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[HIP RESURFACING] 5 Weeks Pain<

wendys

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I don’t know anyone that has had a metal on metal hip resurfacing to ask these questions to.

I had my operation on May 13, 2019 in Columbia SC. Surgery was done in outpatient surgery center. Spent that night in an hotel and headed home next day with four simple home PT exercises to do myself.

By week two I felt awesome! I was walking really well and felt great other than quad tightness. By third week I went back to work at a desk job. I never used the Oxy pain meds as they made me deathly ill.

I’m now at 5 week mark and in AGONY with sciatica and groin pain. I am hobbling and back on the cane. It’s like I went backwards in recovery!

I’m supposed to have left side done on July 8th and cannot even imagine doing that. Seriously don’t know what I have done wrong but Dr's Office keeps telling me to back off for a day and then walk again. I’m two days on ice and doing absolutely no exercise. What the heck.

I’m so depressed and feeling so much anxiety.
 

Elf1

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The admins should be by in a while and they'll have some good info for you. I'm still waiting on mine but from what I've learned here so far it sounds like you have overdone to the max. Not sure about resurfacing but would think you would have similar recovery. Going back to work, even a desk job, at three weeks just sounds painful to me. And if the pain meds made you sick you could have either asked for anti nausea mess or different pain meds. Are you at least taking Tylenol?

So sorry your recovery seems to have derailed. I'm not a medical person so I'm just guessing at some of the possible reasons. Hope it gets better soon
 
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wendys

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Thank you for writing me. I take Mobic w/Prilosec every morning and add extra strength Tylenol every 6-8 hrs. I think I have both sciatica and a nerve issue in the groin. So frustrating and I have anxiety about going to work tomorrow.
 

Layla

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Hi Wendy,
Welcome to BoneSmart. Thanks for joining us. I'm tagging the forum nurse @Josephine to touch base with you, so please check back periodically in case she has questions. She resides in the U.K. so there is a time difference.

I'm sorry you're struggling with pain. It sounds as though you may be doing too much, too soon. I will look forward to Josephine's response. Hopefully she'll have some advice for you.

Please read the Recovery Guidelines below and ice any areas of pain / swelling several times per day from 40-60 mins, no less.

In addition, you may need more effective pain control, something that doesn't make you nauseous. Not sure how many mgs of Tylenol you're taking but the forum Nurse recommends 1000 mgs of Extra Strength Tylenol, 4x daily, not to exceed 4000 mgs in any 24 hr period. If you're taking anything else that contains Acetaminophen, you will need to include the amount in your calculations, making sure you're not exceeding the 4000 mg. within a 24 hr period.

Wishing you comfort and speedy relief.
@wendys


Hip Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:
rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)​
3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.
4. PT or exercise can be useful BUT take note of these
5. At week 4 and after you should follow this
6. Access to these pages on the website

Pain management and the pain chart
Healing: how long does it take?
Chart representation of THR recovery

Dislocation risk and 90 degree rule
Energy drain for THRs
Pain and swelling control: elevation is the key

Post op blues is a reality - be prepared for it

Myth busting: on getting addicted to pain meds
Sleep deprivation is pretty much inevitable - but what causes it?

BIG TIP: Hips actually don't need any exercise to get better. They do a pretty good job of it all on their own if given half a chance. Trouble is, people don't give them a chance and end up with all sorts of aches and pains and sore spots. All they need is the best therapy which is walking and even then not to excess.

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in a majority of BoneSmart's forums, we ask the at each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
 

Going4fun

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Hopefully this nothing more serious than overdoing it. It sounds really bad ... yes, I get the fear and anxiety ... So sorry about that ... Right now, you want to do the absolute minimum movement and allow the hip to recover. And let's just hope there is nothing seriously wrong. Do you have a six-week consult with your surgeon coming up? ... Can you ask for that ... Get X-rays and send them to South Carolina ... to make sure nothing has shifted or moved?

I am little surprised at the advice to "back off for a day." When I overdid things early in my hip recovery, I had to back for a week ... or more! ... There are people who after overdoing things ... have to back off for multiple weeks! A day of backing off ... that's for when you bump up against the corner of a table and get a painful bruise. But for hip replacement and resurfacing, there's a ton of deep tissue that cut and stretched and pulled. This tissue doesn't heal in a day.

People on this forum call it the Over Did It Club. Which means you did too much ... and yes, there can be a furious and painful backlash. Unfortunately after surgery, your body doesn't always immediately signal that you've gone too far ... so many of us don't have pain in real time when we're pushing ourselves, trying to recover fast. But a day later, two days later, three days later, the hip and body will throw a nasty tantrum.

I think going back to work in three weeks was probably much more of a strain than you anticipated. even with a desk job. Sometimes that's unavoidable, so I'm not criticizing you or judging you. But it's the rare hip surgery patient who can return to work at three weeks. I assume your surgeon is Dr. Gross ... I've read tons of stories from patients of Dr. Gross ... yeah, occasionally there's someone with the miraculous recovery ... but many ... talk about a grueling first two months.

Just for reference ... lots of people here who have fantastic recoveries here ... might walk without the cane at 8 weeks, 10 weeks ... I didn't walk without a cane until nine weeks ... and I went to one of the top surgeons in my area who has patients that can often walk more quickly. Just random ... it took me longer. I was off for 14 weeks (I'm a teacher so I got a few extra weeks on top of 12 weeks leave.)

Is there any way you can get a week, really two weeks off of work. Any way, you can simply say to your job that you perhaps returned too soon. Any way to go back on disability if you have disability at work?

Probably not what you want to hear, but likely the best thing for your body is to elevate and ice and not go to work ... and to take adequate pain medication and to chill. There's nothing wrong with returning to the cane--frankly, nothing wrong with temporarily using a walker if you're hurting that much. I wonder if crutches would be less painful.

It would be great if you could be examined to double-check that nothing catastrophic is wrong ... and then cutting way way way back in your activity for a week at rock-bottom minimum. And you might need a much stronger pain medication.

So sorry to hear of the agony.
 
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wendys

wendys

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Oh thank you for that!

I called off work just now. Was all dressed and hobbling around and just said I’m not doing it today. We don’t have disability and I don’t get paid as I’m out of all leave time so that’s why I went back to work as soon as I did. I was walking a lot, doing PT exercises they gave me and walking very well without a cane.

Well, screeching halt on that success. You’re right. I likely went back too soon. I thought sitting at a desk would be no problem.

Yes, Dr Gross did my surgery. I just called to see if they can see me this week rather than next. I also asked for a note to be out of work this week. I cannot even imagine going back for left hip on July 8th!!!

I appreciate your advice. Thank you!!!!!
 

Layla

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Good Afternoon! :wave:
I hope your place of employment allows you the week off.
If you're able to get your doctor appointment bumped up, let us know how it goes.
I hope you have a good day!
@wendy's
 

Josephine

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Would you tell me where your pain(s) are using this chart? Just the reference numbers from the top and side of the chart as described in the smaller example.

aa hip-references-horz.jpg




After that, I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?
 
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wendys

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V R3F /T R1B
Yes I will take any advice and am happy to answer questions. Dr Gross bumped my appointment up to tomorrow. I have asked for an excuse to take the week off. I’m currently using an ice machine. The pain radiates down my outer quad, to my knee and then to my foot. It happens in spasms and when I try to walk on the surgical side. Very hopeful to see x rays tomorrow. Wendy. Thanks so much!!!!
 

Josephine

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So you pain is here?

wendy.jpg


I'd say the red one is Psoas pain
While the blue on is Trochanteric bursitis and may also be ITB (ilio-tibial band)



As for the articles, here y'go!

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 approach did you have for your surgery? Anterior, posterior, lateral? You can look here to see the various types THR approaches or incisions

2. 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 forget to factor in other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness).

3. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

4. are you icing your painful area at all? If so, how often and for how long?

5. are you elevating your leg. If so how often and for how long?

6. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

7. are you doing any exercises at home? If so what and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)

Exercises done at home
- how many sessions you do each day
- enter exercise by name then number of repetitions of each
etc., etc.

Anything done at PT
- how many times a week
- enter exercise by name then number of repetitions of each
etc., etc.
 
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wendys

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1. Posterior Hip Resurfacing (metal on metal)

2. Stabbing & throbbing - level varies from 2 (on ice with no activity) to around 7 (takes my breath away) when walking or riding up from sitting.

3. Meloxicam 15 mg once a day, OTC Prilosec, Tylenol 650 mg x 2 every six hours, Lisinopril 5 mg bid, Vitamin D and Calcium once a day.

4. Using large ice pack or ice cooling unit every hour or so for 20-30 minutes. Unable to do this when at work...only do this at home.

5. I sit in a recliner with my legs up most of the time.

6. I don’t do much at home other than some laundry, cleaning up kitchen, make my bed, feed the animals. My husband is a huge help doing major cleaning and chores. He’s a Godsend. In first two weeks following surgery I went to the mall and walked whenever I could. I felt great! I walked as much as I could tolerate...about 1.5 miles in total per day. Then the muscle pain started.

7. Was given 4 home PT exercises to do for first 6 weeks and told by week 5 I should be able to walk a mile with cane or without.
Leg lifts on 3-4 in rolled up towel under knee for 20 reps twice a day
butt squeezes 30-40 twice a day
foot slides while on bed 20-30 reps twice a day.
 

Josephine

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Thank you! I see you are 5 weeks out.
2. level varies from 2 to around 7 when walking or rising up from sitting.
Okay, got that
3. Meloxicam 15 mg once a day,
OTC Prilosec
Tylenol 650 mg x 2 every six hours
Meloxicam is an NSAID which is not a very good pain killer. They also have some rather unpleasant side effects
Medications: acetaminophen (Tylenol, paracetamol) and NSAIDs, differences and dangers
NSAIDs Diclofenac. ibuprofen increase risk of heart problems: new study

Prilosec is just a PPI inhibitor (see article above) and takes no part in pain control
650 mg Tylenol is not the best way to take this medication. I would suggest you take it 1,000mg 4 times a day at 6hrly intervals. I know the FDA has ruled that 3,000mg acetaminophen is a safe maximum but that would be assuming that the patient is taking another medication that also contained it and thereby inadvertently take an overdose. Assuming that this is not the case, the maximum safe dosage per 24hrs 4,000mgs.

If this doesn't work sufficiently, I suggest you ask your GP for some codeine to take with the Tylenol. 15mgs 3-4 times a day would be plenty.
4. Using large ice pack or ice cooling unit every hour or so for 20-30 minutes.
You accomplish little or nothing in 20 minutes. Ice for at least 40-60mins and more than 4 times a day.
6. I don’t do much at home other than some laundry, cleaning up kitchen, make my bed, feed the animals. My husband is a huge help doing major cleaning and chores. He’s a Godsend. In first two weeks following surgery I went to the mall and walked whenever I could. I walked as much as I could tolerate, about 1½ miles in total per day. Then the muscle pain started.
You started off this comment by saying "I don't do much"! But clearly you do! I'm referring to the walking (in bold)


Was given 4 home PT exercises to do for first 6 weeks and told by week 5 I should be able to walk a mile with cane or without - I would say that was a bit of an overkill in the first 5 weeks! But too late now.
Leg lifts on 3-4 in rolled up towel under knee for 20 reps twice a day - these are known as half leg lifts and aren't generally considered necessary once you can do them
butt squeezes 30-40 twice a day - these aren't generally necessary
foot slides while on bed 20-30 reps twice a day - I have never understood why these are 'prescribed' because they are a knee exercise! I suggest you stop doing them. Besides which, 120 per day is far too many

My opinion in regard to hip surgery is this
Hips actually don't need any exercise to get better. They do a pretty good job of it all on their own if given half a chance. Trouble is, people don't give them a chance and end up with all sorts of aches and pains and sore spots. All they need is the best therapy which is walking and even then not to excess.

In summary:
Adjust your pain meds as suggested
Ice longer
Stop the exercises
 
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wendys

wendys

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Thank you so very much. I’ll take your advice.

I only have 650 mg Arthritis Strength Tylenol. Okay to take two which is 1300 mg 3 x day?

I hear you on the side effects of Meloxicam and I just finished a Lexiscan and echo of my heart because my pre-op chest xray showed aortic ectasia and my EKG was irregular so not thrilled with heart risk factors on this med.

I’ll ask tomorrow at my visit about the codeine being prescribed. I so appreciate your taking the time to give me some great answers!!!
 
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wendys

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Okay well I got really bad news that explains my pain. I have a fracture just below my implant. Emergency surgery tomorrow to put in steel plate and screws. Could have been so much worse had I not gone today. I’m scared and sad and upset but at least I know what needs to happen. Prayers please.
 

Calgal

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Poor thing! Sad to hear of fracture but sending you strength and healing vibes for the fix procedure. One small question, did you have a hip resurfacing or a THR replacement?
 

Layla

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Of course....promise to remember you in prayer. :prayer: I'm so sorry you have to deal with this.
Please update once you're back home and resting comfortably.
Big hugs :console2:
@wendys
 

Going4fun

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@wendys, so sorry to hear you have a fracture. Was hoping you had simply done too much ... but I did have a worry that something bad had happened since the pain was excruciating.

Please update us with your situation after surgery ... are they going to replace the resurfacing with a total hip?

Glad at least that you got an answer though it wasn't the answer you had wished for.
 

Elf1

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@wendys sorry about the fracture but good that you realized something was wrong quickly and you're getting it fixed. Sending healing thoughts and prayers for tomorrow.
:angel:
 
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wendys

wendys

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Dr Gross was so upset...and kind. He said he will go in and secure the fracture with a steel plate and screws. Thank God I went today and didn’t postpone until next week or the bone could’ve broken off. I had a hip resurfacing and he said if it had broken off we would’ve been looking at a total hip replacement.
It’s a hairline fracture underneath the implant. Thanks all. I’ll keep you posted. Looks like a long recovery ahead. No walking or exercise this time.
Wendy
 

Going4fun

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@wendys, yes, great job going immediately to the surgeon ... Great to hear that Dr. Gross responded so sensitively. I had a problem (not as severe as yours), and my surgeon really impressed me by how concerned and alarmed--visibly so--he got.

Here's to Dr. Gross saving the resurfacing!
 

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