skilled nursing facility vs at home care

[YaYa Girl]

Hi!

Newbie here although I've already had THR on one hip and am undergoing surgery Monday Dec 3rd for resurfacing. My question
is should I use a skilled nursing facility post op or should I just do physical therapy with home health care?  I can't recall being
offered either the last time.  My husband will be able to care for me the first week at home and like a lot of people are saying
on this website, everyone heals eventually.  I am 4 years older (57) than the first op, in fairly good physical shape. Just wanted
some thoughts on what some of you might have found beneficial.  Thanks in advance!

YaYaGirl

[Pat Walter]

Hi

Welcome to hip talk.  Is your doctor suggesting you use a skilled nursing facility post op?

I was 61 when I had my hip resurfacing.  I used Dr. De Smet in Belgium.  I was in the hospital 2 1/2 days, then went back to the Holiday Inn for 9 days. We had our PT there.  We all ate 3 meals together each day in the resturant and partied in the lounge every night. There were 8 of us.  I did have my husband with me.  He helped me with my TEDS removing them at night and putting them on in the morning.  Other than that, there was no need for any help.  I was on one crutch at 4 days and no crutch at 4 weeks.  I was sightseeing in Ghent 7 days post op with others.  We learned to do stairs in the hospital. By the time we flew home on day 10, I was walking 3/4 of a mile with one crutch.

Hip resurfacing is a major operation like a THR, but your recovery normally is fast and easy.  I took no meds except Advil after leaving the hospital 2 1/2 days post op.  When I got home, I decided to do PT and they only kept me 3 sessions since I was so far ahead of the THR patients. They did not know what to do with me except tell me to stop using the crutch, which I did not do until 4 weeks post op.  Dr. De Smet tells you to use a crutch until you don't limp. 

I can't imagine why you would need a nursing home.  You can do anything you want several days after surgery.  You learn to do stairs and if you are on one crutch you can walk around carrying things. 

I was not in good physical shape since I could not do anything due to terrible hip pain. If I had to have my other hip done, I would strengthen my upper body so I could use the crutch better. In Europe they use elbow crutches which are much easier to use than under arm crutches.

Was you THR a MOM or ceramic on ceramic?

I am not trying to brag with my story, it is just the experience I and many other De Smet hippies had.  I tell it so you understand that you can easily get around after going home.  You will be very tired and sleep, sleep and sleep.  I did a lot of sleeping in my lazyboy recliner since I just could not sleep well on my back.   I was able to sleep on my unoperated side with a pillow between my legs by about 9 days post op.  The heprin shots to my tummy seemed to be what kept me from sleeping. We took them for 14 days. Once I quit them, I began to sleep better. Most people have trouble sleeping.

A handful of De Smet bi-lats actually traveled to Belgium alone, stayed alone and returned by themselves after surgery. So if a bi-lat can do that, you should have no problems being at home with a hip resurfacing.

Everyone has a different recovery.  The US doctors are normally more conservative than the overseas doctors.  They usually are not as experienced so become very conservative to make sure things go right.  Dr. De Smet has done over 3000 hip resurfacings and over 3000 THRs.  He has it down to a science.

Please let me know what other questions you have.

Pat Webmaster/Owner Surface Hippy

[YaYa Girl]

Thanks Pat for replying so fast.  Went to see the doc today for pre-op and he said he would only advise skilled facility if
I was not progressing "normally".  Said I'd probably be in the hospital 2 to 5 days.  Your recovery sounds monumental!  I remember
the first month with my THR was awful, but I plan on being on the move as much as my muscles will let me. My THR was MOM.
My doc's not a big fan of stockings, but kept my old pair as I knew this day would arrive. Might drag them out if they make
my legs feel better.  I had forgotten about the heparin shots Ugh! Anyway would like to have the next two months behind me
already! Will let you know the progress....thanks again.

Kathy

[Pat Walter]

Hi Kathy

My recovery is very typical of most De Smet, Bose and other overseas surgeons.  Their surgical skills are excellent and they don't seem to bother anything in the hip that doesn't have to do with the surgery. They also have good leg handlers and know how to dislocate the hip with the least amount of tramua.  You can read many real stories here  http://www.surfacehippy.info/hipstories.php

I once asked Dr. De Smet how come we do so well and his answer is:  he has 2 good hands, some brain cells to go with them and a LOT of experience.  It does make a difference in your recovery as to how everything is done during surgery.

I have many stories from people using the US doctor on the above page too. 

I think you are going to be very surprised at your recovery - at least I hope you will be among the normal that are off and running fairly quickly. 

Here is a photo of the great crew of hippies I was with in Belgium. We had great fun.   There were 4 of us here, we are the ones with a crutch    There were 8 of us there at one time.  Now everyone goes to the Villa, a beautiful rehab facillity with a pool instead of the Holiday Inn.  They have you in the pool after you leave the hospital.  The water feels great. In Europe they use waterproof bandages so you can shower and get in the pool. They also use just stitches for the ladies which I thought was nice. 

Please keep in touch. Who is your surgeon?

Pat

[momzer2]

I, too, would suggest going home and having visiting nurses for any rehab the first week or two.  After that you will likely feel well enough to go TO the physical therapy facility.  A lot of doctors don't believe in PT, but I thought it helped a LOT.  My PT gal did lots of balance work, strengthening and stretching (that you can't do to yourself!).  Any agressive PT should be held off til about 3-4 weeks post-op anyway. 

Heparin is not used much anymore, it's been replaced by Lovenox which is less irritating and less dangerous.  I'm a nurse and I haven't seen anyone go home using Heparin in a LONG time.  Not that it matters cuz you may be lucky (like I was) and not have to continue shots after discharge.  I only received 2 injections in the hospital.  I made sure I pumped my ankles/legs and got up and moved around a lot, even though it was a little slow at first.  There isn't a whole lot of pain afterward, especially if you are used to the pain associated with needing a new hip in the first place!  Being in your own home and own bed is worth millions...

I'm now 10 weeks post-op and doing very well.  Going back to my nursing job next week.  I am currently power walking about 3 miles a day.  Can't resume running til 6 months post-op which is perfect cuz in late March it starts getting warm here in the midwest!!  yeah.  Good Luck to you.

Karen 9-18-07 LBHR Barba