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[THR] lotusbuds' recovery thread

Layla

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Good Morning and happy Monday :wave:
Please know that you can work on the limp (heel-toe walking) while using your cane.
You don't need to wait until the limp is gone to begin using the cane alone on a regular basis.
At this point, almost 6 weeks post op, I'd aim for using the cane more throughout the day than the walker, try starting there. I'll bet you can do it!
I hope you have a nice week :)
@lotusbuds
 
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lotusbuds

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Update Just back from PT. I left the walker in the car with my husband and took the cane and walked into PT office and back out with a stop in the BR. I went really slow, did some heel toe concentration. Was wobbly at first but got into it the more I did. Wow! its not easy but I am going to do it more now. PT said my thigh is more swollen than he has seen before. He does lots of hips and knees pre and after surgery. He said to ask my OS. He said there is likely nothing to be done but make sure to ask. Then he suggested I ice more than I am and to set a timer to make sure I am never sitting more than 45 minutes max. So that is what I will do. I do sit a lot and sometimes forget to get up until I am in pain.
So I will continue using the cane most of the day. Lets see if that works.
Thanks everyone!
 

Carriemay60

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I agree with Layla and actually found the cane the best way to practice heel/toe walking. I never felt the walker very beneficial in getting a good gait because somehow your space is conscious of accomodating the walker. If you can, try to lift your eyes pointed towards your destination also (be sure you have a clean path before you regret you didn't check!) If you have a full length mirror that is easy to move I would suggest leaning it against the wall at the end of your longest pathway in the house. It also helps improve your gait and heel/toe if you're watching (almost like a self critique). You are doing very well but be confident in yourself; you do not seem to be a hasty thoughtless person so I am sure you will make good forward strides.

@GrannyC I can get full on flu symptoms for several hours if I am really overtired. They can be so convincing I almost hold my breath until they pass.
 

Layla

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Awesome...good for you!
I recall feeling wobbly initially. I practiced with the cane at home, would walk parallel to the wall, back and forth, so I had something to stop and lean against if necessary. Never had to though. It gets easier and easier just like anything. Lets tag @Josephine on the swelling and see how she advises.
I hope you have a relaxing evening!
@lotusbuds
 

Josephine

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I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?
 

SE Florida

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Good morning @lotusbuds it sounds like aside from the swelling, things are improving. Walking in to your app't with just a cane is a big deal the first time! I am still practicing the cane with heel-toe because I am still having problems with "swaying" when I do it. I can't seem to master a straight line and my hubs said I walk like I've had a few too many! :beer:
 
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lotusbuds

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@SE Florida good morning. Yes you are right. Aside from the swelling things are improving. And the swelling isn't new its just that I have been focused on it the last few days trying to do the right thing for it. We live in a small one level pan abode log house on an acre. Its about 1500 square feet. I am getting more comfortable with the cane and using it more but not all the time. I am doing the little 'dance step' first (its a 3 step process that gets me moving) and then have no limp. But as I use it more I don't need the 'dance step' but do limp a tiny bit until about step 10 then I'm fine. I will use a mirror at the end of the hallway to watch myself later today.
I am due at the OS on Monday but may call them about the swelling to see if I need to wear the compression stockings again (though I wore them for 5 weeks and the swelling is the upper thigh and has been there a few weeks at least). I also finished the 325 mg aspiring twice a day on Sunday so started my baby aspirin regime last night again as I was taking it before surgery. I have a Lounge Doctor pillow for elevation I use once a day to elevate and ice and am icing about 6-7 times a day for 40 minutes or until ice warms up.
Today is an easy day at home so will use the cane. Have a great day!
 

SE Florida

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"Dance step" is a good way to put it I think! I have that problem whenever I've been sitting for awhile and stand up. I had the same thing when I had my left hip done and it probably took a couple of months to finally work itself out. I kind of feel like the Tin Man and need to oil my joints. :loll:It sounds like your progress is going really well though and hopefully your swelling will improve soon too.
 
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lotusbuds

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Quick morning update! I tried out this noisy folding cane I have that I used to use and lo and behold I have used it all morning with no limp or even hesitation on walking. I am in shock but today is the day!!! OMG!
I hope it lasts. ha ha
The swelling is always the same size but doesn't seem to bother me until later in the day or after sitting too much so that is still an issue but graduating to the cane is a miracle.
Thank you again for all your support.
 

SE Florida

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That's wonderful @lotusbuds ! Sometimes that's how it happens, you get up one day and everything just "clicks". Great news for you!!!
 
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@SE Florida @Carriemay60 the cane I am using today folds and is so loud its a 'clicking' sound so I rarely use it. I thought I'd try it and it is a magic cane as its so easy. I think I'll jump and click my red shoes like Dorothy! or is that from another movie..ha ha.
Now the swelling in my upper thigh needs ice and an elevation treatment so see you later.
 

SE Florida

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Yes, same movie so click away!!! It's a small price (er, noise) to pay so you can get walking again and hopefully you won't use it too long. Wear ear plugs? :idea:
@lotusbuds
 

Josephine

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Here y'go then!

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.
 
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Thanks for your time Josephine.

1. Anterior Right hip replacement March 01 2019.

2. Pain level for soreness range from 0 - 5 Most days 0-1 except lately as I am doing more walking. Swelling in upper right thigh can be a 7.

3. At present prescribed tylenlol 500 mg 2 each 3 times per day. Tramadol 50 mg and oxycontin with no refills. I currently take 4-6 Tylenol per day, 2 at a time. I stopped the Tramadol as it makes me too groggy and a bit nauseous. I took it before surgery and it worked well but not now. I take an oxycontin maybe once every 10 days if I have more pain. Was taking 12 per day (2 every 3 hours) for 2 weeks. Now basically off it unless its an 'emergency' as I have a few left. Fine without it. Swelling of thigh worse in afternoon.

4. I am icing my thigh 5-8 times per day and when I go to sleep. I ice for about 40 minutes each time.

5. I elevate my leg once or twice a day with a lounge doctor pillow for 40 minutes. my groin area usually hurts if I do it longer. I do lie down once or twice a day.

6. I am able to cook and do the dishes, clean the toilet and sink area in bathroom, do laundry, change sheets, get dressed. Still use the sock aid. I walk through out the house (one level) whenever I can. I have gone to the grocery store 3 times and used walker walking around. No pain while doing it but 9 out of 10 pain hours later. Gone after icing and elevating. I have walked with trekking poles for 15 minutes once resulting in pain that night and next day. I used a cane all day yesterday but by evening had pain in my groin so went back to walker for a bit. Today back on cane. I sit a lot but never more than 40 minutes.

7. Exercises done at home 2-3 sessions per day
ankle pumps x30
Gluteal squeeze x10 x2
Heel slides once a day x5 .
Marching in spot while holding counter x10 on each leg once a day.
Quad set x10 times x2 a day.

I go to PT twice a week. He stretches and massages thigh and leg.
Squeezing a ball between legs with knee bent x10 times for 5 seconds.
Heel raises standing at bed x10 times once.

Thanks Josephine!
 
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Josephine

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2. Pain level from 0-5. Most days 0-1 except lately as I am doing more walking. Swelling in upper right thigh can be a 7.
That's too high at 6 weeks out.
3. At present prescribed Tylenol 500 mg x2 each 3 times per day. I currently take 4-6 Tylenol per day, 2 at a time.
Tramadol 50mg and oxycontin with no refills. I stopped the Tramadol as it makes me too groggy and a bit nauseous. I took it before surgery and it worked well but not now.
Oxycontin maybe once every 10 days if I have more pain.
Tylenol I suggest you take 1,000mg 4 times a day. I know the FDA has ruled that 3,000mg acetaminophen is a safe maximum but that would be assuming that the patient is taking another medication that also contained it and thereby inadvertently take an overdose. Assuming that this is not the case, the maximum safe dosage per 24hrs 4,000mgs.
Maybe when you get to a pain score of 7 you should take the oxycontin.
4. I am icing my thigh 5-8 times per day and when I go to sleep. I ice for about 40 minutes each time.
5. I elevate my leg once or twice a day with a lounge doctor pillow for 40 minutes. My groin area usually hurts if I do it longer. I do lie down once or twice a day.
Very good.
When you elevate, do you do it with your knee completely straight? If so, don't as it will cause you pain. Have a little bend in it for comfort, like this

elevate 2-horz.jpg


6. I am able to cook and do the dishes, clean the toilet and sink area in bathroom, do laundry, change sheets, get dressed. Still use the sock aid. I walk through out the house (one level) whenever I can. I have gone to the grocery store 3 times and used walker walking around.

No pain while doing it but 9 out of 10 pain hours later. Gone after icing and elevating. I have walked with trekking poles for 15 minutes once resulting in pain that night and next day. I used a cane all day yesterday but by evening had pain in my groin so went back to walker for a bit. Today back on cane. I sit a lot but never more than 40 minutes.
That's far too much for 6 weeks out. Did you read the Recovery Guidelines posted for you at the beginning of this thread - post #3 in fact. It contained this article Activity progression for THRs which clearly states that for 6 weeks out you should be

Weeks 6 and 7
Start taking car trips to the shops but keep them short and sweet at the start, no longer than 15-20 minutes
Take at least one 5 minute rest while you are out.

Activity: ironing, washing, meal prep but get someone else to clear up after, wash up but someone else clears the table, brings you the dirty dishes, dries and puts them away after, not you!!


Exercises done at home 2-3 sessions per day
ankle pumps x30
Gluteal squeeze x10 x2
Heel slides once a day x5 .
Marching in spot while holding counter x10 on each leg once a day.
Quad set x10 times x2 a day.
I go to PT twice a week. He stretches and massages thigh and leg.
Squeezing a ball between legs with knee bent x10 times for 5 seconds.
Heel raises standing at bed x10 times once.
Also in that group of articles was this statement:
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.

In summary
1. Adjust your pain meds
2. reduce your Activities of Daily Living
3. Stop ALL exercises as they are what is causing your pain!
 
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lotusbuds

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@Josephine thank you for all that information! a lot to process. I have a low threshold for pain I think as I never get those numbers right. So I may have made them too high. Regardless I will slow down and take it more easy. Thank you so much for all your feedback.
In answer to your question re icing and elevating...yes I have a lounge doctor which is like the first photo and it has a bend in it at the knee.
I am now using a cane without limping the last 3 days but find it is hurting my groin area so at night I use the walker (Rollater) again. I love walking with the cane but it must be putting more weight on my hip.
The swelling is still the same but doesn't hurt much as I am icing more.
Thanks again! So appreciate your reply.
 
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