Pre-Surgery – Donna

Having physical limitations is a normal result of getting older. But this year both my wife and I are having issues that are going to require surgery at about the same time – for her a hip replacement, and for me foot surgery. I’m going to cover just hers in this posting and mine separately – especially as mine will have a lot longer recovery time and will result in many more blog postings.

Donna has had increasing pain in her right hip for a couple of years. She’s pretty tolerant of pain and so has been just dealing with it, but it got to the point over the past year that she finally thought she should see a doctor who could diagnose her issue and make some recommendations. They took some x-rays and recommended eventual hip surgery. However, for whatever reason, they did NOT show her the x-rays themselves. As she said when we finally saw them, “if I saw them, then I wouldn’t have waited to have the surgery!” But as it was, she just continued dealing with the increasing pain until we decided that the surgery could not be put off any longer.

In the below picture, the left image is what her left hip looks like, but the middle image is what her right hip looks like. There is a definite narrowing of the space between the hip ball and the socket, there are rough projections on the ball, and there are also bone spurs just below the ball on both sides. It’s the bone-on-bone between the ball and socket that is the cause of her pain.

[Hip Replacement steps]

 

Right now, we have the surgery scheduled for March 2nd. We already had a pre-surgery visit (when we finally got to see the x-rays). Next week she has a visit with our family doctor (who has to give written permission based on any other issues she might have [which she does not]), a visit with our dentist (who also has to give written permission because of the impact of the various medications she will be taking), and a pre-surgery phone call to discuss all the details of the day as well as the requirements during the final pre-surgery week. These are pretty simple and mostly just to prevent infection. For the five days prior to surgery, she has to wash with a special anti-bacterial soap (everything from the neck down – it’s evidently too strong to be near the mouth/nose/eyes). She also has a prescription drug that she is supposed to swab in her nostrils twice a day that will help prevent MRSA.

For those who have never investigated this type of surgery, here are some details. First, as you can see in the right-most image above, the ball of the thighbone is removed. The interior surface of the socket is the smoothed out, removing any rough patches. Next, referring to the below picture, the part called the “acetabular component” is inserted into the smoothed-out socket. As we were informed in the pre-surgery visit, if the socket is smoothed out to 53mm, then the insert would be 54mm to ensure a tight fit. The insert also has a rough surface that the bone of the socket will eventually grow into making it a permanent part of the pelvis.

[Hip Replacement parts]

 

Next, the plastic liner is inserted. Then the femur is hollowed out, again making the hole slightly smaller than the femoral stem of the insert as the whole thing is just held in by pressure – no screws, no staples, just pressure [note in the first picture that the hip muscle is pulling on the top of the thighbone and that gives the necessary pressure to hold everything together!]

The femoral stem of the implant (all made of titanium) is then just hammered into the reamed-out hole in the thigh, the ball into the cup of the plastic liner – and it’s done! There are no screws, and no stitches. The wound is simply closed up through the application of an external piece of “fabric” that is applied to the skin with a sticky adhesive. The fabric is waterproof and will hold the wound closed while it heals.

Hip replacement surgery is so routine these days that the expectation is that they will have her up out of bed and walking the afternoon of the surgery and release her to go home the following morning. She’ll have to have a cane or walker or crutches for at most a couple of weeks. We also already have her scheduled for post-surgery PT the following week – which will also be for at most a couple of times a week for a few weeks. We have some friends at church who went through this recently and they were walking normally (and pain-free!) in only a week or so. That is also our expectation for her.

And more importantly, this should relieve the pain that she’s been having and allow much easier sleep!

I wish that my upcoming surgery would get over so quickly – but that’s the topic of another series of postings.