THR My 4th bionic joint!

[Jamie]

My right hip has been replaced with an uncemented Zimmer prosthesis as of yesterday and I’m on the mend. This is my 4th joint replacement, as I also have had both knees and my left shoulder replaced.

Yesterday was a bit rough as they were not able to give me the spinal anesthetic that we had planned. There was too much arthritis in my lower back and the tiny needle just couldn’t find space to do the job. I don’t know if that was an overly cautious anesthesiologist or my back is worse now than before, but I ended up with a general anesthetic. That meant that I didn’t get all those wonderful benefits of good pain management right after surgery.

I really hurt when I woke up in recovery around 2:00pm. The pain finally improved once I got to my room and put ice on my leg.

Then I developed pretty severe acid reflux that got worse into the night and was waking me up constantly. Finally one of the nurses figured out it was my position in the beds they use. The beds are made to raise and lower in the middle. I was keeping the head of the bed elevated to help with the reflux. The way I was positioned, was putting too much pressure on my tummy and abdomen, causing the reflux. As I had eaten more during the afternoon and evening, it put more and more pressure on my abdomen and that’s why the reflux worsened. It stopped immediately once I got higher up the in the bed and I got a really good 4-hour sleep.

Today has been good so far. Pain is controlled with the NSAID Torodol. I’m not even needing Tylenol right now. I took a pretty good walk after lunch and climbed some stairs. I did the normal ankle pumps, quad sets, and short arc quad sets, plus about 6 minutes on a bicycle. All felt really good as my hip feels the need to move fairly frequently. The therapist said my goal will be to move in some fashion every 2-3 hours throughout the day.

My surgeon takes a very conservative approach to weight bearing. He wants to ensure good bone growth into the prosthesis and I’ll be on 50% weight bearing with the walker for 4 weeks. At that point, I will be able to switch to a cane if I want to. My new hip feels amazing and I can already tell that it’s going to be so much easier to get my gait and balance back. My other joints, who had obviously been picking up the slack are saying, “Thank you! Finally!!!”````

 

[Ocean]

Really great to hear that it’s all done and that you are already feeling the benefit. Sorry about the rough start but great that you are on the road to recovery

 

[Klassy]

Sounds like you are doing really well after a rough start. Wishing you a trouble free recovery.

 

[Jockette]

Great hearing from you!

Not that you need these, but…I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

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
BoneSmart philosophy for sensible post op therapy

5. Here is a week-by-week guide
Activity progression for THRs

6. Access to these pages on the website
Oral And Intravenous Pain Medications
Wound Closure

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 the at each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.

 

[sistersinhim]

Jamie, it's so great to hear that you are through this surgery, and are already feeling better! It sounds like your doctor agrees with Bonesmart's way of recovery. Great, no stress there!

 

[Layla]

Hi Jamie!
It's good to see you posting. I always take that as an encouraging sign. I am so sorry to read of the rough
start.

My OS also prescribed Torodol for the first week or so. I'm wondering if yours injected any type of non opioid pain medication, such as Exparel before closing? Mine did and I believe it was key to getting me through the initial 72 hrs. Its wonderful to read your already feeling the benefit of your new hip and through experience you know it's going to get better and better! As we often hear / read from those that experienced both hips and knees, hips are usually an easier recovery than knees so hopefully this is easy peasy.
Hugs and best wishes!

 

[lovetocookandsew]

@Jamie I'm so glad to hear the surgery is behind you, and that it went fairly well, not including the GA. Not happy to hear about the rough start, but happy that you now seem to be doing well. Wishing you a smooth and quick recovery.

 

[Pumpkin]

Welcome to the OtherSide, glad to see you posting.

 

[benne68]

Yay, @Jamie. Welcome back!

 

[Jamie]

I’m not really officially back. It’s just that I have time and feel good right now, so this gives me something to do rather than just watch television. Once I get back home and have to do all this stuff for myself, I’ll probably go back into cocoon mode for a while with lots of naps.

 

[Jamie]

First full day of recovery and I’m feeling great still. Although my therapy session was fairly mild this morning, I had a pretty active lesson around noon and my soft tissues are feeling it a little. I will probably ask for a couple of Tylenol later this evening.

I’ve been sitting up all day as it’s just more comfortable than lying in bed. I found sitting in a regular side chair is much better that the recliner. I can sit up straight and my feet touch (I’m short at only 5’2”). Plus I can reposition my feet and legs better in the chair.

My therapy continued today and I learned a lot! I discovered that, even though my hip didn’t hurt all that much (I have a pretty high tolerance for pain), my body obviously realized the pain and had been making “adjustments” probably for years. And these adjustments were not good and compounded over the years.

When I walked, my surgery leg turned outwards about 20 degrees instead of pointing straight ahead. Even this small outward tilt caused my muscles to change, shortening some and lengthening others. Not good. My therapist literally crawled down the hallway with me while I slowly walked to reposition my foot carefully straight ahead. I tell you, it was a shock to think I was putting my foot down straight and it wasn’t. Walking correctly kind of hurt and definitely stretched the muscles. Since I’m supposed to look up and ahead when walking (for proper gait), I needed to feel what the correct position for my foot so I could focus on stepping correctly. I called it walking pigeon-toed because it literally felt like I was twisting my foot inward with each step.

Then, the therapist showed me that I was not doing the other part of my step correctly where you push off from your heel for the next step. I was turning my heel inward and frequently even kicking the ankle on my other foot. Once again, she crawled down the hallway with me and with each step, helped me get the feel of the proper position for my heel as I kicked off for the next step. I cannot tell you how impressed I was with this approach to getting my stride back. And it worked. I was walking better by the end of my lap around the hallway. And now I can continue to practice my pigeon-toed and heel kicking walk as I go slowly to the bathroom and around my room.

I got released from the “wear the gait belt and call for assistance when walking” today as well, so that’s much better. I was going to the bathroom quite a lot, hoping for that first post-op poop. That was successful today too…..a day ahead of their schedule. They were giving me some stool softeners, but I’ve been down this road before and knew my body needed a little more. So I had prune juice for breakfast and I sneaked in a little of my own MiraLAX.

I did about 10 minutes on the peddler and then went up and down a real flight of stairs in the building stairway. They are taller so it’s more of a challenge. Plus it let me practice using a cane on stairs in case I ever need to do that.

I developed a better understanding of why some formal therapy is needed in post-op. Although what we tell people about walking being the best therapy (and it is for sure), you may not get the most success if you just “walk.” If you have had bad joints for any length of time, your body has made adjustments that now form your “normal.” Much like my pigeon-toed and kick-heel walk, you will just continue to walk this way with your new joint instead of returning to a normal gait. Yes, you’ll be able to function just fine in most cases, but you won’t be your best YOU.

Not all therapists take this approach. Many of them out there just follow the “standard” exercise recommendations and don’t do the individual gait and body analysis that must go hand in hand with the exercises. This is why gait analysis is so important and why we support the OneStep app. But….I feel the app would be best used in conjunction with a local therapist (which they will do) so that you actually have someone who is visually seeing how you walk in addition to the computer measurements of your gait. I’m going to explore this in more detail so that we can update our guidance for pre and post op therapy to give our members the best opportunity out there for complete success.

I did some standing exercises too - Toe and heel raises, hip extensions, and hamstring curls (kicking backwards). Afterwards I felt much looser even though the muscles hurt just a little from their “waking up.”

Things are going really well. I’ve been up sitting all day with no problems. And I feel great. I’m glad I didn’t postpone this hip replacement and feel like it’s going to give me a better quality of life.

 

[Susie-Q]

Good to hear from you, Jamie! Looking forward to reading about your recovery and educating myself on hips!

Plus it let me practice using a can on stairs in case I ever need to do that.

If you have time I'm curious about this statement. Using a can on stairs? What does this mean? *edit, never mind, I think you meant cane! Sorry!

Take care, we are all thinking about you and praying for a good, uneventful recovery. You are such a vital part of this website!

 

[lovetocookandsew]

@Susie-Q "using a can on stairs"-I think she meant using a cane on stairs.

 

[Jamie]

Yep…..it was a typo. I need to proofread more as my iPad sometimes gets a mind of its own. I corrected the “can” to “cane” in my post. Thanks for catching my error, @lovetocookandsew.

 

[Sara61]

@Jamie I'm so glad to hear the surgery is behind you, and that it went fairly well, despite having had a GA. , It's good that we are now learning first hand from you regarding new techniques offered, it sounds like you have a superb team helping you . Wishing you a smooth and quick recovery xx

 

[Mojo333]

So glad to see your posts as I have been wondering how you were but "life" has made my forum time a bit spotty as of late.

I am glad they are addressing your gait issues early on and am sending Lots of Healing Mojo your way.

 

[Susie-Q]

@Susie-Q "using a can on stairs"-I think she meant using a cane on stairs. I corrected the error in my post. Thanks for catching it.

Yeah, I realized that this morning after my coffee kicked in. Duh!! Sorry! Here I thought it might be some new-fangled hip therapy I knew nothing about!

 

[clodaghcov]

well done and recover happily and slowlyxxxx

 

[benne68]

What an amazing therapist you have!

 

[subie2021]

Hi Jamie! Congrats on #4!
I hope your recovery is smooth and goes really well for you.

I think with PT, many people think it only involves clamshells, bridges, and leg lifts etc, and maybe don't realize the benefits of a set of eyes on gait abnormalities, balance problems, and correct proprioception, and the skills to help us improve those areas. From personal experience, I learned that I didn't know what deficiencies I had from years of compensating for pain, and a couple of thoughtful and bright PTs really helped me.

I suggest when the time is right, to ask your PT to use your phone to video your "before THR" gait, then later on, video the "after THR PT gait". You'll probably be blown away by the difference. Even if you aren't, having those videos to remind you what to do, or nor do, might be helpful.

All the best to you!