THR Complex THR....has anyone else been through this?

[Vida]

Hi. I had a left cemented thr thee weeks ago. Due to congenital dysplasia it was my fifth surgery. I am otherwise a healthy, fit 61 and consider myself lucky to have kept my hip until now. I have a plate and three screws in my femur from babyhood, which looks amazingly large on x ray. My surgeon planned to use special drilling tools to remove the hardware but in the end he couldn't do it as he feared the bone would shatter.

However, he was able to 'bang' a sizeable shaft down behind the screws. He sounded quite happy about it, even though on x-ray it looks pretty close to me. Also a piece of bone fractured at the head of my trochanter, the site of a previous surgery. He didn't fix it, just ordered 50 percent weight bearing for six weeks and no abduction. So, my surgery lasted twice as long and this scar is 12 inches, so I have tried to be Zenlike about a slow recovery.

I am exercising as instructed but there is more pain than I expected and a weird new burning discomfort deep in my anterior thigh. It isn't awful... I wondered if it was a nerve thing but I have a nerve impingement on my other leg after 3 hours in surgery. Complicating things is a painful right knee, from years of left limping, which means I have to wear a brace to exercise.

This has been an emotional roller coaster and has brought back a lot of stuff from previous surgeries that was completely unexpected. People are kind but everyone seems to know someone who has bounced back fast after THR and they seem surprised that I can't get out much or sit at the table for long. My husband is wonderful and takes great care of me so I am extremely lucky. I am by nature a positive person but I am having irrational fears that this outcome will bring new problems. Can anyone identify? Thanks for giving me a place to vent, it helps so much.

 

[Jaycey]

Hello Vida, welcome to BoneSmart! So glad you joined us.

Sounds like you have really been through some tough surgeries. I can't really comment on the methods your OS used but I am tagging Jo our forum nurse so she can comment Josephine. But about the emotional roller coaster - we all understand exactly how you are feeling. I cried at just about anything both pre and post op. The buildup to surgery is very stressful and then the letdown after is also hard. Have you spent any time in the Library. Here's an article all about what you are dealing with right now Post op blues is a reality - be prepared for it. Lots of other threads there that might just help you through this journey.

Meanwhile, please do keep posting. It does help and there are many members here who fully understand what you are going through. Take care!

 

[Josephine]

Hi Vida - where are you situated? In the UK? If so, where did you have this surgery done? The deep burning pain is very likely from the trochanteric fracture but do you have any xrays you can post for me? Then I can see more.

 

[swimlikeafish]

Hi
It's hard enough when your surgery is straight foward so don't let anyone judge your recovery rate. You certainly have been through more than most. I'm not medically trained so can't help with much other than to wish you luck and hope you improve soon. There are so many nice people who may offer support on this site and the administrators will help and adv you as much as they can. All the best.

 

[Vida]

Thanks for your support. My earlier surgeries were done at Nuffield in Oxford but today I live in Vancouver. I don't have accessible xrays. My break was the very head of the trochanter but the pain is midway down the femur, it isn't obviously linked. I was wondering about a shaft tip issue? I see him in 2 weeks for an xray so unless it suddenly becomes unbearable and I can't exercise, I thought I would rest it out and take pain meds. Do you think I should ask for another kind of image?

 

[Josephine]

Ah you said "anterior thigh" which I took to be in the region of the trochanteric fracture - goes to show one should never assume! Perhaps you could identify the place using this grid

 

[Vida]

Sorry am having a dopey day and am also fumbling the one-fingered typing.. so its 3 right on the cusp of L1/2 back of thigh.

 

[Jmom]

Hi Vida. You replied to my post and I certainly appreciated it. You are in my thoughts and prayers as you recover esp since we are both congenital hip dysplasia recoverers. I dont know if I will face similar problems, different ones, or smooth sailing. I am certain I will be very emotional too. Its a lot to go through! I think the person going thru it all is the last to be able to see the light at the end of the tunnel. Would you feel better leaving a message with your surgeon's nurse to see if they have a simple explanation for the pain? Maybe Im impatient! I hate to wait for info about my body. Im in Indiana USA. So good thoughts to you from the suburbs!

 

[Vida]

Thanks jmom. I wanted to leave you a longer reply but I have problems typing on my android. I can so identify with you. My daughter is now in her 30s but when she was 5 I had a year-long bout with bursitis that was almost worse than the build-up to replacement. So I know how you are feeling. I am glad you are doing this while you are young, you will get through it and have some great years to spend with your family, hopefully pain free. This is my dream....we travel a lot and I hope life will get back to normal. Start planning now for your recovery, you will need a fair bit of help in the early stages. My husband is a huge support but he doesn't have to work. Arrange for all the help you can get with child care, cleaning, cooking etc then you can concentrate on getting back on your feet. After my third osteotomy I was on crutches for 6 months with a built up shoe, non weight-bearing for 6 months, so this is a comparative walk in the park. Do keep in touch. When you get your date, I can give you loads of helpful tips. I feel better just for talking to people who understand...this journey is not a straight line, it requires being gentle with yourself! This too shall pass. Best wishes.

 

[czak57]

Vida,
You might try taking a picture of the x-ray with your cell phone or camera if you cannot obtain a copy. I did that and the pic came out pretty good. Sorry to hear about your hip woes. I can relate as I am also a hip dysplasia patient awaiting surgery. I have not had 5 surgeries like you, but I have had my opposite hip replaced due to excessive compensation over the years. You may take longer to recover, but each day will get a little better. Hang in there.

 

[HappyHippy]

Hi Vida,

You may be having symptoms of Meralgia Paraesthica (thigh numbness due to lateral femoral cutaneous nerve damage). It's early so it may clear up in time. Nerve injuries can take months to completely heal. There's some other threads related to this condition on the forum.

Best to you.

TH

 

[Poppet]

Hi Vida

Just to clarify for my own information, to be sure I am interpreting this correctly

I read one of your posts in another thread which said: 'I quickly related it to leg lifts with weights that were part of my physio program'. I replied concerned.. so would just like to make sure I have the correct information

Was the use of the leg weights approved by your OS or PT?

It is so different here in Australia

Thanks hon

 

[Vida]

Poppet
PT where I live kicks in at 2 weeks. We get 6 sessions in the outpatient PT department, then group classes, all free through our health care system. They give us a manual and highlight appropriate exercises. Weights were added at week 3... I just did what I was told!!

Once it dawned on me that I was torturing myself and that I had control, I was fine. But because I was in a medicated fog, going through all the emotional stuff that thanks to you and this site I now know is normal, I was just overdoing it. When I told the physio about stopping the leg lifts with weights, she looked at me as if I was nuts. 'Of course.. don't do anything that causes big pain.' Wish she'd said that earlier or maybe she did but I was out of it!

I had my op at another hospital where my OS practices. The physio was surprised that I had restrictions lifted at 6 weeks her group waits until 12 after a fracture. Every health care region/OS here seems to do it differently. Maybe my speed is because my fracture was only at the tip of the trochanter. My husband took a pic of my x ray with his cell phone and sent it to me but I can't figure out how to attach it here. It is pretty unique with the old plate and screws still there. If anyone wants me to email it, I would gladly do so. Maybe someone can post it for me? Am I allowed to put my email address in a post? Sorry to be long winded...

 

[Vida]

Poppet when I said weights were added at week 3, I meant 3 weeks post surgery, in my second PT session.

 

[Vida]

Did it!!!!!

 

[Poppet]

Wow, Vida

Yes, thank you so much for posting your x-ray, I will tag Jo to have a look.. Josephine

Thanks also for explaining how the system worked for you. It certainly is very complicated as you say there seems to be different processes and procedures across the country.

So in effect, there was no direct approval from your OS to add leg weights, but rather the PT program itself, which is decided by the actual PT.

I am so pleased you stopped them. I do appreciate how hard it is when we are medicated to be our own advocate. However the main thing is you stood up for yourself and stopped... Well done you too bad what the PT thought, they would not do an exercise if it hurt.

Slow and steady is the name of the game with joint replacement recovery. The body is miraculous how it goes about healing the fibrous tissue and the cross linkage of the collagen, let alone the other anatomical areas.

I look forward to following your journey Vida.. You will get there, it takes time

 

[C Mac]

I am by nature a positive person but I am having irrational fears that this outcome will bring new problems. Can anyone identify?

Hi Vida,

Welcome to the other side with your shiny new hip and extra, special hardware from your other surgeries

Your statement above, from your first post, is quite normal for those of us that have a congenital issue and multiple surgeries. So, yes, I can identify....

I found that once I was about 6-8 months out from surgery and feeling a bit more "healed" that I then spent a lot of time trying to figure out how I could move and what stretches I could do with the new appliance. It was a period of time to learn or "prove" that this new foreign hip could actually work reliably and move in many of the same ways that the old defective hip had moved. Being on this forum helped with this tremendously because I could hear stories of other people that were doing particular stretches, exercises and activities that were for "normal" hips and they didn't fall apart!!

I also wanted to mention that if you are finding the physical therapy program to be too much at such an early stage out from your surgery I wonder if they'd let you take a break (ack, no puns intended there...) and come back in a few months. I cannot imagine if I'd had to start outpatient PT at 2 weeks after my surgery -- I was still doing my tiny, minimal home based PT exercises in my bed!!

Lastly, you mentioned having some leg pain on the grid picture above that Josephine; had posted. How is that now?

Take care,
Cardie

 

[oldyellr]

Here in Ontario (at least at my hospital) the OS provides a precise protocol to the outpatient PT department. I started going in weekly after my discharge and the therapist gave me instruction sheets with specific exercises highlighted and we went trough them. I did these at home and the next week more were added as required, etc. I never had straight leg lifts, even though I asked about them, because they weren't on the OS's protocol until later. From reading some of the accounts here, it seems that some PTs are quite autonomous and have their own agendas.

 

[Vida]

oldyellr

Hi John. I selected my surgeon because otherwise I would have been assigned someone via the general ortho wait list. I paid for a consult through a private clinic and chose this guy because he had done some complex hips, plus he gets rave reviews for outcome and bedside manner on all the review sites. Plus he is relatively young... now that I've crawled into the 60 zone, all the docs I know are retiring. I figure he'd see the hip thing out for me. As you know, you can't get private THRs in Canada so he put me on his list and ordered special drilling equipment, which you'll see from the x-ray I didn't need in the end. I was lucky to get it done in only 3 months on a very last minute cancellation. He never once talked rehab with me until he told me to lift restrictions a few days ago. Then he just asked if I had a PT. That seems to be the thing out west.. the docs worry more about hardware management and leave the rest to the system. Not surprising given the wait list for replacement parts here in BC. I think the system works well for the most part, unless patients go at it too hard, which we naturally tend to do. I write about health and should know better. I wish every THR and TKR recipient could access this site and get such sensible, supportive information from the likes of you guys (and Josephine of course.)

C Mac

Hi Cardie. The pain eased two days after I stopped the leg lifts with weights, as advised by this group. So if there is pain that is not jaw-dropping and requires a trip to emergency but feels more related to soft tissue and nerves, I've learned its probably related to overwork and is my own fault. But it is scary for people who are doped up and feeling alone and helpless. I felt so much better once I realised that I was in control and didn't have to slavishly do anything. Thanks for your kind encouragement about the walking. I know that will come in time, hopefully better than before. Could you please keep in touch so I can have you as a recovery role model?

Vicki

 

[Vida]

Josephine

Quick question... I had a dental exam before surgery and was fine. A few weeks ago I bit down hard on a stupid gift candy and a back tooth has been bothering me. I had the 3 month no dental work instruction and planned to manage it topically and by eating on the other side. Now it is becoming really annoying on top of everything else. I asked the OS, who said he'd rather I waited but that I should go and check its not an infection... you know, to avoid the mushy hip thing. Have other members have successfully had emergency dental work? I am seeing the dentist for an x ray only at what will be seven weeks post surgery. I know about the antibiotic thing.. but will it be enough at this stage or should I suffer to be safe? Thanks, Vicki.