THR Getting mixed messages on PT after THR<

[KathyD]

Hi Debru4,
I don't have a 6 month follow up either. After my 6 week follow up, my surgeon also said come back in a year. He said this for both hips.

 

[Debru4]

Thanks, Kathy. Sounds like there really is a big range. I just wondered if my one year return was an anomaly, but obviously not!

 

[An54]

My surgeon didn’t suggest a six month follow up either. In fact I can’t even recall if he said I should see him in a year ( guess I should contact his office and ask about that.) My big question at my six week follow up was how long the wait would be for hip #2 when the time came . He said six months.

 

[Debru4]

Actually, An54---mine said to come back in a year "if I wanted" or sooner if I needed. I told him he could count on seeing me in a year!

 

[KathyD]

I wound up waiting almost 2 years for my second hip, but it didn't really start bothering me until about 18 months after the first one. Then I had to fail PT and a steroid injection before the insurance would pay for a replacement. I also waited until January so my husband would be available to take care of me. But it's done now and so far so good.

 

[Debru4]

I had a very different experience in terms of the wait. My doctor would have done it within a couple of weeks based on the X-ray and his exam, but I wasn't able to do it for 4 months due to commitments I had. I did do 2 steroid injections to help me through those months including a 3 week trip to Europe) but he said PT would be of no value, and could damage things further. I imagine a lot of it has to do with where you are located, and what your insurance is as well.

You must feel so good @KathyD knowing they both are done now. My insurance did require an X-ray of my other hip, and I was so scared that they would tell me it was bad as well. (I hadn't had any pain in it, but then I had no warning on my right hip either.....fine one day, and the next day my leg was giving out and I was in terrible pain.) I was very relieved when he said the left hip looked good---a little arthritis, but good space and no spurs, etc. So hopefully it will last me awhile. I do know once it starts going, I will get it done sooner than I did the last one. Recovery from surgery has been smoother than I expected, and the memory of the horrid pain before surgery is one that hasn't left me yet!

 

[Barbaraj]

Good morning, @Debru4. My doctor, too, said "see you in a year" after my 6 week check up. He didn't say anything about doing hip #2, "we'll talk about that later" and we certainly will at my year check up or earlier if hip #2 really starts acting up. He said "stay active, don't gain any weight". I agree that different physicians have different protocols, or maybe it's based on the physician's assessment of each individual patient. I think it's probably different for everyone in terms of timing for #2, assuming the same conditions are found in hip #2 as were present in #1 (probably osteoarthritis). I definitely feel far less anxiety about getting surgery again, although definitely NOT looking forward to the whole experience. On depressed days I think I should be hoofing it back to the surgery immediately, but then I realize I don't feel as if I've given the recovery process a real chance to succeed. I am doing really well, I know, but simply not free from the aching and stiffness which, perhaps very foolishly, I thought would subside after surgery, and certainly at 6 months out. Anyway, it is a gorgeous day in my neck of the woods, with sunshine and warmer than normal temperatures and this sort of weather is such a mood booster for me that despite the usual morning stiffness and aches, I'm ready to get outside and enjoy some fresh air. Have a great day!

 

[Debru4]

I know my doctor would have told me to come back sooner if he had concerns, so I'm sure you're right about how they decide when to have you return.

My recovery has been fairly smooth, and I'm almost afraid to say that aloud---worried I'll jinx it. But as a result of not pushing activity, I have gained several pounds and that isn't good for my joints, or for my psyche either. I am physically ready and able to be more active, and am looking forward to improved weather so I can do so. Feel like I have gotten into a habit of too much sitting and not enough doing at 7 1/2 out of surgery. I'm not a "gym or organized exercise" person---am more of a "walker/hiker/gardener/stay active with projects"person. So I need the weather to cooperate!

It must be so hard trying to figure out the timing on Hip #2. Have you done steroid injections?

Are you affected by the lack of sunlight in the Northwest? I know I would be. Colorado has over 300 days of sunlight, and I still get a bit off in the winter when the days are shorter. Not sure how I'd do in a place with less sunlight.

I hope you had a lovely day getting outside today----I am the same way---getting out in the warmth and sun always picks me up!

 

[Barbaraj]

Good morning, @Debru4. It's another sunny, unnaturally warm (not that I'm complaining!) day in my neck of the woods. It is supposed to reach the high 60's today--wahoo--and I definitely want to get outside for a good chunk of the day. I hope the weather is more cooperative in your neck of the woods so you can get out and enjoy it, and get some exercise as well. You must be one of those motivated persons if you're able to fit in your exercise without the structure of a gym or classes. I wish I was, but I do better when I go to a facility to get my exercise. I belong to a very nice, and pricey, health club and the good thing about that for me is that I think about how much money it costs, that provokes guilt and motivates me to get there and start working out. The Pilates class I go to is through the local parks and recreation department, so fairly inexpensive, but I go with a neighbor friend and it's an opportunity to catch up with her, so social contact as well as stretching and muscle building.

I've never tried the steroid shots. When I saw a physiatrist before my visit to the orthopedic surgeon, he said they could do those but to remember that (1) they may not work, and, (2) if they do work, they are only temporary. That combined with an absolute horror of someone jamming a big needle into my hip (shudder...) convinced me that I wasn't going to try that at all! But, I bet it might work well for someone else.

 

[desertrat]

I didn't have a 6 month follow up either - just 2 wks, 6 wks and 1 year from surgery, unless of course I have problems.

@Debru4 I finally went for a short hike yesterday - about 2 1/2-3 miles. It's warming up here and the wildflowers are about peaked. They are fleeting. Boyfriend and I took my dogs out in the desert mountain park next to my house. He handled the dogs and I used my trekking poles for support and it went well. We're going again later in the week. Have you been able to get out hiking yet?

 

[Debru4]

@Barbaraj --I hope you enjoyed your time outdoors. Your comment about me being highly motivated isn't really that accurate. I am not a very self discipline person at all---actually am pretty random, but I cringe when tied too much to a schedule, especially since I retired.

Luckily I am a pretty active person, and have a lot of interests, so while I'm pretty sure I don't get the same quality of a workout as if someone else were leading me through it, I do typically manage to move around quite a bit----when I can get outside! I have the same sense of restlessness and frustration when I am not able to garden, or be outside doing projects as you seem to when limited in your exercise. If I weren't from this area, and didn't have my family/friends/support system nearby, I'd live somewhere with warm weather year round!

Back in the day when I used to take exercise classes, I always did them with a friend, for the reasons you described. It was a combination of friend time and a workout, and having a friend do it with me kept us both accountable. I may need to consider that again if I find myself unable to get in gear!!

I had steroid shots before both my back and hip surgery. Both times I was hopeful that I was in that tiny percentage of people who end up being cured from pain. Neither time was I. However, the injections I had before my back surgery 9 years ago enabled me to dance at my daughter's wedding and enjoy all of the festivities around that special time, pain free. The ones I had before my hip enabled me to help with my newborn granddaughter for a couple weeks, as well as travel to Europe (not pain free, but not mowed down by the pain either!). I would highly recommend them---With my back, I was sedated, and truly felt no pain. With my hip, I was given a local anesthetic, and while there were a couple uncomfortable moments, there never was terrible pain. I think the procedure sounds worse than it actually is. So if you need to buy a little time before you do a surgery, you might want to keep an open mind about it.

 

[Debru4]

Hi @desertrat ---How fun that you were able to get out hiking, and see some of the wildflowers! That sounds like a pretty ambitious walk so I'm happy that it went well. I have never seen the desert in full bloom---would love to see it, as I am such an avid gardener.

I spent a couple of days in Denver this week with my daughter and 2 granddaughters. We stayed overnight since it was the five year old's spring break, and we have a tradition of taking a girls' mini trip each spring. I walked several miles over a couple of days going to the Denver Aquarium, Children's Museum, and around downtown Denver, and also felt good at the end, which was a relief! Any discomfort was due to getting a bit out of shape in general over the winter.

I haven't been up in the mountains yet, or on anything too wild in the foothills---still pretty snowy, icy in some spots, and very mushy in others. I don't have trek poles---only used the walker and then the cane a couple weeks total, but never got trek poles. However, I am thinking I might want to get some before I tackle those more rocky, uneven trails. I see lots of folks use them, even those who haven't had a hip replaced, and know that I am not as stable/balanced since having it done. I'm not even sure what to look for, or how much they cost---will need to do some research.

 

[KathyD]

Hi Deb,

I got a pair of trekking poles a few years ago at Costco, of all places, but I never used them because I quite often have a dog on a leash and want at least one hand free. But look for a pair that has adjustable height and several interchangeable tips for different terrain.
The main reason that I did PT was so that I would have the strength and balance to hike rocky trails. I am still not there yet, but hope to get started this summer.

 

[Debru4]

Thanks, KathyD! I don't walk with a dog so that wouldn't be an issue for me. I have never had great balance (ankle reflex issue on left side) and since this surgery I can tell my overall balance is worse. The doctor had warned me that since he removed the labrum, which is a stabilizer, I needed to be even more aware of balance issues. Obviously I know nothing about trekking poles because your advice sounds like a foreign language to me---.

I wonder if since I have never used them, I would be even more awkward with them, and perhaps should look into some sort of class or work to improve my balance overall? I may research that as well, since it is a bigger issue than just when hiking.

 

[GrannyC]

Hiking poles are great for long walks, especially on uneven terrain. Using them comes almost natural and is very easy. They take a bit of pressure off your legs or at least that is how it feels, and I think they would help your balance, too. You might be able to check some out and test them in a sporting goods store.

 

[SurreyGirl]

For me they were a natural transition from elbow crutches. I use them for walking long distances and just one as a back up in my bag in case I get tired and need a bit of support... They are telescopic so fit easily into my carry-on suitcase for holidays.

 

[Barbaraj]

Good morning, well, good afternoon, I guess, @Debru4. I have to agree with everyone's comments about walking poles. I ditched that miserable walker within a week and went straight to a walking pole (should have used two of 'em but I'm a klutz and could only figure out how to use one). I found the pole very useful in helping me stand up straight (I think good posture really helps, or it did for me, in recovery) and also to fend off the ridiculous number of oblivious folks walking along with their noses buried in their cell phones! I am not sure what kind of training/class would help specifically with balance issues, but I'm betting a bit of PT might be useful?

And thanks for the observations about hip injections. Perhaps, as with my overblown (as I discovered...) anxiety about the whole sedation/spinal for surgery (which freaked me out way more than the actual surgery itself), hip injections wouldn't be that awful and could afford some relief. But I confess I cringe when I even think about this sort of thing! I am in a low level state of discomfort with my left hip, have (I think) a reasonably high pain threshold, and I'm stubborn. I want to give PT a chance (again...) to see if I can build up the muscles around my hips to, I hope, alleviate some of this discomfort. Again, if I find it beginning to get overwhelming, I can always check in early with the OS and talk about scheduling a second surgery.

 

[Debru4]

Thanks everyone for the useful background info on the poles. I have never used them, but plan to check them out
@GrannyC ---am glad to hear that they feel natural! I think if I want to continue being active I need to be proactive about some things like this.

@SurreyGirl---you answered the question I had in my mind about the telescoping option to transport them;)

@Barbaraj, I too ditched the walker after a few days, and only needed the cane until 2 weeks. So perhaps my balance isn't as bad as I feel it is, since I have been navigating stairs and walking distances for quite awhile, with no falls yet.

It mainly is when I am on uneven terrain that I feel I could risk a fall, and when I am not paying attention, or stumble a bit, I don't seem to be able to right myself easily. While I can walk around just fine, I am unable to balance on one leg for ANY period of time anymore---not even my good one?!?!

I saw a class offered at our local senior center on balance. Probably should look into it, but to be honest, even though I qualify age-wise, I haven't felt "ready" to jump into senior activities. Like you, I have a very high pain tolerance level, but that generally works to my disadvantage on serious things, as I have waited too long to get medical attention more than once. PT for balance might be an option. I probably will wait until my one year appointment with the surgeon to ask about it though, as I want to give my hip plenty of time to heal first.

 

[Debru4]

Thanks @Layla for the feedback on the dual hip X-rays. I thought it was odd, since they didn't take it until my pre-op visit a few days before my surgery. Your explanation makes sense.

It's interesting, because I had triplets about 30 years ago. A couple of nurse friends have said it isn't unusual for people who carried multiples to later develop hip issues. I'm sure that can be said of lots of circumstances, but I'm also pretty certain that going from 115 pounds to 185+ pounds in a few months did put a little extra strain on the hips. And interestingly enough, one of the three triplets settled exclusively on my right side. The other two were more balanced. So maybe I need to tell that one he "owes me"---haha! Funny the things I have time to think about, now that I am a ways out of surgery!

 

[Layla]

Haha! I've wondered if carrying my kids, nieces and nephews and then grandkids on my right hip wore it out sooner. How did we jut those hips out like that anyway?!! Built in seating for baby bums.
One of my kids weighed 10.2 at birth....so he was always a load! I blame him, lol.
@Debru4