THR My Hip Trip - Second Verse

[Josephine]

taking pictures of the nylon thread -- it looks like a fishing line

Not a bad description actually! But it's not nylon. Nylon wouldn't be used inside the body for general wound closure. It's a biodegradeable thread - made from fruit juice, actually! And what's happened here is that the assistant who was cutting the stitches for the surgeon, obviously snipped one off a little too long! Nothing more dramatic than that. What you must do - and are doing quite correctly - is to keep it covered up and don't fiddle with it. What you mustn't do is keep picking or pulling at it. It is unlikely to come out on its own but needs to be snipped off short with a pair of sterile scissors. Closing surgical wounds: how is it done?.

 

[Josephine]

Oops, I see it has resolved itself! Jolly good.

 

[HollyB]

Thank you so much for your response @Josephine. Biodegradable thread from fruit juice -- that's just amazing to me! I read the article you referenced and found it to be excellent and clear. Don't know how I missed it since I often "troll" the Library here at BoneSmart.

Here's a bit of an update for you and for the other "hippies" who might find themselves in the same situation or just be interested. The Home Health Nurse visited four days ago and snipped the emerging thread. She had already sanitized her hands but she put on latex gloves, opened a new,sealed package with scissors, and trimmed what she said was about a centimeter of thread. She then carefully dabbed the area with a stronger disinfectant than she usually uses saying, " Tell your husband not to freak out when he changes the bandage and sees this red color because it isn't blood!" I felt nothing during this process and it was very quick. She covered the area and the rest of the incision with nonadhesive gauze anchored down with easily removed tape. She cautioned me, as she always does, not to touch/scratch the incision area and not to put lotion on or near the area. My skin is a little dry now but moisturizers can wait until I get clearance. And, now, just four days later the area where the stitch popped through has healed over. It looks fine -- not angry red but a peaceful light pink. The puncture wound area has not had any drainage for four days and is also looking good. The main incision seems fine, too. The steri-strips are still in place but they have started to curl. As a matter of fact the Home Health Nurse trimmed a few of them when she trimmed the thread. I'm optimistic that this story will have a good ending!

Josephine, the Bone Smart article cautions not to touch, pick, or pull at the protruding stitch and to keep it lightly covered with gauze. Thought you would be interested in knowing that I was given those exact instructions over the phone by the On Call Home Health Nurse (the stiches emerged over a weekend -- of course!). One thing this Nurse mentioned to me re covering the thread with gauze was that the stitch could get caught on my clothing and pull if I didn't cover it. Just another reason to do the right thing.

 

[agileHippie]

Once my surgical bandage came off, my home health office also advised me to cover the incision with a gauze pad. This keeps my clothes from catching/rubbing. I use paper tape because my skin will react to stronger tape if it is placed over the same spot for several days. The paper tape is less sticky, so once you pull it off, you really can't stick it back.

 

[Josephine]

Josephine, the Bone Smart article cautions not to touch, pick, or pull at the protruding stitch and to keep it lightly covered with gauze. Thought you would be interested in knowing that I was given those exact instructions over the phone by the On Call Home Health Nurse

Well that's good to know! Obviously she and I are of the same vintage!

I am very pleased to hear this has had a good outcome. I might even add a synopsis of this thread in that article so people can read first hand of such an experience. Would that be okay with you?

 

[HollyB]

@Josephine feel free to use the description of my experience. I tried to detail it so maybe it would help someone else -- it really pleases me that you think it might be of use.

 

[HollyB]

@agileHippie, my OS gave the initial instructions for my wound care: seven days after surgery the Home Health Nurse was instructed to remove the hospital bandage. She replaced the hospital bandage with the type of bandage you describe -- gauze anchored by easy removable tape. She showed us how to change the bandage and gave us a spray sterilizing solution for the incision and a supply of gauze and tape. Instructions from the OS were that the bandage was to be changed every day. The Health Nurse told me that as soon as I felt comfortable with the incision (I.e. It wasn't as sensitive) then I could do without the bandage. Doing without the bandage assumed the incision was healing well. But the extra caution and bandaging came up for me because one of the end stitches emerged from the incision area. Sounds like you and I had the same bandage instruction, though. My husband has gotten really good at it!

 

[copsham]

Hi @HollyB
Sounds like things are going well for you re the stitches, very much in control! I am adjusting to "life on the sofa" again. Could be worse. I am having a CT scan tomorrow and then when I see the consultant will decide what next. Another battle brewing to get through admin to an appointment. They were having none of it today. Will worry about it tomorrow using @Sullivand 's approach!

 

[Sullivand]

@copsham ~ go girl! Catch those flies with honey.

 

[HollyB]

Update at 3 weeks and 3 days ( 24 days) : Yesterday ( day 23 after surgery) The Health Nurse arrived in the morning. Vitals were good. The incision looks good !!! There are a few steri-strips remaining but the Health Nurse trimmed the curling edges. The drainage has stopped completely and there is no longer any need to put gauze over the incision. The area where the suture emerged has now closed and, according to the Health Nurse, looks good. She checked another spot that she thought might have been a potential "break through area" but decided it wasn't. She told me she was very pleased with the looks of the entire incision area. I know that all of the BoneSmart Gang understands how thrilled I was with her pronouncement!!!

A second big area of discussion had to do with reducing the pain Meds. I have been taking 1000 mg of Tylenol every 8 hours; alternating tramadol with oxy every 3 - 3.5 or 4 hours except at night when I sleep a full 7 hours without waking. She suggested trying 1000mg of Tylenol twice a day in the AM and PM; then she suggested opening the window a bit more with the Tramadol and Oxy -- alternate every 5 - 6 hours during the day. She said I should now start asking myself if I needed the pain Meds before I take them. The other thing she said was not to worry if I had to close the window occasionally as I became more active. She said that I shouldn't consider myself to be regressing if I needed a higher dose on any given day. According to her, pain med reduction is very individualized. She continues to suggest that I make sure and take pain Meds before PT. We talked about "slotting-in" the Tramadol for the Oxy. Today I tried opening that window a bit and found that 5 hours was doable and in one instance 6 hours worked. All of this and I walked and did my PT exercises. So far so good but if the pain breaks through significantly I will have no qualms about increasing the Meds. I guess I would like to end up with Tramadol and Tylenol to see me through Out Patient PT which should begin in about 4 weeks. With the January Hip I ended up taking tramadol/tylenol before Out Patient PT and then 6 - 8 hours later if needed. On the days that I didn't have PT I usually didn't need any medicine except Celebrex for the unoperated leg.How has pain medication reduction worked for the rest of you?

The final update has to do with Home Health PT who arrived a few hours after the Nurse left. I was switched from the Walker to the Cane!!! What a surprise,too. With the January Hip I stayed on the Walker for 5 weeks.
I'm so happy about this. I don't dislike the Walker at all but the Cane allows for much more freedom of movement. Funny thing though, the PT had to keep reminding me to put the cane in the hand opposite my operated leg. I was too programmed from the first surgery, I guess. I seem to be walking well -- no limp at all. Both legs feel weak, though and the newly operated leg will start to ache in the hip flexor and inside thigh area if I overdo anything. I still cannot do a straight leg lift -- I check it out every few days. I am hopeful that with caution and ice, this will slowly resolve itself. I know that before the surgery my range of motion was severely limited in this area -- couldn't move my leg to the side nor could I do leg lifts although squats and bridges were fine. I was limited in movement for several years so I don't expect a quick fix. Plus I suspect that during the surgery those poor little muscles were stretched and moved in ways I don't care to know about. The only bruising I had after surgery was in this area. The bruises are gone but the area is still sensitive to the touch. Oh, I plan to be super careful.

Here's hoping everyone is doing well in both the Preop and PostOp stages. All the best to every single Bone Smartie!

 

[Sullivand]

@HollyB
What wonderful progress! I am so happy for you that you can put that walker away! For a while, I did keep the walker in my bed room just in case I needed to go to the bathroom in the middle of the night~ I thought it was a good safety measure at night.
As for your meds~ you are so right!
Finding the best way to stop taking the pain medicine is very individual. I was off the hydrocodone after 1 week and switched to Tramadol which I took for about 7 weeks. Now in week 8 I am taking Tylenol.
As for your exercises~ Remember Bonesmart advice~ do only what you can and don't force it if it hurts! Take care of yourself! So glad your recovery is going nicely!

 

[Legin]

Nice one Holly is back in control. Your report made me, smile so you must be beaming. Well done

Legin THR Sep 14

 

[copsham]

Hi Holly lovely to see your detailed progress and going so well. It shows that the measured approach works. Re pain meds I was a bit different than you. I had oxy..?.. and codeine but was so ill, giddy, sick, tearful that I stopped the minute that I got home. I took paracetamol full dose 1000 x 4times a day which was effective for me. The idea of Bonesmart has been when you forget a medication it is time to stop the dose but I found that I would forget a midday dose so the next day stop that dose but pain would come back with a vengeance. My personalised theory was when you forgot a dose carry on taking that dose for much longer than you need. This is coming from someone who had never taken regular pain meds or rarely any meds at all- all of my life.

i have just found that @legins suggestion of taking 500 mg of Vit C helps with pain or at least seems to.

look forward to your next update!

 

[NuMe2014]

@HollyB I just dropped in to check on how your recovery is going? I will assume no new news is good news!
I have been spending quite a bit of time up at the lake, swimming and a little bit of hiking(with a walking pole). Just home for a few days to weed garden, cut grass and stock up on some groceries. We have no cell phone coverage or internet where we go, pretty much cut off from the electronic world,(some have satellite TV, but we don't)! Take care and I hope you are healing well.

 

[copsham]

Hi @HollyB hope you are doing well - you are nearly 6 weeks post op - how time flies and what a year it has been.

Thinking of you - look after yourself x

 

[HollyB]

Hello Bone Smart Gang!
It has been several weeks since I've written an update. I am approaching Week 9 since my second surgery and there have definitely been ups and downs. Here's what has been going on with me of late:

Week 5: I was released from Home Health PT with a referral to Outpatient PT. At this point I am using a cane only when I go outside of the house.
Week 6: Had the Check-up with my OS who was pleased with my progress and pleased with the technical results of my two surgeries. He showed me my x-Rays and what he called the "perfect alignment" of the two hips by superimposing a straight line between the two. It really was straight! He showed me, via the x-Ray, how he measured the various angles and the particular approach he used. It was a thrill for me to listen to him and see how pleased he was. I told him that this was the only thing that had ever been perfect about me! He checked the incision and thought it looked good so I was cleared for pool activity (yeah!). He watched me walk without my cane and said that was looking "pretty good". He had no special instructions for PT except to go slowly over the next 3 months, build muscle and flexibility carefully. He scheduled my next appointment for 6 months although he told me not to hesitate to call if something came up before that appointment. I had two pages of questions for him and he answered every single one of them -- I count myself fortunate to have such a skilled professional on my side! BoneSmart has it exactly right on this one -- pick the very best surgeon you can find.

Release from Home Health Nursing. A little sad about this because the Home Health Nurse was not only really good at her job she was also just a nice/fun person to be around. We developed a friendship during the past 6 weeks and I hope to keep in touch with her. I told her she could discharge me from Home Health but not from her life! She really is one in a million.

OutPatient PT Evaluation: Bottom line here is that I am stiff -- both legs. My range of motion is poor in some areas -- or as the PT said, " You've got nothing!" ( I had to laugh when she said that because it wasn't new news to me.) Surprisingly the January Hip has some areas that are weaker and stiffer than the June Leg. Go figure. I relayed the instructions from the OS (slowly & carefully). Thank goodness my PT is totally onboard with that! She told me it would take 6 months to a year to heal. All to say, we're going slowly.

Week 7: PT started for real. Two sessions each week for the next 5 weeks. Nothing I was given to do hurt although I was appropriately sore afterwards. I was encouraged to "water walk" no more than 15 minutes max but best to stay at 10 minutes. I tried it and it felt good.

Week 8: Two sessions of PT, Pool Walking for 10 minutes plus side-of-pool exercises, two timed 10 minute walks which I had built up to on my own and wanted to continue, and just general increase in activity. Guess what? I overdid it!!! After the Pool Walk/Exercises I felt fine, showered, ate lunch, sat on the bed to relax and I felt a pinch in my mid-buttock near the area where the two buttocks divide. I shifted positions but it didn't help. When I got up and moved around it was still there. You know the drill: ice, Meds (maybe an anti-inflammatory),rest, cut back on activity. I did all of those things. Just to be clear, BoneSmart Buddies, nothing hurt when I was doing activities -- my problem seemed to be a buildup of just too many things.

Week 9: The pinch/soreness in my right buttock has eased up but it is still there. I continue to back off of my activity. I am continuing the PT stretches because they relieve the soreness both when I am doing them and then for several hours afterwards. I am taking Tylenol -- 3000mg daily and the occasional 50mg Tramadol. I tried Celebrex but it didn't help much if at all. I continue to ice as needed and I am resting. I have talked to PT and will report back when this gets sorted out and let everyone know what worked (or didn't).

On an interesting PT note I have been asked to bring my Nordic Walking Sticks to a session as the PT thinks these devices may be very helpful with my walking. Should be fun!

Well, this is my update for now. I hope all of you are doing well and wishing everyone successful healing!

 

[copsham]

Hi @HollyB We must have the same vibes between us. Late last night I mentioned Christmas in one of my updates and this triggered me to think of you HollyB. I thought that I had not been in touch for a while so decided to post to you in the morning. I opened up the laptop in the morning there was a post from you! Your progress sounds good, all that slowly but surely approach pays off. Two hips in 6 months is good going! Just to be different I have one hip and one broken foot in six months. I have been pretty laid up for past 6 weeks and a few days ago had a real "wobble". My patience was wearing thin and I found the thought of more weeks of non weight bearing intolerable. Still, with the support of Bonesmart friends I have got over that blip thank goodness.

Your PT person sounds good. It's rare to find someone so good. How have your allergies/sensitivities been?

I tried the wheelchair Ta Chi with Paul Lam on You tube. It did not do much for me, felt a bit nothing-y. But worth the try!

Your buttock thing sounds really annoying but at least it is going in the right direction. Did you know in UK that tylenol/Paracelamol 4000mg is allowed per day. Josephine said that it was reduced in USA because it is in so many other products!

Glad you are on the mend and hope you have a lazy Summer ahead of you x

 

[Legin]

I chortled then winced at you report. I agree about when a nurse comes in as its nice to be at home and have the visiting calming expert. I got on with mine also and she has shouted hey up lad many times in surgery or supermarket. Keep on smiling lass.

Legin THR Sep 14