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[BILATERAL THRs] JR 2 Hip's Recovery thread<

Discussion in 'Hip Replacement Recovery Area' started by JR 2 Hips, Mar 25, 2019.

  1. JR 2 Hips

    JR 2 Hips junior member
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    Hi - I've joined BoneSmart having just undergone a Bi-lateral THR March the 4th - I'm 62 and had no cartilage left, severe osteoarthritis to the point where there was virtually zero movement left in either hip and have an osteoporosis score of -4.1 (hips of a 90 year old). The surgery was apparently a challenge with a cup size of 50mm having to be increased through 52mm to 54mm just to find some relatively hard bone. I had Spinal, Epidural and General anaesthetic (I think the Anaethetist didn't want me to wake up) so was not allowed out of bed until the morning of day 4. First time up I felt like Bambi on ice with very mixed signals as to where my hips were. I haven't taken any painkillers since the Epidural was removed as the reduction in pain compared to pre-op was enormous.

    I left hospital with no advice on excercise or what to expect recovery wise so have tried to walk around the house with 2 crutches for 10 minutes every hour and have done some excercises I downloaded from the internet - followed all hip precautions to the letter. Things seemed to be going smoothly until 3 days ago (day 18) when my left hip seems to have developed pain when walking just as it reaches the vertical position. The sensation seems to emanate from where the hip joint is and it feels as though the joint is unstable. I have heard lots of stories of 2 week recoveries and walking unaided after 4 weeks but finding myself at day 21 I feel no furhter ahead than I did at day 12. I have been given no advice or cantacts for any queries I may have so you are my only help as you have all been in my position.

    Thanks for any help or advice.
     
  2. hbl

    hbl junior member

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    Am sure bonesmart will step in and give you masses of support, advice and guidance - I've certainly found it invaluable.

    It seems to me though that you've had a rough time of it and that advice has been somewhat lacking to say the least in the surgical dept. As the NHS doesn't do bilateral hip replacements as a matter of interest where did you have yours done?

    I had a first class surgeon and hospital in London who gave me plenty of leaflets on simple exercises. However, they were lacking on the "you may experience many symptoms i.e. bruising/strange swellings, aches and pains/tightness and not just in your hips etc (my knees have been awful) so it has been a journey of discovery. You have read that I've had all sorts of 'slow' progress but that's because I hadn't appreciated how long things would take.

    I'm now nearly into week 6 and as I look back things have slowly changed but same days you feel you're going backwards. The best thing that has worked for me is: daily walking outside and trying to do a little bit more each time, regular icing, listening to your body and if you want to sleep and rest then sleep and REST, find a good local physio who can help you with SIMPLE exercises and pressure point massage and develop plenty of patience.

    Everyone's repair story is different and us BHR patients have been through more than most … and finally don't listen to anyone who says you will be up and about and doing everything better than you did before within a few weeks … it's just NOT true!
     
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  3. Jamie

    Jamie ADMINISTRATOR Administrator

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    @JR 2 Hips .... welcome to BoneSmart! We'll certainly be able to give you some advice to make your recovery journey easier and answer any questions you may have. But please start a recovery thread of your own to tell us what has been going on with you. If we were to try and respond to you here, it would derail this thread. If you need help on starting a thread, here is an article from our How To Use This Forum section which you can find under the Help & Information tab at the top of the page.

    Starting a new thread and posting
     
  4. JR 2 Hips

    JR 2 Hips junior member
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    I had my BHR done at Wrightington Hospital centre of excellence (near Wigan) as I'm in the Lakes. The NHS is reluctant to do Bi-laterals and it took some doing to persuade the surgeon to do mine, however, when he'd finished he did say that both hips were so bad that neither would have supported the other had he only done one.

    I appreciate that everyone is different and recovery also depends on the state of the muscles before the op but it's enormously valuable just to have feedback from people going through this themselves as it seems the surgeons do their job and expect us to just get on with it.

    The knee pain has been a surprise to me and the bruises all around both knees are deep and seriously colourful - I don't know why this should be as it seems to be tissue rather than joint.

    My joints are hybrids (cemented stems and uncemented cups) with metal and plastic. Initially I was supposed to have an Anterior approach with entirely uncemented prosthesis which would have saved any muscle/tendon damage but my osteoporosis left no choice but to cement at least the stem. The approach used was supposed to be a minimally invasive Direct Superior approach (3-5inches) but looking at the scars (9inches) I think the surgeon has gone for the old fashioned Posterior approach which cuts through major muscle groups and will make the hips less stable.

    All of this seems to be ignored when calculating recovery and when designing the best exercises to help.

    May I ask if people remember how far they were walking at 21 days and what aids you needed to walk?

    Thanks again
     
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  5. Celle

    Celle FORUM ADVISOR Forum Advisor

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    Hello @JR 2 Hips - and :welome: to recovery.

    I've moved your posts from hbl's recovery thread adn started a new thread just for your recovery.

    Here on BoneSmart, each person has her/his own recovery thread and where the main topic is that recovery.
    If you post about your recovery on someone else's thread, that derails the thread, so please continue to post about your recovery on this thread.

    Here is the recovery reading that we give to everyone with a new hip:
    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 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.
     
  6. Layla

    Layla FORUM ADVISOR Forum Advisor

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    Hi,
    Welcome to BoneSmart. Thanks for joining us and congrats on your two new hips!
    I think Recovery is an individual thing, different from one person to the next.
    You can use the Activity Progression for THR from the Recovery Guidelines as a rough gauge -
    http://bonesmart.org/forum/threads/activity-progression-for-thrs.13187/

    You may also enjoy reading other Bi-lateral threads which you'll find via the link below -
    https://bonesmart.org/forum/view/hip-replacement-recovery-area.5/?prefix_id=17

    Please stop back often. We'd love to offer encouragement and support as you're recovering.
    Happy Healing!
    @JR 2 Hips
     
  7. KathyB

    KathyB junior member

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    Hi @JR 2 Hips, at 21 days I was still using a walker and doing very little other than walking room to room, bathroom, getting a snack. Most of my time at 21 days was spent elevating and icing, no housework, maybe only a load of laundry a day. I didn't totally ditch the walker until about 3 1/2 - 4 months out. I then switched to a cane and still use a cane today at just over 5 months out. I walk about half of the time in the house without the can but take it with me outside or when I go away from home. I had a bad limp for quite a while prior to surgery and my balance was horrible. Everyone is on a different timeline for different things. I am good with my recovery as long as I am progressing. At just over 5 months out I can now walk about a mile, do some light gardening, grocery shopping, light housework and laundry. All of these tasks were doable at different times in my recovery and I still pace myself with how much I do each day. I only did simple ankle pumps, etc. first 2 weeks. I was supposed to do more home PT exercises but found most of the exercises increased my discomfort. After reading bonesmart guidelines, I quit doing most of the home exercises. Started out patient PT starting at week 3. Only did the exercises at the PT clinic that were comfortable and did not do them at home between PT clinic visits as suggested. The amount of suggested reps everyday at home between outpatient PT visits was insane.
    Best wishes for your recovery. You will get lots of great advice and support on bonesmart. There are a number of bilateral members/moderators who will be able to help you in your recovery, especially @Mojo333.
     
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  8. Mojo333

    Mojo333 FORUM ADVISOR Forum Advisor

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    :wave: and :welome:
    Recovery is a fickle fellow. Alot of ebb and flow...definitely not a straight line. rps20171117_054543.jpg
    I agree that there is not enough recovery guidelines given, even by my OS who I am ever so grateful for. The PT I was originally ordered to go to...I promptly dropped...too much too soon and was not helpful.
    I am amazed you have been managing with two crutches...I had a walker that I used exclusively for first three weeks or so except when cruising countertops or sofa backs.
    You will need to let your body be a guide to what is working for you.
    As others have mentioned, each individual recovery is unique..but you already have some excellent advice here.
    I will say that I found instead of trying to go farther with the walking...these early days...in my opinion it is better to take shorter walks more often.
    Ice is our best friend whenever resting:ice::ice:so do keep that going.
    Great anti-inflammatory and pain reliever.
    Keep the faith friend...early days !:tada:
     
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  9. hbl

    hbl junior member

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    I've experienced dreadful right knee pain (as explained in my thread) that pretty much kicked in a week after the bhr. My left knee was fine and could take some weight bearing but it was the right hip that was the really bad one so on reflection am not surprised this knee became a problem after the op. The bruising was quite something around the back and side of the knee and very puffy compared to the left - 1.5 inches bigger to be specific! I have spent heaps of time icing this knee and also my quads and glutes on the right hand side. I could put no pressure on this knee in terms of standing on this leg unaided. Am now just at the end of my first 5 weeks and a miracle happened yesterday .. I have been having a physio since 2nd week at home and she has done a lot of pressure point work on the psoas, glutes and quads, painful but has definitely loosened up this area. Have been walking with double crutches up until about 3 days ago and down to 1 around the house, not really being able to put pressure on right knee. But yesterday morning the ache and soreness was not quite as bad as before so I could put a little more weight on this leg but was very nervous to do so in case it gave away under me. However, at the end of the physio session yesterday she said she felt I could walk unaided as the right knee pain had subsided even more. AND I DID IT! Yes, I limped a bit but she told me how to correct that and as I gained confidence could take about 40 'normal' steps. Today, am now down to one crutch around the house and in the kitchen walk unaided and consciously avoiding the limp habit. Baby steps but it feels so GOOD! Outside am still double crutching on my long walk of the day - around an hour now - come home and ice up.

    So I would just say, for me knee and other associated pains took 5 weeks before the knee felt comfortable to bear weight whereas my left knee/hip has been good for about 2 weeks or so. I know we assume (I did) recovery would be equal on both hips but has not proved to be the case for me. Hope this helps. As we've said before I just wish hospitals would provide a bit more info on what you might expect post surgery.
     
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  10. JR 2 Hips

    JR 2 Hips junior member
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    Thanks for the replies and I love the recovery diagram! I think it describes my state of mind as well as my physical state.

    I had a bit of a melt down on Monday night due mostly to the frustration of not knowing if the things I was feeling were normal or indications of something sinister but I managed to pin my mood on hubby who got upset when I beat him at Scabble again.

    I suffered for my sins by being blessed with a thumping headache yesterday morning so I took one paracetemol which had the unfortunate consequence of allowing me to comfortably undertake more excercie than normal - I did 2 loads of washing and hung it all out, walked 1/4 mile up our steep road and back, got in (and more crucially 'out') of the passenger seat of our car for the first time, had a shower etc. etc. During the evening I had irritating stabbing pains in my right hip and this morning I have siezed up somewhat. This is why I avoid painkillers as my head wants to do more than my body really should and it's only the pain that keeps my enthusiasm in check.

    Now I have a new worry as my right hip seems to have developed a slight click - no pain or noise just a feeling but as before I worry if I've loosened or damaged something. I could kick myself for being too cavalier (metaphorically) so today I'm taking it easy.

    Just to put more info out there I will say that my surgeon told me he is 100% confident in my left hip but only 90% confident in my right hip as the osteoporosis was so severe that he's not sure how well the bone will bond. For those of you considering holding off on the op please bear in mind the muscle loss, tendon shortening, bone loss due to inactivity will all alter the outcome of your surgery - I should have had the surgery 5 years ago but life got in the way and there is never a 'good' time to have elective surgery.

    Thanks for letting me know about the walking aids as now I don't feel like a fraud for needing to use crutches for everything and I'm glad your knee pain is subsiding @hbl as the last thing you need is to be considering knee surgery!

    I think if there was a way to collate all of the information on this site into a handy Post-Op and Recovery Guide - What to Expect. it would be enormously beneficial to the thousands of us left in the dark after surgery and groping around for a path through this. We're lucky in that we all have easy access to the internet but there is an enormous percentage of more elderly patients who will worry and suffer in silence.

    I have no experience of healthcare in other countries but our NHS has very strict rules (they call them guidelines but they will not bend them) and I tried LOTS of NHS practices from Southampton to Cornwall to Newcastle in an attemp to find one that would undertake a bi-lateral only to be told that the only way was for me to have suffered double fractures making it an emergency repair. I have cashed in my Premium Bonds to get this op done privately but as private practise here is not as joined up as in the US for example, they then hand you back to the NHS for recovery. I love our NHS for the peace of mind it brings everyone and understand that there are limitations to funding but just wish that in those cases where it was imperative to take a different route that the NHS could refer one to another path.

    I'll let you know how things progress as tomorrow is my first car ride 20 minutes to my first PT appointment.

    Take care & thanks - Jo
     
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  11. Jaycey

    Jaycey SUPER MODERATOR Moderator

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    Nearly everyone has this "feeling" post op. All the muscles and soft tissues still need to firm up around the joint again. In most cases this feeling just fades away. Worry not!
     
  12. hbl

    hbl junior member

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    We're all different but from my experience I think you're doing a little too much too soon - take it easier however frustrating that is and this coming from someone who is normally super fit and active. I'm still taking 2 paracetomol every 6 hours; couldn't live without it. Am off the blood thinners as from Friday so I hope I can take an anti inflammatory or 2 instead to help the leg swelling and knee pain but we'll see how it goes.

    My husband has been super good although his patience is now running rather thin after 5 weeks. We play Mexican Train (a form of dominoes for those of you who don't know it, great game) every evening and I've noticed his patience gets even shorter when he loses … may have to consider letting him win more often!
     
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  13. Going4fun

    Going4fun senior

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    @JR 2 Hips, walking after two weeks with a bilateral ... that's asking for quite a lot ... Exercising after four weeks with bilateral ... that's far beyond what is typical.

    So take your time and read through the links to get some recovery guidelines. To back up, there are no universal recovery guidelines--so that's one problem and why you're feeling such lack of guidance. The guideline is move as you can ... if it's painful, stop. I, for example, had no restrictions, none ... from day released. I could bathe, wash, do whatever ... but ... of course, I was limited by how much my muscles were ready to do.

    @You can move and you won't hurt the device ... if movement really hurts, slow down ... literally, doctors cut in various ways ... so different muscles are involved and not just different rates of recovery ... but different qualities of recovery. Took me til week 9 to walk with cane confidently. But I had flexibility immediately, could tie my shoes and all of that. Combine different surgical approaches and different bodies ... and you get the lack of clarity about progress.

    Walk with walker or walking sticks ... whatever works ... Icing ... a ton of icing ... Take your pain meds ... regularly and not just in response to pain ... we won't move if we're in pain. You can call your surgeon's office and the nursing staff there will answer your questions ... and give you feedback ... There is also a nice little therapeutic advantage to calling your surgeon's office and hearing a human voice reassure you ... Report your problems ... and ask for what you need to do ...

    You're likely feeling frustrated and that's totally normal. I don't mean that in a dismissive way ... but yes recovery is jarring. And people talk about this strange phenomenon on this site: somehow when we read about hip replacement our brains apparently selectively remember all the super-amazing fast recoveries. Of course, those are the recoveries that some surgeons like to emphasize ... and those folks with unusually fast recoveries love to write about their experience.
     
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  14. Mojo333

    Mojo333 FORUM ADVISOR Forum Advisor

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    Absolutely and well said .

    I wanted these new hips to work well Right Now...but what I really wanted is for them to work well from Now On.
    We can't work our way to a faster recovery, but we can hinder it with doing too much too soon.
    The time we take to let things heal first is a great investment in our long term recovery.
    I felt like I was 75% good at 4-5 months and there was lots of improvement in strength and stamina up to over a year.
    Bilateral THR has given me my life back.
    I have never regretted this surgery.

    Hope today is a Good Day!
     
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    Last edited: Mar 28, 2019
  15. Carriemay60

    Carriemay60 post-grad

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    You sound like you are doing well but I do agree you need to slow down a bit. I would think one small job a day on top of a bit of walking would be plenty just now. Hoping you didn't carry a basket of wet laundry outside by yourself!
    My husband hates all games. I keep trying by getting a new one every Xmas but it always fails miserably. @hbl My aunt and her sisters used to get together for a few days a couple of times a year and the evening activity was often Mexican Train but that involved a whole lot of Tequilla! Ha ha
     
  16. hbl

    hbl junior member

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    Our poison of choice is a glass of wine (or two). JR2Hips if you don't have Mexican Train don't worry, you can go straight to the wine or tequila ... great as a muscle relaxant too I've found!
     
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  17. JR 2 Hips

    JR 2 Hips junior member
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    Thanks again for the replies. My husband is an eternal optimisist so whenever I comment on variations in sensations he tells me it's probably just healing pains and dismisses it.

    I genuinely don't want any sympathy just an ear to bend and confirmation that what I'm experiencing is 'normal'.

    More laundry today but I don't carry it outside I use the trolley - it takes me ages to hang out as I'm juggling crutches, pegs and laundry but maybe when I'm better I'll have a new skill in plate spinning.

    I have been for a short 15 minute road walk as my right hip feels a bit sore and stiff and my left still has a weird clunking sensation but I'm trying to loosen up for my physio appointment today - bit apprehensive about this as I do feel fragile just now.

    By the way what do you all mean by 'icing'? No-one told me what to do either iin the hospital, PTor OT so this is news to me. A lot of my swelling has gone down especially around my knees and my calves have not been swollen at all, however, I still have a lot of swelling in my thighs (mostly underneath) and particulary at the sides of my hips around the incision sites where the flesh feels hard it's so swollen.

    If I use ice do you mean something like wheat bags from the freezer and do I apply to the skin or through clothes - how long for and what does it achieve?

    Sorry to keep asking questions but being on this site has allowed a bit of light into my head where before I felt like I was running around in circles looking in vain for answers.

    Thanks again - Jo
    PS I've sent hubby to sort out the garage in the daytime which keeps him happy as he has a useful project he knows will ultimately make me happy and it tires him physically so that by teatime he's mellow and amenable to keeping me entertained.
     
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  18. hbl

    hbl junior member

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    I'll leave bonesmart to answer the icing question but I wasn't advised this either and just picked up the tip from this site and I can say it works a treat.

    As for your clunking in one hip, I've had this too in my right hip not all the time but certainly when I do the simple adduction exercises. My surgeon has said nothing to worry about and that this is normal. So I try and put it out of my mind. Am due for my checkup and x-rays week after next (week7/8) so hopefully all will be well. Have you spoken to your surgeon?
     
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  19. JR 2 Hips

    JR 2 Hips junior member
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    I have spoken to my surgeon who was not helpful simply saying we'll see what the X-rays show when I go back on the 18th April (6 & a half weeks post op). I don't think surgeons really listen to patients' experiences but focus entirely on the physical evidence of the mechanics. He did say that if there was continued 'clunking' it may mean the joint could wear more quickly or he may have to perform a revision which wouldn't be something he'd consider until 8 weeks post surgery. Not terribly reassuring.

    Best to listen to real people's experiences I think.
     
  20. Carriemay60

    Carriemay60 post-grad

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    A staff member will be in to address you question about icing in more detail and I think they have a link to some advice. However, what I do know is you should be icing 45-60 minutes several (at least 4) times a day on any area that is swollen or painful. (Be SURE to use a little towel to protect your skin between the ice and your skin).

    Icing will help a lot with swelling and pain. I hate being cold in such a huge way but when desperate after my last surgery, decided I had to try it. I was converted immediately!
     
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