Total Hip Replacement: Post-Op Day Zero

On the 23rd January 2018 something happened that changed my life forever. Whether it is for the better or the worse, I am still waiting to see. But either way there is no going back.

Here's my diary I wrote up day by day at the time...

Written on Wednesday 24th Jan 2018

Yesterday was the big day. The big day that I've been leading up to over the best 30 years.  It was the day of my hip replacement operation. (Or my "hippo frogeration" as Miss T called it when she couldn't pronounce hip operation.) I'm calling it day zero. 

Whilst total hip replacement surgery is a relatively common procedure these days - 50,000 in the UK annually and 300,000 worldwide I believe  (I'm in no fit state right now to double check those figures so it's just based on memory from info I read), it is far less common to have hip replavement at such a (relatively) young age (I recently turned forty although they'd told me since my teens that I would need to have my hip replaced either by late teens, or twenties or certainly thirties and still I kept going with it and made it to a milestone year of 40  - a whopping 30 years after I was first diagnosed with Juvenile Chronic Arthritis (as it was then known as) nowadays referred to as Juvenile Idiopathic Arthritis (JIA) which is what my 5 year old also suffers from.

the consultant marked which hip it was before the surgery

Changed into hospital gown and waiting for surgery

So me being me  (and possibly due to my ASD tendencies) needed to know as much as I could before the operation.  Was it really necessary? (Things were only going to get worse the doctor replied).

What was the likely outcome / what improvement would there be? (I knew and heard of lots of older people who had the procedure with huge success)

What specifically should I expect? Lots of pain in the first 24 hours. A ceramic ball and socket on titanium stalk which should last min of 15 years (often longer).

But I found little else about it all. I know that the human body is quick to forget pain (there's no way I would have had 3 kids if I'd vividly remembered the pain of labour) so I wanted to document the reality of the procedure and the recovery period in an honest way. If you don't want to hear any gory details - look away now. 

The operation I had was under the NHS but I was fortunate enough to go via the choose and book system so have ended up having the procedure done at a local Nuffield hospital.

From the outset I have had masses of confidence in my surgeon. I first met him about 10 years ago when my ankle was being problematic and even then he referred to himself as a hip man. So when my appointment came up with his name on it - I was thrilled! 

My Pre-Op appointment was last week for bloods, mrsa swabs and urine test. 

Then it was an early start on what I'm calling day zero - operation day. No food from the night before and 2 weird pre-op drinks in the evening and 2 at 5.15am on the day of the op. I was given some self foaming sponges to use in the shower and instructed to have a shower before arriving at hospital. 

7.15am arrive and shown to room which is a cross between a hotel room and hospital room. And there we wait. I changed into hospital gown and dressing gown. The nurse checked me in,  anaesthetist visited with some questions and told me that although I would have no feeling of pain during the op by having a spinal block, I would only be lightly sedated as that will help with recovery. So I would still see and hear what was going on and feel pulling movements. A bit like when someone has a c-section. 

After the surgeon visited, he popped back again about 8.30am to say he has decided that part of it will be cemented to help address my leg length discrepancy.  

Then it was a longer wait whilst the first person went for surgery and I was next. I couldn't feel motivated to read or even watch TV so it just felt like a long wait. 

At close to 11am I got taken down in the bed and they then transferred me onto the operating bed. 

I got wired up to the monitor and had canula fitted to back of my right hand. Then it was time for the spinal. A cold spray all over my back. Then weird feeling of pressure on my back as the spinal went in. 

I'd had a spinal once before. It was after my labour with J. I'd had third degree tears and lost heaps of blood but they couldn't get my pesky left hip out the way enough to stitch me up in theatre so they had to do a spinal to be able to. So frustratingly I had all the side effects of the spinal without the benefit of having it during labour. So for the next two babies I had epidural right away to prevent my hip being an issue again. 

Back to the hip operation - Soon it was onto lying on my left side (gets the spinal working quicker as that was the side to be operated on) whilst the spinal took full effect. The absolutely wonderful anaesthetist kept checking with cold spray to establish at what point of my leg I could feel the cold - she explained that was a way of knowing how much the spinal had taken effect. 

By this point my entire body was shaking- whether from fear, from medication, from feeling cold or a combination of all 3 I didn't know. 

They then turned me onto my right hand side and got my top half comfortable - afterall I was going to be in that position for the next 60-90 minutes.

They put an inflatable sheet over me and blew warm air through it to keep me warm. Then I felt clamping as they clamped the bottom half of my body still into place.  

At some point a screen had gone up like you see for cesareans so I couldn't see what was going on. 

But sure enough I felt loads of pulling, pushing, wrenching, hammering and heard loads of noises too. It was like being in a car mechanics workshop with all the noise. 

I asked for more sedation but she explained that my recovery would be much quicker without high levels of sedative. I also wasn't catheterised.

Finally I felt the sensation of being stitched up and was wheeled into recovery room. I had sips of water. It was in the recovery room that I actually came over all tired feeling. 

I remember being in the recovery room at 1.05pm. Richard said that by the time I was back in the hospital room it was about 1.40.

initially feeling good after the op

I actually felt pretty good at that point.  Exhausted but good. With the spinal still in full swing I couldn't feel any pain.  

At about 4pm I was so hungry that I had a late lunch. I started to be able to wiggle my feet. So the paracetamol drip began as did oromorph.  I had an emotional blow when visited by a doctor doing his rounds who said that bending the hip over 90 degrees would always be a no no because of risk of dislocation. I had been led to believe that I would have better mobility with a new hip than with my new one. I couldn't shake the thought that I could end up worse than before. 

Eating my late lunch after surgery at 4pm

The physio reassured me afterwards that actually may not be the case and it is only the first 6 weeks I need to be mega careful. Due to lack of feeling returning to my legs there wasn't much more the physio could do at that point. 

I tried a bed pan to no avail so they had to catheterise me at that point which in a way was a relief as I would otherwise have struggled through the night. Apparently it is quite normal to need to be catheterised after a spinal. 

Although I was given anti-sickness meds I started to feel very queasy, light headed and faint. When they took my next blood pressure reading it had dropped to 77 over 45. i.e. very low!

after my blood pressure and pulse rate dropped

So they quickly reclined my bed flat, called the doctor in and put me on saline drip. Eventually the queasy feeling and cold sweat reduced. 

That evening I said goodbye to Richard then shortly after vomited. A lot. 

I couldn't face dinner that evening. Drifting in and out of sleep. I have these funny footpump things to help prevent DVT along with DVT stockings (or rather anti-DVT stockings known as TED stockings). So each time I was drifting to sleep I felt a push on my feet from the footpumps (They go every 10 seconds or so) or the automated blood pressure meter would squeeze my arm. 

Either way I felt I slept well albeit in less than hourly chunks.

I felt so hungry about 11pm having missed dinner (note to self - however tempting a superfood quinoa and sweet potato salad sounds- after an operation you're just gonna want toast or biscuits). So the nurse got me toast and marmalade and gave me an anti sickness injection. 

Toast never tasted so good.