Hip School

Purpose of Hip School

  • Education
  • Expectations
  • Preparation

I went to Hip School on 22nd November 2018. Along with many others awaiting hip replacements and some of their partners we all sat in a classroom to learn what to expect about the surgery and recuperation. We were told that patients who attend hip school recover much quicker after surgery. Being educated, in my opinion, is the best way to deal with anything. With hip replacement there is equipment to buy and rules to follow so information is key.

Prior to Surgery

Eight weeks before surgery

Stop smoking. This will help with recovery after surgery. The sooner you quit, the greater the benefits will be.

Benefits of quitting smoking

  • Decreased risk of surgical site infections, lung infections or other lung complications.
  • Faster healing times

One to Two weeks before surgery

Eating and drinking

  • Limit your daily alcohol intake to one or two drinks maximum.
  • Continue to exercise until the day of the surgery
  • Eat three healthy meals a day. Ensure each meal includes protein rich foods ie meat, poultry, fish, eggs, beans or tofu.

Night before surgery

  • Stop eating solid foods 6 hours before arrival at the hospital (8 hours before surgery.)
  • Drink 800 ml (3 cups) of apple juice over 1 and a half hours. If you are diabetic then drink water instead of apple juice.
  • Surgery causes a stress response in your body. The nutrients in apple juice will help your body respond better to this stress.

Pack a small bag containing

  • Your OR envelope (from the hospital)
  • Two packages of chewing gum (it helps get your digestive system working post op)
  • Your health card
  • Robe with a tie belt
  • Warm socks
  • Slippers (Crocs have been advised due to swelling post op)
  • Consider ear plugs and an eye mask for sleeping.

Day of Surgery

We were advised to arrive at the hospital 2 hours before surgery. This allows for any outstanding tests to be performed and ensure that the operating theatre runs on time. We were advised to bring something to occupy the time. I intend to take a book and a puzzle book. As my hospital does not have lockers then I don’t plan on taking anything of value.

Unless you have been given specific instructions to the contrary you may take your usual medications the morning of surgery. Do NOT eat any solid food. You are allowed to drink black tea or black coffee (no milk or cream) up until 3 hours before surgery. Finish drinking an additional 400 ml (1 and a half cups) of apple juice 1 hour prior to your arrival (3 hours before surgery.) Do not drink any more fluids.

An intravenous line will be started to provide medication and hydration. You will receive either a spinal or general anaesthetic.

After surgery

I was told that I would be in hospital overnight for one night. Before being allowed home you will be able to get in and out of bed, walk with an aid (usually a walker to begin with) and be able to go up and down stairs.

Later that day after surgery

  • With assistance, sit up at the side of the bed for at least 10-15 minutes.
  • Start doing breathing exercises, coughing exercises and leg exercises at least four times per hour.
  • Make sure to let the nurse know if your pain is preventing you from sitting up or doing any of the exercises.
  • A dressing will cover your incision and should remain in place until the follow up appointment with the surgeon in approximately 2 weeks. I was advised that the dressing will be waterproof so you are able to shower right away.

Pain Control

Staff will ask you to rate your pain on a scale between 0-10

0 = no pain                    1-3 =mild pain

4-7 =moderate pain     8-10 = severe pain

Pain is normal and is not expected to ever be rated a zero when in hospital. The goal is to rate pain at no more than 5/10 when at rest.

Pain will worsen when you are moving, however it is necessary to move.

Pain will be controlled by medication taken by mouth. Taking medication on a timely basis will allow you to participate more effectively in your recovery.

You must ask for pain medication as needed.

Day after surgery

  • With assistance, sit up at the side of the bed or in your chair to eat all of your meals.
  • With assistance, get up and walk as much as you are able.
  • Chew your gum at least 5 times a day.
  • Make sure to let the nurse know if your pain is preventing you from sitting up or doing any of the exercises.

Medication

While in hospital you will receive your usual medications (confirmed with the pharmacist), pain medication, laxative and blood thinner.

When at home speak to your pharmacist for medication recommendations specific to you. Extended release Tylenol (eg Tylenol for Arthritis) should be taken every 8 hours and narcotic medication only when needed.

Be sure to consume adequate fluids as narcotics are constipating. Eating a high fibre diet is advised and taking a stool softener will ensure regular bowel movements. A laxative should be used if you do not have a bowel movement for 2 or more days.

Confusion after surgery

Some patients may experience confusion or hallucinations after surgery.

If this happens:

  • Inform the health care team.
  • Ensure adequate fluid intake.
  • Manage your pain.
  • Have a family member or friend stay with you.

Incision/dressing

  • Your dressing will remain in place for 2-3 weeks until you follow up with your surgeon.
  • You may shower but avoid immersing your dressing (ie swimming or taking a bath)
  • It is normal to see blood and condensation in your dressing.
  • Contact your surgeon if your dressing is draining or is completely saturated with blood and fluid.
  • Staples will be removed at 2-3 weeks by the fracture clinic unless your surgeon directs otherwise.

Catheter

If you are unable to void your bladder after 4-6 hours then a catheter may be inserted.

Your bladder will empty more effectively when sitting.

X-ray

You will receive an x-ray of your hip the morning following your survey.  You will be discharged for home the same day as your X-ray.