One Week Post Op

10thNovember 2015

Today I am one week post op and have been home since Saturday evening, so I managed to only stay in hospital 4 nights this time.

Before you read this, I'd like to say that I did not have the usual post op experience in hospital due to a complication with my blood. So if you are reading this in a pre-op situation, please do not be to freaked out by my description, the actual pain in my hip and my progress was only hindered by that separate condition. The post op pain was not bad at all, when I was able to keep pain killers down!

Trying to remember the order in which things happened over those 4 days is a bit hard. I think it went as follows: I had my wound drain taken out on the Tuesday morning. The  morphine pump & fluids got taken off on the Wednesday afternoon. With the removal of the morphine pump, also came the removal of the ECG and blood pressure machines. It was good to get rid of all that.

I started on the oral morphine (oramoroph) instead, along with paracetmol & codeine but I began to feel quite nauseous again. On Wednesday afternoon, the physios came to get me to just stand up and maybe take a step, using the walking frame. But as soon I sat up, my head started thumping and I passed out so it was back into the bed and they didn't try and get me up again the rest of that day.

On the Thursday morning my urinary catheter was removed. After I had my lunch, the physios came to get me up again but I had such a terrible head ache, as soon as I was upright my head started to bang and I felt dizzy. Then I was sick, mostly on the physiotherapist! I can't remember  much of Thursday afternoon, I think I was sick a fair few times. I tried to keep my eyes closed for the most of that day as my head was banging so hard, they hurt to look through .I can remember them getting me out of my Pj's and into a hospital gown so that it could be replaced easier when I was sick on it. I was also in a fair amount of pain from my op hip, as they had taken it out of the CPM machine and it felt like the joint was just becoming stiffer and more painful without the constant gentle movement. They gave me oramorph for the pain but I vomited it straight back up, along with the paracetmol & codeine. So then I had no pain relief on board. I felt a bit stuck in a cycle of pain and sickness that felt like it lasted hours and hours but I am sure it was only 3 or 4 at the most. The sick bowls in that hospital are ridiculously small, I needed a stack of six to get through one after the other, I can remember thinking how absurd it was that something so horrid as being sick was made into a real challenge of aiming into the silly little bowls. Anyway, that's TMI, sorry about that. They finally got my sickness under control with a anti-sickness injection given in my thigh. Then the CPM went back on and I was able to keep some pain relief down. 

During the day, I had had a blood sample taken and it confirmed my haemoglobin had dropped like last time. I have a blood disorder called Beta Thalassemia Trait which is supposed to be fairly non symptomatic however it is becoming evident for me that my blood struggles to keep my haemoglobin levels up. Normal haemoglobin levels for women are115 to 165 grams per litre of blood. My normal levels appear to be 110, 115 at best. It dropped to 107 in summer 2015 (when I was feeling extreme fatigue) and was 74 after my other hip op. They were now at  80. So it was decided I should have a small blood transfusion. My heart rate was also pretty high, and my blood oxygen levels were pretty low.  That was organised and after a round of "hunt the vein"  (I have the most ridiculously deep veins) , I had more  blood taken and a new cannula/Ven flon placed in the back of my hand and the donated blood was given to me. I had to be hooked back up to the ecg and blood pressure machine and have regular observations done again whilst the transfusion was going on - so no rest.  

Friday morning I was able to get out of bed and use the bathroom on my own, with the walking frame.  My headache had gone but I still felt a bit nauseas so started some anti sickness tablets. My pain wasn't too bad and I managing on paracetmol and codeine. It is amazing how just a pint of donated blood can change the way you feel. The nurses said that they could tell how much better I was just by looking at me. My blood pressure was normal and my heart rate had dropped.

So, mid morning on Saturday, I was able to get out of bed, walk to my room door on the crutches and a few steps down the corridor. The physio took me in a wheel chair down to their exercise room where there is a set of steps, and I managed to go up one side and down the other. So that meant I could home. 

It was 6pm by the time we got home to Weston super mare. It wasn't the best journey I've ever had, pretty painful. So I was glad to get back in my own bed and my cat soon appeared, and she  slept on my chest all night . 

The next 3 days I was surprised how much better I felt compared to when I had my right leg done. I think the combination of relief that it was over and both hips were now fixed-hips, combined with not needing to take a stack of codeine and diazepam that I had last time meant I was more "with it". My Mom and my husband seemed particular impressed with how much better I seemed.

My op leg felt extremely heavy and difficult to manoeuvre , I could hardly pick it up of the floor enough to walk forwards with it. The next 5 weeks were set to be rather dull and boring. The protocol for the pre-op period for the this open debridement surgery is given below.

And here is the link from my first 5 weeks when I had my right leg done in 2013, since I am sure I will only be writing out the same description of my day to day life!:

http://blueskyhips.blogspot.co.uk/2014/02/weeks-2-to-5-post-op.html

1) Toe Touch Weight Baring only on op leg

2) Hip movements allowed.
Hip flex passively to 70 deg.
Hip abduction to 30 deg
Hip extension to neutral (ie. Lying supine or prone)

3) Hip movements to be avoided
Hip Adduction beyond neutral so no crossing ankles
Any active hip flexion or abduction.
Avoid powering up hip abductors.

My husband did the following passive exercises for me twice day.

1) Passive adduction, not more that 30degrees - 10 times

2) passive flexion, not more that 70 degrss - 10 times

These two exercises are important to maintain motion between the hip capsule and labrum (well, what bit I have left!) and to avoid adhesions forming 

I did the following exercise 3 times a day:

1) static quad sets x 10

2) static glute sets x 10

3) ankle pumps

4) ankle rotations

5) Some Pilates exercises for my other leg, like single leg raise, flexion , adduction

My wound at one week post op. 

Op Day

8th November 2015

Today I am one week post op and have been home since Saturday evening, so I managed to only stay in hospital 4 nights this time. 

My admission time on the 3rd was 12:20, so we had a morning to waste. We stayed at a nice hotel near the hospital the night of the 2nd, I wasn't allowed any food from 7:30 am and clear fluids only until 11:30 am. So I got croissants and nice jam to eat in our room at 7am. We hung around the hotel room until 10am, relaxing. I had a long, hot shower, probably the last for the next month at least. I did some yoga whilst my husband went for his breakfast. The last yoga involving my left leg for 3 months. 

My left hip was really sore that day of the op, I was limping on it and could not have any pain killers due to the  amount of drugs I'd be having in a few hours time. We got to the hospital an hour early as we had nothing else to do. My room was ready so we able to go on in and watch tv until things started rolling. I felt really emotional when we first got to the room and had a good 5 minute cry and hug. I think they were a mixture of tears of pain, relief that I made it to this point at last and trepidation at what I was about to do electively. Anyway, a good cry always does me good and I felt better for it, determined to get on get this over with. 

The anaesthetist and surgeon came to see me and I signed the papers and had an arrow drawn on my left leg. I got changed into my hospital gown and got into bed where I would be warmer and comfier with my painful hip. 

They came to get me at 14:45. I was wheeled down to theatre on the bed which was nice. I then had to get out and hop up on the prep table and lie on my back. They anaesthetist and the technicians were all very nice and it wasn't long until I we talking about horses and cats.. I had a cannula placed in the back of my right hand and an oxygen mask. I was given the first lot of meds and I remember feeling floaty and warm. Then I dont remember anything until I woke up, which I was glad about as I really didn't want to feel the epidural going into my spine. 

When I woke up, I was in the recovery room, back in my bed. I felt really Hot and then I felt a bit painful, about a 7 out of 10. I had a load of bubble wrap on me under the blankets and something blowing warm air underneath it, they said I had been cold in theatre. So I got it all that taken off and given some morphine and then I felt pretty comfy. I couldn't feel anything below my waist due to epidural. The nurse kept checking if I could feel her touching my foot or leg. The feeling in my right leg came back before my left leg, which stayed quite numb until after I got back to my room.  I had to stay in the recovery a while because we had to wait to for the "blood cleaning machine" to Finnish its stuff. Because I have a blood disorder called Beta Thalassemia trait, my heamoglobin doesn't need much excuse to drop. So they had collected the blood I lost during surgery and it went into the machine to be cleaned and then into a drip bag. This blood of my own was then given back to me through my cannula. Whilst we were waiting  for this, the nurse showed me how to use the morphine pump they had set up for me, I had a button that I could press to release some of the morphine into the drip line. It would then not allow any more to be released for 5mins.

I got taken back to my room at about 7pm, and my leg was put into the continual passive motion machine (CPM). This constantly, slowly, flexes the leg backwards and forwards, the idea Bieng that the movement prevents adehesions forming in the hip joint. I also had  the flotron cuffs placed on my lower legs, these inflate alternately to compress the leg and help prevent thrombosis. I Had had a urinary catheter placed whilst I was under anaesthetic so at least I didn't need to worry about going to the loo!

I was hooked up to blood pressure machine, Oxygen saturation finger monitor, ECG, the oxygen nasal prongs, and fluid drip with morphine pump attached. That's a whole lot of stuff inflating, going up and down  and beeping.  I felt pretty uncomfortable with it all going on, so kept on pressing my morphine button. I was allowed a cup of tea at 10pm but unfortunately I vomitted it straight back up. And so began the long night I had been dreading. The nurse kept coming in every hour to do my observations. The machines kept on beeping and things kept inflated and deflating. At 1am my morphine pump ran out. It took over an hour for the nurses to get round to getting it changed and the machine kept on beeping to say it was empty. I felt so hot and tired and uncomfortable. I had the blind up a bit with the window open slightly. I can remember looking out at the darkness and thinking it was never going to get light. But it did at last. 

I managed a glimpse of what my leg now looked like. No going back now!! 

Moving towards getting the left hip fixed...

10th Novmber 2015 

A little time has passed since I posted about getting the ball rolling for getting my left hip sorted out. I am now sitting here one week post op for that hip! Things moved quickly from when I went to see my GP to ask for the referral. My health insurance have thankfully decided to cover this hip as it wasn't really mentioned on my medical records. So things moved swiftly and a lot less stressfully then for right hip.

I went to see my consultant on the 27th September. He said that my hip was obviously deteriorating and it made sense to get it sorted now. As the open debridement surgery had been such a success for right hip, and the X-ray of the left looked similar to the right pre-op, we decided the best route was to have the open surgery on this side also. 

The X-ray shows a small CAM deformity on the femoral head and a large pincer or overhang of the acetabula rim. When comparing it to the the right, it's easy to see the difference and what needs to be done! 

I had had my open surgery on the right hip in December 2013. The pain I had in the run up to that was virtually unbearable, as I had a lot of pain in both hips. I had had to place my larger horse in full livery as I physically could not look after him anymore. Obviously that was not cheap and I was worried about what the future might be for me and him. I have owned him since he was 6 months old and he is now 14 years. I was also worried about work. I run a pet care franchise and whilst the actual work of looking after other people's animals is not to taxing, the driving, walking and even desk admin work was getting to be very painful.  By the time I had hauled my body up to December 2013 I was exhausted and frankly rather desperate for something to get me out of the cycle of chronic pain I was in. 

I found the rehab from that surgery tough, mentally and physically. To go from being able to do the things you need to do, even though you are in pain,to not even  Being able to get out of bed on your own for the first few days is a bit of a shock. 

You can read about the rehab for my right hip here onwards. :

http://blueskyhips.blogspot.co.uk/2014/02/op-day-and-day-1-post-op.html

From about 5 months post op I could tell I had done the right thing. I progressed on to doing Pilates, riding my horse and even some gentle skiing in January 2014. I could feel a real difference between left and right hip when I sat on my horse. My right leg hung different in the saddle, it felt much freer and more comfortable against my horses side. My left leg just felt a stuck and useless, sometimes I would get a really sharp pain in the front which I guess was the impingement of the acetabulum & femoral neck. It held me back a lot and I didn't do much riding. I'd hack out with the girls from our yard once or twice a week. I found walk and trot ok, so long as my horse behaved but cantering and galloping were not possible. The last time I galloped my horse was November 2014, it really hurt me, I could feel impingement with every stride . 

In May 2015 my Pilates class got cancelled. I started Yoga, the wife of one of my husband friends had just qualified as a yoga teacher, so I had a private lesson from her and then joined her group lesson on a Thursday evening. 

I really enjoyed the yoga, I found it more relaxing than Pilates. Whilst there was plenty I could not do on my left hip (positions that involved a lot of flexing/lunging or twisting of that hip) the rest of my body really appreciated it so I stuck at it until the week before surgery on my left. If you have never done a yoga sun salutation, I can highly recommend it for stretching and easing your whole body out. I tried my best to start each day with 3 sun salutations.

The summer of 2015 was a long one, and also pretty painful. I did have some good days, when I tried to make the most of it and get things done. My lower back went to complete spasm on two occasions. I had a lot of pain in my left sacroiliac joint, which seemed to shoot through from my left groin. I also had a lot of  illiotibial band pain. Work was very very busy, and working hard whilst in a lot of pain in tiring mentally as well as physically. I run a pet care franchise and whilst looking after other people pets isn't too taxing, I was doing a lot of driving, walking and desk admin work. I did not have a single full day off mid June through to September. I felt like I was hauling my body through each day/week, and could get little enjoyment from things. My hobbies of riding my horse and gardening seemed crammed in around work when what I really needed was a sit down.  I didn't ride my horse much at all, and if I did, it hurt. 

Anyway, I managed to drag my self up to September and our 10 day holiday, without breaking myself completly. We spent our holiday travelling from south to north wales and back with our dog, Ruby, in our camper van. My aim for the holiday was to do a little as possible. I achieved it, but I would much rather of been going for long walks on the beach, walking up Snowdon & Cader-Idris or even going pony treking. Instead I had to settle for a steam train journey that passed the bottom of Mount Snowdon. I took a picture and we planned what route we will take to get to the top next year when I have two good hips. 

As soon as I got back I set the ball rolling for getting surgery on the left hip. Things went smoothly and the date was hooked. 3rd November 2015. I got back on life's treadmill and went back to hauling my body through each day and week, I stopped horse riding as it was just to painful. I was ready to get off the treadmill.