THR Finally on the other side

[Esmeralda]

I'm so pleased to have finally made it to the other side as I was originally scheduled to have my surgery in December but a frozen shoulder, having to find a new surgeon and developing sciatica all helped to extend my journey by much longer than expected.

Surgery finally went ahead on the 30th August and I had the posterior approach on my right hip under a spinal anaesthetic with sedation. Unfortunately, due to a big drop in blood pressure after the operation I wasn't as mobile as quickly as I hoped and apart from a few short steps to my bedside chair on day 2, I was stuck in bed until the 3rd day, which should have been my day of discharge but ended up turning into another night in hospital.

Eventually made it home the next day and it's now my 7th day out of hospital. On the whole, things have been fairly good. I'm sleeping ok (apart from bathroom trips every 2.5 hours !) which I put down to having learnt to sleep on my back a few months ago when I had sciatica. Pain/discomfort has been reasonably well controlled apart from an ongoing concern with paracetamol and codeine, and any worries I had regarding the amount of discharge from my wound were settled after a quick visit to the hospital.

However, since that visit on Wednesday (where I may have possibly walked too far, too quickly using my crutches instead of the offered wheelchair) I've been having problems with a burning sensation down the front of my shin on my operated leg. This wasn't the only pain I had later that day, in fact it was most probably the worst day pain wise I have had since coming home. Thankfully the other pain has now settled back down but the burning sore sensation remains and gets worse as the day and swelling progress. So far, pain relief, icing, elevation or resting make no difference to it during the day but it does seem a little easier first thing in the morning before it fully starts up again. I phoned the hospital today because as well as the above I also had some discolouration to the skin of my knee and surrounding area. They ruled out DVT and sugggested I try a larger compression sock on that leg, which I'm currently doing but so far apart from feeling less tight, the burning sore sensation is still there.

Any advice would be much appreciated.

 

[benne68]

Welcome to the Healing Side, @Esmeralda. Glad to read the you are home! I'm sure that BP drop was unnerving!

The pain you describe sounds very much like what I experienced during my first few weeks post-up. I also had bruising all up and down my leg, and it swelled up to twice normal size. It took several weeks for everything to settle down.

Remember that all of the soft tissues in your leg were upset by the surgeon's pushing and pulling during his carpentry work on the joint. Keep icing and elevating and stay ahead of pain as much as possible by taking your medications on a regular schedule -- don't wait for the pain to start.

I encourage you to read through our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Just keep in mind we are all different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

HIP RECOVERY 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.

If you want to use something to assist with healing and scar management, BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.

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

The recovery articles
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.

 

[Hippie Chick]

Hang in there! I have a follow up appointment (1st one) next week. A wheelchair might be a good idea for real. I hope you feel better soon!

 

[Esmeralda]

Thank you @benne68. I have been looking through the hip recovery guidelines and think I've finally sussed out how to make my own pillow stack which has been useful. Unfortunately I'm not so good with the icing. I don't have a machine but have been trying to use bags of frozen peas but I just find that they are uncomfortable for some reason, even though I am wrapping the bags in towels but still can only bear them for 10 -15 mins max.

I think because I feel I was a bit slow to join the 'mobility party' whilst in hospital that I'm now playing catch up so to speak which most probably caused me to walk too far, too fast on Wednesday.

 

[Mojo333]

Hi @Esmeralda
Welcome to the recovery side... early days are tough

- I used a walker (walking frame) for the first 3-4 weeks as it gave me more stability, work on my gait, seemed like less work, and allowed me to control the weight I needed to put on my new hip...

All Temporary, friend.

 

[Esmeralda]

Thank you @ Hippie Chick, nice to 'meet' another August Hotshot ! I hope everything goes smoothly for you at next week's appointment. Will the appointment be with your surgeon or is it for having your clips/staples/ sutures removed ?

 

[Hippie Chick]

Hi! I think it is with my os. I do not have staples so not exactly sure what I do have. I have 2 steps to go down- no handrails. We are going to practice today. I am scared. Any suggestions for steps are appropriated.

 

[Esmeralda]

Hi @ Mojo333 and thank you. When I left hospital, they sent me home with crutches but I liked the idea of a walker so I also got one of those, which I find particularly useful for my many nightime trips to the bathroom as it does make me feel safer when I'm half asleep. It's also good for hanging my clothes on when having a wash (can't shower as they took away my waterproof dressing as it was causing a skin irritation) and I can balance my grabber on it as well. In an ideal world I would actually like to attach a basket to the front of it, a bit like a bicycle basket, but my husband has squashed that idea as he says I won't be using it for long enough and it would mean more work for him trying to sort it out ! One of the nurses at the hospital said she was surprised that they didn't use them more but got patients practically straight on to crutches.

 

[Esmeralda]

Hi! I think it is with my os. I do not have staples so not exactly sure what I do have. I have 2 steps to go down- no handrails. We are going to practice today. I am scared. Any suggestions for steps are appropriated.

Maybe you were glued ? That was my original surgeon's preference but my current surgeon unfortunately went the clip route, which I can't bear to look at - silly I know. Before I left the hospital I had to pass the stairs test but as I have a handrail at home, I was shown how to go up and down using one crutch and the handrail, leading with the good leg going up and the operated leg side going down. We have steps out to our garden with no handrail and I haven't been brave enough to venture outside yet even though the weather is absolutely lovely at the moment. I was hoping to give it a go today, if I manage to navigate them sucsessfully I will let you know how I did it and if you manage it before me, maybe you could let me know ?

 

[Mojo333]

I had a little plastic basket I used for catch alls in my bathroom that I did zip tie to the front of my walker. Put my phone and things I needed to relocate. Saved hubby Some trips!

Stairs are scary!
Handrails are helpful... do you have rails?
Up with the Good
Down with the Bad
Toddler Style is the best way and how I did it for quite a while as my legs were not always consistently steady. (Problem was, with bilateral, I didn't have a good/bad but I did have a stronger one)
handrail will make stairs easier and safer. Place one hand on the railing and hold cane(s) in your opposite hand. If you do not have a handrail, use one cane in each hand.

To go up the stairs:​

• Place the non-operated leg up on the first step
• Use the cane/handrail to help step up
• Bring the operated leg up to the same step

To go down the stairs:​

• Start at the edge of the step
• Bring the cane and your operated leg down to the first step
• Step down to the same step with the non-operated leg

 

[Clairebella]

Hi @Esmeralda

Being at the same stage as you I have main equal aches and pains right down to my foot. And equally anxious and worried and needing lots of advice! But to give a little back…

For carrying things around - I’m on the crutches and have a little tote bag I use over my shoulder or swing from the crutch. Using it for drinks/snacks etc.

I also had a slight skin irritation from the initial dressing they put on in surgery but it was changed to an another waterproof dressing, Meplilx border which is fine. I have dissolvable stitches and the surgical tape along the incision line and then my dressing. It’s only been changed twice. I think I’ve to keep in on for 10-14 days then take off and let the tape fall off itself
If you want to shower could you stick a waterproof dressing over for just the duration of shower and then take off? When do your staples come out?

For icing also, I got a fairly big ice pack on Amazon which comes with a strap - it’s called the comfy temp large ice gel pack and it was £13.99

I am same day post op as you and still taking paracetamol and dihydeocodine 4x daily. I’m still sore bruised and swollen and I’m not rushing off them.

 

[PolarIce]

Thrilled to see you are on your road to recovery!!!

I had the same blood pressure you had when i got out of recovery and had to spend the night in hospital, instead of leaving the same day. I barely passed the blood pressure issues to be able to go home the following day, but luckily i had great spousal support and we managed to convince staff to let me go home to my own bed.

The worst is done, its all up hill from here my friend!

 

[Esmeralda]

@Mojo333 That is such a good idea using a zip lock to tie your basket to your walker.

I do have a handrail on our stairs but I haven't been upstairs yet. I know I will be able to manage the stairs ok but I just don't want to go upstairs yet - I think I'm being a bit of a wimp for some unknown reason.

 

[Hippie Chick]

If I was comfy downstairs, I would hang out there a while. When I got tired of that, then I would head upstairs. When I wake up middle of the night, I look to see who else has posted. The different locations everyone is from makes that possible!

 

[Esmeralda]

@Clairebella Thanks for the handy tip about the tote bag, that's something I wouldn't have thought about most probably or if it did suddenly dawn on me it would be several weeks down the line - I do seem to be suffering a bit from brain fog sometimes.

Re skin irritation, I was ok with the surgical dressing, it was the waterproof dressing that they sent me home with that was causing my irritation. The nurse I saw back at the hospital did say that the irritation was most probably made worse as I kept having to change the waterproof dressing every day, so I was constantly pulling at the irritated skin. I don't mind too much not having a shower as I'm quite enjoying my husband washing my feet lol ! But I hate not being able to wash my hair and the dry shampoos only help so much, so I going to try washing my hair today standing up using the bathroom basin - which should be fun and messy ! I don't have to put up with this much longer as my clips come out on Wednesday - thank goodness.

It's great that you have dissolvable stitches, those and glue seem altogether less hassle than clips (which I think might be another name for staples but I'm not sure)

I haven't checked out the ice packs on Amazon yet, but the one you have with the strap sounds quite useful.

Re pain relief, did the hospital discharge you with enough pain relief to last you longer than a week ? My hospital sent me home with only a weeks worth but as I didn't need to use the full dosage every day I have some codeine left over but wasn't sure if I should still be using it, I did try just using paracetamol yesterday and I definitely noticed a difference in how much pain I felt.

 

[Clairebella]

@Esmeralda They only sent me home with a weeks supply but I just put in a prescription request to the GP when I handed my discharge letter in. I can request meds online with the GP. I’m in Scotland so also get free prescriptions which is handy but pain relief is one thing I would pay anything for! I’m still taking paracetamol and dihydeocodine 30 mg 4x daily. I usually take 3 codeine through the day and one overnight. I wake up quite sore still in the morning. I’m also just taking them on a regular schedule and not waiting to get sore.

Good luck with the hair wash today!

 

[Hip4life]

@Esmeralda It was a week before I was allowed to remove my dressing and shower. My incision was glued and I still had to keep it covered, especially when I showered up until my 6 week follow-up visit. My skin was so irritated by that time, that there was hardly a place left to "tape." I was so glad to be done with that. I'm sure you are more than ready to get those clips out. Your incision should feel so much better.

I also liked using the large gel ice pack with the strap. Mine was a different brand but same idea. You can also use it without the strap. It was so versatile where you could put it and it covered enough of the sore area to give the needed relief. I used it far into my recovery whenever I experienced soreness as I increased my activity. It still comes in handy on occasion and not just for my hip!

I think I only had enough really strong meds for about 10 days. I was able to decrease to lesser pain meds that the OS had prescribed for a couple more weeks and then it fell to the GP to manage from there. We are all different in how we experience/feel pain. Find what works for you and partner with your healthcare provider to get the relief you need to recover well. You won't need the "big gun" meds for too long but you don't need to suffer through pain, either. Very soon you will be able to get by with icing and Tylenol (paracetamol.) Discuss all of this with your OS at your visit this week. That should help relieve any of your concerns about this.

Slow and easy are the by words right now with activity. If you're unsure about the stairs or any other activity, listen to your instincts. If they say don't do it, then don't. All things will come in time and it is not worth risking a fall. Blessings for continued good recovery.

 

[PolarIce]

You're doing the right thing. Staying on top of the medication schedule is the way to go. People feel better on a uneven schedule and will skip a dose or two then pain kicks in and you have to play catch up which can be torturous. Staying on top of the schedule is the best way to do it. You will figure out as you go when you can start lowering the dose and wean off.

 

[Esmeralda]

@Hip4life and @PolarIce _ Thank you for your replies and advice, I think I definitely do need to make sure I keep on top of the pain. I'm having my clips removed at my GP's surgery on Wednesday so I will have a word with the nurse then, luckily I have enough left over meds from the hospital to keep me going for a few more days.

 

[Esmeralda]

Advice needed please ....
1st Part.
Up until the last day or two my frozen shoulder (left side) has been well behaved but old problems have began to resurface again. A little background history, I've had my frozen shoulder now for approximately 10/11mths (it was triggered by a sore left bicep caused by incorrectly using a walking stick) and have been told that it's now in the thawing stage, and for the last 6 weeks or so have been pain free, able to lay on my left side for an hour or two and ROM are at 75% - 80%, so I've been pretty happy with it, hence going ahead with the THR. When I originally spoke to my surgeon about it a few months ago, it was not in such a good place but he thought I should be able to manage on crutches as I wouldn't need them to be weight bearing.

Unfortunately, me and crutches seem to have a love/hate relationship, I've started using them more over my walker as I feel that I'm able to walk more naturally with them but I'm not able to use them non weight bearing and find myself leaning heavily on them which has woken up my originally problem with the sore biceps and every time I use them now I have soreness in that area. Just to add they are the correct height as the physio at the hospital checked them for me. Any ideas of what to do next ?

2nd Part
Yesterday I noticed a weakness in my right hand (I'm right handed) it started off by having a bit of trouble using a spoon to eat my cereal at breakfast, which puzzled me but I ignored it, like you do. Then when I was washing my hair I couldn't squeeze the bottle enough to get the shampoo out, it was a big bottle and it wasn't full so it would have been a bit difficult anyway but not impossible, so I got my husband to it for me and ignored it again. However, the final thing which made me realise I do have a slight problem was trying to turn the key in the conservatory door before going to bed last night, I just really struggled to get a decent grip on it, it is a stiff lock and a small size key but it's never caused me any problems before yesterday. I did switch back to using my walker more yesterday because I wanted to rest my left side from the crutches and I have been trying to balance my weight more on my right side when using walking aids and on one occasion I noticed a shooting nerve pain going up the back of my right arm from my elbow. I don't know if my walker is the right height for me, should the handles be the same height as my crutches ? Has anyone experienced anything similar ?

Sorry for such a long post, but I am struggling a bit at the moment trying to stay positive, I just feel that the rest of my body is doing it's utmost to make life difficult for me.