THR Boxmaker's RTHR

Boxmaker1917

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Hi, everyone! I apologize for a disjointed message but it's past my bedtime (which seems to be every two hours). I had my RTHR on Monday, 12/13. I will ask the moderators if you could move or allow me to start a post-op thread under my name, i.e., Boxmaker's RTHR. For the present, there are some things I wish I had been prepared for prior to surgery.

This was my first major surgery and I was focused on getting the surgery (are my pre-op results in? did my Covid test come out ok? Chest xray? [needed CAT scan - huh?) EKG "ok but not great" - again, huh?). I didn't actually think much about the surgery itself. It was major -- surprise!!

The surgeon did a great job, my scar is teeny (and glued), the hospital was wonderful - I don't think I could have asked for better. What I was not prepared for: I was in recovery for about two hours longer than expected as I could not move my legs or toes. The anesthesia made me totally incontinent. I would pee, hobble back to bed and lay down, and immediately have to pee again. They tried an external, vacuum catheter which sorta' worked but they had to change the pad under me frequently. Of course, I was not the only patient on the floor and staff could rarely make it to my bed "in time." I was released on Tuesday and my husband brought adult diapers. I find them uncomfortable, but what a life saver.

Shoes: I was concerned about new, unworn out shoes that didn't need tying. We found rubber bands that go across the top of sneaker but not super comfortable and still a pain in the butt (like I need another one?) to get on. I was afraid the curly elastics would not my foot tight enough but would go that direction for the next time.) I ended up wearing the hospital sock (too big, kept sliding down and bugged me) home, including walking in puddles. Tossed them immediately but still better than the discomfort of shoes. (Apparently your leg and feet swell a bit after surgery. I seemed to have missed that part, too.) BTW, have not gone outside and go barefoot inside our condo.

Nausea: A couple of brief spells at home, due to anesthesia. Wish I'd known and had some saltines.

Constipation: I knew this was coming post-op. I started a stool softener on Friday preceding surgery. I've never used one because I ate bran cereal every morning. On Saturday, I switched to a low residue diet. I had very little problem thus far with constipation thus far and had a normal movement yesterday. My current diet is "does it sound appealing" and not very healthy. I will try to get back to a healthier diet tomorrow, but happy that I've been able to eat at "normal" times. I was luck and had spinal not epidural which I think is easier on one's body. However, if I ever have surgery again, I'm doing the Miralax + low residue diet again.

I went to the gym and did what I could until Dec 1. Everything still hurts but I can do all of the at-home PT exercises ONLY because I did similar kinds of things at the gym. I currently walk like an old lady but my walker is too high for me (about 5", according to the PT and big diff in leg length - my upcoming question for post-op side).

Sleep is still elusive. We have a Stressless recliner - great for most things, but wish we had the "old fashioned" push a lever type. Best sleep I've had is a couple of hours in the afternoon in the recliner.

My daughter mentioned that opioids and percoset did not play well with her. I went with that, although of course, every one is different. I tried 2.5 mg of oxycodone one day and 5 mg one night. I felt horrible the next day and for me, it didn't dull the pain enough to make it worthwhile. I have tried 12.5 mg of tramadol before. I took one last night and felt icky enough today that I spent a lot of time this morning crying. Fortunately, I started celecoxib two weeks before surgery. It doesn't even start to kick in until the second week but I could take it up to the day of surgery. I started that again yesterday and it has worked well post-op, too. Right now I take that and 1000 mg of tylenol 2x a day. I took the tylenol pre-op too and wasn't convinced it did much, but it does seem to take the edge off post-op. I would do the same combo pre-op if I had it to do over again.

I wish the rest of you the best of luck. I felt like sh*t the first couple of days but just starting to have longer periods of feeling almost human.
 
Hi @Boxmaker1917!

Glad to see you in the other side, although the first week is definitely miserable. For me, Tramadol didn't help unless I took it with Tylenol, and the two together were great. I don't know if you are desperate enough to try that...

I hope every day gets better!
 
@Boxmaker1917

Hi and Welcome to Recovery! It sounds like you are doing well, all the things you mention are par for the course.

I‘ve started your Recovery Thread for you, as you requested.

I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Just keep in mind all people are 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: 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
BoneSmart philosophy for sensible post op therapy

5. Here is a week-by-week guide
Activity progression for THRs

6. Access to these pages on the website
Oral And Intravenous Pain Medications
Wound Closure

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 the at each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
 
Hi @Boxmaker1917! Welcome to the other side! Your account is similar to mine, in many ways, including the peeing… I did better on the Celebrex and Tylenol combo too, even though Tylenol never did much for me. It does help to take the edge off. Opioids made me feel icky too.

Can you adjust the height of your walker? Is it a 2 wheel rollactor? I found, the most comfortable height was, at the bend of my wrist, even though pt said, it can be at the hip bone too. I also find Sketcher slip on shoes, work the best for me. Good grips at bottom and as I have a wide foot anyway, very comfortable and I use a long shoe horn, to slip my foot in.

You are doing well at day 4! Sleep is the hardest part at this stage, I found. Every day gets a little better :)
 
Welcome to the healing side!
Glad to read you’re already feeling better than you did initially. Something that worked for me was to pick one day of the week and then on that same day each week, I’d reflect on the progress I made over the past 7 days. You'll really notice how things are improving this way rather than looking for daily progress which early on only seems to disappoint.
I hope you find the perfect pain management so you’re able to rest comfortably.
Wishing you a peaceful holiday season!
@Boxmaker1917
 
Hi, everyone! I am so grateful for this site and for the knowledgeable responses I get whenever I pose a question.

I am on Day 6 into my recovery. My post-op with my surgeon is not until Jan 6. My right leg (RTHR) is clearly "pidgeon-toed" and points to the left whenever I lay down. I make a conscious effort to walk "duck footed" with my right foot pointed forward. However, when my leg is straight, my foot clearly points to the left. The hospital nurses said I should make a conscious effort to correct this. I've tried using my left foot to apply gentle pressure and I've tried a pillow between my feet to keep my foot pointed up, not in. These moves hurt, so I stop immediately.

I don't want my hip or leg to heal incorrectly. Is this normal, or should I be on the phone with the surgeon's office?

Thank you for your suggestions and advice.
 
Hi @Boxmaker1917

Yes, I think that warrants a call to your surgeon's office. They might have an early intervention protocol for something like that.

Hang In there! The first week was definitely the worse for both of my THRs.
 
My left didn't do that but my right did. I did my best to keep it straight but it would fall left on it's own. Time and patience and once things started healing everything was fine. Don't panic or think your foot will point the wrong direction.
 
Hello Boxmaker,
Please don’t engage in movement that causes you pain.

I’m wondering if your foot turned inward pre-op? I had the opposite. As my hip deteriorated, my foot turned outward somewhat and my surgeon identified it as external rotation. He told me that surgery would correct it. My mom noticed after my THR that my foot was still turning outward. I brought this up at my first post op visit
(3 weeks after surgery) and was told it would gradually correct as my body adjusted to the prosthetic…and it did. I don’t recall how long it took, but once I was reassured it would normalize, I quit stressing about it and just happened to notice one day that it was back to normal.

You’re only five days out of surgery. I really can’t see that waiting another two and a half weeks until your January 6th visit will cause any harm. I definitely don’t think you should be forcing it since it causes you pain. Please stay in touch and have a peaceful weekend.
@Boxmaker1917
 
Thank you everyone for your observations and suggestions! As Layla observed, my foot was pointing to the left before surgery. ( I noticed it in yoga.) I also was walking more hunched over last year. I try to correct both when I walk. Keeping my foot straight when I walk is not painful, just something I have to do mindfully. Walking with better posture is a bit tougher since my hospital-issued walker is the wrong height. (I had the SuperPath approach and hope to move to a cane in another week, so the PT said not to worry about it.)

My husband sometimes thinks I am am wrong-headed and this is just a reflection of the "real me." If THAT isn't motivation to set a straight course, I don't know what is!
 
Most walkers are adjustable, you or your husband should be able to change it to a better height. I’m really surprised a PT told you not to worry about it, week is a long time to use the wrong height.
 
I do agree that using a walker that is the wrong height for another week is not advisable.
Especially if you’ve determined it’s adjustable and hopefully it is. I believe the easiest way to adjust it is to stand next to, or inside of it with your hands at your side, then have someone adjust the handles so they are equal to the bend in your wrist. This should give you the best leverage and help you have better posture.
Good luck transitioning to the cane. It feels so good tossing those assistive devices aside one by one.:egypdance:
@Boxmaker1917
 
Hi! RE: the walker. I am 4'11" and really should have been given a pediatric walker. The walker given to me by the hospital PT was adjusted to its lowest setting already. My local PT thinks I will transition to a cane (which he will suggest to my surgeon) during the week. The walker is not the most comfortable to use but I've found that if I do "zombie arms," I can walk with good posture most of the time. I take short walks often and that seems to help.

My main issue still is sleep, but I know that will get better. I think the fact that I sometimes forget the walker a few steps away indicates that the hip is healing well. (I had the SuperPath approach where assistive devices often are used only for two weeks. My surgeon insists on three.)

Again, you guys are wonderful and I truly appreciate your help!
 
I think the fact that I sometimes forget the walker a few steps away indicates that the hip is healing well.
It's also a good indicator that you will be able to switch to a cane soon. Then one day you will forget that too and know you can walk without an assistive device. Just make sure you have an appropriate assistive device until you can walk without a limp.
 
Hi, everyone! Today was a banner day for me: First, I slept 8 hours last night and it only took 10.5 hours to get those 8 in. Still not particularly comfortable and I snored so loudly, I woke myself up! Second, I took my first shower (by myself) and got dressed (by myself). Hubby was close by and we were careful to follow suggestions of surgeon's office and PT. Third, I walked outside for 20 minutes. First time I've been out of our condo since last week. Fourth, the PT added a bunch of exercises to those I was doing. (All a part of the protocol that might be specific to SuperPath approach.) Nothing hurt, and I am doing them slow and easy. Last, PT wants another week with the walker until my muscles are stronger, but will switch me to a cane next week. It astounds me that a week ago, I had surgery! I hope it is not against forum rules to mention that my surgery was done by Dr. Elvis Grandic, one of the physicians who helped create the SuperPath approach. IMO, he's a rock star!

Note: I understand that my hip and femur will not heal faster than anyone else's. There just was less initial trauma to soft tissues so there is shorter healing period for muscles and tendons.
 
Wow, you’re going to have some people jealous of the sleep you’re getting and great job on showering and dressing yourself. I’m happy to hear you’re taking it slow and easy on the exercises and haven’t pushed yourself toward pain. It is amazing what can be accomplished within a week of surgery and you’re progressing nicely.
No worries on mentioning your surgeon’s name. It’s not against the rules. :wink:
Wishing you a happy holiday season!
:presents-under-xmas-tree-smiley-emoticon: :merry-xmas-smiley-emoticon:
@Boxmaker1917
 
Hi, everyone! My surgery was 12/13/21, not quite four weeks ago, although I had my post-op yesterday. My hip actually is doing well. I walk without any assistive device, although the disparity in leg lengths gives me a bit of the "full diaper" walk -- not really a limp but a definite side-to-side gait.

My one and only issue has been physical therapy. My surgeon is a 3.5 hour drive away and I consequently was not able to use the clinic he recommends. The home PT was for two weeks only, and done by four different therapists. Each of them had different exercises and protocols -- and none of them followed the protocols presumably supplied by my surgeon. When I complained that my hip was fine but my leg muscles -- not just the thighs, but the entire leg -- hurt, I was ignored. I told the head of the PT group that after going to the gym for 12 hours a week for several years, I knew the difference between having pushed a little too hard at the gym and having muscle strains and tears. She said to keep doing the exercises but to stop walking! Of course, I did the opposite and stopped their exercises. My leg muscles still are sore but I am off all pain killers, at least for the present.

The surgeon was a bit p.o.'ed since he did NOT want exercises with weights. He wants stretches and tissue massage. He gave me a copy of his protocol, most of which is like a foreign language to me. (It starts with adductor strumming -- again, foreign to me.)

My question, especially since so many have had issues with PT, is how to I find a therapist who will follow these protocols? Just call around and start asking, "who's your expert adductor strummer on staff?"
 
Honestly I don't see what a PT can do for me that I can't do for myself. Most times it's more about getting out to the PT site so you have to do the exercises more than what they do for you. I'd say do some google on what your OS wants and keep walking. I don't think we can build on damaged muscles until they completely heal. PT's seem to have the no pain no gain theory which doesn't seem to have much to gain aside from pain.
 
@Boxmaker1917 you sound like you're doing pretty well, woohoo! Definitely keep doing walking, best PT around and it's free! :walking:

As far as walking goes, concentrate on your gait for now, not time, step length, speed or distance; that will fall into place once you get your gait right and your soft tissues healing. Best thing is to practice heal / toe walking. Strike with your heel and roll up through your toes to push off for next step. You really have to concentrate to make sure you're doing it right. Keep up the good work!
 
Hi and thank you for your response. I had the SuperPath surgery where no muscles, tendons or other soft tissues are cut. As a result, the post-op protocols are different than what most physical therapists are trained to do after a hip replacement. These protocols are precisely what my OS would like followed, and they should have been started three weeks ago, as soon as I was discharged from the hospital. Hence, my interest in how to find and vet a physical therapist who understands what my OS is asking to have done and will follow his protocols.
 

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