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[THR] About a month<

Discussion in 'Hip Replacement Recovery Area' started by ely, Jan 11, 2019.

  1. ely

    ely new member
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    Because of avascular necrosis, I had anterior surgery on right hip Wednesday December 12 with spinal anesthetic.

    I awoke in recovery with a major neck-ache and hallucinations like kaleidoscopes. Up in my room, everything sparkled, and my son was sitting facing me, and it was like a gossamer fabric between us. When I closed my eyes, I saw faces. One was sort of scary-looking, so I blinked and changed to a more pleasant one. It really let me know what a highly visual person might experience.

    I walked down the hall with the walker and noticed the surgery had left me with a much longer leg. (It has gotten better. At PT this week, it was measured to be 1 cm longer. Since the arch of my foot is still higher from the swelling, maybe when it flattens a little bit, that will make it closer. My doc said to give it six months.)

    I went home the next day on the 13th. I had to get the final semester grades in, so the next day sat at my table with my laptop and checked to see if any students had turned in late assignments and then worked on final grades and got them submitted on time. That felt like a relief – now I was off work until mid-January.

    I had oxycontin but it made me sick, so I just stuck with the high-strength Tylenol. Thus I didn’t experience any oxycontin side effects from then on. I had to give myself the Lovenox shot every day for two weeks, which made little bruises on my stomach. I found it was better to sit down to give the injection, and I did so every day at 8:30 a.m. It was fairly painless. I kept a tally of when I took the drugs so I could easily tell how long between painkillers.

    The first week, I could sleep only two hours at a time. I found three places to sleep – my bed, my recliner chair, and my sofa, but I didn’t use the sofa at first because it is low until well into the second week. I would get up and walk around between sleeps. I could feel my body was recovering from the shock of the surgery, but I was surprised that sleep was so seldom. I read two books, one for a book group scheduled for mid-January.

    I binge-watched Dead Like Me on Hulu or Netflix, not sure which one. I also binge-watched Gas Corner on Amazon Prime. Add to this some episodes of Cutthroat Kitchen and Nailed It. As you can see, I’ve been more on the comedic end. I’m sure I slept through a few episodes, dozing on in my recliner. I listen to This American Life archive, too.

    On about the fifth day, I woke up with a red foot. So I had to go for a scan to see if it was a blood clot. Fortunately, veins looked good. My doc recommended wearing a compressive stocking, so I ordered a pair. But when I tried to get one on with the sock thing, I couldn’t get it on, so I did not wear it for a couple weeks. But I did also order a leg-raise pillow so I began sleep with my feet upraised. Now I can get the sock on. I have a varicose vein, so maybe that is the cause of the red foot.

    I found it hurt the groin area a lot to lift my leg, but the leg-lifter tool was great. Before surgery, I had bought the kit that included it, the sock thing, the clipper, and a hook. I recommend the kit – it just makes things easier at first. Now it’s doing well.

    Between sleeps, I would do the PT exercises. Now I sleep about 4 hours at once. And then I can go back to sleep for a few more hours.

    I've noticed that when the swelling goes down, the pain goes up. At first my leg was swollen a third or so bigger than its normal size. As the swelling went down, pale-looking bruises appeared down my thigh and calf, around my knee. Even my shin has been sore. Now at four weeks, I do still have that pain. My calf feels like I’ve been running.

    My doc said he keeps patients on the walker for three weeks. So I used it even though it didn't seem necessary. However, I did not take it outside because it jolted on every bump, which felt dangerous. Last week, I switched to a cane, but I don't really need it, so I don't use it inside. I do take the cane with me when I go out. I’ve been walking eight blocks. I fortunately live in an good city walking area, and there are a lot of people out running, walking their dogs, or pushing baby strollers.

    I started driving last weekend. My doc said I could do so any time after the second week, but I waited a bit because my car is low. When I got in, I was able to left my leg in, and it was fine. What a relief. Freeing.

    My outside hip is still numb, but at last, today, some of the numbness is gone along with swelling. So it hurts. Kind of stinging ache. It likes to be stroked lightly. There is still numbness just below the incision. I also observe that at the top of the incision is a bump. I’m wondering if I should start massaging this.

    We’ve got a snowstorm going now, so I just cancelled my PT for this afternoon. But I will continue to do the exercises and will attend next week. It is 60 stairs up to my fifth floor apartment, but I have not done the stairs yet. It freaks me out a little to look down the 15-step flight, but I know I will do it soon. My on-campus classes begin in two weeks, and I'm confident that it will be a smooth process. Now to update my syllabus.

    A bit of an overview of the last four weeks, eh?
     
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    Last edited: Jan 11, 2019
  2. Jaycey

    Jaycey SUPER MODERATOR Moderator

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    @ely Welcome to BoneSmart! Sounds like you are doing very well with this recovery.
    Hope this goes well. Even at 6 weeks out it is still very early to be returning to work. The recommend time off post THR is 10-12 weeks and then a Phased Return.

    Here are your recovery articles. Please note the article on energy drain. This may also impact your early return to work.

    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
    BoneSmart philosophy for sensible post op therapy
    5. Here is a week-by-week guide for Activity progression for THRs

    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.
     
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  3. Layla

    Layla FORUM ADVISOR Forum Advisor

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    Hi, Welcome to BoneSmart. :welome: Thanks for joining us and Congrats on your new hip!
    It sounds like you're doing really well. Wishing you a Happy One Month Anniversary:yay:
    Keep up the great progress and stay in touch. We love updates.
    A great weekend to you!
    @ely
     
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  4. Hip Hip Hooray!

    Hip Hip Hooray! post-grad

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    Congratulations on making it through the surgery. Wow, that's a lot of steps. Keep up the great work.
     
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  5. ely

    ely new member
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    Fortunately my work is health-stimulating. I get to be around all those bright & thoughtful minds. I teach research and writing, so I'm constantly learning. I've been so lucky to have the time off between semesters to go through this process.

    I was thinking of a couple messy occurrences:
    • Spilled the wet coffee grounds down the cabinet and onto the floor the first week. What can be harder to clean when you're not going down to the floor?
    • Fell asleep with the ice pack and awoke to the ice being melted out of pack and leaked all over me and my sofa. Brrr. I disposed of that ice pack, btw.
    • Left the lid open on my smoothie jar, so when I turned it on, it shot blackberries and banana all over the place on my second week.
    I've gotten into making a lot of smoothies. I add protein powder as well as flax to the fruit and coconut water. Easy way to get at least three fruit servings -- and some protein. Protein is so necessary to the healing.
     
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  6. Debru4

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    ely--I know the general guidelines indicate a longer recovery period before returning to work, but I also know as a teacher/instructor sometimes our semester start up times don't coincide with those particular weeks. I am a retired teacher, but believe I could have returned to work part-time---up to 4-5 hours a day after 4-5 weeks. I couldn't have returned to full-time(8-10 hours a day) work at that point. I also had a very smooth recovery and know that isn't always the case.

    9 years ago, when I was 9 years younger:heehee:, I had back surgery and returned to elementary school teaching, 1/2 days at 4 weeks (right after the Christmas break), which is what you are suggesting. It went fine.

    However, the key is, I wasn't on any narcotics, and I had the support of a great school team. If I had needed to take more time, I could have, which also gave me peace of mind. Had I had any doubt about my ability to make it work, I would have asked for more time up front. I think that's so important---to have a back up or exit plan if you choose to return to work sooner than typical.

    Good luck to you!
     
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  7. Mojo333

    Mojo333 FORUM ADVISOR Forum Advisor

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    :wave: a new hippy getting through recovery so they can get on with life:yes!:
    You sound too be doing very well.
    Keep things slow...and if you do go back to work...(I went back too early but finances and my position necessitated my return) the energy drain and extra activity will dictate you do a Whole Lot of Nothing when you get home.
    Hope you are still icing it up!:ice:
    Happy One Month Hipversary!:tada:
     
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  8. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    It's not uncommon for it to make people nauseous.

    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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  9. ely

    ely new member
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    Sure, I'm willing to answer questions. Ask away!

    BTW, I had a brain bypass back in 2005 and was given oxycontin (Percoset) but did not know it was making me sick -- nor, evidently, did the staff. So a gastroenterologist was called in and I went through tests to find out there was nothing wrong. Out of network and an added and unnecessary expense. This August I had a lumpectomy and was again given oxycontin, and it immediately made me sick, so for this hip surgery I was given the anti-nausea pills to take also, but it's clear that drug is not for me unless I'm desperate. Anyway, I knew it was there just in case.

    I am grateful for my ice maker!

    For pain, in addition to the ice, acetaminophen and celecoxib, I did a breathing exercise similar to the Lamaze breathing in labor that I learned back in the olden days. I would completely relax and then go through this mental healing process. I wanted my body to accept this prosthetic.

    It was also interesting to find that getting up and walking was a great pain relief. I would push the walker around my place, often with dance music playing on Pandora. It was almost as if pain was a reminder to walk.


    Hi @Debru4 I suspect I would be quite hesitant, too, if my job was 8-10 hours a day on site. I go to campus and conduct a couple classes four days a week, go to my office for a short time and then return home. I currently have an online course going, but I turned down having a second one at the same time. I grade my on-campus classes at home. So my schedule is somewhat flexible. And parking is close and easy.

    I agree -- no narcotics and great support!

    Thank you for your comments!

    Now at 5½ weeks, I went to a party this week and stood in the kitchen for an extended period of time, a couple hours at least. That night I awoke with an ache in my hip and leg. So I got up and changed sleeping locations, and went back to sleep. Not too bad!

    I had been asked on a form at the PT office how long I can stand but then I'd not really stood around for long. Ten minutes for a shower. Now I know I can definitely stand for a couple hours.

    My PT says I am doing fantastic. My incision is just about healed, and it looks amazing. One weird thing, however, is a bump at the top of the incision. It's painless but feels like a small marble. I talked with the ortho nurse from the hospital -- she calls periodically -- and she said to massage it. As did my PT. I will see my doc again on the 29th and will have x-rays.

    Looking at the healing of the incision makes me believe that the same healing is happening inside. I've noticed that it had become my habit when I stood up to stand for a few seconds to make sure I wouldn't have that sense of my hip giving out. Now it's steel!

    The PT did massage of the incision area -- that hurt! But the numbness is now about gone. And along with that, the swelling. Just like before, when the swelling goes down, the pain goes up, and there are little bruises. But this morning, they have pretty much disappeared.

    My shin is still rather sore. My PT said that is probably the redistribution of my weight that is the cause. My leg is still longer.

    My longer leg takes me back to where I was before I got shorter. I used to be just shy of 5'7", and then started being measured as 5'6". My bedroom window is full length and there is a bar between the top section and the lower section. When I moved in here 10 years ago, the bar blocked my view of the mountains. Recently, I realized that I was seeing the view & thought it must be the osteoporosis. Now I notice that if I stand on my surgical side, the bar blocks the mountains again. So it is my normal height!

    I'm still paranoid of the stairs in my building. But I have done the seven steps leading up from the parking lot to to the grocery store. And I went up and down the five steps leading to the party -- and there is no railing!

    It is four flights of 15 steps to my apartment. (We have high ceilings.) I guess I'll do the shorter flights until I feel confident. I do know that if there were an emergency and we had to evacuate, I could do it. (In June I broke my ankle and there was no way I could have done so then!)

    I've stopped using my cane but since the latest storm, I've not been out walking, and if I had to walk somewhere, I would take my cane just in case of ice. It is a delight to see the melt! My tall building faces north, so oftentimes in the winter, the street is quite icy. But since I park underground, it's not a problem unless I head out for a walk.

    I've so appreciated this site!:flwrysmile:
     
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  10. Layla

    Layla FORUM ADVISOR Forum Advisor

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    Happy Sunday! :hi:
    It's nice to read you're enjoying the site. Thank you for your contributions here.
    I don't blame you for feeling apprehensive about the stairs. Take it slow, you'll do fine.
    It sounds as though you're progressing nicely. And to think it will only get better and better. :happydance:
    I hope you have a nice week!
    @ely
     
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  11. Debru4

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    Sounds like you have the perfect situation, Eli! Glad you are able to get back to work, and still continue a good recovery timeline.

    A little less than 2 months after my surgery, I decided to walk in a parade for a local school district cause I was working on---passing of a bond and a mill levy. I decided I would walk as far as I felt OK, and knew I could drop off anytime. I made it the whole 3+ miles, probably thanks to the start/stop nature of the parade, and was both relieved, and worried that I'd feel it the next day. Luckily, I felt great the next day, and it was nice to know I could do it. I did give myself time to rest before the next long walk however----sounds like your party experience;)

    I think those of us who have had a pretty quick early recovery need to be careful, and aware that anything to excess can undo all of our progress.....sounds like you have a good handle on that!:yes!:
     
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  12. ely

    ely new member
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    I decided not to go to the Womxn's March on Saturday, just apprehensive of ice on the way to the bus stop. It's reported there were 80,000! It seems like ice is a main drawback of having the surgery this time of year -- but by summer, should be feeling fantastic!

    I see you are in Colorado, too, Debru4. My surgery was at St. Joseph's. I appreciated how they gave us the guide, the pre-op session, and the nurse who keeps up with all the patients afterward. The PT gym is at the end of the hall. I appreciated practicing before the surgery, which made me decide to get into my bed from the end instead of the side where I'd have to lift my leg. With satin pajama pants, I could easily slide into place. There was definitely effort to make the procedure as positive as possible. From my hospital room, I had a good view of the mountains. On my surgery day, there was a Christmas meal laid out downstairs, and my grandson had his dinner--and it was delicious.

    Thanks for your support, Layla!
     
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  13. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    @ely you don't need to quote a post to reply to it. Just scoot on down to the bottom of the page and start typing in the box!

    Here y'go then!

    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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  14. ely

    ely new member
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    1. Anterior right

    2. 0-3

    3. I rarely take any pain meds now -- was prescribed celecoxib 2xdaily for first 2 weeks; 3x daily oxycodone as needed (which I did not take after first day home; 3x daily acetaminophen extra strength as needed -- reduced to one pill at a time after second week.

    4. Iced a lot at first 20 minutes on, many times a day. Now once or twice a day on outside of hip

    5. Elevation 3 x day for an 30 minutes to an hour

    6. activity level? All housework ; lot of walking -- outdoors 8 blocks at a time. Indoors -- I pace a lot

    7. Exercises 3 x daily with at least 2 sets of 10 including:
    quad set
    hamstring set
    heel slide
    glute set
    hip abduction
    knee extension
    weight shift
    bridging
    clam shell
    straight leg raise
    chair squat
    balance on one foot

    PT twice a week 2x 10 each
    side leg lift
    clamshell
    straight leg raise
    step
    chair squat
    balance on one foot
    bridging
     
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  15. Debru4

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    Eli---I had hoped to attend the March as well, but my son-in-law had hernia surgery and I was helping them out with the grandkids:) Glad it was well attended.

    We haven't had much snow at all up in Northern Colorado this year---lots of cold, but the snows in Southern Wyoming and down your way keep missing us. I too am hoping to avoid an ice fall!!

    Back in October, when the barometric pressure changed rapidly I had two solid days of awful pain---obviously the tissue was still quite damaged and the swelling about sent me over the moon. I was so worried it would happen with every change, but so far that was the only bad one. Colorado is interesting that way----lots of temperature/pressure changes in short periods of time.

    Sounds like you are doing great---I, too, had a fairly quick, easy recovery and consider myself so lucky. I don't want to mess that up, so keep reminding myself to be patient, and let things heal.
     
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  16. Hippielife

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    Debru4..... I lived in co and the temp swings were crazy. One day summer temps next day rain sleet and snow in less than a hour. And that’s the summers. The winters are even wilder. Blizzards that stack snow drifts 10’ across the garage door and drive. I am so glad I don’t have to drive in it anymore. Moved to the northwest coast and rarely have ice snow. Funny when it does snow they whole city shuts down. Maybe they could learn from co how to prepare for snow. Be safe no sliding on ice. It can sneak up on ya in a second. The cold is still a........issue.
     
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    Last edited: Jan 21, 2019
  17. Debru4

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    Yup....clearly you understand Colorado!:loll:Where in CO did you live, and for how long? Does the damp weather bother you up in the Northwest? I recall being in Phoenix, AZ one time in the winter. The weather was in the 60's and lots of people were wearing winter coats...back in CO those temps brought out all the shorts and flip flops:) However, it doesn't seem to matter where we live, there always are huge blessings, as well as challenges.
     
  18. desertrat

    desertrat junior member

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    @ely We have some stuff in common - I also had right anterior done on 12/12. We're almost the same age - I'll be 67 in a couple of weeks. I'm doing well in my recovery and feel really lucky but I think you are ahead of me - not that I'm really comparing - but it sounds like you're doing great! I can't walk that much without my cane yet but getting better. Your progress is amazing - I hope it stays that way for you (me too) but do take it slow and avoid overdoing it. I've had people get after me for trying to do too much, lol.

    I wanted to go to the women's march too but didn't know if I was up to it. There would have been a lot of walking just to park and get to the march in downtown Phoenix. No excuse of snow and ice. Now I feel a little bad I didn't go. Oh well, another time. I need to walk around my yard more - the weather has been beautiful here.

    You said you watched "Dead Like Me." I love that series!
     
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  19. Mojo333

    Mojo333 FORUM ADVISOR Forum Advisor

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    Yowza! At six weeks from surgery? My hip muscles ache just reading that.
     
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  20. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    Pretty good!
    I suggest you take 1,000mg Tylenol 2-3 times a day.
    You accomplish little or nothing in 20 minutes. Ice for at least 40-60mins and more than 4 times a day.
    That's rather a lot! Did you read the Guidelines left for you in post #2? Particularly this one Activity progression for THRs

    Also in the Guidelines was this "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.

    What you are doing is far, FAR too much! As in this
    Which tells me you need to stop it ALL!
    Yes, it will. Which is a jolly good reason not to do it! I never recommend massaging the scar. It's far too sensitive and tender for all that. Besides which, it will heal very well on it's own.
     
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