Some tips before and after your surgery (July 9 2018 replacement date)

Bones, joints and muscles
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As someone who is on the other side of a hip replacement I'd like to suggest some tips that will help you in your quest to find a good doctor, overcome fears about whether you should commit, pain control, hospital choice, etc. If you don't mind, at the very least, hearing my experience, I would like to share some things I have noticed throughout this journey. If you want to just get the tips, they are highlighted in red.

First off, I'm 46 years old, young by many standards for a hip replacement. If you are looking at a hip replacement due to OA, make sure it's really necessary. I had AVN stage 3 and I was putting it off for as long as I could. Once the hip head collapsed I was going to be doomed. I really had no choice. I broke it 12 years ago, had the pins removed about 7 years ago, had a core decompression done and finally replaced this last Monday. If your doctor immediately screams out replacement, just be a little wary. He/she might only see you as a number, an inanimate object that they can bank off of. This surgery in the US runs about $45k as a charge to insurance. The docs make a good living off this. My doc did 11 surgeries the day he did mine so a little math...$495K

I see a bunch of fearful posts from folks about the process. My doctor is shooting to do 1000 hips this year! Find a doctor who can do this in his/her sleep. Mine was Stefan Kreuzer in Houston. If you need reference information reach out to me. I will be more than happy to help. There is nothing for you to fear with this process unless you've chosen a crummy doctor. Tip 1: DO YOUR DUE DILIGENCE. Choose a doctor not because he/she is in your hometown. Pick a doc that will give you confidence. If you live in New Orleans for instance, you don't have to have surgery there if no one makes you feel confident; this is a big surgery so pick the best person for you and don't blow this very necessary step of preparation.

I didn't have a choice of my hospital but that was arranged with the world class doctor I chose. I was operated on at Memorial Hermann Hospital/Memorial City in Houston, Texas. Some things they did with me that you should ask your hospital/doctor about pre-op...Tip 2: I had a Pre-Op blood draw/health check one month prior to the surgery and a class about how to deal with a new hip following surgery and what to expect. They spoke extensively about infection and how to prevent it. They asked who was diabetic and/or who smoked. I didn't know that the chance of infection as one of these types of people increases 400%! They suggested that if you were a smoker to start the patch that day. They won't operate on you at this hospital if you are a smoker and they are proud of their less than 1% rate of post-op infection and that's for all surgeries not just hips. Diabetics, are a whole other category because of wound healing. Wound healing is delayed in smokers as well. I have no pity on smokers, you are idiotic to keep that habit up so quit today. I quit ten years ago, it takes willpower just do it. I cannot speak to diabetics but I can speak to type 2s who are growing at an alarming rate across the world. Watch "The Magic Pill", maybe that will instill some incentive for you to lose drastic weight and lose the diabetes tag. I lost 22 pounds before surgery to insure I would recover quickest. I also hit the weight room even though it was painful to walk. I figured at the very least to make my upper body strong enough to help me move around with my walker.

Further about infection...my hospital sent me home with a CHG Exidine (sp?) surgical scrub that I was told to wash with the night before. It is a detailed process, was told to wear clean under clothes and climb into a bed with fresh linens. The next morning I scrubbed with the same CHG soap and put on new clothes and went to the hospital. When I was admitted they took me back to the pre-op prep area where I was asked to strip naked and wipe myself down with more wipes with the cleaner and they left the soap on me as a barrier against infection. They then put the gown on me and shaved me for surgery and then applied more antibacterial agent. Five minutes before they wheeled me into the operating room I was given IV antibiotics they said would kill anything in my body before surgery. Talk about overkill so really ask questions. Ask them if they have a protocol like what I experienced. I was operated on July 9 this last Monday. I'm non weight bearing for 6 weeks due to an earlier surgery that compromised some bone structure. This brings me to another tip.

Tip 3: most people will be partial weight bearing following surgery so confirm this if you can prior. This will make your life so much easier than mine right now. We had a gentle post op PT class the morning following surgery and many if not all walked in with a 60/40 weight split. It was super cool to see people who were limping in my pre-op class a month ago, walking with zero pain. My doc had no clue I would be non weight bearing following surgery because he couldn't see the previous surgeon's mistake. This should make your recovery so much better and you should be driving in 2 weeks so don't worry about recovery times and missing a lot of work. I'm in outside sales and will have to have a walker and crutches for the next 1.5 months. You will most likely only need a cane as you strengthen so don't worry too much about recovery.

Tip 4: Get your house prepped and in order in case you have non-weight bearing orders prior to surgery. I had to have my wife go out and buy a bunch of stuff to make me comfortable last minute like a tv tray for eating in bed, a raised toilet because I'm 6'5", etc... Most supermarkets have a home delivery service. Use it and make your life easier. If you've never used it, look up to see if your store brand has an app. Learn it and have your coach/spouse/sig other help with food prep. Tip 5: Download a super useful app called Medisafe. It will help you plan out your meds and will alert you day or night when you need to take your pills. I have now been pain free due to this super useful tool. It's like having a nurse walk into your room to bring you your meds. Tip 6: if you can get your meds ready in the hospital before you leave do it! Chasing around your meds after you are discharged is not fun. Our hospital dropped the ball here but it was partly my fault because I was starting to feel pain once the spinal block wore off and I panicked and asked for Oxycodone. That screwed up my order so we had to pursue outside of the hospital. I ended up not needing it as I took one and it made no dent in my pain like my Tramadol did.

I also was in a pain study paid for by the hospital to get the populace off opiates. I took Tramadol every 4 hours and along with the spinal block I was just fine. Once the block wore off there was no way to not feel aside from taking Morphine. I got everything under control though in about 6 hours and have been in great shape since, even sleeping great now. The appetite never left me. Our hospital had world class food. I had salmon with veggies for dinner that evening even though I was a little nauseous. The flood of drugs they put in your body before and during surgery made me nauseous when I took an afternoon dose of Tramadol. I just laid back my head and felt better after about 20 minutes as I fought the nausea.

From the time I arrived at the hospital on Monday July 9 at 10am to when I left the next day at 4pm that was a total of 30 hours in the hospital. I loved the efficiency of the entire procedure.

If you have any questions, please don't hesitate reply to this post. I have been lucid during the entire 4 days so I even remember them putting in the spinal block and when they asked me to countdown backwards. I remember the recovery area and I have a good recall of conversations with my docs. so don't hesitate to reach out. I love to help others.

I hope this was helpful to any one with fears or questions. Best to you all.

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Excellent information. 2 years ago in the Chicago area my Insurance Company was billed around $85,000. Naturally they didn’t pay that and it cost me $1,000 out of pocket. Posterior approach, no complications and 3 days in hospital.  I doubt if he personally got reimbursed more that $1500.  That’s how the game is played. Every case is different as far as recovery. Key is the best surgeon. My surgeon has 40 years experience with hips but he is not a production line 

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Swimbody, I think I would be worried about a surgeon who did 11 operations in a day. My surgeon in the UK did three, two hips and a knee.

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Mine operates 3 days a week and office hours 2 days a week. I would hate to be patient 11 

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Wow, I am impressed you are so lucid so soon after surgery.  All of your information is spot on.  I a. 1year, 1 month out from my TLHR.  I had my surgery in the morning and went home same day at 5pm.  

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No matter the fact that in UK our surgeons don't do that many procedures in one day and I don't honestly think I would want him too, but on saying that maybe he is fast at

doing them, how long did it take actually in operating theatre,, I am really impressed with your thread though, you make it sound like they are really proactive in trying to keep you infection free.

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I was number 3 that day.  In the US my doc does close to 1000 hips a year.  He's a genius.  His procedures take 35 minutes.  He teaches all over the earth and many to your docs in the UK.  Your docs could learn a ton from how he knocks ops out...it would remove some of the bottlenecks in your NHS system.  You need more surgeons who can move quickly.  Look this guy up Stefan Kreuzer.  He is a machine in Houston where we have one of the best medical centers on the planet.  I keep noticing how the two major websites for hip replacements are BOTH out of the UK.  Why is that?  

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Thank you Staceymaz.  I was not on opioids (I volunteered for a hospital paid study to use Tramadol instead) and that is where the lucid awareness stemmed from.  I also chose to remember everything up until the propofol was injected.  I really wanted to pass down a good gouge for people to know and use before surgery since not many have done so nor could they accurately remember.  Peace.

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They were AlexandriaGizmo.  Infection is blossoming all over the world as bacteria is gaining a foothold on our antibiotics.  My hospital Memorial Hermann Memorial City is over the top obsessed about infection. They are less than 1% infection rate of all operations.  That's incredible.  They will turn away diabetics and smokers, elitist perhaps but you can choose your doctor and hospital both in the US so if you want a janky hospital filled with the infirm and downtrodden you are more than welcome to.

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Your pre-surgery anti-infection procedure was exactly the same as mine.  Lots of body scrubs w anti-bacteria wipes.  My hospital -Hoag Orthopedic in Irvine-has an unbelievably low infection rate.  It might be because all they do there is Orthopedic surgery so no sick, infectious patients around.

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Tramadol is a synthetic opioid medication. 

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Here, here to getting house in order. I live alone and was in huge pain 5 months prior to surgery my house was a mess and it brought me down during recovery. Clean, organize, get the hip replacement kit from Amazon, raised toilet seats with side handles and a shower bench. I also bought a tray that fit over the silver walker they gave me at the hospital and it was heaven! Inserts for drinks, I used one insert to put my grabbers in! That way they were always handy! Tramadol was a life saver as was a recliner. 

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Yes synthetic thus no grogginess and no constipation although it can cause as much

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The ortho department heads must have been at the same conference where they learned about ways to combat infection.  It was a little weird wiping myself down with those diaper wipes before surgery with no clothes on but it will pay off for us when we have no infection.  Stoked that you got through so successfully.

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Yes I am doing great.  Back to almost all of my pre-surgery activities.  I started playing tennis again at 3 1/2 months,  am swimming 60 laps at least three days a week and 3 mile walks on the weekend.  It sounds like you are off to a great recovery.  Make sure and do all of the little PT home exercises. I was off of all pain med by about 8 days, and was outside walking w a cane.  Ok so I was really slow, but hey I was trying.  Driving at 2 weeks, and went to a wedding at 11 days after surgery.  Well I wasn’t dancing or anything but I got there.  I was allowed to walk on treadmill and ride stationary bike for 30 minutes each and started PT at six weeks.  I was, am still am, very disciplined with my exercise and stretching routine.  Take good care of your incision, my husband cleaned it twice a day for me.  I would say it was pretty well healed by 4 weeks.

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In my experience in the US after 2 THR & 1 revision what you described pre and post OP is standard protocol in the US . Depending on each case some revisions can be complex as in your case you are on weight restrictions.

My first hip in my late 40’s was done over 22 years ago and it is still ticking. So good news for you & your new hip which can last for many years and taking care of it is essential. #Tip... No jumping off bridges with bungee cords, down mtn trails on dirt bikes or motorcycle racing . Hard impact sports can wear it out faster or cause dislocation  earlier . Mine will soon need a new bearing after 22 years. I still,skied not black diamonds and rode a easy gated horse.

Swimbody do be sure to ask for swim therapy when your ready ,I suspect this is right up your alley, once the incision has healed.Excellent for building up muscle and tendons, getting back in shape can take several months to a year.Always work on recovery at your own speed. Sleep and diet is just as important for healing as bed exercises are now and later Physical therapy tip..important to walk with good heel to toe gate and posture. #Tip ..old shoes are worn to old walking gate. Start with good arch support new shoes to help the new hip along,

My doc said the body needs 2400 calories a day to heal and protein shakes is a good way to include what the body needs along with daily vitamins.

Patience is your friend listen to your body never over do and take pain meds to stay ahead of the pain issues and while doing therapy.  Icing all the time will be a way to help control swelling and pain and even more important just REST. The App is a great tip.

 A  tip when you can put weight on your new shinny hip is ask for a 4 wheel walker this is the Cadillac of walkers easy to move and walk with correct posture as the muscles are learning how to walk again with the adjustment to the prosthesis in the hip. It takes the brain a few weeks to adjust and make new pathway signals with the new components in the hip. 

One excellent tip is the zero gravity tred mill. Thank you NASA. It allows a starting weight bearing of approx. 25% of total body weight to start. May be something to consider in your special case.  Once the components have been secured by sufficient bone growth then more body weight can be added as tolerated. If you don’t mind the wedgie. 

So many good healing blessings sent your way and that you are given all you need thru recovery. Keep us posted on your progress! 👍

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Did your doctor put one of those two week bandages on your scar?  I don't recall the name of the special bandage but the hospital gave me one extra to bring with me to my appointment at week two (next Monday).  The PA told me they run $150 per bandage!  I can shower with it and all I have to do is dab it when I get out of the shower.  Didn't know if you had a similar one.  My wife won't have to touch my scar it seems.  They swear everything happens underneath that magic bandage.  

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I get dreadful constipation with Tramadol. In fact that is one of its most common side effects. I also get bad nausea. Friends even get hallucinations. 

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I don’t think faster surgery time would improve the bottlenecks in the NHS. Early this year we had empty operating theatres and surgeons hanging around twiddling their thumbs, beds were full of people with things such as influenza. In fact most elective surgery such as hips and knees were cancelled with empty operating theatres. A decent computer system and better management would help the NHS, with better investment.

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I don’t really recall “magic bandage”.  I was really concerned w my scar- I am a woman and I like to swim for exercise.  It was pretty red for a few months but is now back to just a little darker than my skin tone.  I tried all sorts of lotions(after scar was totally healed).  I used Bio Oil on it for quite a few months and Egyptian Magic.  I can’t say they helped much.  But I had Anterior method and my scar is pretty small compared to some older types of surgery 3 1/2 inches.  Yes I measured.  I have grown used to it and don’t worry about it much anymore.  You will probably consider it a badge of courage.