WEBVTT - Health: Hip Replacements

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<v Speaker 1>Okay, Well on health today, I thought we'd have a

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<v Speaker 1>look at something that's become very very common, and that's

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<v Speaker 1>the old hip replacement. You might be someone that needs one,

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<v Speaker 1>You might have had a hip replacement before. Chances are

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<v Speaker 1>that you or someone you know has because the stats

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<v Speaker 1>say fifty thousand Australians undergo replacement procedures every single calendar year,

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<v Speaker 1>fifty thousand. The surgeries are under take it to replace

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<v Speaker 1>damage parts of the hip joint and we now use

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<v Speaker 1>artificial implants and they can be total replacements where both

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<v Speaker 1>the ball and the socket are replaced, or partial replacements

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<v Speaker 1>we're only the ball that is, the ephemeral head is replaced.

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<v Speaker 1>The surgery is often recommended for severe hip pain and

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<v Speaker 1>stiffness caused by conditions like osteoarthritis, rheumatoid arthritis and other conditions.

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<v Speaker 1>The artificial parts are typically made of metal, ceramic, hard

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<v Speaker 1>plastic now as well, and they're designed to mimic the

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<v Speaker 1>natural ball and socket. Action Now has said a lot

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<v Speaker 1>of Australians are waiting for one of these. A lot

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<v Speaker 1>of Australians have had one of these. If you've got

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<v Speaker 1>a question about hip replacement surgery or you've had one

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<v Speaker 1>and you just want a few things answered. I got

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<v Speaker 1>one of the best in the business here with me now,

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<v Speaker 1>doctor John Limbers, specialist orthopedic surgeon on the line. John,

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<v Speaker 1>thank you for your time.

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<v Speaker 2>No worries. Thanks very much for having me.

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<v Speaker 1>Michael, how did you get involved in all of this

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<v Speaker 1>line of work?

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<v Speaker 2>Well, it's funny. You won't believe this, but it goes

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<v Speaker 2>way back to where I was a child. That's when

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<v Speaker 2>my father was an oft peak surgeon and done. He

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<v Speaker 2>described what he did to me. He described to me

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<v Speaker 2>what he did, and I thought that's cool. One day

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<v Speaker 2>I want to do that, and so I did. That's

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<v Speaker 2>pretty much it.

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<v Speaker 1>And with a name like Limbers, I especially had to

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<v Speaker 1>work on arms or legs, didn't you Eventually?

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<v Speaker 2>Well, I guess, to be honest, you're not the first

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<v Speaker 2>person to say not even the second.

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<v Speaker 1>I might be the first today that I'll acclaim. So,

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<v Speaker 1>I mean, look, the technology, the surgery itself has come

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<v Speaker 1>a long way since your father was doing it.

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<v Speaker 2>Hasn't it. Yeah, it has. It has. A hip replacement

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<v Speaker 2>has been around since the nineteen sixties when Sir John

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<v Speaker 2>Charlie really pioneered it. That there had been attempts at

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<v Speaker 2>it before, but that's really when it started, and obviously

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<v Speaker 2>it's just gone from strength to strength since then. It

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<v Speaker 2>is one of the most successful operations of all time.

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<v Speaker 2>It was described by the Lantis, by the Lancet as

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<v Speaker 2>the operation of the century. It really does give people

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<v Speaker 2>a lot of great pain relief and gets people back

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<v Speaker 2>to work and to function, and like any procedure, we're

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<v Speaker 2>always trying to get better and better at it.

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<v Speaker 3>Okay, why what would the average life look like without

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<v Speaker 3>the hip replacement if one needed it in the past,

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<v Speaker 3>Because you know, I mean I'm turning forty, but you know,

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<v Speaker 3>if we go back far enough to your dad's generation before,

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<v Speaker 3>if people had bad hips, I mean, what was quality

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<v Speaker 3>of life like without the option of a replacement.

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<v Speaker 2>Well, that's a good question. I often wonder that because

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<v Speaker 2>I've never known that myself. I often wonder what was

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<v Speaker 2>life like before? You know, some of these people that

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<v Speaker 2>need some of this surgery are actually crippled by it,

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<v Speaker 2>and I can only imagine that. Look, if it wasn't there,

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<v Speaker 2>it wasn't there. For one thing, life is expectancy was

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<v Speaker 2>a lot less. Then, you know, we expect to live

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<v Speaker 2>to whar aight five, you know, or thereabouts. But actually

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<v Speaker 2>before you know, in the fifties and sixties, a lot

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<v Speaker 2>of people didn't live that long. They probably just well,

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<v Speaker 2>bad luck. If you've got a bad hip, well you've

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<v Speaker 2>just put up with it. Will give you pay relief,

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<v Speaker 2>you know. There were some like some rudimentary operations described,

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<v Speaker 2>like for example, osterotomy is where they would cut the

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<v Speaker 2>hip bone and change the position of it so that

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<v Speaker 2>you'd had weight bearing and alex worn out position. But

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<v Speaker 2>the options weren't great, and really it was just we'll,

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<v Speaker 2>you know, just grin and bear it and we'll do

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<v Speaker 2>what we can.

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<v Speaker 1>Why do people get bad hips? Is it because of

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<v Speaker 1>the hips themselves? Or is it because sometimes their back

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<v Speaker 1>alignment is out or one leg shorter than the other

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<v Speaker 1>and there's great were on one side than the other

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<v Speaker 1>as a result of it. Is it cause and effect?

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<v Speaker 2>In the majority of most most hip of for primary arthritis,

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<v Speaker 2>or more correctly primary osteoarthrosis, And in most of those

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<v Speaker 2>cases the real reason is genetics. It runs. We know

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<v Speaker 2>what happens. We know that the cartlers wears out, we

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<v Speaker 2>know these sort of biochemical changes, but we don't know

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<v Speaker 2>exactly why it happens, and it tends to run in families.

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<v Speaker 2>So in most cases it's really genetics. But some families

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<v Speaker 2>their hips and these were out as they get older,

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<v Speaker 2>and other families not so much. But there are other reasons.

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<v Speaker 2>It can be secondary to you know, blatches and trauma

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<v Speaker 2>and injuries and rheumatoid arthritis or you know, other inflammatory arthritis.

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<v Speaker 2>So there are other causes of course.

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<v Speaker 1>Okay, let's take a couple of calls quickly here if

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<v Speaker 1>you don't mind, Ralph. You've had a hit replacement recently, have.

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<v Speaker 4>You, Yes, Michael, I had one done twelve months ago,

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<v Speaker 4>and I'm really not all that happy with the result.

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<v Speaker 4>I just wanted to sort of get an opinion on

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<v Speaker 4>it if I could.

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<v Speaker 1>Yeah, well, you've got a question for John, because you

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<v Speaker 1>know John's one of the best.

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<v Speaker 2>Of the best.

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<v Speaker 4>Yeah. Yeah, Well, I had a total hip replacement through

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<v Speaker 4>the anterior and since I had it done, I've had

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<v Speaker 4>this like a siadic butty pain, but it's only in

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<v Speaker 4>the buttck. It doesn't go down the leg, and I've

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<v Speaker 4>got sort of an aching sort of around the round

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<v Speaker 4>the hip area. I've been back to see a surgeon

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<v Speaker 4>about it a couple of times. And he doesn't seem

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<v Speaker 4>to think there's much wrong with it. And I've had

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<v Speaker 4>an MRI and they they said that there is the

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<v Speaker 4>problems with the medius and maximus tendons in there. And

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<v Speaker 4>but I paint, particularly when I when I sit down

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<v Speaker 4>in the car for you know, like half an hour

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<v Speaker 4>or more.

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<v Speaker 1>All right, John, I mean this probably isn't an uncommon story,

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<v Speaker 1>you hear. What can you recommend?

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<v Speaker 2>Well, it's you know, someone's coming back for paid Obviously

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<v Speaker 2>the best thing to do is, as he's done ses

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<v Speaker 2>surgeon and get it investigated. And it's hard for me

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<v Speaker 2>to know from here exactly what the reason for his

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<v Speaker 2>pain is. But you know, people vary in their recovery

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<v Speaker 2>time and their response to replacement surgery. Not everyone does well,

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<v Speaker 2>but most people do it. But you know, if there

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<v Speaker 2>is ongoing pain, the first thing is to look into

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<v Speaker 2>it to find exactly what the reason is. Often it

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<v Speaker 2>will be a muscle issue. You can get impingement of

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<v Speaker 2>some tendons around the hip joint after replacement surgery, or

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<v Speaker 2>weakness of some of them hip stabilizing muscles. And many times,

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<v Speaker 2>with time it will settle down. With the further time

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<v Speaker 2>and a really good ongoing strengthening and fitness program. So

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<v Speaker 2>you do see patients who are not doing well after

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<v Speaker 2>a year after a hip or and their replacement, and

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<v Speaker 2>then at a year two years they're coming back and

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<v Speaker 2>doing well. But obviously first thing is that the surgeon

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<v Speaker 2>needs to, you know, exclude any specific problems. Make sure

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<v Speaker 2>you know there's not infective, there's no fracture, and I'm

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<v Speaker 2>sure your surgeon has done that, and I'm sure there

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<v Speaker 2>isn't a problem locked up. But that's what I would

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<v Speaker 2>do as a surgeon. You normally exclude a specific problem.

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<v Speaker 2>If you exclude a specific problem, then often it will

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<v Speaker 2>gradually improve with further time and strengthening.

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<v Speaker 1>For Zartha ra our fingers crossed, that's going to be

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<v Speaker 1>your story. You know, I can understand John that you know,

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<v Speaker 1>people waiting one two years before they notice sort of improvement.

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<v Speaker 1>You would expect that that is a long time to wait. Right,

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<v Speaker 1>people are going to say something's not right.

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<v Speaker 2>Here, correct, and then that's certainly at one end of

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<v Speaker 2>the bell curve, and it's not the normal response.

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<v Speaker 1>And so what is the normal recovery period? Just out

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<v Speaker 1>of interest everage operation, Well, the.

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<v Speaker 2>Way I would normally describe it to a patient is

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<v Speaker 2>that you'll get over most of it in the first

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<v Speaker 2>six weeks. A full recovery maybe three to six months,

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<v Speaker 2>but many patients keep improving gradually for a year or more.

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<v Speaker 2>That's probably the way, and I leave it a little

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<v Speaker 2>bit vague like that because that's a rough godeline. The

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<v Speaker 2>patients really do there a lot in their speech to recovery.

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<v Speaker 2>The human body is an amazing you know, Varya booking,

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<v Speaker 2>And there's a certain amount of predictability, so I never

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<v Speaker 2>sort of give exact times, but that's normally the way

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<v Speaker 2>I would.

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<v Speaker 1>Say, Okay, just one more question here, Peter, what's your question?

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<v Speaker 5>Once I've got two problems. What happened? I waited twelve

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<v Speaker 5>months for a Hernier operation in the growing I had

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<v Speaker 5>it done and that was seven weeks ago, and that's

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<v Speaker 5>still got an eight there. But because I waited twelve months,

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<v Speaker 5>I've wakened my hip. And I had an ultracy on

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<v Speaker 5>the other day that said, I've got the side to

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<v Speaker 5>see it now, I've got a way up whether to

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<v Speaker 5>have a quarter zone injection or what can I do?

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<v Speaker 5>And because I'm going over season two weeks time, and

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<v Speaker 5>although it has it has improved a little bit.

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<v Speaker 2>All right.

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<v Speaker 1>Well, it's sort of out of time here, Peter said, John,

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<v Speaker 1>I'll just give it to you in a minute. What

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<v Speaker 1>you don't have all the info there, but what would.

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<v Speaker 2>You say, I'd say, dising strengthening work. Let it improve,

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<v Speaker 2>it's starting to improve. Take some paracenamore, get some topical

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<v Speaker 2>ancient flum trees and rub it on the area. See

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<v Speaker 2>if there's our purpose for a strengthening probe. Go and

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<v Speaker 2>I'll probably keep improving.

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<v Speaker 1>Fingers crossed for you, Peter, and having your very safe

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<v Speaker 1>travels I hope as well. John, it's been very interesting

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<v Speaker 1>speaking with you, and this is something I've got a

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<v Speaker 1>lot of text coming through. We're out of time, but

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<v Speaker 1>this is obviously something when you look at the numbers

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<v Speaker 1>that does affect a lot of Australians. And as we

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<v Speaker 1>get older, on average, you're not going to be out

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<v Speaker 1>of work. I suspect John, you'll be a busy man.

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<v Speaker 2>That's okay, keys to be out of trouble.

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<v Speaker 3>That's it.

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<v Speaker 1>Thank you for sparing some of your valuable time for us.

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<v Speaker 1>I appreciate it. No, thanks for having me my pleasure,

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<v Speaker 1>doctor John Limbers, As I said a specialist orthopedic surgeon,