Post-Op recovery: 1 month milestone
It’s one month today since my hip revision surgery. I find this week 4-6 period of post-op recovery the most boring. The first week is mainly feeling ill and getting over the trauma. Weeks 2 and 3 are about getting more mobile as the swelling and pain subsides; balancing movement with rest. But the second three weeks can drag - I no longer feel ill, I’m not in a lot of pain, but I’m still really restricted in what I can and can’t do. My exercises are still quite restricted, I have to vary my sitting position too regularly to sit in one place for any length of time. And there's not much variety in the days. It's the boring phase!
For those who haven’t read a previous blog post, I had a full revision surgery of my 22 year old hip replacement, one month ago. I’ve had 13 surgeries all due to being born with bilateral hip dysplasia (CDH) with one hip socket missing along with a lot of my pelvis. You can listen to more of my history on this Steps Charity Podcast here.
So what am I up to every day?
Walking, always with crutches.
As well as continuing to march up and down the garden, I’m now also taking a walk around the block each day, on crutches. Walking is by far the best PT for post-op recovery. The surgeon was strict about using crutches for eight weeks, even indoors, and to date I’ve been using them together (ie both crutches go down together as I take weight on my operated leg). As of yesterday, my physio has added a small amount of walking in the garden using the crutches reciprocally, which means a bit more weight through each leg, and a bit more of a natural walking pattern. Sadly, I still can’t walk to the local cafe, as I can’t then sit down (chairs not high enough to meet the precaution height). Nor am I braving the local coop as there are too many ‘hazards’ like people, wet or uneven floors, baskets etc to feel safe. But the daily walk is enjoyable, and extends my bubble beyond the home.
Physio exercises, with some progression.
After a hip replacement you get one NHS physio appointment for post-op recovery and a pack to follow a standard progression plan. So I decided to use a private physio who has worked with me for the last 20 years. She knows my history (so we’re not starting from scratch with me having to explain how different my hips are). She also knows who my surgeon is and how he likes to work. And most importantly, she knows all the ways I can find to ‘cheat’ the movements I find most difficult! Over 50+ years I have become very creative in this regard, but that gets in the way of me exercising the muscles that actually need to learn to work properly. For someone like me, with a complex case, it’s important that the physio doesn’t expect to do much that’s standard, and can be bio-mechanically creative - ie find different positions or props that help me exercise the right muscles safely.
For the last two weeks exercises have been:
- Standing: Heel flexes, Hip abduction, Hip extension, and then standing on my operated leg (with crutches) and moving the other one into various positions (looks like an odd tap dance!) - so that I get comfortable with the left leg taking the weight and encouraging independent movement of each leg.
- Laying: knee/hip bends, hip abduction with knees bent, hip adduction with knees bent (pushing on a rolled towel) and pelvic tilts with knees bent (but still NO bridging allowed).
For the next 3 weeks this has progressed to:
- Laying: hip abduction and pelvic tilts
- Sitting (new position puts more weight through the hips): leg extensions and holds with ankle weights, hip adduction (squeezing a towel between my knees which works the glutes more sitting than laying, and standing from a perch position without using my arms (REALLY hard!)
Short bursts of reading, watching TV, writing, learning to paint :-)
It’s important to keep my brain busy. But I have to be super careful not to sit in one position for more than about 40 minutes. So things I can do in short bursts are good, where I can also switch position between my high seat chair vs. the bed with legs up. I was never an artist at school (I’m very literal, and my creative outlet was always music) but I’ve bought a small watercolour set and a book which is helping me learn to paint natural things like leaves and flowers. Don’t expect the gallery opening any time soon folks! But it’s a very relaxing thing to do.
Visits and calls from friends
I’m very grateful for everyone who has visited or arranged calls/zooms. It’s lovely to see people, hear about things other than my boring little daily routine, and just laugh and enjoy the company of people who I know well. It also adds some variety to my day and means I will still have some social skills by the time I go back to work or choir in the Autumn.
So these are the things, day-in, day-out, that stop me from getting too bored - which would lead to my doing too much, too soon. My surgeon has put the brakes during this initial period of post-op recovery for good reason. So I need to trust in that, until I see him in two weeks' time. Hopefully then I'll find out that everything is going OK and the new hip will have ‘set’ enough, with new bone forming to hold it in place securely. Then, hopefully, the handbrake will the released a bit to allow proper rehab to start - including hydrotherapy. And I'll be rewarded with a chance to see an Xray of my new hip for the first time - Xrays of my hips have always been how I understand and connect with my hip dysplasia.
So until then, thanks for reading this and for following my progress. Stay tuned for the next episode in a couple of weeks xx
Jill Pringle was born with bilateral hip dysplasia in 1971 in Sheffield, UK. She has had various childhood and adult surgeries on her hip and knee. She writes this blog to raise awareness of living with CDH/DDH and being a ‘differently-abled’ walker.
Hip revision precaution height: managing at home post-surgery
It’s two weeks now since I came home from hospital after my hip revision surgery (all due to my hip dysplasia). In some ways time has flown, in others it has dragged. It’s a bit like Groundhog Day; punctuated by exercises, napping, walking on crutches, eating, washing, a bit of TV, a para of the blog and then start again.
What marks out a hip revision surgery is the need to restrict certain movements until the hip socket sets in place securely. So that the screws holding the socket into the filler in the pelvis set. Big movements are a big no. And I have a strict precaution height.
The restrictions are:
- No walking without crutches. To limit my movement and weight-bear sensibly
- No flexing the hip to 90 degrees plus. So I can’t sit on a chair, bed, toilet lower than 47cm (18.5 ins) - my precaution height.
- No twisting or rotating in a way that could allow the ball to slip out of the socket. So no low chairs, no squatting and no stepping in and out of a bath. Flannel wash only for 6 weeks!
- No sleeping on my side even with a pillow between my knees. It is difficult to sleep in the same position all night, but I can only sleep on my back.
- No crossing my legs.
- No hip-bridging exercises. All the physio exercises have quite a small range.
- No driving and extreme caution getting into and out of a car to manage precaution height. We have a mini so this has been fun!
All of the constant thinking, minding how I’m moving, is mentally tiring.
What is a precaution height?
Put simply, the precaution height is the lowest furniture you can sit on. It means you don’t end up flexing the hip too deep when sitting, or standing up from a seat, and so don’t risk the hip dislocating (painful) and then weakening the fixings.
It’s calculated based on the height of your knee to the floor when sitting in a chair (you make the measurement before surgery).
Most dining chairs are about 40cm high. Sofas and toilets can bit lower. I also need arms on anything I’m going to sit on, so I can take the weight on my arms and lower or raise myself up whilst protecting the hip and keeping the leg straight.
This led to me purchase things for home before surgery, like a high seat chair with arms, a raised toilet seat, and a second hand single bed that’s quite high from the ground.
The hospital also sent me home with a loaned sit/perching stool for the bathroom so I can sit at the sink and wash, or at the kitchen counter to make a sandwich. A Leg-Up leg lifter, so when I slide back onto the bed, I have a way of pulling my operated leg round. A sock buddy (weird contraption to pull on socks, which so far has been usurped by boyfriend LOL!), and lots of grabbers to pick things up.
Pain and bruising
The first few days home I was still on power painkillers because I had breakthrough pain from the incisions, the nerve disturbance, and the internal bruising. These also helped me sleep, especially when first in bed. But they do contribute to nausea and dizziness and I don’t need more of that post-surgery!
After three days I’ve been only on paracetamol and ibuprofen, and I would describe it as mild pain and discomfort. Doing my exercises was sore until the bruising and swelling reduced - this subsided after about a week, so 10 days post-surgery.
And I’m on blood thinners, to ensure I don’t develop clots, until the end of July. Which means being super careful not to cut myself or develop any new deep bruises.
Sitting in a chair or perching on the stool was difficult for the first week. Then each day the swelling reduced - it was like an extra bit of my sensation returned. Right now I can can still only sit for about an hour before I have to move due to discomfort. When I first got home this was 15 mins.
The incision/wound
I had the wound checked yesterday by the local GP nurse. It’s all looking clean and healing well (they went in using the same anterior scar from my hip replacement 22 years ago). Thankfully no staples to remove like I had with the knee, just self-dissolving sutures.
What’s worse - hip or knee surgery?
The pain from the knee replacement was 10x that of the hip revision. Those first three weeks of throbbing pain and the lack of sleep for 3 weeks I hope never to repeat. By comparison this hip surgery has been child’s play - pain-wise.
Howvever, the movement restrictions from the hip revision are more limiting right now. I could do more (pain aside), more quickly, with my knee. I didn’t have this 6 weeks of restrictions. So the hip revision is going to take longer to recover from.
Physio exercises
By far the exercising is walking. Weight bearing (with crutches) to build strength and encourage new bone to develop is part of the PT routine.
For the first two weeks I had a few exercises, each with limited range;
- laying: ankle holds, quad holds (pushing my knees back into the bed), hip bends (sliding the heel up to bed bending the knee), buttock squeezes - definitely sore for the first week! Plus straight leg hip abduction which I have never been able to do easily without help.
- standing: hip abduction, hip bend (lifting the knee a bit), hip extension (leg back), and heel raises up to tip toe.
- sitting: seated knee extensions for both legs, strengthening the quads
I’ve been doing these religiously 3x a day. And it’s amazing how much easier they get once my body (and brain) is trained to do them. A marker of progress. Little victories.
Always followed by an ice pack to relieve the pain/soreness from doing them.
Friends on rota - thank you!
After one week home my partner had to return to work (for a rest, LOL) and I’m grateful for the friends who came in on rota that first long weekend, to break up the day and help me. I express just how lovely it was to see you folks; for the lunches, the cuppas, the hair washes, the washing hang-outs, the plant watering, the cat feeding and basically just letting me live vicariously by hearing about things other than my regular Groundhog Day existence.
Of course the biggest thanks go to my loving and patient partner and my emotional support cat. I can’t imagine the last two weeks without them.
And to all of you out there reading these posts, and sending good wishes, thank you and love to you all. Until next time... xx
Jill Pringle was born with bilateral hip dysplasia 53 years ago. She writes this blog to share her experiences of living and walking with this condition, and about her adult and childhood orthopaedic surgeries. Jill is also a proud differently-abled supporter of Steps Charity, who help children and adults who can't take walking for granted.
Post-surgery hip mobilisation and the get home checklist
Restoring independent mobility is a priority after hip surgery. Hip mobilisation reduces the risk of blood clots or chest infections and our joints and muscles were designed to move. But before you can get up it needs to be safe - the sensation needs to have fully returned to your legs, and you need to be strong enough to stand without the risk of falling. In short, being a Fainting Freda is a barrier to achieving this :-)
Fainting and sickness
The day I had my knee replacement 3 years ago I was using a walker the same afternoon. I wasn’t sick because I was awake with spinal pain blocker and very light sedation only.
But for my hip replacement 22 years ago, it took 3 days to get me out of bed due to the sickness and fainting I experienced post-general anaesthetic. My friends all know that where alcohol is concerned I’ve always been a total ‘shandy lightweight’. A couple of glasses of wine on a night out and I’d start puking, and my hangovers were fierce. My body just doesn’t tolerate toxins. So anaesthetics are not tolerated well either. All through childhood surgeries, a lot of vomit was an accepted part of the recovery.
So for my hip revision surgery nearly 2 weeks ago, I wasn’t sure what to expect. I wasn’t having a general, instead they used an epidural pain blocker, but unlike me knee replacement, I was fully sedated. What happened post-revision was more like the hip replacement, with the sickness and fainting, but nowhere near as bad on the sickness. For which I’m thankful.
I was sick twice in the early hours of first morning in PACU, but fast acting anti-emetic injections stopped that. The following morning they tried to sit me on the edge of the bed, but with the epidural still attached, and a catheter still in, I was quickly put back into bed for a bed bath. After breakfast at 930 the epidural was removed along with the arterial line, and by 10am I was wheeled down to the ward in my bed. My legs were not fully thawed, my non-operated lower leg taking the longest to return to full feeling. Hip mobilisation was going to take a while.
Meanwhile, I’m watching everyone else get up an about on crutches. My competitive side was not enjoying this! But I know from my first hip replacement I just need to go with it. My body takes longer. And my surgery was more complex and longer than average.
The first tentative steps on Day +1
At 3pm the physios decide it’s time to try and mobilise me. I move to the edge of the bed and then I’m up and walking a few steps on a walking frame. My new hip feels really heavy and stiff, because it’s swollen. But boy does it feel good to move - physically and psychologically. The physio moves me back to sit in a chair, at which point I start to feel dizzy, and I say “I’m going to faint”. The nursing staff were there fast, I was given oxygen, they kept me focused and conscious. They managed to get me to take the few steps back to the bed, where they could tip the bed back to get more blood to my brain. I didn’t actually faint… so this was progress, but my blood pressure had dropped. The 30 degree heatwave outside wasn’t helping, so they brought me a big fan which is now a static feature by my bedside even at home.
Despite all that, the first night on the ward was quite relaxing all things considered. A nice dinner, chatted to the two other ladies in my ward, and we all read our books until lights out.
Out of bed with some anxiety on Day +2
The nurse assistant got me out of bed and into a chair after breakfast, and I didn’t faint which was a good start. Sitting for the first time felt strange and uncomfortable, but then sitting is not that comfy for me generally. My pelvis is very crooked, and so I can never quite sit straight. But I managed to wash with the help of a long handled sponge, and put on my own nightshirt. Another step towards independence. At this stage in recovery, doing one new thing seriously feels being let out for a night out in Vegas. But I also felt vulnerable in the cubicle. What if I faint and break my new hip? What if they can’t get to me?
I waited for the physios whilst watching the 84 year-old who had her surgery last night get up onto crutches, go off and do the necessary hip mobilisation checklist, then she started packing to leave. It was my turn, first up on the walker again, and then onto crutches. Now, with my history, I’m a dab hand on the sticks, even if I do say so myself! All looking very impressive.
Later the physio came back and I was straight up onto crutches. Yay, look at me, so confident. Star pupil. This feels good. And then, yep, you guessed it, I say, “I’m feeling odd, I think I’m going to faint”. We get back to the bed, she takes my blood pressure which has tanked again, and so I was back in bed and on a drip of fluids. Which to me, was a backward step. I shed a few tears as the physio said no more PT today.
My partner came to visit and brought some lovely messages from colleagues and friends who he’d updated (thank you, they were well timed folks!).
After he left, I lay down and figured out the pay as you go TV. I needed a distraction. Then the nurse came with my blood thinner injection (which is the least painful needle ever really) and I got really anxious. All I could think was - oh no, the cannula made me faint. I got quite upset. He was very patient, let me have my mini-meltdown, then gave me the jab. I settled back to watch Speed (Keanu always helps right?!) whilst taking on the fluids and the breeze of the fan. Watching a movie felt normal and it was the distraction I needed.
This was the longest night. I didn’t sleep at all, the next patient to arrive in the bed opposite was struggling with pain and very vocal, and I almost fainted again when trying to use the loo. So back on the drip, the fan. Was I ever going to get home?
Day 3 - the checklist to get home
It was Friday and I wanted to get home for the weekend. I felt like crap but recognised I needed a plan, and I needed to feel in control. So I started asking the day staff - what do I need to do to get home now?
There were four things:
- Not faint/nearly faint
- Bowel movement and pee without the catheter
- Have an Xray
- Fully mobilised on crutches - on the flat, up a single step, and up and down a flight of stairs
So I had a goal and a plan. I’m good with that, and the fact I asked in itself showed I was ready. I focused on each with determination.
After washing myself in a chair the catheter came out, which made it easier to get up and mobile (dragging a catheter bag around on crutches adds something extra to think about)
The physio got me up and I walked down the corridor on crutches and up and down a single step. I found this easy - up: good leg, crutches, operated leg. Down crutches, operated leg, good leg. When we got back to the bed the physio asked if it was my goal to get home today? You bet it is!! The ward staff said OK, if I could toilet independently.
Shortly after I went to Xray in a wheelchair. I haven’t yet seen the image of my new hip joint, and I’m very curious to see it. I will have to wait until I see my consultant orthopaedic surgeon in 6 weeks.
After lunch, with a bit of extra medicinal help and focus, my bowels finally opened. Poo for victory!
Then the physio took me up and down a flight of stairs, which I already knew how to do. We did my standing, sitting and laying mobilisation exercises so I was clear on them. And proved I could get on and off a raised toilet seat on my own.
We don’t have a walk-in shower at home, so have to strip wash only for 6 weeks (the risk of bending or rotating the hip too far is to big). So I had a sneaky shower in their wet room. Such bliss. Clean hair, the feel of water on my skin. Post-surgery these little moments are so precious. I felt human again.
I then waited for the discharge papers, the sick note, the meds - with the hospital transport already waiting to take me home (we have a mini which won’t easily meet the precaution height of 18.5 ins). Then I was cleared to go. Yippee!!
I was soon cleared to leave, considered fully mobilised. We had to faff a bit with the wheelchair to get me downstairs as it didn’t meet the precaution height. Lots of pillows. It was hard to get into the ambulance, but we managed. It was a 40 min journey, which I shared with a lady who had just had her knee wound staples removed (ouch, remember that one). The ambulance had limited suspension to we felt every speed bump, and the air con couldn’t keep up with the heatwave. But at 5pm, I pulled up at home.
Thankful for home
My partner was there to meet me and with the help of the ambulance driver we got up the two steps. My partner set up a bed for me downstairs, so I have everything I need on one level and don’t need to climb the steep Victorian stairs. Dudley the cat was a bit unsure for a while, but soon came for a cuddle. Another very happy moment.
We ate dinner. We watched an episode of something on the TV (I could sit in a chair for about 30 mins before needing to move). Then got ready for bed. I have never been so thankful for home.
The NHS staff at SWLEOC are incredible. I will also always be thankful for them too.
We’re all differently-abled
As I reflect on this post-surgery mobilisation, I’m conscious that we are all diff-abled. No two people will mobilise the same post-surgery. Some of us just take a bit longer. But we get there.
Until next time, thanks for all the love and support folks xx
Jill Pringle is 54 and was born with bilateral hip dysplasia. You can read more about her experiences of living with this condition, and her various orthopaedic surgeries on this blog, or by following @WalkingJill on Facebook.
Hip Revision Surgery: my first day and night in hospital
I had my total hip revision surgery just over 1 week ago. It’s been a full-on week or so, as I start to recover from a major surgery.
This is not my first hip surgery. Born with bilateral hip dysplasia (DDH) in 1971, orthopaedic surgery has been a regular cadence throughout my life. As I child, I had several surgeries to finally get me walking by the age of 3 and a half, a femoral plate removed when I was 7, a leg lengthening surgery aged 16, a total hip replacement (THR) aged 32, a knee replacement at 50 and now this revision on my original THR.
I had my surgery at the elective orthopaedic centre (SWLEOC) at Epsom Hospital in June 2025.
The morning of surgery
I had to be at hospital for 7am and I’d been fasting since the night before. I had a big glass of water at 6am then nothing. I showered in the same special wash I’d been using for the last 3 days. Despite my hunger, the journey was calm and uneventful as my partner drove me there. Heading for major surgery is a weird feeling, not unfamiliar to me. I know it’s what I need, and have been waiting for it, yet it’s scary. All the what ifs and risks are bubbling under the surface, and just that feeling that I’m about to put myself through intentional pain and trauma is unnatural.
Along with 6 other patients, my partner and I were taken up to pre theatre. It was unexpected and reassuring he could come with me - my last surgery was just past covid so no visitors were allowed at all. It helped to have a friendly face there, someone who loves me. I gowned up, had the usual pre op checks to make sure I was fit enough, ensure no infections, scratches or bruises. They drew a big arrow on my leg and wrote LEFT on it for good measure!
The anaesthetist visited and explained it would be a spinal pain management with a sedative, rather than full general anaesthetic. For me this was good news - I have never reacted too well to the GA hangover. He inserted a cannula in my arm so they could take blood and to later administer the meds. He then listed all the side effects and risks, as they must for informed consent. And then something new happened. The room started spinning, I got dizzy and hot, and I fainted. Next I knew was my partner telling them I don’t like masks on my face, as I came round. It’s called a vasovagal response but to you and me, it’s fainting. It’s a common feature of my previous post-surgery journeys because my blood pressure is naturally low. But I’ve never done it pre-op before. First time for everything!
They put me back on the bed and I was quickly back to normal. The staff reassured me that it’s quite common and all good. My surgeon arrived, which was reassuring as he’s been my consultant since 2002. He explained the hip revision surgery again, showed me a diagram of the hip joint that’s been built, and said I was first up in theatre so not long to wait. It would be 4-5 hours and I might lose blood and need transfusions. He also reminded me it’s going to be a long recovery where I need to be slow and steady, not take any risks for the first six weeks, until the new hip sets in place. He confirmed I will be weight-bearing with crutches but need modified exercises due to the much higher risk of a revision dislocating and the need for the joint to set in place.
Before 9am I said goodbye to my partner, and was wheeled in a chair to theatre. The scene when I arrived was actually fascinating - like a scene from a movie, with lots of people in the background in blue hazmat style suits readying things! I recognised the anaesthetist team, who asked me to transfer to the operating table, undid my gown at the back, asked me to lay on my non operating side then hooked my cannula up to the drugs machine. “First anti sickness” says the anaesthetist. “OK now the sedative." I asked ‘should I be feeling sleepy?. He says yes. And that’s all I remember.
The afternoon - coming round in PACU
I think I remember them first bringing me round in theatre, I have an image of a few people in gowns/masks looking at me and saying hello, including the surgeon. The next thing I remember is being in PACU, with a two lovely smiley nurses, Pam and Suzy, telling me where I was and that they were looking after me. I was hooked up to fluids and they explained that I also had an arterial line on the other side so they can take bloods regularly to check my haemoglobin levels. They gave me my phone and I messaged my partner to say Hallo and sent a selfie, so he knew I was OK and could let my sister and colleagues know. This was at 2pm. The surgery had taken 4.5 hours.
Regular observations (obs) of my blood pressure, temperature, oxygen levels continued. I had some water, a cup of tea and some toast which was heaven. They asked me to wiggle my toes, see if I could lift my legs, and seemed happy. I had no pain, the epidural was still attached and would be all night. And then I almost, but didn’t fully faint, to add a bit of drama. Once again it was over quickly with some oxygen and a big fan (which has become a staple post-surgery friend for me).
The anaesthetist and my surgeon both visited me. They were un-fazed by my fainting - long surgery, lost some blood, I’m lightweight, and I’d been fasting.
My consultant orthopaedic surgeon explained that the surgery went to plan, so he was happy. He reminded me it remains very fragile in there - I have so little pelvis on that side in the first place to work with. And he reiterated no risks at all, slow and steady for 6 weeks, just focus on letting the bone and metal joint bond so it gets nice and secure. He reminded me only to walk with crutches, no twisting, carrying, crossing my legs or over rotating the hip, and be hyper-aware of my precaution height - the lowest furniture I’m allowed to sit on so I don’t end up bending to to 90 degrees or more. More on this in a future blog because, frankly, it’s quite limiting!!
My partner came to visit about 4pm. I heard him coming down the corridor, and it was the happiest thing to see his face and get a big kiss. It was lovely to chat, although I expect I made no sense whatsoever (nothing new there he’d say!!). He brought pics of Dudley, our cat, saying hello :-) I had sandwiches and a protein shake.
Obs continued throughout the evening, once my legs were better thawed they hooked pain meds into my epidural. Then I was sick so they gave me anti sickness injections and fluids. They had to keep spraying my legs, waist and trunk with an ice spray, to test what I could feel below and above my waist whilst the epidural was still in - to make sure that any spinal pain relief was not creeping up my body as that could impact my breathing. The regularity of my obs was a reassuring drumbeat.
The evening - a long night of intermittent sleep, pain, meds
As the evening progressed, many of the people who were in the waiting room with me that morning were mobilised up onto crutches and left either to go home, or down onto the ward. I remember this from my first hip replacement where as the youngest (but also the most complex) I had taken a few days to mobilise whilst all the 70+ patients were whizzing around on crutches on the same day!!
That first night I stayed in PACU. I had a new nurse called Andrew overnight who looked out for me and a couple of other patients all night. With regular obs, ice sprays, anti-sickness and other drugs, and the fan on all night to help keep my temperature stable. My legs slowly thawed - ironically it was the non-operated leg and ankle that was the last to regain all feeling some time the following day.
And just like that, hour by hour, me and my new hip made it into day 1 post op. I could not be more grateful for the care and good humour of all the staff at SWLEOC Epsom Hospital pre and post op that day. Friendly people, amazing professionals. Thank you all so much.
I made it through that first day. And now the post hip-revision journey begins.
More to follow in a few days…..thanks for reading the blog! Love to you all xx
Jill Pringle was born with bilateral hip dysplasia (DDH) in 1971. She writes this blog to share her experiences of walking and living with this common disability.
Mobility aids from the Tip! Getting my home ready for hip surgery
Over the last few weeks, I’ve had to start readying myself, and my home, for my reduced mobility. I’m having a full hip revision surgery next week and after just 2-3 days in hospital, it’ll be down to me and my partner to manage the rehab - and that means shopping for mobility aids.
This is not my first rodeo, when it comes to orthopaedic surgery. I had my first surgery at Sheffield Children’s as a baby, a leg lengthening surgery aged 16, a hip replacement at 32, a knee replacement at 50, and now my hip is ready for a refurb.
Which means I've been dusting off some of my existing mobility aids, and shopping second hand for some new ones...
- I already have my crutches – same pair I’ve had since my original hip replacement, and I still use to get on public transport.
- We have steep victorian stairs, so we’ve picked up a single bed at the local charity shop, and rearranged the dining room to allow me to rest downstairs. Bit cramped but safer.
- Since I can’t bend my new hip more than 90 degrees without potential dislocation, I’ve found a high-backed chair with firm arms. Once again, the local hospice charity shop is a winner. It’s not the most modern style, but blimey it’s comfy (both partner and cat can be found sitting in it far too regularly….)
- I won't be allowed to sit too low, and need arm rests to lower myself, I’ll need a toilet raiser and a commode for upstairs once I get there (we have a downstairs loo). My top tip: visit your local refuse and recycling centre – if they have a reuse shop it will be stacked with a decent array of bath boards, toilet raisers, commodes, crutches, walkers and sometimes folding wheelchairs.
- I already have the bath board so I can sit and shower whilst I’m not able to fully weight bear.
- Couple of long handled grabbers from Amazon to keep things in reach or make sure I don’t bend (yep, cue Dalek impression hilarity when they arrived…)
And then, more personally, it's been about exercising, and getting my kit bag ready for hospital.
- Lots of swimming and exercises
- Stop HRT for 4 weeks (any menopausal women reading will sympathise with how that’s been!)
- Stopped gardening last week – not allowed any skin breaks/scratches or insect bites
- Made sure I have a respectable nightdress, light dressing gown and loose fitting clothes but not long enough to trip over
- Flannels ready for bed washes. Never a joy but necessary.
- Thick socks – feet get cold whilst I’m less mobile
- A pair of shoes that haven’t had external raises fitted (it’s likely my leg length may change again)
- A good stash of library books
- Start using the special hair and body wash and nasal spray the hospital provided from tomorrow.
If you read this wondering is Jill the type of person who likes to be prepared, you have your answer, folks!
It will be hard for me to publish new blog posts for the first week after my surgery. To stay tuned with smaller updates, follow @WalkingJill on Facebook.
Jill Pringle was born with bilateral hip dysplasia. She has had various surgeries on her hip, femur and knees as both a child and adult. She writes about her experiences to raise awareness and had undertaken various walking challenges to fundraise for Steps Charity.
Time for a refit. Hip revision surgery and DDH
It’s 22 years since I had a total hip replacement, needed because I was born with hip dysplasia (DDH). Hip replacements of that time last about 15 years, so I feel lucky that I’ve had over 20 from mine. But over recent years, walking without sticks has become more difficult, and in December I learned it’s time for the hip revision surgery.
What is hip dysplasia?
Dysplasia means abnormality. In short, my hips didn’t form properly. When I was born, the socket was too shallow on one side, which means it doesn’t rotate properly. But on the other side, the socket and part of the pelvis were just missing. I spent my early years in and out of Sheffield Children’s Hospital, with open and closed reduction surgeries and in a hip spica between them. You can read more about that in some of my previous blog posts – from my early memories of surgery, to my leg lengthening, my hip replacement and a stabilising knee replacement in 2022. Like many people born with DDH, surgery is just part of my life.
Why does a hip replacement need revision?
Quite simply, the parts, and the fixings, start to wear. Just like a real hip. We humans take a lot of weight through our pelvis and hips, and they are made to move. Don’t know about you, but it’s quite for me to actually stand still. Should have been a jack-in-a-box!
The polyurethane lining in the socket starts to wear, just like with cartilage, and the tiny bits of plastic get into the bone tissue around the hip joint. This causes something called Lysis – which means the bone stops forming so well, and softens around the fixings. And so the socket starts to get looser and some of the parts need replacing.
I mean really, it’s a bit like a shelf. Nice and secure when you first put it up, 20 years later it’s come a bit loose and so needs taking down, some filler and new rawl plugs (if you’re lucky) or if not so lucky, you have to drill in slightly different places and plug the old holes. If anyone medical reads this I apologise for the massive oversimplification of your immense skill.
But it’s kinda what my hip revision surgery is going to be. So, the shaft into my femur is still secure, so my surgery will focus on replacing the ball, the socket and the polyurethane liner. And using bone filler to secure it in place and plug any holes.
A ‘3D printed’ bionic hip
Tech can be frustrating (someone changes the button you knew on Microsoft Teams LOL!). But it’s also amazing what it’s enabled in the medical field. So my new hip has essentially been ‘custom printed’ to fit my strange little pelvis perfectly. How amazing (again, if a little simplified). And how lucky to live in a country where I get to have that surgery.
Four days to go
So I’m now on the final prep journey, with 4 days to go until my hip revision surgery. I’ve had my pre op assessments, had the handover at work and I've been swimming as much as I can, and sorting out my home for what I’m told will be a “no picnic” kind of rehab. More on what’s involved in that, and some unusual places to get what I need, in my next post.
Until then, I’m hoping for as much sunshine as possible whilst I can still get out and about. Hope the weather is kind to you all too, wherever you are reading.
Until next time….
Jill Pringle was born with bilateral hip dysplasia in 1971. After an early childhood in a hip spica and various surgeries, she now writes about her experiences of living with her DDH, her surgeries and her walking challenges to raise money for Steps.
Learning to live with less mobility: hip dysplasia and surgery
I can’t believe it’s been more than a year since my knee replacement. And if I’m honest, I can’t believe I’m still having to use walking aids of some sort quite regularly. I guess the nice English euphemistic phrase would be that the outcome of my surgery is 'not quite what I’d hoped it would be'. I have to get used to having less mobility.
The medical bit
There is nothing wrong with my new knee itself - surgically speaking that’s a success. And after a visit to my hip surgeon at the start of the year we can see that my left replaced hip, now 20 years old, has not deteriorated as a result. In fact, it’s in great shape for something that’s supposed to have a life of 15 years. My right hip – dysplastic but never bad enough to be replaced – is not orthopedically affected either. However, its rotation has been changed by straightening my leg, and so my hip flexor does limit my knee flexion which is an interesting new twist. In short, my right hip worked better with a valgus ‘knock’ knee to compensate for its limited range. But that’s why my old knee wore out on one side!
In short, whilst each of the parts in isolation is OK, something about the whole combination is more limiting. For the first time in 20 years, I feel disabled again, not just differently-abled. And having less mobility has taken some time to get used to.
Transport challenges
I have written about the social model of disability before. In essence it acknowledges that it’s the world around me that’s disabling. As well as having to use crutches to get on and off trains (high steps, wide gaps, limited handrails, people in the way, time pressure) I also have to consider - and frankly over-plan -any journey. Spontaneity is difficult. I have to think ‘do I know the station I’m going through? does it have lifts, are the steps crowded, can I hold onto a right-hand side handrail not a left-hand side one?’ I have to consider carefully what I can carry; I need the lightest backpack possible and I can’t carry anything in my hands. I can never buy a coffee and carry it on and off a train, I have to pack a flask that fits in my rucksack. When I get to the train, what happens if the seat reservations aren’t working because there are half the number of planned carriages (a regular on East Midlands Trains) - will I even get a seat? And then of course other people are unpredictable, moving hazards; equally I am a hazard to them. In short, any journey is a continuous risk-assessment from start to finish and that makes it exhausting.
I’m lucky that right now my job allows me to work from home most of the time. When I was recently looking for a new job, there were many where the 2 days per week commute into central London meant I didn’t even apply. So many employers these days are brilliant at reasonable adaptations once you get to work, but they can’t control the journey. And being the only team member who doesn’t turn up onsite can be isolating.
Leg length discrepancy
One of the other disabling factors is having to manage my leg length discrepancy. For five years prior to my hip replacement, I got used to having both an external shoe raise and inner insoles but for the last 19 years I was able to just use inner insoles that could fit into most shoes. I’m now back to having just four pairs of adapted shoes and them all being sensible, robust shoes. First world problem obviously, but still annoying. If I’m travelling with a small rucksack I can’t carry a spare pair for evening vs. daytime. And walking with bare feet is no longer an option with one leg so much shorter than the other.
It’s not all bad news…
There are lots of positives here. I’m pretty fit and healthy and with the right shoes and sticks I can walk. I swim well, I still sing, I manage to garden in small bursts albeit with painkillers, I can work, I have a supportive family and partner who does all the physical work when we go camping so I can still enjoy that experience. And compared to many people with hip dysplasia, I am not in constant, chronic pain and I am so thankful for that.
My knee doesn’t hurt much and it won’t degenerate rapidly like it was without the surgery. I have only had one posture-related migraine in the last year, whereas I was having them once every 2-3 weeks in the year before my last op. (The strain of my shoulders/neck trying to hold me steady can give me a headache which becomes so bad I develop a migraine - especially after singing or walking a long way). I’m not missing those!
And with my straighter right leg and the left shoe lift, I am officially taller (well on one side at least). For the first time in my life, I’m the same height as my sister!! It took me 51 years and 13 surgeries but it’s a win 😊
I have lived my life knowing that I can’t always take walking for granted. In the last year I have had to learn to live my life with a little less mobility. But still live it well.
Jill Pringle was born in Sheffield in 1971 with bilateral hip-dysplasia. She has had several surgeries including open reductions, leg lengthening, hip and knee replacements. Her blog raises awareness of living and walking with the condition and to raise money for Steps Charity Worldwide - you can donate here.
“Still on crutches?!” 9½ months post knee-replacement with hip dysplasia
Well, intermittently, the answer is “yes”. I’m still on crutches and yes, it’s annoying me! I find myself at the strange post-surgery stage where I’m more stable than I was before, but less mobile. I meet other people who’ve had a knee replacement after me, or know someone who has, and they’re off crutches and back to full fitness which is a little deflating.
It’s not pain that leaves me still in need of walking aids. It’s 50 years of weakness in my left hip and leg due to hip dysplasia; which of course is what caused my right knee to erode so much in the first place. My surgery has restabilised the knee but hasn’t fixed the root cause. Nor can it be fully fixed. As my physio said to me a few days ago “some muscles on the left side don’t work and never have, so we can’t rely on those like I might with other patients.” It will also take the full year to build up more functional movement.
So where does that leave me right now?
My new knee has less range (bend) but is much more stable (my own knee joints are hyper-mobile so move more than they should and wear more quickly). My orthotics mean I stand much straighter. I’m not in much pain but my muscles start to ache if I stand still for a long time, or walk for too long, and so that strength needs building. I’m weaning off the crutches based on each situation; the types of movement and duration for which it’s required.
- At home I don’t use the crutches at all. The stairs are OK as we have a rail on both sides and as long as I don’t have to hold anything in either hand, so I always have to wear clothes with pockets. If I have a mug of tea I have to place it on the step in front of me and work my way up the stairs 2-3 at a time following the cup. Over the last 6 weeks my physio prescribed an outdoor obstacle course to help me find my ‘centre’ and to move sideways, around or over them (see demo by my cat). So I’m able to walk around the garden with no sticks and do some gentle gardening but without bending or squatting.
- Around the local area I’ve now progressed off crutches and onto walking poles. This has two benefits; they take less weight, so it forces me to use my legs more whilst still allowing a natural rather than lurching gait. And they are also light enough to carry - my goal for the next six weeks is to alternate 1 minute with them, 1 minute off and then build up the time off the poles incrementally.
- To travel into London for my weekly choir rehearsal, I still have to take my crutches. The main reason for this is to get off a train. We still haven’t found a way of getting off a high step down to a platform whilst also traversing a horizontal gap. Next idea is to try stepping off backwards (I’ll let you know how that one goes!). The crutches also help at train stations or other places which for someone like me, is a huge moving obstacle course, every person a trip hazard. The crutches signal to them to avoid me. What I most long for is the chance to buy a coffee at the station and be able to carry it - target #freehandsday!
- I’m now back to working 3 days per week and on set days. I’m very grateful to have a six-month contract that allows me to work from home 99% of the time. Not only does this remove a commute or more trains but also it means I can swim every morning and still be at my desk for 9am (the pool is in walking distance). Sitting is not easy – with one hip 2.5cm higher than the other, a very crooked pelvis, and flat glutes - I lean to one side, balancing either on my hip bones or coccyx. So I try to adjust with my spine and upper body which leads to lots of shoulder and neck pain. The other advantage of WFH is that I can control the environment, desk and chair setup, no boxes, no trip hazards. Never has this been more important. And I don’t work on Mondays which means I have the energy and time to get into London for Choir – singing is my endorphine boost but getting there takes energy!
- The combination of orthotics and external shoe-raise is working well to address my leg length discrepancy. The sad thing is I have to wear something on my feet all the time (see adapted cosy shepherd slippers in the photo) so I can’t walk barefoot without one foot being on pointe! I’m also developing some pain in my left toes so the orthotic needs some adjustment (in progress). I do now have four pairs of shoes adapted so at least I can have some variety!
Don’t get me wrong. In many ways and overall life is good. I’m confident that my surgery will pay off. And I’m not in chronic pain which is not the case for so many people with DDH.
I’m just impatient. I want to progress more quickly. I want to get back out into the hills and do some walking, and that feels like a very distant goal.
Living with hip dysplasia is a ‘one step at a time’ challenge. Most steps forward, some backwards and all steps a little bit wonky! DDH is a lifelong challenge that many people like me face – 1-2 people in a 1000 to be exact. My story is just one of them.
Jill Pringle was born with bilateral hip dysplasia in Sheffield in 1971. She has had several surgeries including open reductions, leg lengthening and hip and knee replacements. She writes this blog to raise awareness of CDH/DDH and undertakes walking challenges to raise money for Steps Charity Worldwide who you can support here.
Camping, Singing, Walking. Doing things I love with and without crutches.
So this weekend I took my new knee camping! I love being outdoors but I have to admit to feeling nervous about it, post knee replacement. I associate camping with a fair amount of crawling around on my knees as we tend to go to basic campsites, with a small tent and minimal furniture; an inflatable mat not a bed; a low folding chair with no table. In short, not ideal for someone with my range of mobility issues on crutches.
And yet I love being in nature and the simplicity. I don’t go camping for home comforts.
We tried a new campsite this time and, as it turned out, it was the perfect pitch for me. Each camper gets their own little bathroom hut so I had somewhere to sit to get dressed (try pulling a pair of shorts or trousers on if you can’t stand on either leg independently and there’s no seat). There was also picnic table next to each pitch, so I had somewhere to sit at a table and so some variety by switching between this and my camping chair (important if, like me, your hips aren’t level so sitting in one position for more than 30 minutes is painful). All of this meant I only had to get down to the floor once a day, to get into bed, which is now about shuffling on my bum instead of kneeling.
What was also lovely, was being able to walk about the campsite without crutches – just like I do now at home or in the garden. It felt natural. This is a big shift from a month ago on holiday in Northumberland – when I felt much more reliant on crutches for most of the time. Especially walking on sand to experience the dunes at Bamburgh!
Getting off the crutches full stop is still proving difficult. I need to be able to walk for a while and then use the crutches once I’m tired – and so build up that distance. But that would mean carrying them until I need them, which of course changes my gait. I need my arms free to help me balance. I started walking up and down our road to build strength, but the pavements slope which knocks me off balance. I’m going anywhere crowded, I need my crutches to keep other people at a distance – it’s a visual clue for them to slow down and give me space.
I also need them to stand for any length of time, my knee and my feet (in their new orthotics position) get tired without the extra support. I’ve loved getting back to singing in choirs, and of course it’s been possible to mix sitting and standing in rehearsals. I’ve only taken part in short concerts to date. My first longer concert, where I have to hold music, is not until November and I’m grateful for that break to build my strength. I don’t have the ideal physiology to be a singer where posture is so vital and it requires stamina.
Then again, I don’t have the ideal physiology for camping or walking either! As Steps say, people with DDH can’t take walking for granted.
I’ve been at this stage before - after my hip replacement this last part of rehab felt so slow. I had one leg I could rely on then; despite my hip dysplasia being bilateral, in reality my left side was my weak side, my right was more dependable. This time it’s 50/50 which side is more stable.
I know it will happen. I have faith there will be that point where I forget to pick up my crutches and it feels more normal without than with them. Until then I need to do more swimming – perhaps with flippers – and more walking in the garden. Not just pottering but consciously counting my steps without crutches.
Jill Pringle was born with hip dysplasia (DDH). She’s had numerous surgeries including closed and open reductions, leg lengthening, and total hip and knee replacements. Jill’s blog is all about embracing being differently-abled.
Mind the gap, find the gap! Trains, parking and the social model of disability.
In the last two weeks I have taken my first train journey and my first solo drive in the car, since my op. Such big steps forward in lots of ways. As it turns out they were very hard steps to take on crutches with poor balance.
I’m in this weird period right now where neither leg is the good, dependable one, and that’s a first for me. It’s really reminded how differently-abled I can be and what the social model of disability is getting at.
Mind the Gap – the train journey
I’ve had intermittent periods on crutches my whole life. I’m pretty mobile on them, relatively quick vs. a novice, and accustomed to using them on public transport. But my first trip into London by train since my knee replacement, was just horrible.
I remembered to take a train 30 minutes earlier than necessary, so I had time for lifts in connecting stations and take my time across a busy London concourse like Victoria. But getting on, and particularly off the train to change, was more difficult than I expected. Clapham Junction is an amazing feat of engineering and I’m always in awe of how many lives it connects every hour. But the platforms are curved, the train leans away from the track and the chasm that awaits when the doors open is huge in both height and width. Before my op I was handling this by taking weight on my right leg. Now it’s Hobson’s Choice which leg is the weaker. Kind people on the platform try to help, but essentially try and grab my arms (which stops the crutches doing their job and puts my weight on the legs I’m trying not to rely on).
I finally got off with a lurch and a hope. It hurt a bit but I was mostly relieved that I didn’t fall into either the gap or the crowd waiting to get on the train. It’s safe to say that by the time I got to where I was going I was quite traumatised really. And so spent most of my lovely first Choir rehearsal in London dreading the journey home.
Next week I’ll be trying this journey again. I will try to find staff at the station and the right door for the guard on the train, so I can warn them I may need assistance at Clapham. Which, of course, requires more time and planning.
There is nothing easily done about this; old Victorian platforms were not built with disability in mind and I’m not suggesting that Clapham has to be rebuilt, for me. I also know that for some people it’s much harder; they have to call ahead to pre-arrange travel to even get access, and I also know that others in the DDH community would love to walk as far as I can on crutches. We’re all different.
It was simply an eye-opener into travelling with a disability - that I’d forgotten. For a while, I suppose, I’d taken trains for granted.
Find the Gap – the car park
I can now drive about 40 minutes without pain in my right knee or hip flexor. Which means I no longer need my partner to arrange his day around any medical appointments. That’s great for both of us, it gives me independence and I’m grateful for it.
But I always experience the background anxiety of “where am I going to park?” I need to make sure I can get out of the car and then be even more certain I can get back in it when I return!
I am able to walk too far (even on crutches) to qualify for a blue badge. I certainly don’t usually need to be right next to the door of a shop (unless I’m carrying a shopping bag in which case it’s a shuffle, placing the bag down on the pavement every few yards).
The big car parking challenge for someone like me is finding a space at the end of a row, where I can open my car door either into a grass verge, a pavement or the road – so that I can get the door all the way out. I need this clearance to swing my legs out and round together (without full flexion in my knee) and then I need to use the door to lift myself up out of the seat. I can’t go in and out sideways one leg at a time. Once I can stand up I need to turn around, lean into the back seat or over to the passenger seat, get the crutches out, put them in my arms and then close the door. Let’s just say it takes a while. Most people are patient and wait. Most.
On the way into a car park, I do at least have the chance to control this - finding the most suitable space or if there are only narrow spaces left, leave. What might happen on the way out is always on my mind. I have mini. If I can’t find an end space then I have to leave enough space next to me to get out at the side. Someone with a big car or van invariably sees the next space as a great place to park - it gives them plenty of room. Why wouldn’t they? It makes perfect sense and they don’t know that I need that extra room. So I return to my car and can’t get open the door even a fraction. Pre-op, I would have gone in the other side and scutched across the seats and hand break as my knee, whilst painful, was hypermobile and very loose. Less of an option now where bending is more challenging the knee is more robust.
So the options are to contort and cause myself some pain and potentially put some things in my upper body out of alignment for a couple of hours; or if it’s too tight, wait for them to come back to their car. The only other alternative is to park in a disabled or parent and toddler space and hope I don’t get a fine. Hopefully I get the can just find an end space.
Again, I’m not alone in this, many older people without a lifelong disability have the same challenge. And I’m happy to be finally out and about. It’s just this is on my mind from the minute I consider the trip, weighing up do I go out to this thing and risk it, or not.
The social model of disability
My reason for sharing this is not to rant or ask for sympathy. I don’t resent others’ mobility and if you have it you should use it – I would! I have a pretty ‘it is what it is’ attitude borne from 50 years being a differently-abled walker with huge variation my mobility across different periods – sometimes highly disabled by the world around me, other times not much.
Since part of my motivation for creating this blog is to share what it’s like living and walking with just one limiting condition, I simply want to share my experience. And ask you to take just a moment to consider what you might take for granted.
If you want to learn more about the social model of disability, there’s a great 3 minute video on the Scope website here that explains it well.
Thanks for reading. Until the next journey…
Jill Pringle was born with bilateral hip dysplasia in 1971. She has had numerous surgeries as both a child and adult, including open reductions, leg lengthening, and both hip and knee replacements. She writes this blog and walks to raise money for Steps Charity – you can donate here.