Be cautious, be wise: AI tools like ChatGPT sometimes makes things up! Would you want a doctor who does that??

You can use AI to gather information and probe deeply for more details. But check your facts before you act. See tips at end of post.

The world is still discovering the things we can do with “generative AI” like ChatGPT, Google Bard, Bing Chat, or Claude.AI. Those of us with medical needs (patients and caregivers) are no different: when we want to understand more, we don’t just google: we also ask an AI.

These tools can pull together immense amounts of information and – importantly – summarize it, distill it, and express it at different lengths and reading levels. If knowledge is power, “genAI” is truly empowering, because it makes knowledge more available and more digestible.

Last night SPM co-founder Jon Lebkowsky was thinking how his cardio fitness has declined since his hip replacement surgery, so he decided to ask ChatGPT 3.5 for advice, just to see what it would say. Here’s his prompt:

“What are some exercises to improve cardiovascular fitness that will work for someone with a hip replacement?”

In a few seconds here’s what came back:

Exercising to improve cardiovascular fitness after a hip replacement is important for overall health and mobility. However, it’s essential to choose exercises that are low-impact and safe for your hip joint. Always consult with your healthcare provider or physical therapist before starting any new exercise program, especially after hip surgery. Here are some exercises that can help improve cardiovascular fitness while being gentle on the hip joint:

Walking: Walking is an excellent low-impact cardiovascular exercise. Start with short distances and gradually increase your pace and distance over time. Ensure you have proper walking shoes for support.

Swimming: Swimming or water aerobics is a fantastic way to improve cardiovascular fitness without putting strain on your hip joint. The buoyancy of the water reduces impact.

Stationary Cycling: Using a stationary bike is a safe and effective way to get your heart rate up without stressing your hip. Start with low resistance and increase it gradually.

Seated Aerobics: Seated aerobics or chair exercises can be done while sitting in a stable chair. These exercises often include arm movements and leg lifts that can increase your heart rate without putting pressure on your hip.

Elliptical Trainer: Some people with hip replacements find elliptical trainers to be more comfortable than regular treadmills. The smooth motion can provide a cardiovascular workout without excessive hip impact.

Rowing Machine: Using a rowing machine is a full-body workout that engages your upper and lower body without placing too much strain on the hip joint.

Tai Chi: Tai Chi is a low-impact, gentle exercise that combines slow, flowing movements with deep breathing. It can improve balance, flexibility, and cardiovascular fitness.

Yoga: Gentle yoga can help improve flexibility, strength, and balance while being mindful of your hip joint. Avoid poses that strain the hip, and focus on gentle stretches and breathing exercises.

Resistance Band Exercises: Use resistance bands to perform seated or lying down leg exercises, such as leg lifts or leg curls. This can strengthen the muscles around your hip, promoting stability and overall fitness.

Modified High-Intensity Interval Training (HIIT): Under the guidance of a physical therapist, you can explore modified HIIT routines tailored to your specific needs. These workouts can be short, intense bursts of exercise followed by rest periods.

Remember, the key to improving cardiovascular fitness is consistency. Start slowly, progress gradually, and listen to your body. If you experience pain, discomfort, or unusual symptoms during any exercise, stop immediately and consult your healthcare provider or physical therapist for guidance. They can provide a personalized exercise plan based on your specific condition and recovery progress.

Imagine how that compares to just googling the question!

Let’s try it with GPT-4

I have a paid subscription to GPT-4 ($20/month) so I pasted in the same prompt. The response was quite different. (Jon says the response above is more what he was looking for!)

Exercising after a hip replacement requires special attention to ensure that the new joint isn’t put under undue stress or strain, especially in the initial phases after the surgery. It’s crucial to speak with a physical therapist or orthopedic specialist to get personalized advice, but here are some general exercises and activities that can improve cardiovascular fitness for someone with a hip replacement:

1. Walking: This is often the first exercise recommended post-hip replacement. Start with short distances and increase gradually as you build strength and endurance.
2. Stationary Biking: Cycling on a stationary bike can be an excellent low-impact exercise. Make sure the seat height and position are adjusted correctly to avoid undue strain on the hip.
3. Elliptical Machine: The gliding motion of an elliptical trainer can offer a cardiovascular workout with minimal impact on the hip joint.
4. Swimming and Water Aerobics: Water exercises provide resistance for strength while being gentle on the joints. Swimming and water aerobics can be great for cardiovascular fitness.
5. Chair Exercises: Seated exercises can be a way to get your heart rate up without putting a lot of stress on the hip. This can include seated marches, seated leg lifts, and seated arm exercises.
6. Tai Chi: This ancient martial art emphasizes balance, flexibility, and slow movements. It can be modified for individuals with joint replacements and provides a gentle way to improve cardiovascular health.
7. Arm Ergometer: Sometimes called an “arm bike,” this machine is used with your hands rather than your feet, providing an upper body cardiovascular workout.
8. Rowing Machine: Rowing can be a full-body cardiovascular exercise. Ensure proper form and technique to minimize any stress on the hip joint.
9. Dancing: Gentle dancing, like ballroom or waltz, can be a fun way to improve cardiovascular fitness. Avoid high-impact moves or anything that might twist or strain the hip.
10. Resistance Band Exercises: While primarily for strength, using resistance bands with higher repetitions and minimal rest between sets can provide a cardiovascular workout.
11. Nordic Walking: Walking with poles can help distribute the body’s weight and give an upper body workout simultaneously, enhancing cardiovascular benefits.

It’s vital to avoid high-impact activities or exercises that involve sudden twisting or pivoting movements. The primary goal after a hip replacement is to ensure that the joint heals properly and remains stable. Over time, as the joint heals and strength improves, more intensive exercises might be possible under the guidance of a healthcare professional.

Remember, always consult with a physical therapist or doctor before starting any exercise regimen after surgery to ensure safety and appropriateness for your specific condition.

Have you asked generative AI for such help? Tell us!

I for one am fascinated by the range of things people are doing. If you’ve done something that you’re willing to share (with name or not), leave us a comment or send email to blog@participatorymedicine.org.

Last week I myself asked it to read the OpenNotes from my last primary care visit and dig out my action items for each of my complaints. The result was so useful – I immediately was more conscious of how I needed to be following up. Hey hey hey, ChatGPT helped me be a more engaged patient!

What do you think??

If you have access to other generative AI tools, paste in Jon’s question and let us know the answer.

One more thing, as promised a top:

Tips to fact-check what an AI told you

Never, ever forget that these tools are amazing but sometimes they lie. They make things up, they forget what they said 5 minutes ago… they can do amazing math yet ChatGPT can’t solve a Sudoku. And nobody knows why. Yet.

Until that gets fixed, here are tips I’ve seen for how to fact-check these oracles. These are just things to try – there’s no guarantee.

• Ask it again, or click the “regenerate” button. This is equivalent to a prosecutor asking a liar to try again, or a teacher asking a student to say rephrase a paper in their own words. :) See if it contradicts itself!
• Ask it “Are you sure about that?” Sometimes it apologizes and points out an error! For me just now, it said “While it’s accurate to the best of my knowledge, there’s always the potential for individual variation.”
• Copy/paste the response you got into a new window and ask the new session to fact-check it. (This makes it read it as if it was an article published elsewhere.)
• Do the same with a different AI (Bard, Claude, Bing Chat) and see what it says.