THR I'm Back at home!

[bjkasz]

I wish I could have your optimism! Everything that I have ever seen or heard before surgery was all rainbows and unicorns - pain was immediately gone, recovery was a breeze, etc -and these are from actual patients that I have spoken with first hand! No way did I expect this level of pain and difficulty one month into this process.

Fortunately for me - this is one and done - no problems whatsoever in the other hip. This one needed to be replaced due to dysplasia. But a year is a really long time to be completely out of my life, considering that these devices seem not to last that long, and revisions have less success.

First appointment with the OneStep PT was interesting - but she is recommending the same painful exercises that my in home PT told me to do - leg swings, squats, etc. I expressed concern and she told me just to leave feedback, and not to do anything that was painful. Let's see what happens going forward.

 

[Jaycey]

Well one month out is still early days. And don't assume you will lose an entire year. I predict you will feel much different at the 6 week mark.

Hmmm...leg swings and squats at 4 weeks out - sounds a bit aggressive. Please don't do anything that aggravates that healing hip.

 

[bjkasz]

And this is from the pilot program (ONE STEP) that I was invited to from this forum - met with the PT through Zoom this morning, and these are among the exercises that she recommended. Definitely not doing them.

I thought that it was more about gait analysis, and walking - not "training". I only want to walk, not hike, play sports, etc. That is my only goal.

 

[Jamie]

@bjkasz ... your comments concern me and I will speak with our One Step representative. The therapy, including gait analysis, is supposed to be geared to each individual patient's situation. It doesn't sound like your therapist is following that concept.

You are so early out from your surgery, please don't be discouraged. Many people have a slower start to their recovery (no appearances of rainbows and unicorns at all) and still go on to do fine in recovery. You're not going to be this way for a whole year. You're going to walk and even more if you want to.

I'm thankful you gave this feedback to us so I can talk with One Step long before it's your time to evaluate their program.

 

[FCBayern]

You will walk, and pain free well before one year @bjkasz, one year is more about "I don't even think about it" because you are COMPLETELY healed. Pain free walking and regular life will happen sooner than that, you just can't rush it. Doing so only slows you down. In this recovery going slow means healing faster.

 

[bjkasz]

So here's the thing with the OneStep PT pilot program - seems as though they are based in Israel, where the "rules" for recovery from posterior THR are different than here in the US. The 90 degree rule, crossing midline, laying on operated hip - all only for the first few weeks, not for the first few months. We seem to be more conservative here. Nevertheless, the program was modified for my use.

I am also going to a local PT place, and today was my first appointment. Really needed the massage and stretching which I cannot do on my own of course. Difficulty with many exercises, and I have a really bad feeling about pain later on and tomorrow, but we shall see. It is a small office, so there is not a crowd of patients on equipment, so I feel comfortable about COVID.

Running out of pain meds - the local PT indicated that I would have to deal with the pain, which I am not willing to do. Calling my surgeon's office once again tomorrow for another refill, and once again, being "interviewed" by the nurse practitioner to prove that I am not an addict. Tylenol does nothing, and I am in tears all night from the pain if I forego the nighttime dosages. Each day seems like an eternity to me with the pain.

 

[Mojo333]

Hi @bjkasz
I certainly have seen on this forum that post-op protocols vary.
Particularly, it seems, from surgeon to surgeon more specifically than from country to country.
My OS gave me no restrictions, except not to do things that cause me pain...so certainly I was "restricted" on my movements while healing.
Each hip is unique, hence each replacement, but Bonesmart educated me on listening to my own body and giving myself time to heal...and I realized that just walking was all I needed the first few months.
My surgeon also prescribed PT very early, one week postop...which was certainly too early for me.
I dropped it and went back at about 3 months for some direction for stretches for tightness and gait training.
One month out was prime time for recovery weariness and post op blues for me.
Hope all gets easier and you are steadily seeing improvements.

 

[Layla]

Missing out on so much for a whole year is so upsetting.

But...you will gradually be adding activity as you move through recovery, not enduring a full year of no activity. I’m sorry you’re struggling with pain and glad you’re not taking your PT at their word that you have to suffer through it. Ridiculous...and as you know, PT is not your surgeon and has no right to make that assumption. I hope you get what you need to manage your pain, keeping you reasonably comfortable and allowing for the mobility you need as you are healing.
Wishing you comfort and a good week!

 

[bjkasz]

I had a great conversation with the OS office, and they refilled my pain meds, and told me to modify my activity so that I feel comfortable - reading the riot act to the PT I just started to go to (the reason that I am going there is for the massage of the scar tissue which really helps). The patient is always the expert in themselves and they need to recognize that and listen, and the OS office is fully supportive of that. And - like the wonderful support I have on these boards - they told me that my "feel kind of better/back to almost normal" will be more like 12 weeks, rather than 8 because of the complexity of the surgery.

So - a little more walking/stair climbing each day, practicing walking without cane, etc. That is my strategy. Pain meds at night when I need them, and waiting for the snow to melt so I can walk outside fo a bit.

Right now my concern is butt pain, which I had before the surgery. Can't sit comfortably for more than 5 minutes. I am hoping that this is just one of those "random pains" that will disappear as time goes on.

 

[FCBayern]

That's great news @bjkasz! I'm glad you can back off the activities, I think you'll notice a positive change to pain and swelling. Unfortunately it sound like you might be having issued with your piriformis, I'll leave you an article below.

Piriformis syndrome

Basically, simply a muscle spasm with consequences, piriformis syndrome is far more common than people (including doctors) realise and really is a pain in the butt on two fronts. First it's extremely distressing and can almost totally disable the sufferer Secondly it can be a long term problem...

bonesmart.org

 

[Eman85]

Everything that I have ever seen or heard before surgery was all rainbows and unicorns - pain was immediately gone, recovery was a breeze, etc -and these are from actual patients that I have spoken with first hand! No way did I expect this level of pain and difficulty one month into this process.

You know it's been over a year since my last THR and although the memory is fading I still remember the recovery. I talked to quite a few people beforehand and non of them gave me the instant recovery story. They all were pleased with the outcome but they gave me the truth. That's the one thing about this forum, we're all actual patients with firsthand experience. My left is a few days from 3 years and after some hard work yesterday I'm not pain free. My right still has some weakness in my hamstring that I'm working on and it's over 1 year. Those unicorns are pretty rare. On the other hand after working pretty hard yesterday I didn't wake last night from joint pain, that's a big win. I know about the missing out on things for a whole year. This Covid thing shut down my racing last year. I had my rt. THR thinking I'd be ready to go in the spring, didn't work out too good.

 

[ljpviper]

I had anterior surgery like two weeks before you and still have some butt pain. It's seems common, I still have a large pocket of swelling from my incision back into my glute. This might be causing some of the discomfort.

When I was recovering I had no glute pain so I attribute it full weight bearing and just angry muscles.

Good luck,

Larry

 

[bjkasz]

Thanks all for your support - and the article! I think I may have scar tissue - lots of swelling and firmness in the butt, and perhaps piriformis as well. Hopefully the surgeon will have answers - the PT massage really does help.

 

[bjkasz]

PT is going well because I told them I wanted gait analysis, and help with learning how to walk correctly. And that has REALLY helped. Looking in a mirror as I walk gives me good feedback. I tend to lean forward and not have even heel strike, and walking correctly helps ease the pain as well. NO strenuous muscle exercises! Balance work also. Practicing walking in the house now with feet closer together and with a longer stride. Thanks so much to everyone on this site for guiding me to stand up for myself and to tell them what I needed!

 

[FCBayern]

Good job @bjkasz! Sounds like you straightened them out and they are providing what YOU need, not some cookie cutter program!

 

[bjkasz]

6 week post op check up tomorrow - so many questions!!! Among them: back to work date (I stand 2-4 hours for my job), pain management (still need something stronger than Tylenol), blood transfusion followup, if any, card for flying in the future, scar minimizing, continuing baby aspirin, when I can "violate" 90 degree, crossing midline, etc rules, and physically caring for my elderly Dad. Hopefully the snow won't start too early here in NY as I need to travel into the city! I will let you know on the other side how it goes - I need an x-ray, otherwise I would ask for a telemedicine appointment.

 

[FCBayern]

They don't issue card for joint replacements any more @bjkasz, TSA won't accept them. If you tell them you have a replacement BEFORE you go through a metal detector, they will send you through the milli-wave machine which a replacement joint isn't a problem. I made the mistake the first time of setting off the detector before telling them I had a joint replacement, at that point it doesn't matter, you get the full pat down if you've already set off the metal detector.

 

[djklaugh]

@bjkasz I agree with FCBayern! And having 4 artificial joints I'd make the metal detectors shriek! So just tell the first person in the screening line that you have medical implants and they'll send you through the correct machine - the one that looks only for metal outside the body ( stand with feet on the marks, hold up arms, and machine scans around you ) -- easy peasy and no shrieking alarms

And most likely any restrictions you've had will be lifted. Sending you easy travel and great out come for your appointment vibes.

 

[Layla]

Hope you made it safely to and from your appt in the city yesterday. Receiving reassurance all looks well and you’re progressing as you should can make ones day.
Stay safe, warm and enjoy the weekend!
@bjkasz

 

[bjkasz]

Thanks everyone! Doc did give me a letter for TSA- I have global entry, so not sure how that will affect the screening next time I fly ( I have been pre-screened and vetted by TSA via an interview, background check, etc). I hate going through yet another x-ray. Rather be patted down!

In other news - I have ischial bursitis, very painful, so new PT script - donut cushion, pain meds, Voltaran, Gabapentin (which did nothing when I took it last Summer). PT this morning did help, though! Hip looks good, and being able to sleep on my side is so much more comfy than sleeping on my back. Cannot physically support my father, which I knew...just wanted the Doctor to say it, so my brothers believe me. I cannot twist my operated leg over the other side, which impedes progress in getting rid of the bursitis, unfortunately, but the 90 degree rule is no more, so dressing is so much easier!

I will need to have a follow up blood test about my hemoglobin because of the transfusion, which I will do with my primary care physician. Mederna and vitamin E oil for the scar, and of course sun screen if we ever get summer! My disability has been extended for 4 weeks, and hopefully by then I will be able to stand for 2 hours straight, and maybe walk more than 200 feet.

I progressed to not using the cane in the house, and I am practicing not waddling when I walk. I feel like a one year old - relearning to walk the right way, and breaking all of those bad habits when one leg was an inch shorter than the other.

Thank you again for all of your support - I truly appreciate it!