Editor’s Note: A first-hand account of hip replacement in a three-part series. Today, Part 3: Recovery.
After three days at Kansas University Hospital, I was ready to go home.
I was recovering from a right hip replacement surgery that I needed at age 40 because of congenital hip dysplasia, which means my hips didn’t develop correctly. My first surgery was at age 2.
In 1972, my surgery was four hours and I was in a frog-leg cast for nine weeks. In 2011, my hip replacement took only an hour and I was walking the next day. My mom was amazed.
Within three days, I was going up and down hospital stairs one leg at a time, and getting around with a walker. I just couldn’t lift my right leg, so I needed help getting in and out of bed.
I hadn’t noticed how much my hip had swollen until I put on my once loose-fitting sweats to leave the hospital. My hip was at least twice its normal size.
“Whoa,” said my younger brother, who came to help take me home. “Looks painful.”
I went home with a walker, cane, gadgets to help me put on my clothes and pick things up, and a handful of prescriptions, including one for shots. For 10 days, I had to give myself one shot to prevent blood clots.
I wasn’t sure if I was brave enough to give myself a shot, but the nurse showed me how. I had to make sure the air bubbles were out of the syringe, then I had to clean a small area on my belly, pinch the skin together, and poke myself. It wasn’t as bad as I thought.
I also had restrictions, among them: No driving or bending more than 90 degrees at the waist until my follow-up doctor’s appointment in four weeks, and no showering for at least a week. These were to prevent dislocation and infection.
The typical recovery time after hip replacement is two months; for knees, three to six months. That’s for the average-aged patient, which at KU Hospital is 62. Its youngest patient so far was 14 and its oldest was 92.
Of course, I’m atypical because of my age and good health. That’s why my doctors and physical therapists said I was recovering faster than most. My recovery took about one month.
Before the surgery, even though I was in pain, I remained active. I walked three miles almost daily on a treadmill — my hands would get numb from holding up so much of my weight — and I biked.
Jeremy Zimney, a physical therapist at OrthoKansas in Lawrence, said doctors will prescribe prehabilitation for certain patients before surgery. Often that means exercises in water.
“We do see some of that, but it’s not common,” Zimney said. “Typically, it’s if there is a severe range of motion loss or if there are cardiac issues that may put them at risk.”
He estimated that one out of 25 clients may have prehab before surgery.
Zimney has worked with clients who are recovering from joint replacement surgery for about 11 years. He typically sees patients between the ages of 55 and 75. His client list is growing.
“People are living longer so they want to have an active lifestyle and maintain the lifestyle that they have,” he said.
The recovery for hips is easier than for knees, according to Zimney and orthopedic surgeons. Here’s what Zimney had to say about recovery:
• Hips — Pain decreases right away and patients are able to walk the next day. For about six weeks, patients can’t bend more than 90 degrees at the waist because there’s a high risk of dislocation. Recovery is about two months.
• Knees — Still painful after surgery. It takes between two and three months before the patients are glad they even had surgery. But, there are no restrictions with knees. Recovery ranges from three to six months.
Like most things in medicine, he said, the type of rehabilitation that a patient receives often is dictated by insurance. Most people get home health services and then have outpatient therapy. But that’s not always the case.
I am fortunate to have health insurance that covered home health services.
“Home therapy is great because you have an opportunity to really see what that person specifically needs to get around the house,” Zimney said.
I returned home on a Sunday, and the next day I received home health and physical therapy services through Douglas County Visiting Nurses Association.
Debbie Fattaahi, a registered nurse, checked my incision and went over my medications. I had an allergic reaction to a pain medication, which caused some dizziness and a red rash across my back, so I was glad she was there to help. Once we switched pain medications I felt much better. She came for just one more visit.
On the first visit, physical therapist Bethany Stadalman went through the house to make sure I could get around and had everything I needed. She checked my strength and then advised me to walk around the house with a walker as much as possible, but at least for five minutes three times a day.
During the next visit — just one week after surgery — she added strengthening exercises and had me exchange the walker for a cane. I also walked outside for the first time and, boy, did the warm sunshine feel good. On the third visit, she checked my incision, we took a walk outdoors and she helped me get in and out of my car. I had to sit on a pillow, so I didn’t break the 90-degree rule.
During her fourth and final visit — just two weeks after surgery — she had me walk outside without a cane and we added ankle weights during the strengthening exercises.
I was wobbly because my body was still adjusting. Also, my right leg is about a half-inch longer than my left. That’s because my right femoral head is round, as it should be, instead of flat.
The unevenness will be fixed when I get a left hip replacement.
She also called my doctor, and he said I didn’t need to put a bandage on my incision anymore. Woo hoo! I was starting to see the light at the end of the tunnel.
Four weeks after the operation, I had the follow-up appointment with my surgeon, Dr. Kelly Hendricks. He cleared me of all of post-operative restrictions and said I could drive again.
He still wanted me to take a daily aspirin and wear TED hose — those tight, white ugly stockings — to prevent blood clots for two more weeks. I was really hoping to get rid of the TED hose, considering summer’s 90-degree temperatures, but he wasn’t budging.
Hendricks said my hip would get stronger every day and gain flexibility.
“Over the next three months, you will get 95 percent better. Over the next nine months, you are going to get incremental small benefits,” he said.
He said I could go back to doing normal activities: playing tennis, riding my bicycle, walking and swimming. Some doctors place no restrictions on their patients once they’ve fully recovered, but Hendricks would prefer that I be more cautious, which means no running.
“I don’t want you running marathons, but using an elliptical machine at the gym or riding your bike around town or doing a biathlon is fine — within reason,” he advised, adding that the new hip could last me the rest of my life.
“Impact aerobics, contact sports, like hockey — to me I don’t see the utility of any 40-year-old needing to do that, let alone somebody who’s got a hip replacement. I’m 40. I don’t need to do that,” he said with laughter.
My husband and I laughed, too.
Hendricks predicts that I will be ready to have a left hip replacement soon.
“What usually happens is when people have both of their hips that are badly affected they get the first one done and then they are like, ‘I can’t wait to get at the other one.’”
He said he would do it anytime after three months — giving my right hip time to heal.
At seven weeks, I am really feeling the benefits. I recently played tennis with my husband for the first time in several years. There was no pain on the right side, but a tremendous amount on the left.
I told my husband after the tennis match to take advantage now because after I get the left hip done, “I’m going to kick some bootie.”
Day 1 — Preparation.
Day 2 — Surgery.