THR Boofit's recovery in Hong Kong

[Eman85]

in a previous post you mention exercises and the one that really sticks out is bridges. it's been discussed here many times that there was no reason in THR recovery to be doing bridges. I tried them on my own with my first THR and found they did nothing but cause me undue pain and suffering.

 

[Boofit]

Thanks @Eman85 - will be most careful with the exercises!!

So far, I am actually not doing much (exercises or walking) this week. Have lots of paperwork etc to do so am taking a break from physical activity for a week or so!

 

[Boofit]

Last night was not as bad as the night before - still getting up for toilet breaks every 2 hours or so. I think tonight I will take a sleeping aid to try break the pattern...

For the last 3 days I have been taking
Paracetamol 1g BD (after breakfast, and after dinner)
Arcoxia 90mg QD (after lunch) usually taken with pantaloc)
Nexium (sometimes before bedtime)

This seems to be working, although around 3 to 4am I get woken up by nagging pain in the operated thigh - probably because I take my second dose of paracetamol around 7pm after dinner and the effects don't last that long. I do ice my hip and upper thigh at around 4am, and manage to fall asleep for another couple of hours without having to take another course of paracetamol.
I don't feel much pain in my hip during the day.
The swelling in my left hip around the operated region is decreasing (it was originally the size of half a papaya), but the left leg is rotated outwards around 15 to 20 degrees. I think this may be caused by the angle the cup was fixed in the acetabulum. Do not think it will affect movement though.

The un-operated hip and right shoulder are playing up though (which is part of the reason for not walking outdoors, as I would have to use a crutch or cane and I want to let the right shoulder rest for a week or so).

I am walking un-aided within my apartment for about 70% of the time, conscious of proper gait when doing so.

 

[Boofit]

Note to self: avoid going to banks for at least a few months.

Was watching a movie about a bank heist - where the robbers ordered everybody in the bank to squat. I immediately thought "Oh no! That might cause dislocation in the early stages of a THR!!"
So what should one do when faced with such a situation (i.e. being ordered to squat)??

 

[Snoopy55]

Sounds like you need to avoid watching movies about bank heists too lol. Regarding doing bridges: I really do not understand their significance in hip recovery. I have just been walking everyday and skipping all the other repetative exercises that my PT gave me and frankly I feel better than ever. I do have to ice everyday once done with walking but only for a few minutes and I will take that over being in pain and discomfort.

 

[Boofit]

I have just been walking everyday and skipping all the other repetative exercises that my PT gave me and frankly I feel better than ever.

I believe walking is in fact a very good exercise. Not only does it exercise the big upper leg muscle groups (the gluteus max, hamstrings, quadriceps), the deeper smaller muscles (e.g. the gluteus med and min) it also works on keeping the pelvis stable when the other leg is off the ground. The lower leg muscle groups are also working as well as those in the upper body. I do think walking is the best exercise for people who have had THR, especially during the early stages.

My OS referred me to Physiotherapy upon my discharge, but I decided not to go because I believe walking is sufficient as lower limb exercise in the early stages and I will only carefully ease myself into doing very gentle leg exercises when I feel I am ready and will progress with caution. It is absolutely true that over-doing the exercises will cause set-backs, and I do not want to go there.

I qualified and worked as a Physio, but that was many years ago and in the eighties I changed to an entirely different profession. Having that training has served me well, especially for my own THR as I am more aware of what my body went/is going through. But I don't think that that by itself is enough. For me, having found this forum is something that has helped me through the "human" side of it, and helped me learn from the experiences of others who have gone through this. It is also a place where I can (on a day to day basis) share my fears and progress with others who will listen (read), help and offer comfort, and hopefully also with those that come after me and have the same fears and questions.

It is comforting to know that there is a group of strangers with whom I can relate to and who UNDERSTAND what I am going through. Strangers with THRs that live all over the world who share what they have gone through or what they are going through, emotionally and physically, who take the time to offer words of comfort. Recovery becomes less distressful. Some threads are actually so much fun to read!

A special big thanks to the BoneSmart Staff and to my friends on this forum!

 

[Snoopy55]

Strangers with THRs that live all over the world who share what they have gone through or what they are going through, emotionally and physically, who take the time to offer words of comfort.

So so true dear Boofit. Although I didn't get an actual THR I hope you still consider me one of those strangers

I believe walking is in fact a very good exercise. Not only does it exercise the big upper leg muscle groups (the gluteus max, hamstrings, quadriceps), the deeper smaller muscles (e.g. the gluteus med and min) it also works on keeping the pelvis stable when the other leg is off the ground.

That's what I am hoping! On the days when I can't walk I am so much stiffer and just kind of uncomfortable Like I have missed something that needed to get done and didn't. Strange. Like today I had a doctor's appointment and I have a lunch to go to and can get the walk in later on in the afternoon. But oh well its ok. I will take it!

 

[Boofit]

So so true dear Boofit. Although I didn't get an actual THR I hope you still consider me one of those strangers

Ah @Snoopy55 ,we are no longer strangers. You are one of my Hippy pen pals (I remember I had a few of these when I was in my very early teens, one from Malaysia and another from the UK. ) and one day, when the travel restrictions are over and God willing, it is my hope that I actually get to meet some of my BoneSmart pen pals in person!

 

[myglasshalffull]

Boofit,
Couldn't agree more, what an amazing community of people here who take the time to help others.
Snoopy and I are close on our surgery dates so we are "hippies in recovery" as well.
Take care.

 

[Boofit]

Week 7 Update (LTHR done on 2 June 2022 - lateral approach)

Post-op Pain Medication
The Arcoxia I have been taking doesn't seem to agree with my stomach and I think is the cause of my gastric pain. So I have switched to Celebrex 200mg since 4 days ago. I have also cut out the Lyrica 75mg that I have been taking.

For the last two days I have been on

• Panadol 1mg TID (cut down from QID)
• Zoplicone 75mg PRN
• Celebrex 200mg PRN

I don't have much pain during the day now, only a feeling of tightness in the upper thigh and hip region. Will try cutting the NSAID altogether soon.

Pain and Swelling

• Occasional Spasms in foot and calf. Both sides (but this has been a long standing problem, since my teens).
• The pain in my operated Left Hip occurs mainly at night, and after prolonged periods of inactivity.
• Pain in R (un-operated) Hip level 2, increasing on walking and sometimes sleeping on R Hip side, it comes and goes.
• L Ankle still slightly tight (?residual swelling internally).
• L Quad slight tight.
• Incision area still hard and lumpy but lumpy area decreasing in size.
• L leg laterally rotated @15-20°

Exercises and Walking
In the past week, I have deliberately given myself a rest from my daily morning walks, but have been going about doing stuff (e.g. groceries, tenancy matters and meeting friends for dinner).
Still using single crutch for markets and for going to places where I know I will need to walk more than usual.
Can walk unaided at home (taking care not to limp) for about 60% of the time since a few days ago.
Gait training to correct mild Trendelenberg.

Not doing any exercises except butt squeezes.

ADL and ROM
Weight gain of 4 lbs. Still need my daily dose of ice-cream and chocolates...
ADL resumed normal. (except left sock which I will not attempt until at least after 12 weeks)

Sleep
Still sleeping in segments. In a good night, I wake about 4 times and take some time getting back to sleep. It seems like I get about 1 to 1.5 hours sleep in one go and then get woken up by discomfort or pain or a sense of urgency. But I do not stress over it anymore as I tell myself I can always nap during the day time if necessary.


So in sum, it appears there is gradual progress, and I am constantly reminding myself to go slow. Time seems to be going faster now though. It is HOT in Hong Kong, but still at a manageable 37°C so far. It must feel terribly hot in Europe with temperatures over 40°C!! Those gel packs may come in handy!

 

[Zoebichon]

I know what you mean about time going more quickly! Before my surgery, I bought a large brightly colored plastic pill dispenser box. There are four boxes for each day.

My surgery was on a Thursday, so that first Friday, I filled up the whole week with my meds and vitamins and calcium/magnesium pills.

It seemed a long time before it was time to refill for the 2nd week.

Now I fill up a week (just my supplements now) and before I know it, it’s time to refill again!

 

[Boofit]

For the last two days I have only been taking Paracetamol (Panadol/Tylenol) 1000mg twice a day for pain and icing where necessary (which is about once or twice a day).
I ice my right shoulder as well, as I feel some pain over the scapula region - supraspinatus and infraspinatus muscle area. Am hoping that as I am able to bear less weight on my walking aids, my right shoulder will get better.

Have been reading a lot these 2 months, and am feeling that my vision is declining. Went to the optometrist to get a new pair of prescription specs yesterday.

So far, life is good and I try to cherish it and live each day to the fullest. Other than knowledge and life experiences, what are the plusses of getting old?

 

[Snoopy55]

supraspinatus and infraspinatus muscle

Those are not muscles us little laymen know) I hope your shoulder feels better soon. Can't be easy dealing with two painful body parts.

Have been reading a lot these 2 months, and am feeling that my vision is declining. Went to the optometrist to get a new pair of prescription specs yesterday

What a coincidence! I was there last week as my vision has deteriorated as well although not too too much. I needed to go up a bit for my readers so I went to the pharmacy and picked up a pair. My prescription is a progressive and I need to go look for frames which I am too lazy to do right now. My daughter came home from London tonight so I will be spending time with her which I would much rather do than pick glasses haha.

So far, life is good and I try to cherish it and live each day to the fullest.

So true. I keep thinking I am so lucky-a hip eventually heals and gets better and yet there are so many out there who are struggling with much more serious issues and illnesses. I count my blessings everyday.

 

[Boofit]

@Snoopy55
You're right - the supraspinatus and infraspinatus muscles are the deeper upper back muscles near the shoulders. They attach to the triangular bone that is found on the sides of the upper back as well as to the upper part of the long upper arm bone.

My daughter came home from London tonight so I will be spending time with her

This is great! So much to catch up with and so nice to have her with you...



I had a 4 hour lunch with 3 friends whom I have known since we were 7 year old kids yesterday. We went to the same Primary and Secondary school. It was a most enjoyable lunch. We don't meet up as a group often (about 3 times a year) so there was a lot of catching up to do. The hip felt a bit stiff after sitting for 4 hours, next time I have to remind myself to get up and walk for a bit!

I am soon coming up to my 2 month mark. The slow and steady approach towards recovery seems to be working for me so far.
This morning I turned to test lying on my operated side for the first time since the operation. There was some discomfort when lying directly over the hip bone (the greater trochanter area), but when lying slightly backwards there was none.

 

[Boofit]

Week8 Update (LTHR done on 2 June 2022 - lateral approach)

Post-op Pain Medication
Have discontinued taking the NSAIDS and am just taking Panadol (Tylenol for my N American friends) 1mg twice a day. It seems to be sufficient in managing the on and off discomforts or level 1 to 2 pain that I feel every now and then in my operated hip.

The un-operated hip has quietened down this last week and does not complain as much as it did a few weeks earlier. It seems to be following the early days pattern of the operated hip, where there were good days and bad days. My hope is for it to have more good days for the next 2 years, so that I can go hiking again before I need another THR.

The right shoulder pain is at level 2 usually. It aches when I sleep on the un-operated Right side, but I don't need NSAIDs for this yet.

I don't have much pain during the day now, maybe some stiffness after I have been walking around for a while.


Spasms, Pain and Swelling
Have been having more frequent spasms in my foot and lower leg (Last night I had a painful episode of spasms in the fibularis longus and brevis (the lateral outer muscles of my left leg). It is the first time that this particular group of muscles seized up and it lasted for about half and hour. Hubby woke up to my moans and helped massage the area. I also drank some tonic water (was told it helps), took a valium (they were to hand), and managed to go back to sleep afterwards.
L Ankle still slightly tight (?residual swelling internally).
L Quad slight tight.
Incision area still hard and lumpy but lumpy area decreasing in size. Found a slight protruding hard bit (rather like the end of a stitch) in the middle of my incision line. Am worried that it may lead to infection.. WIll have to monitor that I guess.
L leg still laterally rotated @15-20°

Exercises and Walking
I have still not resumed my daily morning walks (stopped more than a week ago), but have been going about doing stuff (e.g. groceries, tenancy matters etc) and my phone tells me I average about 2500 steps a day. I can definitely do more (was doing about 3km before I stopped), but I have quite a lot on my plate now and am spending quite a lot of time at my desk or handling other matters.

Still using single crutch when going to places where I know I will need to walk more than usual. I also find an axillary crutch less taxing on my right shoulder compared to when I use a cane.

Can walk unaided at home (taking care not to limp) for most of the time now.
Gait training to correct mild Trendelenberg.

Since Friday, at the 8 week mark, I have started doing
• Bridges in bed (10 times twice a day);
• Straight leg raises (10 times a day);
• Toe raises (10 to 20 times a day to train calf muscles);
• Hip abduction in standing with support (10 times twice a day);
• Marching in standing with support (about 50 steps twice a day) (although I do not have the 90° restriction, I still adhere to it in an abundance of caution);
Will be monitoring to see if any undue pain happens before I continue doing the exercises. Will also be icing (or applying heat pads) after the exercises to improve blood supply.

I feel it is time for me to very gently start doing some exercises in my rehabilitation, as a prelude to strengthening exercises some months later when my hip gets stronger, and hopefully at this stage to improve circulation, restore joint mobility, decrease the likelihood of adhesions forming and restore normal gait.
I will not push to the point of pain as I believe it will be counter-productive.



ADL and ROM
Weight gain of 4 lbs. It's the comfort food I am consuming cookies, ice-cream and chocolates...
ADL resumed normal. (except left sock which I will not attempt until at least after 12 weeks)

Sleep
Have gone back to using Zoplicone and occasionally Valium.
As I grow older, I am finding that things bother me more, and I am having more trouble sleeping. Unlike my husband, who is older, but usually sleeps like a baby! He also doesn't snore much, wakes up to calm me down when I fidget and move around too much, and then falls back to sleep! I do envy him and am thankful to have him. He is most certainly my anchor in good as well as not so good times.

New development
Two days ago I started lying on my operated side. There was some discomfort. I did not do this yesterday, but this morning gave it another go for about 20 minutes. Felt alright. There was some slight discomfort in that it felt like I was lying on a squash ball (where the incision was).

 

[Boofit]

Since about a week ago, I felt a small protruding hard black spot in my incision line, and am wondering whether it could be the end of a stitch for the underlying tissues. If I had to describe it, it feels hard like the tip of a fish line protruding from inside.
Am worried that it may lead to infection..

Has anyone else on this forum had this before? And if so, how was it dealt with?

 

[Layla]

Hello Boofit,
Yes, many experience this. It is referred to as spitting a stitch, or a spitting suture. Rest easy, It doesn't require any special care, one day soon you'll notice it's gone.
Have a nice weekend!

 

[Boofit]

Thank you @Layla !

 

[Mojo333]

Hi @Boofit
Almost 2 months post-op ... I feel like that was the time where I was getting more confidence in my new hips but very weary of the uncomfortableness left and trying to determine "how much is too much or not enough"

My main take away in hindsight, is my hips did well while "doing" (exercises/walking) but only complained when I stopped.

Have been having more frequent spasms in my foot and lower leg

Only you know if your body is ready for the daily exercises you mention, but the nights can be where you can ascertain if there are complaints.

I don't have much pain during the day now, maybe some stiffness after I have been walking around for a while

It keeps getting better.

To hopefully resolve one of your concerns regarding adhesions:
Our Nurse Emeritus, Josephine, who was a long-time surgical nurse with the pioneer surgeons of knee and hip replacements, was adamant that the incidence of adhesions in hip replacement is pretty much unknown... saying it just doesn't happen! This is because there is such a lot of soft tissue around the hip. In the knee it's a different matter because there is so little soft tissue and things can sometimes get stuck down.

I'm sure you are listening to your body and can always reduce the reps or try every other day if you see that your soft tissue grumps at night.

 

[Boofit]

Almost 2 months post-op ... I feel like that was the time where I was getting more confidence in my new hips but very weary of the uncomfortableness left and trying to determine "how much is too much or not enough"

Hi @Mojo333
This is exactly how I feel!!! Plus constantly reminding myself not to rush it...

My main take away in hindsight, is my hips did well while "doing" (exercises/walking) but only complained when I stopped.

Before the surgery, I was walking 5 to 6 km around 5 times a week and doing yoga and strengthening exercises for about 45 minutes 4 to 5 times a week as well. I now feel like a flabby mess and part of me wants to start actively doing more exercises, whilst the other part keeps reminding myself that I should be patient and go slow.

I have had foot cramps since I was a teenager (my dad had bad foot and leg cramps as well when he was alive, so it may well be a genetic thing). My cramps and spasms seem to be getting worse and happening more often in the past two years or so, and whereas it was usually in the big and second toe or less frequently, the calf muscles, it started happening in new parts of the leg about half a year ago. I have been taking magnesium supplements, drinking tonic water and eating bananas in the hope that it will help. [I was so concerned about having leg cramps immediately post-op that I actually smuggled muscle relaxants in when I was hospitalised!! The cramps usually happen at night and I was initially worried that with the abduction pillow post-op I would not be able to reach down to massage it or to stand up to stretch it. Fortunately I did not have cramps when I was in the hospital!!]

On adhesions: Suffice to say I think I should do my exercises because I want to avoid the risk of adhesions.

Wishing you a great weekend ahead!