Hip Replacement Surgery-My New Hips
(Editors note: The following information was solicited by us
as result of questions readers asked about hip replacement
procedure. These are the verbatim notes/comments of a healthy
individual who in his late 60's had one hip replaced and repeated
the operation with his second hip two years later. This was done
on a purely voluntary basis, and he received no remuneration from
any source. We wish to thank him for sharing his observation with
our readers. We will add appropriate comments from other readers
of this web site.)
Eleven days in (an unnamed hospital in Miami, Florida,
replacing my left hip
February 21st-March 2nd, 2005
(And December 2006 for the right one)
Day 1 - Monday, 2/21/05
The scenario began at 6 am at the registration desk in the rear
of the hospital. Everything routine. I walked with a nurse into
the prep room about 6:30 where an IV was inserted, in my left
hand, an epidural plugged into the rear right base of my back,
and my left thigh and hip was carefully shaved with an electric
razor in anticipation of the coming incision. I endured a few
rounds of questions (is it the left or right hip?) and discussed
anesthesia options with the anesthesiologist who would hold my
life in his hands in a few minutes. The surgeon assured me all
would be just fine. Nancy was there until the time came for me to
be wheeled into the OR which seemed to be just a few feet from
the prep area.
The anesthesia must have been pumping really well because about
the only thing I remember about the OR is peering up momentarily
at what seemed to be a very low ceiling, the anesthesiologist
peering closely at me before everything vanished into oblivion.
I had some slight remembrances of the recovery area but true
clarity returned only after I found myself in a semi-private room
with Nancy, Phil and Joy looking at me quizically.The time was
about 10:30 am. I have pain but nothing very severe. I assume
it's being controlled by the epidural. No solids today. Just
liquids but there's no desire whatever for food. Catheda controls
the outflow of body functions and this is no concern. No
sensation of any connection and it's all rather convenient being
able to drink whatever I choose without wondering how it will all
get out.
Phil and Joy left early afternoon. Nancy until much later. Nurses
all very considerate, attentive, caring.
My biggest problem and one that would persist throughout the
hospital stay was sleeping. The first night was awful. No pain
but an overwhelming awareness of time. Must have glanced up at
the digital display every few minutes, in between the temperature
and blood pressure checks. I expected
other problems but not this one.
Day 2, Tuesday, 2/22/05
My first full day as a patient and one that gave me a new
awareness of the importance of sound medical/nursing care. Still
mostly liquids. and Roger were here for visits. I'm starting to
worry about what's going to happen when I begin having bowel
movements. Don't want to use a bed pan, Who does? No problem yet
though because almost no solid food.
Nancy arrived early afternoon and remained until nearly 6 when
valet parking closed. Had a problem with a defective battery in
the Cadillac which was solved only she waited for about a hour
when someone from the dealership showed
Same problem sleeping although I did get a 15mg sleeping pill.
Day 3, Wednesday, 2/23/05
Solid food today although I'm only interested in perhaps half of
the small portions that are offered. Went to therapy for the
first time, which consisted largely in making my way around the
large activity room in the (deleted) to the right of the main
entrance to the hospital. I'm using a walker, of course, and I'm
hobbling from left to right as I lumber along, Naturally, I'm
feeling soreness and tightness in my left leg and the area of the
hip where the incision is located. But at least I feel I'm making
the beginning of some progress. Therapist by the name of Jennifer
seemed especially competent and helpful is getting the muscles in
my very right left knee back into operation.
Bart was here for a visit as was Reina who last saw us Friday
night at a performance of The Magic Flute.Calls from the kids and
Victor. Made a tennis date for April 21st. Will I keep it?
Big moment when I was able to use the toilet seat by myself for
the first time. It's amazing how the utterly commonplace becomes
the extraordinary in a matter of days, but no complaints from me.
So I never did use the bed pan.
Too bad I'm making no progress at night. More clock watching
through the early AM hours even though the dosage on my sleeping
pill was increased to 30mg.
Day 4, Thursday, 2/24/05
Switched today from the hospital to the rehabilitation facility
where I may be staying for up to ten days. Ugggh! But I guess the
longer I stay, the more intensive the rehab and the more complete
my recovery. So I'm ready although I'd feel better about it if I
didn't have such a sleeping problem.
I did have what I felt was sort of an epiphaney (that spelling
isn't even close) late afternoon when I was able to get into bed,
raising my left leg without assistance, somethat I have been
unable to do. Horray!
More therapy. Walking. Stretching. Moving legs up and down, out
and in while stretched out on a mat. I already feel I'm doing
more than yesterday. Senior therapist here seems to be a lady
named Haydee (I think) who has a dour expression but a sense of
humor to go with it and a firm approach to making my muscles
operational again.
Tonight's sleeping pill was a 5mg twin of the diazapan I take at
home > although this was the brand name Valium. Tried watching
a couple of the past Oscar winners being shown on TV this week in
anticipation of the 2005 > Awards beng held this Sunday.
Thought they might have put my in sleep mode. Didn't help.
Day 5, Friday, 2/25/05
Rang for the nurse at 5am and she agreed to let me take a shower
at that strange hour. I haven't showered since Sunday night and I
think my exhausted mind had begun to obsess on how filthy I had
become as I lay awake during the night. In any event, she agreed
and it was absolutely lorious to spray and soap myself in the
early morning gloom while seated on the mobile toilet stand. I
even slept for an hour or so afterwards before breakfast was
brought to the bed.
More therapy during the day. More visitors including Bill and
Joan who brought a beautiful bromiliad with a "get well
soon" balloon attached. So thoughtful. It competes with
Roger's artificial orchard, which is apparently so realistic that
it has deluded a few of the nurses to come close for a sniff.
Therapy continues. Explanations of how to go up and down steps in
safety, stepping on and off platforms properly getting on and off
tables, plus more stretching or muscles that I haven't used
recently because of my problem or were damaged during surgery.
That's where some pain does erupt as the muscles are stretched
and manipulated but it all seems relatively incidental to me.
I've become increasingly impressed with this hospital as the days
wear on. The administrators really seem to have their act
together. I could sense nothing but professionalism and care in
the pre-op stage and - after returning to my hospital room -
compassion, responsiveness and enthusiasm by the nurses and their
assistants in their dealings with me. I always felt that they
were truly interested in my welfare and genuinely enjoyed their
work. I never felt for a moment (and I should not) that I was
intruding or being a bother when I had any request, no matter how
trivial. It seems to me that almost completely this was staff
that genuinely enjoyed what they were doing and that their
patients' needs were never an intrusion but rather, as it should
be, the reason for their being.
The same holds for the rehab staff, first on the hospital side,
and since yesterday in the Rehabilitation Center.
Day 6 - Saturday, 2/26/05
Bad night again with interrupted sleep throughout the early AM
hours. But I felt much better after some breakfast. Brief visit
in the morning from Leonard Hayet and later Nancy arrived with a
new Acer laptop with which I am composing this epistole. Fun
watching my DVDs on the screen and listening to the CDs which
Nancy carried in.
Physical therapy limited to one session where I think I'm making
good progress. Nancy sat in on an Occupational Therapy session
with Iliana who uses sarcasm and humor to ingrain the importance
of safety in my movements here and in the days to come when I'm
set free.
Perhaps my favorite nurse was the one on duty for the week-end,
Pat from St. Lucia, who tried so hard to convince me that I would
sleep better tonight and in a very small sense succeeded.
Day 7 - Sunday, 2/27/05
Still little sleep last night but better than the night before
when I really moved close to the edge.
Very little therapy activity and, as a matter of fact, the only
activity at all was perhaps half an hour with the pleasant
therapist (blond gal to fizzled hair) who walked with me and my
walker and then supervised some exercises in my room. She was
very friendly and pleasant.
Fred and Eva were (aside from Nancy) the day's only visitors.
They're getting ready for a three-week trip with Joan and Leonard
in a few days.
The big event tonight was the Oscar Awards ("Million Dollar
Baby" won best picture) which was great for me because I
delayed my trying to go to sleep until after midnight.
Day 8 - Monday, 2/28/05
It's the start my second week in the hospital, abet most of the
time in rehab. Last night was he first during which I can say I
at least managed a few consecutive hours of sleep. But even this
was relative. Put my head down near 1 am but I did doze off
rather quickly until about 3, when I rose to sit in the lounge
chair for about half an hour. Then back to the bed until about 5
when Nurse Pat awakened me to draw some blood. Then back to sleep
until about 8 when I was awakened for breakfast. That's a
glorious difference from all the nights before.
Two sessions of Physical Therapy today with the usual stretching
and more focus on training myself to walk without a hitch by
keeping my left leg straight before my right leg swings past it.
I'll do it, especially that now it is clear both my legs are the
same length and there's no physiological reason why I need to
limp when I walk. The therapist had insisted that my legs were
the same length when I said yesterday that I had been told there
was a difference so today she and Heyde actually measured each of
them with a tape measure and confirmed that they were
identical.
Made me recall when I first brought up the subject of difference
in leg length when I visited with (deleted), the anti-pain
doctor, about a year ago. She foolishly accepted what I said and
urged me a use sole inserts to raise one leg a bit. That was a
bad idea. Have to remember that even good physicians have
limitations - even someone like (deleted) who I've described in
such glowing terms over the years. Maybe that it true but perhaps
it should be limited to the cortisone injections she seems to
handle so well.
Same gal also took me through the paces of climbing and
descending steps and the proper movements getting in and out of
the front passenger seat in an automobile. The latter exercise
took place in a rather unusual location called Bachelor Village,
a complex with storefronts, counters, a car, even a little beach
where injured people have a chance to practice safe movements in
a miniature make-believe world before they are actually
reintroduced to the outside world. Quite extraordinary, I
thought, and another example of the many things this hospital
does right.
Anyhow, had two additional sessions with Therapist Ileana - one a
group sessions featuring arm, neck, shoulder exercises, and
another on dressing techniques using the "gripper". She
and the others keep up the reminders about no crossing of the
left leg, no turning of the left foot inward, no breaking the
90-degree line between waist and left knee - all safety measures
to prevent any possibility of dislocating my artificial ceramic
ball and socket. Annoying to be reminded so often but I probably
need the attention.
Back in my room at the end of the day, my weight is still about
178. Talked with Glenn, Judy, Denise, Adam, Mary, Rachel and
Bart. Told Nancy to remain at home and catch up on her sleep
which she did. She sounded more relaxed when we talked about 7.
Having this computer makes everything more manageable. Hope I
sleep well tonight.
Day 9, Tuesday, March 1st, 2005
This will probably be my last full day here. Dr.(deleted), who is
the rehab center physician, said as much this morning and
confirmed it later in the day.
Which helped spark more enthusiasm on my part for the four
sessions today. The two PC sessions seemed more advanced as my
latest therapist (a lovely young gal who is actually a therapist
in training) put me through paces to encourage me to straighten
my left leg as I walk so I can return to a normal gait and also
did some more aggressive stretching and muscle shaping, all of
which is designed to strengthen my left leg and extend my stamina
and get me back to normal.
The other two sessions with Iliana were devoted once again to
safety at home (bathroom, kitchen and bedroom) with another group
session focused on some simple experiences and more general
safety considerations.
Nancy visited for a few hours in the afternoon. Bart called to
tell me that he dropped by yesterday in late morning but, when he
found me asleep and snoring loudly, decided to leave me be. Good
idea.
So here it is nearing 10 pm and the end is near. Hopefully
tonight will be the one where I lay me down and sleep normally.
That would be grand but what seems even better is that it appears
that what Dr. (deleted) promised is coming true. I do expect to
return to whatever was normal before the arthritis consumed by
left hip. Already, the type of pain I felt in my
left leg when I awoke each morning at home is gone. Hopefully,
the rest of the positive scenario will play out during the next
six weeks.
***************************************************
January 1st, 2007
Postscript: It is almost two years later, January 1st, 2007.
First, the results of my left hip replacement in 2005, described
on the preceding pages,were uniformly excellent. My rehab - three
weekly one-hour sessions for four weeks - went well with full
strength on my left side returning. Eight weeks after the surgery
I was fully active, even to the point of
playing tennis once again.
But then came some bad news. Roughly a year later, in early 2006,
I began experiencing some discomfort on my right side, with
similar symptoms to those two years ago on my left, including
discomfort when walking continuously for more than about five
minutes. I ignored it for a while but then decided that if the
problem was the same, there was no point in
delaying the inevitable. If my right hip needed replacement too,
I decided to do it sooner rather than later. Who know whether my
health would be the same in the future of if other unforeseen
circumstances might intervene. It was never a matter of survival.
That I could always do that although I assume the crippling
effects of an anthritically affected hip would simply get worse
and worse. In the past, there would have been no other option
other than to curtail one's activities, take medication, grin and
bare it But I was determined, as long as my health allowed, to
take advantage of whatever modern medical science could offer.
So in the Spring I made an appointment with the orthopedist who
had done the first implant to check out the possibility of a
second implant. He took x-rays and concluded that the time wasn't
right, that the anthritis, though evident, had not reached the
point where surgery was an appropriate option. He wasn't about to
be convinced otherwise so I assumed there was nothing to do but
wait.
However, my opinion changed in September, when my wife, Nancy,
was seeing another orthopedist named John W, about a problem she
was having with her neck and shoulder. I mentioned my concerns
about my hip to him and he agreed to take x-rays and render an
opinion. He did that and, once again, the results were muddled.
Yes, the arthritis was causing problems but he suggest we first
try deep cortisone injections to the area followed by four weeks
of leg strengthening therapy.
I agreed and we went through the process. First the injections
under anesthesia on an out patient basis. The next day it was
like a miracle. No more pain, not even a twinge of discomfort.
But that lasted only a day or two. The discomfort returned,
although not with the same intensity, and I undertook the second
segment of the plan - the four weeks of therapy sessions at a
(deleted) Center near my home. They seemed of some help but I
still felt I was postponing the inevitable so, with the
concurrence of Dr. W, I arranged for a second hip inplant (the
right one) for December 14th, this time at (deleted) Hospital.
All the same procedures leading up the big day as two years ago:
the EKG and chest x-ray, the pre-op examination and blood work by
my family doctor, a dontion of blood at a community center to be
used just in case, a final pre-op exam and registration at the
hospital and finally - on December 14th - my admittance to the
hospital.
Having reread my daily impressions from two years ago, the
sequence of event s this time was remarkably similar. In and out
of surgery, a painless couple of days and little food afterward.
Much better, however, were my sleeping habits which, while
restless the first couple of days, were relatively normal.
My rehab within the hospital began literally less than 24-hours
after the surgery and within a couple of days I was managing some
movement of my right leg and hobbling around the rehab center
with a walker.
Four days later I was in an ambulance being transferred to the
(deleted) Rehabilitation Center when I was to spend six nights
passing time and participating in twice daily therapy sessions.
Half of these, inexplicably, were spent on improving my upper
body strength which, while I guess it is always useful, seemed to
me to be a waste of time since my
right hip and leg is what needed the strengthening. But I had no
interest in disputing the treatment. Instead, I looked forward to
leaving the place as soon as possible.
While is what I did on Sunday, December 24th, courtesy of a ride
from friend Bart. The ride happily uneventful and a delight to be
home. > Two days later,the day after Christmas, Bart also
provided the transportation to (deleted)'s office where the
operation was pronounced a success, the staples (stitches) were
removed and the paperwork begun for a
series of rehab sessions at the )deleted) Facility on (deleted).
Today is New Year's Day 2007 and, almost exactly as I ended my account nearly two years ago, I am awaiting the start of the final rehabilitation program which I assume will conclude as successfully as the one two years ago.
FOR AN INFORMATIVE AND PERSONAL ARTICLE ON PRACTICAL SUGGESTIONS WHEN SELECTING A NURSING HOME SEE OUR ARTICLE "How to Select a Nursing Home"
by Daniel Greenberg
posted January 6, 2007
To e-mail: hrubin12@nyc.rr.com or rubin@brainlink.com