THR Anterior THR Aug 19, 2014 Home same day.

[HerbM]

The comment about being "anti-climatic" was originally directed at @CanukTriMom since with all her strength, toughness, and an anterior approach, she stands a VERY good chance of having an outcome similar to mine.

It also could easily apply to you @Me2 since you are preparing so thoroughly and have experience with similar surgery. (But do note I was also teasing a little, the idea being that if everyone goes really well then CanulTriMom MIGHT well think, "I did all this prep for something so easy????")

Me2 wrote: "I see that this hip thing has helped me to develop the ability to make the best of ANYTHING life deals!"

YES! This is part of the idea that anything we encounter in life that is difficult CAN (as long as we survive it) make us stronger and tougher.

Weight lifting (or any physical training) offers a simple physical example. As long you are stay withing safe limits, intelligent training gives you muscles that are bigger, stronger, and/or have more endurance.

The analogy I have used since childhood (my childhood was great even though seen from outside it might have seemed quite traumatic) is that of tempering, quenching, and folding steel to make a great sword.

Done wrong (to excess or injudiciously) results in a brittle sword that breaks on first hard use. Done properly it produces a sword that is both STRONG and FLEXIBLE enough to endure despite hard use.

 

[Me2]

All so true . . . you are so very wise!

 

[CanukTriMom]

@HerbM,@Me2

I really envy both of you having kicked this surgery in the butt! I will keep you all posted but to tell the truth I am still nervous as I cannot control the unknown......I need to go to my happy place with deep cleansing yoga breaths....sounds good think I will go with that plan....and a lot of drugs before getting into the room.

Thanks


Cheryl

 

[CanukTriMom]

@Me2

You have hit the nail on the head with your statement above....I am in the same boat wherein my hip isn't crippling and my external rotation is at 50%. I just started having to take Arthrotec before my last IM but as I had stomach surgery right after the race, I could not do anything (in terms of running, biking, cycling, lifting etc.) for 6 weeks causing my muscles to atrophy around the bad hip. Since the beginning of August I have been back to strength training as well as cycling and swimming. I have had PT since Jan to keep my hip in working order until the surgery. The waiting time for my surgeon, who is only one of two that does the anterior method, is 18 months. Yet when he saw me, he offered to put me first on standby as I was in such great shape and knew I would do the work to recover strong. It also helped that he is using me in a study related to the effects of high levels of fitness for patients before and after surgery. so my wait time was relatively short...4 months.

I told my surgeon that I didn't want to be like the patients in the waiting room that couldn't walk and were in poor physical shape due to their pain. He agreed that the earlier the better when it comes to hip replacement as my hip is bone on bone and has been for the last year. So although people have told me 50 is young.....I look at this a very important action item on my To Do list.




Cheryl

 

[HerbM]

Wow, when I found my surgeon (and remember he really is one of the best, having trained with Joel Matta, helped Matta with AA tools & techniques, and written papers with Matta as well has having taught the AA in Chicago) I waited about 1 day to decide then had my surgery scheduled for 2 weeks out.

Compared with your @CanukTriMom 4 month wait, this was incredibly lucky (again.)

 

[MajorHeidi]

Wow @HerbM 2 week wait! unbelievably good.
Mine was 4 months, but I dilly dallied with trying to go without so it was a 6 month wait

 

[CanukTriMom]

@HerbM

Forgot to mention my surgeon trained under Dr. Matta for 1 year in 2006. So I am thinking that he will be the ideal surgeon for me, in terms of technique.

Oh I would have had my surgery July 8th but I was recooperating from the cancer surgery.



Cheryl

Just picked up a few more items for 50....friend of my sister in law was selling a raised toilet seat with arms and a shower transfer chair with seat back and rail which was bought brand new ...SCORE!

 

[HerbM]

Wow @HerbM 2 week wait! unbelievably good.
Mine was 4 months, but I dilly dallied with trying to go without so it was a 6 month wait

My total wait once the hip became symptomatic was 4 months, but this is my fault (and also due to the first surgeon) in not viewing my own x-rays and understanding that the hip was not a temporary problem and not a relatively minor issue compared with my 45 years of knee deterioration.

It was when seeking opinion, that it was necessary to request my x-rays and the opportunity to view them became available. My first surgeon (although quite a good surgeon in my opinion) told me nothing of this and didn't bother to explain how he would have done an Anterior Hip (I found out post-op from the nurses in the hospital where both surgeons practice) with the opportunity for both a quick recovery AND a quick turn around to the BTKR.

From the moment the 3rd (and eventual) surgeon explained the Anterior approach and the quick turn around, it seemed clear what I was supposed to do, but by that time I had delayed almost 4 months thinking "knees first" and "no hurry, they have been pretty much the same for years or decades."

Two weeks later I had a new hip (and a lot of new friends here on BoneSmart.)

It may not be surprising that even at this late date (6 weeks out, and very happy with my surgeon) my research into TKR methods continues. One thing that is currently intriguing me is the idea of "kinematic alignment" vs. "mechanical alignment" in a TKR.

I will definitely discuss this with my surgeon at the next visit because I must live with the BTKR for the next 5 to 40 years, and the quality of the surgery will affect literally every step I take during those years.

Kinematically aligned TKR:
https://www.drstevehowell.com/ Stephen Howell has 3000+ KA TKRs and is a professor of Mechanical Engineering as well.
https://www.healio.com/orthopedics/...s-mechanical-alignment-what-is-the-difference

My research has caused me to 'find' my way onto a site for OS training where there are videos, presentations, and the surgeons are having an in depth discussion of these ideas. Extremely interesting.

 

[HerbM]

@HerbM

Forgot to mention my surgeon trained under Dr. Matta for 1 year in 2006. So I am thinking that he will be the ideal surgeon for me, in terms of technique.
...
Just picked up a few more items for 50....friend of my sister in law was selling a raised toilet seat with arms and a shower transfer chair with seat back and rail which was bought brand new ...SCORE!

That he trained with Matta is a VERY good recommendation in my book -- not only because my surgeon did so as well and that Matta more or less invented the modern Anterior Approach in America but also because having seen Matta's teaching of other surgeons on DASH and his papers, he seems quite skilled and other surgeons seem to highly respect him.


As to those items: I am TRULY glad you have them. I bought both the toilet seat and the transfer chair and they were both pretty irrelevant TO ME, but it is easy to imagine that had things gone just a little bit differently they would have been very important.

Better to have and not need, than need and not have.

My wife likes the raised toilet seat for daily use so it will stay (despite that as a male WITH bad knees it gives me some trouble being in the way for standing.)


Also, try to make sure you have a REALLY NON-SKID shower mat and something similar OUTSIDE the tub/shower.

I bought a 'grass like' mat (which my wife dislikes for baths) and placed it WITHIN the tub and took are pretty good mat and place it OUTSIDE the tub. Now that my falling risk is normal, we have put the original mat back into the tub for her baths. I will reverse them during my knee recovery period.
Ginsey Aquatouch Soft As Grass Bath Mat, Blue
https://www.amazon.com/gp/product/B0029LHCVS/?tag=ate362da-20

Also, I obtained a forehead thermometer (though any accurate thermometer will do) and pre-calibrated it prior to surgery. That and my blood pressure cuff gave me a lot of confidence in the days immediately after the surgery.

(Always normal except for one temperature excursion to 99.5 degrees on a single night, had it worsened then I would have taken action but just knowing allowed me to stay ahead of the game.)

 

[CanukTriMom]

Got the mat for the shore last week but you are correct about a non slip surface outside the tub......Do you think I will need a hand rail on the edge of the tub? To use for exiting?

 

[HerbM]

I doubt that you will need a hand rail. I did buy a couple of those vacuum seal hand grips* for the shower (to use while exiting.)

* WARNING: These things eventually fall off and would be dangerous so you must RE-STICK them EVERY TIME you wish to use them. Then you must TEST it before putting any weight on it while you still have firm footing.

I tested these things, worked out the method to make them work safely for me but never even came close to using them.

Truth be told, I only took 2-3 showers in OUR bathroom since the surgery (almost 3 weeks ago).

No, I am not running around stinky, but I only took an early shower and one to get to the surgeon for the 6 day examination. After that he let me go to the pool so I have been in the pool and using the Y showers almost every day since then. (Y showers have no step-over lip, a chair, multiple shower heads on cords [shower massage] for handicap access.)

Even the early shower was easy for me to take with nothing special as equipment (except the bathmats). I might have used the transfer stool but if so it was more for testing than necessity.

YOU may have different needs.

BTW: I did sit on the shower stool PRE-OP several times, both to make sure that I could use everything while still not trying to recuperate but also because of the LONG showers I was taking for doing the sterile scrubbing. (30-40 minutes to get that clean so my knees and legs would just get tired.)

Have you got the Hibaclens or whatever your surgeon suggested? (I used that PLUS surgical sponges impregnated with Betadyne.) Channeling my inner OCD (which actually isn't one of my issues. )

 

[jmarietv]

hey Herb...love reading your posts...I am two weeks out tomorrow on my LTHR Anterior....Had my RTHR Anterior in Jan. and it was just like your recovery....This one I tend to have a bit more pain internally it seems ...I too, overdo it a bit in the gym and every time I have pain, I think I have dislodged something....(very paranoid!)

I am just curious....Do you ever feel like you can feel the implant?...Sometimes when I move the hip just so or I am balancing, It feel like I can feel the mechanism...It is hard to explain, no pain, just an aware feeling that it isn't my normal body hip you know?.....Just curious!

Janelle

 

[HerbM]

No, I never feel like I can in any way feel the implant -- I can in some sense 'feel the joint' but it feels just like my original (except no pain.)

I would strongly urge not doing anything that causes pain as you describe at least until you discuss it with your surgeon.

As to the feeling it move, I have even less of an idea about that.

It's probably nothing but stay on the safe side until you can confirm.

 

[jmarietv]

thanks, Herb......

 

[MajorHeidi]

@HerbM The grass mat thing looks useful for the next hip when that time comes.
I got used to holding onto the top of the metal shower insert thing to get in and out....
But, I think that would be good to have next go round.

 

[Jamie]

Do you think I will need a hand rail on the edge of the tub? To use for exiting?

If you're talking about one of the rails that clamps securely onto the edge of the bathtub, it may be okay to use. Just be sure you test it thoroughly BEFORE surgery to ensure that it will not slip or move even with your full weight on it.

We really try to discourage folks from using those vacuum grip assist handles. As Herb noted, they are just not very reliable. They can release over time or if the seal is not absolutely perfect. And...you really have no guarantee that it would work for you when you would need it most....when you are starting to fall and need to put weight on it to stop the fall.

If you don't have grab bars in your shower, I suggest that you have permanent ones installed that are anchored in studs. This is a safety feature that ALL people need. Showers and bathtubs are dangerous places and a slip or fall can happen to anyone.

 

[HerbM]

I agree with Jamie's assessment of those stick on handles.

If you leave them on you DEFINITELY cannot trust them.

IF you decide to use them despite the warning, you MUST restick them IMMEDIATELY before EVERY use.

If you plan a move (like stepping out of the shower) then you definitely should TEST them IMMEDIATELY PRIOR to the move and then do your best to avoid needing them.

Are they worthless? Perhaps not.

Are they dangerous? Decidedly so if you start "trusting" them.

 

[Me2]

@CanukTriMom The hospital social worker had ordered the toilet with handles and walker, etc., for at home. I never used them. I could move so much better after the surgery than before. The two things I needed were some "pretty" canes and a hip ice pack, both ordered through Amazon. I ordered another hip ice pack so to be able to use one and freeze one next time (even now since it does help when I'm aching at the end of the day on the non-surgery one). The canes, I treated myself to when I finally acknowledged that my hips were not working anymore.
@HerbM Once I did acknowledge that I had to have surgery, started "training" for it, and found my surgeon, he had an opening in two weeks or one month. I picked the two week one since it was on Wednesday, and I hoped to and did return to work the following Monday which would give me a 5 days off. The two weeks did not leave me much time to worry! I was so excited up to day or so before when I switched to totally calm. With 11 more days more I meet with the surgeon for making the "final" decision and less than 6 weeks before surgery . . . . I certainly appreciate the words of confidence . . .

I really envy both of you having kicked this surgery in the butt!

 

[Chessie]

Just to comment on the ice thing. I never needed more that a couple of freezable ice packs....I never even used real ice at home, and spending money on an ice machine or cooler/freezer would have been a complete waste. I used my freezer packs maybe twice a day for a week or so, and that was it. Never needed more than that.

Also I took my first 2 showers with assistance from my boyfriend...and was able to shower on my own after that. No shower seat, no special toilet seat or handle.

I absolutely could have returned to work in one week, if I had to, but at work we require a physician note to do so (after being out 5 days), and my post-op appt was not until 2 weeks later. Besides, I really didn't want to go back that early - I was SO looking forward to a vacation!

Very happy about all that too. Just further illustrates how different recoveries can be.

 

[HerbM]

Agreed, although I did find ALL FOUR of my cold packs useful at times -- they are excellent quality and can absorb a LOT of heat so they need time in the freezer before being reused.

Also, I used the cold packs whether I needed them or not so my usage was a bit higher than you indicate even though I really had virtually no pain.

A third reason was that the cold pack was likely more use on my LOWER QUAD than up on the hip due to the minor soreness nearer the knee (from the Anterior method twisting), so frequently I was using two cold packs at once (thus needing at least four to keep them cold.)

For my next surgery, I will have two knees to keep cold and this recovery may not be as trivially easy as the hip was, so that means either I must order more cold packs or get the ice somewhere.

As to the freezer, my wife wants that anyway for food after the recovery, it was VERY cheap, and I can sell it on Craigslist if it becomes a nuisance or doesn't prove useful as she expects.