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JANET'S STORY |
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I had been experiencing a great deal of pain and discomfort from my right hip for about 18 months, and I had to take stronger painkillers. I got to the stage where I was counting the hours and minutes until it was sensible to take more to dull the pain. I was finding life more difficult, especially working as a trainer for Arthritis Care, running the home, and on top of that - moving house. I found that sitting for long periods, managing steps and stairs, and getting comfortable in bed aggravated my pain - I am certain that my 'swearing' vocabulary increased, and my patience shortened! Therefore, I was not surprised that during my six-monthly hospital appointment with my consultant rheumatologist this February, that my x-rays showed extensive deterioration, and the need for an urgent total hip replacement operation. I was surprised when he asked me which surgeon I would like to perform the surgery and I told him that I would like to be referred to the same surgeon who successfully replaced my left hip in 1991. |
Hip Replacement Diary Saturday 17th April 2004: Monday 3rd May: Thursday 13th May:
The nurses were very friendly and supportive, so I really hope that everything goes smoothly so that I can utilise this service. Friday 14th May: Saturday 15th May: Sunday 16th May: The car parks at Derriford were full, it was Sunday afternoon visiting, and it took a while to find a place to park. Fortunately we had taken my wheelchair so my husband pushed me to the ward on level 11. My named nurse introduced herself, and completed yet more paperwork. She put a white name band on my wrist, and a red one as I have an allergy to penicillin. No escape now! I emptied my case and put all the things I thought I would need for my stay in my bedside locker. My husband found out that I was second on the operating list for tomorrow at 10.30am approximately, and was told to phone the ward after 3pm the next day to find out how I was. He left after a while, and I started to chat to my fellow bedmates on the ward. It was a super sunny day (trust me to be in hospital during an unusual heat wave for this time of year) and the view from the window over to Dartmoor helped to pass the time. From my bed I could glimpse the planes approaching Plymouth airport, and the air ambulance landing and taking off again, far too frequently I felt, from the hospital grounds. I cannot remember the delights on the menu for the evening meal, but I was told that the roast beef had been delicious at lunchtime! The night staff put a 'nil by mouth' sign above my bed, and told me, "No eating after midnight, and no fluids after 4am in the morning". I was glad that I had brought a bar of Galaxy chocolate with me, which I had enjoyed earlier with a mug of Horlicks. Drug rounds completed, lights dimmed and we settled down to sleep. It seemed that this was the signal for the patients to activate their buzzers, and the slow march of the walking frames and crutches going too and from the loos had begun! I lay there thinking that I would soon be part of this regime, and pleased at the thought of being rid of this terrible pain in my hip. Monday 17th May: The anaesthetist working with my surgeon was a very calm and confident man, just the sort of person I felt would look after me during the operation. He said, "You must be used to all this now?" "I told him that even if this was my 12th operation, it didn't get any easier!" He told me my operation was planned for around 10.30am, and talked me through the procedure for the anaesthetic and then went off to look at the x-rays of my neck. He was away quite a while, and when he returned he said, "Because of the arthritis damage in my neck, how would I feel about having the operation by a spinal epidural, instead of a full anaesthetic?" "Did this mean that I would be awake throughout the operation, and be able to hear what is happening", I asked. He said that I would be sedated throughout, and he would find me a Walkman and play me some music. From my reading, I knew that the recovery time is so much better using this method, and as I am usually sick after anaesthetic, readily agreed - as long as I could listen to music, and not hear the noises! As he left, a nurse took me to the bathroom for a bath, my last one for three months! There was hardly time to dry myself before my name was being called to go for an echocardiogram test. So at 9.30am I was being pushed in a wheelchair to the ground floor for this ultrasound test. On my return to the ward, I went to the loo only to hear a nurse calling my name and telling me that they had arrived to take me to theatre. I was quickly given a white theatre gown to put on and I laid on the bed. My handover to the theatre staff had begun which meant more form filling. My armbands were checked. "Was I the patient"? "What operation was I having?" " Did I have an arrow marking the spot?" "Did I have any jewellery?" I said, "Yes" pointing to my wedding ring, which was then taped up. "Anymore?" the nurse asked. They explained that they needed to be more vigilant nowadays with so much body piercing! "Did I have any false prostheses?" I answered, "six - 2 knees, a left hip, a left elbow, and 2 shoulder replacements". Checks were made on dentures; lose teeth, caps and crowns, hearing and eyesight. I passed the 'test' and my bed was soon being pushed out of the ward, with my fellow bedmates shouting, "Good luck, and see you soon". Our procession moved slowly along corridors and into a lift, my pushers making pleasant conversation to make me feel relaxed. My bed was then parked in an anti room where soft music was being played. A male theatre nurse introduced himself, and made further checks of the paperwork and remarked about my surname, and my disability. I was not in mood for jokes at this time, and settled back to listen to the soothing music. The tannoy sounded to say that they were now ready for me, so they wheeled me to a small room leading into the theatre, a bit like deja vue, I had been in a room similar to this one before! There was a clock on the wall, and the time was now 10.40am, and the race was on to locate a vein suitable for the procedure. There were three or four attempts to locate veins in my arms, a lot of squeezing and the use of the blood pressure cuff. "I did warn you that my veins are difficult to find," I said pathetically, as they inspected the veins in my ankles. My anaesthetist remained calm and apologetic throughout, but I could sense the frustration of the male theatre nurse (as he sucked hard on the delicious smelling peppermint in his mouth) and the minutes still ticked away. At last I noticed my anaesthetist was not shaking his head this time as he gently said "A sharp scratch again", his patience and perseverance had paid off. The clock pointed to 11.10am we were now ready. As I would have no feeling 'down below' for a few hours following the operation, the nurse inserted a catheter. I was asked to roll onto my right side, and I felt the anaesthetist counting along the bones in my back to insert the epidural needle. It didn't hurt at all, and soon I was feeling happy and drowsy as a relaxant medication was delivered into the vein they had located in my arm. All I can then remember was feeling the sensation of movement as they wheeled me through the double doors into the operating theatre, and me saying, "Don't forget the Walkman, I don't want to hear all those noises!" "Hello Janet, the operation is over, it has all gone very well". I was lying on my left side, and my anaesthetist was talking to me. My left ear was hurting, I had been lying on the earphone of a Walkman, but I can't remember any music! I was asking lots of questions, and what the time was, my anaesthetist told me it was 1.30pm, and remarked that he was pleased that I was so alert after two hours of surgery. I was still on the operating table, so they turned me over, and lifted me back on my bed. I looked around and I noticed the huge theatre table lights. I had never seen inside the operating theatre before as I have had a general anaesthetic in the past. They wheeled me to the Recovery ward, and I told the male nurse that I remembered the smell of his peppermint sweet before my operation. "I'll get you one", he said and soon he was unwrapping me one from a white paper bag and popping it in my mouth. My, it tasted good. The nurse responsible for me said, "There wasn't a place on her observation sheet to record, 'patient sucking a peppermint'!" She checked my temperature, pulse and blood pressure, and asked about my pain level. I was feeling no real pain, though I had no feeling in my legs, in fact it felt as though my legs were strangely bent up towards my chest, but the nurse reassured me that they were not. She told me that she was also called Janet and her sister-in-law's maiden surname was the same as mine, and she lived in Plymouth. My surgeon walked by and said, "The operation had gone well, with very little blood lost". I thanked him for his skills, and felt relieved that all had gone well again this time. The nurses attached my booties (an A-V Impulse System) which was to be my constant bed companion during the coming week. These open-toed slippers (one edged with red and one with blue) wrap around your feet and assist by helping to push the blood around the body via a foot pump. I was very grateful that this equipment was being provided to prevent deep vein thrombosis, but surprised how many patients refused to wear them as they kept them awake! It was now 2.10pm and it was time to return to the ward. My named nurse welcomed me back with a smile, as the theatre staff handed me back into their care. I felt comfortable and slept off and on between the periodic observation checks by the nursing staff. At teatime the trolley provided me with an egg mayonnaise sandwich (those who know me will know it is my favourite), and I ate it slowly and enjoyed the taste along with a small cup of tea. In the evening my husband arrived, and was surprised to see me awake and able to have a conversation. He is used to finding me sleepy after surgery, and clutching the sick bowl! I was a little sick after he left (no, it wasn't seeing him, it was probably the morphine!) The feeling was slowly returning to my right leg, but I still couldn't move my left leg however much I willed it to, (the feeling didn't return until the early hours of the morning). I slept well despite the observation checks, and the foot pumps sounding, and pushing the soles of my feet every 10 seconds. Tuesday 18th May: The pharmacists came to check my medication, and the OT's, who I know very well, arrived to check my set up at home (height of loo, bed, chair etc.), and to give me a replacement grab stick. In the afternoon the physiotherapist introduced herself, she wanted to check that I had been doing the exercises from the booklet every hour, which are:
I was really pleased that the excruciating pain I had been experiencing before my operation had disappeared, the pain from the surgery was different. I still needed to have the liquid morphine periodically to control the pain, but this made me very sleepy and nauseous at times. Wednesday 19th May: Oh dear, a doctor is approaching with a tray containing items for taking blood, it seems that yesterday's samples clotted. The doctor tied a rubber glove tightly around my upper arm; tapped around a bit, and hey presto hit the jackpot! Two patients had knee replacement operations today, so there was a change around of beds and belongings to accommodate them in this six-bed ward. They forgot to remove my catheter today, so hurrah no bedpans. I slept well, but it was very hot and humid. Thursday 20th May: I was taken down the gym today by the physio for my exercises holding on to the bar (no- not a boozy one). Ten of each of these exercises need to be done each hour:
I had severe indigestion after lunch, not sure if I should blame the new medication or the hospital food. I pressed my buzzer and asked the nurse if they could give me something to help. Another nurse approached and said that she had checked my drug chart, and unfortunately she couldn't give me any medication as I wasn't written up for anything, but she could give me some milk - yuck. I asked again at dinnertime, and again at bedtime, but still they couldn't give me anything. Thank goodness I had an indigestion tablet in my purse. I had lots of visitors today, which was good, and bags of cherries from my brother, which are my favourite fruit. One nurse said, "They must have cost a lot!" I said that he had just sold a house near London! I am now taking only my usual painkillers and anti-inflammatory tablets, as the pain is now manageable. I have my nightly injection into my tummy (to help prevent blood clots, and given via a very fine needle), and settled down to sleep. At 11.45pm we were awoken by the fire alarm going off, and very soon firemen were at the entrance to the ward. Voices were saying that a smell of burning plastic was coming from our ward kitchen. Quickly the windows were closed, and anxious staff voices were rehearsing the evacuation process. I remember lying there wondering how far I could get using my walking frame, especially as we were on the 11th floor! The fireman said that he was going to check the roof as the smell was coming through the vents. It was scary stuff, especially as it brought back strong memories of my friend's house fire 34 years ago which led to me jumping out of a bedroom window to escape, and was probably the catalyst for the start of my RA. Fortunately within about 15 minutes the alarm was switched off, and I tried to get back to sleep assuming that all was okay, it would have been sensible for the staff just to have come around the ward and told us though. Next day we were told that a flex left over a cooker ring had burned through in an upstairs ward kitchen. Friday 21st May: My surgeon came by and asked how I was getting on, and was the pain better than before the operation? I said that I felt great and the pain was negligible now, and I was planning on going home tomorrow. He said, "Great idea and good luck, and he would see me at the post op clinic" which provided me with my passport to escape. The physio was pleased to see how well I was walking using my gutter crutches, and my range of movement during my exercises was good. Her superior said I had to try to walk up and down the stairs before I left hospital, despite having no steps, a ground floor bedroom, and a stair lift at home! So they wheeled me along to the stairs, which just happened to be the 14 concrete step fire escape staircase! I tried to pull myself up the first step using this thick banister rail, but had little grip and was unable to achieve it - those of you who know me know that I am unable to use a stair handrail normally because of the limited grip I have in my hands. I freaked out; I was worried that until I passed this 'test' I would have to stay in hospital! The physiotherapists calmed me down, and said it didn't matter. This was really the low part of my hospital stay. Luckily when I returned to my bed, my brother was there and helped me forget this unfortunate episode that pushed me to confront the frustrations of my condition. Saturday 22nd May: I felt exhausted as I lay on my bed, but it was a great to be home again. The two cats were pleased to see me, and curled up on the bed beside me. A spell in hospital helps you to appreciate your surroundings, especially peace and quiet, and your own loo! The Hospital-at-Home nursing team called every day for the next six days. I feel very fortunate that I was able to be part of this scheme. It was comforting to have their daily support, and know that they were carrying out the same checks as would have been provided had I stayed in hospital. I have had to have a variety of dressings on my elbows as I have developed painful pressure sores from pushing myself out of chairs, moving up the bed and using my crutches to get around the house. Hip, hip, hurrah, fourteen days have now passed since my operation, and I have now had my 28 clips removed. I breathed a sigh of relief as I felt the pull of what I thought was the last staple at the top of my scar. Unfortunately then the district nurse said, "Well Janet that's each alternate one removed, if you are okay, I will start at the bottom of the scar again! My brain is active (some would say this is unusual!) but I do get tired easily and I am getting bored with TV and videos. Hopefully I will be able to return to work after 6 weeks, but below is just a reminder of the precautions I need to be mindful of during the next three months.
I am sure that if you are reading this diary and have already been through a similar experience that it raised a knowledgeable smile. I hope that if you are perhaps waiting for a hip replacement operation that this account will prepare you, and allay your fears. If you are reading this diary and know that you will not need a similar operation, then I hope that you have found it interesting. Janet |
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