My Personal Experience with Hip Replacemet

It is almost October, 2006, and I am recovering from my second hip replacement. My first was on Dec. 29, 2000. I would like to share my experiences with both these "implant" stories in hopes that it will quell some fears and also prepare those who've decided to have a replacement done.

First off, let me say that I knew that I had severe dysplasia for two years before the pain began to set in and become unrelenting in its increasing severity. During the last year before my operation I did everything I could to avoid surgery-alternative medications, exercises, the whole works. But none of them worked. Finally I made the decision to go ahead and do the replacement. And thank heavens I did it.

First, I have some advice on preparing for the operation itself. Though there is nothing you can do to physically prepare for this surgery that I know of, I can say that you need to feel confident about your doctor and the procedure itself. Give yourself a donation of blood if you're nervous about transfusions. I had two pints and one I had donated to myself beforehand and the other was from my "universal donor" sister! Check up on your doctor's credentials well in advance. Do Not go into surgery with trepidation about the competence of people who will literally have your life in their hands.

The following are some other suggestions relative to any major surgery. I opted to have my surgery on Dec. 29th. The reason? I knew that hospitals are almost empty during big holidays because elective surgery patients do NOT relish spending them drugged up in a hospital bed. What you can expect is a staff that is less stressed, a more relaxed atmosphere generally speaking, and much better service and shorter response time. There were only three other patients on my floor at any one time during my stay. I also got out of some Christmas obligations that would have been painful and hard to finish had I not been ensconced in my warm, snug room at St. Francis.

Next, I would strongly advise anyone preparing for major surgery to make sure your mail is picked up, your bills are all paid and those you get during the hospital stay are brought to you or taken care of by someone you trust. Notify your immediate neighbors. Tell them you'll be in implant recovery when you get home and that you'd appreciate their help. Take care of your alarm system, forward calls-all those domestic chores that are so easy to put off. This doesn't relate directly to just implant patients, but it will relieve the emotional stress of pain and lack of control natural after your surgery while you are lying in a bed totally at the mercy of your doctors, nurses, and your own recovery.

If you are smoking, as I was, try to make a goal of quitting. I will tell you that smoking will affect your recovery since it restricts blood vessels and raises blood pressure. Here's my story. I was in on morphine for about two days until the staff realized I was enormously allergic to it. Then they put me on another potent painkiller, but it wasn't a drip. I took a shot as an option and after day three I had no more painkillers. I did not experience any withdrawals from nicotine or cigarettes in general. A miracle? I don't think so. I think that you will be centered on your pain, your hip, your SELF. Smoking, for me, was evidently a "diversion" as it is for many people. Yes, the nicotine is addicting, but the physical addiction is gone after two or three days at the most and all that is left is that mental insanity of smoking. Like I was, I believe that you'll be concentrating entirely on your hip and leg the whole time, not on smoking. I even lost weight in the hospital, but then, who couldn't?!! So don't worry if you're a heavy smoker. I was, and it won't be an issue if you don't worry about it. I didn't. I walked out of there with no desire for a cigarette. Staying quit is a whole other matter, but believe me. You will not go into nicotine DTs.
Now for my post op and recovery experiences.

A joint replacement will not precipitate rejection, nor does the patient need to be on anti-rejection drugs or other strong medication the rest of a lifetime. So it's totally different from other types of transplants in those major ways. But with a new joint-in my case a new hip - you will encounter several conditions and restrictions that will lessen over the weeks and the months after your operation.

When I got out of the hospital the first time, I was sore, sore, sore. But the great joy is that this was soreness and not excruciating pain. The pain will be totally gone, believe me. And that IS a miracle. While I was determined to get active as soon possible, I had a lot of help from my family. I stayed with my sister for almost a week after leaving the hospital. She supplied me with a potty "extender" to fit on a commode and create a raised seat. I had a high portable seat to use in the bathtub for showering as well. And I had people to care for me when I couldn't work. All this is tremendously helpful for a great recovery, but the most essential need is for care-helping you with meals, providing reading materials and some diversion, picking up medicines and other items, helping you cope with the onslaught of medical bills and receipts. Do not abuse this caring. But at the same time, don't feel like you owe people something for that caring. I have never been closer to my sisters than I became after both my hip replacements and it was because, I think, they were doing what love is all about-caring for those me, who they love. I gave them my gratitude and they gave me what they could. I truly hope that everyone has and uses those they care about and that they value that caring as an almost essential part of their recovery.
When I was recovering, my hip grew incrementally stronger, but it was really slow going. Many conservative doctors tell you that you shouldn't drive for 6-8 weeks after surgery.

Some say even longer. I will tell you that I drove just short of 3 weeks afterwards, but that this was with my LEFT hip. I did have to use utmost caution getting into and out of the car. I put the seat full back and slid onto it, pulling in my right leg. Then I took my left leg, straightened, and slowly edged it up beside the break pedal (automatic transmission). Your right hip will be much more difficult as far as driving is concerned. I know this, still recovering from my right hip replacement! This specific difficulty is using your right foot on the accelerator and on the break, which happens to be to the left of the accelerator. In normal breaking, the right foot would swivel left, inward to the other foot, which is strictly forbidden for several more weeks for the reasons I mention next. So drive when you feel safe and comfortable, but know that it will be easier doing so with an operative left hip than with a right one.

Universally, it seems, every doctor tells every patient not to bend the hip over 90 degrees (a right angle) to your pelvis. They really mean don't bend it under 90 degrees. In other words, if you sit poker-straight, that will be 90 degrees. Leaning or bending beyond that to less than 90 degrees is what they're forbidding. They tell you that under no circumstances can you turn your operated foot in toward your other foot, ie. "don't be slew foot"! Sleep with pillows between your legs and do not turn on your side without the pillows in that position. Your legs Must be apart at all times and not pulled together. You cannot cross your legs, of course (operated one over the other). All these motions put pressure on the new joint's connective tissues and tendons and muscles that are still struggling to knit and heal, and you stand a good risk of throwing that new hip out of it's socket! These rules are fast and firm for at least a month and some surgeons advise 2 and even 3 months! My experience with my first hip is that I was carefully driving for short trips after just under a month. I drove with my right hip just under 5 weeks with careful maneuvering. I did not cross my operated leg over the other one until at least 2 months later for either operation, I believe. I did adhere to the pillow advice and not turning in my operated foot for about two months, simply because it was easy advice to follow.

About walking. After about 10-12 weeks I was walking pretty normally, but I was walking with a cane after just about two weeks. I had a walker and hated it because it was so cumbersome and clumsy. My experience with my right hip is about the same, time-wise. Walking with a cane for me was and has been very "doable" and I found that I could really practice walking with more freedom than with using a walker. I walked as much as I could. I even began taking walks up and down my street after about 5 weeks from my first surgery and around the same for my second on my right hip. I am impatient and that's the way I behaved after both surgeries! But I was younger than many replacement patients (age 55) my first time around and I had also been a triathelete for years before my pain set in. I do think that your body always tells you you're going too far. Listen to it! But it's really up to how people feel about their own progress and how comfortable they are with what they're doing. "Breaking" the rules of your physician are not necessarily breaking anything, since many physicians tell you many different things. But they all do give you those several restrictions I listed above and I did not break these. As to the timetables about restrictions, I can only say that people heal at different rates. I felt comfortable driving around 3 and 4 weeks. Some might feel timid overall and those people just shouldn't do it.

Exercising is another area of concern. I got home around 3 weeks after my first surgery and I began to get out into my garden in February, about 3 more weeks later. I was already walking, of course, and I began using a hoe some in my beds to clear the soil and add humous to it. I began bending slightly but I was always standing and only bent to pull up a tall weed or scrub and less than a 90 degree angle. My doctor had really told me very little about exercising, but I did get a generalized sheet advising against certain very vigorous sports like tennis, running, kayaking, ball games that involved running and twisting. I hadn't run for several years so that was not a real sacrifice. And I certainly wasn't suffering from not playing vigorous sports. I had played tennis and loved it but realized that it was simply not on the menu for me anymore. What I did do and did religiously was Swim!

All doctors advise swimming or some sort of aquatic exercise for joint problems and also for replacement patients. It is the single best exercise for these people. I began swimming as soon as I could get a "Y" membership, in late February, just barely 2 months after my surgery. It really made me feel better overall and I believe it helped my mobility increase beyond what it would have with no exercise.

I also got some hand weights of 3 and 5 lbs. and I used them to exercise my upper body and arms. I began doing some modified crunches for my midriff as well. I knew that building up and toning my muscles in both my legs, arms and mid section would help me maintain a good weight and feel more energized overall. It did just that. If you can work out in a gym or use weights for your upper body, do it. If you can swim, do it by all means. And if you can do some modified crunches, try those too. But one thing that I would tell any recovering patient to do is to walk. Walk a bit each day, several times a day. Then increase your walking. Try to maintain a normal posture and gait, but walk, walk, walk. It really helped me feel better and get to moving normally. My doctor was very pleased with my progress after my first monthly post-op visit.

I leave the last item for last because it is something I should have done that I didn't do. I am referring to good follow-up therapy for a few weeks. Part of the reason for my neglect of this was my doctor. He didn't do anything but give me a sheet of paper with general restrictions with some conservative time frames. Many doctors are unconcerned with therapy and know next to nothing about it. I did three days of therapy in the hospital but they essentially told me that I was ok and just to walk. It is important to get a therapy program that will really exercise those cut and bruised muscles and strengthen the specific area of the entire thigh and the muscles of the back and hips.

It is Not enough just to walk, which my doctor had implied. Walking is essential to good recovery, but if you want that leg and hip area to be as strong as a normal one, you need therapy which focuses specifically on those areas. My hip and thigh today, five years after my first surgery, is not as strong as it had been when I was younger. If I have to step up on a fairly high step, I have to strain to lift my body weight. Had I focused on strengthening that area with specialized therapy exercises in the weeks following surgery, I don't think I would even know I had had a replacement. As it is, that weakness is the only thing that reminds me of this fact now.

Now you know that joint replacement is indeed just short of a medical miracle. My first scar was 9 inches long. My new one is only 5 inches long and they had to do much more major repair on my pelvis for the recent one. Though we have a "transplant" for a hip, we can only be glad of the technology and dedication that has brought this incredible freedom from a former life of intense pain.

The following is a newsgroup where you can go to ask questions and to read what others are experiencing with their replacement operations. You can also do an internet search yourself to look for more groups or discussions. I have fround the one below very helpful.

Total_Joint_Replacement@yahoogroups.com