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Kneeling after THR...

Discussion in 'Hip Replacement Recovery Area' started by Mtngirl, Dec 3, 2008.

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  1. Mtngirl

    Mtngirl new member
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    I am scheduled Dec 9th for a THR of my right hip. I was a police officer and lost my job as an officer when my position was discontinued and I was unable to return to the road due to my hip.

    I will have the opportunity to try for a reserve position if I can qualify with weapons in mid-January. My biggest concern is at 5-7 weeks post op, will it even be plausible to think that I will be able to go to the kneeling position to fire? Kneeling can be done anyway we choose..both knees, one knee, which ever we want. I have always gone down on my right knee (habit now), and I understand that after THR that it is preferrably to go down upon the side replaced??

    The timing on this totally is horrible, but it's beyond my control. I realize every person is different, and recovery is different for each individual, but should I even contemplate this?

    Thanks,

    mtngirl
     
  2. mvo

    mvo member

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    Hi mtngirl,

    I am 45 years old and just 3 months out of a THR. I can kneel, no problem (it is easier that way to get stuff off the floor than to do the giraffe thing) and I feel more comfortable kneeling on the operated side. I Think I knealt (is that a word?) from about 10 weeks. At 7 weeks post op I my quad muscles were still a little weak, but here in New Zealand we don't seem to do that intensive PT pre or post op that you guys do, so you may be able to reach the "kneeling goal" at 7 weeks.

    All the best for your surgery and recovery,
    Monica
     
  3. newwheels08

    newwheels08 junior member

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    After double THR...even though I felt great and was back at my desk at 4 weeks, I found (and still find at 10 months post op) range of motion issues. Kneeling is still one of my challenges and is not automatic as it was pre-OA. It is still better than I could manage with diseased joints, but I do not get full flexion from either side. Maybe one hip will enable a faster recovery. I think if your goal is to kneel, maybe that is the trick. Mine was to walk without pain and a limp...so I did not push the kneeling part as a priority. The good news is that I (almost) do not think about the surgery ...or the arthritis anymore...That is the real healing process for me. Best wishes.

    Bruce
     
  4. JudyS

    JudyS alpha

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    Hi mtngirl,
    Welcome to bonesmart. I am now just about 6 months post right hip replacement. I started swimming at about 4 weeks post. I did a lot of the frog kick which I believe gave me great range of motion with my new hip. For a few months now, my right hip has much greater range than my left hip (non operated).
    I am trying really hard to remember where I was at around 6 weeks. I believe I was walking a lot and told my doc I could walk without pain meds, but had a slight limp. With pain meds no limp, he opted to keep me on pain meds saying it was better to not limp. I don't remember if kneeling is a big deal or not, I probably did not have to kneel much if at all. I do know that at this point my quad muscle is still atrophied , kneeling is fine, I can get up , but it is a little slow and challenging with the operated side. I do have a medical problem that effects muscles, so that may be the reason.

    but, since 3 months and restrictions being lifted, I have been hiking a lot, lots of elevation climbing, swimming, biking, whatever I want to do. It is all possible. I am very glad I had the hip replaced.
    Hopefully someone will post that is closer to 6 weeks out.

    Good Luck next week, keep strengthening those quad muscles for this last week!!! Work at it right after surgery too!!

    Judy
     
  5. Mtngirl

    Mtngirl new member
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    Thanks for the replies and encouragement! :)

    Oh...and I don't know if this makes that much of a difference concerning my question...but I am told that I will be undergoing a "mini-posterior" THR (minimal invasive posterior total hip replacement...DePuy metal/poly cup prosthesis). :confused:

    sewell: I have been doing my exercises faithfully and will continue to do so right up til they roll me into the OR!! In my pre-PT eval, the Physical Therapist was surprised at the amount of strength I still had in my legs (this after I had lamented about how much muscle tone I had lost), but up until three months ago, I had been horseback riding a minimum of an hour 3-5 times a week. My biggest problem is range of motion...I have less than 15 degrees abduction, plus bone spurs which "catch". X-rays show I have excessive calcium deposits/growths? on the ball of the femur which blocks the motion of the joint, in addition to arthritis and just plain old deterioration of the joint.

    I finally had to give up riding (my real passion) because it was 1) extremely difficult to mount and dismount 2) very painful and 3) my hip would get "locked" or "caught" and I couldn't move certain ways. I tried dismounting on the off side, but that turned out to be impossible. :mad:

    Even my family doctor agreed that I have waited too long to have THR. However, I had some problems locating a doctor in my area willing to operate on a younger patient (I'm 51). Once I did, I'd planned on having it done this past Spring or Summer, unfortunately my mom wound up having open heart surgery and I had to take Family Leave to take care of her...then I came down with a severe case of shingles (so severe it attacked my digestive system) and I was hospitalized for 5 days. Between those two episodes I used up all my sick, vacation and Family Leave time and therefore couldn't take the time to have the surgery.

    This resulted in me losing my position as an officer...and putting me back into a non-sworn job (I am thankful to still have a job at all) and rotating shifts. Between the rotating shifts, sick time and vacation time, I can now take exactly 28 days before returning to dispatching 12 hr shifts.

    As you can tell, this past year has not been a good one for me. It sounds surprising to actually be looking forward to a surgery - but I am. I was at the dentist yesterday (wouldn't you know it, I'd had the beginnings of a root canal last week - only to have the tooth break off beneath the bone - I wound up having it extracted) and the dentist was amazed when I told him I was happy because I only had five more days until my surgery.

    Sorry for such a long post...but as you can tell, I'm grasping at all those good vibes and success stories. I've done about as much research as I can, and am now to the point of asking about some more specific questions from those who have actually gone through THR. I stumbled onto this site a couple of days ago (don't know how I missed it before), and figured I should take advantage of other's knowledge!

    Thanks

    Ann aka "mtngirl"
     
  6. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    Anna - first of all, you should tell your surgeon you had dental treatment before he operates on you as I think there is a optimum minimum period that should elapse between treatment and surgery. I have been unable to find confirmation of this just now, but if memory serves correct, it is something like 6 weeks. Ring him now and find out.

    As for the "mini-posterior" THR that means you will be having a small incision similar to that detailed here - probably the purple one

    ai35.tinypic.com_29bel5j.jpg

    This will involve almost no division of muscles or ligaments so recovery should be swift and virtually pain free.
     
  7. JudyS

    JudyS alpha

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    Hi Ann
    First, call your doc after Jo's info on dental work. I hope what you had done does not cause a delay in your THR

    Sounds like the type of surgery you are having should have great recovery.
    Sorry about what happened with your job.
    I am also 51. My surgeon spent lots of time convincing me hiip replacements were not just for old people!! But of course when ever I tell someone I had one, the first response is , but you are too young!!
    Like I said it is an awesome surgery, I wish my spine could be so easy to treat!!

    I am a special ed teacher and lost my job in the middle of my hip treatment. It was a very ugly situation which I still can not figure out. But, I sure am enjoying my local mountains!!!
    Mtngirl where are your mountains???
    Judy
     
  8. Mtngirl

    Mtngirl new member
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    Josephine: When I went for the anesthesia interview Friday I mentioned to both the anesthesiologist and the nurse about the dental extraction...they said not to be concerned (I could not get in touch with my surgeon at that point...too late in the day). On the plus side, I did take amoxicillian before the procedure and am still taking it...dentist thought it was a wise precaution to take. But I will definitely take your advice and contact the surgeon on Monday. I truly hope this doesn't cause a delay, because the timing on this has been quite difficult, involving scheduling of people to take over my position at work, care givers etc.

    Also, Josephine, I was under the impression that there would only be one incison...but I guess I'll find out. Thanks for the diagram...I hadn't seen that one before and it definitely helps.

    sewell: I am sorry to hear you lost your position too. I was a school resource officer for 8 years and loved it. I had a very special realtionship with our Special Ed teacher. She had a couple of kids that related to me very well when others could get no cooperation out of them! Unfortunately, I work for a small department, and eventually I wound up being the only one wanting to be in the schools, so my position was phased out and the local sheriff's office took over all the schools.

    My "mountains" are the Blue Ridge mountains in western North Carolina. A truly beautiful area to go trail riding and hiking. I am thoroughly looking forward to returning to those activities.

    Ann
     
  9. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    That image was just one I grabbed off Google so don't take it as verbatim. There are many, many different versions, amost one for each surgeon!
     
  10. Laurie

    Laurie senior

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    Josephine, Very interesting diagram re: incisions. '
    Was told before surgery that mine would be MIS and my incision looks like the blue one though it is 6 inches in length. No problem, it is already fading, but just interesting that the angle is different than traditional--wonder why.
    Laurie
     
  11. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    Well, that's because in the traditional approach, special instruments would be used to pull muscles aside to get access first to the acetabulum and then to the femur. This could occasionally result in some force being applied which would account for some of the post-op swelling, bruising and pain. In the single MIS approach, the insertion instruments are shaped with special angles to get access by going under those muscles. This is one of the reasons why placement has often been an issue in this approach, because the surgeon doesn't have as much direct view of things as in the traditional. This was slightly overcome in the two incision approach which restored some of the eyeballing. Of course, this is also where the computer assisted placement comes into its own but not many surgeons have the desire to go down that road.
     
  12. UTdave

    UTdave member

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    Funny. . . mine was supposed to be the "old fashioned" posterior and the incision is about 4 inches and looks like the blue incision, only along the axis of the red incision. To each their own, I suppose!
     
  13. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    Incisions are not an exact science. By their very nature, each is unique both from the surgeon's hand and from your anatomy. We are all wondrously and uniquely made! The image I posted is only a guideline.
     
  14. Mtngirl

    Mtngirl new member
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    Re: Kneeling after THR...updated 12/15 home and doing well!

    Well I'm home and am so far doing extremely well. I haven't discussed this with my surgeon, but evidently he changed plans and went with a traditional incision rather than a mini-posterior. My incision is 9 1/2 inches (24.5cm) long. It pretty much follows the red line in the diagram posted earlier.

    The day of surgery was a really rough one to tough out. Lots of pain and discomfort. Doctor was concerned about a slight fever I was running (99.8) and some redness/heat along the incision line so he kept me one more day in the hospital to watch it and get me started on a high powered antibiotic.

    The hopsital where I had this done has an interesting program called "joint camp". Patients are admitted, and then we all met twice a day for four days and did our physical therapy together. Each person had their own person "coach" usually their spouse, to assist. I'm single, between boyfriends and my "coach", a close friend, came down with bronchitis and therefore couldn't help. For me it didn't matter, as I was light years ahead of everyone else and didn't need the "coach" for help. But doing the therapy as a group was good, because you could encourage each other, cheer their progress, and yet understand their pain and frustration.

    By the 3rd day post op, I was walking (with the walker of course) 4 laps at a time around the orthopedic floor - approximately 500ft...and I did that 4 times that day. So I'd say I was doing pretty good. Now I'm waiting for the Home Health Service physical therapist to make their first visit. Not sure why I wasn't referred directly to the rehab center itself, other than the fact that it was mentioned that for the first couple of weeks post op, it's preferred that travel be somewhat limited if possible.

    The one thing I have notice which is different is that I seem to be extremely emotional. I've had other surgeries before...a couple pretty major, and don't remember this. Last night I completely wet a tissue with tears after watching a TV program. That's not like me at all. I'm hoping this is just a side affect of the anesthesia, pain meds, surgery?
     
  15. Laurie

    Laurie senior

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    Mtn girl, Congrats on getting through the surgery and being home. It is all bound to be uphill from here. After my RTHR on Aug 26, I went to a subacute rehab for 5 days just because I have lots of stairs and wanted to give my husb a break. We had PT very similar to what you describe there and after in otpt pt. I never had in home pt as a result.

    I am always interested in the incision discussions. Seems we never quite know what we will end up with. Mine ended up 6 inches long instead of the 4-5 MIS. However, my Dr. did tell me beforehand that he would make it as long as he needed to get the view he needed to perform a successful surgery. So perhaps that is why you have a longer incision as well. In any case, I find the incision no big deal now and healing nicely, even fading some.

    Hope you can sleep--that was my biggest problem til about 5 weeks.
    Take care and enjoy your recuperation--I am typing on my lunch break, miss my 8 weeks out of the office!!!

    Laurie
     
  16. JudyS

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    Congratulations Mtn Girl!!!
    Can't remember being especially emotional,just glad to be out of the hospital. Sounds like you did great in the hospital. I ended up having very little pt for some reason. I was there on the weekend, one pt said I was asleep and she did not wake me... I was using crutches when I left as I brought mine with me.
    Sorry about the pain on day 1. I had a PCA device and no pain if I did not try to move!!

    Time to keep up with stool softeners, pain meds, rest , elevate!! Baby yourself.

    Judy
     
  17. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    Re: Kneeling after THR...updated 12/15 home and doing well!

    Only 'A' tissue? Dear girl, it's the whole thing - all of the above plus the stress and anxiety, an emotional roller coaster for sure. And it's not just because it's a THR, it happens to people after any major op. I was a tear soaked mess after my hysterical rectomy!
     
  18. Mtngirl

    Mtngirl new member
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    sewell: I too had a PCA...but for some reason after the spinal wore off I was in severe pain...so much that the doctor changed my control times from every 10 minutes to every 5 minutes. I also has problems with my body temp...it got quite low and I was literally freezing. At one time they had 7 blankets (warm ones no less) on me! About midnight post-op there was a significant change for the better, and from there on out, I did great. One pain pill prior to physical therapy and one at bedtime was all I needed. And truth be told, I think I could have foregone those, but the doctors, nurses and physical therapists were insistent.

    Thanks Josephine! I was a little worried there about the emotional bit. I also had a "hysterical rectomy" as you called it (love that phrase!). Plus, gastro bypass 23 years ago and both rotator cuffs repaired. I simply do not remember this emotional issue. I'm hoping that time and getting my hormones back in sync will take care of the problem.

    Home Health and Physical Therapist both came today and stated they thought I was doing exceptionally well. The reason they gave for home health and the PT's coming to my house was that they prefer to limit the times getting in and out of vehicles during the first two weeks post op. In fact, the PT thought I might be graduated to a cane before Christmas and may need little no PT after home care. We'll see. I'm thinking I may need more further down the road to get my ROM back so I'll be able to complete firearms qualification and get back to horseback riding. At least those two goals now seem reachable!

    Thanks for all the encouragement people. This site has helped me to understand a lot of things and given me insight into aspects of THR I would not have thought about.
     
  19. JudyS

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    MTNgirl

    After reading your post I remembered my crying first day post op. I was so frustrated with the nurse and medications that I was crying. I had cervical spine fusion about 8 months before and no crying then.

    There are so many things you don't think about. I was literally saved by finding this site before my surgery. I was really clueless!!
    Glad you are doing so well.
    I had home pt for 3 weeks (twice per week) My pt said she only recommends very active people have outpatient pt after. My doc decided to send me at 6 weeks as I was so unsure what I should or should not do at the gym. I surely did not want to mess anything up then.
    I would recommend swimming if you have a place to do it for ROM.
    I still can not believe how good my range is, especially comparing it to my left hip. I guess that one will have to be done some day too.

    I am sure you will get back to doing everything you want to (except running). I found that running is totally possible, on my really frustrated with the body days, I do run a little on my trail.

    Rest and rest some more!!
    Judy
     
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