Mr Joshua Jacob

Written by a NHS patient at Ashford Hospital

Very friendly and easy to talk to.

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Written by a NHS patient at Ashford Hospital

Please find below my reflections on having a bilateral total hip replacement on 18th Jan 2024. I can say without any doubt that this operation was essential for me and having both hips replaced at the same time was an excellent option. Prior to the operation For several years I had noticed that my hips were losing mobility. As I teach Kung Fu, my ability to carry out moves and stretches was becoming more difficult. 7 years ago, I had a disc herniation in the lower back and thought that this loss of flexibility was due to that injury. An osteopath informed me that my hips were wearing and gave me exercises to help with mobility. As well as teaching martial arts for 35 years, I have been in education for 30 years. It was normal for me to take 18000 steps a day as part of my duties as an Assistant Headteacher. The exercises did help for some time. Gradually I started to experience pain in the hips at the end of the day or if I had walked for a period of time. It became so bad that by April 2023 I was experiencing a lot of pain in the hips and had lost a lot of mobility. I had to modify how I carried out my work and was unable to walk very far. I also became unable to teach martial arts. I also limped a lot and people were noting that I was in pain. I became unable to sleep in a bed and slept on a reclining sofa for nearly a year. Each week the pain and the mobility were getting worse, and sleeping was becoming difficult. In October 2023 I met Mr Jacob, and he explained that the x-ray showed there was severe osteoarthritis in both hips. Due to my age and fitness, having both hips replaced simultaneously seemed the best option. This would mean less recovery time overall and less tome away from work. As both hips needed replacement it would have meant that if one was replaced the other hip would still be causing pain. We discussed that the initial few weeks would be more challenging, but it was agreed that the simultaneous replacement was the best option. Operation and Post-Op As a patient the operation was very stress and pain free. The anaesthetist came to see me and decided that even though the operation would be 4 hours as both hips were to be replaced, an epidural and sedation was the best option. This worked well from a patient view. The only pain was the local anaesthetic injection for the epidural. I was woken up halfway through the operation as planned and as I was sedated this was a stress-free experience. After the operation I moved from recovery to the ECU. Even though there were 4 beds I was the only patient with 2 nurses monitoring me. On the evening of 18th Jan, I had incidence of my heart rate dropping. This was manged well in the unit. This happened again the next morning and seemed to happen both times when I was given the drug intravenously to prevent internal bleeding. By the afternoon this stopped, and I was sent back to the normal ward in the late afternoon. With the medications given pain was well controlled. I was able to move around on crutches and go to the toilet. A member of the Physio department saw me and showed me how to use crutches and stairs etc. I was kept in for one more night to check all was ok. On Saturday 20th Jan I was discharged in the afternoon. I had another session with the physiotherapist who was surprised that I had both hips replaced. I was given medications (codeine, paracetamol and ibuprofen) and discharged. The car journey home was painful due to having both sides operated on. When I arrived home, I was in considerable pain and could not sit in chairs and had to stay in bed. As the medication I was given in hospital wore off the pain became considerable, and I became quite distressed. I called the ward and was informed I could take 60mg of codeine rather than 30mg as prescribed. The pain then become more manageable. A week after the operation I went to my GP practice nurse as instructed and in her room had a drop in BP again. She said this was due to exhaustion and the effect of the operation. Even though my wife took me in the car, I found the journey incredible difficult. The first two weeks were challenging as there was a lot of pain and it was difficult to sit up. I managed to walk around and carry out the physio exercises as outlined in the documentation. I had an appointment with Rachael (Physiotherapist), and she helped me to understand that a double replacement was different to a single and that the documentation given to me was not always relevant to me. She adapted some of the exercises and this helped progress. I saw her again after two weeks and there had been good progress. As she was an experienced Physio, she was able to give good advice and support. Today 13th March, my walking as improved and progress is increasing. Feedback Points: • The bilateral operation was an excellent option with much less recovery time overall. • As a patient the operation and the care in the ECU were excellent. • Was the pain relief prescribed on discharge sufficient? • Do Physio and medical staff need to be made aware of the differences in patients who have a bilateral replacement as they are very rare. • It would have been useful to have had more information on what to expect in the first few weeks post-op. The documentation and timescales for recovery are different for a bilateral. • The physio sessions and advice from Rachael were informative and effective. She helped me understand my recovery process. I am very grateful to Mr Jacob and the team as this operation will allow me to return to a normal life. Christian Parker

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Written by a NHS patient at Ashford Hospital

I had advanced arthritis in my right hip. I was virtually unable to walk, I could not play golf or even put on my shoes. Mr Jacob mentioned it was one of the worst hips he had seen. Today I am walking just under a mile. I plan to start driving soon and playing golf. I am delighted with my new hip.

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Written by a NHS patient at Ashford Hospital

My hip was replaced 6 weeks ago. I can now walk twice the distance I used to before the operation. My pain has disappeared. I have discarded the crutches after 3 weeks.

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Written by a NHS patient at Ashford Hospital

Mr Jacob did my right hip replacement and it has changed my life. I walked 7 miles on Boxing day. I am now on his list for a left hip replacement.

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