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[THR] April surgery August results<

Mudhen

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April 21, had fall, broke right hip with loud snap. 5 hours slithering on floor to reach phone. Emergency surgery Sunday morning. Was discharged 48 hours later. Walking alone a week later. PT pushed me too hard and I spent two days in bed and back on walker for two weeks. I live alone, had someone stay with me 4 nights.

Instructions: no 90% bend, no leg crossing, keep my feet pointed straight (the right leg was totally turned in ), use pillow between legs. Nothing else. Nothing about no weights.

August no pain in hip but pain in leg halfway to knee. Walking only with cane and much more prone to fall now than shortly after surgery. I felt at the time of the fall that that leg cracked. Walking now, other than just short distances in the house causes increasing leg pain. I am resting now much more often, certainly sitting for longer periods for pain relief.

Fever has been a constant companion for the past two weeks. Ice has been a great help to reduce swelling and fever in the leg.

I am looking forward to better health!
 

Layla

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Welcome to BoneSmart!
So very sorry for your accident and the pain you suffered resulting in your surgery.

I'm tagging the forum Nurse Director, @Josephine to weigh in on your pain. I'm wondering if you've contacted your OS of PCP about the fever you've been running for two weeks? Do you know the reason for it?

Josephine will most likely ask you a few questions regarding the pain you mentioned so please check back. She's in the UK so there is a time difference. Wondering about your activity level, exercise routine or whether you're participating in any PT?

I understand it's been awhile since your surgery but please read through the Recovery Guidelines as some of the info may still pertain.

Wishing you well as you move forward. Stop back often we'd love to offer support and encouragement as you continue to heal.

Hip Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:
rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)​
3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​
4. PT or exercise can be useful BUT take note of these
5. At week 4 and after you should follow this

Pain management and the pain chart
Healing: how long does it take?
Chart representation of THR recovery

Dislocation risk and 90 degree rule
Energy drain for THRs
Pain and swelling control: elevation is the key

Post op blues is a reality - be prepared for it

Myth busting: on getting addicted to pain meds
Sleep deprivation is pretty much inevitable - but what causes it?

BIG TIP: Hips actually don't need any exercise to get better. They do a pretty good job of it all on their own if given half a chance. Trouble is, people don't give them a chance and end up with all sorts of aches and pains and sore spots. All they need is the best therapy which is walking and even then not to excess.

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery. While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each, member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
 

Lski

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Welcome to recovery. Sorry about the pain you are experiencing. I would go see your doctor about it and your fever. Did x rays show any fractures of the upper leg bones?
 
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Mudhen

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They would not let me come home until I signed a paper agreeing to PT.
About the surgeon... The orthopedic section of the hospital has 3 doctors but two surgeons, 1 PA, 1 nurse. The PA is excellent but run ragged, surgery and office hours are long. For some reason there are a tremendous amount of hip and knee surgeries here.

X-rays were only done on the hip not on the leg. They know I have pain in the groin area but not why. The pain in the femur above my knee.... Surely not just bruising.
Fever under 103 considered ok....
 

Mojo333

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Hi Mudhen.
I'm so sorry this happened to you and you are still struggling...I'm sure @Josephine will be along to address some of your concerns.
I am guessing you are still icing as much as you can.
Hope your weekend is peaceful.
 

Jaycey

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@Mudhen a fever lasting this long is not normal. Have you tried talking to your family doctor?
 
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Mudhen

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My fever has finally broke. Very happy about that! I have not felt like driving. A friend 35 miles away came and got me. For the first time I had a log leg had to use both hands to pick my right leg up and put it in the car. I feel like I more or less just had surgery instead of almost 4 months ago . Never had any worry about falling then, have caught my self too many times this month. My right foot has always been lead. It started turning in, worked diligently to correct. Seemed alright then it started suddenly leading off right. Would have to stop correct and start again. But when it turned left I came to a stop!! Hopefully that is past. I just don't know about these things... maybe it happens to everyone. Yes I am still using ice.
 

Layla

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Hi,
I'm wondering if you've been in contact with your OS over any of your issues?
When was the last time you saw him?

An office visit, or at least a call, may be in order so you can get reassurance you're on track with your recovery. Consider calling and speaking with a member of your surgeons care team. I'd mention the fever you ran for two weeks also.

A peaceful day to you.
@Mudhen
 
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Mudhen

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I mentioned some but not all of my concerns to the PA. For it was obvious he was struggling to even be there. I could tell, and the nurse had already mentioned that appointments were starting over an hour late because of an extremely bad emergency surgery. He was all in! He did not understand the pain said so. The hip xrays were excellent. My next appointment is in September. No local doctors, the clinic is for other things.
 

Josephine

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Emergency surgery Sunday morning.
Mudhen, who did your surgery? Do you know the name of the surgeon and exactly what you had done?
Instructions: no 90% bend
This would be no bending past 90 degrees! Have you read the articles Layla left you earlier? Specially this one Dislocation risk and 90 degree rule.
I felt at the time of the fall that that leg cracked.
August no pain in hip but pain in leg halfway to knee.
Can you tell me where you feel or felt these pains using this chart?

aa hip-references-horz.jpg
 
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Mudhen

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Thank you Josephine, my surgeon was Dr.Morrison. Although it was posted in my room I would have anterior surgery, after the surgery it was marked out and posterior written in. I do have mild scoliosis which might have been the change.
The pain is R2F W-Y. It is not constant but comes with vicious pain that may or may not go away fairly quick...10-15 min. Or may last days.
 

Josephine

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my surgeon was Dr. Morrison
Sorry, my mistake - I was under the impression you were in the UK!

You pain would appear to be here then
mudhen.jpg


I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?
 

Josephine

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Here y'go then!

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 forget to factor in 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. are you icing your painful area at all? If so, how often and for how long?

5. are you elevating your leg. If so how often and for how long?

6. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

7. are you doing any exercises at home? If so what and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)

Exercises done at home
- how many sessions you do each day
- enter exercise by name then number of repetitions of each
etc., etc.

Anything done at PT
- how many times a week
- enter exercise by name then number of repetitions of each
etc., etc.
 
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Mudhen

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1. Posterior

2. No pain

3. oxycodone/acetaminophen 10. I took for only one week and no more. Had no pain until the last 6 weeks.

4. Icing yes 30 mins. 2 hours

5 . About the same length of time as the icing.

6. I have a garden, I gather the unstaked tomatoes daily and can them. I clean my house sweeping every few days or daily as needed. I have swept the 40x8 ft porch twice. I have spent hours at the sewing machine. I was walking about 800-1000 ft 1-4 times daily. Shopping - which means driving I think the total of 5 times. I will not drive when I have a fever.

6. The last doctor's visit he told me to exercise. I tried them twice and they were painful. I think I get enough exercise. I only learned about this site a month ago. I fully agree with no exercise. But the doctor said I could not come home with out agreeing to a PT
 

Josephine

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Something else I missed. You said "Had no pain until the last 6 weeks" but have made no mention of it in your answers. And if you have this pain, what is it's nature and place, what is the pain score and are you taking any pain meds for it?
 
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Mudhen

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Pain is between knee and hip. A friend suggested it was muscular. My gait has changed to a hard lean to the right.
I can walk straight with the cane and no pain. I am trying the heel to toe pattern but with or without the cane have nearly fallen several times.
 

Josephine

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So can you tell me what I asked?
what is it's nature
what is the pain score
are you taking any pain meds for it?
 

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