THR Hip #2 Detours, Roadblocks, With a Dash Of Hope^

[Layla]

Hi @Daffodill1
I'm not sure about the spasms, sweetie.
If I were you, I'd call the office of my OS and ask to talk to his PA, a Nurse, any member of his care team.
I'd tell them how maddening the spasms are and ask for suggestions. I'm sure they'll offer something along with a measure of reassurance, which usually helps.

I will tell you that many are still using a walker at three weeks post op. There is no shame in that but I also understand that you want to see more progress. I often remind people to try and gauge progress on a weekly basis, rather than day to day. You'll notice improvements more so that way. Pick a weekend day and each week reflect back on the headway you've made since the previous weekend. If you look from day to day, you're setting yourself up for disappointment.

When you say that after a night of spasms the cane doesn't feel safe....is it because your leg feels weaker, or you're just afraid you're going to have a strong spasm that could cause you to mis-step? I'm hoping Josephine stops by to weigh in on this soon. I sense your frustration and I'm sorry, but I bet it will begin easing soon and you'll be on your way.
Hugs

 

[Daffodill1]

@Layla,

I am on lorazepam for muscles. I was at office last week in wheelchair, no makeup, and wearing pyjamas, tears down my face. That in itself says how I felt. There is no reason they give except for the pulling apart the muscles with anterior approach and muscles are still recuperating. For how long? My groin feels as bad as pre op...need some relief before I implode.

Want to see about changing the title of my thread, last time I was here in 2015 we just posted what was happening, but I thing now my title has been resolved, so I see it can be changed. Can it be changed to “Hip #2 Detours, Roadblocks, With a Dash Of Hope”...

 

[Jaycey]

@Daffodill1 You are back to work far too early and your pain levels confirm this. I hope you can slow down and rest a bit. You are only going to lengthen your recovery with so much activity so early out.

Thread title changed for you.

 

[Josephine]

when after 2 nights no spasms, no meds for it.

Did I read this correctly? That after 2 nights with no spasms you stopped taking the medication? That's not right. You MUST keep taking them for the duration.

I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?

 

[Debru4]

My experience was very similar to Eman85 in terms of when I drove, took longer car trips. It varies person to person. I have long been sore after long car drives due to back pain, even before the hip so I've figure out strategies to cope.

I'm so sorry to hear about your mom and imagine you are anxious to see her. I think if you want/need to take a trip, which I imagine a visit to your mom might fall under, you can be prepared to be a little or a lot uncomfortable. But with frequent stops, the use of pillows, ice, and acetaminophen I imagine you could manage it for something important like seeing her. Of course, that probably is dependent on whether you are still having the spasms, or just plain old recovery pain. I hope your cramps get figured out soon!

 

[Daffodill1]

@Josephine @Jaycey , you misunderstood, by office I meant Dr. Office....I am retired! Could not even fathom working right now....
Was told to take spasm meds only when needed, which I found was a huge mistake. Am back on them now and will keep on them formduration.
@Josephine I will be happy to answer questions for you.

 

[Jaycey]

@Daffodill1 Whew - don't like it that you are in such pain but I am very glad you are not working.

I would take the medication as prescribed on a regular basis until this settles. If you wait until you think you need it - it's too late. You need to stay ahead of the pain. Take a look at this article Pain Management and the Pain Chart.

 

[Josephine]

Here y'go then!

It would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are

1. what approach did you have for your surgery? Anterior, posterior, lateral? You can look here to see the various types THR approaches or incisions

2. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't forget to factor in other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness).

3. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

4. are you icing your painful area at all? If so, how often and for how long?

5. are you elevating your leg. If so how often and for how long?

6. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

7. are you doing any exercises at home? If so what and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)

Exercises done at home
- how many sessions you do each day
- enter exercise by name then number of repetitions of each
etc., etc.

Anything done at PT
- how many times a week
- enter exercise by name then number of repetitions of each
etc., etc.

 

[Daffodill1]

@Josephine

1. Anterior without nerve block.

I only mention this because with my first one in 2015 they did a nerve block and had no issues whatsoever, but the physicians decided against doing them because patients who had both knees done, one with nerve block and one without, there was not enough difference in post op pain and recovery for physicians to continue to offer this. That hip was anterior as well, recovery was not anything like this.

2. At 7:30 am, EDT after a night of excruciating spasms, pain level is 7-8. This includes continuing spasms in operated on hip.

3. Oxycodone 325 1 every 6 hours, this last refill was down from 1-2 every 4-6 hours. Lorazepam 1 mg every 8 hours, up to ½ tablet every 8 hours.

After Dr office visit and them knowing what is going on, am flabbergasted they have reduced dosage.

4. Icing causes the spasming areas to bunch up and lock, so am trying heat, 40 minutes at least 4 times a day.

5. Leg is elevated every time I am sitting or laying on bed. Sitting or laying down 75 percent of the time. Have an adjustable bed, thank goodness


6. Activity depends on night before. Last night spasms started at 9 pm and are still going now. I walk on walker as much as I can to hopefully get muscles to untighten. Yesterday was fine, night before was fine, last night was hell almost continuously. No shopping, almost impossible to put weight on leg after spasms have hit. Still on walker.

7. Foot pumps x10 pumps 3 sets
Circular foot movements x10 3 sets
Heel slides x10 each leg, 3 sets
Lateral leg slides, same as leg slides x10 3 sets
Leg lifts, x10 3 sets
Butt crunch x10 3 sets
Standing march x25 2 sets.

All of these are done 3-4 times a day lasting about 30 minutes

Do not start PT until next Friday,

Appetite is lousy. Just sayin.

I really believe I should be on a cane by now, but hasn’t happened yet. Each day staying on a walker is another day I feel I am losing getting better. Apparently not many patients go through these spasms, and if it was not for the intensity and frequency I believe I would be well on my way to being human again.

Hope I have answered for you, and thank you...

 

[Layla]

Good Morning Daffodil,
I'm really sorry you're still suffering. It sounds miserable. I may be out of line here since Josephine hasn't been by yet to respond to the info you provided, but I wish you would please consider stopping all of the exercises you're engaging in until you've heard from Jo. I could be wrong, but I believe she will offer the same advice in the area of all of those reps you're struggling through. Please consider it and re-read the Big Tip from the Recovery Guidelines -

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.

I will look forward to Jo's response and I'm wishing you comfort in the interim.
I hope today feels a bit brighter
@Daffodill1

 

[Jaycey]

I have to agree with Layla - all that exercise is not help you at all and is probably the major contributor to the spasming. At least stop for now and see if this settles. And if you are still having issue I would not recommend PT at this point.

 

[Daffodill1]

@Jaycey unfortunately in the USA now with the opioid crisis you have to do everything your surgeon says or your pain meds are very hard to get...

 

[Jaycey]

you have to do everything your surgeon says or your pain meds are very hard to get.

Well if you stop all this exercise and let that hip ease you won't need more medication. Just sayin'

 

[SE Florida]

Well said @Jaycey and I don't think the surgeon is monitoring every foot pump or leg slide anyway. My surgery was also Feb 28th and I've had my share of ups and downs but I had to find my own middle ground for exercising. It's definitely not by the book because we are all different. There are days when it's all about resting, elevating and icing..........NO exercise. Other days will consist of some light PT. And I still use my walker constantly as I build up my stability and stance. You just need to find your happy place for recovery; it's your recovery and body not your surgeon's. @Daffodill1

 

[Josephine]

oxycodone 325

The 325 only refers to the Tylenol (acetaminophen) in the tablet. There will be another number with the 325 which will be the dose of the oxycodone. Please tell me what that is.

 

[Daffodill1]

@Josephine

The number is 5/325. Also forgot about hydromorphone 2mg every 6 hours as needed for pain. Started out with 30 have over 20 left from prescription date of 3/13. For some reason I just am very hesitant about all of these, so I only take the dilaudid for bad breakthrough pain, yes I know I should not do that, and will def stop. The lorazepam went UP to 1 mg, not down to 1/2.

Hope this helps. Btw, been on cane instead of walker this afternoon seems to lesson few things, so will keep on with that..

 

[Layla]

Hi @Daffodill1
Great news you're using the cane more often and finding things easing a bit.
Happy Three Week Anniversary, by the way....yesterday I believe.
I hope you continue to notice improvement over the weekend.

 

[Mojo333]

@Daffodill1
I hope today will be a better day.
I get that PT recommendations are confusing and I also planned on being judicious about following protocols.
Truth is, it was aggravating my healing process and neither my surgeon nor my PT had hip replacement and even if they had...they don't have my body or my hip replacement.
Your body is in charge of how much and when...
Hang in there...sending healing hugs!

 

[Josephine]

2. pain level is 7-8. This includes continuing spasms in operated on hip.

Not surprising at 3 weeks out.

3. Oxycodone 5/325 1 every 6 hours, this last refill was down from 1-2 every 4-6 hours.
hydromorphone 2mg every 6 hours as needed for pain.
Lorazepam 1 mg every 8 hours, up to ½ tablet every 8 hours.
For some reason I just am very hesitant about all of these, so I only take the dilaudid for bad breakthrough pain

You really have got to get to grips with a proper schedule of taking these medications. With your pain levels,you need to take these medications AS PRESCRIBED and not 'as required'. The key to managing pain is to keep it under control and never allow it to flare up as you are presently doing.

4. Icing causes the spasming areas to bunch up and lock, so am trying heat, 40 minutes at least 4 times a day.

1. I would suggest that it's likely you are applying the ice directly on to your skin which can have that affect.
2. Never, ever use heat on your hip. That's the very worst you can do.

5. Leg is elevated every time I am sitting or laying on bed. Sitting or laying down 75 percent of the time. Have an adjustable bed, thank goodness

Good.

5. Leg is elevated every time I am sitting or laying on bed. Sitting or laying down 75 percent of the time. Have an adjustable bed, thank goodness

That's good.

6. Activity depends on night before. I walk on walker as much as I can to hopefully get muscles to untighten. Yesterday was fine, night before was fine, last night was hell almost continuously. No shopping, almost impossible to put weight on leg after spasms have hit. Still on walker.

All good.

Foot pumps x10 pumps 3 sets
Circular foot movements x10 3 sets
Heel slides x10 each leg, 3 sets
Lateral leg slides, same as leg slides x10 3 sets
Leg lifts, x10 3 sets
Butt crunch x10 3 sets
Standing march x25 2 sets.
All of these are done 3-4 times a day lasting about 30 minutes
Do not start PT until next Friday

Please remember the guideline THE 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.

Appetite is lousy.

That can be because of the pain meds. They can have that affect.

 

[Daffodill1]

@Josephine
3. Let me be more specific. Sometimes things get confused in the explaining. I take ALL of the meds as described except the hydromorphone. That one I keep for nighttime, However, to be honest since I am mostly on a cane now, nights are bad from the change. So I started taking the hydromorphone about 4pm, and 2 usually get me through the worst part. Everything else is on a direct schedule.

4. Ice pack has a cover so ice is never directly on skin. But after about 10 minutes leg is mostly in a lockdown. No kidding, I have to wait 15 minutes before trying to get going. I use the heat in the groin area a few times a day and it really does help

6 update - mostly on a cane

7. Jo, here in the US we really don’t have a choice about PT. In order for the drugs to be prescribed, you have to do what they tell you to, including exercising. I have decided I will go a couple times,. Maybe by then we can start the weening process.

Thanks for your time and advice!!