Resuming Normal Activities after Hip Replacement

Once you get home, you should stay active. The key is to not do too much, too soon. While you can expect some good days and some bad days, you should notice a gradual improvement over time. Generally, the following guidelines will apply:

Weight Bearing

Follow your doctor's specific instructions about the use of a cane, walker, or crutches and when you can put weight on the leg. Full weight bearing may be allowed immediately or may be delayed by several weeks depending on the type of hip replacement you have undergone and your doctor's instructions.

Driving

In most cases, it is safe to resume driving when you are no longer taking narcotic pain medication, and when your strength and reflexes have returned to a more normal state. Your doctor will help you determine when it is safe to resume driving.

Sexual Activity

Please consult your doctor about how soon you can safely resume sexual activity. Depending on your condition, you may be able to resume sexual activity within several weeks after surgery.

Sleeping Positions

Depending on your surgery, your doctor may ask you to avoid certain sleeping positions or to sleep with a pillow between your legs for a length of time. Ask your doctor which sleeping positions are safest and most appropriate for you.

Return to Work

Depending on the type of activities you do on the job and the speed of your recovery, it may be several weeks before you are able to return to work. Your doctor will advise you when it is safe to resume your normal work activities.

Sports and Exercise

Continue to do the exercises prescribed by your physical therapist for at least 2 months after surgery. In some cases, your doctor may recommend riding a stationary bicycle to help maintain muscle tone and keep your hip flexible.

As soon as your doctor gives you the go-ahead, you can return to many of the sports activities you enjoyed before your hip replacement:

• Walk as much as you would like, but remember that walking is no substitute for the exercises prescribed by your doctor and physical therapist.
• Swimming is an excellent low-impact activity after a total hip replacement; you can begin as soon as the sutures have been removed and the wound is healed.
• In general, lower impact fitness activities such as golfing, bicycling, and light tennis, put less stress on your hip joint and are preferable over high-impact activities such as jogging, racquetball and skiing.

Air Travel

Pressure changes and immobility may cause your hip joint to swell, especially if it is just healing. Ask your doctor before you travel on an airplane. When going through security, be aware that the sensitivity of metal detectors varies and your artificial joint may cause an alarm. Tell the screener about your artificial joint before going through the metal detector. You may also wish to carry a medical alert card to show the airport screener.

Dos and Don'ts To Protect Your New Hip

Dos and don'ts (precautions) vary depending on your doctor's surgical technique. Your doctor and physical therapist will provide you with a list of dos and don'ts to remember with your new hip. These precautions will help to prevent the new joint from dislocating and ensure proper healing. Here are some of the most common precautions:

The Don'ts

• Don't cross your legs at the knees for at least 6 to 8 weeks.
• Don't bring your knee up higher than your hip.
• Don't lean forward while sitting or as you sit down.
• Don't try to pick up something on the floor while you are sitting.
• Don't turn your feet excessively inward or outward when you bend down.
• Don't reach down to pull up blankets when lying in bed.
• Don't bend at the waist beyond 90 degrees.

The Spark People Infographic

The Dos

• Do keep the leg facing forward.
• Do keep the affected leg in front as you sit or stand.
• Do use a high kitchen or barstool in the kitchen.
• Do kneel on the knee on the operated leg (the bad side).
• Do use ice to reduce pain and swelling, but remember that ice will diminish sensation. Don't apply ice directly to the skin; use an ice pack or wrap it in a damp towel.
• Do apply heat before exercising to assist with range of motion. Use a heating pad or hot, damp towel for 15 to 20 minutes.
• Do cut back on your exercises if your muscles begin to ache, but don't stop doing them!

Sources:
American Academy of Orthopaedic Surgeons
The Spark People Infographic

"Terminal" breast cancer survivor channels recovery through writing

With National Cancer Research Month approaching in May, as well as National Women's Health Week from May 10-16, millions of people in the United States affected by cancer will be reflecting on this life-threatening illness.

After doctors diagnosed her advanced-stage breast cancer as terminal, San Francisco Bay-area author Alice Salerno started writing as a means of channeling a life parallel to the seemingly shortened one she was currently living. Following her diagnosis and throughout planning for inevitable hospice care, Salerno maintained a positive outlook on life and her continued personal interest investigating hopeful intimations of quantum physics, which ultimately developed into a new fantasy novel, "Jennifer Arthur and All the Gone."

Salerno’s masterfully created world in "Jennifer Arthur and All the Gone" reaches out to readers with a subtle invitation for them to color their own worlds with creatively positive thought patterns. Aiming to alleviate the alarming rate among young people toward destructive relationships and even near-epidemic suicides, she hopes to counteract the overwhelmingly dystopian trend in much of today’s literature.

“It appears more and more certain that we create, both in our personal worlds and our entire world, what we give our attention to,” Salerno said.

Despite forgoing radiation and chemotherapy treatment in hopes of a better quality of life, Salerno is in her 80s and miraculously living out her senior years cancer-free. She is now in three research programs with doctors to determine how she beat the odds.

Hip replacement - Three weeks

My hip replacement occurred three weeks ago.  Usually I would have seen a doctor after two weeks. Last week I contacted a Boise surgeon's office who told me that he wouldn't need to see me unless I was having problems. Then I called my surgeon's office in Utah.  The nurse told me after three weeks I could take the outer bandage off and start showering with my wound open.  The steri-strips that hold the incision together would fall off on their own.

I've been showering almost daily since the hospital with my wound covered by a plastic. Today I pulled off the outer gauze and with it came two of the six steri-strips. It was the first time I saw my incision which is about six inches long.  It looks like a purple marker was used to show the surgeon where to cut. It seems to be healing well. Completely closed, with no redness and no swelling. It was nice to shower without having to apply a plastic cover.  The AquaGuard plastic covers left a brown film of glue in a square that is about 8 1/2 by 11. It will take a couple of showers before that comes off and before the rest of the steri-strips come off.

Nexcare gives the following instructions for removing steri-strips:

"Peel the both edges of the steri-strips towards the incision. Once you peel the sides up, begin at the top and remove them gently from the top to the bottom of the incision. Some dead skin may come off with thesteri-strips. It is not recommended to remove steri-strips like you would a normal bandaid."

I'm now have nine pills left, enough for three days.  Maybe I can stretch them further.  My thigh stings almost constantly, although it is much better when I am rested. My ankle also hurts from the stress. Yesterday I overdid physical therapy and then strained myself closing a window when I got home. I was miserable for most of the day. At about 10 p.m. I was cold and so my son made me pepperiment tea and I got into bed.  I slept for a few minutes then watched some television.  About 11 p.m. I took a pill and ate a peanut butter and jam sandwich.  I still couldn't sleep so I spent about 2 hours grading.  Finally I fell asleep. Two hors later I was awake and in pain so I watched more TV.  I saw the 1941 movie "Yankee in the RAF" with Tyrone Power and Betty Grable.  His character Tim Baker was such a selfish jerk. Betty Grable as Carol Brown was as beautiful as ever, although she looked a little chunky and short on my flat screen.

When the movie was over I turned on BBC TV and learned that a plane had crashed in the French Alps flying from Barcelona to Dusseldorf. Last year my wife and I spent seven days in Barcelona, flying in from Paris and departing for Milan before going to the Balkans. It was surreal to see a plane crashing on almost the same route we flew.

At 7:30 a.m. I was finally so tired I went to sleep. I woke up at 9:30 when my wife called me.

How to get into bed after a hip replacement

It's been two weeks after my hip replacement. I've become a lot more mobile and flexible. Because of that I tend to do a lot of things that maybe I shouldn't.  One is getting into bed.  

As I've gotten better and stronger I have tried going knee first into my bed. The resulting pain suggests maybe I'm not ready to do that. I still need to be goinng in bottom first. 

Here is a video that shows how to get into bed.  

Day 13 - Hip Replacement

I changed the outer dressing on my wound. It appears to be healing. However, the pain continues. Not at the point of the surgery but inside my leg.  I guess that is a good sign. If there is pain it must be healing - right?

I had my operation in Provo, Utah and, after being released from the hospital, I traveled to Boise to stay with family while I recuperate. I had a 100 pills. Now I have 32 - enough for 8 days if I take 4 a day.  That is one every six hours.  The instructions said I should take 2 every four hours.

By the time it was 5 hours after taking the last pill, I was in real pain.  I had a hard time sitting on the bed. At 8 p.m. when I took a pill, I was watching news. I started to get drowsy and nodded off for most of the next hour. Hopefully, I will be able to get to sleep and I can sleep through the next period when the pain medication is wearing off.

(I keep forgetting how to crawl into bed. Knee first can be really painful.)

Because I am six hours away from my place of surgery, I won't be going back until the six week appointment with my doctor. I have been trying to find a doctor here who will give me post operation care. I was finally able to get my chilren's doctor to refer me to the surgeons in his group.  I spent most of the day today trying to get my Provo doctor's office to fax my records to the doctor's group in Boise.  When they see my records, they will assign a doctor, I was told.

Talking to people in doctor's offices is difficult. When you dial in your become part of a que and have to wait in line to talk to someone. Then they transfer you and you go through a series of prompts - press 1 if you are an insurance provider, press 2 if you are a doctor or hospital, press 3 if you want to talk to scheduling, press 4 if you are from a law office, etc. Hangup and call your pharmacy if you need a refill.   I pushed three and was asked to leave a message with my phone number. A half hour later when I called back, I pushed 2 hoping if I was a doctor or hospital that I would get a person to talk to. I got a recording telling me to fax my request for information. I had  a hard time understanding the directions and leaving my message. In fact, I finally left a message three times before I got a call back.  The medical staff are very nice on the phone, if only it was easy to talk to them.

I found out in the conversations that the medication I am taking can't be ordered over the phone or by fax, but that I have to have a perscription on paper. To get the perscription I would have to go back to Utah. It is unlikely the Idaho doctors will provide me the strong medication, I was told. The Utah doctor's office, when I run out, will be able to phone a perscription of a weaker medication, Tramadol, which isslightly stronger than anything I can get over the counter.  I can't take NSAIDS because in dealing with the pain from my arthritis, I got an ulcer. So now I'm allergic to NSAIDS.

Tomorrow I will have to phone the Boise office to see if they got my faxed records. 

Day 12 - Hip Replacement

The pain today seems to be greater than in past days. The outside of my wound seems to be healing well but something must be happening inside.  I've taken my meds on time but the pain is still there.  I stayed home today while the family went to church and did some work on my computer.  I've arranged my computer to be by my bed. I can work a half hour but probably no longer before lying down.

I've been thinking about the day of my operation, Tuesday, March 3. My daughter and I arrived at about 8:30 a.m. and the operation occurred at about 11 a.m. I went from a pre-op room to a waiting room before going to the operating room .  The operating room was filled with equipment including the operating table.  When my bed was moved into the operating room, little room was left for maneuvering around. My bed was removed before the operation began. I was already asleep when I was moved from my bed to the operating table. I was asked to lean forward on the edge of my bed when I received a spinal block of morphine and anesthesia.   

This is what the oprating table looked like. 

Day 11 - Hip replacement

It has been 11 days since my hip replacement.  The recovery progress has been a lot quicker than I supposed, particularly since starting physical therapy and exercises.

Last night I slept longer than I have since the operation.  I slept straight from 2 to 6 a.m. and then got more sleep after taking my meds at 6 a.m. Last night I was dozing off while I watched the news and a movie.  While the pain prevents good sleep, the meds seem to keep me from staying too awake.  I nod off quite frequently.

I was able to save a med in the last day by extending the time for taking meds from four two six hours. For example, I delayed taking my 10 a.m. med until noon.  I didn't seem to have too much more pain.  

This morning when I woke up I cooked eggs for my breakfast.  It is the first time I have cooked since my operation.  I supported myself on the kitchen counter while cooking and cleaning up.

Fortunately, the guest bedroom at my son's house is on the main floor, next to the kitchen/dining area. A bathroom with a walkin shower adjoins the hall leading to the bedroom. I use my walker for support when using the toilet and shower.

I was able to undress and dress and take my shower today without help. Except that I still needed my son to put on my socks. I'm now able to raise my "bionic" leg off the floor about a foot and so can put on my boxer shorts and leisure pants.  I wear leisure clothes (or exercise clothes) that are loose fitting and I can wear in public.

My feet are dry and cracking so my son rubbed them with lotion.  He also helped me with one exercise where I put an elastic cloth around my toe and then stretch.  I couldn't quite get the eleastic around my toe.  I could get an elastic cloth around my knees. I have six exercises from the physical therapist that take about 20 minutes. Then I elevate my legs and ice my wound.  I listened to an audible tape for variety today.

Although I'm getting more flexible, I'm still very stiff and my wound hurts. It stings almost constantly, even when I elevate it. 

Day 10 Hip Replacement

Very tired and sore after physical therapy. I spent 10 minutes on the stationery bicycle and then 5 minutes on treadmill.  My place on treadmill was very slow, maybe .6 of a mile.  I had a hard time getting one foot the same distance in front of the other. I did ankle exercises and then added a new exercise where I marched in place as I set on the edge of the therapy bed. Extending my leg to the side is still very hard. I can't reach down to take off my shoe or raise my bionic leg more than a foot off the floor. But still I'm making progress.

I slept about 6 hours last night but took meds in the middle of the night. The pain was too much the night before.  Yesterday I. Went grocery shopping. A half an hour was too much to be in my walker. Then this morning I got up to go to the bathroom and forgot my walker until I was in the bathroom.  That hurt. I'm still not ready to walk unassisted.

When I showered today I could do everything - dress and undress, put plastic over my wound, soap and rinse, then towel off. Everything except Rowling my foot and taking off or putting on my bionic sock.

Medications and hip replacement

Day 8after my hip replacement.

My doctor prescribed 100 oxycodone acetaminophen 10 325 to be taken 1 or 2 tablets by mouth every 4 hours as needed. When I left the hospital on day 4, 3 days after the operation, my doctor prescribed 100 tablets of oxycodone acetaminophen 10-325 to be taken 1 or 2 tablets by mouth every 4 hours as needed. 

When I left the hospital I was talking them at 2 tablets every 4 hours. I soon realized at that rate I would run out after 8 days. So I modified my pill taking to 1 every three hours.  Yesterday the physical therapist suggested a try taking one before I go to sleep. I took a pill at 12 midnight and then again at 5:30 when I woke up.  My leg hurt badly after exercising 3 times during the day. At 5:30 a.m. my leg was stinging when I took the pill.  

I started with 12 pills daily, cut back to 8 pills.  Now I'm at 6 pills.  With almost 60 pills left that is enough for 10 days.  At the rate of 1 every 4 hours I will run out on March 21.  By cutting back 1 pill per night I can last an extra day.  At 4 pills a day I can last 15 days. 

My goal is to get rid of my walker after 3 weeks. About the same time as I run out of meds.

What pain can I expect from my hip replacement?

I had a hip replacement a week ago.  Since then I have been looking for information on the Internet that would help me understand and deal with the experience.  I haven't found alot. This has left me feeling like I should write something about my own experience.

During the next few emails I will try to catch up. 

Probably the hardest part of a hip replacement is probably not being able to care for myself.  This was no more apparent than yesterday when I peed my clothes trying to go to the bathroom.

(It's 3:30 a.m. and I can't go to sleep but I'm almost too exhausted to write.)