I am the new owner of a ceramic-on-ceramic THR completed with the anterior approach. Today is post op day 3.
Surgery was supposed to start at 8:30 am but didn’t get started till closer to 10am. I was in my inpatient room by a little after noon. Surgeons have different anesthesia preferences and I have to say I wasn’t doing back flips over my surgeon’s preference of a general and a paralytic block (this of course required intubation). My choice of anesthesia would have been a spinal block and one of those mirrors they use during cooking demonstrations so I could watch the whole thing! Since that wasn’t going to happen I came to peace with the fact that the top priority was that my surgeon was in a position to do his best work and that my health was not being placed at any undue risk.
Post anesthesia effects were the cause of most anything I experienced that afternoon and the 1st night. I requested that they remove the catheter that would allow me to stay in bed and not have to get up to go to the bathroom. While it may have been more work on those around me, those periodic rises from the bed and transfers to the bedside commode really helped work out some kinks in those first 12 hours post op. (Fair warning-you get a lot of fluids during surgery so these could be frequent trips and your definitely not independent at that point.) I was pleased that my pain was very minimal and I was not requiring the pain pump. Sleep the first night was almost nonexistent-I was wide awake!
The lack of sleep the first night made post op day 1 very long. I kept hoping to crash for a nap-but no luck. Early in the morning PT came and took me for a walk and introduced me to 3 exercises to do 3 times over the day. He returned and walked me again-a little longer this time- near the noon hour. This was to be our last interaction for the day. My protests that the therapy was a little elementary were met with little sympathy. Nursing let me gain more independence in the room-graduating from the bedside commode to traveling to the bathroom and transferring from the bed to a chair without having to call them. My pain remained well controlled and since I didn’t need the pain pump I was able to lose most of the cords that were attached to me. By late afternoon my attitude was failing-I was feeling trapped, I’d watched the clock tick by in ½ hour increments for more than 24 hours and I’d battled a way too large hospital gown that when tied the neck was still larger than my shoulders (this had been met with an apology from every employee that they just did not have gowns for small people). By the time the PA came in I was cranky and I wanted to go home!! No go-but I was able to lose the hospital gown and get into some of my own clothes-the incision drain was easily managed around pajama pants. Several of my family members brought in dinner and that helped pass the evening. By the time they left I was getting sleepy-Finally! Maybe my earlier protests had some impact because the nursing staff let me cruise the halls again before I crashed.
Night 2 was looking up! I fell asleep for a couple of hours and woke up in PAIN-the worst I had experienced so far-not hip pain but neck, sternum, core, back etc. Felt like I had done a really stupid workout. Some of this had been setting in earlier in the day and I was told that it was from positioning and movement of the table in surgery. (If your thinking about an anterior THR then check out the table and how it works on youtube-somethings gonna hurt!) A few good old fashioned arm, neck and core stretches sitting in a chair helped and I took some pain meds I had elected not to take earlier in the evening. After that I slept all night!!
Post op Day 2-Time to go home!! Nursing changed out my monstrous pressure bandage for a very compact waterproof one that I can shower with and don’t have to worry with until I return to the doctor. Next up it was shower time-I was pleased and surprised at how little impact the THR was having on my function. Although I did not have full range of motion it wasn’t worse than pre surgery and some things were already better. There was a (good) looseness in the joint movements that I don’t remember the last time I felt. I wasn’t experiencing any problems with balance.
PT was next-that included a slight advancement in the exercises, more hallway cruising and stair climbing-I was astonished at how easy stairs were. I had been working really really hard to climb stairs-WOW! My doctor came in while I was cruising around and was pleased with what he saw. The only challenge I really faced in day 2 was pain meds. I walked out of the hospital with entirely different pain meds than I had been taking in the hospital. Transitioning home was surprisingly easy.
Post op day 3-First full day home. My goal for today was to get the pain meds figured out. I just had not experienced enough pain to justify the side effects of the prescription medication so I alternated over the counter ibuprofen and Tylenol with great pain control all day. My original plan was to use the prescription at bedtime but I don’t think I’m going to need it. I met with the nurse from home health and qualified for home PT at least for the next week. I’m still using the walker around the house not because I need it but because I have 2 small kids and 2 dogs running around and the walker is a good reminder for them to give me space when moving around. When I’m in a room by myself I’ve not used the walker and it’s not been a problem. I am still limping and I could really use some stretching but will address this with PT tomorrow. I made a few trips up and down the drive way which sits on a hill without difficulty. Tonight I’m dealing with some mild swelling around the incision but ice packs seem to be helping.
Through this whole thing I’ve sat on the edge of impatient/frustrated with some of the conservativeness I have “perceived.” Today, the home health nurse gave me some very detailed information developed by my doctor specifically for his patients. I’ve realized my doc has a clear and trusted process and it works or he would not be having the success he is having in such a short time. I tell the patient’s I work with all the time to just trust my process. I need to relax take my own advice!!!
A note about my hip-My doctor took some awesome pictures of it and spent some time letting me know what I was looking at. He texted them to me-I’m very grateful for that. He told us that this is one of the more severely distorted hips he’s taken out and he just didn’t understand how I was not in more pain. He’s also offered to let me watch one of his surgeries in the near future-I just may have to take him up on it.