THR I feel like Bionic Woman - recovery

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Hello everyone, I‘ve been lurking for a while. I had my RTHR on July 15th. It was kind of unexpected and an arduous journey to find myself in this position.
I‘ve been having some mechanical problems like locking and sudden pain for over a year. I was diagnosed with Psoriatic arthritis in 2020 and have been seeing a rheumatologist every 4 months since.
He ordered x-rays last year, noticed some “degenerative changes” and sent me to physical medicine. They said the hip was fine but wanted to get an MRI of my spine since I’ve had kyphosis and scoliosis since childhood and they thought the pain was coming from that. My insurance didn’t want to approve until I had physical therapy.
So I went and mentioned my hip pain since PT couldn’t find anything specifically wrong in my back. He thought it was strong. Did some therapy on my hip for not quite 4 weeks and he said I was done ( it didn’t really help much). Never heard back from the doctor so I said to myself forget it. Had other health issues cropping up that were more urgent.
Fast forward to last December at another check up my rheumatologist noticed how my ROM and pain had gotten worse so he referred me to an OS suspecting bursitis. Again had trouble with insurance, they weren’t accepting it even though they were still listed under in network. But the entire orthopedic department had merged with another one that didn’t accept this insurance.
I let it go for a bit since it was the end of the year anyway and a new deductible had to be met in the new year.
Finally in early April I called again and they now took my insurance. Went to see the OS and he thought it was a torn labrum since the x-ray looked “fine“ according to him and “I wouldn’t need a hip replacement or anything”. Sent me for a contrast MRI and that confirmed his suspicion. At the follow up he just burst in the room 45 minutes late and said he meant to contact me not to come in since it was a torn labrum that needed arthroscopic surgery and he doesn’t do that. He referred me to another doctor within his company who specializes in arthroscopic surgery.
When I saw that OS and relayed my experience he asked if that other doctor had looked at my MRI. I said, I did know, he didn’t show me anything, maybe he just read the radiologist summary. This new OS said it wasn’t as simple and that on top of the torn labrum I also had a bone cyst and also cartilage loss. A positive outcome of arthroscopic surgery was therefore not very likely. Taking into account my age he thought a THR would be a better way to go. Of course I was dumbfounded, this coming out of left field.
Seeing my hesitation he recommended getting a second opinion from another OS who does joint replacement. He felt the first surgeon might not wanted to consider it because of my age and he usually works on older patients.
So I started doing some research into the subject and also came across this forum. I found reassurance that this is definitely not something too unusual and the artificial joint could last a long time. I figured I’d rather have good life quality than bad quantity.

The new OS turned out to specialize in hip preservation and would also do joint replacement if warranted. He initially thought we could try for some preservation approach with arthroscopic surgery first and the viscosupplementation. He did sent me for a CAT scan with MAKO profile though to get some better idea of joint space. That CT revealed FAI and that was most likely the cause of the torn labrum.
He then decided that there were too many areas to fix arthroscopically and it wouldn’t buy me more than a couple of years and a THR would indeed be more beneficial.

So here I am 2 weeks post op. I was scheduled for same day surgery but initially didn’t pass PT eval because of dizziness and nausea. Ended up having to spent 2 nights because my bp started to plummet because of blood loss.

Recovery has been going ok, still dealing with low bp. Pain has been tolerable but I’ve been having quite a problem with muscle pain on the side and top of my thigh. Especially trying to sit putting weight on the thigh the muscles get compressed and it’s quite painful.
PT said he sees that quite often in younger, fitter patients as their muscles react stronger to trauma. Not sure if that is true or he’s just trying to make me feel bette, lol.
Anyway I guess time will tell. I was supposed to transition from walker to cane this week but with having that muscle pain he felt that was not stable enough so for now walking with one axle crutch instead.

I’m seeing my OS on Monday for the 2 week follow up. Let’s see what he says.
 

Layla

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:welome:I will leave you with our Recovery Guidelines and type more in a post below.

As you begin healing, please keep in mind that each recovery is unique. While the BoneSmart philosophy successfully works for many, there will be exceptions. Between the recommendations found here, your surgeon's recovery protocol and any physical therapy you may engage in, the key is to find what works best for 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
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. Here is a week-by-week guide

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.
 

Layla

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Hello and Welcome to BoneSmart and recovery. Congrats on your new hip! It sounds like it was a bit of a journey getting to this point, but we're thankful you came out from the shadows and joined us. I believe you'll like the support you receive here.

Two weeks is really early into recovery in the whole scheme of things. Pain is not unusual. My best advice would be to read through the Recovery Guidelines above paying special attention to the article on ICE. Icing really helps with pain.
Best wishes for your appointment on Monday, let us know how it goes. I hope you have a pleasant weekend! :)
 
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Thank you @Layla for the welcome and advice. I am actually icing right now. I bought one of those ice machines at the advice of a co-worker who’s husband just had hip replacement earlier this year and he was offered to buy one from the hospital. Best decision ever.
My PT actually applied heat to the painful muscles and ice to the hip at my last session there. That was quite an interesting sensation. Gives new meaning to “you’re hot and you’re cold”.:heehee:
 

NightQuilter

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Welcome to BoneSmart - its good to see you are on your way to a better quality of life. What a journey you've had just to get a proper and efficient diagnosis. The ice machine should give you a lot of relief. Follow the BoneSmart mantra - rest, elevate, ice, and stay on your pain medication schedule. By the way, how is your pain, two weeks out? Hope all continues well. (I was 52 when I had bilateral hip replacement - you are doin superbly.)
 
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By the way, how is your pain, two weeks out? Hope all continues well. (I was 52 when I had bilateral hip replacement - you are doin superbly.)
@NightQuilter My pain level is actually not too bad maybe a 4. And that’s between the different kinds of pain that seem to take turns. I finished my Naprosyn yesterday and so far it’s tolerable. I couldn’t imagine doing 2 at once, you were very brave!

At my 2 week check up today he removed the prineo mesh and put on some steri strips. Said it looked good. He feels the pain I still get in the groin might be from muscle memory since I had such reduced ROM from impingement for a long time.
I will be allowed to start driving in another 2 weeks and then back to work after a total of 6 weeks post op.

My OS is pretty conservative. I had the anterior minimally invasive MAKO assisted approach but he still want’s me to observe the normal hip precautions until 6 weeks including not bending past 90 degrees. I‘m ok with that since I understand the risks that even with the anterior approach you could cause damage too soon.
I can also get around that a bit by just letting the right leg hang straight down with bent knee and just doing a one legged squat with my left leg to pick things off the floor.

I was also on an injectable biologic that had to be stopped before surgery and seems like I can now continue again. So I suppose I am not the regular hip replacement type as I also have inflammatory arthritis causing other pains.
 

NightQuilter

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He may be conservative, but better safe than sorry. It sounds like your pain levels (at least from the hip) are reducing as they should be and he's set out a good protocol for you. Carry on! :dancy:none of this too soon!
 

zauberflöte

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by just letting the right leg hang straight down with bent knee and just doing a one legged squat with my left leg to pick things off the floor.
@Chocoholic I am having this fabulous vision of a skater doing one of those squatting one-legged twirls! I had anterior for both hips. I was unable to squat or bend over tightly because of swelling and pain. For the first, the cats learned quickly to jump up on a specific table to be fed. Second one, less jumping and more being fat cats, so I spent months practising feeding them with a sort of lunge, good leg in bent front with me leaning over it, op leg extended to the rear providing a counter balance. Used that for cat feeding. And picking things up too I expect. I did get out my grabber for #2, and found it helpful for non-cat things. I've kept it out because it's so good for reaching things in the top shelf of a cupboard or closet when I'm too lazy to fetch and carry the stepstool.
 
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@zauberflöte first of all, love your user name. Are you German by any chance, or do you just like Mozart? I was actually born an raised in Germany and immigrated to the US in my mid 20’s. So anytime I see an Umlaut used(correctly) in an English setting I get excited,lol.
The way you describe your bending is what I would like to do eventually but for now I‘m not supposed to extend my leg backwards yet.I also bought a few grabbers for different rooms.
My cats haven’t learned yet not to stop on the stairs and hunker down so I can‘t get past yet. The kitten will jump up for petting but the older one just plops on the floor and rolls over expecting tummy rubs. Sorry, not gonna happen for a while.:wink: Luckily my husband can take care of that and the litter boxes.
 

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Oh my, your cats remind me of mine. They love to hide on the stairs and surprise you! Not cool for us when rediscovering our mobility!
 

zauberflöte

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@Chocoholic oh my cats are cats, aren't they? I only have one left, whose habit is to run up the short carpeted flight when The Feeder exits the bedroom in the morning, and then spend much of the next half hour directly in front of and/or between/behind my feet! The three cats we had for both my hips took that duty in turns, and I've stepped on my share of paws and tails because of it. There is a particular way I'll bet we all move to avoid putting full weight on a cat body part! And that's such a danger early on in recovery!

I made sure to keep the chest/hip/ankle line very straight in that cat-food lunge, as I wasn't supposed to over-extend to the back then, and make sure I am turned out if I do it now.

Here's another cat story, of something that happened with my first hip that really taught me a lesson for the second. We got home from the hospital, after a stop at the pharmacy, and I was wrung out exhausted and in some pain. I sat on the recovery nest corner of the couch and stretched my legs out along its length. Along comes Mr Mango, soooo happy to see me after thirty whole hours!, and leapt up... onto my lap.... which had a very sore incision on it. I shrieked, the cat panicked and dug in his claws for the launch, landing running, not to say hello to me for the rest of the day! It was pretty funny even at the time, and I kept a large flat chair cushion on my lap for weeks, and same for the second hip!

I am partly of German descent, but the relevant facts are, I'm a flute player, and Magic Flute is one of my favorite operas. I was in school when Ingmar Bergen's movie came out, and I watched it back to back for two nights one frigid winter week, then bought a recording. I was definitely entranced....
 
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Here's another cat story, of something that happened with my first hip that really taught me a lesson for the second. We got home from the hospital, after a stop at the pharmacy, and I was wrung out exhausted and in some pain. I sat on the recovery nest corner of the couch and stretched my legs out along its length. Along comes Mr Mango, soooo happy to see me after thirty whole hours!, and leapt up... onto my lap.... which had a very sore incision on it. I shrieked, the cat panicked and dug in his claws for the launch, landing running, not to say hello to me for the rest of the day! It was pretty funny even at the time, and I kept a large flat chair cushion on my lap for weeks, and same for the second hip!
My kitten likes to do that and also dash between my legs at terminal velocity! That’s why I keep them locked out of my room at night. They seem to have a knack for finding the painful parts of my body and jump on them with gusto! Lol. My hubby keeps complaining how HE now can’t get a restful night’s sleep Since I used to be the buffer.
 
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I'm just thinkin' here………wouldnt the (indispensable‼️) grabber be useful for no-stretch kitty belly rubs…maybe with a soft cloth attached by rubberband?
@Arjay I have had that thought as well,lol. My kitten thinks it’s a fun game to watch the grabber open and close.
 
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Today I’m 24 days post-op. Just got back from PT and he seems happy with the progress I’m making. My hip still seems very stiff as probably expected, like there is a really tightly wrapped bandage around it. Pain comes usually from the incision area in form of burning or pinching. Sitting too long will aggravate this.
Contrary to consensus about walking on this board, my PT does not want me to do a scheduled walk every day. He feels like making it a job would easily lead to overdoing it at this stage. He’d rather I would stick with the strengthening exercises they give me. He does some stretching of the hip - while laying down on the edge of the table he has me move the lower leg off the table supported by a stool and hold for 4 Minutes. Oh boy that’s quite something!:swoon:
I’m walking without a cane most of the time but use it when outside. I took my first real walk outside on Saturday, only half a mile total but that knocked me for a loop.
When riding in the car the side bolster of the seat feels like I’m sitting on a metal rod. I suppose it’s still all that swelling.
 
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CricketHip

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Congrats on that new hip! :wave:

That's too bad, I loved my little walks during the day. I marveled at how taking a simple 50 or so steps eased my stiffness.
When you say to move the lower leg off of the table, is this for the operated leg, also? Interestingly, this is the one stretch that was a big no no for me as I had the anterior approach, like you.

I hope you continue to do well.. patience is a huge help at this stage of the game.. and ice!:ice:
 
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When you say to move the lower leg off of the table, is this for the operated leg, also? Interestingly, this is the one stretch that was a big no no for me as I had the anterior approach, like you.
They only started doing this now at 3 weeks post op. And yes the operated leg is the one that hangs off the table while they have me laying completely flat, but not completely free hanging but only at maybe 20 degrees supported by a stool. And they also started massaging the scar tissue with a rubber ball. Not the most pleasant thing out there, lol.
 

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@Chocoholic I too enjoyed my little walks and did not at all see them as work! The PT exercises on #1, however, were onerous drudgery lol. A turn up and down the deck first thing in the morning cleared my head and warmed all my muscles!

I tried that off-the-bed stretch (self-directed) for #1, a couple of years post-op, and never for as long as four minutes. I did it one time too many, and spent the next few months regretting my actions. That side is also the side that had aggressive scar massaging. There is still pain on certain movements. Also the scar is wide, 3-D, and twisted. The other side always looked better from the start-- OS let his assistants close sometimes, and maybe the female PA for #2 was a better plastic surgeon than the guy for #1, who knows.
 

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:hi:Hi there!
My hip still seems very stiff as probably expected, like there is a really tightly wrapped bandage around it.
This is most likely from swelling. Are you still icing and elevating? If not, you may want to consider dedicating some time to that. I think to will help.
Pain comes usually from the incision area in form of burning or pinching. Sitting too long will aggravate this.
Small sensory nerve fibers are cut with the incision. These nerve fibers run from the inside to the outside of the hip and cutting them causes the hip to feel numb after surgery. It is a temporary sensation that normally resolves over a period of six months to one year post op.

While healing you may experience sensations of tingling, pins and needles, itching, burning and even the feeling of a minor electrical shock. These are usually good signs that the nerves are spontaneously firing through the regeneration process.
Contrary to consensus about walking on this board, my PT does not want me to do a scheduled walk every day. He feels like making it a job would easily lead to overdoing it at this stage.
As you know, it's your choice to do your recovery in the way that's most comfortable for you. Hips don't need exercise to heal properly. Healing will happen without exercise. Sadly, many don't believe this, giving it a fair chance and end up struggling with pain and setbacks stalling their recovery. The best therapy is walking and even then not to excess. Walking is no more of a job than getting ready for and traveling to a PT session and back home. If you start s-l-o-w-l-y and add distance little by little you won't overdo it.

If you're talking about the side of the car seat as a source of irritation while in the car, what helped me was a gel ice pack placed in the area of my incision. I placed the gel pack between the seatbelt buckle and my leg because that's where I felt the discomfort. I couldn't tolerate the confines of the car for more than 30-40 minutes or so early on so this did help.

I hope you have a good week. Happy Monday!
 

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And yes the operated leg is the one that hangs off the table while they have me laying completely flat, but not completely free hanging but only at maybe 20 degrees supported by a stool.
Please do not let PT have you do this stretch. Anyone who has had anterior THR should avoid stretching the op leg like this in the early days. I am certain your surgeon would agree.
And they also started massaging the scar tissue with a rubber ball.
You don't have any scar tissue - you have a wound that is healing. Please don't allow this either. As you are experiencing, this is only causing discomfort.

If you chose to have PT, I would suggest you find someone with more experience in treating patients recovering from THR. This PT obviously lacks basic knowledge about THR recovery.
 

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