THR Brooksy’s Hip Recovery

Brookeer

member
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This is a fairly lengthy review of my hip of on Monday 3rd October. If it’s too long I’ll remove it

DAY 1

Left Hip Replacement
Direct Superior Approach

7.30am admission

When I arrived in the ward room I wasn’t sure what to do as no-one told me. Anyway I unpacked and got into the gown etc.
Not long after the Consultant came and did the consent form. Then the anaesthetist came and we discussed what anaesthetic I wanted and decided on Spinal plus sedation.

I wasn’t sure about the sedation as I’ve never taken anything before and I didn’t want to tell them my life story as I know I have a tendency to reveal all when I’ve had a drink

Anyway as it turns out it was very deep sedation and I was well away.

After the anaesthetist went bloods were taken by a health care assistant (thankfully on the third attempt). The joys of dehydration.

Then the usual admission paperwork was completed by a nurse and I was told what would happen during the day.

All the staff were so lovely. I couldn’t have asked for better.
I was calmer today on admission than I had been previously. I thought I’d be really bad but it was a pleasant surprise. I just kind of accepted what was happening and also felt grateful that it wasn’t cancelled.

It was upsetting for my daughters when we had to say our ‘byes’ and I realised what an awful day it was for my family. In some way it made me feel like I just had to get on with it.

I had nervous aches & pains in my stomach and my heart was doing somersaults sometimes. I sat there most of the time thinking ‘this can’t be happening to me’. (Thankfully it did)

I had another shower which passed a bit of time and watched tv. Started watching a movie which was really good but every advert was about a company called ‘Pure Cremation’ so that got turned off. It wasn’t good timing
I was given Pregabelin, Omeprozole and Paracetamol at 1130am.

The anaesthetist told me my head would spin with the pregabelin. He was right. I felt like Bridget Jones when she was on the magic mushrooms. (You’ll know what I mean if you’ve watched the movie)

I literally staggered to theatre at 2.08pm and held onto the walls all the way. I felt like I was very drunk. Pregabelin is a painkiller but also is good for anxiety. It was rather nice to feel a ‘bit out of it’ after all the pre-op worries.

In the anaesthetic room an IV & drip were attached then just the usual monitoring equipment.

The spinal was fine. A bit of pushing and two times I felt like a shock going down my left leg. It wasn’t painful but just took me by surprise. I was put on my left side first then after a while I was put on my back and wheeled into theatre. Then transferred to the operating table. I was moved to right lateral position and all the supports put into place.

My oxygen mask didn’t want to stay on - it kept on slipping on my hair but we won in the end

The anaesthetist then said ‘I’m going to give you some medication to relax you. (He’d given me Midazolam in the anaesthetic room then Propofol in theatre).

And that was it! I don’t remember drifting off to sleep but I wasn’t aware of anything until I woke up and could see a face talking to me. The anaesthetist said I was very confused and I was. It wasn’t until he said ‘you’ve had your operation’ and I really tried to think about it that my memory came back.

It was all very surreal and still is.

I can’t believe it’s done and I don’t feel as though I’m in the real world.

I was in recovery from 4.10pm for about 40 minutes which was nice and relaxed and not too noisy.

I was given a long acting opiate pain killer there.

Once back on the ward at 5pm observations were done and more paracetamol administered.

I had a cup of tea and a bit later had an omelette. That was very tasty. I hadn’t felt hungry and thought I’d just have it for nutrition but I’m glad I did.

I spent most of my time after that texting my family and watching tv. We also FaceTimed on WhatsApp which was lovely and hopefully stopped them worrying about me.

(I texted my daughters at 2.15am as I knew they wouldn’t be sleeping very well. Replies came back instantly so I was glad I did).

My worries about not getting to the loo were squashed as they used a bedpan (hope that’s not too much information). I didn’t feel like I needed to go anyway. They also put loads of pads under me. I kept some wet wipes handy so I could freshen up.

At 8pm I was given more Pregabelin and looked forward to drifting off to sleep but it didn’t happen. At 10pm I was given Clexane (blood thinner) in my stomach. That smarted a bit but not too bad.

I was also given Paracetamol and Dihydrocodeine. Again sleep didn’t come. I kind of dosed on and off. I was full of wind which because of the spinal I couldn’t control. Thank goodness I’m in a room on my own
I thought I’d be very sleepy on my return from theatre but I wasn’t. I felt like I should sleep but I think there was too much adrenaline coursing through my body for that.

The worst was the back ache.

I’m not used to sleeping on my back so I think that was the reason why. I also had a really bad night’s sleep from snoring (don’t normally) and also the compression boots machine beeped every 10-15 seconds.

I didn’t expect insomnia and at 2.11am I was on this forum. It really was a comfort knowing other people had experienced the same.
I didn’t really get any pain from operation today or during the night. It was a bit sore at the top of the incision.

I didn’t expect insomnia and at 2.11am I was on this forum. It really was a comfort knowing other people had experienced the same.

Feeling very positive though that knowing whatever happens I’m one day nearer to my normal life.

DAY 2

0615

Woke up for bloods to be taken
Hb 105
They haven’t said anything about that being low
My Hb has steadily gone down for a couple of years so I hope it comes back naturally.

Then they took the observations, thyroid meds but no Bp meds.

Cup of tea/very nice


0645

Paracetamol
Omeprozole
OxyContin 5mg
No pain on waking. Feels slightly achy. I thought I’d be in agony now but not allowed up until the physio has been in a couple of hours. I’m expecting it then. I’ll be so relieved to stand up.

Once I know I can do that I’ll know I’m on the way to recovery.

I was given a slow acting pain medication but told to ask for a more instant acting one if I’m in pain.
The Consultant came to see me in recovery and him & the anaesthetist came to see me on the ward later.
He said my hip was a mess, was worn out and really needed doing.
In the afternoon the physio came and I was able to stand with the zimmer. I hadn’t expected my leg to be so stiff and painful. I thought I’d never get out of bed but I did with help. I walked in the room then the loo and has a wash (sitting down). Was so pleased and relieved but as I got up I felt like I was going to pass out. The physio and nurse quickly rushed me to the bed and said I’d gone white, then green.

I was really pleased that the surgeon has done a direct superior approach. It means he hasn’t cut through the muscles, tendons and ligaments so hopefully I’ll have a quicker recovery with less restrictions. He’s only been doing this approach for a few weeks so I feel very lucky.

I started with the worst migraine of my life at 6pm. That and the sickness lasted for nearly two days.

DAY 3

Migraine and too sick for physio

DAY 4

Home after taking endless anti-emetics. I was in a lot of pain by the time I got home but I’d been a long journey with traffic jams and I realised I hadn’t taken any painkillers. I’ve got paracetamol, dihydrocodeine, rivaroxaban and lactulose for home.

I haven’t taken blood pressure meds since the day before my op as I haven’t needed them.
My daughter came to stay thank goodness as I still can’t get my leg into bed.

I was so cold when I went to bed and needed a hot water bottle to stop the shivering and I was burning up. I thought I was heading for an infection but I had a really good nights sleep (only woke 3 times) so I feel a million times better today.

I came home with crutches but I’ve bought a Zimmer frame today for going to the loo as the crutches are just too awkward.

The physio said recovery will be a rollercoaster. Today is a good day and I think being home has helped although I must say I didn’t feel ready to come home.
 
@Brookeer
Welcome to the other side!

Sounds like everything went as expected with a THR, glad you were able to text your family in the middle of the night. Be sure to stay on top of your pain medications in these early days.

Here are the Hip Recovery Guidelines, the articles are short and will not take long to read.

Hip Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:
rest
ice
take your pain meds by prescription schedule (not when pain starts!)​

3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you​
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​

4. PT or exercise can be useful BUT take note of these

5. At week 4 and after you should follow this

6. Access these pages on the website


Pain management and the pain chart
Healing: how long does it take?
Chart Representation of THR Recovery

Dislocation risk and 90 degree rule
Energy drain for THRs
Pain and swelling control: elevation is the key
Post op blues is a reality - be prepared for it
Myth busting: on getting addicted to pain meds
Sleep deprivation is pretty much inevitable - but what causes it?

BIG TIP: Hips actually don't need any exercise to get better. They do a pretty good job of it all on their own if given half a chance. Trouble is, people don't give them a chance and end up with all sorts of aches and pains and sore spots. All they need is the best therapy which is walking and even then not to excess.

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in the majority of BoneSmart’s forums, we ask that each member have only One Recovery Thread. This policy makes it easier to go back and review the member’s history before providing advice, so please post any updates or questions you have right here in this thread.

OneStep information
 
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@Brookeer There’s nothing like being home! Everything you have described is totally normal and all of us have lived some version of it! Keep posting your progress as while you’re sharing your story, others will learn and be comforted!
:loveshwr:
 
Hello Brookeer, I am following your journey with interest and hope things are improving for you
Are you in the UK? I ask that because your medications sound 'British'.
My surgery has been postponed because I have a knee injury on the same side as my hip that needs replacing.
Have a 'good' weekend and hope you are not in too much pain.
 
Oh I’m so sorry your op has been postponed. You must be so upset. Even on the day I dreaded that happening as I knew being last on the list it might happen. I’m in the UK. I went as an NHS patient in a private hospital. I hope it’s relisted soon.
 
DAY 7

The pain isn’t bad at all I have got a high pain threshold though and having such severe pain for three years before the op I can cope with what I’ve got. Each day gets easier. Apart from getting into bed I wouldn’t say pain is the worst part about this op. Unless I’m walking there’s no pain at all.

I’ve split the paracetamol into two hourly doses and Dihydrocodeine every four hours. I’ve only taken painkillers once during the night and I can’t believe how well I’m sleeping. I actually slept 7 hours in one go last night. I can’t remember the last time I did that.

I’m still forgetful so I’m leaving the timing of meds to my daughter. If it was left to my memory I’d be as high as a kite as sometimes I really can’t remember having taken the tablets

The pillow arrangement on my bed is creative

I’ve got three behind me, one each side and last night I split a pregnancy pillow and had one behind my back and one to lean on. The physio said I can sleep on my side with a pillow between my legs but I can’t get on my side easily and I’m worried about crossing my legs while I’m asleep.

I started getting pressure sores yesterday under the top of my thigh so wanted to take the pressure off a bit while I was sleeping.

Also the area around my Achilles’ tendon got really sore in the night so I got pads put on last night.

The compression stockings are so uncomfortable at the top of my calves and the back of my knees were bruised with them last night.

It’s daft really but it’s things you don’t expect that cause the most discomfort. Even the material on my chair is rough on my legs or my nightie bunching up causes discomfort after a while.

I felt so good yesterday morning I decided to shower & wash my hair. I’ve got a shower stool so was sitting down but came over really sick & dizzy. I had to call my daughter in. It took some time to settle and I was exhausted by the time I got dressed and sitting down again. I was fine the rest of the day though.

Later yesterday I realised I was walking ‘properly’. By that I mean not being awkward and I think the stiffness and swelling are going down. Getting into bed was less painful but I still needed help. I’d say the ‘bed situation’ has been the worst thing really. I wish I’d bought some kind of a device to hold on to each side of the bed to get me up and down. I’ve got a strong upper body but still struggled.

I felt quite happy with the walking as it gave me a taste of the normality to come and also the progress I’ve made so far.
 
Welcome, sounds like you are doing just fine so far, just take it day by day.
I had to give in to being patient which is not my strongest trait.
I've read here that a plastic trash bag placed on your bed will help you slide in and out with less trouble.
Maybe give that a try.
I have an office chair next to my bed and I would grab the arm of the chair to assist me in early days of getting out of the bed. Now I can just swing my body out but in early days after surgery you do come up with some creative solutions.
Keep us posted on your recovery and I hope you have a good day.
 
Encouraging progress B ,enough about you, I too was NHS in a brilliant private hospital, if possible at your next check ups , try not to get ditched too soon , my only complaint.I’m assuming they pay for the Op then want you off their books asap, so the after care and I’m talking 6 weeks , 6 month wasn’t available, thank God for Bsmart.
DONT do too much walking / walking is enough, and maybe a lower expectation than moi who thought I’d be running a marathon within 6 month.
Good luck and comfortable recovery .
 
you sound about where I was on Day 7. i had very little pain when at rest — the toughest was walking because I had a pretty pronounced leg length discrepancy (which, thankfully, appears to be settling down). Have you tried using a belt to kind of hoist your bad leg into bed alongside the good one? That helped me at first. And, of course, the pillows. I’m doing two between my legs and one sort of propping me into position. Seems to do the trick. I also can easily forget whether or not I've taken my meds so I keep a little notebook beside the bed and write down everything as I take it. Those compression stockings were HORRIBLE! I was told to wear them after my first replacement but thankfully, the surgeon didn’t order them this time around. You have my utmost sympathy!
 
Many thanks for all the encouragement and ideas. Hearing that I’m about the same as other people are really is a comfort.

I’m just waiting to hear from the doctor about the pressure sore which has started weeping

I don’t think I’d have got that but I felt so sick in hospital with the migraine that I didn’t get get out of bed enough.

I still feel ok pain wise. I run out of Dihydrocodeine tomorrow and I’m not sure whether to get any more as I don’t like the feeling they give me or the nausea.

Has anyone else managed with just paracetamol one week post op?
 
Hi @Brookeer
Glad to see you are on The Healing Side.:ok:

These first weeks are indeed the toughest so keep the phrase All Temporary running through your brain... this really helped me get through the tough bits.

I still feel ok pain wise. I run out of Dihydrocodeine tomorrow and I’m not sure whether to get any more as I don’t like the feeling they give me or the nausea.

Has anyone else managed with just paracetamol one week post op?
Certainly some members have - very successfully...
I took the heavier meds longer but I tried to make sure I took with some food and when I weaned off, I took them at night.
So you might want to refill for "just in case ".
If you opt for paracetamol, be sure you use the Extra Strength (500mg) version. You should take 1000mg at a time at least 4 hours apart and no more than 4 of these doses in any 24 hour period. Paracetamol (Tylenol) contains acetaminophen and 4000mg is the maximum 24 hour dosage. So be sure you count in any other medications containing it into your daily total. It is frequently in over the counter allergy and cold medications, so always read the labels of anything you're taking!
 
Thanks. My doctor’s prescribed just codeine too for when I want to stop the Dihydrocodeine. Then I can start reducing that when I’m ready. He said most people have the painkillers for at least 3 weeks
 
Thank you. I hope you have a good night too
 
I felt so much better yesterday morning that I overdid it a bit. Nothing drastic but after shower etc walked around the flat for a few minutes.
Then the horrid (now familiar) nausea feeling washed over me and felt like I’d pass out.

I think it’s the Dihydrocodeine and low BP causing it so I guess it’ll resolve in time. I felt rough all day after that.

The district nurse said I haven’t got pressure sores and that it’s friction burns on my leg, She said the skin becomes very dry after an anaesthetic and I’ve probably caused it by sliding up the hospital bed with the grab bar. So she’s given me cream for dry skin.

She said the wound is seeping slightly at the top of the incision so she’s put inidine on it and is coming back on Friday. She said not to change the dressing but unfortunately she’s put a non waterproof one on so I wouldn’t be able to shower otherwise.
 
I gave up on the Dihydrocodeine on my fourth day after surgery - it just made me feel revolting, nauseous and light-headed, as you describe. I found I really didn’t need it, and have got by just fine on mainly just paracetamol in the morning. I have some over-the-counter co-codamol (which is paracetamol plus a bit of codeine) in the cabinet in case I think I need a bit more - but I haven’t needed to resort to it so far (I’m now three and a bit weeks post-op and doing pretty well.
 
Thanks for replying. I only took one Dihydrocodeine yesterday and I’ve just taken paracetamol since.
I was walking a lot too (to the loo & back) and it seemed more of a soreness than pain.
The constipation has been so awful I’m hoping that’ll resolve too if I’m not taking them.
 

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