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THR Dorothy's 2nd hip recovery, June 22, 2012

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Don't worry, I learned the importance of resting when my body tells me to after my first hip replacement when I pushed on despite feeling tired and found myself so fatigued that I could barely speak coherently!! I called the surgeon's office and the nurse was really worried about me and told me to go the the ER or a walk-in to get checked out. Turned out to be nothing more than pushing too much and becoming absolutely exhausted. It took me a week to get back to semi-normal. So ... this time, I vowed to rest when needed. I'm amazed at how much energy hip replacements zap from me. I had an abdominal hysterectomy a year prior to the first hip and it barely fazed me. The hip surgeries??? Yikes!!!! Rest or it will MAKE me rest by knocking me on my butt!!!

I'm doing OK. I'm at that in between point where I am not really needing a walker ... but needing more than a cane for most of my walking. I can walk around my house with just a cane, but I walked out to see my horses using my trekking poles and that was too much too soon. You would have thought I was climbing Mt Everest!! It was difficult from a "move the hip/leg" stand point and also it took SO much energy to do it. I'm having to make myself be patient--have to use the walker a little longer for my walking outside of my home. The little kid in me says "But, I don't want to!!!" (whine, whine ...) ha ha!

There is just a little residual swelling and I only had one little spot of bruising at the end of my incision that is long gone now. This incision (compared to the last) is a little more tender to the touch and getting itchy. It looks fine and is slowly disappearing.

My pain is definitely getting better. I still take oxycodone, but the doses are spreading further and further apart and tied more to my activity. If it weren't for the pain in my back and the sciatica that goes along with it, I really don't think I would have any resting hip pain at all. The muscles still complain when I walk--they are definitely still weak and rebuilding. I remember this being frightening last hip--I kept thinking that my hip and leg muscles were never going to be able to rebuild and strengthen--but they did ... and they will do the same this time too. It just all takes time and diligence with doing my exercises and walking.

I've pretty much given up on getting any more home care PT--I received a letter from my insurance company yesterday that gives authorization for the very same number of visits (2) and the very same time period as the first letter I received shortly after hospital discharge! They are either incompetent, or they are telling me for certain that they are only approving 2 visits total, which I've already had. I could call and fuss about it ... but I'm far enough along and I've been through this before with the other hip, so I'll just take over from here and get through the rest of it on my own. I didn't go for outpatient PT last hip and it did fine. Unless I run into problems, I don't see any point in doing so this time either. It is a balancing act, though, to do what I need to do for the hip without stirring up trouble with the back problem. I'm going to ask my surgeon how soon it's safe to receive an epidural steroid injection into my back again. That has worked well in the past--when they injected the correct level--last time in April, they injected the wrong level in error and it didn't do a thing. This time I will double check and not be so trusting.

Just a lazy summer day here in upstate NY. The days have been so warm and sunny--feels like such a gift. But, I know we need the rain--lawns are drying up and my hay farmer's hay fields need to grow again so he can harvest the 2nd cutting of hay that my horses will eat this winter. So, I do hope we get some nice soaking rains soon. And, then after that it can be sunny and gorgeous again for a long time! :-)

Dorothy
 
Hey there, Dorothy,

It sounds like things are going so well for you and that you know how to listen to your body (using the walker for getting to the horses, when finding the treking poles did not work for you.) Your experience wiht the first hip certainly supports you on correct choices.

You are right about the muscles needing to build up again. It is good to know it is possible, but it doesn't happen overnight.

Pity about the insurance. It sounds from your thread that you probably have a handle on the PT needed for your hip, but with the extra issue of the sciatica and back, it would be nice to get some support for that.

Hope you all get some rains soon!

Warmest,
Elle
 
Don't know how I lost track of you, but after the upgrade i swear I seemed to have lost a few people. Just read your thread to catch up and am Glad to hear you are doing so well with Your 2nd hip. I know it must be hard to restrain yourself and not do too much, but sounds like you are holding back and taking care, which is good.

All that talk about the Chinese buffet earlier in your thread had me missing Syracuse. I love that chinese place. We'd go there for lunch sometimes. I actually worked in Widewaters pkwy in back of Marshalls. ...and the doc that did my rotator cuff a few yrs back and the one that did my meniscus tear are both in the SOS Widewaters practice. Actually 2 friends from syr are coming for a visit next weekend.

I can sympathize on the back issues. Sometimes it is my back that causes more problems in my recovery than my hip. Sorry about the sciatica. Dang, that can be a killer and Soo interrupt sleep. Is it making your sleep difficult? , I hope not, because rest is so key. Hope things continue smoothly for you, and hope ou get your back issues under control Cathy
 
Cathy, you are just going to have to come back down for lunch with Diane and me! Isn't it a small world that you remember that restaurant???? I LOVE that place. I found it while going to my many dr appointments at the Widewaters Parkway SOS office. I also see the NY Spine and Wellness for my back, located in the same building. My hip surgeon is at SOS Widewaters (Dr. Clarke). I only started going there less than a year ago, but I've made SO many trips there between the hips and the spine. It takes me about and hour and a half from my house. I think my car knows the way on auto pilot! I took a wrong turn coming out of the SOS parking lot one time and drove further up Widewaters Parkway--Wow! A bunch of nice office buildings up there. They must employ a ton of people just in that area alone.

Alicia and Elle--I don't know if I have everything under control. I still do some things I shouldn't ... although I don't know it until afterwards and I'm either too tired or the hip is a little sorer. I will say, though, that having gone through the first hip is a big help now. I don't get as freaked out over little things that happen with this process. I don't get worried if I'm a little more sore one day ... I know it will sort itself out and get better as long as I don't keep aggravating it. It's all a process and I have learned that there is no "right way" or "only way" to do it ... and that the *hip* is in charge of the process. It calls the shots.

We had some heavy rain yesterday afternoon. It came down fast and furiously and I hope it sunk into the ground so it can do some good. Today is pretty humid but tolerable. Upstate NY really has gorgeous summers. It's our reward for the snowy, cold winters. It's a gorgeous day again!!

Everyone have a great day!!

Dorothy
 
You sound great. And you are SO right... the hip is in control, isn't it?

I've thought.... if I have to do my left.... how much more knowledeable I will be, but it will probably be a totally different experience!

Take care, dear Dorothy!
 
Hello Dorothy,

You sound so good! That is great that you know your hip is calling the shots. You are right that sometimes we don't know if we have exceeded the limits until afterwards. It is a constant balance, as we all want to make sure we are getting enough movement in, too. It takes a lot of listening to the body. Nice that your "freak out" quotient is considerably less with the second hip.

Glad you got some rains and are enjoying your summer...ah, such a magic time!

Keep up!
Elle
 
I had a bit of a scare today. Yesterday I woke up with a bad sore throat. At first I chalked it up to just sleeping with a fan on me (has been pretty warm here). The throat was still pretty sore today, so I called my primary physician. She had a cancellation in the morning. I zoomed through a quick shower and drove myself to the office (this is the first time I've driven that far--about 20 miles one way). I did fine with the drive--just a little extra soreness from having the foot on the gas pedal for so long. She did a strep test, which was negative. She also said my throat doesn't look too bad, just a little red in one area. She suspects it's allergy related.

My big concern was that I had an infection like strep, and with the surgery being so recent ... I was scared that any infection might spread to the hip. That was scary for me and a relief to find out I didn't have strep.

While I was out I also filled the gas tank, bought Chinese food take out (love it!!), and stopped at the post office. Because I hadn't had a chance to get out to do the horse chores before I left for the doctor, I went out to care for them after arriving home. Then I came inside and feasted on my Chinese food--Moo Shu Pork! Now I'm resting and taking it easy.

I'm sore and a bit tired, but all in all I think I did OK! It feels good to know that I CAN do regular things, even if it is a bit difficult at this time (I recently transitioned to a cane and I walk at a snail's pace to be sure I don't limp).

Dorothy
 
It's always such a relief when our fears turn out to be groundless. It sounds like you actually ended up having a great day. :)

Sharon
 
Yes, I had to push myself a little more than I was comfortable doing--that 20 mile drive to the Dr was the longest I've driven yet ... and then I had to drive back home. I figured worse came to worse, I would find a good place to recline my seat and rest my leg for a while if needed, but I didn't need to.

I've found with both of these hip surgeries that people in general are so kind when they see me with my cane (and looking like I definitely need it at this stage of recovery!). They open doors, insist that I go ahead of them in line, and things like that all the time. It's nice to know people still care about one another.

One thing I've noticed about this hip recovery is that I'm not as afraid of tripping/falling or having people bang into me in a store or other more crowded area. I remember being SO afraid of that last time.

I feel like I've made a lot of progress in just the past 24 hours. The hip and leg feel noticably stronger and I'm using my cane all the time, except for night time bathroom runs--I prefer to use my walker when navigating my dark house littered with 2 dogs and assorted cats, lol. Also, I can be pretty stiff when I first get up so it's nice to have the extra support of the walker. Funny how the hip heals and improves a lot for a bit ... and then it doesn't seem like much is happening for a while ... then another "healing spurt" happens, etc etc. It's an odd thing. I find myself not second guessing things and worrying about things as much as last time. I have faith that things will keep improving and I don't worry about it.

The nurse at the GP office was rather surprised when she saw me walking--I think I'm doing fine, but I walk very slowly with my cane--not like a normal person. She knows I have horses and plan to start riding as soon as I can. She said "Are you sure you are going to get strong and mobile enough to be able to ride????" I assured her that this is just a temporary "hobble phase" and I've been through the same thing before--things really do strengthen up just fine. I just takes a while. I guess she hasn't seen many people this soon after a hip replacement. I think I'm pretty normal.

I feel less fatigued and stronger today than I have since surgery. I hope this means I'm entering the next phase of recovery--one where I'm not as fatigued every day and feel like doing more things. My mental outlook is even sharper and "tougher" too--I talked with Mike today and told him that I feel like being kind of bitchy (hope it's OK to write that word, but I couldn't think of a better term to describe how I'm feeling), "I'm not going to take anyone's ****" today. My mood is fine ... I just feel "tough" and "get out of my way". This is so funny for me because I'm not a "tough" type of person at all. I guess I'm starting to feel like The Bionic Woman,and nobody better mess with me!!!!???? ha ha!! It's interesting all the stages of recovery and the emotions that go along with it.

It's supposed to be cooler for a few days, which will be a welcome change here in upstate NY. We aren't used to prolonged periods of heat, so we all fizzle out quickly. It's cooled down a lot in just the past couple of hours and my house is quite pleasant. Should be a good night to sleep and I don't think I'll need the fan on me, which should help my throat. That might be what got the sore throat started. My dog Lucy is having a hard time with the heat. She is very restless--seems like all the fun things she likes to do--run and yell at the horses and the neighbors' dogs along the fenceline aren't happening much because the horses have been hiding in their stalls with the fans blowing on them and the neighbors' dogs haven't been venturing out back as far either. Maybe tomorrow will have more activity going on so she can boss everyone around and feel more useful again. I hope so because she is driving me a little nuts with her restlessness. Crazy dog, but I love her :-)

Dorothy
 
Oh, Dorothy, these are such a wonderful posts! What started out scary with the throat, turned into such good things and so much action! That is amazing your drove so far!! The stop at the Chinese restaurant was a good reward!
Wow, that is exciting about the cane! Congradulations!! I know how you wanted to be rid of the walker. You know, I am just one week further on that you (didn't realize that till now for some reason) and like you, I keep the walker by the bed for night time security. It just feel safer in the dark and when one is a bit stiff.
I agree with you about the progress "spurts'. Nothing; than wow!
Beautiful that people are kind when they see you with your cane. That kindness just feels so good, doesn't it? That melts my heart everytime, too.
Interesting about your "power"personality. Well, you have been through a lot and that has made you realize how brave you really are, how strong. I can just see you riding! Beautiful!!
Well, maybe Lucy is the only one who is not impressed with all of this!
Keep up! YAY!
Hugs,
Elle
 
Elle, what you say about Lucy is so funny! When I first came home, I must have looked and acted as if I'd been through a war ... she was kind of sullen acting and worried "Mommy is dying--I just know it!!" She was on her best behavior. Then after the first few days, my post op fog lifted a bit and she changed back to "OK mom--what are we going to do now! I guess you are going to live, so now it's all about Lucy again!" And, you are right--she is not impressed with my improvements. I still move way too slow for her and don't do anything fun. ha ha! She's such an intense dog--she will never be happy until we can get out and *go*. My other dog, Heidi, is more easy going and goes with the flow better than Lucy. Lucy is the little Queen tyrant who rules the household with an iron paw. I have to remind Lucy that even though things aren't as perfect as she would like them right now, she is pretty lucky--she has a large fenced yard, neighbor dogs to boss along the fence, horses to bark at and boss--(there is a theme here ... she is bossy!!), and a mom who is home with her everyday for a while longer and caters to her more than most dogs ever experience. And, yet I still fall short ... poor Lucy. :-)

Dorothy
 
Dorothy,
I feel so warm when I read your posts about your relationship with your animals and their antics. Lucy is so precious and she must be an amazing worker with the horses. I am so glad you have each other and also Heidi for balance. What an amazing life you must have in the country with so much nature around you and the company of dear animals!

If it makes you feel any better, my cat is not impressed with my achievements either. I am way too slow at getting the fish in his bowl for his standards! (And sadly he lets me know without mincing any meows!)

Warmest,
Elle
 
Hey Dorothy.... wow. A little anxiety for you, huh? I am so glad it wasn't an infection. And, you've given me something new to worry about... could an infection like strep spread to our surgical area?

It sounds like it all happened for a reason to me. It got you out... 20 miles, that is something... and the apprehension of driving again, I remember that well. And, the reward (love Asian/Chinese, as well, but the sodium.... sheesh, I swell up immediately!).

Animals: I remember my poor Harry (pictured left) who I had to put down in April and my existing Walter would both stare at me unbelievably pre-surgery when I would try to get up from a sitting position (it was THE worst); I would have to wait for whatever was left bone/cartiladge-wise of the joint to match up to the socket.... sometimes it took up to 8 minutes. Absolutely incredible, the pain! And their little faces looking up at me like: Come on! What's holding you up! God bless our animals!

Have a terrific night. I'm putting stuff on Ebay to bring some money in and then going back to watch my favorite man - Benedict Cumberbatch from the Sherlock series... SO clever!

Hugs,

Alicia
 
Alicia, again I'm so sorry about your beloved Harry. It's so hard to lose our pet family members.

I don't think we need to go crazy about fear of infection, but it is important to treat any infections promptly. The joint can get infected under some circumstances--bacteria likes to settle into prosthetic joints. I need to double check with my surgeon about more specifics when I see him in August and I'll trust what he tells me and go with his recommendation. But, I figure better safe than sorry. BTW, my throat feels a lot better today. Must have been allergy related and is passing it's way through.

Good news on the PT front. My home PT made a visit today, gratis because she never got approval for any further visits form my insurance company. Very kind of her to do this. I made her some jewelry as a gift and she seemed to like it, so I it was nice to be able to do something for her for all the trouble she went through dealing with my insurance company. She watched me walk outside on the sidewalk with my cane and said my gait is really good until my leg gets a little tired and then I start to lean to the "good hip" side--gotta watch that and either slow down or take a little break. I've also made a lot of progress with my exercises and proudly showed her my solid straight leg raise and my "almost there" side lying leg raise--the primary two post op exercises my surgeon wants his patients to work on during the first 6 weeks. She thought things were going great and she could discharge me. I'm just going to keep doing what I'm doing and continue my rehab on my own, without outpatient PT, as I did last time. I really have progressed a lot in just the past two days--this recovery really IS strange--In just those two days I went from doing barely one inch of a side lying leg raise to doing one that is almost full and going from a hobble with my cane to a pretty solid gait with it. Odd but I won't question it. I'm just happy about the progress.

Alicia, you are right about the longer drive to the GP's office giving me more confidence. I feel SO much more confident when I drive now. I went to the post office and the bank today --about a 10 mile round trip and it felt like a drive around the block. I look a little strange getting and out of the Jeep because I recline the seat back and lean back so far so I don't break the 90 degree rule ... but I get the job done and then I am ready to roll!

Cooler here in upstate NY today. Much more pleasant. We are supposed to have some much needed rain starting a little later. The yards are getting brown, so some rain will be a welcome sight. After that, though, I want some more sunny days for the rest of my time off work. :-)

Hope everyone had a great day today.

Dorothy
 
Thanks for the "Harry Condolences".... it's SO hard to not have him.... he was my man regardless of my current crush on Benedict Cumberbatch; Harry really loved me and was a lovely dog. Sheesh, some things in life are SO hard...I think his loss was harder than my THR!

I am proud of YOU!

Have a great night.
 
Dorothy,

Looking forward to our August lunch date. I changed emails and unfortunately when I did I lost yours and now I'm not sure how to navigate the forum to find yours. My new one is on here "some place" under some part of my profile (I don't even know where) so if you know how to access it will you please email me? then I will have yours again. Thanks so much. So glad to hear things are going so well for you. And yes, isn't the nice break from the heat awesome...almost feels like fall!
 
Hey there Dorothy,

Wow, it sound like you just made a big leap in improvement, especially how in two days you went from barely one inch side raise to a full side raise! (I just got some very useful information from you that the side raise and the leg lift are the two exercises your OS wants his patients to do. I will up repetitions of these in my own PT routine if he thinks they are "the" ones.) You also seem to be doing great in your driving-wow!

That was so kind of your PT to come see you non gratis. I am sure she was touched with your gift. (Wow, you make jewlery, cool! Do Heidi and Lucy have "special" collars?) It feels good when someone can confirm that, indeed, we are not limping.

Ok, Dorothy, looks like you may be up Lucy's expectations and standards quite quickly!

Warmest,
Elle
 
Elle, You seem like the type of person who has a whole bunch of good old common sense and you already know more than most about the body, but I do want to caution you about adopting my exercise routine as your own. Most surgeons are very particular about certain things during recovery because they know what they did in there and may have their own way of doing the surgery. Mine is a "posterior approach," but I think surgeons kind of tweak the approach to their preferences and, therefore, when they say "do this" or "don't do that" specifically, it may be due to their particular surgical style or procedure. That's one of the reasons why we find each other having such a wide range of post op instructions.

There are other surgeons in the same ortho practice who don't want their patients to do side leg lifts until a few weeks post op ... yet mine says to start working on them pretty much right away. My surgeon is also very strict about adhering to the hip restrictions for 6 weeks ... although many surgeons are starting to relax those somewhat with the large diameter femoral heads many of us are getting now. So, do be careful with adding exercises without your surgeon's blessing. Just concerned for you and don't want you to do something that may set you back rather than move you forward. You've been doing SO well!! :-)

I decided to phone my medical insurance company yesterday to discuss the lack of home physical therapy visit approval/authorization. I was very nice and held my tongue even when I wanted to scream--"you Idiot!!" at her. :-) First, I got this song and dance about my PT not submitting the documentation needed to get further visits. I told the rep what she told me she submitted and that seemed quite sufficient. Then, it was "our rep tried phoning her and she never called back", to which I countered with what I remembered the PT telling me about her conversations with the one human she was finally able to reach one time. Finally, the rep admitted "Oh yes, I do see a conversation noted in your file." But, she continued to hold her ground that she was sure the reason for the problem lied with my PT, not with them "she just needs to give us the information we need and I'm sure the additional visits will be approved." Then, I told her that I questioned what she ws telling me because it didn't make sense to me that my PT would make visits without charging me for them if it were as easy as the rep was making it sound ... why would someone choose to not be paid for their time if the process were this easy???? She didn't know what to say about that, but said that she will ask their PT person to phone my PT again to discuss my case further and see if they can work it out so she gets paid for the last 2 visits.

I was thankful for that, but I wanted more. Hey, I've got a lot of time on my hands these days--time to work on changing the world! I told her that I thought the policy of approving only 2 home care PT visits after a total hip replacement ... and then requiring the home PT to submit more paperwork and proof of need was an inefficient way to do things. Most total hip patients need more than 2 home PT visits--two of their insurance reps had already told me this. So, why not just approve, say, 4 visits directly from the hospital when the discharge planner first phones in the case??? This way, the insurance company is avoiding having to re-review the case after that magical second visit when the home PT inevitably requests more visits ... and the PT isn't having to use his/her time to submit more documentation. I used 3 home PT visits the first hip (I went to inpatient rehab for a few days, so I was a little further ahead when the home PT started working with me); 4 visits with the second hip, and then I was declared to be doing well enough to continue on my own, or was able to go to outpatient PT if I chose to do so. If they had just approved 4 from the get-go, just think how much simpler the whole process would be?????

Well you would have thought I had asked for Mt Everest to be relocated. She said "we can't do that--it's company policy to approve only 2 visits after hospital discharge." I asked if I could speak with a person who might be in charge of establishing and managing these policies to give my input and ideas ... to which she responded ... "there is no one at the company who does that. No one establishes the policies--these are just company policies." I honestly think she was confused with my request and wasn't just trying to get rid of me. How stupid is that? OF COURSE a human being within the company works with establishing policies and procedures. Do these policies just fall from the sky?????

Well, it was clear that now *I*was wasting my time ... so I chose to just give up. But, really--I just shake my head ... no wonder our health care and medical insurance system is having problems. There is way too much paperwork and time wasting going on that doesn't need to be that way.

Dorothy
 
Hi Dorothy,

You are doing fantastic -- I knew once you took that little ride in the jeep with the girls that the "horse was out of the barn" as they say. There's no stopping you now :)

Good times calling the insurance company!! It is amazing the things that we are told in order for our benefits to be withheld in spite of all the monies we pay in premiums for coverage...

I have found that sometimes particular aspects of coverage are chosen by the employer when they enroll to participate in an insurance plan. It may be helpful in getting that number of home-based PT appointments after surgery changed by going to the HR person at your employer and speaking to someone there about it; possibly with a detailed letter reinforcing what the true benefits and cost savings of the change would be from your own direct experiences (with 2 hips).

Hope you are having a good weekend and enjoying cooler temps.,
Cardie
 
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