We asked one of our customers, Clare, to write a Blog about her honest experience of having a hip replacement, so that readers would have a better idea of what to expect during and after the operation. She very kindly agreed and here is her fantastic account…
I hope the following will be useful to anyone about to have a total hip replacement operation and may offer some reassurance. At the end there is a list of items I found most useful when I returned home after the operation.
I am 82 and have had two total hip replacements. The first in October 2018 aged 78, and then again in March 2020 aged 80 (the last day before the first lockdown). The pain which I had put up with for so many years has now totally disappeared and, because I am more active, I have lost the weight I gained when I struggled to walk. If you are considering treatment, I think the best time to have either knee or hip surgery is in the colder winter months, as having to wear compression stockings for six weeks (essential at the time to prevent post-op blood clots) can be hot and not at all glamorous!
My first hip replacement was covered by private health insurance. The second was self- funded at a cost of £15,000 – hugely expensive, but in my experience well worthwhile. This cost included an MRI scan and X-Rays pre and post op, blood tests, ECG, hospital and nursing costs, physiotherapy, surgeon and anaesthetist fees and the six week follow up consultation. Both operations were at my local Spire hospital.
In my experience, the road to good recovery depends upon how diligently you do the post-op exercises. After 6 weeks I was able to drive again and felt fully recovered after 3 months.
These are my memories of the operation and aftercare.
Pre-Op
I was sent a pre-assessment form to complete: past medical history, current medication, whether I would have help at home, questions about stairs, handrails, heights of chairs, bed and toilet seats – all very important for when you get back from hospital. Secondly a visit to the hospital with a nurse who checked the form and answered my questions. Then a few tests – X-Ray, ECG, blood and MRSA tests, weight and height, compression stocking size. This appointment lasted about 90 minutes and I took home lots of helpful literature to prepare me for the operation and aftercare at home.
Operation day
I arrived at the hospital with my husband at 6.30 am and was shown to my room, where a cotton gown (tied down the back), paper pants and compression stockings were on the bed – no glamour there then. The nurse made the usual blood pressure, temperature and urine checks and I was asked to undress and get into bed. The surgeon called in for a chat and answered any questions. I was given the time I was listed to go to Theatre and he marked my leg with a large black arrow pointing up to my hip (very reassuring). I also signed the consent form. Next the anaesthetist introduced herself and said that as I appeared relaxed, I probably didn’t need a sedative. In fact, I felt relaxed on both occasions.
A porter wheeled me to a small room adjacent to the theatre and I was helped onto the trolley, covered with a blanket and, after a joke or two, the anaesthetist gave me an injection and I was out for the count.
The next thing I knew was being woken up in the recovery room to hear that it was all over. After some checks I was wheeled in my bed back to my room. The operation and recovery had lasted about 3 hours. I felt very sleepy. There was a small tube running from the wound which drained excess fluid to a bag at the side of the bed. The wound was covered by a large dressing. A catheter had been inserted in Theatre which was draining into another bag at the side of the bed, which meant I didn’t need to be disturbed. The catheter would be removed the following day and the drain a day or two later. I was propped up with several pillows so that I slept upright with one pillow between my knees to prevent me from turning onto my side and crossing my legs. This was the sleeping position for the next six weeks and probably the most difficult part. When I went home, I also put a pillow at the end of my feet to stop me sliding down the bed.
The rules are not to cross one leg over the other and not to bend more than 90 degrees at the waist. So no reaching down to pick anything up from the floor and no twisting when changing direction, i.e. keeping feet aligned with shoulders (a bit like a robot). All this to prevent dislocation of the hip as the ligaments holding it in place were still weak. I found this a bit terrifying, although the surgeon told me it had only happened once, a long time ago. Even so, it focused the mind and made me very aware. This is the reason for exercising after the operation as it strengthens the muscles and ligaments holding the new joint in place.
The night of the operation I was given sleeping pills and painkillers and an injection into the abdomen of a blood thinning drug to prevent thrombosis. I would continue these injections at home for four weeks.
Day One Post Op.
After breakfast, I was given a bowl to wash. The catheter was removed. I was then seen by the physiotherapist (PT) who taught me to do bed exercises which were to be repeated twice a day. She gave me a leaflet on which these were clearly set out with diagrams for me to follow. She then taught me how to get out of bed correctly (with the operated leg first) and I walked to the chair with a walking frame. It felt good not to have any pain (although this may have been due to the analgesics). I sat in the chair for lunch and then went back to bed as I was tired. The PT returned later, and I walked more around the room with the frame and to the toilet where I was taught to straighten my operated leg in order to sit down.
Day Two Post Op
The drain was removed and the wound redressed with a waterproof dressing. There was swelling in my operated leg, but I was told that this would become less over the following weeks as I became more active. I was helped to use the shower and my legs were dried by the nurse and she helped put on the compression stockings. I had a gadget called the “helping hand” for dressing the lower half of the body and picking up things from the floor (I found it invaluable as it can pick up the tiniest thing and also a crutch when inevitably it drops). The PT called with two crutches and helped me walk down the corridor. It felt so good. I was taught a range of exercises holding on to the handrail. After lunch sitting in the chair, I was helped by the nurse to get into bed for a rest.
Day 3 Post Op
Today I was wheeled to the hospital hydrotherapy pool. I had changed into my swimming costume in my room with help from the nurse, as bending down is forbidden. Then with crutches I walked gingerly to the steps. The PT was there to help. There were shallow steps into the water and a rail to hold on to. The water was wonderfully warm and there was a feeling of complete weightlessness, so exercising by walking through to deeper water holding onto the rail was easy. Once in, I had to complete a series of exercises which lasted 30 minutes. There was usually another patient to compare notes with. Leaving the pool was a different matter. As I climbed each step I felt heavier and heavier. But the pool was fantastic and a real boost, as I was completely pain free and felt I could make a rapid recovery if I diligently kept to the exercise regime.
Day 4 Post Op
Hydrotherapy pool again today and walking on my own with crutches up and down the corridor. In the afternoon the PT taught me how to go up and down stairs correctly, using one crutch and one hand on the handrail. She also taught me how to carry my spare crutch in my crutch hand. I soon got the hang of it, although I did need to concentrate. Once I had successfully negotiated the stairs several times, both up and down, I was ready to go home!
Day 5 post op – Going Home
I was given lots more advice and literature and a very helpful illustrated booklet with all the exercises. This showed how to sit down and stand up, showering and getting in and out of the car. I was signed off by the consultant and given an appointment to see him again in 6 weeks. My dressing was changed for another waterproof dressing as there had been some oozing from the wound. I had clips rather than stitches as I was rather overweight and these would be removed in 10 days as an outpatient.
I was also given lots of painkillers (which incidentally I only needed for a couple of days after going home), further dressings, another pair of compression stockings (to be changed daily after showering), 4 weeks of blood thinning injections and a Sharps container for used needles. I was booked in for a follow up PT appointment in one week to check progress and that I was doing the exercises correctly. These exercises would gradually increase over the following weeks. Some of these sessions would be in the hydrotherapy pool. I was reassured that I could contact the ward at any time if I had any concerns.
For the drive home, the passenger seat was pushed as far back as possible and reclined so that there was plenty of room and the journey was spent looking at the sky with my leg straight. I had already been taught how to get in and out of the car, so this was relatively simple with some help. If you have a fabric car seat, then a plastic bag or small cushion would be useful so that you don’t have to twist your body and can swivel round. There were a couple of small steps into the house which I needed help with, mainly for reassurance. I also took home two crutches and a couple of raised toilet seats which my husband fitted straight away, so that when using the loo my knees weren’t higher than my hips – very important. It all felt rather strange not to have any professionals there.
As well as the “helping hand” for picking up things I had dropped, I also bought another very useful aid, the Hopper, which was recommended to me by a friend. This was a multi-sectioned carrying case strapped around the waist which would hold everything I needed whilst I was using crutches – it held my phone, i-Pad, books, newspaper, drink, food, tissues and pills with room to spare. This went everywhere with me during the day and also to carry things upstairs at night. I hooked it over the back of the chair when sitting down so it was always close by. The Hopper enabled me to be almost totally independent, which pleased my husband (!) and took away the stress of having to repeatedly ask for help.
Week 1 post op
Each day was much the same. I was able to shower myself with the help of a long handled soft brush to wash my legs and feet. My husband dried my lower legs and feet and put on my compression stockings each morning, but otherwise I was able to dress myself. I carried out regular bed exercises (morning and night) and standing exercises (three times a day). Walking was gradually increased from 10 to 20 minutes and I ventured outside, accompanied at first and then on my own. I slept in bed after lunch for a couple of hours and this was my routine for 3-4 weeks. At night I slept with 5 or 6 pillows, with another between my knees to stop turning or crossing one leg over the other. Each night I injected a blood thinning agent (these had a very small needle and were ready filled) into my abdomen, each time in a different spot. I also wore a large absorbent maxi pad (obtainable from the supermarket or chemist) as I was worried that I may be too slow in getting to the toilet during the night. This was reassuring and saved a few minor accidents. I slept in a different bedroom in order not to disturb my husband and kept my mobile phone by my bed so I could call if I needed help, but it was never used.
I had a normal diet and lots of fluid as constipation can be troublesome following anaesthesia. I therefore took a laxative (Lactulose is very gentle) until things returned to normal. I was able to shower and used a non-slip mat. The dressing was waterproof and my husband changed it every three days.
Compression stockings are worn throughout the 6 weeks post op and changed every morning after showering. It’s good to have help with these as they are very tight and difficult to put on. A useful tip is to fold over the leg of the stocking down to the heel, place the foot into the opening and just over the heel and then peel the stocking up the leg. It saves a lot of tugging.
Weeks 2-6
On Day 10 I went to the hospital to have the clips removed. I increased the walking to 30 minutes twice a day and was able to walk along the road and up a hill, accompanied at first and then on my own. I was much more confident and able to dispense with one crutch from Week 3. I had physiotherapy at the hospital every 10 days from week 2 and used the hydrotherapy pool several times. After four weeks I stopped the injections at night and returned the sealed Sharps box to the hospital.
Week 6
At last I had an appointment with the consultant in Outpatients and he did a range of movements on both legs to assess progress. Satisfied, I was told I could drive again and no longer needed to sleep sitting up – this was the best news ever!
Since then, I’ve continued going for walks every day. Both hips are now completely fine with no pain at all. I am so glad I had the operations because it has been truly transformative.
Useful items to have in readiness for returning home after a hip replacement:
Two crutches, one walking stick for later
“Helping Hand” for dressing and picking up items from the floor
“The Hopper” for hands-free carrying of everything you need in the day and ready for the night
Travel mug with a lid and a water bottle for carrying hot and cold drinks
6 pillows
Non-slip mat for shower or bath
Long handled sponge for soaping feet and legs
Maxi pads for the night
Sock Aid
Long handled shoe horn
Cushions for any low chairs