Are you, or someone you know, considering a Total Hip Replacement? If the answer is yes, than this article is for you. At the age of 52, and just a short three months ago, I underwent Total Hip Replacement surgery. Now, 52 is a relatively young age for this surgery. The majority of patients are in their 70s or 80s. In my case, I just found out I had Congenital (born-with) Hip Dysplasia (the socket wasn't connected like it was supposed to be.) When I learned of the diagnosis I was shocked because it hadn't been a problem previous to the last 5 years or so. I still didn't know it was a problem until the pain got to be so great that I could hardly walk, and even then, I thought it was an issue with my back.
Now, I'm an experience-based expert on the subject. You might be tempted to chuckle because I'm not a surgeon, nor do I specialize in Orthopedics. But really, who better to ask than someone who's been through the process. As such, I'm going to start my discussion with what happens after the diagnosis.
After the Diagnosis
I think one of the most emotionally challenging times in our lives occurs when someone mentions the need for surgery. That's because the thought of being cut into is counter-intuitive. During all other times of our lives, cultural norms have informed us to be careful around knives, scissors, and other sharp objects so that we don't cut ourselves. In the case of surgery, we have the knowledge that we are purposely cut, and because we are cut, pain will follow. So, whether consciously or unconsciously, we now have the stress of knowing that we'll have to endure a period of recovery that will involve pain.
When the surgery involves the replacement of body parts, another layer of emotions is revealed. When the body part being replaced involves a joint, you get to think about the fact that your old, defective part is going to be removed and it will be replaced with a synthetic copy. In my case, I knew my hip joint would be completely removed and replaced with a metal counter-part that would be anchored in my femur bone. A new cap would be nailed to my pelvic bone, and all would be good.
The same emotional triggers are true if you're having something other than a joint replaced. A friend of mine had bladder suspension surgery that involve placing a band of cow tissue under her bladder to help hold it up. My mom had a heart valve replaced with a pig valve. You can only imagine the jokes that followed.
Regardless of the surgery or the repair, there is still a huge emotional aspect that can't be ignored. The sooner the emotion part can be resolved, the better you'll do with the rest of the process.
Preparing for Total Hip Replacement Surgery
You might wonder what I mean when I write, prepare. Believe it or not, there is a lot to do before having this type of surgery. Of course, you have to get all the routine blood work and EKGs completed. For this surgery, you have to go to the dentist and get a dental clearance prior to surgery. Why a dental clearance when it's your hip that's the problem? It turns out that an infection in your mouth could cause damage to the new joint leading to more surgery. Therefore, the surgeon needs to know before he cuts into you that you don't have an infection with potential access to the blood stream. Fake joints are a magnet for infection because metal attracts bacteria. Furthermore, every time you go to the dentist for the rest of your life, you will have to take a preventative round of antibiotics prior to cleaning or any other procedure.
If you're lucky, the hospital in which your surgery is scheduled will offer a pre-surgery education program. The program I attended was called "Joint Camp." The name generated a lot of jokes, but the program was invaluable. I spent about 3 hours learning about the surgery itself, what would happened when I woke up, and when I would be expected to get up. The answer to the last question is the day of surgery. Yep, don't expect to be lying around. Joint Camp also educated us about the movement restrictions we would have, some of which are for life. For instance, following hip replacement surgery, you can not cross your leg past mid-line (the invisible line running down the center of your body from the top of your head to the tip of your toes) without the possibility of hip dislocation. You also can't bend from the hip more than 90 degrees, which makes putting shoes and socks on a major challenge. Fortunately, the Joint Camp trainers showed us "the hip kit" we would get post surgery that would assist with some of these challenges. The grabber is extremely helpful when you need to pick something up and you can't bend over. There is also a clever tool that makes it easy to put on socks, as well as a long handled shoe horn for helping with your shoes. As part of your preparation, you'll want to make sure you have some good slip on shoes because you won't be tying your own shoes for a while.
What to Expect After Surgery
When you wake up from surgery, you'll have a foam wedge placed between your legs to keep the new hip in place. Don't worry. You'll take it out when it's time to get up, but you'll need to put it back when you get back into bed. So, plan on sleeping on your back for a while. Your doctor will let know know when you can sleep without the wedge.
The most exciting part of total hip replacement occurs the first time you get up. Sure, you're going to have some post-surgical pain, but the most profound effect is the feeling of a nice strong leg holding you up. For me, the pain from surgery was nothing compared to the pain I'd been experiencing from bone rubbing on bone. It's really important that you walk as much as you can the day after surgery. You have to be able to walk a certain distance (with assistance from a walker) in order to be discharged home. For me, that distance was 100 feet. If you can't walk the distance by the time the doctor is ready for discharge, you'll most likely have to go to an in-patient rehab center until you can.
After You Get Home
When you get home, especially if you are discharged straight home, you will need help! It's a good idea to have a raised toilet seat on hand because you're not going to want to bend all the way down and then get up from a regular toilet seat. You'll also need help getting the TE.D. hose on and off. T.E.D. hose are the lovely white compression stockings you'll have to wear to help prevent blood clots. You will not be able to do it yourself!
You can also expect to take blood thinner medication which will need to be monitored closely. Your hospital case manager will set up a home health service for you which will include a visiting nurse who will check your blood thickness every few days. It will also likely include a physical therapist who will come to your home to help with mobility issues. Welcome both of these services with open arms because your overall outcomes will be better.
Of course there are a lot of individual differences to take into account with every surgery, but for the most part, you should be in better shape than you were before surgery. Don't push yourself too hard and follow All the precautions, but don't convalesce too long either. The more you get up and move, the less likely you'll have problems with clots, and the faster you'll heal. Listen to your body. It will tell you when you've had enough.
Finally, the greatest comfort I had post-surgery was a wonderful, microwaveable heating pad my sister gave me. At the end of the day, it was far more comforting than any of the host of pain medications prescribed to me. Use the medications when you need to, especially the first week or so after surgery, but remember, opiate based pain medications cause constipation and a heating pad doesn't.