What To Do At Home After Hip Replacement

welcome to another episode of talking with docs I'm dr. Brad weening and I'm dr. Paul Saldana in today's episode we're going to be talking about post-operative total hip replacement once you leave the hospital yeah yeah I get this question a lot you know where do I go after surgery can I go home to have a special hospital bed at home don't need someone to take care of me so we're going to try and cover some of that stuff today so starting with that Paul what do you usually tell people where are they going to go once they leave the hospital okay so you've had your hip replacement you've been Hospital for two or three days it's time to go home where do you go the main options are one home to to a family members house or someone who can help you three a convalescent care center so a place where you can go where there's some supportive care or or rehab center and these rehab centers can be in your hospital or they can be a separate building altogether yeah I agree with all those choices I think the most important thing that I tell people ahead of time is that they need to have a plan because on the day and they say hey you're being discharged you're like oh I don't know where I'm going that really doesn't work right and as it you know at the time we're making this video like now typically in our area about 90% of the people who have their hips replaced usually go home the remaining 10% may need a little bit of extra time in a convalescent care center or a rehab place and often times we've said this before we were talking about total knee replacement you can you can get an idea of how you're going to do after by an assessment for sure when you go to your pre-op visit they will work with you and determine the likelihood of you being able to go home or the possibility that you may have to go to a rehab center or somewhere for a short period of time 1 or 2 weeks after your hip replacement before you can go home yeah they're good at identifying people who are maybe at slightly higher risk of not being totally independent so when they're going home you have to like take an ambulance or how to get hung can drive home yeah that's a good question I I mean when you're you're probably not going to be driving yourself home after you've just had major surgery you had your hip replaced you're not very comfortable you're probably on some high dose of painkillers still so it wouldn't be safe for you to drive home so you need to arrange for a ride home that's the first thing a ride home or a ride to the rehab place that you're going sometimes you are taken by ambulance though to to the rehab places if you don't have anyone around that can help you okay once you get home are you going to be getting around yeah I think the whole goal of that of the physiotherapy that you get in the hospital right after your hip replacement is to get you mobile enough to get home so you will be mobile after your hip replacement going to be able to get around you're going to be walking and you're probably going to be able to go up and down stairs certainly one of the criteria at our hospital you have to do some stairs before you leave that's with a walker or a cane or crutch yeah so Brad do I need a hospital bed at home after I get this question all the time so obviously if you really want to go out and pay a lot of money to bring the hospital bed into your house because the feeling of the hospital was such a positive one for you you can do that but I tell people that it's not necessary I think having a place to sleep on the main floor is a great option if it's possible but if you do have a second floor master bedroom what I tell people is you'll probably come down in the morning and you'll go back up at night you're not gonna be going up and down the stairs all the time at the beginning the one thing I tell people is maybe get rid of the waterbed people still have what I think so not very many okay so yeah you probably won't need a hospital bed at home you'll be fine and whatever you have but like Brad said you're not going to be going up and down the stairs ten times of the day pain are they gonna have pain oh yeah this is variable actually I mean with the total knee replacement ah i Ju you're going to have pain so high but with a hip replacement you know there is some discomfort usually people say well I have pain but it feels different than the pain I had with my arthritis and usually it's not as it's not very severe now occasionally there are people who still have a lot of discomfort first a few weeks after a hip replacement however there are strong medications that we prescribe that can help with that I totally agree usually I tell my patients that you're going to wake up feeling significantly different and usually people will they have every place ins wake-ups in wow I feel I feel so good but I agree if the operation may be a little more complicated or people that have been on a lot of medication before surgery they seem to struggle a little bit more with pain afterwards so yeah would give you lots of medication to take take care of that so that you can manage at home at least kind of physiotherapy what's your what's your protocol for physiotherapy for the hips Paul very different than the knees obviously or the knees it's all about physiotherapy for hip replacement it's not as crucial to engage in physiotherapy after the one thing because of the approach that that I use the surgical approach I use which is lifting off some of the abductor muscles so the muscles that enable you to lift your leg out to the side the lateral approach yeah he has a lateral approach so for that for six weeks I tell people not to actively abduct their leg which means not to actively lift your leg out to the side other than that physiotherapy is really will see some gait training have to show you how to walk again and a bit of strengthening but it's not as crucial for example if after total knee replacement I would agree so often for hips people come in to a physiotherapist could come in to the house for the first little while and then at six weeks that's when I change similar to you I do the same approach at six weeks we let people strengthen those muscles that we cut through so it's given them some time to heal back together right now unlike Visio what is really really important after a hip replacement when you go home especially is what we call total hip precautions yes those are precautions that you have to take for three months after your hip replacement to minimize the chance of this location because an artificial hip can dislocate so for three months you're going to be given a list of precaution things that you should not do and these are mostly things like sitting in a low chair or bending your knee up too high crossing your legs your leg that guy's yeah very very different than Annie and Eva can't really even can but it can't really dislocate but a hip you get into those extreme positions it levers itself out of the ball and socket right what what about sleeping apology tell people specific things about sleeping with the hi I do okay I do you love yes with a hip you can sleep yeah so the main questions are can I sleep on my side can't sleep on my stomach you know I personally tell people you know by the time they go home they can sleep on their either side you know I'm not a big fan of sleeping on your stomach with a hip replacement because when you're turning one way or another you might break those total hip precautions yeah but certainly on your back or on either side and it and usually it's a good idea to keep a pillow between your legs for the first while because then will keep your your hips in a safer position I agree often at the beginning people won't want to sleep on the operative side just because it hurts but I agreed they say when can I see my left side I say just be careful keep a pillow between your legs move slowly that kind of stuff for the hip precautions how long do you keep the progressions three months yeah a little controversial I think some people have tried to bring it less cos some people think it's not necessary but for me and I I think I could speak for you to the risk of dislocation is high at the beginning and the consequences are so great so for six extra weeks you can't cross your legs big deal alright you know have that raised toilet seat or have a cushion that you bring with you for those chairs you might as well go to three months right okay so we've talked about getting leaving a hospital where you're going to go how you're going to get to where you're going wait what you're gonna need at home hospital bed probably not theirs what do you tell them both the I guess two things one about the wound and what about the swelling in the leg yeah there will be swelling in the way yes we're sure you'll have swelling around the incision and down the leg that's just part of the healing process now that the things you have to watch out for though a blood clot because a DVT deep vein thrombosis can happen it's a risk of hip replacement yeah so that would be characterized by a lot of swelling and pain sort of in the calf or the back leg yep if that happens go see your doctor probably going to get an ultrasound to rule out a deep vein thrombosis or DVT thankfully the risk of that is quite low and routinely we put people on blood thinners after surgery yeah to help reduce that risk yeah and just mobilizing helps reduce that risk too yeah and then the other thing to watch out for is the wound you want to make sure that it's healing well without any infection so how do you tell people to I tell people that is they should keep it covered at least until they see me to have the staples out usually at two weeks as long as it's clean and dry and not actively draining a draining wound is certainly concerning it doesn't mean that you're infected sometimes you can have bleeding blow the skin that comes out through the wound so just keep an eye on that and obviously if you if the amount that's coming out every wound is going up then you probably should phone your surgeon and probably be seen sooner rather than later but as long as you keep it clean and dry I let people shower relatively early keep a covered dry it off and then come see your surgeon typically at a couple of weeks to have a staple so yeah and it's a bit tricky because you know the signs of infection is skin that's red hot and swollen but guess what after surgery red hot swollen and red hots well yeah so one thing I tell people is to see how you're doing from day to day are you getting better or worse generally after surgery every day you should be getting a little bit better if you have an infection every day you're probably going to get a little bit worse yet if the redness is spreading the drainage is increasing or if you get a fever those are potential signs of an infection then you just need to be assessed yeah if you're worried get your doc to check it out last couple things when can I can I Drive when can I travel and can I play golf life I have you I do I can't get mine for please well that's a good question driving is the rule of thumb at six weeks meet you regardless of the leg yeah and then what I drive automatic I Drive standard whatever just six weeks pretty one because your reaction times be able to move your leg has to be quick and often within the first six weeks you're still taking narcotics a nineteen picked up you'll physically you probably could drive if you had to get away from a burning building but if you had to stop for a small child or if you got in an accident what a jury of your peers say you know what his hip replacement may or may not have been to the accident you just don't want to expose yourself to that risk agree traveling generally you know short car rides like driving for now or something like that you can do within within a few weeks but traveling by a plane probably three months is what I tell people I believe that too and one lady got on a plane at six weeks and because of the low seat to the plane she dislocated her hip on the tarmac really yeah she had to be transferred off and then ultimately had surgery yeah so she's got to be careful yeah so uh there are three months is the save time so when you're planning your hip replacement just plan for your trips to be at least three months after golf right now yeah let's go it looks nice up yeah um so golf you get three months me too because the twisting motion I think is a little different sometimes I let my knees go to the range at six or eight weeks but I agree three months out go back earlier but three months Tom Watson almost won the British Open nine months after having a separate booth yeah was in one shot yeah three months and then lastly back to work oh yeah going back to work that's a that's a variable one yes um what's the soonest yeah soonest I've seen I've seen people start with dicing people start working as soon as they get home main tier they work from home I don't know how good their work is because they're probably on still on some narcotics but they can start working from home right away I had a farmer in a barn at two weeks really yeah he's like 80 okay so yeah I mean it's very variable I find people who are self-employed generally I have to get back to work quicker because they don't have any income to cover them but yep you have some sort of benefits plan then you can afford to take three months yeah generally I would use that three month rule again how degree for most jobs stuff where you can work at home or desktop probably sooner very physical or labor intensive jobs it might even be six months yeah and I agree with that in this but it's usually the young feel--it want to go back and I tell them listen I know you want to get back to work but I want you to have a good hip for the next 15 or 20 or 25 years so we can get an extra month idea and not put you at risk in a slippery position or on a ladder or something crazy too so you want to do is cause the problem that's your versa ball so yeah I agree with that philosophy okay so if you have any further questions about total hip replacement after surgery or anything else related please send your questions to talking with docs at gmail.com and remember you are in charge of your own health see you next time

Channel: Talking With Docs

Views: 293,576

Keywords: hip replacement, total hip replacement, replacement, hip replacement recovery, hip replacement surgery, joint replacement, total hip replacement surgery, hip replacement (medical device), hip replacement exercises, less invasive hip replacement, total joint replacement, hip replacement (cause of death), total hip replacement exercises, minimally invasive hip replacement, path hip replacement, hip replacement pain, type of hip replacement, hip replacement near me

Id: 8vkch3R_Mo8

Length: 13min 46sec (826 seconds)

Published: Fri Jun 10 2016