Kac Para Yarismasi

Arthritis Diet and Exercises

Having a hip replacement – Part Two: Recovery


Hip replacement surgery has really changed
over the last 30 years we’re getting people up sometimes on the same day of
surgery and it’s safe to do that we are getting people home after a couple of
days after the surgery and it’s safe to do that as well.
The first 24 hours when you get back from surgery you’ll be seen regularly by
the nursing staff, the routine on the ward is that from about 6 o’clock in the
morning you might be given your medications by the nurses at the end of
their night shift and have your observations taken. Somewhere around
eight to nine o’clock the doctors will come around and visit and see you for
the day, the physios will come one or two times each day they’ll also be the
nursing assistants on the ward who’ll pop in and out on a very regular basis every
couple of hours to make sure you’re okay and if you need a nurse at all in
between times you’ll have a patient call bell that you can press to get the
nurse’s attention. Somebody comes round to check your blood pressure, checks if
you need any codeine or paracetamol. I didn’t feel at all hungry I think I just
wanted to stay in bed and recover but I I know I felt fine and I slept quite
well. For the first couple of days after the operation
you’ll receive strong painkillers either morphine or oxycodone the strong
painkillers can make you feel drowsy after the operation they can make you
constipated so you will be prescribed some laxatives to prevent that and they
can make you feel a bit queasy so we will prescribe some anti sickness
medication as well. For the majority of your medicines they will be given to you
by the nurse the reason why we do this is that you may be a bit sleepy after
surgery and so may not remember to take them and also there may be some that
need to be stopped for a little while for example your blood pressure may well
go down after surgery and so the nurses will measure your blood pressure and
won’t give you your blood pressure tablets if your blood pressure is too
low. It was quite sore just I guess the
anaesthetic had worn off the wound was having an effect and I had to be very
careful changing position in bed which was quite
painful if you did it quickly. We will do everything we can to
manage your pain we’re not going to say there’s going to be no pain because
you’ve had a big operation and you are going to experience some pain so when
you start feeling some additional pain if the pain starts increasing make sure you
ask those extra painkillers earlier rather than later so that we can get on
top of the pain as quickly as possible. Please don’t feel leaving it to the last
minute cause you don’t want to bother the nurses is what you should do because
it’s much harder to control the pain once it’s got too far. After your hip
replacement the physiotherapy team will help to get you up and get you mobile
we’ll either see you the day of your surgery or the next day and we’ll be looking at
going through some exercises on the bed then hopefully getting you up getting
you walking around a little bit using a Zimmer frame and then progressing from
there. It’s best to try and get up and moving as soon as you can it’s not only
better for your hip joint it will be less stiff and you’ll be able to get it
stronger by getting moving quicker but it also reduces the risk of chest
infections and pressure sores and blood clots by getting you moving early. You’re
more than likely going to be using a Zimmer frame for one or two days and
then striaght on to some crutches the advantage of crutches is that they allow
you to walk in a much more normal walking pattern so they bring normal
movement back quicker. They try to help you to get mobile as quickly as possible
and obviously to get home as soon as possible. They help you out with the leg
that’s been operated on the other leg is quite mobile obviously and you follow your injured leg you followed your operated leg. It’s common
after hip replacement surgery to get swelling when you are in the bed and you
haven’t been up with the physiotherapists then it may well be in
your buttock or the top of your thigh once you start getting up and walking it
travels down your leg so thigh gets swollen ankle gets swollen sometimes on
the ward we find that patients slippers don’t fit so when you’re at home it’s
really important that other joints don’t get really stiff at the same time, so
it’s important to take yourself off to bed have a lie down
on the bed for half an hour an hour in the afternoon, that elevates your legs
the swelling goes down and then you’ll be able to get up and move again. The
top-line priority is that you are medically well after this surgery that
has to be done we need to know that your wound is clean and healing up nicely the
physiotherapists need to know that you’re safe and comfortable moving
around probably using elbow crutches and occupational therapy needs to be sure
that you’re able to return to do the jobs that you need to do at home. We’re
going to come round pretty soon after you’ve had the surgery encourage you to
get into your day clothes for many people the hip will feel a little bit
stiff and it’ll be very similar to how you’re getting yourself dressed now.
We do know that toilets can seem quite low after you’ve had a hip replacement
surgery and when you’re on the ward the staff will take you into the bathroom
and see how you’re managing, if you can’t manage to get on and off a standard
toilet we are able to loan you a piece of toilet equipment to take home with
you we do ask that you return that after six weeks. The plastic toilet which
obviously meant that you didn’t have to bend your leg when you go to
the loo and that was pretty important the thing for getting your socks on
which I’ve got one upstairs also once you’ve managed it that was fantastic.
I had a bit of a problem working how to put the sock on and then pull the sock
up onto your foot but once that once I’ve managed that that’s okay. We’ll send
you home walking with elbow crutches or walking sticks whichever you’re more
comfortable using and we tell patients that you can progress off them whenever
you feel confident but the most important bit is how well you’re walking
so I would say that most patients after a hip replacement look to use them
around a month and then if they’re walking nicely without the crutches
then that’s fine they can start progressing off them but if they come
off them and start limping then they need to go back on them for a while and retry. Some patients go down to one
crutch and it’s important that they have the crutch in the opposite hand to
their surgery. I certainly used both crutches for a
fortnight and you use your good leg to take the weight of the leg that’s been
operated on, get rid of one of them had kept on with the other usually using the
stick further away from the leg and use that for another couple of weeks or so
and then decided I didn’t need them. The safest way to do the stairs when you
go home is to hold on to one rail and have your crutches in the other hand so
hold one crutch as you normally would what we do is we turn the other one 90
degrees so that the patients can carry up the stairs and then go up with your
good leg first follow that with your operated leg and then the crutches that
you’re using. We’ll send you home with some injections that you have to do
every day into your tummy these are to help prevent blood clots because you’re
not walking around at home as much as you would usually prior to your
operation you’re at higher risk of blood clots, these two things combined will
reduce that risk and make it much safer for you. Everybody who has hip surgery
has a daily injection of Daletparin or Fragmin however if you were one of
these people that are taking oral medication to thin your blood things
like warfarin, clopidogrel, apixaban you will probably only have a couple of
injections and then get back onto your oral medication as soon as possible.
Because of the operation I’m told that there’s a possibility that you
might get a blood clot or something so you get a lump of your stomach,
you just put it in press the thing and do it once a day and that’s it so if I
did it the same time every day I’d remember to do it. So a relative can come
and pick you up you should be ready by about lunchtime we may ask you to vacate
your bed prior to your discharge if we need it for the patients coming through
that day and we have a discharge lounge that’s staffed by a staff nurse where
they can look after you until your relatives are ready to come and pick you
up. We do know socks and shoes be a bit of a challenge particularly
socks there are gadgets available on the open market our League of friends shop sells these items of equipment you can get them readily out on the marketplace.
To get in and out of the car after surgery we advise that you get into the
passenger side at the front whoever’s driving you needs to push the seat back
as far as it will go and maybe recline the backrest a little bit you’re going
to go in bottom first so you’re going to sit yourself down and if you’ve got long
legs you might want to consider moving yourself back to the middle of the seat
and then bring your legs slowly round into the car.
I very gingerly got into the car that getting help with my hands to get the
left leg to follow the leg that was a that was in the car at the time. Patients
go home whenever they’re ready so once you’ve hit your milestones of
being independently mobile with your crutches your wound is nice and dry and
healing you’re happy going up and down the stairs we know that your home is set
up then recovery will be much more comfortable for you at home it’s been
shown that if you stay longer in hospital then the complication risk
increases again even if you are mobile. We advise patients to do exercises three
times a day after their hip replacement they’ll find in the beginning it’s quite
sore to do them so we advise that they do maybe five repetitions ten
repetitions and then gradually increase as they become more comfortable so you
should eventually be aiming to do them three times a day 15 or 20 repetitions
of each one. If you’re somebody who goes home and doesn’t do your exercises then
the likelihood is that you won’t walk in a normal pattern you won’t get a good
recovery and you’re likely to have pain for longer. You feel stronger each day
you’re able to walk more quickly able to do more stairs
take on a slightly more. It’s a slow process but it’s something that you do just to help
yourself. Try and go for walk every day outside if the weather’s okay and make
sure that you’re aware of how far you’re walking out because you need to come
back so if you go for a nice walk you’re out for maybe ten minutes you come back
you feel okay is nice and controlled you’re not too sore
then that’s really good that’s a sign that you can then increase the amount
you walk next time. After about two three weeks three or four weeks
suddenly everything comes right you know you suddenly recovered from your wound
from the operation and you begin to think what’s all the fuss about?
It’s amazing how quickly you heal and how quickly you recover you notice the
one big thing is that there’s suddenly no pain and that arthritis that is causing the pain is gone. The operation has been a success and your glad you’ve done it.
You’ll find that your recovery is best if you are taking your painkillers
regularly doing your exercises regularly having a walk outside every day and
resting when you need to. If you have a shower cubicle we would suggest
that that’s okay to step in and out of a shower cubicle it’s an easier action
for you to do that. With regard to the healing wound the nurses on the ward
will give you a supply of waterproof dressings so you’ll be able to get the
wound wet in a splash way we wouldn’t want you to sit in a bath and soak the
wound while it’s healing. In regards to housework once you go home you should be
able to manage your laundry and your washing up with ease things like
hoovering you might struggle with a bit more because you’re going to be
mobilizing with crutches and therefore you won’t quite have the balance and the hands-free to be able to do that. We recommend four weeks to get back
to driving this isn’t just about the the hip joint itself it’s about your
reflexes and really recovering from the experience of coming into hospital going
back home and getting yourself well. It’s very usual for people to be really
worried about coming into hospital and having a surgery such as a hip
replacement and we want to give you confidence that everything is going to
go well during your recovery. It’s important that you are realistic about
recovery this is a big surgery we do do a lot of them and it’s a very usual
operation now across the world but that recovery time just takes time so don’t
be disappointed when go home that you feel very tired doing
the simplest tasks will tire you that’s completely normal
that’s what we would expect. It just makes me feel so much younger
I mean pain makes you, ages you you just think I’ll never cope again but
having had this hip done I thought I’ve got that pain I can really sit up and I
can get going and start to plan life again. It was a very straightforward
operation I was well looked after everything worked and went according to
clockwork as far as I was aware, everyone’s prepared for me I was looked
after while I was there I’ve nothing but very good experiences. You feel so much better
after it the pain is Gone you are more mobile you can do
things now that you couldn’t have done the six months ago before. You feel a
new person you

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