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THR 15 year old has first new hip

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My "cohort" in 2013 was big on probiotics for digestive regulation. I was absolutely miserable with constipation, which for 5 days was worse than the pain level! We also took various OTC laxatives. We would then hold a party--all preserved right here on Bonesmart for the world to see!-- every time somebody's plumbing began working :lol:
But yogurt or kefir might be palatable to him, and is certainly easy to digest. Just be sure of those live cultures that it should have.
The nice thing for him? In a short time he will look back on all this as in a dream-- pretty sure it's the narcotics that do that to me. You, of course, will painfully remember every second of it :/


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Still in tough shape. Still very constipated. We are trying to adjust the meds to get him decent pain control with out the horrible constipation. Cutting the 12 hr OxyContin and going to try and just give him one or two 5mg Oxycodone with two 500mg tylenols every 4 hours with senokot.

He is just so wiped out. He did sleep from 2am thru 9am when I woke him. It's so hard to wake him when I see him comfortable but he's so immobile in bed I can't let him just lie in drug induced stupor for hours and hours. His body aches all over when he wakes from not be able to really move in bed.

After very briefly getting up trying to use commode with very limited success, eating some yogurt and taking the above meds, he took just few steps out of his room to a chair. But it was just too much so back in bed now sleeping. Tried to get him to do few of the PT exercises in bed but he's just too exhausted. This is so hard to know if I have to push him a little to move just a little more or if I should let him sleep more.

Seems like catch 22, can't move because of constipation, and exhaustion from the narcotics and without moving constipation gets worse, pain goes up, and then has to take more narcotics.

So I'm just sitting here watching him sleep helpless to help him.


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So sorry for all of his troubles and pain! I will share with you what I was advised to use to prevent constipation after my THR, which was instituted while I was in the hospital from day one, and I used as long as I was on opioids, and I never had one moment's problem with constipation. I used a dose of Miralax (the generic version) every morning, and took two stool softeners every night. I was taking two Norco 10's every 4 hours for 4 weeks, and then tapered off the 5th week. No constipation, no unnecessary pain. Maybe a regimen like this would help him.

As for exhaustion in the early weeks, I had it big-time, even though those other conditions were well-controlled. Have you read the article that was in the #10 post on your thread called Energy drain for THRs? It explains how this is the way it is for all of us, to one degree or another.
 
Dad, you ARE helping him! :) :) :)
Is he able to keep water down? There is also something they call a Brown Cow, which I think is equal parts prune juice and milk of magnesia.
I might consider calling the OS and/or his PCP to see what there might be. Also if you can get him to do some deep breathing, that can help flush the GA out of his system. I know I'm going to be way more conscientious about that for my upcoming left hip than I was the first time round.
I know you feel helpless, but your presence is good for him :)


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Here is some information about constipation, as you scroll down you will find many recipes, see what he likes and make him that one for him.
Constipation and stool softeners
Hope the "Poop Fairy" visits your house soon.
 
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I don't think I had a bowel movement for 7 or 8 days after the surgery. The stool softeners, prunes, pears, and water helped me. His case sounds very severe. I'm concerned that he's aching all over. Is he a very sensitive person? It just sounds like his reaction has been extreme. I feel so badly for both of you.

I'm glad to hear that he is getting more sleep. That is encouraging. The stupor worries me, though. I feel like something is off with his pain medication. I hope the Tylenol will work, and that he can eat and use the bathroom. The drugs in the system from this surgery are intense. I hope he's drinking enough water.

Please don't expect him to do any PT. He might be able to do ankle pumps in bed.

Josephine says not to take laxatives. There's an article in the library. The stool softeners work. Did they give him those in the hospital?
 
Thanks to all for their concern and thoughtful advice. It looks like he mag have turned a corner I say cautiously in order not to jinx it.

After my last post I woke him and he was able to go some. He also is markedly more alert. He was able to get up and walk with walker a little and was able to sit and watch a couple movies this afternoon. He ate a good lunch and dinner and just seems much much better thank God.

Seems like the key was to cut out the 12 hour OxyContin and just stick with Oxycodone and Tylenol as needed which is about every 3 - 4 hours. With each I give him another senocot and that may be starting to do the trick. If not I plan to try the recipes recommended.


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Oh, thank goodness. He sounded over medicated to me. I'm relieved to hear that he is more alert. What fantastic news that he ate a good lunch and dinner. That should make all the difference. Phew!

The Oxycodone and Tylenol should manage his pain, from what you're saying. He may start sleeping longer and be able to stretch out the time between doses. That's what usually happens.

Thanks for posting. I was starting to worry that something was seriously wrong. He shouldn't be in a stupor. That really concerned me when you wrote that in your post. I hope you are doing okay. I have a feeling he is going to improve at a rapid pace. Congratulations.
 
Ow wow I can't tell you how happy your post made me!! Movies! Food! Alertness!
Just a note, in case you aren't already seeing to it-- while he's sitting up, make sure his feet are sticking out in front of him, not down on the floor. Some elevation is better than none :) and if he falls asleep during the movie, so much the better! "Never stay awake if you can be asleep" part of the mantras ;) i had my best naps with Netflix running. I'm sure I missed half a season of the show I was watching by napping through it zzzzzz


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Two steps forward one step back. I knew I probably spoke to soon about how much better he was.

I can't seem to get it right. After doing well yesterday afternoon the plan was to stick with just the shorter acting Oxys with Tylenol. I planed to wake him to take it. But at 1:30 we were both so tired and he seemed peaceful I asked him and he said to wait but he was half asleep. I didn't want him to have to take it because he's still constipated and I didn't want him to be zonked out again. So we skipped it. He slept until 7 then as he first started to move he was in a lot of pain. So I gave him 2 of the Oxy (he was told he could take 1-2 as need every 3 hours, 5mg tabs) and 2 Tylenol as well as a naprosen. That took care of the pain but really wiped him out. His pain starting going up again so at 11 gave him 1 Oxy. That put him right back in bed.

I've read on here about the expected post op exhaustion so I don't know how much of his fatigue is that versus me screwing up by giving too much Oxy. He can't just lay in place for hours or he'll stiffen up but then again one of your mantras is sleep as much as you can. So I'm yet again conflicted and confused.


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Your son is only 5 days out of surgery. I had been home only one day at that point. What really worked for me to cope in the first few weeks were these rules.

Rule #1, Never skip or delay pain meds, even if asleep. I would wake up to take them. Take on the schedule given by OS. (If your son is allowed extra, I'd give those to him on a schedule now, and for awhile, as this is the time of greatest pain and discomfort.)
Rule #2, Never skip miralax and stool softeners to prevent constipation.
Rule #3, Only walk when necessary, i.e., to get to bathroom and dinner table and back to bed.
Rule #4, Don't sit for very long with legs down (caused pain and swelling). I sat in bed while awake and sleeping, with my legs out in front of me. I made numerous movements while in the bed trying to get comfortable, so I was rarely motionless, except while sleeping.
Rule #5, Sleep whenever possible, day or night. I couldn't sleep lying down, so I had to sleep sitting up in bed, and couldn't sleep much longer than 1 - 1 ½ hours at a stretch, so I did that 5 or so times a day.
Rule #6, Don't worry about feeling groggy, or out of it, as I knew that would pass, and it did.
 
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@tbatt9 Like Krista said your son is in the very early stages of recovery. My own experience for the first 10 days was sleep, potty, food, meds...repeat. Meds are important to keep the pain down and allow some mobility. He also need lots of fluids for his constipation. I feel badly for him and I hope he can get past this part relatively soon.
 
You waited a long time between doses and got behind the pain. It's much harder to catch up once that happens. It also worries me when you say that the doctor said her could take two of the Percoset. (if I understood correctly.) It's a very strong drug. I feel it's much better to take one, (with food) on schedule than to sleep several hours, and then take two. I'm not trying to accuse you, but the meds on time are really important, even if you feel like you're doing well. He needs to sleep. That's how you heal. It doesn't mean something's wrong. This is a long recovery.

The mantas here really work. They are tried and true.
 
Recovery is always a process of discovery! I'm not sure you need worry about him "freezing up" while in bed. The narcotics make one pretty loosey-goosey by themselves.
Constipation is horrendous, and unfortunately going once means only that you went once. It will be something to treat the entire time you take narcotics. Maybe his gut hasn't really woken up yet.
I have only one thing to add to @Krista 's list-- all activities except bathroom need to be accompanied by that old faithful, ice packs. Hate to beat a dead horse, but those meds really do have to be on the clock whether asleep or not. I'm tickled that he can sleep for 4 hours straight at day 6, really! That milestone took me a couple of months to stabilize, I think! My best sleep came in daytime naps, and two hours was a long one. But 10 two-hour naps is 20 hrs a day, which is about what we need so soon post-op :)
Perhaps best not to schedule his day into sleep/wake/should do this or that. Just take it as it comes. Body is totally confused, but will return to normal after being pampered for a few weeks.


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Good point, @zauberflöte, about the icing. I didn't find Bonesmart until I was 6 months post-op, so I didn't know about the magic of ice, and I never used it during my recovery from THR. I have a new surgery coming up in a month, and I definitely will be icing as much as I can this time! And I heartily agree about not scheduling sleep, but to just sleep whenever you can for as long as you can, with the exception of being wakened for pain meds.
 
I thought I'd put my two cents worth in. @Krista and @zauberflöte gave you great ideas. What worked for me was taking 10 Mg's of Percocet every four to six hours. Like stated above, the secret is not skipping a dose and then trying to catch up. As far as constipation, I found 400 Mg's (twice a day) of magnesium (okay @Zelda, I know you're laughing right now) and one Colace pill did the trick (I actually had to stop the Colace because the magnesium worked so well). I know once you get the constipation worked out, his pain levels will improve (I've seen it happen over and over again here on BS). Hope this helps some. :-)
 
@Cynthia777 magnesium? Hmm.. I already take nearly that much anyway! How wonderful it worked-- I guess that's somehow related to whatever milk of magnesia (gag!) has in it.
@tbatt9 how is our patient doing? And his caregivers? Are they taking care of themselves? :)


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@zauberflöte
You got it, the "mag" in magnesia is magnesium. I also take a prescription magnesium (I think it's sulfate), but it's a little different than the regular supplement and doesn't work as well for for constipation.
 
So staying on schedule with the pain meds has made big difference. Every 4 hours around clock 5 mg Oxy, 500 mg Tylenol, naproxen twice a day and stool softener with each Oxy along with me mixing Miralax in his water.

He ate today. Watched tv and even got his little brother off the PlayStation to play his favorite game for a little. Just took shower for first time now eating popcorn and watching tv. These little things represent huge progress. Thank you all for your concern and great advice.

One of the things that was said helped me a lot. I was freaking out and it was only day 5 post op. I just needed to adjust my expectations and follow the mantras. Meds around clock, let him rest and sleep when tired, and use ice packs.

Now I hope he can start to gradually get back some degree of independence getting in/out of bed and in bathroom as he starts to move a little better.

Another question for the gang: how long did you wear TED hose? Just took them off for first time to shower and had hard time getting them back on. Seemed to have stretched out some. Maybe I need to get him another pair.


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