THR A Matching Pair of Hips! RTHR

[Pumpkin]

Always something new and exciting in the world of recovery. If only it wasn’t so exciting at times.

 

[Deni444]

@Pumpkin I've censored my post to delete British Toilet humour... In the spirit of international relations. It just doesn't need imagination!

 

[Tuppence71]

Surely this is a safe space in which one doesn’t have to self censor. Especially if it is funny. We need all the funny we can get.

 

[Deni444]

@Tuppence71 It's for your own good... I wasn't sure if it could cause nightmares. Some things are funny in a scary sort of way. I'm sure it's a special recovery experience, that's been reserved especially for me .

Explanation edit: My experience with hip #1 seemed uniquely, toilet prone... I thought I'd gotten away with it hip#2.

 

[Jamie]

Our bodies have a wonderful sense of humor sometimes…..hope this doesn’t last long.

 

[Deni444]

Day 17 Post Surgery... Now everything is calming down since getting the dressing off and starting antibiotics. I've suddenly been able to go light on my crutches. Weather isn't great at the moment and so I'm doing laps up and down my conservatory. Between 5-10 minutes is slow but comfortable. I've been off the Oramorph for a number of days now. I'm taking off the shelf Paracetamol 2, four times a day and 2 x 500mg Naproxen, morning and after supper. I ICE/elevate for anything uncomfortable between doses. Also find the slow walk, maybe just 3 minutes beneficial if things are aching around the hip area. I have to be careful to avoid twisting as it seems to bring on a bit of swelling.

 

[Tuppence71]

I'm taking off the shelf Paracetamol 2, four times a day and 2 x 500mg Naproxen, morning and after supper

Did they say you could take the Naproxen while you are on blood thinners? I’d much prefer that (or even just ibuprofen) to codeine (along with the paracetamol) and think it would actually be much better for me right now, but I was told no anti-inflammatories while I’m on the Rivaroxaban….

 

[Deni444]

Did they say you could take the Naproxen while you are on blood thinners?

I was surprised when it was listed as my post surgery prescription. I was on Naproxen before surgery. taking 1-2 tablets daily, usually just 500mg. With hip #1 they said I was to stop taking it about 3 weeks prior to surgery and was not permitted to resume until after the blood thinners. I was prescribed Tinzaparin injections this time for 28 days.

For someone with an inflammatory element to my arthritis, it was pretty brutal. I'm sure it contributed to my difficult recovery because I was struggling so much prior to surgery and when my knee flared post surgery it wouldn't calm down.

I guiltily fessed up at my pre assessment that I had continued to take it because I hadn't been told otherwise. They said, keep taking it you're going to be on it post surgery too.

My limited understanding is that there is a wide debate amongst surgeons regarding its benefits versus potential risks. Some are fiercely for and some against. Strange thing, I had the same surgeon but different hospitals. I can only assume different protocols.

If you have the opportunity, could you contact your medical team to discuss your medication? Remember, I have not been prescribed Codeine this time and on a different blood thinner regime to you. I'm not a chemist and drug combinations are beyond my experience or understanding. (I'll understandably add a warning note to our discussion)

It's always vital to follow medical guidance and get approval before adjusting what you take. Taking a combinations of drugs requires professional medical guidance. There could be serious health consequences if you fail to adhere to medical advice.

I'll flag an admin in for additional guidance @benne68

 

[Tuppence71]

For someone with an inflammatory element to my arthritis, it was pretty brutal.

Me too! I have always found NSAIDs to be my friends in a way other painkillers aren’t. I may tough it out until my 2 week check in on Monday and talk to my consultant about changing.

(And don’t worry, I won’t do anything without medical advice).

 

[Deni444]

Thanks @Tuppence71 You'll understand my caution with the conversation

 

[Deni444]

Recovery Vent & Rant Warning

Just had a call from my local physio. The hospital physio referred me for general physio at around 6 weeks because of my long term disability.

Backtrack to a few days post opp. I get a call trying to book me in at week 2. I tried explaining that I didn't need physio this early that I had video exercises assigned that I was more than happy with. I explained my history and said, the idea is that I would benefit from help to get back into shape generally after so many years of mobility issues. Flatly refused and said, this is what's on offer. Take it or leave it. Too little energy from surgery to argue, I let her book the appointment knowing I'd cancel when I had a little more energy to deal with it.

I didn't receive an appointment notification but a questionnaire to fill out. Basically the state of my mobility on that day... A couple of days after surgery! I had fun filling it out... They did ask. I tackled the nice lady on this today... She confirmed that is normal. I confirmed your stats must make you look very good at your jobs. Quite an improvement measuring between a couple of days post surgery against after a couple of sessions of physio with you.

Today, I finally get notification via text for the appointment. Not booked at my local hospital as informed but 40 miles away and in a few days time. I cancelled and called the number to discuss.

Lady. Sorry, your wrong. Your appointment is my local just down the road. I have to read the message out. She continues to say I'm wrong. I'm taking every bit of self control to stay calm at this point but I'm getting a bit assertive! Finally she listens and apologised that the system must be wrong but it still seems my problem. We move on to me trying to explain the nature of my mobility and why I want an appointment at 6 weeks. She then says... That's not normal for KNEES!!!

There's more... I won't bore you... Rant over... I'm feeling better already

I love my local physio team... So looking forward to my appointment... Sarcasm alert!

 

[Tuppence71]

Oh my goodness. That is so incredibly inept. It is also maddening when you feel you are being treated like a product for processing rather than an actual human being. Dealing with this sort of thing is hard at the best of times. And these are not the best of times.

How has it been left? Do you actually have an appointment?

 

[Deni444]

That's hysterical laughter... @Tuppence71

Yes, she grudgingly booked me an appointment on 6th October. Great news, with the very nice man who did my (now mandatory) assessment before being referred. He was so thorough... Asked me to stand on my tiptoes to assess my leg strength and kindly ticked the box to confirm I could go forward for hip replacement. Incidentally, I was cleared for hip replacement two years ago! Prior to this!

Edit... He is their top guy... Head of. I feel very special

 

[IndigoKnee]

Goodness Deni you have right to rant!!
I have frequently in the last couple of years, following knee then hip replacement, had to explain what they should already know and it is SO frustrating. Good you have now got the appointment that you need. Sometimes feels like you have to be on the ball and take control.

 

[Deni444]

My laughing is genuine now, rather than slightly hysterical. It's a shame because my hospital experience was really excellent, including the physio team. It's a bit pot luck sometimes with the NHS
@IndigoKnee

 

[djklaugh]

@Deni444 The ineptness of the scheduling folks for the PT is truly appalling! Not only the wrong facility but the wrong joint replacement??? Geesh... and to try to blame you for their mess? I am glad you got it sorted out correctly and brava for being assertive! And I am glad you were finally able to schedule with someone you know and who is top flight!

One thing I did with my PT for both hips and shoulders was to schedule appointments with my "team" (main PT gal and her trainee/assistant) every 2 weeks and then do the exercises they gave me diligently between appointments. That stretched out my benefits and, while it might have taken longer, did do a nice, gentle, effective rehab for me. They would review old exercises, drop the ones that had gotten easy, add new ones, and assess my progress. While many new hips do not need much PT (walking is the best exercise) there are motions other than walking and climbing stairs that hips need to do ... such as getting foot onto opposite knee. And those motions do sometimes require good PT.

 

[Deni444]

@djklaugh Thank you... My comment about top man was a little sarcastic. I'll give him a second chance though. I think this mandatory assessment is new and a bit of a head scratcher for everyone. The GP had already referred me and the MSK guy is now forced to do a bit of a tick box before people go on the waiting list. Quite a bit of changing going on at the NHS... So I'm talking about my previous experience with him asking me to stand on tiptoe and calling it an assessment.

 

[Deni444]

I haven't been able to put socks on or reach a shoe for two years!

 

[Deni444]

Whilst I'm on a roll with NHS local experience, I wanted to pass on a little advice. I hope my experience isn't typical and I'm sure local services can be excellent. At my recent wound check appointment. My nurse had not read the hand delivered and emailed note from my surgeon.

Fortunately, a thumbs up to my excellent NHS hospital team who use an excellent education app that enables direct communication with them. There was a letter for the attention of the district nurse. It very clearly stated and I had both read it and had the info given through the app. They were not to treat the wound or prescribe antibiotics without contacting the hospital.

The nurse checked my wound and says, I'm going to prescribe precaution antibiotics. Now, I know that's prudent... But. I said, I thought you had to double check with the surgical team first. She said, no... Who told you that? I said it's the information that they gave me and I believe it was on the letter they sent you. She goes on the PC and can't find a thing. I insist and she excuses herself and disappeared for 10 minutes. Comes back, letter in hand and states she was trying to locate it.

Great from thereon. She telephoned the hospital and they sent over guidance on the antibiotics they wanted me to have and instructed her to take the swab. The hospital phoned me and explained my prescription would be ready to pick up over the weekend. Knowing my GP surgery, I knew it would be Monday soonest. They are my chemist too. To be fair, they got it sorted but it took a lot of leg work on my behalf.

So my heartfelt guidance is stay alert, read your info and keep an eye out for local services not always being on top of things. If you need support phone the NHS hospital who in my experience are usually very on the ball. I pray my experience is isolated. However second hip and second poor experience at GP level.

I will be feeding back to my surgeon tomorrow.

 

[Deni444]

Edit: Allergic to the Surgical Glue used to seal the wound after surgery (Dermabond or similar surgical glue)

Allergic Reaction to Surgical Wound sealing Glue (alongside the dressing reaction). This is the Dermabond style glue used during surgery to secure the wound.

I had reacted previously Hip #1 to dressing adhesive. With Hip #2 when I attended my appointment to remove the dressing. All did not look well. I had again reacted to the dressing, albeit to a lesser degree than with hip #1. The wound presented as looking like potentially infected. There was no rash at the incision but it was red in places and had some minor weeping.

I was put on precautionary antibiotics and a swab test for infection taken. This was late Friday afternoon and was scheduled to see my surgeon on the following Tuesday.

Upon arrival they directed me to the wound clinic (NHS). They spotted residual glue near the wound and quickly decided that I was having an allergic reaction to the glue used to seal my incision during surgery (dissolving stitches below).

The protocol they followed was to aggressively scrape the incision to ensure the removal of any glue on the skin. I had a steroid cream applied after.

So to summarise, my allergy to surgical glue (Dermabond style) presented as a potential infection rather than contact dermatitis.

My symptoms were those similar to an infection but I didn't have an alarmingly elevated temperature. I had swelling, pain and redness, light oozing at points along the incision.

I didn't react to surgical glue with hip #1, only the adhesive on the waterproof dressing.


I was incredibly fortunate it was painful and uncomfortable but didn't open the wound. Phew!!!

Oh my the instant relief as it was scraped off... Surgeon is very confident there isn't an infection. Swab test still not back and precautionary blood work taken. I feel incredibly relieved not to mention now very comfortable. Drive there incredibly uncomfortable, feeling every bump. Drive home, like I had a little bruise.

If you have an allergy to adhesive, may be a good idea to flag it at pre- assessment. It's pretty rare to have an allergic reaction to surgical glue however a little more likely if you have a history of reacting to adhesive. Always best to raise a hand and let them know.

(Edit to my original post because upon review it wasn't a clear post and the context and details were not there)