Is it normal to feel unwell the day after hip replacement?

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I've just visited my Dad after hip replacement surgery, which he had yesterday.

He's 82 and was in very good health until about 3 years ago when he was diagnosed with cancer. He's now cancer free but the treatment really took it's toll and he's been frail for a while, then a stress fracture leading to the hip replacement.

Last night he was very cheerful, felt well and was in no pain. Today he looks dreadful, really unwell, says he feels very tired but also ill. Also in quite a bit of pain. The physio had him up and walking this morning. His observations are OK, except BP a bit low, but not unusually low for him.

Is he 'just' tired from the op and the physio and the energy going into healing, is this to be expected? He's always been a bit of a hypocondriac, convinced whatever he has is worse than anyone else gets it, but he does look ill.

Yes. It’s major surgery and is a huge insult to the body. However well he was previously it’s going to take quite a long time for him to get back to normal. You don’t bounce back at 82 as quickly as you do at 42. Or even 62.

Anesthesia itself takes a huge toll on the body

It’s also painful - this is often underestimated by surgeons and patients. And the first day post op is the worst.

If his obs are fine I.e no temp etc id say it was the surgery. At that age for major surgery, recovery and side effects from GA and the like will be longer. What pain relief is he on? Cocodomal makes me feel "ill"

Get his bloods properly checked. My MIL had a stroke the day after her hip replacement. She didn’t survive it.

He's had major surgery, its bound to be a shock to his body's system. Hope he's better soon x 💐💕🙏

This is often said but if you had an anaesthetic without an operation (I mean why would you, but if you did!) you would not feel nearly as bad. The body doesn’t know the difference between a careful surgical incision and being mauled by a lion and responds in the same way with massive fluid shifts, hormonal response, adrenaline surge and subsequent’come down. Add in age and the risk of perioperative delirium (not only due to anaesthetic but certainly contributes) and that hospitals are dirty dangerous places with infections in them, too hot, too cold, poor sleep, thirsty and hungry etc and the day after an operation you are going to feel appalling.

Keep a close eye and speak up if you’re worried . Ask for a second or third opinion if you sense somethings not right.

Its a big surgery for someone that age especially after cancer, we have some difficult conversations with similar patients as to whether the risk v benefit is worth it in these type of circumstances so please be very vigilant in case he’s not doing well. Dont get rushed into discharge either if you are not happy.

My dad was a bit younger when he had his knees done and I still remember how awful he looked on the second day when I went to visit. A mix of pain, the after effects of the anaesthesia and some stomach issues as a result of the painkillers really took it out of him. He recovered quite quickly though.

Thanks everyone.

I think PP is right, the surgeon minimised things a bit and he was expecting to feel right as rain within a couple of days, which always seemed optimistic. Apparently when the consultant saw him this morning he was told he was told he could go home today as far as consultant concerned, but needed to see the physio first. Then after physio he feels really unwell.

I run a joint pre-op clinic with a geriatrician and we constantly tell patients not to be over optimistic about their recovery. Also that the time in hospital post-op is very much based on ‘best case scenario’ and a day or two longer is often needed as you get older. (Although you have to balance that with the risks of being in hospital)

But I hope he feels better soon.

Was that the first time hed been stood up?

Hi OP, my mum had a hip replacement in July. She is younger, at 75, but it really knocked her out for at least a week. For mum, it was the codeine that made her sick. I noticed she was better in the mornings but felt really dizzy and nauseous in the afternoons which correlated with another dose. Some afternoons she couldn't even speak just sat with her eyes closed listening to something on Netflix! I stayed with her for the first week and as soon as she stopped the codeine her appetite improved and then it was a leap forward every day.

The hip replacement really changed her life. I hope it's the same for your dad and he's feeling well soon x

My dh was only 55 when he had his hip replacement, the first 3 or 4 days were really shit! He was in a lot of pain and struggling to sleep as he couldn't get comfortable. Its very big surgery for someone in their 80s, and yrs i think the surgeons often downplay how difficult the recovery can be.

Please do make sure they check that it isn’t an infection

Do keep a very close eye in case he has an infection.

However they stop the good drugs after about 24 hours if I remember right, so that can make a difference. I think the good one's oxy something? I only got three doses then onto paracetamol or codeine. Also a hip replacement is an absolutely brutal operation physically, so it's normal to feel exhausted and like you've been beaten up, because you have been.

Yes very normal after a hip replacement and not necessarily an indication anything is wrong, especially given his medical history.
Make sure he keeps taking his pain relief and tries to change his position and move (e.g. Bed to chair) little and often. I'm sure he will be back on his feet in a few days, sometimes people are mobile the next day and sometimes it takes a little longer. Hopefully they are keeping an eye on his bloods whilst he is admitted, particularly his hemoglobin levels just in case that is contributing to how he is feeling.

My goodness yes he’ll feel dreadful for a few days in not a week, his body is in shock!

My mum is nearly 78 and had a hip replacement end of July. She was very tired and in a lot of pain, but she never felt ill. In fact they would have let her go home same day but she hadn't been to the toilet so was kept in overnight. She had an epidural though and not GA so that may have made a difference.

According to a medic I knew via school, each hour of anaesthesia takes up to five days recovery time. My DH had just had deep, long heart surgery and the operation took five hours. So it took seven weeks before he felt normal enough to engage with ordinary life. Proper recovery is a slowish process.

He didn't have GA. Epidural and sedation.

How is he this morning and what is he taking for the pain?

Yes. Dad had hip replacement last year and was in severe pain beforehand so had built some pain tolerance. After the op and into that first evening he was happier than he’d been for months. Next day he was vomiting, felt totally out of it (didn’t get on well with codeine) and felt exhausted. This went on for the rest of that first week and he was quite worried. It was also painful for him, and I said, the pain relief helped with pain but made him feel ill too.

much improvement by about day 6!

I had a fairly major op done (7 hours long) and I was out of it for at least a week. I didn't even have the energy to read or watch TV.