(Almost) Two Week Update

Tomorrow will be two weeks since my total left hip replacement. I am now walking unassisted, have gone back to work full time, and, other than some soreness, am generally getting around easier than I was pre-surgery. 

I had my post-op checkup this past Monday. My surgeon told me that more than one-third of my old hip ball was rubbing against my hip socket every time I put weight on my left leg. That would explain the pain. He also told me that my new hip fit in very snugly during the surgery, and that he had trouble trying to force it to dislocate as he was testing out the fit. All very good news. Plus, I got my staples out. Oh sweet, sweet relief. It's been a huge improvement in my quality of life. Sitting and standing no longer pinch. 

I've also started outpatient physical therapy. I'm finding that my range of motion is coming back pretty quickly, but my strength is understandably lacking. I've also got a pretty tight IT band on my left leg from not being able to stretch the tissue and muscle in that leg properly. PT thus far has involved several different stretching and strengthening exercises as well as some tissue massage to discourage scar tissue from forming. Some of it is painful, but nowhere near as painful as it was trying to exercise with my old hip. 

Happy Thanksgiving. 

8 Days Later

Hard to believe I'm on post-op day 7 and that it's been more than a week since I had my new hip installed.

Today marked my last in-home physical therapy session. I will miss Roger - my physical therapist - whose special blend of humor and drill sergeant-like motivation helped me progress farther than I thought possible in such a short period of time.

I'm cleared to walk around my house without any assistance. No crutches, no cane, no nada. It's not pretty -- I limp quite a bit -- but I can certainly make my way around. Outside my house, I'm down to one crutch, which helps the limp noticeably. I'd like to be done with the one crutch -- and any limp -- in the next week or two.

I'm still following all of my precautions, and still have some pain from time to time, namely right after physical therapy. My post-op appointment with my surgeon is on Monday, and I'm hoping he'll remove the staples on my incision then. Every time I sit down or stand up I have a sharp pain right at the incision site; I'm hoping that's the staples, and that it will go away as soon as they're removed.

Here's something they don't tell you in your pre-hip replacement class: sneezing hurts like a sonovabitch after surgery. I dread the telltale tickle in my nose that tells me a sneeze is inevitable. Regardless of how much I try to brace myself, with every sneeze I feel a stabbing, hot pain right in my new hip. It's close to some of the worst pain I've ever felt. It only lasts a fraction of a second, but it's pretty dreadful.

Sleeping is still a challenge. After laying uncomfortably on my back for three hours last night without falling asleep, I got up and sat/laid down on our recliner. It was the best sleep I've had since I had the operation. Though I'm not enamored with the idea of sleeping on the couch for the foreseeable future, I need sleep badly, and I'm willing to do (almost) whatever it takes to get it.

Still not taking any painkillers stronger than Tylenol.

My next check in will be on Monday following my post-op appointment. I also have my first outpatient physical therapy appointment on Monday, as well. Exciting stuff!

Day 6

My recovery continues to proceed quicker than I expected. Tomorrow will mark one week since my left hip replacement. Though I've not yet returned to work, I have been able to get out of the house for short jaunts, and am able to drive since I haven't needed to take a painkiller for three days now. I'm planning to start transitioning back to work tomorrow -- a few hours tomorrow and Friday, and then, hopefully, a normal work schedule beginning next week.

The pain has been surprisingly manageable without any prescription painkillers. I've been doing just fine using only Tylenol for the last several days. I'm also able to walk without any support, though it isn't pretty to watch. So I'm still relying on crutches to assist me. 

I've enjoyed physical therapy thus far. It's pretty amazing to see the progress I'm able to make with my new hip from appointment to appointment. Whereas I was barely able to move the joint last week, I'm now able to move my hip in most directions with some effort. There are of course still some movements that I'm unable to do, or that are particularly painful.

The biggest challenge thus far has been sleeping. Because I'm not allowed to sleep on my sides or stomach, I sleep on my back every night (or try to), which isn't a natural sleeping position for me. I wake up in the middle of the night with the joint feeling sore and slightly painful, and try to move a little bit to ease the stiffness. Sometimes it works, other times it doesn't. I therefore haven't been able to get a good, solid night of sleep since before the surgery. I have been trying to nap during the day whenever possible.

Almost one week down...seven more to go until I don't have to worry about my precautions (no bending past 90 degrees, no twisting my feet, no crossing my legs).

2 Days at Home

I've been home for the last two and a half days, having been discharged from the hospital on postoperative day 1. I'm finding that the stairs in my house are no big deal, but I am having trouble getting into and out of bed or cars.

I also came very close to fainting yesterday morning when I first woke up. I got out of bed, crutched to the bathroom, and was in the middle of taking my medications when I suddenly felt woozy and very warm. I sat down and called my wife in. She had to support me while I was sitting so I wouldn't fall over. (Did she win the lottery when she married me or what?) The feeling eventually passed and I went back to bed.

I had my first at-home physical therapy session yesterday, as well. Lots of simple exercises to loosen up the new joint, both standing up and laying down. And I was encouraged again to walk as much as I'm able to.

Finally, I also had a nurse come to the house to check on me yesterday. Everything looks good, except I have a low grade fever just under 100 degrees. That's not terribly uncommon right after surgery and nothing to worry about unless it gets closer to 101 degrees. So I am to keep an eye on it.

Very little on the agenda for today -- maybe a short walk outside -- and then in-home physical therapy again tomorrow.

24 Hours Later

I am 24 hours post total left hip arthroplasty. Since my last update yesterday evening, the numbing agent in the hip joint has begun to wear off. Around 9 pm last night, I began to experience searing pain in the hip and groin. The very nice nursing staff quickly administered pain killers, but it took about an hour or an hour and a half for them to start working well. Between the pain and the multiple rounds and check ins by the nurses and the medical staff, I only slept in fits and starts throughout the night. After being woken up at 6 am so that I could take medication (antibiotics, blood thinners and a long-lasting painkiller), I decided to cut my losses and stay awake.

My second physical therapy session is scheduled for 11:45 this morning and I'm told I'll be focusing on stairs, getting around with crutches, and some occupational therapy. Assuming all goes well, I should be discharged shortly thereafter.

I also got my first good look at the area where my surgeon made his incision for the surgery. It's still covered by dressing, mind you, but I can kind of see through it. It's bigger than I was expecting it to be -- somewhere on the order of 8 or 10 inches long -- running along the back side of my hip. I'm sure it will heal well and become barely noticeable, but the size of the impending scar definitely surprised me.

I've been doing some of the post op exercises, as well. I find many relatively easy, particularly those involving ankle movements, but am struggling a bit with knee bends and exercises more focused specifically on the hip area. But I'm sure those will get easier over time.

Post-surgery Update

It's been just less than 12 hours since my hip replacement surgery began this morning. I'll be staying in the hospital overnight but expect to be discharged tomorrow morning, which is pretty incredible. I've had my first physical therapy appointment, which covered how to get out of bed and sit down, and also involved me taking my new hip for a test walk down the hospital corridor. I was able to put full weight on the operated let, and though my hip area feels stiff, I've had absolutely no pain whatsoever. This will likely change as the long-lasting numbing medication wears off in 24-36 hours.

My surgeon stopped by on his way home to see how I was doing. From his perspective, the surgery went perfectly. The artificial pieces fit perfectly and he didn't need to make my leg any longer. He told me I could go home tonight if I want to! Unfortunately, the head nurse for the floor had to leave early and she would have to sign off on my discharge, so I'm staying the night. Not a problem, though -- I had planned to anyway. And everyone here is exceptionally kind and helpful.

Surgery

The surgery this morning went on without a hitch. I'm currently in my hospital room with inflatable cuffs around my legs to ward off blood clots. I'm also on a ton of pain killers and nerve blockers.

I'm very happy to report that I have no memory whatsoever of the surgery or of even receiving the spinal anesthesia injection. Just before the spinal, I was given some sedatives to help me relax. The next thing I remember is becoming alert in the recovery room, having oxygen tubes in my nose, and being offered ice chips and apple juice.

I'm currently completely pain free, but that's due to the painkillers and some long-lasting numbing medication my surgeon injected into my new hip during the procedure. I start physical therapy at the hospital sometime this afternoon, and have to demonstrate to the nurses that I can urinate within the next 90 minutes. Otherwise, I'm afraid they'll need to insert a catheter, which I'd very much prefer to avoid.

So -- surgery done, onto recovery!

24 Hours Away

If all goes according to schedule, I should be waking up in the recovery room at the hospital around this time tomorrow with a new left hip.

I'm a little bit nervous about the spinal anesthesia and worried about how aware I'll be of what's going on during the surgery. I've read on various joint replacement-related boards that the anesthesiologist is able to heavily sedate joint replacement patients even if they elect to go for spinal anesthesia. I'm hoping my team will give me this option -- I don't want to be aware of anything until after the operation is over.

I'll try to post to this blog as I'm able to over the next few days. See you on the other side!

Preop at the Hospital and More About the Replacement

I was scheduled this afternoon for my preop appointment at the hospital. The utility of this appointment was to allow me to preregister for my surgery on Thursday -- allowing me to go straight to the surgical suite -- and to draw additional blood and give me last-minute preop instructions. These instructions include my having to wipe myself down with antibacterial wipes the night before surgery. I'll evidently have to repeat the process at the hospital on Thursday morning as well. Other than that, a pretty straightforward process and I already have my hospital wrist band. I'm really, finally, getting a new hip!

Speaking of the hip, while I was researching hip replacements over the last several months, I read quite a bit about the relative merits of the posterior and anterior approaches -- the place on your body through which the surgical team reaches and replaces your hip. Generally speaking, the posterior approach is a bit more old school, whereas the anterior approach is newer and marketed as less invasive and easier to recover from. This is because the surgeon must cut through muscle in the posterior approach but not in the anterior.

My surgeon is not a fan of the anterior approach and only does posterior approach replacements. In his experience, he finds it more difficult to see the hip joint using the anterior approach and is generally more confident of the fit of the artificial joint when using the posterior approach. He also has explained to me that the femoral nerve runs down the front of the leg near where the incision is made on an anterior approach patient, meaning there is a risk (albeit a small one) of the nerve being severred.

So I am having a posterior approach replacement. My doctor tells me this might slow my recovery in the first week or two as compared to an anterior approach patient, but the odds of long-term success are higher.

Just a few more days to go.

Pre-op Interview and Clearance

I had my preoperative interview this afternoon with one of the nurses in the joint replacement center at the hospital where I will be having my surgery next week. It was a relatively straightforward 30-minute conversation about my health history and what to expect during and after surgery. I learned that the joint replacement center at this hospital gives each patient their own private room for the duration of their inpatient stay. That is excellent news. It's embarrassing enough to be this young and need a hip replacement. Being confronted by roommates twice my age would be rubbing salt in the wound.

I also learned from my primary care doc that one of my presurgical tests came back semi-positive, which initially caused a bit of a scare. I had a MRSA swab done to check for mediation-resistant staph infection. The good news is that I don't have MRSA. The bad news is that I do evidently have staph bacteria living in my nose. I spoke to my surgeon's office and they told me there was no need for concern: more than one-third of the population lives with staph somewhere on their body and are asymptomatic.

The other exciting news to report is that I've ordered my hip kit. This a 20-something dollar package that includes a reacher, an extended shoe horn, and a bunch of other items that will be useful for someone who won't be able to lean forward for the foreseeable future. Thanks to Amazon, I should have it in hand tomorrow to start practicing.

Less than 10 days to go. I have a bit of a cold and am hoping that it abates before next Thursday. I'm not sure whether I'd be allowed to have the replacement done if I'm congested. No use worrying about it now, though: there's still plenty of time.