THR 12 Dec 2016 - Frustrated<

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Charlee

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Hello,
I had and anterior hip replacement of the right hip on 12 Dec 16. I had a few complications which might add to the reason I swelled up so much and bruised excessively. (for me)

The top of the femur chipped when hammering in the hip stem. so my surgeon put metal straps around the femur to prevent it from splitting. I bruised and swelled considerably. The bruising moved across my belly to my other hip and down the leg along the outside of the thigh and calf to the ankle. I have had most of my pain along the route of the bruising, in the thigh, knee, calf and now the ankle where the bruise is still visible. It is very tender to the touch and painful with walking, exercising etc. These are my areas of pain for the most part.

I was doing very well walking, exercising etc almost pain-free and barely needing a cane... until I tweaked my hip and had a real set back. Swelling came back (in the knee) and the pain intensified both in the bruised areas and now the hip and buttocks. X-Ray showed nothing wrong and OS didn't think too much of it. I had to go back on hydrocodone to be able to sleep. It seems as though I am now taking forever to get ahead.

I'm now unable to put full weight on the hip. PT concentrates on massaging the areas rather than exercises and this was helping however it seems to be getting more painful. I think I had another little tweak last night and couldn't sleep again due to hip pain & down the leg.

Any suggestions. I thought I'd be cane free by now. Frustrated and blue!
 
Congratulations on that new hip! When you say you "tweaked" your hip what exactly did you do?

First, back to basics. At just over one month out of THR - and given your complications I think you are expecting way too much. You are in recovery and will not be off pain meds or cane free until that hip is ready. Trying to push this will only result in what you are seeing - a setback. Far better to take the slow and steady approach coupled with loads of patience.

Are you icing and elevating? That will help reduce the swelling that is causing you pain.

I'll give you a bit of reading to do. These articles might give you a bit of insight as to what this journey entails. Be sure and read the articles on How long does healing take and Activity progression. I think you will find you are right on track with this recovery.
First are the BoneSmart mantras ....
- rest, elevate, ice and take your pain meds by the clock
- if it hurts, don't do it and don't allow anyone - especially a physiotherapist - to do it to you
- if your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again
- if you won't die if it's not done, don't do it
- never stand when you can sit, never sit when you can lie down, never stay awake when you can go to sleep!
- be active as much as you need to be but not more than is necessary, meaning so much that you end up being in pain, exhausted or desperate to sit down or lay down!

Pain management and the pain chart
Healing: how long does it take?
Chart representation of THR recovery
Dislocation risk and 90 degree rule
Energy drain for THRs
Pain and swelling control: elevation is the key
Activity progression for THRs
Home physio (PT)
Post op blues is a reality - be prepared for it
Myth busting: on getting addicted to pain meds
Sleep deprivation is pretty much inevitable - but what causes it?
 
@Charlee, No tweaking allowed! Gosh, but your surgery sounds like it was complicated. Don't be in such a hurry to be ambulatory. You need to rest up and let your body heal. Congrats on a successful surgery and I hope you have a successful recovery too!
 
The bruising moved across my belly to my other hip and down the leg along the outside of the thigh and calf to the ankle. I have had most of my pain along the route of the bruising, in the thigh, knee, calf and now the ankle where the bruise is still visible. It is very tender to the touch and painful with walking, exercising etc
That does sound pretty extensive but not out of the way. You should take a look at this Bruising after surgery. I understand that witch-hazel is very helpful in taking the soreness out of bruising. I've tried it and it really does work.

And btw, one BIG tip: Hips actually don't need any exercise to get better. They do a pretty good job of it all on their own if given half a chance. Trouble is, people don't give them a chance and end up with all sorts of aches and pains and sore spots. All they need is the best therapy which is walking and even then not to excess. So I suggest you quit the exercising and allow yourself to get some relief from all this.

I'd also like to give you some more structured advice but it will require me getting you to answer some questions for me. Would you like me to do that?
 
@Jaycey by tweaking I twisted and bent a bit at the same time sending a shooting burning, stinging pain from buttocks straight down the leg. Yesterday was much less painful than the first time but the first time really set me back. I also tweaked it by falling asleep with it at a 30% angle across my husband who was massaging it. When I woke from the pain it was in from that position I pulled it back and sent a pain down my leg which kept me up all night even on max hydrocodone and Tramadol, ice and elevation.

That was the first time I ever had pain in the hip joint and it has been there since which was a week and a half after surgery and now has lasted about the same. Last night's small tweak has re-wakened that hip pain.

I am always icing and elevating when not walking. have a great orthopedic foam bed that raises feet and head separately. Love the bed.

I will read your suggested reading and get back to you.

The bruising is still a stripe from hip down to my ankle not real dark but still a shadow.
 
@Charlee You tagged Jaycey but you left a space between the @ and her name. Plus you never spelled her name correctly (small j instead of an upper case). You'll always know if you've done it correctly or not because after you've posted it, it should have been turned into a link. Then you know she (or whoever you tagged) got the alert. If there is no link in it, then it's not been done correctly. I edited it for you, btw
 
@Josephine
Sure I'll answer any questions and will get some Witch Hazel as soon as I can get to the store. We're in quite a winter storm right now so no hurry to get out of the house.
I looked at the bruising and mine wasn't any worse than those photos except I looked as though I had a black bikini on at about 4 days that quickly changed colors and moved downward crazy. My blood pressure was in the low 60 over 40 coming out of surgery & for 2 days and finally popped over 100 the 3rd day and was able to go home. I also received several bags of saline and 2 units of blood to try to bring up my BP. This all may have contributed to my swelling.
I was under the impression that with the anterior approach I should be walking unassisted in a month.
A bit of background. I'm not over weight and pretty active up until Sept. When I hiked the hip beyond the point of return. I do tend to not heal rapidly I've had doctors tell me it's because I have lupus others say it doesn't have anything to do with it. Who knows. I had a partial tear of my Achilles tendon that took 3 years to fully heal. PT helped a bit just took it's time. I'm on 200mg of Celebrex twice a day for the Lupus. Eat very healthy, don't smoke or take drugs.(ever) TMI??? LOL
 
Hi @Charlee, sorry to hear of this setback. You were progressing so well, but any inadvertent wrong movements can really set off an 'episode' which requires rest, rest, rest. I am sure most members would identify with this - myself included. Some of the movements that set us back are accidental - just not remaining aware/mindful enough, others are from overdoing it/doing something silly. Other set backs are caused by gung-ho PTs :-( Twisting and bending in your case sounds like a recipe for disaster - please avoid!

To let you know you are not alone - like you, I had 2 units of blood and saline drip after surgery, and had very, very low BP in hospital. In surgery my BP was up and down (resulted in abandoning the bilateral THR, so an unfortunate but necessary outcome. Just had one done). Like you, I had massive swelling. My GP said the tissues become saturated due to the blood loss, and this can be responsible for excess swelling. Also lymph glands are affected.

Elevate on three sloping pillows as shown on this web site. I didn't elevate correctly, nor did I ice (joined the forum too late for this pith advice!). I had bruising in very unexpected places too.

Keep caring for yourself well, and baby that new hip with its special metal ribbon.

PS: also keep working on that 'tag' lol - Josephine won't get your reply as you left a gap between the @ and the name. A tip, when you finish your post, double check what you've written to make sure the tag is blue, then you know it's an active link.
 
I was under the impression that with the anterior approach I should be walking unassisted in a month
All marketing hype. Recovery is not dependent on the approach used. More on how you react to the procedure.

Jo will be along soon with her list of questions for you.
 
@Charlee hi there and:welome: to the forum. I know how frustrated you are feeling. I also thought and expected too much from my surgery and thought I wasn't progressing like the hospital and their leaflets said. Then I found this forum which was a godsend. It took me ages to get my head round all the rest and baby steps and length of recovery but don't be discouraged. I see by your post that you had a bad start but things can only get better from now on. I too have lupus and know how tiring life can be with it so you are battling not only energy drain from the op but also from lupus. Rest, rest, rest and follow the mantras on here and you will soon be feeling much better. Good luck and keep smiling - the only way forward from now on is one of success.:dancy:
 
I had an anterior, saw a friend sail through the Recovery and seemed normal in a week.

I thought I'd be back to normal in a week or two - wrong. My surgery was on Oct. 19. I've seen tremendous improvement. But I'm still extremely careful how I move (except when. my 100 lb. dog chased a Chihuahua who ran into my house and I had to run and grab him before he killed her).

The worst of the pain is gone. I can sit in a chair more comfortably and am not as stiff when I stand up. I walk normally without any aides (most of the time). The Recovery is definitely taking longer than I anticipated, but this web site has been incredible, with its information, support, and camaraderie. I'm sure you're doing just fine. Just be patient, and no more tweaking. Be overly cautious how you move for a while. Have a great weekend. Barbara


Sent from my iPhone using BoneSmart Forum
 
I twisted and bent a bit at the same time sending a shooting burning, stinging pain from buttocks straight down the leg.
I know your surgeon probably did not give you any restrictions. However new hips do not like any twisting movements. And bending can also cause discomfort. Just move a bit slower than usual for now. Your hip will tell you when you go too far - it already has. And to make sure you are following the mantras.

This will all ease soon. I predict marked improvement will be seen in the next 2 weeks.
 
@Sunny girl Thanks for the encouragement. You are 4 weeks ahead of me. How are you doing? Did you have your pain in the bruised tissue as well? I fortunately was told to ice from day one and I have. MY PT taped my thigh and it alleviated the swelling remarkably fast. My PT's have been very gentle and are always telling me to be patient so I guess I'm lucky that way.
 
@Cas How are you doing? I know I can't keep comparing myself to others, however hearing that others are doing well makes me hopeful. Thanks for reaching out.
 
@baclectic Thanks. I expected to be that one better in a week. I had a 70 year old friend like that. Then 8 weeks later did the other hip. Better right away. So I know I would be too.
Wow sounds like you had a hard go of it too. Hip #2 soon? Hopefully they will be prepared for your BP.
Glad you saved the Chihuahua and hope you didn't dislocate your hip.
 
My other hip looked fine in the X-ray. Hopefully it'll stay that way. Didn't hurt my hip grabbing my stubborn dog - I managed to put (throw) him outside. And found the owner of the Chihuahua, who was tearfully thrilled she'd gotten her baby back. I really forgot I had a bad hip and just reacted. Was extremely lucky. But I'm so sick of this Recovery process. It's long enough!!! :)

The real bad pain seems to have gone, replaced by a nagging ache. What really makes it rough is I can't seem to sleep more than an hour or two at a time. (I think I have the same type bed as yours. It's certainly come in handy). I'm single so don't have the luxury of someone fetching me things. I've asked Miles, my Afghan Hound, but he refuses to bring me a glass of water.

Hope you had a pleasant day. I'm working hard at accepting what is, and finding that balance between not over-doing and doing enough. Try to be patient. It's a Recovery Process. I had horrible bruising too. It was scary looking. Hope you had a good day and have a very comfortable night. Hugs - Barbara


Sent from my iPhone using BoneSmart Forum
 
@Charlee Morning ( at least it's morning here ). Thanks for asking how I am. I'm post op 10 weeks on Thursday and it's been an interesting ride!!! LOL! It really is a roller coaster and sometimes you may feel weepy and not think you are getting anywhere - that's normal we all feel like that to start with! It really does get better and better I promise. I had the flu and it put my recovery back a bit but the hip is doing brill at the moment. It' amazing how much you will improve week by week. Never sit and fret if you have any worries - come on here and someone will be here for you to help in any way we can. Be kind to yourself, rest, take baby steps - you'll get there. Have a lovely day or night as the case may be. can never get my head round the time difference LOL ! By the way Love your dog. What is he?
 
Sure I'll answer any questions
Sorry, I took a day off yesterday! Here they are ....

I'd like to ask you some questions if you don't mind, and it would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are

1. what approach did you have for your surgery? Anterior, posterior, lateral? You can look here to see the various types THR approaches or incisions

2. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine)

3. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

4. are you icing your painful area at all? If so, how often and for how long?

5. are you elevating your leg. If so how often and for how long?

6. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

7. are you doing any exercises at home? If so what and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)

Exercises done at home
- how many sessions you do each day
- enter exercise by name then number of repetitions of each
etc., etc.

Anything done at PT
- how many times a week
- enter exercise by name then number of repetitions of each
etc., etc.
 
:friends:@Charlee morning just checking in to see how you are and how you're feeling. Hope all is well with you - keep us updated.
 
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