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Old 12-21-2008, 09:59 AM   #1
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Question getting ready for a new hip - help.

Hello,

I am 53 with a history of Slipped Capital Femoral Epiphysis ( rare hip condition - meaning I had a large pin put in and removed a year later in my early teens and on crutches for 1 1/2 years in Jr High!! ) Done at Stanford.

Not one problem until 6 years ago- I fell and hurt my hip- many many opinions later as to why my hip hurt the pain slowly went away but I was firmly told a new hip was in my future for conflciting reasons no two could agree on! I had MRIs, CT scans and more xrays than I can count...Once the pain left I kept getting the x-rays as asked of me twice a year for comparisons...the hip seemed stable with no real changes... arthritic , good joint space etc. but not worsening, in fact at first it was improving. I was told to wait for as long as I could due to the fact the technology was improving.

Finally, in too much constant pain and limping these past 6 months sent me seeking again I also finally asked to see my xrays so I could take a recent set with me. I was slow to do this and not sure why. I could see a problem!

I finally found a doctor who was familair with my above hip condition ( rare) and also noted after a swift glance what I knew but no one seemed concerned about -the sore leg was a 1.5 cm shorter. He clearly said I should have been in a lift all these years ( why did everyone miss this?) He asked for a 3 phase bone scan as I was in more pain than my xray indicates and the bone is swelling- plus I am now set for a hip replacement March 2nd. So I have time to plan. (as long as the bone scan allows that )
His plan is to do a THR with anterior min. invasive. He works for a clinic in Palo Alto that only does hips/knees. His class was VERY helpful. His clinic is state of the art-

I also saw my chiropractor who is helping me with lifts etc.


My questions are numerous-

1) I cannot wear nickel earrings- allergy. Will this be a problem?

2) He wants to lengthen my leg a bit and I am now wearing graduated lifts to adjust- what questions should I ask in this regard?

3) He prefers a spinal with a light sleep if I wish as he says the pain is better managed and patients wake up quickly and easily. Never had a spinal - makes sense the numbing for 12 hours would be good as there is less pain meds needed.. any questions I should ask?

4) I teach- 3-5th grade. I think 10-12 weeks wise to set up a sub... Can I return to work after that? Dr said he'd like me to take the full 12 as the kids could bump into me etc....

5) Does your walk/gait change after this surgery?


6) Helpful tips for recovery? I live with my hubby and frisky cat in a gorgeous mountain home nestled in the redwoods.. but with stairs leading into the house.

Thanks for now!

Debbie

 
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Old 12-21-2008, 12:44 PM   #2
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Re: getting ready for a new hip- help.

3) He prefers a spinal with a light sleep if I wish as he says the pain is better managed and patients wake up quickly and easily. Never had a spinal - makes sense the numbing for 12 hours would be good as there is less pain meds needed.. any questions I should ask?



Debbie[/QUOTE]


Hi Debbie:

For my right hip replacement in December of 2007, I chose the spinal combination. I had never had this before but was very satisfied with the result. My daughter was at my bedside pre op and helped me decide, after the anesthetist explained the procedure. I had no problems. I would not hesitate to do it again.

Shirley H.

 
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Old 12-22-2008, 12:14 PM   #3
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drlene47 HB User
Re: getting ready for a new hip - help.

Hi Debbie,
Am almost 6 months post op. Am 61 and taught school also, 5th grade. At retirement didn't know I had a hip problem except for some stiffness now and then. Within 6 months I was at the OS wondering why one leg was shorter than the other. OS informed me the hip was worn out and I could also see it on the exray. He said to preserve it as long as I could which was another 6 months.
The increased and different activities I was doing after retiring from teaching was the straw that broke the camel's back. Prior to that, I walked from my car to my desk to the main office, etc. back to my school room and stood at the podium and walked around my class. Was usually too tired and stressed after work to do much else so the arthritic hip was not under much of a strain.
Am wondering why, if you surgery is scheduled for March, you can't just let a sub finish out the year for you and take the summer also to recoup and get your strength back? Possibly your school is year round or you are on one of the modified school years. It does take a while to get your strength back.
Concerning the steps up to your house, it would depend on how many there are. They teach you how to do steps before you leave the hospital but if there are a lot of steps it would tax your strength the first day home. You wont be doing much getting out and around for a few weeks so the problem would be just accessing your front door on that first day home.
I had the epidural and was NOT conscious for the surgery either. Told the anesthesia guy that I did not want to know anything. The epidural stayed in for a day or so after the surgery keeping me virtually pain free. I was fortunate not to need much pain meds even after I came home but every one is different. Am still not walking with a normal gait mainly cuz the surgery leg is now longer than the other (this does NOT happen with everyone and lifts DO help) but am also still improving in all areas.
Good luck,
Darlene

 
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Old 12-22-2008, 07:50 PM   #4
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Re: getting ready for a new hip - help.

Hi.....

Definitely discuss your allergy to nickel with your surgeon. Most prosthesis parts are made of mixed metals. Do you know what type he prefers and will be using? I see that he will do an anterior approach. I had the same for my second hip and there are virtually no restrictions. The difference between my first.......posterior/lateral approach...and the second were like night and day. The muscles are separated rather than cut making a huge difference in recovery.

Your leg should lengthen after the replacement. In fact, most patients complain that their leg feels longer than the other after surgery (real or perceived).

Most surgeons recommend the Epidural/Spinal with IV sedation. Much safer than general...no nausea afterward....much more alert. I had a spinal with sedation for both hips.

Your gait may be a little off post-surgery.....especially if you've been limping around for a while. Specific PT exercise would address that.

There are tips listed on the sticky at the top of this message board...i.e.; a raised toilet seat, a sock tool, grabber, leg lifter, pant tool. Most people are released on a walker and graduate to a cane....and possibly crutches. You will be taught how to do stairs during therapy while in the hospital. Not a problem.

As for missing the leg length discrepancy, it's anyone's guess. Docs focused on the hip changes. A good physical therapist would have probably recognized the problem and suggested a lift. I wore a lift in my left shoe after my first hip surgery (right side). A definate discrepancy. Three months of fairly intensive outpatient PT helped. I'd hoped that when I had my second hip was replaced that I'd finally be even. I'm not. My right side is still higher than my left. It's really noticeable when I wear slacks...at least I think it is! Not a big deal!! A small tradeoff for pain-free hips!

Good luck to you and keep us posted,
Linda

 
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Old 12-23-2008, 08:53 AM   #5
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Re: getting ready for a new hip - help.

Hi,

Thanks for your replies. It sure does help. I am nervous- but finally ready mentally. I have heard the Min. invasive ant. approach good with less restrictions and faster recovery- thanks for confirming this!

As to the materials he is going to use- he showed me a Zimmer model and another to familairize me with what they look like generally and how they work. ( They are heavy!) I told him of my nickel allergy and he mentioned ceramic. I will be meeting with him after my bone scan the 2nd and will be asking more specific questions with all your help and all I am learning.


I limp now and have off and on for most of my life due to shorter leg already...I was hoping this would go away with time after surgery. They offer a 'gait class' they recommend . I went to the hip replacement class taught by the DR- the gait class is by the PTs. Anyone gone to a gait class?

I am trying to figure out where those 'stickies' are you mentioned.


Debbie

 
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Old 12-23-2008, 09:00 AM   #6
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Re: getting ready for a new hip - help.

Darlene,

I teach special ed and have a student teacher starting Jan 5th I can train a bit before being out. (Why I am limping thru all this until March 2nd) I may indeed stay out thru the rest of the school year but I was thinking of returning part time only to do IEP related stuff while student teacher 'teaches'.

At the moment I am asking for 12 weeks. Also if you knew me- you'd know I will go stir crazy.. This hip thing has really slowed me down this year... I am an active person...



That is my hope anyway...


Debbie

 
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Old 12-23-2008, 09:47 AM   #7
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libloom HB User
Re: getting ready for a new hip - help.

Hi again......

I think it's great that your facility offers gait class, which can address specific problems if necessary.

As for the stickys......they're at the top of the "Knee/Hip" page and, rather than read through tons of posts that don't address home/recovery tips, try doing a specific search on the main page of Healthboards for "home recovery tips after hip replacement." There are so many variables. Your facility sounds excellent and, depending on your insurance plan, they will probably release you with the necessary "tools" for recovery.

I think you should be able to get back to work part-time at around 6 weeks. With my second hip, I went back part-time at 4 for a few hours a day (was driving at 2). We all recovery differently. Your surgeon will determine what's right for you.

Best wishes,
Linda

 
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Old 12-26-2008, 01:58 PM   #8
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judybee7 HB User
Re: getting ready for a new hip - help.

Quote:
Originally Posted by dezool View Post
Hello,

I am 53 with a history of Slipped Capital Femoral Epiphysis ( rare hip condition - meaning I had a large pin put in and removed a year later in my early teens and on crutches for 1 1/2 years in Jr High!! ) Done at Stanford.

Not one problem until 6 years ago- I fell and hurt my hip- many many opinions later as to why my hip hurt the pain slowly went away but I was firmly told a new hip was in my future for conflciting reasons no two could agree on! I had MRIs, CT scans and more xrays than I can count...Once the pain left I kept getting the x-rays as asked of me twice a year for comparisons...the hip seemed stable with no real changes... arthritic , good joint space etc. but not worsening, in fact at first it was improving. I was told to wait for as long as I could due to the fact the technology was improving.

Finally, in too much constant pain and limping these past 6 months sent me seeking again I also finally asked to see my xrays so I could take a recent set with me. I was slow to do this and not sure why. I could see a problem!

I finally found a doctor who was familair with my above hip condition ( rare) and also noted after a swift glance what I knew but no one seemed concerned about -the sore leg was a 1.5 cm shorter. He clearly said I should have been in a lift all these years ( why did everyone miss this?) He asked for a 3 phase bone scan as I was in more pain than my xray indicates and the bone is swelling- plus I am now set for a hip replacement March 2nd. So I have time to plan. (as long as the bone scan allows that )
His plan is to do a THR with anterior min. invasive. He works for a clinic in Palo Alto that only does hips/knees. His class was VERY helpful. His clinic is state of the art-

I also saw my chiropractor who is helping me with lifts etc.


My questions are numerous-

1) I cannot wear nickel earrings- allergy. Will this be a problem?

2) He wants to lengthen my leg a bit and I am now wearing graduated lifts to adjust- what questions should I ask in this regard?

3) He prefers a spinal with a light sleep if I wish as he says the pain is better managed and patients wake up quickly and easily. Never had a spinal - makes sense the numbing for 12 hours would be good as there is less pain meds needed.. any questions I should ask?

4) I teach- 3-5th grade. I think 10-12 weeks wise to set up a sub... Can I return to work after that? Dr said he'd like me to take the full 12 as the kids could bump into me etc....

5) Does your walk/gait change after this surgery?


6) Helpful tips for recovery? I live with my hubby and frisky cat in a gorgeous mountain home nestled in the redwoods.. but with stairs leading into the house.

Thanks for now!

Debbie
Debbie: I am unable to wear pierced earrings also. When it became obvious that I would need a hip replacement, I ordered a blood test from a lab that specializes in testing for metal allergy. I have an allergy to nickel and the surgeon had to use a hip implant of titanium with a ceramic head which he said contained no nickel. You may want to discuss this with your surgeon before the surgery so he can advise you. Jan 9, 2009 will be 4 mths for me and my progress has been slow but gradually I am able to see a difference. I had a spinal with light general anestesia. I was allergic to oxycodone pain medication & that made me miserable. I believe the most helpful advise I received is "everyone is different and recovers at their own pace." My best wishes for your successful recovery.

 
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Old 12-27-2008, 07:26 AM   #9
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dezool HB User
Re: getting ready for a new hip - help.

Hi,

Thanks for th reply about the allergy testing. I did tell my DR and I assume he will order the test..I will remind him when I see him next time.

You said after 4 months you are seeing some positives. What type of surgery did you end up having? Yes I hear people heal differently- this has also been an isssue for me as I can only give my school an approximation for time needing a sub...I have asked for 12 weeks.

Thanks!

Debbie

Debbie

 
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Old 12-28-2008, 07:49 AM   #10
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judybee7 HB User
Re: getting ready for a new hip - help.

Quote:
Originally Posted by dezool View Post
Hi,

Thanks for th reply about the allergy testing. I did tell my DR and I assume he will order the test..I will remind him when I see him next time.

You said after 4 months you are seeing some positives. What type of surgery did you end up having? Yes I hear people heal differently- this has also been an isssue for me as I can only give my school an approximation for time needing a sub...I have asked for 12 weeks.

Thanks!

Debbie

Debbie
Debbie, I had total hip replacement. I am also older than you at almost 68 when I had it done. My doctor has not released me from my 90 degree hip protocol so there are things I am still unable to do. I see the doctor again on Dec 31. I am retired so don't have to worry about returning to work. My hip replacement was covered by Medicare and I believe that you have better health coverage than I do. I am also a participant in a group of 500 of a hip replacement trial so will be returning annually for reevaluation. I have a friend who 55 who will have THR on Dec 31. She calls me frequently with questions. You are also encouraged to contact me with questions. If I can help it will be my pleasure to do so.

 
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