THR Knitquilt’s little bumpy recovery<

[Mojo333]

Little smokie sausage in crescent roll...haven't been by for a bit. Fairly sure you weren't sitting on edge of seat waiting for the answer.
Hope you are feeling better..Josephine might be able to shed light on cause...try to let her know one way or the other as she checks on many on the forum.
Hope today is a Good Day!

 

[Knitquilt]

Oh, Josephine, thank you for your concern, but after reading my own post and the replies to it, I realized that I just overdid it! Have no idea why I thought baking 5 loaves of bread and a double batch of biscotti all in one day was a good idea! Since Christmas, I have taken it much easier and feel so much better.

I’m resuming my normal activity level now, and if the swelling I had been getting comes back, I’d be very happy to answer your questions @Josephine Very grateful for your concern
And Happy New Year!

 

[Josephine]

You're probably right but here y'go anyway!

It would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are

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

2. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't forget to factor in other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness).

3. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

4. are you icing your painful area at all? If so, how often and for how long?

5. are you elevating your leg. If so how often and for how long?

6. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

7. are you doing any exercises at home? If so what and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)

Exercises done at home
- how many sessions you do each day
- enter exercise by name then number of repetitions of each
etc., etc.

Anything done at PT
- how many times a week
- enter exercise by name then number of repetitions of each
etc., etc.

 

[Knitquilt]

1. Anterior

2. Pain level 1 - slight swelling above and below incision. Occasionally if I overdo, the front of my thigh swells. Some stiffness after I get up if I’ve been sitting awhile, so sometimes pain level 2-3. At night after medication wears off, pain level is 2 -3 until I go back to sleep.

3.just take 30mg Tramadol and 2 extra strength Tylenol (total 1000 mg) before bedtime. I do not take more if I wake up in slight pain (pain level 2) after meds wear off because I’m usually able to get back to sleep.

4. I now ice about twice a day which includes at bedtime for an hour each time.

5. I elevate when I ice, so about 2 hours a day.

6. I’m back to my regular activities with many breaks (usually after 40 min of activity or so) where I sit with my leg up on a pillow on the couch. Cooking an easy dinner, dusting, light vacuuming, short shopping trips, getting together with friends. Ironically sitting at a book club meeting (about 2-3 hours) leads to more swelling than vacuuming.

7. no PT - had 5 sessions when I first got home
20-30 minutes on treadmill most days - walk at a comfortable walking speed

Thank you! @Josephine

 

[Josephine]

2. Pain level 1 - slight swelling above and below incision. Occasionally if I overdo, the front of my thigh swells. Some stiffness after I get up if I’ve been sitting awhile, so sometimes pain level 2-3. At night after medication wears off, pain level is 2 -3 until I go back to sleep.

You did see that swelling is pain and needs to be included in your pain score? So I would suspect that your pain is a little more than 1? Yes?

3.just take 30mg Tramadol and 2 extra strength Tylenol (total 1000 mg) before bedtime. I do not take more if I wake up in slight pain (pain level 2) after meds wear off because I’m usually able to get back to sleep.

30mg? To my knowledge, Tramadol only comes in 50mg and 100mg sizes. So I suppose you are taking 50mg Tramadol on 1,000mg Tyleno. which is good. If you need anything during the night, two Tylenol should do nicely.

4. I now ice about twice a day which includes at bedtime for an hour each time.

Not bad

5. I elevate when I ice, so about 2 hours a day.

Good

6. I’m back to my regular activities with many breaks (usually after 40 min of activity or so) where I sit with my leg up on a pillow on the couch. Cooking an easy dinner, dusting, light vacuuming, short shopping trips, getting together with friends. Ironically sitting at a book club meeting (about 2-3 hours) leads to more swelling than vacuuming.

That's excellent.

7. no PT - had 5 sessions when I first got home
20-30 minutes on treadmill most days - walk at a comfortable walking speed

That's all okay too.

So I needn't have worried about you!

 

[Knitquilt]

Thanks, Josephine! I wasn’t really worried, but it’s nice to hear I’m doing ok from an expert! Thanks for taking the time to check on me

 

[Jackie222]

Wishing you a continued good recovery in 2018. Happy New Year

 

[Layla]

Hi @Knitquilt
Wonder how your recovery is going at almost THREE months post op?
Time flies in recovery. At least I found that to be the case.
Hope you're doing well.
Wishing you a great rest of the weekend!

 

[Knitquilt]

Hello again, it’s been awhile! I had surgery 3½ months ago and had my follow-up with the surgeon yesterday. My operated hip looks great on X-ray and feels great. However, he said my left hip is ready for replacement.

This summer when I first saw him, he told me that only my right hip was ready and it would probably be a few years before left hip was ready. I was surprised since I did have pain in that hip also. I now believe he probably said that because he didn’t want to do two hips at once. The left hip has not really bothered me since I had surgery on the right.

I would really appreciate if @Josephine could answer two questions.

I had a problem with low blood pressure after surgery (spinal anesthesia). It was pretty bad as I would get very nauseous and feel faint - had vomiting and out-of-control diarrhea at the same time. They kept me in the hospital an 3 extra days. Doctor thinks maybe it was medication which was Norco but really didn’t know why this happened. If this happened once, is it likely to happen again??? Are there other meds that might not have this effect on me?


Second question-
I need to preface this by saying my son is getting married this next year, but the date isn’t set. I’m trying to decide if I wait until the pain becomes progressively worse but not constant before I schedule surgery. The OS did say I have a cyst on the hip that has gotten bigger since the August xray. This is the first mention of a cyst - does this change the prognosis and make it more urgent to schedule surgery?

If my son wasn’t getting married, I would definitely wait to see how I feel. But now I just don’t know the prudent thing to do. I was so surprised when the surgeon said the left hip was ready, I didn’t even ask any questions!

I am including the latest X-ray, but I know the quality is poor.

Any advice you can give me, Josephine, is greatly appreciated

 

[Josephine]

I had a problem with low blood pressure after surgery. Doctor thinks maybe it was medication which was Norco but really didn’t know why this happened.

Feeling nauseous after surgery is not uncommon. The doctor was correct in that we still don't know exactly why this happens but we do know some contributing factors which are low blood pressure from the anaesthetic or the post-op drugs. Almost all of them will cause this in different people. The second part of your question is less easy to explain because some people will just have a one-off episode and others will have repeated episodes. There is no way to know why or how. But if you had this episode, the anaesthetist can give you some antie-metic (anti-sickness) medication as part of your anaesthetic to ward this off.

The OS did say I have a cyst on the hip that has gotten bigger since the August xray. This is the first mention of a cyst - does this change the prognosis and make it more urgent to schedule surgery?

Bone cysts in the hip joint are very common and a frequent occurrence as part of the arthritis disease. It depends where the cyst is. From your xray it looks like it's in your femoral head and/or neck in which case it will be removed when the head is removed. No fuss. However, they can also occur in the pelvis around the socket in which case the cavity has to be cleaned out and packed with bone graft. This is usually obtained from donated bone which is ground up into bone meal. So as far as you are concerned, this also is no fuss for you! And generally it doesn't make for any urgency in the surgery.

 

[Knitquilt]

Thanks so much for replying so quickly @Josephine
You have eased my mind about the nausea and the cyst!
I know you’re not a fortune teller, but from my X-ray, do you think I can delay surgery for a year or more? I want to dance at my son’s wedding! What would you do?
ETA: was in pain this past summer from both hips, but since surgery in Oct. left hip pain has been intermittent and around a 3 when I do feel it.

 

[Josephine]

I know you’re not a fortune teller, but from my X-ray, do you think I can delay surgery for a year or more? I want to dance at my son’s wedding! What would you do?

I can't comment on this. Maybe it will be okay and maybe it won't. It's really in the hands of God.

 

[Knitquilt]

Thanks for your input, Josephine! I’m less nervous now. The surgeon really threw me for a loop and I couldn’t think. Even now, I don’t know why he used a screw in my right hip, and I’m sure he had a good reason, but he didn’t tell me. And I didn’t notice it in the X-ray until I got home.

If you ever get your fortune-teller license and can foretell the future, please let me know if I should just go ahead and get the left hip taken care of. In the meantime, I’ll calm down and see what that left hip tells me to do!

I really appreciate all that you do - thank you!

 

[Mojo333]

Oh Knitquilt. What a dilemma. Don't have any insight but glad to know your other hip is doing well.

 

[Knitquilt]

Thanks, @Mojo333! I’m hoping that if my hip is going to act up, it acts up in the next few months! I REALLY don’t like uncertainty. Once I know the wedding date It should help me decide.

 

[Josephine]

Even now, I don’t know why he used a screw in my right hip, and I’m sure he had a good reason, but he didn’t tell me.

You see, you're getting into a state over something that is really nothing at all! That screw is dictated by the design of the cup, nothing more. It's not a portent of disaster! And that's why your surgeon wouldn't mention it because he does this every time he uses a hip of this design. If you had mentioned it to him, he would have told you exactly the same.

 

[Mojo333]

I have two in my right and none in my left.

 

[Josephine]

And does that worry you?

 

[MammaT]

I have one in my left hip and one of those ring things they use for some reason (can’t remember what). I figured he put in what he needed to keep it together and it seems to work just fine. Looks better than it did with all of the arthritis in there!

 

[Layla]

Hi @Knitquilt
As long as there's a reasonable explanation and you're pain free, I wouldn't be concerned. Screw it!
Aaah! I'm fully expecting someone to come running after me with a bar of soap for that one.
It's so fitting.. I can't help it! Maybe I should just flag Jo and surrender.
White flag......I surrender!