Carol's Hip Replacement Diary: Pre-Op and Post-Op Thoughts

Going Through the Process

Hip replacement on x-ray
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October 2, 2005 - The Long Wait for Surgery

I have known I needed surgery since mid-July. The decision was made one evening at my orthopedic surgeon's office. X-rays and bone scans show that a previous hip replacement is loose in the acetabular component and the prosthesis has "shallow positioning". My doctor recommended revision hip replacement surgery. I was told my surgeon's scheduling secretary would call with the date of surgery.

I was anxious to know my surgery date and wish they could have told me that evening in his office. But I waited for the scheduling secretary to call and she did around the beginning of August. In my mind, I expected to hear a date in September or October. It wasn't to be. My surgery date was scheduled for mid-November. How could I make it to November? The hip was very painful. The date was over 100 days away!

I truly wondered how I was going to pull off the waiting game. I wrote an email to a dear friend of mine who has had many joint surgeries and many long waits. Her response was "Yes, I know about waiting. My experience is that when something shifts or pops, it settles down in a few days to a week. There were a couple times - after the initial injury (a metal plate snapped), after the shift in July 2003, after the dislocation in Spring 2004, when the pain was so significant, I wondered if I'd have to be confined to my bed and doped up the whole time.

But each time, my body adjusted, and the pain lessened. You think you can't possibly wait 4 months, but you can. You take it one day at a time, do what you're able to do, take it easy on yourself. And eventually, the day of surgery will come."

Sound advice I thought. I bought into it and I'm so glad I did.

What my friend said was right. You can make it through the long wait before your surgery date. It's your time to do whatever you need to do prior to surgery. You should use the time effectively.

My 100 days have been whittled down to less than 50 days. Time is going amazingly fast actually. It's clear my "how am I going to make it" never really needed to be asked. I have been through hip replacement surgery before and revisions too, the last being in 2001. I have even endured the "long wait to surgery" before, yet when you're in the middle of the process it's sometimes hard to think with clarity.

Here are some tips for using your time effectively during The Long Wait for Surgery.

October 14, 2005 - Autologous Blood Donation

Time is still going fast as I approach my surgery date for revision hip replacement. It's about 33 or so days before surgery and I have several medical appointments scheduled, necessary appointments to ensure my surgery and recovery will go smoothly.

I donated one autologous blood unit yesterday at the local blood bank.

I have done this before prior to other joint surgeries, as it was recommended by my orthopedic surgeon. It's a simple procedure, not unlike having your blood drawn for testing purposes, except when donating you must fill up a whole unit which is 450–500 milliliters or about one pint.

The whole blood donation procedure took about one and a half hours. They began by checking my insurance cards and identification. After that came an interview regarding my medical history, checking for anything that might disqualify me from donating my own blood. I had my temperature and blood pressure taken, and a finger-prick to obtain a drop of blood to measure my hematocrit. Everything checked out fine so I was cleared for my autologous blood donation and I was told to get comfortable in their contour recliner.

The technician said they only have one size needle, so small veins make them cringe, but she seemingly had no problem with me. It took about 15 or 20 minutes to fill the unit with blood once the needle was in my arm.

I sat up after they had obtained the unit of blood, went to their reception area where refreshments are encouraged and you are encouraged to wait 15 minutes before leaving the blood bank. I ate 2 cookies and drank two small juices and felt well enough to drive home. I'm pleased that I have one unit of my own blood reserved for my surgery. I will go in two weeks and try to give a second unit.

Read What Is An Autologous Blood Donation?

November 9, 2005 - Pre-Op Tests

The last month before surgery has not been overly eventful. I have taken the time to organize, prepare, and anticipate everything I will need during the post-op phase. I'm exactly one week away from surgery.

On October 21, I was able to donate the second unit of blood for my revision hip replacement surgery. At times, for prior surgeries, I was unable to donate the second unit because my hematocrit dropped just below the level required for autologous blood donation. This time, I am happy that I will have two units of my own blood on the shelf in the blood bank.

PreOp testing had to be done within 30 days of the date of surgery. I have completed the PreOp evaluation which consisted of:

  • brief physical by primary doctor
  • EKG
  • chest x-ray
  • C1/C2 (neck) x-ray
  • pulmonary function
  • blood tests
  • urinalysis

PreOp tests determine if the liver, lungs, heart, and kidneys will be functioning properly at the time the body undergoes the stress of surgery. I was surprised to get a call from my primary physician informing me they discovered that I have a bladder infection. I had no clue, no symptoms. I'm glad it was caught early so I can take a course of strong antibiotics to rid the infection. I'm hoping this doesn't delay being "cleared" for surgery by my primary doctor. I believe we caught it in time.

I also have had a PreOp interview with the scheduler in my surgeon's office. She gave me papers to take to the admission interview and to the hospital on the day of surgery. She also gave me a medical history questionnaire which is for the anesthesiologists so they can get to know you quickly.

I also stopped taking Mobic 10 days prior to surgery, per instructions from my surgeon. I'm not in horrible pain, besides the hip which needs surgery. But I can tell Mobic is missing. I take enough other medications though which are keeping me relatively comfortable.

It's crunch time, as they say. With just a few days left I can honestly say I am calm and peaceful, and looking forward to being well again. It's time for the hip pain to go! Keep me in your thoughts and I will be back writing in this diary after surgery, and sharing more of my story.

November 22, 2005 - Surgery & Recovery

I arrived for surgery on time on November 16th. I was told to arrive 2 hours before my scheduled time. My preadmission was completed a few days prior. I was admitted fairly quickly, but the "hurry up and wait" plan was soon put into effect. I changed into a hospital gown and sockies, and put my street clothes into a plastic bag already labeled with my name.

Three nurses scurried around; one entered my medical history into the hospital computer, another started an IV, while the third covered me with a toasty warm blanket. Then we waited for my orthopedic surgeon and his team to be ready.

Almost 3 hours after my arrival, my surgeon was finally able to come by to discuss my surgery and to answer any questions. An anesthesiologist also came in for a brief conversation. It was decided he would put in a spinal block so I could use a pain pump after surgery but I also would have general anesthesia. In surgery, it was discovered that the cup portion of my last hip revision (done in 1994) was never well fixated, but rather held in place by fibrous tissue and a screw. As the acetabular cup loosened over the past 11 years, the screw had broken too. During the surgery, the cup was revised and replaced yet again. I was told the procedure went very well. I came home from the hospital 4 days after surgery. I have a home care nurse coming to do wound care a few times a week. I'm also having a few sessions of physical therapy from a home care physical therapist. So far during my recovery I've made two observations: #1) Nausea - I was quite nauseous in the recovery room. I used to brag that general anesthesia didn't make me sick in past surgeries. Could it be "advancing age"? I wonder if general anesthesia is harder to tolerate as a person ages? #2) Pain Tolerance - I underestimated the level of post-op hip pain. Having been through several past surgeries, I had some base of knowledge and experience. The mind is a wonderful thing and the memory is even more amazing. I had forgotten or blocked out the fairly intense pain which shoots through the operated leg those first few days or weeks post-op. This shows me that the mind has the ability to block out pain. Not a bad thing! I do know one thing for sure, each day will be a little better than the day before.

December 5, 2005 - Appointment With Surgeon

When I went to see my surgeon in his office about 2 or 3 weeks after surgery, he asked how I was feeling, encouraged me to work hard with the physical therapists who had already started coming to my house, and of course, I was there to have my staples removed. The doctor appointment was uneventful, but that's a good thing. Uneventful implies no complications! The surgeon did approve me to drive at around 6 to 8 weeks depending on how I felt I was progressing.

January 28, 2006 - Weeks of Physical Therapy

A physical therapist came to my house 3 times a week for 8 weeks following surgery. We started gradually with easy leg exercises but as soon as I mastered one, they had another exercise ready for me. I must say I worked well with my physical therapists (I had two - but only one at a time). Never really knowing how much they expected of me, I worked hard and gave 100% effort for every exercise they taught me. I was determined to build my strength back.

At the beginning of the 8 week PT session, I was still using two crutches. At around 6 weeks post-op, I was able to walk with only one crutch. Shortly thereafter I turned in my crutch for a cane and used my cane until I felt I was stable when walking without it. I'm now walking strongly on my own without any mobility aids.

The last 3 weeks of PT, my therapist took me outside to walk. We increased the distance we would walk each time we went out. He also added weights into my exercise regimen - just 2 lb. weights on my ankles - to give more resistance during exercise.

It's important to work hard at rehabilitation and physical therapy. Wherever you find your motivation to work hard - do it! I was told on the last day of therapy that I surpassed the goals which were written for me (they don't let you see that) during my initial evaluation. I am happy with my progress. I am now walking unassisted and pain-free in the operated hip. I have my final appointment with my surgeon Monday, January 30. I know he will be as pleased as I am with the surgical outcome. I do however have a pair of red, swollen ankles to show him. Not sure what to think of that latest development yet.

Our Orthopedics Guide at About, Jonathan Cluett, M.D., has written excellent articles related to hip surgery.

Also read:
Surviving The Loss Of Oneself (Carol's Personal Story)
The diagnosis of rheumatoid arthritis at age 19: a continuous challenge and evolution.

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