Diary of a hip replacement: week 1

The countdown to my hip replacement

My right leg that has had the hip replaced is my stronger leg and taking a lot of the strain, as is my back. In my assessment, the consultant writes in the notes sent to my GP and myself that there is a 3cm difference in leg length. No wonder my back is hurting. He notes that the un-operated leg is ‘withered’.

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Walking any distance causes considerable pain in my lower and middle back, so before the op I am doing 10 pool lengths at the local leisure centre and a series of exercises to keep myself mobile. I can put it off no longer. I must get this hip replaced to even up the discrepancy in height and to alleviate the pain.

At my pre-assessment a week before the surgery, a nurse takes my blood pressure, asks me a series of questions about my lifestyle, weighs and measures me, takes urine and blood tests, and gives me an ECG heart test.

Coping with anxiety before my hip replacement operation

But perhaps my biggest worry regarding the hip operation was going under general anaesthetic. I don’t know why. After all, I have had plenty of hip ops over the years - seven major operations before the age of six. Some surgery in my twenties and then, in 2000, the right hip replaced.

I had never even thought about the general anaesthetic before, but this time, it is a huge concern that looms over me. I am 54, not 24 or 14 or 4. Would I survive the anaesthetic?

I know it sounds ridiculous, but it was absolutely real for me for about a fortnight before the day. In the end I found the best way to cope with this irrational fear (I am menopausal) was to deep breathe whenever the anxiety hit and keep busy, distraction being a coping strategy. That’s why I went swimming the night before the operation, because it calmed me down.

When I did meet the anaesthetist, I said to him, ‘I am very nervous’. ‘Of course, you are’ he replied. And of course, the op was going to happen. How else was I to be knocked out? With a Roger Rabbit- style cartoon mallet and chirruping cartoon bluebirds circling above me?

What you need to know about hip operations

Day 1: the day of my hip replacement operation

A week later I am at the hospital where I meet the consultant and the anaesthetist.

The anaesthetist tells me that I will have a total general anaesthetic, asks me if I have any loose or false teeth and asks me to move my neck from left to right.

The time has come. After not eating or drinking from midnight I am asked to put on a gown and some paper pants. They are ready for me.

Wheeled down to operating theatre, the anaesthetist asks me what I do for a job (15 years ago it was a ’10, 9, 8...’ countdown), while inserting a cannula into my hand, as he injects a solution we say goodbye to each other and...

I am woken up by a man saying my name and telling me that it is all over. I have felt nothing at all and had no conscious knowledge of anything being done to me, or memory, I am amazed and relieved. 

I am pushed back up to my room I am lifted from the trolley to the bed. The consultant comes into the room and tells me that my hip was very stiff, and that I bled a lot and have a drain with a bottle of blood connected to me. The nursing staff take my blood pressure regularly and give me an anti-sickness drug into the cannula in my hand.

The first night passes, I have to ask for a bed pan twice. The staff check on me regularly. I am connected to a pair of electric ‘socks’ that pump and grind throughout the night, and have on a pair of tight knee-high elastic socks, both to prevent blood clots. I am also given an injection into the stomach.

Day 2: my post-hip-replacement physio begins

The following morning I meet the physiotherapist for the first time and given a walking frame so I can get up to go the toilet.

I must sit on the toilet and any chair carefully, placing my operated leg out straight. I mustn’t go beyond a 45 degree knee-leg posture. When my right hip was replaced in 2000, I was issued with a raised seat to put onto to the toilet itself but now the physio tells me that simply stretching my operated leg out in front of me will do the trick.

I must not bend over, or lie on my side, as there is a risk of putting the ball and socket out. I must not cross my legs. Gingerly, does it, I cannot move anywhere quickly.

Pain relief is a box containing morphine with a switch that I can press if I feel I need pain relief, I also have an oxygen nose pipe.

Later, I go for my first walk with the physiotherapist, out and up and down the corridor outside, there is a bar along the wall like in a dancing school.  I do some small bends and try to lift the knee of the operated leg. This is difficult as the leg still feels swollen and numb from the surgery.

How a physiotherapist can help

Day 3: the physio encourages me to get out of bed

The physio comes back and we walk up and down again and do some more simple exercises, she talks to me about waking the muscles up, and stresses the importance of getting the surrounding tissue moving again, even while the new joint is bedding itself in my body. She also encourages me to get dressed and sit out in a chair rather than just keep climbing back into bed. I confess that I feel very tired in those first two days and spend a lot of time dozing in and out of sleep.

Day 4: my morphine pump is removed and I practise going up and down the stairs

The morphine pump is removed along with the oxygen mask which makes me free to move around. Two nurses come and remove the drain that is inside my leg and the bottle of blood that goes along with it. They tell me to take a deep breath as they pull the drain out, there is a slight tugging sensation. It is not unbearable.

I am taken out by a physio and we do the stairs. One step at a time: ‘Good leg up to heaven, bad leg down to hell’, which means going up the stairs you place your unoperated foot on the step first; on the downward journey your newly operated leg goes first. This is slow progress as you lift one leg then up with the crutches and haul up the other one, pigeon style; 15 years ago, you were not allowed to do stairs, today you are encouraged to be as mobile as possible.

Day 5: going home after the hip replacement

I’m going home today. A nurse packs up my bag for me, I am not allowed to bend, and takes me through the medicines I will take home with me.

The pain relief now recommended is two paracetamol and two ibroprofen every 4 hours.

I bid farewell to the staff, who have been wonderful, and my sister drives me home, in the front passenger seat. It is recommended that you place a strong plastic bag on the seat, so that you can swivel into the seat without moving the new hip joint. It does feel strange sitting in the car seat and I can feel that something has happened in that hip joint.

Home at last (my birthday) but we keep cake and candles to a minimum. I have to negotiate the stairs and do my exercises, some standing up holding onto a strong chair, and some lying down in bed, each set has to be done 4 times a day.

You must sleep on your back, turning over could cause the hip joint to dislodge, not a good situation as you would certainly find yourself back in hospital.

I am glad to be home without the sounds of the busy ward, and settle down into my new routine. I am using two elbow support crutches, some hospitals let you leave with walking sticks, it depends from hospital trust to hospital trust.

Tips for recovering well after a hip replacement operation

Day 6: sleeping on my back and doing the bed and standing exercises

After a night getting used to sleeping only on my back, in my bed at home, I get up with help from my husband, I have very little appetite and am able to manage some fruit and one of those little yoghurt drinks.

We decide that I would do both the bed and the standing exercises four times a day, with a set daily timetable, for these, though it tends to slip from time to time. The bed exercises consist of Deep Breathing to start; Ankle Pumps (raising my feet and doing foot ‘circles’);  Quadriceps & Gluteal Contractions (raising my knees and calves, feet an inch or two and holding it for 2 seconds; Heel Slides (bending both knees no further than 45 degrees); and Hib Abductions moving the operated leg out to the side as far a comfortable). This exercise is the toughest and I need my husband to move the leg as I find it almost impossible to move it under my own steam. 

Surprisingly, the standing exercises are a lot easier. Holding on to the end of the bedstead or dining room table or chair, I follow a series of knee bends, unoperated-leg swings to the side and to the rear; hamstring curls; mini squats and heel raises.

Day 7: getting used to moving around the house after my hip replacement

I get used to moving around the house, slowly, I continue my exercises. I eat very little, though it’s reckoned that you can be prone to weight gain while in recovery, due to lack of movement. My daughter cooks a spaghetti dish in the evening which I enjoy, the first meal I’ve actually savoured since the op.

I am taking painkillers every 4 hours, and as I go up the stairs for the nth time, I remind myself that my 80-year-old mother has in the last couple of years had both her knees replaced and managed it. If she can do it at 80, so can I. I am very concerned, however, that the thigh of my operated leg has swollen to twice the size of the other one.

After two full days at home, I appreciate the very simple ‘precautions’ around the house. We have hand grips all over the house. These are so valuable, as my crutches fall to the floor whatever I rest them against. The inventor of gravity defying crutches will make a fortune. I have my mobile phone in my dressing gown pocket when I’m around the house. I must remember to wear a jacket with pockets.

We’ve also bought a second-hand, straight-backed wooden chair for me to sit in in the living room. Low seat, soft cushion sofas and armchairs are a strict no for the next few weeks.

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