Hip Replacement with an Ostomy

Question:

I have had an ileostomy for 39 years I am now 80 yrs old and need a hip replacement has anyone else had this surgery at my age I am fairly healthy?

Response:

Hip replacement surgery is a common enough procedure today. Your responsibilities will be to work closely with your healthcare team, don’t be afraid to ask questions, get clear answers, follow the instructions given to you, and enjoy a speedy recovery.

Hip

Your hip is a ball and socket joint. It is made up of 2 parts: the femoral head which is the top end of your femur (thigh bone) and a socket in your pelvis called the acetabulum. The femoral head is a round surface that looks like a ball. I fits into the acetabulum and allows the smooth motion of the hip.

There a 2 types of hip replacement, a partial hip replacement and a total hip replacement.

The following is basic information designed to help you with your surgery preparations:

Important to Prepare

Before your surgery it is really important to prepare. Your healthcare team will work together with you to prepare for your surgery.

Make sure your healthcare team members are aware that you are an ostomate, and that you require special attention to your ileostomy requirements, (equipment, daily care, dietary needs, etc.) before, during, and after surgery. If they require further information, you can answer any of their questions. If there is a question you are unable to answer, recommend that the healthcare individual(s) contact an Enterostomal Therapist (E.T. Nurse) for recommendations and guidance.

As an ileostomate, you will probably be expected to bring your personal ostomy equipment to hospital with you. Ask your healthcare team if they require you to provide your personalized ostomy equipment. Also ask your healthcare team if they will be attending and changing your equipment during and after surgery until you are able to resume taking care of your daily ileostomy requirements. If so, ensure he or she are experienced with working with ostomy equipment and an ostomy patient. If not, you may need to provide your own training. Or, ask if they will be providing an in-house or external Enterostomal Therapist (E.T. Nurse), to provide this training and/or service. This is very important to your emotional and physical well-being while in hospital and during recovery.

You will be scheduled for a pre-surgical testing appointment.  Ensure you have the date, time, location and appointment reminder from your surgeon’s office.

Ask if you can eat and take your usual medications on the day of your pre-surgical testing appointment. During this appointment, you will be with a nurse practitioner and anesthesiology staff. He or she will review your medical and surgical history with you. You will have tests that are necessary to plan for your care. They will talk with you about which medications you are taking. It would be very helpful  for you to bring the following with you to your pre-surgical testing appointment – 1. a list of all the medications you are taking. 2. The name(s) and telephone numbers(s) of your doctors. 3. The name of a person who will speak for you if you are unable to communicate for yourself.

Questions you will want to ask your physician:

  • Should I do breathing and coughing exercises before my surgery?
  • Should I be doing some exercises such as walking before my surgery to help my body get into its best condition before my surgery?
  • What healthy and well-balanced diet (taking in consideration that I have an ileostomy), do you recommend to prepare me for surgery?
  • At what date should I stop taking certain medications, vitamins and herbal remedies prior to my surgery date?
  • A day before and on the day of my surgery who will be calling me to tell what time I should arrive at the hospital, when my surgery is scheduled, and who do I call if I haven’t received a phone call?
  • What are my instructions for eating and drinking before my surgery?
  • What are my medications instructions the day of my surgery?

Things to remember:

  • Do not put on any lotions, creams, deodorants, make-up, powders, or perfumes.
  • Do not wear any metal objects. Remove all jewelry, including body piercings.
  • Leave your valuables, such as credit cards, jewelry, or your cheque book at home.
  • Before you are taken into the operating room, you will need to remove your eyeglasses, hearing aids, dentures. If you wear contact lenses, wear your glasses instead.
  • Bring only the money you may need for taxi, newspaper etc.

After surgery

Always remember your healthcare team are available to answer any questions, and they will teach you how to care for yourself after your surgery. You will learn how to safely recover from your surgery. Ensure before surgery that you write down any questions you have and be sure to ask your doctor or nurse.

What to Expect

When you wake up after your surgery, you will be well taken care of. Most people return from the Post Anesthesia Care Unit within a few hours. A nurse will be monitoring your body temperature, pulse, blood pressure, oxygen levels, etc.

Your healthcare team will be fully on top of your pain management requirements.

Your healthcare providers will advise you and monitor your recovery requirements such as when and how long you should sit, stand, walk, etc.

Basic Commonly Asked Questions: During Your Hospital Stay

Will I have pain after my surgery?

You will have some pain from your incisions after your surgery. Your doctor and nurse will ask you about your pain often. You will be given medication to manage your pain as needed. It is important to control your pain so you can cough, breathe deeply, and do your leg exercises.

Will I be able to eat?

Yes, your diet is very important during your recovery because you body needs nutrients to heal. If you have problems with your appetite, tell your nurse so that he or she can arrange for you to see a dietitian.

What exercises should I do while in the hospital?

Your healthcare team at hospital will make recommendations and support you through this process. They will also provide you with precautions. The exact length of time may vary, so speak with your doctor about how long you must follow the precautions.

How you will prepare to leave the hospital?

You will be assigned a case manager who will help you with your discharge planning. Some people go to a short term rehabilitation center after discharge from hospital. Others can go home directly. Everyone’s plan is different. Your medical team will work with you to determine the plan that is best for you. They will help you make arrangements for any equipment, nursing, or rehabilitation you will need after discharge.

After You Leave The Hospital

Your sutures will remain on your incision until your doctor removes them at your first visit after your surgery. You will need to care for your incision at home. Make sure you ask your healthcare team for detailed instructions on your incision care at home.

Ensure your healthcare team advises you on when you can take a shower or a bath.

Ask what activity restrictions you will have after discharge from the hospital, when it will be safe for you to drive, when you can return to work, etc.

Ask your healthcare team if there are any other precautions that you must take.

IF YOU HAVE ANY QUESTION OR CONCERNS, CONTACT A MEMBER OF YOUR HEALTHCARE TEAM.

Good luck with your hip replacement, you’ll be up and back on your feet ready to once again enjoy life to the fullest!