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Original poster

Hip replacement/anaesthesia/weight issues

32 replies

suedonim · 30/07/2007 18:34

It's looking likely that my almost 80yo mum is going to need a hip replacement op in the near future. I'm rather concerned as she's very overweight. At a guess, I'd say she is at least 15st and she's 5ft 4in tall, which makes her BMI over 30. She seems to be in denial about her weight.

My understanding is that hip ops are not offered if the patient is overweight, partly due to the strain on the new joint and partly due to the danger of anaesthesia. Are there any guidelines about weight? And how on earth can can I get my mum to face her weight problem?

OP posts:
tiredemma · 30/07/2007 18:37

Not much use, but I recently observed a hip replacement on a 85 yr old woman whose BMI was over 30, so it can be done.

will look in some of my textbooks to see if I have any more info for you.

Original poster
suedonim · 30/07/2007 19:32

Thank you!

OP posts:
Slubberdegullion · 30/07/2007 19:50

If she is/has been referred to a Orthopod regarding a THR then they will be blunt with her. Orthopaedic surgeons have a notoriously bad bed side manner and IME most will say.'You're too big, you need to loose x amount of weight, then we'll do it. Come back and see me when you have'.

They don't beat about the bush but for a lot of people being given such a blunt message is often what they need to kick start them loosing weight. Her GP should offer referral to a dietician if she is serious about the op.

Original poster
suedonim · 30/07/2007 20:17

Lol, SlubberG, that's what ds2 says about surgeons! He works closely with various specialists and the surgeons have zilch people skills. Seriously, though, I think that's what my mum needs, someone to lay it out in front of her. Trouble is, I'll probably never know because I'm pretty sure she's only giving me half the story anyway. I'd be prepared to put money on some of her weight problem being due to water retention yet she tells me her GP says she's 100% fit for surgery.

OP posts:
lilymolly · 30/07/2007 20:28

I work with orthopaedic surgeons and yes some are tossers, but some are really nice, esp to their parents, not so much to sales reps

The risk to your mum, is the anaesthetic, risk factors include age and weight.
Some NHS trusts will not perform any procedure, esp joint replacment, on a pat who is overweight, as not only is it s anaesthetic risk, but also they have to weight bear ASAP to prevent blood clots.

HTH

lilymolly · 30/07/2007 20:30

Ha Ha not parents but patients

christywhisty · 30/07/2007 20:40

RE the aneasthetic risks
My MIL had both her hips done under a spinal block. She has lung problems and they were worried about using a general aneasthetic.
They gave her something to feel happy, but she was awake through both operations and was aware of everything going on ,

Original poster
suedonim · 30/07/2007 21:32

This is all v interesting, thank you. The local anaesthetic sounds scary.

Lol, Lilymolly, though I'd hope they are nice to their parents as well!

OP posts:
saggarmakersbottomknocker · 30/07/2007 21:34

My mum had hers done with a spinal too. Had some sedation I think and said she could feel the movmenys but no pain. Was up and about very quickly.

saggarmakersbottomknocker · 30/07/2007 21:35

That odd word was movements lol

Original poster
suedonim · 31/07/2007 17:28

Sounds like doing a hip op with a local is quite common, then! I hope you don't mind me asking, but was your mum also overweight, Saggar?

OP posts:
saggarmakersbottomknocker · 31/07/2007 22:09

Perhaps a stone overweight suedonim. Certainly not obese. The spinal seemed to be the norm on the ward.

Original poster
suedonim · 31/07/2007 22:20

Okay, thanks, Saggar. So your mum didn't face the same weight issues as mine. The spinal sounds a much better prospect, so I hope maybe that'll be the way to go.

OP posts:
saggarmakersbottomknocker · 01/08/2007 08:13

The anaesthesia issue can certainly be overcome but I can understand why there may be concerns otherwise. A good recovery from it is very reliant on them getting up and around and being fairly active within a short space of time. There's a risk from DVT too - mum had to wear those support stocking thingies for a good while. Is your mum keen to have it done sue?

I feel a bit sorry for orthopods as they seem to have such a bad press re bedside manner. I just think they know how much input they need from patients post op to get a good result, with physio etc and they probably despair sometimes. dd's surgeon is fab though - very straightforward but not too harsh lol!

It's a vicious circle though isn't it? - your mum needs to lose weight but if she can't get around because of the pain from her hip then she's going to find it hard to lose. And even more so if she's in denial. My MIL really needs a knee replacement but she's very overweight and sadly it's not going to happen.

Slubberdegullion · 01/08/2007 08:29

All (bar one) of the orthopods I have worked with in the past have been great. They just don't do fluffy words and long, warm understanding chats. They tend to just say it how it is....which is why their bed side manner has a reputation. I liked working with them, so long as you were direct and quick with what you wanted to say. ( I was an orthopaedic physio BC)

re THR under spinal. Well obviously it reduces some of the respiratory risks re anaesthesia but tbh, personally if I had to have one I would want to be out cold. It is not a delicate op. There are saws, there is a lot of banging with hammers, the leg gets moved around a lot. Don't tell your Mum this suedonim !

saggarmakersbottomknocker · 01/08/2007 08:35

lol about not delicate. Mum did say she felt like her leg was in positions she never dreamed she could get it. But all she really remembers is the theatre staff talking about handbags....

Slubberdegullion · 01/08/2007 08:36

, I guess the patients head it screened off behing a big green sheet....but then you're just left with the noise and sensation of being hauled about. That would freak me out even more.

Slubberdegullion · 01/08/2007 08:37

sorry to handbags..........

Original poster
suedonim · 03/08/2007 00:09

Hello again, sorry to abandon you! I've been so busy I've not switched the pc on again until tonight.

Saggar, my mum has been overweight for years so it's not as if her hip problem has caused the weight gain, although I do think she's piling on even more pounds atm. She is very keen to have an op, as she's in a fair bit of pain as well as restricted in mobility. It's all happened in the last 6mths or so.

Slubber, ds2 told me that such ops under a local are rather...er...noisy!! Mind you, my mum has the loudest voice so she'd probably drown it out for everyone concerned.

OP posts:
oops · 03/08/2007 00:22

Message withdrawn

Original poster
suedonim · 14/02/2008 12:57

I'm returning to this thread to say that mum is having her hip op as I write! Her weight didn't seem to be an issue at all with the surgeon (who is lovely apparently!) which really surprised me, tbh. So I'm like a cat on a hot tin roof here, waiting to hear how the op has gone. It's not helping that the phone lines are really bad atm and we're having trouble communicating within Nigeria let alone abroad. Will post again when I have more news.

OP posts:
Original poster
suedonim · 14/02/2008 14:26

.

OP posts:
GryffinGirl · 14/02/2008 14:42

Hope your Mum's op is going well. Thinking of you.

My dad had a hip replacement while very over weight (around 20 stone, 5'11"), but the surgeons (while being very blunt with him about losing weight) did the op anyway. That was in November and he is slowly shedding the extra pounds - 2.5 stone to date and counting - which is made much easier by his ability to exercise. before he was in too much pain with the arthritic hip.

RTKangaDYSONMummy · 14/02/2008 14:46

Any news?

Hope it all went well

My parents have both had both of their hips done, and a tip from me/them would be to encourage her to do ALL the excercises they give her afterwards

Original poster
suedonim · 14/02/2008 15:06

Thank you for such positive posts! I've just called and she's back on the ward and is fine.

You dad's weight-loss is impressive, GG, in such a short time. Kanga, I think my mum will be very diligent about exercising, she's so keen to get better.

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