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[THR] DanInAK's RTHR (anterior) Recovery

Discussion in 'Hip Replacement Recovery Area' started by Dan_in_AK, May 11, 2019.

  1. Dan_in_AK

    Dan_in_AK new member
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    Hello Everyone,

    I'm a 43 year old male in Fairbanks, AK. I had my right total hip replacement done on May 8. I came to the point of replacement after worsening arthritis and impingement, after another doctor planned to just do an arthroscopy (in Sept. 2018) but my insurance denied it (too much existing arthritis) and a second and third opinion sided with the insurance and instead recommended THR. From September till now, pain was somewhat controlled with steroid injections and anti-inflammatories.
    May 7: Today found me driving from Fairbanks to Anchorage, for the pre-op visit with the doctor's PA, Rich. Rich went through a lot of information with my significant other and me. We went through the hospital's registration after meeting Rich, and were scheduled to be the first surgery for the hospital at 7:30AM May 8.
    May 8: We arrived as the hospital opened at 6:00AM. There wasn't much waiting. As usual, I got lightheaded as they inserted the IV port. We met the anesthesiologist, some nurses, and Doctor Prevost came by. A little later, we said our goodbyes, and they wheeled me to the OR. Among all the hustle-bustle, Rich and the nurse anesthetist were talking to me, and had me bend over for the spinal. Next I remember waking up and being wheeled to my 7th floor Ortho recovery room, 100% pain free. Given my usual neck, back, hip, shoulder, and headache pains, this was bliss. Heidi came to see me around 11:00am, but I wasn't there yet. She says around noon they let her come in.
    It was kind of a blur still, but I remember pain slowly coming to my operative leg, lots of checkups, and drifting in and out of sleep. Heidi left, and came back with friends later, they stayed about an hour till visiting closed at 9:00PM. Around 9:30PM, a nurse took me for a short walk (50ft) with a walker. Dr. Prevost visited, but I can't remember when.
    May 9: PA Rich came by around 6:00AM to check on me and remind me about all the anti-clotting measures and movement precautions. I took a morning walk with a nurse and used a walker. This time, about 100 yards, two trips around the Ortho ward. Pain has come, but is reasonably managed by Oxycodone, gabapentin, and flexiril. Later today the PT lady came by, we did some exercises, and to my surprise, we walked. I don't know how far, but it was the longest yet, included the little practice stairs, and a 1.5 staircases in the fire exit, all on crutches since that's what I'll have at home. She cleared me to walk on my own, which leaves the discharge up to the doctor. He approved and we arranged to leave after my hospital dinner. I managed to get in the front seat of the car, and we headed to our hotel with a handicap room and separate beds for the night, where friends met us with (more) food.
    May 10: Woke up, used the toilet, and did PT on the hotel bed. We got me into the car, hooked up the ice machine and the calf-squeezer to an inverter we bought last night. It was late morning, so breakfast was a DQ cheeseburger, and we started our 7 hour trip home, with 2 stops for walks. We got home in early evening, and got me situated on the day bed/couch so I can sleep here and watch TV here. Managed a walk down our driveway and back on dirt, about 1/8 roundtrip. Hooked back up to ice and topped of on pain meds, and off to sleep.
    May 11: Only one trip to bathroom in the middle of the night… I woke up fairly rested this morning and with the stiffness back in my hip/thigh from not moving. Ate a light breakfast, and went for a walk--about 1/4 mile, and other than the steps out of and back into the cabin, I just carried the crutches in place, and just occasionally use them for stability. Today I've taken two more "wandering" walks around the property, surely consisting of at least 1/4 mile each. The last walk, I used the crutches for safety down the stairs, then left them against the house and just walked. This was about an hour after the last dose of Oxycodone. Now, I'm back in, on ice, without much pain, trying to chronicle my experience.

    The swelling bothers me, but it's not bruised and really just seems fine. I've got to do round two of PT for the day. Pain is controlled and I'm taking 5mg doses of Oxycodone 4-6 hours apart, not the 10mg I'm allowed to.

    Walking has its own set of new pains from the muscles being wrenched apart, but I happily do not have that sharp pain of bone-on-bone. While it this time it could still be masked by medications, I think the joint is good and fixed. My back gets sore sitting/laying here, but walking helps that. Now to just get that swelling going down.

    While this will not be anyone else's exact experience, it's been mine, so I'll share. I was hesitant going in to this at 43 years old, but the old pain made my quality of life pretty poor and I was unable/unwilling to do a lot of the activities I used to even after PT, OTC drugs, and prescription meds. That's what sent me to surgery.

    Dan
     
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  2. LAbabymama

    LAbabymama member

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    Hi @Dan_in_AK. Welcome to the other side! Sounds like you’ve done a lot in the short time since your surgery. 7 hour drive home! That must have been tough. Glad to hear you’re doing well. The others will be along shortly to give you all sorts of advice about your recovery. Just wanted to say our stories are similar - I’m 42, bad arthritis, got tired of it affecting my quality of life and just had a LTHR on May 1st. So I’m only a week ahead of you. Welcome to the Bonesmart family!
     
  3. Opera

    Opera new member

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    Hello @Dan_in_AK, I had a left anterior THR Mar 4/19 after I fractured my perfectly good hip in an accident and for the first few weeks had a lot of swelling in the leg, after 2 weeks this subsided but I still for the next weeks especially if I sat up to much had a very puffy ankle. I was concerned about the swelling especially as 2 days post op I fell off the toilet ...note to self don’t use the toilet paper holder as a support when getting up ‍♀️. I ended up getting x-ray done & all was good & at that time I was told swelling was not unusual. They said with an anterior repair you don’t need a raised toilet seat but if I was doing this again I’d for sure rent one.
     
    Last edited: May 12, 2019 at 6:04 AM
  4. Layla

    Layla FORUM ADVISOR Forum Advisor

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    Hi Dan,
    Welcome to BoneSmart. Thanks for joining us here.
    Below you will find the Recovery Guidelines. Please pay special attention to the article on ICE and begin icing if you're not already. It will help ease the swelling and pain. Stop back often, we'll be here to offer support as you're healing. Happy Sunday!

    Hip Recovery: The Guidelines
    1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
    2. Control discomfo
    rest
    elevate
    ice
    take your pain meds by prescription schedule (not when pain starts!)​
    3. Do what you want to do BUT
    a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
    b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.
    4. PT or exercise can be useful BUT take note of these
    5. At week 4 and after you should follow this
    6. Access to these pages on the website

    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: Hips actually don't need any 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.

    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 the at each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice. @Dan_in_AK
     
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  5. Tarajeane

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    Hi! Glad to hear you are doing so well! Are you walking with no walker/cane? Are you limping? I’m 42 and scheduled June 5 to have hip revision surgery to left hip with THR. Car accident when I was 18 and current have a plate and screws with now a lot of arthritis.
    Tara


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  6. Jaycey

    Jaycey SUPER MODERATOR Moderator

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    @Dan_in_AK Welcome to the other side! Keep that icing and elevating going. Swelling and bruising are very common post op. Short walks and if laying on your back is bothering you put a small pillow under your knees.

    I look forward to following your recovery.
     
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  7. Dan_in_AK

    Dan_in_AK new member
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    @Tarajeane, I can walk nearly without a limp or assist device, however that is only at the height of the pain meds, about an hour after taking them. Normally, I am limping and holding on to something or have the crutches.

    I have a special case for recovery, in that I live in a very small space (300 square feet) with my girlfriend and two 90-100 pound dogs. The small space means I had no use for a walker, and limited room even for crutches. My walks have to be done outdoors on dirt/gravel, with 4 steps down to the ground, and then not much level area to walk on.

    My swelling is only from the waistline to the knee, my calves look like my same old skinny chicken legs.

    Muscles are very tight and sore waking up, or after on-movement, like a daytime nap, and hobbling around the cabin is somewhat painful, so I'll walk outside with just one crutch after I'm down the stairs.

    I'm sleeping with the giant foam wedge strapped between both legs, which helps the hip but hurts the back. It prevents me from unconsciously rolling on my side, where I'd prefer to sleep.
    Enough writing for a bit, its breakfast time.

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  8. leejaa

    leejaa post-grad

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    Dan, have you tried sleeping on your side with the wedge between your legs or pillows. With my last THR, the PT person said I could turn on my side as long as I kept something between my legs so that my legs would not cross over. This really helped to relieve some of the back discomfort and made me feel more human. You have to sort of roll like a log. I used extra long body pillows crosswise so it would not slip out and extra pillows in front of me so I would not roll over unconsciously but it did help relieve.

    I understand being in limited space since my house though much bigger was sort of crowded and left very little room for ease of movement (though not anything like yours especially with the dogs) and with one 90# dog. I did use the walker as a block on the dog since he is a lover so he would not get overly enthusiastic..

    You are doing great so far. Keep up the good work. It takes time but it will come.
     
  9. Dan_in_AK

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    I have tried rolling onto my side with varying thickness pillows between my legs. The pain I got from that was closest to my pre-surgery pain, although less intense. Oh, and it's the wrong side, I normally sleep on the operated leg.

    Just went for a bumpy car ride to the store (30 min each way) and walked around with 1 crutch, am back home now, tired, back on ice machine. It's still early here, 1:00pm, but so far I feel like I'm just holding steady compared to yesterday.

    Pretty impressed with how it's going so far. I had both a bunion and tailor's bunion removed and my heel cut off and moved over to prevent more bunions, all on left foot in Sept. 2017, and it was way more difficult and painful than the hip has been. It was also zero weight bearing for 6 weeks. This is a comparative cake walk so far.

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  10. Carriemay60

    Carriemay60 post-grad

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    Although a little tight on indoor space, I bet your surroundings are absolutely stunning. I used to live in a 250 sq. ft. cabin on the water on Vancouver Island. It was heaven! The uneven walking outside will be a challenge so do wear decent shoes and be very aware of any holes / tree branches that might trip you up. We sure don't want you falling! :no-fin:
     
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  11. Dan_in_AK

    Dan_in_AK new member
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    A little less swelling today, 5 days after surgery. Feeling like taking shorter walks, but more of them. Still using the ice machine when not up and about.

    Already bored with staying put. It's nice out, except for the mosquitoes.

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  12. Dan_in_AK

    Dan_in_AK new member
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    First day of PT today, 6 days out of surgery. He only had me do about 3 exercises, then ice. I thought "that wasn't too bad," till I tried to walk out to the car on my one crutch. It had worn me out. I got into the car, and couldn't find comfort on the way home. Keep in mind I'd planned ahead with the slurry of pain meds taken an hour before the PT appointment, oxycodone, gabapentin, and cyclobenzaprine. One more oxycodone was due a little while after getting home, ice and elevation immediately. Now, 7 hours after the beginning of the appointment I'm feeling pretty decent.
    I think I can back the pain meds way off except on PT days now. I'm still sore and swollen but that's the temporary price to pay for fixing the debilitating pain.

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  13. Debru4

    Debru4 senior

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    You might want to rethink your PT. In general, most people find that extra PT isn't really necessary, and may actually make things worse. At an early follow up appointment with my surgeon, I recall telling him that as I was increasing my activity, some days I needed more pain meds than others to deal with the discomfort. His comment was to be sure I wasn't using the pain meds to address pain I was creating by being more active than my hip/leg were ready for. He was right, and I'm so grateful I got that advice at 2 weeks out. I ending up having a very smooth recovery, and found that just living daily life, with walks, (and stairs as I was able) were all I needed. It sounds like you're doing great with the walks, in general. Just remember that you are still very early in your recovery.....go slow to go fast:)
     
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  14. Dan_in_AK

    Dan_in_AK new member
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    Hi Debru, I thought I should address your comment today, after my second PT appointment. I had read similar opinions and went into PT knowing full well to speak up if something (anything) we did caused pain. It really didn't on any one movement, but man was I tired. The next morning (Wednesday) I dropped all the previous scheduled pain meds to just a single 50mg Tramadol per day. The doc wants me on a regular regimen of aspirin for clots, tylenol for pain, and Naproxen for inflammation. Those have been since discharge. So, I was certainly sore after PT #1, but soreness similar to the end of a long hike, or a hard workout, in pre-hip-pain days.
    Yesterday was day 2 off PT. Couple light walks, 1/4 mile, 1/2 mile, and various chores. One tramadol in the afternoon and then zero pain. Swelling is noticeably absent now, as in absolutely none.
    Today, I was scheduled for PT #2, with a different therapist. Knowing that, I only did a 1/4 mile walk down the driveway in the morning. Felt stiff and anticipated some soreness, so took a tramadol. Arrived at PT feeling stiff/tight in the right quad. Loosened up well with non-resistive movement, and found what I thought was great strength in balance and exercise, for 9 days out!
    Managed a pain free Costco trip afterwards, and 4 hours post PT (6 hours post-tramadol), have zero pain, am much looser, normal feeling, and walking with no assist and very little limp.
    I'm careful to adhere to the doctor's restrictions on movement, and at the height of pain after surgery took around half the dosed pain meds. I'm finding that lots of gentle movement doesn't hurt, and a hard 1-time exertion is what does hurt.

    My PT lasts about 35 minutes after you take out waiting on the therapist, then 15 minutes of ice and elevation.

    I'm pretty thrilled to be able to walk without the sharp joint pains. I don't believe PT is a good recommendation for everyone. For me, I think it's right. I'm fairly young man (43) and was active even in pain before surgery. I agree that if it hurts the next day, and causes any setback, it's too aggressive or too soon. Today it helped me begin learning to walk without a limp again, and did not hurt. Hooray! auploads.tapatalk_cdn.com_20190518_960c25ae310ebc01376b68df729107c5.jpg auploads.tapatalk_cdn.com_20190518_04c411beb1831f6a66584e34452fb7dc.jpg

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  15. Debru4

    Debru4 senior

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    Dan---it sounds like you are doing really well, and that your sensible approach is working for you.:egypdance: I think that is the key to recovery, whether you do PT or not. I've heard other people who also prefer the support/structure they get in PT, and it seems as long as a person stays reasonable and in control of what goes on, they do well.

    If you've spent time on this forum reading people's accounts, I'm sure you've also read about people who pushed too hard, and couldn't seem to find that balance. They seem to adhere to the no pain/no gain way of thinking, or believe they can speed up the process by pushing extra hard. And then they end up suffering setbacks. I think recovery can be especially hard for those who are athletic, used to exercising often, and who rely on exercise for both their mental and physical well being.

    I am unable to tolerate opioids/narcotics or NSAIDS, so following any surgery, I typically am only able to take acetaminophen and Tramadol. The first few days always are rough, but like you, I've been able to get down to minimal medication pretty quickly. And on the plus side, I tend to feel more alert and clearer headed as a result.

    Where are you in Alaska? Are you able to walk on dry ground?Because they remove your labrum, which is a stabilizer, balance can be an issue. I was fine at first....it wasn't until about 8 weeks out when I was walking longer distances, on sometimes uneven terrain that I realized how my balance had been affected!

    I hope your recovery continues to be smooth! Keep us posted:)
     
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  16. Layla

    Layla FORUM ADVISOR Forum Advisor

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    Hi Dan,
    Thanks for the update and photos. Always interesting.

    Wow...PT and a Costco run on day 9 post op is pretty ambitious and it sounds like you did well.
    Hopefully you're not paying for it today.

    Even with a little limp it's recommended that you use an assistive device until the limp is completely gone.
    A tip -
    Try heel-toe walking when / if you're limping. Let your heel hit the ground first followed by toes.
    It takes a concentrated effort but I believe you'll notice a difference. Give it a try.

    Sounds like you're doing really well. I hope you have a nice weekend! :wave:
    Stay in touch, we'd love to follow your progress.
    @Dan_in_AK
     
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  17. Dan_in_AK

    Dan_in_AK new member
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    The heel-toe walking was a big (very helpful) part of yesterday's PT! It felt so good to get that normal rhythm back!

    I am happy to say I'm definitely not paying for it today! So far, pain wise, it's more a general discomfort instead of a true pain today. No pain meds, either. I did my morning walk, practicing a deliberate heel to toe walk, with an average step distance. This normal gait is something I haven't done for months (actually well over a year), as the hip got worse.

    Granted I'm not out of the woods yet, but so far I can only say I wish I found this potential solution much earlier.

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  18. Dan_in_AK

    Dan_in_AK new member
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    Debru,

    I'm north of Fairbanks, and off-grid, off the Elliott Hwy a couple miles. It's mostly dry right now, but given my location, theres not much ground that's flat and level.
    I can't walk in the "house" because I live in a 16'x20' cabin, so there's never more than two steps before furniture, dogs, or the wall!


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