Poppet
Nutritional Advisor
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THR 17 days Post-op and Getting There...
- Thread starter Dkp
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OP
OP
Dkp
junior member
Thanks, Poppet. I needed that hug. 
MajorHeidi
big-cheese
OP
OP
Dkp
junior member
I'm frustrated! I've been doing SO well. I'm 11 weeks post surgery and was feeling almost back to normal. No pain, sleeping well, done with the cane and barely limping, good energy. Feeling great.
Nothing has changed, but for the last 2 weeks, I feel my recovery has been slipping--I've started feeling some pain again in the groin and hip. I'm having a little swelling around the scar--just enough that it feels tight (and just slightly warm by night time). It's not inflamed and the incision is healed up--just a scar at this point. And I'm starting to have more trouble lifting the leg to dress and get in the car. And it's difficult to get comfortable to sleep again. I'm not doing anything different! The only thing I can identify is that my knee (somewhat affected by OA and with erosion and bone spurs on the patella) is starting to bother me again--sometimes painful and sometimes just uncomfortable as I feel stuff moving around and catching inside the joint. My PT says the knee seems to twist a little when I walk, so maybe that's causing it? She recommended that I walk only for daily function until it's resolved.
I did get an appt with my OS's PA this Wednesday and hope he'll have a solution. It's not awful, but I'm definitely losing ground. I'm worried and frustrated. Meanwhile, I'm resting, icing, have discontinued PT until it's resolved (except for some gentle stretching that provides some relief) and taking pain meds when it gets to be too uncomfortable.
Has anyone else experienced this at this stage? Advice anyone?
LTHR 5/29/2014
RTHR 9/20/2011
Nothing has changed, but for the last 2 weeks, I feel my recovery has been slipping--I've started feeling some pain again in the groin and hip. I'm having a little swelling around the scar--just enough that it feels tight (and just slightly warm by night time). It's not inflamed and the incision is healed up--just a scar at this point. And I'm starting to have more trouble lifting the leg to dress and get in the car. And it's difficult to get comfortable to sleep again. I'm not doing anything different! The only thing I can identify is that my knee (somewhat affected by OA and with erosion and bone spurs on the patella) is starting to bother me again--sometimes painful and sometimes just uncomfortable as I feel stuff moving around and catching inside the joint. My PT says the knee seems to twist a little when I walk, so maybe that's causing it? She recommended that I walk only for daily function until it's resolved.
I did get an appt with my OS's PA this Wednesday and hope he'll have a solution. It's not awful, but I'm definitely losing ground. I'm worried and frustrated. Meanwhile, I'm resting, icing, have discontinued PT until it's resolved (except for some gentle stretching that provides some relief) and taking pain meds when it gets to be too uncomfortable.
Has anyone else experienced this at this stage? Advice anyone?
LTHR 5/29/2014
RTHR 9/20/2011
fulafoto
supremo
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Hoppy Nanny
big-cheese
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@Dkp. Sorry you are feeling that your recovery is slipping. I do believe that once we start to feel better we take back a lot of the chores, etc without noticing and end up overdoing it...and the muscles sure do let us know it. I too suffered bad knee pain after 11/12 weeks...had physio, hydrotherapy etc.... Physio advises it due to pre op bad gait & muscles still being reeducated! I'm hoping so ! however my hip is great...no pain at all.....although I do remember getting some pain reappear at about this time...so I took a few steps back and rested up for a week which seemed to help! Take care...x
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PuppyLove
graduate
My knees are really bad (TKR scheduled for Nov) and I find that I sometimes have some hip pain when my knees are giving me grief b/c other parts of my body are compensating for the knees. I had a lot of back pain before my THR due to that. I'm a few weeks ahead of you and I have incision pain at times (tightness, like maybe I should have massaged more to break down scar tissue?). If I overdo it in the pool the next day I tend to have some hip/groin area pain. My ROM is not anywhere near what it used to be, but my OS says it prob. won't ever be again. My recovery has been great, and I think some days I expect more from my body than I should. Sorry I don't have any answers, but I can commiserate.
Hoppy Nanny
big-cheese
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OP
OP
Dkp
junior member
Thank you all for the support.
My surgeon's PA believes I've developed bursitis in the hip. Most of what he proposed as treatment, I've been doing: NSAIDs (which I already take regularly for my lupus), stretches, ice, limiting activities (especially anything that moves my leg out to the side).
He recommended that I switch from ice to moist heat in a couple of days and continue that 2-3 times a day for 2-3 weeks. I'm wary about that since it's already swollen and slightly hot, but I'll give it a try.
He seems pretty confident that everything's okay with the prosthesis, so that's reassuring.
I canceled Physio sessions this week, but look forward to talking with my PT next week to restructure my program to account for this. From what I've read tonight, I might need to stop the cycling for awhile, which would disappoint me! But feeling better and avoiding a chronic condition are important!
Time for meditation, deep breathing, journaling, letting go and moving on.
LTHR 5/29/2014
RTHR 9/20/2011
My surgeon's PA believes I've developed bursitis in the hip. Most of what he proposed as treatment, I've been doing: NSAIDs (which I already take regularly for my lupus), stretches, ice, limiting activities (especially anything that moves my leg out to the side).
He recommended that I switch from ice to moist heat in a couple of days and continue that 2-3 times a day for 2-3 weeks. I'm wary about that since it's already swollen and slightly hot, but I'll give it a try.
He seems pretty confident that everything's okay with the prosthesis, so that's reassuring.
I canceled Physio sessions this week, but look forward to talking with my PT next week to restructure my program to account for this. From what I've read tonight, I might need to stop the cycling for awhile, which would disappoint me! But feeling better and avoiding a chronic condition are important!
Time for meditation, deep breathing, journaling, letting go and moving on.
LTHR 5/29/2014
RTHR 9/20/2011
OP
OP
Dkp
junior member
Also meant to add that the PA said the most effective treatment would be a cortisone injection into the bursa, but there's no way he'll stick a needle in my hip until it's been 6 months. Good to know there's an additional option if this is still a problem by then.
LTHR 5/29/2014
RTHR 9/20/2011
LTHR 5/29/2014
RTHR 9/20/2011
Hoppy Nanny
big-cheese
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Do hope you feel better very soon x
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Sent from my iPad using BoneSmart®
OP
OP
Dkp
junior member
Meditation works well for me, too, Poppet. I mostly just use soft music (or better yet outside birdsong) now and do a mindful meditation focused on breath.
I remember confessing to a meditation teacher once that I was having trouble staying awake for the whole meditation and asking what I could do differently. She smiled and said, "Are you getting enough sleep?" Well....no! So now I use meditation both for preparing for sleep and for general wellness. If I am getting enough sleep, I can stay awake for them. If not, I know I need the sleep.
LTHR 5/29/2014
RTHR 9/20/2011
I remember confessing to a meditation teacher once that I was having trouble staying awake for the whole meditation and asking what I could do differently. She smiled and said, "Are you getting enough sleep?" Well....no! So now I use meditation both for preparing for sleep and for general wellness. If I am getting enough sleep, I can stay awake for them. If not, I know I need the sleep.
LTHR 5/29/2014
RTHR 9/20/2011
OP
OP
Dkp
junior member
LTHR 5/29/2014
RTHR 9/20/2011
Josephine
NURSE DIRECTOR EMERITA
I don't get this - the trochanteric bursa is inches away from the hip joint so unless he's a fearfully bad shot, it's most unlikely he'd get anywhere near the hip joint!
But with all due respect to your doc, I'd like to ask you some questions 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 are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't compare this with the bone-on-bone pain you had before surgery!
2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?
3. how often are you icing your knee and for how long?
4. are you elevating your leg, how often and for how long?
5. What is your ROM - that's flexion (bend) and extension (straightness)
6. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and
7. what kind of PT/exercises are you doing? How much and how often? (and detailed details would be appreciated, please! Reps, sets and session and all that)
Note:
If you're not familiar with this, it goes like so:
1 lift of a 500kg bell bar = 1 rep or repetition.
Doing 5 reps and then a brief rest = 1 set of 5.
And doing 5 sets and finishing = a session.
beachgal
post-grad
Buster is beautiful! What a sweet face!!
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OP
OP
Dkp
junior member
Thank you, Josephine, for helping with this issue. I don't know how the PA is with a needle, but my GP is excellent, and I'm considering asking him to do it if this doesn't resolve soon!
In response to your questions:
1 - pain levels vary by what I'm doing. Sitting -- 1-2 for an hour or so, after that increasing to 4-5; walking 2-3 for short periods, increasing after a block or two to 3-4 and after 3 or 4 blocks to 5-6 (so I'm not walking that far!); standing 1-2 for about 5-10 minutes, increasing rapidly after that to 6-7--MUST sit down; lying down -- 1 for the first 20 minutes; increasing to 3-4 after an hour or two, which eases some if I shift to another position. With any sudden movement, it shoots up to 7+ briefly and then slowly eases back down.
2 - I regularly take daily anti-inflammatories for my lupus: meloxicam 15 mg once daily, sulfasalazene 500 mg twice daily (also plaquenil 200 mg twice daily but I don't consider it pain med). For the THR, I was prescribed oxycodone 5 mg with acetaminophen 375 mg every 6 hours as needed. I had discontinued those until the last 3 weeks, when I returned to taking one if I awake during the night with pain (about every other night) and if I have pain during the day that I can't relieve by changing position or applying ice--maybe every third day. In between I take one or two Aleve every few days. I also have Voltaren Gel (diclofenac) that I put on both my hip and my knee at night and in the morning. (I used a sample Flector Patch on the hip and it worked fabulously, but my insurance won't cover it!)
3 - I ice my hip every night and at least once during the day. If it's more swollen or sore, I increase that. I do ice my knee, as well--mostly at night, switching the ice pack between hip and knee every 20 minutes or so.
4 - I elevate my leg at night. I have an adjustable bed, and it's easy to raise legs above head. I keep it that way most of the night, lowering it a few times a night to shift to sleeping on my side when I get stiff. I elevate my leg during the day whenever I'm sitting in the recliner (maybe 2-3 hours over the course of a day), but not quite high enough to count as elevation.
5 - I don't really know my ROM--I'm not facing a TKR quite yet and haven't had it measured. I think I have full ROM, but significant (sometimes debilitating) knee pain. My PT observed that the left knee tends to twist slightly when I walk.
6 - My activity level was getting pretty normal, but is slipping again because of the new pain. Currently, I'm doing the grocery shopping again, but I make more short trips rather than an untenable long weekly trip. I do an occasional load of laundry, but leave most of it to my husband. I have a cleaner now and don't do any mopping, dusting, vacuuming, etc. A little wiping up in the kitchen, but husband is doing the majority of the washing up. I'm self-employed and my work is sedentary. I can do almost everything but my weekly workshops from my recliner. I have great long-term students who are doing all the room set-up for my workshops for me, so even the workshops involve minimal activity.
7 - I discontinued PT about 2 weeks ago. I had worked up to twice weekly:
50 reps of hamstring curls, bridges, toe lifts, front and side kicks, and band extensions,
20 reps of clamshells,
3 modified lunge stretches (modified to limit knee involvement)
50 reps on the shuttle with minimum weight,
30 reps on the hip machine
10 minutes of stationary cycling with no resistance,
3 reps of 30 seconds balancing,
3 reps of 30 seconds calf stretches
5 minutes of isometric leg extension (15 sec up, 5 sec rest)
I can see typing it out that that was a crazy amount of PT! I am currently doing only 30-second knee to chest stretches X 3 reps twice daily and short (to the mailbox and back or around the pool and through the grocery store) walks 3-4 times a day.
Again, Josephine, I appreciate your help and heartily welcome any advice.
~Debby
In response to your questions:
1 - pain levels vary by what I'm doing. Sitting -- 1-2 for an hour or so, after that increasing to 4-5; walking 2-3 for short periods, increasing after a block or two to 3-4 and after 3 or 4 blocks to 5-6 (so I'm not walking that far!); standing 1-2 for about 5-10 minutes, increasing rapidly after that to 6-7--MUST sit down; lying down -- 1 for the first 20 minutes; increasing to 3-4 after an hour or two, which eases some if I shift to another position. With any sudden movement, it shoots up to 7+ briefly and then slowly eases back down.
2 - I regularly take daily anti-inflammatories for my lupus: meloxicam 15 mg once daily, sulfasalazene 500 mg twice daily (also plaquenil 200 mg twice daily but I don't consider it pain med). For the THR, I was prescribed oxycodone 5 mg with acetaminophen 375 mg every 6 hours as needed. I had discontinued those until the last 3 weeks, when I returned to taking one if I awake during the night with pain (about every other night) and if I have pain during the day that I can't relieve by changing position or applying ice--maybe every third day. In between I take one or two Aleve every few days. I also have Voltaren Gel (diclofenac) that I put on both my hip and my knee at night and in the morning. (I used a sample Flector Patch on the hip and it worked fabulously, but my insurance won't cover it!)
3 - I ice my hip every night and at least once during the day. If it's more swollen or sore, I increase that. I do ice my knee, as well--mostly at night, switching the ice pack between hip and knee every 20 minutes or so.
4 - I elevate my leg at night. I have an adjustable bed, and it's easy to raise legs above head. I keep it that way most of the night, lowering it a few times a night to shift to sleeping on my side when I get stiff. I elevate my leg during the day whenever I'm sitting in the recliner (maybe 2-3 hours over the course of a day), but not quite high enough to count as elevation.
5 - I don't really know my ROM--I'm not facing a TKR quite yet and haven't had it measured. I think I have full ROM, but significant (sometimes debilitating) knee pain. My PT observed that the left knee tends to twist slightly when I walk.
6 - My activity level was getting pretty normal, but is slipping again because of the new pain. Currently, I'm doing the grocery shopping again, but I make more short trips rather than an untenable long weekly trip. I do an occasional load of laundry, but leave most of it to my husband. I have a cleaner now and don't do any mopping, dusting, vacuuming, etc. A little wiping up in the kitchen, but husband is doing the majority of the washing up. I'm self-employed and my work is sedentary. I can do almost everything but my weekly workshops from my recliner. I have great long-term students who are doing all the room set-up for my workshops for me, so even the workshops involve minimal activity.
7 - I discontinued PT about 2 weeks ago. I had worked up to twice weekly:
50 reps of hamstring curls, bridges, toe lifts, front and side kicks, and band extensions,
20 reps of clamshells,
3 modified lunge stretches (modified to limit knee involvement)
50 reps on the shuttle with minimum weight,
30 reps on the hip machine
10 minutes of stationary cycling with no resistance,
3 reps of 30 seconds balancing,
3 reps of 30 seconds calf stretches
5 minutes of isometric leg extension (15 sec up, 5 sec rest)
I can see typing it out that that was a crazy amount of PT! I am currently doing only 30-second knee to chest stretches X 3 reps twice daily and short (to the mailbox and back or around the pool and through the grocery store) walks 3-4 times a day.
Again, Josephine, I appreciate your help and heartily welcome any advice.
~Debby
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