Hips Replacement Day Approaches

 

fter months of waiting, After months of waiting, it looks like things are finally moving along.

It seems like forever ago (it’s been three months) since we made the decision to replace the hips. Now, the day is looming fast, it seems. I have a number of things to do to prepare.

Pre-op Visit

First on the list was a pre-op visit with the PA. He ran me down the things that I could expect, as well as some things I need to do.

Per usual, they had the procedure wrong in their records: they had me listed for a single hip replacement. I had to correct them — I had discussed this with the office manager and we had gotten clearance from the surgeon to do a bi-lateral (both hips at the same time.)

There were some blood tests and a cardio evaluation and clearance to obtain. Normally, they would have had them done in-house, but I had already cleared it with my cardiologist from another office, which I had forwarded to the surgeon. Along with a lot of other blood tests for diabetes and thyroid issues I’ve been treating forever.

After lots of going back and forth and checking on the computer, they determined that, yes, they had the cardio release. They just needed blood tests. I gently reminded them I had blood tests at the hospital that should fill the bill. More back and forth and checking on the computer: yes, those tests should work.

Except for one, which I would need to have done there.

Overview

One thing that stood out in the run-down was that they’re likely going to keep me overnight. Given all the research I’ve done, I didn’t expect that. But apparently, the bi-lateral procedure warrants extra observation.

The procedure(s) themselves don’t take much time: the PA informed me that each hip would take about an hour and a half — when the first one is done, they just move over and do the next. The rest of the day is devoted to prep and recovery.

I’m going to wind up with about a 5 inch incision on both thighs, with a tape dressing to cover. This will require periodic re-dressing, which means they’re going to assign me a home care nurse to take care of that.

I asked what was expected out of Rose‘s participation and the answer was, “Not much. Maybe help you out of bed and keep you fed…”

Projected Recovery

I should be up and walking around almost immediately. They’ll assign me a walker, but it’s not so much for support as balance — when you’re loaded up with pain-killers, you can get the dizzies.

And falling is simply not in the cards.

I asked what restrictions there would be on movement/positions. I wear compression socks, for instance, and they can be a bugger to get on and off even under normal circumstances, requiring me to pull my ankle up on the opposing knee and manipulate the tight sock over the foot, ankle, and over the calf.

I demonstrated the movement involved.

“No,” he said, “there are no real restrictions. The main indicator for restricted movement is going to be pain.”

In short: if it hurts, don’t do that.

(I’ll get some low cut socks, just in case.)

Other Concerns

Something that comes up in any surgery is the danger of blood clots. I’ve had issues with them before, up to and including pulmonary embolisms (2). I’m not on blood thinners now, but I have been. As a precaution they want me to go on Eliquis immediately after the surgery and continue for 30 days.

Haven’t been on that specific formulation, I’m used to Coumadin. I argued for that, since I’m familiar with it, but they reminded me that it takes a number of days to take effect — they would have to combine it with Lovenox for a period and monitor the levels closely with blood tests.

Right. Eliquis it is.

The possibility of clotting also makes an argument for continuing with the compression socks, somehow. Have to think about that.

Preparation

The procedure is now less than two weeks away. In the time between here and there, the first order of business is to make sure I’ve got good muscle tone in my legs and hips. That will go a long way to facilitate recovery.

Fortunately, I’ve been doing a lot of that already: every day I run up and down nine flights of stairs in the mornings. In the evenings before dinner I do leg stretches and monster walks with a heavy band. I’ll continue that and look at any other exercises they want me to do. And, I’ll try to do some more cycling (but that’s been difficult since we’re currently experiencing 110˚F temperatures…)

I’ll post more as it happens.

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