All's well that ends well ...

HarryB

Over the last two years the osteoarthritis in my right hip had been causing increasing difficulties. My range of movement without pain was limited. I couldn’t put my right sock on without using a ‘sock assistant’. Anything other than very limited gardening was impossible. Instead of 5-6 mile hikes without a problem, I could manage only a couple of miles on the flat at a slow ramble. And worst of all, I had to quit walking football, which I had played for eight years since my early seventies.

On 5th April I had a total hip replacement. The following afternoon I passed the mobility test and was back home in the evening. The post-operative pain relief provided in hospital eventually wore off around three in the morning. I was grateful for the morphine I’d been given for such eventuality.

Apart from that first night at home the pain was never horrendous and could be managed with standard painkillers. I learned to take a stronger analgesic an hour or two before any activity that promised to be more strenuous than my usual routine of short walks, which were around the house and garden in the first week, progressing outdoors from week two. It seemed I was the average, straightforward THR recovery patient, improving my range of activities on a daily basis.

One day short of two weeks post-operation, I went back to the hospital to have the clips removed. The nurse expressed slight concern about the swelling around the wound and a small unhealed bit of the incision, and arranged for my return in two days for a check. In the meantime, fluid continued to seep from the wound and my wife had to change the dressing morning and night. Back at the hospital the nurse summoned the consultant, who thought that there did not appear to be any infection. Nevertheless, ‘to be on the safe side’, he prescribed a course of antibiotics.

Three days later, after more wound drainage and dressing changes at home, I was back for a further check. The consultant ordered the blood-thinning injections to be stopped and asked for another checkup appointment in two days. At this appointment, upon inspection of the still-seeping wound, he advised immediate treatment to minimise the risk of infection.

So the following day I was readmitted and for the next two days the wound was attached to a VAC (vacuum assisted closure) machine, a device that uses suction to drain fluid. On the second morning a different consultant was on the ward round. He was a little surprised that the wound was still draining. In the circumstances, he advised me to be prepared for further surgery. The wound would be reopened, the joint flushed out, and the removable ceramic parts of the prosthesis replaced. I learned that the procedure was called DAIR (debridement, antibiotics, implant retention). Operation Mark 2 was on 29th April, three and a half weeks after the first one.

Back on the ward in my side room, I realised that my mobility would be somewhat curtailed for a while. There was a drain from the wound into a plastic bottle; a Pico suction dressing replaced the VAC machine; I had a catheter for urinary purposes; and twice a day a drip provided strong antibiotics via a cannula.

Confined largely to bed or a chair for the next few days, I did some internet research (a mistake, most people say). Hip replacement is the most successful elective operation the NHS does, but occasionally there are complications. DAIR is necessary in about 1% of cases. I was one of those unlucky few. I didn’t regard myself as unlucky, though, because infection had been found and was being treated in the best way possible. Cultures from the second operation had revealed two types of staphylococcus bacteria. Once I was stable enough to be discharged, I would be on antibiotics for up to three months.

A week passed with the drain bottle remaining my constant companion. When I saw the consultant on his morning round, he explained that the full laboratory test results could take seven days, possibly longer as we were now into a Bank Holiday weekend. The drain might be removed tomorrow. (That’s what I was told every day).

The next night the drain removal question was violently resolved when I trapped the tube in the door on a visit to the toilet. It came adrift from the wound and I was patched up by the nurse on duty. On his next visit the consultant said that the dressing could be removed, together with the Pico pump. The lab results were in at last. A key infection marker called CRP (C-reactive protein) was moving steadily downwards. All that was needed to trigger my release was a plan from Infection Control.

Next morning the consultant arrived unexpectedly early to inform me that the CRP marker was down again. He briefly disappeared to phone his colleague in Infection Control, then returned with the news I’d been desperate for – home time! I simply had to wait a few hours before the hospital pharmacy sent my bagful of medicines up to the ward.

That first night back home I managed more than five hours sleep in total, more than any of the twelve nights I spent in hospital. On my second day at home, I started to feel really tired. Just moving around the house, up and down stairs, occasionally around the garden - my new hip was not used to this. As others have reported on this forum, it’s often a case of ‘two steps forward, one step back.’

Five days after release, I returned to the hospital for the removal of alternate clips and a blood test. My body was starting to adapt to the antibiotics. Sleep patterns improved - not normal, but definitely better. Social life resumed: a walking football friend drove me to our favourite coffee shop where the group meets after the weekly session. The banter hadn’t changed. I’d missed being verbally abused on a regular basis.

A week after the hospital visit, I returned to see the consultant, who said the blood results were good, and in particular the CRP score was down again. The remaining clips were removed - this time the wound had healed cleanly.

Tomorrow, four weeks after Operation Mark 2, it’s another Bank Holiday. I’m still downing the antibiotics, which seem to be having other beneficial effects, as well as fighting the bacteria. My taste buds are sharper. I don’t usually have a cooked breakfast, but today I have enthusiastically scoffed egg, bacon and black pudding. My mobility improves day by day. Around the house I manage without a walking aid. Outdoors I use a single crutch and try to walk at least a quarter of a mile every day. On the physiotherapist’s advice, I’m not obsessed with increasing the distance too quickly. I try to keep up the daily exercise routines. Most importantly, I’m pain free and almost back to a full range of movement of the hip.

If you are awaiting a THR and have managed to read this far, I hope my story has not caused undue alarm. I was the one in a hundred THR patients for whom things didn’t work out quite as planned. Yet here I am, only about four weeks behind where I had hoped to be at this stage, with the summer ahead and a targeted return to walking football in the autumn.

Naomi33

Thankfully alls well that ends well !

Well done you 🙌

Lizziebeth

thank you for sharing. It’s very helpful. Hope your recovery continues apace.

Fran54

@HarryB thank you for letting us all know how your hip replacement went and so glad that you are finally on the mend. You now have something to look forward to regarding your walking football and hope it all goes well. Take care.🙂

Janlyn

@HarryB - what a time you have had, but thankfully you are on the right track now, amazingly not too long after your original op. It is helpful to know that even for the 1 per cent where this happens there is a process in place and it all works out in the end. Take care.

Nurina

I'm so glad you are recovering well after the scary moments you've had.

Bevdav123

You’ve been through a lot over the last few weeks! Onwards and upwards from now on, I’m so glad you’re on the mend and you’ll be back scoring goals soon 😊

HarryB

It’s now five months since my total hip replacement. Over the last five or six weeks, I really started to feel that my recovery was accelerating: in particular, my walking gait was almost back to normal, and that meant that the lower back pain connected with the old arthritic joint was much improved. I had progressively stepped up the exercise regime, which included kicking a football against the garage wall. I also found I could walk at the brisk pace that I was accustomed to before arthritis struck.

So last week I decided the time had come to attempt a return to walking football. It was good to be welcomed back by fellow players I hadn’t seen for eight months. The first session brought home to me how much my mobility had suffered in the two years before the operation. I could turn, put weight on my right foot, and hit a pass more than five yards! Since then, I’ve taken part in two more sessions, with no obvious adverse effects.

I echo the comment of @JPT in ‘My THR recovery diary’ dated 4 September 2024: “For everyone going through this recovery, stay positive, it does get better.”

Ellen

Wonderful update @HarryB thank you so much for coming on to let everyone know how well you are doing.

Best wishes

Ellen.

KC1

https://community.versusarthritis.org/discussion/comment/727094#Comment_727094

so good to hear you’re recovery is going so well after such a tricky start

Janlyn

@HarryB fantastic update - five months was when I suddenly realised I had made real progress and the good news is that it's now over nine months and I've made more progress. It is a long haul at first but with exercise and patience we can really get our quality of life back. I don't know if you are the same, but I really didn't realise how long I'd been struggling until I wasn't.

Take care and let us know how you go on.

JPT

@HarryB that's great news, there's no looking back now :-)

HarryB

@Janlyn It's encouraging to hear that you've made yet more progress between five and nine months post-op - well done. When you said, "... I really didn't realise how long I'd been struggling until I wasn't", you certainly hit the nail on the head. That was exactly my experience. I think I hadn't appreciated how much arthritis was sapping my energy. I was avoiding most household tasks other than the absolutely necessary ones, because it meant thinking carefully about simple movements like stepping, reaching, bending and stretching. What once were routine processes had become tiring obstacles.

Today, by mid afternoon, I had been for a three-mile walk, done a bit of gardening, and cleaned and tidied an area of the garage that had been crying out for attention for more than a year - and I still didn't feel tired! When I was a youngster in the 1950s, I used to see so many elderly people struggling to walk, and now realise that many of them were suffering from arthritis in their hips or knees. Arthroplasty wasn't an option for them - we are so lucky that our quality of life can be vastly improved by these wonderful joint replacements.

Janlyn

@HarryB and you've hit the nail on the head too. I really feel we are so lucky to get our quality of life back with these replacements. I've been finding myself smiling and feeling happy, whereas I'd spent so long taking time to do the essentials, knowing I couldn't do everything.

I have to admit I overdid my walking last week and realised that although I was walking, and sometimes managing around 20,000 steps a day, I was generally having plenty of breaks. Putting my walking boots on last week and setting off for more of a hike I realised I'm not quite there yet, but I'm more than happy with my progress at 10 months.