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[THR] A not great first day home...

Discussion in 'Hip Replacement Recovery Area' started by KY hipster, Jan 10, 2019.

  1. KY hipster

    KY hipster new member
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    First, I was just told about this site and forum, glad to have found it and joined! I might have just read and not posted had I not had a not so great go of it since my right anterior THR yesterday...
    Had it performed by a well respected and experienced surgeon at a surgery center, which they told me presents less MRSA/pneumonia/etc. risk. The first little inkling that something was amiss was when I kept feeling discomfort at the IV site in the crook of my arm. I was pretty wiped out and out of it when I got back from surgery, so apparently did not realize until early evening that they had actually sent me home with the IV port still in my vein and taped down to my arm! So a call to the answering service and they told me I could go to an ER to have it taken out or do it myself, so obviously did it with my wife at home...ok, kinda weird and a bit unsettling. I then spent a pretty uncomfortable and restless night, in pain, shaky for some reason and very dry feeling. This morning, I use my walker to get into the bathroom, start to feel really dizzy and lightheaded, and proceed to pass out, fortunately my wife was able to get me back into a chair and off the floor. I had a scheduled post op visit from a home health care nurse about an hour later, so she arrived and immediately saw my blood pressure was very low (it typically is low for me), and when I was sitting up or standing it would drop even further, systolic sometimes getting as low as the 70’s or 80’s. The nurse said this is no good, I need fluids to get my pressure up, so I end up in an ambulance back to a hospital this time for a saline IV bag and tests. The nurse asks me if they either got me up after surgery or gave me fluids at the surgery center, I didn’t really remember but my wife confirmed they did not, just put me in a wheelchair to the car and did not give me any fluids afterward, so needless to say the nurse wasn’t so enthused about this. So now I am home again after like 6 hours of going to, staying at and returning home from the hospital, my bp and vitals were stable and good and I feel much less lightheaded now, but obviously am not so happy about any of this...

    Btw, I am an otherwise healthy, active and fit 56 year old man.
     
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  2. Layla

    Layla FORUM ADVISOR Forum Advisor

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    Hi, Welcome to BoneSmart. Thanks for joining us. I'm so very sorry for your unfortunate experience. I'm glad you're resting comfortably and feeling better. The IV situation is unbelievable! It sounds as though you're safer at home considering what you've been through. I hope you're pain is well managed. Stay well hydrated and ice your incision area if you're not already. It will help with pain and swelling. Stop back often. We're here to help in any way we can and to offer support and encouragement as you're healing.
    Please read the Recovery Guidelines below. The info in the articles will help with your recovery.
    Wishing you comfort and a peaceful night!

    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. Here is a week-by-week guide to

    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 that each, member have only one recovery thread. This policy makes it easier to go back and review history before providing advice. @KY hipster
     
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    Last edited: Jan 10, 2019
  3. Celle

    Celle FORUM ADVISOR Forum Advisor

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    Hello @KY hipster - and :welome:

    It sounds as if you got off to a rough start, but I'm glad things are going better now.

    Please will you tell us the full date of your knee replacement and which knee it is, so we can make a signature for you? Thank you.:flwrysmile:
     
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  4. Debru4

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    That's a rough way to start your recovery! Glad you are back home (for the 2nd time) and ready to start healing. I had my surgery done in a surgery center, and the experience was very positive. Does your surgeon do many surgeries at that particular center? Be sure to share your concerns with them when you have your follow up appointment.

    I had a similar bad experience following a back surgery I had about 9 years ago, only my return to the ER was due to a bad reaction to medication. I came home from surgery at the surgery center feeling really good and within a few hours had a blinding headache and low blood pressure/dizziness. My bad experience took place at the ER. Even though I had had back surgery 11 hours earlier, they decided I needed to have a spinal tap to rule out meningitis. It was the worst medical experience of my life....my surgeon was incensed when he learned that they had not called him, and that they were holding me down, with multiple attempts to get the needle in. :gaah:He said had they called he would have suspected it was the medication, given my history.

    With that said, all's well that ends well, and fortunately I suffered no negative effects from the ER experience, and had a very positive surgical outcome. I am sending good vibes to you, that the worst is behind you:)
     
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  5. Jaycey

    Jaycey SUPER MODERATOR Moderator

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    @KY hipster Welcome to the other side. So sorry you had a rough start. Low BP is very common after surgery. Frankly that's why I am not really in favour of early discharge. There are many issues that need to be addressed just post op and that takes time.

    But you are home now and hopefully resting more comfortably. Do read the articles Layla left for you. Lots of good information about this recovery.
     
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  6. Bionic

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    Hi @KY hipster
    Oh my, what a worrying start. Hopefully things will now improve for you though.
    I too had low bp and felt light headed and nauseous but luckily I was still in hospital.

    Now that you are home again you can start properly on your recovery journey. The first few days can be a bit trying so don't be surprised at that and also don't be surprised if you get a dose of,the blues now and again. It seems to come on for no apparent reason but is fairly common.
    Best wishes for a full recovery.
     
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  7. Mojo333

    Mojo333 FORUM ADVISOR Forum Advisor

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    :wave: and :welome: to the
    Healing side!
    First days can be rough...and frustrations in BP not uncommon.
    Best not to do too much solo venturing if you can for a few days until things settle.
    I'm guessing your wife was also frightened after that incident.:flabber:
    Things will level out so just roll with it for now.
    You Will be glad you had this done!
    Ice it up and hope today is a better day.:ice:
     
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    Last edited: Jan 11, 2019
  8. Wayfarer

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    KY, you got a bump(s) in the road early, I’m sure I’ll get mine in due time. You’re due now for some smooth sailin’...catch the wind!
     
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  9. Hip Hip Hooray!

    Hip Hip Hooray! post-grad

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    @KY hipster, Geez, what a story. My doctor told me that the insurance companies are trying to rush people home from this surgery now. I don't think it's safe. I'm sorry to hear that you had those problems. I was happy to stay in the hospital a few nights in order to get the pain medication at the right strength, and to start healing. Thank God your wife was with you. That could have been very dangerous with you passing out. I'm glad your wife was there. I hope your pain is well managed now.
     
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  10. Debru4

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    Good point @hip hip hooray--Both my back surgery 9 years ago, and my hip surgery in August went incredibly well, and I was released within 12 hours after both---I had met the check points for discharge and like everyone, I wanted to get home.

    Both times I ended up with bad drug reactions after I got home. One time I returned to the ER that night. Had they kept me a bit longer, I think the drug issues would have surfaced when I was under medical care, and not at home.

    No one forced me to go home early---I wanted to. However, no one suggested I stay longer either. If the protocol was to keep you at least 24 hours, I think many of our early recovery woes with medicine or other issues would be identified by medical professionals.

    If I have a future surgery, I plan to override my desire to get home ASAP, and make certain that whatever pain meds I am on, are ones I can tolerate, and maintain on my own at home. (Insurance approval being key, of course, and that is a big issue I understand.)
     
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  11. KY hipster

    KY hipster new member
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    Thanks all for your helpful input. So a fairly big gap since I posted this thread, and while I have regained strength and am no longer feeling lightheaded and just out of sorts, I must admit that this has been a long and arduous slog for me. Perhaps my expectations were completely unreasonable, I have unfortunately had a colon resection, emergency bowel obstruction surgery, and two incisional hernia repairs as a result of these two in the past 12 years, so I kind of figured how much worse could this recovery be? Um, yeah, a lot worse. Just so slow and sore, and you are laid so low and so dependent on others, it really is hard not to get down and a bit disagreeable. Probably doesn’t help that it is 42 degrees and gray all winter long here, and taking a bit of fresh air always helps me. After continuing to feel lightheaded for a while I talked to my internist and we cut back on a medication I take for BPH that causes dizziness (terazosin) and that combined with a general regaining of my strength has me feeling much steadier and better. My hip itself seems to be coming along and responding to PT, I have now done two outpatient PT visits this week and my PT says I am where I should be. I am however experiencing incredible soreness, discoloration and kind of lumpiness in my quads, hamstrings, glutes and particularly my IT band, which is just really tender. They seem to be really getting me back for what I have put them through! I went for a massage Thursday (with a licensed massage therapist who is very good and who was referred by the PT clinic, his son is a PT), I did this ostensibly for chronic neck pain which has been really bothering me since my THR, but he worked a bit on my quads and especially IT band and glutes. I then did outpatient PT yesterday with some new exercises (and went out for dinner) and I found myself so sore last night I could only get through a few of my home exercises afterwards. I don’t know if it was the massage (he is monitoring how I feel, and told me to keep myself well hydrated afterwards which I have done), the new PT exercises, including some step exercises, or the combination of both, but I was about as sore last night as I’ve been. Better this morning though, did my exercises comfortably and just got my new muscle massage roller (thanks amazon prime!) which I am looking forward to using instead of the two tennis balls in a sock.

    3 general questions—1) is the IT band usually/often this sore, bruised and tight? Yeowch! 2) anyone see anything wrong with getting therapeutic massage from a qualified pro on my thigh and glutes, and 3) I still have a tiny tiny bit of drainage from the bottom end of the incision, no signs of infection (ie, not too swollen or red, no fever, few drops of drainage are clear/light pink tinged), it was closed not wI th staples or sutures but glue, which is now starting to scab and flake off. Surgery was 1/9, it was also draining a bit more last week, and I spoke with nurse in my orthopedist’s office and she said it was normal and as long as no swelling, fever, discoloration or yellow/green/dark drainage I shouldn’t worry, but I haven’t felt the need to call them again. Thanks in advance for insight and advice!
     
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  12. Layla

    Layla FORUM ADVISOR Forum Advisor

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    Hi @KY hipster Happy Saturday!
    I'ts good to read you're feeling better. Thanks for updating. You've been through a lot over the past several years!

    Winter weather in many parts of the US mixed with feeling cooped up, dependant and bored can cause low moods. I'ts good you made it out for a dinner. I hope it was enjoyable.

    I think it's normal for any part of your leg to be sore right down through your knee. Think of all the trauma the area took on through surgery. I'm not sure about massage at this point since you're only a little over two weeks post op. I know I wouldn't consider it. I'd want all to settle and heal before anyone started manipulating the area. I'm sure others will drop by with opinions also.

    Just as an FYI here are some common signs of infection to watch for -
    Fever
    Unusual or increasing pain
    The incision is hot to the touch
    A change in the size of the incision
    A change in the odor of the discharge
    A yellow or green discharge that is increasing
    Redness or hardening of the surrounding area
    Excessive bleeding that has soaked through the incision

    It's your body and you Recovery but please also keep in mind -
    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.

    One more article -
    http://bonesmart.org/forum/threads/post-op-blues-is-a-reality-be-prepared-for-it.7591/

    I hope you have a comfortable and peaceful weekend!
     
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  13. Hippielife

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    :wowspring:I think your doing great. It’s great to hear your story . It’s still very early in your healing journey. Bone is still aligning to new prosthesis to secure it to the area and the muscles/tendons take time to heal. In about 3 months I was steady on my feet yet had IT band issues which were eventually worked thru just by walking and some gentle strengthing exercises. It is good that you remain cautious in the early stages of healing .
    One day at a time. It will get better with time and soon you’ll find a comfort zone. :flwrysmile:
     
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  14. KY hipster

    KY hipster new member
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    Thanks for the advice, and particularly the encouragement, Layla and Hippielife! I think I may wait a while to do any more massage on the leg. I did look at the sensible post op therapy link and did note that I am doing a number of the exercises that the link advises against, such as bridges and squats, though in moderation and not past discomfort point, so now am also a bit wary (and confused) about it all. I go to a well established Rehab center, actually located in a hospital building, my PT has multiple degrees and accreditations including doctor of PT, they and he see many THR patients, so it is a bit strange. Of course, one has to be one’s own best advocate...
     
  15. Layla

    Layla FORUM ADVISOR Forum Advisor

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    Hi @KY hipster
    PT is a choice you must make for yourself. I initially found it confusing also. To go, or not to go.
    I did attend three sessions and decided it wasn't for me. Just know that it's not necessary for recovery.

    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.

    If you choose to engage, please don't do anything that hurts. If it hurts, STOP. I like to think of it this way...if the trauma you sustained through this major surgery was due to a car crash, would you feel the need to exercise the injury? Something to ponder.

    I wish you well in whatever decision you make. Stay in touch, we'd love to follow your progress.
    Have a nice evening and Sunday!
     
  16. Wayfarer

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    KY, one thing I got from this site is the "issue" of PT. I'm not really doing any, my PT didn't really push anything although we do/did go over exercises which I will work on down the road. I just keep moving, and we have stairs in the house which I can get up and down no problem and do them multiple times of the day. I'm also out and about every day, and have been caneless this weekend.

    Man, I don't know that I would be doing massage on my body (legs); they are still really sore almost three weeks in to this recovery. I do ice EVERY evening; are you doing that?
     
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  17. Mojo333

    Mojo333 FORUM ADVISOR Forum Advisor

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    :hi:
    I agree that massaging injured soft tissue doesn't sound helpful especially this early on.
    The PT is not helping either...but I certainly know how confusing this issue can be.
    You want to do what the "professionals" tell you will be best for your recovery...but honestly many of them want too much too early.
    My quads were super sore for months and aggravating them with PT was not helpful. They needed time to heal.
    Wayfarer has it right...walking is enough and ice, ice, ice!

    Many Physical therapists feel all can be solved with PT.
    To a carpenter - everything looks like a nail!:umm:
    Listen to your body, it will let you know when and how much.
    It is your recovery so don't let someone push you. Less definitely is more at this stage.
    One month out is primetime for cabin fever and the good old post op blues.
    I too feel better when I can get outside.
    Hope the weather clears as well as your spirits..:SUNsmile:
    Keep the faith...this too shall pass!:yes:
     
  18. SurreyGirl

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    The physio got me doing bridges and clams and squats and it overstretches things too much and put me back by a month. Physio was useful later on. Gentle walking and stairs seems to be the way to go.

    Don’t come off the crutches too early either as gait and walking without a limp is the target here. This is where a physio will be able to spot gait issues. But this is all to come! Concentrate on pain management and healing and ice, ice, ice!
     
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  19. Bionic

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    @KY hipster
    At 6 weeks after my LHR I specifically asked my PT if I could have a massage. The answer was a definite NO.
    Shoulder/back massage is ok, although needs to be sitting, rather than lying on my front, but nothing below the waist for a few months.
     
  20. Carriemay60

    Carriemay60 post-grad

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    You have had so much to cope with in recent years! I think it would collectively drop most of us to our knees!

    To help with your spirits maybe try looking for an alternative to being out in the weather like a indoor garden. Even getting someone to take you for a short drive might help a bit.
    :flwrysmile:
     
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