Depression/post-op blues - open for all

[Jaycey]

@Hopefulhopalong indeed post op blues are real! We all experienced this to some degree. For me it was the tears of total frustration at not being able to do the simplest task. And getting outdoors in the sun (sometimes a challenge depending on time of year in the UK) was a great stress reliever.

Hope you are having a brighter day today!

 

[dapplega]

@Hopefulhopalong - I come back to this forum occasionally specifically to check this thread and hopefully help others. My RTHR at age 52 was my first surgery and at about week 6, even though I was having a great physical recovery, I knew something was wrong mentally. Having to accept the need for surgery and that we aren't as invincible as imagined was a shock to my ego . I think it is important going in to be in as healthy a spot mentally as possible. If there are other things going on in your life they only get magnified during recovery (IMO). I had another surgery since then and it went well physically AND mentally. Likely because I knew what to expect AND I had become more accepting of my situation and alternatives. The best and first step is to acknowledge you are having difficulty and reach out to trusted people in your life. Looks like you are well on your way and I'm sure positive days lay ahead.

 

[Dolby]

Thank you all for sharing your thoughts. My emotions are lower than I hoped would be and I think
so many things going on in hospital, the pt accidentally banged into the bottom of my operated leg
while I was sitting on the chair, second day after surgery, and they swooped me up as I was about to pass out from the pain. This is a smart guy but his back was toward me, I don't know.. Anyhow, X-ray taken, no damage done, was frightened damage was done but thru X-ray they said all ok. More happened later on, hospital life and don't want to ramble on but my heart is being monitored now for rhythm, hopefully all ok, said often can be episodic with rapid beat, lasted short time then reverted, but I never had any of this and I was in a really good hospital
And then visiting services are hard to navigate. Most were good but one was too fast, competent, but didn't really care, cared more about her schedule, so I find now I feel angry, a little lost. In spite of husband trying to be supportive and some friends. I can't focus on bills, what needs to be done.
Three and half weeks home, doctor said all well, but I find myself sad. Hope. this feeling lifts soon.

 

[Jaycey]

I can't focus on bills, what needs to be done.

This is very common post op. Many of our members try and return to normal activity levels too quickly and report that they just can't concentrate. And post op blues are just a part of this recovery.

The good news is this will all fade with time. Still very early days for you!

 

[CatchAll]

I'm just going to leave this here to get it off of my chest. There are probably other people who feel the same.

I started to get depressed after my first meeting with a surgeon about my hips. I was 40 years old and this guy walks in, takes a quick look at my xrays, and says "I'll be replacing that right hip soon and the left one eventually. Deal with it until you can't take the pain. I'm usually scheduling about six months out, so take that into account. have a nice day." Meeting over. It's like it didn't even occur to the guy that he was delivering news that my life will never be like I expected. Up until I was 38 I was doing crossfit up to four days per week, and sometimes twice per day. I was lifting weight and running. If I was in a hurry in the morning I would do sprints. Sprint 50 yards, walk 50, sprint, walk, and repeat.

I ground it out for almost 5 years until I couldn't do anything and my cartilage was gone. Walking 100 yards was all I could do. I did some research and found one of the best hip replacement surgeons in the area. I asked him about resurfacing because I read that it was an option for younger people who wanted to be more active and he told me that it was a bad idea because of a risk of metallosis. So I had him do a total replacement. His advice was that I can walk, hike, cycle, or swim, but no running for exercise or sports; it would be ok to run from a bear though. My recovery from the surgery was easy, but I wasn't mentally better. I want to go back to crossfit or go for a run. I've come to realize that my mental wellness and clarity was always tied to physical activity. I now lack focus and motivation. I recently had my primary care doc prescribe an antidepressant. Maybe it made things a little better.

I have a young son and a while ago he challenged me to a race across the yard. I took him up on it, but ran half speed and the whole time thought that I'm risking the longevity of my hip replacement. My new hip felt ok and left hip was killing me, but it felt good to be moving faster than a walk. I probably won't do that again. I know a guy who had a staph infection in his hip about 10 years ago when he was in his early 30s and had a total replacement at that time. He was kind of a fitness nut at the time. They moved away and I hadn't talked to him for about 9 years. I found his number and gave him a call the other day to see how his hip was treating him. He says that he is happy that he can walk without pain, but he doesn't really exercise anymore. His boys are a few years older than mine. I mentioned the race with my son and he said that his kids would never ask him to race... they know that dad doesn't run.

Just recently I found out that a nearby surgeon has been doing hip resurfacing for 30 years and is a pioneer in the field. Some local guys in their 50s or younger have had him do their hips. I spoke with one of them and he doesn't have any restrictions on what activities he can do. He has a friend that had both hips resurfaced 20 years ago and has not had a problem and does whatever he wants. I have now done more search and found out that very few surgeons do the resurfacing because it is a more complicated procedure and there is very little room for error in order to get long lasting results. It is way easier for them to bang out 5 or 6 total replacements in a day. The risk of metallosis is actually quite small and some of the modern resurfacing acetabular cups are using a poly liner so the metallosis issue isn't a problem. The 20 year data on new resurfacing is really good. Why didn't my surgeon encourage me to talk with the resurfacing specialist whose office was only 10 miles from my surgeon's office instead of talking me out of it? Maybe I would have concluded that it was the right surgery for me.

I should be happy that I can walk, hike, and lift weights but I miss the intensity of crossfit, rugby, football, running and sprinting. I probably didn't have too many years of that stuff left, but it is hard to get over it. I know that I need to focus on the bright side; my hip doesn't hurt and I can do a lot of my old activities. It's hard for me and the way I'm wired to just get over it, but I will sooner or later.

 

[Jaycey]

@CatchAll Sorry you are still struggling with the decision to have THR. Yes there are many who recover very well from resurfacing and go on to active living. There are also many who go from resurfacing to THR.

Has your surgeon specifically restricted you from the sports activities that you want to pursue? We have many members who have returned to the sports activities they did pre-op (or pre-pain).

Are there other more intense exercises that you can do that won't cause impact? Can you find a personal trainer who has experience in getting post THR patients back to an active lifestyle?

Just a suggestion - I would focus on what you might be able to do versus the decision you made about surgery. There is life after THR. It might be slightly different. But I am certain you can find the balance you need.

 

[Schaargi]

@CatchAll

I'm with you. I had my first hip replacement at 56 and was pretty active (not CrossFit active, but still). I was horrified that I would need a replacement, but my personal trainer was very positive about it (he is a CrossFit guy himself). He had had many clients come through it well.

So I met with the surgeon, who assured me that I would be back to my life after the surgery. (Although, thinking back, he really had no idea what my life looked like.) Coming out the other side, and after another surgery, I find out that, no, I won't be able to do a lot of the activities that I have been doing all my life, and, yes, it's tied to my mental health.

Those activities bring me joy. Racing around an ice rink as fast as I can go, with the cold air whipping in my face. Having my dog pull me on my rollerblades. Walking an unruly, 60 pound dog that could knock me off my feet if I wasn't braced. Running my dog through a dog agility course with sharp turns and obstacles. Scrambling up a rocky mountain hill.

And yoga. That one makes me cry. I'm doing chair yoga (!) now. It helps a bit, but will never be as satisfying as my old practice was. Part of it is the confidence of trying new things that, for example, might make you fall over. While I don't like falling or wrenching my leg, I never before had such fear that I wouldn't even try a new pose.

I didn't know how much I relied on those things until I realized they might not be in my reach. I'm still holding out some hope. (Don't tell my surgeon.) If you talk in terms of stages of grief, I guess I'm still in the denial stage.

So I see you. I get it. I'm with you.

Yes, I'm very grateful that the pain is gone. And am grateful that I can do a lot of things that I haven't been able to do for 2 years. Sincerely, very grateful. And super excited when I get to another milestone, like being able to drive and baking without pain.

But I'm not going to get stuck on "I should feel better about this." Gratefulness doesn't erase the loss that I am feeling. Gratefulness doesn't erase the constant fear I have that I am going to damage my implants.

I understand this fades with time, but I'm not there yet. I don't know how to reconcile it. It's a roller coaster of feelings, and a lot of grief and loss. I hope this doesn't make you feel worse. I hope it helps that others like me are feeling the same way as you are. You aren't alone.

Thank you for posting here. I'm glad to know I'm not alone.

 

[Debru4]

Great post @Schaargi . I think your post reflects what many people experience when they undergo a replacement surgery, but not everyone is able to express it so articulately. I've seen that any type of surgery that alters physical activity in a huge way is especially difficult, and those who were accustomed to more active lifestyles really do experience even more loss, and have huge challenges with recovery as they work back as close as they can get to their previous fitness level. I feel for them.

I am 3 1/2 years out of having my right hip replaced, and almost immediately I felt such incredible pain relief that that alone carried me through the initial months. Just doing daily life activities was almost all of the "rehab" I needed to return to many of the activities I had done before. But while always active, I've never been an extreme sports type of person, and so for me, at that point, being able to walk distances, garden, get down on the floor with my grandkids, etc. were wonderful. Within a few months I was able to hike in the Colorado mountains and resume almost all of my previous activities. I did not experience a life shattering loss, this time, and know I was lucky.

But based on everything I have seen with others, I know that with future surgeries, there are no guarantees that I will bounce back so well---as each surgery, and each person is so unique. I know that if I lost the ability to do things that were essential to my mental health, I too would go through this grieving process that you describe so well. We often only associate loss with death, but in reality, we encounter it in so many forms in our lives. When I retired from teaching, I felt a huge sense of loss, and labeling it that helped me give myself the permission and space to grieve. The same with the aging process in general.

One thing I can say with confidence, having had both back and hip replacement surgery, is that the likelihood of successful recovery and getting back to the things you love is increased if you listen to your body, and don't force things. It kind of is a slow and steady wins the race proposition, and for those of us who are used to a faster pace and being able to achieve goals simply by working harder, recovery is especially challenging. Letting go of some of that and just being may even produce some unexpected benefits in terms of being able to find additional interests and things to enjoy.

 

[Schaargi]

Hi @Debru4

Thanks for your post. I never thought I was an extreme sports person, either, so I was under the assumption that I would be able to get back to my moderate lifestyle and activities. It's hard when everyone says what a life changing surgery it is and how much they can do, where I keep stumbling into, "Oh, I said that you would be able to do ALMOST everything you used to, but not that. Or that. Or that." I never thought of myself as super active or anything, so it has hit me hard.

My first hip surgery went awry and I ended up retiring from my job as a teacher-librarian in a middle school because they simply couldn't accommodate my needs. I just couldn't keep fighting for my job, so I retired early.

My first hip is 1 1/2 years out and my second is 5 weeks out. I really am doing remarkably well, especially with my recent surgery. It's just hard when I think of something I might want to do in a year and my surgeon or PT tells me that it would not be a good idea. Just too many surprises that keep chipping away at my former expectations.

I really appreciate you acknowledging my feelings. It helps when we know we aren't alone!

 

[Debru4]

@Schaargi --I think doctors vary in terms of their follow up advice. Once you are through the first few months/year and know what you are/aren't dealing with in terms of recovery, you may want to seek out a second opinion/additional advice from another doctor.

My doctor encouraged a very natural return to daily life and never really told me things I should never do. I asked about whitewater rafting and hiking and he said to wait a year and then see how my hip and body felt. I felt ready for a few shorter hikes at elevation after one year, but decided that I didn't want to risk white water rafting, not as much out of fear for the replaced hip, but thinking more about my other hip and the fact that I have osteopenia.

At this time I've done a few more strenuous hikes, but use poles and make certain not to overdo, and to take breaks while hiking, and between hikes. Another person I know who had hip replacement surgery done by the same doctor does Pilates and long bike rides. But he was told the high impact of running wasn't a good idea. However, I've heard of other people here on the forum who do some running. So, I guess what I'm trying to say, is not to get discouraged, and to maybe do some additional research to learn more about the things you really love to do, and see if they are in the realm of possibility in the future.

I retired 6 years ago after 38 years of elementary teaching. I can only imagine how painful it must have been to retire under the circumstances you describe. You have been dealing with so many life changes and loss for a couple of years now, and must feel a huge sense of loss of control as well. Hang in there and know that others do understand!

 

[Debru4]

@CatchAll ---It sounds like you had a very bad initial experience with your surgeon and very likely that made an impact on your later thinking as well. Sometimes things like dealing with a doctor that doesn't listen or offer appropriate advice and support can really color future events. Also, it's impossible for any of us to know exactly how we will respond to an event that we've never experienced before.

The first 3-4 days after my surgery I was incredibly nauseous and out of my head from the pain meds, and all I could think about was what a mistake I'd made and how if I'd known I'd be so sick, I'd never have done it. Lucky for me, once I got the pain medication out of my system, I was able to reset and get out of that cycle of thinking. It seems that you are still processing so many things from the whole surgical experience and as you said, it may be take time for you to shift from focusing on the loss of the more strenuous activities you loved, to enjoyment of all the things you can do. There also may be some things you haven't done before that would be new and fun to get involved with.

 

[CatchAll]

@Debru4 You are right. The conversation I had with that first surgeon totally impacted my thinking and my approach to dealing with my hips. I was in denial that I would need a replacement for a long time, but also mildly depressed about it, so instead of researching all of my options I went fishing two or three days per week for a couple of years instead of working out. That certainly didn't slow the degeneration, but I got really good at catching fish and that is something I can definately do with fake hips. I suppose that if I had focused on staying fit, or even losing weight, I could have bought my hips a few years. I went the other direction instead. Needless to say, when I finally decided it was time for surgery I did not go back to that surgeon.

 

[Coddfish]

Hi @CatchAll

I am sorry you are missing the activities you love. I am quite a bit older (64) and have reached the decision that it’s more important to me to do the things I love than to protect the longevity of my new hip. Fortunately I had a surgeon who is a “weekend warrior” and understood these needs. I have just started running again. It will take me a while to rebuild confidence I think, but am fairly sure any problems I may have will be in my head, not my hip. Obviously I hope the hip will see me through, but if it doesn’t, I will have to live with the decisions I have taken.

 

[BrokenBeaker]

@CatchAll

I was in a similar situation. I'm 43 and had my left one done in October and had my right one done in December. I went to a surgeon about 12 years ago with pain and some problems. I was around 30 and it was rather daunting to face down a hip replacement surgery then. Hip resurfacing came up, but I wasn't a good candidate due to my circumstances.

I was relatively active; I did moderate amounts of yoga, running, working out, hiking. Not a hardcore gym guy, but a fair amount.

Over the years from that initial appointment, my ability to do things greatly diminished. I gained a fair amount of weight from not being able to be active. I had worries about not being able to do the things I used to do, but as the wife pointed rightfully out, I wasn't able to do those things anyhow.

I think there is a lot of mental and emotional baggage that comes with making the decision. It's a one-way trip and regardless of what anyone says, there will be changes to your lifestyle. Mileage may vary.

I'm still in recovery a bit two weeks out from my recent hip replacement. I don't have any regrets. I'm looking forward to be able to get some sort of exercise in. My surgeon said I can do just about whatever I want, but high impact activities just mean less time before needing the wear components replaced. I always hated running, it just kept me healthy, so going to start with an exercise bike. I enjoyed yoga, but the surgeon said I shouldn't try to put my leg behind my head. I think I can deal with that exception. So while I think I do need to consider some lifestyle changes, they aren't really likely to impact me in any measurable way.

 

[newguy]

Well I must say I feel different about my running now. I was a state champion back in NJ in the early 1970s . Ran fast 880 yards under 1:57, ran thousands of miles over 55 years . Ran because I could because it was me who I am . I was winning 5K races up into my mid 50s and ran a 1:29 half marathon at 55 years old . Fast forward to my arthritis diagnosis at 58 and my doc says hey when you can’t walk we will talk . Well I struggled for the past 7 years to getting on a bike and in the pool . Trying to run which became pitiful. To now 6 days PO to yes I am bummed about not being able to run much when healed . Surgeon is an athlete and said some interesting things . Probably smarter things than I have listened to by many others. I have decided that fitness can be done in many ways . I have been given a new lease on life . Heck I was having a hard time coaching my high school cross country team this past fall because I could NOT WALK!!! It is all about priorities . I have a brand new hip and I will not climb ladders to paint 40 foot walls ever again and running 4, 7 or 15 miles is not going to happen again either . I will be happy ))

 

[Jaycey]

@newguy Very early days out for you. Don't assume life will be limited by your THR. For most of us, life did change a bit. We found other ways to stay fit or remain active. Bottom line, THR is life changing. No more horrid hip pain to plan your life around.

I will not climb ladders to paint 40 foot walls ever again

Hmmm... I climb ladders frequently and I have 2 replaced hips. Yes, it's not something you will do just months out. But given time you will get back to it.

Running may not be in the cards. But what about power walking or nordic poles? There are plenty of ways to get that buzz from a workout. Just give that hip time to heal. Then start thinking outside the box.

 

[newguy]

Oh I understand. I think my years of running and being the athlete, the winning and getting older and then really not winning anymore was the thing that in my mind said hey I do not need to prove anything to anyone anymore. Going into the surgery physically healthy and emotionally better than I expected. I will say even at 65 years old and a man when the surgeon told me in recovery that everything went well I was crying. Yes I am ready for my next 35 + years on the planet being able to walk again.

 

[Layla]

Surgeon is an athlete and said some interesting things . Probably smarter things than I have listened to by many others. I have decided that fitness can be done in many ways . I have been given a new lease on life .

Love this! So true.

I will say even at 65 years old and a man when the surgeon told me in recovery that everything went well I was crying. Yes I am ready for my next 35 + years on the planet being able to walk again.

Love this too!

If I cried post op, I don’t recall, it would have been because I realized I was still alive and breathing. Never experiencing anesthesia or surgery, I was terrified. My crying took place quietly in bed the night before surgery when I thanked God for the 60 yrs he gave me with my natural hip and all the places and things I was able to do with that once healthy hip. It was my way of letting go…

You're doing great @newguy and you have a very healthy attitude. It’s refreshing. I’m happy for you.

 

[KitKat3]

Oh I understand. I think my years of running and being the athlete, the winning and getting older and then really not winning anymore was the thing that in my mind said hey I do not need to prove anything to anyone anymore. Going into the surgery physically healthy and emotionally better than I expected. I will say even at 65 years old and a man when the surgeon told me in recovery that everything went well I was crying. Yes I am ready for my next 35 + years on the planet being able to walk again.

It’s difficult when we realize that we may not run like we used to in the past. Several years ago I had to give up my running due to severe arthritis in both of my feet. Then earlier this year, it was determined that I needed a new hip since it was too painful to walk, etc. I am learning to accept my limitations and do other activities.

 

[PolarIce]

I'm just going to leave this here to get it off of my chest. There are probably other people who feel the same.

I started to get depressed after my first meeting with a surgeon about my hips. I was 40 years old and this guy walks in, takes a quick look at my xrays, and says "I'll be replacing that right hip soon and the left one eventually. Deal with it until you can't take the pain. I'm usually scheduling about six months out, so take that into account. have a nice day." Meeting over. It's like it didn't even occur to the guy that he was delivering news that my life will never be like I expected. Up until I was 38 I was doing crossfit up to four days per week, and sometimes twice per day. I was lifting weight and running. If I was in a hurry in the morning I would do sprints. Sprint 50 yards, walk 50, sprint, walk, and repeat.

I ground it out for almost 5 years until I couldn't do anything and my cartilage was gone. Walking 100 yards was all I could do. I did some research and found one of the best hip replacement surgeons in the area. I asked him about resurfacing because I read that it was an option for younger people who wanted to be more active and he told me that it was a bad idea because of a risk of metallosis. So I had him do a total replacement. His advice was that I can walk, hike, cycle, or swim, but no running for exercise or sports; it would be ok to run from a bear though. My recovery from the surgery was easy, but I wasn't mentally better. I want to go back to crossfit or go for a run. I've come to realize that my mental wellness and clarity was always tied to physical activity. I now lack focus and motivation. I recently had my primary care doc prescribe an antidepressant. Maybe it made things a little better.

I have a young son and a while ago he challenged me to a race across the yard. I took him up on it, but ran half speed and the whole time thought that I'm risking the longevity of my hip replacement. My new hip felt ok and left hip was killing me, but it felt good to be moving faster than a walk. I probably won't do that again. I know a guy who had a staph infection in his hip about 10 years ago when he was in his early 30s and had a total replacement at that time. He was kind of a fitness nut at the time. They moved away and I hadn't talked to him for about 9 years. I found his number and gave him a call the other day to see how his hip was treating him. He says that he is happy that he can walk without pain, but he doesn't really exercise anymore. His boys are a few years older than mine. I mentioned the race with my son and he said that his kids would never ask him to race... they know that dad doesn't run.

Just recently I found out that a nearby surgeon has been doing hip resurfacing for 30 years and is a pioneer in the field. Some local guys in their 50s or younger have had him do their hips. I spoke with one of them and he doesn't have any restrictions on what activities he can do. He has a friend that had both hips resurfaced 20 years ago and has not had a problem and does whatever he wants. I have now done more search and found out that very few surgeons do the resurfacing because it is a more complicated procedure and there is very little room for error in order to get long lasting results. It is way easier for them to bang out 5 or 6 total replacements in a day. The risk of metallosis is actually quite small and some of the modern resurfacing acetabular cups are using a poly liner so the metallosis issue isn't a problem. The 20 year data on new resurfacing is really good. Why didn't my surgeon encourage me to talk with the resurfacing specialist whose office was only 10 miles from my surgeon's office instead of talking me out of it? Maybe I would have concluded that it was the right surgery for me.

I should be happy that I can walk, hike, and lift weights but I miss the intensity of crossfit, rugby, football, running and sprinting. I probably didn't have too many years of that stuff left, but it is hard to get over it. I know that I need to focus on the bright side; my hip doesn't hurt and I can do a lot of my old activities. It's hard for me and the way I'm wired to just get over it, but I will sooner or later.

It is definitely a tough journey to go through, and I can relate to all your emotions and "what if's). I also went through asking about resurfacing vs THR questions with my surgeon and also heard that resurfacings are really not an ideal option for women of child baring age. As you previously mentioned there are also a lot more difficult to put in, and the risk of complications if they happen is not as forgiving in the BHR.
Having said all that, I think part of the journey is to learn to trust that hip again. I can see myself having issues with that when I get mine in a month. Up until about 4 months ago I was training and riding horses almost full time(show jumping, cross country eventing. I DEFINITELY intend on doing that again and know for a fact that it's not something that a THR will stop me from doing.

Asking yourself all those questions about the new joint "Should I be doing this??" "am i risking it's longevity if I do this?" is absolutely normal and don't feel alone when feeling awful or having regrets about your decision, it's something that all of us who are VERY active and athletes have asked ourselves. Take your time in your recovery and start trusting that amazing joint you now have, you will slowly learn you can trust yourself and your decisions. You've got this.