THR Alexrd in recovery

Alexrd

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A quick update for you on my surgery and first few days post-op.

Admission to the hospital all went smoothly and I was very relieved that I was to be first on my surgeon’s list for the afternoon - no hanging about, no starving & dehydration to make the wait even more uncomfortable. Also, very pleased to be offered a spinal nerve block automatically as well as the general anaesthetic, as I’d heard this appeared to be the best way to go. Surgery itself was very speedy and I was coming round in just under 90 minutes in the recovery room. Swiftly moved back to my room and transferred back onto my bed - a bit clumsy, but since I still had no sensation below the waist, it didn’t bother me, though I was just surprised that I didn’t get to stay in the bed I was on in recovery; no doubt I missed something about the different types of beds!

It was a new and disconcerting experience as the nerve block gradually began to wear off, but sadly the rapid increase in pain quickly overtook all other impressions and sensations. Although I was given many different analgesics to help to control the pain, I’m sorry to say this aspect of my care was pretty poorly managed by the hospital in the first 12 - 24 hours post-op. It was also exacerbated for me by the fact I couldn’t pass urine without the aid of a catheter, which was particularly uncomfortable, perhaps all the more so because the staff were not on top of my pain management at that stage. Needless to say this was the single most uncomfortable and painful night of my 53 years and not something I would wish on anyone. I didn’t manage any sleep at all until 36 hours post-op, and only when I’d managed to talk to one of the staff to get them properly to address the pain management issue - it turned out my anaesthetist had prescribed oral morphine as and when required, but nobody appeared willing to offer this. And they only did when I specifically requested it quite forcefully, as I had to, once I discovered that this had been prescribed for me but never actually provided.
Things improved rapidly after this on day 2 post-op and the further rounds of bed exercises and walking practices with the frame supported by my physio all went very well.
I was very sceptical when I saw my consultant again on the second morning (after he’d sent me for an X-ray the previous evening to check the prosthetics were all in the right place) and he suggested I’d probably be ready to go home later that day, as I still hadn’t been exercising with the crutches at that point. But the physio reintroduced me to walking with crutches that morning, and it was so much easier when my pain was finally under proper control. We resumed with the crutches after lunch and I demonstrated easily that I could manage stairs, getting in and out of bed, chairs etc. without breaking any of the restrictions. My physio signed me off as ready for discharge and I was back home by 6pm the same day, courtesy of my sister.
I was so glad to be home and I was pretty exhausted after the simple exertion of getting in and out of the car, so sleep was not a problem that night!
Since then I’ve been icing very regularly, taking lots of pain killers, doing my exercises and generally trying to find a comfortable balance between sitting, pottering about, walking laps of the patio outside and bed rest.
So far so good, things are generally improving, all be it very gradually. My pain is well controlled and the stiffness is under control. Perhaps the only thing I’m struggling with is increasing swelling down my thigh and knee and around the scar on my bottom, which can make it tricky to get comfortable in a chair or in bed at first.
I’ll continue to ice very regularly in the hope this will now help to get the swelling down.
 

Jaycey

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@Alexrd Welcome to the other side! I moved your post to a recovery thread for you. Please keep all your updates on this thread so we have all your information in one place.

Sorry you had a rocky start to this recovery. Well done on insisting you needed your pain controlled! Do keep icing and elevating. Getting that swelling under control will also help decrease your pain.

I'll leave your recovery reading list here for you:
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
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 this BoneSmart philosophy for sensible post op therapy
5. Here is a week-by-week guide for Activity progression for THRs
6. Access 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 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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Alexrd

Alexrd

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Thanks for moving my post to the correct place; I’d recognised post-op that I’d just joined a new club of people with prosthetics, but I’d not thought of it in terms of being on the “other side” now of the surgery finally. Everything was all about the run up to securing the THR surgery & getting to the big day - I guess I’m now firmly at the start of a new journey of recovery. There may be bumps in the path ahead, but there’s no way of going back as such. Hm, something to ponder on.
Hope all’s well for my fellow 17th November surgery club members & everyone with earlier dates or those with later November dates too. Stay safe & positive!
 

Layla

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:hi: Welcome to recovery! Sorry to read of your rough start. Especially since you described it as the single most uncomfortable and painful night of your 53 yrs and wouldn’t wish it on anyone. Sadly, this shouldn’t happen. Thankfully, it’s behind you and you seem to be doing well. I look forward to following your healing journey and hope you have a relaxing weekend with lots of restorative rest. :yawn: :sleep:
Happy Saturday!
@Alexrd
 

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Congrats, Alex!

You will be shocked at how great you will feel in a few days!

Short list of things I found helpful:
1. Paracetamol at 4G/day in 4 1000 mg doses
2. Elevating and Icing (an hour at a time with ice to bare or barely covered skin)
3. Walking
4. No PT - other than light stretching and things like foot slides in bed
 

Parsley Sage

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Congrats Alex on being on the other side. :yes!:. So happy to hear you are moving around well. Unfortunately I didn't get to join you as the Covid monster caused my hospital to cancel my surgery. I'm suppose to be scheduled for 12/8 so if it really happens I'll just be a few weeks behind you so I will be following your progress!
 
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Alexrd

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Update, 10 days post-op:

Apologies for the delay in posting; recovery went into reverse after the first few days back at home, so sadly I’ve yet to get to the point where Forum User suggested

“You will be shocked at how great you will feel in a few days!” - I wish!

With hindsight from my post-op experience from my failed arthroscopy, I should have anticipated much more extensive swelling and bruising after THR than I initially appeared to have. Also, I bruise really easily (possibly now exacerbated by the rivoraxaban?).
I woke up on Sunday morning and was determined to have my first post-op shower. A bit of a milestone I’d been so looking forward to. The first challenge was getting the compression stockings off; I managed the good leg ok as I’ve still got reasonable ROM, but the operated leg was just as fraught and exhausting as I’d feared. My 88 year old Mum struggled long and hard, but she no longer has the strength or dexterity for the task. I managed the final hard push to get the stocking over my heel with brute force and determination using my reacher-cum-dressing stick. A fantastic and much sturdier tool than I’d previously appreciated! I’d already prepped the bathroom and shower cubicle and adjusted the height of the shower seat to make sure I could keep to the restrictions. All went smoothly although it took a lot longer to manoeuvre round correctly. Dressing in fresh clothes was a nice boost. Ended up asking our very kind neighbour who’s a physio to help me with the fresh stockings.

Despite lots of rest, elevation and regular icing in the afternoon, my operated leg, hip and buttock swelled up hugely by the evening and overnight. I was also shocked by the extent and colour of the bruising all the way down the back of the leg and just below the knee - it still resembles one of those dense coverage tattoos you see on the internet!

The swelling is very gradually easing today, but the bruising and associated discomfort remains - it’ll be interesting to see see how long it lasts this time ( it was 6 weeks by the time it disappeared completely after the arthroscopy).

I’ve increased my meds significantly and am taking 100mg tramadol 4 times a day now, as well as the 150mg pregabalin twice a day which I’ve been on since it became apparent the arthroscopy had failed. I’m also taking the 500mg naproxen to combat inflammation, as prescribed by the hospital. I’m not looking to taper down the tramadol any time soon/until the pain and stiffness when I wake first thing noticeably begins to ease. I’ll live with the constipation and headaches as a trade off for adequate pain management.

I’m sticking to the basic exercises recommended by the hospital and have no intention of engaging help from a physio for now, as I’ll trust the BoneSmarties conservative walking as the best exercise approach this time round. It’ll be interesting to see how quickly my walking picks up once the pain eases up sufficiently and my mobility returns. For now I’m happy pottering about the house. I’m pleased to have been free from the cumbersome walker on discharge from the hospital and manage quite well on one crutch, even outside for my laps round the patio. The leg length discrepancy is only noticeable first thing in the morning or when I first get up from resting on the bed and elevating properly or have lost track of time in the recliner and not remembered to get up to move as frequently as I know I should. As I walk more I imagine my pelvis and new hip will come to an accommodation and this will resolve itself!

I’m staying positive, and looking ahead to the immediate milestones of having my wound reviewed/dressing removed (next Tuesday) and then my post-op follow up consultation with my consultant on 22nd December.

My thanks and best wishes to the staff, volunteers and fellow BoneSmarties for your encouragement and support, and belated good wishes for a happy Thanksgiving for those of you stateside.
 

Jaycey

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@Alexrd All sounds normal for just 10 days out. The leg length difference is a very common feeling post THR. In most cases this feeling just fade away once the body balances again. Give it at least 3-4 months before doing anything to address this. Here's an article from our Library on LLD Leg length differential - LLD.
 

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I remember being concerned about difference in leg length following my left THR three years ago but after a few weeks I stopped noticing it. Now having had the right hip done coming up to four weeks ago, I am pleased so say that this time I have noticed no difference. I have, however, noticed that the achy back that I had before surgery is much better and I am wondering if this is because my legs now match again.

Just take it easy - I was terribly tired for three weeks post op and had a nap every afternoon. Glad to say that this week I am feeling much more energetic though.
 

Woodstockhip

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Hi, Alex! Yeah, we hear about these folks who have super-smooth recoveries but I have a feeling that people like us, with major ups and downs and zings and zaps for weeks, are far more common. Early days, still.
 

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Happy One Month Anniversary! @Alexrd
I hope you’re doing much better since you last posted. Even at one month post op it’s such early days in the whole scheme of things.
Wishing you all the best for your post op appointment next Tuesday. Also wishing you a Merry Christmas if we don’t hear from you before then. The New Year should be a good one with your new hip...minus the pain. :yes!:
:merry-xmas-smiley-emoticon:
 
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Alexrd

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Many thanks for your message, Layla. I’ve been taking things as they come - I guess I’m a slow healer so I’m not going to be able to miraculously fast track my recovery. I’m fine with that - it’ll take as long as it takes. Just glad to be in significantly less pain and tapering off the opioid painkillers quite drastically now, which means the awful constipation is less of an issue, finally LOL!
My bruises are much faded now, and the tissue swelling down to my knee on the operated leg is much less painful and restricting. I don’t have a lot of energy and I’m slightly frustrated that I’m not walking better and more freely. But if I still need my single crutch for stability and safety for a bit longer, so be it.
I’ll se what my consultant says next week at my post op appointment.
My wonderful companion rescue cat, Cal(ypso) is very affectionate and keeps me sane and distracted.
I’ll post a further update after I see my consultant.
Take care everyone and stay safe.
 

Mojo333

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I know it is said ad nauseum, but one month out is still early days.
Keep the faith friend, lots of healing happening.
:friends:
 

Layla

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I don’t have a lot of energy

This is normal. Our body's energy supply isn't limitless. So when we're in healing mode after major surgery our energy will be used for healing first, not leaving a great reserve for all the other activity of daily life. It is completely normal to feel tired for quite some time. How long....most likely relates to your body's rate of healing. Making our best effort to get adequate sleep and rest is beneficial. Our body does it's best healing while we're sleeping.
:yawn: :sleep::)
 

FCBayern

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Actually it sounds like you are right about where you should be for one month into a 12-18 month recovery @Alexrd. Unfortunately time is the only thing that will give our bodies a chance to heal. Better days ahead my friend.
 
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Alexrd

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Quick update from my follow-up post op appointment with my consultant yesterday. He removed a couple of dissolvable stitches from either end of the incision which stubbornly had decided not to dissolve, but says the wound is otherwise healing up as it should. I’m certainly more comfortable today as the few tender spots are less sensitive now and so far haven’t given me any little zingy reminders that catch me by surprise! The pronounced ridge of swollen tissue parallel to the incision is beginning to resolve as the swelling continues to go down. As a Xmas treat I’ll see if the remaining swelling has gone down enough to let me put on a regular pair of corduroy jeans on Xmas day, Lol!
Consultant was surprised the hospital hadn’t done a follow up appointment for me with a physio yet and will sort something out for the New Year - I’m happy to wait to be honest and will see what happens and how I’m progressing at my own pace as walking becomes easier. I’ll hang on to the single crutch outside for now and for the stairs at home for as long as needed.
He was quite happy with my gait and said it’s up to me to decide when I’m ready to resume driving; I need to be confident I’ll have full control of the car and I’ll have a go early in the New Year when I’m walking more freely and using the stationary bike to help gently build up my leg strength.
He advised that I keep to the 90 degree restriction for another 4 weeks, which I’ll observe as a sensible precaution. The final bits of the consultation were a review of my X-ray taken the day after surgery (all good) & a brief chat about how soon I should initiate the referral process for THR for my left hip next year. As I’d assumed, he confirmed I should aim for the 6 month mark after my first replacement, but given the rapidly deteriorating COVID-19 situation here in the UK and its inevitable impact on our NHS’s ability to maintain elective surgery, quite when I might get further surgery is anybody’s guess right now.
So, that’s my news for now; it just remains for me to wish everyone here a safe and peaceful Xmas and my good wishes for a much better and more hopeful 2021!
 

Layla

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Thank you for sharing an update. You’re doing well! I hope your non op hip holds out awhile longer without causing you too much discomfort. I’ll bet you’ll be driving in no time.
Happy healing as you continue the journey and a very Merry Christmas to you!
@Alexrd
 

Layla

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Happy Two Month Anniversary!
Hope you’re doing well. We’d love to hear from you. Roughly calculating it looks as though you’re nearing the end of restrictions. Woohoo! May it only get better in the new year.
Stay in touch! :wave:
@Alexrd
 
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Further update at 3 months +

Feel like I’m making slow but steady progress finally now. Pain is now the occasional twinge if I push up against my limited ROM, which is still proving stubbornly elusive. I finally had my first physio outpatient session 3 weeks ago and go again on Friday. Stretches and strengthening are helping and I even managed to walk in and out of my first appointment without my walking stick to meet my new consultant to get the wheels in motion for my left hip replacement.

NHS here in UK has not yet resumed elective surgery, at least not where I live, but new consultant seems to think it will start again fairly soon. If that’s the case I might only have to wait for another 3 months or so for surgery, so might still be on course for second surgery around the 6/7 month mark as I’d originally hoped to be.

Grateful for the support and wisdom of everyone here. Best wishes to all!
 

Layla

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Hello @Alexrd :wave: Thanks for the update.
Good to hear you’re making steady progress! Even better to read the wait may not be too long to have your Left THR. Fingers crossed it’s soon so you can move toward a brighter future without the pain. Please keep us posted and share your date with us once you’re on the schedule. We’ll be here to cheer you on. :yes!:
A great rest of the week to you!
 

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