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THR I'm Back at home!

bjkasz

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Had L THR at Hospital for Special Surgery 1/7. Finally released on Sunday afternoon. It was a lot harder than I thought. One inch leg lengthening, which is great, so I won't have a limp, hopefully. I did not need a bone graft, but I did need a blood transfusion, which is not unheard of with this surgery. That threw me for a loop - very weak, and still weak at home. They had a lot of trouble controlling the pain, and I was in tears the first two nights. Finally ended up on dilaudid, and tylenol, which surprisingly increases the efficacy of the dilaudid. HSS is an AMAZING place - they really have everything down to the smallest detail. I had my own room, which was fortunate, because of the problems at night with the pain, and it had an East River view, which was so pleasant. The nursing staff was very attentive, and all call were answered within one minute. Everything was clean and new, and comfortable.

I am starting in home PT today, and in home nursing service as well. I do not know how other patients do this on their own - I am totally helpless, need help going to the bathroom, getting water, ice pack etc. By the way, I am returning the ice machine I purchased- used it once and it was so inconvenient, you had to stretch the tubing across the room so the line didn't kink, so it created a tripping hazard. Using the 1 cup alcohol/4 cups water in several zip loc bags did the trick. Put it in a travel pillow case.

I will keep you posted as time goes on- this is only the first week so I don't want to get too impatient with myself!
 

Jaycey

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@bjkasz Welcome home and to the other side of surgery. Keep that ice on that hip. It will help ease the inflammation that is causing you pain.

And do be very careful with PT. It's really a bit early to start this - especially since you are still feeling weak.

Here are your recovery guidelines:
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 this BoneSmart philosophy for sensible post op therapy
5. Here is a week-by-week guide for Activity progression for THRs
6. Access 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 that 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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bjkasz

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Ok-ONE WEEK POST-OP. Still reeling from the blood transfusion. I feel super weak. Finally got the BMs under control - prune juice, milk of magnesia (best taken in one shot!) and finally, suppositories.

Visiting nurse took the dressing off - 5 inch scar, and it looks good! PT just to navigate the stairs, and for safety. Am able to take a shower on my own, brush my teeth, etc. So progress is being made. I realize that there will be ups and downs.

Pain management is a concern - okay during the day, but at night it is hard to control. With things being the way they are these days, everyone is super-cautious about opioids, but those are not even doing the trick at night. I can't get comfortable. Ice helps, but not completely. Hard to fall/stay asleep.

Let's see what the next few days bring! Cheers!
 

Texas1965

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Yes nights are the worst, I use ice all the time, seems to help. Hope you the the pain under control.
 

Eman85

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Rough if you can't get comfortable. It's a shame your ice machine didn't work out, I slept with mine on every night for the first weeks. The continuous icing helped a lot.
 

Layla

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Ice helps, but not completely. Hard to fall/stay asleep.
Consider switching out the ice when you wake in the middle of the night. If you live alone and the thought of doing so sounds like too much work, you could store extra ice packs in a small cooler bedside. Sounds silly, but some members have done this. Wishing you comfort tonight and hope you sleep well.
 
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bjkasz

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Ok - now going on two weeks post-op. Not much progress yet. PT every weekday, but not able to do more than the basic exercises - too weak/too much pain to go further. I went downstairs to my main floor over the weekend, as recommended by the PT, for an hour to sit and eat lunch, and walked around the kitchen a bit. That increased my swelling so much that the next day, I called the surgeon's office because I was concerned that much. Fortunately the doctor said that increased swelling is expected and that I should not worry. Incision looks great, not redness, drainage, etc. Still icing like crazy and elevating my leg.
The pain just down not seem to abate, no matter what I try. I completely understand about the opioid crisis and addiction, but I need many more pain pills than I have been given so far. There is no way that I will be weaned off in another day or two. Doubling up at night, just so I can get a few hours sleep.

Here is my plan: call the doctor's office to get another refill, and see if there are alternatives - Tylenol does not work, and I am allergic to motrin, etc. Also ask doctor when I should feel less weak from the blood transfusion, so at least I have a better expectation. Talk to the PT about where to sit on my main floor so the swelling does not increase, and I am able to participate in my family life a bit more. And practice more patience. Everyone has been so sympathetic - family, friends, neighbors, and so helpful too.

My brother went home Saturday, but good news - my other brother and his wife came to help with my Dad - so that was a great relief! They COVID tested before they drove up.

Trying to get some sleep now - writing really helps! Thanks to everyone here for your support!

I will keep at it and let you know how it goes
 

19K30

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I’m six weeks post op and I’m NOT a professional on this subject by any stretch of the word. In my situation I felt I didn’t have much improvement the first two weeks, but after that the progress has seemed to pick up exponentially. I quit taking the oxycodone after about a week and was just using the Tylenol. I found that for me it was best to take the Tylenol regularly. Wether I thought I needed it or not. Also I iced all the time. I don’t know if this is any help, but your not alone in this. Trust it will get better.
 

Mojo333

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Hi @bjkasz
First weeks can indeed be tough and I'm glad you are checking back with your OS office about concerns.
Here is my plan: call the doctor's office to get another refill, and see if there are alternatives - Tylenol does not work, and I am allergic to motrin,
Many members have found that Tramadol is a good pain reliever ...when I stopped using my high powered meds, this is what was prescribed along with Tylenol and it was very effective
Talk to the PT about where to sit on my main floor so the swelling does not increase
I found my recliner was my go to spot, but if you don't have one, perhaps you can elevate on the sofa... This was harder for me to do without twisting about...but You need to be able to be able to elevate when you are not up walking.
@19K30 is right...Time will be the main healer, so keep the faith.
All temporary and you will get there.
 

FCBayern

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What are you doing during daily PT @bjkasz? You really don't need any PT at this stage and it's likely contributing to your pain and swelling.
 
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bjkasz

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Thanks everyone for your support! I use Tramadol for my hand arthritis - it's okay, but not really effective for that moderate pain. Tylenol doesn't help my headaches, much less this pain. I feel that the pain is out of control, and I am on dilaudid, which is really strong.

interesting that you mentioned about the exercises exacerbating the pain. I know that walking is key, but right now with the weakness, I can't do that a lot. I am going to ask again today about walking on my patio a little bit instead of the isometrics and leg swings.
 

Jaycey

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isometrics and leg swings.
Well if this is the exercises that you are doing I now understand why you are hurting. Leg swings this early out are just not good. You are not in training - you are healing. Plenty of time for strengthening once that hip is fully recovered.

I would stop all that PT and get your medication sorted. You need to get the pain managed so that you can increase your mobility. Short walks around the house while you are still feeling weak.
 

Eman85

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I understand the Tylenol thing for as much good as they do me for a headache I'd be as well of rubbing them on my head.
You say you're doing isometrics and leg swings? Walking is important but being pain free is important too. I think the majority of us that have experienced a THR will tell you that sitting and resting is more important than walking or doing PT especially in the first weeks. You'll have to trust us but if you do nothing for a few days it will actually speed up your recovery. Doing things that cause pain and swelling slow down the recovery.
 

Mojo333

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Might want to keep some options open
Meds can work differently on different types of pain, often.

I was prescribed Dilaudid post op also. I had to keep a tight schedule to make sure I stayed ahead of the pain.

Meds like Tramadol or Tylenol did nothing for me pre-op, but worked amazingly well for me for post op soft tissue pain.
I was able to get several one week refills for the Dilaudid but then went to the Tramadol/Tylenol combo.
 
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chialiyu

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+1 on ice/elevate, no PT.
I did a lot of PT (thought they will help to regain my quad control because of the nerve damage) last time before I found bone smart. I did them with lots of screaming/tears. My thigh was swollen and constantly in pain --> until I started to follow the BS advice to take it easy, ice/elevate, let it recover. Much happier after that.
 
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bjkasz

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I am going to take all of your advice - more movement, but less exercise itself. I still feel weak from the transfusion, and I know that this takes weeks to resolve, so doing only what I can, and moving without exercising/isometrics/etc. I think will help. I have two more PT sessions before they discharge me to outpatient PT - which I don't want to go to because of COVID anyway. I cannot picture me on a treadmill, cycle, etc next week anyway, so what is the point, if I just continue to move at home. There is going have to be a LOT of convincing to get me to go to a PT office at this point, and really good reasons
 
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bjkasz

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Had to put my foot down with PT yesterday. Stopped when exercise started to hurt.(lifting leg off chair in seated position, squeezing thighs together sitting). Wanted me to put all my weight on operated leg - told her I could not do that. I know that the OS will prescribe more outside PT, and as I mentioned earlier, I do not want to go, I just want to walk around my house, maybe walk up the stairs for practice, get my own lunch, etc. Why, oh why, are they prescribing all this PT when experience shows that it is not helpful and may be harmful to recovery? I just don't get it. Maybe they think that without a structured program, patients would not move at all, so they have to do something to get them out of bed.
 

FCBayern

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Let them prescribe all they want, that doesn't mean you have to go @bjkasz. After learning with my knee when they tried to schedule me for PT after THR I just said no thank you, I'll call in 3-4 months if I think I need you then. I didn't call back, just activities of daily life as you describe above were more than enough to have a full, less painful recovery.
 

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