What they NEVER tell you about hip operations!


Personal account: Bel Mooney has shared details of her painful hip surgery 

My path towards a total hip replacement operation began 12 years ago. 

Newly separated after a long marriage, I was busily reconstructing my life — and that involved taking up proper exercise for the very first time.

At the age of 58, it wasn’t a moment too soon. Working with a personal trainer made me focus on parts of my body I’d never thought of — and it was then I detected the slight stiffness in my left hip.

At the same time, one of my oldest friends — a keen tennis player — had to have a hip replaced. ‘Wear and tear,’ he shrugged.

Like me, he’d never signed up for health insurance, yet because of the time pressures of a high-powered job, he had chosen the expensive convenience of private treatment. 

Afterwards, his bank balance suffering as much as his recovering body, he told me: ‘If I were you, I’d take out insurance — at our time of life you don’t know what’s coming.’

I took that advice. To me it felt a bit like the shopping ‘clubs’ my grandmother joined when I was a child — paying so much every week so that at Christmas there’d be a little pot of money to spend.

With pressure on the NHS ever-growing, I reckoned if I ever needed an operation, the NHS place I’d funded all my adult life would be used by somebody else. The standing order was set; I quickly forgot the relatively modest monthly premium.

Last year, as I was approaching 70, that pesky left hip grew worse and worse and X-rays arranged by my GP revealed osteoarthritis.

The crunch came on a short autumn trip to Italy, when I limped around the museums and churches I love so much. Something had to be done.

So in January I had my first appointment with Matthew Burwell at one of the Circle hospitals (this one just south of Bath), which does NHS work as well as private.

Then came the first revelation. I was pretty cavalier about the whole operation, but the experienced consultant quickly put me right. He pointed out that nowadays so many hip replacements are carried out that the operation tends to be viewed as ‘routine’.

Common procedure: Thousands of patients undergo surgery to replace damaged hips

Slow recovery: Bel suffered from painful nights and struggled with the reduced mobility

It may be routine to me,’ he said, shaking his head, ‘but, make no mistake, for the patient this is major surgery.’ I had a preparatory session with the physiotherapists, as well as an occupational therapist who explained all the equipment I must borrow from the NHS: two special seats to sit above our loos, two walking sticks, a piece of equipment for raising my armchair, a grabber for picking things from the floor, even a device to help you put your socks on.

When all this was delivered at home I started to become nervous and gloomy — realising at last that this wouldn’t be a doddle. The operation itself takes less than two hours. The recovery might take anything up to a year.

On February 14, my Valentine’s gift to myself was a new Oxinium (a ceramicised metal alloy) on polyethylene hip joint — a part of me now bionic for ever.

Rather than a general anaesthetic I elected to have a spinal block, where it’s just your lower half that’s anaesthetised, combined with complete sedation, a technique widely recommended, since it guarantees a swifter recovery.

The last thing I remember is lying down; next, I was waking in the post-anaesthesia care unit, having my vital signs monitored.

The day after the operation is counted as day one — when you’re expected to get out of bed, shower and start moving. The staff get you going with almost sadistic speed — even though it’s agony.

Days two and three are a whirl of physio visits, tough-but-kind nurses telling you that moving on your own is essential, painkillers — and constipation. Nobody talks about that, do they?

Hard work: Patients are immediately expected to get up and use their newly-fitted hip

Codeine makes you constipated; constipation makes you feel absolutely rotten. At one point I vomited with discomfort. It was all worse than I expected.

When a physiotherapist breezes along with a walking frame to urge you out of bed, you want to weep and say: ‘Please, no . . .’

Even ten years ago hip patients would expect to stay in hospital for over a week; these days, they expect you to be ready to leave on day three or four. No choice but to push yourself. The cocktail of ibuprofen, dihydrocodeine and paracetemol is supposed to keep pain at bay — but doesn’t entirely succeed.

In addition, because of the real danger of a blood clot, there is the blood thinner rivaroxaban: all these drugs continued at home. 

Something I didn’t expect was the lack of confidence. Even though I’m blessed with a caring husband, I was afraid of getting into the car, anxious about going home, scared of pain, worried about something going wrong.

The first night home was pretty terrible — because if you need to go to the loo in the small hours you can literally be caught short by your painful slowness. Getting in and out of bed is a big task. After that, my husband, Robin, set his alarm for 2am to get me up in good time.

The nights were very uncomfortable — and still are. Forced to sleep on your back like a helpless beetle, you ache and ache, with a bad leg that seems to weigh a ton, a bag of frozen peas on your groin to numb the pain, and the minutes ticking with cruel slowness. I was glad of soothing classical music on my iPod.

How do people cope if alone? Patients are advised to have somebody with them for the first week, but I would double that time. You need help to dress, to get to the loo, to shower.

As a naturally ebullient and independent woman, the sense of vulnerability was upsetting. The simple physiotherapy exercises must be done — but you still resist doing them.

Why? Because your muscles and tendons have been cut and as they slowly start to heal they hurt. You stiffen up very quickly — and there were days when I thought I was going backwards, not forwards.

Now, three months later, I can walk with no stick, although the pretty flowered one I bought online is still indispensable if I’m tired. But my confidence remains fragile: I’ve been warned it can take up to a year, but for now I have to resist feeling slightly gloomy at feeling less active, less gung-ho about life.

I’m sure this will pass soon — and I find it helpful to reflect that the slowing-down has perhaps been good for me. I feel humbled to realise how little I knew, and how far I still have to go.

The discomfort I had in my hip before the operation wasn’t in fact much worse than this experience has been — although I know if I keep exercising, the stiffness in the new hip will ease.

And how interesting it is that the increased levels of physiotherapy have taken me full circle, right back to when I realised at the age of 58 that I needed to exercise and first noticed the pain in my hip, as I am more conscious than ever of its importance.

I might have needed surgery anyway, like my tennis-playing friend, but I just wish I had worked on my flexibility much sooner.

I firmly believe that all of us should try to keep supple and take care of the one body we’ve been given, and I shall soon return to the gym and pliates, as well as keeping up the physio exercises at home, because I want to keep the other hip as healthy as it is at the moment. So on we go. What matters most of all is the good news: I can dance!