THR Continuing pain after one week

Snoopy55

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As usual my friend @myglasshalffull is right on the money! Definitely do listen to your body and I do agree that alot of this recovery is mental. I was fearful of a couple of things like going down the stairs normally and for months I was going up and down toddler style and then one day I just started coming down the stairs normally! My brain told my body I was ready!
I also agree with PT being repetitive and boring so just do the exercises at your own pace. I do encourage you to walk around but not too much. The one good thing my PT said was "motion is lotion" so I did listen to that. My doctor recently told me to get on a bike and try to cycle as my hip joint was super stiff. Someone here said cycling inflamed their hip so I decided to swim instead. In my book someone who has had hip surgery knows better than the doctor that performed the surgery but never actually experienced it!
 
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FraidyCat

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I had my postop appointment with the surgeon this afternoon. I had noticed an extensive hardened area on the upper aspect of the thigh a few hours before that; I don’t know whether it formed recently or if it had been there for awhile. The surgeon said it was a hematoma and that we needed to give it another few weeks to see if it would resolve. He said PT would do nothing to address it. He confirmed my own suspicion that my recovery should be further along by now, at six weeks; he said 90% of patients no longer needed crutches at this point, whereas I’m still reliant on them. Needless to say, this development is discouraging. And from what I can find online, it sounds as though hematomas that don’t resolve on their own may require further surgery.
 

Layla

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Hello @FraidyCat
I'm sorry you're discouraged.
Hematomas do develop sometimes after surgery. I have read of hematomas here many times over the years. It‘s usually not a problem if they’re not large. I believe the body often naturally reabsorbs them, resolving the issue without treatment. Be aware though, It can take awhile. Try not to worry as surgery may never be necessary.
Is PT trying to help you transition to only one crutch, or a cane?

Thanks for updating, we're here for support when you need us. :)
 
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FraidyCat

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Thank you, Layla. The hardened area that the surgeon said was hematoma does seem rather large to me. I got the feeling he was concerned about it as well. The PT would certainly like me to transition to one crutch or a cane, and I do at times use one crutch in the house. But the surgeon said not to do anything I didn’t feel confident about, and so far I feel more stable using two crutches.

The PT’s entire mindset has seemed to be that I should push myself more, whereas the surgeon conveyed the opposite. I don’t think the PT realized there was a hematoma, which may have had something to do with her stance. I will point it out to her tomorrow, which will be my last session with her anyway.
 

Boofit

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I had noticed an extensive hardened area on the upper aspect of the thigh a few hours before that; I don’t know whether it formed recently or if it had been there for awhile.
Hello @FraidyCat A couple of weeks after my surgery I noticed a hardened lump the size of half a small papaya on the upper lateral aspect of my thigh, but it has been gradually decreasing in size without any specific treatment - much like what @Layla described in her post above.
In my case I think it is some sort of fluid retention (but it felt hard) that is gradually being reabsorbed by the body. I also think my gentle exercises are helping in the reabsorption process.
 
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I developed hematoma on both hips even though only had surgery on one. My OS said she could drain them but they weren't all that painful it was just limiting my sleeping on my side cause it hurt.
She advised me to us Voltaren, it's an arthritis/Ibuprofen gel you rub on. Comes with very specific instructions on how much to use and where you can actually use on your body.
Helped somewhat but I like the Arnica gel better.
Also felt ice helped just as much, but Ice is my best friend.
I'd dump that PT, sounds impatient to me, you will be ready when you are ready to use one crutch, cane or whatever. Don't beat yourself up.
My OS said no PT, just keep walking.
 

Eman85

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But the surgeon said not to do anything I didn’t feel confident about, and so far I feel more stable using two crutches.
Wise OS! You say you use one crutch in the house so you're transitioning and going at your pace. Pushing could lead to a mishap.
I used a shopping cart to give stability and relearn how to walk post-op. It was very stable and I could go very slow and no one knew I was rehabbing as I walked around the Walmart. I could walk it from the car, around the store and then back out to the car.
 
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I developed hematoma on both hips even though only had surgery on one. My OS said she could drain them but they weren't all that painful it was just limiting my sleeping on my side cause it hurt.
She advised me to us Voltaren, it's an arthritis/Ibuprofen gel you rub on. Comes with very specific instructions on how much to use and where you can actually use on your body.
Helped somewhat but I like the Arnica gel better.
Also felt ice helped just as much, but Ice is my best friend.
I'd dump that PT, sounds impatient to me, you will be ready when you are ready to use one crutch, cane or whatever. Don't beat yourself up.
My OS said no PT, just keep walking.
Correction to my post earlier, I developed bursitis, not hematoma. Sorry, I have to finish my first cup of coffee before I post!!!
Rest of post is correct as far as the Voltaren recommendation for the bursitis.
so sorry.
 

cold_brew

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You need a PT that is on the same page as your surgeon
 
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FraidyCat

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Hi, myglasshalffull. I have been using Voltaren for awhile. Hard to tell if it’s doing anything helpful or not. It didn’t seem to prevent the hematoma from forming.
 

Jaycey

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@FraidyCat as myglasshalffull indicated, the Voltaren was suggested for bursitis, not for a hematoma.

Voltaren gel is a topical anti-inflammatory medication. It would not prevent the hematoma and I doubt it would do anything to treat it either. You should check with your surgeon on using this. If you are on any other NSAID medication your surgeon should advise on using Voltaren gel.
 
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FraidyCat

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@Jaycey, I've not used the Voltaren for over a week, starting with when the OS said the hard, swollen area in the upper aspect of the thigh is a hematoma.

I've been able to walk for longer distances outside using crutches over the last few days, which at first I thought was a good sign. Now I'm not so sure, as each walking episode has been followed, either hours later or the next day, by severe pain. Also, a physician friend wonders why the OS hasn't given me "a path to mobility," i.e., transitioning from crutches to cane, since OS said PT wouldn't be helpful at this point, but I don't feel confident trying this transition without guidance or oversight. I've tried calling the surgeon at his office; his staff seem committed to not doing anything to convey my messages.

What is most puzzling is whether the walking -- though longer than before, still within a small area -- is actually causing the pain episodes. While I'm walking, I don't feel pain; it's only afterward. If even a modest amount of walking is causing substantial pain, it's hard to escape the conclusion that I should basically not be moving around much at all until my next medical appointments: with my rheumatologist next Monday and with the OS on 9/1.
 

Jaycey

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I would definitely ask your rheumatologist about this pain. Meanwhile cut down on the walking if it is bothering you.

Does icing and elevation ease this pain?
 
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FraidyCat

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I would definitely ask your rheumatologist about this pain. Meanwhile cut down on the walking if it is bothering you.

Does icing and elevation ease this pain?
Jaycey, both the surgeon and the PT (before my final session with her) said not to elevate anymore, and they seemed neutral about the icing. I've stopped doing both.

Since I last posted, I spoke on the phone with the surgeon, who said the hematoma would NOT be the cause of the pain. He said it could be a hairline fracture or an instance of the implant not having bonded properly, though he also said that both are "extremely rare." The pain over the last few days has been infrequent. Sometimes it's a sharp but not overwhelming pain. There have been only about three instances of more persistent, severe aching, which Advil has relieved. Perhaps these episodes aren't unusual even at 7.5 weeks out? And perhaps I should be proceeding with trying to transition to a cane? Surgeon said, however, to continue with using two crutches until I see him on 9/1.

I feel my medical guidance has been far from either clear or consistent, which is a problem in itself.
 
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You need to be your own advocate in these crazy medical times.
I'm 6 months post op and I still ice almost everyday. Not for hours but my back gets very tight when I stand for long period at counters in kitchen prepping meals.
So if he thinks you might have a hairline fracture why isn't he having you come in for X-ray???
If icing brings you some relief I would continue to do it.
 
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FraidyCat

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myglasshalffull: X-rays were taken at the postop visit; they did not pinpoint any specific problem. X-rays will be repeated on September 1. My hope is that I will have improved enough by then that no more imaging will be necessary at least for awhile. If the pain and mobility problems have persisted, my guess is that imaging other than x-rays might be used.
 

Eman85

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Ice is your friend, there's no ending point for it if it feels good, I'd rather use ice than any medications. Problems with the implant like a fracture or it not bonding are extremely rare, usually the first thing we think but rarely the case. The soft tissue pain persists for quite a while and of course it's triggered by use, so some pain is to be expected and it will go one for some time. It is a fine line to figure out just how much movement is too much. I did a lot of the figuring it out and transitioning on my own. It was much easier to do with my 2nd THR as I had the first's mistakes to learn from.
 

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I see you just passed your two month anniversary. I am sorry you're not more pleased with your progress and hope with time you notice improvement. I wish you the best at your appointment on Thursday. Please let us know what you hear. We're here for support if you need us.
Take Care.
@FraidyCat
 

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