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THR Newbie, scared and alone

chickenlady

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I just got the news that I need a hip replacement. What a shocker that was.
I told the surgeon that I was alone and would not have any help. In retrospect, I realize he seemed to be minimizing the post-op pain and recovery. He said most patients go home the same day, that I WOULD BE ABLE TO SIT ON THE TOILET, that bending would be no problem. He dodged my questions about pain meds after surgery.
Now that this is sinking in and I have been looking around the net for information, I now wonder if what he told me I could expect was pure baloney.
Does anyone out there think I could do it on my own? I have 2 dogs, but even if I came home the next day, they would be ok. Hungry, but ok.
All I have is Medicare to pay for this, so I don't think I would be allowed to get a second opinion. Or could I? Having these doubts is setting off that internal alarm we all have - that something is not quite right. It might be only that he is not the surgeon for me.
Did you all go home the same day? Is getting into a car and remaining flat (in back seat?) going to go over well with an Uber driver?
Tell me the truth. Am I being a big baby in advance, or should I be listening to the clanging alarm?
So glad I found this forum.
Roz
 

djklaugh

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@chickenlady Welcome to BoneSmart :welome: Nope you are not a chicken! Nearly everyone facing a joint replacement is nervous and has tons of questions. And most everyone does just fine with the surgery and the recuperation period. It's also not unusual (sadly) for surgeons to be less than helpful in planning for the recuperation time. Your surgeon's nurse or assistant might be better at answering some of your questions. And yes Medicare will pay for a 2nd opinion Here's the link to the Medicare web site with pertinent information https://www.medicare.gov/coverage/second-surgical-opinions

Average hospital stay for a hip replacement use to be 3-4 days - now with the COVID pandemic hospitals are discharging many people sooner - BUT for you that depends on your medical condition or issues following surgery. They will not send you home if there is any concern for your well being.

Do you have any family, friends, neighbors who could come stay with you for a while? I was 64yo when I had both hips replaced and had my cousin come stay with me for about 2 weeks - a day or two before surgery, hospital stay, and about a week afterwards. I think most hospitals would not let you use a UBER or Lyft ride to get to and from the hospital - they want a responsible adult to drive you and someone who they can notify if there were problems. Many folks have gone home without having any help - and they have done fine. If there is no one available to come stay with you, seek help from people close by who can run errands for you , check in with you every day, walk dogs, etc. With a bit of planning you should do very well.

Also with dogs you may need to have some one help you with walks and poop patrol - unless you have a secure yard they can go out to do "business" in.

It sounds like your surgeon does not put any restrictions on your movements after surgery which is good. However, reality is, the leg is going to be stiff ( feels like it weighs 100lbs and is made of wood - called "log leg" around here) and sore. So you will not feel like doing much for at least a couple of weeks. Most surgeons are good about pain control after surgery and they will work with you to find what works best for you. Most folks with hip replacements need narcotic medication for at least a week or two - and some folks need it longer. Then they change over to NSAIDs such as ibuprofen or acetaminophen. Also it is very normal to feel very tired after such major surgery - and to have those episodes of fatigue ( to the point of needing to nap!) for several months.

Depending on many factors - such as how long you have been limping on a bad hip, your general health, etc - full recovery from hip replacement can take 3-12 months.

Keep us informed on how you are doing and ask any other questions you may have :)
 

Eman85

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You're not being a chicken, just facing the unknown. Listen to the alarm, if you're not comfortable with the OS find another. I'm surprised that being told you need a THR surprised you. Are you in pain? Can't help you about the insurance part as it seems everyone's is different.
I'll try and answer a few questions, searching on this site and asking will answer all of your questions. Yes some go home the same day, I didn't, I did have the option with my second but I wanted to spend the night in the hospital. Sitting up in the passenger seat of the car is doable after surgery. Might not be a comfortable ride but for me the day after surgery it took 2 hrs. to get home. We did stop to eat on the way so I could get out. The toilet is doable, for me it took a raised toilet frame over the commode. Help for the first couple of days would make life a lot easier as you'll be sore and very drained of energy.
 

Rikapa

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very understandable that you’re scared, Chickenlady. Not getting sufficient answers makes the fear even worse. Getting a 2nd opinion might be the best idea. Whether he is doing anterior or posterior, there are precautions you must take. My surgery was 2 weeks ago yesterday and I’m doing well, but still using both my raised toilet seat and reacher. please consider finding a doctor who will answer all your questions. Having confidence in your surgeon eliminates much of the stress, so all your energy can be spent on recovery. Also, talk to Medicare and get answers about your coverage. Perhaps it would cover a home aide for the first few days, or in-patient rehab since you have no one to help you out. good luck and use this forum. It helped answer many of my questions.
 

eaglemom

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Since your questioning the physician maybe its best to get another opinion. I see you've been given that information.

As for Urber most hospitals will not release you unless someone is with you. Alone in Urber most likely won't be allowed.

Let us know what you decide to do.
 

Celle

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Hello @chickenlady - and :welome:

Here are some articles to help you prepare for your surgery:
Score Chart: How bad is my arthritic hip?
Choosing a surgeon and a prosthesis

Longevity of implants and revisions: How long will my new joint last?

If you are at the stage where you are planning to have surgery but are looking for information so you can be better prepared for what is to come, take a look at these links:
Recovery Aids: A comprehensive list for hospital and home
Recliner Chairs: Things you need to know if buying one for your recovery
Pre-Op Interviews: What's involved?

And if you want to picture what your life might be like with a replaced hip, take a look at the posts and threads from other BoneSmarties provided in this link:
Stories of amazing hip recoveries
 

Celle

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As you will mostly be recovering on your own, you may like to look at this thread, which has some helpful tips:
Home Alone After Surgery

Stock up your pantry with non-perishable food items and you can cook and freeze meals, so all you have to do is re-heat them.

You will need to arrange transport to and from the hospital, to follow-up appointments and probably PT/physiotherapy.

Here's an article that suggests how much activity you should expect to be doing in the early weeks after surgery:
Activity progression for THRs
 

Spex10

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@chickenlady what a shame. It's come as a nasty and worrying surprise for you. Probably the surgeon is quite right. A second opinion won't take away the need for you to have help once you get home. Could someone take your dogs for a few days at least? Is there anyone in your family who could move in with you for a bit?
Once you get used to the idea you can start on the practicalities. It's a shock. Sleep on it and come back in the morning and tell us how you're feeling then.
It's just the immediate worries. Just think after your op you'll be on the way to a much more comfortable life.
 
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chickenlady

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djklaugh:

It's really my first day on this forum and I am overwhelmed at the supportive replies already. I will be doing a lot of reading, I see.
No friends, my life has become quite isolated. Family is gone except for a couple of cousins in other states. The thing is, I would rather NOT have help if I can pull it off. It sounds like I will need a ride home, however.
What has been your (meaning all of you "hippies", a great term) experience with the posterior approach? The anterior looks like it would be easier to heal from. Could it be that he just didn't bother to learn the "new" approach?
I have so much advice to respond to.
Roz


[check in with you every day, walk dogs, etc. With a bit of planning you should do very well.
 
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chickenlady

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Eman85:
I was totally gobsmacked when he told me and showed me the X-rays. It is bone on bone, the term he used. He also said that considering what he saw on the X-rays, he would have expected me to be more "debilitated".
My first thought about that is he was blowing smoke up my skirt, trying to psych me a bit, into doing better just because he said I was doing better. I have been limping for quite some time, months, maybe a year, well, maybe longer than a year. Then, shortly before I finally got the referral it got considerably worse. I have been using a cane I picked up years ago in the second hand store. I must be prescient.
Looking at the xrays blew me away. The capsule and whatever-the-head-is-called are gone. I thought I had some sort of muscular problem, or a bursitis, but THR did flit across my brain once or twice. Now it's worse, but I have to wonder if that is only because I know what it is and "it's all in my head". Tylenol and anaprox together helps.
I now know the "clunks" I have been feeling are not tendons snapping around, but the bumps in the bone rubbing and clunking over each other. I am a big baby about pain, and I don't understand why I don't hurt as much as others here have.
You had a 2 hour car ride home? eeeyah. Stopped for a meal? I guess narcotics were your best friend at that time.

You're not being a chicken, just facing the unknown. Listen to the alarm, if you're not comfortable w
 

djklaugh

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@chickenlady There's an article in our library about the different incisions for hip replacement https://bonesmart.org/forum/threads/thr-approaches-or-incisions.5428/

The real key is the skill of the surgeon - each will use the method he/she is most familiar with. Over all there is not too much difference in healing/recuperation time between the different approaches.

I had what's called anterior-lateral approach and did very well with that.
 
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chickenlady

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Rikapa:
The home aide sounds like a good idea. I have so much to do to prepare. There are some home repairs I have been putting off, but I must get them done before surgery, don't want to deal with that and recovery, too. I'm a little paralyzed by fear of this whole thing, but at the same time, I am tired of hobbling around with my cane like a troll.

very understandable that you’re scared, Chickenlady. Not getting sufficient answers makes the fear
 
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chickenlady

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Eaglemom:
Your list of surgeries!
Do you play professional football or something?

Since your questioning the physician maybe its best to get another opinion. I see you've been given that information.
 

Eman85

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@chickenlady Yes it is 2 hours to the big city hospital where they did my surgery. It worked out great for me as we went the night before and spent the night at the motel. I was scheduled early and driving to get there would have been too much.
Stopping on the way home was really no big deal. Yes I had taken my pain pills before leaving the hospital but nothing that did much more than ease the pain. Honestly I'd had bad hips for 50 years at that point so the pain was nothing I hadn't experienced before.
 

BBCG

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Hi Chickenlady... I love your sense of humor!

I had a TKR (new knee) and my husband cannot care for me as he battled leukemia and the chemo badly affected his eyesight and his balance, so I had a friend who was in the process of moving, so she agreed to stay with me for 4 days right after surgery, and brought me home.

Here are some of the things I did to get through the first month, since I really couldn't get much help from my spouse...not that he didn't want to help, but I have the good eyes, it's unsafe for him to carry heavy things, etc...

My friend who stayed with us helped us get things in order so my husband could take/carry the ice machine back and forth. We had a friend (a former yoga teacher when I could still do yoga!) who set up a Meal Train for us, since I wasn't able to stand long enough to cook. People brought us meals 3x a week and there were enough leftovers to sustain us the rest of the week. I set up orders at grocery stores that I could ask someone to go pick up until I could drive. I pre-cooked a few favorite meals in enough quantity that I could freeze 2-3 meals of each one for later. I hired a friend (who needed the cash) to drive me to appointments and to do the grocery store retrieving.

If you were near me, I'd help you set up a Meal Train.... you need a list of emails to send to and the person who sets it up asks your friends via email to help you out by bringing you food....

Maybe make a list of things that you will need help with, assuming you will not want to be up and about for a period of time... I don't know how long it is with a hip, but with my knee it was a month. What things will need doing? What can you set up ahead of time? People even gave me GrubHub gift cards, too, so I could order in dinners.

Let me know if I can help you brainstorm!
-- Barbara, a newish Kneezer!
 

Freedom

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When I had my left THR 4 years ago, I learned about the anterior approach here on this forum. Only some surgeons are trained in this, in my area. I decided from online reading that I needed that approach; it would get me back to independence quickest. I called around to find a surgeon trained in it. At the time, I had 8 cats and 5 dogs. I lined up a pet sitting service to tend to them. I was in hospital 2 nights, then inpatient rehab about a week. Once I was home, I had the service come morning and night for a week to 10 days. That way I figured if I fell, someone was due soon. Once I felt more stable, I just had them come once a day until I was cleared to bend so I could clean the cat litter boxes myself. I had done this same routine twice the year prior, with each of my knee replacements.

I currently have 5 cats and 5 dogs, getting things organized for the right hip. Same surgeon, getting anterior approach again. I need to be able to bend for cleaning litter boxes, food and water bowls, sooner rather than later.

Learn about the 3 main approaches. If one suits you better, call around and find a surgeon who is trained in that one.
 
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chickenlady

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Freedom: I want the anterior but he said he does the , posterior, or lateral? I forget right now. I do NOT want posterior. I asked why no anterior and he said "they" have not found any results to prove it is better than the other. I am considering a second opinion.

My biggest fear is the pain. The thought terrifies me. Bone has been cut, muscles separated, yet the :censored: surgeon said people describe the pain as similar to a pulled muscle. I find that hard to believe. He pooh-poohed my concern of bone pain, but I didn't get to ask , then, why do broken legs hurt so bad?

I called his MA who has yet to call me back. Three days.

Now as I look at this in print, I think I really will get that second opinion.

Pre-surgery pain questions:
Many have mentioned how much horrible pain they were in before the surgery and
that it was so great to have it gone. The dr. said it was bone on bone, and that sounds pretty painful, yet I am doing ok with Tylenol and anaprox together (his suggestion) and a cane. I am a first-class baby when
it comes to pain. Am I really abnormal to not have that much pain right now? I saw the X-rays, it looked pretty bad. I'm a nurse and have looked at a lot of X-rays, so he didn't need to explain to me what I was seeing.

With walking or other movement, I get a clunking in the hip. I thought it was tendons snapping
over bony prominences (seemed a good theory), but he said it was the rough pieces of bone
rubbing over each other , like making fists and running your knuckles over each other. Has anyone
else had this? It seems like if it's doing that, there would be sandy bits of bone worn away each time it happens, and that would be grinding away inside the joint every time it moves. It doesn't hurt when it happens, but it seems like it should.

I'm sorry to be such a pest with questions, but it's clear to me now that I won't be getting any
answers from the surgeon or his assistant. I continue to read posts with concerns identical
to mine.

Imagine that!
 

Freedom

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So that is fine. Call around and fine a surgeon who does anterior. I did that 4 years ago. I think I phoned 5 before one office said yes, he does anterior approach. "Great, may I have an appointment please?" That's what you need to do.
 

Celle

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Learn about the 3 main approaches. If one suits you better, call around and find a surgeon who is trained in that one.
Freedom: I want the anterior but he said he does the , posterior, or lateral? I forget right now. I do NOT want posterior. I asked why no anterior and he said "they" have not found any results to prove it is better than the other. I am considering a second opinion.
In spite of the advertising, there is really very little difference in pain or recovery time between the anterior and other approaches.

Your best chance of a smooth recovery depends far more on the skill of your surgeon than on the approach used.

Seek another opinion by all means, but don't get hooked on the idea of a certain approach. Choose the best surgeon you can find and then let him/her choose an approach with which he/she has had consistent success.

My biggest fear is the pain. The thought terrifies me. Bone has been cut, muscles separated, yet the :censored: surgeon said people describe the pain as similar to a pulled muscle. I find that hard to believe. He pooh-poohed my concern of bone pain, but I didn't get to ask , then, why do broken legs hurt so bad?
Try not to focus on the post-op pain. You will be given medications to cope with it. It isn't common to have unbearable pain post-op.
Some people have even been surprised at how little pain they experience.

Think, instead, about how much better your hip is going to feel without that pain from osteoarthritis.

While the first month post-op can be difficult, your pain will be decreasing all the time, instead of getting steadily worse as it does pre-op.

Much of the pain after breaking a bone is caused by the impact of the fall, damaging soft tissue as well as breaking the bone, and sometimes because of bleeding into those soft tissues.
During surgery, although the soft tissues are pulled aside , they are not subjected to that same impact trauma.
 

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