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THR Finally back home...

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Day 30...

Physiotherapy and a very major concern.....

Today was my third session in the torture chamber when I get to exercises, stand on wobble-boards, pedal a bicycle thingy and all the usual stuff. The good news is I am making progress, the slightly bad news is I am behind compared to others who were done at the same time as me. I will admit I had been walking a lot before I went in so I was fairly exhausted before I started (my fault) and for some reason, my wound and the surrounding muscles have been aching like mad the last few days (I think I may have twisted myself at some point - maybe during the night). I would also add this is now the fifth week I have not slept properly and I am permanently fatigued, tired and I admit a little cranky and given to mood swings. I'm sure my pharmacy got my prescription for sleeping pills mixed up with a box of tic-tacs, for what use they are.

To be honest, all things considered, I don't feel too bad about the way it's going. I am getting better and my general movement is improving. Although I can walk a finite distance on one crutch, walking unaided is an issue as I cannot yet bear full weight on my hip (one foot off the ground, no hands) at least for no more than a few seconds, my muscles scream at me and I quickly lose balance. But it's coming albeit slowly.

Now we come to the very serious stuff! (I would like to ask Josephine; for an opinion on this)

The subject was raised about me returning to work (I'm only week 4!). When I started this journey - when I first came to BS and read all about hip replacements and time off work, I was understood it was the norm to be off work three months. I later asked a question about sick notes in the UK, as they are now 'Fit-notes', which list what you can do, as opposed to what you can't. Given this is a major surgical procedure and not something like the 'flu, I was given to understand this would not be an issue.

The bottom line is, I do a physical job. My car is my office. I can work alone with heavy equipment and weights, large gas cylinders, working at heights etc etc. My work area means I have to drive considerable distances, averaging between 50 and 180 miles a day, also long hours and expected to perform in a 7 day/24Hr call-out rota once in three weeks. (Doing all the above in the dead of night)

When I saw my Consultant in March, he explained to me he expects me to go back to work in 6 weeks. There is NO WAY do I feel anywhere remotely near doing anything like that. To complicate matters, everything we do is performance-measured and makes no account of working at a 'slower' rate. My head office of 'light office work' is 50 miles away from my house. My work comes to me via a computer.

The bottom line is, I want to return to work when I feel comfortable and safe to do so - I told my company not to expect me for the full 12 weeks and that's when they expect me back. I want to return when I am out of enough restrictions to be able to sleep and not risk crashing my car because of pain-induced sleep deprivation, or to be able to make technical decisions without a muddled brain. I want to return when I can physically and safely capable of climbing and carrying equipment, or to squeeze into tight places without aggravating my wound, or doing something to myself and I need rescuing (bearing in mind I work alone on remote locations).

I have my appointment in two weeks time with my substitute GP to refresh my sick note and later my Consultant and I feel I am going to be 'told' that 'I have to go back', regardless what my condition is. This is causing me a major upset. I have had a bumpy ride from the start of this and I feel I still have a very long road ahead to recover properly, without being pushed 'out the door' to fend for myself in situations I should not be in.

I would kindly ask if someone who has had to deal with work and sickness protocol/THR's what their opinion is. I'm not wanting to come off as work-shy, I am losing money by being at home (no overtime/allowances), but I would rather be at home recuperating and pick up the reins when I feel happy to do so. And right now, that feels a million miles away.

Thanks in advance.
 
Graham, there is no way you should be considering going back to work without restrictions lifted. Actually as you say, when you feel confident and have the energy you might consider a phase return. I tagged Jo for you. She is actively working in this area now and can give you tips on how you should deal with this subject with your GP. Hang tough! Your recovery is the priority now!
 
Point one: in the UK, the patient is generally discharged from hospital into the care of their GP. Your surgeon has no jurisdiction over when and if you return to work or anything else.
Point two: things are supposed to be done by consensus and informed consent. (I thought Sir Lancelot Spratt was laid to rest about 50 years ago but he seems to have been resurrected in the person of your surgeon!)
Point three: doesn't your firm have an Occupational Health Service? That should be a requirement for firms who have lone workers as that on its own comes under the H&S regulations. In your situation, an OH referral would probably support extended leave for you. If someone was working part-time as a clerk or receptionist, then I MIGHT consider a return at 6 weeks but not in your situation. It's ridiculous. And I've not heard of a "fit slip" and I work with them on a daily basis. :scratch:

I suggest you also talk to your GP about this and tell him when you envisage returning to work. He is likely to be more sensible.

As for this
Today was my third session in the torture chamber when I get to exercises, stand on wobble-boards, pedal a bicycle thingy and all the usual stuff. The good news is I am making progress, the slightly bad news is I am behind compared to others who were done at the same time as me.
Click to expand...
Never EVER compare yourself to anyone else. They might have had a totally different procedure and/or anaesthetic to you, almost certainly had a different surgeon or anaesthetist and their condition was very different to yours going in. In other words, you are different people and different people have different recoveries!
this is now the fifth week I have not slept properly and I am permanently fatigued, tired and I admit a little cranky and given to mood swings.
Click to expand...
It's quite obvious really - you are doing too much. At only 5 weeks out, you should still be spending most of your time resting to recover. Hips have a neat way of sorting themselves out, anyway. Unlike the 'hinge' knee, the hip is a universal joint and a good ROM is almost guaranteed. A bit on the bike is okay and other than that, walks out in the fresh air are as good physio as you need, take a look at this Hip recovery: progression of activity for THRs, see what you ought to be doing in week 5! Remember that your muscles are not weak, they are injured and the best treatment for an injured limb is rest! Plus your mood swings are due to Post op blues.

You should read these again too
Pain management and the pain chart
How Long Does Healing Take ......
Chart representation of THR recovery
Energy Drain for THRs
Elevating your leg to control swelling and pain
Some suggestions for home physio (PT) and activity progress
 
Thanks Josephine. Its just sometimes I feel the only support I'm getting is the people on here. My surgeon / relief GP just seem to be keen on pushing statistics (At least that's what it feels like) and no one has taken the time to ask how I am emotionally coping with this (Not brilliantly I would say, re: lack of sleep). A victim of 'tick-box culture', I guess. I will see how it goes when I see my docs.

Thank again.
 
Hi Graham!

Firstly, I'm so impressed you were out there getting pics of the Olympic Torch! Are you able to post them here? How exciting. I've always wanted to travel to London.... some day.

Separately, I have to agree with the above posts; I was given similar advice by these same people... I couldn't sleep, I had pain (less during day like you).... I upped my meds (they preach Pain Management here in the US, but make us feel worried about addiction), and was on my way! It just helped so much to get a bit more sleep, as well as get me through the PT sessions.... and wow, you just feel so much better.

I still have sleep issues. It sounds like a lot of us do. So, know that you are not alone, and that you can always log on to Bonesmart when you can't sleep!

Take care of you....

Alicia
 
Hi Graham,

I hope that you get the support you need from your GP -- if you look like hell and burst into tears at some point during the appointment I'd hope that would help your doc see how you are doing emotionally and focus a bit more on you vs. the ticking of the boxes...

We are all different in our recovery from THR. FWIW, I did not venture in to outpatient PT until I was about 10-12 weeks post-op. I'm not sure my PT clinic does group classes, but if that had been the option I would have requested individual work for a few sessions first. You really do need to be feeling a bit better and sleeping well enough to try to add the additional stress of PT work on to your body, then it will seem less like torture.

Remind yourself that you are still healing from surgery -- as Jo says, this is not about weakness but about injury to muscles.

Take care,
Cardie
 
Hi Graham,
I hope Josephine managed to set your mind at ease and give your good suggestions in how to handle your work situation. When I read the decription of your work, there is no way that should go back in less than 12 weeks and even then, that depends on your body's healing. As others pointed out, you are still very early on in the process. I am one week ahead of you and feel I am still in the early stages of healing!
Take gentle care,
Elle
 
Graham - your GP will take all your concerns on board when issuing a note. My THR was just before yours and I discussed with my GP how long I thought I would be off work - I work in a school and have decided that I will be ready to go back on the first day of next term on 5 Sept and my GP then wrote me a note to say I will not be "fit for work" until that date. Nobody's going to force you to go back to work before you're ready, and given that your job seems very physically demanding, I'd also go and see your employers and see what they have to say also. Maybe you could go back on a part-time basis?
 
Day 37 (Week 5)

Life goes on...

I'm still a fully paid-up member of the 'sore butt club', at week 5, the wound is not really painful, but I can always feel it and I'm constantly fidgeting when I sit as I can never seem to be comfortable for a length of time. Paracetamols these days don't seem to do anything, so now I hardly bother with them and have noticed no difference. A case of 'grin and bare it'.

My mobility has noticeably increased, I am more-or-less free from crutches around the house, although I am still hobbling and wobbling around. I can get into bed a lot easier (which is low to the ground and needed a lot of time and manoeuvring to get in and out of) and I've more-or-less stopped using my hand-grabby thingy.

I am trying to go 'one-crutch' outside, but I guess I have a bad posture as my back (good side) aches something rotten after a short time and I have to go back to two. Although when I am on two, I probably put less than a few percent of my weight on it, almost carrying it. But it does help having it handy.

My distance is probably around three-four hundred yards (very hard to judge), possibly a bit more, but I tire really quickly. At that point, my new hip feels like its going to burst out of my wound (imagine the scene from 'Alien', but with a hip joint) and I really do start to wobble around and have an urgent need to sit. I dare say the extreme hot weather we are having adds into the equation. When I go out, I come home exhausted and need to lie down, but I cannot seem to nap. Next week comes the ominous question of seeing my relief GP and sicknotes. I'm going to be really useful at work if I'm still like this.

Sleep patterns have only marginally improved. I average four hours of broken sleep a day, although one day I managed six, another night I had less than three. I tend to doze for an hour, awake and play PC games, doze again, read my Kindle, doze, more games, doze and then up. I just can't seem to rest and 'switch off'. I'm now week 6 without a full night's sleep and wondering how much longer I will have to wait - or what the longer terms effects of sleep deprivation are.

Stopped taking that worthless Zopiclone, as I feel more tired reading the leaflet in the box than popping the actual pills. Probably better drinking a glass or two of wine before bed as I don't take any drugs now.

I had a less-than minor accident in a department store and took a bad step and fell down a few stairs. Something wet/greasy caught my crutch and it slipped away from under me. Instinctively, I fell forward and turned to my good side as I slid down about four-five steps. No damage except a bruised knee, grazed elbow and ego. It did scare me a bit there.

I have been chatting to a lot of people I know about my hospital treatment, or specifically, the way I was treated in hospital and I'm being urged to raise a complaint. It seems academic now as I'm five weeks out and I'm still mulling over if it's worth doing anything - and to what end. I have been invited to speak to one of the senior staff members, but I don't know what this will achieve, even though their glossy blurb of "highest professional care" failed miserably on my occasion. I do know it left an indelible emotional mark on me and if I had to have my other hip done, or a revision, I'm going to ask for a wheelchair first. I would not want to go through that experience again! Ever!
 
Wow. What a trooper you continue to be.

Your fall in the dept store.... how frightening. I find that falling is something in the back of my mind constantly, and I am aware of uneven pavements, and find myself looking down; and then I think: I have titanium in me. Weird, isn't it. But, I'm sorry to hear of your fall. I think it affects us more in a "mental" way than the physical.

Good to hear that you have figured out which meds help and don't.

Sleeping: I am still struggling, as well (It's now going on 2am here in FL); and, I do the same thing when I get home from the dog shop. Go to bed, elevate, ice, grab my laptop and/or a book... doze, but it's not for long. Constantly have the Sherlock Series on (1 & 2)..... I expect that the sleeping will even out eventually.

Complaints and/or survey response: I had a HORRIBLE hospital experience, although the surgery itself was perfect, and my OS is exceptional. I have written letters to those involved and copied Sarasota Memorial Hospital, and also sent copies to the US group here which accreditates healthcare facilities. I also wrote a letter to the rehab center I was at for less than an hour. I don't know if it makes any difference in the "big picture", but I felt my situation needed to be known and "in ink."

The Olympics Opening started tonight here at 8pm, and don't you know it, my cable is out.... our whole building is out. I so wanted to see it! So, I went online, and saw that the Queen was picking at her nails, Kate looked lovely as usual, Kenneth Branagh and a host of incredibly talented people were all part of it... and I'm embarrassed for the US that Mitt Romney had to throw his two cents in regarding the UK's "readiness." Sheesh.

Okay. Going to see if I can sleep, as I have four dogs to groom in the AM. Hope you take it easy, focus on yourself and your healing, and enjoy each day that you are out of pain.

Best,

Alicia
 
Hi Graham

Just catching up after being offline for 8 days...

Wow! and Wow! Again... I can hear such a change in your posts, I think you are doing fantastically Graham - except for the slip and slide.. that was scarey.. but so pleased you are ok :)

You will eventually get a full nights sleep, truly, it just takes time and you are doing your best to amuse yourself during the 'wee small hours'

I too saw what I would class as appalling lack of care whilst in hospital.. I mentioned it to my OS and he gave me the name of the Executive Director and said... 'she would love to get this feedback'... I pondered, well actually agonized whether to go ahead and in the end I thought I have to get the other hip done at the same hospital in the not too distant future, so my approach will be more assertive, if I see something not up to scratch.. But you must do what your conscience dictates..

Hope you get longer and longer sleeps soon :)
 
Graham, it's good to see your recovery is progressing so well (and despite how it feels sometimes, it really IS). I'm having pain issues now, too, as my surgeon recommended stopping the prescription painkillers. I've been sort of fudging, because it's just too hard to sleep at night "cold turkey." Frankly, I believe they have to put the kibosh on you with the "good" drugs, for the reason that Alicia noted: there is an outsized concern about "dependency." I've been feeling behind the curve regarding walking without assistance, too -- at 7 weeks, it is still out of the question to walk more than a few steps without my cane, waaay too painful. I was happy to find out from my PT that there is a good reason for it, as my scar tissue is adhered to my muscles, preventing smooth muscle movement. We are working on it. Josephine is SO right: everyone has a different healing path, it is just counterproductive to compare ourselves to any "norm" because that just doesn't exist with this surgery. I wish you restful nights and pain free days, and freedom from worry about returning to work!!
 
Hi Graham...wow I have just read through your thread. You do seem to hav ebeen through the mill! But I am so happy for you that recent threads are so much more positive and you have progressed sooooo much!
My RTHR was July 9th so I am a little behind you but doing well. I am so grateful for the input and advice on these threads. The overwhelming point that comes across is that each of us has a different case! You cant say you äre behind" others. You are only pushing your own body and must do what is right for you.
I hope you get your work issues sorted out,,,good luck with that. I was very lucky here in Australia . My surgeon said 2 months off for an office job and 3 months off for an active job. No questions.
Surely your Gp will be undertsnding when they see what point you are at?/

take care and continue the good progress
warm regards
liz
RTHR July 9th 2012
 
Hi, Graham.....I'm glad to hear you are progressing. It sounds to me like you need more time before going back to work, though. Make that very plain to your doctor so that you can get the needed paperwork to allow ample recovery time. Whether or not you actually fell on your new hip, that fall did impact your recovery. Things like that are a trauma to your body and result in a setback....minor maybe, but a setback nonetheless. Be sure and also mention that event to your doctor.

You are still very early in your recovery so just be sure you're not pushing yourself too hard. No need to overdo the distance walking or trips out to stores or trying to walk without both crutches. You have plenty of time for all of that when you are better rested and stronger.
 
Jamie said:
Hi, Graham.....I'm glad to hear you are progressing. It sounds to me like you need more time before going back to work, though. Make that very plain to your doctor so that you can get the needed paperwork to allow ample recovery time. Whether or not you actually fell on your new hip, that fall did impact your recovery. Things like that are a trauma to your body and result in a setback....minor maybe, but a setback nonetheless. Be sure and also mention that event to your doctor.

You are still very early in your recovery so just be sure you're not pushing yourself too hard. No need to overdo the distance walking or trips out to stores or trying to walk without both crutches. You have plenty of time for all of that when you are better rested and stronger.
Click to expand...

Thanks for that. Of course you're right, I have this habit of going out for a walk and staying out far too long and coming home exhusted. My wound sometimes feels like its going to burst apart. I think it's something to do with having too much time at home and a total abscence of sleep. (I had only two hours the other night). I feel run down and without a drop of energy at the moment, being kept awake with coffee, and to top it all off, I now have a family crisis to deal with. I have my Doc and Physio on Friday and my Surgeon on Monday for my 6 week overhaul. I am still worried I'm going to be sent packing back to work...:sad:
 
The sleeping thing is really difficult; I'm still trying to understand it.

Sorry to hear about your family crisis; that's how life is, isn't it? Never how we'd "plan" it or according to our schedule... just take a deep breath and move forward in your own way, and I'm sure you will contribute in whatever way is needed that you are available to offer (been there too.... ).

Regardless of the sleep, I was thrilled to be back to work in two weeks.... but, owning your own dog shop as a sole proprietor is totally different than working for a corporation/bigger company so to speak. I keep saying: if I don't work, I'm not making money. I'm just grateful that I feel strong enough to do it! Take advantage of your benefits.... I'm sure the "family thing" isn't helping right now.

Have been watching the Olympics.... must be very interesting from where you are!

Take care of YOU.

Alicia
 
Hi Graham, I'm an ex Pompey lass, born in Cosham and if I was still in Pompey I would be sat on that pebbled beach just next to South Parade Pier watching the sea and the boats.
I have read your journey and I can understand your concerns about going back to work as I have just written about my concerns on my post too. As with regards to sick notes, the doctor will sign you off for as long as it takes you to become independent to fully functional.
Just take that example of you slipping with your walking stick and your lack of sleep etc. The doctor has to take these things on board as they have a duty of care NOT to send unfit people back on high risk jobs.
They are very aware of the outcome of this surgery and they are in the front line of your emotional well being and health post surgery.
YOU tell THEM you are not fit. It's your recovery and they have to abide by what you are telling them.
You're not work shy, you are intelligently assessing your physical ability to work.
And You are the only person who can make that assessment.
 
GrahamDee said:
I have been chatting to a lot of people I know about my hospital treatment, or specifically, the way I was treated in hospital and I'm being urged to raise a complaint. It seems academic now as I'm five weeks out and I'm still mulling over if it's worth doing anything - and to what end. I have been invited to speak to one of the senior staff members, but I don't know what this will achieve...
Click to expand...

Hi Graham,

You know, letter writing can be very cathartic. Helps you get many feelings and emotions processed, clarifies thoughts, gives a validation to one's experiences, helps to line things up chronologically on the timeline of events, something to do when the project list seems boring/overwhelming. Even if the letter does not make it into an envelope and off to the "recipient" it can still be a viable tool for processing through a trauma.

One other thought, when you have that feeling in your hip that an alien is going to burst forth maybe it is related to inflammation of the soft tissues in there. Ice can be helpful for inflammation and also cutting the walking distance in half to see if that produces less inflammation/alien rising. :thumb:

I hope your upcoming doctors appointments go well.
Take care,
Cardie
 
C Mac said:
Hi Graham,

You know, letter writing can be very cathartic. Helps you get many feelings and emotions processed, clarifies thoughts, gives a validation to one's experiences, helps to line things up chronologically on the timeline of events, something to do when the project list seems boring/overwhelming. Even if the letter does not make it into an envelope and off to the "recipient" it can still be a viable tool for processing through a trauma.

One other thought, when you have that feeling in your hip that an alien is going to burst forth maybe it is related to inflammation of the soft tissues in there. Ice can be helpful for inflammation and also cutting the walking distance in half to see if that produces less inflammation/alien rising. :thumb:

I hope your upcoming doctors appointments go well.
Take care,
Cardie
Click to expand...

Thanks all for your replies. I appreciate everything everyone says.

I have my Physio and GP visit tomorrow and I guess I'll have to see what happens then. As for my complaint - It seems a bit moot now, I have one final physio session next week and if I'm so inclined, I may decide to speak to someone at the hospital. I would not want anyone to go through what I did, especially when they are feeling terrified, vunerable and in some ways neglected (not medically, but emotionally.) If someone took a few moments with me, listened to what I said and wanted, showed an ounce of compassion, this whole episode would have been a million times better than it was, instead of being lied to and reduced to a humanless statistical digit on a spreadsheet and a squiggle on a whiteboard - just a worthless lump of meat taking up space - that's what it felt like and what I assume to be their 'highest professional care'. I take a small consolation from the fact that others were treated in a similar way. The only good thing I can say is my surgeon did an excellent job.

I guess I should have had a barcode tattooed on my forehead or a implant and they can scan me whenerver they wanted something instead of taking the trouble of having to speak to me or cause some other inconvience to them.

And this is a PRIVATE hospital, not an NHS one.
 
Hi Graham, I sense you feel strongly enough about it, especially wanting to right what is obviously not a professional approach to our emotional needs as well as our physical needs.. Personally, I would say something :)

Good luck with you Physio and GP apt's :)
 
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