THR A Matching Pair of Hips! RTHR
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myglasshalffull
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Great update & so happy you made it home.
Nothing like being home that’s for sure!
I’m guessing your recovery will go smoothly. You’ve already been through this once and even though each surgery is unique you have the knowledge in your back pocket.
Hope I never need another joint surgery but if I did I have all my bonesmarties to give guidance & advice!
Nothing like being home that’s for sure!
I’m guessing your recovery will go smoothly. You’ve already been through this once and even though each surgery is unique you have the knowledge in your back pocket.
Hope I never need another joint surgery but if I did I have all my bonesmarties to give guidance & advice!
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Deni444
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My apologies for this long post... I've said most of it already but I want to add a journal entry for my personal record of what happened. Someone may find it useful too.
Right Hip Surgery, Hospital, Discharge Experience: Bilateral Staged THR, 5 months apart (posterior, standard)
Early days but what a difference, they say no two hips are the same and I'm joining my voice to that chorus now!
My experience with the NHS was better than my experience with the Nuffield going private. If only we didn't have such a long wait! The NHS staff went above and beyond far more caring, compassionate and efficient. They were nice at the Nuffield but it felt more genuine and with more resources at NHS Wansbeck. I think that North East reputation for hospitality and a respectful nature shone out. I ended up in a four bed ward all to myself as one by one the other three ladies were discharged before bedtime. So I got a very large private room in the end too with a very smart TV on an ingenious pull out. Not that I used it!
Surgery Experience
I had a posterior RTHR, I'm not entirely sure if I ended up with a dual mobility implant due to developmental dysplasia or they went for standard in the end. My notes say, the surgery was standard and so I don't believe they did anything out if the ordinary. I'll have to clarify at my 6 week appointment with my surgeon. My surgeon assessed the need for release work during surgery as is best practice as they have greater access and visibility, so I'm told. He reported he did a lot less release work than he expected to need to but didn't go into detail. He said the joint was on the bad scale of horrible, his personal descriptive measure of severity. Any hip needing replacement being horrible but this was apparently, near the end of his scale. Not a man of words but a really fantastic surgeon. The results of the little he did was clearly evident when I could raise my foot up high in the air unexpectedly the next day! To my shock and the physio watching who said, you're not allowed to do that yet! Similar with lateral leg swing out when laying down. Went a lot further with great ease and speed than I've been able to do in a very long time.
Anaesthetic
I had a spinal with mild sedation. The worse bit is the cold spray that numbs the area so you don't feel anything much. I had the same surgeon as last time but a different anaesthetist. As I literally shake the chair at the dentist, I get so nervous. With my left hip I asked to be totally asleep and my anaesthetist agreed. This time the anaesthetist wasn't as accommodating but said I'd be very sleepy and lined up music to listen to. I was sold on the idea for one reason. When I woke up after my left, I had a lot of pain in my shoulder that troubled me for ages after (they position you on your side). The anaesthetist explained that with less sedation they could spend time positioning me once the surgeon had my hip positioned and clamped in. Actually this worked really well! They had pillows under my head and spent time getting it just right. They then had a sling contraption to rest my hand and arm on and I was able to move my arm around during surgery a little when my hand got a bit stiff. They asked if I wanted to listen to music. I imagined they would give me earphones and so said, I only really enjoy old style US Gospel hymns and I particularly liked Dolly Parton. They said that's fine, we'll find it on YouTube, you can help us. Then I realised they'd have to listen to it too. I said, look I like it but if there is a danger my surgeon won't, I'll give it a miss and go for a bit if classical. They assured me it would be near my head and the surgeon wouldn't hear it. Once we got under way, I was enjoying the music and asked if it was OK to sing. They said, yes. It's OK I had a mask on so they couldnt hear my terrible attempt to sing like Dolly . I got a bit bored of Dolly eventually, and had a bit of Alan Jackson, Blessed Assurance on repeat. I could hear them chatting away so, I don't think they were bothered by choice of music. The other end of the table sounded like they were busy making their own music with hammers but despite the sounds of stuff normally coming from a garage, I wasn't bothered in the slightest. Honestly, the sedation is that good, even being awake. If it didn't bother me, I can't imagine it bothering anybody! I couldn't see a thing and I wasn't really aware that the noise was in connection with me.
Recovery Room
Everything was cleared quickly after they finished and I was wheeled to the recovery ward. Nice quiet area with a warming blanket and monitored with one specialist nurse at my side, chatting and reassuring me. I was given a tasty carbohydrate strawberry drink (they had loads of flavours). It was nice and refreshing. I was then wheeled back to my ward to wait for my legs to wake up. They said it would take a couple of hours but I could wiggle my toes a little and gradually it all came back. They monitored me frequently and checked on my pain levels. I didn't have any.
Back on the Ward
Pain was well managed and minimal throughout. As soon as I reported any I was topped up. I was up and walking after about three hours using a walker with two front wheels. My blood pressure was a bit down at times so they only did a little walking. I felt mildly dizzyish but not really enough to say for definite that I was. I had the inevitable hot flush when I first stood up to walk (Had one last time, sweat running down my face). My temperature was not officially up. I explained it was a hot flush that women of my age are prone to, I wasn't dizzy at all. They kindly got me a damp cloth for my face. Otherwise, I coped well and managed to avoid a bed pan on the bed because I could walk accompanied to the bathroom with the walker. Embarrassing because they wanted to measure what I did and put a pan on the raised toilet. I ended up sitting in my own pee like one of those bum bath things because it was so full! The lovely nurse helped clean me up though. Thankfully, this time that is the one and only embarrassing urination story I have to share!
Next Morning Physio Assessment
I was astounded at my range of motion and ability to perform physio. I still don't know if that is due to pain relief they give you or if this is an amazing unexpected stiffness recovery. I astonished myself when I tried to lift my leg to demonstrate that I couldn't lift my foot and up it went! She said, you shouldn't do that after surgery! Although you don't technically have restrictions, so it's OK. I haven't been able to lift my leg in the air for a very, very long time. I can't lift lefty yet! I guess it's a good indication of what is achievable without soft tissue swelling and tension. Or just a very talented surgeon! I'm hoping it doesn't revert back! I had diligently been doing 10 reps of the same exercises for a number of weeks twice a day prior to surgery.
I passed all my physio and occupational health tests with ease and was signed off to be discharged. No restrictions as they believe that even with posterior, the restrictions can cause people to be overly cautious and it can delay recovery. Apparently a respected study showed no greater risk of dislocation but a significant improvement in recovery.
Instead of strict restrictions they say be very careful and if anything hurts or feels not right, don't do it until it feels pain free and comfortable. In reality that is pretty much a 90 degree restriction in my personal humble opinion but I guess we're all a bit different. Bending isn't comfortable for me at this stage and neither is sitting in a low chair or twisting. They warn that bending and twisting should be treated with caution and care. They said a booster cushion would be helpful and make standing less of a struggle in the early days but if sitting and getting up without one was comfortable and pain free, it could be done with care. They advised a firm chair with arm rests for the same reason. It is pretty hard to get up without arm rests. I had a booster ready for my chair but find I'm comfortable without it. I have a personal technique for getting up that works for me. My chair has low arm rests, I often use my crutch at a slight angle ( well held in position on a deep pile carpet, practiced a lot before surgery) to give me a bit more lift. I'm a little chubby, so lifting a bit of weight there.
I've had a great first night, managing 4 hours of sleep. I've had a great appetite and using the raised toilet and aids has been easy because I'm now well trained. I haven't been prescribed Codeine this time and I feel great. Clear headed, just a bit tired. The challenge now is not to be tempted to do too much because I feel great. I got a bit of swelling this morning because I did the bathroom session followed by trying to sit at the table and it was just a bit too much. Not overdoing it but was a warning that I could quite easily be tempted!
I'll do a long weekly update for the next few weeks for my personal journal. Thanks for reading along, if you got this far
Right Hip Surgery, Hospital, Discharge Experience: Bilateral Staged THR, 5 months apart (posterior, standard)
Early days but what a difference, they say no two hips are the same and I'm joining my voice to that chorus now!
My experience with the NHS was better than my experience with the Nuffield going private. If only we didn't have such a long wait! The NHS staff went above and beyond far more caring, compassionate and efficient. They were nice at the Nuffield but it felt more genuine and with more resources at NHS Wansbeck. I think that North East reputation for hospitality and a respectful nature shone out. I ended up in a four bed ward all to myself as one by one the other three ladies were discharged before bedtime. So I got a very large private room in the end too with a very smart TV on an ingenious pull out. Not that I used it!
Surgery Experience
I had a posterior RTHR, I'm not entirely sure if I ended up with a dual mobility implant due to developmental dysplasia or they went for standard in the end. My notes say, the surgery was standard and so I don't believe they did anything out if the ordinary. I'll have to clarify at my 6 week appointment with my surgeon. My surgeon assessed the need for release work during surgery as is best practice as they have greater access and visibility, so I'm told. He reported he did a lot less release work than he expected to need to but didn't go into detail. He said the joint was on the bad scale of horrible, his personal descriptive measure of severity. Any hip needing replacement being horrible but this was apparently, near the end of his scale. Not a man of words but a really fantastic surgeon. The results of the little he did was clearly evident when I could raise my foot up high in the air unexpectedly the next day! To my shock and the physio watching who said, you're not allowed to do that yet! Similar with lateral leg swing out when laying down. Went a lot further with great ease and speed than I've been able to do in a very long time.
Anaesthetic
I had a spinal with mild sedation. The worse bit is the cold spray that numbs the area so you don't feel anything much. I had the same surgeon as last time but a different anaesthetist. As I literally shake the chair at the dentist, I get so nervous. With my left hip I asked to be totally asleep and my anaesthetist agreed. This time the anaesthetist wasn't as accommodating but said I'd be very sleepy and lined up music to listen to. I was sold on the idea for one reason. When I woke up after my left, I had a lot of pain in my shoulder that troubled me for ages after (they position you on your side). The anaesthetist explained that with less sedation they could spend time positioning me once the surgeon had my hip positioned and clamped in. Actually this worked really well! They had pillows under my head and spent time getting it just right. They then had a sling contraption to rest my hand and arm on and I was able to move my arm around during surgery a little when my hand got a bit stiff. They asked if I wanted to listen to music. I imagined they would give me earphones and so said, I only really enjoy old style US Gospel hymns and I particularly liked Dolly Parton. They said that's fine, we'll find it on YouTube, you can help us. Then I realised they'd have to listen to it too. I said, look I like it but if there is a danger my surgeon won't, I'll give it a miss and go for a bit if classical. They assured me it would be near my head and the surgeon wouldn't hear it. Once we got under way, I was enjoying the music and asked if it was OK to sing. They said, yes. It's OK I had a mask on so they couldnt hear my terrible attempt to sing like Dolly . I got a bit bored of Dolly eventually, and had a bit of Alan Jackson, Blessed Assurance on repeat. I could hear them chatting away so, I don't think they were bothered by choice of music. The other end of the table sounded like they were busy making their own music with hammers but despite the sounds of stuff normally coming from a garage, I wasn't bothered in the slightest. Honestly, the sedation is that good, even being awake. If it didn't bother me, I can't imagine it bothering anybody! I couldn't see a thing and I wasn't really aware that the noise was in connection with me.
Recovery Room
Everything was cleared quickly after they finished and I was wheeled to the recovery ward. Nice quiet area with a warming blanket and monitored with one specialist nurse at my side, chatting and reassuring me. I was given a tasty carbohydrate strawberry drink (they had loads of flavours). It was nice and refreshing. I was then wheeled back to my ward to wait for my legs to wake up. They said it would take a couple of hours but I could wiggle my toes a little and gradually it all came back. They monitored me frequently and checked on my pain levels. I didn't have any.
Back on the Ward
Pain was well managed and minimal throughout. As soon as I reported any I was topped up. I was up and walking after about three hours using a walker with two front wheels. My blood pressure was a bit down at times so they only did a little walking. I felt mildly dizzyish but not really enough to say for definite that I was. I had the inevitable hot flush when I first stood up to walk (Had one last time, sweat running down my face). My temperature was not officially up. I explained it was a hot flush that women of my age are prone to, I wasn't dizzy at all. They kindly got me a damp cloth for my face. Otherwise, I coped well and managed to avoid a bed pan on the bed because I could walk accompanied to the bathroom with the walker. Embarrassing because they wanted to measure what I did and put a pan on the raised toilet. I ended up sitting in my own pee like one of those bum bath things because it was so full! The lovely nurse helped clean me up though. Thankfully, this time that is the one and only embarrassing urination story I have to share!
Next Morning Physio Assessment
I was astounded at my range of motion and ability to perform physio. I still don't know if that is due to pain relief they give you or if this is an amazing unexpected stiffness recovery. I astonished myself when I tried to lift my leg to demonstrate that I couldn't lift my foot and up it went! She said, you shouldn't do that after surgery! Although you don't technically have restrictions, so it's OK. I haven't been able to lift my leg in the air for a very, very long time. I can't lift lefty yet! I guess it's a good indication of what is achievable without soft tissue swelling and tension. Or just a very talented surgeon! I'm hoping it doesn't revert back! I had diligently been doing 10 reps of the same exercises for a number of weeks twice a day prior to surgery.
I passed all my physio and occupational health tests with ease and was signed off to be discharged. No restrictions as they believe that even with posterior, the restrictions can cause people to be overly cautious and it can delay recovery. Apparently a respected study showed no greater risk of dislocation but a significant improvement in recovery.
Instead of strict restrictions they say be very careful and if anything hurts or feels not right, don't do it until it feels pain free and comfortable. In reality that is pretty much a 90 degree restriction in my personal humble opinion but I guess we're all a bit different. Bending isn't comfortable for me at this stage and neither is sitting in a low chair or twisting. They warn that bending and twisting should be treated with caution and care. They said a booster cushion would be helpful and make standing less of a struggle in the early days but if sitting and getting up without one was comfortable and pain free, it could be done with care. They advised a firm chair with arm rests for the same reason. It is pretty hard to get up without arm rests. I had a booster ready for my chair but find I'm comfortable without it. I have a personal technique for getting up that works for me. My chair has low arm rests, I often use my crutch at a slight angle ( well held in position on a deep pile carpet, practiced a lot before surgery) to give me a bit more lift. I'm a little chubby, so lifting a bit of weight there.
I've had a great first night, managing 4 hours of sleep. I've had a great appetite and using the raised toilet and aids has been easy because I'm now well trained. I haven't been prescribed Codeine this time and I feel great. Clear headed, just a bit tired. The challenge now is not to be tempted to do too much because I feel great. I got a bit of swelling this morning because I did the bathroom session followed by trying to sit at the table and it was just a bit too much. Not overdoing it but was a warning that I could quite easily be tempted!
I'll do a long weekly update for the next few weeks for my personal journal. Thanks for reading along, if you got this far
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Deni444
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Not exactly breakthrough pain but I did experience a very uncomfortable night ushering in day 3. Just couldn't get comfortable. Reminded me, I have just had a hip replacement 
I think I set it off sitting for too long in one position in the evening. I got some swelling and as a result didn't get a lot of sleep despite medication. Can't seem to find the ice sweet spot this time. Wound in a different place. I'll keep trying but it's because I haven't had to use it much. I seem to remember a similar episode last time. I don't think I can tolerate too much sitting, lefty doesn't like it! My approach today will be to walk much more frequently but only 2 minutes at a time (monitoring pain and swelling). I'm taking my pain meds on schedule...
On a plus side, nearly half way through the first week and first winge!
I think I set it off sitting for too long in one position in the evening. I got some swelling and as a result didn't get a lot of sleep despite medication. Can't seem to find the ice sweet spot this time. Wound in a different place. I'll keep trying but it's because I haven't had to use it much. I seem to remember a similar episode last time. I don't think I can tolerate too much sitting, lefty doesn't like it! My approach today will be to walk much more frequently but only 2 minutes at a time (monitoring pain and swelling). I'm taking my pain meds on schedule...
On a plus side, nearly half way through the first week and first winge!
myglasshalffull
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I think you are doing exceptionally well!
Yeah sitting for long periods makes new hips not too happy.
I think you have good plan to get up & move around for a couple of minutes here and there during the course of the day.
I would get up &/do 5 laps around dining table then change direction & go other direction, then back to bed!
I was lucky cause from very beginning I could stand at kitchen counter to make a pot of coffee or an easy meal.
I’m so excited for you. After so many years of not being able to do what you love I can now see it all for you on the horizon. You are such a wonderful motivator for anyone recovering or facing this surgery.
Yeah sitting for long periods makes new hips not too happy.
I think you have good plan to get up & move around for a couple of minutes here and there during the course of the day.
I would get up &/do 5 laps around dining table then change direction & go other direction, then back to bed!
I was lucky cause from very beginning I could stand at kitchen counter to make a pot of coffee or an easy meal.
I’m so excited for you. After so many years of not being able to do what you love I can now see it all for you on the horizon. You are such a wonderful motivator for anyone recovering or facing this surgery.
Pain can take a variety of forms and restlessness is certainly one of them. When you feel this way, don’t hesitate to take either your prescription meds or Tylenol for your discomfort. You are no doubt correct that the sitting in one position too long fueled the problem. This is why we suggest that people get up every hour or so and move around a little.
You’re doing GREAT!!!
You’re doing GREAT!!!
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Deni444
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Thank you @Jamie 
It's something I remember from last time. Pain comes in different forms and we are very individual in how we perceive pain. When, all of a sudden we become very uncomfortable in these early days and unable to relax, it is a form of breakthrough pain. Personally, I can miss the signal to up my pain medication when I experience extreme uncomfortableness rather than piercing pain.
I try to avoid the Morphine Sulphide medication prescribed for breakthrough pain because it gives me a really dry mouth. I took your advice and counted the discomfort when sitting as a signal I needed to take a small dose on schedule for the nighttime. I had a strange, broken nights sleep with more trips to the bathroom than I care to remember but I did get plenty of deep sleep.
What a difference, sleep makes!
It's something I remember from last time. Pain comes in different forms and we are very individual in how we perceive pain. When, all of a sudden we become very uncomfortable in these early days and unable to relax, it is a form of breakthrough pain. Personally, I can miss the signal to up my pain medication when I experience extreme uncomfortableness rather than piercing pain.
I try to avoid the Morphine Sulphide medication prescribed for breakthrough pain because it gives me a really dry mouth. I took your advice and counted the discomfort when sitting as a signal I needed to take a small dose on schedule for the nighttime. I had a strange, broken nights sleep with more trips to the bathroom than I care to remember but I did get plenty of deep sleep.
What a difference, sleep makes!
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Deni444
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Had a really good day after getting some deep sleep through the night. This hip is a bit different because the incision is longer and at a different angle making it more uncomfortable to recline. I've probably developed a posture habit of taking pressure off the other side over the last few months adding to that. I managed to find a sequence of sitting up, fluffing cushions, reclining/icing, standing, walking a little... Rinse and repeat. I can't sit for much longer than half an hour but I'm actually enjoying getting up and mooching around the house a little, careful to keep my eye on my watch and cut it out at a max of five minutes. I'm thrilled that the dreaded constipation has cleared already. They prescribed 15mg Sennosides at bedtime and that seems more effective for me than my previous medication with hip #1.
Sounds like doing doing well and figuring out the puzzle of this hip recovery. My #2 was similarly a bit different, but I think have experienced #1 helps you more quickly figure out what works best for #2. Slow and steady!
Tuppence71
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With my left hip, Day Three was the day I decided to stop taking the codeine, as I couldn’t stand the (ahem) ‘digestive slowness’ any more. And I was just fine on paracetamol only. So Day Three can be a good day. Of course, I may regret saying that in (*counts on fingers*) 8 days time, when I am on Day Three once again…..I got home to my recovery nest a couple of hours ago. The discharge wheels were on a go slow at the hospital. Remarkably I was able to easily get in the Jeep (without a step) and had a really comfortable two hour journey home. I had a gentle physio session before leaving hospital and was able to do everything in comfort without it causing any additional pain. I could walk well on two crutches with an opposite leg stride. Easily navigate bed, toilet and steps. I'm on a low dose of Morphine Sulphide more as a precaution for breakthrough pain than feeling I need it particularly. I'm also taking 2 Paracetamol (Tylenol) 4 times a day. Pain is currently very mild but I'm keeping an eye out for day three. Swelling is very minimal at this point. My knee actually feels better than before I went to surgery. All good so far!
Thank you for all of your beautiful well wishes
I’m finding your thread very encouraging as I prepare for #2.
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Deni444
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I'm celebrating, I think relief didn't arrive until day 6 last time! Day 3 is quite a turning point, regardless of the recovery symptoms it kind of puts you on a solid recovery footing. Very much out of the surgery mindset and putting on a recovery mindset. Not long for you now, time will fly and you'll be well on the way to a new you!
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Deni444
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Sing it again Den... No two hips are the same... 
With Hip #1 the whole of my thigh was incredibly tender and prone to swelling and pain. The skin was super sensitive, even a light fingertip touch would send a shockwave of pain up to my hip. The hip didn't actually hurt too much.
Hip #2 is completely different. My thigh is relatively normal and I can touch it and even rub it. The only painful area is mid quad and I twinged that before surgery, overdoing it. All my discomfort between medication is in the area of my incision and the swelling deeper inside.
Last time having to get up a nightmare, this time a pleasure!
With Hip #1 the whole of my thigh was incredibly tender and prone to swelling and pain. The skin was super sensitive, even a light fingertip touch would send a shockwave of pain up to my hip. The hip didn't actually hurt too much.
Hip #2 is completely different. My thigh is relatively normal and I can touch it and even rub it. The only painful area is mid quad and I twinged that before surgery, overdoing it. All my discomfort between medication is in the area of my incision and the swelling deeper inside.
Last time having to get up a nightmare, this time a pleasure!
myglasshalffull
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You are acutely aware of your body cues which is half of the battle on this recovery road we travel.
So you are in an excellent mind set.
You had posterior approach this surgery so sitting for any length of time is uncomfortable. I found standing or laying down my best position those early days.
Even friends that wanted to visit I had to let them know I can’t sit for too long. One friend wanted to take me to lunch an hour from my house. Very sweet but between the drive and then sitting to eat. & drive home I had to decline. We ended up just enjoying a short visit back then.
So you are in an excellent mind set.
You had posterior approach this surgery so sitting for any length of time is uncomfortable. I found standing or laying down my best position those early days.
Even friends that wanted to visit I had to let them know I can’t sit for too long. One friend wanted to take me to lunch an hour from my house. Very sweet but between the drive and then sitting to eat. & drive home I had to decline. We ended up just enjoying a short visit back then.
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Deni444
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I've been remembering a lot of your golden nugget recovery tips @myglasshalffull 
It came in very useful when I realised reclining for too long was a no go. Getting up regularly/frequently or simply standing helps a lot. Sounds obvious but it's easy to get in a pickle over these things in that pain moment. Hearing and remembering someone say it worked for them helps.
It came in very useful when I realised reclining for too long was a no go. Getting up regularly/frequently or simply standing helps a lot. Sounds obvious but it's easy to get in a pickle over these things in that pain moment. Hearing and remembering someone say it worked for them helps.
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RGLieblein
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In my experience, every day brings something different—the good and the “less good.” Ice and equanimity can be your best allies at this point. 
All the best as you continue to heal and get back into your life!
All the best as you continue to heal and get back into your life!
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Deni444
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Thanks @RGLieblein I'm finally getting into my ice groove, equanimity... You are right, it can be more effective than medication at times.
You are right, it can be more effective than medication at times.
