THR Anterior THR Aug 19, 2014 Home same day.

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How many 10-Day Post-Op THR Patients does
it take to replace a light bulb?
(in the ceiling)


Answer: one if he has a step stool and a wonderful wife he loves to please.
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End of Day #10

1 Hour Pool Rehab with my wife at the YMCA

51.23:48:22 Days.Hours:Min:Sec until BTKR​
 
I look forward to following your BKTR @HerbM - that time will pass quickly.
 
Hope not for you Herb :) I can only speak from the point of view of my THR recovery. The little I have read on the knee side of the forum, I get the impression TKR's take longer with recovery and I guess in your situation you are having multiple surgical assaults on your body in a reasonably short time. :)

Might be worth reading this articles...

The following is a link to an article which provides the current science regarding the healing beneath and around the implant and approximate timeframes for the healing phases and processes and the relevant nutritional information for each phase.

Healing Phases & Nutrition

This second link is to other nutritional articles which you may find interesting, including one relating to bone health.

Nutritional advice for pre op and recovery

This third link refers to my ongoing research..

nutrional-snippets
 
Thanks @Poppet

Someone asked me a question and it occurred to me that others might be (vaguely) interested.

My 5" surgical incision wound seem to be "high up into the groin". My reply follows:

The top part (last 1/2" or so) had some 'irritation from the surgical tools' according to my surgeon, and ends right at the body-thigh joint crease.

He asked me to pad it with Neosporin and gauze to let it heal without chaffing in the crease but it really was not an issue for me (especially since I have followed those instructions.

Except for that small area, most of the incision stays open to the air now, except for when swimming for that he wants me wearing a waterproof bandage for another 10 days (from now the 11th day).

You many also not be used to seeing incisions photos from so near to the time of surgery. My first post was on Day #6 when they removed the bandaid and pulled the stitches from the (3) tracker poke holes.

The main incision stops RIGHT at the thigh crease, but you may also be seeing the two poke holes a couple of inches up on my body. (The 3rd hole is down near my knee and already healed.)
 
Herb

I just posted on the old PreOp thread in error. I am having an Anterior Left THR on the 16th of Sept. Although I am in pain, I keep working out to ensure the strength of the muscles and tendons for the best possible outcome. I hope to get back to the Ironman circuit is year after the surgery. How much do you think your excellent fitness contribute to your speedy recovery? Any tips you can send me would be great!

Cheryl
 
@CanukTriMom /Cheryl I hope your surgery too goes as well as mine, but my main wish is that YOUR surgery goes as well as it is POSSIBLE for YOU.

When I get my other hip done, I may not have all of the same results (it would be VERY difficult to beat this surgery since there is so little room left for improvement over "near perfect".)

My physical condition definitely helped as did my mental strength, but likely these two attributes will be far more important when I get my BTKR (both knees) on Oct 21st. Knees are harder, two knees are harder still.

THE KEY item for the THR for me was the Anterior approach (which you are having), without that my quick early recovery would have literally been impossible

Merely the post-op PRECAUTIONS caused by the posterior approach would have stopped me from doing MANY things, and made me far less comfortable (crossing legs, adducting/legs together, breaking 90 degrees upper leg to body, twisting leg outward are all Verbotten with PA.)

Sitting on a (much larger) incision for the past 11 days would have been a real pain (literally and figuratively)

Consider DIPS and/or PUSH UPs if you are athletic as essential pre-surgery exercises -- if you aren't already using a cane etc., consider getting your cane NOW to train your arms to use it.

The cane might make you more comfortable in the next month while waiting for surgery. (You could do the same with crutches, but having an Anterior approach hip, I never used either walker or crutches, went straight to a cane 2 hours after surgery on my first "check out" walk.

[There are more advantages, e.g., I can take care of my own wound better if it is in front instead of behind me, but you are having an Anterior THR so the other differences aren't really important to you.]

A GREAT ANTERIOR SURGEON was certainly part of it as well, my surgery was actually a bit more difficult than the norm as he spent about 1/3 longer getting my surgery correct.

I really would not have wanted to do this with someone on the low side of 50 Anterior replacements and more than 500 is really better.

But to be clear, I would take a 500+ Anterior surgeon over a 2000-Posterior surgeon for the 2nd hip if my surgeon (Dodgin) isn't available then.

Exparel was perhaps ALMOST as important as a Great Surgeon -- this bought me 72 hours of NO PAIN in the joint, and for me this meant NO PAIN AT ALL (literally a single 1/2 second flash of pain when I sneezed the night the Exparel wore off -- that was the ONLY thing that was painful in any significant way. My right thigh was a little stiff and sore to stand at first but only about like doing a bit much at the gym after a long layoff.)

Ask if you are getting Exparel and if not, ask WHY? I might not change surgeons but I would likely change hospitals to get it (the hospital anesthesiologists may have more to do with this than your surgeon). This stuff probably isn't allowed for everyone (is anything?) and there may be some surgeries where it makes no sense, or even something BETTER (someday?).

I asked Dr. Dodgin at my post-op followup on Monday (which was mostly a discussion of doing my knees in Oct),

Me: "Are we going to use Exparel again?"
Dodgin: "Yes, absolutely!"
Me: "Good, because otherwise I have to find another surgeon QUICK!"
Dodgin: <LAUGHING> (He actually has a great sense of humor.)
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Knowledge: Bone Smart and the other fine people here helped me immensely, in ways they will never realize since much of that was my reading older threads rather than asking questions. Reading the list they provide to each person planning a replacement or recovering from one.

RICE: REST, ICE, COMPRESSION, and (proper) ELEVATION were keys to getting me ready for the Exparel to wear off. I knew that, but BoneSmart makes a mantra of it and emphasizes it so thoroughly, especially the explanation of the PROPER way to elevate. Check out the library or reading list.

GREAT ICE PACKS helped quite a bit I am sure. I used these (knee) wraps https://www.amazon.com/Elasto-Gel-Cold-Wrap-3-9-Pound/dp/B000S5GKHY/?ie=UTF8&qid=1409460935&sr=8-1-fkmr0&keywords=Elasto Gel Hot/Cold Therapy Wrap 9&#34; x24&#34; which worked great for my hip. They are a little expensive ($40 on Amazon) and you need to order them now to get a good price.

Also, order enough. I only ordered 2 but Amazon accidentally doubled the order so I just kept the EXTRA 2, and was happy to pay for the mistake. 4 were enough, 6 would not have been too many (unless you have the Polar Ice therapy working well.)

Sometimes I wrapped 2 (especially at bedtime), one high including as much of my hip as feasible (my incision starts almost precisely at the "hip/body crease" and goes exactly 5" (12.5cm) on the slightly lateral side of the front of my thigh), the second one OVER but mostly below the first and down to the knee.

The straps on these pads are EASY to get set, and then easy to tighten as needed but I seldom could walk without having them drop so get to your resting place to put them on.

As a woman they will likely be easier for you to deal with (no not what you might be thinking) because your thigh is likely smaller than my 225 lb body offers. I could not always get the pad FULLY around HIGH on my thigh, but that is ok because the BACK of my thigh had NO issues and didn't really need to be covered by the pad and the straps stretched enough to make contact with the Velcro mating surface.

I iced through my (long) gym shorts or long gym pants OR I put a "tea cloth" (knapkin or thin towel) and never had any problem with frostbite etc.

Also note one of the few mistakes I made (didn't matter but it might have been important:

My polar ice machine was IN MY HOSPITAL ROOM when I woke up, but my focus was so dedicated to getting OUT and my pain level was ABSOLUTE ZERO (on the Kelvin scale) that I didn't notice or ask much about it (sitting in a box still sealed up.)

No one offered to set it up; no one offered me a single ice pack even though I was there and awake for about 6-7 hours (mostly waiting on the PT and then the surgeon to come back to release me.)

That was at least 5 hours of missed opportunity to ICE and ELEVATE (I was mostly resting and hips don't compress that well anyway.) Being in bed, the elevation wasn't so bad though. BUT NO ICE all day until I returned home.

MAKE SURE you or your surgery helper (spouse, friend, etc.) DEMAND they ice you even if you are only going to spend the day there.

FYI: For home use the Polar Ice is NOT QUITE worthless without your own ice machine or VERY mobile surgery helper who can run to the store a LOT to get more ice (at least once, maybe 2-4 times per day.) That silly thing will eat all the ice in the refrigerator ice maker in one swallow and still want more. I am buying or renting an ice machine for my knee recovery ($200-800 to buy, probably not getting it "plumbed" but using a portable type.) It wasn't critical in the THR since my recovery was so near to ideal.


I did a LOT of other research and this was very valuable as well. Not everyone should WATCH surgeries, some people would be disturbed too much thinking of them doing THAT "to me", but I watched many surgeries, and tried to find one on every element of my procedures (I was still considering knees first up until two weeks out.)

IF you are Ok with it, I would WATCH a couple of anterior surgeries MAYBE (for me this was more important because it was part of my decision process but you have that already decided.)

FYI: My WIFE wanted to watch but quickly changed her mind and I took it OFF the big screen TV to watch on my personal laptop -- and she wasn't even the one getting the surgery though that may happen by early next year.

MILD WARNING: If your anterior THR is anything like mine (and you get the Exparel) then your hip won't hurt (much or at all) but the LOWER HALF of your Quad down to just above the knee will likely be somewhat stiff and sore -- this was the ONLY (minor) issue with getting up from a low chair or the toilet.

For me this wasn't "true pain" but about a 1 (of 10) as if I had laid off tennis for a couple of years and then played 5 sets but somehow oddly only one thigh was sore. Or like you went to the gym and did too many leg presses with too much weight. Nothing drastic but "Hey, that's not exactly comfortable."

If you are prepared for that it makes dealing with it easier in my opinion but for me it really wasn't a deal.

Luck -- you can do everything right and get lucky or not -- best to set it up to create your own luck but sheep happens, so no matter what your condition on the other side, just start doing everything you can to make the best of it. (Mental strength matters the most if you get thrown a curve during your surgery or recovery.)


For example, I prepared as well as possible, especially MENTALLY, in case I spiked a fever or otherwise showed an infection. It was on my list of things to accept and MOVE ON with fixing.

Dips (closer to the real movement you'll need to get out of chairs, toilet, etc.) and pushups (easier to do at home) are to prep you for getting up and down with the assistance of your arms. Note you don't NEED to be able to do your entire body weight, because just HELP from your arms is usually enough.

Presumably you are needing some help already from your arms (or you wouldn't likely need the hip replacement.) While needing help from you arms is unfortunate it does help you prepare for post-op.

MISCELLANEOUS: I bought a LOT of accessories to make this easier but many of them were pretty optional (or worthless), or more relevant for when we do my THR in October. (Only two weeks before my surgery I decided to do the THR first; until then the plan had been BTKR first.)

My biggest decadence was an expensive La-Z-Boy Power Recliner to replace my broken down recliner but I need that for the next 10 years (I work from home and sit in it all day), this was just a good time to buy it and use it.

At some point I intend to post the full list of things I purchased and did or did not use, what helped or didn't etc.
 
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Herb

I just posted on the old PreOp thread in error. I am having an Anterior Left THR on the 16th of Sept. Although I am in pain, I keep working out to ensure the strength of the muscles and tendons for the best possible outcome. I hope to get back to the Ironman circuit is year after the surgery. How much do you think your excellent fitness contribute to your speedy recovery? Any tips you can send me would be great!

Cheryl

@CanukTriMom

You should also know that you have (at least) 3 real advantages over me:
  • You are likely near your ideal weight.
    Despite being in very good condition (especially strength), I am at least 30 lbs overweight (not obese but definitely not skinny) and even stripped to correct weight my muscle & bone mass makes me HEAVY and my knees and hips have to haul it around no matter what the composition.

  • You are 12 years younger (probably won't mean as much as the other things)
  • You are a Woman (well an Iron Woman is even better :) )
Surgeons learning the anterior approach to a THR are advised to choose candidates JUST LIKE YOU (really): women in good condition, with no excess body fat, and good flexibility.

Old, (morbidly) obese, inflexible guys, are the LAST patients they should 'train' on.

See the DASH Academy website if you wish to read and watch videos that teach surgeons how to do the anterior approach, including patient selection etc.. DASH Academy is a virtual school (they do seminars and such) to educate orthopedic surgeons on the anterior approach. https://www.dashacademy.org/

Note: You must register to view the materials but that is quick and requires no medical credentials etc. Some of the DASH videos are also on YouTube (that's how I found them) but they are better organized, outlined, and explained on the actual DASH Academy site.
 
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:sneaker: Oh, Herb, your recovery thread here reminds me that it can be just that easy -- my recovery from my first THR was just as "easy" as yours and now I'm working on convincing myself that it can be that way again -- you've nearly done it.

I too had(have) a great surgeon who does anterior approach with the Exparel -- I think I used the Christmas morning feeling to describe how I felt the first couple of days, too! I had agreed to stay in hospital for the 3 days as my surgeon asked though he had said he would release me second day if I wasn't thoroughly enjoying my stay at his "hotel." (A small group of orthos own the 15 bed hospital, and it is more like a hotel including restaurant food - they purchase food from a local $20+ a plate restaurant). I was back "at work" on Day 5!

I loved reading your recovery and hope to hear more from you! My next surgery is tentatively scheduled for October 15!
 
@Me2 it really CAN be that easy but we have no guarantees.

As long as you are prepared for any or all of the issues OTHER people have posted here, so that a set back doesn't become mentally devastating, there is nothing wrong with planning to do it the easy way.

This is the key point behind my other signature tag line: Plan for the worst; shoot for the Moon.
 
It is not always easy coming to grips with the fact that we are not in control of our recovery - our body is. We can help it, but in the end we are not in control..
 
It is not always easy coming to grips with the fact that we are not in control of our recovery - our body is. We can help it, but in the end we are not in control..

Coming to grip with such realities *is* under my control as it involves mental strength, determination, and perseverance.

Most everyone CAN access these qualities if they work at it, especially with prior planning, but not everyone typical does this or has an easy time doing it.

For some of us, such is a long standing habit -- this is the advantage of people like @CanukTriMom and ex-Special operations soldiers (including most Marines), and elite athletes. That was great training for LIFE as well as a particular job, advocation, or event. Most everyone who has dealt successfully with serious combat injuries (not me) or other losses of limbs etc. has gained this ability. A hard trade but still a valuable asset.

This is not to say that I am perfect at it; there are certainly time when it take me anywhere from moments to hours to adjust but the times that take hours (or days are rare for me.) Even that is process you learn, i.e., recognized you aren't 'dealing' and start building the internal resources to make it happen.

And one doesn't have to be an IronWoman like CanukTriMom to do this -- @Me2 is working to prepare this as well (and I don't think she has ever run an IronMan) but then if I recall correctly she quite something of an athlete.

Athletes don't even need to be 'elite' if they practiced with this type of mind set. I was never really a GREAT athlete.

Even that isn't necessary, there are plenty of people with the fortitude to make the best of ANYTHING life deals and even more with the ability to DEVELOP this capability.

However for those who don't know, here is the reference to what @CanukTriMon did WHILE facing a serious disease and surgery, PLUS having a hip in bad enough shape to replace it:

An Ironman Triathlon consists of a 2.4-mile (3.86 km) swim, a 112-mile (180.25 km) bicycle ride and a (running) marathon 26.2-mile (42.2 km) run, raced in that order and without a break. It is widely considered one of the most difficult one-day sporting events in the world

https://en.wikipedia.org/wiki/Ironman_Triathlon

Typically an IronMan Triathlon has a 17-hour cut-off (with individual cut-offs for finishing each element so it's not possible to just "take three days" to finish it.)

Anyone (probably) CAN do this with enough time to prepare and the knowledge to understand how.
 
Well, it's been fun (literally I enjoyed almost every minute of the THR event) but likely this thread will start winding down. Anyone is welcome to ask questions here or add suggestions even but essentially there only a few more things for me to post.

I still need to bet the surgeon's official check out in a few weeks, it will be another week before I can officially bath and swim without the waterproof bandage, and like everyone else my bones need another 4 weeks to finish growing fully into the implant. I might post another picture of my wound just for grins :).

I also intend to post the list of items I bought and how they worked out (or didn't) for me -- most of the list is elsewhere here on BoneSmart as I used my own ideas then went through the BoneSmart list and a few other people's threads to augment it.

However tomorrow will make two weeks since the surgery and that isn't much more that is likely to happen that will be interesting or require assistance.

:egypdance: Day #13 Post-Op :type:
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This morning I went to Aqua Yoga. Carol was intending to go with me but the grand twins are still here, slept in after a long day yesterday at the Grape Stomp, and she wanted to wait for them.

This occurs at an inconvenient time of day for my work, but today being Labor Day, I have off (probably.)

Before yoga I did my new routine in the weight room at the gym. :treadmill: Lot's of dips on the negative weight Nautilus. I am now doing multiple sets of 10 multiple times with about net 70 lbs. Not a lot but I am doing VERY deep for a full stretch and fully controlling the entire movement slowly.

Also doing about 75 lbs on the leg extension machine for my quads. Only got to about 5 of the last set of the last pass so that is pretty much my max for the next few days probably.

It's miles ahead of where I started (10-20 lbs) just 10 days ago though.

:swim:
The Aqua Yoga was generally a very good activity. A bit boring and not too hard most of the time but some of it was challenging. Really convinces me I need to find an ordinary (restorative or beginner's) yoga though.

I would do it again, even regularly, if my schedule were more amenable. I think it would be even more effective about about 10 session to get the hang of the postures (in the water and in my body).

You can probably guess there were no other men there -- about 15 ladies.

It was (past) time to remove the waterproof bandage (with the Pre Tape spray adhesive under it) which I have been wearing for 3 days. The wound looks and feels fine; the 2 poke holes above it are essentially healed and gone.

I will go the cleaning and disinfecting the surgeon gave me to do and leave the wound uncovered until my next visit to the pool.

My wound AREA has been itching a little bit the last couple of days. My mother always claimed that this meant it was healing. I have no real idea if there is any truth in that but it does mean there is a little bit of feeling in the area. Another nice advantage of the transparent waterproof dressing is that I could see the actual wound and scratch or rub the smooth plastic with any chance of digging into the wound itself.

The whole THR process has been an actual joy and incredibly fun :yahoo: and much of that is due to being able to share it with you kind folks, and of course the help everyone gave me to prepare which was a significant part of having such a near perfect experience.

:thankyou: Thank you all and virtual hugs for everyone.:console2:
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@HerbM

I have really enjoyed your posts! Yet I am harbouring some jealousy at your gym exploits post surgery! I sincerely hope that I have a recovery similar to yours as this will be my second majorly surgery in as many months and it's getting kind of old if you know what I mean. Yes please post your list of necessities as I tend to be a list maker and find comfort in being prepared. Sounds like aqua yoga was fun.....think I will try that at my gym as well. How long did you have to wear the compression stockings?

I admire your tenacity regarding your upcoming BTKR so soon after your hip! You are going to be bionic! Will you ever go back to running once everything finished or jogging? Curious as there is a lot of literature out there regarding running and hip replacements.

Later

Cheryl:swim:
 
The good and bad news is that you get YOUR recovery. I wish you the best possible and suspect you will be a star due to your conditioning and mental fortitude.
I'll try to get the list together soon but it is based on the lists here.
Aqua yoga was ok, and the general idea is even better since you can do stretches in the water that might be impossible on dry land (safety reasons.)

It's easy to be tenacious at the Start line -- we'll see at mile 20.

I doubt that running is much in my future. If I can run enough to do combatives which involves short sprints of a few steps 10 feet to 10 yards at most.

I don't know anything about literature on implants and running -- haven't research that (yet) so share if you find some good stuff.
 
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Two weeks today since my surgery. It's all over but the shouting.

Today I did water therapy, the weight gym (mostly shoulders and upper legs to get ready for BTKR), and finished with Basic Yoga at a local place.

Yoga was really hard (for me), and I hit my limits several times but gained quite a bit of ROM and flexibility during the 75 minute class.

Surprisingly I could fake a not too ugly Warrior, and separately touched my head to my LEFT knee. Procedure (Right) knee is still about a fist width away from the knee (for me this is pretty dramatic even when fully healthy.

The knees, especially left, were really annoying during the yoga and when trying to WALK OUT from the water therapy this morning.
 
Good updates, Herb.

You'll find the whole gamut of opinions about running after joint replacement surgery....all the way from don't do it more than those short sprints you're talking about now and then.....to do whatever you enjoy and can tolerate. Some will say it might wear out your joints sooner. To my knowledge there isn't scientific data to support that opinion. And there are people distance running on artificial hips and knees. Frankly, no one really knows with the current implants, so our take is to leave it to the individual and their doctor to decide what is right for them.
 
@HerbM

I wanted to thank you for all your messages on the forum and to me privately regarding waterproofing etc.

You know I was specifically told that yoga would be out of the question until I was fully recovered due to possible dislocation as some of the moves are very twisty and require a shift in the centre of gravity.
 
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If I were in @CanukTriMom 's position and had her interests, I would definitely be researching it and talking it over with my surgeon.

I did ask my own (first) surgeon and he was pretty clear that with him the answer was "No", at least for me.

But then I weight 190 at the best of times and currently 225 so that might be a factor the surgeon would consider.

Running is also not my passion though I have been pretty good at it during some times of my life -- you have to learn to at least accept running to be in the Airborne, and I could do 8 miles comfortably back in the days when few people were running very far (circa 1973). Today a lot more people run and 8 miles is not considered very far.

I do love combat arts however and will do my best to continue to convince my surgeon that this is appropriate for me. :)
 
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