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THR Cstinchcomb's Right Hip Recovery

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cstinchcomb

cstinchcomb

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Hi Everyone, all good here. It's a hot :SUNsmile: day as these things go here in the Land of Perfect Weather (compared to real Seasons in Colorado, anyway). Just got back from a walk :walking: with the poles and don't really feel the need for ice, I should go ice anyway but I am ... jeez, I am losing a little momentum with the ice when I don't have any pain. Down to the occasional daytime Tylenol, mostly because Inflammation is Bad. Still taking meds at night, but I really should stop, they are not meant to be sleeping pills. Maybe I'll cut back to just a half for a few days and see how that goes.

I am still fiddling with the PT exercises, but somewhat lackadaisically, which I figure is OK (Take it Easy plan). I am kinda trying to keep with the ROM restrictions but ... jeez, after No Restrictions the first time, I do admit to picking up things from the floor occasionally etc. BUT I am not pushing it. It is useful for me to start to gently address and engage the individual muscles there, mind-muscle connection and all of that, helps with the walks.

One of the great things about the SF Bay Area is that there are a lot of choices for, say, Physical Therapists. One of the bad things is that there are a lot of choices. So @dlp, @djacksonsf and especially @bml ... who did you use? Did you feel that it was helpful? I would really appreciate your insight.

Yes, my Video PT person is still on the list, but I am the one who always over complicates everything ... if I actually do PT then I want to try to optimize the experience.

Scar looks really pretty good, slightly "pleated" from the still dissolving sutures. I think that when this one heals up it will look even better than the left, and the numb spot is way smaller even now. BoneSmart recommends active scar gel, but my surgeon said nothing on there -- I like covering it with a silicone scar strip because it makes me feel more secure, and doesn't seem to do any harm. I have some leftover ScarAway from Hip No. 1 so that's on there for now, but I will probably buy some of the much cheaper tape next, unless the Amazon price for the ScarAway strips drops significantly. So many things now cost twice as much during this Time of Covid.

4 weeks today ... brain fog lessening, and more energy altogether.:yes!: Sitting is more comfortable too, really good thing since I have a ton of work to catch up on.

@Carita howzit going?
 

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It is wonderful to read of your progress Cst! Less fog, more energy, pain low... yay!

I have a great PT and see the benefits of a skilled therapist. It's good to have choices but also hard to narrow it down. Mine works with my surgeons practice so it was an easy choice as I had confidence in her as his colleague. She taught me how to get down and up from the floor yesterday...now I can do some simple pilates and yoga! She demonstrated some safe poses and reminded me to go SLOW! The best part is her reassurance that I am on track and doing well. This experience really kicked up anxiety for me and her assessments have been helpful. I hope you find someone you work well with.

I'm interested in the scar treatment you mentioned. Mine is steristrip free and looking good yet I wonder if some sort of dressing would be beneficial. I will look into it.

Thank you for asking about my healing...I appreciate your concern. I will write a 6 week update on my thread soon.

Again, so good to know you are well on your healing path!

Carita
 
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cstinchcomb

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She taught me how to get down and up from the floor yesterday...now I can do some simple pilates and yoga!
Yay! Excellent news! It must feel so good for you to be back on your mat. Hugs. Looking forward to specifics ...

Now, as always, I am trying not to do anything stupid and go backwards.

The ScarAway strips have a fabric backing. I peel the strip off (carefully, with soap) when I shower, wash it well with soap, dry on a lint free cloth, then stick it back on after I've finished my post-shower stuff. I am not putting any body lotion on the scar area; I think it would interfere with the scar strip adhesion. I have the Large size and trim them down (I need about a 5 inch piece, the Large are 7"). So far, this one has lasted about a week. Eventually the silicone lining tears and the strip must be replaced.

My incision is fully closed. With the scar strip, it seems to be flattening out a little more each day. But I don't know if it'd be flattening anyway ...

If I buy the tape instead (search Silicone Scar Tape on amazon), I'll post about how it compares. It's a lot less expensive and can be cut to fit. But I am not sure if it will wash and reuse; it's thin and has a plastic? backing instead of the fabric.
 
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Thanks @Layla and all of you for your ongoing encouragement. Hard to believe it's been a month already.

I scheduled my onsite PT, with my previous video therapist, starting next Thursday. I'm looking forward to it; I want someone knowledgeable to give me feedback. We don't have a lot of mirrors in this house. The gyms are still closed and I don't think I'd feel safe from Covid going to 24 Hour Fitness anyway. 24, the price is right, equipment is great, miss the people, but it's never been the cleanest.

I'm now walking about a mile twice per day, :walking: with the poles, still all flat. Really looking forward to getting back in the pool. Stopped the hard drugs but taking one tylenol every 6 hours during the day ... looking forward to no painkillers, but that might be a while.
 
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I responded to @jpg717 regarding situps, pullups and lifting light weights early on because I think that BoneSmart skews strongly to difficult or slow recoveries and minimal activity and I think that we chase off hippies who have uneventful or expedient recoveries. It'll be interesting to see if Jay ever responds.

From the perspective of my first hip -- my "I need a WHAT??" hip -- this was terrifying. I thought my life was over, but surgery was still the only real alternative. The experiences of my in-real-life friends who've had replacements (not Bonesmarties) supports my hypothesis that the fitter, stronger and more flexible you go in, the faster and better you come out the other side, and it was their experiences that helped me feel more hopeful, and be more active early on. Everyone's recovery is different, one's surgeon matters, but I'd like to help with the balance of difficult vs. easier recoveries. My first recovery was kinda risky, but completely successful. I am so early in my second recovery that all I can say is that things are going really well so far.

That being said, I am risk averse right now, and I am continuing with the Take it Easy plan. I keep hearing Josephine's remark about walking being the best exercise, and even then not to excess. If something goes sideways, either with the implant itself or with the soft tissue, the penalty is just so high. My surgical area, the quad of my operated leg, and the level of bruising and swelling that I have this time, with Not Much Activity, seems better than the first time through. As I watch my hard won upper body gains in the weight room ... disappear for now.

I haven't fallen off my bicycle in probably 25 years. But as much as I want to get back on it during the Time of Covid, I think it's too much stress on the quad / pelvis / hip, the angle is wrong, and I'm afraid of crashing. So ... we're waiting a while, probably a few months. I think that swimming will be, overall, safer (and more upper body, really not a bad idea).

Personally, I figure my body has only so much rebuilding power per day, and I kinda want it focused on integrating the new hardware and healing up the damaged muscles / tendons /etc.
So @zauberflöte is taking this to heart for her hernia recovery. Truly all my best wishes for an uneventful and speedy healing up. Abs are part of "the core" for a reason. I think that you will know, with one potentially partial rep of a movement in your barre repertoire, whether or not it's a good idea to do any more of that particular thing now. I find that testing things out gently, initially with isometrics and small motions, is beneficial.

The other side of this is well, what about scar tissue? Do we need to move around more so that we don't end up with crappy range of motion, or with adhesions that we have to work on later? Wisdom here says this is not an issue for hips, that walking is plenty, fingers really crossed that this is true for me since I have high expectations for both flexibility and strength one year out. I think we know what the plan is to get to the best minimum recovery (which is sooo much better than a bad recovery). But what are the best practices to achieve an optimal recovery, for an athlete?
 

zauberflöte

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@cstinchcomb I have thought, from 2013 to now, that BS skews heavily towards active, athletic, social people who are interested in a good long term outcome. Some come with severe problems to start with, such as collapsed hip joints, or AVN. Others such as I come with a garden variety need. I also came with a huge amount of ignorance, and BS seems also to skew to knowledge-seeking types.

"Minimum recovery"-- is that sort of for a couch potato who has no intention of doing more than walk the dog? All the people on here who were in my "hippie cohorts" had much more than that in mind, and a great many of us got what we set out to get. "Optimal recovery for an athlete"-- I don't know, that's a good question! How do athletes get over ordinary injuries? I told my hernia surgeon I wanted him to consider me "a geriatric athlete", as my impression is that most of his patients are overweight, out of shape, middle aged men. I am none of that! Most older athletes who I know lead a charmed life genetically. They have no prior injuries, their bodies are going strong at 78, nothing ever hurts, they are a Marine, whatever, lol. Young athletes recover from injuries I don't know how. But I would expect that a pitcher who had shoulder surgery would do exactly as the best care team baseball can buy told him to for the furthering of his career. Olympic athletes have to sit seasons out. There is an Olympic equestrian who (I think?) took home a medal some time after aTHR, forget who it was. It would be interesting to know how much pain he did or did not put up with. Dancers dance with pain day in and day out. And their bodies are shot at 35-ish. I think for myself, I am willing to be patient for the near guaranteed safe and permanent recovery, but I've been sneaking standing glute, leg and arm/shoulder/upper back barre work in this past week just because I have to use those muscles or go nuts. (Very challenging to keep good form while consciously only using your abs as much as you do to walk!) Covid made me do it! Floor work will be a bit longer wait.

My recoveries were comparatively quick. I never used a walking aid for the second one-- folded the walker up about 15 minutes after I got home because I didn't need it, and it was in my way/a trip hazard in that house layout. My right scar, the hip where I faithfully did my PT three times a day, had adhesions, and is not pretty. It's wide, white, and wavery. The left is a thin silver line. No PT (and my OS's new PA applauded me on that!) nothing except frequent short walks in a very hilly neighborhood (after I was comfortable walking down the steep bumpy gravel driveway to get to the road). Go figure! Each implant is different. Each hip has its own strengths and weaknesses. They both coexist in a now-68-yr-old frame, which is very far from genetically gifted. I do what I can with what I've got.
 
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cstinchcomb

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@zauberflöte, your post wasn't argumentative. There are so many topics to unpack in all of this.

First off, truly all the best with trying to do your standing barre without too much abdominal engagement, after what I expect is many years of having it be all about abdominal engagement. I hope you heal up fast.

Genetics, yes, I sure wish I had better genetics, arthritis runs in my family; someday we will have less invasive treatments.
 
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First off, I'm sorry that I was cranky in some of the above posts, and not in a good way. I really appreciate everyone's support and counsel. So a few thoughts, then an update.

There is, I think, a Bonesmart Best Practices for Optimal Recovery - can be summed up as "don't overdo it with early activity". This approach helps prevent setbacks and keeps us from annoying the injured soft tissues or worse, disturbing the new hardware before the bone's grown into it. I've really tried to adhere to it this time, as much as I can make myself do it -- and I think I am having a better, even easier, recovery with this approach. But that doesn't mean that I don't have an argument with myself every single day about whether or not I could really do some more things that I want to do.

Ok, now for the update. I am almost six weeks out. I had my first onsite physical therapy appt last Thursday afternoon, with the therapist that I met on video. I like her a lot and it was super fun. I have some exercises, and I am starting to fiddle with more of them, with no ill effects so far. I now will organize all the exercises that I have permission to do into three or four separate small workouts that I can cycle through daily, so that I am not doing the same exercises every day. This probably sounds like more exercise than it really will be, and a good portion of these will be abs and upper body. I've unpacked all the resistance bands to help with the upper body work.

My PT watched me walk in a 10 meter? hallway, she asked me, so which hip was it? I am :happydance:elated, this means that I've conquered the limp. I feel fairly balanced but not completely symmetrical; that will come with time. I am not doing any twists yet; I think twists will help with the symmetry when I'm able to do them (and more actual yoga).

I'm taking two walks per day, still flat, still with the poles, up to about 1.3-1.5 miles per walk. Walking pace is about a 20 min mile (3mph). If there were any small hills near me I'd try them, but there aren't. I should probably do some shorter walks without the poles. But walks with poles, 40% more calories, some upper body / lat work ... poles are great.

All the best to all of you. This is truly a life-changing restorative surgery.
 

zauberflöte

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@cstinchcomb better to be in major recovery mode here than snapping at hubby as I did, or worse, bursting into tears when the cat looks at you crosseyed! We are the ones who get it!

That PT's question must have had you floating on cloud 9 all day! Well done! And your little exercise "tour" sounds interesting. Keep us posted!
 
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Hi Everyone,
Another week (I am now almost seven weeks out), another bunch of steps forward :walking:. I saw my PT again this past Thursday; it's been really helpful to have her watch me, make sure I am using the right muscles, make sure I am even and balanced. I emailed her my two little workouts for feedback and got a couple new exercises to add in. I will add a third workout sometime, so that I am not doing too much at once.

I asked her if they had a stationary bike that I could try out sometime, so that my first attempt at cycling would be in a very controlled circumstance. I did not want my first time on a bike to be on my actual bicycle without first finding out if I was ready to even do that motion. And of course they do -- an upright LIfeCycle type bike with a wide supportive seat. It went perfect! I am surprised; the first hip took way longer than this to be ready to cycle. I spent 5 min on the bike, with some resistance, and got my heart rate up a tiny amt (didn't want to crank up the resistance) for the first time in months. :upright::wowspring:

One more thing on the workouts. I can do upper body weights (arms and shoulders) as long as I am seated. I am using very light weights, and some bands. That feels great. I am also working on my pullups and dips, and some seated lat pulldowns with the bands. 24 Hour Fitness is open here in the Bay Area but ... we are still covid shy, it's not getting any better out there. Oh, one more thing. Wall sits! These are great; I had forgotten about them, and they are helpful.

This Thursday, I see my surgeon (Dr. Hartford) for the first time since he did such an excellent job of installing the new hardware. Time for me to make a list of questions. I hope he lifts the 90 degree restriction anyway. And of course I hope that the Xrays look like they are supposed to.

Still two walks per day. One day I did 1.7 miles (thinking about something, just kept walking) and that was a little too much at once so I am now trying to stick to about a mile ish a couple times per day. Too much meant that I sat on some ice afterwards. No drugs (not even Tylenol) in a couple weeks.
 

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Wonderful progress and must feel good to be able to do some of the exercising you were missing. I bet your visit with your OS will be great and he will be impressed with your progress. Have a great week end.
 
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must feel good to be able to do some of the exercising you were missing.
Yes!!! having the little workouts (each one takes about half an hour) is helping my mental state. I hope that Dr. Hartford gives the go ahead for more activity so that I can start getting a little cardio.

One more thing -- I don't need the support of the poles anymore, although I do sometimes take them with me. It's about time for me to start some actual short hikes with some at least modest hills (with the poles), but I am waiting until after this appointment to start with that. I really don't want any setbacks.
 
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Still cruising along here. I don't really notice day to day improvements but each week makes a difference. I had what is probably my last physical therapy appt yesterday and see my surgeon for the first time since my surgery tomorrow. Fingers crossed that things look as good as they feel, and I really do hope he lifts the restrictions, which I am ... kinda following.

On the unfortunate side, I lost a filling and I'm going to need to see a dentist. It's not a complete emergency but it's going to have to be soon. I'm keeping it clean, listerine twice a day, etc. I will discuss this with my doc tomorrow. Has anyone had early dentistry? I had hoped nothing would happen for a year ...
 

zauberflöte

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All sounds very well @cstinchcomb ! I'm sure your appointment will go well!

I have a dental appointment for an overdue cleaning next week, at which we will discuss a crown replacement and filling that we postponed in January because I was waiting on some other medical news. Since this crown dates from 1978, I figure I'd better git 'er done now quickly before dentists shut down again! This practise has been using full PPE for a couple of years now anyway, so my only worry is the previous patient's status. However (you knew I was going to say however), do check with your OS. I had an enforced moratorium on dental work for three months each side of the op. Oh. Is that what you meant by "early" dental work? .... feeling foolish if you did!
 
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@zauberflöte, thank you again for such a useful and informative post. I hope you git 'er done before things close up; I would guess and hope that everyone is being just so careful. This covid thing, ugh. I so envy those in the countries that got it under control early.

And yeah, I was hoping to wait at least 6 months, but now I think I need to see someone next week. This is not made any easier by the fact that I do not actually have a local dentist; my dentist is in New Mexico which is not going to happen anytime soon. I have a local referral from a friend that I trust; now I can only hope that they will take me. I am going to ask for the least invasive solution for the near term.

And I'll ask my doc if I should start on antibiotics now ...
 

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