THR dysplasia<

[Kiwi71]

Hello all

Well I'm actually 4.5 weeks post op from a THR in my right hip. I go back for a THR in my left hip in exactly 3 weeks time. I'm 45 years old and I have hip dysplasia in both hips.

So a bit of background - I didn't even know I had a hip problem until I was 31 (after my first child) and I wasn't even diagnosed properly until I was around 36 via x-ray - then it was like oh wow you have severe dysplasia and will need both hips replaced. Well for probably the last 7 years I have lived with severe pain - lots of drugs and cortisone injections trying to delay the inevitable. For anyone reading this now considering an operation DON'T delay. I was so restricted for a number of years - what I couldn't do with my kids, that looking back I should have made this decision a long time ago. The decision was taken from me really as 3 months ago the cortisone stopped working along with any pain relief as I was bone on bone from wear of the joint.

So now like I said I'm 4.5 weeks post op from my first hip replacement (right hip). It's been up and down - I felt so good after 2 weeks post op that I ridiculously started walking on one crutch and took myself off all pain relief... of course this was a disaster resulting in pain in my new joint and total bed rest for a week - also I'm back on panadol and ibuprofen 4 hourly. (No other drugs though!) I think I expected to much from myself - it's a major operation and everyone heals differently - as well as having a one hip replaced I need to learn to walk 'properly' after waking screwed up for 45 years due to my dysplasia. So I'm on two crutches until my second hip is done in 3 weeks and then I'll make sure I'm on 2 crutches for 8 weeks after that. Don't judge your recovery time line by others - we are all different.

Sleeping has been a challenge. Being a total side sleeper to try and sleep on my back has been a nightmare... but I decided again to help myself and take a small sleeping pill at night. Our bodies need to sleep to repair - I can now at least sleep 6 hours before waking , a huge improvement

I still have pain in the hip that was done and in fact intermittent pain all down that leg. This is my muscles and ligaments realigning I know. I just make sure I get on my stationary bike 2 or 3 times a day for 15 mins to keep things moving and do a few physio exercises.

It's going to be a long recovery for me I know - I cried buckets at 2-3 weeks with my self inflicted set back (don't overdo it!) But it will be worth it in the end - just to be able to walk around the block with my dogs or along the beach with my kids - things I haven't done for years.

Anyway my advice is patience To anyone out there with hip pain I know exactly what you suffer through. Don't wait to long to do something about it much love xxxx

 

[Clipper]

@Kiwi71 - Welcome to bonesmart. I too waited several years until I could hardly walk before THR's. The first hip was so bad the OS had to cut the femoral head off while still in the pelvic socket (Yikes!). The experts on here will tell you the longer you wait for replacement, the weaker you are post-op and the longer it takes for recovery.

I should think you need a follow-up appointment with your OS to x-ray and discuss your progress. I had follow-up appointments at 2 and 8 weeks. I still have pain sometimes in my left buttocks 11 months post-op. It happens sometimes when walking but eventually stops. Getting your 2nd hip done at 7 1/2 weeks is pretty brave. Best of luck!

 

[Jaycey]

@Kiwi71 Welcome to BoneSmart and well done on that new hip. Yes, the slow and steady approach to recovery works every time. Trouble is this recovery is not a "straight line". There are many up and down days. What seems impossible one day is easy the next. Just keep trying!

I'll leave you with some reading to do. The articles are short but may clarify some of the aspects of this journey.
First are the BoneSmart mantras ....
- rest, elevate, ice and take your pain meds by the clock
- if it hurts, don't do it and don't allow anyone - especially a therapist (PT) - to do it to you
- if your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again
- if you won't die if it's not done, don't do it
- never stand when you can sit, never sit when you can lie down, never stay awake when you can go to sleep!
- be active as much as you need to be but not more than is necessary, meaning so much that you end up being in pain, exhausted or desperate to sit down or lie down!

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
Activity progression for THRs
Home physio (PT)
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?

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 that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.

 

[Kiwi71]

@ clipper - yes i had an x-ray done at 3 weeks when I over did it and was in pain. All ok - plus the OS examined me. I have another x-ray sceduled for the 6 week mark also. Yup I know 7 abd a half weeks isn't long in between - I asked for both at the same time but he wouldnt do it - so I took the next best option. My thinking is they are both as bad as each other so if I don't want to lurch / limp and continue on pain meds I had to get both done in quick succession. Thanks for you advice !

 

[Horseshoe]

@Kiwi71 congrats on the new hip(s). I had my two thr's months apart and the second one was much better with being able to recover with one good hip. Agree it's best not to wait, the limping and pain wears you down.

Believe most of us have had an episode of overdoing it here and there and paid the price for it but hey, it's exciting to walk again

 

[Kiwi71]

Thanks horseshoe - yip looking forward to that second op now. 3 more weeks for this first one to heal up a lot more - I am projecting myself 6 months down the track when I'm going to Europe for a holiday - at least hopefully by then I'll be mostly healed and able to take in the sights ? Just a bit worried about the ache in my hip after 4 and a half weeks but the x-ray was all good.. so patience is required.

 

[Jaycey]

@Kiwi71 4.5 weeks is still early days. Yes, patience is prescribed! Ice and elevate as much as you can.

If you give me the exact dates of your surgeries I can pop them into your signature for you.

 

[Josephine]

I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?

 

[Kiwi71]

My exact date for surgery was 13th February 17 - right hip. And yes Josephine I can answer any questions - more than happy to do so

 

[Josephine]

I'd like to ask you some questions if you don't mind, and it would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are

1. what approach did you have for your surgery? Anterior, posterior, lateral? You can look here to see the various types THR approaches or incisions

2. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine)

3. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

4. are you icing your painful area at all? If so, how often and for how long?

5. are you elevating your leg. If so how often and for how long?

6. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

7. are you doing any exercises at home? If so what and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)

Exercises done at home
- how many sessions you do each day
- enter exercise by name then number of repetitions of each
etc., etc.

Anything done at PT
- how many times a week
- enter exercise by name then number of repetitions of each
etc., etc.

 

[Kiwi71]

Thanks.

1. Anterolateral approach

2. At rest pain level 2 - walking on two crutches 2 - without crutches 4

3. Pain meds

500mg x 2 panadol 4 hourly 4 times a day.
200mg x 2 ibuprofen 4 hourly 4 times a day.
15mg × 1 of codine - once before bed
125mcg x 1 of triazolam - once before bed.

4. I stopped icing 2 weeks ago.

5. Does lying on the couch count as elevation? I definately don't put it up on pillows - stopped that 2 weeks ago.

6. Activity level is very low. I get myself basic meals - my family cook and do the houswork for me - I mostly rest. No walks outside etc.

7. I go on my stationary bike 3 times a day with no resistance for 15 mins. I do physio exercises after my bike. 10 sets of leg ups, leg to the side and leg behind.

I went to physio and they said I didn't need to come back unless I wanted to use the pool as was biking at home etc.
Thanks! Operation date for right hip was 13-2-17 and I'm sceduled for the left on 6-4-17.

 

[Josephine]

benzodiazepines

I do physio exercises after my bike. 10 sets of leg ups, leg to the side and leg behind.

Can you define these in the manner I requested which was like this?

- how many sessions you do each day
- enter exercise by name then number of repetitions of each

 

[Kiwi71]

Ok twice a day I do the following sets.

Leg up / knee up bent in front of me x 10

Leg extended straight out to the side and held extended for 5 seconds. X 10

Leg extended directly backwards behind me (straight leg) x 10

 

[Josephine]

Thanks! Sorry for being such a pedant!

2. At rest pain level 2 - walking on two crutches 2 - without crutches 4

Okay

500mg x 2 Panadol 4 hourly 4 times a day.
200mg x 2 ibuprofen 4 hourly 4 times a day.
15mg × 1 of codeine - once before bed
125mcg x 1 of triazolam - once before bed.

Interesting you are prescribed triazolam as it's been banned in the UK.
Panadol is just paracetamol which is a bit mild for a 5 weeks out and 15mg codeine is also a very small dose and practically useless being taken only once a day.
Ibuprofen is also far too mild a medication to be of any real help.

Here in the UK we normally prescribe 30-60mg codeine with 1,000mg paracetamol 4 times a day.
I suggest you have a chat with your GP/surgeon, whoever sees to your aftercare, and see if you can't get a prescription that's more effective.

4. I stopped icing 2 weeks ago.

Why? Was it not helping to manage your pain?

5. Does lying on the couch count as elevation? I definitely don't put it up on pillows - stopped that 2 weeks ago.

Not really. You need to still be elevating it properly. It helps with pain management.

6. Activity level is very low. I get myself basic meals - my family cook and do the housework for me - I mostly rest. No walks outside etc.

Good stuff!

I go on my stationary bike 3 times a day with no resistance for 15 mins
Leg up / knee up bent in front of me x 10
Leg extended straight out to the side and held extended for 5 seconds. X 10
Leg extended directly backwards behind me (straight leg) x 10

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. So stop these exercises!

 

[Kiwi71]

Thank you for your reply - it is much appreciated. I will cut out the exercises and just stick to the bike 2 times a day. My next operation is in 2 weeks time so I'll just rest. Thanks for all your tips!!

 

[KsKid]

@Kiwi71, welcome! I was diagnosed with bilateral hip dysplasia April 2016 after 5+ years of hip/thigh pain. Long story! I changed OS in November as the original surgeon told me to wait until I was 65-70 for hip replacement. I had my RTHR same day as you.

I like you had hopes that I would be further along in my recovery (i.e. Pain free) by week 5. I still have some aches and pains in the operated hip and am struggling with pain in my left hip, knee, SI joint and lower back. Not near the pain I had before thank goodness!

I have found it helps the pain in my right hip when I walk. I think just the movement gives me some relief. However, if I overdo, it is a different story!

I have my 6 week follow up appointment next Tuesday and will start my transition to work after that. I work at a hospital so I see my coworkers when I go in for PT. some of them see me moving around so much better than before and think I should be ready to come back to work. I think it is hard for people to understand that long periods of sitting actually can become very painful and that it works best for me when I can vary my position

I am glad to meet you! I am excited for you to be on the other side with your surgeries. I think our biggest problem is patience with the healing process!

 

[Kiwi71]

Wow so great to hear from you I can relate so well to all you have written. Yes people don't understand or even comprehend the pain and are very quick to think that after your surgery you are 'better'. It's not that they are uncaring - just we live in a rush rush world and if your standing and smiling you must be ok

Both you and I know better - it's a slow recovery and we have to let our bodies heal at their own pace. I have accepted now that my recovery will be longer than the usual hip replacement. We both have to 'learn' how to walk properly after all of our lives walking incorrectly with dysplastic hips. My next surgery on the left hip is 2 weeks away - at that stage I will be 7½ weeks post op on my right. I am not going back to work until 8 weeks after my second operation.... although I do a couple of hours computer work remotely from home at the moment. Yes! I can totally relate to the sitting for to long thing...ouch!

I'm still on two crutches - not so much for pain but to keep my alignment correct while the hip heals.

So how old are you if you don't mind me asking ? And when are you having your next hip done? I am so excited for you that you decided on an operation, a really good decision - I'm 45 ( diagnosed at 37) !) And I expect to get 20 years out of my new hips - and then who knows what medical science has moved on to?. After being pretty sorry for myself at 2-3 weeks I am now projecting myself 3-6 months on the future - no pain or pills ... now that will be amazing and worth it

All the best my new friend and don't do to much! (Hard I know!)

 

[Josephine]

I have accepted now that my recovery will be longer than the usual hip replacement.

Actually it won't be. Your recovery will be pretty standard.

And I expect to get 20 years out of my new hips

That's a pretty poor estimate! At your age you could confidently expect this one to last your lifetime or at least 40-50 years.

You should read these
Hips that have lasted 32, 40, 41 and 45 years
67½ year old - the THRs, not the patient!

 

[Kiwi71]

This really encouraging, Josephine. Thanks so much for the articles - it's great to read positive stuff. Thank you!

 

[Josephine]

You're most welcome. Glad they gave you a lift!