|Posted: 8/31/2010 3:15:53 PM|
My mom will be having hip replacement surgery next month and we're wondering what to expect in terms of the surgery and recovery. She is 73 and at this point feels the pain is interfering with her daily life. She has tried physial therapy and medication, but since she has degenerative arthritis, these things along prolong the inevitable. From what we've been told, she'll expect to be in the hospital for several days and then they'll transfer her to rehab. Has anyone gone through this type of surgery that can share their personal experiences??
|Posted: 8/31/2010 3:28:21 PM|
I teach a class for patients about to face total joint replacement surgery!
Do you know if the doctor is doing the new "anterior approach"? or the conventional approach? That makes a BIG difference in recovery time. With the new anterior approach, the patient can bear full weight on that leg, lay in whatever position is comfortable, and does not have to be as carful because the chances of dislocation are lessened. Those patients typically are discharged after 1-2 days in the hospital.
With the conventional approach, she would have to be very careful the first 2 months, not laying on that side, not letting that knee go higher than the level of her hip, no crossing the legs, sleeping with a pillow between the legs, not sitting in low chairs for about 2 months. It's very difficult learning to get in and out of beds, chairs, cars, ect. Length of hospital stay typically 2-3 days. If she has some underlying medical issues, her stay could be lengthened.
Also, Medicare has changed their guidelines for Rehab acceptance. Typically a single, elective joint under the age of 83 does not qualify for in-patient rehab! The patients need to think about having a family member stay with them, or vise-versa, home health care, or going to an extended care facility (AKA Nursing home) for a few weeks to recooperate.
Remind her, this is a big surgery, and she is going to have pain! The procedure is not pain free, but once she has healed, the pain she is having now should go away.
Feel free to PM me if you have more questions
kiwi: a cute bird
Loc: New Zealand
|Posted: 8/31/2010 3:33:05 PM|
My Dad had both hips and both knees replaced over the years because of severe arthritis. He often said how amazed he was at what a difference it made. Before he went into hospital his joint would be aching and constantly sore, and he would be finding it difficult to move freely; when he came out he would be pretty much pain-free and able to walk again.
Each time he was in hospital a few days, and then was released home with no problems. We don't have re-hab here, but the District Nurse (employed by the hospital service to visit patients in their own homes) visited for a while to make sure the wound was healing well and that there were no problems.
Having four joint replacements showed that my Dad was a fan of the procedures and the difference they made to his life!!
**Disclaimer: Any errors in spelling, fact or tact are transmission errors.
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|Posted: 8/31/2010 4:01:45 PM|
I'ma PTA that works in an hosp, and I see thousand of total joints a yr. I'm going to tell you MY experiance.
I work with 4 ortho's. 3 of them do things the same, 1 is different. ha.
The prev poster mentioned an Anterior approach (thru the front) vs Posterior. Actually the Ant approach is NOT new. been around for yrs. (I've been doing PT for 25 yrs, started when I was 10, HA), and it's not new. Our dr's have elected to all go posterior as complications going thru the front have been higher, more chances of nicking nerves, more pain, and more discomfort with the incision. VS the posterior, which is where you have the 3 precautions that you have to follow stricly for at least 3 mos. No bending fwd past 90 degrees, no crossing your legs, and no twisting. ALL our THA's are allowed to bear full wt right from the beginning. Post or ant makes no differance.
Traditionally, with your mom's age, I would say she's going to have a short stay in the hosp. 2-3 days..and then d/c to home.
She will need a walker. we prefer 2 wheeled walkers, and a reacher, long handled sponge brush, etc. She will start PT the day OF surgrey or the day after. They will get her up and start ambulation and exercises. Traditionally our THA's don't have much pain. Or the pain is different then the deep sharp pain they used to have.
Any other questions let me know.
Some patients still do go to an acute rehab unit. But they need to qualify for it.
luv my bulldoggies
|Posted: 8/31/2010 5:19:04 PM|I've worked with these types of patients, and if her pain is controlled well (i.e. taking the pain medicine regularly** and NOT waiting until the pain gets too high, plus applying ICE!!!), if there aren't any incision complications, no serious underlying health issues, plus good physical and occupational therapy, she should do very well.
The reason I mention pain management is that I've worked with patients who are very afraid of becoming addicted; therefore, they are afraid to ask for or take their narcotics, and of course, they suffer. We educate them that if they're in pain, therapy/ recovery is much harder. Make sure they are applying ice (if allowed), because I know of MANY nurses who forget this simple intervention!!!
I'll show you how the doctors where I work write the home prescriptions, which allow for weaning:
example--a couple days post-op and for a couple weeks, they might say:
1-2 Percocet every 4 hours as needed
then they might write 1 Percocet every 6 hours
then Percocet "as needed only"....and take 2 Motrin instead, etc.
Hope she does well! Almost every patient I've worked with is VERY happy with the results.
luv my bulldoggies
|Posted: 8/31/2010 5:31:29 PM|some other stuff I forgot to tell you for the recovery phase (although they should educate her on this, too!)....Blood Clots (aka "deep vein thrombi", or "embolus" she will most likely be wearing "TED" hose, which are long, white stockings from the foot to the thigh---these prevent blood clots. On top of that, she may also wear "SCD"s (sequential compression devices), which are plastic sleeves from her ankle to her knee.
Many patients DONT like this combo, because they can get HOT!
Yet another thing they'll probably give her are heparin or Lovenox injections in her abdomen---also prevents blood clots. They should warn her that her tummy will become bruised from these injections--totally normal.
Another VERY important post-op intervention is for her to deep breath and cough and/or use an Incentive Spirometer--which is a little plastic machine that she breathes into which exercises her lungs. After surgery, there is always a risk of pneumonia (and blood clots) because the patient is spending more time in bed, and the blood and lung secretions can get stagnant....
Also, especially with her age, be sure she knows that the anesthesia, narcotic pain relievers, plus less activity can all lead to major constipation! This is one of the BIGGEST problems I see, and it can be avoided by giving regular doses of stool softeners, things like Metamucil, Miralax, etc. And of course, if needed, we give the patients a more aggressive laxative. Encourage her to drink water, water, water! Prune juice, and eat as much fiber as possible!!!
Also, they should have a toilet seat elevator so she doesn't have to sit down as low----it is about 4 inches high, you can also buy them at Walgreens if she'll need one at home.
Even though some patients are given GREAT education before and after surgery, a LOT of times, they forget what they were told, OR they were "altered" by narcotics and can't remember,OR (I HATE to say this)....some nurses do NOT explain things, so I thought it would be helpful for you to know some things....Hope this helps
luv my bulldoggies
|Posted: 9/8/2010 6:13:33 AM|has she had the surgery yet? Hope she's okay!
Carolina Girl 71
Knee deep in the water somewhere
Loc: Some Beach, Somewhere
|Posted: 9/9/2010 4:27:50 PM|
has she had the surgery yet?
No, she hasn't had the surgery. The day that I posted, my mom was going in to see her orthopedist who had diagnosed her with the degenerative arthritis in the hip as well as the bone spurs in the hip back on January. When she came home from her appointment, she said she was told she wasn't a candidate for surgery because there was still cartilage between the ball and socket of the hip. The doctor did some further x-rays and has now decided that all of her walking issues and pain are cause by spinal stenosis -- at least that's what he's thinking at the moment. She needs to schedule an MRI for further imaging. He also told her she has bone spurs in her back. So, that threw her for loop because she had finally made up her mind that she was going to go through with the hip surgery once and for all and was hoping all of her pain issues would be over and done with. Now, I'm not sure what she's going to do. The doctor prescribed a medication that will help alleviate some of the inflammation of the nerve (which my mom swears is her sciatic nerve) when she will be doing a lot walking. She is still taking her Motrin twice a day though.
Thanks for your concern and all of the responses. I appreciate it.
|Posted: 9/9/2010 5:25:23 PM|
My husband is now two weeks out from his total hip replacment. He had the anterior approach surgery. He drove for the first time yesterday, took himself to the store. He's had some pain, some swelling, will need some rehab to learn to walk correctly after favoring his bad hip for so long.
Given a choice opt for the anterior approach. DH has two co-workers who had the surgery done, the one with the anterior approach has done significantly better than the one with the traditional approach.
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