Private or NHS

Hi Philip,

?I had my operation via the NHS, but electively in the local private hospital. The surgeons are the same ones you would see in the NHS hospital. As already commented on, I think it is far less likely for you to be cancelled on the day, unless the surgeon or anaesthetist isn't happy with your health, which could happen in both types of care. It is lovely to have your own room and bathroom, and I think the nurses are a little more available to come when buzzed, as I don't think they have so many patients each. The only downside is, as I have seen as an NHS nurse myself, is if you are unfortunate to suffer a medical / surgical emergency out of hours the emergency cover isn't there. And then you get carted off to the NHS as a 999 anyway. That being said, as an elective patient, hopefully the risks are less as they are operating on a 'well' patient.

Hello Philip

You have received a lot of good pointers and a variety of experiences.  To add mine to the mix, I opted to be seen by a consultant in the private (Nuffield hospital), just down the road from me.  I never had any doubts that I would have my operation there on the NHS as it has a good reputation.  The same surgeon works at the local NHS hospital as well.  I had it done at the age of 63 this year and like you had no experience of hospitals outside of the birth of my son.   I had no known medical problems to worry about. My mother has had 4 of these operations in a huge NHS hospital in southern Hampshire and the nursing care has not always been that good.

I can appreciate that if things go wrong you would have to be transported to the local NHS hospital.  I was told that there was an experienced doctor on call at night, no newly trained.  I had my own room and bathroom.  The food was good, but a bit wasted on me and the staff, from the porter to the nurses and admin staff, were lovely.  When I pressed my bell the nurses or carers came very quickly.  

Only thing I was aware of was that as a private patient I would have received much more after care, but then I got what the NHS was willing to spend on me.  I had 3 physio sessions, each one with a different physio and then I was on my own.  It would have been nice to have seen someone for longer and in fact I'm paying to go back and see someone shortly for advice.  Nothing to do directly with the operation that worked very well and I was back to my office job in 6 weeks.

Good luck.

No idea but wanted to share my experience.

This site was of some help but I felt the need to just give an account of my recovery.  I realize many have health problems that go beyond my routine. I hope this helps with the days ahead. This will be my last entry.

Daily  Chronologue:

I am 80 years old and have had 3 stents installed-no heart attack.  My only other hospital problem has been getting a new shoulder-good health otherwise.  I am doing everything I have been told to do.

Posterior procedure.   

I am using coumadin for blood clots. They take my blood twice a week to monitor the level.  Since coumadin I have only taken 3 BP pills out of a possible twenty. MY BP apparently has been driven down by the coumadin.

Have not used pain meds yet

Day 1 & 2: in hospital 

In the following days cited. I have not taken any pain meds yet 

Day 3: Getting home no problem-just followed instructions-now that the hip was done tryng to understand how to organize the house needed changes. Which chair? How many pillows? What to use to get up out of chair? Where to sleep? These would all change as the days went by. I found out what better or worse means. My wife, always my hero, was awesome.

I did the basic therapy for the day and I felt fine. I am walking fine.

That night we got me into our bed which we thought would work well because it is like a hospital bed. The head and foot can be adjusted. No good. (I simply could not use the leg wedge provided in the hospital. It did not work in the hospital as I wound up in the chair every night.) So we decided to use the couch which would keep me on my back. We put some barriers next to the couch.  I slept for three hours and had to get up. Yes, she was there to help.  Anyway it was somewhat of a fitful night.

Day 4:Thanksgiving-The therapist showed up and we went through some extra exercises. I again felt fine.

Sleeping was about the same. I was sleeping during the day sitting up. I used an airplane pillow. I am still feeling only discomfort-not pain. Eating normal. No problem walking.

Day 5: My leg is swelled-the hip and calf about 11/2 /  2 inches larger. We were concerned because no where were we told to expect swelling. So we called the VNA visiting nurse association.A nurse was dispatched. We began icing and raising the leg.. In the meantime I looked on line and found this site which affirmed that some people had swelling-it was a relief. The nurse affirmed it was onl swelling and not a blood clot. Sleeping improved but still somewhat fitful

Day 6: Therapist shows up and we do some exercises and he also affirms swelling is just trauma.

Sleeping still fitful.Walking good. Struggling with swelling.

Day 7: Sunday       Walking well. Icing leg a lot-keeping elevated as much as possible. Doing exercises.

Struggling with swelling.

Day 8: Therapist showed and we do our workout-helpful with ideas and knowledgeable about other folks problems. Struggling with swelling. Sleeping a little better but still getting up a few times at night. Sleeping during the day a lot.

Nurse took blood.

Day 9: Therapist showed. Walking getting better-went outside for a walk. Still no real pain just limping along.

While I still got up two times I slept much better-a good 8 hours.  Still struggling with swelling but I am winning. This morn I was able to jog my leg off the couch while sitting up.

I have decided to do this chronologue because It might help. I will be glad to answer specific questions. I will do a complete update every few days.

Doctor office called and doubled my coumadin dose.

Day 10:  Still not taking any pain meds or other OTC stuff.  Therapist showed.  Total walking inside and outside for day about ½ hour.  Still struggling with swelling and winning but I am forgetting about the swelling at the top of the hip above my butt. I have to ice that once a week. It seems.  While I feel more power in my leg I still can only lift it about 15-20 degrees above the floor while sitting. I was quite tired at the end of the day. 

Day 11.  Sleep was not great.  Started the day dong ankle pumps, knee presses and hip squeezes before getting up.  I also iced the calf and hip area before rising.  No therapist today. I did exercises and then walked our circle outside my house.  I skipped the BP pillls again because my numbers were in line. Later in the day I did the exercises again and also walked the circle two more times.  Total walking for the day about 25 mins.  

It appears that I now have a very sore op side butt. When I sit it hurts. I get up a lot and put a pillow on the side that does not hurt to ease the pressure.  I am lying down now when icing. It is easier on my buttock. 

At this point I cannot imagine I will have to use pain meds. But I have not eliminated the possibility.  

Doctor called and increased my intake of coumadin again. He wants my blood to show a certain level.

Day 12:  Slept well-only got up once. Did icing and exercises before rising. Completed standup exercises. Went for a walk on our circle. Later walked again on circle.  Then still later did icing lying down and exercises. Again completed standup exercises. Later took a walk on circle.  I wanted to go again but decided to wait another day. Did more icing lying down.  Practiced quite a bit walking around house with cane staying close to things I could grab with free hand.  Did icing and exercises before going to sleep.

Day 13: Sunday.  Slept well-up twice.  Still sleeping only on back-not easy.  Very similar to Day 11.  My op butt is not hurting today. I am still getting up often. Swelling there but not bad. Therapist put me through exercises. 

Day 14: Slept well on back-up once.  Similar to Day 13. No therapist.

Day 15: Slept on back-ok not great.  Icing and exercises before rising. Able to get out of bed by maneuvering my op foot.  Therapist put me though entire exercises and added another where I move my op foot to the rear while standing. Marching exercise is getting better with a higher step. Walked circle 4x. And leg did not feel very much discomfort. Butt is not hurting very much.  Practiced walking with cane and also on my own for short distances.  Kept up icing and did the final icing while laying down ready to sleep.

Day 16: Slept on back-sleep ok Visited Doctor -xrays look good. Stopped iron and vit C pills.  Coumadin untill next Tuesday.

Similar day as before.  But seeing a vast improvement in leg mobility. I can get leg into and out of bed without much effort. Swelling still there but getting more under control. Still practicing with a cane. I am also walking, albeit with a gimp, without anything, but only short distances and again able to grab on if necessary.   Have to be very careful turning.  Getting up and down on chair without any extra effort. Legs showing strength.

Day 17: Tried to sleep with pillow on non op side-fuhgeddaboudit. Still cannot sleep on op side because it feels bulky and uncomfortable-no pain. Any ideas on sleeping would be welcome.

I walk around the house without a cane or walker. I am doing 4 or 5 trips around our circle using only a cane. I need someone with me because I have a tendency to lean left at certain times, My op is on the right leg. I no longer have a bandage and can shower with no problem. Iam just supposed tolet water run over the wound. The wound was glued so there are no stitches or staples.

Day 18: Still sleeping on back. Still icing for swelling. Walking without aid around house with a shuffle and a gimp.. Day  similar to Day 17.  Went to a restaurant for my 80th B’day. I start outpatient therapy on Monday.  The idea is to strengthen  and stabilize my leg. I will go 3x per week-perhaps for 4 weeks. As long as my insurance pays for it no problem. Nevertheless I may go less because of Christmas and New Year. Life goes on.

Day 19: Still sleeping on back. Swelling has reduced a lot-foot swelling the most.  Walked outside with cane but did not need it-using it as a precaution. I can now get up and down with a lot less effort. I still feel stiffness around my knee and calf. My blood pressure which had been lowered by using Coumadin for blood clots has gone back up again and I am using BP meds again based on BP readings

Day 20:Same as 19 only BP went down again

Day 21: Sunday Same as  20 Trying to sleep in bed. Had to get up during night and go back to couch. I am going to start each night in bed.

Day 22:Same as 21 but now going to the mall and walking a mile with 3 rest stops-have cane but not using.  Exercises have expanded to include strengthening.   

Day 23: same as 22 but iy looks like my swelling is mostly in the foot and only slight in calf and thigh. Stiff feeling remains in calf. Last day for coumadin. 2 stops on Mall walk-no cane.

Day 24: I slept the whole night in bed and slept on op side, back and non op side with pillow. Hopefully this will continue. Still some swelling.  I am going to ease up on exercises and space them out more.  I can feel the effect on my leg muscles. I monitor my BP every day about 5x. 1 stop on mall walk-not using cane.

Day 25: Same as Day 24.

Day 26: Same as Day 25.

Day 27: Caught a cold so had to limit activities.  Swelling minimal.  Sleeping in bed but awake at times. BP still not back to my normal-not taking pills consistently. Calf still stiff.

Day 28: Slept through the night sleeping on back, and both hips.  Slight discomfort on op side and doing ok with pillow on non op side. Calf still slightly stiff with foot still swelling. BP inconsistent. Still have cold but better-back to exercises but not walking a lot.The walking I do is near normal.

Good luck>