THR Allahere_recovery

[fulafoto]

@allahere glad your progressing well but sorry it is still painful for you. Some things I have learned from the terrific members and staff off this forum; Judge your progress on you and what you can do and not on others - we are all so different and recover at different rates. Also it took your hip so many years to deteriorate to the level it was to require a THR so it would only be expected to take some time to recover, especially the muscles and surrounding soft tissue which has been undoubtedly affected by your hip.
Please know we are here thinking about you and feel free to vent your frustrations as well as share your achievements with us all.

 

[allahere]

That's not at all uncommon.

@Josephine - I asked the nurse about it and she said that not all their OS"s visit patients, normally it's done by their assistants (or did she say internists? I just understood as "younger guys") but my surgeon (dr bostrom in Hss) likes to do by himself. Next morning I actually observed as my neighbor was visited by her OS (dr Pellicci) with the whole entourage ( several folks in white coats). It was at 9:45 am. Whatever that means... I was bored and I was watching everything around me


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[allahere]

Does anyone here know how long we are supposed to continue with clot preventing measures? I am 17 days in post op and still taking aspirin 325, twice a day, along with Protonix. Somehow my discharge papers state the dosage for aspirin and Protonix but didn't specify for how long. My 6 week follow up with my OS is July 25. Does it mean I should continue with aspirin til then? I wrote an email with this question to RN of the surgeon"s office but - no answer :(


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[MajorHeidi]

Hi @allahere I took aspirin 2x day for 4 weeks. I would continue your aspirin.

As for a recliner, they are awesome. I got 4 5 inch chair risers from amazon to raise it up to make
it easy to get in and out of. Great $10 buy.

 

[bottomshollow]

@allahere, I am responding to you regarding your LLD. I have actual LLD of 5/8" as a result of my hip replacement. If the difference is 3/8" or less, you can put a riser inside your shoe in the heel portion. More than 3/8", you can't keep your shoe on unless it is an oxford type shoe or sneaker. I have the sole of my left shoe made 5/8" higher.

However, I have found that I can now put a riser inside my left shoe and even though it's 1/4" off--I am not uncomfortable with it if I am not doing a lot of walking and being up on my feet for long periods of time.

I was told that it would resolve itself--and for most folks it does. But I put a couple of Dr. Scholl's heel pads in my shoes around 4 weeks post op. At my 12 week check up, the OS and his PA agreed that I did have a real LLD.

It really annoyed me at the time, but I now find it a small price to pay for pain free living.

 

[allahere]

Dear @bottomshollow - thank you VERY much for this post. It's exactly me on this picture, during my 4 years in the pre op, with OA in my right hip. I didn't have any leg length issues before OA. Eventually the crookedness provoke first tension and then pains and then several very acute episodes in my low spine, neck and even headaches. I was seeing pain mngt specialist in Spine Institute and they convinced me that I must do the THR b/c with such wrong posture and movements my spine overcompensates and suffers. I thought the surgery will correct it (right away?) although I'll have to relearn the gait. But now it's VERY much the same, VERY uncomfortable, although without an OA pain. I totally agree that the pain-free life outweighs many problems. I am just afraid to develop even more pains in my back, neck etc. And the dislocation too...

If PTs and doctors say the body should resolve LLD with therapy and time - does it mean I better NOT have any props in my shoes and just try harder (if I can, at all) to learn a normal walk? You obviously chose to have heel pads... I totally understand that when we can't we just can't and we look for other solutions. I really appreciate your answer!

 

[alexthecat]

We generally recommend that people not use any sort of lift in their shoes during the first few months of recovery. That gives your pelvis a chance to settle and, for most people, that apparent difference in leg length decreases or disappears. I agree with your surgeon that it will probably get better in the coming weeks.

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[allahere]

We generally recommend that people not use any sort of lift in their shoes during the first few months of recovery. That gives your pelvis a chance to settle and, for most people, that apparent difference in leg length decreases or disappears. I agree with your surgeon that it will probably get better in the coming weeks.

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"Let your words go into my Guardian Angel's ears" I don't want to continue my spine problems and limp:( thanks for your response @alexthecat!

 

[bottomshollow]

You're quite correct that it usually works itself out. But if you're one of the ones that it doesn't work out for, spending several months with back pain issues doesn't seem practical.

 

[Jamie]

You need to stay on the blood thinners as long as your surgeon directs it. This is something you need to call and check on. It can vary from doctor to doctor.

 

[allahere]

@Jamie - yes, RN from my surgeon"s office finally answered that I should take aspirin for all 6 weeks till the follow up appointment with the doctor on July 25. Thanks Jamie for your note!

 

[Zebra]

@allahere, that is exactly me on that picture also, right now (pre-op), with my pelvis tilted, lower back pain, and my right leg about 2 inches shorter than my left. I have been using a cane for a year to help compensate for the lack of balance and can't walk without it ( the cane). Both of my hips need THR. An OS has confirmed one leg is functionally shorter, regardless of the "actual" leg length on x-ray, which doesn't take into account stuff like the mechanics of actually walking.

Just to clarify, did your operated leg feel shorter before your surgery? And now it feels longer?

Did Dr. Bostrom do a physical exam and discuss the crookedness issue with you beforehand? Or say if he would be able to correct it?

I don't want to bother you with my own LLD issues, but I just happen to be seeing Dr. Bostrom at HSS in a few weeks for an initial appt. specifically to have a thorough physical exam and for an "expert" to address my
already existing LLD, pelvic tilt, muscle tightness issue and whether he can correct it with the THRs.

I live in NJ and getting into Manhattan is very difficult for me so I was hoping HSS would be "the answer" and worth the trip. Are your sutures the ones that dissolve, is that why the post op visit is 6 weeks? You didn't need to have your stitches taken out 2 weeks later?

Thank you for posting your recovery story. It helps to understand what it is really like.

 

[allahere]

Dear @Zebra, I'm glad to share my experience especially b/c you're going to the same OS

@allahere, that is exactly me on that picture also, right now (pre-op), with my pelvis tilted, lower back pain, and my right leg about 2 inches shorter than my left.

How do you know it's 2 inches? Who determined it? An ortho doc? Or your PC? I've actually never been examined, by any doctor, for LLD. Although I did complain many times in different offices, but when the docs saw 1. the way I walk (very crooked, with a huge limp, although no cane) and 2. my X-ray (bone on bone) they all said "what do you want? You need to do THR. You're overcompensating with your body".

I've seen Dr Bostrom only twice - during my initial visit to him and right before the surgery. Oh, no, actually, I've seen him three more times around 6:30 am during his brief visits when I was at the hospital...

During the initial visit, I asked about the leg length. Dr B asked me if I had LLD before the problems started (OA), I said no, never before the OA. He said then that I should be ok after the THR, he doesn't need to measure me b/c they do the surgery based on the X-ray, that is all they need.

Right before the surgery, when I was scared to death, and saw him for those 5 minutes - I just asked "will the legs be the same? will you do a nice scar?" (I didn't cry, but I was like a baby... really...it's funny to think of it now .) He simply answered "everything will be ok", smiled and walked away.

I know that he does a huge amount of surgeries a year (500? is it possible at all?). He does a lot of revisions, nurses say. He's reserved, kind of distant, but if you really wish you can talk him into a frank talk, you just need to ask very specific questions and it's ok to be even very emotional (at least I was ), I could see he gets it...

Yes, he did that 'cosmetic' scar and a dissolvable glue on top. I had a couple of blisters, since my skin is so sensitive to everything... I don't know why exactly my next visit to him in 6 weeks, but even those papers that he gave me after the initial visit stated 1. brief instructions before the surgery 2. "you should schedule a 6 week follow up appointment" and 3. when and how to pre medicate to avoid infections, for the rest of your life.

That is probably part of his protocol, that is how he does it.

It's hard to get the access to him while you're out of his office. Other surgeons gave me their emails (and answered!), some have patients' portals online where you can ask your questions. Dr. B has RN and PA, they gave me their business cards with the emails. I could get hold of them when I needed ( a couple of times) but I'm not sure if I got the answers from the doctor or from them.

So, in my search of a "great surgeon", I've seen better offices and better stuff, but I kind of didn't care - I wanted a skillful surgeon, 0% infection rate and good nurses in those first days of recovery. I was VERY scared but I 'm happy how it all happened. I pray now (and train myself in PT) so I won't be limping for the rest of my life.

Today I had another in-home PT session and he liked my progress in general so I specifically started to ask him many questions about LLD. He recommended 1. NOT to walk with the limp and instead use whatever aids I find best to walk smoothly and evenly (at the moment it's one crutch, under an opposite arm) and 2. to gain strength in ALL muscles in my operated leg. He demonstrated, with several simple exercises, that many muscles in my operated leg, small and big, are simply not functioning well yet. Some - because of the injury of the surgery, and some - because of being underused (or unused?) during my crooked pre op years. Only when I'll get more-or-less equal strength in both legs, my body will start to re-align itself. It did make sense, right?

Thus, it's a looooong process, but I hope I'll get there. I'm happy that the OA pain is gone. I started to sleep on a side which is a huge relief. There are still discomfort, stiffness and occasional aches while moving and for some reason especially while sitting on chairs. I tried so many...I need to find one to work on computer, for hours; also my family likes to go to restaurants... All chairs feel bad now when I sit more than 15-20 min...

But still, with every day something in my body is getting easier and easier. I even went to theater yesterday, although at the end I almost didn't feel my leg, it was so numb, my back was killing me... But I'm so tired on missing things in life, and we had those tickets... I'm sure many folks here can relate to it!

Let me know, @Zebra, if you'll have any more questions and stay in touch. I'd like to know your progress and Dr. B's opinion on things. He is "my doctor" I wish you a VERY successful surgery, with all your issues, and slow and steady and FULL recovery!

 

[Zebra]

@allahere, what your PT said makes a ton of sense, especially to use whatever aids you have to walk smoothly and evenly & the leg getting stronger slowly.

I don't know if this would work for you (or for me, post op) but I use a mesh drafting table chair, which is like a high office chair with plenty of padding and lumbar support. You can get one on Amazon for about $200. they adjust up or down and come with arms also. It works for me because I work on my computer at the "bar" of my kitchen. My knees are definitely lower than my hips sitting on it, but I don't know if it would be safe or not.
It is on rollers and you need to have a rug under it. Then it stays in place.

I have to ask you. Did Dr. Bostrom do a physical exam? Did he gown you, move your hips around or have you lift your legs to check your range of motion, watch you walk, etc.? Look at your hips on an exam table?

I'm not saying it is necessary, but I am looking for an OS who does do a physical exam.

Thanks so much for your help with this.

 

[allahere]

@Zebra - yes, Dr B did a physical exam: in the gown, asked me to do the walk, my ROM was 0 and muscles were so weak and I was pouring questions (I had a long list with me), so he switched to the talk with me and spent good 30-40 min answering my questions after the exam. We even discussed my (relatively young then) grandma who died during the surgery and since then many family members avoided surgeries like plaque, B was asking "what happened" etc...

If you're curious about other docs at HSS, on someone's thread I posted a sort of "report" of my experience with them during my search of the doctor. Below I paste it again, perhaps you'll find it helpful:

"In my pre-op, being super nervous, i"ve seen 8 surgeons at Hss Maymen was giving a good impression, but when they started to send me pre -op paperwork, everything was messed up: a wrong name on paperwork, even a wrong operation (a left knee instead of a right hip ) I didn't like it. I was asking every nurse I met, every assistant at HSS, my other doctors (not HSS) about who is great for hips. There several names who stood out several times: Westrich, Pellicci, Alexiades, Bostrom, and Su. They have subspecialties, a huge amount of surgeries every year, and of course different personalities. Not all of them take all insurances. The stuff and the office protocols are somewhat different. I went with Bostrom due to several personal circumstances. I"ll reserve my opinion about him til later, when I see the great results, hopefully: it's too early for me (17 days post op).The best part about HSS is low infection rates and nurses. I'm sure all these OS"s know what they do as much as it is possible in the field. But It's still a scary ordeal, I totally understand, and we patients try to calculate things into "a perfect picture". I give all this info b/c I think that patients deserve to know more about their doctors. Btw to be fair, my dental assistant"s father did thr with dr maymen and he is very happy with results - 5 yrs later he is skiing and totally forgot about his problems.

And as for the technicalities - no matter how many tech details you want to know (I wanted to know EVERYTHING !) - when you'll decide on your OS, you'll have to trust him re those choices. In my search for a doctor, I was learning from each, and asked more and more med. questions for each next one, and of course they all had answers, but I was only more confused b/c after each visit I only needed to learn and understand even more... Then I just gave up, somewhat, b/c I can't get a full medical education so quickly, even if for only one (very important to me) problem. Although I DO understand that some amount of information is totally necessary for some patients, and this forum is filling the gap. People are certainly different: I have a dear friend who a week before my surgery did a much bigger surgery on his spine and he didn't want to know anything at all. When he saw the x-ray of what has been done on his neck and the spine a few days after his surgery, he fainted. He still prefers to know nothing..."

And about the chair, @Zebra, thanks for your suggestion: I do have a Herman Miller chair at home (similar to what you describe) and in my pre-op years it was the only one for me. But after the surgery it turned out to be extremely inconvenient: b/c it has so many curves (it's "hugging" your body, right?) it is rubbing around my scar and the curves make it very hard to follow the precautions. The best chair was actually in the hospital during those first post op days: tall, straight angles, a bit padded, with straight arm handles, with a little bench that they prop for the leg. You see those chairs in all ortho offices, and I always thought how and when on earth they can be comfortable? Now I know With cushions and pillows I am trying to repeat the same shape on my straightest chair at home. But again - no handles :( I'll know to rent such an ortho chair if I need to do another hip (hopefully NOT!).

 

[CodeGirl]

I had an Anterior LTHR 5 weeks ago and have been using a heel lift because of a LLD. My OS said that there was a difference but that it would be resolved after my RTHR which I am having tomorrow. He claims that I will not actually be taller but rather the space that I lost in cartilage would now be restored. He did tell my SO after the first surgery that he had lengthened my femur by 1 - 1.5 cm. I definitely felt the difference and will be glad after tomorrow when I can ditch the heel lift.

 

[allahere]

@CodeGirl, you r so brave: 2 surgeries in 5 weeks, wow. The second one will be anterior too? Same doctor? Where do you do it?i sincerely wish you the best recovery possible and will keep you in my thoughts tomorrow!

 

[CodeGirl]

Thanks, @allahere ! Yes, both are anterior, same doctor. He recommended that I do them separately 4-5 weeks apart. I'm using Anderson Orthopaedic Clinic in Alexandria, VA and my OS is Dr. Nitin Goyal. He is amazing. I highly recommend him to anyone in the Washington, DC area seeking an anterior THR.

 

[Zebra]

@allahere, thanks so much for the info about your experience with Dr. Bostrom. I just wanted to make sure it would be worth my while to go all the way into NYC for this and it sounds like he is a very thorough, caring doctor. That ordeal with the hospital changing the procedure times though sounds a little harrowing, but once again it is useful to know it can happen.

How are you doing? Any better? I did see some high hip chairs on Amazon and I am thinking about getting one, they are expensive but a lot less cost than getting a recliner. Very similar to the ones in the docs' offices.

Since I am getting both hips done, I am very concerned about the leg length issue, because I feel I will still be needing to use a cane for balance if they are off as much as they are now. I know the OS docs don't like to acknowledge the LLD issue too much, because it is hard for them to get it right, to get the legs even.

But apparently for many people the operated leg initially feels longer and then does settle down as the body adjusts to the brand new hip joint.

Thanks again for your help.

 

[allahere]

@Zebra - glad the info will be helpful... I totally share your worry about the possible LLD, but as far as I understand now, the OSs see it as a "mechanical problem" that is hard to foresee and to correct. Dr B and his RN said to me that they simply measure our bones on Xray and make the lengths even, BUT how our body handles it and the way it got adjusted and crooked and even physiologically conditioned is a totally different matter. This is why everyone recommends to wait for long time before complaining about the "real" LLD... We just need to allow our bodies to relearn its parts and relationships between them.

I'm doing fine: the recovery is not too fast comparing with other members here (I'm jealous when I read some posts on BS ) and not too terrible comparing with some others. One thing is good for sure: every day something in my body is easier and better. The leg is stronger with every day, even if I don't do any exercises. I walk with a cane or a crutch or even by myself (at home, with a limp, for now). Since my lower back is painful, almost all the time - from too much sleep on the back, from a very uneven walk - I do a lot of stretching and my hubby does massages. My back didn't bother me before OA started, and when we did Xray and MRI in the pre-op they didn't show any problems. So the docs said it was "overcompensation due to the bad hip"...

I'm happy that I can and even "am required" to do exercises. My body was craving for more motion in the pre op. I plan to do outpatient PT starting next week, and after the follow up with Dr B will get back - hopefully - to biking, yoga, pilates and - who knows - maybe even dance classes, my favorite way for cardio which I could not do for 4 years.

As for the chair - if I'd know beforehand and if I'd have more room in my tiny apartment I'd certainly rent either a recliner or an ortho chair or better yet both! But since somehow I'be already kind of survived those first (most difficult) weeks after the surgery without a good chair, I don't think I'll need it now. Literally, every day is easier... For example, today my friend visited me, we had lunch at home, and for 2 hours I was sitting in my regular square table chair and didn't feel any discomfort. First time! Also, during the PT session today he asked me to go up and down of one long flight of stairs in my building (26 stairs per flight) and I did it with the cane, not as a toddler, only one good leg steps up or down and the second one joins it, but like "a big girl", smoothly changing legs for both up and down stairs. I was "wow I can do it".

My opinion now is that all these aids - a surgical bed, a raised toilet seat, a shower seat, a grabber, an ortho chair, a walker, crutches (elbow ones are the best btw), canes, etc. etc. - although very helpful first are (relatively) quickly become not needed and you won't know why did you buy them. For example, I didn't use the shower seat, at all, but some folks cant imagine being without it and use it many months after the surgery. I've learned from folks on BS that if you have a prescription from any doc for all this equipment, the insurance may reimburse at least some money. I didn't know. Since all recoveries are unique and different and one doesn't know what exactly will be needed, I'd buy everything I can think of and would keep all the receipts and boxes and would return things that were not needed a few weeks later....

Being comfortable is certainly important for thinking more positive and for better recovery. I personally can not force myself into happy thinking if I suffer physically. This website is certainly very helpful to understand such things as well as calm down and properly prepare in pre op and stay on course in post op. Josephine and Co. should be proud of their creation.