Considering Hip Replacement
Sounds wonderful doesn't it? Also, it sounds pretty easy. From the operating room forward has been remarkably easy. The most difficult part was making the decision to have a hip replacement. I had been struggling with hip pain for four years. When it first began I was hopeful that it was temporary, I would modify some things and it would go away. And remarkably it did go away, for months at a time and then it would come back and over time the pain and limping increased.
You might be thinking: who is in pain for four years? I think people like me because of my and determination to “overcome” something and develop a kind of denial or amnesia about the severity of the situation. The doctors told me they let patients tell them when it is time. Some people have very little pain with their diseased joint and want to have it replaced quickly. The doctors did tell me I had severe arthritis in that hip and I told them I wanted to try “one more thing” before deciding to have a hip replacement. The truth is: during those four years I never once remotely considered having a joint replacement.
Here is a partial list of things I tried: (Not in any particular order)
- Physical Therapy
- Cherry Juice
- Joint Juice
- Steroid shots
- More exercise
- Less exercise
Some of these things worked, for a time. Nothing ever worked well enough so that I was free of pain.
Even the super-duper pain pills didn't relieve the pain and even if they had no one can take those for long unless being in rehab seems interesting. In spite of the pain and the limping I continued to lead a “normal” life. I traveled extensively, including trips that required a lot of physical activity and long flights, took care of grand babies, entertained and enjoyed many other interests. I was undeterred.
When I finally decided I had to have a hip replacement, the decision came instantly. Here's what happened: One day I got out of the car, and I was nearly unable to walk. Something felt very wrong and I knew: this is not going to get better. Believe it or not, I called the Dr.'s office that day and made an appointment to talk about surgery. It took nearly a month to get everything in place. During that time, I did not look back, re-think my decision, or think of one more thing I should have done. My determination to have the surgery was as firm as my determination NOT to have the surgery just days before.
Preparing for Surgery
Once I had the surgery scheduled, I was required to have lab tests and visit my family doctor to sign-off on my health status for surgery. The most important and beneficial thing I did to prepare for surgery was to attend a program jointly sponsored by Genesis Health System and ORA Orthopedics. I think they call it “Joint Camp.”
When I first received the notification, I wondered if it was worth my time to spend two hours in a class. I was surprised and delighted at how good the class was. Each health-care discipline (for example, anesthesiology, physical therapy, pre-registration, nursing) that is part of the hip-replacement spends a few minutes talking about what to expect. What I really liked is that each presenter was brief, and to the point. Everything that was said, I could absorb and apply to what would be my situation. Before going to the class, I was anxious and had a lot of unanswered questions. I was almost giddy with relief afterwards because I felt like I knew what to expect. For most of us, that is what we need.
I also discovered that there were a few modifications needed for my house that would help facilitate the first few weeks after surgery. For example, we installed a grab bar in the shower (not one of those industrial strength ones! ) It turns out they have decorative ones that come in different finishes. We also installed a hand-railing.
After this, I felt set and was looking forward to my new joint. As much as I had resisted the idea, I now embraced it.
Surgery and Hospitalization
Hip replacement surgery is a well-oiled machine. Everyone from the physician to the nurses to the physical therapists to the nurses aides are familiar with the routine and repeat it many times a week. I suppose you could feel like a number because of that, but I felt like I was being taken care of by experienced people with a solid routine.
I went to the hospital on a Monday morning and left on a Thursday morning. The time went quickly. They kept me very busy! My surgery was at 12:30, and by 4:30, there were two physical therapists in my room helping me stand at the bedside, which I could do without much difficulty. By the next day, they had me walking down the hall with a walker. Every day the Physical Therapy Assistant had me adding new “tricks.” Before I left, I had to show her I could go up and down three steps using a cane. Nearly everyone I came in contact with kept reminding me about "hip precautions” (see below), and I had to repeat them everyday to show that I fully understood them.
Don't plan on getting a good night's sleep in the hospital. It doesn't seem to make sense but it's just how it is. In the first few days, they come in frequently to check vitals and make sure everything is OK. Every day, there is lab work to check on the blood count and the lab people come in around 3 or 4 in the morning so the results are there by the time the Dr. makes rounds. I get it from their perspective but didn't like it.
All the hospital personnel I came in contact with were super-helpful. It was almost surprising how good they were. When it was nearly time for me to ask for pain medication, the nurse would check on my pain level. I never had to wait for pain medication. The nurses aides were there to help me find a comfortable position. Not easy when you have to have a piece of foam rubber the size of a refrigerator (okay...not full size but a dorm size, for sure) between your legs. That's all part of hip precautions.
One thing I know for sure: being appreciative and kind to everyone who comes in to take care of you is a good idea. Even if things don't go exactly as you might have wanted the hospital personnel are only human and there is no point (for you or them) making their lives harder. I know this sounds very common sense and kind of “duh,” but you might be surprised how demanding and thoughtless sick people can be. My Mom's a nurse so maybe I just have a soft spot for them.
What are hip precautions?
- Bending or flexion of the hip beyond 90 degrees
- Crossing Legs
- Turning the operated hip inward toward the center of your body
After hip replacement surgery and apparently forever there is a possibility of hip dislocation. As time goes on, the chance of that decreases but never returns to zero. The possibility of doing any of the things I wasn't supposed to freaked me out. I was scared it would accidentally dislocate and even had nightmares about it. Okay, I am a really extreme case. I get that. Still it's important to be cautious especially in the first three months. The Occupational Therapist will show you how to dress yourself and pick things up without violating the hip precautions. I don't worry about it like I did but I am very aware ALL THE TIME about keeping that 90 degree angle.
I finally asked the Dr. to demonstrate for me which moves cause dislocation. I needed to understand the physics behind it. That's what helped me. Find what helps you so that you are appropriately cautious but not afraid.
Travel After 10 Weeks
About 10 weeks post-surgery I flew to Chicago, and took the El into the loop. I got off at an El stop with no elevator so had to carry my luggage down a steep flight of steps. I was doing okay but clearly struggling. I noticed a man in a hard-hat (CTA worker) coming up the stairs toward me. He grabbed my bag, and we walked down together. I was explaining to him that I had had my hip replaced and so was having a little trouble.
He had just had his hip replaced, too, several weeks before I did. He was already back at work and carrying luggage down the stairs without even using the handle rail! I was pretty impressed. We had a good laugh at the coincidence of our meeting. He was, by the way, quite a big younger than I. But still...why aren't I carrying bags up and down stairs with ease? After that, I walked the mile from the train to my hotel with my rolling bag. That was an accomplishment!
My Dr. gave me permission to drive fairly soon after the surgery (I think three weeks) which was great.
I decided I needed a Handicapped Parking sticker so when I went out I could park close to the building. My Dr. gave me one good for six months (you actually get it at the DMV). In the beginning, I loved having it. Now that I am better, I question every single time if I really need to use it. Shouldn't I be walking further anyway? What is someone who is “more” handicapped needs the space? Do I need to emphasize my limp when I use it so that no one will think I don't really need it. Oh, the moral dilemmas of having a Handicapped Parking Sticker!
I just had my 12-week check-up at the Dr. I am doing very well and resuming most of my regular activities. I swim laps or walk every day and go to physical therapy once a week. Every day I feel happy and grateful that I was able to have my hip replaced. Happy that there are people with the skill and knowledge to do it and grateful that I have the resources to pay for it.
I have thought a number of times about what my life would be like if I had continued with the pain and disability. It has even occurred to me that I might not have retired a year and a half ago if I had done this sooner. What I interpreted as being tired of work and commuting was most likely just the fatigue of dealing with chronic pain. Do not underestimate the effect of pain. I did not realize that the quality of my life was severely comprised by the pain. I literally feel like a different person.
Even though I am still in the recovery stage, I have more energy, no pain except for a bit of muscle soreness, and a renewed zest for life. I am somewhat shocked by all this. One of my greatest strengths if that I am adaptable but this was a case of over-adaptation. This has been a major life lesson for me. I am paying more attention to my body and listening to what it has to say.