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[THR] Hiptopia!

Calgal

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Hello hipsters (and hipbros). I'm 6 weeks out from posterior THR and doing well. I've been hovering around this forum, reading and responding to others, but felt my story wasn't particularly eventful or interesting enough to start my own thread. The admin's and moderators finally convinced me that yes, there is a place on forums for recoveries like mine (what I call 'boring'). Everyone's recovery is different. Please don't compare mine to yours, this is just FYI. But don't worry - I'm no superstar, not running marathons at 3 weeks or anything like that - just following my relatively conservative OS's instructions day by day, step by step. On the other hand, it's no walk in the park and there are definitely ups and downs, and I've got a long way to go for full recovery, but compared to the excruciating pain I was in before my op, this is truly HIPTOPIA! :yes!:

This first post is where I'm at today. I'll 'reverse post' my weekly journey in posts following this one.

PAIN: My hospital and OS was VERY big on keeping pain under control at all times, and I can truly say I have not been in true pain since my op - but have diligently taken ALL the pain meds they prescribed for me at EXACTLY the right times. I think that might be one reason why I've had an uneventful recovery - I've always stayed ahead of the pain curve. Once back home I was on codeine (and paracetamol) for the 1st 10 days and after that just paracetamol 1000 mg x 4 a day. Just in the past day or 2 I've tapered off the paracetamol too - only took 1000 mg yesterday in the morning. But I have also been icing my wound/scar area every night while watching TV, and that has been helping a lot. Although I'm really happy with my scar, my incision area is the only place that has been and still is tender and somewhat uncomfortable, especially when I sit for very long. It sort of feels 'swollen' and feels like it's getting pushed out a bit. (well, with my butt anything would get pushed out when that is sitting on it!) So ICING REALLY HELPS. I didn't do much icing at the beginning, but did do a lot of elevating. So it's never to late to ice, ice baby! :ice:

ACHIEVEMENTS: I was discharged with 2 arm crutches, but have been using 1 crutch since last week. I have had to do stairs since day one, but still do them toddler style. I'm concentrating on my gait and posture, standing straight and walking heel/toe without turning my foot out.

OTHER ACTIVITY / PT: My OS has cleared me to drive (which I haven't tried yet but hope to this week), to sleep on my side with a knee pillow (thank God for Amazon - coming tomorrow) and to swim (which I haven't tried yet, but hubby is setting up a new hot tub which I hope to try tomorrow). I am still on 90 degree precautions for a few more weeks (as I said, my OS is really conservative, which is fine with me). I have had 2 external PT sessions and due for another in 2 weeks. I've done stellar, although I really haven't done much of their exercises - ha ha! I very gradually did heel slides in bed early on, maybe at 2 weeks, to get my tight front thigh muscle stretched out, and that worked a treat. But I didn't push anything. My PT is also very conservative, mostly looking at my gait and ROM. I now have some specific stretches to do because I can't open my legs ala clam very well (but haven't been able to do that for YEARS!), and I'm going to slowly try to improve that flexibility. Husband will probably look forward to that! :giggle: I went on an exercise bike last week at PT (no resistance) and did fine. However, our exercise bike here at home, purchased for hubby's TKR 2 years ago, has a TERRIBLY uncomfortable seat so although I can do it, I'm going to have to pad that seat out before I spend more than 2 minutes on the thing!
:biking:

So that's were I am and I'm happy with that. I hope you are all keeping your pain under control, icing, slowly moving as your body sees fit, and on your own happy roads to hiptopia.
 

Fit4Family

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:welome: to BoneSmart @Calgal

Happy to see you are joining this group.
It’s been a wonderful supportive community for me.
Hope you continue to have a great recovery!
Lots of healing to come. Look forward to getting to
know you.
 

linette333

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Your story isn't boring at all @Calgal ! As you are just 2 weeks ahead of me, it's really useful. Like you, I am dutifully following the instructions given by my OS, who also is very conservative. There is no way I am going to mess this up now!
I haven't been offered any PT sessions, so I would be interested to know what you do there.
Well done on your recovery so far!
Keep on posting! :loveshwr:
 
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Calgal

Calgal

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haven't been offered any PT sessions, so I would be interested to know what you do there
Not much really. They are more of a checkup to be fair. She watches how I walk (with eagle eyes!), then makes recommendations as necessary (eg the foot pointed out no no surfaced this week). I show off my ROM and she makes recommendations for stretches to correct weaknesses. I get sent via email some picture instructions to refresh my memory. I think my next appointment in 2 weeks might be my last. My homework before then is to work on strengthening my op leg so I can take more weight on it and not rely on crutch so much for balance. She thinks it's more proprioception (Google that one!) than actual strength/weaknesses, and I need to retrain my mind and nerves in my hip talk to talk to each other. So I'm practicing balancing on the op leg while waiting for the kettle to boil, having the countertop to hold onto lightly if I need it. So bottom line is very low key. Which fits in nicely with the advice on this forum.
 

CricketHip

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Hello and I love your report! This is what gives all of us hope when we are worrying over this little thing and that.
I like the thoughts of using PT more for evaluation and guidance. The sounds wonderful and you are so correct about proprioception and teaching our brain to work with our muscles again. That is a great little nugget and I hope people do Google it.. it's fascinating to me and keeps me in awe of just what our lovely human bodies can do to recover.

I'm on day 12 of my second THR and am so happy to be bionic and a double hippie.
thank you again for your uplifting report!! :SUNsmile:
 

Cecropia

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@Calgal
I googled it. Proprioception.....
I just told my brain to get with the program....:heehee:
Actually before surgery I did a daily exercise where you close your eyes and stand on one leg and try not to fall over. This is a balance exercise for aging well. Anyway I was pretty good at it, but right now my left hip does not want to play....:nah:
 

Layla

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Hi @Calgal
It's so good to see /read your thread! You've been so supportive of others it will be nice for you to have a home where others can encourage you also. Having a record of your recovery all in one place to look back at may come in handy one day. I wish I would have recorded more than I did on my own thread.
I hope you're having a lovely Sunday across the pond :wave:
 

Mojo333

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I didn't do much icing at the beginning, but did do a lot of elevating. So it's never to late to ice, ice baby! :ice:
I iced regularly for three or four months...then often interrmitently up to six months.
I have had to do stairs since day one, but still do them toddler style. I'm concentrating on my gait and posture, standing straight and walking heel/toe without turning my foot out.
Normal for most of us at this stage.

So bottom line is very low key. Which fits in nicely with the advice on this forum.
We love the slow and steady approach.
Lots of improvements to come.
Well done @Calgirl
 

Layla

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I'm sure you've read the Recovery Guidelines by now but you've earned your very own copy :wink:
Enjoy!

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
5. At week 4 and after you should follow this
6. Access to these pages on the website

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.
 
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Calgal

Calgal

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Thanks @Layla ! I've read all the articles several times and they are truly helpful. I even PRINTED the Activity Progression one out and have it posted on my refrigerator for the benefit of hubby and everyone else who comes into the house to see. Avoiding stupid questions at week 2 for example like 'are you still using crutches?' Grrr! I also found the healing and the energy drain articles particularly reassuring. Thanks for compiling this package of knowledge for everyone.
 

Layla

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Smart idea posting the Activity Progression for THR it in plain sight for all visiting friends and family to see.
Many have stressed over a well meaning know-it-all making them feel like they're lagging behind in recovery. It always seems to be someone who's never experienced THR, which makes them an expert, right? :heehee:
Hope you have a great week!
@Calgal
 
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Calgal

Calgal

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FLASHBACK Post 1: pre-op and hospital stay experience

I had been diagnosed for 3+ years with OA, although it had been there for many years before that. It got progressively worse over the previous year, and then one night turning over in bed I had excruciating pain and couldn't move my leg! Went back to GP who ordered xrays and they suspected trochanteric bursitis. I got some codeine and was referred immediately to an OS - bypassing the usual physio / evaluation step. My OS was obliged to treat the bursitis first, with a steroid injection that very day. It was the most painful thing I've ever been through, but the relief was instant! After 2 weeks I went back to him to evaluate the progressing OA, and he immediately agreed 'it's time for a new hip' and I said 'how about tomorrow?'. Luckily I got a letter in days that the surgery was scheduled within the month - record speed for the UK / NHS system.

Doctor and approach: Now, being in the UK and having the hip done [FREE!!!] on the NHS, I didn't choose my OS. Over here, we get what we're given! I suppose that if you got a referral and you really didn't like the doc, you could ask for a different one but that would mean waiting. And my pain was getting so bad I didn't want to wait one more second! (see above) Reading posts of USA hipsters agonizing over which surgeon to choose took me back to my earlier life in the US. I had a 24 year career in the health care industry both on the clinical side and on insurance side, and had several orthopedic procedures on a badly dislocated elbow. I know all about choosing well known surgeons, worrying about who is 'in network' and all that stuff. But really, in the end sometimes you've just gotta put your faith in the medical community. I was really blessed that my local healthcare authority is outsourcing their THR and TKR backlogs to private hospitals, so I was referred to a private hospital (BMI group) right in my own town for my surgery. I had heard a little about anterior vs. posterior, and one of the doctors there was also advertising he did superpath, but my doctor did posterior. And that was ok with me. Heck, I was in so much pain I wouldn't have cared if he did my THR through my NOSE! :groan:

Anesthesia: Both the doc and hospital preferred spinal, as they felt there were fewer complications and people were 'up' faster. But I was PETRIFIED! :yikes: I mean, a needle in my spine?! Could I be paralyzed for life if they got it in the wrong place?? My previous healthcare experience meant nothing when a long needle headed for your spine was coming your way.... But a friend's comment a few days before my op set my mind at ease. She said 'but aren't a million pregnant women given spinal anaesthetic every year to have their babies?'. Duh. So I tried to relax. In reality, it was a total breeze. I felt the tiniest little stick then....nighty nights! Now for the worriers you ask, did I wake up? YES. But it was at the very end of the procedure. I remember opening my eyes, seeing the monitor, and politely telling the anesthetist 'isn't my blood pressure a little low?' (once in healthcare always in healthcare - and it really was!). He laughed and said it was all under control. I felt warm air being pumped around me and was conscious of being on my side. They were almost done. I heard what sounded like rustling of paper sheets and cello tape being pulled out (that would have been them putting on my steri strips). Then I was asleep again. Woke up in recovery room attended to by a lovely male nurse. I had some water and we chatted about California. I wasn't in pain but I couldn't really feel my legs yet. Got wheeled to my lovely private room and greeted hubby, had a nice cup of tea and a biscuit (cookie to USA'ers). All told, 1- 1/2 hours.

Pain was well under control. They must have given me some good stuff in OR! The hospital / doc policy was to always keep your pain at 0-1 out of 3. And they did. Lots of meds. The only side effect I had after op was I started to itch. I've got lots of allergies and very sensitive skin on a good day. I read that it could is a possible side effect of the anaesthesia, but it was driving me nuts. But nurses quickly gave me Piritese (antihistamine) which took care of it. No pain, but my leg felt like lead. I had the 'squeezers' on my lower legs, which felt good. I started feeling my legs again and could wiggle toes ok, but couldn't really get up so had to use bedpan to wee. (I had to wee a LOT! Hated the bedpans!!) My blood pressure was indeed low, and continued to be low, so getting up was a bit of slow start. Ate a late lunch and a nice dinner. Got IV antibiotics 3 x that day, and at 10pm started the blood thinner injections in tummy. (Clexane). They weren't bad at all. I continued with them for 27 days once home. Also had IV paracetamol in the evening and got another dose of oramorph at 10pm. Nighty nights!

Day 1 postop was busy. I was looking forward to getting up and using the toilet! But no luck. Dizzy and low BP still. I got a nice bedwash by nurse and changed into my own soft nightgown. Brushed teeth and combed hair and felt sort of human except for the bedpan dependency. Grr. Got whisked down to xray and back. The PT was due that morning to get me up, show me how to get leg out of and back into bed, etc. I did get up and stood on walking frame for a milisecond - amazing - NO HIP PAIN for the first time in months. But I got dizzy and had to lie down again. She came back after lunch and I got vertical with no dizziness. SUCCESS! Used walking frame to get to the toilet on my own! Hurrah! Spent the rest of day 1 resting, napping, doing easy crossword puzzles. Unfortunately when I tried again to get up to use toilet I got dizzy.... so back to bedpans for the evening. Low BP persisted. I was REALLY disheartened. Had a cry after hubby left. A wonderful night nurse (bedpans every 4 hours that night!) gave me a pep talk and reassured me that tomorrow would be a better day, and it was. Moral: one day at a time.

Day 2: Started well. Nurse had me get up at 9am and I was fine. Used walker well. I washed myself at bathroom sink. Using real toilet - so grateful. The squeezers were removed and I get the beloved TED stockings put on. Physio came in morning and I did great. She switched me to arm crutches and I walked down the corridor. Felt like a marathon, but I was still ok with pain even before my morning oramorph. Afternoon phisio I did some more mobility exercises (leg to side, leg to back, etc.) - only about 3 reps each though. Walked down the corridor and we did the stairs up and down using crutches! Felt very tired by then so she wheelchaired me back to my room. Off the morphine tonight - they switched me to codeine and paracetamol, in preparation for discharge tomorrow. Wanted to be sure that would continue to keep me pain free, and it did. They gave me senna tablets last night to help with BM...a condition of my discharge. Did the trick so all boxes ticked. OS came in and was pleased with progress. Discharge home tomorrow, day 3.
 

Fiona444

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Loved your account calgal. I too was in a BMI hospital and out on day 3 which is today. I am much mire mobile which is great but still need a high level of pain relief. Were you really in no pain at all after your op ?
 
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Calgal

Calgal

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Were you really in no pain at all after your op ?
Yes @Fiona444 . I was uncomfortable at times but not in pain. I don't know why since I don't have a high pain threshold. I can only attribute it to good analgesic medication from the op onwards. Or perhaps the surgeon? I didn't have major swelling nor bruising. But as the admins here say all the time, every person and indeed every hip op (even on same person) is unique. Maybe I'm just lucky? I'm thankful every day though. Good luck controlling your pain in the upcoming weeks. :SUNsmile:
 

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