THR From the Other Side

[KathyH]

I had a left TKR eight years ago this August, which is when I became a Bonesmartie. The knee deterioration was due to a car accident several years earlier. Recovery was slow and very hard, with five months off work. But in the end, it was a very successful knee replacement and one of the best decisions I have ever made. I made a couple of lifelong friends on this site.

Fast forward a week ago. I had a fall in the garden from a bit of a height, flew through the air and landed very badly directly on to my left hip. Taken to hospital where it was pronounced broken. Aaargh! They planned to insert two screws the next day, a half hour operation. When they opened me up, it was worse than they thought. Three hours later I was waking up and being wheeled into the recovery room after a three hour total hip replacement.

Been at home for four days after five days in hospital. Never thought I would be here in a million years! Two accidents, two replacements!

So far, touching lots of wood, recovery is good. I understand hip surgery is a quicker recovery from knee surgery. I am walking quite well on two crutches. Pain is non existent, just a little achey now and again. Am walking little and often and doing my exercises four times a day. Hubby is waiting on me hand and foot.

I am retired now, so don't have to go back to work this time, although that could have been a good incentive really. But hey ho....

Due to the Corona virus I'm not have physio at home, or anywhere for that matter. So I don't have anybody, apart from here to ask questions. Like what I should be aiming for:

1. What timescale is average for progressing from two crutches to one.

2. What timescale is average for progressing from one crutch/walking aid to none.

3. When did you first venture to walk outside after surgery.

Many thanks for listening to me. Am sure I will be asking more questions.

 

[Hip4life]

Welcome back. I wish it were better circumstances. My, you have been through a lot and not much time to prepare! Everyone has a unique recovery schedule and a lot depends on what your extenuating circumstances are, as you found out with your knee. My THR recovery was a little longer but not as long as others. I also had a drawn out presurgery time that I’m sure had something to do with that. Anyway, ice and elevation are the mantras around here, as you might remember. Be patient with yourself and don’t overdo. Your hip will be happy to remind you what it’s been through. Lol. My THR was 2/28/19 and I remember being outside mid-late March, so 2-3weeks, enjoying a sneak Spring preview. I’m in the middle of the US, so still usually cold at that time. I walked the driveway off and on while I sat out on my glider a good couple of hours. I used a walker then but later graduated to a cane. I had to use that 3 months plus because I had a persistent limp. My tendon was acting up even then. Again, we’re all different but I wish you healing blessings and a speedy recovery so you can enjoy a little of the summer.

 

[Layla]

Hello Kathy,
Welcome back to BoneSmart! Thanks for re-joining us here.
I’m sorry to read about your accident, thankfully you’re on the mend.

Timelines for the use of assistive devices vary from person to person. Some heal more quickly, some are in worse shape than others at the time of surgery. I’ve read everything from several weeks to several months. Most importantly, you want to have a strong gait, feel confident with your balance and make sure you’re not limping. The natural progression for most is they Increasingly find themselves walking away from their assistive device without any thought. That’s the best sign you’re probably ready to set it aside.

As far as walking outside, I don’t see why you couldn’t now for 5-10 minutes if you’re feeling strong enough and have a nice flat surface to navigate. I probably wouldn’t stretch it much longer initially, very slowly / gradually building on time and distance.

Please leave the exact date of your Left THR so the info can be applied as your signature.

Check out the Recovery Guidelines below. Lots of great info and the articles are short and easy to read. Stop back often, we’ll be here for support and would love to follow your healing journey.

A peaceful weekend to you!

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​

6. Access to these pages on the website

Oral And Intravenous Pain Medications​

Wound Closure​

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

 

[Jaycey]

@KathyH Welcome back to BoneSmart! Sorry you are back due to an accident. Yikes - that must have been very scary. Especially as it's not really a great time to need a hospital.

Please don't be concerned about not having PT. As it says in the guidelines Layla left for you hips don't really need PT. Walking is the best exercise for that new hip. Remember, you are not in training - you are healing.

 

[Layla]

Hi Kathy,
Happy One Month Anniversary!
I hope you’re doing well. Please leave an update as time allows. We’d love to read about your progress.
All the best as you continue healing!
@KathyH

 

[KathyH]

Thank you all for your kind replies. Sorry I haven’t been back sooner, my laptop has been out of action ‍

I am now 5 weeks post op. Most unexpectedly, a physiotherapist started coming to see me at home a week after I left hospital. She is a nice young lady. She has given me lots more exercises to do. She is very encouraging, but at the same time she doesn’t push me if I can’t do something (unlike the bullies I had after my TKR, who really did push me to do things that were painful and made me feel like a failure when I couldn’t do what they wanted ).

I am down to using one crutch indoors since last week. But I use 2 crutches when I take a walk outside, as my confidence needs to grow. Also the lane where we live is rather uneven.

I do get a bit of discomfort around the hip and groin now and again. Not pain, but more like pressure. Is this normal? I take paracetamol when this happens.

I do find it difficult to be comfortable when sitting. I sit on the sofa with a board underneath an extra cushion and my legs up. Otherwise the sofa is too soft. But if I sit on that too long it can get uncomfortable.

I have cooked a few easy meals i.e. things that can go straight in the oven. My mum has been a godsend as per normal. She lives literally next door and has been doing most of mine and Ray’s dinners. She’s also been doing my housework. Don’t know what I’d do without her

 

[zauberflöte]

Hi @KathyH ! You're amazing-- at one month I was finally off the night-time narcotic, the aspirin, and the celebrex, so I could move to my cocktail of choice which was advil and acetaminophen/tylenol. By the clock! I wonder if the "pressure" is the remains of your swelling. Are you still icing? I iced for-ever!
Your mum is a very special lady. She must be in her 90's! I hope I can be like her.

 

[KathyH]

Hi @zauberflöte, I don’t feel amazing, lol, but thank you.

Oh dear, I have never iced my hip (iced my knee all the time, for which I purchased a contraption on Amazon. It’s in the loft somewhere). Silly question, but what is the best way?

My mum is 89 and she amazes everyone with her energy, bless her.

 

[zauberflöte]

@KathyH what is the best way? Um... ice what hurts! I had two anteriors, and mostly I liked the ice over the incision. I could sit, lie, or elevate with an ice pack just lying on it. If I wanted to walk for more than 5 minutes, I had to get creative with tea towels and Ace bandages. I had a pair of loose floppy linen pants which had huge deep pockets just perfect for putting an ice pack into! Also, I pretty much wore ice 24/7 for most of a month. It's a great pain killer!

 

[KathyH]

Thank you @zauberflöte

 

[Layla]

Hello Kathy,
We recommend you ice any / all areas of discomfort for no less than 45-60 mins each time you ice. Always make sure to have a piece of fabric between your skin and the ice source. Following is an article on ICE -

Ice (Cryotherapy) to control pain and swelling

Updated 22 November 2020 Please note that though this article primarily talks about knees and hips, the information applies equally to shoulders and other joints as well. Using ice (cryotherapy) is an excellent means of controlling pain and swelling after joint replacement surgery and it...

bonesmart.org

Wishing you lots of comfort and a peaceful evening!
@KathyH

 

[KathyH]

Many thanks @Layla

 

[leejaa]

Icing is your friend. I iced non stop except when walking. I even took a small cooler to the bedroom upstairs with ice packs so that when I got up to go to the bathroom I would get fresh ice pack. I iced for months any time I was sitting/reclining/laying down. Later on I would ice as needed when I did a little too much or when I was feeling achey.

 

[KathyH]

I will try to purchase some ice packs.

I had my physio this morning (I think I am lucky to have this at home). Going forward from last week from two crutches to one, today she brought along a cane thingy (a crutch without the top arm bit) and wants me to use that indoors from now on. It was unnerving at first, but am getting used to it. Each step forward is unnerving. It's all a matter of confidence.

Then she had me walk round the dining room table a couple of times, without any aid. Crikey, I didn't think I would do that. But I did, yay, albeit a bit wobbly. That's an extra exercise for me to do. also left me a stepper last week.

I thought I was making good progress at 5.5 weeks, but then I read someone else's post who is at 5 weeks and they are walking around as normal. I know everyone's case is unique, but that is just extraordinary!

I know I HAVE improved immensely since the beginning, but sometimes you can't help but feel you will be like this forever I'm afraid I'm not a patient patient

 

[Mojo333]

my hippy pal.
You will get there...just lots of healing still happening and I agree with the above advice that ice is a huge help.
Keeping that inflammation down really helps things.
There are some miracle recoveries, but mine fit the definition of slow and steady.
I am 3 years put now from BTHR and have no issues.
The first 6 weeks was trying and nerve wracking and it kept getting better and better for well over a year.
So keep the faith and stay cool.

P.S. Not sure about the stepper
Seems unnecessary to me especially this early out.
Do take care not to overdo.
PTs tend to always want to fix things with more PT...often time is the best healer and overtaxing those healing muscles and tendons with exercise just keep things angry.
Lots of time for strengthening and toning later.

 

[leejaa]

I read those miracle recoveries and go WOW. My recoveries were great - but not miraculous just slow and steady lead to great. Patience is the one muscle that needs to be exercised the most during recovery. We need to be patient with ourselves and our bodies. I would ignore the stepper for now and concentrate on walking with a good gait using assistive devices. Our bodies need to relearn how to walk correctly again especially if we were hurting or limping for a time. You are doing great for so early in recovery and the rest will come with time and of course patience. I hope you have a good day.

 

[zauberflöte]

@KathyH a stepper?!?! If I had had to use mine, all previous recovery would have flown out the window. I had anterior, so the flexors were very tender. In fact, I think it was many months before I was comfortable using mine.

I am one who did in-home PT faithfully for the first hip, and zero PT for number two (except the ankle pumps for circulation and glute squeezes because they made sitting easier). The second hip felt better faster, with the result that when I did begin strength training again, all was well.
I will say, my home PT was not as aggressive as yours sounds, but I didn't really give him the chance to be. I "fired" him after I think 4 visits, as I wanted to save my health benefits for out-patient PT later. See if you can get yours to do some hands-on work-- that can feel soooo gooood!

 

[Hip4life]

I think we need a club for everyone who is an impatient patient. Oh, wait! That IS everyone! Yeah, at first I compared myself to other people’s recoveries and thought what is wrong with me? My OS helped me with “Pat, it just takes the time it takes.” Of course, this forum was good about emphasizing the same thing. So there really is no pressure except to keep moving by walking, increasing gradually as those healing tissues tolerate. I think one of the most misunderstood things preop is when will you get back to doing normal things. We like the concrete concepts. Normal and healed are both such uniquely fluid and separate dynamics, I have discovered. Yet we equate them to be the same thing. Silly humans! Lol. Anyway, blessings for continued good healing and progress.

 

[Ava J]

My surgeon must be so different. Both hips he was just, "Just walk. You don't need any PT." I had a PT visit me at the hospital just to make sure I could walk and use the crutches, but he also didn't make me do any exercises. They were all very laid off.

 

[Hip4life]

@Ava J no, not really. I had 3 different OSs on my hip journey say the same as yours. I remember clarifying because I thought I had misheard them. Nope. Just walk and resume activity as tolerated. Other procedures or joints maybe not so much. Lol.