THR Diary of my journey to happy times

[Going4fun]

As someone who is four months out ... I feel like I'm now reading guidelines on hip recovery far more closely than I did before surgery ... Those guiidelines that say at X months, the patient should be able to return to "normal activity." ... uhh ... Exactly what is normal activity?

For me normal activity includes exercise ... well I've twice now had to back off from exercising at the gym after overdoing it ... Return to "normal activity" implies ... no worry about the hip ... But actually people continue to have twinges, and tightness and random sore spots ... for a year or beyond ... I think patients considering surgery read those guidelines with naivete and hope ... "normal" means I will have recovered and don't have to think about the hip. Actually it's not clear what "normal" means ... and at 3 months, it's quite normal, it seems to be icing still and taking pain meds still.

A lot of the high-activity exercise folks whose recovery accounts I've read ... say it takes them about 15 months or even 18 months to return to their "normal" activity. And now, with some experience, I am thinking ... oh ... I bet they still occasionally get twinges and soreness ...

 

[Klassy]

I’ve just clicked the “Contact Us” button on NHS website and sent them this message. I’ll let you know what if any response I get.
“I am interested in your Hip Replacement Recovery web page. Please provide the reference for the studies from which you drew the conclusion “Generally, you should be able to stop using your crutches within four to six weeks and feel more or less normal after three months, by which time you should be able to perform all your normal activities.” “

 

[Layla]

Interesting, Klassy. Let us know what you hear. Wondering if / when you'll get a response.
I hope you're having a good day so far. We're freezing and blustery here. Coffee is almost down and it's about time to get some things done around here.
Enjoy the rest of the day!
@Klassy

 

[Klassy]

Day 45, and all’s well. Unappealing weather so I did my walking indoors to music. I used both crutches and concentrated on going as fast as I could, did manage to get slightly out of breath so a bit of an aerobic workout.

Stood on the operated leg for 30 seconds, big improvement on yesterday’s 10 seconds.

As I was getting ready for bed I noticed my trusty water bottle was only 1/3 full. I thought about topping it up, then thought it was probably enough if I got thirsty in the night, and if not I’d just get up and go to the kitchen to refill. I had a sudden flashback to Day 10 or so when I first started carrying my own water bottle, in a bag slung round my neck, and the days before that when my husband would check I always had 2 full bottles at my bedside. Those early days seem so far away, and I realise how far my recovery has come.

 

[Layla]

Yay, progress!
When looking back you do realize how far you've come.
I hope you have a nice weekend, Klassy.
@Klassy

 

[Klassy]

Day 46, and my 6 week follow up with surgeon. The first thing he said as I walked in with my crutches was, “You aren’t actually using those crutches”. I said I know, but I like them for security, he said fine.

I was a bit disappointed in the consultation to be honest. He didn’t examine my hip or scar at all, or ask me about pain or meds or how far I could walk or anything, just asked me if I had any questions. And I’d specially worn my best knickers!

He answered my questions as follows:

Should I stop aspirin? Yes, as my medical history shows that I am at low risk of blood clots.

Can I stop precautions, eg bend to tie shoelaces etc? Yes with caution. Move only to the painfree limit, which will gradually increase. That sounds good to me, I’m not wanting to push through pain, but now I don’t have to worry when I realise I’ve just done something that involved bending.

Ok to swim? Yes.

Ok to drive? He paused then said, Yes, legally. I was a bit surprised by his hesitation and thought of going into that more, ie explaining we have an automatic car etc, but decided to leave it. I don’t want or need to drive at the moment, but now I can whenever I feel ready.

What prosthesis do I have? He probably told me this pre op, but I didn’t want to know too much then. Now I’m curious. It’s a Depuy Corail/Pinnacle. Uncemented. I’ve googled it and it looks very elegant.

May I take a photo of my X-rays? No. I was surprised, as I’ve seen them posted on here, which is how I got the idea of taking a picture on my phone. Apparently the hospital forbids it, and they own the X-ray ( like copyright I suppose), so if he let me and I posted it on social media he would get in trouble.

I still have some lumpiness round area of incision, why? He didn’t check or ask me how much lumpiness (for the record, it’s about as much as if someone smashed up a small apricot and pushed the pieces under my skin, pip and all). He said “of course, that’s the normal healing process, you only notice it because you are skinny”. Naturally, as a plump woman, I was flattered, but demurred that I was hardly skinny. ( My BMI is about 24). He said, “Believe me, you should see my other patients, you are definitely skinny.”

Given that the other hip could be seen in the X-ray, did he have a view how long it would last before it also needs replacement? No, impossible to say. Just eat well and exercise and hope for the best.

How is my progress compared to his other patients? He said “It’s not a race, don’t worry about it, you’ll end up in the same place as a person who is ahead of you at this point. This isn’t a hip for 6 months, it’s a hip for life.” All very true of course, but I pushed him, do his patients generally walk in for their 6 week follow up without aids? Well yes, he conceded, but if I wanted to be cautious that was fine, he would much prefer that to a patient who was overconfident and did themselves an injury. I guess I should be happy with that, but I do still feel a bit pathetic.

My final question was, did he have anything to ask me? No, he said, if a patient came in smiling, he knew all was well. I guess that’s a fair answer. He knows what he is doing, he knows it works. He told me at the pre op consultation that hip replacements were routine for him, he has done thousands and indeed had 7 scheduled for the next day. And I liked that. I hardly wanted a surgeon who was excitedly looking forward to his first go at cutting up a real live human. So I can’t complain that he wasn’t particularly excited by my recovery, it’s just what he expected, a success.

I’m now discharged, but can call for an appointment if I have pain that doesn’t get better quickly, or any concern.

 

[Hippielife]

One last question not involving skivvies...ie; bloomers....how much weight can be safely lifted ? You can lift as much weight as you can comfortably tolerate. Once tissues have healed, lifting, climbing ladders or stairs, getting up on roofs, and related activities are safe. Avoid these things for about three months after surgery, until you are sure that your bone has healed into the implants.

 

[Bone-obo]

It’s a Depuy Corail/Pinnacle. Uncemented. I’ve googled it and it looks very elegant.

Oh, it is. All the kewl kidz are getting one.

Note the sculpted racing stripes, the elegant lines, and the splash of purple that brings it all together. Every time I think of this gorgeous thing in my hip I think this wasn't a replacement, this was an upgrade!

(Further note: the purple only comes with the ceramic lining - the polyethylene lining is gray which is a total buzzkill and something I shall never mention again.)

And congrats not only for a drama-free report, but for being called out for your sylph-like stature!

 

[Klassy]

....getting up on roofs, and related activities are safe..

I can assure you Hippielife, roofs are definitely safe from me!

 

[Klassy]

Every time I think of this gorgeous thing in my hip I think this wasn't a replacement, this was an upgrade!

Oh yes, love that!

 

[HertsHippy]

My BMI is about 24

- My aim is to get by BMI down to 24 (where it was before my hip got really bad) - that would make me slim but not skinny.

he has done thousands and indeed had 7 scheduled for the next day

- sounds scary - each op takes and 75 to 90 minutes with some being longer. Add in breaks and turnover time and that makes a very long day - I don't think I would want to be his seventh patient!!

My 6 week appointment was incredibly quick but the surgeon did do a comprehensive check of the movement of my hip in all directions and checked my walking. It does feel like a conveyor belt at times but although the costs may seem high (my hospital charges from £15k) it is good value for the work involved.

I am also a bit worried about my other hip - I have cam FAI (a bone spur which limits RoM) but no other damage - to minimise risk of damage I need to keep the leg strong but avoid high impact sports etc - so no running and a shame that I cannot join my wife on her next half marathon.

 

[HertsHippy]

Stood on the operated leg for 30 seconds, big improvement on yesterday’s 10 seconds.

- that's impressive (I assume you didn't hold on to anything!!) - I couldn't do that at 6 weeks but I had dispended with my stick and walking a moderate way - I am sure you will be rid of the crutches very soon.

When you can balance well on one leg the next goal is the one legged squat - I cannot do that yet except when in the pool and even then the muscles really feel it.

 

[Klassy]

Hi @HertsHippy . Yes 7 ops in a day is a lot. Perhaps I have misremembered, or misunderstood- perhaps he was seeing 7 patients that day for pre op. I was done early in the day, so possibly lucky there!

Yes that was 30 seconds not holding on, though I had both hands hovering a millimetre above the kitchen counter. No risk taking here! I’m pleased you consider it impressive, I was impressed myself!

My physio actually was trying to get me to do one legged squats at week 5. Ridiculous. I’m beginning to suspect she has her book of exercises, she has given me pages 1 and 2, I could be wheeled in in a wheelchair and we’d still be moving on to page 3. At my next appointment I’m going to be firm. I’ll say I didn’t do the previous exercises as I felt they were too advanced for where I was at. Please don’t give me another set of exercises. Please look at my gait, look at my ROM, then advise. We’ll see! I make these plans, but I tend to be diffident when it comes to it.

 

[Mojo333]

I think it was a Bone-obo who said he would often distract the PT with a particular concern..gait, etc to pull them off their checklist of what they think you need to be doing.
I don't know where you are from..but it is surprising to me that you can't have a copy of your xrays..even if it cost a small fee.
My OS printed me off copies and I framed them (shoddily) so as I recovered..I would be reminded of the new hardware and not overdo.

My incisions had a lot of bumpiness in places..but it all smoothed out pretty well as the months went on!

Hope you have a good weekend, @Klassy

 

[Carriemay60]

Your comment about wearing your best knickers gave me a good giggle!
I always wear yoga pants to my surgeon appointments because a couple of times he has asked to watch me walk and once he had a Doctor of PT do a full assessment of me. So last time he asked to see my hip. I stood up and picked my shirt up to the waist. He kind of laughed and said "are you ok with me actually seeing your skin"? As it turned out he was looking at the previous scar

At my next appointment I’m going to be firm. I’ll say I didn’t do the previous exercises as I felt they were too advanced for where I was at. Please don’t give me another set of exercises.

Actually, now that the surgeon has discharged you no one will be tracking to ensure you even go so if you think walking is enough, just do that. If you do decide to go, certainly be firm. You can call the shots now! Try to remember this is a service YOU are paying for and you can ask for what you want.

 

[Bone-obo]

I’m beginning to suspect she has her book of exercises, she has given me pages 1 and 2, I could be wheeled in in a wheelchair and we’d still be moving on to page 3.

Yes - that. Crazy frustrating, and you're absolutely right to put your foot down (gently, so as not to agitate the bits contained therein). @Mojo333 was right about distracting your PT from their prescribed routine - I got good mileage out of making my own goals and co-opting the PT into helping me achieve them.

Please look at my gait, look at my ROM, then advise.

That's exactly what I did. See if it helps, and let us know!

 

[Layla]

Happy Saturday, Klassy!
It sounds like you had a good visit with your surgeon overall.
I resorted to being a flasher when it came to my incision / scar. Without warning I pulled up my skirt, yanked up my panties on the side and asked "Does this look okay?" No inhibitions, I wanted reassurance as long as I was there. I figured he saw a lot more than that when he was slicing my flesh. I'll bet yours assumed if there was an issue, you'd inquire.

Like you, I was a little surprised to read that your OS didn't ask you about meds, or watch you walk. I'm wondering if you don't specifically ask about something, like how you're walking, or med schedules, the surgeon figures you must not have any questions, issues, or need prescription refills. Sounds like yours uses facial expression to gauge progress. Smile = content with progress.

I don't understand the inability to have a copy of your x-ray. I wasn't aware it was like that in the UK. I'd consider digging deeper in that regard. I went to the website of my Ortho office and found I could download a form to sign and either mail, or drop off in person to obtain the notes from every office visit involving my hip from initial consultation through post op visits. Surgery notes and x-rays also. It was easy peasy but that must not be the case in the U.K. I'm glad you at least snapped a pic off the office computer.

Obviously your surgeon is satisfied with your progress or I'm sure he wouldn't have released you. It sounds like you're recovery is going well. Slow and easy. You're doing it. Have a nice weekend, Klassy
@Klassy

 

[HertsHippy]

@Klassy - I had my Hips x-rayed when I was treated by BUPA three years ago. Without asking they gave me a disc with the x-rays in case it might be helpful for any other specialist in the future. I think they also sent the x-rays to my GP. Mind you I am not sure I really want a picture of my insides. Apparently some people ask for the old bone and even use it as a cane handle - weird. So I don’t think it is a UK issue.

Your physio sounds a bit harsh - mine is very thoughtful and has a good look at my motion and strength before choosing exercises. And she warns me not to overdo it.

 

[Layla]

I am not sure I really want a picture of my insides. Apparently some people ask for the old bone and even use it as a cane handle - weird.

Cane handle?!!
It's like re-cycling. It wasn't supporting them any longer while "inside" but they found a way to have it support them "outside". Strikes me as funny, lol.

 

[Klassy]

Thanks for the comments!

I hadn’t thought about asking for the X-rays, but I have just sent an email to the private hospital asking if I can have copies. It makes sense because I hope to go via NHS if next hip needs doing, or if private will probably be in another part of the country and therefore a different company. Besides, now @Mojo333 has put the idea in my head, I rather fancy a framed pic on the wall. Though with only one hip done, it won’t be as impressive as Mojo’s.

@HertsHippy , before my op a friend told me, jokingly, to ask for the bone. So when I saw the surgeon on his quick visit to see me on the day of surgery ( got to give him credit for that, he may have done 7 ops but made the time to come in and tell me it had gone very well) I asked him if my old hipbone was lying around and could I have it. He took me seriously and was very apologetic that it would already have been thrown away.

I did read somewhere that the offcuts are harvested for a central bone bank for bone grafts. I would have been delighted if my spare part could have helped someone else. But since I didn’t sign any permission form I guess that doesn’t happen any more.

Day 47. We drove to the coastal walk and walked for 45 minutes, covering a little bit further than last visit. Although the thermometer claimed it was 9 C, (48F), the wind chill factor and lack of sun made it decidedly bracing. I like to think I was benefiting from the sea air, but given the westerly wind it was probably London’s smog. It felt healthy all the same. We saw a stonechat ( small bird identified with help of H’s phone), always a pleasure to see something different. We found a new cafe for lunch, I had a savoury crepe, tasty. Then we took another walk, not too far as I could feel the left thigh tiring. It’s a bit extravagant to be lunching out most days, but it gets us out of the house and walking, and I walk further with the break in the middle. I was glad of my crutches, not just to help with balance, but every time we approached a boisterous dog and the owner saw my crutches, they put the dog on the leash. I’m touched by the thoughtfulness of strangers.

We drove a scenic route home. I was pleased to find 50 minutes in the car wasn’t uncomfortable, as I want to build up to long distance journeys.

On the way home we stopped at the supermarket. Until now H has gone out to shop by himself, or I have waited in a safe corner while he trolleyed round. This time I went with him, so I could exert a little control. H is a perfectly competent shopper, more efficient than me, but he has a tendency to get carried away, and then it is a battle of racing the use-by dates and cramming stuff in our miniature freezer. Our next house will have a big kitchen with a big American style fridge/freezer! The crutches were an asset once again, because there are some manic trolley drivers out there.

I feel pleased to have walked a considerable distance today. Even my phone, which on some days has been reluctant to acknowledge that I had moved at all, is willing to admit to 3800 steps. Now resting and icing, feeling good.