From the Frying Pan to the Fire

[CanukTriMom]

Hi everyone! I have been reading the hip forums with great interest as I will be having a Left THR via the anterior method on Sep 16th. Due to severe OA caused by a sports injury 20 years ago, I require a new hip yet I am getting nervous as the time approaches. My life since April has been quite a ride as I was diagnosed with a very rare form of cancer in the small intestine wherein the cure was surgery. I had been training for 9 months for the Ironman 70.3 here in Canada at Mont Tremblant when I was told after a routine colonoscopy that a white spot amidst a sea of really pink tissue, not a bump or polyp, was biopsied.

Long story short, I kept training with this hanging over my head and my hip was holding its own with lots of exercise and medication. I received a call on the Friday before Mothers Day that I had a very rare cancer tumour NET ( neuroendicrine tumour) and that I was scheduled to see surgeon, oncologist and needed to bunch of tests to see if it spread (didn't spread to any major organs). So I had that successful operation on June 26th, 4 days after my Iron Man Race and began a very quiet home recovery.

Up until that point, my hip was bearable but for the recovery time of 6 weeks after surgery I couldn't exercise, use my foam roller, lift anything.....so my hip muscles atrophied causing increased pain and a pronounced limp. I was cleared to go back to training two weeks ago and I did but everyday the pain is there not going away and now I don't know how I am going to go with out my meds for three days before the surgery....not working out makes my hip worse.....so I am just counting the days.

I guess the recovery from the cancer surgery is in the back of my mind as I found it difficult and depressing to do nothing....I am tired of the recovery process and afraid It will be worse this time around on the mental aspect....I had a very bad reaction to the Dilaudid they gave me for pain after the other surgery....Does anyone have any suggestions as to what pain meds I could take? Also I have to do a surgical scrub at home before I go to the hospital? Has anybody else done this?

Cheryl

Happy Labour Day Weekend to my fellow Canadians!


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[PuppyLove]

@CanukTriMom I'm so sorry to hear about your cancer experience. You will receive a lot of support on this forum- feel free to ask questions, vent... whatever you need. The surgical scrub is very common as hospitals are worried about infection rates. I see it as an added precaution, which I don't mind as I will do whatever I can to prevent an infection. My hip recovery went very well and you should be able to take short walks and go to physical therapy within a few weeks. Movement is encouraged from the day of surgery, though you won't be doing heavy training for a while. You will notice that the pain you have now will be gone immediately after surgery, though you will need to discuss pain meds with your OS before surgery. Pain control is SO important! Hang in there!

 

[CanukTriMom]

@PuppyLove

Thanks for your support! I am definitely not going to be doing any heavy training for awhile. As long as I can swim after the incision heals, I will be so happy. Do you recommend a cold therapy machine for recovery? A
Also how early do I need to carry out the disinfecting scrub? What did you use to elevate your hip while recovering. I have seen those big wedges that keep your knee straight and leg in the air while you are sitting. I also read all of the information the moderator of the site sends to those waiting hip surgery. These are all questions surgeons don't answer. We had a tutorial class at the hospital Joint Assessment Centre but there items they didn't mention that others have posted on this forum that sound like great ideas.

Cheryl

 

[PuppyLove]

I love the pool for therapy. My PT gave me some specific exercises to do (PT didn't have aquatic therapy but I have a pool).
I did not have a cold therapy machine. I asked for ice in the hospital, and the ice packs leaked and soaked my bed, so I gave up for those two days. I made some big (11 inch x 17 inch) ice packs from rubbing alcohol, water, and my Foodsaver. They stayed cold for hours and did not leak. I made two and switched them out in the freezer.

You should be given instructions for the scrub. I had a chlorhexidine scrub that had to be done the night before surgery, then put on clean pajamas and climb into clean sheets, then another scrub the morning of surgery, put on clean clothes, then when I got to pre-op area they gave me scrubbing cloths to use before I put hospital gown on.

I did not have a wedge. I have a power recliner that puts me almost flat, and I added pillows under my lower legs for elevation. I slept in the recliner for a few weeks. In bed I tried to use pillows to elevate, but the recliner was easier for me. I was blessed to not have any swelling.

I don't think surgeons give enough pre-op info. I went to the hospital pre-op class, which was helpful in learning what I would do for PT while there and what equipment would be provided. I don't think they give enough practical information. Some of my must-haves (I'm having bilateral TKR on Sept. 17, so I'm stocking again! ) are :
Sunsweet prunes (start munching them the day after surgery to prevent constipation), shower bench/stool and long handled scrubber, several long handled grabbers (my fav is Unger brand on Amazon.com), extension cord for hospital to charge phone and Ipad (I couldn't reach the outlets), same extension cord next to my recliner when home (I also plugged my table lamp into ext. cord so I wouldn't have to stretch to turn the light on and off- just plugged/unplugged it), basket or bag to hang on walker to carry things. I'm also going to get a tray for my walker so I can carry food and drinks from the kitchen without help- I saw them at Walgreens pharmacy and on Amazon). I still have kids at home, so I premade freezer meals that could be heated up, as well as individual servings for when I was hungry.

I came home two days after surgery and went straight to outpatient PT the next week. PT came to my home for an evaluation but I wasn't impressed and felt I would need more. Some people do great with home PT.

Sorry for such a long entry- let me know if you have any other questions!

 

[PuppyLove]

@CanukTriMom when is your surgery? You can add it to your signature section.

 

[Poppet]

Welcome @CanukTriMom - Would you add a signature to your user profile please, it helps us tremendously. Many thanks

The instructions to do this are in here How to create a signature

 

[HerbM]

...I will be having a Left THR via the anterior method on Sep 16th.
...I had been training for 9 months for the Ironman
...I had that successful operation on June 26th, 4 days after my Iron Man Race

.....my hip was bearable but for the recovery time of 6 weeks after surgery I couldn't exercise, use my foam roller, lift anything
.....so my hip muscles atrophied causing increased pain and a pronounced limp.
...pain is there not going away and now I don't know how I am going to go with out my meds for three days before the surgery

That is really tough about the cancer but you are a TOUGH LADY, IRON MANY @ 50 WITH that AND with a hip needing replacement so you are GOING TO BE A CHAMP AGAIN.

So happy to know you had a good operation for the NET.

My hip too had atrophied a bit -- not that you could SEE it, but I couldn't pick my knee up off the floor due as much to lack of strength as to pain. I couldn't do a straight leg lift; I could kick ANYTHING not even doggy toys on the floor.

I have already answered some of your questions directly to me elsewhere the forum but one thing to emphasis is to consider GETTING A CAN now if you haven't already.

1. It will help you manage up until surgery
2. It will allow you to train to use it (remember generally, left problem means right hand cane)
3. You will want it anyway after surgery to get rid or walker or crutches (both of which you may never need -- I didn't; the walker has a bag of DOG FOOD on the seat and has sat in the kitchen during my ENTIRE 11 days of recovery. It will be there when I do my knees however.)

We cannot and should not tell you what pain meds to try, but I can tell you how *I* made it through and make one suggestion:

They took my diclofenac away from me 1 week prior and this was the ONLY NSAID that helped MY HIP (about 70% reduction when sleeping, sitting, driving or otherwise not moving the leg.) After two days, the pain was BAD for me again (as I had already discovered when trying to skip it in the previous couple of months.)

They did let me have Tylenol which did NOT TOUCH my hip pain. I only took it because some surgeons want to pre-load with it or some other drugs. I took it on orders, not for the benefit -- there were none FOR ME.

[One surgeon wanted to pre-load Celebrex the other (who did the actual surgery) didn't ALLOW me to have the Celebrex, so I never found out if it would have helped.]

So here is the SUGGESTION: Call you doctor (or the PA or the nurse) IMMEDIATELY you are able and ask for some help.

Maybe there isn't anything since you have trouble with dilaudid but TELL THEM and have THE DOC figure out what YOU can do.

For me this was (early) narco: Tramadol, might have been Hydrocodone if I'd complained more but YOUR SURGEON will likely HELP YOU but only if YOU ASK.

Tramadol was plenty good enough FOR ME (but I couldn't use it and drive etc.) and the only bad time after that was on the (narco free) drive to the hospital.

Cheer up IF YOU CAN because you are in GREAT SHAPE, YOUNG (by THR standards at least , are gathering your supplies and strength, and have a GREAT MENTAL TOUGHNESS which will see you through this NO MATTER what fate throws at you.

This is probably going to BE EASY -- well if you compare it to training for and running an IRON MAN -- it might even be actually easy like mine but you must just DEAL.

No one can run your Iron Man for you so you just prepared and saw it through. My guess is you are better prepared ALREADY than 99.9% of those going to a THR.

 

[HerbM]

@PuppyLove

1. ...As long as I can swim after the incision heals, I will be so happy.
   
2. ...Do you recommend a cold therapy machine for recovery?
3. ...Also how early do I need to carry out the disinfecting scrub?
   
4. ...What did you use to elevate your hip while recovering. ...I also read all of the information the moderator of the site sends
5. ....These are all questions surgeons don't answer

Cheryl

1. Surgeon will tell you (ASK) about bathing swimming, mine said no bathing then at 6 Day post op said IF I used a special waterproof dressing (for 2 MORE weeks) I could swim
2. Cold therapy IF you can feed it enough ice -- didn't help me much, but next time (BTKR) we're getting an ice machine
3. Ask surgeon (or his PA/nurse) or the pre-op education folks -- two different surgeons told me 3 days ahead,
and "night before and morning of" (I am an over-achiever so I did both My leg was virtually sterile on arrival at hospital (I also taped it off with sterile draping. Overkill but you know, over-achiever)
4. Re-check the suggested articles -- one of them has SPECIFICS (foot and knee above hip & body if I read it correctly) and show various ways to do it both incorrectly and correctly.
5. Bug the surgeon(s) until you get an answer (or PA/nurse)

I will post more (in my thread) or send you my complete instructions for the waterproof bandage (that finally worked) if you wish.

 

[CanukTriMom]

Thanks Herb!

Yes please post the waterproof dressing information. I had to laugh at your draping your leg to go to the hospital, I have OCD and that is definitely something I would do even on my OCD meds!

I looked over the articles showing what type of elevation and it showed a wedge with a groove in up wherein the toes would be above your heart.


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[CanukTriMom]

@herb

I have made my checklist based on your responses as well as @PuppyLove's.

Number one on the list is to get the issue of the pain meds straightened out. I will call the OS on Tuesday.

I purchased my Hurry Cane this am at Bed, Bath and Beyond. I am not going to bother with the crutches as I would rather use my core muscles and a cane. Actually I inherited my Mother in Laws deluxe walker with horn, seat, basket and streamers on the handles! She passed in October and I brought it to the house to donate to the Hospital but then I started on the THR road!

I have been scouring the internet for a ice machine on sale but if I don't find it, I will purchase a couple more large sort gel freezer packs that we will use next summer in the coolers for summer BBQs. I just really liked the idea of laying in my recliner with continual cold packs not needing to be replaced every hour.

Cheryl



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[Jamie]

When using an ice machine, don't use cube ice. Instead freeze water in cool whip container or regular small water bottles (depending on the size of the water housing) and use those. A couple of frozen water bottles would give me 6-8 hours on the machine.

 

[CanukTriMom]

@Jamie

Thanks, I have written that in my PreOp notebook, in case I find one on sale.

Cheryl

 

[HerbM]

Ice machine: Might be different in Canada but since my doctor wrote the Rx my insurance company paid for it, and the hospital provided it (I think).

I did have to ask because the surgeon doesn't habitually write the Rx with a THR, only TKR. He was happy to do it.

Somehow the Durable Medical Equipment supplier (DME) talked me into paying $50 for the non-standard "Hip Pad"; I still claim it should have come with ONE PAD either knee, hip, or generic but gave up asking finally. (My surgery was pretty much free; my knees are going to be free.)

We didn't have a lot of room in the freezer with 4 of those big ice packs in there and I never felt like starting the process so we bought one 10 lb bag of ice, and I only used the machine through "2 loads of ice" (Carol used some of the 10 lb ice for ice tea etc. so there were like 2 full runs in that 10 lb bag)

Crutches/Walker: I too inherited my mother-in-law's walker (my wife brought it back after her mother passed). Used it a couple of times during the EARLY days of the hip gone bad, back in April or May, to roll around the back yard with the dogs safely and comfortably.

I had PLANNED to use the walker or TWO hurricanes. The walker was never needed and I lost one of the hurricanes pre-op (left it somewhere of course.) I figured if crutches were necessary and useful they would give me some.

Post-op I didn't REQUIRE the assistance, but the cane was much better than not having it, and I am still carrying it most of the time today on Day 12 Post-Op. Much of the time I am literally "just carrying it" but it's really helpful, mostly due to MY KNEES, to walk:

• Longer distances
• Longer times
• Faster
• With less of a limp
• With Confidence

HurryCane, One caution: It is safer overall than a ordinary cane because when you hit a wet spot on hard floors (our puppies frequently dribble in the kitchen etc.) a regular cane will SLIP BADLY sometimes. Also for uneven or insecure terrain outside it's more stable.

However, IF you put your same-side FOOT on one of the (3) little feet and lift the cane to take another step you MIGHT disconnect the cane segments, and then it isn't STIFF, nothing but the bungee cord holding it together.

Were one to place WEIGHT on it for that next step there can be NOTHING THERE.

Just knowing about this likely removes 99% of the risk, but it is NOT ZERO, be careful; when you think about it in tight spaces (e.g., going out doors with two GIANT puppies trying to 'help you') then it is best to consciously turn the 3 feet so that 2 of then are on the inside and not available to step on easily.

Waterproof dress info is posted in my THR Post Op thread.

OCD/Overachiever Scrubbed and Draped: I literally had sterile scrubbed myself first with Betadyne sponge brushes (like in surgery scrub room) AND with Hibiclens (one surgeons instructions suggested this was better than Betadyne) except I was using just tap water from our fairly clean city water.

Yes, I actually BOUGHT a box of those little scrub brushes with bristle on one side and betadyne infused sponges on the other (also has a little plastic fingernail cleaner in each one). I am NOT a germaphobe but everything convinced me that *MY* biggest risk was infection.

Since the surgeons/hospital told me to do what seemed like a stupid task (pre-scrub) since they needed to do it again in the OR, I decided if I am going to do this stupid thing then I am going to do it completed. (This is the first time I've admitted or written the details of this little "Prep Ritual".

THEN, I figured why scrub it followed by traipsing through a HOSPITAL of all places -- anyone in town with a disease takes it TO THE HOSPITAL.

So I had also bought (yes it took prior planning) some 24" x 12" drapes and also a box of surgical/hospital paper tape rolls (which I have gotten a LOT of use from post-op that actually makes sense.

I had scrubbed from below my breast/chest line because in one of the operations videos (on DASH Academy IIRC) this was recommended.

I taped the drape around and down the right side of my body (my wife helped wind tape around me) and down my thigh to cover what would be the incision area and beyond (24" total.)

The pre-op nurse sure gave me a funny look when she asked me to disrobe and WIPE with this pre-op wipe they give patience (not a scrub for some kind of rub on disinfectant, and not sterile according to package; I probably got LESS sterile doing that but didn't argue). Had to tear off the tape and drape (it was paper).

Ok, I was being a little OCD or as I like to call it THOROUGH (but I didn't get an infection. )

You don't need to do all that (I think.)

Power Recliner/Chair: It is REALLY nice and I will be using it some 12-16 hours a day for the next 10+ years.

It allows me to pick ANY position (which was actually more important PRE-OP when the HIP HURT so much). If I get tired or cramped, I can make small (or large) infinite adjustments to the foot stool, back, upper back/neck, and lumbar support. It was expensive but considering long term daily usage "I'm worth it."

I sprung for the 4 position (foot stool, back, upper back/neck, and lumbar support) control (there are 5 sets of up/down buttons, but one is a stool/back combo and doesn't do anything you can't do with the separate SPECIFIC button sets.)

BTW: I LOVE this chair. Most will likely never NEED it but it is comfortable.

 

[Poppet]

Peri prosthetic infection is something we all face - it is an unknown!

 

[CanukTriMom]

Well I am keeping busy by working out everyday --- it is the biggest way for me to relieve stress. Today I had a great 2km open water swim in the September sunshine! Then I went to the gym and did some strength training for my core and arranged to out my membership on hold for a couple of months. Only 7 days, I cannot believe it.....I am so excited to get this done! Whether the recovery is good, bad or ugly....I am ready.

Later



Cheryl

 

[HerbM]

I am excited for you as well.


Swim -- September -- Canada??? My gosh, the THR is going to be nothing for you woman.

 

[MajorHeidi]

@HerbM @CanukTriMom
I wish you all the best!
I was reading your thread and read about Herb and his hibiclens use against infection.
I was diagnosed with colonized MRSA in my nose. Ugh.
I had to take antibiotic ointment in the nose, and was given quadruple hibiclens application.
So, on the day before surgery, every six hours I did a total shower with hair shampoo all with hibiclens.
I cannot even imagine a time the next day when I was 'cleaner' ever.
It worked well......

You will do fine!

 

[CanukTriMom]

@HerbM, @MajorHeidi

Thanks for all your support! Herb.....I usually swim until October outside but wearing a wetsuit in Sept most definitely!



Cheryl

 

[HerbM]

Wetsuit, oh, ok. (I used to be a commerical diver so that is a bit different -- more sane. )

 

[CanukTriMom]

@Jamie

I revived my Ossur cold therapy machine and I wanted to double check how you used the water bottles versus the ice in the machine. My machine calls for water and ice and instead I want to use waster and your idea of the frozen water bottles. When you say 5 or 6 hrs of usage for you machine...is that the length of time the bottles stayed frozen? If you could let me know that would be great!



Cheryl