THR Break on through to the other side...

[Stan H]

I'm just using an old upright model "Voit". It's probably 35 years old. I'll switch to my real road bike that I put on a wind trainer later when I can push with more resistance.
But for now I just feel like no resistance and just easy revolutions are doing me a whole lot of good.


Sent from my iPhone using BoneSmart®

 

[BoomerBabe]

Thanks, Stan.

 

[BoomerBabe]

Site protocol question: If I must always "keep to one recovery thread" with the same subject line, how can I post a specific question and get the attention of the forum to (hopefully) get answers?

BB

 

[Poppet]

Hi @BoomerBabe - if you have a specific question, you can always tag one of the staff and we get an alert. You can tag other members also.

Here are the instructions, if you want to "tag" someone you just type in the @ sign immediately followed by their user name and you'll see a small box in the posting area where the members user name will display. Sometimes there might be a very slight pause, but the member user name will appear.

it will show their correct name which you can click on -- then when you submit your post the member's user name/link will turn blue and send a message to them person, like this: @Poppet

Ask away, we keep an eye on the new posts

 

[BoomerBabe]

Yo, fellow posterior THRs and Experts: how did you fare when your hip precautions were finally lifted? (Mine are up Thursday.) Could you immediately get dressed without issues and prop your legs up to tie your shoes? I have been walking (slowly) and even dancing (nothing too wild) at the first of many summer parties, but my affected hip and leg still feel break-out-in-a-slight-sweat weak, particularly when I have to climb lift them high up steps or over cones in physical therapy sessions.

 

[BoomerBabe]

Question: Both my ankles swell up by mid-day. They look like they're wearing life preservers. Anyone else?

 

[Josephine]

Could you immediately get dressed without issues and prop your legs up to tie your shoes?

I don't think so! It might be another several weeks before you manage that.

Both my ankles swell up by mid-day

The reason for that is invariably that you're on your feet too much and doing too much as well.

I'm going to ask you some questions and it would be very helpful if you would answer each one individually in as much detail as you can then I'll come back as see where you are ....

1. are you elevating your leg, how often and for how long?

2. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

3. what kind of PT/exercises are you doing? How much and how often? (and detailed details would be appreciated, please! Reps, sets and session and all that)

 

[BoomerBabe]

Oh, Josephine, I hesitate to answer because I fear your wrath. You are clearly knowledgeable and devoted to helping us, but it is apparent that we Americans with our focus on lots of exercise and getting back to normal within weeks sometimes drive you mad. You need to understand that surgeons here do not tell us much--if anything-- about the process of recovery. They write Rxs for PT and see us for follow-up many weeks later. Their silence implies that everything else is up to us and our therapists. What is implied is that recovering completely and feeling great will happen in a matter of a few weeks. And that all we must do to ensure that is the right kind of exercise.

Preface: I am doing really well. My arthritis pain is gone. I no longer limp. My incision looks fantastic. I'm able to stand, walk, go up and down stairs, weed the garden, dance and more. One of my friends said I look 15 years younger. I am a poster person for hip replacement! My physical therapist says I'll be done after the next visit, when I hope to figure out how to get up from a sitting position on the floor without hanging on to something or someone, something I have not been able to do for many years.

My only real problem/question now is swelling of both ankles, which does not completely diminish during the night and gets steadily worse during the day. (The neuropathy in my fingers is still there, but that's another matter entirely.) Here goes:

1. No. I have not been told to do this by anyone except by this site and one visiting PT back four days after surgery. I did not think I had to do it indefinitely. I assume you will tell me this is dead wrong!

2. My surgeon's PA (who sees patients before the surgeon does and takes care of questions) told me two weeks ago that now I may move any way I want and do everything except high-impact activities. She told me he wouldn't like me to ride horses or ice skate because of the risk of falling. I am currently doing almost everything I did before surgery, but with no arthritis pain. Yes, there is a little pulling and soreness here and there, but nothing serious. I try not to do "too much" anything but I am not sure what that might be until I am a bit sore the next day. No activity has sent me to bed or knocked me out. I've been shopping, gardening, going out to dinner and theatre, working at a desk and dancing at two weddings in the past two weeks.

3. My hour-long PT sessions include working on a hip machine, leg machine and other equipment designed for strengthening. I do leg lifts and balance exercises on foam pads, and with steps and cones. I try to walk around my suburban neighborhood when it's not too hot--a mile or two every two or three days or so.

There it is, Josephine. Please don't scold me!

Appreciatively,
BB

 

[jackspratt]

Hi @ BoomerBabe,
We are exactly the same regarding our op dates. You seem to be coming along so well and are probably doing better than me at the moment! I too had swelling in my ankles and lower calf, especially on my operated leg. It has lessened to a degree now although my good leg is fine (no swelling), but the op leg still gets swollen most days. I largely ignore it apart from putting my feet up when sitting down. I just presume it will go eventually on its own. I have read that it can takes months to settle down. One thing I do is keep it creamed around the ankle as I noticed the skin was getting a little dry and I had a crease forming due to the swelling above the front of my foot. This has mostly gone now so hopefully the swelling is going slowly.

I read that you say the surgeons over there do not tell you much about recovery or have much to do with you apart from issue you with PT forms. It is very similar here in that we get hardly any contact once our operation is done. Whether this is just my experience or more common I don't know but I had my op and saw the surgeon the next morning for a very short visit and since then I have only had contact with anyone medical when I went for my post-op appointment. Even then he wasn't present at that and an O-nurse just asked if I felt ok and could I stand on one leg!! She then said I was fine and come back in a year!

Over here we get no PT offered. I sometimes think we should get a little as it clearly helps. I did my exercises from a piece of paper I was handed on discharge, admittedly somewhat erratically! I haven't even got to go to see my GP before I return to work.

Even so I am doing well and have no pain in my hip itself. I too am mostly back to normal in my everyday life. I still get tired some days which I expect but generally am coping well.

I still have a bit of a problem with fastening shoes and buckles etc and putting on pantyhose. And getting up off a chair sees me struggle a bit to straighten up and walk straight away as I am always very stiff.

I wish you well and hope your recovery continues safely.

 

[Josephine]

but it is apparent that we Americans with our focus on lots of exercise and getting back to normal within weeks sometimes drive you mad.

Don't be daft! It does, but that's not reason to not answer my questions. I'm only trying to help.

You need to understand that surgeons here do not tell us much--if anything-- about the process of recovery.

You think it's any different here in the UK? It is not!

What is implied is that recovering completely and feeling great will happen in a matter of a few weeks. And that all we must do to ensure that is the right kind of exercise.

Now that is where we differ. Most UK surgeons ascribe to a different process because we know it works better. Which is to spend the first 3 weeks simply resting and allowing the traumatised tissues to heal and settle down. The other protocol is that hips actually don't need much 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.

So if you think my replies are 'wrath' you are gravely mistaken and I am extremely hurt.

 

[BoomerBabe]

Josephine! I was joking about "wrath!" I thought the "uncertain" emoticon and my citing my appreciation of your devotion to helping us would convey that, but I guess they didn't and I'm sorry.

And I did answer your questions, 1 through 3, to the best of my ability.

(As an aside, I had tests yesterday for the neuropathy in my fingers and feet and am awaiting results. It's possible that one may have nothing to do with the other.)

BB

 

[Josephine]

She told me he wouldn't like me to ride horses or ice skate because of the risk of falling.

"wouldn't like" is not "don't do it"! And how may times have you fallen off your horse in the past? You should also read this Nick Skelton (GB) wins Olympic gold one year after THR!!.

I am currently doing almost everything I did before surgery, but with no arthritis pain.

Please don't tell me that surprises you?!

I try not to do "too much" anything but I am not sure what that might be

You're 11 weeks out! Do whatever you can and see what happens tomorrow. If you get aches and pains then you'll know it was a step too far!

3. My hour-long PT sessions include working on a hip machine, leg machine and other equipment designed for strengthening. I do leg lifts and balance exercises on foam pads, and with steps and cones. I try to walk around my suburban neighborhood when it's not too hot--a mile or two every two or three days or so.

Yes, but you haven't given me the detail - I asked for reps, set and sessions.

If you're not familiar with this, it goes like so:
1 lift of a 500kg bell bar = 1 rep or repetition.
Doing 5 reps and then a brief rest = 1 set of 5.
And doing 5 sets and finishing = a session.

 

[BoomerBabe]

@Josephine, thanks very much for your response. I have been away and apologize for the delay in getting back to you with answers.

I finished formal PT last week, pronounced "in great shape" by the therapist. I'm ashamed to say I do not know all the names of the machines or the exercises I was doing on them, but I will try to describe what I was doing in in a typical session in the last weeks:

Warm up for 10 minutes on stationary bike
Hip machine set at 45lbs: 3 sets of 10 reps abductions, then 3 sets of 10 reps extending leg backward
Leg machine (lying down and pushing out) set at 80lbs: 3 sets of 10 reps
Hip abduction side lying: 3 sets of 10 reps
Stepping up and down on a step: 3 sets of 10 reps
Wall slide: 3 sets of 10 reps
Balancing on a foam block on one foot for 30 seconds: 1 set of 10 reps
Balancing on a foam block on one foot for 60 seconds: 1 set of 10 reps
Stepping over a line of cones spaced apart: 3 sets of 10 reps

I have instructions to do these simple exercises at home: "hip abd uni sidelying; knee stepup/down lateral partial; hip ext stand and knee wall slide bil partial." Good thing they are accompanied by drawings or I would be scratching my head!

We went to New York last week to see some shows, go to museums and galleries, and test my new hip. I walked a lot and did well, but moved more slowly and carefully dodging the crowds and potholes and uneven sidewalks.

My ankles and feet continue to swell during the day to the point where they are quite swollen by early afternoon and numb on the front portion of the soles. I saw a neurologist who diagnosed mild peripheral neuropathy and ulnar neuropathy, but gave me a therapy Rx only for the latter. Few of my shoes fit. I am trying to stop and elevate during the day, but it is impossible to do so when one is out and about. Is this swelling normal and will it diminish with time? No one (PA, neurologist) seems to think the swelling is a big deal except yours truly, but when I look at my ankles and feet and they remind me of the sad old ladies sitting at the bus stop, I get worried. When will the swelling go away?

Sorry for being so long-winded. Hope you can help.

 

[Josephine]

It's 1am here and I need to go to bed! I'll see to this tomorrow!

 

[BoomerBabe]

Thank you!

 

[Josephine]

Warm up for 10 minutes on stationary bike
Hip machine set at 45lbs: 3 sets of 10 reps abductions, then 3 sets of 10 reps extending leg backward
Leg machine (lying down and pushing out) set at 80lbs: 3 sets of 10 reps
Hip abduction side lying: 3 sets of 10 reps
Stepping up and down on a step: 3 sets of 10 reps
Wall slide: 3 sets of 10 reps
Balancing on a foam block on one foot for 30 seconds: 1 set of 10 reps
Balancing on a foam block on one foot for 60 seconds: 1 set of 10 reps
Stepping over a line of cones spaced apart: 3 sets of 10 reps

Geeze, that's far too much stuff for a hip and only up to 12 weeks out to boot. Have you been doing these all along?

I have instructions to do these simple exercises at home: "hip abd uni sidelying; knee stepup/down lateral partial; hip ext stand and knee wall slide bil partial." Good thing they are accompanied by drawings or I would be scratching my head!

I can imagine! I do that too sometimes!

We went to New York last week to see some shows, go to museums and galleries, and test my new hip. I walked a lot and did well, but moved more slowly and carefully dodging the crowds and potholes and uneven sidewalks.My ankles and feet continue to swell during the day to the point where they are quite swollen by early afternoon and numb on the front portion of the soles Is this swelling normal and will it diminish with time? No one (PA, neurologist) seems to think the swelling is a big deal except yours truly, but when I look at my ankles and feet and they remind me of the sad old ladies sitting at the bus stop, I get worried. When will the swelling go away?

That's quite a lot for only 10 weeks out. I would say it was a lot for 14 weeks out. I will stick my neck out here and say that without doubt this is the cause of your symptoms. The swelling is not normal because neither is your level of activity but it should settle in time. I suggest you limit yourself to 60mins walks from your house (or your parked car!) and by that I mean 30mins there and 30 back again!

 

[BoomerBabe]

@Josephine, I was doing most of what I described above all through the last month of PT sessions, but they're over now. I'll do the home stuff, try limiting my activity as you suggest and report back here in a while. I stopped taking my daily NSAID a few days with the thought that it may have been contributing to the swelling, so we'll see. Right now it's so hot outside that I tried to take a walk this morning and returned home after just a few blocks!

BB

 

[BoomerBabe]

@Josephine and anyone who cares to chime in: Okay, I've cooled it on the exercise, keeping it to a minimum in the past several weeks. I am on my feet, doing errands, housework, walking or driving or sitting at a desk a portion of each day. I still have edema in my ankles and feet that increases through the day, with my toes and the balls of my feet feeling increasingly numb-ish through the day, like they're encased in a layer of rubber. Is this normal for three and one-half months after hip replacement or should I start seriously searching for other possible causes?

Thanks for any insight or suggestions you can provide.

BB

 

[nmljrhus]

BoomerBabe,
You might consider light grade "support" hose for the short term. I'm currently wearing 14-20hg (that's the strength) knee highs. I have some other issues (varicose veins, high BP) that contribute to swelling in the ankles, but I find if I wear the hosiery, it lessens the problem, my feet and ankles feel much better AND I can wear my shoes. It might be worth discussing with your physician
Congrats on your recovery - sounds like things are going well for you!

 

[Josephine]

I agree with the previous poster. Try some ordinary support hose (i.e. not TEDs!)