Preparing for a Hip Replacement: What They Don’t Tell You

Helping my mother through her hip replacement has come with a rather sharp realization. Among all the information and training they give you – and they do give you a lot — there are a number of things they don’t tell you. Crucial things. Things you need to know to make your recovery from a joint replacement much easier and less stressful. 

To wit:

Have an Advocate. Whether it’s from the aftereffects of the anaesthetic, coping with the post-op pain, or the opioid -induced fog, chances are your brain won’t work very well for the first several days after the surgery. Somehow, the medical staff don’t seem to be aware of this, throwing an intense amount of information at you, while expecting you to make the arrangements surrounding discharge planning and aftercare.

Designate an advocate. This should be someone you trust, who knows you well, and who has no problem being assertive with medical professionals. If you don’t have someone who can do this, get in touch with the social work department of the hospital before your surgery. Some hospitals also have patient advocates who can help you.

Prepare Visitors. You will be glad to see family and friends visiting you in the hospital, but you won’t have enough energy to interact much. They should be prepared to mostly sit by your bedside, chatting briefly and amiably when you wake, and otherwise leave you alone to sleep. Hospitals also aren’t staffed adequately, often relying on family and friends to do non-medical care, such as getting blankets, water, helping to make you comfortable, getting staff when you need them, etc. Try to set up a bit of a schedule that ensures someone is around for the better part of the day until you go home.

Hospital food will suck and you will be off your feed. It’s a good idea for your visitors to bring in light, enticing meals (clear soups, etc.), to help you get a bit of nourishment that isn’t too challenging for your stomach.

Assume Early Discharge. The sooner your advocate starts getting the information they need for when you go home, the better. They should start talking about discharge planning to nurses, physiotherapists, occupational therapists, social workers and the like the day after your surgery. They kick you home quickly these days, partly because the hospital is no place for sick people — you recover better at home. Another reason for the quick turnaround is financial pressure from hospital administrators to move patients through as quickly as possible. If they told you that you will be in hospital for four days, assume it’s going to be three.

Line Up a Companion. Make arrangements to not be alone for at least the first week after discharge. You will likely spend the first week tottering between bed and a chair, gradually spending more time in the chair than in bed. You will not be able to make a cup of tea, get yourself an apple, or lean forward to grab the remote (to prevent dislocation, you’re not allowed to bend your hip past 90° for the first three months). It’s important that there’s someone in the house to be with you when you are on your feet (with a walker). That someone should be comfortable potentially helping you with going to the washroom, putting you to bed, changing your clothes, and other personal tasks. You should also start getting ready to be comfortable with receiving help with all sorts of intimate tasks.

Dealing with Constipation. You will be blocked. The anaesthetic, strong painkillers, and not eating much will combine to making things move very slowly. The hospital may send you home with stool softeners. Also be sure to drink plenty of liquids and make some of that prune juice. Nothing else works like it.

You Know You’re Getting Better When… For the first week or so, you’ll be busy just getting through the days. Then you’ll notice yourself starting to get cranky. Don’t worry. It means you’re getting better. It will be frustrating for weeks, but minding about being uncomfortable and not being able to care for yourself is a sign that you have regained enough strength to want to be independent. Hang in there. And remember that one of the great things about surgery is that you will get a little bit better every day.

Do you have any little-known tips for recovering after joint replacement?