Bilateral hip replacement

dreamdaisy

Well hello! It's lovely to hear from you again and congratulations on getting through the whole thing as well as you have. You had an epidural on top of a general, then factor in all the other pain meds and I am not surprised that you are getting headaches. It is essential to keep up the fluid intake and plain salted crisps are a wondrous way to increase one's salt intake (a slightly healthier option would be to dip celery sticks into a little mound of salt - my mum used to dip tomatoes too).

Don't underestimate the trauma your body has recently endured. GA can take up to a month to completely clear the body, there is much deep healing to be done and I would imagine that tiredness is likely to be the overwhelming feeling for a little while yet. The job interview is bad timing, I doubt very much that you would be able to get there - given the fact of all those stairs I don't think you should even countenance trying but another opportunity may arise when things are better. We none of us know what is round the next corner. Your main priority now is healing and recovery and I wish you well with that. DD

stickywicket

Hello Rachel and how are things today? Has the headache subsided at all? I hope so. If not, maybe it's time to get it investigated. I don't think we should ignore these 'fairly normal' things in a post-op situation.

I'm sorry about the job opportunity but maybe if you explain the circumstances they will still consider you next time. I hope so.

wildway

Hi Stickywicket,

Thank you for your concern.

The headache wasn't as bad although it was still there in miniature form this morning. I'm expecting a visit from the District Nurse a bit later so I shall run it past her. I drank more in the night which may have helped but I suspect it's a gathering of the toxic meds.

I'm a little concerned that there is a bit of a click in the left hip and a strange feeling and pain that I'm not getting in the right one. I'm sure they will be different but not sure how different and quite what to expect. I am keeping up with the physio as much as possible, headaches not withstanding, and I think I'm improving very very slowly in walking.

I've been playing games with the care system again as the carer didn't turn up for the new schedule they were meant to start this morning at 8.30am so the RR team kicked in again and someone came at 10.15. Then the actual carer came at 11.15 even though I said I didn't need them then. I do wonder how elderly people with any form of memory loss cope and sticking to pill taking schedules if you need to eat first.

Yes I cancelled the interview and they were understanding. I asked if there was an option to put it back but there wasn't. It just wasn't meant to be. My friend suggested showing willing and getting some stuff prepared - she said they'd be impressed at my efforts at least under the circumstances - but as tempting as that sounds I'm not sure that today (my heads a bit spacey and tired) that that would work for them or for me.

How are you Stickywicket? Do you get about ok?

stickywicket

Meds plus anaesthetic, of course. That alone takes some time to find its way out of the system. Keep up with the drinking but don't let it slide. If it continues to bother you do ask to see a doc.

Similarly, with the click, keep monitoring it but I think they're quite normal in the early days after surgery. I had one in my knee after my knee revision. I was sure I'd messed it up by getting into the car completely wrongly (putting all my weight on the operated leg and twisting it :oops: ) but it's great.

Yes, the care system is very overstretched and it must be horrible for the elderly. However, you have enough on your plate right now without worrying about how others are affected

I'm sorry about the job but, hopefully, the new hips will make others more possible.

I'm fine, thank you. My first hip was done in about '93 and hasn't given a moment's trouble. Neither has the other which I've had for about 9-10 years now.

dreamdaisy

Hello, how are things today? I hope you've had as good a night as possible and not too much of a headache this morning. Don't forget the stockings! DD

wildway

Thank you for your post. I do have a headache this morning - they tend to be accompanied with tinnitus on the left side of my head. Not as bad as the one's over the weekend - but never-the-less I think I will tell the doctor today. The District Nurse didn't turn up to change my dressings yesterday, so they've not been done since Thursday and I wasn't able to ask about the headaches. I did ring up to find out where she'd got to and they said they'd check and call back but they never did. :shock:

I'm supposed to be hearing from physio/OT as part of this package but it all seems so fragmented. I was told my 'team' would be in touch but not sure who they mean. So I'm just waiting to see who contacts me. Meantime I am doing the exercises and waring the stockings! :roll:

There has been an article on breakfast TV about care for the elderly in Sweden being joined up unlike here. I think fragmentation isn't just the case for the elderly. Communication is the key across the board but how to change a culture as Norman Lamb acknowledges, is the difficult thing. I'll ponder on it between naps :!:

barbara12

Hello
Glad to see you got the stockings back on, I only had my dressing changed when I came out of hospital then when I had the staples out so it was on just over a week, its awful when you are relying on the care team and they are not turning up..have you not got a num you can ring..or is that a waste of time..hope they turn up soon..

stickywicket

Sorry you still have the headache. I think it's a good plan to ask about it. What medication are you taking? It could be a cause.

Exercise, resting and wearing the stockings is a good basis for your current situation so don't fret if you can't do more

Swedish care for the elderly probably is better than ours because Sweden has a very high rate of taxation. You get what you pay for. The \Brits don't like high taxes :roll:

wildway

Well the headaches have started to subside : ) that's the good news. The downside is that i have quite a lot of pain and difficulty standing on my left hip while the right one is doing rather better. Not sure if this is normal but I am also fairly sure the right leg is now longer than the left!

I was wondering how people with hip replacements were cared for after surgery. Did you have access to a Re-enablement Team? I have one but I was meant to be referred 48hrs after surgery and visited by physio/OT etc to see how I move about my home space and help in the rehab. My file apparently got lost so I didn't hear for over a week after my discharge from hospital.

I eventually got a visit from the case-worker who had no awareness that I'd had both hips replaced. She has chased the physios but I wouldn't be surprised if they don't know either. So I've been called into St.Thomas's for an outpatient appointment this Thursday! I've told them I can't yet get down my 17 steep steps and up again, let alone get around a hospital. I asked what was meant to happen about the home visit and I'm still waiting to hear. Is this normal? What should I do?

I'm getting quite emotionally upset as after some amazing surgery on both my hips it seems the after care is seriously wanting.There have been other issues now sorted but it takes it out of you, chasing people and trying to find out information when I just want to put my energies into getting better!

stickywicket

Well, I'm very glad the headaches are easing up but the rest of the news isn't so good, is it?

At this point in time I wouldn't worry too much about one leg seeming a bit longer than the other. Truthfully, it can happen. The more replaced joints one has the harder it is to get them to match perfectly but you have a long way to go before thinking of that as a possibility especially if the left leg is harder to stand on because that could simply mean that the muscles in the right leg are stronger and, as soon as you can start putting the same amount of pressure on the left one, those muscles will strengthen too and the legs will seem more 'normal'. I guess you could try doing a few extra exercises with the weaker one but, if you're doing the maximum suggested already, check that out first.

In all my ops I've never had a Re-enablement Team (or even heard of them). I'd guess you do (theoretically at least :roll: ) because of the double implants and the fact that you live alone. What I have had is a post-op appointment both with the surgeon and physio. I was also given the ward telephone number on discharge with instructions to call them if I had any problems.

You need the post-op care to ensure the success of the surgery. If you've got an appointment for Thursday then ring the department and explain your situation saying you'll need transport and assistance. They got you up there when you were discharged so surely they can get you down again. Appointments are important as they're the only way of finding out if we're on course with our rehab.

As for any other chasing – of course it's draining both physically and emotionally and it shouldn't happen. Do you have someone who will fight your corner? A good friend or neighbour who will be prepared to make the phone calls for you? It would share the burden and take a bit of pressure off you.

wildway

Thanks for the advise SW - I don't have anyone to fight my corner. I have to do it myself.

I thought I might email the surgeon although I'm not convinced they are terribly interested post op. It said in my discharge papers that the surgeon would provide a 'personal care plan' but I haven't had anything.

stickywicket

I think you need your follow-up appointment so I'd be chasing that up and ensuring they're aware (a)that you had a bi-lateral and (b) that you have all those steps. I think that's your best bet of getting all the help you need.

You could try emailing the surgeon. I don't know how much notice is taken of emails so, if you do, mark it urgent.

I'm sorry you're having to do everything for yourself. As you say, you don't need this. You should be concentrating on those quad exercises and getting your muscles strong. Please keep us updated.

dreamdaisy

This breakdown in communication happens far more often than it should. It is totally unreasonable that you are having to sort this out but I don't see how you can make it to this appointment next week without assistance - Sticky is bang-on with her advice.

I hope the headaches are continuing to decline. You certainly had a great deal of anaesthesia so it will take longer to fully clear the body. Post-op weepiness is a well-known phenomena, major surgery is a trauma to the whole body and our emotions. DD

wildway

I guess I'm most worried that I'm not doing the right things at home - through, I hope, no fault of my own. I only have the few exercises in the booklet I was given in hospital and have had no more instruction than that on what exercises would help. I have been doing those from the booklet three times a day but due to the pain in my left hip I struggle sometimes. I only saw the physios briefly in hospital who helped with a few basic things like the hospital stairs that bare no resemblance to mine. :shock:

I did think of writing to the surgeon but if things then move forward early this week it won't be necessary but I'll see what happens tomorrow.

stickywicket

Post-op I was told to do my quad exercises about 6 times a day - 10 repetitions each. I would assume it's the same for a bi-lateral but I don't know. I had the luxury of a husband who cooked, cleaned and did the laundry for me at first then I slowly eased myself into making a brew, washing up etc. It will be so much harder for you if you have to walk about more to do all the essential tasks. You do need professional advice on this and, for your own peace of mind, you need it quickly. Don't wait too long.

stickywicket

How are things going, Rachel? Any progress made with the appointment?

wildway

After getting a bit more pushy yesterday with the case worker I finally got a call back from the community physio. He was concerned I hadn't seen anyone since returning from hospital and came at 9am this morning! He said I was right to be concerned as my left hip shouldn't be so different to the right.

We are starting on some physio at home, he confirmed it wasn't necessary to go to the appointment at the hospital on Thursday as it was just a new patient assessment which I was meant to have at home anyway as part of this re-enablement package, especially having had two hips done at once.

He was a very pleasant chap from Brazil. He spent more than an hour here helping with certain movements with my left hip which he thinks is caused by the way they would have cut through muscle and possible nerves. But he also said he wanted to keep an eye as it may still be necessary to send me for an X-ray. He is sending someone to help with the exercises on Thursday as some of the exercises I need help with.

Also, importantly, he said my gait was wrong and this needed correctly straight away before it got set in a certain place - my toes are pointing inwards. Further delay would have compounded this.

So I am much happier today that things are moving forward

The only negative now is that the District Nurse was meant to turn up yesterday to change my dressings. She didn't come so I called to find out what was happening and was told I'd be called back today but never heard. This is the second time this has happened. So the dressings have been on since last Wednesday and really need changing

I hope things are well with you?

stickywicket

That sounds much better. What a lovely man! He seems to know his job well and enjoy it. That makes so much difference. At last someone has taken charge of your recovery and seems to know the score. I hope things continue in the same, positive vein.

I also hope you get your dressings changed today.

I'm fine thanks. We were over visiting some friends for a meal yesterday. This is a much more pleasant experience for me since they had their downstairs loo installed

dreamdaisy

Hello, I've been away and lost wifi thanks to a lightning strike but I'm back and connected. I am pleased that your Boy from Brazil was so helpful, I reckon you've found a good 'un there so hang onto him! I hope the DN did get in touch and that your dressings have been changed (hopefully more than once) and that you are making steady progress. DD

wildway

Hi All,

Well I was thinking I'd report on a few things. Challenges and plus points!

I have a lovely carer who comes in from Monday to Thursday and I have to report this as a real plus - it's easy to moan but not always report the positives. She has common sense, a 'can do' attitude, she also cooks light food to instructions. She calls in and out from the phone to log her time here. The carer I have been getting at weekends is quite the opposite - no common sense, does things wrong on purpose so you don't ask her again and by the end of Sunday I was becoming exasperated with her. You don't like to be like that. My nice carer said most don't want to log in and out as they want to spend the minimum time here and get out again - they certainly don't want to cook. I could list the incidences but I won't go into, suffice to say that each little thing adds up to lots of issues and stresses. I'm amazed the care company don't make them log in rand out but apparently not.

The district nurse who was meant to come Monday last week didn't turn up so when I called on the Tuesday I assumed that someone would come that day or the next (the same had happened the week before). When no-one had turned up by Friday!!! I called to tell the receptionist who was appalled and said she'd get the head of the department to call me which she did and assured me that a DN would come on Saturday. No-one turned up! So if it wasn't for the fact that I changed the dressing myself last Wednesday, it is nearly two weeks since anyone had seen to my wounds!!

After the great Brazilian physio I was sent a very nice lady to help with the exercises as I can't lift my left leg currently without help. As I lay on the bed she proceeded to tell me to cross my legs and lift them off the bed! I almost took her at her word as I thought she must know what she's doing. However, in the back of my mind I thought I'd been told I couldn't cross my legs for risk of dislocation and the severe pain and problems etc this would come with. So I asked to look at the diagram and description that went with it. The image, whilst it could have been interpreted that way, actually showed one leg raised higher than the other and the description with it certainly pointed to this. Just as well that I knew to question it as this could have caused serious problems!! So my initial joy at being finally seen by someone who took control was somewhat shattered. I couldn't believe this person had no knowledge of the condition or familiarity with the exercises. I am addressing this as it could cause serious problems for others with no knowledge and trust as i did!!

It helps to write these things here as I can document the pluses and some terrible minuses. I'm also learning a lot!! But how do you address the carer issue? My nice carer said that the majority at her place were just in it for the money : (

barbara12

Hello sorry I haven't been back to you I have a sticky keyboard and give up half way through..blimey you are having some ups and downs I am glad to see you have a good carer..but you always get the bad one that dont really want to do the job, has for the lady physio cross your legs its a good job you knew what was what..and yes report her before she does any harm to someone..have you not had the stitches or staples out yet..one they are out they leave the dressing off.
You do seem to be doing well, and on your own I was so worried at the beginning but you have got on with it..just a shame some of the people are letting you down, keep us updated..and I do wish you well x

rayray

Hi,

I have been reading your posts with interest. I had a THR three years ago when I was 49 and two years before that had an open dislocation and debridement on the same hip with which I found the recovery quite awful as I wasn't allowed to move my leg unaided at all. I have a hubby but he was out working all day so I did have long periods alone so had just a small taste of what you are experiencing. We didn't get any help but wish we had for the ten hours on my own although I can see how frustrating some of the 'carers' are.

I found the THR easier to recover from than the open dislocation surgery but of course only had one hip done. Having come through two big surgeries on my hips and listening carefully to my surgeon I found that apart from doing the leg slides on the bed that simple walking helped the recovery the best. I just kept at it slowly slowly until it got easier and I was surprised how fast things improved after the first three weeks.

It can be a long road. I recovered really well with my first surgery and was 100% within 3 months but unfortunately I had complications and the hip became much worse again. I think the intervening two years slowed the recovery up as I couldn't get about much and after the THR it was two years before I felt 100% recovered i.e. could walk long distances with no pain. It has been a steady recovery though. After the initial few weeks although I built up walking distances for the first year I wondered whether things would ever feel normal again but they do now.

My surgeon said not to bother with physio apart from the initial exercises and building up the walking. I know this may not help you much and perhaps for bilateral replacements the recommendations are different. I was able to go back to physical type work (on my feet) after around three months although I couldn't have stayed on my feet all day. At times I do a great deal of photography for my own business and was able to do this quite quickly although I don't have loads of equipment to carry around.

I understand how tough it must be dealing with this alone. I was ready to scream when my husband walked through the door each night when I had the dislocation surgery and I recall getting very weepie. All part of the frustration of recovery but there really is light at the end of the tunnel.

I hope this helps and doesn't hinder. Good luck.

stickywicket

Thanks for the update and its lovely to know you have a good carer most of the time at least. I knew a woman who took this up after early retirement and she loved her job but gave it up when she simply wasn't allowed enough time to do it properly. I never asked about money but I do know a dedicated care worker in a residential home. The pay is minimum wage and many fellow workers had a second job too.

The district nurse situation is appalling but not as bad as a physio who has no knowledge of what can actually undo all the surgeon's work. Good for you for taking it in hand. I wish you success.

wildway

Hi all, it's been a while so I thought I'd give an update and ask a question.

I had my first trip out on my own on a bus yesterday! I needed to go to the bank and buy a new top or two as I'm off to Paris for three nights on Monday : ) - an arrangement to meet an old friend from Oz I've not seen for 19 years!

I didn't do too badly but have a new understanding of elderly and disabled who are flung along the bus when the drive takes no notice of your slow approach to getting on the bus or your crutch!! But I got to the bank in Brixton and I managed to get to Morley's department store for my tops

I'm still having issues with my left hip. What I would like to know is whether at six weeks others have had problems with pain? Specifically my right hip and leg have no pain at all apart from some stiffness and slowness still in walking. But the left leg seems to click somewhat and I was uncomfortable on the bus seat with pain going down my leg. Also, when I walk without a crutch I have no pain on the right but pain all down the front of my leg and in my groin.

The surgeon when I saw him on Wednesday said I'd been lucky with my right leg rather than there being a problem with the left. there was no issue on the X-ray. The good physio is concerned with this pain and clicking as he said this should have subsided after two to three weeks. What are other people's experience with this?

So I have the ok for Paris - it will be lots of sitting at cafes catching up but no complaint there

stickywicket

Oddly enough, I was thinking of you today and wondering how you were getting on. Three nights in Paris sounds wonderful and what a lovely place in which to re-connect with an old friend!

Buses. I used to hate them in the days when I could actually use them. Being young, unable to use walking (which are also visual) aids and looking perfectly OK, I found the whole experience very scary. Well done you for braving public transport.

I'd say, if your surgeon is happy then it's probably OK. I think people with OA sometimes seem to expect more of surgery than those of us whose entire bodies are rubbish :roll: Six weeks doesn't sound very long at all to me. I'd guess that your physio wants you to continue with the strengthening exercises as well as seeing the sights of Paris?

I think this is a problem that anyone could have after a THR rather than just related to a bi-lateral one. So, you'll probably get more answers if you start a new thread entitled something like 'Clicking 6 weeks after THR'.

Meanwhile, enjoy Paris Oh, and, if flying there, get wheelchair assistance at the airports. (You have to ask in advance.) Even if you can walk the distance(s) it's the standing around that gets to you.