THR 36M - Worried about my mental state (depression) in committing to recovery. Any resources for this?

[Solar7]

Hey all, first time posting, did a fair amount of lurking. I have Avascular Necrosis in my left hip, and the doctor has told me a THR is necessary. Last year I fractured my pelvis in a freak fall in the United Kingdom, on the opposite side. I didn't need surgery, but I spent three months mostly bedridden, and occasionally on crutches/in a wheelchair. When I got off the crutches and was supposed to go to PT, I had a limp, and pain in the left side, so I had to stop PT, get back to doctors, and finally got this diagnosis.

So, I have some problems. I've struggled with depression most of my life. I'm lacking in motivation for most things and only slog through work because I have to. I hate exercise even though I'm not particularly overweight (more in the "could stand to lose 10-15 lbs territory). My legs aren't very strong because they functionally atrophied over those three months where I wasn't walking, with no PT, and with the limp and the pain, I never really got back to walking much. I can really only make it on like a short grocery shopping trip with a cart to support me. I know being in as best of shape as possible before surgery can really help you get better... so this scares me even more. And having already just been in a **** situation for recovery, I can't fathom doing that all over again.

With my depression, I just don't feel like I'm mentally prepared to put in the work needed to get healthy again once I have this surgery, not to mention I'm just flat out scared since I've never been under the knife outside of a minor dental procedure or two. I know I need to do something to get my mind right, but I don't know if a normal therapist is enough for this. Any suggestions?

I know logically this is a common procedure but no amount of logic is shutting off that part of my lizard brain that's freaking out.

 

[PSCMom]

Hello! I am 16 days post op from my left THR. I asked a similar question to yours and the wonderful moderators and members here were super supportive. One response they sent was the following:

Take a look at an article in here called, 'Post op blues is a reality - be prepared for it'

From your post I can tell you've had a rough time. This situation can definitely be motivation depleting as well. You may be able to find articles about pre-op PT at home or ask the surgeon or his/her office about that resource. One thing I was advised to do by a coach is to choose something in your life you want to get back to when you're physically ready. For example, he wanted to coach his grandson's football team and to do so, he had to have eecover from knee replacement surgery. To maintain motivation, he a put a football and his grandson's picture on a shelf he could look at while he did the PT. I think it's a wonderful idea! I haven't done it yet because my own PT has been walking a little and some as I'm on my laptop or watching TV.

Another consideration is to consult with a therapist regularly if you're able to. They can help when motivation becomes stagnant.

Prayers and positive thoughts your way! You've got this!!

 

[Hip4life]

Hi and welcome to BoneSmart! @Solar7 The recovery from your injury is different from what the recovery from THR will be like. Even better, walking is the only exercise that is needed and that in moderation. Many of us were not at our greatest fitness level when we had our surgeries due to prolonged delays before them. Any exercise you’re able to do without significant pain is better than none: mine was gentle stretching, water exercise and swimming but that also had to be limited. Many just concentrate on upper body strength to be better able to handle any assistive devices (walkers, canes, crutches) that you’ll need in the first few or so weeks after surgery. You can’t “train” for this and you certainly don’t do it in recovery. PT wasn’t part of most of our recoveries except for the simple sessions in hospital to prevent blood clots and make sure we could navigate stairs and get into our vehicles. You’ll get up and walk shortly after surgery so no having to lie around in bed.

Depression can be a part of any major surgery. We even have a depression thread for members to share their stories and get support. Knowing ahead of time of your predisposition will help you be forearmed. You can speak to your surgeon, primary care and your therapist so they can help address this before and after. I love the idea above about focusing on something you really would like to get back to. Sometimes not only our physical world but our mental world gets limited by our recent and current challenges. I’ll leave you with some of our guidelines. If or when you have a surgery date, please let us know and which hip and we will get a signature created for you. We wish you all the best going forward and we’ll be here to help support you in any way we can.

HIP PRE-OP GUIDELINES

If you are at the stage where you have joint pain but don't know for sure if you are ready to have surgery, these links may help:

Score Chart: How bad is my arthritic hip?
Choosing a surgeon and a prosthesis
BMI Calculator - What to do if your surgeon says you're too heavy for joint replacement surgery
Longevity of implants and revisions: How long will my new joint last?

If you are at the stage where you are planning to have surgery but are looking for information so you can be better prepared for what is to come, take a look at these links:

Recovery Aids: A comprehensive list for hospital and home
Recliner Chairs: Things you need to know if buying one for your recovery
Pre-Op Interviews: What's involved?

And if you want to picture what your life might be like with a replaced hip, take a look at stories of amazing hip recoveries

 

[Eman85]

Well the best part of THR recovery is it requires no motivation or exercise! Of course occupying your time and your mind can be the hardest challenge. Eating correctly post op to give your body the nutrition it needs is more important than comfort foods.

 

[ladyj]

Make sure that your doctors know you are prone to depression, so that any medication that you need can be kept at the right level.
Don’t worry about the op, you really won’t know anything about it.
Make sure you have a really experienced surgeon.
You can do this!

 

[Jaycey]

@Solar7 We have many member who have a history of depression and recover just fine. Tell you surgical team you have an history and keep talking here! Several years ago a started a thread here about Depression and Post-op Blues. Our former Nurse Director transferred the thread to the Social Room so that everyone could access the information. Feel free to post there or here on your own thread. We are here for you!

First off - recovery from THR does not take lots of exercise. In fact, if you ice, elevate and rest in the early days you will be fine. Walks in fresh air once you are feeling confident will be all that is needed.

Bottom line - there is no "work needed". Just listen to that new hip and take things slow and steady.

 

[CricketHip]

Hi there Solar! How good of you to come here to ask your questions and to share with us. That is a brave thing to do and you did it! That shows that there is some motivation there.
I think the best thing for you would be to get scheduled with a psychiatrist to get you the proper medication for your needs. Then when the time is right they will refer you do a good psychologist to talk about your worries and fears with. At least that's what my Dr. does with me.
I had an extremely upsetting event over 2 years ago that I am still recovering from and seeing my Dr. weekly has been so helpful. Some days I have nothing that I really want to talk about but she always approaches things that help me feel so much better afterwards. The visits are all via video chat so there hasn't been any need to travel to her.
Not sure what other states and doctors are doing but I'm guessing they will work to your comfort level.

What a nasty fall you must have had!! No wonder you are now where your legs are weak. You will be happily pleased at how much that walking will help you while healing. Nice gentle walking where you can enjoy the outdoors might be uplifting in of itself.

So glad you reached out on BoneSmart. We are a good support system.

 

[kneeper]

I think you've had some good advice about tying in your depression care therapist/doctor to this process.

I had knee replacements and from what I hear hips don't take quite as long but it is a process. [I think my hips will be next on the list] I found that having a surgeon who gave me realistic expecations of the healing timeline (and Bonesmart) very helpful when I would have those days when I thought the recovery was taking forever.

TKR was my first surgery and I was nervous, but I found everyone involved to be so professional it was very reassuring.

 

[Charly]

Hi @Solar7, I know how you’re feeling with depression and anxiety. My surgery for left hip revision is coming up next week. I have a hard time going through this for a second time when my original THR was in August 2018. I’ve been using a walker since then and decided finally that I didn’t want to continue to live like this any longer. I fell this past October in my home and landed on my left side(hip replacement side) and I believe that contributed to the new symptoms of soreness and weakness. I also hit my head on that fall and ended up with 2 brain bleeds and thank goodness they have healed on their own. A hairline fracture at the top of my spine also showed up when an MRI was done at the ER. So, I’m super anxious about going in for my surgery wondering if it will make a difference. I do have osteoporosis and I’m really scared I may fall again. I’m also very worried that once I’m opened up that my femur will be strong enough for the surgeon to cut and work on without it falling apart. I’m think up the craziest things. I just can’t stop thinking of what could go wrong. My original THR left me with a very significant leg shortage on the operated side. I asked my surgeon’s PA if that could be corrected. I was really hoping it could be corrected. Her answer was he will do the best he can but is concerned that the sciatica nerve may have shortened up and he will not stretch it in fear of I could lose the use of my left foot. So that’s a huge disappointment for me to face going in because I was really looking forward to wearing regular shoes without a lift on the short leg for the rest of my life. So there you go I feel depressed about this. I am on anxiety and depression meds prescribed by my cardiologist and pc and I think that is helpful. I also do zoom meetings monthly with a psychologist and she helps me a lot. Gives me ideas on how to look at things differently. Good luck to you and as everyone tells me, you’ve got this!!! I’ll wait and see.

I think you've had some good advice about tying in your depression care therapist/doctor to this process.

I had knee replacements and from what I hear hips don't take quite as long but it is a process. [I think my hips will be next on the list] I found that having a surgeon who gave me realistic expecations of the healing timeline (and Bonesmart) very helpful when I would have those days when I thought the recovery was taking forever.

TKR was my first surgery and I was nervous, but I found everyone involved to be so professional it was very reassuring.

 

[PolarIce]

I can relate in that I think I had developed some depression going into it. At my age and the amount I had been suffering for so long, really didn't do my soul any good.

I think getting yourself a therapist is a good place to start. They can keep an eye on you and keep you on the right path and the talk therapy can do wonders. Also know that many of us ended up in your shoes and have come on out on the other side strong.

I feel like most of what you are describing is depression for sure, but being able to get surgery will change your life and will only improve. You've got this, just make sure you reach out to friends(and here online), and remember that YOU DESERVE this great care coming in for you.

 

[NewShoes]

I had R-THR on 4/10/23 due to avascular necrosis. I have a history of anxiety and am currently back to taking Lorazepam as needed after a fire from a neighbor's house spread to our roof which caused our roof/ceiling to collapse from the weight of the water on 1/7/22. Doc says a have a touch of PTSD - read: hyperventilating, sweating, dizzy, shakes, body tingling/numbness, nausea, tinnitus, etc. whenever I have to leave the house, go in the shower or even go to sleep.

I just told my surgeon I would be taking Lorazepam on the morning of the surgery; dosage to be determined. He just said to let the anesthesiologist know when and how much I took.

I was using a walker before surgery. The hip pain was unbearable even with pain meds. I did prehab at home; as much as I could. Nothing crazy, just trying to engage the muscles that shut down over the years.

Get your meds right and resign yourself that you're having the surgery. Research and make your plans for the surgery and post-op.

You're in the right place here. The people on here are priceless. Listen with an open mind and use the advice that suits your situation. Ask questions...and then ask more questions. We're here for you.

Regards,
Camille

 

[Jaycey]

@NewShoes Thanks so much for your kinds words. We are indeed here for everyone facing surgery and recovery. Going into this process with a "can do" attitude goes a long way. Well done on your recovery!

 

[Solar7]

I had R-THR on 4/10/23 due to avascular necrosis. I have a history of anxiety and am currently back to taking Lorazepam as needed after a fire from a neighbor's house spread to our roof which caused our roof/ceiling to collapse from the weight of the water on 1/7/22. Doc says a have a touch of PTSD - read: hyperventilating, sweating, dizzy, shakes, body tingling/numbness, nausea, tinnitus, etc. whenever I have to leave the house, go in the shower or even go to sleep.

I just told my surgeon I would be taking Lorazepam on the morning of the surgery; dosage to be determined. He just said to let the anesthesiologist know when and how much I took.

I was using a walker before surgery. The hip pain was unbearable even with pain meds. I did prehab at home; as much as I could. Nothing crazy, just trying to engage the muscles that shut down over the years.

Get your meds right and resign yourself that you're having the surgery. Research and make your plans for the surgery and post-op.

You're in the right place here. The people on here are priceless. Listen with an open mind and use the advice that suits your situation. Ask questions...and then ask more questions. We're here for you.

Regards,
Camille

Unfortunately I can't get meds, at least not in a timeline before surgery.

 

[NewShoes]

I had R-THR on 4/10/23 due to avascular necrosis. I have a history of anxiety and am currently back to taking Lorazepam as needed after a fire from a neighbor's house spread to our roof which caused our roof/ceiling to collapse from the weight of the water on 1/7/22. Doc says a have a touch of PTSD - read: hyperventilating, sweating, dizzy, shakes, body tingling/numbness, nausea, tinnitus, etc. whenever I have to leave the house, go in the shower or even go to sleep.

I just told my surgeon I would be taking Lorazepam on the morning of the surgery; dosage to be determined. He just said to let the anesthesiologist know when and how much I took.

I was using a walker before surgery. The hip pain was unbearable even with pain meds. I did prehab at home; as much as I could. Nothing crazy, just trying to engage the muscles that shut down over the years.

Get your meds right and resign yourself that you're having the surgery. Research and make your plans for the surgery and post-op.

You're in the right place here. The people on here are priceless. Listen with an open mind and use the advice that suits your situation. Ask questions...and then ask more questions. We're here for you.

Regards,
Camille

Unfortunately I can't get meds, at least not in a timeline before surgery.

Oh, you have me stumped now.

All I can say is that for a lot of people, this surgery is life changing.

To be perfectly honest, this was my 7th surgery, I've had complications after 5 of them but not this one and have even healed a little quicker than some people. Sometimes I feel a little guilty about that.

Just keep coming here with any questions, issues or feelings as much as possible...even if it's several times a day.

For me, going from posting in pre to post op was an exhilarating rush.

Regards,
Camille