Have you ever had to make a crucial decision that would cause you to experience pain, discomfort and challenges requiring you to adjust your way of life to possibly benefit you in the long term? As I briefly talk about in my blog post, Succeeding in the New Year: Don’t be Afraid to Walk a Tight Rope, I recently had to make that crucial decision to have total hip replacement surgery.
I am grateful to have had the opportunity to have my right hip totally replaced on March 4th using a surgical procedure that is referred to as the anterior method. After a short hospital stay I came home on March 7th. I was home quickly due to the fact I had an excellent surgeon and had very few post surgical complications. Also after careful consideration I elected to do my recovery/rehabilitation at home with my wife Kathy’s assistance instead of a Skilled Nursing Home/Rehabilitation Facility. If you have read some of my other blog posts you might have noticed my wife and I are experienced at overcoming challenges, difficult times and leveraging assistance as required.
CONTEMPLATION
I have been apprehensive over the past years and months considering the best time to have surgery to replace my deteriorating hip. I considered the time I would be away from work, lost wages, medical expenses and professional and personal commitments. I compared these priorities to my long term medical health and how well I could tolerate the pain to assist me in selecting the best time to have my surgery. I also took into consideration that the X-Rays and MRI consistently showed that my hip bones were crumbling away and the pain and my ability to walk was getting considerably worse the longer I postponed the inevitable. The pain had been so terrible for so long my blood sugars were being adversely affected. My last X-Ray also showed that I had a crack across the head of my right femur which confirmed that I could not put off the inevitable any longer. I finally decided to take action and scheduled my surgery.
In preparation for surgery I planned and anticipated extra challenges to overcome since I am completely blind, have diabetes, neuropathy and nerve damage in my legs caused by the critical medical condition which took my eyesight away in 1999. I also expected I would not be able to do many of my normal activities without assistance for some time while my bones, muscles and tendons healed after such a major surgery. As part of my preparation I learned that recovery and rehabilitation is critical in helping prevent a dislocation of my new hip which would require doing the surgery all over again. Recovery and rehabilitation is also critical in this type of surgery. I had to allow my new artificial hip to bond naturally with my existing bones in my leg and hip to help insure the new artificial joint is stable, strong and will last.
DAY ONE IN THE HOSPITAL:
After checking into the hospital I met the anesthesiologist and talked with my surgeon to cover last minute questions as I was being prepared for surgery. I remember holding conversations with everyone. The next thing I remember was the sensation of the gurney I was lying on being rolled on the smooth hospital floor producing very little sound from the wheels. Soon I heard voices which sounded like my wife Kathy and my mom. I asked them if the surgery was over. When I heard them respond “yes” I said in astonishment “I cannot believe the surgery is over”. At this point I was not experiencing any pain or discomfort probably due to the medication. Just after I briefly talked with my wife and mom I fell asleep due to the pain medication and any remaining general anesthetic which I was given for the surgery.
After I woke up I heard voices around me. When they identified themselves I learned these were the nurses and rehabilitation therapists - physical therapist (PT) and occupational therapist (OT). They were preparing me to stand for the first time on my new right hip. This group tested my blood pressure and oxygen level. My blood pressure was low although with the suggestion of the therapists I started to stand with the assistance of a walker. Before I was completely standing I felt very faint and felt like I was going to pass out. I was told I looked very pale. After this unsatisfactory reaction the nurse and therapists said I should wait for my blood pressure to come up before I attempted to stand and they helped me back into bed.
I was told I had lost one-third of my blood during the surgery which was normal and could be the reason for my low blood pressure. Now that I was awake I was aware that my right leg was experiencing moderate pain and my leg muscles felt very tight which was uncomfortable. These sensations were due to the fact my surgeon was required to cut many muscles and tendons. He also dislocated my old hip to remove it and replace it with the new artificial hip.
After the surgery my right leg was swollen and looked like one large multicolor bruise that covered three-quarters of my leg and continued partially up my back.
DAY TWO IN THE HOSPITAL:
To assist my hip healing properly and to help prevent the dislocation of my new hip I was required to sleep with mobility restrictions. These included having to sleep on my back with my legs straight out and my legs surrounded by pillows to help prevent me from turning over in the night. Another option I had while I slept was to lie directly on my side with pillows between my knees, ankles and other pillows surrounding my legs to help insure I did not turn over or cross one leg over the other. My nights were restless with these mobility restraints. The nights were also uncomfortable with sporadic sensations of pain and muscle stiffness. Luckily I was provided enough pain medicine which allowed me to get some needed sleep to facilitate healing and helped me be rested during the day so I could concentrate on my therapy. Although I would experience an uncomfortable night I was willing to accept any challenges to expedite my recovery.
Following breakfast it was time for therapy and my chance to practice walking. My nurse tested my blood pressure and found it was high. After consideration of high blood pressure my nurse and therapists decided to proceed and allow me to attempt to stand. With determination and some struggling I pulled myself up to the standing position with assistance from a walker. I stood for a few minutes before I was told to get back into the bed.
After rest and lunch it was time to work with my therapists and continue to learn how to walk with a walker. On my next attempt to stand I pulled myself out of bed and stood with much more confidence and energy. Since I am completely blind my therapists were required to improvise and verbalize any instructions instead of actually demonstrating the techniques. After listening to the instructions on the basic techniques to walk with a walker I simultaneously visualized the technique my therapists were describing in my minds-eye and was soon walking with my new artificial hip. While walking my therapists verbally instructed me in which direction I was to walk to help avoid obstacles, including other patients who were also walking as part of their rehabilitation. I required verbal assistance to help guide me because a walker provides minimal orientation to a completely blind user compared to using a long white cane. A white cane is used by rhythmically swinging the cane back and forth in front of me very close to the ground while tapping the cane tip on the ground when the cane reaches the end of each swing as it assists me in locating and avoiding obstacles. Since I am used to walking with one long white cane and one support cane walking with a walker made me feel very unsafe if I attempted to walk without verbal guidance. I truly would feel as if I was walking blind.
DAY THREE IN THE HOSPITAL:
I continued to eat my three meals a day, walk twice a day and rest to help me recover. Each time I walked with my walker I was getting more proficient, confident and stronger. In preparation to leave the hospital I practiced walking up and down steps with my walker. This was so I could navigate the steps required to get into and out of my house.
DAY FOUR IN THE HOSPITAL:
On my last day in the hospital I practiced getting in and out of our car safely with the therapist's help to prevent injuring myself or my new artificial hip. The last thing I requested before I left the hospital was to be bathed which included washing my hair. I had no idea of how I would get to the shower at home to do these things because of the obstacles and my new mobility restrictions. Therefore I took advantage of the extra assistance I currently had at the hospital.
RECOVERY AND REHABILITATION AT HOME
On March 8th I started my at home physical therapy (PT), occupational therapy (OT) plus had a nurse visit me a couple of times. In addition to receiving therapy and health monitoring services from these agencies during the first two weeks of recovery my loving wife was my full time caregiver and therapist. After the first two weeks of professional therapy these visits stopped and it was up to my determination, commitment and my wife’s tireless assistance to continue with my daily rehabilitation therapy and recovery. I completed the recommended stretching and muscle strengthening exercises daily as prescribed by my therapists. With Kathy’s assistance I walked outside with my walker to further strengthen my legs, bones and increase cardiovascular endurance. Also these exercises assist with restoring my balance after such a traumatic experience.
This initial recovery and rehabilitation process took re-prioritizing our life’s activities since these tasks took many hours each day to accomplish. This is especially true with the mobility restrictions which required Kathy’s help to perform many of my daily activities. This dedication took a complete commitment for success.
A FEW SUGGESTIONS TO ASSIST IN PLANNING
• Medical Insurance Preparation
If you have medical insurance, be sure to cover all insurance questions with your provider prior to your surgery/procedure. If your insurance agency verbally tells you a service or medical supply is covered get the answers to your questions in writing if possible.
• Rest
Get plenty of rest and try to be in the best possible physical condition prior to the surgery/procedure.
• Diabetes Preparation
If you are diabetic attempt to get your blood sugars under control prior to the surgery/procedure.
• Get References
Select a surgeon you know or can get references to follow up with the surgeon or patients who have had the same surgery or medical procedure from the doctor you plan to use.
• Accommodations / Accessibility
If you are disabled or require special needs visit the hospital/medical facility and explain any specific needs you may require. If you need accommodations explain your request with suggestions on how the staff can assist.
• Be Prepared To Be Your Own Advocate
The medical staff is usually very busy and if you are not able to fully understand and participate in all communications regarding your medical needs someone needs to look after your requirements, communicate the requirements and follow up with all hospital staff to help insure you get the best possible care.
• Be Patient
Understand you are not the only patient in the hospital/ facility and you will have to wait to receive assistance at times.
• Balance Recovery Enthusiasm
Balance your recovery enthusiasm with the recovery/therapy requirements provided by your physician. Exercise patience in returning to your normal daily activities to assist in maximizing your long term benefits over taking short cuts in recovery and rehabilitation to accomplish short term advances that may not last.
• Plan For Your Unique Situation
I understand that everyone is different and my surgery, recovery process and recovery/rehabilitation length will be different than yours. Understand what I have described is my own unique situation. Please consult your own physician for assistance with your own unique requirements.
Now that my mobility restrictions have been removed I will continue to do physical therapy and orientation and mobility training as I transition back to my support cane and long white cane for independent safe navigation. Now that I have the ability to start walking with my long cane this added exercise will strengthen my muscles and tendons. This exercise is also vital to aid in hip and leg bone growth and bonding around and through my new artificial hip allowing for a strong joint.
I know it is still early in my recovery but I am very pleased with the results of my total hip replacement. My minimal discomfort is mostly at night and in the mornings and is typically stiffness and muscle pain while I am continuing to heal and strengthen my leg. My blood sugar levels have been consistently getting better than prior to the surgery allowing me to be in better health, think more clearly and make better decisions to assist with enhancing my life. I was also very satisfied with the care I received by all the doctors, nurses, therapists and staff at the hospital. All of the staff made appropriate accommodations when possible to enhance my stay.
The last several weeks of exercise, stretching and walking with a walker multiple times a day have been well worth the time I dedicated to help insure a successful transition to my next phase of recovery. I am also thankful I followed my doctor’s recovery/rehabilitation plan and did not give into my own temptation and do more activities than I was supposed to do risking injury thus causing a longer recovery period.
Do you have any tips you want to share that might help prepare one for surgery or medical procedures? Do you have suggestions about maximizing the benefits of any required rehabilitation? Do you have suggestions for people with disabilities or special needs to assist with recovery and any required rehabilitation?
We all look forward to hearing your comments.
Bill Tipton
Contributing Author,
Global Dialogue Center
http://www.globaldialoguecenter.com/
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