Getting a new hip
ChiloquinNews article October 5th, 2012
I got a new hip last Tuesday morning and what I realize from having done this is that there is very little real information just about the nuts and bolts of this procedure out there for the prospective ‘hipee’. So here’s rather a long article on what you can expect if this is in your future.
After about 2 years of messing about trying to get a diagnosis, it finally became obvious that my hip was just no damn good. All I did was sit about and eat, getting less fit and fatter by the day. I started researching and came across the term ‘minimally invasive hip replacement’ and discovered that there was a young surgeon in Medford, Dr. Omar Abdul-Hadi, using this technique. I looked him up, watched a YouTube video of him, and made an appointment to see him. Tip – don’t watch any actual surgery videos until after it’s all done.
Next was an appointment at Rogue Valley Med Center for their ‘joint replacement class’, at which a lot was stressed about ‘hip precautions’ – those movements that you cannot make after surgery for fear of popping the new ball out of the socket, until the muscles that hold it all together have had time to regain their strength. No bending more than 90 degrees at the waist, no crossing the legs, even at the ankles, and no standing pigeon-toed. No sitting in a low chair, or an arm chair, and better get a raised seat for the toilet and a walker and cane. Next day I saw Dr. Abdul-Hadi and learned that I had no hip precautions! None! This, he explained, was because he would not be cutting those muscles that hold the ball in the socket and so they would continue to do their job even after surgery.
The night before the surgery we went to a house concert in Ashland – an accordionist from Minnesota – and I enjoyed every second of it. If you ever get a chance to hear Dan Newton play, jump at it. Then it was home to start the pre-surgery routine. Of course, no more food or drink. A shower, followed by an hour of cooling down and drying off completely and then a wiping down with somewhat sticky antibacterial wipes in exactly the right sequence, some sleep, then waking up early enough to repeat the wiping down, but with no shower this time and getting to the hospital by 6:30 AM.
Day 1, surgery day, it was into their heavy gown, which had air channels though which they pumped warm air. The IV was started – gosh I hate them, a quick visit by Dr. Abdul-Hadi who looked extremely youthful in a bright green T-shirt and jeans, and then I was whisked off to the operating room through 60 degree corridors, at which point I appreciated the warm air in my gown. I was greeted by the surgeon’s assistant wearing a blanket tied around her waist, trying to warm up. Always before I had been pretty drugged by the time I got to the operating theatre. Not this time. The anesthesiologist sat me up to start the spinal, which as he promised was just a sharp prick in my lower back, and I laid back down and watched as my toes wriggled less and less and two assistants tickled my legs as they painted on orange betadine. Then I heard him say ‘Going to put you to sleep now; wake up, you’re all done and in the recovery room’. 1 ½ hours condensed into no time.
When I arrived in my room around 10:30 AM, Richard was waiting, looking more worried than I felt. The nurse wanted me to take a pain pill, and even though I chose the lowest dose with the lowest narcotic, I did end up a bit nauseous after taking it. Gosh was I trussed up now! There were drain tubes poking from my leg and emptying into a container clipped to the end of the bed. The IV now had an antibiotic drip along with the saline. With a history of atrial fib after surgery I was hooked up to a heart monitor, and my lower legs were wrapped in pneumatic leggings used to reduce the risk of blood clots, connected to an air pump that turned on every few minutes. I was still wearing my heated gown and its air pump buzzed away. The nurse pointed out the various controls – for the bed, the call button, the gown heat, but I just dozed, feeling no pain, though as the legging pump turned on it felt like huge hands were grabbing my legs and I half expected to hear a ‘gotcha’ from the end of the bed.
The physical therapist arrived at 1 PM, saying, ‘time to get you out of this heavy gown’, which I had already shut down after waking in a sweat. What they don’t tell you is that the spinal may wear off last in the bladder area, and that waking to a wet bed with no idea of how it got that way is not uncommon. The physical therapist had the final word on what I could or could not do. All I did at that session was stand up, but having accomplished that I was cleared to stand to transfer to a commode with assistance, each time requiring that all those tubes be rearranged.
That afternoon I felt well enough to send a few emails on my Kindle, listen to my audiobook, break out the knitting, order the grilled salmon dinner.
They measured everything. Liquid in, liquid out, solid food in, and we all waited for the famous BM (bowel movement) without which I could not go home. They measured the blood lost from the surgery site – not enough to bother with putting it back. I was woken at 11 PM and 2 AM for vitals (blood pressure, pulse rate and temperature) at 5 AM for a blood draw (to check cell count in case of infection) at 6 AM for more vitals, at 7 AM for breakfast and at 8 AM back came the physical therapist. The lack of those hip precautions was wonderful. It meant I could sleep on my side, securely wedged in by multiple pillows that the nurse seemed to pull out of thin air.
Day 2 started the exercises and the walks around the corridor, heart monitor box in my pocket, blood collector clipped to the walker, the IV stand trailing behind. By afternoon I’d had my 2 bags of antibiotics dripped in and the IV was capped off. It was getting painful though, since it was inserted in my wrist right where it bent on the walker, and also where my wrist bent while knitting. The leggings were also abandoned because now that I was moving there was much less chance of blood clots. The afternoon session had me climbing a couple of steps and being cleared for independent walking, the therapist leaving as I set off down the corridor, promising to come back next morning to take me down the stairwell. Finally they turned off the bed alarm so that I could get up and down as I pleased. This day Dr. Abdul-Hadi stopped by with his wonderful smile and there were visits from several people who needed to clear me for discharge.
True to his word, day 3 started with a trip up and down a flight of stairs with the physical therapist. The nurse removed the IV from my wrist, the heart monitor and the collection tubes from my leg and put a fresh stick-on pad over the incision – just about a 4” cut, tacked together with dissolvable staples and covered over with steri-strips. There will be no showering for 2 weeks, but once I start showering and the steri-strips fall off, there will be nothing more to do. Then I got dressed, was wheeled out by a pink lady, and back at home in my armchair before lunch.
And how is it progressing? Every day my leg feels stronger. I can now walk around the block, one arm on Richard’s and the other holding a stick. I’m taking 325 mg aspirin twice a day for 6 weeks, once again to fend off blood clots, but not much else in the way of pain pills. Does my leg hurt – yes, a bit, but mostly it’s my thigh that feels bruised rather than any pain from my hip. The antibiotics did their job well and so I am drinking kefir, swallowing probiotics and scarfing down gelatin in an attempt to get the gurgling stomach back under control. It seems to be working. Tomorrow I’ll come home to Chiloquin, just 1 week after I left!
The cats will be pleased.