THR Charlie's RTHR Recovery Thread

[myglasshalffull]

Good news, happy you were able to get SI injection and hopefully will ease the pain for awhile.
Let us know how you do.

 

[thepuckhead]

Green beer anyone? lol

Make that a black and tan and you're on! Here's to your continued improvement and continued being an advocate for yourself and not stopping until you're where you want to be.

 

[Charlie33]

Hi all: So I got a second opinion on a hip replacement number 2, timing and computer versus non computer assisted. Learnings to share:

1) Didn't go for second opinion on first replacement but they gave it anyway: first replacement looks perfect, top shelf. I agree, no issues, very happy.
2) Right hip moderate, not as bad as left when operated on but right causing pelvis to be slightly out of whack. This results in quad tightness, SI & knee pain and other symptoms I've struggled with on non-op side.
3) OS #2 agrees with OS #1: All the PT in the world likely won't let me 'recover' fully, i.e. live with the moderately bad hip for 5-10 years. The second replacement will restore pelvis to neutral position and allow me to recover fully versus the struggles/frustrations I've posted about, mostly related to non op side! They said I could do it now, but they recommended enjoy the summer and try for the fall. They dont think I should wait longer than a year....

I'm inclined to muddle along through the summer and take a wait and see approach. That said, at least I know why this is happening.

So here's the question: both OS's are fantastic, same approach to surgery. The second OS uses the computer assisted approach, which uses a CT scan for optimal implant placement. I trust my original OS, but also hear making sure the pelvis is perfectly level is key (like within a milimeter). My view is a skilled surgeon, computer or not, can do a good job but welcome anyone who has experience or knowledge on computer assisted.

Welcome any and all feedback on folks who dealt with implant #2, timing, decision process and on the computer stuff. Thanks!

 

[Merrimay]

Wow, @Charlie33, you've been doing your due diligence! You and I have dealt with identical postop spinal issues that refer to the nonop hip. Interestingly, I made an appointment yesterday for March 31 with my original surgeon. His PA is going to give me xrays of my lumbar and nonop hip, and we'll take it from there. If I need a 2nd thr, I'll stick with him since he did such a great job the first time. My hindered progress is not about the operative hip. I think I've had a misaligned pelvis for a decade or more, and a vital and well-done surgery just triggered a worsening of symptoms. But we'll see. I'd like to postpone the second hip til Fall if possible so I can enjoy the summer. Last year I was so disabled I was housebound from June to Oct!

@Charlie33 , I'm so sorry you're encountering a situation like mine, but being able to commiserate and share our experiences with various alternative protocols has been such a help to me.

Hang tight!

 

[Charlie33]

@Merrimay glad to hear and great help to me too! My sincere hope is someone reads our stories and benefits down the road. Pay it forward as they say

 

[Layla]

Others WILL read your stories and benefit, so thanks for sharing here. Happy Four Month Anniversary, Charlie!
I hope you comfortably make it through the Summer since that's your wish and have clarity in making decisions as they arise. Take good care and stay in touch!
@Charlie33

 

[Merrimay]

@Charlie33 , did either of your surgeons suggest hip arthroscopy?

Anyone else know if hip arthroscopy is ever a possible considerstion for pelvic misalignment pain?

 

[Merrimay]

To be more specific, this would be hip arthroscopy on the nonoperative hip after THR?

 

[Charlie33]

@Merrimay Hi, no just that joint is shot and to ditch it! Haha. I can ask

 

[Merrimay]

No, if the joint is shot, its time for the trashcan!

 

[Mojo333]

Hi @Charlie33
My opinion for what it's worth.
Both my hips were very bad apparently (one slightly worse than the other) and I wish I had known so I didn't spend those last 2 years pre-op So miserable...but I'm very glad that I had both done at once as, indeed, I believe it would've been impossible to get things right until both were done.

My bad hips caused horrible lower back pain and SI pain, not so much HIP pain, really just decreased ROM.
The doctors investigated my back without considering my hips, hence the delay in the diagnosis.
After BTHR, it took some targeted PT at 2-3 months to relieve the SI issue due to Pelvic tilt and hip flexor issues which affect the pelvis.
I don't think waiting will help anything...waiting until all the cartilage is gone so you HAVE to have a replacement (all the while being unable to recover properly from #1 due to posture/gait from bad hip) on top of the 2 surgeons agreement that it will take getting the other hip on board to get things right seems unhelpful.

I did not have computer guided surgery but several member here have to great success.
Again, only my opinion...
if the surgeon who did #1 still has your confidence, and doesn't deem the other THR unusual or complicated... perhaps I'd be inclined to stick with him...
However if you feel #2 will give you an advantage for alignment, I might would give it a hard look also.

If you are healthy otherwise and up for doubling down, then I say... do it sooner than later.

 

[Charlie33]

@Mojo333 Thanks for your response. Very helpful insight on SI and pelvis which has been focus for @Merrimay and I. OS2 said non op side will just remain out of whack until replaced.

If I can get things somewhat better over next few months will try but overall think #2 a 2023 event. Prefer not to do before summer.

I’ve read many threads on double or wait 6 weeks between implants, but haven’t seen like @Merrimay and I where you’re about 3 months into recovery from #1 and non op side starts affecting overall recovery. Another one for the library!!

Thanks again!

 

[Mojo333]

You are welcome.

I’ve read many threads on double or wait 6 weeks between implants, but haven’t seen like @Merrimay and I where you’re about 3 months into recovery from #1 and non op side starts affecting overall recovery. Another one for the library!!

Can't think of the examples but we've seen many cases of this on the forum.. and also seems many times where surgeons suggest 3 months between surgeries.
Baby that brat hip, and hopefully your SI pain doesn't get too awful while you wait.
That pain is horrid...was for me.

 

[Charlie33]

WOW.. So here we are a year later.... A few early morning reflections...

- If you have a hip that you struggled with early on (like me, injury at 20, at 35 doc said you'll need a replacement at 40 and finally get it done at 54) it takes longer to recover, or at least it did for me. The longer biomechanics, balance and all sorts of stuff are out of whack, the more time you need to recover.
- Younger THR folks with high level of activity often want more from their body and new hip post Op. Again, this simply takes more time and you have to be patient.
- After about 4 months, low level pain (say under a 3) is tricky: you shouldn't exercise or do anything to incur pain, but sometimes weak, tight tissue screams a bit. Balancing when to back off versus understanding the pain is sending 'false signals' is very important to get a grip on to aid recovery process... this took me about 6-9 months to figure out.
- Mental mindset pre and post op may even be more important than any physical therapy or exercise.
- Recovery gains continue way after surgery and will continue if you put the work in!
- Look at your new hip like a new employee at work; welcome your new hip, it wants to do a great job! Sounds funny, but I got this advice and helps with mindset!
- Moving in all sorts of ways is the best therapy. Remember playing on the jungle gym as a kid? Rolling around on the floor? Your body is meant to move in many different planes of motion...to extent you can, do it!
- On exercise: locking yourself into a bike seat for 100 miles or running 5 miles? Cardio important, yes, but repetitive stuff is icing on the cake and shouldn't be a core fitness program: all you need is a 10 minute warm up, body weight, a mat and maybe some rubber bands for a bit of resistance.

Happy Holidays!

 

[Mojo333]

Good morning.

Great thoughts and great advice @Charlie33
I know my new employees kept improving well into year 2 and I found that alot of that improvement came in the realm of less discomfort from the adjustments my body was making after the years of bad gait, bad posture and bad compensatory habits due to my bad hips.

Wishing you a happy Christmas and a great 2024!

 

[thepuckhead]

Hey, you!

Wanted to stop by and crack a beer and read your thread. I always learn something - my PT warned me against repetitive motion and locking into one form of exercise and here you are, saying variety is key. I have found this to be very true - my first time incorporating an elliptical into my workouts was a little weird, but totally worth it. Likewise with weight lifting - it's actually fun to try new things as opposed to grinding out the same old reps on the same old machine.

You are a wise one, friend. I hope you're doing well!

 

[Charlie33]

@thepuckhead Hey I was wondering if you'd be back! Great update and glad to hear you are cruising on the ice again! Yeah things tool a while for me.. I have range back from 10+ years ago but do find to build range and maintain it, programing your brain not to forget it thru mostly proprioceptive training (no machines, body weight, single leg) has been most helpful. Keep flying on the ice baby! Nothing like it!!

 

[Charlie33]

Ok, this is a random thought for anyone following my rants (haha!)......cuz its happening and worth sharing...minor sciatic nerve pain.

In last 14 months there have been periods I dont think about my hip at all...and more often in the last six months... that said, as I sensibly push to get more range and strength, I've experienced a few mini set backs mostly related to my back: nerves are funny, they shrink with your muscles when not used, so in the post op journey when you grease them back up and lengthen as you gain muscle range is another tightrope of sorts to work through as sciatic nerve can flair up (pain under a 3, more annoying like any ache in butt cheek). I say work through because totally backing off (in my experience) and 'resting' has not worked (and will generally guide folks this applies at plus 6 months post op so newbies don't get too excited and push through).

A relatively safe 'hack' I've used to overcome this is a seated or standing sciatic nerve glide (also called flossing). The secret is to look up when bending the leg when standing or extending leg when sitting (looking up takes pressure off nerve). The whole idea is to get the nerve gliding through the nerve sheath to relieve pain. Easy one for work or airport. There are many variations, but this one seems the safest (at least for me!) https://www.youtube.com/watch?v=7QSHr6-Gbr0

Also, for folks that have desk jobs or sit a lot: try not to! Get a sit/stand desk (most now electric and can be provided by employer or cheaply purchased for at home use). Also there are many very affordable walking treadmills. If you are on calls (video or otherwise) seems like more people using these versus just sitting and staring at a screen. Both have helped and suggest a trip to amazon where you can find loads of affordable options.

Happy days all... again and as always journaling this in hopes it helps someone else!

 

[Elf1]

@Charlie33 as always, sharing your tips and tricks as to what's worked for you so others can benefit as well! I definitely like the tip for sciatic pain. I've dealt with that off and on since before my THR and spinal fusion. Will have to give the stretch a shot. Thanks for all you do here in supporting others traveling the recovery road.

 

[Charlie33]

Question for all around timing of second surgery:

Backstory: I am about 16 months out and was well till about 10 weeks ago when I injured my knee on operated leg. Yes it was doing what I thought was a relatively safe exercise but caused an injury where I had some pain and fluid in knee joint for a few weeks. ODIC plus a bit more.

Injury 10 weeks ago: The injury wasn't that bad, but the biomechanical stress on my left side (and despite all my efforts) built over a few months (sort of like people that wear a boot for an ankle injury, back gets out of whack etc) and left me with an angry piriforus muscle coupled with sciatic pain which bottomed out a few weeks ago. Yes no fun!

Care team response: Went to OS. Nothing ongoing with knee, implant fine, but pelvis tilted a bit. CHECK. Went back to my pelvic floor specialist DPT (which took me six months to find!). Overall OS and PT think it is likely nerve irritation at Piriformus versus disc issue in back. CHECK. MRI from a year ago looked fine. PT is doing soft tissue work and also reviewing my exercises to tweak (sort of like a coach, do this stop that), which has resulted in sciatic pain going away and now rebuilding some lost range in piriformus. CHECK

So slowly on the mend... BUT:

When to do right hip?: Here is the question: my other hip shows moderate degenerative change, does not give me real pain but VERY limited ROM. So the disease process in the other hip keeps your pelvis in a tilted position and your sort of fighting the other side. My PT sees it: she said I can move/rotate replaced hip WAYYY easier than the other side.. I got so much ROM back after my other hip was replaced it was crazy I lived the way I did for 20 years (similar to @Eman85 story, we both waited a long time)

As many know have busted my behind to recover, but feel like at times this is waaaaay more effort than it needs to be if I wasnt fighting the other hip (and yes THR major surgery so don't want to rush).

So I'm not 'code red' but if anyone can recommend forum members or threads, or would care to share experiences on timing of second surgery, would welcome feedback. Also in a GREAT work situation and insurance so tempting to help with recovery. Also if you prefer to message me directly cool with that too!

Thanks!