THR Surgery scheduled for next week, have never had surgery before

[JoeyRamone]

I’m scheduled to have my right hip replaced next week, direct superior (superpath) approach, ceramic on ceramic, outpatient in a surgical center.

I’ve done a lot of reading here in the past few days after seeing references in the Reddit sub and the Hip Runners group in fb. Everything I’ve found in various places is really helpful and I have a good idea of what to expect for the surgery and in recovery. I’ve bought all of the stuff - my husband can tell when I stay up at night reading obsessively because we get boxes of various post-op things soon after.

The part in all of this that’s really freaking me out is I’ve never had surgery before. The plan is to use an epidural and propofol, no general. I was scoped several years ago (different body part) so have been under anesthesia, but only then except when my wisdom teeth were removed in my late teens many, many years ago. I talked to my mom and she said the worst part for her was the incision healing - she said your skin feels like when you get stitches. I’ve never had stitches. I have no frame of reference for this. Any advice?

Anyone else have a THR as their first experience with surgery? (I did a couple of searches for first surgery and variations but could not easily identify any, apologies if I’ve missed a thread.) Thank you!

Some background if that’s helpful:
I started running in 2008, going from fun runs/5ks eventually to my first marathon in 2011. I continued doing marathons (not quickly) but started having problems with my right hip. It would occasionally give out, I would feel a sharp stabbing pain and it wouldn’t support my weight, then I would be fine again and could continue. I went to drs, got referred to PT for an impingement and continued running, eventually doing several 50ks, and a few longer distances, all without significant hip problems. Between work and the pandemic, my training fell off for a couple of years 2020 to 2022, but I started again, built up slowly and last year finished a few 50ks last year. During training, my right hip was pinching again but not consistently. During the 2nd 50k last year, I experienced a new kind of pain in my right hip. I was fine for 26 miles, was even back to my old pace, then for the last 5 my hip was just done. It was a new kind of discomfort, like my hip was out of place and I couldn’t get it to pop back in. I took it really easy for the next several weeks and felt fine, so went ahead with the next planned race. I was tired the whole race and went quite slowly, but finished with no problems, had absolutely no hip pain during or after the race - until 2 days later when I could not walk on it at all. I was in terrible pain for the next week, hardly able to walk.

I was able to get into see a dr in an orthopedic practice a few weeks after and they saw nothing in the X-rays, ordered an MRI and saw mild arthritis, no narrowing of joint space, and ended up telling me that what they could see suggested I was fine so nothing they could do.

I sought a second opinion from the surgeon who had replaced my mother’s hip 8 years ago - she absolutely loves him, Her surgery went well and she went back to running half marathons after - in her late 60s through early 70s. I shared the X-rays and MRI with him and he said severe focal osteoarthritis. He is conservative in his approach and did not recommend surgery for my mom until she felt her quality of life was being affected. We talked about pain management and what I could try, so I’ve been on celebrex and I guess hoping I could avoid this for a few more years. The celebrex helps, but not enough that I can run, or even walk more than a few miles at a time. I stopped taking it for a while in December because I convinced myself it wasn‘t really helping. It was really helping. It was really, really helping.

So I did all of my research on approaches, questions to ask, concerns people have had, and went back to the surgeon and asked him everything. He was great at taking time to answer everything, explained what he does and why he does it the way he does, and generally addressed all of the concerns I have that he could address. I have no concerns about him doing the surgery.
I travel a lot for work and we set the April date for my surgery back in December so I would have a few months between trips to really focus on recovering. I have been worried about this since we first talked about surgery as a possibility almost a year ago, but I am really losing a lot of sleep now with it being less than a week away.SoII

 

[mendogal]

I'm glad you already found us helpful! I'll be back in a few minutes to add information to this post about what to expect in preop and in recovery.Usually our members have had surgery and know what the actual process is like. It can be a scary process if you're unfamiliar with it!

The meds they are using for your surgery are standard. The propofol will have you fully asleep, but you'll wake from it pretty quickly.

When you arrive at the hospital or outpatient surgery center, you'll be walked into the pre-op area to change into a gown and lay on a guerney (your head can be as high as you like and you'll likely be offered a heated blanket). The nurses will ask you a ton of questions and start an IV line. The anesthesiologist will come in and talk with you. He may or may not plan to give you meds by IV to help you relax or counter any nausea. I have had many surgical procedures and every single time have had the nurses and anesthesiologist be very patient and supportive, answering questions and overall being calming.

You might be visited by the surgeon in preop or you might not talk with him until your guerney is wheeled into the OR. The propofol will tend to make you forget everything that happens in the OR even before it's administered!

You wake up in the recovery room. You may be aware of a very dry mouth or slightly sore throat from the anesthetic. The nurses will want to make sure you're fully awake before offering ice chips, water, etc. Don't be shy about reporting pain! There will be pain meds available - usually short acting IV ones at first.

When you're fully awake they may offer you a hot beverage and light snack. You won't be discharged until you've been able to drink, eat, walk, and pee. Physical therapy will be there to get you started on mobility and make sure you're safe.

If there are any concerns about your health or safety, you won't be discharged. Sometimes folks have pain or nausea or blood pressure issues and need an overnight stay.

 

[mendogal]

Here are some useful articles

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:

Pre-Op Interviews: What's involved?
Score Chart: How bad is my arthritic hip?
Longevity of implants and revisions: How long will my new joint last
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 stories of amazing hip recoveries.

 

[JoeyRamone]

This is helpful, thank you! They have given me a similar outline for the day. One of my concerns is that’s it’s a surgical center so if something does not go as planned, I’ll need to be transferred to a hospital and admitted overnight.
The dr has strongly recommended to take only tramadol if meds are offered so that I’ll be able to go home more quickly. It’s a two hour drive home for us and the surgical center has me scheduled for noon, so the sooner I can get out the better but reading here, it seems there are frequently unexpected things that happen, so I’m trying to plan for multiple possibilities.

 

[benne68]

Welcome to BoneSmart, @JoeyRamone

I can only imagine how anxious you must be, given that this is your first surgery! But please know that this is a very safe surgery and the vast majority of people do go home the same day when they have local instead of general anesthesia.

Although it's good to be prepared, try not to worry too much about the unexpected. In the unlikely event you need to be moved to the hospital overnight, it will be something you want them to do. For example, I was hospitalized overnight because of low blood pressure. It stabilized with some IV fluids and they released me the next morning.

If you have a skilled surgeon whom you feel good about, try to put your trust in him/her. There are just some thing we can't control (like my BP ).

Try to focus on the future and how great it will be to get your life back once you recover.

 

[mendogal]

My knee replacements were an hour from home. A few pointers...

Members here recommend using a plastic garbage bag on the car seat to make it easier to slide/pivot once seated.

I chose to use the front passenger seat but many prefer the rear seats so they can elevate.

The two small cold packs I was discharged with were useless between the long ride, the size of the human knee, and the intial bulkier dressing. Even if you plan on having an ice machine at home (100% recommended!!!!) you might buy a couple of larger cold packs and have your husband pack them into a picnic cooler in the trunk.

 

[Caison113]

Hi @JoeyRamone and welcome to the club no one wants to be a member of! I had my first hip done at 50 and my second at 51 (almost 1.5 calendar years apart). The procedure you have explained sounds very normal, including the anesthesia process. The first two weeks post-surgery are not fun, I won't lie, but the pain you will have is mitigated by knowing it's temporary and the old pain you had will be gone! My life is so much better now that it's hard to explain. I'm doing all my old activities plus some new ones, and I never have to worry about if a walk in the park is going to put me in pain for three hours afterwards.

Be patient with yourself after the surgery and don't try to rush your rehab. Give those muscles time to heal and just walk. No need to go crazy with PT appointments. Good luck!

 

[Hip4life]

All I can add @JoeyRamone is to remember that everyone involved with your surgery wants the best outcome for you. This is their normal day in the life so ask questions if you don’t understand and above all, let them know what you need or how you are feeling. If you do have to stay overnight, it won’t be the first time they’ve run into that either. I recently had that experience. The change of plan was upsetting to me but it was a nothing burger to my care team. They wanted me to be safe and I’m glad they kept me. Blessings for a smooth surgery next week and a good start to your healing journey.

 

[luvcats]

I'm sorry to hear you are so anxious. I am awaiting my hip replacement May 1, but I have already had both knees done. Surgery can be scary, but most of the warnings they give you are more outlying trouble most people won't have to deal with. The people in hospital surgeries are good at their jobs. If you already know you cant trust your surgeon, then you can be confident in their team.

Do you happen to be a red head? Sometimes people with naturally red hair have weird drug interactions.

 

[Oakley]

seems there are frequently unexpected things that happen, so I’m trying to plan for multiple possibilities.

I would question if this is so. It may seem that way because people who have complications or concerns tend to post here in order to get feedback From my experience most of the hip surgeries these days are routine, especially among those your age. The worst part for me was the apprehensiveness before the surgery. Recently I had my second hip replaced; Both of my surgeries were uneventful I am older than you, was told by OS after surgery that I have soft bones but went home same day. I wouldn’t say there was pain from either surgery but rather a soreness and discomfort. Aside from childbirth and wisdom teeth removal many decades ago, I had not had surgery of this magnitude either and was quite apprehensive both times. It sounds like you have done your due diligence and all sounds normal to me Agree that it is best afterward to not push PT, and to take it easy resting, icing, and elevating frequently. Icing is perfect for soothing any discomfort and swelling. I got by with only Tylenol both times, as I am not keen on taking drugs unnecessarily. I feel certain that you will be fine and very relieved after surgery. All the best to you!

 

[trailrunner]

I wanted to say hello to a fellow ultrarunner, although it's been a while since I've done one. When I was in my 30s and 40s I did a bunch of races, ranging from 5k to 50 miles. My favorite trail distance was 50k, and my favorite road distance was 10 miles. In between running races, I did a lot of triathlons and bike races. In my 50s, I started playing tennis, and by my late 50s I was playing 10 hours a week (plus some running and biking), and most of that was pretty hard.

I think my hip problem started with a slip on ice about 10 years ago, which caused my left leg to slide out sideways. I'd like to say it was during some epic 24 hour race, but I was just walking in a parking lot. That hurt like @#*& and I still think I might have dislocated it. I recovered for a while, but about 5 years ago my groin started hurting, and I noticed I was having trouble getting on and off my bike, and other small limitations to my range of motion. About a year ago it got so painful that after playing a couple of hours of tennis, I'd have to lay on the sofa for a few hours before I could get up again. One day our coach was recording us playing, and I saw how I was hobbling around, and I decided that I needed to see a doctor. I was shocked at the diagnosis.

I haven't had my hip surgery yet. Like you I'm also apprehensive about it, but I also overthink things. It isn't a trivial procedure but either my wife or I have met numerous people who have had this procedure, and all have had positive outcomes. Hundreds of thousands of people have this surgery every year, so if they can do it, so can I. I've had five surgeries of sort of this type (one shoulder, two knees, and two feet), and they all went fine. I keep reminding myself of these positive outcomes and that I need to remain positive and not think about it too much. I fully trust the medical professionals.

Anyway, good luck to you.

 

[AlanInAZ]

it seems there are frequently unexpected things that happen, so I’m trying to plan for multiple possibilities.

I am now 4 weeks post op. Same day return home from a surgical center. Nothing special happened. My most discomfort came from shivering in recovery from the anesthesia and that took a few hours to resolve. Be aware that the first few days can be uncomfortable but generally not horrible. Take your pain meds. In recovery I was given a Percocet for the pain, got up from the bed and I walked with a walker to the toilet and emptied my bladder. As soon as I was able to empty my bladder they were happy to send me home. They checked my blood pressure, put a safety strap around my waist and using the walker I walked to my car. My wife drove home. Very routine for the staff. The many problems discussed in posts on this site are not typical of most recoveries from hip replacements for cases involving OA. In my case I expect the full recovery to take a few more months, possibly even a year.

 

[JoeyRamone]

Thank you all for the helpful replies!
@mendogal - adding the ice packs I ordered a few months ago to the list of things to pack for the trip home, thats a great idea!
@Caison113, so good to hear that the surgeries were unquestionably worth it. Part of my worry is the typical one that this will be a mistake and I will somehow be worse off, but that sounds unlikely. Looking forward to being able to move without pain again!
@Hip4life - thank you for the reminder that this is a typical day for the surgical team! They have been great about answering all of my questions (including today‘s - do I REALLY have to stop shaving my legs today?!) with patience and kindness. I’m ok staying the night, it’s just the uncertainty of what will happen that’s unsettling.
@luvcats, not a natural redhead but that is really interesting, I’ve never heard about that! (I also love cats and not looking forward to explaining to ours that the bed will be cat free for a while)
@Oakley great point about the tendency to post extreme/unusual outcomes. Those probably stand out to me more right now anyway as a kind of confirmation of my fears. There are a lot of stories of no complications here too and I appreciate you and @AlanInAZ sharing yours. I hope I have a similar experience!
@trailrunner - yours was one of the first stories I read here and could definitely relate! Looks like you are scheduled for next week also?

 

[mendogal]

Re cats... Yeah... We have three and have had to banish them from the bedroom overnight..

 

[OsteoBionicGal]

Hi. I’m double THR veteran.
You said you’ve done a lot of reading and you have confidence in your doctor. However, I missed the approach they would be using? I’m assuming it’s anterior, not posterior? Anterior. requires more skill on the part of the doctor, but the best results for the patient since it does not cut through muscle. For me, both THR’s were a walk in the park. Able to drive within 2 to 3 weeks after surgery. Both scars barely visible. But then that’s a genetic thing. Although, if you tend toward keloids, the silicone tapes work extremely well. It’s easy to get off the meds since relatively light pain-wise compared to other surgeries.
I’ve had 12 ortho surgeries beginning in 1970 and over 25 hours in the operating theater. Basic orientation is: ‘you will get through this’ understanding it’s always ‘two steps forward and one step back’. Just follow Dr. orders and PT regimen.
Me? Drank lots of water, extra D3, zinc, vitamin C, and additional good (plant-based shakes) protein. Myself, with the understanding prosthetics themselves have a lifespan, I would shy away from running or any kind of high impact activity. I think even doctors don’t approve continuing anything high impact? (Though, kudos to your mom if that’s their passion.)
I’ve progressed from running/biking/gym; to discarding running; to bicycling for sport/transportation coupled with gym workouts; to current regimen of electric bike/Pool/Yoga.
Good luck!

 

[trailrunner]

Thank you all for the helpful replies!
Part of my worry is the typical one that this will be a mistake and I will somehow be worse off, but that sounds unlikely.

I keep having this thought also. When I notice myself thinking this way, I try to think about all the positive outcomes that I know. I think about the 6,000 hips that my doctor has done. I think about the guy I've played tennis with (and lost to) had a hip replacement. I remind myself that I'm using the same doctor that did his and his wife's hip. I think about my yoga instructor, who had hers done last December and had a fantastic outcome. I think about several of my friends who had this operation with a great outcome.

And my condition is not getting better. I'm running out of activities I can do, and none of them are pain free. For a while I could run through the pain, but now I can't. I went for a short easy hike with my wife this week, and I was in lots of pain and I was limping a lot. At this point, almost all the doubts that I had (like you have) are gone. Eventually the pain will be debilitating. I think as our condition gets worse, we keep accommodating and living with it, and we forget what it feels like to be pain free.

@trailrunner - yours was one of the first stories I read here and could definitely relate! Looks like you are scheduled for next week also?

Yes I am. Good luck to both of us!

 

[Layla]

Hello and Welcome to BoneSmart, JoeyRamone! Thanks for joining us.

Like you, I was feeling pretty apprehensive going into surgery and having wisdom teeth pulled in my early twenties was also the only time I’d ever been put under. My mind was often flooded with all of the “what if’s” leading up to my scheduled date. I didn’t join BoneSmart until a few days post op, but I had been lurking here trying to muster up the courage to schedule my surgery. I was inspired by the many positive accounts I read and I completely steered away from topics I didn’t want to dwell on.

It comes to a point that you realize your world is growing smaller. You’re unable to enjoy activity that you have a passion for, begin turning down invitations because you don’t know how far away you will need to park from the door, or walk, or if there will be stairs involved, or if you’ll be consumed with pain at some point. It’s a sad existence for sure. So….we take a chance with a brighter future as our focus.
No one goes into this surgery without fear, anxiety or reservation. No one wants to lose their natural hip. But it's no longer serving you well. We choose between allowing doubts to rule while suffering discomfort or committing to a procedure that can provide a better quality of life.

Joint replacement surgery is one of the most prevalent surgeries performed worldwide. The outcomes of these surgeries have become excellent based on a number of techniques changing over the years. The implants are durable and long lasting, with longevity much greater than before offering an increase in the likelihood you’ll never have to experience this procedure again.

I quietly made peace with losing my natural hip the night before my surgery. I gave thanks for all of the years my hip served me well, shed silent tears and actually got some sleep.

I was pleasantly surprised how quickly pre-op went. While I can’t say I wasn‘t nervous, they do give you something to calm your nerves and it does take the edge off. They keep you pretty busy between a visit from the surgeon normally, to initial your op leg, possibly the anesthesiologists and lots of confirmation of your name, birthdate and what procedure you’re there for. I found the care team kept it light, engaged in humor and were generally very kind and encouraging. It is simply another day at the office for them, doing what they are trained to do, and what they do best. They want the same perfect outcome that you do and all parties work toward that end. You’re soon whisked off to the OR, next thing you wake up and realize surgery is behind you! It’s amazing.

I used a large trash bag on the seat for the ride home which makes it easier to swivel to front facing (windshield) position for the drive. My ride was only about 30 minutes so I didn’t really need ice, or stop for a stretching / walking break as we advise if the ride home is a lengthy one.

You will love the camaraderie, support and encouragement found here as you’re healing. Also, the tips and advice you receive from those that have “been there, done that” as well as those healing along with you in real time.

I’m happy you found us and look forward to following your recovery. Not too long now….Lots of comfort to you as you’re waiting!
@JoeyRamone

 

[djklaugh]

@JoeyRamone Just another bit of advice to add to the already wonderful ones you have gotten. Look at the bottoms of the shoes you wear most often. See the wear pattern on the soles and heels? That is the current limping/bad hip pattern and it is NOT good for new hips! That old pattern can interfere with you regaining a normal gait and can put extra stress on the new hip. So, unless those shoes are very new and have virtually no wear pattern, GET NEW SHOES!

 

[luvcats]

@JoeyRamone Just another bit of advice to add to the already wonderful ones you have gotten. Look at the bottoms of the shoes you wear most often. See the wear pattern on the soles and heels? That is the current limping/bad hip pattern and it is NOT good for new hips! That old pattern can interfere with you regaining a normal gait and can put extra stress on the new hip. So, unless those shoes are very new and have virtually no wear pattern, GET NEW SHOES!

This is absolutely excellent advice! My new Kiziks (slip on sneakers) are in a box waiting until the day of.

 

[mendogal]

Oh! I was considering Kiziks as a next-shoes option! Have you used them before?