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REPLACEMENT OF ARTHRITIC HIP submitted by gil on Sunday, May 4, 2008, 03:53:56
What The Doctor Didn't Tell Me
Some of the small tips and fine points about post-surgery recovery in and after the hospital - things that would have made my life just a bit easier.
What I Discovered
Hip Replacement 101: Comments from a Recent Patient December, 2000 [Note: I'm writing this just over a month after my total hip replacement (THR) surgery. I suspect that much of this is similar to what a knee replacement patient would experience but there will be obvious differences. This isn't meant to be medical advice - just my personal observations (in no particular order) about what this process was like. Your best source of information is your doctor, nurses and therapists - not me. Also, please note that my surgery was in 2000 and the surgery for THR is now much less radical and thus the healing and recovery should be simpler in most cases. However, much of what follows still should apply.]
1. This is Good Surgery to Have Nobody likes being in the hospital and nobody likes to have surgery. But, based on the reading I did and on discussions with former THR patients, I went into this feeling that if fate has dealt me a card that says “you need surgery” on it, this is just about the best kind to have. It is a tested procedure with great success. This is important to remember as you go into the surgery and, especially, in the first few days after when you're lying in bed feeling uncomfortable and wondering why you did this to yourself.
2. Listen to and Rely on the Hospital Staff You will be surrounded by people - from the time you check in until the day you are discharged - who really do want you to feel comfortable and to take care of your needs. They will help you if you let them, and they will do what you ask as long as you remember your manners and your expectations are reasonable.
3. Be Realistic About Pain I'm not a pill-taker, and except for the quantities of Advil I'd been taking over the years for my hip, and vitamins, I prefer to avoid taking medication unless I really need it. After the surgery, I was in pain - not what I'd call excruciating by any means, but enough to be pretty uncomfortable. It didn't take me too long to learn that there is no virtue in being a martyr; the pain medication is available for a reason, and it's pretty hard to overdo it. The less pain you have, the more comfortable you are - and the more comfortable you are, the sooner you start feeling like yourself and start wanting (and being able) to move around.
4. I Hate Hospital Beds My roommate and I decided that the reason they call them “hospital beds” is because you need to be in the hospital after spending a day in one of them. This isn't a criticism of the hospital - it's just the fact that even though the bed is well-designed and adjustable, it is not very comfortable for some reason. The good news, however, is that this provides excellent motivation for getting out of bed and into a chair when you are allowed to do so. I ended up getting out of bed when I could; the change in position really helped a lot. One suggestion: the triangular-shaped grab bar suspended over your bed will become your best friend. It is strategically designed and placed to help you re-position yourself and get more comfortable.
5. The Unmentionable Dilemma Everything I read mentioned that a very common result of just about any kind of major surgery is that you become constipated. I read that, and understood it, but felt that “this won't happen to me.” So, when the nurses asked me in the first couple of days after surgery if I wanted a laxative, I bravely said, “No, that won't be necessary.” To be honest, I think my answer was based on wanting to avoid the awkwardness and embarrassment of using a bedpan - which, as it turned out, was a really, really stupid decision. I'll spare you the details, but suffice it to say that we are talking about world-class, record-breaking constipation here - having it and finally getting relief from it were not experiences I ever want to repeat.
6. Use the “Tools” From the first time I stood up using a walker and took the first few halting steps - which was an incredibly scary and exhilarating feeling - to today, I have benefited from a variety of items that are designed to make recovery easier. These start with the elevated chair in your room, and go on to the walker and crutches, and your “hip kit” with its long-handled grabber, sock-donner, and more. All of these things really do work; it takes a bit of patience to learn to use them the right way but the therapists are there to help. I was surprised how easy it was to get myself dressed on the first day I was home. (Of course, it helps to cheat: you will learn that slippers or slip-on shoes and baggy sweat pants are your best companions…)
7. Dream of a Shower “No shower until the staples are removed,” is the rule. That's generally two weeks after surgery, and all I can say is that I'm glad that I didn't do the surgery in the summer - and my family would probably agree with that. You'd be surprised how much you begin to long for nothing more than a simple, hot shower. Meantime, you have to content yourself with one or another kind of sponge bath. I did mine by standing on a towel and washing myself using a wash cloth and then “rinsing” off with clean water. This is not much fun, but you do end up cleaner than when you started. It is also remarkably refreshing and a good way to give yourself a little mental boost in those crucial first few days.
8. Don't Do Stupid Things It would be dumb to ignore any of the hip precautions you will read about and be instructed about. I'm told that dislocations of a new hip are rare, but serious if they happen, and not worth taking a chance about. I learned that it is equally stupid to do things that you feel you're ready to do but your body isn't ready for. The good news is that I was fortunate enough to start feeling well and able to get around easily on crutches as little as a week after surgery; the bad news is that I used that sense of feeling good as an excuse to start increasing the amount of exercises I was doing. It's not that I was trying to train for a marathon - it's just that I felt pretty good and thought that gradually increasing the exercise would help the leg. Well, I can't tell you what a mistake that was. The problem is two-fold: not only have the muscles in your leg been disrupted during surgery, but those same muscles (and others) in that leg have been underused and/or misused for several years because of how the old hip messed up the way that leg worked. Therefore, it makes no sense to try to do too much too soon. You won't heal any faster, and you'll end up feeling worse. It took me two episodes of this kind of stupidity to really understand this; I guess that makes me a slow learner. Don't make the same mistake.
9. Don't Fight Being Tired - and Be Sure to Eat Compared to something like a heart transplant, THR may not seem like “major surgery” but it is. It isn't just the surgery itself that takes its toll - it's the accumulated effect of the anticipation and preparation, of being in the hospital, and all the rest that goes with this event. Once I got home I couldn't figure out why I was so tired much of the time and why I was going to bed so early, and then I realized there was a good reason. After that, I decided to make the best of it - watched a lot of junk TV, read a lot, and took lots of naps. If you haven't discovered the joys of napping, this is a great time to do so. As for eating: once I got past the first couple of days and started to have an appetite again, I found it made me feel better to eat. All jokes about hospital food aside, it's important to at least try to eat well to help regain your strength. And when you get home, you can take advantage of all the people who want to look after you and (if you're lucky) who bring you cookies and other goodies as get-well gifts!
10. Every Day is Better Anyone with a hip that's bad enough to need replacement knows what it's like to feel pain with every step - to wiggle around in bed throughout the night trying to find a comfortable position - to watch strangers watch you limp when you aren't even aware you're limping yourself - and to gradually find that you can do fewer and fewer of the things that you like to do. When I was a few days away from going in for surgery, and began to get apprehensive, I realized one very important fact: for the last seven or eight years, each day that went by meant I was getting just a little bit worse. After the surgery, each day that went by meant I was going to get just a little bit better. This realization made all the difference for me.
That's it - those are my ten tips for THR. I hope this helps, and wish you the best!
Posted under topic(s): Hip Replacement
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