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THR My Hip Trip - Second Verse

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Update for PostOp Week Four. It's hard for me to believe that I have passed the four week mark since my surgery (posterior/RTHR). The week has been busy with a visit from the Home Health Nurse whose report to me was that everything looked good and that there would probably be only one more visit from the nurses. The second visit was from an Occupational Therapist who showed me how to navigate the kitchen correctly. She demonstrated the movements for getting items out of the lower cabinets (the golfers' reach) and transferring food from the refrigerator to the kitchen island as well as how to load the dishwasher. She then asked me if I would make a cup of coffee for her. We both laughed at the idea and she promised me that she would watch my every move and stop me if I started to break any of the restrictions. So, I prepared coffee, transferred cream from the refrig., got the cups out of the cabinet, sat at the kitchen island on a barstool, and drank coffee with this sweet lady. We talked and laughed and I've got to tell all of you that I felt so...normal! It was a terrific experience for me. I had two visits from Physical Therapy this week and although there are some new exercises there is no push to do lots of reps. And, interestingly enough a couple of the new exercises were strictly for abs and some upper body stretches. I am being told that walking is the best thing to do (I believe Josephine would agree!). I have been slowly building up my walking and today managed a full 15 minutes without stopping and no pain at all. Folks I am still using my walker and that doesn't bother me at all. I've got to believe that the walker is preventing me from "stirring up" my unoperated bad leg. Funny thing, sometimes the unoperated leg hurts more than the operated one. Just a reminder that the other leg needs to be fixed sooner rather than later. After today's PT session, I iced, rested, and had no pain at all! I am doing 2 ab exercises, a series of upper body stretches, a 15 minute walk, 5 bridges, 5 leg lifts (hold 3 sec. at the top), 5 small movement squats (I only bend in a squatting position until I touch the top of my mattress which is pretty high), and then a 5-10 sec. balance on each leg (holding on lightly to either the walker or a table top). I have not been working on stairs nor has the cane been introduced.

I am still taking pain Meds: Tramadol 50mg 4 times a day for a total of 200mg and Tylenol for a total of 3900mg a day. I was taking oxy as well but stopped that completely after the first week and a half. The oxy certainly helped with the pai but I had a bad reaction to it (nausea). I continue with the 325mg of aspirin twice a day as a blood thinner. I am scheduled to stop the aspirin therapy on March 11.

My incision looks great. It was glued and most of the glue has worn off leaving a tiny, tiny incision line. It's unbelievable really. I no longer put a dressing over the incision ( as per instructions) and it isn't extremely sensitive-- surprise.

My vital signs are good or as the Monitoring Service noted to me today, ". Your numbers have been rock solid". So, I am pleased and thankful for that.

Now here's a question for the BoneSmart Gang: have you any suggestions for starting to reduce the pain Meds? Should I pull back a little on the Tylenol ( say to 3000mg daily) and/or start a slow reduction of the Tramadol (from 240mgs a day to 215mg, to 190, etc.). I have a nice little pill cutter that will let me cut the pills easily and I can do a slow withdrawal. My pain levels have been well controlled so far -- generally 0 to perhaps a 2.5 or maybe a 3. I'm not in any rush with this and have no fear that I will become addicted. Just thought I would get some input. Thanks everyone for all of your support!
 
Hi @HollyB Great update! Sounds like things are tracking along beautifully for you, I'm so glad :) It's great that you're not pushing yourself, it really is the "safest" route to a full recovery... and probably quicker to that "full" recovery too. Your PT regime sounds perfect, not too many reps and a common sense approach, keep your therapist in mind for hip 2... good PTs are worth bottling :heehee:

As far as reducing the meds... there isn't any "right" way to do it, generally you find yourself missing doses. The advice i got, which worked brilliantly for me, was to keep up the Tylenol (it's a "safer" drug... in hospital they were dispensing them like sweets!!) while reducing the Tramadol... and not to mess with the night time/ pre bed dose initially.... so if you find you need it it's during the day and you'll be aware and able to get onto and it's not really going to impact your sleep.

I found I didn't miss it from the beginning ... I was taking Tramadol morning and night, so I stopped the morning one first then when I realized that it made no difference after a week I stopped taking the night dose. If you're taking it during the day, maybe you could just drop one of the day doses or stretch out the time between doses first, then go to the morning/night time routine. I was told I could take Tylenol for as long as I liked... I stopped taking that regularly, but I do still go to it for the tendinitis, I am confident that it's safe - and the fact that it lets me be mobile offsets any harm it may cause. I was also told not to cut my pills in half, there can be a discrepancy in the amount of active ingredient in each "half" of the pill so it's efficacy cannot be guaranteed.

Like I've said before, it's different strokes for different folks, but this is what worked for me... and it was completely stress free - easy in fact as I didn't have to think about what I'd taken when:rotfl:

Hope your recovery continues apace... put the pot on, that coffee sounds lovely

Donna :hugzz:
 
HollyB said:
Now here's a question for the BoneSmart Gang: have you any suggestions for starting to reduce the pain Meds?
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When you start forgetting doses that is your body's signal it's time to reduce your meds. Usually it's the midday dose. Until then, I would stay ahead of the pain. It will help increase your mobility.
 
@craftdee and @Jaycey thank you so much for tips on approaching the med reduction part of rehab. After reading both of your comments I realized that what has been happening to me is that I am just naturally stretching the time between dosages during the day. Instead of 6 hours between pills sometimes it is 7 or even 8 hours. I hadn't really noticed just as both of you mentioned. I'll just follow your good advice and let the tapering off happen naturally. And, if I have a flair-up, I'll not be afraid to increase the doses again. This entire process really is an art form, isn't it?

By the way Craftdee I read your post about the stellar weekend at your home. I shut my eyes and imagined myself in your pool and then later letting the sun dry me off. A-h-h-h pure bliss! Then I opened my eyes, looked out the window and saw more than a foot of snow! Shut my eyes again and just took a little swim. Thanks for the vaca.
 
:dancy: Celebrate with me BoneSmart Gang-- today is my 5th week PostOp AND I just transitioned from my Faithful Walker to a a Hot Rod Cane!!! The future's so bright I gotta wear shades :cool: .
 
Love the image of your hot rod cane! Every little thing we do seems a giant step forward! Well done!
 
@copsham you hit the nail on the head--it really is the little things that are such hugh thrills. Using the cane today was right up there with taking my first PostOp shower! And, just think, that fresh cotton duvet that you sent to me a few weeks ago helped bring me to this very excellent point in my rehab.
 
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Thank you so much, @mydog. I'm still pretty much "over the Moon" with this latest development. And, a question for you: have you just had your second THR? I was looking at your thread (which sounds like everything is going great for you!) and was a little confused by the dates at the bottom.
 
Wonderful news regarding your transition to the cane. It gives one a little more freedom with regards to mobility. Slow and steady is definitely the way to go!
 
Thanks @NuMe2014 . You're right about the cane as it really has given me a new sense of freedom. For one thing I can get into my closet now ( the door was too narrow for the Walker).

I think we should have some Tshirts made with the slogan Slow and Steady. What do you think? For me, it has really been the way to go and you have been saying it from day one.
 
Week 5 + 1 Day and Another Milestone! Today I was released from the nursing part of Home Health Services. This involved a final check of my vitals (all good) and a look at the incision which is now healed -- no more glue, no more scabs, no redness. The incision is barely visible which is just amazing to me. The Nurse making this final visit is not only a Registered Nurse but also a certified Herbalist. We've had several interesting conversations over the past few weeks; but, today she talked about building up my immune system for the next surgery (and for life in general) plus what I can do to protect my bones. Basically she suggested working on both areas through a good, healthy eating plan (how about that @Poppet ?!). She is not a big proponent of supplements. She gave me some tips about researching these two topics and naturally I will start by rereading the info here on BoneSmart! We talked about weight bearing exercises -- "Walk", she said. She also mentioned going back to the gym but not right now. If the eating/exercise plan doesn't completely hold the line on bone loss for me I'm considering seeing an Endocrinologist to try to get a better fix on what is causing my problem before I start out on any sort of medication. I've tried Meds before (Hormone Replacement before the Nurses' Study was published, Actonel, Fosomax). Not much success although Fosomax seemed to slow the loss a bit. I'm leery of some of the new drugs like Prolia which have infections as side affects . If anything interesting pops up, I'll pass it along.

Question of the day for BoneSmart Gang: the Nurse told me today that I could start putting some sort of moisturizer on the incision area. Vitamin E? Regular Body Lotion? What worked for you? Have a good, healthy, healing day and night!
 
I am happy to hear that all is well with you HollyB. Some say you don't have to put anything on your scar but I did! I use Vitamin E oil, I'm not sure if it made any difference with my first one but the scar has faded to a very fine line and is very soft and supple with no hard scar tissue underneath, so I am doing the same with this one. I have heard others who have used BioOil with good results too.
 
You're doing great, Holly!! Your updates are a joy to read.

As for what type of moisturizer to use...it really doesn't matter. Your body will heal itself with or without help from topical products so just use what feels best to you. It's not necessary to spend a lot of money to have a gorgeous scar. After a year or so most are just a thin white line. We like to think of them as badges of courage!
 
Holly, I have just finished reading through your entire "adventure" and am once again so appreciative of how much information we all share with each other! This is an amazing forum, isn't it? There's literally nothing else like it anywhere.

I have two colleagues who had THR in the last 3 years, and they just flew through it. Pain free, didn't need the walker or cane within a few days...piece of cake. Naively, I expected the same kind of progress. But my experience was as different as it could have been. I was in terrible pain, used a walker for 3 weeks, used a cane for another 3 weeks or so...no rhyme or reason to the differences, other than my having been born with internal hip rotation, making me quite pigeon-toed. But that didn't seem like a plausible explanation!

Reading this forum, and especially detailed and active threads like yours, reassures me that this is a MAJOR event for many of us. At 16 weeks post op, I am still finding my way through my recovery. I trust you find your way through it, as well...with a little help from your friends. :-)

Alison
 
HollyB said:
the Nurse told me today that I could start putting some sort of moisturizer on the incision area
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Not really needed! I never put anything on both incision areas and they heeled up beautifully. Nature has a way of taking care of this!
 
Hi hollyb
Every where I went in the early weeks I was told to moisturise the incision. It did not feel right or necessary but I gave in to the advice. I used bio oil which looks so pure and innocent. It was only when I had a reaction that I researched its ingredients. Lo and behold it had PHENOL in it - one of my many allergies. Since then my wound has been erratic, inflamed, infected, hot, itchy etc have had antibiotics but is it flaring up again? So be really careful and I would suggest looking at the ingredients first . Life is complicated but over all I am just about glad I had the op. But hang on the roller coaster has come to take me away xx
 
Calling all BoneSmarties (@Josephine ,@Jamie , @Jaycey , and others) plus those of you who may have experienced this (@NuMe2014 ) and just anyone who wants to weigh in. As most of you know I had RTHR on 27/01/2015 via the posterior approach. I will be six weeks PostOp this coming Tuesday (10/03/2015) and my first checkup with my OS is the next day.

The hip has been doing very well. I have transitioned from the Walker to a cane. PT is fine and I don't hurt during or after any of the exercises which are: several seated upper body stretches(e.g. shoulder rolls), two ab exercises (seated ab contraction and lying down modified pelvic tilt-- 12 of each), 5 each of bridge, leg lift, standing side lift. I've also been started on a little balance progression which begins with both feet on the ground holding onto a countertop then not holding on then raising the nonoperated leg slightly and holding back on with both hands to finally balancing on the operated leg without holding on. I have slowly progressed to standing on the operated leg and holding with one hand. None of these exercises have caused any pain. Then there is the walking (probably 1/2 mile a day maybe a little more)and I'm doing fine with that but I've noticed that the unoperated leg starts hurting and the unoperated leg feels fine -- a good thing I think except I don't know how to best approach the rehab for the operated leg. Just so you know, I'm going to arrange surgery for my left leg as soon as I've recovered from this current surgery.

I don't do any of the PT exercises (e.g. Leg Lifts) on the unoperated leg because I don't want to stir it up any more than it already is from the walking. I've started splitting my walking sessions into short walks (5-6 minutes three or four times a day). I'm still taking Meds probably as much for the unoperated leg as for the operated leg -- 50mg Tramadol every 6 -7 hours for a daily total of 200mg and 975mg of Tylenol every 6-7 hours for a total of 3900mg daily.

So the questions: do you have any suggestions for continuing rehab on the right leg without stirring up problems with the left leg? How should I approach this with my OS? Should I ask for Meds to help control the pain in the left leg until surgery can be scheduled? What signs should I be looking for to let me know that I'm ready to have that second surgery? Any tips at all will be so appreciated. Thank you in advance!
 
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