Guy Churchwood – Patient View of a Total Hip Replacement
Total RIGHT hip replacement, motorbike accident accelerated what was later discovered to be a birth defect where the cup of my hip joint was too shallow.
May 23, 2009
Pre op day
Worry level very low, still felt I was there in the 3rd person e.g. way off timing and not really me.
Discussed with the doc on what was going to happen, what drugs they’d use, there were a large amount of forms filled in one set by the nurse another the doctor and one by us.
One more set of x-rays and some blood being taken…
Things I found out
Surgery would take around 1.5-2hrs
Putting in a metal hip, ceramic ball and plastic cup with metal surround
They use the equivalent of a circular cheese grater to fit the right cup size
The joint replacement is basically a stake that is hammered in with increasing increments till the right one fits snuggly
The replacement had what looked like a perforated surround allowing the bone to grow into the replacement so not cemented
Spinal injection and drugged up NOT general anesthetic for the operation (worried me greatly)
Should be walking on it the next day and a hospital stay for 3 days most likely
6 weeks basic recovery, have to baby it, never cross your legs, never bend more than 90 degrees etc etc..
Staples out in 11 days, can’t shower till they are out
Physical therapy the most important thing and keep that up also
Less than a week
Worry level now hit a concerned status
Ordered some shoes that I could slip on without having to wear socks, figured that was a good idea, one less thing to worry about
On the day of the operation
Leave all jewelry at home
Worry level as I arrived was calm but pensive
Had packed a bag with loose clothes for the three days etc (turned out to be a waste of time)
Packed a PSP and iPod (turned out to be a waste of time)
Worry level as I was shown to the bed and changed – definitely pensive
Signed consent in case I needed a transfusion
If you have power of attorney or whatever its proper term is (someone to speak for you while you are under, that’s smart), we did a temporary one there so my wife could speak for me.
Worry level when the intravenous went in – through the roof
Was wheeled into the operating theatre, last thing I remember is being placed on the bed and seeing a tin tray full of what looked like little disco balls, the next 10 hrs, all I remember is my wife giving me some ice as sustenance.
Days in Hospital
I had Intravenous morphine or something similar and a Percocet button
They tried to get me to eat some broth, unfortunately as soon as it arrived I threw up, so I had to go onto another drip that gave me supplements.. the drugs make you light headed and nauseas and as a repeating theme here, you HAVE to keep your liquid intake very high.
BTW, they will ask you to rate your pain between 1-10 the higher you go the more the pain obviously… just make sure you ask them if it is when you are still or moving your leg.. When I was still seriously, I had no pain, but if I lifted my leg.. Well that was a different story all together.
They tell you to drink fluids; you will literally go through the next few days in and out of small sleeps, in between drink as much as you can, I found the nausea the worst thing to cope with was this feeling. So whatever you think is a lot, drink double, ask them what liquid intake target they feel is right for you, I’d guess a couple of liters but who knows, I’d love them to have told me this.
Physical therapy person came, I’ve a frame and crutches, I tried both but found the crutches more maneuverable so opted with them (frame had some bad images for me, especially if I stuck tennis balls on the feet). Getting out of bed the first time is rough; I had a catheter, a blood drop out of the incision and an IV so it was like walking connected to a telephone exchange. We took 50 steps or so and a couple of exercises and back to bed as I was light headed and nauseous.
Here’s a couple of surprises, you have to wear stockings or tights for your duration and for that matter the best part of the next 4-6 weeks due to risk of blood clots.
Well that freaked me out so enough and they said prevention was to also wiggle your toes, so when I was awake I was drinking and wiggling my heart out.
OK, so why the drinking.. Well after two days of being there I had not done a #2 (poop), totally constipated and I have a regular constitution so this was very foreign to me..The narcotics turn out to be very bad for that so fruit smoothies, fruit juices, fruits, water, you get the picture, fruit, liquid etc etc.
On the 2nd day I was feeling much better, I felt no pain when lying still, had the drip and the catheter and the blood drain pulled out (catheter…OMG I cannot even explain how much I hated that 5 seconds of removal). I could have gone home on the second day but felt it would be pushing it rather too much so I relaxed into another day of being pushed and prodded and tested.
I did feel my skin was itchy, apparently this is a reaction to some of the drugs they used in the operation so I got a couple of doses of Benadryl that did the trick so watch for that, it’s usual and quite relieving
So more physical therapy, this time I did stairs, tried with one crutch, tried walking over curbs etc and got some standing exercises to do twice a day.
On the third day, I was set to come home. We had packed some pajamas and that was a god send as my leg was so swollen that not much else would have worked.
The wheeled me out which was IMO worse than me walking myself being uncomfortable and close to a 90% angle on my hip which worried me greatly
The ride home was 25 mins and based on my sickness and light headedness, it wasn’t the most pleasant ride I have ever had, just close your eyes and hope it ends
Following Few Days
Prep for the house, you WILL need a riser on the toilet, they make this chair with a hole in it, do yourself a favor, don’t wonder if you can cope or not, go with the flow and get it, they look pretty horrid but even standing up for a pee, the arm rest help you support yourself so you can take the weight off your hip and concentrate on your business.
Chairs wise shallow upright, high back and all important arm rests are best.
The chairs we thought would be good weren’t and the ones we didn’t think ended up as better.
Day one at home, OMG, felt like a wreck, you have the fear that you need to keep the circulation going in case of blood clots but of course this means you have to stand up and walk around or sit up and any of these cases was making me feel sick which was pretty rough
Food wise, couldn’t eat much, very very small portions and keeping it bland felt best, yogurt and fruit is good but watch for bananas as they also cause constipation
So I spent the day pretty much in bed
The worst sadly is that I was still constipated so was increasingly getting worried about that and added a rumbling sour stomach feeling..I drunk and drunk and drunk and even went for evil prune juice.
Finally it was time and I have to say it was like passing a tennis ball, I could swear my staples were going to burst out of my leg (another over liquefy advertisement)
The nurse came that afternoon and the incision had bled a little but this was apparently normal and all things were as they should be
By now my leg was localized pain in my thigh and a ache over the top of my leg, my leg was a black, swollen with a tint of yellow.
Feels like someone has stuck their knee into your side in the playground when you were a child to give you a ‘dead leg’.
Now to my 2nd and worst mistake so far.. We were convinced that the nausea and dizziness was the drugs being taken every 4 hours 24/7, we spoke with the doctor and he prescribed an alternative drug assuming that everyone reacts differently. Well my wife rushed off and got the prescription (BTW, these can’t be phoned to the pharmacy and have to be picked up at the hospital) and I decided to move to them right away and give them a few sessions to see how it went. A few means 3 times at a 4 hour increment or all evening and night in my case. Well, the drugs had absolutely no benefits for me, I might as well have chewed pieces of newspaper, the night was spent with me assuming my leg would inflate and explode making the award of ‘all time low point’ for sure. You have to keep does pretty regularly, you need to keep the clip going at 4 hour increments for at least the first week IMO, if you drop off the meds, the ramp back from pain to coping is a hard hill to have to climb.
Once I realized they were useless I moved back to the original drug and felt a lot better within a few hours.
The home nurse by now had visited around three times and in each case my blood pressure and heart rate has improved leaps and bounds
What I naively thought is as everyone is so blasé about how well I will feel after and ‘it’s only three days in hospital, I assumed I could resume working from home on the Monday following a Thursday operation.
Well per the above, I did and this was not the recommendation I would give.. Take a full week off and feel sorry for yourself, one because you will still feel like crap and two, you have no idea what will come out of your mouth in conversations so there’s a risk at both sides of this coin.
Within a week my dizziness and nausea subsided, I started to become a little more regular once I realized how much liquid ‘plenty’ meant and I am able to walk around with short rests and sitting for a couple of hours at a time, can’t tell you how much that made me feel human.
Talking of human, I did take an attempt of a pair of underpants and some Jeans and hobbled to the bottom of the drive in the sunshine.. WOW, how great do you feel when you can smell the outdoors, look almost human and realize you’re on the other side of what’s been years of pain management, sleepless nights and discomfort.
Staples out after 11 days
Wasn’t as bad as I expected, yes the staples are like stationary staples but three prongs, I had approx 35 of them, the method of removal is a scissor like device that bends them in the middle and bends the legs of the staples out out. This feels at worst like a bee sting but in general not such an awful ordeal
Interesting my leg had started to itch and with the removal came relief on that and also the incision didn’t feel like it was being as stretched.
I now have adhesive strips over the staple holes to heal and they apparently fall off over time.. This does mean that I can now a shower safely
Oh, that’s one thing I forgot to mention, till the staples out you can’t shower.. Well you can with caution but being wobbly on your feet and in a slippery environment AND not allowing the wound to get wet was an adventure in itself.
My wife had to cling wrap and sticky tape the whole area and assist in the proceedings whilst I planted my feet on the ground, oh yes, not a pretty sight but another cathartic moment and a few laughs along the way. They do put this yellow ointment on your leg so one other thing to note is if someone is helping you shower, let them know coz they might just thing you relieved yourself in the shower which is a thrill for some but a surprise for many!
To accurately describe the swelling in my leg at this point, if now feels like someone’s inflated a football to 10% and stuck it to my right buttock, when I sit down it feels odd but at least I can sit and the overall pain levels in my legs and back is way way less that prior to the surgery.
The swelling byu the way works down the body so although the operation was obviously at my hip, my whole leg is swollen and seems to work down so at some point in the last 7 days my foot bloated noticeable which was rather disconcerting but has deflated now to the size of my left so that’s an interesting little twist to watch for.
Days proceed to the 2 week mark
Well I’m now taking less and less medication (2-4 tablets every 24 hours); in fact I got some over the counter anti-inflammatory for the swelling and have been trying to use that as opposed to the prescription medications
Both for worry of the addictive capabilities and also the constipation aspect.
Most days this works well, I am still getting up at least one or two time a night as my body clock got conditioned to the ‘once every 4 hours’ treatment but I hope that will subside over time
I can hobble around the house now without a crutch but generally have one near to me as it is tiring still and I have ordered myself a rather cool walking cane form ‘Hugo’ so I can ham it up when I finally get to make an appearance in work
Swelling is still noticeable now but not ‘really’ noticeable, my leg is still yellow and any inflammation is directly around my incision
One final thing is that the muscles on the top of my leg also ache, I spoke with the nurse as I was worried these shouldn’t have been impacted but the stark reality is that when they operate they have to move everything out the way and as such the muscles get pried a little and leaves you with this lasting aching feeling.
So I feel I’m on the road to recovery, I wanted to write this note as when I went through the discovery and research I never found any 1st person information and hope at least this helps in some respects as you might enter the same path as I have just gone through.
There is no guarantees that anyone will go through the same steps as I did as there are so many factors that come into play but I’m happy to report that I am very positive on my progress, I’m still really only a 3rd of the way through the initial 6 week recovery period but feeling bullish to the future and somehow with the background pain not constantly eating away at me, I have a more positive outlook.
Work has been tough, I hate not being in the action and have a fear of letting the company and my team down, I think however I should have taken a few days away from the Blackberry yet they’ve been immensely understanding and I’m now up at full capacity with back-back meetings all day without feeling like I need to lie down for a break (well dependent on who’s on the meeting that is)
Finally, my wife’s been a real trooper, dealing with the added chores, having me to cope with, putting those damn tights on but I guess it’s nearly done and we have years ahead of us, she’s my partner and my best friend and I could not have gone through this process without the strong and understanding support.
I wish you luck if you venture down a similar path, I hope this note give you some glimmers of what to do and what to avoid, find a busy specialist, take control and get your life back.
Sunday, June 7, 2009
Update to the Hip Replacement – Week 3 & 4
Well here’s the interesting thing, I expected weeks three and four to be great, the surgeries out the way, I can languish in the excitement of full mobility but I have to say this was not the case. The primary reasons I can split into four buckets and I’ll give you them in my priority order.
Sleeping and Sitting – I am absolutely sick and tired of sitting upright or lying flat, it’s like eating bland food every night and trying to figure out how to spice it up. I leg still hurts enough to wake me up and there are only so many creative ways I can find to lie still and on my back (two pillows under the head and one under my legs, one under my head, none or three and more upright.. come on !). Sitting and watching TV and not being able to kick back and relax in a squishy seat is driving me nuts, I almost fear that part of the evening.
Pain management.. Now don’t get me wrong, I am now feeling around 75% complete e.g. I can walk without a crutch but the pain has coalesced around the incision, my scar is numb to swollen and I feel like I have half a cricket ball stuck to the side of my leg. My heavy painkillers ran out and in an effort to not get hooked, I figured it was manageable enough with generic brands. Well, that’s fun, try taking something before you go to sleep and see if you wake up sore, aching and somewhat grumpy.. I’ve tried them all and seem to have settled of some Advil and half an Ambian to make it the most part through a night
Enough Already – The first couple of weeks it was a struggle, you’ve been through a major surgery, you’re getting the attention, you have lots to think about and treat every day as progress and hope, now you’re in a holding pattern, you have no major pain, you have enough to restrict your movements and you are pretty much house bound as you can’t drive. You feel embarrassed to lean on your significant other and you feel disconnected from work regardless of whether you were stupid as I am went straight back or took a week to get straight.
It’s Back – So this whole thing started with a birth defect BUT careless motor biking led to acceleration. What this also led to is a string of other back pains and discomfort and as my leg got worse I couldn’t exercise as much. Apparently my operated leg was slightly shorter than the left and as part of the surgery I was ‘blessed’ with Symmetry so I had a hope that as part of this procedure, my body wouldn’t be adapting to the hip etc so my other back issues would go away. Alas, they are back so now I know I have to recover from the hip, get mobile and work on these issues before I am feeling normal again. This isn’t anything to do with the specific surgery but the compound of the wait mode; concerns over being a nuisance and being disconnected from work have led to a few pretty low points.
So I wanted to add this update as I was somewhat surprised that weeks 3 and 4 have turned out to be pretty low points in the process so as to keep you posted and be braced for it. Right now I am a week and a half away from being signed off, I can ‘sort of’ lie on my side and I am thinking of braving COSTCO’s today so that tells you how brave I’m feeling .