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THR 15 year old has first new hip

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It takes a while to get movement back. I remember trying to move my leg forward while sitting on day three and it just sat there refusing to twitch - I could do it the next day without any problem! Other movements took longer to return but did all come back.
 
I had some other kind of number that must have been applied to the joint/tissues before they closed or injected before I woke up. I think my leg moved as though I were 20 for a while.
There is a simple movement we all call ankle pumps which aids circulation in the legs. Flexing at the ankle, point toes down towards bed, then up as far as the ankle will let it go, repeat ad finitum. It becomes an unconscious habit. On your long drive home, can you plan to stop every hour for him to stretch his legs and walk a few steps? If your car is wide and his height allows, could he sit sideways on the back seat? To keep legs elevated and straight.
Once the anaesthesia flushes out of his system, he'll start to feel human. Rest, rest, drink lots of water in tiny sips if nauseated, get some high quality protein in his stomach. Nurse mom (me!) says, ice cream is wonderfully restorative.


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So the plan will be to head home tomorrow. But he's had a bit of a setback pain wise tonight and is worried about going home. His leg weakness improved and he was able to walk with a walker about 30 feet down the hall. Later though after sitting in chair for couple hours he was getting uncomfortable so he tried to shift his weight and he had big spike in pain. One of the difficulties he has is his IV is in the wrist making it hard for him to brace himself when shifting positions. His hope is that once that comes out it'll be easier. But after that pain spike it took a lot out of him getting from chair to bed and he's worried about being able to get home tomorrow. After they pull the catheter out that's giving him the numbing medicine I'm concerned about if he'll be able to manage the pain. I guess we just will have to see how it goes in the morning.



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He may need to stay another day. It's important to get the pain medications adjusted before you leave. It's traumatic. I had an emotional breakdown the second day, then I was okay. It's good just to go slowly, and not rush things. You don't want him to be worried about going home. It's kind of overwhelming to do the PT in the hospital. It will get easier. Sometimes they try to make you walk to far...you can always refuse and do less. I did the bare minimum, and explained to them why.
 
I agree, getting those pain meds right is #1 on agenda before home. If you're able to tell them you'd like him to stay below a 3, that would be a good way to approach it.
Wonder why he sits up in a chair? Can't elevate, can't sleep. I know sleeping was the only thing I wanted to do after exercise.
Mom says, don't let them be the boss of him. ;)


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Well now it's decidedly unclear if we will be discharged today or not. He had the nerve block catheter removed and his pain increased. Apparently that is a relatively new technique that supplies a local anesthesia thru a catheter in the back directly to the nerves effecting the hip area. The surgeon came in this morning and explained that they only fairly recently started using this for the immediate post op period and that it's a good idea to get him off it and accustomed to just the oral pain meds. But as he was getting increased pain they just gave him IV Demerol. That has made him lightheaded. He just asked me how he was going to be able to go home if it hurt that bad and he can't get the IV meds. Tried to reassure him that it will improve and that the meds they ordered for him at home (OxyContin ever 12 hrs and Oxycodone as needed up to every 3 hours) will take care if it. The surgeon also just added Naperson which they say is Alieve for its anti inflammatory properties as well as the benefit of it thinning his blood a little as a form of DVT prophylaxis.

I hope he can handle trying to walk some when PT gets here shortly.

The surgeon did warn us that in his experience with very young patients for some reason their inflammatory response is greater than older people and therefore to expect an initial rough patch, but to also expect a fairly rapid improvement thereafter.

So the journey continues. Lots of steps forward, a couple back, hopefully more progress today.




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Hi, @tbatt9! It's good that your son will remain in the hospital until they have the pain issue properly taken care of. I just wanted to warn you, though, about the 12 hour OxyContin. If you google any words like "12 hour OxyContin problem doesn't work for 12 hours", you will come up with a multitude of articles talking about the statements last May about how it really works more like an 8 hour pain med for many people. It was reported in every single news outlet that I know of. People have been complaining for years about how it doesn't work for 12 hours. I would check it out, if I were you, before that is what is prescribed for him at home. I would hate for him to have to suffer unnecessarily. Why take the chance that he is one of the many for whom it doesn't work? Then you would have to be playing catch up with the other med.

If I were you, I would ask the doctor if he could take something else, that you take every 4 or 6 hours. Even if he has to take it in the middle of the night, at least his pain will be managed better. For example, I was on two oxycodone 10's every 4 hours for the first three weeks, and it worked well to keep me from the worst of the pain. I weaned down from there for the next few weeks, and then was fine.

I just shudder thinking of your son suffering for no reason.
 
I was thinking about your son last night. It's so important to find the right pain medicines for his system before you leave. In the hospital, my pain was a three or less most of the time. After PT, it would go up to a six or seven. I found the oxy, (percoset) gave me immediate relief. I alternated that with tramadol. It's such an individual thing. They have a whole pharmacy there, and I'm sure they will find what works for him so that he experiences relief. The correct drug will numb the area, like novocaine.

When you are afraid, or anxious, your pain increases greatly. The nerves are affected. Deep breathing helps a lot. I had to inhale in healing light, and exhale out fear and pain. They wanted me to sit in a chair, and I really felt like that was crazy. I just wanted to lay down and ice. No movement. I did the ankle pumps, they didn't hurt, but I felt like a wounded animal. Very protective of my hips and wanting to sort of hide and sleep.

I think he will improve; it's probably just too soon. It's a lot of pressure when they want you to walk and do PT. I remember thinking that standing was okay, but I wanted to wait a few days to walk any further than to the bathroom. It felt wrong to me to do laps around the hospital. I told my surgeon, too. (quietly.) He agreed that some people walk too far after this surgery.

Please tell your son that it gets better. Maybe you could drive partway home, and then stay in a motel? I think the main thing is that he doesn't feel rushed and pushed. I did. An extra night or two can make a huge difference in confidence and strength. Good food helps, too. Keep us posted.
 
Well one thing he has learned is he really doesn't like how IV Demerol makes him feel. He said why do people like to take drugs? Because this stinks. I'm hoping that wears off shortly and he can start trying to move some. It really made him lightheaded and tired. I think he's done with the IV pain meds and will work on just the Oxys orally.

Thanks for the tips I will talk to the Dr about the dosing and frequency.


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Wise boy, your son! I'm glad you're starting oral route meds. He will feel quite nauseated from them unless he eats something solid with them. Peanut butter, nuts, ice cream (the real thing) a glass of whole milk with a banana, something to quiet that response, which can be pretty unpleasant and surprising if you're not prepared.
I was given celebrex twice a day for a month plus 2 tabs oxycodone/tylenol 5/325 every 4 hours for the first two days, then every 6 hours from then on. I wore ice, and spent very little time actually sitting up in a chair for two weeks. I sat sideways in the couch so my legs would be semi elevated at all times. Wearing, as I cannot emphasize often enough, ice :)
Ice literally numbs the area, and with anterior you don't have to sit on it!
Returning to the meds I took, I was able easily to titrate my dosage because the pills were scored for splitting. Rather than wait longer between what quickly became a sickeningly large dose of narcotic, I'd take, say, 1 1/2 oxy+1/2 of a 325 tylenol on the same every-6-hours schedule. I can't tolerate narcotics for long!
Then as I tapered over the weeks I'd just subtract percoset (the oxycodone I had) one-half pill at a time, putting in an equivalent amount of tylenol. The night dose remained highest longest-- I'd theoretically be asleep so not nauseated. Theoretical sleep is what you get at night for quite some time. Real sleep happens during the frequent nap attacks!
I aimed for, and was extremely fortunate to mostly achieve, pain of 1-2 almost all the time.
I think of your son frequently-- does he know he's got all these extra mamas and grandmas rooting for him? :) :)



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I just thought of something-- to a 15yr old, an hour is subjectively maybe 4 times longer than it would be to me. So to your son, a day is worth more than half my week! Pretty sobering. It WILL get better, and I'm betting that by the end of next week you may have to sit on him to keep him from horsing around too much! :)


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Stopping in to send Matthew well wishes and encouragement. I've had both hips replaced and at five months (first THR) and about 10 weeks (second THR), I'm feeling really great. Once past this first week or so, things should be a lot better (I had the anterior approach as well). I was sleeping on my side about a week after surgery. Lots of trips to the bathroom in the middle of the night (may be due to age, not sure). I purchased a bedside commode, but never used it (if the bathroom is quite a distance from him, it might be useful). If he can get those pain meds right (taking them right on schedule) and uses ice 24/7, hopefully he won't experience too much pain at all.
 
As someone who had hip surgery (sfce) at 12 and then again at 17(pins removed). I can assure you, in the beginning all of it is very taxing to a young persons system. Sending best wishes for this rough patch to pass quickly and on to a speedy recovery.:)
 
I sure hope he is feeling some relief soon. I will be praying for Matthew's quick recovery.
 
We made it home last night. He was discharged around 3:30 and we got home after stopping couple times by 9. He handled car ride very well. A little awkward getting in/out but he did fine. He even was able to walk a little with his walker when we stopped. But he had big set back when we got home.

I was so consumed with worry about whether to have him have the surgery or not I didn't give enough thought to how he would recover at home. Walking from the van into the house really took a toll on him. As we traveled he took his Oxycodone on time but I screwed up by forgetting to give him the 12 hour OxyContin when we got home. Also screwed up by thinking he could try sitting on couch. That was too low for him. Compounded all these errors by trying to help him sit on toilet which was also way too low just like some on here predicted. His pain went off the chart. It was horrible to have to see him like that especially because of my poor judgments. Called the on call dr and was told ok to give him more Oxycodone which settled him down.

The only thing I did right thank God was to stop at drug store and buy him an elevated bed side 3 in 1 commode which he has had to use all night due to initially constipation followed by several bouts of the opposite. The poor kid was mortified that he needed my help with all that.

He's now back on the pain med schedule and is resting fairly comfortably in bed. Hopefully his
stomach settles down.




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I was so afraid that would happen. I really relied on that raised toilet, bedside commode, grab bars and shower seat, and walker. They made me feel safe. All of the aids make a huge difference. I'm glad he made it home. The commode at bedside will give him the reassurance that he only has to walk a few steps with the walker to get there.

Many doctors are making light of this surgery, but they don't know how it feels. I'm so sorry that his pain escalated. That oxy was like a miracle drug for me. If I didn't take it at first, I paid for it with severe pain. I'm glad he is resting comfortably now. I hope he can eat some nutritious food, and get some sleep.

Poor guy. Hopefully the worst is over. That must have been really hard for you. It's stressful. There's lots to remember. It helps to write down the meds as you take them. The restrictions are protective.

Prunes and pears help greatly with the constipation. I think he will do much better now, as long as he rests and doesn't push. It will probably take some time to recover from the trip and the trauma of what happened.
 
Thanks for the input. Last night was real rough. What I'm debating know is do I wake him to give him his next 3 hr dose of the Oxycodone or let him rest more. At some point he'll need to get up and move some and I don't want to have a repeat of last night so I think I should keep him taking it every 3 hours with the OxyContin ever 12. But on other side he needs to be able to eat and get his stomach right.

Next time I won't allow him to leave hospital so soon I guess.


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I feel for you and him! I don't know what you decided re waking him but YES you must wake him by the clock, or he will get behind, and then have to catch up, which is no fun. My time limit was six hours, and I set my alarm for that, so that I would keep up with my pain meds.
I'm glad you had a decent trip home! And don't worry about messing up, we all do it. I know exactly how you feel. :) :) :)


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I did wake him and will keep him on schedule. It's just that I'm not sure giving Oxycodone every three hours on top of the OxyContin every 12 is too much. He and I are both scared about having recurrence of last night but he's still on and off the commode with constipation and is so wiped out with fatigue, not sure if just due to everything or if that's from the narcotics.


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Poor thing. It constipated me, too. I got relief from lots of prunes, pears, fruits and vegetables, and water. I was taking one Percoset every four hours. I had the Tramadol every four hours, too. So I was taking something every two hours. I definitely needed them. I think it's good that you're waking him up. Is the ice helping? That makes a huge difference.

Had he been able to keep any food down? That's such a shame that the meds are making him sick. Some people can take Tylenol. My friend had to do that because she threw up constantly. But, she wasn't in pain, just stiff.

The fatigue is normal. He's had a very difficult time, and had to endure a lot of stress and trauma. You're exhausted even with an easy recovery. I hope that he starts to feel better and maybe you can let him sleep an extra hour between doses. It's a tricky balance. I'm saying prayers for both of you. This must be very difficult as a parent.

Time will help, but the first few days are the worst.
 
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