THR Grannyhippy's Recovery Thread

[Cynthia777]

Wow @Grannyhippy, your determination is amazing! I can feel such an inner strength coming through your posts. I'm really interested to see how the hydrotherapy helps you versus regular PT. Since I've been blessed with a swimming pool, I'm kind of leaning towards water PT once my second hip has been replaced. Thank you for sharing your journey in such detail, it's been very informative and quite interesting. Hugs!

 

[Grannyhippy]

Thanks @Cynthia777, I guess I am pretty determined to do whatever I can to help my recovery. I too am interested to see if I get better results from having a session in the clinic instead of the pool.

My elderly neighbour has offered to let me use her pool any time I wish to but I hate smothering myself in greasy suntan lotion and her pool is not covered. Nor is it heated. I often say I will go over to her place late in the day when the sun is low and the pool has been warmed up by the sun but somehow I never seem to get there. I know she goes to bed fairly early and even though she said I can still go over then I don't like to. She does not have a railing on the pool stairs either and I am still not that steady on stairs.

 

[Cynthia777]

Not heated? BRRRRR!!!!

 

[Grannyhippy]

It's early Autumn here at the moment so the pool water is not too bad at the end of a hot day. I dipped my foot in it earlier today when I was over her place. Just to test the temperature. I didn't swim today though. We went ceramic cooktop hunting for her instead. Both of us with canes. She is 89.

 

[Grannyhippy]

I had a session in the clinic the other day with my physiotherapist instead of in the pool. She was on holidays when I had my initial assessment so another physiotherapist did the assessment and copied all my accompanying notes into their computer. He also did the first two sessions in the pool with me.

Anyway because I am still having problems with both my back and hip she wanted to see me in the clinic to review the situation and perform some hip and back stretches and manipulations which she could not do in the pool. She also tested my flexibility and leg and hip strength. I have certainly made progress since I started the exercises but I still have a long way to go. I am walking much straighter because my muscles are becoming stronger but I still have a pronounced limp. She looked at my leg lengths and reckons that there is about a 2 cm (1 inch) leg length difference. We were discussing the possibility of trying a shoe lift to see if that settles my back down because the leg length difference could be setting my back off.

My orthopaedic surgeon initially said that my hip stem had subsided but indicated that it was only quarter of an inch and I should not notice the difference. At a later visit he said my leg lengths were the same and upon the following visit when I thought my back was involved and had the MRIs etc. he said maybe if I had my back fixed I could get away with a shoe lift instead of redoing the surgery which he wanted to do in the first place. I really don't know where I stand because he contradicted himself with each visit.

My orthopaedic surgeon thought I might need surgery to decompress some nerves in my back and maybe even a spinal fusion because of my spinal spondylolosthesis and mild scoliosis. I also have some spinal stenosis. My neurosurgeon does not think my back is bad enough to require another surgery (I had a lumbar microdisectomy in November 2008). I really don't know what to do or where to go from here. My neurosurgeon said not to be in a hurry to jump back into any surgery for my hip or my back but to try hydrotherapy in the pool for three months and go back to see him if I am still not OK after that.

My physiotherapist is going to talk to a podiatrist friend of hers to ask about shoe lifts. They are very expensive.

She is going to try to read my notes over the weekend before my next session and she will then make a decision as to whether I would be better off having sessions in the clinic or the pool or maybe even alternating between the two. I don't think I can afford two sessions in one week and I think the physiotherapist is aware of that.

She also suggested I massage my scar as she felt a few hard spots underneath and thinks it might be scar tissue.

I have also been successfully losing weight slowly over the last few months as I think that would be of benefit to both my hip and back. So far I have lost about 5-6 kg and feel better for it. That is where exercise in the pool is good because I can do so without full weight bearing.

 

[sharonslp]

Grannyhippy, I'm tagging both @Josephine and @Jaycey to comment on post #125, especially in light of the contradictory input about shoe lifts.

And a huge congratulations about the weight loss. I took off a large amount over the past few years, and I can tell you that it makes a wonderful difference in a variety of ways. It doesn't guarantee the end of all pain....but it contributes to a sense of mental and emotional heaviness being streamlined right along with the body.

Sharon

 

[Grannyhippy]

Thank you @sharonslp for your comments and for tagging both @Josephine and @Jaycey I do still have pain when I put my weight on the operated hip. Each time I step on that leg I feel discomfort on the outside of my hip where the scar is. I guess at the point of the trochanter. It is a sharp feeling. I also get pain over the iliac crest, in the buttock area and a couple of different spots on the right side of my spine. I also have a catching/pulling feeling in the front of my thigh in the middle where the thigh meets the torso. I did notice that pulling feeling in the front of the thigh when I was in hospital. The pins and needles in legs come and go but are not as bad as before. I have them in the front and back of my right thigh, the outside of my right calf and over the top of the foot. I also get fleeting pins and needles in the left leg but mostly just the second and third toes. I no longer have that cold feeling (which I think must have been nerve damage) in my mid buttock area on my right side.

When I walk I have the sensation that my operated hip juts out when I put my weight on it. The more I am on my feet the worse it gets.

My physiotherapist tested my reflexes a couple of days ago and some of my reflexes are down a bit. Especially on the operated leg. I seem to have normal sensation in both legs when a tissue is brushed over them lightly.

I think my physiotherapist is a little stumped with the situation. Among the other things she has been doing she has been working to try to eliminate my pain. The pain is annoying and debilitating but not bad enough to require strong narcotics or anything like that. I do take Panadol Osteo though when I need it.

A couple of weeks ago my therapist suggested I take my Celebrex for a while to see if that settled things down. I did so for about a week but stopped because my GP does not want me to take it continually as it was affecting my blood pressure.

The last few days I have had a lot of crackling in my lower back when I move. That is something which seems to come and go. It is probably just my arthritis but who knows.

I know the first physiotherapist at one stage suggested I may have some bursitis but I think that idea has now been dismissed although there are areas which are tender to the firm touch.

One good thing is that when my therapist tested and timed my sitting and standing with arms crossed exercise I had slightly more than halved the time from my first test. I had to do it five times and the first time I took 25 seconds, the second time I took 11 seconds. Whoopee.

I know it is hard for anyone to make a diagnosis from such a distance without actually seeing me face to face but any opinions and information would be appreciated.

 

[Jaycey]

My orthopaedic surgeon initially said that my hip stem had subsided but indicated that it was only quarter of an inch and I should not notice the difference. At a later visit he said my leg lengths were the same and upon the following visit when I thought my back was involved and had the MRIs etc

I would question this. Either you have LLD or you don't. This can be measured on your x-ray or your PT can do this for you.

My orthopaedic surgeon thought I might need surgery to decompress some nerves in my back and maybe even a spinal fusion because of my spinal spondylolosthesis and mild scoliosis.

Based on this statement I think you need a second opinion on your hip. Recommending back surgery to correct what could be a problem with your implant is crazy. I have had decompression surgery. I would not consider this unless it is your last resort.

Back issues can be aggravated by LLD. If indeed you do have LLD then a lift in your shoe may ease your back (it did for me anyway). Surely trying the least invasive route first is more sensible.

 

[Josephine]

She also suggested I massage my scar as she felt a few hard spots underneath and thinks it might be scar tissue.

Well of course there will be scar tissue in a scar! What a strange remark. But considering your wound is 8 months or more old, I would suggest that what you have is what you are stuck with. No amount of massage is going to make any difference now.

So far I have lost about 5-6 kg and feel better for it.

Well done you!

My neurosurgeon does not think my back is bad enough to require another surgery

TBH, I wouldn't let a surgeon with a scalpel within a million miles of my spine for anything! The outcomes are invariably poor and there is very little in a spine a good chiropractor could manage anyway. So why even think about surgery!

Each time I step on that leg I feel discomfort on the outside of my hip where the scar is. I guess at the point of the trochanter. It is a sharp feeling. I also get pain over the iliac crest, in the buttock area and a couple of different spots on the right side of my spine.

Those three I have highlighted would almost certainly be Trochanteric bursitis and Piriformis syndrome which very often go together.

 

[Grannyhippy]

@Jaycey and @Josephine. Thank you both for your input.

My husband once had his leg lengths checked by a PT and was measured from his naval to the inside joint of his ankle on each leg. I believe this is the more accurate method of measuring to check if the legs are really different lengths or apparent different lengths.

Neither my PT or OS used a tape measure. I just had to bend my knees up when lying on my back and they checked different angles.

I have heard that scoliosis can make a difference in apparent leg length because it throws the hips out of alignment.

Josephine what does TBH stand for? I have had a lumbar microdiscectomy L3/4 back in November, 2008 and I do have another bulge there. My neurosurgeon once said the more surgeries you have the more it weakens your back.

I did mention Piriformis Syndrome to my PT but she did not comment. The PT I had for the first two sessions did suggest that I may have a touch or bursitis when I told him the hip was sore to touch.

I do have facet joint arthritis in my spine as well and that probably accounts for the crackling. Just part of aging I guess.

When I lie on my right side I have a tight stretched feeling between my lower ribs and down to my hips. I do feel this stretch at other times as well. I did have this before my hip surgery. I am working on this with gentle stretching.

I will continue with the physiotherapy for a while as it has helped me and I will consider looking into shoe lifts.

A couple of months ago I contacted a lady who worked at the same place I used to and we had a long talk at the time. She had a hip replacement back in 2010 and ended up with different leg lengths. She put up with it for a year and ended up relenting and getting a shoe lift. She said it improved the situation. She did find someone who made them at a cheaper price but could not remember his name. I have not spoken to her since then but I left a message on her answering machine the other day. She moved away so I don't see her very often. She said the surgeon who did her hip also did both of her husband's hips before he passed away (her husband that is) and he never had any trouble with his. He was a house painter and was back up ladders painting in no time afterwards.

Jayce I will wait awhile before getting another opinion but I will talk to my GP about it next time I need to renew my prescriptions. My GP referred me to my OS.

Josephine I felt that my PT was trying to do adjustments to my back the other day in the clinic. PTs sometimes do the same adjustments that Chiropractors do.

Thank you both again for your input.

 

[Josephine]

Sorry, TBH is just shorthand for "to be honest"!

measured from his naval to the inside joint of his ankle on each leg. I believe this is the more accurate method of measuring

I've never even heard of this method! Usually one has to measure between two bony points because they don't move. Using the naval is using soft tissue which will. So more correctly the bony points used should be the anterior superior iliac spine (marked the spina iliaca in the image) and a malleolus (bony ankle joint in the image).

I have heard that scoliosis can make a difference in apparent leg length because it throws the hips out of alignment.

Indeed it can!

I have had a lumbar microdiscectomy L3/4 back in November, 2008 and I do have another bulge there. My neurosurgeon once said the more surgeries you have the more it weakens your back.

And he would be absolutely correct.

There was once a study done which I can't find anymore, search as I might. But this group of medics got a portable scanner and set up in the town centre, inviting people to have a spinal scan. As I recall, anyone with significant history of back pain was excluded so these were all people with no previous back pains. What they found was that a huge number of them, about 40% as I recall, had evidence of bulging discs but no symptoms. This confirm the theory the medics had that intravertebral discs are designed to bulge and generally cause no problems doing it. They repeated the scans some time later and found a) that previous bulges had disappeared b) that other bulges had appeared, also asymptomatic and c) bulges that still remained evident were still causing no problems. Moral of the story being, don't worry about bulges, the discs are doing what they are designed to do and part of their job as a shock absorber.

I did mention Piriformis Syndrome to my PT but she did not comment.

Probably because either she didn't know what it was or didn't know what to do about it!

 

[Grannyhippy]

@Josephine. Thanks for that information about how to measure leg lengths. To be honest I am not sure whether I have a true leg length difference or apparent leg length difference. Either way, do you think a shoe lift on the so called shorter leg would help

If you were me would you be getting another opinion and if so should I go to another orthopaedic surgeon or a podiatrist to check leg length and gait etc. As I said before my gait is a lot better than it was before but still not good and I still have a limp.

I have been working with my PT on strengthening my core muscles. I do have a tendency to stoop forward and I know that can also put strain on my back muscles. Prior to my microdiscectomy in 2008 the PT I had back then wrote a letter to my doctor saying I was stuck in forward flexion.

The only reason I had the microdiscectomy years ago was because of unrelenting sciatica. Even a transoraminal epidural injection did not help it. The nerve was badly squashed and even my neurosurgeon said that he did not think the injection would help at the time but we gave it a try.

You are probably right about my physiotherapist and Piriformas syndrome.

The information about the study of people's spines was interesting. My physiotherapist sister-in-law whom I don't see very often said months ago that disc degeneration, bulges, stenosis etc. are all part of the ageing process and don't necessarily need surgery or show symptoms. When I told her of my concerns about maybe needing surgery on my back she advised against it saying that it is rarely successful. She said if surgery on my back was suggested I should get another opinion, then another one and then say "No thank you". I told my OS what she said when he did suggest surgery at a follow up visit and he said that she was "soooo wrong" and that back surgery can be successful.

I might add that she has not seen any of my scans but my husband did email a copy of some of the reports from my MRI and x-rays to her. She made that statement before I saw the neurosurgeon who also does not think an operation is necessary.

 

[Josephine]

do you think a shoe lift on the so called shorter leg would help

At your stage, can't do any harm.

If you were me would you be getting another opinion and if so should I go to another orthopaedic surgeon

Most definitely a different surgeon. There's no point in getting one if you're going to go to one of your surgeon's colleagues or golfing buddies.

I told my OS what she said when he did suggest surgery at a follow up visit and he said that she was "soooo wrong" and that back surgery can be successful.

Oh sure there are successes but they tend to be few and far between!

 

[Cynthia777]

Boy, I sure hope you can get the help you need! For what it's worth, I have a LLD of about 1/3 of an inch (my OS showed me by holding up his fingers, not an actual measurement) and I definitely get back pain when I walk, which I've never had before. I can feel the strain in my back every time I walk any distance. My LLD will be corrected with my next THR (hopefully). I agree with Jaycey about trying the easiest fix first with the shoe lift. Just my two cents worth.

 

[Grannyhippy]

@Cynthia777 I'm just sitting here at the moment waiting for my PT to call. I was baby sitting my unwell grandson the last two days and my husband said my PT rang regarding having spoken to my Podiatrist about shoe lifts. She said she would ring back today. I know she is in the pool in the mornings so I have not phoned her. I also have a an appointment with my GP in half and hour to renew my BP prescription so won't stay on here for long.

I guess trying the easiest fix first is the way to go but I am so frustrated to think that I will need to wear expensive closed in shoes all the time to accommodate a shoe lift. In summertime especially I like to walk around the house in bare feet or thongs (flip flops) not the undies kind. Something I can slip in and out of easily and be comfortable in.

I just wish I had not ended up with this leg length difference but so be it. Although I am not in a hurry to have another surgery I do wonder that if I had done as the surgeon suggested and replaced the stem I might be OK by now. But then again, I could have ended up worse off.

I found baby sitting my grandson who was feeling a little off colour very tiring and my hip is sore today. I am lucky he is a good child and was just a little quieter than normal. He is only 23 months old.

 

[Grannyhippy]

Well, I just had an interesting chat to my GP while I was seeing him this afternoon. He says that a leg length difference of up to 5 cm usually does not need corrective surgery. I parked close to the surgery entrance so I went in without my cane and he commented that I was walking a lot straighter and I was more upright than before I started the hydrotherapy. He was glad that I had lost some weight and said that it would help my hip. I'm am now hovering around 70 to 71 kg. (around 154 to 156 lbs.) I still want to lose more weight.

He was pleased that I have been going to the pool for hydrotherapy and said that just swimming was good as well. I told him I do that between sessions anyway.

I told him that the physiotherapist was pushing for me to try a shoe lift and that she was going to ask her podiatrist friend about them. My GP agreed that it might be worthwhile trying a shoe lift but he said not to get them from a podiatrist as they would be too expensive. I agreed with him as I have had orthotics in the past and I also had asked the podiatrist how much orthotics cost these days and he said $400.00. Then one has to buy shoes to accommodate them. So my GP suggested that I just buy an innersole about one centimetre high to put in the shoe of my short leg and see how I go with that. He also said that the method the physiotherapist used to measure my leg lengths is inaccurate and he sketched out and explained the correct method. Even then things such as pelvic tilt can make a difference. My GP used to assist my OS in surgery many years ago so he knows what he is talking about.

I called my PT back after my visit to the doctor but she had gone home already so I just left a message that I would talk to her when I have my next visit. She was going to call me today.

 

[Cynthia777]

I'm so sorry @Grannyhippy, I so wish I could help in some way. Living in SoCal, I can imagine your disappointment in having to wear close toed shoes. I'm always barefoot at home, so I really relate to what you're saying. I sure hope they can figure a better solution for you. I hope your little guy feels better and can brighten up your day. Hugs Grannyhippy!

Edited: We posted at the same time.
So, does your doctor feel the hydrotherapy may help get rid of the limp possibly?

 

[Grannyhippy]

@Cynthia777 My GP hopes that I will continue to make improvements. He did not comment about whether I would eventually lose my limp or not. I also got the results of my bone density test which I had taken about a month ago and my bone density is fine even though I stopped taking Fosamax Plus about 10 months ago. I have a bone density scan every two years because of my Osteoporosis. Obviously things must have improved there. Perhaps all that exercise in the pool has helped. I love the water. I also love my dairy products.

We talked about the neurosurgeon saying surgery was unnecessary on my back even though my OS thought I did need nerve decompression. He did not have a copy of my last MRI on his computer (the one ordered by my OS) so he just read the report from my neurosurgeon which basically mentioned radiculopathy of L5 and mentioned my L3/4 bulge etc. and that he suggested I go in the pool for therapy and go back and see him in three months.

My physiotherapist said that I have come to a stand still at the moment because I have built up all my muscles and she feels that the leg length difference is causing my back to flare up, thus undoing the good that therapy has done. She wants me to try the shoe lift to see if that helps settle things down. I feel she is genuine in wanting to help and not just suggesting a shoe lift because she knows the podiatrist who by coincidence just happens to be the one I go to anyway.

My "little man" was feeling much better yesterday and I was not needed today so I think he went to day care while his parents went to work. I am sore today though and need time to recuperate.

Thank you for the hugs, and hugs back to you as well. You seem like such a caring person with a lovely personality.

 

[Cynthia777]

Please do keep us posted. You are in my prayers! Hugs Grannyhippy!

 

[Nana757]

Hi @Grannyhippy
I just caught up on your thread and wanted to add my 2 cents about the shoe lift. I know they can be very expensive, if obtained through a podiatrist. I purchased a couple, with different heights, at the local drug store, which only cost about $10. They not only helped with my gait,but eased my back pain, too. I wear them whenever I have closed shoes on and will be doing a lot of walking (like golf an shopping). The rest of the time, I just go barefoot or wear my sandles. And, BTW, there are inserts out there just for sandles, too!
Hope you find relief soon!