Surgery Game Day:
Up with the Good! Down with the Bad!
By Susan Flansburg, ORA Orthopedics Hip Replacement Patient
In Part 4, Susan describes her experience of total hip replacement with Dr. Joseph Martin, total joint replacement surgeon, performing at Crow Valley Surgery Center.
At long last, the date of surgery was upon me. I was told to arrive by 8:30 a.m., and with Alan at the wheel, we were only a few minutes late to ORA Crow Valley Surgery Center. It was “game day” for me, so I acted confident and even cheerful.
My nurse, Rebecca, started my IV and kept the mood upbeat. Now in a hospital gown, I was cold. She piled warming blankets on me until I was comfortable. Dr. Martin came in to say good morning and mark my surgical site. The anesthesiologist arrived to administer my spinal anesthesia. I had been dreading this, sure that it would hurt terribly.
I waited for the jab of the needle, but instead felt only a mosquito-type prick. I was told I could roll back over onto my back again. I asked Rebecca why I didn’t get the injection, and she laughed and told me I did! And that’s all I remember.
Anesthesia is an utterly empty moment in your life that is wedged between memories. I remember being in the prep room, and I remember being in recovery. But I remember absolutely nothing in between.
So suddenly, it was over. Rebecca wheeled me into the room where I would stay the night. It was about noon. I felt absolutely great. Rested, cheerful, and hungry.
She handed me a menu from Hy-Vee Market Grill, and told me to order something even if I didn’t feel like eating now. I’d be hungry eventually. Ha. I was starving!
I ordered an omelet and fruit for lunch, and a spinach salad for dinner. (I ordered the fruit and veggie foods partly because I was worried about the known side effects of narcotic pain pills. They can cause constipation, and I wanted to do everything I could right from the start to minimize that.)
It was the best “hospital food” I’ve ever had!
I was piled high with more warming blankets, and contraptions designed to prevent blood clots continuously massaged my legs. This was a comfortable situation until I was told it was time to get up and walk.
Once again, however, it turned out I had worried more than necessary. With help, I sat up and then stood. I was seriously shocked that it didn’t hurt at all. I walked a few steps with my walker – and could easily have walked more – but suddenly felt nauseated. Rebecca gave me something to stop the nausea, and within a few minutes I continued on to the bathroom. The toilet was high enough that it didn’t hurt a bit to sit and then stand.
The rest of the day was spent sleeping, walking, getting nauseated, and then feeling great once I was back in bed again. I slept better that night than I had in ages. Of course, the spinal was still in effect!
The next morning, Rebecca popped in to say goodbye. She had been unable to wish me well the night before, as I had already fallen asleep when her shift ended. It was near 7 a.m., the beginning of her shift. Physical Therapy was already buzzing on the bottom floor, and it was time for me to get going, too.
My nurse helped me get dressed in my own clothes, and I said goodbye to the place that had been my overnight home. She pushed me in a wheelchair down to PT, and I met the therapist who would teach me how to navigate everything from stairs to a bed and car.
It didn’t hurt one tiny bit. Rachel stretched my leg gently, and watched as I practiced the exercises she gave me: foot pumps, glute squeezes and heel slides. (Here are some illustrations.) When we were done, she gave me a sheet with the exercises spelled out and helped me get into the car Alan brought. (It’s a mid-sized SUV that doesn’t require sitting down too low or climbing up into.)
By then it was time to fill my prescription for Hydrocodone, and get on a schedule that would keep me ahead of any pain. I also would get a prescription for an anti-nausea medication, but never needed it.
We pulled up in front of the house and I looked at all the stairs I would have to climb just to get inside. Never mind the stairs to the 2ndfloor, where the bathroom and bedroom were. In my mind, I counted at least 163.
Alan came around to help me out of the car. We managed.
Walker in hand, I made my way to the first set of steps remembering the mantra I had been taught: Up with the good, down with the bad.I handed my walker to Alan and began. Amazingly, I had no problem with either set of steps outside!
Cats and dog met us at the door. I looked at the next set of steps. Fourteen. I made my way over, handed Alan the walker again, and accepted the proffered cane. Up with the good.
Alan walked behind me, lest I lose my balance. (He would walk in front of me, later, on the way down.)
Success. Now to the bathroom. 2 sturdy grab bars flanked the raised toilet seat. No problem.
Back on my feet and down the hall to the bedroom. I sat on the side of the bed, pushed back a bit, and Alan raised my surgical leg up and onto it. I lay down, and he placed a wedge the hospital had given me between my legs to keep them from crossing.
“I can’t find a position or place to sit to enjoy a cup of coffee. Who knew I wouldn’t own a single chair I could safely sit in.” (Susan’s journal)
No Crossing legs and Other No-No’s
I hadn’t really paid attention to this one small detail before surgery, but it turned out to be a BIG DEAL, at least for me. That is, there are such things as “hip precautions” that are absolute no-no’s if you want to avoid dislocating your hip.
And I can’t think of another thing I want to do less than that.
First, and at least initially most fearsome for me, was the injunction against crossing your legs in bed. I honestly thought I’d have to sleep with that wedge forever, because I always used to sleep with crossed ankles before my surgery.
The other precautions are that you must not turn your surgical leg in toward the other leg, and you must not sit or stand or bend over in a way that creates less than a 90-degree angle between your surgical leg and your torso. Ever.
Your surgeon and PT will demonstrate these no-nos for you, and you will both remember and get used to them. There are ways to work around them, though. The most useful work-around right from the start – for me, anyway – was the one that has you stretch your surgical leg behind you as you lean over to pick up what you need off the floor. This requires good muscle control and balance, so it’s not for everyone.
The Rest of the Day
My sister, Beth, arrived from Des Moines about noon. She’s more fun than almost anyone I know, so I knew we’d have a good few days no matter what I felt like physically. My friend, MacKenzie, brought over some beautiful tulips, and my friend, Jodi, sent the prettiest pink carnations and purple irises I’ve ever seen in a bouquet. And some cards arrived in the mail.
By early evening, though, I was feeling a little antsy upstairs. I had insisted Beth join Alan and our son, Jamie, to enjoy some social time. I called out to announce I wanted to come down, too. Beth ran up to get my walker, take it to the first floor and come back up to walk in front of me. It was clear she’d be getting some exercise.
Down with the bad, I repeated as I landed every step – cane and foot – with a clonk. Success! I took a lap around the house, piled cushions up high enough to not broach the 90-degree hip precaution, sat for a few minutes, and then was ready to go back to bed.
My friend, Kim, delivered homemade quinoa tacos for dinner, which I ate in bed, just minutes before I fell asleep for the night.
Tips (if you’re reading this before your surgery):
- Seriously, do all the tips outlined in Part 3. You won’t regret it!
- It’s alarmingly easy to forget what pills you have and haven’t taken. Create a checklist for every day, and mark it as soon as you take your medication.
Up Next: “I Hate Feet” and Other Tales of Post-Surgical Adventures! In Part 5 of this series, Susan says that the role of caregiver is key to your happiness as a patient. “It may be too late for this advice, but choose carefully if you can.”