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.