THR 2 weeks post op

[sharonslp]

Adrienne, here's what I think. You are not even two months out of surgery. That's the danger stage....when we start to feel well enough to actually go about our real lives. So in addition to whatever walking and/or exercises we do, we resume housework, and running errands, and going out with friends. And aren't we surprised when our body rebels and says TOO MUCH!! TOO SOON!!

So yes, go backwards in time. Take some pain meds, and rest A WHOLE LOT. Use the old ice bag too. Can you tolerate ibuprofen or aleve? When I'm having trouble, I need an nsaid to get inflammation under control.

In regard to your earlier question about sex....a definite yes. We'll just leave it at that.

Sharon

 

[BarbaraR]

acbelmar, almost the exact same thing happened to me. I worked till 2 Saturday, and we babysat our 3 year old grandson Saturday night (I only picked him up once). Yesterday morning I did my usual exercises, but then I baked two batches of cookies (My sister-in-law and brother-in-law are visiting), cleaned up after that, and made dinner--an easy fish stew, but still lots of chopping and stirring so lots of standing. Anyway, by the time dinner was over, I was taking an extra dose of tylenol+ibuprofen, and I went to sleep with an ice pack on my leg. This morning the muscle is sore and achy exactly where you describe. (I was thinking about emailing the PA today when I saw your post.) It's early so I'll ice this morning, but I have to work today so I'll rest as much as I can. I hope you get some rest and that you feel better soon. sharonslp, thanks for the good advice. I'm taking it, too.

 

[acbelmar]

BarbaraR and sharonslp Thanks for your advise. Its so confusing!! When my OS gave me the shot for the bursitis he took me off PT..told me to just walk. So I walk 2 times a day. I do the exercises they tell you to do in the hospital..butt squeezes, leg pumps and the foot flexing...thats it. These spasms in my leg are driving me crazy! They come and go but when they come...OUCH!!! I didn't walk yesterday and today its raining so maybe 2 days off will help. I do ice a lot..but the heating pad usually eases it more for me...that blew out the other night because the wire frayed!!! Blew a circuit breaker and everything!! I'll go out to buy a new one today. I canceled my dinner with my sister yesterday because I couldn't even clean up the kitchen a bit and make it nice. Very disappointing. As far as meds I still take 1/2 a vicodin 2x a day and 1/2 a valium for the spasms when they are bad. Last night I took a whole one before bed to get a good night's sleep. I think in my head I should be better than I am at 9 weeks...I'm so worried I won't be able to go back to work in May....

 

[BarbaraR]

May is a long way off...don't worry...you have another month to heal. How about going to PT just for some stretching and pain relief? My PT does ice or heat with electro-stim when I first walk in-- it's supposed to help with the pain and muscle spasms. Do you do the IT band and hip flexor stretches after you walk? I find that those help me, too. Sometimes I do them at work if I've been up and down a lot. I hope today is a better day for you.

 

[sharonslp]

Have you tried magnesium supplements for the muscle spasms? I had an intense period of something like restless legs at the 1-2 period, and that helped immensely. Are you able to get in a bathtub yet? If so, a soak with epsom salts is heavenly. But I couldn't do that until around 5 months.

I'm also thinking that 1/2 a vicodin twice a day is not sufficient to get you through this time period yet. The vicodin lasts only 4-6 hours, so you are always just trying to catch-up, instead of actually getting ahead of the pain. I'm not suggesting more vicodin....but what about alternating ibuprofen or naproxen between doses. I just reread your whole thread, and I see you don't want to take tylenol. Did you ever discuss other alternatives with your doc that wouldn't be a concern with your liver? I had good success with tramadol early on, and I still need Celebrex even now more than I like. But it gets the job done. There are a lot of medications out there....yes, there is always some risk from side effects....but you're looking for some short-term help to get you past this stage. Talk to your doc about other options.

Everything you are describing still sounds you have lots of inflammation yet from surgery itself, and perhaps from too much activity overall. You said you were walking 2x a day....how far do you walk each time?

I can't imagine that worrying about May and returning to work is doing you any good. For right now, you need to get the pain you still have properly managed, and you need to slow way down to give all your angry tissues time to settle down. Then you slowly....very slowly.....work back up to increasing activities and backing down the meds. If you have a plan B for work, then let your mind adjust to the idea that it might need to be used for a while, and so be it. Take pressure off yourself....both physically AND emotionally. There are no "shoulds" about recovering....your body doesn't care what you think you should be like at nine weeks. It doesn't care what your doctor thinks, or your PT thinks. It's just working overtime trying to heal, and you have to get out of the way and let it do its job.

When do you have your next check-up with xrays? I had them at 6 and 12 weeks, so I had the peace of mind of knowing that everything implant-wise was just as it should be.

Sharon

 

[acbelmar]

BarbaraR
I know you told me before but what exercises do you do? How are they done..after walking that is. I think maybe that is my problem. I am in so much pain from spasms in the morning I can hardly do anything..but they gradually ease up and I can walk better. My problem is now ever time I go to take a step I'm afraid I willfeel that pain again...so I'm walking so gingerly. I'm back to the cane full time except in the house..
sharonslp My walks are usually 2 to 3 times around a good block..almost 1 mile..twice a day..sometimes only once. When I'm walking I feel good...I practice carrying the cane and doing heel toe because I really want to beat the limp! I will probably go back to PT next week, but my old place that my insurance didn't cover was so much better..they massaged you and stimmed you..she helped me so much I wish I could go back there. WHere I go now they are very nice but there are 2 PTs and 5-9 people getting PT. Not much attention.

 

[sharonslp]

Adrienne, I know what you mean that walking feels good. And using the cane still is excellent...if you are limping still, you probably need it all the time for right now. Broken record here....it still sounds like getting adequate pain meds are crucial. I'm tagging Josephine to advise again. But she mentioned early on to talk to your doc about alternatives to tylenol, and that won't change. If your early fatty liver disease is a concern, you have to get doctor input on this.

And when you go back to PT, make it just to help you with correct gait. Go very easy on exercises that hurt. Your hip needs to heal, plain and simple. PT may simply be too much for your hip right now. Pain management and walking and plenty of rest and maybe PT won't be needed.

Sharon

 

[BarbaraR]

acbelmar, the IT band stretch is the one where you stand next to a wall and tip your affected hip towards the wall. When that gets easy, you can cross your affected leg behind the good leg and tip further (You bend the front knee to get more of a stretch on teh back leg.). The hip flexor stretch that they taught me involves lying on the bed with my good leg completely on the bed and my affected leg on with the thigh only and letting the shin dangle down vertically. As that gets easier, you can try grabbing the ankle and pulling it toward the thigh to stretch the hip flexor more. I'll see if I can find pictures again and post them for you. BTW, I probably walk a mile around my office every day. It tires me. Maybe a mile twice a day is too much right now?

 

[Josephine]

As far as meds I still take ½ a vicodin 2x a day and ½ a valium for the spasms when they are bad. Last night I took a whole one before bed to get a good night's sleep.

Oh gosh really? an actual whole Vicodin? Really, my dear. Taking half a dose of anything is a bit like having half a lamb chop for dinner or half a vitamin pill - what's the point? If you were on medication for an underactive thyroid or antibiotics for an infection, would you take half a pill then? Of course not! There are amounts of medication that are working doses, that do the job they are intended to do. Taking half a dose means you are not getting any good value from the stuff you've taken. So take what you've been prescribed, which I imagine is probably 1 or 2 every 4-6 hours. If you do that, you will find your symptoms abate considerably because most of them are simply on account of you a) doing too much and b) being undermedicated.

I think in my head I should be better than I am at 9 weeks...I'm so worried I won't be able to go back to work in May....

Well, let me tell you, you are well on your way to a self-fulfilling prophecy. That means what you are doing is going to achieve what you are fearing. For instance this at only 8 weeks out .....

I went out Saturday for my birthday with a group of friends. Felt good enough to leave the cane home. .... but when I tried to clean up a bit because my sister was cooking dinner for us, I had the horrible spasms back in my leg!! They were in the front between the thigh and knee..and I also got them in the back of my leg as well. They were off and on all day .

and this

When my OS gave me the shot for the bursitis he took me off PT..told me to just walk. So I walk 2 times a day.

You say you are walking twice a day but haven't said how far, for how long and how fast!

And let me tell you one immutable fact that invariably seems to go unnoticed across the pond - hips don't need much PT. Honestly, they are really pretty good at sorting themselves out provided we are sensible and live normally! Did you ever read this article Activity progression for THR? I guess not since you have been doing too much right from the start when your sister came to stay and made you "get up every hour and do a few laps around the house"! I think this was where it all started. Plus the insane PT you were put on, making you step over bars at only 2-3 weeks out!

But what to do about it now? First you need to slow down, take your pain meds - proper doses this time, ice your TB ferociously and then start again more slowly! I think you may still be able to get back to work in May but maybe not until later in the month.

For icing the TB, I used large gel type ice packs and would throw on onto the settee and sit on it! As soon as the cold wore off, I would swap it for the one in the freezer and apply it again. It's fine through your clothes, just right in fact.

 

[acbelmar]

Josephine
Thanks for your response. I really do believe they rushed me with everything and I did too much too soon. At 3 weeks I was doing those rubber band exercises (front, back side pulls) the stepping over the bars, cycling, treadmill and side stepping on and off mats...because I was taking pain meds I really didn't feel bad, so I didn't think it was hurting. I know now that it was too much...because once the meds wore off the spasms and troubles began. I will do what you suggested and ease up..I think I may also need another shot for the bursitis as its not completely gone..if I get another one should I rest for a few days or continue to walk? The Dr. never said anything except I should feel better in a day or so.
I am sorry for being so stubborn about everything...I'm so eager to get my life back but I don't realize just living by myself and keeping my house in order is tiring in itself! On my birthday I got picked up..dropped off at the door, sat and ate and was driven home. I really didn't think it would bother me, but because I wore regular shoes I think that threw my body off a day later. Back to sneakers and icing and full meds. I promise!!

 

[acbelmar]

You say you are walking twice a day but haven't said how far, for how long and how fast!

I usually walk around the block twice which takes about 15-20 minutes..about 1/2 mile...the most I walked was 1 mile twice in one day...felt fine because it was warm and sunny and I was so happy it wasn't cold and damp!!

 

[BarbaraR]

acbelmar, wow, that was some PT regimen 3 weeks after surgery! When I was first diagnosed with arthritis 4 years ago, I went to PT and found out really quickly that I can't do band exercises-- they put too much strain on my ankles and knees. So my PT suggests it and I say no. And I think you're right that just taking care of yourself is a lot not even 2 months after major surgery. Why don't you try icing the side of your hip to see if you can get the bursitis to calm down. I have bursitis, too, and I did before surgery. It only bothered me if I laid on that side on a hard surface. But it hurts a lot after PT, so tomorrow I'm having that conversation about not doing things that are so straining to the side of my hip. Anyway, I hope you feel better soon.

 

[acbelmar]

Barbara....
Ice has been my friend through this adventure! I probably leave it on a little too long!! The spasms seem to feel better with the heating pad but it doesn't last as long. The bursitis isn't as bad as when he first found it..so maybe its still settling down. My recovery was also hard to gauge because of the weather we've had...a long cold damp winter!! My PT believed HR patients really feel the weather and I tend to believe him! I feel much better today than yesterday ..thanks for asking. Hope you're doing better as well.
Adrienne

 

[Allycat]

Oh boy, when I read things like this, at first I wonder if I should be doing more exercise-wise. On discharge from hospital I had a physio come to my house every second day for 2 weeks. He gave me some lying down exercises (to help with getting in and out of bed) and some standing up ones. The whole thing took around 15mins to complete and I did it twice a day. As I progressed, he took away the easy ones and added in some harder ones, so still around 15mins. He then started to concentrate on improving my gait, and getting rid of my limp. This just involved walking up and down my hallway. After 2 weeks, he said I had really good movement so could quit the exercises and just keep practising the walking. And that's all I do. I have no pain and get around the house using nothing. I still take the walking stick outside, but I reckon that will only be for another week.

 

[Josephine]

I think I may also need another shot for the bursitis as its not completely gone..if I get another one should I rest for a few days or continue to walk?

TB can require several injections to get rid of it. Really bad cases like yours are rarely resolved with just one treatment. And don't worry about having a few. I've had dozens over the years and am still alive to tell the tale! Read this Cortisone shots: are they safe and is there a limit to how many?

but I don't realize just living by myself and keeping my house in order is tiring in itself!

Being in the same place, I know what you mean. I dealt with it by just not doing anything for ages but then, I'm a natural sloth anyway! I'm sort of with Quentin Crisp who famously never cleaned his London pad for years and declared that "it doesn't get any worse after 2 years"!!! (though I'm not quite that bad! )

I usually walk around the block twice which takes about 15-20 minutes..about 1/2 mile...the most I walked was 1 mile twice in one day

Yeah, y'see there's a big difference between what we can do and what we should do in recovery. It's something I battle with daily on this forum - interestingly mostly with US members! Short of nailing their feet to the floor, it's very difficult to get people to understand they have to decide what NOT to do rather than go for what they feel able to do.

My PT believed HR patients really feel the weather

That's a canny way of fending off complaints about his treatment!

Oh boy, when I read things like this, at first I wonder if I should be doing more exercise-wise. After 2 weeks, he said I had really good movement so could quit the exercises and just keep practising the walking. And that's all I do.

Allycat I say this at least once a week, hips don't need intensive PT. Truly, they have a way of taking care of themselves provided you walk a bit even if it's only to the bathroom and kitchen in the early days. You can see my recommendations here Activity progression for THR.

 

[acbelmar]

Josephine
I agree about the PT shrugging off my complaints to the weather. It happened a few times and he never really took them seriously. The PT I went to a few years ago after getting injured at work would massage me and work with me one on one. Unfortunately she's not in my HMO and money is tight. I need to have stretches to do..I'm sure of it. This morning when I got up I had the cramp down my thigh to my knee. After walking around a bit and doing the wall stretch for the IT band...it went away. I was not given any stretches to do at home...I really think thats what is ailing me..besides doing too much.
I was confused because your link says Activities for THR but when you go there it says Knee replacement. Is the progression the same? I have heard knee is much harder than Hip replacement and that your recovery is much quicker with hip.

 

[Josephine]

Sorry, someone pointed that out to me the other day and I completely forgot. It's just linked incorrectly. This is the correct one Activity progression for THRs.

Plus you can do stretches all on your own. You don't need to be given them by a PT. Take a look at these
Exercise websites For THR
Adductor/groin pain exercise
Iliospoas syndrome
Trochanteric bursitis with THR

And I'll tag Alex for you to see if she can suggest anything else alexthecat

 

[BarbaraR]

Here I am sitting in PT with electro stim and heat on my hip wondering of this is really helping. Thank you all for this conversation. It's really helpful to me. I'm going to a meeting in Baltimore tomorrow and I hired a driver rather than walk thru the airport parking lot. I've been feeling kind of wimpy about that-- y'all make me feel better about being cautious.

 

[acbelmar]

Allycat Do not worry about not doing enough exercise!!! I agree with Jo and Sharon..I think my PT was too aggressive too soon! I changed my PT yesterday because the old PT never worked on my gait and blamed all my pain on the weather!!!I went back to a wonderful lady who I had gone to before but was not in my insurance. It is worth the money!! She showed me how I was walking incorrectly ( I was not extending my hip properly..when walking your hip should be over your ankle before you move your other leg) which may have been causing the spasms in my thigh! She massaged my leg and stretched me and explained things to me! She believed my exercises were too aggressive and I need to practice walking correctly! Since seeing her yesterday I have not had a spasm...just some pulling which is probably because my muscles need to be stretched! I see some hope going back to work in May..maybe the middle of May..if I get begin to walk correctly without concentrating!! I guess when you limp for 6 months you have to learn all over again!

 

[sandybeach]

@acbelmar I think that if you feel you've done too much, taking it easy a day is good. After PT and other activities I need to let things settle so I will relax with ice and take a pain killer, usually that works for me. I get those muscle spasms and cramping too. For the spasms I try to rub it out. My PT showed me to press on the spasm, it will hurt, and just apply pressure to the point of it hurting and hold it till it quits. I have had spasms last as long as 5 days and this helped. It's not a quick fix, it took a couple days to work mine completely out but it continued to be less and less. I think we are all in for surprises along this journey called recovery.