Hip Resurfacing Birmingham Recovery

[AlbinoRaven]

Hey all! Finally back home, had a Birmingham on Monday and I was discharged today. It got rough at times, I have social anxiety and all the nurses buzzing around pushed me a bit more than I am used to (especially since I can't do a lot of things now, like put socks on, reach for chargers, etc.). The worst part was generally my paranoia (in tune with my anxiety) about my pain meds. They pulled back and only gave them when I asked for them, but I was so anxious about asking for them or seeming like a drug addict that I skipped them and got myself in trouble a few times. That is one of the reasons I really wanted to go home, my mother and one of the doctors (out of 4) suggested I move to skilled nursing because I live up 2 flights of stairs, but the physical therapist really worked with me and it was no problem (other than the 96 degree temperatures).

Right now I am finally home and I am loving it. I just need to get used to how to sit in my couch properly, I think one of the cushions has sunk to one side and I am at risk of going past the 90 degrees so I'll try propping myself up with pillows. Still anxious in general, but its nice to be in familiar surroundings and not have the hustle and bustle around me at all times (certainly will help me sleep, I've been sleeping well I just wake up with pain or from the nurses taking vitals).

Last night was really bad because instead of asking for pain meds at the 4 hour mark like I was prescribed, I waited till the 5th hour (when I usually hit a 4/10) but fell asleep and woke up in a 9/10. It took a few hours but I got back on track. I just can't beat/understand this anxiety about my pills, like I have to prove something. Hopefully since I'm home that will be much better. I read the article about it, but I know its not my fear of becoming an addict, its something else.

Now I just need to deal with getting to two doctors appointments within the next 3 weeks, and I lose my back-up driver on Sunday. I'm sure I'll find a solution. I have paid time off (it eats my vacation time and sick leave, but you gotta do what you gotta do) so that's very nice.

My inflammation disorder is going hog wild though, the general practitioner did some research and stated "you're going to have above average inflammation which means you're going to have more pain and more swelling to control", so at least I'm not starting out on a bad foot! But it feels way too good to be at home again! Thank you all for all the information and help deciding on this, it took a lot to get here but it seems worth while (can't wait for airport security!).

Raven

 

[Vida]

Well done Raven, that can't have been easy. Good for you for biting the bullet and starting down the road to a much happier life. I am sorry to hear that you are struggling with the pain meds. Your recovery will be so much smoother if you can manage your anxiety and take your pain medication by the clock. Every time you miss a dose your pain will ramp up and be that much harder to control. And in turn, it will be harder for you to get past the inevitable post-op blues that accompanies this surgery. Pain control is an important component in a successful recovery. You don't mention using ice-- that is also very important. Use it as much as you can comfortably manage. I hope you get comfy on the couch and don't worry too much, you have to really yank things badly to dislocate your hip. If you do it, you'll know it! Stay in touch and let us know if we can help. Vicki.

 

[sharonslp]

Airport security actually turns out to be pretty easy most of the time. I don' fly often, so I finally caved in and let them use the machine that sees through me or something, so I zip right through. But even when I went through the regular scanners, I rarely set them off.

Sharon

 

[AlbinoRaven]

Thanks guys, I use ice addictively, with my disease it would be impossible otherwise. I am learning my lessons slowly and surely,

Yesterday I twisted my hip a little too far out (not as far as they indicate but farer than I had until then) and I heard a snap or something (it might have been my imagination) and terribly pain. But I was able to walk and move it as well as treating it with my pain meds, today it works fine again so I think I just pulled a muscle, I've been pretty hard on them (and they said I have huge thighs, apparently my running still has not left my system).

Sharonslp, I heard they are ending that program, which I think is sad, I liked those scanners. You never set off the metal detectors?! WOW!

Thanks for the help guys, it really makes the difference, as you well know.

 

[Jamie]

Hi, Raven....welcome to recovery. It sounds like you are slowly becoming more comfortable with yourself in recovery mode. It's good you recognize the importance of pain management and what it takes to get there. Hopefully each day will make you less anxious about staying on that schedule for pain medication. It is soooo important in these early days. We're here for you!!!

 

[Josephine]

There's a thread with a poll in the Social Room, been running for years. People are logging their airport experiences - haven't visited it lately but last time I did it made interesting reading.

Have you set off the alarms at airports?

 

[AlbinoRaven]

That looks interesting, I thought the doctor's note would help a lot. Ah well, the way I look at it, flashing my scar will just make them jealous!

I might have an issue as well in some of my work, we go into nuclear plants sometimes and they have metal scanners as well. It will be a while though, I need to be able to stand and move around for around 5-6 hours without a rest, and I am far from that. But if I go back to that (when I am ready, they know I'll have limits) I'll encounter the airport security first! What an exciting week that will be! HA!

On a really positive note, my physical therapist (who works with the san antonio spurs) was terrific. He didn't just give me movements, he found better solutions to how to get comfortable, explained to me why I was doing exercise A or exercise B, and taught me how to position myself in bed (based on which parts were sore).

The one thing I did want to ask is that my insurance company assigned a case worker (I have united health care) and they asked me about what the cause might be and I explained how it could be corticosteroids from all those years I was put on them, or something like that. I get a little paranoid, especially with big companies and money. Has anyone had their insurance try to get out of paying for their surgeries/etc. when everything was in network? I'm not sure if the pre-existing condition clause from the ACA went into action yet either.

I've been managing the pain well, I'm taking 5-325 Codone and Acetaminophen 1-2 pills (always 2 so far) every 4 hours (The bottle says 6 but they had been giving me these exact drugs in the hospital every 4 hours and it starts hurting around the 4 hour mark). The in home nurse said I shouldn't be on such a low dose because I'll burn through them so quick, so I called my doctor and they said that they have no problems calling in refills (there is 1 on this bottle of 60). I calculated it out and I should have a 10 day supply if I keep this up (I hope I can drop down to 1 soon, or maybe every 6 hours, but I won't make a move till I'm at least a week out).

Other than that, PT is getting easier every day, although like what was posted in my pre-op area, the more I do the more I get tired (nothing is free). But last night I slept like a baby! That PT is amazing! I did exactly what he said and I was comfy all night long (had to get up every 4 hours for pills/bathroom).

Also, if anyone reads this, don't youtube your surgery, lol... oh god I only lasted until they popped out the hip...

 

[bottomshollow]

AlbinoRaven, forget the doctor's note---they will pay no attention to it. Look at their position---it could be a note written by anyone for all they know. You'll have to go through the scanner. Sure glad you had a good night's sleep. Absolutely nothing beats that early in recovery.

I have found two avatars that I thought you might like to use. They are already sized to fit perfectly as I have tested them. Just right click on the attached picture and "save image as" in your picture files. Then hover your mouse of your user name at the top of the page and from the drop down menu select "Avatar". The click the browse button and find the picture in your files and double click it. Then click "Okay"and you are done. The first pic is the one above, the second is here:

If you are not interested, my feelings will not be hurt. I just enjoy doing this when the opportunity presents itself.

Take care, keep you PT painless, and keep us posted. We care.

 

[AlbinoRaven]

thanks bottomshollow! I appreciate it, but I have one already I use on most forums, never got around to updating it!

On another note I can feel something move around my surgical leg. I was told its blood, it used to be just a tingling but now it tingles and slightly hurts. My blood thinners have me in the therapeutic range though, so I wouldn't think its clotting.
Definently getting some knee pain too, whenever I think I can go another hour for my meds the knee starts hurting, then it moves to the thigh, then to the hip (most times I intercept before this).

Thank you all for your help and wishes!

 

[Josephine]

we go into nuclear plants sometimes and they have metal scanners as well

Well, since airport scanners are not a problem and neither are magnetic resonance imaging scanners (MRI) I doubt these will be either.

The one thing I did want to ask is that my insurance company assigned a case worker and they asked me about what the cause might be and I explained how it could be corticosteroids I'm not sure if the pre-existing condition clause from the ACA went into action yet either.

The use of corticosteroids and their role in AVN is well documented so there shouldn't be a problem.

 

[AlbinoRaven]

Yea, I was just worried they could say "pre-existing condition" and deny me.

I had a horrible night, I got a nice bath and had a good tiring day (plenty of self imposed PT), and then I put on the stockings my doctors gave me at the hospital (washed, I had another pair my mother got at walgreens). It was 1.5 hours before my pain pill, and I started hitting 3, then 4, then 5, then it accelerated and next thing you know I'm at 7 with still 45 minutes left! I ended up taking them 30 minutes early (over the last two doses I reset the clock because I was sleeping. I couldn't figure out what was happening! I was worried about drug interactions/etc... then I realized before my pills kicked in, that my knee felt number than usual... a lot number (some of the epidural is still in my system, they said I was very sensitive, as sometimes it dropped my blood pressure to 60/30! They got me off it as soon as possible).

So I start taking it off and I experience IMMEDIATE RELIEF, my girlfriend took the rest of it off, and I looked at the two thighs in a mirror and the surgical leg had grown even larger! I realized that I had been too numb to notice that the stocking shrunk (not such a big deal on my right leg which was a little sore from the ordeal) and was cutting off circulation. I will never repeat that mistake, I tossed them and bought another pair so I have 2 available at all times. Wow though, just wow.

I slept the night without a stocking on my surgical leg, and put the old stocking on my right leg, might try the large stocking today, my knee still hurts when I move it (last night it took 45 minutes for me to move it after removing the stocking). In general I am hovering around a constant 3 with twinges of pain while I move. Is there any chance I messed up anything with my fiasco?

 

[bottomshollow]

(never looked this good on me)

AlbinoRaven, there is NO definitive evidence that compression stockings prevent DVT. And we all have to take some kind of blood thinner for a while to take care of that. For some the stockings help with swelling, but most of us just want to toss them into file 13. So you can feel free to take them off, leave them off, shove them in the back of the drawer, and forget about them.

Take care and keep us posted. We care.

 

[AlbinoRaven]

7 days out! My new physical therapist (the original man was just for an initial check up) said I have made significant progress and she is impressed. I've been extremely diligent in getting in each individual exercise twice a day (even if all of them aren't done at once). The pain is getting easier to manage (I am pushing 5 hours now instead of 4) but it is harder to completely get rid of. It seems that certain areas (around the hip and knee) always hurt, but hurt a whole hell of a lot less on the painkillers. Swelling seems to be going nowhere, more of a constant now. I can't tell yet if the numbness is getting better or worse. I also only have 12 pills yet, it has one refill on it but it won't let me refill quite yet (I think I can still a day and a half out of it), but I'm not sure I can get to cvs within the small timespan they are giving me, we'll see. One of the issues is of course that the bottle says take 1-2 every 6 hours, but in the hospital/doctor told me every 4 hours (I found out it was because of the new fda limit on acetaminophen).

Overall I feel alright, my disease hit hard today, had a fever and those aches I know so well, after a few hours and a nap I recovered a bit, but I can't wait to get back on my meds for it (Enbrel). It also has the joyous effect of increasing pain! Me and the PT are going to be working on stairs soon too, hopefully I can keep up this progress.

Also, the nurses think I might be developing one hell of a rash from the hydrocodone, they told me to take benadryl, hopefully that will help. We'll see how things turn out, only 7 days out!

 

[AlbinoRaven]

Swelling is down a whole lot I think, hopefully that makes things easier!

 

[AlbinoRaven]

Ok, that was just a brief respite, my leg has swelled even more than what it was before. I callde my doctor and I made it to get an ultrasound before closing. I have a feeling they have no idea what to do with the results since it finished after 5 pm. Iwas doing alright, got a lot of work done (two flights of stairs, a cab ride back and forth, and my first shower). But now I'm settled in reading and I'm in so much pain... my doctor really screwed me on this one, he put me on those 5-325, but since there is a new limit on the acetaminophen you can have in a day, his instructions differed from what was printed on the bottle, and to have anything before now and the refill I have to cut my dosage in half. Of course the swelling hurts like hell, with stabbing of pain along the entire leg. Its funny, everything but the hip seems to hurt. I'd hate to see what would haeppn if I totaly ran out. I saw this coming and I warned him but the nurse at the answering said there'd be no probelm.

Ice is keeping it at bay for now, I just need to last until 1 pm tomorrow to get anything eles.... the rash is improving, guess I'll end on a high note...

 

[bottomshollow]

The new limit on acetaminophen is in place because it is in so many products. If you are not taking anything else with it, then it is still safe to take up to 4000mg per 24 hours---so you can take 2 of your pain pills every 4 hours---and that's what you should do. Pain is counterproductive to healing---and you've got a lot of healing that needs to be taking place right now.

Just be sure you aren't taking acetaminophen in anything else and take those pain pills----YOU NEED THEM!!!!

Take care and keep us posted. We care.

 

[sharonslp]

Yes, AlbinoRavin, go back to every four hours. Your surgery was like five minutes ago. Of course you're swelling. Of course there is pain.

Sharon

 

[AlbinoRaven]

Well, the problem was that if I had kept taking them at 2 every four hours I would be out and I would be without any pills for 2 days. Luckily cutting down on them hurt like hell, and really messed with me, but I'm back on track with a new bottle (until I run out again). The doctor's should not be allowed to tell a patient one dose and the pharmacy another dose so he doesn't get in trouble with the pharmacy (but screws the patient because they run out before they can refill, days before).

Right now there is still a ton of swelling, and nothing I do seems to matter. I have a throbbing/stabbing pain in my knee that doesn't improve with ice/elevation(worse with ice) and only kind of responds to pain pills (still is there just not as much). The physical therapist tried to elevate it in special ways, ice it right on the foot, and do some exercises to get the blood flowing but the swelling is going nowhere. The doppler thankfully came back negative, but I'm still just stuck with this damn thing.

My solution is as follows:
I have an inflammation disease, I have too much of the signaling protein that triggers inflammation and fevers. Now the disease can be pretty serious, it pretty much caused the reason for the replacement, and has killed me in the past (Yay for cpr). I take enbrel to shut it down (I got lucky that the protein that I have too much of is the same protein that that drug bonds to). I have been off Enbrel for 4 weeks (I noticed instantly the changes), and I've had swelling even before surgery. Now the doctors explained to me that if my disease was serious enough they would let me restart enbrel after 2 weeks instead of 4 weeks. So they talked to my rhuematologist, and she explained it this way:

"If this were rhuematoid arthritis I would insist and force the surgeon to agree on 2 weeks following surgery because RA is very serious condition and RA would immediately attack the new joint and possibly damage that new hardware, but your disease isn't as serious and appears to be completely under control"

I've heard this argument before (and left my previous rhuematologist because he thought "less medicine is best" and wanted to take me completely off the drug that completely changed my life and gave me the ability to live without constant pain and without a cane), and I have very natural push back to it. Such push back is, "this killed me, how more serious do you want it?" and "too much inflammation is not a bad thing?" and "this thing is so rare I am their first patient with it, what do they really know?" and "of course my disease appears to be under control, its like a diabetic with insulin, just because they seem to be doing well with the drug doesn't mean you take them off, their body still doesn't function right, the drug helps fill the gap!".

So, I'm going to keep trying to reduce the swelling traditionally, but I want to start up my enbrel again since I'm hitting that 2 week mark. The nurse from the surgeons office tried to tell me the reason the swelling isn't getting better is because the stocking isn't on and I should work hard to reduce the swelling to get the stocking back on. I asked about my disease but she believes that since the other joints aren't swollen that it must not be systemic (ignoring that my disease never presents with more than 1-2 joints swollen). She also said that the birmingham hip always has a lot of swelling.

http://en.wikipedia.org/wiki/TNF_receptor_associated_periodic_syndrome

I am also worried about burning through all my pills again, because I don't have more refills left, and even then they might now be able to call it in right away because of the discrepancy between the acetaminophen doses (god I love that so much).

 

[AlbinoRaven]

Thank you both so much, it really helps to have a sounding board, you make me feel so less crazy!

 

[Josephine]

this thing is so rare I am their first patient with it, what do they really know?

Spot on, my friend! ? Spot on!

do some exercises to get the blood flowing

Bull! Getting the blood flowing does nothing for swelling!

The nurse from the surgeons office tried to tell me the reason the swelling isn't getting better is because the stocking isn't on and I should work hard to reduce the swelling to get the stocking back on

More bull! If it were a knee maybe it would help, but a hip? God give me strength! These nurses nothing nothing, they are making it up as they go along!

RA is very serious condition and RA would immediately attack the new joint and possibly damage that new hardware

There is nothing your body can do to "attack the hardware". Nothing whatsoever. I don't know who told you this but it's more of the same.

So let me ask you this, when you say there is a 'ton' of swelling, with what are you comparing it? Because you are not even two weeks out yet, an HR is an extremely invasive procedure (much more so than a regular replacement, believe it or not!) and apparently excessive swelling is not uncommon. I understand you're having a battle royal regarding your pain meds and it is a fact that under medicated pain causes swelling as well. So I'd still like to know how you quantify this as being a lot. I'm not disbelieving you, not at all - please don't think that. In the absence of actually getting a look at it (unless you feel like posting a picture of your behind on the internet!) I need some parameters to be able to understand what you are concerned about.