How to prepare for a hip replacement operation - 10 things you need to know.

This January is the second anniversary of my hip replacement. 23rd January to be precise.

This time two years ago I was filled with fear of what was coming...the unknown. After all, I'd lived with my deformed hip joint for 3 decades so despite the pain, discomfort and limited mobility at least I knew where I stood with it. But at the relatively young age of 40, I now needed a hip replacement. 

BEFORE: Joint damage of left hip caused by JIA (left hip shown on Right side of this image)

I wish I could say all was plain sailing and a huge success, and from the point of view of the surgeon and how the surgery went, it was considered a success. The surgery went as planned. The recovery went smoothly overall. The scar is neat and healed well with no complications. 

But here are some things I wish I had known...

However brave you are and whatever you have been through in life, you may feel terrified beforehand

I remember shaking with fear on the way down to the operating theatre. I was terrified throughout the surgery as they did mine under sedation and spinal rather than general anaesthetic and I could hear everything and feel the sensations of being pulled and movement but not pain. 

You may feel rubbish for a while after surgery

Initially I felt fine in myself immediately after surgery. I was surprised at how 'good' I felt. But then my blood pressure dropped suddenly and nausea kicked in which wasn't pleasant. It left me feeling wiped out and exhausted. 

A hip replacement is not a miracle cure

Having heard so many positive success stories of hip replacements and my surgeon telling me I'd be able to do things I'd never been able to do before, like skiing for example, I had hoped that I would notice a significant difference after the surgery. Sadly, two years on and it turns out that my case was different. Having had my hip damage for so many years before surgery means that everything surrounding the hip doesn't work properly and so replacing the hip joint itself has only helped to a limited extent. I don't have a massively improved range of motion. I can't do things like most exercise and certainly not skiing. It hasn't helped my back pain as anticipated. I still can't put my socks on the normal way. 

It is a major operation

Hip replacements seem so commonplace these days that it's easy to forget that it is still major surgery that you are undergoing. Whilst the surgeon may be doing these operations every day, for the patient it is only going to be happening maybe once or twice or possibly three times in their entire lifetimes. So it is OK to realise that it is a big deal and ask as many questions as you need to. Keep yourself as well as possible beforehand. So I tried to avoid places which were likely to be germ-filled and kept contact with others to a minimum in the run up to the operation as I didn't want an illness to result in having to cancel the operation. 

You must plan ahead for aftercare

I would recommend to anyone having hip replacement surgery to ensure they have some live-in help at least for the early days after the operation. If you have a husband/wife/partner then it is a good idea for them to make sure they are around for the days following surgery. If you live alone then think about whether you have a close friend or family member who is happy to stay with you for a while. However independent you are, this is not a time to be stubborn. Ask for and accept all the help you can get! Remember that in the very early days after surgery you will struggle to even get yourself a glass of water. 

Once you get to the stage of walking with one crutch (for me it was at the 2 week mark for around the house) then life becomes easier as you will have one hand free to carry things if you need to. 

Get your house ready! 

The early weeks following surgery are not the time for taking any risks. There is a reason why there are rules in place about not bending beyond 90 degrees and so on because it is the time that the risk of dislocating the new hip is at its highest. 

So before you go into hospital, think about what changes you can make around the home to help. Can you move any food and kitchen items you regularly need onto accessible cupboard shelves rather than low cupboards? 

The physio team should ensure that you are confident with steps before you head home but perhaps you can find a small lightweight bag with a long strap that you can use to hang around your neck for carrying small items up and down the stairs with you. I used a small bag to make sure I had my phone with me at all times in case I needed to call for help urgently. 

Check the height of your chairs and sofa. To avoid bending beyond 90 degrees or risk getting stuck on your low sofa you might want to think about whether you can raise the level of the seat using cushions or pillows. Or perhaps someone can lend you an armchair with a higher seat on it. Having the armrests to push down upon to stand up is really important. 

In terms of other equipment you may need, I was given a grabber by the hospital to help if I dropped something on the floor and needed to pick up without bending over. They also provided a raise for the toilet seat.

We borrowed a loo frame to have support for getting onto and up from the loo and we borrowed a shower chair. The shower chair proved particularly useful as I wasn't comfortable in bed and I wasn't comfortable on my armchair so the shower chair was also used in the living room at times for me to be able to sit and watch TV for short periods of time when I was in too much discomfort to sit anywhere else!

I also invested in a leg pillow. I believe this was the one I ordered and although it seems pricey, it was worth every penny. Some people can cope with a regular pillow to stop their legs from crossing over in those crucial first 6 weeks where risk of dislocation is highest but I really valued that this was full length and had the waist strap too. 

I used a lot of other pillows and cushions all around me to stop me accidentally rolling over in the night too. You'll need to wear compression stockings for up to 6 weeks too - so you'll need someone to help you change those. Mine were provided by the hospital and they gave me several pairs to keep me going. 

You need to prepare yourself mentally and emotionally

Rather naively I had planned a load of reading, deskwork and other low-movement activities to keep me busy during the recovery period. What I hadn't bargained for was brain fog... and a lot of it! 

As romantic as it sounds to be forced to spend time relaxing in bed and reading a stack of your favourite books and magazines, the reality was very different. My brain couldn't focus on anything for a while. Even my favourite pastimes and hobbies. I couldn't even bring myself to watch TV for any length of time. The brain fog and restlessness and not being able to get comfortable was awful. The first week post surgery was the worst. Things do improve. 

At night, panic attacks became a regular feature and the lack of sleep went on for a long time, waking hour by hour through the night. 

Perhaps this was just me but I wasn't prepared for it. I hated feeling helpless and useless and although I kept telling myself the first few weeks of recovery are the toughest and things would soon improve, when your going through it, those few weeks really drag on. 

It was during this tough time that little messages coming through on social media kept me going. Whether it was from people who understood (social media is great for finding others in a similar situation or who have been through what you are going through) or friends sending me messages of hope and support, it was all much needed and appreciated at that time. There are times that we all need a cheer-leading squad to keep us going when we don't feel we have the strength within ourselves to do so. 

Get inspired but don't compare

On that note of social media, I found it incredibly inspirational to find others who were ahead of me in the hip replacement timeline and were onto doing amazing things. It gave me hope of continued improvement day by day. BUT I never got to where they are at so remember that no two cases are going to be exactly the same so there is no point in directly comparing. After all, I STILL can't put my left sock on! 

I didn't come across many relevant blogposts on the topic of hip replacements but one sticks in my mind as being particularly helpful. I read the series on the SAGA website, written diary style and the section entitled Day 23: Doing my dirty laundry helped me have a shift in my thinking. Rather than thinking how useless I was because I couldn't do things I would usually do, I started to focus on what I could do rather than what I couldn't. I remember deciding one day that I too would do the laundry (or at least part of it) however long it takes so I did the flinging each item down the stairs technique. It literally took hours in all but it was satisfying knowing I had achieved something simply by shifting my mindset from I can't to I can - but recognising that I would have to be patient and do things differently. It's a technique I've kept in mind ever since whenever my back pain flares up - I try to be kind and patient with myself and work out different ways to enable me to still do what I need to do. 

Recovery timescales are just a guide

Whilst most people may well be OK to drive 6 weeks after surgery, this won't be the case for everyone. I had 6 weeks as a magic milestone in my mind where I imagined life being back to normal...Walking and driving and doing many more things than I could ever do before. How wrong I was. Having said that though, the fact I stopped regularly blogging about my recovery beyond week 7 means that life did return to enough normality to not warrant documenting it further apart from a 5 month update. 

You'll be celebrating the little wins

The first time you brush your teeth by yourself post surgery. The first shower (albeit with a lot of help). The first outing (for me that was a tiny walk outside on crutches at 2 weeks post op). Being able to / allowed to sleep on your side again. The first steps with one crutch, then no crutches. These are all little wins you'll be celebrating. 

Here are the links to the blogposts that I wrote at the time of surgery following my recovery journey. I realise that a lot of it makes for miserable reading because the early days were tough but it IS a good news story overall: 

• Hip Replacement at 40
• Total Hip Replacement: Post-Op Day Zero
• Total Hip Replacement surgery: Day 1 post-op
• Total hip replacement: Day 2 Post-op
• Total hip replacement surgery: Day 3 post-op
• Total Hip Replacement Surgery: Day 4 post-op
• Total Hip Replacement Surgery: Day 5 Post-op
• Turning the corner after 1 week - Total Hip replacement: Day 7 post-op
• Swelling below the knee - Total Hip replacement: Day 8 post-op
• Total hip replacement - day 9 and 10 post op
• 2 Week update post-op after Total Hip Replacement
• Day 15 - Day 18 Post-op: Total Hip replacement surgery
• Total Hip Replacement surgery: 4 week post op update
• Total hip replacement in Younger Patients: Week 5 Post-op update
• Total Hip replacement - Quick update for week 6 and week 7 post-op
• 5 month update - Younger Hip replacement surgery after JIA

AFTER: My new hip 

PLEASE NOTE THAT THIS DOES NOT CONSTITUTE MEDICAL ADVICE - ALWAYS FOLLOW THE ADVICE GIVEN BY YOUR OWN DOCTOR AND MEDICAL TEAMS