What do Billy Joel, George HW Bush, and my grandmother all have in common? They all had successful hip replacement surgeries and joined the ranks the 285,000 Americans who go under the knife for this surgery each year in the United States.
For 91 year old Mrs. W* (name changed), the decision to have hip replacement surgery came once her doctor told her that due to the bone’s deterioration and crumbling, it could break even if she were sitting in a chair. Today, two months after surgery, she sits down with Homecare Advocate to tell her story.
HA: What non-surgical approaches did you take to relieve pain and improve function prior to surgery?
Mrs. W: I’ve used a cane for years, but the pain progressed significantly over the past year or so that by the end I was hardly even able to use a walker. Though some may use pain pills to relieve pain, I’m on Coumadin [a highly-sensitive blood thinner medication] and was only able to take Tylenol. Tylenol would dull the pain but never relieved it.
HA: At 91, what were your primary concerns with having hip replacement surgery?
Mrs. W: Well my heart doctor originally told me a year or two ago that I shouldn’t have it. The surgeon was more concerned once he heard that and wouldn’t consent to surgery until I had tests run. They marked me at “high risk”, which made it hard for me to take that risk and proceed. I was also worried about the risk of stroke as I had to stop taking Coumadin before surgery.
HA: When did you know it was “time” to have the surgery?
Mrs. W: The pain increased from last Christmas until November when I made the decision to have it. Every week I could tell it was getting worse. But what finally convinced me to go ahead was when the surgeon told me my bone was crumbling and that because of that, I could be sitting in a chair and it break. Beforehand I thought I could only break it if I fell, so I did everything I could not to fall. Once I heard that it could just break on its own, I felt like I lost control over it and had to do something.
HA: Did you have to do anything special in preparation for the surgery?
Mrs. W: I had to do slight exercises and deep breathing, which I think was to help ward off pneumonia. I also had to take showers with special soaps 2 nights before, the night before, and the morning of surgery. They [the surgeons] wanted me to be as sterile as possible before surgery. Of course, the biggest change for me was having to be off Coumadin for 5 days.
HA: Why did the doctors want you to be off of Coumadin for so long?
Mrs. W: Hip replacement surgery is a bloody surgery, and they don’t want you to lose too much blood. Since Coumadin is a blood thinner, you bleed more freely if you’re cut. Even being off of Coumadin 5 days before surgery, I had to have two pints of blood.
HA: How long were you in the hospital after the surgery? Did you go home or to a rehab center during recovery?
Mrs. W: I was in the hospital four days; some aren’t there as long. Since I was recovering during the holidays, I chose to stay at a rehab facility in town and was there for 28 days. They had excellent nurses who were there any time I needed them. Once I got home, a physical therapist visited me weekly to continue my recovery.
HA: At what point post-surgery did your pain drop below your previous pain level pre-surgery?
Mrs. W: I was unaware of everything for four or five days following surgery because of the pain medication, but by the time I roused, I was not in the pain I was accustomed to. It was an amazing feeling.
HA: What types of exercises did you do in physical and occupational therapy?
Mrs. W: We did ankle rotations and knee bends, straight leg exercises, standing exercises, and balance exercises. I also did upper-body strength training with weight machines which helps me rise properly from a chair. We practiced getting in and out of a car; I learned the farther back you put the seat, the less you twist the hip. We also learned the safest way to get out in bed, which is to get in with the good leg first. They teach you all of this to help regain strength and to keep you from dislocating your new hip while it bonds to your bones. They worked us hard, two times a day, six days a week with each session lasting 1.5 hours!
Above and beyond what all doctors, nurses and therapists could do, my faith and trust in God gave me the strength each day to keep me going daily and do what is expected for recovery. Some of the other patients at rehab refused to go to therapy and never learned how to help themselves. Surgery for a 91 year old is major, so after I agreed to have it I was determined to do everything required of me to get the biggest benefit I could.
HA: Do you still do any exercises now that you’re at home?
Mrs. W: Before I had surgery, I never exercised. The pain took over to where I could hardly do anything at all. But now that I went through rehab and learned what to do, I continue my exercises and stretches at home. I do ankle exercises while watching TV, perform deep stretches while seated, and walk around my house and backyard.
HA: What have you done at home to create a safe, accessible environment?
Mrs. W: I already had a lot in place and was using it before surgery since my hip was so bad. I think that may have prepared me more for using them after surgery than those who had never had anything before. I use my reacher for everything! I have handrails on stairways and a stair lift if I need it again. In my bathroom I use a raised toilet seat, shower bench, grab bars, and long-handled sponge. I turned a plastic hanging shoe organizer into my “catch all” by my favorite seat lift chair that holds the remote control, phone, tissues, reading materials, and such so that everything is nearby.
HA: What are you looking forward to now that you’ve had a successful hip replacement?
Mrs. W: I’m most looking forward to being carefree from other people. I’m an independent person that likes to take care of myself and do things myself. I hope to do that as long as I can. I would love to drive again, but… maybe later [she chuckles and her eyes sparkle mischievously].
HA: What is the one piece of advice you’d give our Homecare Advocate readers contemplating hip replacement surgery?
Mrs. W: Have it before you get to the point where you’re suffering like I did. And remember, it’s all in a matter of adjustment, tolerance of pain, and change of activity. I’m happy to have done it all, and I truly think I succeeded!
Tune in next week as Homecare Advocate digs into the details of hip replacement surgery. We’ll cover surgery trends and advancements, risks, and benefits of what the American Academy of Orthopaedic Surgeons has called, “one of the most successful operations in all of medicine.”
::AWP::
Josh’s story reminds me of Bryan Anderson, a vivacious young man who lost both legs and left hand during his military tour in Iraq. Bryan visited Lambert’s a few years back to speak to our patients about how adaptive equipment can still enable you to live a full, active life. Bryan was filmed by our local news doing skateboarding tricks and talking about the sports he still enjoys doing after his injuries in Iraq. He has since appeared on the cover of Esquire magazine and acted in TV and film for CSI: New York, All My Children, and The Wrestler starring Mickey Rourke.
Bryan recently released an autobiographical book on his courageous journey, “No Turning Back”, which is available here. In it, he candidly describes the transformation as he realized that his life would never be the same & how he was determined to live fully after the accident. His outlook on life kept him going through 13 months of rehab and is an inspiration to other young amputees and people with disabilities. “This book, ” Anderson writes, “is not about being wounded. It’s not about struggling. This book is about living. It’s about life.”
