I am 78, never had major surgery before,but I'm due a total hip replacement and can't stop worrying about a couple of pretty minor seeming things.
First : I need to get up in the night to pee but also because I'm a bad sleeper so often get up and walk around which helps me go back to sleep. This is my "normal" and I'm trying to imagine how I can physically pee or walk around safely in the night immediately following hip surgery. Sleeping pills turn me into a zombie, so I'm not keen on using sleep medication.
Second , my surgeon only does posterior approach to hip replacement, as he says it gets the best results. He has a good reputation and I can't find a doctor to say whether anterior would be better. But I am hyper mobile and also often change position when sleeping, curling up or sprawling out. I don't want to dislocate my hip, so I wonder should I be looking harder for a surgeon who does anterior.
These may seem rather small questions but thanks for any suggestions and personal advice.
You may want to ask why your doc wants to do posterior as there could be a definite reason why and also what type of sutures / bandage he will be placing.
Surgery was a Thurs AM; from recovery was admitted for overnight hospital stay; that afternoon got a visit from OT and then PT and they made him get up go to the bathroom, use pinchers to pick up a towel on the floor, get in & out of bed and a chair, using a walker. PT had him walk down the hallway and then go the PT room to do short set of stairs and turn around on its platform then down. He had regular but light meal that evening too. Next AM same thing with OT & PT, discharged midday, late afternoon had a Zoom call with ortho. In home health came by Sat AM to go over exercises and do a visual assessment of his walking, sitting, using stairs. In-home was abt 3 weeks, twice a week. Then he went to out patient PT center for regular PT plus a weekly aqua therapy for 3 months. fwiw imo the inhome PT were fairly lackluster at best but the outpatient PT center was fab.
There was absolutely no way he all on his own could have been at home as not being able to bend over limits so much. He could not be able to put stuff into the dishwasher, drive, change linens, tying shoe laces, putting on socks. No driving!. There was to be no ABSOLUTELY NO bending over at all and no crossing of your legs as well. He ordered a couple of pairs of those slip in Sketcher’s shoes, which worked perfectly. Our son came in for a couple of weeks as I still freelance. It was great as he could take his Dad out for lunch and a drive while I reset the house.
Our situation was more intense due to hubs RA. But realistically I think it would be oh so hard to be 100% at home solo for the first week to 10 days after surgery.
He had physical therapy for 6-8 weeks each time. I had to help him put on shoes and socks only. In terms of driving, he was cleared to do so after two weeks for right hip and after one week for left hip. You do have to be off the opioids to get clearance to drive.
He now sleeps way better than he has in years, and he can walk 4 miles no problem. Hopes to get back to playing tennis within a couple of months.
My husband was off two weeks to take care of me. If I didn’t have him, I’d have to get an aide or sign up for rehab. You will definitely need support from a physically healthy person. Oh and if staying at home, install a raised shower seat.
You should do very well. Most of my total joint patients would tell me that they were sorry they waited so long to get it done.
You'll also need help at home for the first week. Help getting to the bathroom, for one. You won't be walking around during the night.....you're recovering from surgery, but you'll still need help that first week. Keep a walker and a cane at home, you'll need both. I had no PT....walking was my only therapy, per the doctor. First with the walker, then the cane.
I'd also find another doctor to do an anterior hip replacement. There is NO REASON to do a posterior at all. You'll have a much longer and more painful recovery if you go that route.
Good luck to you.
The main thing with the posterior surgery is that you just can't bend over more then 45 degrees which is the most challenging thing.
I'm a side sleeper, and obviously couldn't sleep on my left side with new hip for a while, but could still sleep on my right side and of course my back.
And I certainly wouldn't be taking any sleeping medications as I think you're just asking for trouble there.
The nurses will get you up walking the day of your surgery, and PT will work with you the following day to be able to walk up a few steps and get in and out of their cut in half car, and then they'll send you home.
I had my surgery on a Tuesday morning and I was home by noon Wednesday, the following day. And yes, you'll be using a walker for a while until you graduate to a cane, but then you'll be good as new and won't need either.
And I'm not big on pain medications either, so I only took them the first couple of days and then only ibuprofen if I needed it.
You're going to be just fine and will be so glad when it's all said and done.
And trust your doctor about the posterior decision as they know best, and obviously have their reasons for choosing the posterior verses the anterior just like my doctor did, and my doctor did explain the reason for him choosing the posterior verses the anterior so you may want yours to explain that to you as well so you feel better about it.
You may be told that results come out about the same for both types of procedures 6 months in - which is true - but in the days to weeks following the hip replacement, you will be up and about with pretty much no pain very soon after the anterior hip replacement.
I was up walking within hours. My hip felt better than pre-surgery immediately, with less pain and easier walking and movement. Within half a day they had me doing stairs, and I went home within 24 hours. I stopped pain meds within days.
Physical therapy is slow and gentle. You need to do it, but it’s not at all the extreme, arduous exercise usually portrayed. It’s wiggle your toes. Flex your legs. Carefully walk with a walker. You do need someone about for the first few days, and shouldn’t drive for a few weeks (mostly, I found, because of the possibility of needing to brake hard in an emergency stop - you want to be sure that would be okay).
"Anterior hip replacement is a muscle-sparing procedure where the surgeon accesses the joint from the front of the hip. By working between major muscles rather than cutting through them, patients often experience less post-operative pain, a lower risk of dislocation, and faster early recovery."
"The posterior approach to hip replacement involves an incision on the side/back of the hip near the buttocks. The surgeon accesses the joint by splitting the gluteus maximus muscle fibers and detaching the short external rotators, leaving the major walking muscles intact. It provides excellent visualization for implant placement."