Sixteen days ago, I had my wobbly arthritic left hip replaced with a shiny new synthetic joint. I’m still reeling with shock (albeit very carefully, so as not to dislocate it); and while I recuperate, I thought I’d share some surprising discoveries I’ve made for the benefit of anyone about to undergo the same thing.
- Look after your legs. If you have the least little break in the skin, like a scratch or infected midge bite, to avoid infection risks your operation may be cancelled. (If that had been made clearer to me, I wouldn’t have shaved my legs in the shower before my last pre-op check-up!).
- You can stay awake. Apparently most people choose epidural anaesthetics, (with the small associated risk of leaked spinal fluid and paralysis), and remain conscious throughout. Not me. I find the idea of having a needle stuck in my back completely horrifying, and had not the slightest desire to be mentally present while the top of my leg was sawn off and my pelvis re-bored – so I went for a full general, (with the small associated risk of brain damage and death). Admittedly, it’s disappointing to know that had I died under the knife, my last word would’ve been, ‘Ow,’ (as the anaesthetic flowed, painfully cold, into the back of my hand); and that my first utterance on flicking back to consciousness, (‘Oh – is it done?’) was equally banal. But a half-hour later I was happily phoning family, drinking tea and tucking into cheese butties while my two ward-mates were still zonked out after their epidurals and sedation; plus I escaped the unpleasant indignity of being catheterised (short-term bladder paralysis is a common side-effect of epidurals) – so give me the knock-out every time.
- It isn’t too horribly painful. The drugs – initially oxycodin, then codeine – help on that score, of course, and my body responded enthusiastically to both, (although they make some people chuck up). But considering that the op involves an incision some 8 inches long, the after-effects didn’t hurt as much as I expected. The wound itself I’d rate as no worse than ‘sore’. My thigh muscles were painful for the first week, (albeit less so than after my first-ever session of Tae Kwon-do, when I couldn’t lower myself onto a loo-seat for 3 days), but that’s hardly surprising; it’s a pretty forceful procedure, and I had fingertip bruises where the surgeon had grasped my flesh to pull it apart. In the early stages, I found the main pain was a deep ache, bad enough to be extremely uncomfortable until the drugs kicked in, but not enough to make me moan and writhe in agony…
- …unlike the constipation. We eat a wholefood diet rich in fruit and veg, so we’re not usually at home to Mr. Bung-up. However, opiate painkillers make the gut sluggish (especially when combined with the sphincter-clamping effect of a strange toilet, which is one of my personal foibles); so despite choosing vegetarian food, snacking on extra fruit and high-fibre cereal bars, and taking the prescribed laxatives, I couldn’t ‘go’ – and no-one could be discharged until we’d delivered the goods. Consequently our bowel activity – or lack thereof – became a major topic of conversation on the ward; even my fellow inmates’ visitors started enquiring after my bottom, leading to some rather more personal conversations with strangers than I’m wont to have. By Day 3 my appetite had disappeared (no room left inside) and I looked 6 months pregnant; this was probably the worst part of the whole hospital experience, and it took 2 glycerine suppositories to shift things enough for me to be allowed home (where, naturally, my innards greeted the familiar porcelain with a rip-snorting hurrah and promptly began making up for lost time).
- You’re back on your feet very soon. It’s essential to bed the new joint in, strengthen the muscles, guard against deep-vein thrombosis and prevent death by boredom. The moment I stood up after my op, I could feel I had a functioning hip joint again; it bore my weight easily, and the horrible limp I’d had for years was miraculously gone. By the end of Post-Op Day 1, I was roaming round the Orthopaedic Suite on elbow crutches; on Day 2 I could go up and downstairs; and by Day 3, I’d blagged my way off the ward twice and gone outdoors for a breath of fresh air. Back home, the crutches rapidly became an annoyance and I only carried one if I was venturing farther afield than the garden gate; and on Day 8, I came back from physiotherapy with just a walking stick. Meanwhile right from the start, I was less disabled than I expected. OK, I can’t yet drive, take my support stockings on and off, wash my feet, or kneel down to fuss the cat/deal with yakked-up hairballs/scrub his victims’ blood off the kitchen floor; but I’m perfectly capable of light housework, shopping, gardening, and a little computer work. It certainly helps that I’m relatively strong, fit and young for this procedure, and had no other medical complications – not everyone is so lucky – but I’ve been able to resume a surprising degree of normality surprisingly quickly, can already walk better/further than I have done for years, and have the comforting knowledge that things can only go on improving.
- Post-op swelling is quite normal. I was relieved to hear this as my left hip-to-knee ballooned to such monstrous proportions – almost twice the size of my un-operated leg – that it stuck out at 45 degrees, and I feared it had become possessed by the ghost of, say, Henry VIII. Ice-packs, massage, elevating the limb and drinking plenty of water to flush toxins out helped a little; then, mercifully, ‘Big Leggy’ maxed-out after a week and began to subside, going down a lot faster than it had swollen, and is now almost restored to its customary shape and size.
- Nights are hard. Even in hospital, day-time activities, distractions and analgesia keep discomfort to bearable levels – and sometimes, when sitting or walking, the wound hurts very little, if at all. Night-time is a different matter; having to sleep on one’s back for 6 weeks (to prevent the joint popping out) is extremely irksome, and the longer periods of immobility make it stiff and painful. So I husband my codeine for bed-time, (whereas during the day I can get by on the odd paracetamol), wash it down with a little drowsiness-inducing alcohol, (not medically recommended!), and supplement my poor nights with an afternoon nap. Yup, it’s a bit of a drag – albeit a small price to pay for being able to walk properly again.
- The NHS can be brilliant. Only five weeks between my initial consultation and having the op; every conceivable precaution taken to make sure I was fit enough and free from MRSA; a pristine incision with soluble internal sutures which will leave a barely-perceptible scar; good-humoured staff who did their best to make my hospital stay as pleasant as possible (to the point of going down to the shop to fetch me a soft drink I was craving); provision of all necessary aids like medication, crutches and raised loo seats to help out at home; and comprehensive after-care including free transport to physio sessions. Sure, sometimes I had to ask more than once for things I wanted when staff were hard-pressed, and found some confusing contradictions between the generic pre-admission information and practical realities; but considering how overstretched our health service is, I’m extremely impressed by my hospital and out-patient care – not to mention extremely grateful for it.
So all in all, if hip arthroplasty looks like featuring in your immediate future, try not to worry. It may not be exactly fun, but it’s not nearly as bad as some surgical procedures – and if my experience is anything to go by, your life will be transformed in no time!