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THR Aloha From The Other Side

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Thank you, sharonslp! That is what I've been thinking. I do understand the difference between dependency and addiction, and have had no fears for myself. I was just surprised that my surgeon's nurse had such a strong reaction to me still taking Oxycodone. I believe continuing the oxy at night and tramadol during the day is the best route for me. Also, my GP has no problem prescribing them for me. She is of the mind that in these "healing" weeks, there is no need to be in pain. And I am still in some pain.

I am :happydance:about your comment re: all going into rehab together! We'd have a blast, for sure!!
 
You are such a recent surgery, and again we are all different. Take one day at a time. You will know when to ease off meds and when to increase exercise.... our bodies are amazing; I can't believe how I have healed so quickly.

Take care of YOU.
 
Apparently, I have a pretty stubborn case of adhesion. It seems to be the main thing that is making it painful for me to put my full weight on my surgery leg and walk without a cane or brace. How many of you can speak to this problem? How did your dr or PT treat it? How long did it take to be resolved? My PT is doing massage & e-stim 1 x per week & I have one session of hydrotherapy a week. I do the stretches & some of the massage myself at home. I'm starting to feel a little impatient with both the lack of progress & the ongoing pain issues. I walk as much as I can, maybe a mile or so every couple of days.
 
Deb....I'm going to tag Jo so that she can provide comments for you. I've merged your threads since your newest one concerns an issue with your recovery. We like to keep each member's updates, questions and concerns in a single thread so that it better tells the story of your recovery.

When was the last time you saw your surgeon to discuss this problem? Was it your doctor who diagnosed the source of your pain?
 
Sorry, I was going to put it in my thread, but I really wanted people who might not be reading my thread to see the title...my PT diagnosed it. I won't be seeing my surgeon for another 3 weeks. PT is very experienced w joint replacement problems & ID'd it immediately.
 
Slow, Poppet. I still have too much pain to walk on my own yet at nine weeks. I feel strong enough, but the adherence issue is just taking a long time to treat. Going to talk to my PT this week about stepping up my therapy. In many ways, I can see worlds of improvement, certainly since my surgery, and no reason to complain. On the other hand, the improvement in the past two or three weeks seems almost negligible. Or I feel great for a day, then backslide the next day. I am still delighted to have had the surgery; I just wish I'd known about the danger of adhesion and been doing something to prevent it in my 4th week onward.
 
Josephine, can you give me your input about adhesion and how long it takes to treat? I've been in PT now going into my fourth week. My PT diagnosed adhesion immediately, and began working on it with massage and a little traction. I've been doing some massage on it myself, moving the scar tissue around gently over my muscle, etc. I'm also getting aqua therapy to work on my strength and flexibility. I'm still walking with a cane; it's quite painful to walk without it, there is a lot of tightness and I can FEEL that my muscle is not moving right. I have my next appointment with my surgeon on August 30. We'll be at about 12 weeks then. If I am still having this problem, should I ask about MUA? I am still thrilled about my surgery, but feeling discouraged about the persistent pain and inability to walk without aid. I'd love to hear your feedback.
 
Hi debkakes,

I don't know if with hip replacement (vs. spine) "adhesion" is the same/similar thing or not, but I had two minimally-invasive spine surgeries the last 2 years. The 1st one was about 2 years ago, and resolved a lot of problems that I'd been having (numbness and pain in the legs, to the point that if I stood for > minute, I couldn't feel them), but after that, I had several areas in my back that continued to be painful, even to the touch. I went to PT for months, and then finally, I changed to a therapist that does a lot deep friction massage. I was warned that it'd be painful, and it was, but he worked on me for several weeks (2 per week), and I think that what he did helped a lot to eliminate those.

I think that you said that the therapist that you're going to was doing massage, and I don't really "know" much about PT, and I'm definitely not in the medical field, so these are just comments, but having been to several therapists over the years, it seems like they don't all do the same types of therapy...

Jim
 
Well, for starters, it's much more likely you are doing far too much and a little less activity would be the cure.

I have some questions to ask you:
1. what pain meds are you taking, how much and how often?
2. how often are you icing your knee?
3. how often and how high are you elevating your leg?
4. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping and PT?
 
1. Taking 50mg Tramadol, 1 morning, 1 late afternoon, 1 or 2 before bed.
2. It's my hip -- and now, about 1x a day after I get home from work.
3. Hmmm don't know -- usually the first reclined position of the recliner. So not above my heart.
4. My activity level is pretty high. I'm working now, but sitting most of the day. I go out for about 1/2 mile walk every day or so; I get up from my desk and walk around about every hour). I have been cooking dinner and cleaning up the kitchen (my husband helps); we have a maid service 2x a month, so I haven't been doing any heavy cleaning, just laundry. I do some shopping, not a lot. PT 2x a week, 1x on land (as described, mostly massage and a little traction), and 1x in pool (lots of stretching, stepping, bicycle, other strengthening exercises). I also have a sewing class I attend, sometimes a play or movie or concert once a week.
 
Still hoping to hear from Josephine -- but for now, I have my PT's input that since I am still in an inflammatory stage (10 weeks post-surgery), icing is still recommended; and once we have freed the fascia, I should have much less pain and more mobility. He estimates another couple of weeks. We are starting to do strengthening in our land workout now, despite the pain. Nothing too strenuous, bike, walking unaided, balancing on surgery leg, side steps leading with surgery leg. I really hope it IS a couple of weeks. I have my next follow up with my surgeon on 8/30.
 
Hi Deb, sorry you are experiencing pain, frustration and discomfort, it is tough!

Recovery from this surgery takes a long time, at 9 mons post, although I am walking and working unaided and for 60-70% of the time I feel great and life is good, there are still days when the odd pain reminds me that there is still much healing to happen..

Hang in there hon... You will get better :)

Jo will be along to chat and offer her expert opinion xoxox
 
sorry - unexpectedly got called into work ...

If it's your hip (your question about adhesions threw me as they are not usually a problem in hips) then I cannot conceive how she thinks that's what it is. If your pain is that high, then 50mg Tramadol three times a day is barely going to cut it. The usual prescription is 1-2 tablets UP TO four times a day. Plus you can take 1,000mg Tylenol with each dose which gives the Tramadol a nice non-narcotic boost!

I estimate you are only 10 weeks out and doing far, far too much. I don't wonder you are in so much pain. Your PT said it: you are still in the inflammatory stage but she forgot to add that all that you are doing is making it MORE inflamed and therefore more painful. I have another thought for you - inflamed tissues are far more likely to develop adhesions. Read this article (I know it's for knees but it explains the process of how adhesions develop MUA (manipulation under anaesthetic) and adhesions.

So these are my suggestions:
debkakes said:
My activity level is pretty high.
I'm working now, but sitting most of the day.
I go out for about ½ mile walk every day or so;
I get up from my desk and walk around about every hour).
I have been cooking dinner and cleaning up the kitchen (my husband helps);
(I do) just laundry.
I do some shopping, not a lot.
PT 2x a week, 1x on land (as described, mostly massage and a little traction), and 1x in pool (lots of stretching, stepping, bicycle, other strengthening exercises).
I also have a sewing class I attend,sometimes a play or movie or concert once a week.
Click to expand...
I'd nix the daily walk, you do enough as it is. I can't tell you to stop anything else but you might lessen it all a bit, perhaps the pool stuff, maybe stop the stepping and bike.

Another thing you need to bear in mind is that your muscles aren't weak, they are injured. Let them recover and you will find they are quite healthy really. it's all this frenetic activity that is making them SEEM weak.

So maybe even take a week of from PT altogether. And give yourself at least one FULL day with no exercise or activity whatsoever. See, you really, REALLY need to let those muscles settle down and recover and all you keep doing is beating them to death! Truly, take this pain as them crying out that they need some time off from all this! Goodness, even the Good Lord Himself took a day off at the end of the week! Don't you think you deserve some too?
 
What wonderful wise, wise words from our Mother Hen.. Aren't we lucky to have her helping us all Deb..

I am sure Jo's suggestions are going to assist greatly - be gentle with yourself.. You have the rest of your life to enjoy this fabulous new hip... xoxoxox
 
Thank you 1000x, Josephine! I will take your advice to heart. This week I actually did ramp down the activity a bit. After my PT appointment on Wednesday, I actually took the day off work, rested and slept and iced. I also haven't done my usual walking since then. I am feeling SO much better and a lot less pain. I have been fighting this much more than I thought I was, and needed a reality check.
 
I have my 12-week follow-up tomorrow, and think I can report some solid progress. Although it's been a bit of a roller-coaster the past few weeks (and I happened to fill out the surgeon's questionnaire on a bad day), I've felt quite positive this week. I am walking without a cane in "enclosed" situations (office, home, PT office), but using it outdoors and for outings; my gait is still sort of painful and a little wonky, but certainly improved (back pain plays into this); I usually ice about once a day, when I get home from work. I am working on strengthening my muscles in PT now, along with the fascial massage to loosen up the scar tissue adhered to my thigh muscle. My energy level is pretty good, probably 80%. I take the occasional 50mg Tramadol during the day, and one or two before bed. I hope my OS officially lifts my 90-deg restriction (I've been breaking it right and left, or I should say up and down!), but I have a feeling the inward turning and leg crossing may remain for another 4 weeks. I expect another 4 weeks of PT as well; hopefully, I can ride my bike on short jaunts after that. What I have NOT done is go to the pool on my own to do water exercise. I think when I am off pain meds at night I may be able to stir myself a little earlier -- but it's also a question of breaking a pattern I've gotten into of sleeping in til the last minute. After 3 years of rising most of the year at 4:30 AM for crew 4 days a week, I've been REALLY enjoying NOT doing that, I'll admit :whistle:
 
Deb, when I was teaching, I always got up at 5:30am. Since I'm a night owl, it meant many years of 5 hours sleep. I have no idea how I managed to function that way, but I did. Since I retired....7 seven years now!!!...I get the double luxury of staying up as late as I want, and still getting 7-8 hours sleep every night. I do occasionally have to set an alarm clock really early....like for catching an early morning plane....but I can't picture ever going back to that regularly. So I hear you about the need to sleep in to the very last moment. Glad to hear the pain has backed off, and you are progressing. Hope it continues in a steady forward motion. :)

Sharon
 
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