Hip Replacements-What You Need to Know and What your Doctor Doesn’t Know

 

Your doctor will likely tell you that you will swell and have pain. But, is he or she going to tell you that it will hurt to pull up even your underwear after surgery unless they are really big and stretchy? Will he or she tell you that even the loosest pants still may not fit over your giant thigh after surgery?  Keep in mind that often you will go to physical therapy within a day or two after surgery so ladies a dress is out of the question…..best to find you some big shorts girlfriend.

The answer is your doctor is not likely to share these things unless you have a very close personal relationship with your surgeon.  Most times, you are fortunate if your surgeon or their team reminds you to take a stool softener several days before surgery (no knock on them, I just have had enough surgeries to tell you that it is a rare thing for them to suggest).  Don’t get me wrong, I had a fabulous surgeon and experience, and they prepared me well, but I did learn some hip things that I want to share. I started my Colace and fiber days before surgery. This was not my first rodeo, so I know that starting after surgery is too late.

I had my total hip replacement “THR” nearly three weeks ago. It was a lateral approach. This means that my incision is right along the side of my hip where pants have a side seam. My swelling was all along there and up my abdomen and along my entire leg as well.  In addition, I retained water in general post-surgery and could not put my rings on for a week. I could not recognize my body at all from my neck down for quite a while.

Fortunately, I have a variety of loose clothing (eating disorder history) but not nearly enough because it had to be so stretchy to get over the new girth of my hips. My right hip was swollen for a while too; during surgery, I was sideways and in a vice like a slab of wood (not joking). However, even my long pull-on skirts, which were convenient, were painful to pull over and take off my new womanly width.  Loose elastic soft pants are your best friends……put your cute, high-compression Lulu leggings away for about six weeks or so. There isn’t any way those are going on free of pain…… if you manage to get them past your knees. Joggers are a good option because you don’t want wide legs that you can trip on.

On the upper half, go for the loose and large options as well.  Remember the first two weeks, you will likely be icing a lot so even though it might be hot outside, you may be cold due to an ice machine being on your midsection and you may have some abdominal bloat so you will not want anything hugging you anywhere.

As for the underneath, minimal is best. Go as minimal as you can personally tolerate. Enough said? Maybe try out some types ahead of time? A lateral approach is wonderful, but it might be the most difficult underwear-wise due to where the incision is located which is on the side and higher up on the leg (at least mine was). No matter the approach, the undies can hurt when going up and down.

While we are on the sensitive private matters, showering. You are not going to be able to safely get in a tub for a while. Plus, initially you are not allowed to submerge your dressing anyway. So, you have to shower or sponge bath. You need a walk-in shower.  You will not be able to safely step into/over a bathtub shower. A shower seat is worth the few dollars to purchase. Even though you are able to stand right after surgery, it is hard to do very long, and the washing is safer and easier sitting. This is also the time to embrace not shaving…it is hard to bend from the waist and you often are not allowed. So, don’t! No walk-in shower? I don't know what to say. Have surgery in the summer and hose off outside? Join a club and shower there? You can only sponge so long, know what I'm saying? (I started planning my bathtub and toilet reno five years in advance). 

Comfortable posture after surgery.  My recliner and our reclining furniture were a Godsend. If you have it, use it. If you don’t have it, try your best to work something out that closely resembles it like a chair and ottoman or your bed with some leg and back elevation. Having your legs up is a must but having your back slightly reclined is too.

Getting into and out of your car and bed will be the hardest things you do, and you will need assistance getting your leg to lift for a while. Next in line is getting up and down; sit to stand. Sitting upright in a desk or kitchen chair are also pretty painful in the early days. I lived in my recliner for two weeks essentially. Stairs surprisingly are not that difficult but if they are required, I would suggest having a cane immediately.

Don’t be too proud to use a walker. Whatever it takes to walk with the best stability, posture, and most natural gait is what you should use. Your doctor can give you an RX or you can likely borrow one. You will need it for only two weeks in all likelihood unless you are elderly. After that, I progressed to a cane for a about 12 days. People were super nice and extra friendly to me in public while I carried my cane by the way.

Getting out. If you are replacing your right hip, you may not have great muscle strength/control and it might be a while before you are comfortable driving. If it is your left hip, as soon as you are done with your pain killers and are ready, your doctor will likely give you permission to drive after a week or two.  As far as socializing, I could have gone out to do something socially after about a week if I had to but I certainly did not want to until about two weeks out and then it was still a bit tough to sit up without pain.

Working was tough again due to the sitting. It was much easier to work from home and only sit for short periods at my desk during the first three weeks. The first two weeks, I worked minimally and the third, I was keeping a much more normal work schedule but from home.

Healing. Fatigue. PT. Ice. Sleep. Speaking of going to work. You will be tired those first few days and weeks while you heal. You and your helper, hopefully you will have one at home to get ice and medications for you, will be busy.  You will have PT exercise to do, ice to have on, you will be resting, and eating. The days flew by surprisingly fast for me doing just those few things….and I did not even feel like reading a book or watching a movie the first few days. Just think veg. Each day does get better, and the improvement is measurable each day. 

After two weeks, I could put both my socks on which is one of them most challenging things mobility-wise….I am pretty bendy anyway which helped me. You may have different precautions depending on your surgical approach.  My lateral approach allowed me to bend forward more once pain allowed me. But you can see you may need assistance with shoes and socks for longer than you thought (there are tools available for this if you live alone). Speaking of tools. Let's talk about aids.

The only tools needed if you do NOT live alone are the shower chair and walker and possibly a cane. Assess your toilet situation ahead of time, if it is a higher one, fantastic. If you have handrails or something to allow yourself to hold onto (a counter), great. If your toilet is a standard height one and you do not have grab bars, consider how you are going to make this easier. you are going to need to hang on for a period of time. There are seats with rails to go over the commode if you do not have handrails or someone or thing to assist you. You might consider installing a handrail.

Planning! No need to get a grabber/reacher or sock tool or shoehorn when you have a house assistant😊 There are several things that you should be aware of on your schedule that must be considered. You cannot have any dental procedures within three months after your replacement…..and ladies, you may also have to consider your visit to the lady doctor as well. I was thrilled personally, I had to reschedule the dentist as I was supposed to go three weeks after my surgery. There are a few other things that you cannot take or do about a week before surgery so keep that in mind as well. 

Typically, dental exams will need an antibiotic going forward for the rest of your life as well….and no exam a month before or three months after surgery. So, plan those wonderful visits accordingly! Also, you will likely be on aspirin for about a month after hip replacement and also an anti-inflammatory as well, so you won’t be able to have any other surgery…too bad right?

And again, you may be surprised at how unusual you look for a while. This is not like having a swollen wrist, knee, or ankle. When your hip is swollen, it can mean clothes literally do not fit.  According to most documentation, it can last up to twelve weeks or so. If you are going to be in a wedding or wear a form-fitting gown for a special event, I am just saying plan ahead! Good thing those wide legs are in style!

My swelling has come down but based on where it still is, it could be a while before I am evenly sized again.  I will not be wearing anything remotely form fitting for a while. Nonetheless, I could not be more pleased about my new hip.

One of my biggest complaints about my hip was back pain and I am feeling relief in my back already. I am so happy about the way it has all gone and I have the best family and friends who have showered me with good food and their time. I hope your experience is just as good as mine. There are definitely a lot of other more important things to know about before and after surgery, but Google can tell you most of that already. Do your research about your doctor, surgical approach and implant!!

Final Note for the Elderly

Elderly individuals should go to rehab for two weeks unless they have a young and able caregiver for 24/7 for at least two weeks. My mother had THR and her doctor did not send her to rehab or even PT... this was before I had mine and I was clueless at the time. (That was a huge mistake, and I cannot believe he allowed it). We were able to care for her thankfully, but this surgeon's pre-and post-operative care were dismal.