THR I have a cold, my mother has her THR today<

[Cynthia777]

I've had two THR's and I was able to walk with very little pain from day one of my first THR (I walked 300 feet) and 50 feet the day of surgery with my second THR. It really sounds like the hospital is not staying ahead of her pain (once in pain, it's more difficult to get it under control). You should make sure they are giving her the pain meds around the clock BEFORE the pain starts up again. I gave direct orders to the nurses to wake me up every four hours for the meds and it worked like a dream. This is very important! Also, make sure she ices the painful areas all day long. This helps keep inflammation down and helps numb the painful areas as well. Oh, and make sure she eats a couple of saltine crackers before every pain medication to help avoid nausea and/or vomiting.

 

[nevillek]

Theyre giving her only 1 tablet for the pain. Gave her one at 630 pm and now one at 10 pm. She gets terrible pain when moving the operated part.

She passed urine on the bed itself three times because of this. And even a stool once. I'm afraid this could go near her dressing which is on her buttocks?

 

[nevillek]

You should make sure they are giving her the pain meds around the clock BEFORE the pain starts up again. I gave direct orders to the nurses to wake me up every four hours for the meds and it worked like a dream.

Did you decide the 4 hour interval yourself and does this mean every 4 hours in the night too like 10 pm, 2 am, 6 am, etc?

Also, should she put the ice pack on 24 hours?

 

[Cynthia777]

Your mother's OS will have left instructions for the nurses as to the maximum frequency her pain meds can be given. I was allowed Percocet every 4 hours, but if this didn't keep me out of pain, the nurses were allowed to give me something stronger through an IV. I did request the IV meds for two days after my second THR, as I had more pain than I did after my first THR. Yes, every four hours as you described above. She should NOT be experiencing the level of pain you have described. The early recovery period can be a bit uncomfortable, but not where she can only take a couple of steps because the pain is so bad. You (or your mom) REALLY need to be very firm, demanding better pain control than she's been experiencing and making sure she goes home with the right pain med cocktail!
As far as the ice goes, I used it 24/7 during my waking hours and requested fresh ice whenever it had melted to a slush, but you do not need to wake her up for it if she is resting peacefully.

 

[froggymom]

Nevillek I was just looking at where you are from because of the time difference your from Mumbai that's far away so cool and maybe the medical care is different. I hope they control your moms pain better and the bathroom thing should get better if the pain gets better. Keep your hopes up it will get better.take care.

 

[lizzicat]

I agree. My pain was not managed due to the fact that my OS does not use injections and the hospital pharm didn't have my normal meds.

It took until the afternoon of second day for my pain to be controlled so I could walk. The nurse had me bring in my own meds, but then gave me 20 mg of Percocet every 4 hours.

The pacing worked and id be happy instead of a nervous wreck now if pain doc kept me on that schedule for this week prior to slowly tapering.

My normal tolerance is high and I was shocked that my OS never used IV. I feel betrayed and I was healing and doing so much better in hospital than home.

I can't stand being away from ice for 5 minutes. ICE is excellent pain reliever but PT told me that I skips leave ice off for 15 minutes every hour and I just can't.

Pain mgt is critical due to the cortisol and fight flight hormones and adrenaline it produces. Stress hormones do not heal.

I'd get enough pain meds to make your mom feel under level 5 pain. ( if that's okay for her. I'm used to nothing lower than level 6 for years so YMMV )

Take care of you too. I know how scary it is taking care of an elderly mom. I worry to death and now I have to remind my mum to do her care and she needs to help with my ice.

Be gentle and loving to yourself. Easy to say, hard to do.


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[nevillek]

Tysm Lizzy, Froggy, Cynthia.

Well, I have sent a text to her OS regarding today's pain and he will be seeing her tomorrow morning and hopefully giving her better pain meds.

She's been unable to move that leg much since afternoon today which scares me of DVT as well, as her leg compression pump bands are also removed. Plus she's been feeling stiff and unable to lift/move that leg herself at all.

@lizzicat, did you put ice on at night time during sleeping too? Wouldn't it be a little too much to do that? Also, was it for managing pain when lying down or pain when moving? My mom has no pain when lying down.

 

[Jamie]

Is there any danger to the hip with the tab close to it? Or danger from holding the tab in the hand full of needles for long..

There is no danger with your mother using a tablet during recovery.

She just almost cried to me and said she doesn't feel "okay".. When I ask her what exactly doesn't feel okay, she doesn't know.. She seems very uneasy..

This feeling is caused by the pain she's in. She is undermedicated for her pain. It would be helpful if you could post the pain medication name, strength, and frequency of dosage for us so we know what she's getting. Be firm with the doctor. It's not good enough.

Theyre giving her only 1 tablet for the pain. Gave her one at 630 pm and now one at 10 pm. She gets terrible pain when moving the operated part.

She passed urine on the bed itself three times because of this. And even a stool once. I'm afraid this could go near her dressing which is on her buttocks?

Have the hospital place a portable potty right beside her bed and then ask the nurse to show you how to help your mother stand, turn and sit to use it. This should be routine for a patient who is having these problems. The accidents in bed will not be a problem providing they are cleaned up quickly. Does the nursing staff respond quickly when you push the "call" button?

 

[nevillek]

Tysm, I'll find out about the exact pain killer dosage.

There's already a portable potty next to her bed and the Physio taught her to sit on it today morning, but since all the soreness began today afternoon, she's been unable to use it as its hurting to move the hip.

How quickly is "quickly"? She urinated almost 4-5 times from 7 pm to 1 am today. Once they didn't come for 10 minutes and she couldn't hold it anymore so I put the device myself to make her pee but put it wrongly so and she peed on the long pamper type sheet under her and got frustrated. They cleaned that up in 5 mins but the leg again pained her when they replaced the sheet because they had to move her legs.

In the night, they put a pamper (although I wasn't happy with the idea of letting urine sit it in all night if she peed) so when she wanted to pee at 1 am, I opened the pamper and tried to make her pee in that device myself but put it on the wrong place again and it went into the pamper, which they replaced in a minute. Told them not to keep any pamper afterwards.

Can't they just put the catheter instead?

Also just curious where exactly to put the ice pad? This nurse has put it below her buttocks exactly below the dressing. Is that okay or should it be on the side?

 

[nevillek]

They just gave her a Lanol tablet at 3 am for the pain which she gets when moving.

 

[Josephine]

Is there any danger to the hip with the tab close to it? Or danger from holding the tab in the hand full of needles for long..

Why do you think the tablet would be a danger to her? And what needles does she have in her hand?

First in the morning, the Physio came and made her walk the entire corridor.. After that, she's feeling a lot of stiffness/discomfort now.. Not pain but discomfort

It#s quite possible she is holding herself stiff and tight because she is scared of pain or something. She needs to be reassured and encouraged to walk so she relaxes and then it won't hurt so much.

The doctor said she can sit on the toilet seat now but the Physio hasn't even taught her to sit down on any other chair

She doesn't need to be taught. She's been sitting on the loo all her life! The only thing she needs to be taught - which the physio would have taught her already when she gets out of bed - is to not make twisty movements or 'spin' on her feet, but to take many tiny steps to execute a turn.

Wondering why they removed the pressure pump bands??? I thought people wear that or the stockings for several days/weeks after surgery

She's active, that's why. Those devices are only required while the patient is inactive.

I asked the sister for more painkillers and she said they'll give it to her 2 hours later (after dinner) but I wanted it right now. But I'm not sure who's right.. Don't want her to feel worse from excess medication..

That's an odd way to look at it. She's already feeling worse because she's in pain! She needs to have her pain meds every 4hrs routinely and not when the sister deems it appropriate! Is she ever asking your mother what her pain score is? If not, how does she know if your mother actually needs medication or not?

Can't they just put the catheter instead?

Absolutely not! You really want to risk her getting a bladder infection?

Also just curious where exactly to put the ice pad? This nurse has put it below her buttocks exactly below the dressing. Is that okay or should it be on the side?

It depends where her incision is? Since you haven't told us, it's a little difficult to give an answer to the question.

Do remember that she is only 4 days out yet so
a) needs regular pain meds
b) needs little physio
c) needs to rest lots
d) needs lots of reassurance

To help you more, I would like to know the following:

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

1. what are her pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine)

2. what pain medications has she been prescribed, how much is she being given (in mg please) and how often?

 

[Jamie]

Don't be afraid to let them use the disposable underwear if she is urinating frequently. They work just fine and wick the moisture away from her skin when wet. She will not have any skin irritation if it takes a little time before they can change it. But.....she really should be getting up to use the toilet at this point and that's going to require a strict schedule of adequate pain medication. Without proper pain management, this is going to be a lot more difficult for her.

If her only pain medication is Lanol (which is Paracetamol or Tylenol), it is no wonder she is in pain. That is NOT adequate after major surgery! You must insist that she be given something stronger as long as she is in pain.

 

[nevillek]

Dear @Josephine

It's the posterior approach I think (cut is behind).

I'll ask the nurses about what meds are being given to her in a while. They're snoring in the duty room right now (530am).

I and mom have been up almost all night. She's in a lot of discomfort. I'm also worried that her op leg has remained inactive for the last 15 hours without the blood circulation bands. She's just lying like this in bed since so long. I'm making her do the ankle, knee and bum exercises though but not the up/down left/right movement as it pains her.

Please pray for her. Waiting for the PT/doctor to come after 10 am. (530 am now)

 

[nevillek]

Hi dear @Josephine

Please find attached the list of all her meds.

They're giving her an IV injection right now after I insisted.

 

[nevillek]

They're giving her this drip right now.. Praying it helps her

 

[nevillek]

It's almost 1 hour since she finished taking the drip, although she feels better and is having breakfast now, she's still getting pain when moving the hip at all. Should I myself ask them to give her another dose of the same drip after a few hours as the doc won't be here until noon (it's 8 am now)? If so, when exactly? @Josephine Can there be side effects?

 

[nevillek]

Theyre giving her Levofloxacin, lanol and pantacid after breakfast right now (9 am).. She's sleeping so I'll give it to her at 930ish as she anyway had the drip at 6 am.

 

[Jamie]

They're snoring in the duty room right now (530am).

Are you serious? The nurses on duty are sleeping??? If so and your mother is having problems, wake them up to help. They are supposed to be working!!

I'm also worried that her op leg has remained inactive for the last 15 hours without the blood circulation bands.

Your mother should be getting up when she needs to use the toilet at least. Please ring the nurses BEFORE it is time to have them help her if you are not comfortable doing the transfer. You're correct that she should not by lying in bed for 18 hours straight.

 

[nevillek]

She's still the same. The OS came and ordered an X-ray. They're giving her two drips right now.. Dynapar and Paracip.. They said we have to ask for the next dose when she needs it.. Now I'm confused and will call the doctor in the evening for it..

He also asked to stop the Physio for a day or two until he sees the X-ray because she cannot do it with this pain..

 

[nevillek]

Also given a morphine patch that works for 72 hours. Transdermal something.