I had hip spacer surgery (hip replacement stage 1)

It’s been just a month now but I’ve had my first stage of hip replacement surgery and I wanted to write about my experience. I’m 28 years old and I am being treated for septic arthritis caused by Group B Strep.

I went into hospital on Monday 5th August at the Hallamshire Hospital in Sheffield with Septic Arthritis in my right hip. The septic arthritis was caused by group b strep from my pregnancy with my second child, who was born in May 2019. The group b strep infected the hip, caused septic arthritis in the hip, and in just 3 months completely destroyed it. I was in the worst pain imaginable and went from walking with a limp to not being able to weight bare at all and relying on crutches to walk a few steps. It was honestly horrific and the worst thing I’ve ever been through. What happened to me is extremely rare and tragic how quick it happened, it really has changed my life forever.

It took all the 3 months it was happening to get diagnosed. It could have been prevented if treated sooner but, that’s another story for another day. What I’m talking about here is the actual surgery. When I was told I was going to need a hip spacer in before a hip replacement, I had no idea about it. I’d heard of a hip replacement but never a hip spacer, and when I did some research about it online I couldn’t find out much about it.

As my right hip joint was just beyond repair due to the infection, it needed to come out and be replaced: i.e a hip replacement. But because my hip joint was so badly infected, and the infection was in my blood, too, it wasn’t just as straight forward as taking the hip out and putting a new one in. The infected hip needed to come out but before I can have a new one in, the infection needs to be treated completely. Because, if a total hip replacement goes into my hip joint whilst I still have the infection then the group b strep could infect the hip replacement… meaning, months down the line, I’d have to have it removed again.

To treat the infection three things needed to happen. First, the infected hip joint needed to come out. Second, the hip joint was to be replaced with a fake hip, not a hip replacement, but a fake-fake hip: like a fake hip replacement, so to speak. Third, lots and lots of antibiotics to get rid of the infection before the new, fake good hip goes in. Complicated but makes sense.

The hip spacer replaces the hip joint and acts like bone. The ball is made up of cement, and it’s attached into the hip space with metal rods. It’s going to be there for 3-4 months.

I was so scared to hear that I wouldn’t need just one surgery, not “just” a hip replacement but two surgeries. Not only that but the hip spacer doesn’t even give me the ability to walk, in-between the surgeries. I can’t weight bare at all on my right hip even with my old, infected hip out so I’m still completely reliant on crutches, wheelchair/mobility scooter.

So what exactly happened when I went into hospital?

I had hip spacer surgery (hip replacement stage 1)

As I said, I went in on August 5th. I’m quite anaemic thanks to the infection, so I needed 2 bags of blood transfusions over the Monday and Tuesday before the surgery on the 7th. I had those over the course of those 2 days.

Plans had been put in place for Felix to stay in hospital with me, as he’s breastfed on demand and only 3 months old at the time.

I was pumping breastmilk throughout those 2 days, too, as I knew Felix would need some while I was gone for surgery and probably for a few hours after, too.

During that time I had to do these special chemical washes on my body and hair and put a gel in my nose to prevent MRSA. I ate and drank as normal and didn’t have any other type of medications.

On the night before my surgery, I was told I couldn’t eat after my evening meal and only was to drink water. By 10pm I couldn’t eat anymore at all and by 6pm I was ‘nill by mouth’.

I met with my consultant who would be doing the surgery, he came to my room and discussed what would be happening… I was of course, really really nervous. But it was great to see him. Then, the anaethesiologist came to see me around 8am to discuss what anaesthetic I would have. I opted for a spinal block and sedatives because the thought of being put ‘asleep’ really bothered me… I was scared of never waking up again. Just the lack of control made me scared and I didn’t want that, so he agreed it was actually much easier and safer to go without a general anaesthetic. Once I’d made that decision though, I was really worried I’d made the wrong choice! I thought I was going to be awake and know what was going on the whole time of my surgery… how horrible would that be?! It wasn’t like that at all, though.

After that part was over, it was just a waiting game. I knew I was the third patient on the list for my surgery and the other patients before me were also being done by my consultant. I just tried to stay calm and not think about it much, but obviously that was really difficult. I also tried to breastfeed Felix as much as I could and prepared to be separated from him for what could have been up to 5 hours. That was really scary. I was texting my mum and missed Eric (my eldest son, he’s nearly 4) who was at home. They sent me photos and videos and told me to be brave. That really helped. <3

Time for surgery

The nurses put TED stockings on my legs, took my observations then around mid day surgical staff came to get me. I laid on my bed and they wheeled me up to theatre rooms. The theatre rooms were brand new, so light, clean and airy. I was taken to a recovery room first, I had about 20 minutes before it was my turn. I was so nervous at this point so they gave me a gossip magazine to read to try take my mind off it. I was so hungry and thirsty, too. I’d been breastfeeding so much for the last 12 hours and been nill by mouth! All I could think about was food and drink! But because I was so nervous I also felt really sick.

Once it was my turn I was taken on my bed to a small room where I’d be given all the anaesthetic. The anaesthesiologist was there and some other staff members who made conversation to take my mind off what was happening and put me at ease. I got off the bed and transferred onto an operating table. This was when they took my observations again, put IV’s in and did the spinal block. Before I was given the spinal block, though, they attempted to put 2 ‘A Lines’ in my wrists… it was going to track my blood pressure throughout the surgery but it failed. I was given local anaesthetic while a needle and IV line was threaded into my wrist vein but it didn’t work… I was so uncomfortable and lots of blood came out of both my wrists during the procedure. I really hated that. For nearly 2 weeks after the surgery I had big bruises all down my wrists onto my arm from those attempts.

After those failed A lines in my wrists, I sat up and was given the spinal block. This was familiar as I’d had an epidural before and a spinal block twice – for forecep delivery in childbirth and a hip aspiration a few weeks before. I was laid down once the spinal block was in my back, it wasn’t very uncomfortable during because local anaesthetic was given, and then I waited. To test it had worked I got sprayed with an ice cold spray and a cold heavy stone was rolled up my body. It worked pretty quickly and then I’m sure I was given a sedative into an IV because I don’t remember much after this, but what I do remember is seeing my consultant come into the room at that point. He greeted me and said something like, “hi naomi. it’s time to get started now!”. I was rolled over onto my side with the right hip upwards, I remember my arms/wrists going into these sort of arm rests/stirrup sort of things, and that’s that.

In recovery

I had hip spacer surgery (hip replacement stage 1)

All I remember for the rest of the surgery until I came ‘back around’ was the following weird things: seeing my consultant in a suit that looked like an astronaut, seeing the room full of balloons, hearing the anaesthesiologist talk to me about something but I can’t remember, and lots of drool down my face. I don’t remember any noise, being aware of anything happening at all. When I came around… all I remember was being moved around, tugged, rolled and cleaned up, lots of drool down my face, bright lights then I was sat up, smiling. After that I was being wheeled into recovery room and I felt great! The after effects of whatever sedatives they gave me worked wonders because I was completely out of it but totally awake. I didn’t have any pain, I was on cloud 9, laughing, smiling, thinking about fun things, honestly I felt like I had NOT just had major surgery.

Luckily I didn’t have to go to special care, that had been planned before the surgery but during the surgery I didn’t lose lots of blood and it went very well so it wasn’t needed. I was really pleased about that. In recovery, lovely staff just checked my observations, asked me if I was OK, gave me water and talked about my kids to cheer me up. But to be honest, I was happy as Larry and still drugged up at this point. They didn’t give me any pain relief because the spinal was still acting as the pain relief. But just as I was about to be taken back down to the ward, I started to feel pain on my leg.

I was still sedated when I got back to the ward, really happy to see Ollie and Felix. It was safe for me to breastfeed straight away so I did <3. And this was when I was given the first lot of pain relief as the spinal block was wearing off quickly at this point.

And that’s when it started to go down hill… and quickly. As the spinal block wore off, the pain medication they gave me didn’t work quick enough and it wasn’t working. I was in a LOT of pain and it only was getting worse as time went on. I became irresponsive, unable to think, talk, I felt sick and was heaving. I couldn’t move, the pain was just unbearable all down my leg and around my entire lower body. It didn’t just feel like one hip but both hips, bum, vagina, lower back, legs, thighs; everything.

Because I was in so much pain I was getting dehydrated, my blood pressure was low and I had to be given lots of fluids. I tried all the pain medication available but I was crying with pain, nothing seemed to be working. I couldn’t hold Felix, I could barely talk to any doctor or nurse, I was sweating. It was honestly the worst experience. I’ve never been in that amount of pain before. The pain was worse than the pain before I even had the surgery. It felt out of control, so I cried because I worried how long it was going to be like this. The staff seemed to be panic a little, too, and got an on-call doctor to come as I’d tried all the pain meds they had on the ward.

The on-call doctor prescribed a higher version of morphine but in an infection rather than the liquid oromorph I’d already had. It did work but it made me feel incredibly drugged up, spaced out, it gave me hot sweats, and the sensation of crawling ants all over my face. I was constantly scratching my chin, cheeks and forehead… it wasn’t pleasant at all. My arms felt heavy, I felt really tired but couldn’t sleep. The pain was still there but I couldn’t feel it… it was numb. A very, very strange feeling. I had around 3 injections of that throughout the night and it was the only thing that made me stop crying in pain.

By the morning I could cope without that infection (thank god, the side effects were awful) and was back on the oromorph instead (liquid morphine). I couldn’t get out of bed at this point so if I needed a wee had to use a bed pan. It hurt so much to try lift my hips to get the bed pan underneath me… not pleasant at all.

I really missed Eric, too… words can’t explain how much I wanted to be at home.

Trying to walk after surgery

On this day, so day 1 after my surgery, I had an X-ray and oh my, it was soooo painful having to move from my bed onto a bed to be taken down to X-ray. It took around 45 minutes for me to move centimetre by centimetre from my bed onto another one and I had sweats from pain every time I moved. The X-ray itself was fine, I didn’t have to move at all they just did it while I was laid there. But then when I got back to the ward, I really needed the toilet and decided I couldn’t use the bed pan anymore so I tried a commode. This was the first time getting out of bed and I used a zimmerframe.

Being on my feet didn’t hurt as much as the feeling I had of just… pain in general. Compared to before where it hurt to move because of the joint (and the hip joint itself had no cartilage left anymore due to the infection) this pain was mostly on the side of my thigh/bum where I’d been cut open for the surgery.

Once I started to be able to get out of bed and use the zimmerframe things felt better. It went really quick from there and I’m proud to say by 3 days after my surgery I was using crutches, going to/from the toilet and the physiotherapists cleared me for discharge. I was pretty happy about that and really enjoying less pain. I could immediately feel the difference between the hip before and this new hip spacer… it didn’t hurt as much. I was able to move my ankle without my hip hurting, wiggle my toes without any pain, lift my leg up and off the bed slowly and none of those things I could do before. I felt soooo positive.

I was having antibiotics in a cannula IV three times a day. Not only those antibiotics but the hip spacer inside, in the actual cement, they packed it full of antibiotics, too. And inside and around the hip joint lots of antibiotic dissolvable beads were placed. So, basically, I’m a walking antibiotic.

I was in hospital up until day 8.. so 5 days after my surgery. My consultant was able to give me a very, very strong dose of an antibiotic that lasts 2 weeks with 1 IV bag dose, rather than staying in hospital for 2 weeks and having the IV cannula antibiotic 3 times a day. I’m so grateful he was able to do that for me because I really needed to be home for the sake of my family.

Before I left hospital I was already feeling better than before. I’d actually planned a trip to Birmingham that weekend on a coach, hahaha. I’m crazy, I know. My mobility was the same, but the pain was less. The pain was a lot, yes, and I was on a lot of pain killers, still, but it was less than before and so it was already so much better in that sense. I just wanted to get home.

How things are now

Norfolk Heritage Park, Sheffield

It’s now been a month since my surgery. My mobility is the same as before: I can’t walk without crutches, I can’t weight bare, etc., but the pain has dramatically reduced. My mental health has improved and so has the relationship with both my children. I still need liquid morphine at least once or twice a day, but the biggest improvement is night pain. Before I had my infected hip removed, the night pain was horrible… at night it hurt SOOO much more than during the day to the point where I couldn’t sleep and I would just have to lay in bed on my back in pain all night, usually crying and wishing it would stop. Now I can sleep as well as I can – it still hurts but I can fall asleep – and in-between breastfeeds!

It hurts to do things like bend down, move quickly, turn around, get in/out the shower, try to put my jeans on or shoes on, things I can’t and shouldn’t do… and also I can hear the hip spacer actually move inside me when I try to do these things, which is so strange. It sounds like creaking/rubbing/scratching. I can feel it moving around and the texture of it, it really goes through me.

I wish I could do the things I want to do for my children. Not being an independent mother of 2 is really difficult. My self esteem is rubbish now and I have so much anxiety.

I’m still anaemic and will probably need more blood transfusions before my next surgery. I feel weak, light headed and have lost weight.

The antibiotics I’m on make me feel sick. I’m also tired in general from having 2 kids so it can be really tough sometimes.

I saw my consultant 2 weeks after I was discharged from hospital, that’s when the super strong antibiotic IV I had before I left would have worn off. He prescribed me with 3 weeks of oral antibiotics having spoken to the microbiologist (who has been growing my infection all this time, from a little bit of it they took out of my hip a few weeks before the surgery). It’s confirmed that the infection to have caused all of this is group b strep. It’s just unbelievable.

My next appointment with my consultant is 1st October. He’s hoping by then that I am clear of group b strep and hopefully, that means my body can rest… try to recover from the surgery, get stronger and prepare for the next surgery. It’s possible I’ll have the final total hip replacement sometime in December.

Thank you for reading <3

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