Hip Hip Hooraay

This page is dedicated to documenting my recent total hip replacement operation and subsequent recovery.

I have suffered from arthritis in my left hip for probably at least five years. I have put off having the operation for various reasons, not least the apprehension of the operation and rehabilitation. I discovered that there is probably some family link to arthritis, my mother having had both hips operated on and one recently ‘revised’. I wonder if this will trickle down to my daughter, and I sincerely hope not. Prior to the operation I made the mistake of google-ing videos on the internet. Not sure that was a good idea, but did at least make me aware of what would happen during a 90-minute operation. I don’t recommend that to anyone else, though, unless you are really up for it.

Anyhow, I have had some private medical insurance for at least ten years, and they were willing to cover the operation so it was much more convenient to be able to fix a date that ‘suited’ rather than hang around for yonks waiting for a place in the NHS system. My consultant surgeon is Mr A. Addison did the operation on Friday 26 April at Fawkham Manor Hospital. I arrived at 7am, got sorted out and was on my way to the operating theatre by 9am. Somewhat glad not to have to wait around all morning. On the advice of Mr Addison and the consultant anesthetist, I opted for a spinal numbing and a sedation. I was initially a bit apprehensive about this, but it seems to be the standard procedure and there are certain benefits, e.g. less risk, less bleeding, and a slow return to feeling that allows suitable pain killers after the operation.

A spinal is not the same as an epidural, although they both involve an injection of local anaesthetic between the bones of the spine in the small of your back, the injections work in a slightly different way.

In the prep room, the anesthetist stuck some sterile covering over my back, and introduced the needle with the spinal anesthsia.

Illustration of spinal anesthesia

It stung a bit but wasn’t painful.

  • When the injection is finished you normally lie flat as the spinal works quickly and is usually effective within 5–10 minutes.
  • To start with the skin feels numb to touch and the leg muscles are weak.
  • When the injection is working fully you will be unable to move your legs or feel any pain below the waist.

Once the painkiller began to take effect, your knees feel warm and then you lay down on the table. I was aware of the feeling beginning to seep away. After that I don’t remember anything until waking up in the  recovery room. There are some potential side effects of this anesthesia, one of which is the commonly seen Low blood pressure – As the spinal takes effect, it can lower your blood pressure and make you feel faint or sick. This can be controlled with the fluids given by the drip and by giving you drugs to raise your blood pressure. For some while after the operation and while the feeling returned to my lower body, it wasn’t particularly apparent. However, you are encouraged to get up from your bed at some point during the first day. That was when I found the room spinning and a degree of nausea when sitting up. A spell of  breathing oxygen and rest helped, but it was a good few days before that feeling finally subsided. While waiting for the effect of the numbing to wear off, it was a bit odd waiting for the feeling to come back to my toes. It was a Kill Bill moment, ‘wiggle your big toe’. First of all the message didn’t get through, but after a while my piggies responded. Slightly surreal.

The first couple of days were uncomfortable, but not painful. A combination of paracetamol and codeine seemed to be sufficient, with an oral dose of a morphine-based painkiller at night to allow some sleep. The most difficult thing was finding the right technique for pushing oneself up and into a position to get off the bed safely, always remembering not to let the operated leg cross the centre-line. I felt washed out, though. And had no appetite. Tea tasted odd and water had a strange metallic taste. The hospital were brilliant at providing meals, and I survived on an excellent small bowl of fruit salad, a yoghurt and a boiled egg. Even almost two weeks later, I am still struggling to enjoy eating. Let’s hope that a bit of weight loss ensues, as it is a godsend in all this.

First of all, when you get up you use a walking frame, or zimmer frame, when enables you to get up, into a chair or to the bathroom. The resident physio comes by and helps you get a bit more mobile and encourages you to get dressed, and by day three you are moving about on two crutches. Some people go home on day three, but I definitely wasn’t ready, mainly I think due to the anesthesia side-effects. I made several forays up and down the corridors on two crutches with the aid of my husband. On Day two, my surgeon came by to see how I was doing and wanted an x-ray taken. That meant I had to go in a wheelchair as it was too far to walk, and in the x-ray room get onto the table. That was the most awful experience. I felt sick and dizzy, not to mention hugely uncomfortable. However, the nurses aided me and we got it down. by the time I got back to my bed I was completely done in!

I was discharged on day five, and managed to get into the car in a safe manner and it was quite a relief to get home. Having practised stairs at the hospital, it wasn’t too bad getting up and down, but is still a bit difficult. I have exercises to do, and a visit back to the hospital to see the physio in the second week. By this time I am moving around the house with one crutch which makes doing some things a bit easier. You need the aid of a ‘helping hand’ long grabber to pick up stuff that always seems to end up on the floor, however careful you try to be.

Helping Hand

On my first night at home I had a broken sleep, waking at 3am and 7am and my husband gallantly got up and helped me downstairs and then back up. I managed to snooze in between and when sleepless tried exercising my leg to bend at the knee, which I was totally unable to do the previous day. Strange how something so simple becomes an impossible task. Gradually over the course of the next few days, the muscle memory came back. I washed my hair in the bathroom sink, the first time since the operation. I couldn’t get a shower as the dressing had to be kept dry. There was a lot of water on the floor, but I managed to do it and felt so much better. Mind you, looking at my reflection in the mirror, a pale and washed-out face greeted me. I lacked any energy and a task like washing and drying my hair sucked everything out of me. The rest of the day seemed to be taken up with walks outside up and down the driveway and talking to friends on the phone. My appetite is still very low, and I was grateful for a mid-day rest and snooze on the bed.  The evening was an enjoyable TV show of the Bayern Munich v Barcelona match, Bayern beating Barcelona 7-0. There seem to be so many pills to take, and the daily injection in the tummy until 3 weeks are up.

I saw my consultant after two weeks, and he was pleased with the healing of the wound which has had the same dressing on since the operation as there seemed no need to remove it. There was no drain from the wound and seemingly very little bleeding. He took out two stitches top and bottom which just stung a bit and now I can have a shower! A friend who has recently had major heart surgery recommended Bio Oil to help minimize the scarring. When I mentioned this to my surgeon, he was quite adamant that none of that was necessary, and that he wanted to discourage me from using it.

One thing that seems to have been on my side is the lack of bruising or swelling. I was told that both were quite likely, but although my leg swelled a bit, it wasn’t a problem. Having seen some examples of bruising, I feel I am very lucky.

On his advice I need at least another two weeks before thinking about going out to a restaurant because of the seating and the loos. I should be able to drive after six weeks. We have an automatic car, RHD, so I don’t use the operated leg when driving. Its just getting in and out that will be the problem. I expect to be off work for 10-12 weeks.

Week Three – learning to ascend and descend the stairs at home without ‘backup’, so that I can be more independent. Stairs are the awkward bit, balance and confidence seem to be obstacles to overcome. I have been going out for walks every day. My husband has taken me in the car (and thus getting practice at getting in and out safely) to places we can walk around in the dry since the weather has been awful. Garden centres and the supermarket are the places of choice! Doing exercises as directed by the physiotherapist and trying to do ‘normal’ stuff around the house. Things like putting the washing in the machine needs dexterity with the helping hand, as does getting it out and into the basket. My husband takes it outside (during breaks in the rain) and I’ve worked out I can put the basket on a small garden table and drag it up and down the line as I peg stuff out.

Week Four – Now using just one crutch for getting around indoors. Having two for longish walks is helpful, but for short trips one gives me more freedom and makes me feel less of an invalid. My consultant suggested I ask about hydro-therapy and the physiotherapist made an appointment for me to go next week. I still need a break lying down in bed during the day to do some of the exercises and rest. Sleeping is difficult, lying on my back, and I sleep lightly for a few hours, wake and then feel too uncomfortable to go back to sleep.

As week four progresses, I am getting around much better, but find that for longish walks, two crutches still offers a better balance than just one. I have been going out at least once a day, more often than not to a garden centre as my OH ha been working outside and we needed to put some plants in the garden. Its fun, but every trip seems to cost money! Once I get to the end of my ability, I find I need to depend on the assistance of a crutch a bit more than I would like. I am still doing the exercises, and taking less and less of the painkillers. I am doing more of ‘normal’ stuff around the house, filling and emptying the dishwasher and washing machine, preparing and cooking things in the kitchen, and finding the ‘helping hand’ pretty useful. Tomorrow I go for some hydrotherapy.

Week Five – Well, the hydro therapy appointment was a disaster. The staff weren’t expecting me as no appointment seemed to be confirmed. Now, at the end of week five, I am booked in for more physio, but not hydro yet. I have found that although I can move around happily on one crutch, I am getting pain in my hand which is pretty severe. From what I’ve read, it seems to be a fairly common complaint. My husband wrapped some padding around the handgrip but even so, I think the pressure is causing the pain. I try to put the minimum weight on the crutch, just using them for balance, but a long walk just makes the pain quite unbearable. So, when going for extended walks (such as around Bluewater as the weather is just ghastly and wet) I take 2 crutches as it seems to even out the walking. I can hobble around at home without any crutches, but seem to have a pronounced limp which I just pray gets getter over time. I am so glad the injections have come to an end. I felt like a pincushion! I am also hardly needing any painkillers – just occasionally taking a Codeine/paracetamol when going out for a long walk and at bedtime. Having a bit of trouble sleeping which I hope goes away very soon.

Week Six – continuing to gain mobility, now down to one crutch, can just about manage a circuit of Bluewater retail park. Can’t tell you what a relief it is to finally get rid of the anti-embolism stockings at the end of week six. Had a physio appointment and with the physio’s encouragement, looked to more strengthening exercises. These involve stair/step aerobics  (well, to me, at least!) stepping up and down. Finding it quite difficult as my operated side is obviously weaker when doing this sort of exercise. Although it is ‘possible’ to start sleeping on your operated side, in reality the pressure on the healing wound makes its uncomfortable to the point that there is no way I could sleep like that, so still sleeping on my back. Also at the point of getting back to driving. Since we have an auto, and it is my left leg that was operated on, driving is not a major problem, its just getting in and out of the car that requires me to adapt to. In fact its not too difficult as there is an electric seat adjustment to move the seat back to allow me to get in, and then forward to reach the pedals.

Week Seven – Have been working on stepping up and down on operated leg, doing a sort of step aerobics on the bottom stair at home! Its unbelievably awkward at first. I had my first hydrotheraphy session during the past week. All the exercises you do are so much easier in water. The buoyancy helps you without fighting gravity. I am getting more confident about driving, and since the hydrotheraphy session, its been a lot easier to walk around the house with much less limping. In fact, the therapist told me to continue with the crutch as much as needed in order to develop a ‘normal’ walking pattern, otherwise the ‘limp’ becomes embedded and much harder to lose. The weather has been ghastly, wind, rain, brief spells of sun and it feels like autumn, not summer! Last weekend was quite nice, and last Saturday I went out with my camera and walked around a local park, trying out less even ground. I did notice that in the evenings my foot and ankle began to look swollen a bit, as I was warned as a result of losing the stockings. However, its fairly minimal and goes down when I lay on the bed. Further in to this week I have noticed the problem less.  So progress, even if it feels slow.

Week Eight – Thanks go to my super OH for passing on to me his horrid throat infection/cold. I’ve felt pretty awful this week, finding it hard to sleep at night because of the sore throat. To add to the misery we had arranged for a new carpet to be fitted on Thursday, so spent Tuesday and Wednesday clearing out the cupboards read to move the furniture. Having to crawl out of bed early to get things ready was really hard. And then Friday, putting it all back! At least a good opportunity to reassess stuff that’s been unused for ages. Went for Hydrotherapy on Thursday afternoon and after that session felt pretty wiped out. I was talking to a lady at the hydrotherapy who told me she’d just had a knee replacement op. She then said she had previously had one hip and the other knee replaced. Wow! Permanent surgery. She seemed to be making excellent progress, but she said she wasn’t wanting to have her second hip operation in the near future!  I’ve had lower back pain, mostly noticeable when standing for a longish time – like packing glasses away. Hopefully it will go away when the throat infection clears.

Weeks Nine to Eleven passed quickly, with weekly physio and plenty of exercise in preparation for return to work.

Weeks Twelve to Sixteen – having agreed with Occupational Health that a staggered return to work would be sensible, I started by coming in later and leaving earlier than normal which helped avoid some of the rush hour crush. Having said that, the very first day I was back, the early train home was messed about, eventually arriving late and being quite a crush. So much for an easier journey! In the first six days of travel, three of them were badly disrupted, and in the middle of summer. Just how bad can our public transport system get? In addition to the tiredness created by the travelling, I noticed a severe amount of what I thought was lower back pain, only to be informed that it was caused by pelvic problems. That was just too much. It was painfull to stand and move, and lying in bed was uncomfortable, so sleeping was much disturbed. I am not sure if this was a result of return to work or just part of the general recovery. Mercifully, at the end of week sixteen it appears to have resolved and is much less noticeable.

I happened to read about this incident in the Evening News last week. Some poor chap trying to fly was submitted to a pretty humiliating experience just because he had had a hip replacement operation.

Nigel Lloyd-Jones

Businessman, 59, ordered to drop his pants by airport staff to prove he had a hip replacement that set off metal detectors

I also found this report,  the comment on the page posted by another passenger:

I have a replacment hip and every time I travel through Gatwick Airport I have to undergo a strip search because I fail the ARCH detector, I have to suffer this massive indignity to show I am not concealing anything untoward. If this is done on the pretense of security then I must ask the question why if I travel on Eurostar or use the Channel Tunnel do I not have to remove my shoes or asked to drop my trousers. Mike Harrison, Reigate, UK

And another report on TripAdvisor

I have two metal hips and always set off the alarms in security. I’ve had them 5 years and as the years go on the searches get worse. Recently at London Heathrow I was physically searched, wanded and finally put through the scanner. I went through Milan airport a couple of months previously and they were very careful and I didn’t mind the check at all. I found the Heathrow experience very upsetting.Has anyone any experience of UK airports or any tips that may help? 

All that nonsense makes me very uncomfortable with the thought of flying abroad. It seems from our last few trips that despite not carrying or wearing anything to set off their devices, I always get pulled out for checks. I hope I get treated with a deal more respect than poor Mr Lloyd-Jones and Mr Harrison. My surgeon just shrugs and says ‘show them your scar’ but do I really want to do that?

More to follow …

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