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[REVISION THR] Dislocation following revision

melquist

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I have never posted to a thread or anything like this before, but this website is the first place I have been able to find any help. I had an anterior THR in 2/2015. It never went right. That implant failed due to a loose rod. After two years of trying to get to a revisionist specialist, I finally did. He only does revisions and has probably done 1,000 of them. I had a posterior THR revision on August 6th of this year. It was at exactly 7 weeks this past Monday, 9/23 when I had a full anterior dislocation. Under sedation, they reduced it that same day. I have never known pain like that, and as you would expect am terrified now that it will happen again. Prior to this, I was doing fantastic. I was walking 30 minutes every other day with some light terrain height changes, PT exercises, no pain, no limp, just 100% success. It didn't dislocate easily. I have been good about my precautions, but I can only think I got a little sloppy. I was on my back, on my bed, doing an adductor stretch or moving into or out of the position. I did have my upper body elevated a little with pillows to monitor what I was doing. I remember leaning forward a little, but I had done this before, so I didn't think twice about it when I heard the pop out of the blue. Initially there was no pain and I was able to straighten my leg out. About five minutes later, I couldn't move my leg, and the pain continually mounted. I realized I was in trouble and fortunately had a phone next to me. Ambo trip to ER and heavy meds, sedation, they did a closed reduction. My surgeon feels that the soft tissue from the original failed anterior hip replacement was the problem. He now wants me to follow anterior hip replacement precautions, and I will see him in one week to discuss what is next. I just feel like I need a place to come and voice my intense fear of it happening again and not knowing if I have to just give up on my lifestyle of gardening permanently. I became skilled at gardening working around a failed THR for the past 5 years, but this is different now. I just want to know what I am up against going forward. I seem to have emerged from the doomsday mentality and want to be proactive about this going forward. For now, I am being excessively cautious, and just holding on. Thank you so much for being here and a place to find support. I am 62 and the original surgery was due to severe osteoarthritis that was resulting in the hip starting to fuse. I had the first surgery when I was 57.
 
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@melquist you came to the best place ever for support. Your story sounds so similar to mine. I completely relate to your concerns and anxiety. My hip has become stronger with some PT and time. I do not think it will dislocate again, but I am very concerned and careful. It is very scary to experience pain like that, it was unbelievable. I also feel this was a HUGE setback for me. I do not have a sense yet as to how long the recovery will now take.
Come vent anytime, we are all here to support one another. I wish I could meet everyone in person one day!
 
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melquist

melquist

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Onestepatatime: I admit, I started crying when I got your response. I have an incredibly supportive husband who has been there for me through every minute of this past 5 years, but to be able to "hear a voice in the wilderness" from someone who has lived and is living through this gives me hope. Wow, when I look at your surgery dates, we have been through similar paths. It gives me hope too that as you progress, you have not dislocated again. I live in the countryside in a place of my dreams, retired, and an avid gardener. I landscaped all around our home, extensively by myself, and my husband did much of the hardscape. This hip stuff sadly has made our beautiful gardens a burden. I'm thinking my gardening days may be over, and I can't wrap my head around that. We want to age here on our land that we have been on for 20 years. I know I should just take this a day at a time, so I will do that. Again, thank you for reaching out and to all of those who have posted on this website. It is a gift!
Right anterior THR 2/2015
Right posterior Hip Revision (rod and cup liner) August 6, 2019
Anterior Dislocation 9/23/19
 

Jamie

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@melquist.....this is your official recovery thread. Please continue to let us know how you're doing with posts here. If at any time you would prefer a different thread title, just post what you'd like and we'll get it changed for you.

You are part of the BoneSmart family now, so no worries, okay? We'll be here to help and support you in whatever way you need. :console2:
 

Layla

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Welcome!
Thanks for joining us here. What a long journey you've had. I'm sorry for the pain you've suffered and all you've been through, my heart goes out to you. You've come to the right place for support and I see you've already found a common bond with (Onestepatatime) you're not alone here and you'll find others who've journeyed through revisions and are back living life. You'll get there also, so emerging from the doomsday mentality as you described it is a good thing. An added bonus is the support you receive from your husband but reading soothing words from someone on the same path (Onestepatatime) is comforting and I'm sure gives you hope.
Stop by anytime, we'll be here and we care. :console2:
@melquist
 
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melquist

melquist

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Thank you Jamie. I will post my doctor visit results after seeing him on 10/3.

Anyone reading this thread, I am looking for input. I am having a plumbing company come to give me a quote on a taller toilet. I am having problems with the plastic ones that fit over the toilet. I am 5'7" tall with my lower leg being long. I will always be in a hazardous position if I don't do something more permanent. The problem is I am still going to need armrests to get up. Up until the dislocation I was starting to get enough leg strength to be able to get up without rocking forward. Now there is pain, weakness, and fear. Anyone have recommendations for the armrests part. I've looked at quite a few on Amazon, and the reviews are all over the place. Thank you!
 
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melquist

melquist

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Thank you Layla for your warm welcome. I know I am in the right place, finally.
 

gertie

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@melquist I remember looking at frames for the toilet on Amazon and also noting how mixed the reviews were. Do you have a medical equipment store near you? They might carry something that you could look at, check the sturdiness, etc.
 

Layla

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You're welcome and I know you'll like it here!
I can't offer any advice on the arm rests but I'm sure others will come along.
I can tell you at just a smidge under your height, we have the comfort height toilets in our home that you've mentioned and thankfully I didn't even need a toilet riser after my surgery. The extra 2-4 inches makes a big difference in my opinion. As an aging adult I haven't regretted making that choice when purchasing plumbing fixtures.
@melquist
 

gertie

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thankfully I didn't even need a toilet riser after my surgery.
I'm a bit taller at 5'9" and am very glad I have a sink/countertop next to my comfort height toilet--no way could I get up without something to push up on.
 

Eman85

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Sorry to hear of your problems. As far as a toilet goes I couldn't use the plastic donut deal and mine had handles to lift yourself with. Instead I found a bedside commode which is an adjustable frame with arms and a toilet seat It has a container under the seat which can be removed and you place it over the toilet. It can be adjusted for any height and has a regular seat. It's what they use in the hospitals over the toilets so you can lift yourself up. There are plenty of these on Craigslist,Marketplace and at goodwill stores.
Not sure what stretch you were doing. I know at 6-8 weeks the only stretch I did beyond the basic restrictions was to reach my foot.
 

KathyB

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@melquist Hi, sorry to hear about your revision dislocation. I agree with @Eman85 regarding the bedside commode. I had one of these to use over our regular toilet during recovery. It is height adjustable and has arms to use while rising and lowering and is sturdy. I am over 5' 7" and continue to use a removable seat riser (I no longer need arms to use the toilet) which is much easier on aging hips and knees. Best of luck to you in your recovery.
 

Layla

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:hi: Happy Friday to you!
I hope things are feeling brighter today. We're here if you need us.
Sending wishes for a peaceful weekend :SUNsmile: :flwrysmile:
@melquist
 
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@melquist I just wanted to stop by and see how you are doing.You are my "recovery twin". I completely get how you feel down about the thought of not doing gardening again. I had a complete meltdown today, feeling overwhelmed I will not get better, and get a new job and back to work. I think we just need to stay positive. Yes, it is easier said than done, to take one day at a time. My pain issue is more my back than my hip now.
Please let us know how you are doing, and keep posting!
 

CricketHip

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Hi @melquist :welome: and I am so happy you found @Onestepatatime. I don't have anything to add, but wanted to join in on welcoming you too Bonesmart. By now hopefully, you are reading through some of the great articles on here that can be so helpful. In fact, even though you've been through a THR recovery, I'd like to leave you some specific Hip Recovery Tips. We all can use the reminders, I know I needed to refresh my memory a few times when having my second THR.
Of course some of it may not pertain to your situation, so just pick through what you need.

Happy Reading! Hopefully it will help. It will at least keep you busy for a while during one of your elevating and icing sessions.


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 discomfort:
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
BoneSmart philosophy for sensible post op therapy
5. At week 4 and after you should follow this
Activity progression for THRs
6. Access to these pages on the website
Oral And Intravenous Pain Medications
Wound Closure

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.
 
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melquist

melquist

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Thank you everyone for all your wonderful input. I ended up having a taller toilet put in today and a safety bar to help get up. Our toilet was old and needing replacing, so this was a good route for us. It is working out well so far, but I know I can put the armrest removable commode one back on this one if I find I still want even more lift. I think I am just in that fear mode that waves in and out, since it has only been 4 days since my dislocation.

Some of you asked which stretch it was that I was doing, when I dislocated.
It was an adductor stretch, but laying on the bed I think I lost focus and moved my upper body forward maybe resulting in breaking the ninety degree rule. I still am not sure, and I find myself trying to think about it too much. It is all a blur. It happened so fast, and there was zero warning.
My surgeon thinks that the front of my joint capsule is the issue due to the original failed anterior THR. It did dislocate anteriorly, so it would make sense, and I had horrible problems with that first THR for 4.5 years.

The thing I seem to be obsessing on the most today is will the pseudo hip capsule or scarring that takes place around the joint be stretched out or torn and not able to hold my joint in going forward. I will ask that when I see the surgeon on Thursday.

I also told myself that if I follow the precautions and it still dislocates again, then it has got to be fixed and nothing I am going to do will stop it. I admit that I am so tired of all of this. Years of hip pain, a failed surgery and the results of that for years, the hope of this one, then this let down of dislocation.

I know I will get through it, and I know I need a support group like you all to keep me sane. Thank you everyone. I am going to try and get some sleep. The surgeon wants me to not lay flat for now, so I am doing the best I can with pillows laying on my back like Mrs. Zombie here.
Good Night everyone...I appreciate you all so much!
 
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melquist

melquist

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Good morning everyone. I did a site search for dealing with the heel pressure in bed. I did see info. about massaging my heels with cream. I don't see how you can do that with my current restrictions. I did see the slip on cushioned bootie pads for being in the bed on amazon, but has anyone tried them? When you get up out of the bed to go to the bathroom are they slippery? I tried manipulating my pillow under my knee to my ankle etc. but I woke up feeling that my femur felt unstable. I panicked and quickly adjusted. It is still probably just my fear of dislocating again. My heel is hurting like the dickens though. Maybe I am not looking in the right place on our site here for anything I can buy to get the pressure off my heels. I would like to find something that doesn't require my husband having to wake up during the night to put them on me or remove them to prevent slipping enroute to the bathroom. Thanks everyone.
 

Pumpkln

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You can try sleeping with your heels off the bottom of the bed. A convoluted mattress pad may reduce pressure. You could also look at medical grade fleece.
I think gel heel protectors would be fine as long as you use a walker or other assistive device while learning if they are stable enough for you.
I have asked Amazon if gel heel protectors are safe for walking.
 

helenium

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Hello @melquist.
I’ve just spent 4 weeks in hospital on my back. My heels started to feel very sore.
The nurses applied a thin layer of barrier cream to my heels. Each application was supposed to last a couple of days. Could your husband do that for you?
Then they rested my lower legs on a very thin pillow. The hospital pillows were exceedingly flat, but ideal for this! The pillow was just above my heels so that the sore heels escaped the pressure of the pillow and the bed. The pillow ended before reaching the backs of my knees to avoid any pressure there. The part of the pillow that my calves were resting on was squashed fairly flat, sometimes squishing out at the sides. Did the job perfectly.
I managed to manipulate the pillow with my grabber to get it just right.
Hope this makes sense!
Best wishes for your recovery.
 

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