By the time surgery day arrived, I had spent quite a while preparing for what recovery was supposed to look like.
At my preoperative physiotherapy appointment, I was given a booklet the hospital had prepared with the information I would need before and after surgery. We went over how to walk safely with a walker, how to manage steps, what equipment I should have at home, and the hip precautions I would need to follow.
The precautions were straightforward: don’t bend past 90 degrees at the waist, don’t cross your legs or ankles, and don’t twist the hip or leg in or out.
The reason for those precautions is to protect the new joint while the muscles, capsule and other soft tissues around the hip are healing and regaining enough strength and stability to support it. During those early weeks, certain positions can increase the risk of dislocation, so movements that had once been completely automatic suddenly needed some thought.
The booklet also included a few simple leg exercises that I was to begin immediately after surgery to help keep the blood moving and reduce the risk of blood clots while my activity was still limited.
I took the preparation seriously.
I found a raised toilet seat with arms so I would have something solid to push up from. We have a walk-in shower, but I knew that simply being able to step into it didn’t mean I would necessarily be able to stand there comfortably, so I found a bath chair as well.
One of the precautions that concerned me was the instruction not to use a La-Z-Boy-style recliner. That was a problem because our couch has reclining seats, and that was normally where I sat with my feet up.
Our bed is adjustable too, and I usually sleep with both my head and feet raised a little, so I asked the surgeon about it.
He explained that the problem wasn’t really the reclined position itself. The concern was getting out of a typical recliner. To stand up, you often have to lean well forward, which can take the hip beyond that 90-degree limit.
That was reassuring when it came to the bed. I could simply flatten it before getting out.
The chair was another matter.
So, while I was already making the rounds of thrift stores looking for equipment, I also found a sturdy chair with arms that I thought might work. It was a little low, but I figured I could add a firm cushion to bring the seat height up enough to make getting in and out safer.
I found a walker at a thrift store that had wheels on the front. Because the recommended walker for those first days was a standard straight walker without wheels, I knew I would need to remove them initially. I ordered replacement legs and converted it to a four-legged walker for the first part of my recovery.
Several weeks later, once I was more confident and after discussing the safety of the change with my physiotherapist, Glen put the front wheels back on for me.
And then there were the reachers.
I already had several around the house, which turned out to be a very good thing once bending over was suddenly off limits.
We also made sure we had several ice packs ready in the freezer. I expected swelling and discomfort, and I knew icing would be part of managing both.
By the time surgery day arrived, I had thought through the toilet, the shower, the chair, the walker, the steps, the ice packs and how I was going to reach things without breaking my hip precautions.
I thought I was ready.
I already knew the operation itself would probably take about 90 minutes. I believe I had asked the surgeon about the actual surgical time when I met with him in his office, and I also had some sense of how closely his surgeries were scheduled because my own surgery time had been changed once.
I tend to ask questions that many patients might not think to ask. After spending much of my working life in nursing, I’m interested in what is happening behind the scenes as well as what is happening to me.
In the end, I believe my total time in the operating room was about 95 minutes.
It is still remarkable to think about. In roughly an hour and a half, a badly arthritic hip can be replaced with an artificial joint.
The plan afterward seemed fairly straightforward.
I went first to the recovery area for the immediate post-anesthetic period. I had X-rays taken of my new hip there, and once I met the criteria to leave recovery, I was transferred back to surgical day care.
That was where the waiting really began.
Once I was back in surgical day care, Glen could be with me again. That mattered because the spinal anesthetic still had to wear off and the plan was still to get me sitting, standing, walking to the bathroom and eventually home.
Twice, when I was sat upright, my blood pressure dropped before we even got as far as standing. Each time, I had to lie back down and wait before trying again.
I was given plenty of fluids to drink, and we waited between attempts to give my blood pressure time to recover and the spinal more time to wear off.
When standing was eventually attempted, I depended a lot on Glen’s help while he was there.
At the time, I don’t think I understood the significance of what was happening.
I may have had a nursing background, but between the spinal anesthetic, the pain, the exhaustion and the pain medications, I wasn’t thinking with my usual clarity. Mostly, I assumed I was simply taking longer than the average patient to recover.
Eventually, though, it became clear that same-day discharge was not going to happen.
Later, I was transferred to an intermediate ward and finally moved from the stretcher into an adjustable hospital bed. The thicker, more comfortable mattress was a relief, but even more important was being able to raise the foot of the bed. A stretcher doesn’t give you that option, and with my spinal stenosis I needed my feet elevated a little to take some of the pressure off my back. After so many hours on the stretcher, being able to adjust my position made an enormous difference to my overall comfort.
Then, around midnight, I got up to go to the bathroom with a nurse assisting me. The lights were low, as you would expect at that hour. But we didn’t get far enough for the lighting to matter.
As soon as I stood at the bedside, my operative leg buckled underneath me.
I nearly went to the floor. Not a little wobble or a moment of unsteadiness — I was very close to actually being on the floor.
Being that close to falling makes you a little more hesitant to give it a second try.
But I did.
This time I leaned heavily on the walker and managed to make it about ten feet before the leg wobbled again.
At that point, the walking attempt was over and I was given a ride the rest of the way to the bathroom.
From that point on, I wasn’t just dealing with weakness. I was dealing with the fear that the leg might suddenly give way again.
I learned very quickly that I needed to put a significant amount of my weight through my arms when I used the walker. I simply did not trust the operative leg to hold me.
At the same time, I had been told I was weight-bearing as tolerated, which I understood to mean putting as much weight through the operated leg as pain allowed.
What I didn’t understand yet was that pain wasn’t really the main limiting factor. The bigger problem was whether the leg would actually support me.
The leg could bear some weight when I was supported with the walker, but I could not independently lift it at all. I could not simply lie in bed and bend and straighten that leg the way I could with the other one.
For the rest of that first night, I was given a bedpan rather than being asked to try walking to the bathroom again.
I was relieved.
By then I had come frighteningly close to falling, tried again, and made it only about ten feet before the leg wobbled a second time. I was quite happy not to have to repeat the experience in the middle of the night.
The following day, I watched as many of the other nine patients in that area were seen by physiotherapy and sent home.
It was difficult not to notice the difference.
Everyone else seemed to be having a much easier time getting up and moving than I was. One by one, people progressed through what I had expected to be the normal pathway after hip replacement and left for home.
When physiotherapy came to see me, I did manage to walk to the bathroom using the walker. But that was about as far as I could go.
We talked about trying the stairs, but the decision was made that I wasn’t ready for them yet.
By that evening, instead of going home, I was transferred to the ward.
It was there that I had another near-fall.
I was in the bathroom with a nurse assisting me when the leg gave way again and I came very close to going down.
That nurse had seen enough.
She told me there would be no more walking while she was caring for me. If I needed the bathroom, I would be taken rather than risk another fall.
I appreciated that enormously.
There is a difference between encouraging mobility after surgery and recognizing when a patient may not be safe to keep trying in the same way.
For most of my hospital stay, I still don’t remember anyone giving me a name for what was happening.
I knew my leg wasn’t working properly.
I knew it had buckled more than once.
I knew I could not lift it independently at all.
And I knew that I had arrived expecting to go home the day of surgery and was now several days into a hospital stay.
But I still think I understood it largely as me recovering more slowly than expected.
I spent the next two nights on the ward, gradually learning how much I could and could not trust that leg.
By Thursday, my final day in hospital, I was dealing not only with the weakness but also with a very real fear of the knee buckling.
That was the day I worked with the physiotherapist on the ward.
He was kind, encouraging and seemed to understand that my fear had become part of the problem. He found me a knee brace, which gave me some additional support and, just as importantly, a little more confidence.
He also took me to the physiotherapy room to practise the steps.
I had been taught how to manage steps before surgery, but doing them after surgery with a leg I no longer trusted was something else entirely.
To my surprise, I managed them better than I had anticipated.
It was an odd combination.
I could manage the steps with instruction, support and concentration, yet I still had a leg that could buckle unexpectedly and that I could not independently lift or control normally.
It was also on that final day that a doctor told me they believed I had femoral nerve palsy.
Those were not words I had expected to hear after a hip replacement.
After several days of trying to make sense of a leg that would bear some weight but could not be independently lifted or reliably trusted to support me, I finally had a name for what might be happening.
An ultrasound of the femoral nerve was ordered, although it had not been done by the time I left.
I was discharged at around three o’clock that afternoon.
I had gone into the hospital on Monday, expecting to go home the same day. Instead, I left three days later with a new hip, a walker, a knee brace, a leg I could not independently lift, and a diagnosis I understood clinically but was only beginning to understand from the patient side.
I had prepared for pain.
I had prepared for a walker.
I had prepared for an awkward shower, a raised toilet seat, reachers and weeks of being careful about how I moved.
What I had not prepared for was losing control of part of my leg.
I thought hip replacement recovery was going to be the next chapter.
Instead, I had somehow acquired a second story running alongside it.
And that story was only beginning.