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Hip Infection Excellent recovery until it wasn't

919THR

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Hello fellow bonesmarties. I have been wearing out the search function of this site in my recovery so now it is time for me to finally post. The site has been a great resource of info in my recovery. I had a left anterior THR on 10/2/18 due to osteoarthritis. I'm a 46 year old male, 5'11" 245lbs pretty active up until a year before surgery when arthritis continued to slow me down.

So post surgery I was off work for two weeks with sick leave then worked from home for two weeks, desk job doing computer work. First four weeks of recovery went well. Stayed overnight at the hospital after surgery. Got around fine the day after surgery with a walker. Operated left leg muscles very sore after surgery. So much so that I couldn't really appreciate the lack of pain where I used to have it in my hip. I had in home PT for two weeks. Four very light excercises, two sets of 15 for each. Took naps every day first two weeks, lots of laying down and relaxing. A nurse in the hospital said I would feel about 3% better each day and that is about how I would describe my improvement. Each morning I had a little less soreness in muscles and I could support more weight. Within two weeks after surgery I was walking with no aids. I was walking about 15 minutes a day outside and by the end of my walks I would feel it a little bit. I would return home and take it easy. I had stopped taking narcotic pain meds during day probably around day 5, only taking them at night to sleep. By day 10 I was sleeping on my non operated side as I am side sleeper. 2 week follow up with my OS had an xray that showed everything looking good.

I started doing outpatient PT at 21 days after surgery. There I did some clamshell exercises, rear leg extensions. Some side to side stepping with elastic bands at my ankle. It did challenge myself from a strength point at the PT sessions, but they were relatively brief and I did not feel to bad the day after PT. I tried to purposely take a walks daily during week 4 after surgery to be sure I go exercise. I didn't desire to overdo it realizing it was going to be a while before I could do any "real" activity so I was in no rush.

Around day 23 or 24 after my surgery I took my longest walk probably 30 minutes and in hindsight I walked through pain for 10 minutes. At this point I was going up and down my stairs at home one leg at a time comfortably. Then on day 25 day after my surgery I thought I was moving around well enough that I could drive from Raleigh to Charlotte (two hour drive, I had driven alot around town sometimes for an hour at a time so sitting in a car was not new) to take my daughter to a 2 day lacrosse tournament. I knew I would have to walk some but not a lot more than the walks I had been taking and I was progressing so well I assumed I was up for it and did not feel I was pushing myself. I would get to sit down during games (albeit in those not so supportive nylon fold up chairs). No fast walking needed. I made it through the first day well I thought. But I do remember not sleeping well due to leg pain and not having my tempurpedic mattress from home. Day 2 of the lacrosse tournament I was definitely more sore. It started to hurt to bear weight on the operated leg and I was getting stiff sitting down so I would have to get up and walk. Made the two hour drive home in the car and by the end of the night day 26 I laid down in my bed, pain level at 8 that kept me up just laying there and required an oxycotin.

The next day Monday 10/29/18, 27 days after my surgery I needed to go back to the office for work. I woke up that morning and could barely bare weight on my leg and need to go back to using my cane. I would say I went from feeling 60% back mobility wise with very little pain prior to this weekends activity to 30% mobility with significant pain. So from day 28 on I had to start taking acetominophen 4,000mg a day from nothing before. Narcotic pain medicine at night to sleep. The frustrating thing is that it has been one week since my recovery set back and I have had no improvement since then. Each morning I wake up and have an inability to bear much weight on the leg and have to use my cane and some mornings my walker. I make it through my desk job and each time I stand up I have the stiffness and inability to bear weight. I can bear more weight as the leg warms up most times. I have pain all round my thigh randomly particularly at the top of my thigh. For the first few days after the pain started flaring up I tried to not use the cane in an effort to make my muscles work a little, but unlike the first 25 days of my recovery I saw no day to day improvement from making the muscles work and resorted to just always using the cane to see if complete rest and walking aid reliance would result in some diminishing pain.

So that has been my saga for the first 35 days/5 weeks of my recovery. 25 days of linear great recovery going from bed ridden to comfortably walking around; a two day weekend trip with a 2 hr road trip each day with only slightly more activity than I was doing prior; 8 days of inability to bear weight on operated leg without walking aids can random flare ups of 5-8 rated pain in top of thigh. That I have had no improvement in pain or my ability to walk comfortably since my recovery setback it has made me wonder if I had an infection or an implant issue. But I have been back to my OS and got blood work done that indicated no infections. I don't think its an implant issue because there are times that there is no pain while I'm being still and I can even walk for a short time with no pain. My guess is that sitting in the car for two hours straight, 50% more walking than I was used to, walking with some pain for while on day 2 of the tourney, and increased PT prior to the tourney created a flare up of all kinds of muscle pain that is taking me quite a while to recover from. I quit the PT and will stay away from it for now. I just keep icing and taking the acetominophen and look forward to the day when my recovery starts to show improvement again.

Matt
 

Mojo333

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:wave:@919THR and welcome to the forum, officially.
Sorry you are dealing with the aftermath of probably a little too much too soon.
It seems this recovery business can be a bit of a dance...and these are still very early days for you.
My guess is that sitting in the car for two hours straight, 50% more walking than I was used to, walking with some pain for while on day 2 of the tourney, and increased PT prior to the tourney created a flare up of all kinds of muscle pain that is taking me quite a while to recover from.
I'd guess your guess is probably right.
Sometimes we overdo in order to find our boundaries, but I'm also guessing your current plan...rest, ice, elevate will get you back on track!
Things will get better...patience is prescribed in large doses!

Hope all eases very soon!:yes:
 

skigirl

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I will give you the recovery articles we recommend to those with new hips. all of the articles are short and easy to read and I think some of them will have information you will want to have!! Welcome to Bone Smart.

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

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

skigirl

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Most of us have overdone it. I did it and like you was absolutely shocked by the amount of pain that I had! I could not believe it was from overdoing it. so, now that you are working, you are right, just go home and start resting, I would take the weekends off and rest. No lacrosse games, no going to the farmer's market with the kids---just rest. a week or two and you will begin to feel better, but your recovery is in the early stages and you need more rest than you think you do.
 

Going4fun

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Hi @919THR, sorry to hear of the prolonged pain ... Yeah, it seems you overdid things ... somewhere starting in week 3 ... I've overdone it at times ... But ... recently when I overdid it ... I felt it the next day ... so I immediately went to ice and back to using my cane more ...

Here's a way of thinking that has helped me ... might not help you ... but I'll share it. I can now walk better and longer without the cane for longer and longer ... But ... I don't want to extend the distance or intensity every day.

Instead, I think of reaching a new plateau of improvement---and holding there for a good week. So when I make one improvement, I'm trying to hold it there, celebrate it ... And then later I'll add something or extend the distance ... and hold at that! ...

Sounds like you did the zero to 60 in a short period of time ... and the pain unfortunately was delayed so you got late feedback, which people talk about all the time on this board.

You might want to consider giving your surgeon a call. Surgeons actually want to hear when a patient suddenly can't put weight on the leg or is suddenly in big pain. This is a perfect problem to discuss with the surgeon's nurse ... let them comfort your mind that nothing serious is wrong ... or bring you in to check the X-rays ... I called my surgeon's nurse once after I thought I overdid it ... She said do more ice ... and baby leg for a few days ... My nerves calmed significantly just by hearing this from the nurse, though that's what I was gonna do on my own.

Good luck.
 
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Lski

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Welcome! Sounds similar to my recent set back. I have bursitis and tendonitis. Remedy is a steroid anti-inflammatory along with PT. The therapy and this medicine is helping. My therapist stretches my muscles so they are not so tight & stiff which reduced the pain and increased my range of motion. Also massage with a roller helped. See your OS and ask if this could be your issue, or maybe it's something else. Wish you well.
 

Eman85

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Welcome You have done over done it and if you keep doing it will not get better. The hardest part is trying to figure if you did damage to the implant, usually not, or if you just aggravated unhealed tissue which is more likely. My story was I did it at 3 mos out, took 3 weeks of chair sitting and icing to get me back to where I was. I felt like I was back at about week 2 or 3 and starting over. After the 3 weeks of resting I was able to go on my planned outing and started progressing again at a slow pace. A week or so ago I was working in my shop and there was a point where I knew I was crossing over the line and this is at 8mo!
 

wonkyhipoy

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Based on my own experience of over doing it, you have over done it. I think we all feel this overwhelming need to keep pushing ourselves... even when we know we shouldn’t. My recommendation (well, actually two)... first, strap yourself to a couch for two days straight (the weekend for example). Treat it like your first couple of days after surgery. Get up only to use the bathroom, eat, make a drink, etc. Do literally nothing else. And while you are there, ice ice ice and ice (minimum 40 -60 minutes for ice is what works for me, and is what most recommend on that forum). I am willing to bet you will feel much better after a couple of days complete rest... though not completely better. If after that, if you feel no better, reach out to your OS.

Second, remember this in a few weeks when you overdo it again... and trust me, you will... we all do. Some of us chronically (like yours truly). The fix seems to always be the same rest and ice (and some pain meds help too :snork:).

Cheers
 

Alitm

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@919THR . It is so disheartening to be doing so well and then to really over do it. I'm almost 8 weeks out and tend to push the envelope every other week it seems. I have not pushed anywhere as far as you have, but it seems so easy to do. If it wasn't for this forum, I'm sure I'd be in bad shape! There is are two good comments here, "Just because you can do something doesn't mean you should" and "when you think you are here, you are actually still back there"! It is a constant struggle to not do to much when one feels better. It is such an exercise in patience.

I believe that cutting out the PT, and dialing way back, sitting on ice and rest rest resting, you will see a shift in a positive direction, and the reassurance of speaking with your OS's office and/or seeing you OS will help too.

Take care and let us know how you are doing!
 
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Debru4

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For me, the most helpful support I have received on this forum was the reinforcement of my surgeon's belief that physical therapy was not best for those recovering from THR. When he said that I had trouble believing it, because it seems PT is pretty typical following many surgeries. But he insisted daily activity and just using the hip in normal life was the answer. When I asked that question on here, I received resounding support for his opinion. Was it your wish to do PT, or your doctor's? (Just curious, because some folks say their doctor recommends it.)

I too started off great, and really was thrown when I had some unexpected burning, tearing pains for several days if I moved wrong along the incision. It is so frustrating to feel you are stuck, or going backwards! Those tearing pains are gone, but I still have minor pain and stiffness after I sit, and then stand to walk. It doesn't seem to matter how long I sit, it still takes awhile to stabilize and move comfortably. (Although the longer I sit, the longer it takes to move with no pain.)

With that said, I have no doubt if I had been exercising and pushing myself harder than I have, I would not be doing as well. I suspect if you back off the PT and get your pain under control you will start improving quickly. Icing and taking tylenol regular for a few days helped me a lot.

I am active--I garden, do housework, babysit my infant granddaughter a day a week, and have walked a fair distance, but those things feel much gentler, and more under my control than having prescribed exercises.

Please don't get too discouraged. With that said, if it was me, I'd give it a couple days, and if things still felt off, I'd listen to my body and have my doctor checkout out. Good luck.
 

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There I did some clamshell exercises, rear leg extensions. Some side to side stepping with elastic bands at my ankle.
My guess is that sitting in the car for two hours straight, 50% more walking than I was used to, walking with some pain for while on day 2 of the tourney, and increased PT prior to the tourney created a flare up of all kinds of muscle pain that is taking me quite a while to recover from. I quit the PT and will stay away from it for now.
Two big red flags. Using any type of band so early out is bound to cause you pain. And a big hint - new hips so not like clamshells or bridging. Then you did your marathon drive and additional walking. All this at only just over 4 weeks out. Your hip is begging you to stop.

Slow down, ice and elevate and take medication until this pain flare eases. Please don't try to push through - it will only set you back. I hope this eases for you very soon.
 
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919THR

919THR

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@Debru4
My OS gave me a script for PT at my two week check up. I remember at that point thinking I was tired and I put off for a few days calling the PT. The doctor gave me the script for PT but didn't tell me I had to go, just acted as if it was part of the process. I think the bad thing that they always do was to tell me I could go to any PT and that would work. In hindsight I think you should only go to a PT that specializes in hip replacements so they don't push it too far and maybe just work on stretching and massage. But I also buy into doing no PT and just walking based on my experience.
 
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919THR

919THR

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Thanks for the input everyone. I will not be pushing through it. I am resting until my body can comfortably bear weight again. That's my biggest issue right now. The thing I'm struck by is I didn't "think" I was pushing it. I was taking a long term approach. But in hindsight I kept walking when it started to feel some discomfort. If I had to do it over I would always stop at pain/discomfort and I would be more conscious of doing only 5% more than yesterday no matter how good I was feeling.
 

Layla

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Uh oh! Somebody entered the ODIC. Sorry to read all about it. I think you've heard it enough by now but I'll repeat it anyway. Lots of rest, lots of ice, lots of taking it easy and you'll be golden in no time.
Wishing you comfort and healing!
@919THR
 

Layla

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:walking::walking:
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.
:walking::walking:
 

Constanze

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Hi @919THR ,
I seriously hope you haven't damaged the implant and keep my fingers crossed that you haven't:SUNsmile:. I overdid it after 3 years and can confirm that recovery from overdoing can take up several weeks or even months. So do give yourself those weeks to heal. I did not wait that long and had setbacks time and again so much so that my daughter's partner thought my hip replacement was no good. But that's not true. My hip replacement works perfectly. I finished 2 marathons on it and - last June - a half-Ironman. This overdoing thing resulted from me having a fall on a slippery floor at an indoor swimming pool and bruising my buttocks and thighs, so that they were sore. I took up my running training too soon after this fall and became so sore that I was limping around almost in the same way as I did pre-op back in 2015. That set me back in my ironman training for another month - but I decided to take it easy - no running for 1 month, got there in the end and managed to do my ironman. I think you will get there, too, annoying though this may seem having to wait so long. Good luck and happy healing!
 

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You said you were taking a long term approach yet were working at the 2-4 week mark. This is a major surgery and long term approach means 1 year, the short term approach is 3 mos, the crash course to setbacks is 6 weeks.
For some reason these OS don't get the point across or they're afraid they'll lose business if they tell the truth that you're going to be out of commission for months if you want this to work. My OS warned me not to go to any PT's as they will hurt you.
 

Debru4

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If your surgeon is nearby, and your insurance will cover it, I think you should feel free to go back to them and have them X-ray the hip again, or examine you if you are concerned the implant isn't OK, and the pain isn't resolving. Sometimes some medical reassurance can be helpful.
 

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