Revision THR A new year and new hope: revision for loosened THR

[Mojo333]

Happy one month @prairienut

Tonight, we just celebrated my son's brand-new BA in Mathematics summa cum laude.

I know you are beyond proud!

Hope you're weekend is happy and continued good wishes for healing!

 

[prairienut]

I was going to wait for the 5-week mark to give a recovery update, bit I couldn't wait to tell you all that I have mostly ditched my one crutch while in the house. I am walking quite smoothly with no assistance. An exciting moment for me! I still feel a little raw on the surgical side but the only pain is from the incision. I'm not quite ready to dance in the streets, but maybe by summer! Still use one crutch for stairs and when going out of the house.

I have noticed that I no longer have to help my operated leg into the car. I read somewhere in this forum that this was called the "car sign" and indicated some sort of soft tissue weakness. In my case, I have had this "sign" for years, and it was caused by my loose femoral stem. Happy to bid good bye to that annoying detail.

Tomorrow is my first outpatient PT session. I will be sure to do nothing that jeopardizes my recovery. I'll report back on how that goes.

 

[Mojo333]

You sound very well!
So Happy for you.
Do take care tomorrow, um...today!

 

[Carriemay60]

Great news, you are doing very well in your recovery!

 

[SurreyGirl]

That is so good to hear you are finally getting there. You must feel great. Have been following your progress and frustration and so pleased for you!

 

[prairienut]

Today's first outpatient PT session went very well. The therapist comes highly recommended and is very knowledgeable. (Among the locals, she is a legend when it comes to treating intractable back pain problems.) She didn't push anything too hard but showed me a few things I can do to start to improve balance and strengthen muscles needed to walk up stairs. She agrees that PT should not hurt. I did some very slow cycling for a few minutes, for range of motion not for stamina. She reminded me it was OK to flex the hip UP TO 90 degrees, just not beyond that. I was being so cautious, I was not flexing anywhere near 90 degrees. She thinks I will need only a few weeks of sessions to get me on my way. She is a big believer in elevating and icing. When I told her I had stopped icing, she said I should continue icing as long as there was any swelling at all. So I need to break out my giant bag of frozen peas tonight....

 

[Layla]

Happy One Month Anniversary! (a tad belated)
Sounds like you have a reasonable PT. Glad your session went well.
I hope you have a good week as you continue to heal.
@prairienut

 

[Mojo333]

glad all went well.
I've is a great anti-inflammatory and pain reliever and was a Major tool in my recovery.
Hope today is a Good Day

 

[Klassy]

Hi @prairienut . I saw you had kindly popped by my thread so came by catch your story. I’ve been avoiding any thread with “revision” in the title because the last thing I wanted to think about in my recovery phase was the prospect of needing revision, particularly after only 10 years. But it is indeed reassuring to read how well your recovery is going and to know that if it does come to it, a revision is not such a dreadful thing to go through.

I was fascinated by your mention of 300 year old houses, not how I picture USA. I have just googled Hurley. What a beautiful place! Seems like a really nice community, the annual Stone House day looks like fun.

May you continue to go from strength to strength. Isn’t it great to be counted no longer among the “Ruptured and Crippled” LOL!

 

[prairienut]

Hi @Klassy, Yes, I was fascinated by your detailed description of ringing a "plain course of Grandsire Doubles". I did in fact read to the end of your post and learned something!

Hurley, NY, is an old Dutch colonial village founded in 1662 but was under Dutch rule (New Netherland) for only a couple of years. Soon the English swooped in and declared it their colony. The Dutch, ever practical and self-sufficient even at that early date, decided it wasn't worth fighting and dying just for the privilege of reporting to one distant and despotic monarch vs. another. So it was a bloodless coup. The Hurley Dutch kept their customs and language for more than two centuries after that. The village, originally named Nieuw Dorp (New Village) was renamed Hurley by the first English governor after Hurley, Berkshire, which was the homeland of the Barons Lovelace. The annual Stone House Day is when the private homeowners open up their houses for public tours. Lots of fun.

I am at 5-1/2 weeks post-op. I have reached a plateau of sorts but not a bad place to spend a little time. Still mostly using no walking aids in the house, but lightly using a cane when going out. I can go downstairs with alternating feet with some help from the handrail. Upstairs is still one at a time, leading with my unoperated side. Getting in and out of the car is becoming easier and easier. I have enough confidence now to take the dogs for short walks on the flat part of the yard. I had a resurgence of a sort of stinging pain around incision area yesterday that is intermittent. I assume/hope it is a temporary effect. The incision looks dry and normal with just a slight pinkish cast in the skin around it. I had tried wearing a pair of "real" jeans yesterday which are a little snugger and not as stretchy as my athletic pants. I wonder if that added to my discomfort. Back to the baggy athletic pants and break out the giant bag of frozen peas again!

Next post-op appointment with the surgeon is on Feb. 20. Looking forward to perhaps dropping some restrictions. My son will be driving me there as it is a two-hour drive, and I do not want to go it alone. He is such a blessing.

 

[Klassy]

Thank you @prairienut, I have learned something too! Those Dutch were wise. How interesting that they kept their own culture for so long.

If you have plateaued you have reached a pretty good level to do it at. Though I hope it will just be a pause before progress resumes. Downstairs with alternating feet is impressive. I am still non alternating in both directions. My physio wasn’t concerned, but said she wouldn’t discharge me till I could alternate going upstairs. I said up, but not down? She said that’s right, down is harder and would be expected to come later. So you are a contrarian!

 

[prairienut]

@Klassy, And the English were wise to allow the Dutch settlers to continue to live their lives virtually unchanged. Made for a smooth takeover. Cool story: The Dutch were such prolific bakers, flooding the local market with baked goods, that the colonial government had to put limits on what they could sell. They shipped out so much cheese that people talked about the "pot cheese mines of Hurley."

I just talked to my surgeon's PA about the new intermittent incision pain. Hubby had the fun of taking a photo of the incision to send to her. She saw it was a slightly pink around the edges but it generally looked fine, and I should keep an eye on it for the next few days. That gives me some peace of mind. Worrying about infection comes with the territory I guess.

 

[Carriemay60]

I think fretting over every little thing is part of the territory unfortunately but then if we don't keep tabs on ourselves, something could go very amiss so much better to be vigilant.

I have found your stories of Hurley quite interesting and from the photos I an find of your little corner of NY, so quaint! It is refreshing to see a bit of interesting trivia such as yours and that of @Klassy and the bells. Takes the minds off the grind of aches and pains.

 

[prairienut]

Today was my 6-week post-op appointment with Dr. Waddell. I drove the two hours by myself and did not use cane or crutch! He was happy with the incision, my mobility, and the x-ray so won't see me again until June at 6 months out. I still have the 90 degree restriction but he said I could start to "cheat" a little by flexing a little past 90 degrees. I just am not supposed to flex the hips and twist at the same time. I told him I could still not sleep on either side because it causes achiness in the operated side. I have to sleep on my back always. He thought that was normal post-op incision pain for only 6 weeks out. I asked about the fastener for the cerclage cable on the femur. He showed me in the x-ray a smooth, low-profile connector on the backside of the femur, NOT a big knob on the side where it could interfere with tendons and other tissues.

I asked him again what he thought caused the aseptic loosening. The possible causes are number 1, bad luck, and at a distant second, an undersized prosthesis. It is also possible there was some biological reason preventing or interfering with bone ingrowth. Out of pure curiosity, I asked him how he decides to use cemented vs. uncemented prostheses. He said virtually all revisions now are uncemented. Primary THRs can use cemented or uncemented implants, but usually uncemented. My OS knows a surgeon at HSS who does 90% of his primary THRs cemented so the frequency varies with the surgeon. For the bone cement to work effectively, it requires the porous or honeycomb part of the bone to be intact so it can take on the cement and create a solid bond. In a revision, the bone of the femur has lost a good portion of that porosity and so is not a good candidate for using bone cement. There is a risk factor with using bone cement that I had never heard of before. Forcing the cement into the honeycomb of the bone pushes the fatty components of the bone out where they can enter the bloodstream. This has the potential of causing a pulmonary embolism. May not be a high risk, but it's there.

I'm happy with this revision so far. It feels so great to go out of the house without a crutch or cane. I no longer deserve to use the handicapped parking tag. I have my third outpatient PT session tomorrow and am looking forward to it. This therapist really knows her stuff and helps me understand which muscles are weak and what I can do to strengthen them until they are in balance with the unoperated side.

 

[sansabosa]

Great news from you
Impressed how you could drive for two hours

 

[Mojo333]

Great to hear how far you have come...
Hope your weekend is sweet, @prarienut!

 

[Layla]

Hi @prairienut
Great update, very informative also, interesting too! You're doing so well!
Thanks for sharing your OS's opinions and responses to your questions.
I hope you have a nice weekend!

 

[prairienut]

Eight-week update: Any last vestige of being pampered disappeared last week when I rushed hubby to the ER for an intestinal blockage! He is now at Albany Medical Center awaiting surgery! I am now making the daily one-hour commute to visit him while looking after the house, dogs, grounds, and rental units, not to mention making progress on my Winslow Homer exhibit. I cannot lean on my son any more because he just left on a 4-week trip to Australia to attend my nephew's wedding. All this is actually the best therapy ever for my hip. Mostly, I'm not even thinking about it. I still remember I have a replaced hip when going upstairs and when trying to sleep on my operated side. I'm so pleased that I'm recovered enough to give hubby the attention he needs right now. Thank you HHS and Dr. Waddell, and of course Bonesmart for the advice and emotional support.

 

[Jaycey]

Gosh - I hope Hubby is OK @prairienut ! That's certainly a lot of activity to suddenly have to take on. Please ask for help if you need it.

 

[prairienut]

@Jaycey Hubby's prognosis is good. They at first thought the blocking mass could be cancer but labs were negative. Whew! Still it is a serious situation for him even though a not quite complete blockage. Surgery scheduled Thursday. I am getting great help from my exhibit committee. My museum buddies have been bringing by ready-to-eat food which is a perfect gift. I am boarding the dogs as needed. I lined up neighbors to help with snow removal. The fish and the birds, I can handle easily. My hip is amazingly free of pain and feels more natural than the original replacement ever did. Another first in my recovery was taking the dogs for their morning walk up the grassy ramp in our back yard to the meadow. Felt soooo good to be out walking in the fresh air again. Have to admit it does scare me that the revision femoral implant is so long but I think that is one of the reasons it is working well so far. I mean if God forbid I need another revision, the new implant would have to be even longer! I saw another thread where a new short femoral implant had been used. It looks like a child's toy compared to what I am walking around with.