THR Cassidy's hopalong recovery<

[Josephine]

@Cassidy can we start by you showing me where this pain is using this chart?

After that, I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?

 

[Cassidy]

Yes, thank you @Josephine

The pain is generally around ZL2F, YL2F, YL1F, XL1F, WL1F, VL1F and WL1B and VL2B. I'm more than happy to answer any questions. (The pain is mostly shooting and only when I put weight on the leg, unless it graduates to a dull burning ache.)

 

[Josephine]

So your pain is like this?

I'd say that the red spot it likely to be quads tendinitis
And the blue is probably Trochanteric bursitis and ITB (ilio-tibial band) issues


As for the questions, here y'go then!

It would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are

1. what approach did you have for your surgery? Anterior, posterior, lateral? You can look here to see the various types THR approaches or incisions

2. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't forget to factor in other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness).

3. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

4. are you icing your painful area at all? If so, how often and for how long?

5. are you elevating your leg. If so how often and for how long?

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

7. are you doing any exercises at home? If so what and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)

Exercises done at home
- how many sessions you do each day
- enter exercise by name then number of repetitions of each
etc., etc.

Anything done at PT
- how many times a week
- enter exercise by name then number of repetitions of each
etc., etc.

 

[Cassidy]

Hello @Josephine

Yes, your chart is pretty accurate, although I notice this morning that the tenderness extends up to TL2B.

1. I had the anterolateral (Hardinge) approach

2. When sitting, pain is negligible (a 1 - 2 soreness in the side/top of my buttock), sometimes nil when walking, but shooting up to 9 - 10 in my thigh on occasion when putting weight on the leg.

3. I'm not taking any pain medications (I haven't been to the GP and can't take NSAID's, as they disagree with me).

4/5. I've restarted icing over the last couple of days, mostly in the evening (and not at work|).

6. My activity level is back to normal for a part-time working domestic goddess! (My op was just over a year ago, and everything was fine until a few weeks ago).

7. I've started doing stretches whenever I get the opportunity i.e. waiting for the kettle to boil, whilst drying my hands, etc., (one foot behind the other and stretch to the side, for example), but haven't had any PT since leaving hospital.

I try to swim once or twice a week.

I hope the above clarifies the situation @Josephine. As I said before, I don't have a point of contact since being discharged 6 weeks post surgery, and if I can sort the problem at home/with PT, that would be a simpler option for me - getting to see the GP and then waiting for referral, etc., etc., could take weeks! (I'm sure you're aware of the UK situation at present.) Many thanks for taking the time to look at my case.

 

[Josephine]

TL2B.

That would be Piriformis syndrome

1. I had the anterolateral (Hardinge) approach

Oh gosh! It's such a long time since I heard that name!

2. When sitting, pain is negligible a) 1 - 2 soreness in the side/top of my buttock. Sometimes nil when walking, but shooting up to 9 - 10 in my thigh on occasion when putting weight on the leg.

That's a combination of the conditions I gave you before and the one in this post.

3. I'm not taking any pain medications (I haven't been to the GP and can't take NSAID's, as they disagree with me).

What's wrong with a couple of paracetamol 4 times a day?

4/5. I've restarted icing over the last couple of days, mostly in the evening (and not at work|).

And what about elevating? Plus you've not said how long you're icing for. Please tell me.

6. My activity level is back to normal for a part-time working domestic goddess! (My op was just over a year ago, and everything was fine until a few weeks ago).

I got it!

7. I've started doing stretches whenever I get the opportunity i.e. waiting for the kettle to boil, whilst drying my hands, etc., (one foot behind the other and stretch to the side, for example), but haven't had any PT since leaving hospital.
I try to swim once or twice a week.

Okay

I don't have a point of contact since being discharged 6 weeks post surgery, and if I can sort the problem at home/with PT, that would be a simpler option for me - getting to see the GP and then waiting for referral, etc., etc., could take weeks!

Honey, your point of contact IS your GP and you should discuss your needs with him (or her). They should have no need to refer you to another doctor. Certainly the hospital consultant has no need to advise or counsel you about pain management.

But you can make do with OTC meds such as paracetamol. They should do very well.

 

[Cassidy]

Thank you @Josephine. I'm icing at this very moment, - I try to do at least 45 minutes or so each evening, and again in the day when I'm not at work, and will add elevating into the mix (shame I passed on my recliner!). I can certainly take the paracetamol if you think they would help - I didn't think they'd help with the shooting pains? NSAID's (and sometimes paracetamol) mess with my digestion.

If I carry on with the gentle stretching, icing and elevating, do you think the problems will sort themselves out in time without the need for going back to the consultant? Ironically I'd been thinking of writing to thank him for how well the op had gone - maybe I'll hang fire!

Actually getting an appointment with my GP can take up to four weeks.

I've had a look at the stretches you suggest for piriformis syndrome, and have ordered a foam roller. I really can't think of any one thing I've done to irritate so many parts of my anatomy - can it be caused by simply getting back to doing things that I haven't done for some time?

Incidentally, is the Hardinge approach old hat? I thought my surgeon was up to the minute, but his associate at the hospital told me it was the approach most often used at Orpington Hospital. I also know it was a Stryker implant.

Thank you for all your help. I can resign myself to being patient if I know it's nothing too sinister! At least icing and elevating give me a good excuse to watch the telly!!

Goodnight.

 

[linette333]

Hi @Cassidy ! I have been reading about your recent problems with your hip. I am really sorry you are suffering, especially after doing so well for so long. I suppose we can never be complacent with this recovery.
I have decided that I have developed piriformis syndrome following my THR 8 weeks ago and I see my symptoms are similar to yours. I am also in the UK and don't want to be waiting at least 6 weeks for my GP to refer me for physio, so I am interested in your purchase of a foam roller. I have looked on Amazon and I am somewhat bewildered by the choice! Could I ask which one you have bought?
Good luck and I hope that your pain lessens soon.

 

[Cassidy]

Hello @linette333 - I'm sorry to hear that your troubles started so soon after your op, although I had a short area patch in the early says when my thigh muscles played up, but this passed and I was trouble free for some time until my latest episode. It seems to be a very up and down process!

I haven't received my foam roller yet. I ended up going for a fairly cheap one as, like you, I was boggled by choice but advised by a friend that expensive isn't necessarily better. I'll let you know what I think of it when I've tried it.

I don't know whereabouts in the UK you live (I'm in Kent/South London), but it can genuinely take up to four weeks to get a non-urgent GP appointment.

I've also been icing and elevating, which I hadn't done for some months, and I think that is helping.

Watch this space!!

 

[Mojo333]

@Cassidy

. I really can't think of any one thing I've done to irritate so many parts of my anatomy - can it be caused by simply getting back to doing things that I haven't done for some time?

This certainly seemed to be so in my case. As much as a year - and after, especially when I ceased being as cautious and mindful and gained confidence in my new hips.
I certainly hope the exercises and roller helps.
You could always make an appointment for a consult and continue working on this.
I'll be checking in...you stand out in our mind as such a strong member who pushed through early days of recovery fearlessly due to your husband's unfortunate medical emergency.
Wishing you well and hope all resolved quickly.

 

[bickypeg]

So sorry @Cassidy I remember you from way back as being a great example of a successful op despite other difficulties. So not just me then! I've been so uncomfortable these last couple of weeks after what I thought was a great recovery. Too much walking, weeding, trips out and thinking every day I was improving. Have self diagnosed as GTPS/trochanteric bursitis.
Same problem as you - 7 GPS left our practice at once and not replaced, with locums and nurse practitioners and weeks to wait for an appointment. I too was on the point of ringing the hospital to say thank you. Taking ibuprofen 4 times a day with some paracetamol and trying to rest but worrying I'm not exercising enough. Spraying Radian B on my knee is soothing. Going to try @Mojo333 's stretches but I'm frightened of doing more damage. Having to sleep on my back again, trying to avoid steps and slopes which with 3 floors and living on the side of a hill isn't easy. Do you find swimming helps?

 

[Josephine]

shame I passed on my recliner!

You can elevate just as well on your settee with a pillow stack Elevation: the do's and dont's

I can certainly take the paracetamol if you think they would help - I didn't think they'd help with the shooting pains?

It's always worth a try!

NSAID's (and sometimes paracetamol) mess with my digestion.

There was a report a couple of years ago issued by the college of gastroenterology saying that gastric bleeds had increased exponentially within the past few years and further research had shown that a great number of the patients had been taking NSAIDs, some on a regular basis but others only once or twice! Scary, huh?

do you think the problems will sort themselves out in time without the need for going back to the consultant?

Hopefully.

Actually getting an appointment with my GP can take up to four weeks.

Me too. However, I do find my GPs will do telephone consultations.

Incidentally, is the Hardinge approach old hat?

Hardinge (pronounced 'hardinj") was a prominent hip surgeon back in the 1950s. His approach was hailed as an innovation then and has continued to be since. It was also often referred to as the 'direct lateral'.

I can resign myself to being patient if I know it's nothing too sinister!

Well I can assure you it's nothing sinister!

I am also in the UK and don't want to be waiting at least 6 weeks for my GP to refer me for physio

I wouldn't bother. I've never found or known physio to be the least bit helpful for this.

I am interested in your purchase of a foam roller. I have looked on Amazon and I am somewhat bewildered by the choice!

This is the best thing for piriformis or IT band issues - though not trochanteric bursitis
And you use it where it hurts! Just put it on the floor, bed or seat and roll your body back and forth on it.

Amazon Spiky Balls

 

[Cassidy]

Thank you for the tip about the spiky ball @Josephine - I'll give one a go. I didn't realise the Hardinge approach was such old hat - my surgeon went out to Canada or some such to study the latest techniques, so I didn't realise he'd stick with the tried and tested! Seems to have worked well though, apart from the tendinitis, which is probably self-inflicted.

Sorry to hear you're suffering too @bickypeg. I have good days and not so good days - it's strange how it comes and goes. Hopefully it will soon go for good!

I'm still pushing on @Mojo333 - I'm fairly determined not to let things get on top of me. I think it's mostly frustration that I feel at the moment, as I had a glimpse of "normality" and I've regressed a bit, but I won't let it get the better of me!

 

[bickypeg]

It is frustrating @Cassidy especially when we've had a taste of freedom! I've booked to see a different physio this week recommended by @Apricot ages ago. Hoping she'll advise on how to do the stretches properly and have some thoughts on what I should and shouldn't be doing. I'm tired of sitting about and just doing bits around the house.

 

[Fit4Family]

Hello @Cassidy

Nice to meet you here. I am so sorry for you recent troubles. Some of what you are describing sounds familiar. Mine started with acute tendonitis and bursitis, but the lingering issues are more cranky tight muscles. They really can lock me up. Especially struggling to sleep again. I have the spike balls, a roller and a foot roller. From what I can tell, the internal tendon gets sore, then it’s a chain reaction down the leg. Muscles seize up to protect movement from flexor.

So, my efforts first off were on the source, inflammation at tendon and bursitis of hip. Same area as long blue. The long blue responded well to ice and rest.

The tricky part has been the front bits. They ratchet up and cause pain like I haven’t had since running track years ago. Deep tissue massage really helps. Finally called my PT and asked if they could just do deep tissue massage. They said yes! So, I am not doing any active exercise there, just massage, bicycling no resistance, gentle stretches at home. So far, huge help.

@CricketHip does a much better job at describing proper form. Maybe she will chime in. But, every time I get in and out of bed. I lay with both legs hanging off bed at knee, then grasp good leg and slowly pull knee to my chest. Hold for a few seconds then gently Lower the leg. Gentle, easy, movement is so important. Also breathing. Deep, not shallow. Watch you aren’t holding your breath. For me the anxiety of hurting myself more made me more locked up and was holding my breath for stretch. Been at this for 4.5 weeks so I can tell you it is slowly healing and ever so slightly improving. Another thing to consider is magnesium and potassium. Muscles love magnesium. I have zero medical training, so this is all just me trying things I’ve read here. Really hope this resolves quickly for you. Sending healing vibes.

 

[Layla]

I think it's mostly frustration that I feel at the moment, as I had a glimpse of "normality" and I've regressed a bit, but I won't let it get the better of me!

You've come so far, Cassidy. I'm sorry you're struggling. Thinking back to the days pre-op when anxiety ran high, then your early recovery interrupted by your husband's health crisis and recovery. You're one strong woman! I hope the discomfort you're dealing with soon resolves and allows you to move forward without pain.
Hugs and best wishes!
@Cassidy

 

[Cassidy]

Thank you all for your responses, @bickypeg, @Fit4Family and @Layla. Sorry for the delay in replying, but it's been a hectic couple of days.

I've now decided that my leg plays up if I've either stood, or sat, too long in one position. Once I get moving again it sometimes passes after a couple of steps or, in the worst case scenario, sends pains up and down my thigh so that I have to limp and can't walk properly for some time. This too passes eventually.

I had a day off yesterday and was helping hubby build a shed, of all things! This involved standing in one position for an hour or so whilst I sawed bits of plastic. When I tried to get moving again I couldn't, and my plans of bussing it in the afternoon went out of the window! So frustrating. I hope that all of this will pass in time, as it's not as bad as the original hip pain, by a mile, but it does take away the carefree aspect of life!

I'm attempting all the stretches and so far so good.

We're forecast torrential rain and gale force winds this weekend, so I won't be venturing out far anyway - it might be a good excuse to rest the leg!

Have a good weekend everybody.

 

[Mojo333]

You too, Cassidy

 

[Calgal]

Yup. Standing or sitting too long is murder. I still ache after sitting for an hour, even at 11 weeks. I start squirming. It makes dinners out quite interesting for my dining companions. They think I'm standing because I need to go to the toilet, but I just stand there (or take a few steps around the table) and sit down again! .

Take it easy. Rest and ice and paracetamol will continue to be your best friends for quite some time.

 

[bickypeg]

Nay lass! Shed building !!!

 

[bickypeg]

Seriously though! Check out my recent posts. Great easy exercises. Have you tried ibuprofen gel by the way?