Revision THR Looks like maybe a revision will be needed...

[chalcedonian1]

Oh the other point I forgot to add--I got an Ossur Cold Therapy system device and I use it for HOURS every day. I got the right hip pad which wraps around the hip and upper leg. I am amazed at how fast the swelling has gone down--icing really seems to be the key.

 

[Layla]

Wonderful news! @chalcedonian1
Thank you for the update. I love that you mentioned this surgery already feels different than the last.
I agree that if the three screws help do the trick.....love the three screws!
You sound great. Hopefully optimistic and happy. It's refreshing. May it only get better and better!

 

[Harryn1]

Nice report @chalcedonian1, thank you.

You have been through such trauma, be good to yourself.

May you recover completely and go from strength to strength.

 

[Mojo333]

Hey, so glad you posted! Ive been thinking of you!
You really are screwy now!

Please be so gentle for this first bit...as I am very encouraged for you.
You are a brave determined person...you've got this!

 

[TerryB_TX]

@chalcedonian1 , that's good news. It sounds like everything is progressing well. I guess it's now just taking it day-by-day, keeping your positive attitude, and continuing to heal. Nice to hear the old stem and cup were able to be removed without much collateral trauma. That should speed the recovery, I would think. You give lots of good advice. I think I'll try following the 3 day liquid diet too. I've got a history of diverticulitis, so the GI side affects of the pain meds can be big problem for me.
I think the continuous icing really helped me control my swelling and pain. It took a toll on my poor wife, who was constantly swapping ice bags out of the freezer for me. This time, I'm going to get the Ossur Cold Therapy machine, as you suggested. My wife and I will both get more rest that way. Maybe we can swap right/left pads when it comes time for our other hips to be replaced . I also continued to wear the thigh-high compression stocking even after I started walking around the house. I think kept the swelling and fluids from gravitating to my knee. Seems like your swelling may be well under control, though.
What did you end up doing about the NSAIDS? Did you take them? I'm of a mind to skip them all together, but am a little nervous if the surgeon thinks they may be necessary to reduce inflammation in the initial stages.
I'm meeting the first of three revision surgeons tomorrow morning. I've got my focused list of questions prepared (thanks to you and Josephine). I don't know why I'm so anxious, but I am. Perhaps because I know how high the stakes are and I want to get it right this time. Wishing you continued success in your recovery. You and all the wonderful supporters on this site are giving me the confidence to go forward.

 

[zinnia]

@chalcedonian1 Such good news coming from you; I am so pleased. How wonderful that your pain is mostly minimal and controlled. I wouldn't be too concerned about breaking the 3 or 4 restrictions you have once in a while; you are listening carefully to your body's response and heeding the pain. I would try though to remember. From my experience I was always afraid of a another dislocation or a misalignment of the cup which would disturb any early bone ingrowth. That cup has to remain at least 50% aligned with the pelvis I believe. Thus the screws; I have them as well. In fact, the surgeon had to build up my pelvis as it was fractured in the first two surgeries. So there are screws in the augmentation as well.

Your recovery is going so very well. I applaud you on the care you are taking. I wonder if a walker would be more comfortable for you than the crutches. I have one on wheels with a seat as well. . .there are different styles of this fancier walker and they are not very expensive at all. I still use mine daily as well as the cane. It is worlds better than the hospital walkers.

I enjoy reading your updates especially the news that you feel so different from the last, surgery. It is quite a revelation, isn't it. Look forward to hearing more good news coming in your recovery updates. Meanwhile, rest, listen to your body, and try following the recovery schedule out of Bone Smart. It is a good guide.
Happy Days!

 

[chalcedonian1]

@TerryB_TX Good luck today. I was very, very nervous with my first meeting of a possible revision surgeon, and I was also still a bit dazed and shocked. I think you seem to be handling the news better than I did, and that will help. My husband and I did a data dump right after the meeting, the information starts to fade pretty quickly after hearing it. Then we were able to compare all of our notes after we met the second and third surgeon. If you go alone, the data dump might be a good thing for you too.

re: Celebrex: It's funny, I said I would take the Celebrex right before the operation and the 2 days in the hospital, but when I had dominion over myself completely I would probably not do it at home. That is exactly what has happened. I am doing the Tylenol regime instead, which was also prescribed by the surgeon. Ironically, the Celebrex gave me TERRIBLE heartburn and GERD almost immediately, and while I was given Omeprazole to counter it, it just wasn't enough. I had this burning "golf ball" right in my chest that would not diminish. In addition to the nausea from all the other meds, the heartburn was just too much after surgery. My surgeon does not believe the Celebrex in the doses he gives for the period of time he gives it has any effect on limiting bone growth except possibly for HO (but how can it distinguish between the two? I just don't understand that), and helps greatly with inflammation. He was not argumentative with me, he was quite scholarly, and aware of the research. I don't think I have crazy inflammation as a result of not taking the Celebrex, but wouldn't really know as I am fairly pain tolerant, I guess. I just don't want anything to jeopardize bone growth since I didn't seem to have much the last time, so I opted out for those two reasons.

The liquid diet was so key, no problems like the last time when I was in AGONY the day after surgery. Also, I would be sure to take some kind of Dulcolax when you get home and still are on opioids. I am just taking Colace now, but until the other day was taking Colace and Dulcolax together, which is a powerful combination--and you might not quite get it right, but better out than in. The hospital care really focussed on this issue, 3 years ago not so much. Hope that is not TMI!! The Ossur machine has been really great--delivery took longer than expected and I could have ordered it a bit sooner, but we are so glad we have it here, it works for hours and I have to believe it has contributed to lack of swelling in my knees and lower legs, along with the compression socks. I wear them all day and take them off to sleep, per surgeon's orders, and these too have been fine.

@zinnia thank you for the lovely message. I am really trying to pay full attention to the restrictions--and I glued a note in my bathroom to not twist to flush the toilet--get up, get both crutches, turn the ship around slowly clockwise so my foot does not go inward, and then reach and flush! A simple little thing like that was so painful when doing it wrong... And thanks for the explanation of the screws. I saw the surgeon for a fleeting few minutes right before discharge and forgot to ask why I had them, though assumed it was so the cup/implant would stay in place. You are right, a walker would probably have been helpful, but by the time I would get it delivered, I hope to be (or almost be) on one crutch on the non-torn arm. I do have pain in the groin and upper thigh and around the scar, and some bruises there too (no big deal). I am really anxious for that groin pain to subside, it took a long time with the first operation, and then it seemed to morph all over my leg in pings, pangs and severe jolts for several years. This time, still, I have no pain in my thigh at all--which is almost too good to be truly believed. I hope it is not just the pain meds talking! My thigh is where I notice the difference most, for sure. May it continue. The perception that the operated leg is longer seems to be fading, and my hip doesn't seem to be pointing up at the ceiling when I walk, the first couple of days it felt robotic and slightly off angle, but I tried to not focus too much on that--I have worried plenty in the months preceding this operation, enough to carry me through recovery I think. I do remain guardedly optimistic, I know I have a while for the bone to grow around this implant, so I don't want to get ahead of myself here too much. But certainly so far, so good, and the expressed optimism of my surgeon has buoyed me, I hope not falsely. The weather here in NE has been gorgeous, a bit hot from time to time, and I hope to be getting outside soon to sit and get some rays of Vitamin D. I wish this time would shoot by quickly, it is such a slow process to heal. I hope you are doing well in your recovery, I haven't seen an update from you in a bit. You have been the essence of grace and composure in all that you have been through, it continues to inspire. Thank you for your encouragement and kind words before my surgery, they meant everything to me, and for continuing to root me on. Keeping my fingers crossed (but not my legs).

 

[zinnia]

I hate to see others go through as much distress and pain as I did for 2+ years. I saw a friend the other day who had a hip replacement 6 weeks ago and she is walking unassisted. I asked who her surgeon was and it was my first surgeon that messed me up in 2 surgeries, the primary and the first revision. Go figure. It happens. I am his worst nightmare and he mine!

But as we have already discussed, the revision by the second surgeon was like a miracle. . .I had no hip pain from the get go and only minor pains else where. And it has lasted. I hope that is encouragement for you @chalcedonian1. I do hope that pain at your thigh and groin subside soon but they/it are no doubt from moving around working tender muscles, tendons and soft tissue. You are doing and will without a doubt continue to do your recovery with aplomb and confidence. I don't remember, are you non-weight bearing at all?

I am coming along slowly. Two years of relative sedentary life has not only added 10 to 15 extra pounds but almost atrophied my muscles so there is a great deal to make up for. Luckily I was in very good shape before this happened. As it stands now, I am walking unassisted in Layla's heel/toe; heel/toe pattern to get my gait back. My ROM is good/normal. But my thigh muscles are not as strong as they need to be. My surgeon tells me it is the smaller surrounding assistant muscles that need work and walking is my best exercise and time is my friend. So walking I do and a few exercises. I am back on my 3 wheel bike and the Nu-step at the gym and am looking into an "easy" Tai Chi class. These plus trying to be patient with myself; now that restrictions are off I try to do as much as I can for myself except my husband still insists on helping me with the shoe and stocking thing. I have to wear compression socks a great deal for other problems. So I am coming along, sometimes more quickly than others; sometimes no progress at all for a time. It's a learning experience.

So stay hopeful and enjoy the positive feelings and know that the more troubling ones have a time element to them and will be gone sooner than later. You are a success story. Enjoy it!

 

[TerryB_TX]

@chalcedonian1 , I took your advice and documented my notes immediately following the appointment. Good idea, much appreciated. My wife is out of town for my appointments, but I called her immediately after to debrief and that helped. Even then, I find have to be careful about transcribing what was actually said versus what I wanted to hear or versus my own biased extrapolation and speculation beyond what was said. This is such an emotionally loaded topic, it's a chalenge to be as disciplined as I need to be.

 

[chalcedonian1]

@TerryB_TX I really do understand! It is hard to catch all that is being said because the ideas of going through surgery again and still not knowing whether it will succeed are indeed loaded with emotion. I was so focused during my first interview on what he thought my chances of success would be (as if I had a choice in having surgery -- obviously I didn't), not having LLD permanently, and also what could have gone wrong the first time, and I was rather surprised (shouldn't have been) that he was not forthcoming or comforting on any of those fronts. In fact, this revision surgeon said to me when he saw my x-ray that it was 'obvious the implant had not been put in upside down or backwards' -- his feeble attempt at humor which really caused my "internal" temper to flare because it was no laughing matter and I didn't appreciate being talked down to. He then said 'you'd be surprised what I have seen in my practice... ' which also didn't help because I wanted him to comment on what he thought about MY x-rays. And this is a surgeon who is spoken very well about on this forum by people whom he has operated on, and he has an excellent reputation in Boston. I just didn't know what to make of my reaction to him, so I wrote it all down and went on the second interview a week later, which went far better and was much more informative. The second surgeon took a lot of time with me, initially because I had to wait 1.5 hours to see him and he was very apologetic about that, and then, because we really made a good connection. I think I also was able to keep to the subject better in that interview too. (I might have used him for the revision, but he was moving to a smaller hospital in a month, and I wanted a crew that knew the surgery room like the back of their hands, not a crew new to the equipment and surroundings.)

Ultimately I chose the third surgeon who seemed to me to be a combination of intelligence, knowledge, skill and compassion. He felt I should schedule surgery sooner rather than later given my x-ray. He said to me at the end of the meeting he felt he could help me (all things being equal and depending on what he found when he went in), my chances were quite good and probably even better than that for a really good outcome. He had faith in himself and didn't hedge. We talked about LLD, I said I was a professional and didn't want to be limping and lurching around my clients, and he understood this immediately, did not make fun of my fear, as did the first surgeon who announced we all have LLD, which was besides the point---not all LLD leads to a permanent limp! Also the third surgeon works in a hospital which only deals in orthopedic surgery--so that seemed the ticket. But still I pondered the decision back and forth before scheduling. I also then reached out to a few physicians I know who are well-connected in the area, and asked for some "inside scoops" on the surgeons and their reputations in the medical community itself. It turned out that these physicians said all of the revision surgeons I saw had excellent reputations and track records, none would be a mistake, and I needed to use someone whom I could put my faith in. Not such an easy task after a miss with the first surgery.

My heart was in my throat when I did schedule it, I remember my voice shaking a little bit, even! So your reactions seem quite normal to me under these difficult circumstances. It is a process that has to play itself out, and at some point you will probably realize there is no more research or interviewing you can do, but it is time for a decision. Keep us all posted on your thoughts and progress, if and as you feel comfortable doing so.

 

[chalcedonian1]

I wanted to touch base for anyone who might be facing a revision and is tracking my recovery--as of tomorrow afternoon it will be two weeks out since my surgery. I am walking with 2 crutches, two laps down and back in my house every hour or so. The walking helps me feel looser, and I am walking better than even 2 days ago. It feels still like I am kind of like a ballet dancer walking under water, not quite right for land, but moving nonetheless. My operated leg feels a bit longer than the other, but nothing that can't be coped with at the moment at least, and less so than when I first came home.

I was stupidly optimistic and on Saturday decided to see what happens without my regular opioid every 4 hours. HA! OMG, by Saturday night I was really in a lot of pain, and realized how premature this thought was. The pain was in my groin (and lower back from laying down too much!), and I really couldn't move in my bed or otherwise without sharp pain. I am back on a regular regimen now, but up to 2 Dilaudid every 4 hours was prescribed, and I have not needed that since I got home. I am taking 1/2 a Dilaudid every 4-5 hours, and that seems to do the trick. I am also taking Tylenol every 4 hours, the Celebrex prescribed for two weeks after surgery killed my stomach, I had a golf ball in my throat from heartburn when I came home from the hopsital, and was hesitant to take Celebrex anyway given that NSAIDs can be seen to discourage bone growth. Giving that up was a no brainer, as it turned out.

For the moment, I have mastered the balance between opioids and my digestive tract, but still will be happy when I can get rid of the Dilaudid for good. But I do understand its usage and necessity.

I am still using my Ossur cold water/ice machine it is a Godsend, we change the ice and water every 4-5 hours or so and I am constantly using the hip pad. I think it really makes a difference -- I am only moderately swollen around my scar, and otherwise seem to almost be back to normal.

Showering and washing my hair has been exhausting for some reason. I get in the shower, and the steam and being vertical without both crutches makes me a bit dizzy and I have to sit down to get back to normal. I now have a walking stick in the shower to hold onto along with the shower hold bar, so I am hopeful I will do better at this particular task. So odd, a simple shower and shampoo just wipes me out.

My surgeon called me on Thursday to discuss a point about PT. During the conversation he pulled up my x-rays and once again told me that the hip looks terrific, and 'isn't going anywhere it is not supposed to be'. I am really pleasantly surprised at his demeanor and optimism, which I share somewhat in part, but not yet in whole--only time will tell. After 3 years of constant pain of one sort or another, it is hard to fathom not having such pain, o that my bone will be cooperative and grow properly this time and stay that way. My thigh remains pretty much pain free, and I do not feel that odd pulling sensation I often did with my first hip replacement. Again, I am still on pain meds, so am anxious to know how I will feel without. But I will let time heal.

The nurse came Sunday and took off my bandage for good. Absolutely dry, no leakage or anything coming from the scar. I still have steri-strips running across it, but they will supposedly fall off. Thank God for a dry scar!

I have had a very nice PT person come to my house, and she has not overdone anything with me so far as I can tell. I will not do any adductor exercises, just too painful, so most of the exercises involve simple movements, not taxing and if it hurts, I stop it and/or dial back. A PT who believes in not hurting oneself is a gift! I am happy to have the movement in my leg and hip, there is nothing I dislike about it. The first time around, I felt PT was painful and really resented the poor person who came to my house. I just don't look at PT as "the answer", it is part of a whole package of healing we need to go through. I am hoping I can continue some kind of upward trajectory---so far, so good.

Like @Layla I am counting improvement from one weekend to the next, the weeks start to blend together so I really like that theory of checking on progress. I have had 2 weekends at home, and the 2nd one, despite the pain rising because I was too quick to stop pain meds, shows a big increase in mobility over the first weekend.

I am trying to remain as positive as I can, not because I think a positive outlook truly overcomes physical trauma (believe me, I have been through enough to know it does not), but because it makes me a nicer and a better person to be around, and gives me a sense of hope. My husband has been fantastic to me, his favorite part is putting on my compression socks and seeing my toes come through, which he thinks is so cute (!!) (and yes, my toenails are painted, I like to remind surgeons and the operating team I am someone who cares about her appearance, so HANDLE WITH CARE ). My husband stayed home with me until today, but we both feel very confident I can get what I need as I need it now--he brings me lunch in a cooler in the bedroom or office, and otherwise I have all that I need. His natural sense of optimism buoys me up, and I am grateful for it. I could never take as good care of him as he does of me!

I have been watching BritBox, lots of English detective TV series, and all in, I really feel quite spoiled as I haven't been able to actually "veg out" in a long time, and all this with little to no guilt! So except for pain, which I would assume is natural to feel two weeks out from major surgery and which so far proves to be easily managed, I think things are going fairly well. Let's hope this continues. My first recovery was uneventful too, but it did not turn out the way one would hope...it still irks me from time to time that I don't know why the bone did not grow into the first implant enough... but I try to remember what so many including @zinnia told me about not dwelling in that dark land for too long.

 

[TerryB_TX]

Good to hear you are steadily healing and maintaining a positive attitude. I remember how liberating it was to regain some independence - bit-by-bit, over time. It's such a miserable feeling lying in bed with loved ones waiting on you hand and foot, feeling like such a burden. So much better for one's disposition to be out of that mode!

The narcotics are a great help with the pain, but the side affects for me were horrible. I found that taking some probiotics, as well as the Colace and Miralax helped. I even threw in some Milk of Magnesia to get some quicker relief when I got really uncomfortable. It seems everybody needs to discover the right formula for their own bodies.

Wishing you continued healing and a successful outcome. I'll be following your progress closely.
Hope you don't mind a periodic question here and there. You've been a such great help to me on my own journey. Answer these questions only as you feel up to it. I don't want to tire you out or burden you at a time when you need to focus on your own recovery.

BTW, I had my second revision consult this morning, confirming Josephine's observation of a loose stem and an unequivocal need for a revision. I've got a third consult tomorrow, so I'll post an update on my thread after that.

 

[chalcedonian1]

@TerryB_TX Yes of course, always ask, there is absolutely no burden! If I can help just one person, that is a delight. It sounds like today's consult was pretty sure, and was unequivocal about needing a revision. I must say I still haven't squared up what the first consult surgeon said to you, but as I mentioned, I am also not a medical professional, just a logical thinker and inveterate asker of questions. I am very interested to hear what the third consult says to you tomorrow.

 

[Mojo333]

So happy happy to see your progress report.
All sounds wonderful.
You sound tentative, but I can understand why.
I'm feeling super stoked for an uneventful recovery and send all the best your way.
Hope today is healing and happy!

 

[Layla]

Thanks for the positive update @chalcedonian1
It seems you have every reason to feel optimistic.
Your recovery is going well. All you can do is continue to move forward.
I understand how easily your mind would gravitate toward your last recovery
but I think Zinnia's advice to not dwell in the dark land is good. A sentiment I like is -
"It's okay to look back, just don't stare."
My wish for you is that the joy and progress of each day takes away the temptation look back.
I hope today is a good day!

 

[Mojo333]

Thinking of you.
Hope today is a Good Day!

 

[chalcedonian1]

I just wanted to weigh in briefly on my recovery. I am now using a walking stick instead of one crutch, and have been able to walk unaided a few steps here and there (not pushing it, just seeing how it feels). I don't have too much of a limp or a lean without a walking aide, but it is present and will need some work. With the aide of the stick or the crutch I have a pretty fluid walk and no limp at all. My operated leg is settling in and I hardly feel any LLD at this point, and I am VERY relieved about this. I do have groin pain and some occasional burning sensations in the scar area, but the thigh pains from the prior loose implant are no longer.

I last took a pain med 3 days ago, and am just on Tylenol now. I am still taking it easy in terms of positioning myself at angles etc. and I am icing everyday. I do need to increase my cardiovascular tolerance as I am out of shape having babied my hip/leg for the past 6 months and more, and can't wait to get back to the gym as it is very hot outside right now to do any kind of substantial walking. But I won't go to the gym until my scar/wound is completely closed and well healed.

I see my surgeon on Thursday and am anxious to see what he says, but I do know that my recovery has been pretty smooth with only a few hiccups. I still do not know if this implant and my bone will integrate properly over time, and that to me is the most important thing, so still waiting on this. But I am relieved so far to have had a good recovery period.

It is 4 weeks as of tomorrow that I had the revision, and these 4 weeks have gone by incredibly fast. I am hoping that the next 4 weeks go by quickly too and show even more improvement, but I am happy to take this day by day and to feel thankful so far.

Hope everyone is doing well too--this is quite an experience!

 

[Harryn1]

@chalcedonian1 After the extent of everything you have been through, I would say you are doing brilliantly, and are setup for a great recovery- and this is my hope for you.

4 weeks out from a revision is nothing. You are going to heal up nicely. I do hope the groin pain resolves quickly.

I wish you well!

 

[Mojo333]

Oh my stars..that certainly sounds promising.
I've almost been afraid to tag you and ask as I know how tentative you've been...which I can't blame you!
I know your appointment Thursday will give you added reassurance.
Let's think good good good
Hope your week is sweet!

 

[chalcedonian1]

@zinnia @Layla @Mojo333 I just got back from the 4-week-from-surgery consult with my revision surgeon. He could not be more pleased. I looked at the X-rays and even thought with my inexperienced eye that this was a tight fit, it looks so different from my prior implant (it is also a lot longer than the original implant, common with revisions).

I have been cleared to drive and resume life. I can walk without my walking stick for as long as it feels comfortable, and so long as I am not limply greatly. I can continue to use the walking stick for up to 2-8 weeks as needed, when and if needed, but I am encouraged to go without aids if I can. Do what I want, just be careful and work my way up to longer walks, and doing things like bending carefully and slowly. If I feel apprehensive, don't do it. If it hurts or even feels too uncomfortable, back off and rest (no problem there!). He said my current lack of stamina and sense of fatigue at this point is normal and quite common.

Most importantly, this revision surgeon said, as has @Josephine and others on this site, that surgeons have now found that PT does absolutely nothing to help replaced hips. That is a direct quote. Another quote: Physical therapists will in fact hurt you, and set you back; it is just not recommended. So he did NOT and will not prescribe ANY PT for me. He said walk, walk, walk, ride the incumbent bicycle, do work on the elliptical. I get discharged from home PT next week, and am glad for that. In 3 months I will be cleared to do weight lifting, leg presses etc. at the gym and anything else that I would consider a sport. I find his advice to be quite valuable as I have felt conflicted about PT for awhile, wondering if there was some small benefit I would not get from any other form of exercise.

The groin pain I am experiencing should dissipate within about 3 months +/-. I see the surgeon again in 2.5 months and will have another x-ray taken. My scar looks terrific and is healing perfectly, he pulled some thread stitching out and there are a couple of steri-strips left that still need to fall off. The ROM in my hip is excellent. Honestly, I feel like I just got one get-out-of-jail-card free. And while I am still a bit cautious about potential longer term issues because this is my nature, this surgeon is incredibly confident the hip is not moving or going anywhere--he said the polyethylene that is used in the cup has not been shown to get involved in an osteolytic process and neither has the titanium to date. He said he just doesn't see how this implant is going to loosen. His surprising buoyancy gives me more hope than I have had in a long time. May he prove to be correct.