Early hip replacement - please help!

[SadHippy]

I am 40 and have had hip pain since DS was born 11 years ago. It has gradually become worse, and is now affecting daily life and making me very miserable. I have gone from regularly walking 8 miles every day to being unable to walk downstairs without pain.

Over the years, I have tried osteopathy, acupuncture, physiotherapy, pilates and chiropractic. I have variously taken rosehip, glucosamine and chondroitin (which disagreed with me), and fish oils. I've also had steroid injections into the joint. None of these has helped . I'm now on the maximum dose of naproxen plus paracetamol. I don't want to start taking the addictive painkillers, as I know this is just exchanging one problem for another.

I've seen a consultant several times, who says that the only real option now is a double hip replacement, and that he will put me on the list as soon as I can't bear to carry on as I am. The waiting list is about 14 weeks at the moment.

If I were on my own with no children, I would probably get it done now, and face the dreadful prospect of revision surgery in the future. Every day is governed by the pain in my hips. However, DH is often away, and DS has Asperger's and is extremely challenging for every single second when he's not at school. I also have a 9 yr old DD (neurotypical, but expert in winding her brother up) and a dog.

What I'm wondering is how on earth I could cope with the post-surgery part? DH could hold the fort while I'm in hospital (for how long??) - but I'm terrified at the prospect of trying to cope with the children and dog whilst being out of commission. We have a downstairs loo (can you climb stairs post-replacement?) and friends who could take DD to school and collect her - but DS is a very different matter. My family live too far away to help out.

Please, please could anyone advise me who has experience of what's involved in the recovery, and tell me how they coped more or less alone with children??

Please?

Oh dear, I've only just seen this and must get off to bed. Tomorrow I will come back and tell you how I did. I will say I had my first hip replacement in 2000, that's an experience I would not like to go through again which is why I stupidly was as stubborn as a mule and point blank refused to face up to the fact that the other hip needed doing and revision on the first. So despite reassurances that hip surgery had really altered I allowed myself to literally grind to a halt, one hip became fused and the one needing revision the cup was loose and had worked up into my pelvis. It was my own stupidity that allowed me to get in that state and the pain was awful.

So I finally had one hip replaced and could have cried for the wasted years. It was so easy and all the pre op pain gone. I've since had revision on the other, don't believe the horror stories you might read. I am now pain free.

Don't be like me and leave things until you can't function at all because that is the outcome in the end if left too long.

I'll come back tomorrow and tell you how things work after :)

Ohhh, and don't panic if you have worked out my first hip replacement didn't last long. The cup was knocked loose when my feet slammed into the car floor when we were in an accident. A hip replacement lasts heck of a lot longer now then they used to years ago.

don't panic, hippy. a friend has recently had a replacement in her forties after years of pain like you. Massive success. Another friend aged 32 had one following a skiing accident.

My DM is 20years on from bilateral replacement and has seriously never looked back. the only lasting thing is the angle and height of her car seat has to be just-so (that may be an individual thing, I don't know) but there is absolutely nothing else hip related that slows her down. It was life changing for her, and for the better. she had them (both) done in her early fifties, at that time it was mainly folk in their 70s+ who were having it done, so she felt much like you do. Flipping brilliant. The surgery has improved and the scars will be much smaller than DM's. She's possibly the only granny I know who wears girl-boxers to hide hers

My DH has just been told he needs both his hips replaced. I will be keeping an eye on this thread for more positive information. He is quite worried because I have pretty serious health problems & I rely on him a lot for help around the house & with shopping. I have told him I will be fine & he will feel so much better after it is done but I think it will be better coming from people who have actually had it done.

Hello, I will share DH?s experience in case it is helpful, although not quite the same situation as only one hip and also was some time ago, so things will no doubt have changed since then.

DH had a hip replacement 16 years ago when he was 34. He had a congenital abnormality that had deteriorated and the hip had fused. By the time he had it done, he was like you, had tried most of the things you have listed and could barely walk to the end of the street and was in dreadful pain. DH had an uncemented hip replacement. What type is being proposed for you? It makes a difference in terms of post-op recovery. The uncemented replacement was recommended for DH due to his age. It is designed so that the bone grows onto the surface of the replacement part which makes a much stronger joint for a more active younger person. His surgeon was also of the opinion that this method is better for revision in the future. He also had a ceramic coated type which was fairly new at the time and considered more suited to a more active lifestyle of a younger person. He had conventional surgery so about a 10inch scar and also more invasive to the muscles etc. so physio and exercise afterwards was really important (mind you he had significant muscle wastage anyway due to lack of movement caused by the fused hip so needed it for that anyway). I believe now there are more minimalist methods of surgery that mean very small scars and far less impact on the muscles.

Think he was in hospital for about a week to 10 days (can?t exactly remember) but this may be quite different with more modern surgery. His pain management was not very good immediately post-op but this sort of thing has improved massively since then (he recently had major surgery on the other leg for an unrelated reason and had virtually no pain post-op as this was managed so well). He was non-weight bearing for 6 weeks post-op and then partial weight-bearing for another 6. This was particularly due to it being uncemented as this allowed for the bone growth to secure the replacement. He was shown how to use crutches to get about, up and down stairs etc. and was up and down them straight away, and out and about on the crutches. He was not allowed to drive for about 3 months I think. This could well be different with current techniques and depending on what type of surgery is considered most suitable for you.

Post-op he has been entirely free of any pain and went back to work as a joiner, coaching football etc. 16 years on it is still entirely problem free, although given a 16-20yr ?lifetime? for the replacement he has started to wonder when he might need another. The type he was given has been shown to be very successful in follow-up studies so we are hoping for a few years yet, especially given his recent surgery.

We did not have children when he had his done (although DD1 was born about a month later!) and I can understand your worries about that, particularly with your DS (we also have a 12 year old DD with aspergers so can understand this is particularly worrying). Are your worries more about practical aspects of it ? i.e. does he need physical help that you are concerned about providing? Or is it more about him coping with the changes and disruptions to routine? It might be worth posting on the SN boards for specific help on this aspect? I am sure people over there have had experience of managing in similar situations?

It was absolutely the right thing for DH to have it, and transformed his life at the time, particularly in respect of the pain. If you can manage to get through the disruption of the op and initial post-op period, I would think things would be a lot easier for you than now.

I hope that is a little bit useful.

I've not forgotten, we have unexpected visitors! Will be back this evening when they have gone :)

Thank you all so much. What a lovely collection of kind posts.

(And I'm most entertained by GrannyShrek's girl boxers. I am sure I still have v large pants left over from my c-section).

I have managed to survive a c-section with a toddler, and a burst appendix when DC were 4 and 6, so a hip replacement shouldn't be impossible.

Turningupside down: the thing that worries me about DS is his meltdowns. He's at the ultra-high-functioning end of the spectrum, and also at the ultra-high-meltdown end. DH can't cope with him at all when he's here, which means that I'm the one who has to prevent him from trashing the house/trying to kill the dog/a sibling/himself and so on (I am only mildly exaggerating). I hadn't thought of asking on the SN boards, though, so that's a v good idea.

Alwaysme, I am looking forward to hearing more!

Thanks again, all you kind folks.

Back at last, sorry I have been so long!

Hip surgery has changed, when I had my very first 13 years ago, in hospital for 10 days, awful after op pain. couldn't lift or lower the leg for 3 weeks without help. Couldn't get in or out of bed without help. On 2 crutches for 6 weeks, then one crutch for another 12 weeks. Without those crutches, I was rooted to the spot, my leg wouldn't hold me up.

2nd hip replacement 2011, in hospital for 3 days, apart from soreness at the incision site and the leg feeling a bit like lead, nothing I couldn't cope with. Pre op pain gone. Physio shows you how to get out of bed and back in day after op. And, you can put weight on the leg and it actually holds you up. That I found amazing after my first horrendous experience.

They will show you how to climb stairs, it is surprisingly easy. You may get bruising come out in various places on the leg and your knee might get quite sore, that is all normal. Ice packs are useful and you should make time if possible to sit with your leg raised for the first couple of weeks, helps swelling. The first week you will feel quite tired and if possible take a nap where you can. Also, take pain relief regularly (I only took paracetamol and ibuprofen didn't need anything stronger). Where before the op pain relief doesn't seem to do a thing, after it does because this time it is just to help battered sore muscles. Everyone is different so you might not need them for long.

When I got home, I walked in and said look no sticks I might have been walking like a penguin but I could do it. First time round no way!! Seriously though, use at least one stick at first in the house, you will find sometimes you can get around just using worktops. Outside use 2 sticks at first, just until you feel safe to use one. Only takes a little time. At some point you will find you walk off without the stick, then you know you are nearly there.

Sleeping is the worse bit as you have to sleep on your back, they say for 6 weeks. This is so your operated leg cannot cross the middle line if you sleep on your side. I managed for 2 weeks, then slept on my good side with a pillow between my legs to stop the operated leg dropping to the mattress. Worked well and I got some sleep.

You will need a chair with arms where you can sit and your knees are level or lower than your hips. You will need the arms to lower and push yourself up for a while.

Oh, and you will be supplied with the dreaded raised toilet seat, one of those things you can't do without in this situation but can't wait to see the back of!!

Housework wise I just carried on as normal although a bit slower. Brilliantly, hoovering is banned for a while, too much swivelling of the hips apparently. Thing is though, the pain before was so bad that I actually found things easier after. You should avoid lifting heavy weights for a while apparently, no one told me until my 6 week check up. Twas a bit late then but doesn't seem to have done me any damage. Driving is usually out until 6 weeks although I will confess a sin. I nipped to the local shop at 2 weeks, not far but still risky. It is to do with having to suddenly do an emergency stop, especially if the operated leg is the one stamping on the brake.

I hope some of this has been helpful, child wise I can't be much help. All I can say is that things in general were much better after the op because of less pain despite still needing the other hip revised. The first week home is probably the hardest as you recover your energy and adjust.. We do have 2 dogs and 2 cats though, one of the dogs was an 8 week old puppy at the time, now that was a bit tricky.

Oh and the revision surgery, I finally had done 8 months ago. Only in hospital for 2 days instead of 3 and the recovery and discomfort was no worse than the other. Maybe I was just lucky with that but I have heard the same from others.

Try not to put it off too long because things will just get so bad in the end. If there is anything else I have missed, just ask.

I forgot, my surgeon said the most important thing for hip recovery. Walk and walk some more, that's all the exercise you need after hip surgery. Hips have a way of sorting themselves without masses of physio. You get a few simple exercises shown you at the hospital which were useful for getting the leg moving but it was the walking that really helped. Start with really short walks and gradually go further. It really works :)

I was just re reading turnings post and it reminded me about cemented and uncemented.

Different surgeons all have their own opinions on weight bearing. When I saw the physio in hospital who showed us the few exercises, there was me with screws (yep them things you buy in a hardware store ) and the other lady uncemented. We both had the same surgeon and we were both allowed to put weight on the leg. Other surgeons say no weight bearing or 50% weightbearing for so many weeks.

Likewise when I had my revision surgery, I had two large bone grafts. I was still allowed to put full weight on the leg. Yet I know patients with other surgeons are not allowed. I suppose it's just different opinions.

I do know though that the surgery is really different now, less invasive and the muscles are separated instead of cut through. Hence the leg being able to support you unlike my first ever surgery. Couldn't put weight then even if I had been allowed. Oh, and the scar is much smaller, half the length of my original one.

Thank you alwaysme I will share your experience with my DH too.

My dh had. A hip replacement last year. It was the best thing that he could of had. He had no pain afterwards. I think the worst thing was having to sleep on his back, the horrible white stockings and the daily injection of clexane ( which I did with glee ) he did exactly as he was told by the hospital, did his daily walks, sat in chairs the right height etc. they did not let him come home unti e could walk up stairs which they do at the hospital. He went in on thurs and came home sat lunchtime. Hth

hippy, I also have a very intelligent aspie ds, but mine's 12. He has had to deal with dh having 6 months chemo and 9 months off work - so huge changes to how thigs run in our house. we also have 2 younger nt dc. Ds1 deals in facts. with added scientific / biological info, obv it was "dad is having chemo. this [insert treatmemt detail] is what happens, he will feel like [crap/ok/superman] and his hair will all fall out because of the medicines." he actually came in to see dhs first treatment and quizzed the nurses about how the iv line worked etc, and once well informed was mostly extremely well behaved (so long as he understood why his routines had to change) He even managed a very successful transition to high school in this time.
Give your ds as much info as he can deal with, and tell him exactly how he needs to behave and what helpful thing he can do regularly (feed the cat or dry the dishes?) we went very close to social story-ing at times, so that info was honest and factual. even at a very young age, and certainly by 8, ds could understand even abstract stuff if the explanation was decent. if you can get a pre-op quick visit to where uou will be, he is likely to be more happy. Sorry for extreme posting. (I'm also an asd specialist teacher ) don't push the play button or I will go on and on and on ....

See, it's amazing how soon you forget. How could I have forgotten those awful white stockings

First hip replacement I didn't have them (2000) think that was down to the surgeon again. Also blood thinning medicine wasn't used at least not as routine. I survived !!!

Hip replacement 2011, had the stockings, or as I called them shocking I stuck with them at home for three days, until the third night I woke up in agony. They had cut in below the knee and were so tight around the ankle because of leg swelling, if I was going to get a blood clot it would have been because of them I reckon. My husband had heck of a time trying to get them off as the leg was so painful, but the relief once off. I never put them on again and the revision op I took them off as soon as I got home. I'm not advising anyone else to do the same but there is varying opinion as to how helpful they are in preventing blood clots.

Another thing I remember is to place a pillow under your leg to prevent the heel resting on the mattress. As you are not moving normally in bed and stuck on your back the pressure from the mattress causes real burning pain on the heel after a while.

I was so relieved not to have to do those blood thinning injections, I had heard about them beforehand. I was given the drug in tablet form to take home. I am in Bristol and I think it depends on what part of the country you are as to if it is tablet or injection.

I shall shut up now

I agree about the damn whits stockings. I am only small whilst my dh is 6 ft and big. I struggled so much to put them on each morning. It was getting them over the foot and ankle, after that it was ok. Not that far away in terms of geography. Am in Bournemouth. They gave him a spare pair to bring home which seemed to be even tighter ! Also occupational health camr round to see height of bed, chair and toilet. They lent him a seat to place on top of loo as would of been too low. Also gave him a shoe horn thing. But in three months was ready to return to work. Hospital were great.

I havent read all your posts in detail so sorry if i am repeating
I work in rehab so lots of people i see have had Hip replacements
It a big op but very common they do loads and most are fantastically successful
people tell me its wonderful that the pain is gone
You will be up quickly in hospital and go home with crutches - physio should teach you to go up and down stairs
if you sit with your feet flat on the floor get someone to measure your lower leg from the back of your knee to the floor - usually about 16" everything you sit on post op should be at least 2" higher. An OT should teach you what you can and cant do whilst you are healing
walking is great- getting into a car can be tricky
you just have to make some adjustments but should be provided with aids and equipment but you are not out of action

mummylin you are probably right about the spare pair being tighter. The pair that caused me agony in the night were put on as a clean pair before leaving the hospital. My husband struggled but couldn't get them on, he is strong! A nurse took over and she had them on in no time.

First pair I was given to take home and wash, which I duly did and hung up to dry. When I came down in the morning with the pair which caused all the grief, I was shocked that they were half the size of the pair hanging up and dried. I think the packet was either mismarked for size or the nurse just grabbed the wrong size. These looked more child size.

Alwaysme: thank you so much for taking the time to explain all this so fully. What's funny is that I have to sleep on my back at the moment because of the pain if I lie on either side. I've always been a side-sleeper, so this is something I particularly dislike about the hip problem - I can never get a decent night's sleep.

I'm fascinated by the difference between your earlier and later operations. It does tie in with everything I've read. My consultant is apparently particularly good (just the luck of the NHS draw), which also makes it quite tempting.

The more I hear about it, the more I think I should go for it before I get really desperate. DH isn't keen, but neither is he keen on me being on long-term Naproxen and paracetamol twice daily (which give me very little relief, and the Naproxen makes me feel sick and tired).

I think I could even cope with the stockings.

I am a frightful pain in hospital, as I am not a great one for lying still. I tried to discharge myself on IV antibiotics when my appendix burst, so I am not one for lying around and feeling sorry for myself. With a bit of luck, this would help my recovery.

I shall mull it over some more. Thanks again for all your help!

Sad truly, you will be so pleased when you get them done. That's the thing pain relief now does nothing, please don't leave it much longer, or like me you will find the pain so bad that you can't function at all.

I did actually choose my surgeon, thing is he is so good and so popular that his waiting lists are horrendous. I was offered earlier with a different surgeon but he really wanted the one I chose, especially for the revision.

One thing I will say, once you have one hip done, you will find yourself moving much better and the other one will go downhill fast. At least that was my experience and then or course you find you can't use your repaired hip so well. It's a bit of a vicious circle, try to get the second one done as soon as possible.

Ha, I just saw the bit about you being a pain in hospital. I was never in my bed when they wanted me, usually to be found roaming the corridors. I always feel like I am in prison.

A couple of years ago I was in hospital with pancreaititis (spelling) after an ERCP to remove stones that had been left in the bile duct after gall bladder removal. I refused those blood thinning injections that seem routine now no matter what you are in for, like I told them I am never still, always up somewhere think they were right brassed off with me. They were forever changing my ward then and I ended up in a locked one, only unlocked at visiting.

I'm afraid I went one further than you, there were 5 mins. of visiting left and I suddenly found myself packing my bag. Gave it to husband and followed him out, complete with canula. I removed that when I got home and had to confess my sins to my doctor who gave me oral antibiotics in place of the IV. I just couldn't stay another minute once they stopped me leaving the ward.

Hip experience completely different though and I even accepted the blood thinning injections

My DH had a hip resurfacing (similar to a replacement, but typically done for younger patients as it makes a replacement replacement easier when it wears out) 3 years ago when he was 35.

He was in hospital for 4 nights but was walking the morning after the operation. There was no major problem with climbing stairs (slowly!) immediately after he came home. It honestly transformed his life. He has to have the other one done soon (congenital bone abnormality). Once he was home, he was able to get around fine on crutches straight away. He was fit to abandon the crutches after 3 weeks, though at the time he was told he'd probably need them for 6 weeks. He is a farmer and was pretty much back to full work at that stage (no choice really, but it wasn't a problem). You aren't supposed to drive for 6 weeks I think - he got himself a cheap automatic jeep and drove after about 2 with the doctor's consent, but it was only his left hip that was operated on so he could use the right leg just fine).

Of course he could feel the scar and his butt cheek was swollen for much longer while all the muscles healed. I think after 3 months he reckoned he felt 80-90% strength but it was probably a year before he didn't feel it at all. But the pain was gone immediately, he said the pain of the incision healing was nothing like the pain of the joint grinding and he only took painkillers for 2 weeks afterwards.

in terms of being in hospital, i think the first two days you probably won't even notice it as you will be on fairly strong painkillers. DH is the worst patient EVER and it wasn't til the last day that he got antsy and wanted to leave, the rest of the time he was still pretty groggy and slept a lot.

This is all v encouraging! According to my consultant, there's a maximum waiting time here of 18 weeks, but most hips are being done within 12-14 weeks - so if I do go for it, I'll try to time it for after the school summer holidays, as it would obviously be much easier if the DC are at school.

Always, I'm interested in what you say about needing the second one too. At the moment, my left hip is distinctly less bad than the right (I wouldn't have the right one done if it felt like the left one does now...)

MrsShrek3: my DS's particular problem is his monstrous rages which come from nowhere. He could cope with my absence if a clear alternative routine were in place - but he is so completely mind-blind that he wouldn't be able to see that things would not be the same once I returned home. In his mind, if I'm there, that means I can do everything just as normal; he's completely unable to make allowances for other people's needs/feelings/problems, because all he can see is his own needs...

And smaths, I love the idea of being out of it on painkillers for two days.

I still have happy memories of morphine during the appendix fandango...