THR Boofit's recovery in Hong Kong

[Mojo333]

@Boofit
Yay.... Home and showered!
Hopefully, being able to be vertical more and move about will help with the constipation.

I had some real trouble with it myself and got very frustrated with the well-intended advice.
I remember bemoaning the situation to my mother over the phone wherein her suggestion was to get a magazine and sit on the toilet and Relax!
Sounds like a plan unless you just had double hip replacement and sitting on the toilet riser long enough just to pee was a challenge.

I stayed on stool softeners even after "going" for some weeks to ward off constipation.
I also remember having a yummy bean soup that seemed to work better for me than the prune juice and other remedies suggested.

Drink lots and ice plenty.

You are doing just fine!

 

[Klassy]

@Boofit , you write a great tale! I particularly enjoyed the bit where you faced down the nurse and her “protocol”. Did you think of telling her that you were packing a Smith and Whatsit at your hip and you weren’t afraid to use it?

It’s great that you are home now, and showered too. And some signs of movement in the motion department is better than no action at all. I suffered that way with my first hip, but avoided it second time round. We all have our preferred weapons, mine are dried figs and corn on the cob. Not at the same time.

I hope you are keeping the pain at bay, sorry that it seems to have a love for you. But I don’t think too many hippies cope so soon with just paracetamol. You are wisely cautious about being your own pharmacist, but there is a suggested medication schedule on here using paracetamol and Tramadol. See below

I never took Oxy, just Tramadol but am down to 13 pills. I was only taking 2-3 a day which doesn’t help much with pain but I am surviving.

Have you tried taking Tylenol as well as Tramadol? The two medications work well together.
Here's a suggested schedule for taking them. The first schedule is for 4-hourly doses and the second for 6-hourly.

The most effective way to take Tylenol is 2 x 500 mg tablets (Tylenol Extra-strength) 6-hourly, to a total of 4,000 mg (4 doses) in 24 hours. You need to take it regularly, to keep up the levels in your bloodstream. If you just take the odd dose now and then, it's far less effective.

Check all other medications you're taking, to make sure there is no Tylenol/Acetaminophen/Paracetamol in them. If there is, scale back one or two of your regular doses, so you stay within that safe 24 hour limit of 4,000 mg.

 

[Layla]

I am so thankful....

Aww, this says it all. What a lovely update, I’m so happy for you that you’re home and it sounds like your discharge and ride home went well also. First showers ARE THE BEST!
Wishing you a peaceful day.
@Boofit

 

[Boofit]

Fell oblivious to the world at around 8pm last night, sleeping on an air mattress that I bought recently pre-op to place on top of my bed. I thought it would raise the height of my bed a bit (at the time I bought it I didn't know I would not have the 90 degree restriction) and provide a firmer support. That was a mistake.

I was woken by excruciating pain at around midnight, a level 8 pain.
I couldn't move my leg at all and it felt like everything inside my upper thigh was smashed and torn.
I was moaning loudly apparently, and that woke my husband.

He got up immediately and helped place pillows under my thigh and knee and the pain subsided to a 6.
Then slowly he helped me stand up with the walker and pain went down to a 5.
We decided that it was the air cushion that was causing my hip and knee to be extended and that this was the cause of the pain.
So we ditched the air cushion.

Walked to bathroom and back to my original bed, which I feel is a bit too soft. But decided to just sleep with pillows under knee and hip (using the maternity pillows that I bought pre-op, they are great)
Got one large ice gel pack and strapped it onto my hip. (These large ice gel packs are super good for pain relief, can get them on Amazon for about USD18 now).
Didn't take any pain killers or sleeping pill but soon fell asleep till 6am this morning when my back started complaining. The "must sleep on back" rule is indeed challenging..

My pain level on waking was around 3. I can almost full weight bear on my operated leg.
Able to walk well using a walker and able to use the toilet raiser without any issues. Thanks to reading the other posts on this forum, I bought a toilet raiser with side-rails, and that is proving to be very useful.

There is some swelling in the upper part of my thigh, and some bruising. But the wound dressing appears ok. Doctors said there is no need to do any wound care, the stitches will absorb by itself. I attach a photo of my wound site here if anyone is interested!

Decided to stay ahead of the pain, so took my NSAID arcoxia pill together with my panadol 1000mg. My drug intake plan (based on what has worked for me so far) is as follows:
Morning after breakfast: Arcoxia 90mg and panadol 1000mg
After lunch, around 2pm: Panadol 1000mg
After dinner, before bedtime: Panadol 1000mg and Gabapentin (lyrica) 75mg.
Will see how it goes and adjust accordingly.

So here I am, first day back home. Am icing with the large ice-gel packs. Bought 3 so have a good supply ready in the freezer...

 

[Layla]

Hi Boofit,
I’m sorry for the misery the air mattress caused. Aside from that little detour it sounds like you’re doing well. I agree about the large ice packs. I had one that was jumbo sized and it was definitely my favorite due to the area it covered. It sounds like your pain is pretty manageable which is a blessing. I think you’re off to a good start!
Let me see…you’re 13 hrs ahead of me I figured the other day, so your going on noon and I’m going to bed soon.
Have a wonderful Wednesday!
@Boofit

 

[Boofit]

Good night Layla Talk to you soon!

 

[Ocean]

Hi @Boofit, I hope you are feeling more comfortable now and you can get your sleeping arrangement sorted for tonight. You seem to be doing well though.

I woke up yesterday wondering if you had had a no.2 yet and was strangely pleased to see that there was some movement in that direction. Isn’t it funny that this forum lets us connect with people so far apart but in similar situations.

It sounds like your husband is doing a great job too.

 

[Boofit]

Good morning Ocean, Since you are in Wales it must be around 11am now.. As you say, it is so good that this forum connects us up.

Your surgery is going to be in a month's time, right? How is the preparation work going? I think the more preparation we do the better we fare. When I knew my approach was likely to be lateral I started doing abduction exercises to train up the Gluteus Medius and Gluteus Minimus which would likely be cut. I also kept on daily walking and 4 times a week floor stretching and strengthening exercises right up to around 2 days before my surgery and ceased these exercises only because I had (on my own) stopped all daily NSAIDs I was taking 5 days before the operation..(the Hong Kong doctors said there was no need to stop the NSAIDs, but after reading about the practice in the US I decided to stop them.)

Which part of Wales are you in? I have never been to Wales and was planning on doing so before Covid struck. I have lived in the UK (London) for short periods of time in the past and feel very at home there!

My number two made a brief appearance yesterday, and then a grand entrance today. So problem solved and I am a Happy Hippy!!
Lying in bed, doing a lot of phone calls, friends calling in to see how I am doing and to catch up, doing ankle pumps and isometric quadriceps exercises every now and then. Haven't even started reading the Jack Reacher "Blue Moon" novel that I was planning to read in hospital!!
Am also walking well with a walker. Seems like the hip is very solid and I am told I can do full weight bearing on it!

There is a Red Thunderstorm Warning here in Hong Kong, meaning heavy rains, lightning and thunder. So glad I am back home and was discharged yesterday!!

Take care and keep well everybody!

 

[Jaycey]

@Boofit Sounds like you are doing really well with this recovery. Don't worry if you can't manage reading just yet. Concentration is sometimes difficult just post op.

Stay warm and dry during that storm!

 

[Mojo333]

Happy to see your update.
I remember my quads were so tender and I was very tentative about putting weight on my new hips.
It took a few days to get it into my head that my hips were solid, and I was happy to baby the soft tissue that was disturbed in order to get back to healthy and happy!
Hope your day is restful and you stay chilled.

 

[Klassy]

That night pain must have been awful- it was lucky that your husband was there to get you into a better position. Otherwise it all sounds like excellent progress.

Your mention of Blue Moon reminded me that I too took a Jack Reacher novel to hospital, and another novel I was part way through, and neither have been opened even now 5 months later! I have read a couple of other novels, but nothing like my usual rate of literary consumption. In the first month particularly I just didn’t feel like concentrating, and spent a lot of time watching old sitcoms.

BTW, Blue Moon is about number 23 in the Jack R series. Out of interest, have you read the previous 22? Not that they have to be read in order.

 

[Ocean]

@Boofit, I am in Swansea, South Wales, lovely coastline and countryside.

I am trying to get things ready, I got my appointment through for my pre admission appointment and meeting with the physiotherapist afterwards.

I am trying to prepare my son, he’s 24 but has autism and learning difficulties with very limited language. He knows that I have to have it done but is afraid of me being in hospital. The surgeon said that I will be in for two nights but because I only have limited use of my right hand it depends how I get on with crutches. Because of my son we already have a disabled shower with seat and two handrails going up the stairs.

My husband has been very ill since just before covid so they will be looking after each other while I am away. That’s my biggest worry, but at least it takes my concentration off myself.

 

[Boofit]

@Boofit Sounds like you are doing really well with this recovery. Don't worry if you can't manage reading just yet. Concentration is sometimes difficult just post op.

Jaycey, I don't know if it's the coffee or the coke zero that I am drinking, or simply the excitement of being home and having a successful surgery done, I just fee so elated!! And my husband says with all the texting, phone calls and blogging, no wonder I have no time to start reading yet.

So far recovery is going well. I can walk without much pain using a walker. Still not putting full weight on it, about 85% I'd say, cos leg feels leaden.

I was happy to baby the soft tissue that was disturbed in order to get back to healthy and happy!
Hope your day is restful and you stay chilled.

Yes, Mojo, icing non stop. As a former PT I believe ice is a great pain-killer, and for such situations I think it is much better than heat (which I believe would increase the swelling and tenderness). I ice and do isometric exercises whilst icing with my leg elevated.

Blue Moon is about number 23 in the Jack R series. Out of interest, have you read the previous 22? Not that they have to be read in order.

Oh Klassy, another JR fan!!! I brought Grisham's The Guardians (which I have gone through 2/3rds) as well as the Jack Reacher Blue Moon book into hospital but never went near them! I have not read all the previous 22 JR books, but have read most of them. I also watched the Jack Reacher TV series and, having read the Reacher books, cannot get over Tom Cruise playing the part of Jack Reacher!! Just couldn't help saying: that is NOT Jack Reacher.
My husband, who doesn't read much fiction, preferring more neuron-challenged works, has never read the JR series, enjoyed the Tom Cruise as Reacher series though.

I hope to get back to my books soon...

Ocean - do you know what approach your surgeon will be using and whether or not there will be any restrictions thereafter? I you know you will need to lie supine for some time after the operation, then maybe practice sleeping on your back more these few weeks? I was a side sleeper originally, but when I knew I would not be able to side sleep for some time post-op, I started training myself to sleep on my back. I did it by placing a pillow under my knees and two small wedge shape pillows (see attachment) on each side of my lower back near my hips to sort of stop me rolling over. Wasn't too easy at the start, and my back used to get sore. So I rolled up a towel and placed it round my waist like a belt (fixed the front part together with rubber bands) to provide some sort of lower back support.
I can now sleep on my back for about 6 hours at a stretch.
Alternatively, as many others here have mentioned, a recliner may help with sleeping initially post-op.
If you don't have a recliner (I don't), pillows are your friend. Big ones for under knee support as well as to prop you up, and small wedge shaped ones to place where- ever needed. I also bought the heart-shaped type pillow (see second attachment) to place between my thighs as an abduction pillow (the hospital one was uncomfortable, and this one placed vertically high up between the thighs did its magic and was unbelievably comfortable.

If your bedroom is upstairs, would you be able to set up a temporary sleeping place on ground level? If you have a toilet downstairs it would be great. If not, what I suggest is you get one of such plastic utensils (see third attachment), they should be available in many supermarkets. I actually tried placing it (without the lid) snugly between my thighs and discovered I could use it as a urinal, no leaking at all. I read about this trick somewhere on this forum a long time ago, so decided to put it to the test pre-op, just in case I could not get to the bathroom at night at home post op. Rather than buying a commode, I found this to be a handy alternative. This cheap and cheerful utensil does indeed serve the purpose! I haven't had to use it though, now that I have bought it, because I can get up and walk to the bathroom using a walker at night, and hubby insists on accompanying me.

I guess preparing as much as you can will help. Don't worry too much, God works in mysterious ways and things will turn out okay in the end.

 

[Boofit]

Day 7 Progress Report
Standing with walker support - doing stepping and walking.
L Hip flexion to 45 degrees only (pain in hip starting when going beyond 45 degrees, so stopped at pain threshold)
L Knee flexion in standing position: 60 degrees (tightness and slight pulling pain in quadriceps)
When standing, can abduct hip slightly about 25 degrees (no pain at all)

Walking with about 85% weight bearing on left leg (probably psychological factors coming into play too). Leg feels leaden and heavy. No pain on walking.

Although Surgeon said "no restrictions but to use sense", I am trying to adhere to the 90 degree rule for a while. I sometimes go beyond it (e.g. when trying to reach something), but will try to keep to this rule for a few weeks.

Elevation and icing when in bed.
Bed exercises: ankle pumps, gentle heel slides, isometric quadriceps and gluteus maximus (buttock squeeze) exercises.

Physical Inspection
Swelling and hardness in upper thigh (Icing)
Some mild bruising in upper thigh (applied Hirudoid)
Tingling (pins and needles) in left foot -- (nerve? circulation?) not sure of cause but reckon it is the swelling in upper thigh causing slight compression on the Sciatic nerve, alternatively maybe during surgery the nerve was affected during the retraction process.... in any event, not unduly concerned, think it will resolve by itself soon). Doesn't feel like a circulation problem cos foot is warm to the touch, but could be the Ted stockings being too tight at the knee, so have removed the stockings. (They gave me a small size - I have never been a small size)

 

[Klassy]

@Boofit I so agree, Tom Cruise as JR NO NO NO!!! There is a new series, based on the first book, just out on Amazon with a far better casting. It really captures Reacher.

You are doing very well in recovery. I admire your organised approach. It befits a former PT.

 

[Ocean]

@Boofit, I love your philosophy of things working out in the end, I’m going with that too but am worried that I’m living in a fool’s paradise for thinking that it will all work out.

I sounds like you are improving every day and it’s great to read your posts.

I don’t know what approach my surgeon will use but I think it’s usually on the side whatever that’s called. I’m thinking that as he’s the expert I’ll let him do his thing and whatever implant he decides is right will be chosen using his experience. Although I think that here in the UK we don‘t tend to question the consultants like I’ve seen people do on here. I’m paying privately because the NHS is so far behind now but I still don’t know enough to question the consultants decisions.

We don’t have a bathroom downstairs and no room for a bed so I’m hoping that I can come down each morning, then go up in the evening. I have a commode in the garden shed that my husband had to have when he was very ill so I will dust it off and use it downstairs as necessary. I haven’t got a recliner so it’ll be my orthopaedic chair or the sofa during the day.

I’ve bought lots of different cushions and grabbers etc. I’m fed up of thinking about it, it’s exhausting isn’t i.

 

[Layla]

Although Surgeon said "no restrictions but to use sense", I am trying to adhere to the 90 degree rule for a while. I sometimes go beyond it (e.g. when trying to reach something), but will try to keep to this rule for a few weeks.

Same for me!
I self imposed restrictions. Figured what’s good for one, can’t hurt another.

Tingling (pins and needles) in left foot -- (nerve? circulation?) not sure of cause but reckon it is the swelling in upper thigh causing slight compression on the Sciatic nerve

Small sensory nerve fibers are cut with the incision. These nerve fibers run from the inside to the outside of the hip and cutting them causes the hip to feel numb after surgery. It is a temporary sensation that normally resolves over a period of six months to one year post op.

While healing you may experience sensations of tingling, pins and needles, itching, burning and even the feeling of a minor electrical shock. These are usually good signs that the nerves are spontaneously firing through the regeneration process. This process is not to be confused with the initial post op numbness resulting from anesthesia or a regional block which can produce numbness lasting for up to 72 hrs post op.

I love your update! You‘re doing great. Wishing you a peaceful relaxing weekend!

 

[Boofit]

I don’t know what approach my surgeon will use but I think it’s usually on the side whatever that’s called. I’m thinking that as he’s the expert I’ll let him do his thing and whatever implant he decides is right will be chosen using his experience. Although I think that here in the UK we don‘t tend to question the consultants like I’ve seen people do on here. I’m paying privately because the NHS is so far behind now but I still don’t know enough to question the consultants decisions.

Same here in Hong Kong. I was (and still am for my post-op treatment) what is the "public" health system in Hong Kong which in many many ways is equivalent to the NHS. The waiting list is also in terms of years, and although I have had this hip problem for a long time, I only went on the waiting list last July when the doctor at one appointment said that I should agree to place my name on the waiting list as it would be a 4 to 5 year wait at the Prince of Wales hospital. All along I was thinking "ah well, my ideal timing would be to do it when I am 70" so was not unduly concerned.

I also had the option of going private if the need arose, and had been giving it some consideration. But this team of orthopaedic doctors at the Prince of Wales Hospital that I had been seeing for years have always struck me as being particularly (dare I say unusually) efficient and caring. Plus I never ever thought my condition would go downhill so fast and so suddenly. But I was lucky when my half yearly appointment came round in January this year, I had a senior experienced doctor (a Professor Ong) see me. He looked at my x-rays (we get x-rayed before each half yearly appointment), compared it to my earlier ones, examined me and then said it was time and I should have it done. I then learnt that if I got lucky, I might have Dr Kevin Ho do the surgery, as Dr Ho specialised in Hips particularly.

The reason that I got a private room was because of my previous employment. Many years ago, I changed professions from being a PT to joining the legal profession. I continued working in the civil service, and reached the requisite rank for certain benefits. Of course it all depends on availability and I was again lucky (especially given these Covid times when they actually shut down private wards) to get a private room. I ended up paying very very little for what turned out to be first class service!

The "side" approach that you mention is probably what is sometimes called the "lateral approach". My understanding is that in this approach, the Gluteus Medius and Minimus are usually cut. This was the approach used in my surgery (My surgeon was trained in the University of Manchester). For my part, as soon as I knew this, I started doing more training for these relevant muscles (e.g. clamshell exercises and side-lying leg raising exercises).

I agree it is best to trust in the consultant's judgement and decisions and not seek to "question" him per se. Some surgeons may not take it the right way

This forum is a wealth of information, and in my case, it has helped me as I read through the many different experiences others have gone through. It definitely helped in my preparations and help reduce my anxiety and fear!

 

[Boofit]

I self imposed restrictions. Figured what’s good for one, can‘t hurt another.

Great minds....

 

[Boofit]

Here's an example (out of many) how reading up on this forum helped me:

Last night I woke up at 3am with excruciating back spasms. Lying supine for hours definitely does not agree with me. At that point I remembered how many posters on this forum mentioned sleeping in a recliner helped them in the first few weeks. I don't have a recliner, but hubby got up and rearranged a lot of big pillows behind my back and at my sides (sort of simulated a recliner). After that, I managed to continue sleeping for another 4 hours.