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Guy Churchwood - Patient View of a Total Hip Replacement
Link to Guy
Churchwood's Original Blog
Total RIGHT hip replacement, motorbike
accident accelerated what was later discovered to be a
birth defect where the cup of my hip joint was too
shallow.
May 23, 2009
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Worry level very low, still felt I was there
in the 3rd person e.g. way off timing
and not really me.
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Discussed with the doc on what was going to
happen, what drugs they'd use, there were a
large amount of forms filled in one set by the
nurse another the doctor and one by us.
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One more set of x-rays and some blood being
taken…
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Surgery would take around 1.5-2hrs
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Putting in a metal hip, ceramic ball and
plastic cup with metal surround
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They use the equivalent of a circular
cheese grater to fit the right cup size
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The joint replacement is basically a
stake that is hammered in with increasing
increments till the right one fits snuggly
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The replacement had what looked like a
perforated surround allowing the bone to
grow into the replacement so not cemented
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Spinal injection and drugged up NOT
general anesthetic for the operation
(worried me greatly)
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Should be walking on it the next day and
a hospital stay for 3 days most likely
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6 weeks basic recovery, have to baby it,
never cross your legs, never bend more than
90 degrees etc etc..
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Staples out in 11 days, can't shower
till they are out
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Physical therapy the most important
thing and keep that up also
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Worry level now hit a concerned status
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Ordered some shoes that I could slip on
without having to wear socks, figured that was a
good idea, one less thing to worry about
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On the day of the operation
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Leave all jewelry at home
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Worry level as I arrived was calm but
pensive
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Had packed a bag with loose clothes for the
three days etc (turned out to be a waste of
time)
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Packed a PSP and iPod (turned out to be a
waste of time)
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Worry level as I was shown to the bed and
changed – definitely pensive
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Signed consent in case I needed a
transfusion
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If you have power of attorney or whatever
its proper term is (someone to speak for you
while you are under, that's smart), we did a
temporary one there so my wife could speak for
me.
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Worry level when the intravenous went in -
through the roof
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Was wheeled into the operating theatre, last
thing I remember is being placed on the bed and
seeing a tin tray full of what looked like
little disco balls, the next 10 hrs, all I
remember is my wife giving me some ice as
sustenance.
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I had Intravenous morphine or something
similar and a Percocet button
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They tried to get me to eat some broth,
unfortunately as soon as it arrived I threw up,
so I had to go onto another drip that gave me
supplements.. the drugs make you light headed
and nauseas and as a repeating theme here, you
HAVE to keep your liquid intake very high.
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BTW, they will ask you to rate your pain
between 1-10 the higher you go the more the pain
obviously… just make sure you ask them if it is
when you are still or moving your leg.. When I
was still seriously, I had no pain, but if I
lifted my leg.. Well that was a different story
all together.
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They tell you to drink fluids; you will
literally go through the next few days in and
out of small sleeps, in between drink as much as
you can, I found the nausea the worst thing to
cope with was this feeling. So whatever you
think is a lot, drink double, ask them what
liquid intake target they feel is right for you,
I'd guess a couple of liters but who knows, I'd
love them to have told me this.
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Physical therapy person came, I've a frame
and crutches, I tried both but found the
crutches more maneuverable so opted with them
(frame had some bad images for me, especially if
I stuck tennis balls on the feet). Getting out
of bed the first time is rough; I had a
catheter, a blood drop out of the incision and
an IV so it was like walking connected to a
telephone exchange. We took 50 steps or so and a
couple of exercises and back to bed as I was
light headed and nauseous.
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Here's a couple of surprises, you have to
wear stockings or tights for your duration
and for that matter the best part of the
next 4-6 weeks due to risk of blood clots.
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OK, so why the drinking.. Well after two
days of being there I had not done a #2 (poop),
totally constipated and I have a regular
constitution so this was very foreign to me..The
narcotics turn out to be very bad for that so
fruit smoothies, fruit juices, fruits, water,
you get the picture, fruit, liquid etc etc.
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On the 2nd day I was feeling much
better, I felt no pain when lying still, had the
drip and the catheter and the blood drain pulled
out (catheter…OMG I cannot even explain how much
I hated that 5 seconds of removal). I could have
gone home on the second day but felt it would be
pushing it rather too much so I relaxed into
another day of being pushed and prodded and
tested.
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I did feel my skin was itchy, apparently
this is a reaction to some of the drugs they
used in the operation so I got a couple of doses
of Benadryl that did the trick so watch for
that, it's usual and quite relieving
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So more physical therapy, this time I did
stairs, tried with one crutch, tried walking
over curbs etc and got some standing exercises
to do twice a day.
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On the third day, I was set to come home. We
had packed some pajamas and that was a god send
as my leg was so swollen that not much else
would have worked.
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The wheeled me out which was IMO worse than
me walking myself being uncomfortable and close
to a 90% angle on my hip which worried me
greatly
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The ride home was 25 mins and based on my
sickness and light headedness, it wasn't the
most pleasant ride I have ever had, just close
your eyes and hope it ends
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Prep for the house, you WILL need a riser on
the toilet, they make this chair with a hole in
it, do yourself a favor, don't wonder if you can
cope or not, go with the flow and get it, they
look pretty horrid but even standing up for a
pee, the arm rest help you support yourself so
you can take the weight off your hip and
concentrate on your business.
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Chairs wise shallow upright, high back and
all important arm rests are best.
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Day one at home, OMG, felt like a wreck, you
have the fear that you need to keep the
circulation going in case of blood clots but of
course this means you have to stand up and walk
around or sit up and any of these cases was
making me feel sick which was pretty rough
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Food wise, couldn't eat much, very very
small portions and keeping it bland felt best,
yogurt and fruit is good but watch for bananas
as they also cause constipation
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So I spent the day pretty much in bed
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The worst sadly is that I was still
constipated so was increasingly getting
worried about that and added a rumbling sour
stomach feeling..I drunk and drunk and drunk
and even went for evil prune juice.
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The nurse came that afternoon and the
incision had bled a little but this was
apparently normal and all things were as they
should be
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By now my leg was localized pain in my thigh
and a ache over the top of my leg, my leg
was a black, swollen with a tint of yellow.
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Now to my 2nd and worst mistake
so far.. We were convinced that the nausea and
dizziness was the drugs being taken every 4
hours 24/7, we spoke with the doctor and he
prescribed an alternative drug assuming that
everyone reacts differently. Well my wife rushed
off and got the prescription (BTW, these can't
be phoned to the pharmacy and have to be picked
up at the hospital) and I decided to move to
them right away and give them a few sessions to
see how it went. A few means 3 times at a 4 hour
increment or all evening and night in my case.
Well, the drugs had absolutely no benefits for
me, I might as well have chewed pieces of
newspaper, the night was spent with me assuming
my leg would inflate and explode making the
award of 'all time low point' for sure. You have
to keep does pretty regularly, you need to keep
the clip going at 4 hour increments for at least
the first week IMO, if you drop off the meds,
the ramp back from pain to coping is a hard hill
to have to climb.
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Once I realized they were useless I moved
back to the original drug and felt a lot better
within a few hours.
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The home nurse by now had visited around
three times and in each case my blood pressure
and heart rate has improved leaps and bounds
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What I naively thought is as everyone is so
blasé about how well I will feel after and
'it's only three days in hospital, I assumed
I could resume working from home on the
Monday following a Thursday operation.
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Well per the above, I did and this was
not the recommendation I would give.. Take a
full week off and feel sorry for yourself,
one because you will still feel like crap
and two, you have no idea what will come out
of your mouth in conversations so there's a
risk at both sides of this coin.
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Within a week my dizziness and nausea
subsided, I started to become a little more
regular once I realized how much liquid 'plenty'
meant and I am able to walk around with short
rests and sitting for a couple of hours at a
time, can't tell you how much that made me feel
human.
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Talking of human, I did take an attempt of a
pair of underpants and some Jeans and hobbled to
the bottom of the drive in the sunshine.. WOW,
how great do you feel when you can smell the
outdoors, look almost human and realize you're
on the other side of what's been years of pain
management, sleepless nights and discomfort.
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Staples out after 11 days
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Wasn't as bad as I expected, yes the staples
are like stationary staples but three prongs, I
had approx 35 of them, the method of removal is
a scissor like device that bends them in the
middle and bends the legs of the staples out
out. This feels at worst like a bee sting but in
general not such an awful ordeal
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Interesting my leg had started to itch and
with the removal came relief on that and also
the incision didn't feel like it was being as
stretched.
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I now have adhesive strips over the staple
holes to heal and they apparently fall off
over time.. This does mean that I can now a
shower safely
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Oh, that's one thing I forgot to
mention, till the staples out you can't
shower.. Well you can with caution but
being wobbly on your feet and in a
slippery environment AND not allowing
the wound to get wet was an adventure in
itself.
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My wife had to cling wrap and sticky
tape the whole area and assist in the
proceedings whilst I planted my feet on
the ground, oh yes, not a pretty sight
but another cathartic moment and a few
laughs along the way. They do put this
yellow ointment on your leg so one other
thing to note is if someone is helping
you shower, let them know coz they might
just thing you relieved yourself in the
shower which is a thrill for some but a
surprise for many!
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To accurately describe the swelling in my
leg at this point, if now feels like someone's
inflated a football to 10% and stuck it to my
right buttock, when I sit down it feels odd but
at least I can sit and the overall pain levels
in my legs and back is way way less that prior
to the surgery.
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The swelling byu the way works down the body
so although the operation was obviously at my
hip, my whole leg is swollen and seems to work
down so at some point in the last 7 days my foot
bloated noticeable which was rather
disconcerting but has deflated now to the size
of my left so that's an interesting little twist
to watch for.
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Days proceed to the 2 week mark
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Well I'm now taking less and less medication
(2-4 tablets every 24 hours); in fact I got
some over the counter anti-inflammatory for
the swelling and have been trying to use
that as opposed to the prescription
medications
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Most days this works well, I am still
getting up at least one or two time a night as
my body clock got conditioned to the 'once every
4 hours' treatment but I hope that will subside
over time
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I can hobble around the house now without a
crutch but generally have one near to me as it
is tiring still and I have ordered myself a
rather cool walking cane form 'Hugo' so I can
ham it up when I finally get to make an
appearance in work
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Swelling is still noticeable now but not
'really' noticeable, my leg is still yellow and
any inflammation is directly around my incision
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One final thing is that the muscles on the
top of my leg also ache, I spoke with the nurse
as I was worried these shouldn't have been
impacted but the stark reality is that when they
operate they have to move everything out the way
and as such the muscles get pried a little and
leaves you with this lasting aching feeling.
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So I feel I'm on the road to recovery, I wanted
to write this note as when I went through the
discovery and research I never found any 1st
person information and hope at least this helps
in some respects as you might enter the same
path as I have just gone through.
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There is no guarantees that anyone will go
through the same steps as I did as there are so
many factors that come into play but I'm happy
to report that I am very positive on my
progress, I'm still really only a 3rd
of the way through the initial 6 week recovery
period but feeling bullish to the future and
somehow with the background pain not constantly
eating away at me, I have a more positive
outlook.
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Work has been tough, I hate not being in the
action and have a fear of letting the company and my
team down, I think however I should have taken a few
days away from the Blackberry yet they've been
immensely understanding and I'm now up at full
capacity with back-back meetings all day without
feeling like I need to lie down for a break (well
dependent on who's on the meeting that is)
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Finally, my wife's been a real trooper, dealing
with the added chores, having me to cope with,
putting those damn tights on but I guess it's nearly
done and we have years ahead of us, she's my partner
and my best friend and I could not have gone through
this process without the strong and understanding
support.
I wish you luck if you venture down a similar path, I
hope this note give you some glimmers of what to do and
what to avoid, find a busy specialist, take control and
get your life back.
Sunday, June 7, 2009 Update to the Hip
Replacement – Week 3 & 4
Well here's the
interesting thing, I expected weeks
three and four to be great, the
surgeries out the way, I can
languish in the excitement of full
mobility but I have to say this was
not the case. The primary reasons I
can split into four buckets and I'll
give you them in my priority order.
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Sleeping and Sitting
- I am absolutely sick and tired
of sitting upright or lying
flat, it's like eating bland
food every night and trying to
figure out how to spice it up. I
leg still hurts enough to wake
me up and there are only so many
creative ways I can find to lie
still and on my back (two
pillows under the head and one
under my legs, one under my
head, none or three and more
upright.. come on !). Sitting
and watching TV and not being
able to kick back and relax in a
squishy seat is driving me nuts,
I almost fear that part of the
evening.
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Pain management..
Now don't get me wrong, I am now
feeling around 75% complete e.g.
I can walk without a crutch but
the pain has coalesced around
the incision, my scar is numb to
swollen and I feel like I have
half a cricket ball stuck to the
side of my leg. My heavy
painkillers ran out and in an
effort to not get hooked, I
figured it was manageable enough
with generic brands. Well,
that's fun, try taking something
before you go to sleep and see
if you wake up sore, aching and
somewhat grumpy.. I've tried
them all and seem to have
settled of some Advil and half
an Ambian to make it the most
part through a night
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Enough Already
– The first couple of weeks it
was a struggle, you've been
through a major surgery, you're
getting the attention, you have
lots to think about and treat
every day as progress and hope,
now you're in a holding pattern,
you have no major pain, you have
enough to restrict your
movements and you are pretty
much house bound as you can't
drive. You feel embarrassed to
lean on your significant other
and you feel disconnected from
work regardless of whether you
were stupid as I am went
straight back or took a week to
get straight.
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It's Back –
So this whole thing started with
a birth defect BUT careless
motor biking led to
acceleration. What this also led
to is a string of other back
pains and discomfort and as my
leg got worse I couldn't
exercise as much. Apparently my
operated leg was slightly
shorter than the left and as
part of the surgery I was
'blessed' with Symmetry so I had
a hope that as part of this
procedure, my body wouldn't be
adapting to the hip etc so my
other back issues would go away.
Alas, they are back so now I
know I have to recover from the
hip, get mobile and work on
these issues before I am feeling
normal again. This isn't
anything to do with the specific
surgery but the compound of the
wait mode; concerns over being a
nuisance and being disconnected
from work have led to a few
pretty low points.
So I wanted to add this update as
I was somewhat surprised that weeks
3 and 4 have turned out to be pretty
low points in the process so as to
keep you posted and be braced for
it. Right now I am a week and a half
away from being signed off, I can
'sort of' lie on my side and I am
thinking of braving COSTCO's today
so that tells you how brave I'm
feeling .
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