What happens before hip replacement surgery

A month after my surgery

Everything seems to be going well for me at this point. I will catch you up on after surgery soon, but here is how it went up to the day of surgery.

Now I just want to get it over with.

I made sure I was going to get the direct anterior method hip replacement I wanted. That was stressful, now let’s just get it over with!

(If you haven’t read my previous post about this, here’s the link – https://lynntowin.ca/what-you-need-to-know-about-hip-replacement-surgery-and-nobody-tells-you. This post is really important to read if you need a hip replacement.

My surgeon came up with the solution to my request for this method less than two weeks before the surgery date, on a Friday.

Appointments before hip replacement surgery

The following Monday, the phone calls starting coming, fast and furious. I needed to go for blood work, and x-rays on both hips. Oh, did I mention that my left hip has the same problems as my right? And that double hip replacements are a thing? More on that later.

I went to an appointment at the hospital for an electro-cardiogram to make sure my heart was up to it.

A physiotherapist from the hip and knee clinic called to get me the paperwork to pick up the available after-surgery aids (a walker, a bathtub seat, and a $10 disabled parking pass).

Any time I could, I mentioned that I was having the direct anterior method of surgery. The x-ray techs and the cardio tech had never heard of it.

My pre-operation appointment was by phone call. We went through health questions, previous surgeries, and medications. They told me I would be in hospital for several days. I said I was having anterior surgery so I should be out by the next day. They didn’t know I was having the anterior approach, so assumed the more common lateral approach.

I watched a webinar the day before my surgery. It showed exercises to do before an operation, ways to get your home ready for your return, what to take to the hospital. The webinar should have been offered to me when I was put on the waiting list a year ago. But, that was one of the steps that was skipped for me because of covid.

Conflicting information before surgery

Two days before surgery, I tried to set up my bathtub seat to try it out. That thing was huge, and it didn’t fit either my bathtub or my shower downstairs. I called the hip and knee clinic to see if there was another option, and no there isn’t. You can buy your own bath seat. Fortunately a friend had one so then I was good.

When talking to the hip and knee clinic physio, I said I had read and watched all the information available, and it was all geared towards the regular lateral surgery. They explained there were very few of the anterior operations done, so yes that’s what the information they give is based on. Okay, totally makes sense.

I asked how that works then for after surgery, since the timelines in all this information are much longer than what I would expect with direct anterior surgery – based on everything I read about the surgery.

They said the same timelines would apply, they have not seen any difference in recovery here! Is that because so few of these surgeries have been done here? No, we have done tons of these surgeries here. Okay, totally doesn’t make sense.

Many caregivers told me many times – all after care and timelines are the same no matter the type of surgery. I believe we just don’t have enough experience here. Patients are told they must not walk without a walker for at least 6 weeks or risk dislocating their new hip, so they will use the walker for 6 weeks and not try to progress more quickly. More progress is not expected, so it doesn’t happen.

These guidelines need to change, and I will keep telling my caregivers at every opportunity.

What happened the day of surgery

I was the first surgery of the day, whisked in to the pre-operative area shortly after I arrived at 6 am. My good friend Kathy, who happens to be a nurse, was my amazing support person who came with me. (A support person is so great to have – they do not have to be a medical person just a solid helpful friend.) If you don’t have someone who can do this, you must let your caregivers know. An extra night or two in hospital could do the trick.

I got into my gown and hair cap and slippers in the pre-operative area. I tested for covid. The caregivers asked me many questions all over again about what I had to eat and drink lately (nothing) and my medical status.

I asked something everyone wants to know – will I be covered up? They confirm more than once that you are buck naked under the gown. Doesn’t that make you wonder? I don’t want my bits in everyone’s faces in the operating room. That would be embarrassing for me and distracting for the surgeons! The nurse assured me that my dignity would be preserved with draping. I will never know for sure though.

Anesthesia

A whiteboard behind me showed my surgeon’s name and another name that I did not recognize. What! I knew the name of the other surgeon, so whose name is that? It was the anesthetist. I knew the method of anesthesia was discussed only on the day of surgery.

The anesthetist made his appearance. He introduced himself and asked if I wanted general anesthesia or a spinal anesthesia. Well how would I know, I’ve never done this before. So I told him I needed him to explain the pros and cons.

He explained that the general anesthetic had a risk of nausea afterwards. The spinal anesthetic meant numbness for several hours after surgery. I asked if there were any other stipulations, such as if I have one or the other I can’t have it again for six months or something, and was told no.

I have no desire to hear sawing and hammering on my body, that sounds like a horror movie! And I know I want to be walking not long after surgery. General anesthesia it is.

In the operating room

My support person was with me until it was time to go. Someone wheeled me off to the operating room where I saw my surgeon, Dr. Rodwan.

The cheerful nurses in the room assured me that they were prepping me for direct anterior surgery. Yes, I asked again. The operating room records still show me as having “regular” hip replacement surgery. I’ve had to correct many people.

I met Dr. Ardell, the direct anterior surgeon, so I finally believed I was getting the surgery I wanted.

I told Dr. Rodwan if they were having fun and felt like it, they should do the other hip too. He was waiting for that I think, and smiled and said no, one at a time. (He’s heard me talk about this a few times before and was probably thinking will you shut up already…..)

The anesthetist put the gas mask over my nose and mouth and after a while that was it for me.

In the recovery room (I think)

The next thing I was aware of was massive pain from my hip to my knee, and a voice asking my pain level several times. My eyes were fluttering trying to open but I saw nothing. I think I said “8” three times, but that was the most pain I’ve felt in my life. (Someone coached me at some point on how to describe your pain – 10 being the very worst.) The pain was actually a 10. I don’t think it lasted long though, but again, I will never know for sure.

This must have happened in the recovery room. It’s a room with many patients just out of surgery, where you are kept until your vital signs and pain are stabilized. I believe I was there for about two hours.

In my hospital room

And next thing I knew I was in a room with no pain at all! Of course the morphine was helping, but I felt pretty good. I made it to the other side!

The month after surgery

Stay tuned and I will let you know how it has gone!