Vidéo : témoignage patient : prothèse de la hanche (version accessible)

Hi, I’m Philip Keach and fifty years old and it’s ten months since my total hip replacement surgery. I work at the international school of Luxembourg. I can’t really say when it began. I’ve been an international sportsman when I was younger and I thought that aches and pains in my body as I got older were payback for time spent doing sport when I was younger. But I do know that in the last two years the deterioration in my hip became really really prominent and it was very quick over a two-year period. A sudden that’s the only time I can remember really was about two years ago thinking there was something wrong. And then in that two-year period the deterioration was really rapid from then but I was shocked, I was shocked when the doctor told me I needed a total hip replacement. I thought I was too young. I thought this was an operation for old people. I think the the thing that convinced me to go through with the operation was. I wanted to be able to do all the things that I enjoyed doing. I wanted to be able to sleep at night but she’s always enjoyable but I also wanted to be able to ride my bike swim run walk hike. All the things that my wife and I like to do that are important in my life and the doctor said this was a way to be able to do that again. That was the that was the reason why I went through with it you prior to the surgery. I said the the deterioration was rapid over about a two-year period and in that two years. I tried physiotherapy and that didn’t really work it helped for a little while but they didn’t really work. I tried different pain management, pain medication which helped a little bit but then eventually not enough. Cortisone injections which again for a short while helped but ultimately nothing was working. You know I didn’t ask myself any of those questions. I didn’t want to know what it looked like or what it was made of or anything. I’m a big baby when it comes to things like that and and so no I just wanted to know what would. I would be able to do after the operation was done. I know they were going to fix me. I didn’t want to go into those details. I mean I was interested. The doctor was really good. He showed me two or three different types of prosthesis and he explained the benefits and drawbacks of each one and then he recommended based on my age in my lifestyle. He made a recommendation but he gave me a lot of time. I didn’t have to make a decision there and then he gave me time. He said go away think about it and then you know if you have any questions contact me. We don’t have to make a decision today you can think and take your time because it’s your decision. You can make the decision and having that time to think it was extremely helpful. I really appreciated that the opportunity to consider everything. You know it’s just my wife and me here in Luxembourg and so everything fell to gal. She had to help me with everything so she was amazing. She was very supportive. She came to the doctor every appointment had with the surgeon. She came with me and that was that was a huge helped when the doctor tells you something which comes as a shock. Sometimes you stop listening because you’re dealing with the shocks or to have. Those meetings were really helpful because afterwards I was able to say okay. After he said I needed a total hip replacement.

What did he say but what was the rest of the conversation because I stopped listening at that time that was a big help. I think in terms of just reassuring me that that everything was going to be okay that I wasn’t alone in in this situation, that I was going to get expert care and attention from the medical services here in Luxembourg. Just being there and being willing to understand. We were always very active. We are active, we hiked together, we train at the gym together, we swim, we ride our bikes and things. I wasn’t able to do a lot of those things so Gayle changed some of the things she was doing so that we could still do things together. I’m very grateful for that and it was a big help.

I mean, she visited. That’s the nicest thing when I came round after the surgery and the first person I saw when I was back on the ward. The first person I saw was Gail. I mean you drift in and out of consciousness obviously in those hours after the surgery but to be in the moments to be awake to know Gail was there was it was nice. I would encourage anybody to try and be there on the first day because you probably at your lowest in those first hours and a day or so after the operations or that was a big thing too well shoot she was brilliant because she bought me a raised toilet seat because going to the bathroom is difficult when you can’t bend your hips properly. That was very helpful and she did that she went out and bought that and when I came home back to the apartment that the bathroom was all set up for me she bought some ice packs. That really helps with to keep the pain and the swelling under control and so she bought about four or five ice packs. Even though I was using one or two at the time, there was always ice packs ready in the freezer. She bought me a thing which I could use to to pick things up off the floor so that I didn’t have to bend down. She bought me a like a shoehorn, a long-handled shoehorn so that I could put my shoes on more easily. She bought with some elastic laces for my training shoes so that I could slip my feet in without having to tie the laces and things like that. She really thought of everything and and she also made made food when she went out to work. She made food sandwiches and things so that I had things to eat in the apartment so I didn’t have to struggle and make too much stuff myself. She made me a flask of coffee in the morning so there was hot coffee and tea and things and that was also really helpful particularly in the first few days of being back home. Which is quite tricky because it’s different to the hospital. In the hospital, everything is set up for people with limited mobility and when you get home, you realize that moving from the living room to the bedroom is full of obstacles and things. It’s coming a bit challenging the first couple of days back home. All those things were really helpful. We’re lucky we live in an apartment. It’s all on one floor and there’s an elevator in the apartment blocks or I was able to to move around the apartment. There were no stairs. I didn’t have to get upstairs downstairs and things like that. One thing she did do though she prepared the spare bedroom and she moved into the bed the spare bedroom so that I could have the main bed all to myself. Because you’re quite tender still for a few days after the operation and she was concerned about maybe maybe rolling over in the night and and maybe banging into me. Because you have to sleep on your back. You can’t sleep on your side to begin with and so you have to remain on your back. She basically moved into the spare bedroom and made sure that I had a completely rest restful evening.

You I think that the thing that we didn’t do at home which I wish we had was we didn’t we didn’t make sure we had a comfortable chair to sit in in the living room. The depth of the chair and the angle of the armchairs and the sofa is really important to get up and down. When in the first week or so, maybe the month after your operation, I ended up using a deck chair like a like a garden chair because it had the right back angle and and the right sort of seating angle. I think there are better options around there so my tip to anybody would be look at get some advice on the best kind of comfortable chair. You can sit out of bed in a comfortable place. That would be the biggest tip I think and that was the one thing maybe. We didn’t get right I think. I walk everywhere now which was something that I didn’t necessarily do before the operation but walking is is a fantastic exercise for recovery from a hip replacement so I’m trying to walk as much as possible. Walk to work, walk home, walk into the city, whenever possible. That’s new. I’ve been able to resume a lot of activities too so I can ride my bike again. I can swim, I can hike, I’m even running again now even ten months after the operation little bits at a time but it’s running nevertheless. I’m eating more healthily. I’m trying to make sure my weight is controlled. I’m not sure it’s a good idea to be all the weight and have a prosthetic hip and I’m drinking less alcohol. I think prior to the operation that was one of the things I noticed that maybe I was a bit depressed and I was drinking a bit bit too much wine and maybe the odd whisky or two. So I’m doing that less but basically it’s to do with being able to resume an active lifestyle. That’s the biggest thing since the operation is I can do again the things that I used to be able to do and that’s wonderful. I didn’t have many questions actually about the surgery itself. I had the utmost confidence in my surgeon, having met him several times and discussed the procedure. I knew that he was going to do a good job. I felt that very strongly. I had a lot of confidence in him and so I asked about what you know where would the point of entry be would. It would be at the front at the side from the rear. How big would the incision be, what kind of scar would I have afterwards. That kind of thing. We talked a little bit about how he would calculate the the prosthesis so that it minimized the risk of any difference in leg length. My main concern really was not necessarily what the surgeon was going to do to me to fix the problem, it was I didn’t really care what they were going to do as long as I could do all the things that they said I would be able to do afterwards and that was my main focus.

I’m going to get this thing done and I hope that I can do all the kinds of things that I wanted to do afterwards and and I can so that’s good. I took to the hospital. I took some clothing which I thought would be would be good for after the operation so I took a nice new bathrobe. I didn’t need a new bathrobe but I thought it would be nice to have something new and soft and paying for the hospital stay and so that was very useful to have. I took some cotton pajamas natural fiber. You spend a long time in bed for the first few days and saw having natural fibers felt more comfortable and the pajama bottoms were shorts not long because your leg is quite swollen after the operation and having shorts was just easier to get on and off and you I also took some loose jogging bottoms and some nice loose-fitting t-shirts because eventually you’ll be up out of bed and around in the in the ward on your crutches trying to do some physiotherapy and that’s very easy to get on and off footwear. I took some training shoes which were a proper and closed shoe but I put elastic laces in there so that I could slip them on and off more easily and you can get them with like a velcro fastening to tie in shoelaces is tricky for quite a while after you’ve had a hip replacement and there must be something about bending down and the movement to tie shoelaces. So the elastic laces were really good and because you’re up and about moving with the physiotherapists when they get you up and about you need a stable shoe to put in so slippers and no you see it’s got to be something fairly stable and so training shoes were good. I like to read and so I took an e-reader so that I could add all my books that I could dip into from time to time. I took my headphones and so that I could listen to music on my iPhone and listen to the radio. I like crosswords so I had a few crossword books that I could do you spend a lot of time asleep or at least I did in the days after the operation. I think sleep is a really important period for your body to start to recuperate after a traumatic experience like that and so you spend a lot of time asleep and so I never felt bored in the hospital because when I was awake had something to read or something to listen to but but a lot of time as I say it was spent resting and recuperating in that way. I’m very lucky because I live in a small apartment and everything is on one level so I don’t have any stairs to negotiate or anything like that and there was an elevator in the in the building too which made things very easy my wife and I don’t have any children so we didn’t have to worry about children’s toys being left around. We don’t have a dog or any other pets so I would imagine if you live in a house and you and you’ve got children and pets and things like that maybe there’s a bit more preparation to do to make sure that the route from the bathroom to the bedroom for example is clear of any obstacles that you might trip over. Especially during the night when you you know you’re trying to maneuver on your crutches with a very you know maybe a painful hip and you know that would be a difficult period. We were lucky we didn’t have any cables to trip over. When we were trying to make food and things Gail would make food and she would leave it out on the countertop in the kitchen so that it was easy to get. I didn’t have to bend down into cupboards or reach up into into storage areas and things like that so when we made drinks in a flask then we left those easily accessible – and those kind of things really helped but in terms of remodeling whole rooms and stuff I don’t know. We didn’t need to consider that too much our bathroom is tiny so we have like two bathrooms. We have a bathroom with a shower in it there’s no bath it’s just a shower base and a toilet and then we have another room with a toilet in it. The room with the toilet only in it that’s where we put the raised toilet seat and that became my bathroom for the period that I was at home for the first few weeks. Clearly when I needed to shower I had to use the other bathroom and showering was something that for a while. I needed Gayle to help me to get in and out of the shower to make sure that I didn’t slip on though on the bathroom floor and things like that but that was not such a bad thing really.

Regarding the anesthesia, I had heard that some people went through this procedure with a local anesthetic so they were awake during the procedure and I did not want to be awake. I really am a big baby when it comes to this kind of thing and I the thought of being able to hear what was going on and maybe see things and that I didn’t want that at all so I talked a lot of any statistical options for anesthetic and I made it quite clear that I really wanted a general anaesthetic so that I was completely out for the whole period. I wanted to sleep through the whole thing I wanted to go into the surgery and then wake up later with everything done. I didn’t want any other kind of experience the night before the surgery. I was admitted to hospital the night before and the nurses on the ward gave me something to make sure I got a good night’s sleep and I did I slept very well. I was very comfortable and then they woke me up quite early in the morning and they helped me prepare for the surgery so they shaved certain you know areas around the hip and waist region and then I had to shower thoroughly with some like antiseptic soap and some special mittens which were and they showed me how to wash myself that morning because it was important to be as clean as as possible. Once I was ready to go down to the theater they they came and took took me down to the theater I waited for a short while in kind of an area where there were two or three other patients waiting to go into different theaters for different procedures and then I went into the anesthetist and it was a familiar face because I’d met him before and talked about things and that was really nice because he smiled and said good morning and and said you know and are you ready for your welcome cocktail and I remember smiling at him and it eased a bit of the tension and then I remember waking up in the recovery room. After that when I woke up in the recovery room I remember being in quite a lot of pain and discomfort the nurse is in the recovery room were very quick to respond and they quickly got that under control and and they were able to help me to settle down a little bit I remember being quite agitated actually when when I came round it felt I felt very uncomfortable and what had he but quickly helped me to calm down and then I remember I don’t know how long after that but I came round again and and I was being taken up to the ward again. I was in an elevator going up to the ward and from that point on then the rest of that day was just drifting in and out of consciousness really but I remember feeling comfortable and I remember coming round later in the day and being conscious and and seeing my wife and and saying hello and and then drifting off again and and then being there again. When I came round it was only really the next day that I started to sort of balance out and be fully aware of what was going on again really. You I think the most reassuring thing about my stay in hospital was the way that the the nurses and the physiotherapists and the surgeon all seem to be working closely together. They all knew it seemed what needed to be done in terms of providing me with the best possible care and I don’t know that that would be the same in every country or every place. You know I guess the teamwork was very strong on the ward that I was on and I felt like all the nurses when the nurses changed shift for example the new nurse coming on. I never felt like they didn’t know who I was or what I needed and when the physiotherapist came they knew me and knew what I needed and where I was at in terms of my development and it and sometimes it was a different physiotherapist on different days so that was really really powerful I think – and very reassuring to know that that everybody knew who I was and what I needed with regard to the pain management in hospital that was really good – because I was able to administer had sort of a pump mechanism and I was able to control the the pain medication and then at night. I was able to have sleeping tablets to help me to sleep the other thing which was good I don’t know maybe it’s the general anaesthetic or something but he’d go into the bathroom was delayed for several days and that could be quite that got quite uncomfortable and so I’d talked to the nurses. The nurses checked with me every day have you been to the toilet : have you have you produced a stool you know and so I was able to keep them informed of that and they helped me with some kind of some medication which which loosened and relaxed things and that was important to resume natural bowel function again and that made a big difference once you know after three or four days that started to get back to normal that helped me to feel a lot better too. But I think that’s a common reaction to a general anesthetic too me. I think the the holes success of the hip replacement procedure. It lies in how you respond to your physiotherapy re-education if you commit to it and you listen carefully to what the physiotherapists say and you do exactly what they tell you to do you will recover if you don’t if you do if they tell you to exercise more intensely then then do that if they tell you to stop then stop don’t try and and and and take it into your own control too quickly these are highly skilled people and and then they understand precisely what’s happening with the muscles and ligaments and all the the other elements of the operation and the impact on your musculature and stuff. I honestly think that you know the clearly the surgeon has to do a great job that’s the first thing but once the surgeon has done a great job. It’s really down to you and your response to the physiotherapist and get a good physio and do what the physio says listen to them, do what they said do the exercises and rest. When they tell you to rest that’s a difficult thing for you know maybe young and active people to rest. You always think okay well if I can do this then maybe I can do a bit more and it must be better for me but that’s not the case so the physiotherapy.

I’ve received has been outstanding and as I said ten ten months on from the operation and I’m almost back to a hundred percent I feel not quite but I’m almost there and in another year or so then I’m gonna be fine and that’s really down to the surgeon in his skill and the physiotherapists and their understand their nerve of what I wanted to be able to do the goals we set together the physios and we set goals together and they said what do you want to be able to do so I told them and they said right then we don’t stop until we get you as close as possible to that. I think that’s the thing set to set a good clear objective with the physiotherapist and and then knuckle down and and do it you know since I’m in the operation I can now do all the things that I used to be able to do. I can’t yet run as far as I caught on for as long as I could before but I can ride my bike. I can hike, I can swim, I can go for walks, I can put on my underwear and my socks and I can be fully independent again and be very active and prior to the operation all of those things had been affected and got to the point where I were. I wasn’t able to do any of those things with any degree of regularity so it’s been it’s been profound that the the change since before the operation and afterwards I think the best way perhaps to think about it. It is that every day before the operation the pain the discomfort the lack of mobility the general feeling everything got a little bit worse every day and since the operation every day everything has got a little bit better. It’s the exact opposite trajectory than before and I think you know that’s that’s wonderful to be in a position where each day I can look forward to another little bit of improvement and another little bit of life and and activity coming back to me whereas prior to the operation. It just seemed to be getting worse and worse and worse if you and your doctor agree that the total hip replacement is necessary. Then I would recommend you do it as soon as possible commit to the operation commit to the physiotherapy, commit to the re-education work hard in rehabilitation be optimistic throughout and and you know keep a good sense of humor and you will make an astonishing recovery.