Hip replacement in your 30s or 40s? Ten things I wish I’d known before surgery

Rebecca Beesley, a Patient Representative for the Board of the National Joint Registry, shares her top tips below on how to prepare for having hip replacement surgery.

I’d known for a long time that this day was coming. Having had Juvenile Idiopathic Arthritis (JIA) since the age of 10, I remember being told that the damage to my hip was permanent and that the only solution would be to later have a hip replacement. The damaged joint meant that I had very limited mobility in my left hip, a huge amount of pain, and leg length discrepancy where my left leg was a fair bit shorter than the right, meaning that I spent most of my time walking with a limp.

Despite the challenges, I continued to live with my damaged hip well into my twenties and thirties before the pain became too much to cope with and, at the age of 40, I accepted that the time had come to finally have that hip replacement.

Forty is generally considered to be a relatively young age to have a hip replacement and I struggled to find much information about how those having a hip replacement at this age got on. There were a lot of success stories for those of older generations but very little for someone aged 40 having a hip replacement. It left me filled with fear of the unknown. After all, I’d lived with my deformed hip joint for three decades so despite the pain, discomfort and limited mobility at least I knew where I stood with it. But now I needed a hip replacement and was stepping into what, for me, was unknown territory.

I wish I could say all was plain sailing and a huge success, and from the point of view of the surgeon and how the surgery went, it was considered a success. The surgery went as planned. The recovery went smoothly overall. The scar is neat and healed well with no complications.

But here are some things I wish I had known in advance…
However brave you are and whatever you have been through in life, you may feel terrified beforehand

I remember shaking with fear on the way down to the operating theatre. I was terrified throughout the surgery as they operated under sedation and spinal block rather than with a general anaesthetic. A spinal block completely numbs the area from the waist down. I could hear everything and feel the sensations of being pulled and movement but could not feel any pain.
You may feel rubbish for a while after surgery

Initially I felt fine in myself immediately after surgery. I was surprised at how “good” I felt. But then my blood pressure dropped suddenly and nausea kicked in, which wasn’t pleasant. It left me feeling wiped out and exhausted.

A hip replacement is not a miracle cure

Having heard so many positive success stories of hip replacements and also my surgeon telling me I’d be able to do things I’d never been able to do before, like skiing for example, I had hoped that I would notice a significant difference after the surgery. Sadly, in my case, having had my hip damage for so many years before surgery means that everything surrounding the hip doesn’t work properly and so replacing the hip joint itself has only helped to a limited extent. I don’t have a massively improved range of motion. I can’t do things like most exercise and certainly not skiing. It hasn’t helped my back pain as anticipated. I still can’t put my socks on the “normal” way.
It is a major operation

Hip replacements seem so commonplace these days that it’s easy to forget that it is still major surgery that you are undergoing. Whilst the surgeon may be doing these operations every day, for the patient it is only going to be happening maybe once or twice or possibly three times in their entire lifetime. So it is okay to realise that it is a big deal and ask as many questions as you need to. Keep yourself as well as possible beforehand. I tried to avoid places which were likely to be germ-filled and kept contact with others to a minimum in the run up to the operation, as I didn’t want an illness to impact on having to cancel the operation.

You must plan ahead for aftercare

I would recommend to anyone having hip replacement surgery to ensure they have some live-in help, at least for the early days after the operation. If you have a husband, wife or partner then it is a good idea for them to make sure they are around for the days following surgery. If you live alone then think about whether you have a close friend or family member who is happy to stay with you for a while. However independent you are, this is not a time to be stubborn. Ask for, and accept, all the help you can get. Remember that in the very early days after surgery you will struggle to even get yourself a glass of water.

Once you get to the stage of walking with one crutch (for me it was at the two-week mark for around the house) then life becomes easier as you will have one hand free to carry things if you need to.

Get your house ready!

The early weeks following surgery are not the time for taking any risks. There is a reason why there is guidance about not bending beyond 90 degrees and so on, because it is the time that the risk of dislocating the new hip is at its highest.

So before you go into hospital, think about what changes you can make around the home to help. Can you move any food and kitchen items you regularly need onto accessible cupboard shelves rather than low cupboards?

The physio team should ensure that you are confident with steps before you head home and perhaps you can find a small lightweight bag with a long strap that you can use to hang around your neck for carrying small items up and down the stairs with you. I used a small bag to make sure I had my phone with me at all times, in case I needed to call for help urgently.

Check the height of your chairs and sofa. To avoid bending beyond 90 degrees or risk getting stuck on your low sofa you might want to think about whether you can raise the level of the seat using cushions or pillows. Or perhaps someone can lend you an armchair with a higher seat on it. Having the armrests to push down on to stand up is really important.

I used a lot of other pillows and cushions all around me to stop me accidentally rolling over in the night too. You’ll need to wear compression stockings for up to six weeks, so you’ll need someone to help you change those. Mine were provided by the hospital and they gave me several pairs to keep me going.

You need to prepare yourself mentally and emotionally

Rather naively I had planned a lot of reading, desk work and other low-movement activities to keep me busy during the recovery period. What I hadn’t bargained for was brain fog… and a lot of it!

As relaxing as it sounds to be forced to spend time in bed and read a stack of your favourite books and magazines, the reality was very different. My brain couldn’t focus on anything for a while. Even my favourite pastimes and hobbies. I couldn’t even bring myself to watch TV for any length of time. The brain fog and restlessness and not being able to get comfortable was awful. The first week post-surgery was the worst. Things do improve.

Perhaps this was just me, but I wasn’t prepared for it. I kept telling myself the first few weeks of recovery are the toughest and things would soon improve, but when you’re going through it, those few weeks can really drag on.

It was during this tough time that little messages coming through on social media kept me going. Whether it was from people who understood (social media is great for finding others in a similar situation or who have been through what you are going through) or friends sending me messages of hope and support, it was all much needed and appreciated at that time. There are times that we all need our own cheer-leading squad to keep us going when we don’t feel we have the strength within ourselves to do so.

Get inspired but don’t compare

On that note of social media, I found it incredibly inspirational to find others who were ahead of me in the hip replacement timeline and were onto doing amazing things. It gave me hope of continued improvement day by day. But I never did get to where they were at, so remember that no two cases are going to be exactly the same, so there is no point in directly comparing. After all, I still can’t put my left sock on.

I didn’t come across many relevant blog posts on the topic of hip replacements, but one sticks in my mind as being particularly helpful. I read one that helped me shift my thinking. Rather than thinking how useless I was because I couldn’t do things I would usually do, I started to focus on what I could do rather than what I couldn’t. I remember deciding one day that I too would do the laundry (or at least part of it), however long it took, so I did the “flinging each item down the stairs” technique. It literally took hours, but it was satisfying knowing I had achieved something simply by shifting my mindset from “I can’t” to “I can” while recognising that I would have to be patient and do things differently. It’s a technique I’ve kept in mind ever since whenever my back pain flares up — I try to be kind and patient with myself and work out different ways to enable me to still do what I need to do.

Recovery timescales are just a guide

Whilst most people may well be okay to drive six weeks after surgery, this won’t be the case for everyone. I had six weeks as a magic milestone in my mind where I imagined life being back to normal – walking and driving and doing many more things than I could ever do before. At six weeks, I didn’t feel ready to drive, but by weeks seven and eight things were a lot better for me.

You’ll be celebrating the little wins

The first time you brush your teeth by yourself post-surgery, the first shower (albeit with a lot of help), the first outing (for me that was a tiny walk outside on crutches at two weeks post-op), being able to sleep on your side again, the first steps with one crutch, then no crutches – these are all little wins you’ll be celebrating. And for some, the surgery will be life-changing to the point of being able to go out there and celebrate some really big wins too in terms of travel and sports and being able to enjoy life to the full with a brand-new hip joint.

Best wishes and good luck with your own journey!