'm very nervous. your words give me hope.
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replied February 4th, 2012
I'm in my mid 30's, have had both my hips replaced and single. I'm facing the reality that sex won't be the same. I'm scared to be intimate with someone and experiencing difficulty finding people who want to be with me, knowing that i've had both my hips replaced. I'm wondering if you could offer some advice. I've looked on-line for which positions are ok and those that aren't. It's hard to talK to my friends because they just don't get it.
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Thanks for your patience!

replied March 18th, 2012
i can relate to your story cuhelp, i have a boyfriend now and i don't know how to tell him that i had my hips replaced 5yrs ago. am in my late 20's and we have been intimate for a couple of times. have tried the doggy, missionary and the side position, and nothing happened to my hips. am planning to tell him soon, if he wants to marry me, fine and if not so be it.
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replied April 15th, 2012
i am 30 and im now 4 weeks post op having had a left THR during which i had to have a tendon cut in my groin, i know have a lump there which causes me great discomfort the leg is as stiff and has as little range of movement as it did before surgery therefore i cant imagine returning to sexual activity any time soon although i am desperate to ... my hubby as been very undersanding but im am starting to feel like this was not worth it!! i am suppose to be off crutches at 6 weeks ... i want to know based on your own experiences is it normal to still have this pain and discomfort this long after surgery as i get nothing when i ask my physio's .... thanks
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replied March 9th, 2013
I am a little confused. You and your boyfriend have had sex several times and used several different positions, but he hasn't noticed the large scars on either of your hips? Are you embarrassed about the scars and only have sex in the dark. If he loves you, it shouldn't matter about your replacements. Good luck and enjoy each other.
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replied February 5th, 2012

Please add me for chat. i want to talk to you reg my THR. I m 30 and single female
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replied March 19th, 2012
Double Hip Replacment
Kemcr
Hi I have just had my 2nd thr and now have both hips replaced so i am wondering if you can offer any suggestions as to safe sex positions with a double hip replacement. I never had a problem with my 1st but I am now a little cautious about the double.
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replied May 18th, 2012
Hello, I had my first replacement for right hip before I turned 21 then had for the left when I turned 22. It's getting to a year now, I would love to talk to you privately if you don't mind, would like to ask you some questions about your experience and the revision surgery, how long did it take you to need one? How did you cope with the hips during childbirth? You can please send me a mail so we can talk. Thanks
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replied May 18th, 2012
Hello, I had my first replacement on my right hip before I turned 21, had the left hip done after I turned 22, it's been almost a year now. I would like to talk to you privately, if you don't mind, about your experience, the revision surgery, how long it took you before needing one, how you coped with the hips during childbirth. I would like to talk privately please if you can. Thanks
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replied January 29th, 2013
Hi I recently under went a total hip replacement of the left hip and I myself am 22 years old. It's an osteointegrated ceramic ball on poly cup (no screws or glue was used) and thus far recovery isn't bad. My incision is healed for the most part nothing leaks out (ew!!) and it's no longer really painfull I'm also very OCD about doing my physical therapy at least once a day and have in three weeks post op now rebuild and almost tripled the muscles that had atrophied in the five years Ive lost my range of motion. That being said my finance and I were wondering when we could resume some activity in the bedroom I know most doctors say six weeks but I have already received my driving privileges back and for the most part do not take pain meds except for one before bed now. If we follow the precautions to the 'T' would it be safe to resume some activity? I feel confident we both have a great understanding of my limits, but is it too soon?
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replied January 29th, 2013
Especially eHealthy
hipreplacement22,

It is usually best to follow your surgeon's instructions. At six weeks, the soft tissues are physiologically healed, and are much better able to withstand the stresses applied to them.

But, you are an adult, you can do anything you wish. Just remember, you are only 22, so you really need to protect your prosethesis. You want it to last as long as possible. You are already looking at having the hip revised a few times in your life. And, each surgery done is more difficult and carries higher risks. So, you want to keep your revisions to a minimum.

Thus, is it worth risking your hip joint right now? Can you wait just a few more weeks? If not, then just be extremely careful to not put your hip at risk.

There is a good article on the AAHKS (American Association of Hip and Knee Surgeons) website, on sex after total hip replacement. It includes pictures of the proper positions which are safe for the replacement patient.

Good luck. Hope you have an uneventful post op course.
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replied September 5th, 2005
Sex After Hip Replacements
Lillie,

i found a little info for your question:


when may I resume sexual activity?

Sexual activity may resume at four to six weeks post-op, but please ask your physician for the handout titled “sex after total joint replacement.”


safe return to sexual activity after hip replacement

posted on: 2/01/2005
most surgeons agree that sexual activity can be resumed safely after total hip replacement (thr). The patient usually must wait one to three months after the operation. Certain positions are safe to use. But according to this study, doctors rarely talk about sexual activity with their patients.

Doctors who are members of the american association of hip and knee surgeons took a survey on the topic. They were asked how often patients ask questions about sex after thr. They were also asked how often they bring the topic up.

Data on hip dislocation during sexual activity was collected. The surgeons also looked at sketches of 12 common positions used during sexual activity. They were asked to tell which positions are okay and which ones should be avoided after thr.

Eighty percent of the surgeons surveyed don't talk about sex with their patients. Those who do a lot of hip replacements are more likely to bring it up. Any discussion of sex takes up less than five minutes of the office visit. Twenty percent of the doctors reported at least one case of hip dislocation during sexual activity.

The authors conclude that waiting to return to sexual activity after thr is advised. Wound and muscle healing improves comfort. It also decreases the chances of a hip dislocation. Most hip dislocations happen in the first three months after the surgery.


References:
diane l. Dahm, md, et al. Surgeons rarely discuss sexual activity with patients after tha. In clinical orthopaedics and related research. November 2004. Vol. 428. Pp. 237-240.
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replied April 14th, 2012
i am 30 and im now 4 weeks post op having had a left THR during which i had to have a tendon cut in my groin, i know have a lump there which causes me great discomfort the leg is as stiff and has as little range of movement as it did before surgery therefore i cant imagine returning to sexual activity any time soon although i am desperate to ... my hubby as been very undersanding but im am starting to feel like this was not worth it!! i am suppose to be off crutches at 6 weeks ... i want to know based on your own experiences is it normal to still have this pain and discomfort this long after surgery as i get nothing when i ask my physio's .... thanks
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replied September 20th, 2005
Sex After Hip Replacement
Lilllie,

my wife had both of her hips replaced 2 years ago. We are in our mid forties and were both interested in resuming our sexual relationship. Unfortunately, we ran into the same problem as you. My wife's doctor told her that she could resume sex but offered little advice. We went on the internet and luckily found a hospital site that had some graphic drawings of positions that could be used after hip replacement. (i will try to locate the link and post it here.)

basically, the missionary postion is easiest for the woman. However, you must follow hip precautions. This means that you can not bend your legs back towards your chest and you cannot wrap your legs around your partner. Either move will greatly increase your chances of dislocation. My wife generally bends her knees and keeps her feet flat on the bed. Truthfully, this is not the easiest way for the man to do it because it restricts his entry and does not allow for a deep penetration. With time we worked it out. (in the begining I think my wife was very nervous and probably in some pain so it made it more difficult.)

female on top is a no no because of hip flexion. So is doggy style. Go slow and you will find a comfortable routine for you and your partner. My wife also found that using a small pillow between her knees made things more comfortable when we wanted to hug and kiss facing each other on our sides.

Hope that helps!
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replied July 17th, 2011
Sex after Total Hip Replacement
Rich,

I hope you are still watching this post of almost 6 years ago. I am a womaon in my 50s and about to get a hip replacement. This is discouraging - and you two were in your 40s!

My question for you: When you say "cannot bend your legs back towards your chest and cannot wrap your legs around your partner" - do you mean EVER? Or for a period of time?

Thanks!
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replied January 4th, 2012
Don't know if you are still watching this blog. I am 47 and had a total hip replacement 6 weeks ago. My husband and I resumed our sex life 3 weeks post surgery. Try laying on your side with the affected leg up over the top of him. He has to be gentle but it works! My most comfortable position now is on top with my replacement leg on the floor. I can control the depth of his penetration and the speed of the motion. We are both tall so it helps that I can reach the floor off the side of the bed. I am now 6, almost 7 weeks out and we have resumed a very normal, satisfying sex life-even better than before surgery as there is no longer the hip pain. I keep reading that the missionary position is the best one for post surgery. I for one cannot imagine that it would be comfortable at this stage. Hope this helps.
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replied January 5th, 2012
Especially eHealthy
tmarie1,

The reason that the missionary position is recommended is that it is the position that is least likely to cause the hip to dislocate. The surgeon is not really concerned about comfort in this time period. In the early post-op period, you do not want to put pressure on the joint capusle, stretching it out and causing the joint to be loose, or possibly even dislocating the joint.

After the joint capusle has healed well (around 6 weeks or so), then it is not quite a critical, but all THR patients should avoid certain positions (adduction, internal rotation), that could still lead to a dislocation.

That's mainly why the missionary position is recommended in the early post-op period, to reduce the chances of a dislocaion.
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replied January 5th, 2012
I understand that you MUST be careful with any activities that may affect the position of the hip that was replaced and that everyone heals differently. I am an extremely active person and am fortunate to have healed at an extremely fast pace.

I have been an avid horsewoman for over 40 years and my surgeon as well as physical therapists have all commented on the more than average strength that I have in my legs. I also started strengthening exercises and dropped 15lbs six months pre-surgery. I am also very diligent about my post op physical therapy.

I keep my affected leg completely straight and have total control the entire time. The position with the man on his side and the woman on her back with the affected leg over him is one that was easiest for us at first and actually recommended by my therapist. Again, everyone is different-I have been a week to ten days ahead of schedule during my entire recovery with virtually no pain after about 12 days post surgery.

My husband and I have enjoyed an extremely happy marriage and sex life for 27 years and sex was most certainly a concern with this whole ordeal-in reading some of the postings on here, I am empathetic with the people going through this. My advice is to listen to your doctors and therapists and prepare your body and mind before surgery. DO the leg strengthening! DO the therapy! I believe it has made a world of difference in my case.
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replied April 14th, 2012
Intamacy after total hip replacement
Two weeks post op Monday for me. 53 years old. This is encouraging. Thank you
Kellie
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replied September 29th, 2005
Sex After a Hip Replacement
Dear rich 48,
thank you so much for the personal view points. I can not tell you how many statistics I have heard. After reading the problems that you and your wife had I couldn't help but think I can't wait to show this to my husband. It was the exact same concearns and conditions that we have faced. Our sex life has started to get better but I don't believe it will ever be what it once was.
I see in your letter that your wife is alot further advanced in postop time then I am. I had my surgery june 30 of this year. I am still in terrible ,constant and sleep interrupting pain. I was wondering is your wife feeling all better and if so how long before she started feeling good.

Hope to hear from you soon.


Lillie
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replied October 1st, 2005
Sex After Hip Replacement
Hi lillle,

i've had trouble posting here, this is my fifth and final attempt! My wife had her right hip replaced a bit over 30 months ago. Her left hip was replaced was replaced 22 months ago. I would say the pain was bad the first three months. It gradually diminished by the end of a year. Even now, if she bends the "wrong way" she will complain of pain for a day or two. She says it is muscular, not hip pain. Fear not, however! Last month my wife and I hiked to the top of a 7,000 foot mountain! No hip pain, but we were both out of breath....




I would think that three months post op you should be fairly mobile. You should be walking, climbing stairs, etc. Without much difficulty. If you are having problems, make a list and go over it with your surgeon during your next visit. If you are in a lot of pain, see the surgeon now! Maybe something is wrong. Don't let him blow you off.




Sleep. Well that is an interesting topic. If your experience is similar to ours, you won't get much in the beginning. My wife had to sleep on her back for the first five weeks after both hips and it drove her crazy. After her right hip, she slept in bed with me and neither of us slept much. After five weeks, the surgeon allowed her to sleep on her side with a small knee pillow between her knees. (which she still uses to this day.) after the second hip she slept in a reclining chair in the living room. I would give her a pillow and wrap a blanket around her and pray she would sleep a few hours. It was a long five weeks for her. She still doesn't sleep well, but now she attributes that to perimenopause. What can I say?




Sex, well I guess I got off the posted topic. It is a shame that we so equate sex with intercourse. Will your sex life be the same as it was? Probably not. Can you still enjoy sex with your husband? Absolutely! Be creative! Try mutual masturbation and / or oral sex. The point is, you have fallen out of your groove. I assume that you and your husband have been together for a while. When you first take a new lover, it takes a while until you establish a routine. Well, have fun establishing a new routine! The key is communication. Don't be afraid to tell your husband that it hurts to have intercourse right now. Do tell him that you still want to be intimate and then go have some fun! This will allay his fears and pump up his male ego. When my wife and I first attempted sex, it was difficult. She was uncomfortable spreading her legs wide enough for my hips. (and I am a thin guy!) I was concerned I was going to cause her pain and for the first time in my life I experienced erectile difficulties. It was a little rough in the beginning and the surgeon didn't offer any guidance. We developed some new routines and little by little we worked things out. To be totally honest, intercourse is not as good as it used to be. I miss my wife being able to bend her legs or wrap them around me. I am not able to penetrate her as deeply. Do I still enjoy it? You bet! And I am grateful that she was willing to try, despite the ocassional discomfort. Since you only had one hip done, your experience will probably be some what different than ours. And probably better!



good luck! Please let me know how things work out for you.




Regards,
rich
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replied October 5th, 2005
Oh, Dear...
:shock: rich: thank you very much for your postings...They have answered several of my questions & raised many more.


I am scheduled for a bilateral thr nov '05. Have done extensive net research re: tech specifics. The question of sex I realized was never addressed so I went back to net searching. After reading your posting, I am now totally freaked!! Why? I apparently was wrongfully under the impression that my sex life would return to something more normal after 6 months. No doggy; no "on top"; limited missionary!!!! Oh, dear.....

What else is not allowed on the thr sex diet???


Can you post (re-post?) the link for the hospital site with the "positions"?

As you can tell, I am having a hard time being positive about this (a young 55 years & unmarried).


Regards, lesley
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replied May 31st, 2011
sexual intercourse following partial hip replacement
Don't freak out! I am your age and had a Birmingham hip replacement exactly 8 weeks ago. True, you want to uphold certain hip restrictions for 12 weeks, which means not bringing your knee up higher than a 90 degree angle. However, the missionary position is fine. You might have trouble turning that knee completely outward however. I have found that placing a puffy pillow under the knee helps you to be able to open your knee to the side partially, while having it supported and protected from opening all the way. Hope that helps! If you can get a Birmingham (partial) hip as opposed to a full hip replacement, that is definitely the way to go! Good luck!
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replied May 31st, 2011
Especially eHealthy
spring23,

Welcome to eHealth, I noticed that this is your first posting. However, did you notice that the person you are replying to, placed that message over five years ago?

But, I wanted to point out that the procedure you had done, the Birmingham Hip Resurfacing, is a lot different than a total hip replacement. In the Birmingham resurfacing, a lot less bone is removed and the surrounding support structures do not have to be taken down as much. So, it is somewhat like comparing apples and oranges.

Thank you for providing your experience with the Birmingham hip resurfacing procedure, but patients have to understand that it is much different than a total hip replacement.

Again, thank you for providing your experience.
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replied November 6th, 2012
I am 36 now just had a revision two weeks ago the total was done 3 years ago and i did all potions and in 3 months will continue with my own way of sex. I didnt ever have a problem with the positions (i did them all) but my hip felt very stable. The reason i had to have a revision was it was metal and ceramic and doctor felt hard on hard was causing my problems. Yes he did say he saw were i had over extended and hit the part that is screwed in but it did not pop out of socket. He said to try not to do that anymore. But i live very active life and built muscle up to have an active normal sex life. I believe if you don't hurt and feel stable with your hip when try starting out slow and go from there that is what i did. But everyone is different. Hope that helped, Amy
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replied November 6th, 2012
I am 36 now and just had a revision two weeks ago the total was done 3 years ago and i did all positions and in 3 months i will continue with my own way of sex. I didnt ever have a problem with the positions (i did them all) but my hip felt very stable. The reason i had to have a revision was it was metal and ceramic and doctor felt hard on hard was causing my problems. Yes he did say he saw were i had over extended and hit the part that is screwed in but it did not pop out of socket. He said to try not to do that anymore. But i live very active life and built muscle up to have an active normal sex life. I believe if you don't hurt and feel stable with your hip then try starting out slow and go from there that is what i did. But everyone is different. Hope that helped, Amy
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replied October 5th, 2005
Sex After a Hip Replacement
Lleslyl,

first let me wish you a successful surgery and a speedy recovery.

Please note that I am not a doctor. Any advice that I post here is srtictly based on my experience living with someone who has had both hips replaced.

Please note that having your hips replaced is not a death sentence; sexually or otherwise. I know several people that have had knees and or hips replaced and all have experienced a wonderful improvement in their quality of life. Lets face it, the reason you are having your hip replaced is because you are in pain and probably have a limited range of motion. You will be in pain after your surgery. Exactly how long, I can't say. My wife is a trooper (she had our only child vaginally, without anesthesia) and she can tolerate a lot of pain. I know she was suffering before the surgery because she was desperate to have it done. My wife hates going to doctors (she is a nurse); she would have climbed the empire state building before going to have her hip replaced. So the pain was bad, even with pain killers.

After her surgery, my wife came home and rehabed herself. Our bedroom and bathroom are on the second floor and she would use her crutches and get herself up there despite the post op pain. Before your surgery you should get yourself a hip chair (you will be sitting in it quite a bit) an adapter for your toilet with side rails and adjustable crutches. I picked up these items at a local surgical supply. We rented the hip chair by the month. You will not need it permenantly. One other good item to pick up is a gripper. The sell them at linens and things and probably at surgical supplies too. You won't be able to bend over so it will help you pick up the morning paper or items you might drop on the floor. Dressing will be a challenge in the begining until you get the hang of it. Another good item to buy at the surgical supply is called a sock aid. It will help you get socks or pantie hose on your foot and part way up your leg.

One other item to consider is bathing. Of course you can't take a bath. Showering is kind of off limits too -- for at least two weeks until they take out the staples in your surgical site. My wife couldn't wait until she got home from the hospital to get cleaned up. She desperately wanted to shower, so I rigged up something. Not too pretty, but it worked. (duct tape and some 4 mil plastic to seal all around the dressing. While it kept the dressing dry, it was nasty to remove. Eventually we hit upon a roll of wrapping plastic, you know, the kind they use to wrap around boxes in stores. I would wrap it over her hip and around her leg and it worked, but it is a bit tricky around the hip area to make sure it is sealed against the skin. This is not something you can do yourself. Don't even try it unless you have help.

I know you didn't ask me any of this, but I think you should know so you can be prepared.

So, back to the sex question. You can still have sex after your hip is replaced! You just have to try some different positions! Please try the links in my 10-01-05 posting above. They do work. If they don't work here, please copy and paste them into your web browser. One of the links is a site which offers an illustrated manual for $3 which will provided you with information on various sexual positions. If your doctor will give you the time of day, have him look at it for his advice.

Pretty much anything you can do before hip surgery, you can do afterwards. (ok, no running, no doubles tennis, that's about it.) you have to make some subtle changes to maintain hip precautions. For instance, being a lady, you can no longer cross your legs when sitting in public. Getting in and out of your car will require some thought. No sitting on big plump sofas. No sitting on low chair or low toilets. It takes some practice for these things to become second nature. After two years my wife has incorporated all these things quite gracefully and only once did she slip up getting into the car. She kind of freaked worrying about dislocating her hip.

My wife is not a big experimenter, so missionary position has been the way to go. Some of the information I found while reasearching all of this shows woman on top to be ok. I suppose my wife could manage it as she has taken that position to massage my back. We just never tried having intercourse that way because she didn't care for that position long before her surgeries. What it comes down to is this. You will be able to have very satisfying sex with your partner. It will require patience on his part. It will be different than you existing routine. You can't cross your legs and you can't bend your leg past 90 degrees relative to you body. (so no pulling your knees up to your chest!) you will find some comfortable positions that work for you.! Be creative and have fun experimenting. (like when we were all younger!) and please remember, your experience could well be different than ours.

Good luck and I hope all goes well for you!

Rich
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replied October 5th, 2005
:) rich: you're great for taking the time to write back in detail length & address my concerns. I do feel more hopeful on the sex issue & appreciate the aside personalized situations. Books do not at all convey the day to day issues that make up this total experience.

Again, my thanks...Lesley
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replied October 5th, 2005
Sex After Hip Replacements
I too have had double hip replacements. The first was may of 2003, right. The left was replaced just last october 2004. Right after the right hip surgery my husband and I divorced not due to the surgery although it certainly did not help. Sexual events, however were very scary and did not succeed.

There is a new interest in my life and am wondering how a full and happy sex life could be achieved safely and comfortably. My hips were replaced not because of athritis but fractures. Would this be a factor?
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replied October 6th, 2005
Sex After Hip Replacements
:?: merri: would you care to elaborate on the "very scary" aspect? As I am not in a actual pain--more like major ache & substantial limp in left hip & very, very minor deterioration in right and scheduled for nov '05 for both in an effort not to have to go though this again--i am seriously considering postponing the event for a couple more years.

The ongoing concern of dislocation & a real crimp on one's sex life (not that positioning is totally perfect currently) makes me wonder if I am really ready for the required tradeoffs. I am a very active person--offshore sailing, japanese gardening, & again not married at this time.


Is it that you think find your self thinking about dislocation during sex or that it is too painful still after all this time? Appreciate for feedback...
Lesley
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replied October 8th, 2005
Sex After Hip Replacement
My husband just had his hip replacement on 9-22-05.He has been in a hospital bed for a number of years due to his arthritis.We have had only one way to make love.Me on top.I read the other post.Where one kind of blames the limitations on the correct positions for the fail of their marriage.There must have been problems before hand.The allowed positions are great fun.There are good positions that are allowed.I can't wait :d :lol: .It's been only one way for about 7 years.Maybe just enjoy each other no matter what kind of accomadations you have to make.If there is love between the both of you then it should be very enjoyable. :lol:
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replied December 5th, 2005
Hip Replacement
Hi I am 26 years old and I am going to have to get a thr. I'm really scared. Will I walk with a limp, will I be able to have babies? I thought that my sex life would go back to the way it was, but I guess not. I can't tolerate the pain anymore, but i'm really scared. I'm also looking for a good surgeon. Any suggestion on how I should do so.

Thanks
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replied December 5th, 2005
Some Answers...
Hi all,

i’m sorry to hear how little info is available to those who are having their hips replaced, and as a result, so many of you are fearful or nervous about its effects on your life afterward. I am an occupational therapist who works on a reconstructive orthopaedics ward and I want to help if I can. For those who already know all this, please bear with me.

Here are the three things you cannot do:
1. No bending of thigh relative to trunk past 90 degrees.
2. No crossing the legs.
3. No twisting of the torso.

Yes, there are movement precautions or restrictions after your thr, and here’s why. Your hip joint is the most secure joint in your entire body. Seeing as it supports all your body weight, makes sense, right? It’s a ball and socket joint. The thigh bone (head of the femur, the ball) inserts into a cup-like space (acetabulum, socket) on your pelvis. The security of the joint comes from the number of ligaments (connecting bone to bone) that cover that head from the outside of the cup, under the muscles and under the skin.

Now, when your surgeon operates, he has to cut one of those ligaments in the back towards the side, to get at the head. When he has replaced the joint, he then sews back up the ligament he has cut. Ligaments, unlike muscle, cannot be exercised and strengthened. They are pretty inelastic. And that spot that he has sewn up is a weak spot. If you insist on moving the ways listed above, that spot will stretch, and the ligament does not bounce back after it stretches. You must let it heal, if you want the security of your hip joint to return. But here’s the good news… the 90-90-90 rule. We say that these rules need to be followed religiously for the 90 days after your surgery to regain 90% of the strength in the ligament for 90% of our patients. They are not forever. During those three months, you will need to avoid sitting on any surface that comes lower than your knees. If you take good care of that joint, and don’t go running or skipping rope or playing contact sports on it, it should last you at least 15 years. People commonly say within the week after surgery that they should have had the joint replaced years ago. The improvement to your quality of life will be very dramatic. Trust me.

Here’s a list of equipment that you must have:
a raised toilet seat
a raised bathboard (for bathtubs with curtains), or a tub transfer bench (for bathtubs with glass doors) or a shower chair (getting in and out to bathe is the single most dangerous thing you will be doing after surgery)
a long handled reacher/grabber, 26 inches
a sock aid
a long-handled shoe horn, 24 inches
crutches/walker

recommended equipment:
a firm, 4-inch foam cushion (for raising the height of any seat lower than your knees)
elastic shoelaces / slip-on shoes
furniture raisers
grab bars in the bathroom (wall-mounted or tub clamp-on)
a sponge on a stick

finally… sex… good positions for the man who has a thr include: the spoon position with his partner (remember the pillow between the knees for him), or on the bottom with his partner above him or, lying on his side with his partner on her back, with her knees/legs draped over his hips or doggy style, provided that his torso stays more than 90 degrees from his thighs (so not too bent over).

Good positions for a woman with a thr include:
being spooned (remember the pillow), or the missionary, or doggy style, with the upper body propped on a firm cushion/ bunch of pillows to keep her torso up.

I am long-winded, but even this is not a definitive reply. I just figured I should answer the most pressing questions.

Hope it helps!
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replied April 14th, 2012
Yes, thank you
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replied February 5th, 2006
Sex After Hip Replacement
Thank you all those who offered practical advice, you have given more help in the short time it took to read your contributions than the doctors in the 12 weeks since my op. All the booklets they hand out say you can resume sexual intercourse but the how is not addressed.

I am a 56 year old female who has been married to the same man for 33 years and had my right hip replaced. After all these years, we are willing to try anything together but were both worried about causing damage to my new hip.

I am pleased to hear from the physio that doggy fashion is ok, and from another contributor that woman on top is manageable. I may wait a while for that, though.
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replied March 11th, 2006
Sex After Total Hip Replacement
Hello everyone, I’m a 26 years old female and I'm not sure if you (syro1997) have had your total hip replaced yet, I saw your message on the ehealth forum. Like you, I’m concerned about the hip replacement and how my sex life is going to be after the THR. I'm schedule for surgery in June, 2006. I have had 2 osteotomies on both hips, one when I was 9 and the other one when I was 14 years old on both hips. I don't know anyone my age that have had THR and that's why I’m trying to get in contact with you so you can tell me your story. Like everyone else, I’m thinking really positive that everything is going to be ok and that my daily activities and sex life will get better.

I will really like to hear from you and how are you doing with the THR if you have had the surgery and if you have tried sex yet?

Based on what I’ve researched is better to try sex after 3 months so that the ligaments heal and the muscles get their strength back.

I was born with congenital hip dysplasia on both hips. I visited 4 doctors to get different opinions and now I’m going to have my THR at Georgetown University Hospital in DC. I will probably need to get my right hip replaced sometime, but not now. This surgery is for my left hip only. I have pain sometimes because of the arthritis and I am also limping a lot because the femoral ball has moved up and it is practically out of the socket. I do not have a perfect socket and that's why the ball is kind of dislocated. I’ve been walking with a cane for 2 years now and I haven’t being able to enjoy my 20s too much. On top of that I also suffer from Roussy Levy Syndrome, which basically if I don't exercise I lose the strength in my extremities really fast, but I can gain it fast too. I' a little weak right now, and is kind of painful to exercise my left leg because of my hip.

The doctor said that after the THR I will definitely have a leg shorter that the other one just for millimeters, and because I’m not that tall (5'1'') he said I am going to feel the difference. When I get my right hip done he will try to even them out.

The doctors have told me that I can have kids and that the weight that I gain from the pregnancy will not affect the THR. I guess I just have to exercise a lot to keep the muscles strong to prevent dislocation.

I have a boyfriend, and we have had tough moments in my relationship because of my hips. We have been together for 6 years now, but my hips have really worsened since I meet him. I'm hoping that the THR will give me a lot of range of motion so that I could open my legs more, but I know is going to take time. I guess I just have to be patient.

I also discussed with my doctor the option of getting ceramic on ceramic prosthesis and he said that that material will be perfect for me because they last longer, but it just depends on how good they will fit since I’m petite (115 lb, 5'1'').

Where I live the winter gets really cold sometimes and I’m hoping that the cold weather won’t affect my hips (discomfort, ache, pain).

Any feedback is appreciated.
Thank you
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replied January 22nd, 2012
THR
hi i hope that you are still watching this post! i am 30yrs old and scheduled to have a thr in may,, i have never come across someone else who has had this done at such a young age ... as it is now a few years since you had yours i was wondering if you could let me know how and if it did affect your sex life and you day to day life in general any feed back would be greatly appreciated thanks
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replied January 22nd, 2012
hi i hope that you are still watching this post! i am 30yrs old and scheduled to have a thr in may,, i have never come across someone else who has had this done at such a young age ... as it is now a few years since you had yours i was wondering if you could let me know how and if it did affect your sex life and you day to day life in general any feed back would be greatly appreciated thanks
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replied January 22nd, 2012
hi i hope that you are still watching this post! i am 30yrs old and scheduled to have a thr in may,, i have never come across someone else who has had this done at such a young age ... as it is now a few years since you had yours i was wondering if you could let me know how and if it did affect your sex life and you day to day life in general any feed back would be greatly appreciated thanks
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replied January 22nd, 2012
hi i hope that you are still watching this post! i am 30yrs old and scheduled to have a thr in may,, i have never come across someone else who has had this done at such a young age ... as it is now a few years since you had yours i was wondering if you could let me know how and if it did affect your sex life and you day to day life in general any feed back would be greatly appreciated thanks
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replied January 22nd, 2012
Especially eHealthy
jojo,

Welcome to eHealth. I doubt you will get a response from PTY, as that was her one and only post, nearly six years ago.

While 30 is quite young to have a total hip replacement, it is not that uncommon. The youngest I have seen a THR done is in an 18 year old.

Activity after a total hip is encouraged, as long as it is not of the impact nature. While total joint prostheses are getting better, they still do wear out. So, you want to protect the joint from as much wear and tear as you can. However, you do not want to be sedentary, as that can cause a whole host of problems itself (ie muscle atrophy, cardiovascular deconditioning, and osteoporosis).

While everyone recovers from the procedure in their own way, most of the time the patient is up, ambulating (with a walker/crutches) within 24 hours of surgery. There are certain activities and positions that have to be avoided in the first few months, to make sure the joint capsule heals and dislocation is avoided.

Walking is a great exercise for THR patients. Swimming, bicycling, light weight lifting, light jogging, golf, and the elliptical trainer are all good activities also. You should be given a list of exercises that you are supposed to do during your rehabilitation and what activities than you are to avoid.

As to sexual intercourse, that is usually allowed once the post-op restrictions have been lifted, and when the couple feels comfortable. Be sure to speak to your surgeon concerning sexual intercourse. Ask any questions you wish to have answered; such as how soon and what positions. Do Not feel embarrassed, or that you may embarrass the physician. This is actually a topic that is extensively covered in orthopedic residency training and during total joint fellowship.

Intercourse is a very important part of a patient's health, both physically and mentally. So, again, it is a well covered topic. Ask all the questions you want.

Good luck on your surgery. Get as much information as you can pre-op. The informed patient does much better in the post-op period.

Again, good luck.
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replied January 22nd, 2012
Thanks so much for your feed back Gaelic. I am no stranger to surgery or recovery having had 2 hip reconstructions, tracantric plates n so on n so forth, now needing the hip replacement due to avascular necrosis and oesteo-arthritis.

i am having a ceramic hip not a titanium as my surgeon feels i will benifit from this more, he has been trying to get me on the waiting list now for over 12months but through my own insecurities i have refused up untill now that is as i can no longer take the pain in my hip,back and knees (both secondary pains).

However i have asked my surgeon about sexual intercourse post op 2 which he replied that it was possible after the 3 month recovery period but to be careful ... i did not find this reassuring, i am happily married and i do not want this to become an issue ... but i also do not want my physical health to suffer any longer its a bit of a catch 22 situation. I have only been with my present surgeon for 18months as my previous surgeon who i had been with since childhood felt i needed someone with more expierience in THR i on the other hand dont have to much confidence in him, i feel he doesnt acknowledge my concerns/fears.

hopefully though, now that i have found this site i shall be more informed and shall definatley update post op to let people know of my experience as i feel that there just isnt enough information on this subject out there.

Again thank you for the reply it is nice to be informed for a change. I am extremley grateful.
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replied January 22nd, 2012
Especially eHealthy
jojo,

As to the sexual intercourse, by three months it shouldn't be a problem, at all, unless you are into really odd positions, that would put the wrong stress positions on the joint.

But, the missionary position is actually one that does not put the hip in any danger. In that position, the femeral head is actually pointed into the acetabulum.

Since you have already had a couple of major reconstructions on your hip (as opposed to just a percutaneous pinning of a SCFE), you really need a hip surgeon well versed in complex total joint replacements.

If you are not confident in your current surgeon, find another one. You need a surgeon who does a lot of total hips, and preferably one that does a lot of revisions. The surgeon should have fellowship, or extra training, in complex revisions. Your replacement is not going to be the usual run of the mill primary replacement.


Also, if the surgeon is that put off by you asking about sexual intercourse, a very vital part of a patient's life, what else is he not going to care about? Seriously, you should find the best total joint surgeon you can. You have already experienced what complications are all about. You want to avoid them if at all possible.

So, good luck. If you have other questions about intercourse, if I can answer them I will. Hope you have a great day.

Good luck.
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replied January 23rd, 2012
I had a THR 9 weeks ago today. My surgeon also opted for the ceramic hip. I was told that with the ceramic is chosen for younger, more active people. My recovery has been amazing! I was back up on a horse 7 weeks post surgery! My husband and I resumed our sex life 3 weeks post surgery with no issues what so ever. It gave us an opportunity to be a little creative and sex is better than ever! Be careful and enjoy it!
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replied January 23rd, 2012
Thanks for your input tmarie1 this is very reassuring!!
I am not the most active of people but having 3 children to run around after and been of a young age i suppose this is classed as much more active than a more mature person. 3 WEEKS!!! AMAZING!! I hope that i feel comfortable enough at such an early stage. I am so glad to of found this site, its answering so many questions and getting valuable info from people with 1st hand experience. Again thanks for taking the time to reply and i hope that you continue to make whats sounds to be an excellent recovery!
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replied January 23rd, 2012
can i also ask tmarie1 what strengthening exercises you did pre-op as i have had no advice on this and would like to be in as fit a state as possible to help my recovery. Many thanks.
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replied January 23rd, 2012
thanks to gaelic for your input too ... its very reassuring
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replied January 23rd, 2012
Let me dig up the notes the doctor gave me and let you know. I had my surgery in November of 2011 and I was still riding horses until July of 2011 when it got too uncomfortable. Try squeezing a ball, like the size of a kickball between your knees to strengthen those inner thighs as much as you can. It helped to have strong upper legs during recovery so you don't have your knee turn in to support yourself. I will get back to you soon!
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replied January 23rd, 2012
Especially eHealthy
jojo and tmarie,

If you Google "AAHKS, total hip replacement, sexual intercourse", you will get a link to the American Association of Hip and Knee Surgeon's web based resources page.

Scroll to the very bottom of the page and you will find a section titled, "Everything you wanted to know about sex after your total hip". There are several links to very informative articles on the subject (some with pictures).

Hope this helps. Good luck.
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replied January 24th, 2012
thanks tmarie and gaelic i will try using the ball while i wait and i will be sure to have a look at that link much appreciated.
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replied April 14th, 2012
Gaelic i am now 4 weeks post op and it seems like a never ending road,i have more pain and discomfort now than i did before surgery,when doing the op my surgeon had to cut a tendon in my groin that had become extremley tight so i expected to have some soreness but i now have a lump which digs and pulls to the point i cant stand straight,i ask my gp he says it could be a bone cavity but he isnt sure although hes confident it isnt infection,i ask pyhsio they say its the tendon healing ( even though its a good inch up from where the tendon was cut), my hip has as little range of movement as it did before surgery and hardly any abduction, i cant see my self been able to do missionary again!! the aftercare i am recieving is horrendous(meant to see my surgeon 6 weeks post op appointment has came for 14 weeks post op ... pyhsio are meant to come to my home once a week they havent been for 2!!) i need some answers and reassurance,, i am meant to be fully mobile at 6wks post op ... this also i dont see not how my hip is at the moment ... i asked my pyhsio if there were any muscle strenghening exercises i could do when in bed ... her reply ... dunno!! please help ... thanks in advance
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replied April 15th, 2012
Gaelic, I googled this and went to the link and it says it's no longer available.

I am 53 and 2 weeks post op and this looked very interesting and helpful

Sad

KAN
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replied April 10th, 2012
Wow, sitting hear waiting for my PT one week and one day since THR on the left side. 53, female and looking for answers regarding intimacy, etc. I am going to do my exercises and get back to this forum today!
Thanks,KAN
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replied April 15th, 2012
Hi nuthatch, I had my last in home PT yesterday and starting as an outpatient Tuesday. Did some of my exercises this morning before getting out of bed and did them all again a little later. Definitely important to get them in at least 2 times a day. Even though they came here to help me, I get a lot more out of them by myself.

Looking forward to finding more info on the AAHKS site that Gaelic posted in January. If I find anything helpful I will post it.

I feel like I am doing pretty good. In home rehab, tried using a cane a couple of days ago to go to the Dr, but I think it was a little too soon. Just using one crutch though and slept through the night for the first time last night. It was tough getting up though after not moving too much all night.

On another note, regarding your handle, are you a bird watcher? Nuthatches are one of my favorites although I have to say what ever I am looking at at the moment can be my favorite.

KAN
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replied April 16th, 2012
can i ask what exercises you do in bed, as all my PT has given me is standing up abducting, no muscle strengening to do in bed, whe n i asked her what i could do she said 'dunno' my aftercare is ridiculous, i am 30 yrs old and 4 weeks post op from a left THR.

Thanks
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replied May 1st, 2012
YOUNG PATIENTS THR
Hi jojo

I am 27 yrs old, just had a THR less than a month ago and full functional, no pain or complications but slight discomfort at the incision location. I am height/weight proportionate and was active quite before the surgery. I have DDH and just last year discovered I needed surgery to relieve severe arthritis.

Regarding exercises in bed, be sure to do plenty of ankle pumps (pointing and flexing at the ankle), heel slides (sliding your heel back until your knee is at 45 degrees), gluteal (tightening your buttock, hold 5 secs and release), quads (tightening your thighs, hold 5 secs and release), and leg lifts (keep the knee opposite of the leg being lifted slightly bent). All can be done in bed, whenever you think about them do it! Try 3 repetitions of 10 sets at a time--cease if you are in pain or fatigue and resume later. I promise you, if you do them religiously you'll be able to graduate to even more challenging exercises, and continue to get stronger and better.

My operation was at the Hospital for Special Surgery, which was a blessing as they are #1 and have cutting edge knowledge. Check out their website are tons of very helpful post-op articles. They have a post=op sex document as well--I haven't tried it yet, a little nervous but looking forward to experimenting to see what works!

I hope this helps, I understand how having this surgery so young is a challenge. It can seem like an unfair blow, but feel good you had the resources to get it done and overall it will improve your quality of life. Just take baby steps and make your MIND and BODY stronger (TOTAL body, don't neglect the other non-operated areas). Every day you do so, you'll see improvement. Get a better physical therapist--the one you have doesn't sound very professional and could threaten your recovery. If you ever need a follow up I have a great surgeon. Good luck:)
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replied March 28th, 2006
Sex After Thr
Hi christi
i was glad I read your article on ehealth (i have never done anything like this before) I am 26 also and am booked in for a right total hip resurfacing!
I was born with congenital dislocated hips and had perthes disease! I had little or no pain until I was 21 and then had to have a femoral osteotomy and trochanteric advancement - I thought I was fixed after that - even though it was teh most painful experience of my life! But alas I have had further surgery since then! I am never one who likes to complain about my pain! And its hard to talk about it with alot of people - as its hard to comprehend someone young having major probs with their legs! I feel for you - and although I wouldnt wish this kind of thing upon anyone - its nice to know that there are other people out their experiencung the same kinds of issues, pain and frustrations.

I am hoping that my resurfacing will change my life and make everything easier and better - now I am begining to question that ! The thought of not being able to have sex is driving me crazy! I suppose its always been an issue as my hips and knees have always restricted me somewhat - but I thought after surger - well 3 months - that it would be all better

id like to know what your thoughts are - from one 26 year old to another!!
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replied August 13th, 2006
Not That Bad!
I had my hip replaced two months ago, I had sex with my wife a 10 days after the surgery, (her on top), however a week after that, we had sex again and I am back on top, no problems, well i'm only 26 so that may help. Just remember your hip procautions. If it hurts then do not do it.

Good luck
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replied September 19th, 2006
Post Subject: Sex After Hip Replacement
I just had al long talk with my physical therapist about this. His advice was very uplifting.

I am a 37 year old single woman, ik broke my hip in an accident over half a year ago and this led to a thr 3 months ago. Till this talk a was very worried about my sexlife becoming less interesting.

He told me you can do just about anything, except for getting your legs in a higher angle then 120 degrees. So putting you leg over his shoulders fo instance is not advisable. Sitting on top is ok, as long as you don't bend over forwards to much.

Wrapping your legs around someone will not be a problem, cause turning them outside is fine. Turning them inside would be problematic, but thats not a very likely thing to do during sex. And doggy style? Fine.

He did advice me to let the guy do all the work in the beginning, so starting in the missionary position is not a bad idea, and to buy a copy of the kamasutra so I can look up good positions.

He also said not to worry about postings about a decreasing sexlife. Cause most thp are done to older people, your and my muscles will be able to handle a lot more.

So, in the words of my therapist, enjoy!
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