THR Counting My Blessings
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Debru4
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Post surgery update: Just checking in to report that my left hip replacement on Wednesday went well! I'm incredibly relieved that the medications I was prescribed really enabled me to manage the pain without having to take stronger opioids. I was really concerned heading into surgery, given what a mess I was after my first hip replacement 8 years ago. This time I’ve been taking Journavx (the newer pain relief medication), Celebrex, acetaminophen, and Tramadol, which is a weak opioid in a different class than the traditional ones. I began reducing the Tramadol on Day 3 and continue to feel good. Right now I'm able to go up and down steps with the use of a cane to reach my bedroom and have very little swelling and no obvious bruising yet. I know that as my activity level increases, likely my pain and swelling will as well. But for now, I am counting my blessings, feeling so grateful to have the surgery behind me. A big thanks to those of you who have already offered encouragement—it helped me so much heading into this surgery!
This is wonderful news!! I'm so glad to hear you're doing this well. Sometimes people get a flash of increased pain on the third or fourth day when the meds that were injected into the tissues just before closing in surgery wear off. But it sounds like you may have avoided that with your prescribed meds. The Journavx is new and shows really promising results with post-op pain. I'm happy it's working that way for you.
You might want to consider changing your thread title to better reflect your surgeries.....just a thought. We can make changes for you.
You might want to consider changing your thread title to better reflect your surgeries.....just a thought. We can make changes for you.
myglasshalffull
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Great news! Welcome to healing side.
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Great to hear from you Debru! It sounds like you're off to a good start. I hope today is peaceful, relaxing one.
I'll leave a copy of our Recovery Guidelines below as a refresher. We'll be happy to change your thread title, if your interested let us know. Take care!
As you begin healing, please keep in mind that each recovery is unique. While the BoneSmart philosophy successfully works for many, there will be exceptions. Between the recommendations found here, your surgeon's recovery protocol and any physical therapy you may engage in, the key is to find what works best for you.
HIP RECOVERY GUIDELINES
(Note to Basic Members: The links below are a premium service available only to Insiders Club Members. To learn about membership, click here ).
1. Don’t worry: Your body will heal all by itself. Relax and let it; don't try to hurry it. Don’t worry about any symptoms now; they are almost certainly temporary.
2. Control discomfort:
rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
3. Do what you want to do, BUT
If it hurts, don't do it, and don't allow anyone - especially a physical therapist - to do it to you.
If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.
4. Good Nutrition is essential for successful recovery:
Dietary Tips for Recovery
Nutrition Basics
5. PT or exercise can be useful, BUT take note of these
BoneSmart view on exercise
BoneSmart philosophy for sensible post op therapy
6. At week 4 and after you should follow this
Activity progression for THRs
7. If you want to use something to assist with incision healing and scar management, BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.
8. If you're still in need of recovery aids, check out the -> BoneSmart Recovery Shop for popular products at reasonable prices to support your healing.
Recovery articles
Pain management and the pain chart
Healing: how long does it take?
Chart representation of THR recovery
Dislocation risk and 90 degree rule
Energy drain for THRs
Pain and swelling control: elevation is the key
Post op blues is a reality - be prepared for it
Myth busting: on getting addicted to pain meds
Sleep deprivation is pretty much inevitable - but what causes it?
BIG TIP: Most hips do not need physical therapy to recover. Our hips do a good job of healing on their own, given time. We can't rush the healing phase, and pushing a new hip too soon after surgery can cause unnecessary aches and pains.
The best exercise is walking -- and even then, not to excess. Distance should be built up slowly over time and walking aids should be used to prevent limping. Once the hip has healed, physical therapy can be helpful for regaining muscle strength and range of motion and for addressing soft tissue issues related to post-op structural change.
We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery. While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
I'll leave a copy of our Recovery Guidelines below as a refresher. We'll be happy to change your thread title, if your interested let us know. Take care!
As you begin healing, please keep in mind that each recovery is unique. While the BoneSmart philosophy successfully works for many, there will be exceptions. Between the recommendations found here, your surgeon's recovery protocol and any physical therapy you may engage in, the key is to find what works best for you.
HIP RECOVERY GUIDELINES
(Note to Basic Members: The links below are a premium service available only to Insiders Club Members. To learn about membership, click here ).
1. Don’t worry: Your body will heal all by itself. Relax and let it; don't try to hurry it. Don’t worry about any symptoms now; they are almost certainly temporary.
2. Control discomfort:
rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
3. Do what you want to do, BUT
If it hurts, don't do it, and don't allow anyone - especially a physical therapist - to do it to you.
If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.
4. Good Nutrition is essential for successful recovery:
Dietary Tips for Recovery
Nutrition Basics
5. PT or exercise can be useful, BUT take note of these
BoneSmart view on exercise
BoneSmart philosophy for sensible post op therapy
6. At week 4 and after you should follow this
Activity progression for THRs
7. If you want to use something to assist with incision healing and scar management, BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.
8. If you're still in need of recovery aids, check out the -> BoneSmart Recovery Shop for popular products at reasonable prices to support your healing.
Recovery articles
Pain management and the pain chart
Healing: how long does it take?
Chart representation of THR recovery
Dislocation risk and 90 degree rule
Energy drain for THRs
Pain and swelling control: elevation is the key
Post op blues is a reality - be prepared for it
Myth busting: on getting addicted to pain meds
Sleep deprivation is pretty much inevitable - but what causes it?
BIG TIP: Most hips do not need physical therapy to recover. Our hips do a good job of healing on their own, given time. We can't rush the healing phase, and pushing a new hip too soon after surgery can cause unnecessary aches and pains.
The best exercise is walking -- and even then, not to excess. Distance should be built up slowly over time and walking aids should be used to prevent limping. Once the hip has healed, physical therapy can be helpful for regaining muscle strength and range of motion and for addressing soft tissue issues related to post-op structural change.
We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery. While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
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Debru4
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Thanks @Layla for the review materials. Since I have a different surgeon and he has some different protocols, reading through these things will be especially helpful.
Yes, @Jamie and @Layla, I would like to change my thread title. As a newbie, I didn't realize 8 years ago it would follow me far beyond my initial question! Shall I private message you, or???? Also, I would like the thread title changed, but I want to keep everything on this same thread so I can look back. Please let me know the best way to take care of this. Thanks.
Yes, @Jamie and @Layla, I would like to change my thread title. As a newbie, I didn't realize 8 years ago it would follow me far beyond my initial question!
Shall I private message you, or???? Also, I would like the thread title changed, but I want to keep everything on this same thread so I can look back. Please let me know the best way to take care of this. Thanks.
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Thanks @Layla. Let's change the thread title to "Counting My Blessings" because that is exactly what I am doing! 
I am doing really well and am so very relieved! I had my first in-home PT session today and it was helpful with NO extra pain. Following my first hip, my surgeon did not feel PT was needed unless something showed up a few weeks later with gait, etc. That approach worked well for me, but this new surgeon (other one retired) prefers PT 2 times a week for 4 weeks. I was skeptical, but willing to give it a try, and it was nice to have an assessment done at only one week out. I learned 8 years ago from Bone Smart to stop if there was too much discomfort, and this PT agrees 100%. He doesn't feel I'll need the full 8 sessions based on my current progress.
I will update in a separate post about the specific medication regimen that made all the difference in the world for me between the two hips and the first days after the surgery. This time the protocol included Journavx instead of the traditional opioid pain medications that I don't tolerate well at all. More on that to follow soon!
I am doing really well and am so very relieved! I had my first in-home PT session today and it was helpful with NO extra pain. Following my first hip, my surgeon did not feel PT was needed unless something showed up a few weeks later with gait, etc. That approach worked well for me, but this new surgeon (other one retired) prefers PT 2 times a week for 4 weeks. I was skeptical, but willing to give it a try, and it was nice to have an assessment done at only one week out. I learned 8 years ago from Bone Smart to stop if there was too much discomfort, and this PT agrees 100%. He doesn't feel I'll need the full 8 sessions based on my current progress. I will update in a separate post about the specific medication regimen that made all the difference in the world for me between the two hips and the first days after the surgery. This time the protocol included Journavx instead of the traditional opioid pain medications that I don't tolerate well at all. More on that to follow soon!
myglasshalffull
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Great update! You know your body better than anyone else and have had a previous replacement so you are already ahead of the game.
And you have educated yourself which is the best thing we can do when facing any type of surgery.
I only wish I had known more about hip replacement prior to falling & fracturing my hip and ending up needing surgery. I knew nothing. Just acquaintances that I knew had replacements but not the real knowledge we need.
So happy after a few weeks I found bonesmart!
Keep us posted, you sound like you are doing very well.
And you have educated yourself which is the best thing we can do when facing any type of surgery.
I only wish I had known more about hip replacement prior to falling & fracturing my hip and ending up needing surgery. I knew nothing. Just acquaintances that I knew had replacements but not the real knowledge we need.
So happy after a few weeks I found bonesmart!
Keep us posted, you sound like you are doing very well.
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Hi Debru,
It's great to read that you're doing so well. Love that you and your PT are on the same page and the assessment that eight visits may not be necessary.
Thankfully your prescribed meds are working well for you. I look forward to your update on the topic.
Happy Wednesday...hope it's a good one!
@Debru4
It's great to read that you're doing so well. Love that you and your PT are on the same page and the assessment that eight visits may not be necessary.
Thankfully your prescribed meds are working well for you. I look forward to your update on the topic.Happy Wednesday...hope it's a good one!
@Debru4
@Debru4 I'm so glad you are doing so well. I'm also very interested in your drug regimen. The world of medicine never stays static.
It really is a blessing when you find a good PT. They most certainly are NOT created equal. I've found mine and I hope they don't go anywhere if I need them in the future. Continued good healing to you. Keep us in the loop.
It really is a blessing when you find a good PT. They most certainly are NOT created equal. I've found mine and I hope they don't go anywhere if I need them in the future. Continued good healing to you. Keep us in the loop.
Legseleven
BoneSmart Staff
@Debru4 welcome to the healing side and all sounds good. Your meds sound a great mix and I can’t wait for journavx to be licensed in the Uk as I can’t take any opioids at all, not that I’m queuing up for more surgery anytime soon.
I also have a really good PT and yes it makes a huge difference.
Looking forward to your next update, just take life one day at a time for now and sending blessings.
I also have a really good PT and yes it makes a huge difference.
Looking forward to your next update, just take life one day at a time for now and sending blessings.
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Hi Debru,
How is it going?
We're cautioned not to compare recoveries because they vary form person to person, and even with the same person, but it's natural to do so. So I'm wondering how you're doing and how does this second recovery compare to your first? I'm especially curious because with your first you weren't prescribed any PT unless you needed it. This time it's two times a week for four weeks. Are you finding it helpful?
Cheers to a nice weekend!
@Debru4
How is it going?
We're cautioned not to compare recoveries because they vary form person to person, and even with the same person, but it's natural to do so. So I'm wondering how you're doing and how does this second recovery compare to your first? I'm especially curious because with your first you weren't prescribed any PT unless you needed it. This time it's two times a week for four weeks. Are you finding it helpful?
Cheers to a nice weekend!
@Debru4
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Just checking back in for an update. My surgery was 3 1/2 weeks ago and I continue to do really well. I am incredibly relieved, as I am 8 years older than I was for my first one in 2018 and am recovering even faster than before. There have been a couple of questions asked that I wanted to get back to about the pain medication Journavx that was my primary pain medication.
Like many people, I do not react well to any of the traditional opioid pain medications, and the worst part of recovery from surgery for me has always been the reactions to opioids. Once I have gotten past the original pain and have gotten the opioids out of my system, I've always recovered pretty easily.
This time my surgeon said that for people like me, they prescribed Journavx, Celebrex, and acetaminophen, with Tramadol prescribed as needed for breakthrough pain. You take 2 Journavx the night before surgery and one the morning of to get it in your system. My surgery was outpatient in a surgery center, and I came home about 5 hours after surgery. I had a spinal that was short lasting so I could get up and walk and be able to come home the same day.
I did end up needing to take Tramadol twice daily, in addition to the other medications for about a week, but this was the best recovery I have ever had from any surgery, including less involved ones. At no point did I ever feel drugged or disoriented, I wasn't nauseous, had no itching, and my pain never got above a "5". I can't say enough about the difference Journavx made for me. It is the first non-opioid pain medication approved by the FDA in 25 years and has been a game changer for many people. I know it isn't available everywhere, or covered by all insurance companies yet, but I'd urge anyone with issues like mine with opioids to ask about it. I had to get preapproval from my insurance company but that went through immediately. It is noted in my medical records that I have extreme side effects/reactions to opioids (not anaphylactic shock) and that may have made a difference in insurance approval. I am especially happy to have a medication protocol that works for me and can be used for future surgeries!
Like many people, I do not react well to any of the traditional opioid pain medications, and the worst part of recovery from surgery for me has always been the reactions to opioids. Once I have gotten past the original pain and have gotten the opioids out of my system, I've always recovered pretty easily.
This time my surgeon said that for people like me, they prescribed Journavx, Celebrex, and acetaminophen, with Tramadol prescribed as needed for breakthrough pain. You take 2 Journavx the night before surgery and one the morning of to get it in your system. My surgery was outpatient in a surgery center, and I came home about 5 hours after surgery. I had a spinal that was short lasting so I could get up and walk and be able to come home the same day.
I did end up needing to take Tramadol twice daily, in addition to the other medications for about a week, but this was the best recovery I have ever had from any surgery, including less involved ones. At no point did I ever feel drugged or disoriented, I wasn't nauseous, had no itching, and my pain never got above a "5". I can't say enough about the difference Journavx made for me. It is the first non-opioid pain medication approved by the FDA in 25 years and has been a game changer for many people. I know it isn't available everywhere, or covered by all insurance companies yet, but I'd urge anyone with issues like mine with opioids to ask about it. I had to get preapproval from my insurance company but that went through immediately. It is noted in my medical records that I have extreme side effects/reactions to opioids (not anaphylactic shock) and that may have made a difference in insurance approval. I am especially happy to have a medication protocol that works for me and can be used for future surgeries!
myglasshalffull
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Morning Deb!
Great update and you are doing fantastic!
I don’t like oxy either. Makes me so nauseous. Give me extra strength Tylenol which I was given after my hernia surgery along with Tramadol. Much easier to tolerate.
I’m so happy to hear how well everything is going for you.
Keep it up. All my best.
Great update and you are doing fantastic!
I don’t like oxy either. Makes me so nauseous. Give me extra strength Tylenol which I was given after my hernia surgery along with Tramadol. Much easier to tolerate.
I’m so happy to hear how well everything is going for you.
Keep it up. All my best.
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Happy Saturday! Thanks for the update, Debru.
It's wonderful that you were able to work with your surgeon to find a pain protocol that's worked well for you. Sounds like you're doing really well at three and a half weeks post op. May the rest of your recovery be smooth sailing all of the way! Keep us in the loop...we love updates.
@Debru4
It's wonderful that you were able to work with your surgeon to find a pain protocol that's worked well for you. Sounds like you're doing really well at three and a half weeks post op. May the rest of your recovery be smooth sailing all of the way!
Keep us in the loop...we love updates.@Debru4
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@Layla asked me in an earlier post about the differences between my two hip replacements, with one surgeon not suggesting early PT and the other one wanting his patients to do it twice a week for 4 weeks. I would say that this hip recovery has gone even better than the first, but I can't say that it was the PT that accounted for most of the difference. I feel like the medication protocol that didn't leave me in such a terrible mental state for the first week like the first one did is a big part of it. Additionally, knowing what to expect and what to be concerned about (or not) also had an impact.
I did at home PT twice a week for 2 weeks (starting one week after my surgery) and the therapist was great. After the first week he said that I had already met most of the goals for the first 2 weeks. We continued for a 2nd week and at that point he assessed again and determined I had met all of the goals for the first 6 weeks, and his report to my surgeon would reflect that. He had given me some exercises to work on, which were helpful, but not hugely different than what I was doing already. What I appreciated the most about PT was having someone to check in on me regularly early on and assess how I was doing, as well as to answer questions. The in-home option was wonderful.
He didn't feel I needed another 2 weeks at this time, and echoed what my first surgeon had said, in terms of perhaps waiting until after my 6 week check up with my surgeon to see if there were specific things he felt I should be working on at that time. When I met at 3 weeks with the PA to get the dressing removed, she agreed that I should stop now and see what the surgeon thought later.
I know this has been kind of a wishy washy answer to your queston about PT @Layla. I liked the support of the PT, while also appreciating that there was flexibility on the part of the PT and also my PA in terms of what therapy was needed, and at what time. I don't think that formal PT made a huge difference, BUT if I hadn't naturally been healing as well as I was, and I hadn't done this before, I can see how it would be helpful! In the future, l likely would do PT again if I could use my same person, or someone with a similar approach.
Until my appointment with my surgeon in a few weeks, I will continue doing the PT exercises, as well as walking as much as possible and resuming my daily life activities as I'm able. This past week I began doing light gardening --just simple things like pruning, weeding, etc. and it was wonderful for my mental, as well as physical health. A caveat---being on Bone Smart for my first hip, the avoidance of joining the "Over did it club" made a huge impression on me, and I know that this time I am doing well at pacing myself as a result. A big should out to Bone Smart for that!!
I did at home PT twice a week for 2 weeks (starting one week after my surgery) and the therapist was great. After the first week he said that I had already met most of the goals for the first 2 weeks. We continued for a 2nd week and at that point he assessed again and determined I had met all of the goals for the first 6 weeks, and his report to my surgeon would reflect that. He had given me some exercises to work on, which were helpful, but not hugely different than what I was doing already. What I appreciated the most about PT was having someone to check in on me regularly early on and assess how I was doing, as well as to answer questions. The in-home option was wonderful.
He didn't feel I needed another 2 weeks at this time, and echoed what my first surgeon had said, in terms of perhaps waiting until after my 6 week check up with my surgeon to see if there were specific things he felt I should be working on at that time. When I met at 3 weeks with the PA to get the dressing removed, she agreed that I should stop now and see what the surgeon thought later.
I know this has been kind of a wishy washy answer to your queston about PT @Layla. I liked the support of the PT, while also appreciating that there was flexibility on the part of the PT and also my PA in terms of what therapy was needed, and at what time. I don't think that formal PT made a huge difference, BUT if I hadn't naturally been healing as well as I was, and I hadn't done this before, I can see how it would be helpful! In the future, l likely would do PT again if I could use my same person, or someone with a similar approach.
Until my appointment with my surgeon in a few weeks, I will continue doing the PT exercises, as well as walking as much as possible and resuming my daily life activities as I'm able. This past week I began doing light gardening --just simple things like pruning, weeding, etc. and it was wonderful for my mental, as well as physical health. A caveat---being on Bone Smart for my first hip, the avoidance of joining the "Over did it club" made a huge impression on me, and I know that this time I am doing well at pacing myself as a result. A big should out to Bone Smart for that!!
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Thanks for stopping by, Debru, and sharing an update on your PT experience. It sounds like you're doing really well and it's wonderful that you're finding this recovery better than your first. I'm sure the medication changes, knowledge from past experience and minimal gentle PT all played a part in the great progress you've made so far. May it only get better from here on out. I hope you have a nice holiday weekend!
@Debru4
I hope you have a nice holiday weekend!@Debru4
