Question
All the info I read on hip replacement surgery is usually geared towards senior citizens, so my questions are rarely, if ever, addressed.  I am a 45 year old woman scheduled for THR in two weeks.  I am wondering about how I am going to handle having my period for up to 10 days after surgery, since I am also pre-menapausal, and can never depend on my periods being regular.  The dr's don't want me on birthcontrol to stop my periods, so I was just curious how other women have handled this situation.  Also, what about sex after surgery.  I'm not quite "sick" of my husband yet, (ha ha) and we have a healthy sex life.  How long must we wait after surgery to resume normal relations?  Is there a position that will be advisable after THR?  I can't find any answers or anyone it seems that is my age to discuss these issues with.  Thank you.

Answer
Hi Lisa

Wonderful questions and I feel honored that you would choose me to answer them for you.

First of all, I had my period many times during hip revision surgery.  You might want to wear a pad on a regular basis, if not only for your period, but to catch any leaks of urine when you are in bed, and then when your period comes, you can switch to a tampon for the 10 days you are bleeding.  I don't know if you are going to have help when you come home, but if you have to use a bedpan, I'd keep a roll of toilet paper near the bed to wrap up the items I used for my period.  Many personal assistants are very aware these things happen and are more than willing to help. You should be given a visiting nurse for a few weeks and also a physical therapist should be given to you to come to your home.  If you have no help, you might want to look into agencies in your area who can give you names of people who can come help you wash in the morning and precook some meals and do laundry.

One of my revisions was a very hard surgery, and I had to have my husband clean me after I had a bowel movement.  Yes, it's embarrassing, and it's humiliating, but people who love you understand this is a very hard time for you.

Also be aware that you will be on pain meds after surgery and if you use the bathroom always use a high toilet seat extension so that you can have bars to hold on to.  If you have to twist to clean yourself or pull out the tampon, be very aware that your balance might be off a bit and don't hesitate to ask for help.  Believe me, if you fall, that's worse case scenario than just asking for help and being a tiny bit embarrassed for a few minutes.  I fell off a toilet due to the large amounts of pain meds I was getting and had to have my mother call EMS to get me up again.

Normally you can wait 6-8 weeks for actual intercourse sex.   You can certainly do other things until the six weeks is up, but I don't know how interested you'll actually be.  If you are interested before the time is up, you're a better woman than I was!  LOL  

Be very aware of your positions though.  Do not ever put yourself on top of your husband unless you are sitting up.  If you go on top, and you bend over to even kiss him, you are risking dislocation.  I dislocated during sex in that position, and believe me, that's one position I never used again.  The last thing you want to do is dislocate during sex, it's a hell of a thing to explain to the EMT when they have to take you to the hospital in an ambulance.

You can use the missionary position, you can use a side position or you can go on all fours or bend over the bed and he can enter your vagina from behind.  Just be careful that you do not bend your hip more than 90 degrees or you don't rotate your knees inward, that is a sure fire way to dislocate. Try not to feel awkward discussing this with your doctor, believe me, they have heard more crazy things than you will ask about sex.  If you feel funny, ask your physical therapist what your options are.

The one other suggestion I have for you, is this.  Because you are in perimenopause, you might want to look at going on a short term antidepressant until surgery is over.  The hardest thing about this surgery is that for six weeks to eight weeks, you are completely dependent on others to assist you in your daily tasks.  That is really a hard thing for women to go through since we tend to "do it all".  I always go on short term Celexa for the surgery and then as my life returns to normal I wean off of it.  The reason I suggest talking to your doctor about that is because it takes about a week or so for the drug to work at an optimum level, and if you start it during your recuperation, you will have to wait for it to take effect.

Other suggestions would be to cook meals in advance and freeze them for when you are in bed and unable to cook and to get yourself reading material or books on tape.  I'm a voracious reader but I find when I am recuperating from surgery, I cannot find the patience to read long books due to the pain meds.

Please feel free to email me with any other questions and I wish you the best of luck with your surgery.  You'll do fine.

Sharon Davis

Your doctor will talk to you about dislocations, and the ways to avoid them and I would suggest taking those suggestions very seriously.  If you dislocate, you will up the chances of the hip failing.  Your first 3 months are the ones that you have to be very careful about.  Always be sure your shoulders and hips are in alignment and don't twist your body around fast.