Bilateral hip replacement

wildway
wildway Member Posts: 26
edited 20. Sep 2014, 10:26 in Living with Arthritis archive
I'm about to have both my hips replaced at the same time. Firstly I'm nervous about it and have a number of questions that some of you may be able to help me with. I am 49 years old and have been working as a photographer. I also live on my own. So the questions are:

1. Has anyone been through this and can suggest any useful tips?
2. How long does it take to be able to climb stairs?
3. Should I get Social Services involved before I go into hospital baring in mind my situation and will they be interested in advance of the operation?
4. They say you get back to work after about 8 weeks but baring in mind my occupation I think this unlikely as I believe I won't manage the equipment?
5. How long before I can use public transport?
Anything else that you think might be useful for me to know about the recovery and assistance available out there would be useful : )
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Comments

  • stickywicket
    stickywicket Member Posts: 26,774
    edited 30. Nov -1, 00:00
    Hello widway and welcome to the forum. I've had both my hips replaced but not at the same time. I know we have had at least one forum member who had hers done together. Her username was 'weejean' and I'll try to bump up a thread of hers for you. As we haven't seen her for some time I'm guessing her op was a big success :D

    As for your questions, we are all individuals and there is no 'set time' for doing things even after an ordinary ie one hip, THR though I'd guess at your pre-op appointment, you'll be given all the info you need. That's also the time to ask any questions you may have. One thing common to all THRs is having to sleep on your back for six weeks post op.

    Why would you want to involve Social Services? Are you thinking of equipment? The Occupational Therapist in the hospital should assess you before you leave. They usually give out grabber sticks and other small items and loan out bigger ones like raised toilet seats.

    I can't tell you about public transport. I have RA. I wasn't able to use it for years before my THRs and I still couldn't use it after :lol: Again, I suspect it will depend on you and whatever form of transport you were thinking of.

    The one thing I personally emphasise to anyone going for a THR or TKR (Yup, I got those too :lol: ) is that it's easy to mess things up by either doing too much or doing too little after the op. Be guided by your physio. Do the exercises to get the muscles strong. Don't assume that walking is a good enough exercise.

    Do you live alone or will you have help there post-op?

    I'll bump up a thread by weejean.
  • wildway
    wildway Member Posts: 26
    edited 30. Nov -1, 00:00
    Thanks Stickywicket. I do live alone in a one bedroom flat (split level). There if is a flight of 12 steps then a small landing then 5 more, and a flight of 5 steps down to my bedroom. I noticed someone else who'd had a hip done mentioned getting social services involved before so that one could plan in advance but I've also been told what you said. I've had my pre-op but apart from telling me I'd be about 6 days in hospital, they said the same thing that everyone takes different times to heal. But as I also work for myself it's hard to know what to tell people as regards when I can get back to earning some money and not losing clients along the way. I don't have a car so I'd be reliant on public transport.

    Thanks for looking for the other thread :D
  • stickywicket
    stickywicket Member Posts: 26,774
    edited 30. Nov -1, 00:00
    Phew! I won't lie to you, I think you have your work cut out. The steps. Being alone. The pressure to get back to work. The type of work. The public transport. None of this is in your favour. What is in your favour is that you seem to be approaching it all wisely, not minimising problems and not flapping about.

    Firstly, please ensure that everyone who deals with you in hospital, but especially the Occupational Therapist and physio, know how many stairs you have and that you live alone. You may be tempted to play down difficulties in order to get out :wink: but please don't as while you're in hospital is the best time to sort things out.

    Secondly, I honestly don't know how you'll manage some things with no help at home. You'll find putting on socks, shoes, undies and trousers really difficult because you mustn't bend a new THR beyond 90 degrees owing to the danger of dislocation. I'm sure they'll give you aids but it's still tricky, time-consuming and exhausting post-op.

    How will you manage for meals? You won't be popping out to the shop for some time. At the very least I suggest online supermarkets that deliver and nutritious ready meals (if that's not a contradiction in terms :roll: ).

    For a single hip replacement I believe they usually reckon about 3 months off work and crutches for 4-6 weeks. I don't know about doubles. I know you'll want to get back to work asap but that could actually delay your recovery. The process can't be rushed and trying to rush it is counterproductive. If you must tell clients when you'll be back in action I'd suggest you allow for longer than you really think and want. The surgeon would be your best bet for a 'time schedule' but even he will know better after the op than before.

    I suggest you get in touch with our helpline people, either on their forum or by phone or email. You sound very 'together' and not in need of a shoulder to cry on but they are good at the practical stuff too and know who to contact for what.
  • wildway
    wildway Member Posts: 26
    edited 30. Nov -1, 00:00
    That's really helpful. I am trying not to flap! I do have some good neighbours but I wouldn't want to drive them mad and I certainly wouldn't want them doing the really personal stuff! Hmmm, that's a tricky one :?

    I'm meant to have an interview tomorrow to teach art history in a care home once a week. I told them what was happening and of course they couldn't say don't come for interview but I don't think I can commit to a timescale on recuperation which I think they will need me to do. I won't need my camera equipment but I would need to get there by public transport. Not sure whether to even bother putting myself through it or them but maybe too late to pull out! Although I'm sure the elderly people there will have much empathy.

    I started off with the helpline and a lovely helpful woman called Linda. She's sending me some pamphlets. She advised me to use this forum to get some personal experiences so weejeans thoughts would be useful. I'm sure I will need some support too when I'm going through it all. This is a great resource and thanks again :D
  • barbara12
    barbara12 Member Posts: 21,269
    edited 30. Nov -1, 00:00
    Hello wildcat
    l had one hip replaces 12 months ago, I was fine with the stairs, but I dont have a clue how I would have managed with bothhips replaced at the same time . suppose it gets it overwith in one go.
    The hospital supplied all I needed ..The toilet riser, a stool that adjust in height...
    Could I ask why you are having both done at the same time, I know in America it quite common but not here,
    I had help off my husband, have you no family that could help out, I would say the first week and a half were hard,but after that you get into a routine.and things soon get easier
    The only help I needed with personal stuff was the ted stockings you have to wear..
  • wildway
    wildway Member Posts: 26
    edited 30. Nov -1, 00:00
    Thanks Barbara, I have a brother in London but he has a full time business, lives a bit too far away and is a full time single carer for his son so I don't want to worry him too much. That's the thing with London friends/family - everywhere probably - that lives are so busy.

    It's hard either way - one or two - both hips aren't good and I don't think I'd manage to put weight on one while the other heals so it was suggested getting them done at the same time. Also hard having a job that relies in part on fitness and carrying things so best to get out of the way at once.

    I'm staying hopeful and positive. Seems this op is getting more common here although my doctor said he hadn't dealt with a bilateral for over in five years!
  • barbara12
    barbara12 Member Posts: 21,269
    edited 30. Nov -1, 00:00
    Hello again, am I right in thinking the recovery is quicker with bilateral,
    Like I said the stairs were not to bad but you put your good hip first then your crutch then the new hip...so not sure with both done, unless you can manage downstairs for a couple of weeks.
    I brought to grabbers because of the 6 weeks rule no bending down, I had one up stairs and one down.
    Also The grabber helps putting on underwear,you could get some feezer meals in, but on crutches you can't carry anything, so maybe they could supply you with a walker come trolley.
    Please ask away if you have anymore questions :)
  • wildway
    wildway Member Posts: 26
    edited 30. Nov -1, 00:00
    Thanks Barbara - I don't have a downstairs (I live in a first floor split level flat) and I don't have a freezer! Not to worry, will get there somehow :)
  • stickywicket
    stickywicket Member Posts: 26,774
    edited 30. Nov -1, 00:00
    No freezer :o Meals will be tough.

    Right, I'm trying to think of (a)problems and (b)solutions. I'm doing better at the (a)s than the (b)s :lol:

    1. Clothing. Top half OK. Bottom half – if I were a bloke (and I feel you are) I'd invest in some elasticated waist shorts (and hope for warm weather), forget socks and wear maybe slip-on shoes. You won't be able to deal with laces but don't want to leave them trailing.

    2. General tip. Remember the 90 degree bend rule and, before you go in for the op, put anything you're likely to need – food, clothes, books etc – at a level you can reach without bending.

    3. Don't refuse any help offered especially the basic essentials such as making a cup of tea or coffee or washing up or even getting your next day's clothes out ready to put on. Don't be afraid to say "That's very kind of you but I can manage that. I'd be really grateful if you'd do .........though."

    4. Leave a key with a neighbour and keep your mobile on you at all times so that, in an emergency, you could get help.

    5. Whatever your standard drink is – tea, coffee, water – have plenty to hand, maybe in a flask and maybe asking any visitors to brew you another. Brewing up is difficult at first and carrying a mug, with a crutch under each arm, even harder :roll:

    I'll keep thinking but my family is about to descend on me tomorrow for several days and, as a 7 yr old grandson is involved, I'm not expecting to have much free time or energy :wink:
  • wildway
    wildway Member Posts: 26
    edited 30. Nov -1, 00:00
    Thanks Stickywicket, I'm a woman actually :D

    The tips you are providing are so useful to know!!

    Have a great time with your family and I look forward to any further advice as it comes to you in due course.

    Wildway (Miss)
  • stickywicket
    stickywicket Member Posts: 26,774
    edited 30. Nov -1, 00:00
    Sorry about the inadvertent sex-change :oops: Probably easier for you as a woman. I'd buy one or two cheap wraparound skirts that'll wash and dry easily. There are times for us women when no knickers are required and this may well be one :wink: And/or just slob around in nighties at first.

    I re-thought the low drawers and cupboards thing. Much will depend on your drawer handles. The pick-up sticks aren't very strong (I find them no good with heavy objects eg tins) but, if your hands and arms are strong, they'll probably cope with opening most handles as long as what you're extracting isn't too heavy.

    One thing I would do is to measure the seat height of your chairs and bed before going in. You'll need something pretty high at first. The Occupational Therapist will check this before you leave hospital but best to know where you're starting from. Plus, having been sat in for some time, chairs are lower when you want to get out that when you sat down in them :roll: With some models they can fit little 'pots' that the chair / bed sits in to raise it up.

    I'm sorry, I ignored the matter of your interview today as I really have no idea what to suggest. Good luck if you go ahead.
  • barbara12
    barbara12 Member Posts: 21,269
    edited 30. Nov -1, 00:00
    Hello again
    SW has given you some great advice, not sure what your finance are like but there is help out there if you pay...and meals can be delivered from one of the sites ..but then again they go in the freezer..but I am sure some of the carers would be able to cook something..or you could eat soups but I think you would get fed up of that...like SW says everything at the height you can reach..I moved plates, pans, cups all to top cupboards..but you cant twist' so stand in front of the cupboard you are using...things do soon get easier, but like I said its the first couple of weeks..another thing I had a water bottle at the side of me in bed for the meds in the night..much easier than a glass that can be knocked over..to have awash I would use the stool provided and also the feminine wipes area must..if I think of anything else I will get back to you :)
  • wildway
    wildway Member Posts: 26
    edited 30. Nov -1, 00:00
    Hi, well just a couple of days to go. I started to get worried last week that my living situation may not be suitable if the bilateral goes ahead, so decided to get more information from the 'experts' to make a more informed decision as to whether I should go ahead with both or stagger it. And to see what special measures I may need to put in place if both are done.

    - The surgeon doesn't do phone calls and a consultation date would have been too far in the future ;
    - the senior nurse on the ward said she could understand the dilemma and that a bilateral is not routine - in fact they only do about 5 a year - she said she would speak to the surgeon but I missed her call to say she was going away for a week and would not be back until the day of my surgery but gave no indication of any chat with the surgeon.
    - My doctor said speak to the surgeon, and that he hadn't dealt with a bilateral for more than 5 years!
    - The nurse said to contact social services in advance of my operation so they could do an assessment, the doctor said they wouldn't be interested until I was coming out of hospital.
    - I followed the nurses advice but have been passed round three times in social services as no-one had a record that I exist and now I can't get hold of the team that are meant to be dealing with me - meanwhile the clock is ticking. :?:

    So Sticky Wicket, you mentioned I was being calm and asking all the right questions. Well it seems I can ask away but there are very few means to get answers. My patience and stress levels are being stretched!

    I am so pleased with the tips you have given me so meanwhile I am preparing all that you suggest at home - thanks again to you and Barbara who have responded :)
  • dreamdaisy
    dreamdaisy Member Posts: 31,520
    edited 30. Nov -1, 00:00
    Hello Wildway, I haven't replied before now because I've not had any joints replaced but, on reading through, a small idea has popped into my head: is it worth buying a small free-standing auto de-frost freezer? Do you have the room for it? There's only so much living on soup one can do - and I hope a kindly neighbour would fetch fresh fruit and veg for you. Another thought: keep a substantial wodge of cash somewhere very safe in your flat so you don't have to worry about getting to the bank.

    One of my real-life friends had a foot operation last October and spent three months house-bound because she was not allowed to weight-bear for that length of time. Friends helped out (apart from me because I was moving house!) she lived in her nighties (easier to wash and did not need ironing) and had on-line groceries delivered so she could keep up a reasonably healthy diet.

    I am sorry that your professionals are not getting back to you, we do seem to get things the wrong way round with this type of situation, forward planning is always better than emergency; for what it's worth I think you have been dealing with this prospect remarkable well, please keep in touch and let us know how things progress. I wish you well. DD
  • stickywicket
    stickywicket Member Posts: 26,774
    edited 30. Nov -1, 00:00
    I think DD's suggestion of a small freezer is a very good one. Actually, in your shoes I think I'd be rushing out today to buy one and, post-op, be transferring much, if not most, of my food from freezer to microwave. This is in no way how I normally live but when needs must....

    It might also be worth placing a dining chair in your kitchen so that you don't have to stand and wait for kettles to boil etc but can sit to do so. You might think you'll be OK to stand but your big problem, as I see it, will be trying to get the balance between doing the absolute essentials (And I mean absolute essentials such as getting to the bathroom , getting food and drink) versus the stuff you really need to be doing for the new implants - resting and exercising. While in hospital please ask the Occupational Therapist for guidelines about carrying essentials such as a drink or food while using crutches. I don't personally see how you can. I'd guess there will be times when you'll have to just use one crutch and vary which one you use.

    I'll keep thinking :)
  • wildway
    wildway Member Posts: 26
    edited 30. Nov -1, 00:00
    Hi there, Thanks for the information DD - I don't have room for a freezer of any kind as I have the tiniest of kitchens however, a neighbour of mine has kindly offered to put frozen meals in hers so I will at least have those to fall back on when necessary.

    I now have my little bag packed and I've decided to spend tomorrow winding down and leaving it to all at the hospital. I guess being the only person in charge of my life I'm not too good at putting myself in other people's hands although it would probably have been easier with my questions to the 'experts' answered.

    Thanks for your good wishes....: )
  • stickywicket
    stickywicket Member Posts: 26,774
    edited 30. Nov -1, 00:00
    That's a good plan to use your kind neighbour's freezer and another one to wind down. Before an op I always do everything I can to make life easier for afterwards and I trawl what I call my brain :roll: to ensure I've not omitted any medical details to the hospital staff and then, always, comes a point when I feel all is done, the wheels are in motion, just relax and let it happen. And it's always happened well :D
  • dreamdaisy
    dreamdaisy Member Posts: 31,520
    edited 30. Nov -1, 00:00
    This is a very big deal, yes? I am very used to surgery and don't have any concerns about it - I always blithely assume all will be well and so far so good! :wink: I also have a husband who, despite being a poor nurse, does take some time off work (or rather he works at home) to help me through the initial stages of coming home. My last op was a double carpal tunnel so I was without my hands for around ten days or so - that was an interesting time in our marriage. :lol:

    I promise I will be thinking of you - you will be in the right hands for what is about to happen and please make full use of your stay in hospital; you will have people there to bring you things and take rubbish away, physios to talk you through the exercises, the dos and the don'ts of your new life, to help with you the exercises and ensure you rest. Surgery is a trauma to the body and it may be a little while before you feel like yourself again - your moods may fluctuate, tears may come for no reason, anger may surface but that is all par for the course. We'll be here on your return and we will do our best to help and support you through the next few weeks. DD
  • barbara12
    barbara12 Member Posts: 21,269
    edited 30. Nov -1, 00:00
    Thought I would bump this up to see how things went, that is when you get on the comp, I really do hope it is over with and you are doing ok, with the help of your neighbours...(((()))) xx
  • dreamdaisy
    dreamdaisy Member Posts: 31,520
    edited 30. Nov -1, 00:00
    I too have been thinking of you, I hope all is as well as possible and that you are on the road to recovery. DD
  • wildway
    wildway Member Posts: 26
    edited 30. Nov -1, 00:00
    Hello all,

    Well I've been through my double hip replacement on the 24th July and out a week later! Apologies for the delay in getting back to you all but I've been trying to get my head in gear s well as the rest of me :shock:

    The operation went well although it has felt like two alien lead weights to carry around. I am managing a little of the physio each day :)

    Immeditately after the op I was in recovery for nine hours. Placed underneath a ferocious air conditioning system for all that time I was very cold. Seeing people coming and going I was still there close to midnight. Despite attempts to get them to move me away from the unit I ended up with a sore throat and my blood pressure not moving off 94 ish. So I was moved to the ward regardless as it appeared nothing was going to change and it didn't for a couple of days.

    The day after the operation wasn't too good. They'd given me an epidural for the duration of the op as well as a general anaesthetic. The following morning the epidural was meant to continue working but my left leg started to get painful. Well, despite multiple requests by myself to the nurse and the nurse to the pain team - who kept saying they'd be there to see me - they never came - not for the whole day. By about 5pm I was quite distraught. It was interesting as the nurse shouted back - what do I expect her to do - I said to her I realised it wasn't her fault but who else could I speak to?! She seemed to soften a bit after that but I found out she had a bit of a reputation for having an attitude. So moving beyond that, with the nurse now on my side as I realised her inability to act unless they said she could I still waited. Eventually the anaesthetist turned up and apologised and said the epidural had become detached and not working. No-one until this time - about 8pm that night had bothered to check it!! After this things improved with morphine and other anti- pain treatments.

    So after an agonising bout of constipation - suppositories, enema and all that goes with taking lots of drugs, I was glad to be let out on Wednesday. There were, by the way, some great and helpful nurses too (question: do you ask them to do one small thing or save them up to do at once? e.g. pick up phone from floor, get notebook and pen from bag etc - prioritise in small separate asks or all together?!! :?

    Back home has been interesting working my way round the care system - who does what when etc. I also by chance, found out that I should have been assessed and given advice about what I could and couldn't do with my new hips. In fact the OT said as I was only 49 I probably would't be eligible for any 'free' care. This was incorrect as I get a package up to six weeks. This was meant to kick in this evening when my friend left but yesterday I was told they couldn't start until Monday. So then the Rapid Response Team kicked in which was a blessing in disguise as they they sent a very helpful woman who assessed everything and put some provisions in place including a commode in the bedroom (I'd been struggling up five steep steps to the loo previous to this) and she assessed where and how I was sitting which had been wrong.

    The advice from those on this blog has been great and I've spent the last couple of days putting systems in place that work for me.

    And if you're still reading - can anyone advise, I've been getting very bad headaches at night - across my eyes and back of my head. My blood pressure was checked this evening and that was fine. I'm wondering if it's because of spending all night on my back or something more sinister - anyone suffered similar?

    Otherwise. the hips are still in place and I'm beginning to get them to work with me instead of against me - very small steps.

    Cheers all,

    Rachel
  • barbara12
    barbara12 Member Posts: 21,269
    edited 30. Nov -1, 00:00
    Rachel,I am so pleased to see you back with us, and have that out the way, you poor thing not having pain relief,I had a prob with this ,but not has long as you did..you do have to rely on the nurses for most things and they should understand this although its not easy having to keep asking :roll:
    I am so glad you have got a care package..even though they didn't turn upon time..but good on the fast response team they are good...
    You really have been so brave having both done at once ... :) I wouldst have done it... :o
    I wounder if the headache is from the epidural they can be quite bad, but I would mention it to your care team or GP..just in case it is some form of infection but I would think your temperature would be up...I think you have done brilliant I really do..keep us updated when you can...and no bending or twisting...xx
  • stickywicket
    stickywicket Member Posts: 26,774
    edited 30. Nov -1, 00:00
    Hello again and how lovely to see you back with the new hips despite a certain amount of trauma. As for the constipation and all that followed - maybe I should have warned you to drink plenty and eat the right foods. Strong pain relief coupled with immobility are not good for the bowels.

    You certainly should have been told about what you could and couldn't do with the hips. The general rule of thumb in the early days is RICE - rest, ice, compression, elevation.

    Headaches? I don't know but the pain relief itself can sometimes cause them. At least you know your BP is OK but check it out with a doc if they continue.

    Great to have you back :D
  • barbara12
    barbara12 Member Posts: 21,269
    edited 30. Nov -1, 00:00
    Good thinking SW , drinking plenty to ward off blood clots they were very strict on the ward I was on id you didn't drink the tea they would fill up your water and keep an eye on that, constipation we had lactalose...but when home I took that and prunes...it worked.. :lol: carrier bags became my best friend for carrying things...and the feminine wipes...till I could have a proper shower..I know you have your grabber so make good use of it don't be tempted to bend...and walking and rest and more walking and rest .hope today is a goodish one...and you are doing ok for meals..x
  • wildway
    wildway Member Posts: 26
    edited 30. Nov -1, 00:00
    Hi All,

    I've woken up with another headache this morning so felt off colour all morning too. I took an anti-sickness as I've been feeling sick too .I think I'm drinking enough fluids but may be dehydration as it's quite hot. I'm already making good use of my new commode going about three times a night so not sure more fluids is the answer? My blood pressure this morning was normal.

    The carer came this morning and helped me take my first seated shower since leaving hospital including hair wash which was good. She came back at lunch time and sadly not up to eating except for a few crisps which I was recommended for the salt.

    Unfortunately she forgot to put the surgical stockings back on after my shower and I forgot to ask her when she came back at lunch time so hopefully it's ok to leave them off until this evening? when I must remember to mention it or they'll be off all night! My brain isn't managing to remember all these things :?

    After applying for a job at the same place for the past 4 years I finally got asked via email on Thursday for an interview there on Wednesday I applied for about four months ago!! I was feeling optimistic on Friday and told them the situation but said I would be there. I'm not sure what I was thinking particularly as I don't think I'd manage all my stairs down to get to the road and then I'd need to arrange a wheelchair let alone all the prep they expect including a presentation! So I will have to let them know on Monday it just isn't going to happen - such a shame - I doubt they'll put it back - i would imagine at least a couple of weeks? because they said they had so many to short list from in the first place. I guess I'll just have to be pleased with the fact I got that far :)

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