Total hip replacement, 3 weeks on

Coddfish
Coddfish Member Posts: 85
edited 28. Sep 2021, 10:32 in Living with arthritis

3 weeks ago I had my right hip replaced following a number of years of increasing stiffness. I am mid 60s, female, and had been very active - regular swimmer, runner, user of weights, gym classes etc. Exercise had probably enabled me to manage the condition for a number of years, but poor posture and gait was starting to generate various muscle strains. A hamstring injury at Easter which stopped me running, and generally deteriorating mobility, led me to see a private physiotherapist in June. He took one look and said it was my hip. He said he had just arranged X rays for another client and the local NHS waiting list just for elective X ray was 8 weeks. He asked if I could afford to to have a consultation with a hip specialist privately. I said yes - £200 for the consultant and £160 for the X rays. I was in the consultant’s office within a week.

The X ray and the consultant’s professional eye confirmed what I probably knew, but had been in denial about - that my hip was distorted, lots of osteoarthritis and bone on bone. There was only one way forward. I am conscious of my privilege in being able to pay to go privately, but faced with a short(ish) private queue (I was still quoted 3-6 months) and knowing others waiting well over a year for NHS surgery, I decided I would get value from using savings to get my life back and went on his private queue with a fixed price package including physio etc costing just a bit less than £14k.

The wait wasn’t actually that long, just over 2 months. I had my operation at a Spire Hospital, a 2 night stay, surgery completed under a spinal anaesthetic with a light sedative. I could hear the banging and talk to the surgeon from time to time. For the technically minded, I had the operation done with a posterior approach, which means I have a nice half moon shaped scar on the side of my leg. The health of my bones and musculature meant the implant didn’t need to be cemented, which I hope will give me a better long term outcome and enable me to return to running.

The operation was in the afternoon and I remained numb and in effect paralysed until around midnight. The next morning, they got me walking with a frame. The following day it was walking with elbow crutches, tackling a couple of stairs and then going home.

3 weeks on, the staples are out and the wound is well healed. I have excellent mobility in the new joint and am gradually rebuilding strength. I can walk for about 30 minutes with a couple of rest stops. I am using 2 crutches when walking a lot, 1 when not. I intend to start static cycling and swimming in the next week or so.

I have found a number of aids useful. Most important was to get a comfortable chair at a suitable height, a booster cushion for dining chairs, and a raised toilet seat with handles. A long looped resistance band was useful for helping lift the operated leg in and out of bed in the first few days. My husband has found a ‘Rolly’, a continuous tube of ribbed silicone, helpful for getting compression socks on and off. A long handled shoe horn / dressing stick, a long handle for a razor, picking handles, a sock aid, and a turning circle for the car seat have also been useful. A wedge shaped cushion to put between my knees at night has been essential. I also got a perching stool but haven’t found I needed it as I was soon able to get around the kitchen on one crutch and stand quite well. It has however enabled me to return to volunteering at parkrun.

I think I am incredibly lucky that I was able to address this at the right time and am confident I will get my life back. Addressing it before it became seriously painful (although the surgeon couldn’t understand why I hadn’t been in serious pain) meant that I went into the operation with a good level of fitness, and that will aid my recovery. Whilst I don’t think it’s right that I should have needed to spend savings on this, I am not sure I can put a price on the quality of life it will give me. I also don’t feel comfortable that most people don’t have this choice and I just hope we can soon return to a point where everyone can get the operation at the time of need, and it doesn’t depend on wealth.

For anyone afraid of the operation - you will have a few uncomfortable days but I am confident it’s worth it.

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Comments

  • Ellen
    Ellen Moderator Posts: 936

    Thank you @Coddfish for this excellent post about your THR.

    I am sure it will really help people facing the prospect of surgery very much 🙂

    Best wishes

    Ellen

  • frogmorton
    frogmorton Member Posts: 27,376

    @Coddfish you have done incredibly well to be so mobile and healed so quickly too.

    This post will really helps some people who are fearful of having hip surgery especially the bit about the spinal block.

    Do not beat yourself up about paying to have the operation done privately it's a shame you had to resort to it but did you see this last night?

    I did and you are not alone. Maybe someone else has moved up the queue now as you aren't in it.

    Take care

  • Coddfish
    Coddfish Member Posts: 85

    To answer one of the. questions above. I did see Panorama last night, and in particular the plight of the lady needing both hips replaced. It was that that led me to this site, where I thought it might be helpful to post my story. I am enormously blessed to be able to resolve this so quickly and very sad that it’s like it is for the vast majority who can’t. I am also fortunate enough to be retired, but can certainly see that the difference it has made would make a real difference to how easy it would be to work / commute afterwards - certainly a consideration for anyone who has had to give up work but has the potential to work if only their hip were ok. Knowing what I know now I think if I didn’t have the money I would try to raise it in order to get a quick resolution, even if I was worried I would need to work to pay it back (assuming mobility would mean I could earn enough). I would also be tempted to look at the cheaper fixed price packages available in overseas hospitals, subject to doing my research on the quality. It’s a frequently done operation with generally good outcomes.

  • RogerBill
    RogerBill Member Posts: 116

    @Coddfish I totally agree with your comment and share your sentiments:

    Whilst I don’t think it’s right that I should have needed to spend savings on this, I am not sure I can put a price on the quality of life it will give me. I also don’t feel comfortable that most people don’t have this choice and I just hope we can soon return to a point where everyone can get the operation at the time of need, and it doesn’t depend on wealth.

    Like you I've just reluctantly paid for a private hip replacement operation (further details in my post in the "hello" section of this forum).

    I'm on the committee of a cancer charity based at our local NHS hospital. The stresses and strains on the NHS were noticeably increasing some years ago and as a result the NHS wasn't in the best shape when the pandemic hit. The following quote is from https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthcaresystem/articles/howdoesukhealthcarespendingcomparewithothercountries/2019-08-29

    In 2017, the UK spent £2,989 per person on healthcare ...

    of the G7 group of large, developed economies, UK healthcare spending per person was the second-lowest, with the highest spenders being France (£3,737), Germany (£4,432) and the United States (£7,736).

    As a percentage of GDP, UK healthcare spending fell from 9.8% in 2013 to 9.6% in 2017, while healthcare spending as a percentage of GDP rose for four of the remaining six G7 countries.

  • Coddfish
    Coddfish Member Posts: 85

    Just a little update, 2 weeks further along the process. On a day by day basis, nothing seems to change that much, but looking over it week by week, the changes are enormous.

    I had already stopped using painkillers when I wrote the first post and I don’t have any pain at all now. In the two weeks since, my walking range has extended considerably, I rarely need rest stops, and I have gone from 2 crutches outdoor, 1 inside, to 1 or none outside depending on what I am doing, and none indoors. Other than tie my own shoe laces, there’s nothing much I can’t do. I have returned to the gym, returned to swimming, and gone back to driving. I can lie in comfort on both sides so long as I keep a wedge between my knees. I can walk more or less normally up and down stairs leading on either leg. I can get up and down from the floor with relative ease (certainly more easily than before surgery).

    The purpose of posting this is to give people about to go through THR hope that there is a light at the end of the tunnel. Your own journey will be different from mine and may be at a different pace to mine, but it will follow the same broad direction at the pace that is right for you. Any effort you can put into remaining as fit and healthy as possible before surgery will pay off. In my case, I lost the ability to do a lot of exercise pre-surgery, but could still swim and do Aqua classes, so I did these relentlessly, multiple times a week, and I am so grateful I did. Doing the exercises you have been asked to do after surgery is also essential.

    The journey will be frustrating too. I think if I had had a harder time of it, I would probably accept the limitations more easily than I am doing. I look forward to looking back in another 2 or 3 weeks when I expect to be more or less back to normal. The one thing I think I need to wait a while before reintroducing is running - something a lot of people don’t recommend after hip surgery - but something so that is so important to my sense of self and mental health that I have to find a way. It won’t be in 2021, but once a runner, always a runner.

  • RogerBill
    RogerBill Member Posts: 116

    Thanks for your post @Coddfish which certainly contains a good positive view. As I had my hip replacement just two or three weeks after you its it's providing me with some really encouraging and useful measures against which I can judge my progress. Admittedly everyone is different and at 69 I'm a few years older and I wasn't quite so physically active as you. Walking was my main exercise with regular eight mile walks and then only being able to manage fifteen minute walks was one of the key reasons why I decided to have a hip replacement.

    Although before the operation I couldn't walk much and was increasingly less able to tackle jobs around the home I was fortunate in being able to do quite a few exercises I found on the internet. I spent long tedious hours doing the exercises I could and I firmly believe that effort is now helping my recovery.

    As soon as I left the leaving hospital I found I didn't need all the pain killers I'd been prescribed and in less than three weeks I stopped all pain killers. I do get aches and discomfort but only occasional short, sharp pain. After five reps one of the exercises causes cramp like pains in my inner thigh so I do some other exercises then return to complete the ten reps required by my program. Otherwise an occasional ill advised movement can cause a short, sharp pain. I admit I do sometimes forget and break the bending or twisting rules.

    Sleeping on my back is not pleasant. Every two hours, sometimes more often, I find I need to get up and potter around for a few minutes.

    It's three weeks since my operation. I've gradually built up to now doing a slowish 30 minute walk twice daily mostly just using one crutch but I carry the other and use it for the more uneven parts of my walk.

    All in all the recovery process is going well with some ups and downs along the way. The exercises are tedious, the limitations on movement are frustrating and the disturbed nights are tiring. But I keep a note of my progress so that I have a reminder that things are improving and it's truly remarkable how good I am in such a short time after what is a brutal operation. I can see there is light at the end of the tunnel especially after reading the posts by @Coddfish

  • Coddfish
    Coddfish Member Posts: 85

    @RogerBill i think the worst thing about sleeping on your back is it leads to a dry mouth, and you end up in a cycle of drinking water, waking two hours later to get rid of the water, drinking more water. I have been a bit better with the cooler weather but still have the occasional troublesome night, for no obvious reason. Last night was one of them. Whilst I can spend a bit of time on my side now, I am still more comfortable on my back, so spend the majority of the night there. Suspect this part of it doesn’t quickly go away - but it presumably becomes more bearable as it becomes routine.

    The only discomfort I have had right from the start is in my groin. But I didn’t really process the pre-surgery state as pain - stiffness, discomfort, difficulty in doing things but not outright pain. Perhaps I generally have a low threshold for this.

    They had me on aspirin for 5 weeks for blood thinning purposes. Last tablet today. Hoping my gums will return to normal now!

  • RogerBill
    RogerBill Member Posts: 116

    @Coddfish I'm self injecting blood thinners (another seven days to go). While I was in hospital I also had compression stockings but thankfully they said I could didn't need to wear them after discharge. The sock puller I have is OK for normal socks but I doubt it would handle compression stockings and wherever possible I like to be independent even if some things are a fiddle and take time. An easy grabber is essential in my view to help with dressing and other things.

    Like you I have what I think is muscular stiffness, aches and discomfort rather than what I think of as pain. As they have to pull the muscles apart to get at the hip and to separate the joint, I guess it's not surprising that the muscles need time to repair after the operation.

    It's the muscular stiffness, aches and discomfort or an itching foot rather than a dry mouth which wakes me and it seems better to get up for a potter around rather than staying in bed and trying to get back to sleep. As I'll be sleeping on my back for six or more weeks I must be careful that this doesn't become a habit.

    In one of your other posts you mentioned you had a regional anaesthetic plus sedatives. I understand this is the most common and generally preferred alternative. My surgeon and anaesthetist recommended a general anaesthetic but said I could have a regional anaesthetic if I wanted. I'm not sure whether this was because I've had occasional back problems for many years or whether it's because my brother and grandparents had ankylosing spondylitis or whether it was because the operation was assisted by a Mako robot or whether it was the preferred choice of the surgeon or anaesthetist. Whatever the reason I was happy to accept their advice especially as seven years ago I had a much longer operation under general anaesthetic without problem. I don't think I suffered any particular after effects but as with all these things everyone is different.

  • Coddfish
    Coddfish Member Posts: 85

    Hi @RogerBill I do find the differences between different surgeon’s recommendations quite hard to get my head around. Mine wanted me to start out sleeping on my back, but wasn’t at all bothered if I went on my side once it seemed comfortable. The seeming comfortable bit gates it quite a lot as far as I can see. I thought it would be fantastic to sleep on my side when I first tried it at around 4 weeks (with knee wedge and pillow). First few times I couldn’t tolerate more than a few minutes. I can now fall asleep on my left side (right hip replaced) but will inevitably wake up within the hour and want to roll on my back, which means rearranging or removing either the cushion or pad. On my right side I am not very comfortable at all, presumably because of the wound. Same as he was happy for me to drive once I felt I could execute an emergency stop, whereas a lot of people are told not to drive for 6 weeks

    In all these things I think you just have to trust your own surgeon. Just wish I could fasten my own shoe laces - maybe when I see him in a couple of weeks I will be clear to do that.

  • RogerBill
    RogerBill Member Posts: 116

    I share your bewilderment @Coddfish re different surgeon's recommendations. I've heard "everyone is different" in so many answers. But I'm much more use to the black and white world of engineering and computer programmer where we can usually experiment and prove solutions based upon hard measurable facts. Medical people have a much more difficult job of interpreting x-rays, MRI scans, patients explanations of symptoms, etc.

    I know there are differences between posterior and anterior hip replacement and that the choice of procedure determines certain post op recommendations. But as so many hip replacements have been done, you'd think there would now be a little more consensus on best practice. Information held by organisations like the National Joint Replacement Register seem a good basis which could surely be developed further?

  • Coddfish
    Coddfish Member Posts: 85

    Update, almost 6 weeks on. I saw the consultant today for my post-op check. He was happy. I was intrigued to see the X ray taken just before I left hospital and to understand a bit more about what I have got. It’s a Smith & Nephew uncemented system, an R3 acetabular cap made of titanium with a polyethylene liner, and a Polarstem titanium femur implant with an oxinium (oxidised zirconium) head. He was happy I would be able to run with it further down the line, so long as I mixed running up with other forms of training. I am now free of all restrictions except he didn’t recommend crossing my legs.

    In terms of progress, nothing seems to have changed much over the last week. The longest single distance I have walked without rest with 1 crutch is 3 miles; considerable less for walking without any crutches. I still have a slight limp without a crutch. Swimming for 30 minutes is no problem. Occasional wound tingling is confirmed as nerves regenerating.

  • RogerBill
    RogerBill Member Posts: 116

    @Coddfish You're doing incredibly well and I'm sure your success must be largely due to the effort you put into your recovery and your level of physical fitness before the operation. Like you I am keen to learn more of the details of the type of hip joint when I have my followup appointment with the surgeon. In addition to the x-ray I'm hoping I'll be able to have a copy of the report on the operation, if there is such a thing. I had an operation for prostate cancer seven years ago and the operation report was really interesting (after I'd spent time with Google translating all the medical terms and jargon). It is, of course, a patient's right to have copies of any medical records.

    I'm almost four weeks after my operation. Although I haven't missed any of the stipulated exercises, my progress is much more gradual than yours. I'm now only doing twice daily 3/4 mile walks with crutches at a slow average speed of 1.3mph including pauses. I had hoped to be closer to the 4k (2.5 miles) walks you were doing at 26 days but realise that wouldn't be realistic as I'm a few years older and wasn't so physically active before the op. Perhaps I should push myself harder or maybe take some painkillers before my walks. I haven't taken any painkillers for over a week now except for one bad day when my back, abdomen and thigh hurt after my second walk of the day.

    Like you my wound tingles possibly because I don't think the person who sewed me up would win any prizes on the Sewing Bee TV programme 😊😊

    Please keep us up to speed with your progress. You provide a wonderful, positive and hopeful example for those worrying about whether to have the op.

  • Coddfish
    Coddfish Member Posts: 85

    I think you have to take things at your own pace @RogerBill. It sounds to me like you are doing pretty well. Not sure taking painkillers to go further is necessarily helpful. I do find some days are better than others and that if I push myself too much I pay for it later. The 3 miles was actually parkrun last Saturday morning. I hadn’t intended to do the whole course, but found myself walking with someone who had recently had both knees replaced, and we sort of egged each other on. We finished in 1hr 03 (5k so 3.1 miles). Hoping to do it without crutches and within the hour in a couple of weeks.

    My wound is very neat if still quite pink. Looks great snaking out of the bottom of my swimsuit.

  • kking93
    kking93 Member Posts: 9

    Hi, thank you for your post, I’m surrounded by negatives at the present time and it’s a breath of fresh air reading a positive outcome.

  • Coddfish
    Coddfish Member Posts: 85

    Hi @kking93

    I think I saw on one of your other posts that you are suffering from Perthes disease. All I know about that is learning Ellie Robinson, the Team GB swimmer at the Tokyo Paralympic Games is a sufferer and that it causes problems with the head of the femur. So I am guessing you are relatively young and facing the prospect of a double hip replacement. I obviously don’t know about your general health but would just say do whatever you can to stay as mobile and healthy as you can. If you do have surgery, the operation itself and the aftermath really aren’t that bad. Most hip surgeries are done with a spinal anaesthetic, which is not as scary as it sounds. You can be completely out of it through sedation if you want, and once they turn the sedation off, there’s no nausea or feeling weird.

    The first few days for me were ok. I never really had pain and I was delighted to see the day by day improvements. All the way through this I have found it better to focus on what I can do, and try not to worry if I can’t yet do something. My husband and family are really supportive and I have a good network of friends. Hoping you can find people to help you get through this.

  • kking93
    kking93 Member Posts: 9

    Hi @Coddfish

    I read your experience and to say the least it’s inspirational.

    I am 28 years old, both hips need replacing. However it’s my left that I get more pain from I believe. I also get the hip dysplasia, mainly in my left hip but has happened in my right.

    if I was to get the operation my left I would get done straight away. I would then see how I was about my right as I don’t think it’s anywhere near as bad as my left.

    I’ve been told there’s not a lot to worry about with the procedure. I just want this pain to stop. It’s stopping me working, socialising and just getting out the house.

    however I’ve been making appointments and things to see physiotherapist although I’m going to ask on here for recommendations.

  • Coddfish
    Coddfish Member Posts: 85

    Hi @kking93

    For me, the new hip removed all the stiffness and discomfort I had been experiencing, so it’s just been a case of physically recovering from the operation. At 6 weeks I feel 95% there on regaining function, but there’s a bit further to go on recovering full fitness and resilience. I met a lady at last Saturday’s parkrun who had had both knees replaced in August at age 33 due to a rheumatoid condition, I was a little surprised to find she had had the surgeries with just 7 days between them. The knee is a more complex joint than the hip but she was making really good progress and was able to walk the whole parkrun course (5k) with no mobility aids.

  • kking93
    kking93 Member Posts: 9

    it’s so good hearing of positive outcomes, I’m feeling a lot better in myself today. I’m talking about it more which I think is helping loads. Hearing of others stories is giving me hope.

  • Coddfish
    Coddfish Member Posts: 85

    It’s now 7 weeks, 2 days since surgery, and I am delighted to say I broadly feel back to normal. I am walking well, the last bit of limp has gone. I have continued using 1 crutch for longer walks but can now manage around 3k without a crutch before getting tired. I have just ordered some walking poles so I can lose the crutch altogether. All other forms of exercise are going well, other than I haven’t yet attempted to run. Swimming is good, static bike is good, I have returned to lifting lighter weights including deadlifts, and am returning to Aqua classes next week. I can now lie comfortably on either side, and (great relief) can fasten my own shoe laces. I celebrated by having a bath for the first time yesterday. I am normally a shower person anyway, but it was a lovely change. We managed a few days away last weekend, really nice to do normal things. Just got to rebuild my fitness.

  • Lilymary
    Lilymary Member Posts: 1,502

    That’s brilliant news Coddfish, your hard work and fitness have really paid off.

    If anyone needs a bit of encouragement from a 62 yr old duffer, my glacially slow and painful recovery from THR 6 months ago has gone up a gear, and I found myself doing 6-8 mile walks on the beaches of Northumberland a few weeks ago, mostly without stick, although i confess I did pop a sneaky cocodamol towards the end of the longer days, and a half pint of beer helped on some of them too. But my walking is much better as a result of all that, still have a bit of a limp to work on, and I’m stiff if I’ve been sitting too long, and hills still set of some of my irritated muscles, but a definite improvement. I even find myself overtaking people dawdling along pavements now 😅! The joint itself is pain free, just have a few soft tissues to work on. So for those feeling they’re behind their notional “targets”, take heart, you’ll get there in the end. We all just do it at our own speed.

  • Coddfish
    Coddfish Member Posts: 85

    I have now reached the magic 8 week point. My surgeon told me I could expect to be largely back to normal at 8 weeks, and my recovery has been spot on. The crutches have now been consigned to the cupboard. I have bought a pair of Nordic walking urban poles in the hope that I can use them to turn walking into a proper aerobic activity ahead of being able to start running again. I just intend to use them for exercise outings in the situations where I would previously have gone for a run, not for day to day use. I have been happy walking a reasonable distance without aids for a couple of weeks.

    I still have the raised toilet seat although I am fairly comfortable on a normal one. I am sleeping on either side reasonably comfortably, but still wake up several times a night. As mentioned last week, it’s a relief to be able to manage my own shoe laces.

    As well as the attempt to turn my exercise walks into power walks, I am swimming regularly and also using the gym. I tried an Aqua class on Monday, which was ok, but not great - not helped by the normal instructor being absent and the substitute providing an Aqua Zumba class. Not a great first class as it involves humans behaving like prancing horses with lots of pivoting. However I survived.

    Possibly the best thing is I have reached the point where I don’t really think about it. There’s no pain, the movement is great, and I am in a better place than I have probably been for 18 months. I have been driving for 3 weeks now, but had my first longish (2 hour) drive on Sunday. Given how hard it was to previously to get out of the car after spending any time in it, the wonder of just getting out and up without incident still catches me by surprise.

  • Coddfish
    Coddfish Member Posts: 85

    The 3 month point is looming up soon (my surgery was 7th September). A few milestones have been achieved - travelling into London on the train, spending a number of hours sitting in a West End theatre seat, spending an afternoon in Twickenham stadium. Pre-surgery, train, theatre and stadium seats would all cause problems due to my right leg having been permanently stuck in abduction. It’s been great to experience these things without pain and discomfort. All in all, I am so pleased I had this operation and so delighted with my recovery. I said on the last update that I was in a better place than I had been for 18 months. Prior to surgery I had been asked to complete an assessment based (I think) on the Oxford hip assessment, and, I think scored around 50 out of 100. Last week they asked me to complete it again, and I was amazed there was only one area where I dropped a point - for still not having full reach to my toes for shoes and socks. I can put them on, but it’s still a bit awkward. The revised score was 98.

  • RogerBill
    RogerBill Member Posts: 116

    Well done @Coddfish you're doing really well - a five star THR patient to serve as an example to reassure others considering whether to opt for the operation. I'm sure your success is down to your dedication to exercise plus, of course, a little luck and the skill of your surgeon. Are you still doing THR rehab exercises assigned by your physiotherapist or just your walking, swimming, weights, etc?

  • Coddfish
    Coddfish Member Posts: 85

    Hi @RogerBill I incorporate the rehab exercises into gym days but I don’t routinely do them every day any more as it doesn’t see to be necessary. I am pretty well back to normal anyway. I work with a personal trainer once a week (I went back to him very soon after surgery but it was a few weeks before I did anything other than get him to correct my form on the physiotherapist’s stretches and similar), and am happy he will keep me progressing.

  • Thank you all so much for your posts. Having my hip replacement on 15 Dec, and it has been so helpful and reassuring to read your experiences

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