Pre Op Fitness and Preparedness

Bones, joints and muscles
1

I have read a number of posts regarding symptoms post op.  They all seem to fit into a similar category, and that is a lack of knowledge of how the anatomy of the hip and leg work together.  I am going to do a search on the www to see if I can find something on there about the muscalature and nerves of the hip and leg, that may be of some help when symptoms of one sort or another flare up post op.  Hopefully, it will give reassurance to us all when these "quirks" make themselves known as our bodies repair post op.  

Also, there does seem to be a variation on how the first few days after release are managed and the level of assistance that is required.  I find these variations worrying, as I live alone, with no outside support other than what can be arranged independently.  I have a daughter, but she cannot drive, so would not be of any assistance, even if she could leave her work commitments and get here!  I am sure she will try to help, but her commitments are strong ones.

I am becoming increasingly alarmed about those first few days now, as I feel that I have been given misinformation on the levels of what the hospital would regard as sufficient competence to manage on my own before they will release me! 

2

Hi Susie

Good to hear from you...point well made.

I'd add, at 10 months post op, as well as the importance of pre op fitness, a need for a self knowledge of ones' own psychology and motivation - so that folk are often too reckless or timid in their recovery phase. Too much different hospital information and advise too.

But, stay with it. Most of us find a way forward, and six months on despite confusion seem to be very happy.

I wish you well...and accept it will be harder for you without someone to put your sox on during the first weeks.

Warm hugs

Mic

X

3

Hi Mic:

Immense confusion regarding the various reports of post op experiences.  Most of this is down to the age and fitness levels of those reporting their experience.  Whether or ot not they have tried to maintain any level of fitness pre op, etc., and whether they have any idea at all of their own anatomy and why recovery symptoms flare up in the various nerves, muscles, etc., as they readjust, and what to expect as the wound heals, and the muscles and ligaments that were involved in surgery,  

I hall now have to pseak with my GP again about what she had said regarding post op assistance.

4

Susie - Having been there twice over, you can move about, 12 hours after your surgery, with crutches, mine were elbow crutches, because of my pre-existing arthritis in other joints, more than I expected, I know when the Dr first told me I would be in hospital 3 days I nearly fell off my chair, and the idea of such a short time scared me, take all the time they will give you in hospital, food???? supplied, nursesand physio's to support you physically and mentally, I found I was very active, getting around, the house, and out into the concreted area in back yard, but only for a few minutes at a time, then the tiredness kicks in, husband set up a chair in the backyard as well, but he used to get annoyed with me saying you have only been there 2 minuets, getting out in the sun seems to be very healing, know this is almost impossible if you are in England at certain times of the year. But the first week or so after you get home you will have no energy, probably a little depressed, you won't even feel like eating. You just have to go with the flow, and sleep rather than fight it, yes your day and night will be a little muddled up for a while, and I think worrying about it is wasting even more energy, but you do seem to come right after a few weeks. Getting those pressure stockings on is one of the biggest hurdles if you are alone, do you have district nurse service, or do you have a charity home helper in your area. Re meals, for after surgery, prepare beforehand some very light meals, eggs, easily digestable well cooked chicken, beef, fish, protein is very important after surgery, re-building muscles, and marrow. You are not going to know yourself after its all over and wonder why you were soooo anxious, natural to be anxious with the unknown I think. The then later you will be able to help others with your experience.

5

Hi Susie

I hear what you are saying, the problem is that no matter what your age, your fitness level and even your knowledge of anatomy you dont know how your recovery is going to be until after your operation. After the experience of 2 hip operations this year, I would suggest that you prepare as much as possible in advance to make life as easy as possible for the first two or three weeks when you get home after your operation.

I dont know if you have got a date for your operation yet but if possible could you arrange for your daughter or a friend to stay with you for the first few days (on the couch if you havent got a spare room)?

I have been lucky to have my husband who has been a great help, after the first week at home he went back to work so I was by myself from 8am-6pm every weekday and I managed. But it helps to have someone you know you can contact in an emergency and/or who can help out from time to time.

I know you have done lots of research over the last few weeks and that is going to be a big help as you start to plan for post op at home but there are things you may need help with. The Ted stockings for instance - first of all does your surgeon insist on his patients wearing them and if so can you or your Occupational Therapist arrange for a carer to come in to put them on/change them every couple of days usually for 6 weeks? You might be lucky and you wont have to wear them!

Im not trying to worry you, only trying to give some practical advice. I am 65 and each operation and recovery was slightly different and I have luckily had no real problems post operative just the usual roller coaster highs and lows that all the lovely hippies experience in the first few weeks which can really take you by surprise.

Linnet x

 

6

Hi Lyn

Are you American?  I have lived in San Francisco, New York and LA for most of my life, following my career, and have always been self reliant, directing 60 + staff and their staff.  So do not make it a practice to rely on others unless strictly necessary.

I know I shall feel pretty rough for a few days; went through hand surgery in SF twice. If I don't feel like eating, that's fine, a few prawns and an avacado will do very nicely for lunch, and will take it a lot easier on the coffee and tea pots!  I drink a lot of cranberry juice and Welches grape juice.  It will probably be late Spring early Summer before the op is over and done with, so I shall be able to sit out in the garden for as log as is practicable, smelling the honeysuckle, jasmine and the roses, and watching the birds at the bird table and the feeder.  

Will take to my bed whenever necessary.  

We do have provisions over here for physio and other help. Groceries can be delivered by the supermarkets.    

My understanding is that the first two weeks are the worst, and that is probably down to the effects of the anaesthesia, as much as anything else.  Painkillers, are obviously crucial ad the correct prescription may have to be adjusted as time goes on.

I have done my researchm and watched a f=video of the op itself, which Ii will go through again, now that \i have more information.

Very few people appear to have knowledge of the anatomy of their hip and legs, and so when pain presents, they have no idea what may or may not be a warning sign. 

I a already looking at the best resousrces for the occasional ready meal, although I do not care for them.  I know that it is possible to order direct from some of the farms.  My diet consists mainly of salads, vegetables, seafood/tuna, cheeses, some pulses and free range eggs.  If I have red meat, it is usually a small steak or calves liver.  But not durig the summer months.  Very wary of chicken unless I know where it originates!

All the best,

Susie

7

Hi Linnet,

I have already takenn on board most of what you have said.  I do not have a surgery date, and will see the consultant in mid January.

I shall refer back to my GP and the surgeon's secretary for any addiitional help and advice  

I have no idea about whether or not I shall be required to use the TEDs, but presumably there will be some sort of help with those, if necessary  I understand that there is also the opotion of injection.

My daughter lives and works in Bath,  She does nt drive, so would be of little help.  My support system is around the globe, Cape Town, San FRancisco, \los Angeles and \new \york, and \i do not expect them to drop everything and come her to sleep in my second bedroom and get me up to go to the loo for example.  My understanding is that you are not released until you can do that independentlym anyway,  As I have an en suite, it should be too much of a problem.  i do have issues with en suites in bedrooms, when the main bathroom is jst a few steps away!

My recollection of post surgery in San Francisco x two was that I had more difficulty recovering from the aneaesthesia than the op itself, but that was hand surgery.

I know what preparations need to be put in prior to surgery, but it is still too early to put all that into practice.

I have been advised that there are several self reliant people (living alone for whatever reason) on the site, who have managed by themselves without too much outside help.  

Overall, I think it depends on the patient's inner resources, genereal fitness, the surgeon, and the help and advice of not only the usrgeo, but the GP.  

We all recover differently.  My Mother. for example, recovered, at the age of 96 years from a general anaesthetic for the removal of a Merkel Tumour on her leg,  She had a couple of minor heart attacks, after release from which she recovered.    Flu at age 98, followed by pneumonia, for which she was hospitalised, recovered from that and was sitting up in bed lucid, and discussing football with her nephews, before being injected with diamorphine, and dying a week later.

 

8

Absolutely, I think you are going to be very well prepared and will manage well after your operation especially if you are like your mother.

Linnet x

9

Are you in the UK?

If so, you should be able to arrnage to spend a few days in a community hospital between your stay in the hospital where you have your op & going home.

I also live alone & so was able to arrange this (in the Scottish Highlands): the extra couple of days, moral support & physio treatment & advice meant I was keen to get home & had no real problems once I did so - in spite of my bog & bedroom beings upstairs.

Make sure before you go in that you've put everything you'll need (cooking gear, cups, glasses, cutlery, etc.) high enough up on shelves/work surfaces so you don't need to bend over to get anything.  (But, in any case, by shoving your operated leg straight out behind you you can bend quite low ~ enough to get the ice for the brandy & soda/G & T out of the fridge!)  Various supermarket delivery systems work well to stock you up once you get home (provided you havew access to the internet?).  I used the biggest UK supermarket & the service was spot on: driver happy to carry box containing order in to kitechen & leave it on top of the fridge.

Good luck.

10

Very like my Mother, stubborn, obstinate, an enquiring mind, and like a dog with a bone.  Will not give up until I find the answer and get the required result.  Very anaytical and love research...  In general, I can be a real pain in the rear end....

All the best,

Susie

11

Hi Ross:

I am in the UK, but have no intention of going into community care, or rehab.Once I am released, I intend to remain that way, unless there are indicaions that all is not going as it should be, on which case, it will will be either 999 or the GP or surgeon.

All preparations at home, will be taken care of well before time, and I will maintian as much upper body strength as necessary.  I brought my small bar bells back with me from San Francisco, amd continuing with the pre op exercises and have added push ups, etc.

As the op is probably going to be in the Spring, I shall rely mainly on salads, cranberry juice, etc.  Fresh eggs are very versatile, and I do a good American style tuna salad.  

I have already sussed out the supermakets, and it comes down to Waitrose and Sainsburys for deliveries until I am back in my car.

I am very self sufficient and reliant; have had to be, as director of 60 staff, and their department staff, too.

Personal care aids have been identified and what the NHS does not provide, I shall order in online.

I have watched the surgical procedure, so know what to expect, and will print out a chart of the skeleton of the hip, leg, muscalature and nerves.  My former partner in SF was an orthopaedic surgeon, but in a different area to hip.  Out of touch with him, now, but have a good idea of what goes on in US hospitals, at least, both as a patient and his partner!

It really boils down to when the surgery takes place, bringing in what is needed for post op, and recovering from the anaesthesia, which in my case, can be problematical, but I was probably over sedated the first time around.  The second was general, and easier to overcome.

Trust all is well, with you, and you are recovering well.

All the best to you,

Susie

12

I am in Queensland Australia, and here if you are having a hip replacement in public hospital you are having a spinal block.

I was lucky enough to be part of a study by my consultant/professor on the difference between spinal and general, and the nurse, about my age, 64, showed me the graph charts of the differences, Wow, was my reaction, and she laughed and said thats why we are using spinal block, the results are astounding, recovery times, pain, pain control after surgery, lack of peunomonia.

They leave to connected up to a computer giving you a background dose through the spinal of painkillers for the first 24 hours or so, as even with all the tubes connected up you can still move about with help.

So sad about your Mum, recovering from puenomia, a morphine injection I would have thought would have been the last thing they should have given her, wonder about the Dr's thinking there.

Looks like you and I alike have alot of longevity, my Dad's brother died last year of advanced undiagnosed lung cancer, no obvious symptoms, until he collapsed at 97, lived another 6 weeks, with no quality of life, his mother my Nana died 89. Nana also had 8-9 brothers and sisters who all died in there late 80's.

On the other side of the family, lots of war and war related deaths, but sisters of that family also lived into their late 90's.

If I go back a couple of generations I keep hitting 90 year olds even back into the 1890's in England, so I think my chances of living a long life pretty good.

13

Hi Ross

Good to hear from you...tho in Devon the feel from the hospital is 'get on with it, you'll heal best if you hand the crutches back at 6 weeks, and as for the very few places in community hospitals don't even dream it. Got to say it worked for me, but I went into hospital pretty fit and am writing this now from my gym!

Your supermarket service sounds great! Hope you've friendly neighbours too if probs. Like snow, are you in winter wonderland now...tis damp and horrible here and would love thick snow!

Have a good day..

Cheers

Mic

14

Hi Lyn:

I have a meeting scheduled with my cosultant in the middle of January.  I have been assured that surgery will take place within 18 weeks, maybe sooner.  I have had a lot of very conflicting and at times alarmig, advice on the site, But, I have realised that it is wise to read between the lines.  The problem is that you have no idea of the age, and general health and fitness of the person posting.  So, the more alarmist posts of how bad things are going to be once at home, and alone, would seriously alarm those who take a lot of this at face value.

I have no doubt that the first few days will not be that good, but it is early days yet, and although I have already put in a lot of research, I need to speak with the consultant and my GP.  Social Services should have some input, as well.

It does rather sound as though the epidural is the way to go, but I do remember, that in San Francisco, it took me a while to recover from the sedation,  It is possible that I was over sedated.  If I am in a vegetative state for a few days, I may have a problem, but as long as I can get to the loo and have access to water, I should be able to cope.

It is early days yet, and the conflicting information on the site is very disturbing at times.

All the to you in Australia,

Susie 

15

Dear Susie -

I totally understand your concerns - 

Please remember that these are personal stories and experiences - I don't  think that I am exaggerating when I say that 97% of us have found this site when we were looking for an answer to a problem we were having at that moment - 

I was about 3 weeks post-op from 1st LTHR and had pain in my groin - the rest is history   9 months and 2 THR surgeries later !!!

I have lived in Los Angeles for 34 years and returned to Holland in June 2014 - my support system is there also - moved from close to Amsterdam to the country side in East Holland and had my surgeries - I live alone with my ex suster in law close by ... 

I was very worried about coming home and being in a tiny house, unfamiliar surroundings and this hip thing - noone stayed with me - 

My challenge was that I would be dependent of others --- HORROR!!! and I didn't know people !!!! and had to  ask ???? 

However .... you will see that you are so much more capable of doing things than you are thinking right now - you seem like a very organized, practical can-do woman - 

Problem is that you might not be in full control at some point - Your body will use her intelligence and repair the damages done , at her own speed, her own course, her own time - Being fit pre-op is great and will be a big help ... Unfortunately I was unable to keep it up due to mobility restrictions which caused too much pain .... Had to surrender that part too -

what did help me and made me very aware of the anatomy of hip/leg etc, was when I was watching the surgery on you tube around the same time when I found this forum ! Not recommended for the squeemish of stomach and pre-surgery -

It will be okay Susie ... really - 

What are you going to do over the Holidays ????  so many christmas days here, huh? I do miss the merry and joy - but the sounds of silence out here in the forest seems more matching my mood - 

big warm hug

renee