Countdown to Hip Replacement Surgery: A Patient's Diary

39-year-old Damon recently had hip replacement surgery. In the final weeks leading up to his replacement, he agreed to write a weekly entry about what he was thinking, doing and going through during this “crunch time”. In these entries, he talks about his fears, setbacks, and leaps forward (large and small) as he gets ready for “due day”.

Get inside a real patient’s mind before joint replacement surgery. Read Damon’s weekly journals documenting the final weeks before hip replacement surgery.

About Damon

Before we jump into Damon’s weekly journals, we thought it’d be valuable to provide a little background. Damon is a healthy 39-year-old. He’s a successful professional and married father of three. About a year-and-a-half ago, Damon had been more physically active than in recent years, started a new job, and then, experienced sharp hip pain for the first time in his life. Soon after, he was diagnosed with avascular necrosis of the hip.

Avascular necrosis is the death of bone tissue due to a lack of blood supply. It causes the bone to collapse, fracturing or dislocating the joint. If the bone degrades enough, a hip replacement is often the suggested long-term fix.

With a diagnosis of avascular necrosis, Damon’s physician suggested that he could avoid surgery as long as his hip didn’t collapse and pain wasn’t affecting his quality of life. Damon felt fine for the first 6 months, his pain kept at bay without any real issues. Damon explains, “my pain was stabilized, only hurting about 3 days out of the month”.

With his quality of life relatively unshaken, Damon worked to mitigate symptoms. He changed his diet, focused on losing extra weight, kept up physical therapy, and preemptively started PeerWell’s PreHab program for hip replacement surgery prep.

After making significant lifestyle changes, including losing 10% of his body weight, Damon explains that “the imagery [X-rays] showed that I had arrested progression. However, there was still no recovery. Necrosis had been arrested, my circulation was back, but it was still bad.”

About 6 months ago, in July 2017, Damon experienced a massive flare-up. He described the flare-up as “ the most excruciating pain I had ever felt”. With that, he knew something had to happen. His surgeon scheduled surgery for October 2017, which at the time felt like a lifetime away. Damon explains, “I thought this was emergency. I thought, ‘I can't possibly wait until October.’ But it did calm down and I’m glad that I had more time to prepare for surgery.”

Damon sums up the period of his diagnosis to the final weeks before his total hip replacement as: “First denial. Then dismission. Followed by ‘What did I do wrong?’. To ‘This is serious’. To finally, ‘I am ready’”.

Continue reading for Damon’s weekly journal entries about his final days before hip replacement surgery.

Damon’s Joint Replacement Journal

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22 Days Until Surgery

It is now less than 30 days to my total hip replacement surgery—22 to be exact. My mindset definitely changed this week. I am now significantly more anxious than I have been in recent months.

I was diagnosed with avascular necrosis almost a year ago and since then have known that surgery was the likely outcome. I even had a major inflammation flare up two months ago and at that point set the surgery date with my surgeon. But it wasn’t until last week, the pre-surgery physical evaluations, blood tests and EKG that I got really nervous. I keep thinking: this is actually happening and it is happening soon.

I am 39 years old, a father of three, and generally a healthy person (aside from always wanting to lose some more weight). But after being confined to a bed for three 10 day stretches, I decided that I couldn’t delay surgery any longer. At first, I was pretty depressed that I even needed to have surgery but eventually I dismissed that and said “screw it”.

Good news is that I feel really good about the progress I have made over the past year and hope I can keep it up. Once I was diagnosed with AVN, I completely changed my diet and started using PeerWell. I have lost over 10% of my body weight, strengthened my hip and core muscles and am overall in much better shape than I have been in recent years. Despite this, the gravity of my situation is growing.

On one hand, I want the surgery to happen tomorrow so that I can get back to playing with my kids without pain. On the other hand, I still wish none of this was happening to me at 39 years old.
In order to not get too overwhelmed by the situation, I am going to break the next 22 days into chunks to help me stay focused. The main milestone next week is the pre-op appointment with my surgeon and making sure the my coworkers and close family know the schedule for my surgery and recovery period. As long as I can get through those two tasks and stay on top of my exercises, I think it should be a good week.

13 Days Until Surgery

The last week was long. I started with a good mindset, focusing on daily exercises and preparation for surgery. I had a great appointment with my general practitioner and got clearance for surgery as well as learned that my efforts to improve my health over the past few months have really been paying off. Overall my blood tests showed great improvement across the board, which is really exciting and gratifying.

My anxiety about surgery decreased and I even got excited about continuing prehab through my surgery date to stay healthy and speed up my recovery. Everything seemed to be on track until my kids threw me a curveball…

Two of my kids came down with a virus that knocked them out for a few days. I couldn’t fight it, and caught the bug over the weekend. Unfortunately that coincided with a flare up in my hip. I was out of commission and in pain—a striking reminder of how fragile my health can be at times. This triggered a new nervousness. What if I am sick surgery day and they need to postpone?

Thankfully I am back to full strength (albeit with some lingering pain in my hip). Now I am even more focused on staying healthy and getting to surgery day. The thought of postponing is just too overwhelming. Now that I am so close, I need to get to that date. I am sure that next week (one week prior to surgery) will bring some more anxiety but I’m ready for that.

Next major step is my pre-op check-in with my surgeon. Here we go - 13 days until surgery!

12 Hours Before Surgery

Last week was pretty jarring. Now, I am 12 hours away from having a new right hip and I am excited. I guess I should have expected that in my final week before my surgery I would have a huge flare up and be in pain most days. The pain was a constant reminder of how bad my quality of life has become and how much I need to have this surgery.

The anticipation was building this week and I was feeling more optimistic until I had my pre-op appointment. The seriousness of that appointment caught me off-guard. We didn't discuss anything new. Everything was repetitive from prior appointments but the finality of it was a wake-up call. Planning for the 24 hrs prior to surgery and the first few days after surgery was sobering. It took me a day or two to digest the appointment and now I am finally getting excited again.

I look forward to finally focusing on healing and building strength. I am excited to think about not being in pain for the winter holiday and my 40th birthday early next year. This surgery is like I get to pick myself up and take advantage of being pain-free and healthy again. It really sheds light on how limited my lifestyle has been for the past 18 months.

I am ready to go. Hopefully I can get some sleep tonight because tomorrow is a very big day!

3 Days After Surgery

It is Friday afternoon and the last 72 hours have completely flown by. My total right hip replacement (TRHR) was scheduled for Tuesday at 10:30am. On our way to the hospital we got a call saying the operating room (OR) was running ahead of schedule and they wanted to know if we can get there earlier. Awesome!

I am confident that the PeerWell mentally prepared me for surgery day. Luckily we were close and arrived around 8:15am. I was in surgery by 9:50am and out by 11:05am. Everything was moving so quickly that I didn't even have a chance to get nervous!

I think the biggest surgical pain that morning was getting the IV. Literally before I knew it I was in recovery. Surgery day couldn't have started any better!

The recovery time in the hospital went according to a plan as well. However, there were more pains and strange sensations than I expected. Some motions—sitting up, getting in and out of bed, and adjusting my surgical leg in bed—were very difficult and very painful. Eventually it was difficult to just lie still without immense pain.

My Dr. and I had discussed starting with a non-narcotic pain medication before moving to stronger meds. A few years ago I had a severely herniated disk in my lower back and needed to take heavy narcotics every 4 hours for a couple weeks prior to surgery. I absolutely hated it. The initial pain relief was great but I just felt gross after a couple days and developed a true hatred for taking opioids. With that experience I can see how that pain relief can take over someone's life...they are really powerful.

This time it took about 14 hours for us to find a medication that got the pain under control. Unfortunately, it ended up being an opioid but that just increased my motivation to build strength, start walking again, and get off the pain meds.

Things were under control and I was eager to start physical therapy (PT) and occupational therapy (OT) in order to get clearance to go home. Therapy was very helpful but I didn't hit my goal of leaving the hospital using just a cane. I was too wobbly and my stride was too weak for a cane or crutches. I left using a walker. It was frustrating but I definitely wanted to be safe vs. sorry.

I’m happy to say that after about 12 hours at home I transitioned to crutches. I think that tomorrow I should be able to move to a cane. I began exercises and am figuring out which ones are going to be harder in the coming weeks. I want to hit the two-week mark very ready for PT.

Overall everything has gone well. The only scary part of the last 3 days was yesterday afternoon when I started shaking. I starting getting chills which progressed to violent shaking chills within 10 minutes. I took my temperature and it had spiked to over 103 degrees out of nowhere.

I honestly think it was more of a panic attack than anything else. I put some warm clothes on, drank a cup of tea, and did very deep breathing and mental focus exercises. In about 30 minutes my chills were gone and my temperature had fallen to 101 degrees. That episode was not fun. It definitely heightened my attention to preventing infection, fever and shock. Remaining calm is an absolute priority.

Now the current plan is: avoid germs, wean the pain medication (I think tonight will be the last night I take them), do exercises, transition to a cane and prepare for PT in two weeks.

Being on this side of surgery is incredible. I already feel like a new person even though there is a lot recovery time left. I can't wait to get through the next milestones

Damon’s Advice for You...

My biggest take away is to avoid underestimating the small things that can help you in the long run. My advice for others getting ready for surgery is simple: don’t look for quick fixes to your preparation. Small changes will ultimately have a huge impacts. I made diet changes, started following the daily PeerWell plans (which are super short), focused on core exercises and flexibility at a fitness studio twice a week, and started getting my mind prepared for surgery months before my procedure.

Put yourself in the right mindset so you can push through the most difficult periods. The hip pain was temporary and the surgical pain will be temporary. My newfound appreciation for how much I need to prioritize my own health will be a constant and that will help me enjoy my life and family without any regrets.

Having a hip or knee replacement? Join PeerWell and be matched to a great surgeon near you who offers PreHab and ReHab for free. The more you do today, the better you'll do tomorrow.

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Hi, I'm Grace. I write all things surgery for the PeerWell blog. You may remember me from such titles as: "Diabetes & Joint Replacement 101" & "Sex After a Joint Replacement".

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