THR Coddfish’s second hip

[Coddfish]

I am on the other side for hip number two (left hip). All seems to have gone smoothly. It’s an uncemented implant so I will have restrictions on not fully load bearing for a few weeks.

Hospital check in was at 7am, even though I was second rather than first on the surgeon’s morning list. Visited by nurse. Visited by physiotherapist who delivered a walker and crutches and reminded me how to use them. Visited by anaesthetist who was so tall he had to duck to get under the door frame. Visited by surgeon, large arrow drawn on left leg. One should not objectify one’s surgeon but he’s very good looking. For any English rugby watching readers, he resembles Maro Itoje and could probably lift me up single handed. If you are in Australia, watch him in the upcoming Lions tour (Maro, not the surgeon). The surgeon also boxes for fun. Not sure about that.

Then the weird experience of walking to surgery. Cannula fitted, blood pressure monitor and heart monitors attached. Local anaesthetic then spinal block applied. I think that was the first time I felt emotional, I had been surprisingly calm until then. Some of that is because I have been through this before and lived to tell the tale. Some of it down to having had lots of unpleasant things done to me or happen on my cancer ‘journey*’.

Last time I seem to remember the spinal worked very rapidly. This time I spent several minutes worrying it hadn’t taken enough effect, but then the sedation was applied and the next thing I knew I was in recovery. Last time, the sedation was lighter and I was aware of sawing and banging noises. Not this time.

Then down for an X-ray which apparently looks good. Spinal wore off after about 6 hours and I was able to mobilise with the walker, use a commode and then transfer to a chair. Next time I need to go will be allowed to use the bathroom.

Slight conflict between the physiotherapist and the pharmacist. Physiotherapist wants me to go home tomorrow once I have transferred to crutches and stair walked. Pharmacist will have to come in specially if they want to do that as she will need to sort out my take home drugs and isn’t due back here until Monday. (Small private hospital with only today’s surgery patients onsite as in patients - 1 other hip and a knee from my surgeon and some from a second surgeon). So I expect discharge will be first thing Monday morning. My self pay package included 2 nights so I might as well enjoy the Spire hotel services.

* Metaststic triple negative breast cancer diagnosed in 2022. 3 surgeries / procedures yo breast and liver, 2 6 month blocks of chemo, immunotherapy, radiotherapy. Serious adverse reaction to immunotherapy causing acute kidney snd thyroid injury. 9 months on high dose steroids.

In contrast am expecting this to be a breeze.

 

[Layla]

Welcome to recovery, Coddfish! Thank you for joining us as an Insider.
Glad to read your very tall anesthetist and good looking surgeon took good care of you.
Walking to surgery would feel odd, I can't imagine.

I hope the meds are allowing you to rest comfortably and your able to get enough peaceful sleep until they discharge you on Monday. We're here for company if you get bored and you know the drill.
Ice, Ice and more Ice. I hope they're providing it for you.
Best wishes as you begin your recovery journey!


HIP RECOVERY GUIDELINES
(Administrative Note: For those reading here, please be aware that these links are a premium service and only available to Insiders Club Members).

As you begin healing, please keep in mind that each recovery is unique. While the BoneSmart philosophy successfully works for many, there will be exceptions. Between the recommendations found here, your surgeon's recovery protocol and any physical therapy you may engage in, the key is to find what works best for you.

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.

If you want to use something to assist with healing and scar management, BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.

2. Control discomfort:
rest
elevate
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
BoneSmart philosophy for sensible post op therapy
5. At week 4 and after you should follow this
Activity progression for THRs
The recovery articles
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?

Nutrition is of paramount importance. Available here are dietary tips, nutrition basics and additional food supplements. These articles are both general advice on food and specific guidelines aimed at people both pre- and post-surgery.

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 a 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 history before providing advice.

 

[benne68]

Welcome to the Healing Side, @Coddfish! You've been through this before, so you know what to expect. Just remember that every hip is different, even two hips in the same person.

Let us know how we can help.

My self pay package included 2 nights so I might as well enjoy the Spire hotel services.

Love this! You have a great attitude.

 

[Jamie]

I’m so glad to hear things have gone smoothly so far. I love the idea that you’re in a relatively small hospital that would appear to do a fair number of joint replacements. It sounds like you will have attentive care. Be aware that the surgeon likely injected a pain cocktail into the incision right before closing. Most do this these days. This gives you excellent pain relief for 2-3 days and gets you off to a good start. But there could be an increase in pain when that injection wears off, so be careful to take things very easy even though you may be feeling great through Monday.

I’m with Layla that it would feel strange to have to walk to the surgery theater. I’ve heard of others in the UK that had this experience and it always seemed strange to me. I wonder why they choose to do that rather than keeping you comfortably on a gurney?

We’re here for your next updates and to answer any questions you may have. You’re definitely on your way now!

 

[Coddfish]

Ice? I am in a UK hospital. They don’t have ice machines. I have an orthopaedic ice pack in the freezer at home.

It’s normal to walk to surgery in the UK if you have gone in on the day of surgery. If you have been there the night before they treat you to a bed ride.

I don’t think anything was injected into the site other than local anaesthetic and that and the spinal block have long since worn off. I don’t tolerate opioids very well either so have managed all my surgeries on paracetamol and ibuprofen.

 

[myglasshalffull]

Congrats. All sounds good so far. Enjoy your relaxing day & take full advantage of any pampering!

 

[Deni444]

So glad to hear the surgery went well. Looking forward to hearing your recover story

 

[Layla]

So sorry they don't use ice. I am surprised they don't see the benefit from using ice therapy in an effort to reduce pain and swelling.

If curious, consider asking if any medications were injected into the surgical site during your THR, before closing the wound. I wasn't made aware of the multimodal pain management to be used until afterward. I don't know that they always tell you, unless you ask, at least that was my experience here in the states.

Hope you have a good day and week!
@Coddfish

 

[IndigoKnee]

Well done! I hope all goes well with discharge tomorrow.
Re the walking to theatre : my recent hip replacement was due to a fracture so I was wheeled down to theatre but when I had a planned knee replacement two years ago it was quite bizarre as I was wheeled down to outside the theatre then hopped off the bed and walked into the theatre! Both mine were spinal anaesthetics and with the knee although also sedated I was aware of them moving round me. With the hip I was totally out of it.

 

[Deni444]

Ice? I am in a UK hospital. They don’t have ice machines. I have an orthopaedic ice pack in the freezer at home.

That was my experience too in a UK private hospital. My experience of using ICE during recovery has been very positive however. I now use ICE as an alternative to taking a paracetamol if I get a little pain. I find it works very quickly to calm things down. I use the gel ice packs that go in the freezer too.

 

[Coddfish]

I actually went home today. Medically fit and able to shuffle up and down a short flight of stairs on crutches. I do feel more sore than I remembered last time. Posterior approach obviously covers a range of incision sites. This one is definitely much further into my bum cheek than the other, which was on my side. With staples in situ for the next couple of weeks, it’s going to add to the complications of sitting and back sleeping.

 

[IndigoKnee]

Great that you are home!
Just be gentle with yourself and don’t try and do too much.

 

[Pumpkin]

Glad to hear that you are at home, hope you can get the ice on your hip.
I am a couple of days behind you, my THR is on Wednesday. I will be keeping up with your recovery.

 

[Coddfish]

Hope it goes well @Pumpkin
It will be a tough few days but worth it. Feeling a lot better for getting a decent night’s sleep at home.

 

[myglasshalffull]

Happy you are home & posterior approach makes it uncomfortable to sit for very long in one spot.
You got this. Being a hip recovery veteran you will know the cues your body will send.
All my best.

 

[Deni444]

Glad to hear you are home! I found my recliner really helpful after my posterior. What really helped was being able to adjust my angle frequently. If you don't have a recliner, multiple pillows could help.

 

[Coddfish]

Yes I have a riser / recliner. Quite a long walk at snail’s pace from where it is situated to the downstairs loo (it’s a large Victorian house). I am finding the best thing to do when I feel uncomfortable in a position is to take that return walk. The longer I sit, the stiffer I feel. The hospital has booked in the first 2 physio appointments, 1 at 2 weeks after surgery and 1 at 3 weeks. Hopefully I will have made sufficient progress by then to get benefit. It does feel more difficult than last time, but perhaps I have just forgotten those early days.

 

[Jamie]

It is easy to “forget” what you go through with a joint replacement once time has passed. Perhaps it would be good to read back through your previous hip recovery thread and you’ll see that there are a lot of steps to be taken in this journey to recovery. No rush. Your body is in charge and will get the job done as long as you listen to the signals and respond accordingly. Your body will let you know when you may have done a little too much (scale back for a few days) or when it’s ready for a new challenge (you’ll feel the energy to attempt just a bit more in terms of activity or exercise).

 

[scorow]

Following closely, as my hip #2 is set for June 4. I'm wondering how it will compare to last time, but I suspect that I have probably forgotten and/or minimized the difficulty of the early days and mostly remember how the recovery seemed fairly quick and resulted in a hip that seems 100% natural. Your post is helpful in reminding me that it may seem disappointingly difficult in the early days/weeks.

I guess the best idea when it seems more difficult than you recall from last time is to remind yourself of how you progressed and the short-lived nature of the tough early days.

 

[Coddfish]

Hi @scorow
Yes, I am sure I had chosen to forget or minimise just how tough the first few days were. First climb / descent of stairs, finding a way of getting out of a bed that doesn’t having anything you can use to pull yourself up, navigating the shower etc. I feel totally dependent on my husband at the moment. But it’s already a bit easier each day.