THR Am I dreaming? Not anymore!

[wcgirl]

Wow! So proud of you! I'm sure there will be lots of trial and error to find your comfort level. Hugs & well wishes!

 

[Midchild54]

Hi all! Well today is much better. The leg pain I had was caused by too many pillows under legs and ankles. I went to sleep around 12:30am woke at 5 for restroom and meds, then promptly went back to sleep till my brother call at 11, wow! I can't remember the last time I slept in much past 8. Guess I needed it. I am finally starting my second week post op and I know it can only go up from here. The first week is always the worst. I read somewhere about laying on couch with chocolate and wine, hum, sounds tempting. Lol

 

[sunbunny]

Sounds like you are on the upswing! Hugs to you.

 

[mydog]

Hi Midchild - It's sounds like you are doing great the second time around! Are you sleeping in a bed? Just curious because so many new hippies have issues with sleep. I slept in a motorized recliner for 2 weeks, then switched to my bed. Slept with a pillow between my legs until wk 6 (because, it was comfortable). Yes - I found the first week miserable (cause on the pain killers which didn't agree with me) and the second week annoying...(cause I was feeling better but couldn't do much). Good for you on your recovery...but you know the drill! Happy, uneventful 2nd recovery to you Midchild!

 

[souldancer]

@Midchild54 - kudos on your 2 week recovery ! As each of us have find out the healing
process is quite a journey and can illuminate our strengths and weaknesses.

 

[Midchild54]

@mydog I do seep in a bed, actually it is a softsided waterbed. The first replacement I was still stuck in the spare room on a regular bed. There are good and bad about both. I've never really had a problem sleeping with either THR. Maybe because I save the strongest of my pain pills for taking at night before bed. I've been having a lot of problems with stiffness in operated hip that I don't remember being a problem with my other hip.

@Josephine I was hoping I might get some insight. Is the ice helping or causing stiffness? I tried getting up and walking my home more often, thinking I'm stiff from non movement. But it seems as though it doesn't help at all. Could taking too much Tylenol cause stiffness? I'm confused as to what to do or not do. Any thoughts would be appreciated.

 

[Josephine]

Maybe because I save the strongest of my pain pills for taking at night before bed. I've been having a lot of problems with stiffness in operated hip that I don't remember being a problem with my other hip. Could taking too much Tylenol cause stiffness?

I'm going to ask you some questions and 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 compare this with the bone-on-bone pain you had before surgery!

) Also don't forget to include 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. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

5. what kind of PT exercises and exercises at home are you doing? How much and how often? (and detailed details would be appreciated, please! **Reps, sets and sessions** and all that)

** If you're not familiar with this, it goes like so:
1 lift of your leg = 1 rep (repetition)
5 reps and then a brief rest = 1 set
5 sets and finishing = 1 session.

 

[Midchild54]

@Josephine
1. I had posterior approach again. There is a lot more swelling around incision, especially in the glute. Very hard. In my 1st surgery, only my knee and upper calf bothered me. This time it is my whole leg, aching, mostly knee and upper thigh.
2. My pain level is pretty consistent between a 4 and a 6, sometimes as high as an 8 or low as a 2.
3. My prescriptions read that I take 1-2 oxycodone every 4 hours as needed. Norco 1-2 every 4 as needed when oxycodone is gone. Tramadol 1-2 every 6 hours as needed (Norco has to be taken with tramadol in order to work. My Dr's office is pretty stingy with pain meds and I've been trying to make them last, trying different mixes. I take Norco 5/325, Tramadol 50mg, Oxycodone 5/325, Tylenol 500mg. I have kept in mind what you've said before and trying not to go over 4000mg Tylenol in 24 hrs. I take something every 4 hrs but sometimes work it to take something in between at 2 hours, depending on pain, at lesser doses. The best combo I've found for pain relief for at least 4 hours is one oxycodone, one norco, and one tramadol. As of now, I don't have any more oxycodone, only 5 tramadol, and 10 Norco left out of 20,20,&40 of same since last Sunday. So I have been adding in a 500mg of Tylenol to stretch them out longer.
4. My activity level is very minimal. I get up for restroom and feed animals. Back and forth to kitchen for drinks and meals that take less than 10 minutes. I only ice a few times a day because I'm not sure if it's helping or hurting right now. Everything I do seems to make me stiffer after I rest.
5. I received no PT before or after surgery. I've been doing the laying down exercises they gave me for the last few days. Ankle pumps, quad set, gluteal squeeze, hip abduction, hillsides. All 2-3 sessions, 10 times per day. Starting today, I've been getting up and walking at least every hr for about 40 feet. Again, no matter what I do, I'm just as stiff if not more when I get up again. The leg pain isn't as bad now.
I hope I have answered your questions the way you needed me to. Let me know if you need something clarified.

 

[Josephine]

2. My pain level is pretty consistent between a 4 and a 6, sometimes as high as an 8 or low as a 2.

okay

3. My prescriptions read that I take 1-2 oxycodone every 4 hours as needed. Norco 1-2 every 4 as needed when oxycodone is gone. Tramadol 1-2 every 6 hours as needed (Norco has to be taken with tramadol in order to work

'as needed' is a bit vague. Please tell me exactly what times you take pain meds. Such at this
8am
12md
4pm
8pm
12mn
4am
Get the picture?

My Dr's office is pretty stingy with pain meds and I've been trying to make them last, trying different mixes

Then approach your GP and get him/her onside. You can't do this without adequate pain management.

4. My activity level is very minimal. I get up for restroom and feed animals. Back and forth to kitchen for drinks and meals that take less than 10 minutes. I only ice a few times a day because I'm not sure if it's helping or hurting right now. Everything I do seems to make me stiffer after I rest.

Only you can say if icing is helping or not. Personally I found to the greatest relief.

5. I received no PT before or after surgery. I've been doing the laying down exercises they gave me for the last few days. Ankle pumps, quad set, gluteal squeeze, hip abduction, hillsides. All 2-3 sessions, 10 times per day.

Good. And you don't need any. These are all too much. If you really MUST do some, do them once a day and as I've suggested

My comments in bold
each 10 reps x 2-3 sessions per day - no more than once a day and nothing at weekends
ankle pumps - these are just anti-clot exercises and don't really count
quad set - do 5 only
gluteal squeeze - do 5 only
hip abduction - don't do these - too hard on the hip muscles.
hillsides (I take it these are heel slides!) - these are knee exercises, not necessary

Starting today, I've been getting up and walking at least every hr for about 40 feet.

That's not necessary either. Just walk as necessary for kitchen and bathroom. You're only 9 days out and should be resting more than anything.

Again, no matter what I do, I'm just as stiff if not more when I get up again.

Exactly my point! But you main issue is inadequate pain management. Remember that stiffness is a form of pain too, along with soreness, burning, stabbing, throbbing, aching and swelling.

It seems to me that you are not taking an adequate dose of anything. You need to stick with one medication so it can work. If you take small doses of three different meds, none of them have anything to work properly.

This was the schedule I worked out for myself for my knee replacements - you might find it helpful!
(paracetamol = Tylenol)

 

[Great Aunt Janet]

Hi @Midchild54 - I do hope you can sort out that pain relief and get a bit more comfortable than you sound. It is all a bit of a vicious circle isn't it, and I'm sure Josephine's advice will help you break it. I use ice and heat - ice where the swelling is, and then a little warm wheat bag where it is just stiff and weird feeling - seems to help jumpy muscles relax for me, might be worth a try.

Many happy thoughts in your direction, and wishing you a comfy, relaxing day - and night!

 

[Midchild54]

Hi all, I thought I'd post an update. I was in a lot of pain last week. But thanks to @Josephine advise, I got the courage on Monday to fight for my right for pain meds. I got myself all worked up to a tizzy, but in the end, I didn't have to try too hard. I think she heard the pain in my voice (shaky) and readily agreed. So I'm on the correct amount of meds to manage my pain. I've been doing much better these last few days. I feel like I'm where I should be at day 13, moving more freely and occasionally, without support. I hope all the rest of you are doing much better as the days roll on. Thank you for your support, it really means a lot.

 

[Midchild54]

Hi all, thought I'd give an update. I'm at my 4 week today. A lot has been happening. I can walk with just a cane most of the time except first thing in the morning. I had my first stand up shower today and I'm not near as worn out as I thought I'd be. I plan on going back to work as a taxi driver next Tuesday. Only part time for a few weeks. I'm only taking narcotics at night now. Today is my 4 week mark. Last Thursday at 3 weeks, I drove myself to the Dr because there was no other way. I did alright. Today I'm going to venture out again and shop a little at Wal-Mart. I'm running out of some essentials like coffee, LOL. There's a lot to be said about the riding carts at most stores and my cane will fit nicely in the basket.

I have lost almost another 10 pds. I lost 10 with my first surgery, 5 in between, and 7 with this one. I can't remember the last time I weighed 175. At 5'10", that's just about right, maybe another 5 if I can manage it. If your wondering how I did it, I drink a lot of protein shakes and eat protein bars, with a good meal about once a day. Its easy to do when you live alone. I have done very little exercise and no PT. I do need to do something to tighten things up a bit. There's so many things I still can't do because of low back pain. Hopefully I'll think of something. I hope this finds everyone well and happy even if in pain. I would love to hear from you.

 

[Erushka]

Hi Midchild, I had my right hip replaced on April 6, so I guess we're both April babies! Glad to see that you're making progress--we all move ahead at our own rate.

I'm doing a lot of PT--in the clinic twice per week and daily at home exercises--but in my opinion the best exercises are walking and just doing as much at home as possible, you know, the day to day stuff that clinicians call activities of daily living. As my wife says, you need to move your body! Don't be lazy! She's right. Just do what you can, then try to add a little more tomorrow.

You aren't alone with Bone Smart. Don't be shy! I found that BS has gotten me through my darkest days, and has gotten me back on track when I got off course.

Gotta go. Take good care of yourself.

 

[Midchild54]

Yes, I definitely had to fight the lazies. What's amazing to me is how fast I'm recovering. With my RTHR in November, I couldn't go back to work for over six weeks. It took that long to do a stand up shower too. I truly believe that the difference is because I had to have a general anesthesia the first time. I had a lot more energy drain and dizzy spells with that one. I'm so glad I was able to do the spinal this time.

 

[Erushka]

Oh yes, I had general anesthesia for my left hip in 2012. 3 weeks of nausea, just felt miserable. Got a spinal this time and it was so much better. Felt like a long deep nap. Spinal rocks!

I've had a much easier time with the right hip, and I'm sure that the anesthesia was a major factor.

 

[sunbunny]

@Midchild54 koodos to you. You are going great. Driving and going back to work. So proud of you. I am a little behind with my progress compared to yours. But I do see progress which is what counts. I was eight years younger with my last knee replacement and my giddy up and go is more like pudding. Strength and endurance have always been my issue. Keep up the good work.

 

[wcgirl]

@Midchild54 i am 10 days behind you, so half way thru my 3rd week. I am working on 2 crutches for 'perfect gait'. Occasionally i use only one esp in the kitchen.
I had no issues w general anesthesia -- as far as i know. Ill be going for OS apptmt for the go ahead to drive. Its hard for me to imagine but i look back over 2 weeks and see how quickly i've progressed. Today i've actually had to stop myself when standing i felt ready to walk unaided.
You make me realize that it won't be long now before i too can get out and actually drive. Glad to hear you are back to work. That must make you feel really good.

 

[Midchild54]

Well, I started back to work as planned on Tuesday and did much better than with first THR. I'm only working about 6 hours a day, 5 days a week. I rest whenever possible. I have some real nice cushions to sit on while I'm in taxi so sitting for a few hours is not an issue like I thought it would be.

I had a real scare these last couple of days that had me stressed out bad. I have a Comercial drivers licence (CDL) and so have been required to have a DOT physical every 2 years. I thought I had till end of May to renew but found out it expired on May 20th. I was concerned about the whisper test as I have some hearing loss of low tones. I got away with it in the past because the Dr that was doing it did it differently. I went to a clinic and sure enough, I didn't pass the hearing test. The nurse practitioner was very sympathetic and agreed to stop the physical and pretend it never happened so I could have the chance at seeing the Dr I used before. She even gave me my money back. I went out to the taxi and called to make the appointment, he no longer does DOT physicals. So I just sit there and cried. If I don't pass the physical, I can no longer work until I'm able to get a hearing aid, which would take at least a month or more. My hearing doesn't effect my job in any way except I might have to ask soft spoken people to repeat. So I'm freaked. My boss turned my DDS back on so I could work because I told him I'd go in that day, Thursday. he just asked me to be careful and send him a picture of my certification.

I called and asked the clinic I'd be going to if I could use an amplifier for the whisper test. Since it didn't state that I couldn't in the regulations, they said they would allow it. If I didn't pass the whisper test, I couldn't use it in the tone booth. I wasn't convinced I would pass so I worked the whole day, convinced it was my last for awhile, before trying the physical again. I passed, yea God!! . I had no problem hearing the whisper behind me. Such a huge relief. Even though I don't have to worry about it again for two years, I plan on trying to get hearing aids for the next one. I never want to go through that horrible fear again.

Now that that is over, I'm pretty sure I can go back full time next week. Its amazing how fast my recovery is compared to my first THR. I hope all of you are doing well too. I've been trying to keep up with the posts but haven't been on Bonesmart for awhile. Take care and God Bless.

 

[sunbunny]

@Midchild54 so stressful. I am so proud of you. Back to work and all. You are an inspiration for recovery! Keep it up kiddo! Prayers your way!

 

[Erushka]

Getting back to work--such a major milestone! Well done.