THR 49 y/o LTHR After AVN Recovery thread

[Elf1]

I would double check with your doctor but normally it would be every 6 hours I believe. Would hate to contradict your doc. Glad you're only doing the 4000 mg, that was my big worry.

 

[ForumUser]

Every six, but my understanding is ok up to 4 g per day.

 

[BruceH]

FYI I asked this question recently and was told that the US max dosage had been lowered to 3g per day.

Not sure about max dosage in the UK but humans are human everywhere.

 

[Movinon/(3)]

Hi. I am on day 10 of my healing journey. I would be cautious of the amount of Tylenol you are taking. I wrote down every pill I put in my mouth so I wouldn’t exceed more than 2000 per day. I couple of years ago I had blood work done when I was sick and my liver enzyme shot thru the roof!!! I gave up Hydrocodone at day 6. And now take 1000 mg per day of Tylenol 200 Celebrex 2 baby aspirin and .5 prednisone Ice is my best friend I do hope you are feeling better. My biggest problem is sleep getting clamps out this Monday!!!

 

[Celle]

I’ve been taking the paracetamol at 8am, 12, 4pm and 8pm so a maximum of 4000mg a day. Is that ok or Do you think I should increase the time in between the dose ?

I would double check with your doctor but normally it would be every 6 hours I believe. Would hate to contradict your doc. Glad you're only doing the 4000 mg, that was my big worry.

it's usually recommended that the dose is taken 6-hourly, but 4-hourly is OK, as long as you don't exceed 4,000 mg (4G) in each 24 hours. Don't take it more frequently than 4-hourly, though. By not having a dose between 8 p.m. and 8 a.m., you are leaving yourself with 12 hours without cover.

FYI I asked this question recently and was told that the US max dosage had been lowered to 3g per day.

While the US FDA recommends a maximum dosage of 3,000 mg (3G) in 24 hours, this is because of the fear that people will not take into account any Paracetamol/Tylenol/Acetaminophen that may be in other medications they are taking, such as in cold cures. Some narcotics also have a component of Acetaminophen.

Check all other medications you're taking, to make sure there is no Tylenol/Acetaminophen/Paracetamol in them. If there is, scale back one or two of your regular doses, so you stay within that safe 24 hour limit of 4,000 mg, which is the recommended amount in the UK.

By the way, we prefer that members don't advise each other about medications. Please leave that to staff.

 

[Prem1234]

Great thank you all for your replies....I read through my medical discharge summary and it says 'Take TWO tablets four times a day. Leave at least 4 hours between each dose and no more than 2 tablets in 4 hours or 8 tablets in 24 hours.

I've had a bigger icing session already today and will continue to. I've swapped the cane for a crutch as well and have noticed a better slow and steady walk.

I've finished the Oxy last night which has now be replaced Codeine, keen to get off of the meds and will look to reduce as soon as I get the chance especially with increasing the

Many thanks again for all your support.

 

[Mojo333]

You sound very well...I was still in full fledged whine panic mode for the first week.

I've had a bigger icing session already today and will continue to

It really was the most helpful thing throughout my recovery.
And only side effect was Cold.

I've swapped the cane for a crutch as well and have noticed a better slow and steady walk.

Glad this is working better for you.
Hope your weekend is restful.

 

[Fit4Family]

Welcome to the healing side @Prem1234 Sounds like you are doing very well. Writing everything down gave me peace of mind. Elevating and ice are the most helpful for pain from inflammation, Agree on crutch first few days. Helps with keeping you more upright too. All the best to you.

 

[Prem1234]

You sound very well...I was still in full fledged whine panic mode for the first week.

I've had a bigger icing session already today and will continue to

It really was the most helpful thing throughout my recovery.
And only side effect was Cold.

I've swapped the cane for a crutch as well and have noticed a better slow and steady walk.

Glad this is working better for you.
Hope your weekend is restful.

@Mojo333 Great thank you for your reply...There's still plenty of panic going on thinking it's loose or I've damaged something etc but fingers crossed everything is going in the right direction.

I think the PT pushed me a bit to much on my exercises before leaving hospital especially leaving on one cane but luckily I still had my Crutches from my initial Femoral Fracture at home.

Wishing you a great weekend

 

[ForumUser]

Ah ... just started checking the Tylenol thing ...

Some American organizations say 4 g and some say 3 g.

Found a reference to a study that may explain - in funny way - having zero to do with the effects of the material and lots to do with mathematics ...

Study by American Pharmacies Association, in 2018 (https://www.japha.org/article/S1544-3191(18)30232-2/abstract) had some interesting findings ... my somewhat stumbling summary is that 4000 mg limit divided by 500 mg equals 8 pills, and 8 pills divided by 2 pills equals 4, and 24 hrs divided by 4 sets of 2 pills equals every hours. Or, one could reverse the math. The net result is that taking two 500 mg at a time every six hours equals the 4g limit.

BUT, when Americans, some unable to divide 4000 mg by 625 mg, take the same two pills every six hours as they do when using the 500 mg pills, end up taking 5200 mg (5.2 g).

I know this sounds silly, and I may have put too fine a point on it, and I am NOT making any recommendations, but it does seem to explain the differences in positions.

 

[Hip4life]

Stopping by to wish you a peaceful, healing weekend. Re: leg lifter: You can also use a belt or bathrobe belt in the meantime. I used the gait belt they sent home with me. These were my panic, whining days as I recall. I did a lot of up and moving around because I couldn’t get comfortable. Unfortunately, I didn’t know about BoneSmart at the time. I eventually discovered that I wasn’t elevating enough remembering past times when I had injured my ankle. Hopefully, armed with this site’s knowledge and support, these early days will pass much easier. It sounds like you’re doing the slow and steady approach which is perfect. Listen to your body. Try not to worry too much. We’re here for you. Have a great weekend.

 

[BruceH]

@Prem1234

Any more random clicks or pops? I can empathize. In my case I think it's something like a tendon going over a bursa. It doesn't hurt, the artificial hip feels solid, it's random and I'm probably only becoming aware because the pain is receding and I can think about other things when walking.

Have a great day.

 

[Celle]

BUT, when Americans, some unable to divide 4000 mg by 625 mg, take the same two pills every six hours as they do when using the 500 mg pills, end up taking 5200 mg (5.2 g).

The 625 mg Tylenol (Tylenol Arthritis) are slow-release and it's recommended they be taken 8-hourly, not 6-hourly. The over-the counter packet clearly states "8 hourly". Therefore, you should only take three doses in 24 hours.

If you take 2 x 625 mg each time, you are taking 1,250 mg in a single dose. Normally, it's not advisable to take more than 1,000 mg each time, as a larger dose could be too much for the liver, but the slow-release quality of these capsules means that the entire dose does not hit your liver all at the same time.

Taking 3 doses or 1,250 mg eight-hourly will give you a daily total of 3,750 mg, which is within the recommended limit of 4,000 mg in 24 hours.

Here on BoneSmart, we recommend using the 500 mg Tylenol tablets (Tylenol Extra Strength) and taking 2 x 500 mg tablets 6-hourly - with the precautions about checking other medications that I mentioned earlier.

Now, Prem1234 has seen the advice about her Paracetamol/Tylenol regime and has moved on, so please can we end the discussion about it?
Any further discussion will be hi-jacking, as it would be taking his thread off the main topic, which is his recovery.

 

[Prem1234]

@Prem1234

Any more random clicks or pops? I can empathize. In my case I think it's something like a tendon going over a bursa. It doesn't hurt, the artificial hip feels solid, it's random and I'm probably only becoming aware because the pain is receding and I can think about other things when walking.

Have a great day.

Hi @BruceH It's settled down now thank you....I got my wife to hold my left knee when i was walking and she could feel the 'clonk' there while I held my hip which felt solid.

I have been doing some stationary heel flicks (stand upright hold on to something solid and bend the knee to bring my ankle up to my Bum/Butt slowly and repeat for 20 reps) I think this has helped align and tighten the knee up. My knee is OK but not the best as I had a lateral release and patella re-alignment 30 years ago.

I hope all is good you're end

 

[Prem1234]

Day update 5

I’m off of my Oxy now and taking Paracetamol 1000mg every 4-6 hours (not more than 4000mg in 24 hours). I have Codeine if pain high.

Current Prescription Meds:-

10 AM Apixaban 2.5mg (blood thinners) Celecoxib 200Mg (anti inflammatory)

10 PM Apixaban 2.5mg (blood thinners) Celecoxib 200Mg (anti inflammatory) and Gabapentine

Icing as much as possible

I’m doing light physio exercises 2-3 times a day and walking with my crutch lightly touching the ground for 2-3 mins every 2 hours.

I can stand upright and lift my knee up towards my chest I can’t make 90 degrees due to moderate (3-4) pain in my hip flexor and a light burning in my incision site which I suspect is the internal stitches so stop at a less angle to protect from this.

However I do have a lot of pain (8-9) in the front of my hip (hip flexor?) if I lie on my back and try and lift my straightened leg up or I try and lift my leg up on to the bed. The pain is so severe that I can not do it and don’t want to.

Is this normal have others experienced this ? Do you think it’s due to the Acetabular cup being reamed out which is close to one of the hip flexor muscles or damage/strain of the Hip Flexor or something else due to the surgery/manipulation etc ?

Many thanks

 

[Jaycey]

I can stand upright and lift my knee up towards my chest I can’t make 90 degrees due to moderate (3-4) pain in my hip flexor and a light burning in my incision site which I suspect is the internal stitches so stop at a less angle to protect from this.

I strongly advise you stop trying to do this so early out of surgery. Even if you were not given any restrictions your hip is telling you very clearly it does not want to go there. Please don't.

However I do have a lot of pain (8-9) in the front of my hip (hip flexor?) if I lie on my back and try and lift my straightened leg up or I try and lift my leg up on to the bed. The pain is so severe that I can not do it and don’t want to.

The same applies to this position. At only days out of THR why are you trying to do leg raises? Totally not necessary and new hips do not like this. In a few weeks you may be able to do this. But at only days out - please stop. You do not want to risk ruining all your surgeon's work.

You need to give that hip a chance to heal. When is your followup appointment with your surgeon?

 

[Hip4life]

I totally relate to your front flexor pain. I even experienced the sliding, “clunking” there as well. My recommendation is to not try and straight leg lift that op leg any more than is necessary without support. Those soft tissues suffered quite a bit of controlled trauma during surgery and need a lot of TLC right now. They will be sore for a while. Elevate and ice as much as possible right now. Walk frequently to keep from getting too stiff. This is the time to be very good to and patient with yourself. You’ve been through a lot, you have every reason to. Keep us posted.

 

[leejaa]

My home PT had me try the leg raise with a leg lifter and that was uncomfortable past 1" so she just said do not do this. She would show me something to do but always ask if it hurt and if it did we did not do it for weeks if not longer - she would just say check to see how it feels in a week or two. Also pretty much told me the same as bonesmart- if it hurts stop doing it and give your body time. Walking around the house with the proper gait was my main exercise as well as ankle pumps and thigh and butt squeezes and even those I just did 5-10 depending on how my hip felt. Slow and steady without too much forcing of healing soft tissue will really get you there sooner than straining tissues that are already inflamed from surgery. As someone here says patience is the muscle that really needs to be worked for a good recovery.

 

[Eman85]

Yes we've all experienced pain, some from different movements, but pain. You have been in a pre planned trauma, it might have been in a sterile environment but still a trauma. Day 5 your walk to the bathrrom should be your biggest strain of the day. Sitting and icing is what should be done. You'll recover no faster by pushing the limits. No pain no gain does not apply.
Do the google on knee clicking, much of the cause is weak quads, your quads have been along for the trauma ride you went on.

 

[Prem1234]

I can stand upright and lift my knee up towards my chest I can’t make 90 degrees due to moderate (3-4) pain in my hip flexor and a light burning in my incision site which I suspect is the internal stitches so stop at a less angle to protect from this.

I strongly advise you stop trying to do this so early out of surgery. Even if you were not given any restrictions your hip is telling you very clearly it does not want to go there. Please don't.

So this was from my post physio session, I've only just started them but will stop now.

However I do have a lot of pain (8-9) in the front of my hip (hip flexor?) if I lie on my back and try and lift my straightened leg up or I try and lift my leg up on to the bed. The pain is so severe that I can not do it and don’t want to.

The same applies to this position. At only days out of THR why are you trying to do leg raises? Totally not necessary and new hips do not like this. In a few weeks you may be able to do this. But at only days out - please stop. You do not want to risk ruining all your surgeon's work.

So really that was me trying to explain the pain I was experiencing when getting in and out of bed etc but again I'll look to not push that and protect from getting in those situations

You need to give that hip a chance to heal. When is your followup appointment with your surgeon?

The Follow up session with my consultant surgeon is Monday 27th

@Jaycey Thank you for your reply....I've responded inline and in bold so to make my responses easier to read.

Many thanks again