THR Hospital and post-op experiences?

[LeslieZ]

I can't say enough good things about my hospital experience. On a scale of 1 to 10, they were a 100! Plus the food was good!

My OS had me and my husband attend a class at the hospital about a week prior to the surgery. We were given a comprehensive overview of exactly what to expect from checkin, surgical prep, the OR, how blood would be auto transfused, what things we may find ourselves hooked up to when we awoke, posterior approach restrictions, all the goodies needed to follow the protocol from commodes to shoehorns. I was given an ointment antibiotic that I had to coat my nostrils with twice a day to lessen the MRCA risk for 5 days prior to surgery. My OS made me shower with an antibiotic soap provided by him the night before and the morning of surgery. I was given a lot of written materials to review including exercises to do in bed. It all really demystified the surgery for me and helped prepare me mentally for it. There were no surprises. Because of the MRCA risk, he routinely releases his patients to home care rather than a rehab hospital unless it it really needed.

My OS was aggressive about pain and nausea control. I took Celebrex the night before and morning of the surgery. Novocain type meds were injected into the soft tissues before I was closed, I did not have to ask for pain or nausea medications, they were part of my standing orders. I only experienced a brief bout of nausea the first time I sat in a chair. My surgery was at 8am and I was up and out of bed walking on two crutches by noon. I wore these automatic compression bandages on my legs around the clock when not up and walking to lessen the blood clot risk. The PT came twice a day and nurses were constantly checking on me. Even the guy who came in to clean the floors in the morning was sweet.

My OS saw me each day and removed my staples just before discharge and removed the stitches about 10 days post op. My surgery was on a Friday and I was home on Sunday with visiting nurses and home PT. I had to inject myself with Lovenox blood thinner for four days after discharge and the nurses thought me how to do that while I was in the hospital. Whhile my OS did not call me, I did call him with medication questions and when I developed a nasty dermatitis from the dang bandages. My primary physician called me about a week after the surgery to see how I was doing. Overall I feel I was well prepared and well cared for. I would recommend this hospital to anyone.


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[Peaches]

Hi, Acleme1 ... I think all of us are worriers about this stuff. Otherwise, we wouldn't be here.
My post-op hospital experience was mixed nuts: was neglected in some ways, not others. I went to an excellent hospital, so in general that helped me feel confident about it. I had never been in the hospital before, so didn't know what to expect about some things. Next time I will know to lower my expectations about some things. And recognize that nurses and how attentive and caring they are can vary all over the map. I had some with real attitude and snottiness during the day; but the ones at night were wonderful. I had to ask for ice in recovery, which I thought was odd. I think it's all luck of the draw, and that will pertain to the visiting nurse and PT, too.

My surgeon did NOT call me, that's for sure. He visited twice, very very briefly, in the hospital, and was so serious and closed-mouthed, I wondered about it. He did tell me as a parting shot that if I had any post-op questions or issues to be sure to email his nurse. Well, that changed everything for me, because I'd never heard him say that before. So knowing that I could email his nurse and PA made a huge difference.

One thing I would caution all pre-op people about is the infamous "hip class" that most hospitals offer beforehand. While it is very informative, it is not necessarily going to be the place to get all questions answered. I was told several times by a pre-op counselor at the hospital that I could have practically a one-on-one Q&A at the time of the pre-op class. So that was her way of avoiding answering some of my valid questions about how to make the home environment restrtiction-friendly (I did not have the anterior approach, so I had all of those restrictions to deal with). The hip class was conducted at warp speed and was filled with people and there was not enough time to really get all questions answered. Had I known that I would have done a lot more legwork done beforehand. I was concerned about buying the wrong things--toilet risers and shower seats that would fit in my old, odd shaped bathroom--so wanted to wait till the class to get info as to which ones to buy. Also needed info as to how to get home from hospital when you don't have a car. Stuff like that.

Bottom line is, you are doing great, it sounds. And to have PT tell you how fast you are recovering should give you reassurance that will go a long way. The less you have to worry about, the easier you will rest literally and figuratively.

Best of continued luck for you!

 

[Jamie]

Acleme1.....I agree that it's not really feasible for your surgeon's office to call and check on you after you're home. They depend on you to notify them if you have a problem or concern. This might seem like they don't care. Believe me....they DO care. But, there are many, many patients in various stages of pre-op, post-op and recovery that are actively supported by each surgeon and staff in a clinic. It's just not possible to make those calls.

The important thing is how your hip surgery is doing. And from the sound of it, you're doing fabulous!!! Eight days out and you're driving??? My gosh, I'd say you were healing just like a champ. Just be sure you don't leap out there and do too much too soon. If you read the links Josephine left for you, you'll see exactly how long it takes the body to go through all the phases of healing.

I do think it was wise to ask what all the pills were. Accidents can happen on medications and a good patient will be assertive enough to ask what meds are being given. You are a partner in this process and you have a right to know. I'm sure the nurse didn't mind at all explaining them to you. That's part of his/her job.

By the way, I merged your latest thread with your original recovery thread. Please keep all your updates, questions and comments here in this one thread. This is important so that we can look back over your recovery history more easily when needed to respond to you.

If you decide at any time you prefer a different thread title, just post what you want here and we'll get it changed for you.

 

[GeekGoddess]

I agree with Jamie ... Every time they bring pills to me in the hospital ANYTIME ( I've had way to many surgeries) I ask the, to identify each pill. The nurses and doctors have many patient single hospitals, AND they change the meds frequently. That said, on every hospital stay I have been given incorrect meds at least once. But using this process, I know it and hand the wrong ones back.

My mother was very ill and hospitalized frequently since I was about 9 years old, I learned from the best,

Another tip. After a MAJOR surgery, it is wise to have someone stay over in the hospital WITH YOU. Because you are too out of it to keep track of the meds. I've done this for others too.

I used to be in the medical field..it is a tireless, exhausting job.
I give them all a lot credit for how they try to take care of all of us at once!




Happy healing!
Kathy

Left TKR Oct 15, 2013
Right TKR Scheduled for Jan 2014 ?

Background:
Diagnosed bilateral bone on bone and OA knees Oct, 2012
Implanted intrathecal pain pump. 2008
4-6 additional herniated disks (lumbar and thoracic), 2004-now
Replacement damaged neck disks (c3-c5) 2004

 

[Poppet]

Hi Acleme1... Welcome to recovery just when you thought you were done with reading here are some more interesting articles.

The following is a link to an article which provides some approximate timeframes around the healing phases and processes (and relevant nutritional information) for you to read.

Healing Phases & Nutrition

This second link is to other nutritional articles which you may find interesting, including one relating to bone health.

Nutritional advice for pre op and recovery

 

[Acleme1]

Thanks for the support and the links everyone. Now, I need some guidance.

I was doing great! Just a little bit of pain when I would get up from a chair or bed...but once I started walking, I was pain free and loving life.

I've had a bit of a setback, and I'm not quite sure what to do about it. Somehow within the last 3 days, I've tweaked my new hip. Now, I get these really bad sharp pains in the joint when I get up from a sitting or laying position, or if I twist my leg to the left or right. I would say the pain is a 7 or 8 on the pain scale. It's scaring me a little. I was doing so well... Then all of a sudden I'm getting these sharp pains. Any ideas what might be going on?

The only thing I can think of is that I tried sleeping on the incision side a few nights ago. It wasn't very comfortable, so I don't think I laid that way for long. Maybe 30 minutes or so. Other than that, I've been pretty careful.

What should I do? Rest and wait it out, or try to get in to see the OS (which might be impossible with such short notice)?

I feel like I've taken 1 step forward, and 12 steps back. Thanks for any advice you can give.

Aaron.

 

[sharonslp]

Hi Aaron. First, I'd suggest icing, if you aren't still doing that. (At just a couple weeks, you should be.) Also, you probably shouldn't be twisting yet either. And it sounds like maybe you aren't medicating adequately for pain. Can you tell us what you're taking now....and how much, and how often. Josephine can give you recommendations for pain meds if you're under-medicating.

Really, you're about 12 days out, yes? Way too soon to try sleeping on the incision side (usually 3-6 weeks or even later is the norm.) In these early days, the mantra is key....rest, ice, elevate a bit, and take pain meds consistently and adequately. I have a feeling you've felt so good that you took 12 steps forward all at once!!

Sharon

 

[Jaycey]

Sounds like post-op pain Aaron. Do give Jo some idea of what you are taking for pain so she can advise.

 

[Josephine]

I'm waiting .....

 

[Acleme1]

1. I stopped taking pain meds 3 days ago. I know this sounds like I'm trying to be all macho and hardheaded, but I really did not need them anymore. At least I didn't 3 days ago. I was doing great with very little pain. Probably never above a 2 on the pain scale. I just figured it was time to give my poor liver a break from all the meds. I'm now back to 400mg Motrin every 6 hours.

2. I'm not icing. There isn't any visible swelling, so I didn't think I needed the ice.

You're probably right Sharon - I think I took at least 10 steps forward in a very short amount of time.

Putting full weight on my hip/leg causes pretty severe pain now. Worse than at any time before or after the replacement. I'm just hoping I haven't gone and done something stupid.

Thanks so much for the help. Aaron.

 

[Jaycey]

Hi Aaron, could you please put your surgery date in your signature? Here's a link on how to do it.

1. I stopped taking pain meds 3 days ago. I know this sounds like I'm trying to be all macho and hardheaded, but I really did not need them anymore. At least I didn't 3 days ago. I was doing great with very little pain. Probably never above a 2 on the pain scale. I just figured it was time to give my poor liver a break from all the meds. I'm now back to 400mg Motrin every 6 hours.

You are way under medicated. By my calculation your surgery date was Oct 31? You need your pain control medication to get moving. You will not get addicted but until you start forgetting doses you need to control this post op pain. Take your meds as prescribed.

2. I'm not icing. There isn't any visible swelling, so I didn't think I needed the ice.

There is swelling internally and ice is a natural pain killer. Ice and elevate often.

Putting full weight on my hip/leg causes pretty severe pain now. Worse than at any time before or after the replacement. I'm just hoping I haven't gone and done something stupid.

Frankly Aaron, you are not doing yourself any favors. No medication and no icing or elevating. You just had major surgery. This is all temporary but you can not cut corners. Get back on track and you will quickly move forward.

 

[flowergirl]

Believe me you need to ice, elevate and medicate. I got all off schedule for just a day and a half and went from a dull ache to raging pain, including not being able to bear any weight on operated side...not fun. Call the OS office if you feel uneasy, I get a nurse who is very fast acting on everything from prescription refills to hand holding!

My recent bad pain was a combination of a messed up med schedule and no icing. I couldn't see swelling but I could feel the football (American style) in my thigh, the softball/small melon in my but and the baseball/large orange in front of my incision...I never realized swelling could get as hard as a rock! It took a few days of almost constant icing to get the areas to soften and the related pain to go away. Today, 7 days later it is day and night difference.

Hope your home PT helped. Mine is pretty good at pushing me, but is very quick to say "if this ever hurts stop immediately". I'm doing things with this hip that I didn't do with the other and feel much looser.

Also I am a firm believer in asking...what is that?, why am I getting it? what is it going to do? I believe it is the professionals job to explain it to me...maybe I'm just a bit demanding

 

[Acleme1]

Hi all. Wanted to check in and update everyone on my progress. Tomorrow will be 6 weeks since I had Anterior THR on my right side. I hate to say it, but things aren't going so well for me. I returned to work on November 25th, and was feeling pretty good. A slight limp and some pain when I would get up from a seated position, but overall not too bad.

Hip pain has gotten worse in the past couple of weeks, though. It does OK once I'm up and moving, but really painful when I first put weight on it from a seated or lying position. Last night was the worst yet. I would say the sharp pain was at an 8 or 9 for the first few steps after putting weight on the hip. I'm doing 1 hour of Physical Therapy 3 days a week at the moment. It's helping, but not with the weight-bearing pain.

With the anterior approach, I thought I would be pain-free and loving life by now. I read countless stories of people being pain-free a few days after the anterior surgery. Being only 39, I just assumed I would be one of those stories.I have a post-op appointment with my OS on Friday. I hope he can tell me what might be going on in there.

My left hip replacement is scheduled for December 19th, and I'm just not ready to go through with it yet. I'm going to talk to my doctor about postponing until next year.

 

[Acleme1]

I also wanted to add that I'm really struggling with anxiety at the moment. I have an anxiety disorder that I take medication for (Zoloft), and I have been doing really well since the surgery.

However, A few days ago this latest bout of anxiety/depression set in, and I just can't shake these feelings.

I stopped taking my Vicodin 3 days ago, but I was only taking three 5/325 pills in the evening. I was doing that for a couple weeks, then stopped. I'm wondering if that has anything to do with how I'm feeling also.

Thanks for any insight you could give. Aaron.

 

[sharonslp]

Hi Acleme. Sorry to hear you're still struggling. As I look over your thread, I am guessing that you are way overdoing and/or still under-medicating. You returned to work less than a month out....whoa! Right there is an enormous energy drain. Then what happens when you get home from work? Are you running errands, doing anything around the house, attempting to do any PT exercises? If so.....more huge energy drain. There's nothing left to help you cope with anxiety. You say you're doing 1 hour of PT 3x a week; I assume that's at an outpatient facility. On top of working all day???? Can you drop the PT right now? It may be doing more harm than good.

Okay, you see where I'm going with all this, yes? Can you back off on work for a couple more weeks....give yourself time to just rest and recoup? If not, can you get some accommodations at work to make sure you get adequate rest periods, adequate get up and stretch periods, and comfortable seating? Once you leave work, can you come home and just relax until bedtime....and then get some good healing sleep? And are you taking anything for pain? Even tylenol will do a good job, if you take enough consistently. (Spread out 4000 mg through a 24 hour period)

Once you've alleviated some pain and exhaustion, I would hope that your anxiety will quiet right down. Now I'm going to tag Josephine to see if there's something I'm missing.

Sharon

 

[Acleme1]

Hi Sharon. Thanks for your reply. PT actually comes to my workplace 3x a week, so I just have to go down to the medical department and I'm ready to go. It's a really nice perk at my workplace.

I don't do much when I get home after work except rest. It's a pretty long walk to work from our parking garage, so by the time I've walked to and from my office and worked all day, I'm pretty exhausted. I usually just lay in bed and talk to my kids and watch television.

I WAS taking Motrin, but the hospital told me to stop taking it because my other surgery was coming up. I'm not taking anything currently. I will try the Tylenol for a couple of days and see how that goes.

Since I've already returned to work, I can't really take off more time to rest. Work is crazy busy right now, which is contributing to the anxiety I'm sure. I do try to get up and walk around frequently while I'm there though. The longer I sit, the more it hurts when I get up and try to walk.

Thanks again for your post Sharon. Have a great evening.

 

[Josephine]

I read countless stories of people being pain-free a few days after the anterior surgery.

Moral of the story being - don't believe everything you read on the internet!

Being only 39, I just assumed I would be one of those stories.

so they say but the reality is that younger people tend to have a rougher time.

I stopped taking my Vicodin 3 days ago, but I was only taking three 5/325 pills in the evening. I was doing that for a couple weeks, then stopped. I'm wondering if that has anything to do with how I'm feeling also.

No kidding! All that your described is post op pain which I am sure your surgeon will confirm. Also that there is nothing wrong with your hip.

Whilst repeating much of what Sharon said, I will list the things that are your problems
1. you returned to work too soon (after 3½ weeks - were you insane? )
2. you stopped taking pain meds much too soon
3. you are doing PT at work which is the very last place you should be doing it - PT and a hard day's work is bound to make you achy and sore

Actually, you don't need to do any PT at all. Hips really don't it as they have this neat way of working things out for themselves if given half a chance. All they really need is some short walks in the early days and longer walks in the later days. Nothing more.

Did you ever read the recovery articles I left for you in post number 34? It would seem not from the things you have been saying here. Also you need to read this article - I know you can't change that you've started work now but there's more than that in this article Phased return to work.

I strongly suggest that after your second hip you plan to return to work no earlier than 10 weeks if you possibly can.

 

[Acleme1]

Hi Josephine. Thanks for your reply. I have read all of the recovery articles you recommended. It's just that there's no way I can baby this hip as much as the articles suggest. My insurance company only approved me for 4 weeks of Short-term disability pay. Anything after that and I would not get paid. I can't afford that right now. I'm just trying to "hobble" along the best I can. I'm back to taking Tylenol around the clock, so hopefully that helps.

I saw my doctor today and was very specific about the pain. After he looked at the X-rays, he explained that my bone is not growing onto the femoral stem yet. The pain I am experiencing when I get up from a resting position is the femoral stem shifting (very slightly) in the bone.

I am both relieved and worried. I'm relieved that there is a cause for the pain and that I'm not just a big baby, but I'm also very worried that my bone isn't going to attach to the stem.

He suggested I start taking 2,000mg of calcium a day and to make sure it contained Vitamin D.

He said that worst case scenario: we would have to open the hip back up and replace the short stem with a longer femoral stem. :(

Wish me luck on my ability to grow bone quickly. If anyone has any insight or had a similar experience, I'd love to hear from you.

 

[sharonslp]

Acleme, I have a short, uncemented stems also. My OS said it would take 9-12 weeks for a good amount of bone growth. It's never been a problem for me.

I'm surprised your OS let you take Motrin during this time. Ibuprofen is known to inhibit the bone growth. You're okay with tylenol. So just give it some more time.

Sharon

 

[Acleme1]

It's funny you said that Sharon. He said the exact same thing. He didn't know I was on the Ibuprofen...his nurse is the one that told me it was okay to take it. I could tell he was surprised and a little embarrassed.

I hope the Ibuprofen was the cause of the delay in bone growth. Only time will tell.