Hip Replacement: Getting Ready for Surgery

Getting Ready for Hip Surgery

Once the decision to go ahead with surgery is made, there are several things to be done (Pre-surgery Timeline). Your orthopedic surgeon may suggest a complete physical examination by your medical or family doctor. This is to make sure that you are in the best possible condition to undergo the operation. You may also need to spend time with a Physical Therapist who will be managing your rehabilitation after the surgery. The therapist may begin the teaching process before the surgery to make sure that you are ready for the rehabilitation afterwards.

Finally, you may be asked to give some of your blood before the operation. This blood can be donated once a week beginning about three to five weeks before the surgery. Your body will make new blood to replace the donated blood. If you need to have a blood transfusion at the time of surgery, you will receive your blood that has been stored in the blood bank.

This is a really useful and inexpensive series of videos on hip replacement
This is a really useful and inexpensive series of videos on hip replacement

Hip replacement is usually scheduled weeks in advance. (However, hip replacement due to a broken hip is done within a few days.) Use this time wisely. There is a lot you can do before surgery to make your recovery at home go smoothly. While you are getting ready, carefully follow your healthcare team’s advice about

  • changes you should make in your diet – Good nutrition can help you heal and reduce your changes of infection. A healthy diet includes fruits and vegetables and foods low in fat and sugar. If you have diabetes, keeping your sugar under control is very important.
  • exercises you should start, stop, or keep doing. You may be scheduled to see
    a physical therapist and begin exercises before surgery. Be as active as you can before surgery to improve your heart, lungs and immune system.
  • helping your recovery by losing or gaining a few pounds
  • your medicines. There may be medicines which you should start, stop, or
    keep taking. Tell your surgeon about all medicines that you take regularly or
    occasionally, including prescription medicines, over-the-counter medicines, natural
    remedies and dietary supplements.

During this time (Pre-surgery Timeline.)

  • try to arrange for someone to help you out for part of the day, every day for the first few weeks after surgery.
  • prepare easy-serve meals and freeze them. Stock up on fruit, heat-and-serve soups, and bottled water.Make a Plan to Get Your Home Ready
  • rest and relax. Take good care of your physical and mental health. Don’t overdo things. And make sure you plan some enjoyable activities to relax your mind and give your spirits a lift. Spend some time putting together “entertainment” for your recovery at home like books, magazines or craft projects.
  • report health changes to your surgeon. Tell him if you have any cuts, scrapes, or sores on the affected leg. Tell your surgeon if you have any signs of an infection, such as chills, fever, coughing, or runny nose within a week of your scheduled surgery. If an infection does not go away, your surgery may have to be rescheduled. Also, your surgeon may want your regular doctor to give you a check-up before surgery.
  • learn about your insurance coverage. To avoid surprises later, talk with your benefits manager at work or call your insurance company. Find out what will be paid for by insurance and what must be paid for by you. For example, if you have a need for home care or special equipment when you return home, your surgeon may order it for you. Find out before your surgery if your insurance will pay for these items.
  • if you haven’t been to your dentist to have your teeth check in the last year make an appointment at least 6 weeks before surgery. If your teeth or gums get infected, the germs can travel to your new hip joint and cause complications and you may need more surgery on your hip. So it’s best to get all dental work done well before your hip is replaced.

If You Smoke

Nicotine slows down the healing process. Quitting smoking even a week before surgery can lower your risks of having surgery. Rather than have the stress of nicotine withdrawal while your body is recovering from surgery, try to quit smoking a few weeks before surgery. Talk with your surgeon before using nicotine replacement products such as a patch, gum, or cigarette substitute or to help you find ways to quit.

Breathing Exercises

After you have surgery with general anesthesia you need to do breathing exercises. Doing these exercises will help prevent lung problems such as pneumonia and bronchitis. The breathing exercises include deep breathing and coughing. Learn and practice these exercises before surgery; practice everyday for at least a week before your surgery.

Deep Breathing
The purpose of deep breathing is to completely fill your lungs with air. Use your chest and stomach muscles to breathe the right way.
1. Breathe in through your nose as deeply as you can (your stomach should go out as you breathe in). Hold your breath for 5-7 seconds.
2. Let your breath out through your mouth slowly—take twice as long to breath out as you did to breathe in. Purse your lips (like you’re blowing out a candle) as you breath out. Your stomach should go out as you breathe out.

Do this exercise 10 times. After you do the deep breathing exercise, do the coughing exercise.

Coughing helps keep your lungs clear.
1. Take a slow, deep breath in through your nose. Try to fully expand your chest and back.
2. Breathe out through your mouth; you should feel your chest sink downward and inward.
3. Repeat 1. and 2. for a second breath.
4. Take a third breath, but instead of breathing out, hold your breath for a moment and then cough hard forcing the air out of your lungs.

Do the coughing exercise 3 times. Do the combined breathing and coughing exercises every hour while your awake.

Incentive spirometer
Incentive spirometerSome hospitals give out an incentive spirometer (image right) to help you do deep breathing exercises before and after surgery. Someone will show you how to use incentive spirometer when you get it. If you’re given an incentive spirometer before surgery, don’t forget to bring it to the hospital with you when you come for surgery.

How to use the incentive spirometer:

• Sit up as straight as you can. If you’re in a hospital bed, sit on the edge of your bed or raise the head of your bed so you’re sitting up straight.
• Hold the incentive spirometer in an upright position. (see picture at left)
• Put the mouthpiece in your mouth and close your lips tightly around it forming a seal.
• Breathe in slowly and as deeply as you can to raise the piston in the air cylinder up to the top of the cylinder.
• Hold your breath as long as you can (at least 5 seconds), then let the piston fall to the bottom of the air cylinder.
• Rest for a few seconds and repeat the steps above at least 10 times every hour while you’re awake.
• After each set of 10 deep breaths, do the coughing exercise above to be sure your lungs are clear.

Once you’re able to get up and walk around, take some good breaths and cough well as you walk. You may stop doing the breathing exercises or using the incentive spirometer unless your health care teams tells you to keep doing the exercises. If you’re unable to get up and move around at home, do your breathing exercises on the days you’re inactive.

Getting Ready for Your Return Home

Getting Your Home Ready

Sturdy chair with armsFollowing your hip precautions will affect where and how you sit, and how you should get up from a sitting position. A good rule to remember when sitting is “always sit with your hips higher than your knees”. So, before surgery, check out your usual sitting areas.

Be sure to sit on your favorite chair, the side of your bed, the sofa, the toilet, and the seats in your car. Are your hips always higher than your knees? If not, you can raise the level of your hips by placing a firm pillow in the seat. You can rent or buy a raised toilet seat that has arms. These items will make it easier and safer for you.

If your bedroom is upstairs, it is very helpful to make a temporary bedroom downstairs until you are able to go up and down stairs. Dining rooms make great temporary bedrooms because they are close to the kitchen and many are not used every day. Set up a recovery center in your bedroom or dining room so that you have everything you need close by. Have a cordless phone, TV, remote control, wastebasket, bottled water,  medicine, tissues or paper towels, books to read or a radio and a near-by table. Make sure you have lighting between your bed and bathroom. Keep a flashlight at your bedside.

In the bathroom, consider installing grab bars on walls or the shower or tub. There are suction-cup grab bars available at many drug stores that are good for balance, but may not allow you to put your entire weight on them.  Move the toilet paper so you don’t have to bend over, reach forward or twist around to get to it.

If you don’t have time to get your home ready before surgery, ask a family member to do this before you go home from the hospital. When you return home, sit in chairs that have arms. When getting up from a chair, push up on the chair arms while pushing yourself up with your unaffected leg. Be careful not to lean too far forward or “rock” forward when getting out of a chair or off of the toilet.

Remove any throw rugs and area rugs that can cause you to slip or trip. Rearrange your furniture so you can get around with your walker or crutches. Wear shirts or an apron with big pockets, or attach a fanny pack to your walker.

Special Equipment

Following your hip precautions can hinder daily activities such as dressing and bathing. However, you can use special equipment such as sock donners, dressing sticks, and long-handled shoe horns to help you get dressed. Elastic shoe laces can turn lace-up shoes into slip-ons. A grabber will help you pick up things which are on the floor without bending over too far. A long-handled sponge makes it easier to wash yourself while taking a shower or bath. If you are not able to stand in the shower, a shower seat can straddle one side of the bathtub. Install grab bars (there are temporary ones now) near the toilet, bathtub and the shower. Crutches or a walker will allow you to walk by yourself; the physical therapist will teach you how to use these. Try not to get frustrated doing daily activities. Remind yourself that this is only temporary, and you will be as good as new in no time!

It is helpful to get needed special equipment before you return home. If you cannot find any of these items, ask the occupational therapist or social worker at the hospital where you can get them.