THR Constanze's recovery diary

Your journey is so positive! Reading it makes me so happy for you! Keep up the excellent recovery!
 
Doing catch-up and it's so good to hear your surgery went well and you are home on Day 6 !! You are
doing great, woman and hearing how you set you are to getting into the pt and fitness assets part of your rehab centre & with pool !!

Keep doing wonderfully...isn't it great being under the rainbow !!
 
Day 7
Hi all,
I'd like to carry on reporting from rehab centre in Germany, especially since that form of rehab isn't known in the US, England, Australia, New Zealand, Canada and any other English-speaking Country I may have forgotten.

I think both systems have their advantages and disadvantages. While going to rehab for 3 weeks after a stay in the Hospital is safer, a short stay in Hospital and going home afterwards gives the Patient more Independence, this may be conducive to recovery.

Today was a bit chaotic. I waited for the Nurse in the morning who was supposed to give me my thrombosis injection, so I was told, but she did't turn up by 7 and so I went down to the reception to look whether there were any changes to my therapy plan (maybe I don't Need a thrombosis injection after all). We have to check at the reception twice daily whether changes have occurred to the therapy plan, because they can occur at any time, and if we miss any appointments due to not looking, we will be in Trouble, that's what we were told. I found no changes so I went on to my next appointment at 7:30 which was that they wanted to draw blood (fasting as usual). There was a Queue. By that time I was hungry and wanted coffee. There was a Long wait and I felt quite dizzy and faint. A Lady who reported that she had bilateral hip replacement reported that she had also been waiting for a while. I admire her. She has Diabetes as well and didn't look anything as miserable as me. She preferred to stand because the chairs were to low for her.

Finally had my blood taken and had some breakfast. Then things got better. I had to go up to my room again for the medical round but that was the doctor I saw yesterday and he feels confident that I'll recover fast anyway, so he didn't do anything - in other words a bit of a waste acutally.

But then I started with the real Sport. I did some gymnastics exercises with a Trainer and later some Fitness Training with another Trainer using machines - similar to a gym. I've been told I was fit enough to go on an exercise bike tomorrow. This is in my plan.

In the afternoon, we went to a class about how to cope with everyday life after a hip Operation. We learned how to cope with the 90°C rule, how to use a sock putter onner or towel to put socks on etc. That wasn't new to me of course.

I have Little pain, I'm using pain meds (diclofenac or whatever the Thing may be called) and can do Baby steps with one crutch or nothing.

Today, I had to get new Access Details for my Internet here, because the Provider had been fiddling around with the Internet Access or the wireless Lan. That was another annoying Thing but all in all, I'm in a good mood because my wonderful leg makes me happy. The Food they provide is actually quite good (others were complaining who assessed this rehab facility on the Internet), but I don't thinks so.

The silly autocorrect keeps changing what I type, even on my Laptop. I know you don't capitalise nouns in English, but I can't be bothered to correct everything manually :).

Cheers and happy healing to everybody - see you again soon.
 
Very interesting @Constanze. Certainly already you can see the pros and cons. The expense to the system for everyone to do rehab must be great?. Reading of your exercises today made me shudder. I wanted and needed a quiet life so early on in my recovery!! Good luck with tomorrow.
x
 
Be careful with these exercises. You are only 9 days out yet and it's so easy to set up inflammatory issues in the ITB (ilio-tibial band) and Pes Anserine. Youmight also remember 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.

What you're doing is all about strength and fitness training and that should wait until at least week 10 when you're all healed up and ready to go!
 
Hi @Josephine,
Actually, I'd agree with you. The exercises they offer at this rehab clinic are far too strenuous and too premature. I manage well but some of them don't feel so good and then I say so. But what about People who didn't have as much time as me to Keep fit? I don't think the exercises are suitable for all of them, and if we Train in a Group, they can only do half.

There is one Lady who has got bilateral hip replacement - she has to struggle. Then there is a man with only 20 kg weight bearing on the operated leg. The Trainer didn't first understand why he was put in that Group. This man could only do the exercises which involved sitting down, not Standing, of course. However, most of the exercises I'm given feel fine and are actually a relief, especially the ones lying down.

I also like Walking. And for the first time yesterday, I had a session in my Training plan on the exercise bike for 20 minutes. That felt good.

Improvements: I can walk with the crutches without a limp and I can get up from a chair normally - without pain and without looking like someone who is very very decrepit.

This morning, I had minor muscle soreness, to the extent which is normal for he after a good workout. Now it's all gone.

However, I thought this rehab place was there to make People recover and healthy for work and everyday life. Sometimes I wander whether it's counterproductive. Not only are the exercises too tough for some People (I mean I understand my doctor here knows I'm pretty sporty, so I can understand that he makes it a bit harder for me, but it's probably not suitable for everybody). I think the Organisation is chaotic. Rushing up and down in the lifts and queuing up for blood drawing or receiving one's pain meds is terrible, especially for those who are in pain. Besides, the Wifi was down yesterday and I was very frustrated, because I couldn't communicate with my nice friends in bonesmart. Anyway, I'll Report more some time later. Happy first of May to everybody.
 
I forgot to ask:
For those of you who received a thrombosis injection, how Long did you have to receive it for post-op?
Thanks and best wishes
Constanze
 
Just a few comments regarding exercises & restrictions:
While Trainer and physios seem to be very pushing with the exercises, they make pretty much of a fuss about the restrictions (90°C rule, not crossing the mid-line, twisting).

The gait Training Lady with whom we also had this "how to cope with the restrictions in everyday life" class. Says restrictions are 12 weeks. Full-stop (my surgeon says I have six weeks Maximum - depending on how I Progress, I reckon. I had the lateral Approach, minimal invasive).

In the gait Training lesson, we don't just do plain Walking - we walk sideways, Slalom, up and down a step, on a soft mat - actually it's fun, but hard for the Lady with the bilateral hip replacement and the man with only 20 kg weight bearing find it a bit hard.

I also a single physiotherapy gymnastics exercises (not in a Group) again. This physio from Croatia is trying to give me exercises to strengthen the thigh muscles on my operated leg because they have atrophied (actually, I feel how they are getting stronger already). She makes me move that leg up and down in a stretched Position. Quite an effort. With the unoperated leg it's easy-peasy. She say one should never ever cross legs, such as the operated leg on top of the unoperated leg while sitting in a chair (life-long restriction).

Never heard of that one before. I thought as a rule of thumb it was 6 weeks will the lateral and anterior approaches (some surgeons say no restrictions for the anterior Approach), and 12 with posterior, and after 6 and 12 weeks, respectively, the restrictions (90°C, ban on leg crossing) would be lifted. Would anyone like to comment on this? Thank you.
 
Hi @Constanze Mmmm, I'm happy to comment :heehee: Firstly, congratulations on how well you're doing
[Bonesmart.org] Constanze's recovery diary


It would seem every surgeon, hospital and system in the universe has their own idea on who's thumb to use as the rule :rotfl: You'll be out of the rehab centre soon... your OS is the one I'd be listening to, he gets paid the big bucks to advise YOU :SUNsmile:

The first surgeon I was going to have do the surgery was a nice enough man, very experienced and able, but he used "never" a lot in our conversations about what life after THR would be... he was one of those surgeons that said that I would never be able to cross my legs or ankles again; a lifelong restriction :yikes: That's a LONG time! He required 6 weeks of other restrictions (he called them restrictions, was very stern about how vital it was to observe them, the significance of which I'll explain in a moment) he required 28 days of anti thrombus injections, TED stockings for that time and the usual 90 degree rule with no twisting or crossing the midline... so, sleeping on my back :sigh:

The surgeon that actually DID the surgery (because I procrastinated and the first surgeon was going away for a one year fellowship) was a REALLY nice guy, and part of what I liked about him was how positive he was; he required 12 weeks precautions which was a bummer.... but he called them precautions, designed to protect me not punish me... to reduce the already VERY LOW risk of dislocation, which made me feel differently about them - more like I was in control. He told me not to make my life miserable obsessing about them, that it's a "numbers game" and that if I "broke" a rule once in a while the chances of dislocating were only very slightly increased... if I broke them all the time, of course the risk went up a bit. Actually research has shown that the difference in dislocation rates between those THR recipients that follow precautions and those that follow none is very low indeed:shrug:

Most importantly (for me) my OS said he wanted me to think about nothing but my hip for 12 weeks then never think about it again!! that the idea of having the THR was to enable me to lead a normal life, if I had to factor in my hip to every decision I made henceforth he hadn't done his job!! I'm sure there's little difference in real terms between the two surgeons, .... for me the fundamental difference between them was attitude. I had the 90 degree "rule" (I used the golfers reach so it was easily got around) and slept on my back as "required" (though my OS said he's not a policeman and wouldn't be in bed with us checking up whether I was complying :heehee:) He also didn't require me to have thrombus injections or TED stockings - so it's not as if he's ultra conservative; just has a different set of priorities in recovery to other surgeons.... used a different thumb to rule by :rotfl:

Your PT does sound very "rigorous". I'm all for early ambulation, I walked on two crutches after a few hours (even though I had Posterior Approach) and it gave me confidence and I'm sure it assisted with avoiding some of the other issues that can come up early in recovery - I felt really able to do so I "did" was proud and happy to.... BUT I am nearly 7 months out from my THR and I am still suffering tendinitis issues that presented after two or three weeks... at which time my physiotherapist said they "were probably" aggravated by doing too much too soon. In fact I started taking NSAIDs again yesterday as total rest is the only thing that works... and total rest is NOT what I had a THR to participate in.... I'm not suggesting you sit around all day, but please do be wary of overdoing it; once you have it is SO hard to reverse. Of course you may just be fine, You are obviously a health conscious, fit and active person you will be back at full pace soon enough :)

Keep posting, I find it really interesting to see the variations in this process across the world (we really are laid back here in Australia, PT almost non existent and our success rates exactly the same as the US and other countries where PT is hard core!)

Hope your healing continues at the same pace, one you're happy with. I admire you immensely being in a rehab centre... I really would have struggled being in that sort of environment for an extended length of time, I survive in them but thrive at home :yahoo:

All the Best
Donna :flwrysmile:
 
Hi @craftdee, You're so Kind answering me. I agree with you. I'll listen to my surgeon - he's the most positive surgeon out of those 3 I consulted. And he is involved in sports, too. So he doesn't have this don't and never again attitude. While the other 2 surgeons said I should never in my life go Jogging again (you see I'm a Marathon runner of 15 years), this surgeon didn't acutally say that. I think I'll wait a year and then see about that. My device is robust anyway - titanium, ceramic lining, ceramic ball.

My Progress continues to be good - the pain is almost non-existent. Best wishes - Constanze
 
The exercises they offer at this rehab clinic are far too strenuous and too premature.
I have to agree. Unfortunately many of these organisation offer a "one size fits all" approach. Sometimes damage is done!
For those of you who received a thrombosis injection, how Long did you have to receive it for post-op?
I had 30 days of these - looked like a pin cushion!
In the gait Training lesson, we don't just do plain Walking - we walk sideways, Slalom, up and down a step, on a soft mat
Now gait training is really helpful! I wish we had more of this in the UK. So many new hippies need this as we have limped around for so long. I'm anxious to see how you get on with this.
She say one should never ever cross legs, such as the operated leg on top of the unoperated leg while sitting in a chair (life-long restriction).
My LTHR surgeon said the same thing - basically not because it's bad for your hip. It's just bad for circulation. My RTHR didn't give me any restrictions except "if it hurts don't do it".
 
But what about People who didn't have as much time as me to Keep fit? Not only are the exercises too tough for some People (I mean I understand my doctor here knows I'm pretty sporty, so I can understand that he makes it a bit harder for me. Sometimes I wonder whether it's counterproductive.
What about them? The point is that recovery is not the same as fitness training and should never be combined. And yes, they are counterproductive which is why I'm always banging on about it!
Then there is a man with only 20kg weight bearing on the operated leg.
oooh OUCH! :scaredycat::shocked::sos:
For those of you who received a thrombosis injection, how Long did you have to receive it for post-op?
6 weeks, 12 weeks, it varies according to the choices of the surgeon. Some don't have it at all but had oral instead.
The gait Training Lady with whom we also had this "how to cope with the restrictions in everyday life" class, says restrictions are 12 weeks full-stop (my surgeon says I have six weeks maximum - depending on how I progress, I reckon. She say one should never ever cross legs, such as the operated leg on top of the unoperated leg while sitting in a chair (life-long restriction). Never heard of that one before
Oh we have! It's quite ridiculous really when you consider there are lots of surgeons globally who don't bother with restrictions at all. Very few UK surgeons do actually. Neither of my sister's surgeons did. And though some patients might be told 'it's for life' I bet you anything that before the year is out they're not bothering or have even forgotten about it altogether! :heehee:
 
Hello to all!
I had Lovenox injections for 14 days and I hated it. An older woman (80) who has a cottage near us had a THR last May and died in July from what everyone suspects was a blood clot. She was not very fit at all but it kept me needling myself every night as I did not want a blood clot. I suspect that a lot of these precautions depend on the general health and age of the patient. Glad to hear you are doing well Constanze!
 
Oh I meant to add, as Jaycey said the gait training was very important. I got a physio to come to my home to do some acupuncture on my sore quads and IT Band... well I didn't KNOW she was going to do acupuncture, she offered it and I was desperate and it worked brilliantly - and immediately! I got her to check my gait as I was walking a lot and wanted to make sure my technique was correct... which it wasn't, so she really helped me with that - explaining technique and giving me "tips" - she also suggested walking sideways as a way to get the abductors working. I liked it as it was easy to incorporate into daily living; instead of walking from the sink to the fridge for example I just went crab like... she also suggested walking backwards, which really helped build my glutes etc.... but was harder to incorporate into daily life :heehee:

Jaycey is right about crossing your legs being generally bad for you too (especially at the ankles) but it was hearing the word "never" from a surgeon that's about to do surgery designed to give your life back that jangles I suppose. We know eating chocolate's not good for us too... but to hear that we should never eat it again would get us thinking if it was worth it:rotfl: I have found, as a side note, that I don't cross my legs anywhere near as much as I did pre surgery... but I do bend my non operated leg up and rest the ankle on the knee or thigh of my operated leg... so pretty close. I don't know why that changed, maybe I broke the habit :shrug:

Donna :SUNsmile:
 
What about them? The point is that recovery is not the same as fitness training and should never be combined. And yes, they are counterproductive which is why I'm always banging on about it!
Hi @Josephine , you are absolutely right wondering what about them and saying that recovery should not get mixed up with physical fitness. The same goes for the experience I had at table at mealtimes. We have a table allocated to us - that's ok. But the meals ladies also make sure we have a fixed seat at each table. They told me several times that I sat in the wrong place, although I can talk to the other guests - we're responsible adults. And then she allocated a place to me right in the very Corner where I have to squeeze in. Thinks they have to consider the People with mobility impairments. But what about me? I've got a new hip and have a right to my recovery. While I can manage to squeeze in, it's a bit awkward considering the restrictions.

But let's stop complaining. @Jaycey and @craftdee : The gait training we are receiving is very good actually. In incorporates Walking sideways and Walking backwards and we are always joking in that class and have good fun. We also have mirrors to Monitor our gait. My husband says my gait has improved. With this one size fits all Thing, that is not actually the Approach of my rehab. I have my individual Treatment plan. But they are pushing me too hard because - that at least the Impression I'M getting - they think I'm too healthy. At least, that's what I can gather from some remarks they make.
 
The same goes for the experience I had at table at mealtimes. We have a table allocated to us - that's ok. But the meals ladies also make sure we have a fixed seat at each table.
Oh brother! I had a real belly laugh at that - it must have felt like being back at school again! :loll:

BTW, keep your eyes peeled for post I shall be putting up soon about gait analysis. It's a new thing that uses GPS monitors to track gait. I have a Youtube demonstration but I'm at work at the moment and the system won't allow me to post it. But if you look for Gaitsmart on Youtube you'll find it.
 
Been following your thread. My surgery is May 29 and I hope my recovery is uneventful. Thanks for sharing your journey. The more I read about others experiences the more I see all surgeons have so many different restrictions etc. also there is such a great difference between countries and the protocol to follow. I was shocked to learn that I needed a hipmreplacement. Like you, I am very active and just kept pushing through my pain mistakenly believing I just had pulled a groin muscle. I am still able to work out regularly so hope my fitness level will aid in my healing. Best wishes to you.
 
Hey @Constanze - you will feel so freeee when you escape from rehab to home. I'm sure it is good at keeping you on the straight and narrow (maybe a bit too narrow?) but at least you aren't being as lazy as me! :)
 
Hi all,
It's been almost 2 weeks now since I had my surgery.

Here are the recent improvements and steps of Progress:


I can stand up painlessly, work in the kitchen (cook, fill up and clear out the dishwasher) without pain, walk downstairs Holding onto the railing like a normal Person (upstairs not yet - that I still Need to do toddler style). Walk indoors without the crutches and without limping. Standing up and sitting down pain-free.

Now a question regarding the exercise bike. The Supervisor who monitored my exercise bike Training told me to slow down on the bike. Now while I understand that it is wise to go slowly at this early stage, the reason he indicated was for reasons of wear and tear of the device. Said the muscles have to get strong first, otherwise there would be too much like abrasion on the device. I have a ceramic ball and ceramic lining. While I would understand that this would be the case with metal or plastic, I thought ceramic was very durable. If I think logically, I come to the conclusion, you can rub off very much off a ceramic head. Some of you might think it's very early for the exercise bike, but it was the doctor who is taking care of me in rehab who put this on my rehab plan. He probably thinks it's good for me for endurance (cardio) reasons.

My surgeon says, I've got to work out because I've got osteoporosis.

@Molly12 - I'm so pleased you're interested in reading my thread. Yes do Keep up your exercise if you can. I did Swimming, cycling, gym Training (on the machines), and Walking with my husband preop. It has helped me a lot with my recovery.

Best wishes to you - Constanze
 
@Constanze - I like your training program! It doesn't make sense to me that the device would be harmed. I went ahead and started biking on the stationary bike at week 4 -20 minutes only - no tension- just to get cardio and movement of the legs -without permission from any medical person. I just went by the guide "if it hurts don't do it". I see my OS on Tuesday so I will ask him about biking and abrasion of the device - I want to get on my mountain bike and outside although I am a little afraid of falling. I'm a good biker and will stick to easy flat trails until I feel competent and strong. I know of a male who cycled on the stationary bike and recovered very quickly. I walked 2 km on Friday but was tired afterwards. I get exhausted so easily now and at my age it takes much longer to recover form injuries than when I was young.
Keep us up to date as I enjoy reading about your athletic recovery.
 
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