Rehab after operation

distantshores

Hi - I find it appalling that there is no after care/rehab offered after a hip replacement (and other operations) and that you are discharged after 1/2/3 nights with nothing more than bits of paper and list of instructions. In some countries people are kept in hospital longer and then have the option of going to a rehab unit - here there is nothing at all. The only place you can go is a care home and they are not equipped to deal with post operative rehab. I really feel that a lot of people would benefit from a stay in a rehab unit post-op (any op not just joint replacements) and that recovery might be quicker. I am sure some people end up back in hospital due to lack of post op support. What do other people think?

😡

Nurina

I asked the hospital physiotherapists for an outpatients referral. They can't say no. I've received the referral letter today to call them for an appointment. Under my point of view, we all need the guidance of a physiotherapist after the surgery.

Janlyn

I do think we need physio, especially in the early weeks. I'm seeing a chiropractor who I saw pre-surgery and I trust. He gives me good advice and exercises and I am sure I am in a better state that I would have been without seeing him. I think without help we only recover so far but to get to our full potential it takes time, and the correct exercise.

Regarding hospital/care home I was concerned about coming home alone but actually after two nights in hospital I was happy to come home and look after myself. But, of course, we are all different and so our treatment/care needs to be different. I do think I recovered better by being in my own home and, as my surgeon said, procedures are different to a few years ago and so it is much safer to be up and about quicker.

Trish9556

Hi think the opinion of the NHS is that people recover quicker from any illness or surgery in their own home. I tend to agree. It is too easy in hospitsla when you have everything done for you and I certainly wanted to get home, even though I was in a private hospital I only stayed for 2 nights.

I had physio day zero, day one and day two before I went home. They made sure I was confident and able to use the stairs and had me going up and down two flights with both sticks and crutches. They also made sure I could use the bathroom, stand and wash myself and dress myself.

I had physio appointments in the hospital for an hour each at 3 weeks and 6 weeks and paid for one more at 9 weeks.

I saw my surgeon at 6 weeks and he was amazed at my progress and discharged me.

This was paid for by the NHS under the choices option, and, apart from the additional physio session, it was free to me.

I would have paid for physio regardless if it hadn't been given to me - there are many excellent physios out there.

My sister in law broke her hip in the USA. Yes she had excellent care but because it was paid for on insurance she had everything thrown at her whether she needed it or not and unnecessary (their words) tests and consultants checking every little thing out.

She stayed in hospital for a week and had daily physio. On discharge they paid for advanced rehab where they had a gym set out with every possible thing you could do / need/use from mock ups of kitchens, cars, supermarkets, footpaths etc. Yes, this was amazing but st a horrendous cost to them on top of the insurance.

Back in the UK they are still dealing with the insurance company and have no idea what is going to be paid for and what they are goingi to have to pay for.

Excellent treatment yes, but at what cost?

How many of the countries you mentioneod have free health care or do you pay either per service or costly insurance ?

I know which service I prefer, the NHS. I have been in hospital many times and had many surgeries throughout my life and always taught by my parents that if you have a positive mental attitude and tell yourself you can, you do and you get better quicker.

I could have ended up a vegetable in residential care at age 5 for the rest of my life 63 years ago but for positive mental attitude I proved everyone wrong by making a success of whatever challenge I faced. This has seen me through life and I have raised my sons with the same sense.

Trish

frogmorton

I think they want us up and about these days so we don't get a DVT (also full of blood thinners for the same reason).

It can be really hard for people living alone to cope at home, but for me I know I'd recover better in my own home when I can take my painkillers on time (often you are waiting in pain in hospital for them to come with them), eat what I want distract myself with my own activities - TV talking on the phone to friends etc

What I do think it wrong is the lack of real physiotherapy like they used to give you. This includes private hospitals and is absolutely NOT just an NHS thing.

Finally though I know of at least two people, (friends one a hip one a shoulder both within the last 6 months),who were readmitted because they were discharged too soon. Both with unmanageable pain and one also had an infection.

So not sure 100% what I think really. Perhaps it shouldn't be a one size fits all response, but tailored to the individual more🤔

Toni x

distantshores

@frogmorton I agree - it should not be a one size fits all and I know I would have recovered better in a proper rehab unit. It is not that I am lazy and expect someone else to do everything for me - in fact quite the opposite I prefer to do everything for myself and do not ask for help. I was not ready to come home after 3 nights and am sure it has hindered the recovery.

I am doing all the exercises and moving around as much as I can but can't go out as my foot is too swollen to put shoes on and I am not walking barefoot in this weather. Before the op I was quite fit and did as much exercise as possible and wasn't in much pain although it was stage 4 so was not prepared for the level of pain or incapacity.

I know it isn't just an NHS thing and that those who pay are not offered anything either. I just think it is counter productive for some people and, as you say, some people end up back in hospital.

@Trish9556 I am sure the cost in the US is very high and hopefully the insurance will cough up. I would have been willing to pay to go into a rehab unit like the one you described if there was one available as I am sure it would speed up recovery for me. I am not wealthy but would be happy to pay for that and forgo other things.

As I can't put shoes on I did manage to get the community nurse to come to change the dressing yesterday. However, she wanted me to roll over on my side to take it off but the pain was so bad I couldn't do it and had to have it taken off standing up. Someone I know who has had a hip replacement said they had never heard of anyone being asked to roll over on their side to have this done. I didn't know so tried to comply but just couldn't. Is this now the norm? Or maybe the nurse just didn't want to have to get down on her knees to do it (she had to)? Anyone else experience this.

Janlyn

@distantshores I was stood up when I had my wound checked/dressing taken off.

Have you any lace up shoes that you can lace up very loosely? I used some that I used to wear with thick socks and I used really thin socks and managed to get them on. My feet and ankles were very swollen for some time and that's how I coped. Not easy but eventually the swelling went down. I did try to keep my legs raised as much as I could to help with the swelling but it did seem to just be something that took its own time. Once off the blood-thinners everything seemed to improve much quicker.

It can be miserable but you're surely through the worst now and hopefully you'll see some improvement soon.

Nurina

Honestly, I prefer to be at home than in the hospital. The problem is they use statistics not individual cases and they apply the protocol according to this. This surgery protocol is targeted to the average patient of 68 years old so even if you are 20 years younger or 20 years older, they’ll treat you exactly the same.

NHS spends the same money in patients with surgeries done in NHS hospitals or in private ones. NHS patients in private hospitals don’t have the same rights as paying ones (not with insurance) which usually have unlimited physiotherapy sessions from day one.

@distantshores I went today to get my staples off. I was shocked when asked me if I wanted to lie on my side like it was a normal thing for her. I found the bed was really high and I didn’t want to hurt myself trying to climb it up so I asked to get them removed standing up like I did with the other leg.

jj72

Hi, I'm new here. I'm due to get a hip replacement in the coming months.

I have already been looking around for ways to heal afterwards.

I have found that some of the Nuffield hospitals run free rehabilitation courses throughout the year.

Hope this helps x

noddingtonpete

Hello @jj72 and welcome to the Online Community. We are a friendly and supportive group and I hope that will be your experience as well.

I've put in the link to Nuffield below in case others are interested and also a link to Escape Pain which is also free.

https://www.nuffieldhealth.com/about-us/our-impact/healthy-life/joint-pain-programme

and

https://escape-pain.org/

Hope you get something that helps.

Best wishes

Peter

Trish9556

@distantshores @Nurina @Janlyn

When I went to have my staples out I asked the nurse to lower the bed, which she did. After climbing onto the bed, with the help of a step, she then helped me to roll gently onto my side. I could not have had them taken out standing up, especially as two staples were rather persistent and the wound needed re-dressing

Trish