THR Balancing Exercise & Hip Health Prior to Revision Surgery

Thank you as ever Layla - at a hotel 15 minutes away from the hospital, and watching a Scandi Crime Drama to try and keep centred! Check in at the hospital at 715am - just over 8 hours. Crikes!!!!

Will keep you posted - and pray this revision will be a trifle more straightforward than the left hip one
 
@Layla
@myglasshalffull

Right hip revision surgery done, and now say 6 hours from when surgery started, but not seen surgeon yet post op. Due to be in HDU (High Dependency Unit) overnight, feeling pretty perky. Much less whacked than post the left hip revision. Surgery was 3 hours, vs 3.5 hours for left hip. No 100% quad inhibition this time, can move right leg fine - post the left hip revision, the quad was dead weight for say 3 weeks or so. Blood loss was so minimal that Cell Saver not used. Weight bearing as tolerated seems likely from tomorrow, implying cemented stem as my Surgeon Mr Steele hoped for at pre-op 27 April? After the left hip revision, WBAT was only allowed indoors after 10 weeks, and after 14 weeks outdoors.Catheter settling in nicely - initially felt as if needing to wee all the time, now fine.
So, overall, quietly measuredly optimistic, grateful, and full of admiration for this excellent ortho only hospital and Steele my Surgeon. And so pleased that my desire of the two revision being done 6 months apart was fulfilled.

BUT, as always, slowly slowly catchee monkey!
 
Love this for you:xmark:
So happy to hear from you and know you're doing well.
Happy dance all around. :happydance::chuckmarch::happyfeet:
Keep us posted...we're here for you and ready to cheer you on. :thumb:
@hipcycle
 
@Layla

Just saw Mr Steele, my surgeon, 5 hours post op. He was very pleased with what he saw intra op, and also the result so far - xray to confirm tomorrow. Cement removal was fine. Smith and Nephew socket, De Puy stem - cemented, as planned. He was wary of pushing the stem too far in, which fitted into the original primary stem canal = probably 1 to 1.5cm leg length discrepancy = perhaps shoe lift. I countered, saying i did without that post primaries even with physio giving me a shoe lift and circa the same leg length discrepancy, and in time achieved very high athletic function and totally normal gait. He said see how I get on.Thoughts on my confidence that I can achieve normal gait, with no shoe insert?

Lying on my side in bed allowed from tomorrow, Zwift indoor cycling allowed as soon as home, but cages not cleats first 2 weeks, limit to say 100w for 20', then build that up. As to walking, he said to aim for 1 mile by POD 42. I was doing 3 miles re left hip revision at POD 28 after a major complex uncemented revision! One mile seems very very limiting, but granted the aforementioned 3 miles was with crutches 50% weight bearing, and with the right hip WBAT allowed from POD 1.

I forgot to ask him re reintroducing my indoor suite of planks, side planks, press ups, dead bugs, prone i y t, single leg stance, donkey kicks, prone superman pose, figure 4 piriformis stretch, supine leg over knee piriformis stretch, clanshells, lateral side leg lift, doorframe rows, squats, standing ab roller, prone ab roller etc etc etc - will do that when I see him tomorrow.

So, overall, very happy, but as always grounded by healthy caution, that this is still a revision, and to do the rehab work conservatively, consistently, progressively, and with patience - CCPP! I knew my anal retentive obsessiveness would come in handy one day!!

Finally finally, thanks for your lovely encouraging message
 
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Thoughts on my confidence that I can achieve normal gait, with no shoe insert?
You won't surprise me if you do. Time will tell. :fingersx:
I forgot to ask him re reintroducing my indoor suite of planks, side planks, press ups, dead bugs, prone i y t, single leg stance, donkey kicks, prone superman pose, figure 4 piriformis stretch, supine leg over knee piriformis stretch, clanshells, lateral side leg lift, doorframe rows, squats, standing ab roller, prone ab roller etc etc etc - will do that when I see him tomorrow.
I Yi Yi :yikes:
I'm glad you forgot. :heehee:
I hope you forget again tomorrow. :wink:
Glad you're happy and surgery is in the rearview.
 
Morning & so happy to hear you are feeling very good post op.
You have experience on your side so you now know what body cues to listen to.
Keep us posted!
 
OK first full day post surgery. Transferred from High Dependency Unit to normal recovery ward at 930am - catheter removed before that. At the ward could not urinate for the life of me. At circa 1030am physio came and allowed me to stand up for first time and use Zimmer Frame for say 15 steps. Then transferred to crutches for say 150 steps, then climbed 6 stair steps, and physio very happy with me, and he discharged me from his service - I suspect the spinal block was still active then. After standing I was able to urinate ok.
As the day wore on, pain broke through in spite of say 60mg Codeine and 1g Morphine twice. I walked the length of the corridor of say every two hours three times- say 150 steps each time, all with crutches and reciprocal gait, with WBAT allowed, but refraifned rom. I did this to try and stop stiffness in the operated side, but perhaps too much activity contributing to it. In the meantime had xrays confirming how happy surgeon was with the result.
By tonight, I am in more pain and stiffness than ache, not wincing pain, but more "solid" dull inhibition mix pain. On top of this, constipated badly still.
With all this happening, being sent home tomorrow by ambulance with two paramedics, who will help/carry me to my third floor flat if needs be, no steps inside.
So, good news overall, but very apprehensive about tomorrow going home after less than 48 hours post coming out of theatre. Plus suppository inserted, glycerin, to help re constipation. Excuse the language etc. Even spelling.
 
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Sorry the pain has ramped up. I hope they get it under control so you're comfortably mobile and you're able to get the restorative rest you need. Safe travels home tomorrow! Let us know how you're doing once you are settled in at home.
@hipcycle
 
Rant over! Last night was a mix of pain, the dreaded quad inhibition showing its face, peak Drama Queen, and also the near euphoria of the first say 18 hours post surgery coming crashing down.
Morphine at regular intervals overnight has brought the pain down to more manageable levels. Also the nurse looking after me last night said my whole body was wound up so tight with stress/anxiety, which doesn't exactly help! To which I replied jokingly "No Kidding Sherlock"!
 
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So peak anxiety over, and arrived home this afternoon, exactly 48 hours post revision. Paramedics carried me the 28 stairs steps to my flat - they actually insisted on it. They made me tea, got a casserole from my freezer, then my neighbour came round for an hour - she now has a spare key in case I fall. I am happy to be home in the end. I did have a quick strip bathe, pottered around, but am very tired now. Hardest bit is sitting down or standing up. Will look forward to my own bed tonight. Keeping ahead of the pain with regular paracetamol and codeine, with morphine if required.
 
Happy you made it home and had great paramedics to help you up 3 flights of stairs. I had to manage 6 steps when I came home and that was enough for me!
I’m pleased you have a neighbor who can look in on you if needed.
You know the drill, rest, ice, walk around, repeat!
 
POD 3 (third day post op). Looking back, yesterday was pretty tough, but slept 5 hours overnight. Woke up in pain 5am today, the worst being on getting up or sitting down. Took my analgesia, and within 30 mins pain on lying down pretty much gone. Spent most of the morning napping and relaxing, getting up to make coffee, do no. 2 etc. Now back ahead of the pain curve again.
As to the pain, I’m reassured it is pretty much all soft tissue mediated. Hence the pain on getting up/sitting down, whilst near full weight bearing on the operated side evinces zero pain.
Another major win is re quad inhibition. The quad inhibition on the just operated side is ameliorating fast already, whilst during the revision last year, the inhibition lasted for weeks before even beginning to lift. Finally, beginning to feel that familiar most welcome tickly healing sensation on the lateral hip.
Early days, but so far very pleased with my revision’s progress 72 hours in, and beginning to dare believe that everything will be OK!
 
Paramedics carried me the 28 stairs steps to my flat - they actually insisted on it. They made me tea, got a casserole from my freezer,
Wow, thoughtful chaps, eh?! It's nice you have a neighbor you trust enough with your key and know that she'll check on you, or is there if you need her. That has to be somewhat comforting.

Five hours sleep overnight is pretty decent. :thumb: Those finding sleep more elusive may be envious of the five hours you logged. Glad you're taking it slow and easy. I'm sure everything will be okay!
 
Thanks for those words of reassurance Layla, and yes, the paramedics were wonderful.
I know that all evidence points to a successful revision, which is great, but I still get bouts of intense pain to a point of causing me to shiver/shake, which then stops once the pain meds kick in.
But number one is the fact that weight bearing tolerated well seems very reassuring.
Will have to ensure I have sufficient analgesia to last the weekend, before I can call my regular GP Monday.The paracetamol/codeine/morphine triple whammy works very well for me. Also, I think tonight I will start using urine bottle to avoid bathroom visit, if hip painful.
But, overall, I am very pleased with the revision so far, and I have to remember I am still only circa 80 hours post op.
 
@hipcycle I remembeer how painful those first few days and week or so were. Your'e doing all the right things. Ice, elevation, regular pain meds and regular, gentle movements are your best friends right now. Technically, we'd have to classify you as an "old hat" at this but I'm going to give you our post-op hip guidelines for your review. I know I often forget some of the little reassuring details they can provide. Blessings for continued good recovery!

Following are BoneSmart's Hip Recovery Guidelines. Each article is short, but informative. Following these guidelines will help you have a less painful recovery. Just keep in mind we are all different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.” Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

HIP RECOVERY GUIDELINES
(Note to Basic Members: The links below are a premium service available only to Insiders Club Members. To learn about membership, click here ).

1. Don’t worry: Your body will heal all by itself. Relax and let it; don't try to 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
If it hurts, don't do it, and don't allow anyone - especially a physical therapist - to do it to you.
If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.

4. Good Nutrition is essential for successful recovery:
Dietary Tips for Recovery
Nutrition Basics

5. PT or exercise can be useful, BUT take note of these
BoneSmart view on exercise
BoneSmart philosophy for sensible post op therapy

6. At week 4 and after you should follow this
Activity progression for THRs

7. If you want something to assist with incision healing and scar management, BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.

8. Still need recovery aids? The BoneSmart Recovery Shop offers BoneSmarties best-loved recovery products at great prices.

Recovery articles
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: Most hips do not need physical therapy to recover. Our hips do a good job of healing on their own, given time. We can't rush the healing phase, and pushing a new hip too soon after surgery can cause unnecessary aches and pains.

The best exercise is walking -- and even then, not to excess. Distance should be built up slowly over time and walking aids should be used to prevent limping. Once the hip has healed, physical therapy can be helpful for regaining muscle strength and range of motion and for addressing soft tissue issues related to post-op structural change.


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.
 
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