Surgery and the Hospital Stay

On the day of your operation, you will probably be asked to get up at an unearthly hour, take an antiseptic shower, and report to the hospital for admission and preparation. This is one time that you do not need to worry about lack of sleep, I promise you.

I chose to avoid a final decision on anesthesia until meeting with the surgeon on the morning of the operation. Everyone was 50-50 about using a general versus a spinal. I decided that I had no interest in seeing the operation, even if my memory would get wiped. And, as it turned out, if the surgery takes extra time, like mine did, then a general is the better choice. You'll have to make your own decision based on your condition and the advice for your doctors.

If you've ever had surgery of an kind, you'll know that one minute your wheeling along in a cart on the way to the OR, and then suddenly you're groggy and on your back in a different place. My surgery (on Monday 6 August) took over two hours because the surgeon needed to work a little harder due to my hip dysplasia.

I had been told that Birmingham patients do PT on the day of their operation. Well, sort of. It consisted of being moved out of bed to a recliner, maybe 1 meter in distance. I almost passed out on this long journey. Impressively though, my surgery ended at 10 am, and by 2 pm I was in the recliner, awake. My family visited and watched while I picked at my dinner (I had ordered the meatloaf selection as comfort food, but my appetite was beyond comfort, certainly any comfort that meatloaf could offer).

When I awoke, I had a urinary catheter, an IV for pain med, antibiotics and fluids, and a dressing on the incision but no surgical drain. The wound was closed internally by dissolvable stitches and externally by steristrips (compared to other Frankensteinian sutures I've had, the closure was gorgeous and tight; too bad this is not the most photogenic and oft-displayed part of me!). The catether came out the next morning (no real pain), the dressing got changed daily (no real pain), and I did PT morning and afternoon starting Tuesday afternoon (no real pain). Constantly asked about pain on the 1-10 scale (WTF is a 10 supposed to be: slowly being crushed by a truck??), I never went beyond about a 4, thanks partly to the opiates, including morphine over the first two days. Probably the most pain I had were brief sharp tugs in the area of the incision; these diminished over time as the wound healed and the sutures adjusted.

By the way, there are various ways a surgeon can access the hip, but if your view of the hip is of the hands-on-your-hips variety, you may be surprised to find your incision is on your ass as much as anywhere else! Hip surgery = ass surgery.

One thing to be prepared for is an unpleasant norm for post-operative, opiate-filled life: constipation. They give you some palliative stuff, but really, in my experience from years spent traveling in remote areas and using various "stomach" remedies, once an opiate gets into you, your intestines just go on holiday, extended holiday. What made my life worse was the toilet extender they had perched around the hospital toilet. I am not a huge guy, but sitting in there pinned my legs together in such a way that even if something was maybe gonna happen, nothing was gonna happen. I had to get home to find relief. If you're lucky, this will not be your experience. Moving on...

The biggest post-operative issue I had and am still getting over is the trauma to my quadriceps. If you have the right constitution, find one of the detailed surgical videos posted on the web and watch the Birmingham operation. You'll see that fairly early in the procedure, Igor the Assistant gets the word to dislocate the hip, and this involves a rotation of the leg that ain't natural. Your leg is twisted in a weird way, the femur is exiting the incision and I assume pressing up against connective tissue and muscle, and you are unconscious and not in a position to say 'ouch -- I'm cramping'. That goes on for like two hours. So I found that while I could bear weight on my hip, and right from the start could walk on my left leg with a walker or crutches, my quad was shot, and any attempt to raise it, say in a straight leg raise, let alone climb a stair, was hopeless. I don't know if this is just something that happened to me, or is common to hip operations, but I was a bit surprised. I thought that all the pain and trouble would relate to the incision and the cut tissue there, but that has not been the case.

I was discharged on Thursday (Day 3) and was able to crutch to our car (a Prius, with nice high seats), comfortably get in, and escape to home.