After two hip replacements in 5 weeks, I will hopefully never know more about hip replacement than I do now. Right now I’m 12 days post-op hip #2. Both were the Birmingham Hip Resurfacing, so may not exactly apply to you. So here’s some of the subtle and not-so-subtle things that you should known.

For me, carrying 25 lbs of recycling to the curb was hurting like hell. If you’re 25 lbs overweight, that’s the same as me carrying 50 lbs of recycling down to the curb and then hauling half of it back up to the garage. Sorry, baby; but if that was the case my garage would have been looking like one of those “Hoarders” shows on TV. Not to get preachy, but if you lose weight you will be less miserable. And since you’re reading this, you are miserable. Building upper body strength will also be key to a better hip replacement experience. After the surgery, you’re flat on your back for two or three days. I could lift myself up by the hand grab above my bed and let the blood flow back into my butt every couple of hours. When the nurse was changing the sweaty sheets under said butt, I could again just lift myself up by that hand grab. Without it I’d have had to roll over one way, then roll back over the wadded up bedding, then roll back over the wadded up new bedding, then roll back onto my back. That’s a lot of twisting at a time when twisting is the enemy. Getting out of a chair involves one leg instead of two, and a big push from your arms. If the arms on the chair were high enough, I could pop up and down pretty easily; not so if I were heavier and weaker. So do it for yourself: commit the time and energy to work out and lose that extra baggage. Easier said than done, but big benefits await you.

After the first hip, I felt like I had been hit by a truck. My leg was all black and blue, very weak, very tender. Not so the second; it was like night and day. According to my surgeon, that’s just luck of the draw. After both hips, I did get some significant swelling in my lower leg and ankles, but again less in the second hip. But my second hip had some of the advantages listed below:

My therapy for the first hip strengthened and increased flexibility for both legs. So work out your lower body also during the pre-op stage even though it hurts like hell to do so.

Apparently, I had lost a bit of blood for the first hip, and was woozy and actually passed out two days after the surgery. I’m told by the nurses that this was an exciting event. Anemia, perhaps? So I took a couple iron tablets each day up until 5 days before the second surgery. Also, at home I typically eat five or six smaller meals a day instead of three big ones. Hospitals feed you three a day, and the first day or two you’re on a liquid meal plan until someone pays attention enough to switch you to real food. And remember also that you can’t eat anything from midnight the day of your surgery. That means your tank is running on empty. So bring food with you; soft easy to eat things like bananas, hard boiled eggs, or whatnot. After eating, I always came back to life. Eat before that need arises. Have someone bring you real coffee. Also, sports drinks that don’t have a lot of artificial coloring would be a good choice.

They put an I.V. into the back of your hand that stays there for two or three days. Ask the nurse to put it into your forearm instead. It will be less likely to bang into things, which sucks. I cut the toe end off of a sock and used it to cover the I.V.–HIGHLY RECOMMENDED! The nurse said that she didn’t like putting the I.V. into your forearm ‘cause the tape hurts when you pull it off; but I think that‘s bad advice. Shave your arm if you have to. If you use those nose strips to sleep with, bring some to the hospital and use one during surgery.

For two days after the surgery, you will itch like crazy. It’ll feel like you rolled around in a poison ivy patch, from head to toe. Some nurses said it was the morphine, some said it was the pre-surgical scrub soap they make you use which dries out your skin. Bring with you some skin moisturizer and have your mate cover you from head to toe in the stuff ASAP when you‘re back to being awake. Get a back-scratcher from The Dollar Store. For the first two days they put your lower legs into these cuffs that inflate and deflate to prevent pooling of your blood in your legs; this cuts down on blood clots. But those cuffs are plastic, and you can’t get in there to itch your legs. And you sweat onto the plastic cuffs, which makes it all worse. Again, have your mate liberally apply the moisturizer, and also bring a couple cotton scraps to wrap your legs under the inflatable cuff. A little Benedryl lotion would be a helpful for the really itchy areas, but don’t over-apply it or you may get too much Benedryl crossing over into your blood.

It’s noisy in the hospital, what with the HVAC unit humming away, your neighbor’s call button, the pump that inflates those damn cuffs on your legs, and whatnot. Bring ear plugs and use them. You’ll sleep better, you’ll feel better. You probably won’t feel like reading to pass the time; music was a better choice for me. Bring your better headphones, not your cheap ones.

After the surgery, they put this giant foam wedge between your legs to keep them from crossing. If you really need two new hips, that means that the non-surgical hip will feel like someone is pulling your legs apart like a wishbone; it just doesn’t go that way. Holy sh#& that hurts! Have your mate be at the ready to convince the nurses that this is the case, and that you haven’t crossed your legs in three years anyway so there’s no chance you’ll be starting that tonight. Much of the nurses’ and P.A.’s reluctance to ditch the wedge pillow seems to be a legacy item related to patients freaking out after waking up from regular anesthesia. If you do the spinal, you don’t wake up felling nasty and the spinal anesthesia is still in effect so you can’t really do any more than wiggle your toes.

Potty seats, walkers, remote grab-it sticks, and the like: You’ll need them, but not for long. Our town has a place you can borrow them for free with a modest deposit. ( http://www.fliconline.org/ ) Check to see if your town has one before you buy stuff that’ll just take up room in the garage before long. You’ll need a raised toilet seat, walker, cane, bath seat, and a handle in your shower. Google “Rehab Accessory Pack” for other doo-dads that help a whole lot. The thing that helps you put on your socks is pretty nifty. For the shower, I have a handle that attaches to the shower walls by suction cups. It works well, but keep in mind that it won’t work on tiled surrounds, the suction cups need to be reapplied before each use, and it’s not as sturdy as one that mounts right into the wall. Use it for balance, but NOT TO LIFT YOURSELF UP!

Time off from work: I went into this thing very healthy, so your timetable might vary. I could have gone back to work as an optometrist after two weeks for the first hip. I did three weeks instead, but the extra week was real nice. Four weeks would be too much for most people; but might be right if you’re not too healthy to begin with. For the second hip, I’d have felt comfortable going back after one week if it was scheduled as a short day. I know that didn’t help you know what to schedule for yourself; the point is that it’ll be difficult to predict and therefore difficult to schedule. Sorry.

During recovery, you will get tired very easily. You will need to nap quite often, even if you never ever take naps. Don’t fight it. For my first hip, I needed to sleep on my back for the first two weeks. If you’re a stomach sleeper, that sucks. Sorry, no way around it that I know of. For the second, I was able to sleep on my stomach on the fifth night. Don’t get in bed on your back and flip over; that twisting action on your leg isn‘t much fun. Instead, get in bed stomach side down with your good leg on the side of the bed. You’ll need a little help getting the covers on and off your feet. Don’t bother trying this if you’re not confident that it’ll work; you don’t want to be stuck in some position that you’ll have a hard time getting out of without violating your post-op leg rules. And those rules are for real, even with resurfacing. At one week post-op hip #2, I think I pulled my joint out just a little when getting up off the floor doing physical therapy for hip #1. It didn’t totally dislocate, but did cause me a bit of anxiety for the next 20 hours or so. My lower leg, calf, and foot got a bit swollen, and my hip was a bit sore which set me back a couple days. At the time, I thought I was being rather careful. So there you go.

Don’t bother asking if they’ll do both hips in one day. Although it seems like a good idea to you right now, they won’t say yes, and you really, really don’t want them to anyway.

Morphine machine: after the first surgery, they didn’t plug mine into the wall in the recovery room. After awhile the backup battery stopped working, and so did the button that you push to get more morphine. Have your mate check this for you, as you’ll be in no shape to do the trouble shooting on your own…

Catheter: On my second surgery, they couldn’t get the catheter in right, so I went without. For me, it was better that way. I could pee into the urinal just fine, and it was easier to have one less tube sticking out of me. For you ladies, I have no idea which would be easier. If you use a catheter, it empties into a bag-in-a-bag so if the inside bag overflows, it’ll be caught in the second bag. So nurses can get lazy. But the outside bag isn’t replaced often. Mine leaked pee all over the floor; I got wet feet when I went for my first walk the day after surgery. Don’t let this happen to you. Have your mate keep an eye on the bag; don’t let the nurses convince you that it’s OK when it really isn’t. To be fair, the nurses were wonderful to me. I don’t fault them for things like this, as their plates are pretty full. It’s just that your mate’s extra pair of eyes is very valuable.

Five days after the first surgery, I got a tremendous headache. It felt like the worst hangover of my life. My hip center people said that it wasn’t their fault this far our of surgery, so they sent me to my regular physician who Rx’d prednisone, which didn’t please my hip center people. So if you have any issues and your hip people send you somewhere else, be firm and say to them, “No! I don’t care if this isn’t your fault. I’m your baby till this thing is healed. End of discussion.”

There’s no pretty way to talk about this. Sorry. Pooping after surgery: For two or three days after surgery, you won’t poop because the morphine slows this process down. They give you lots of stool softeners to get things going again. For my right hip (but not my left), I had issues with sitting on the toilet seat in a way that would give the poop a clear egress path to the toilet. So it was messy. Be prepared with some washcloths and towels, or similar baby-wipe accoutrements.

Be militant about making sure that every chair that has wheels on it has the wheels locked before you stand up or sit down on them. Every damn time, no exceptions.

Your mate is your advocate. You need them. Don’t try to do this alone; especially so if your hip is more like my first one than my second. So trust them, and treat them like gold before and after this event is over. Get all your affairs in decent order before the surgery: make sure the fridge is full, the bills are paid, the dog has a place to go, the garbage has been taken out, the laundry is done, the car is inspected, etc. You won’t really be too interested in dealing with surprises after the fact.

FWIW: If you’re even just considering this surgery, you probably need it. My advice is to push your chips all in, baby, and just do it.

Best,

Paul K