THR My Intro...

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C Mac

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Hello Everyone,

I am new to the list and thought I’d write an introduction. I am 13 weeks out from RTHR surgery, anterior approach. I had congenital hip dysplasia that was not diagnosed immediately. After trying a frejka splint and two casts I had osteotomy surgery and a third cast at the tender age of two years.

The head of my femur and my acetabulum both had their own different shape but stayed in place for forty some odd years. About 6 years ago I began to have some catching in my hip on the upward movement of climbing stairs and hip pain. My first visit to the orthopedist, which I thought was for tendonitis, revealed that the recommendation was for total hip replacement. I rebelled against this recommendation for 6 years and 3 orthopaedic surgeons, acupuncture, physical therapy, exercise to try to impact they way the muscles held the femur in the socket, herbal remedies, vitamin supplements, chiropractic adjustments and a sprinkle of denial.

I found my current orthopaedic surgeon, Dr. Hamilon, two years ago through a network of recommendations via physical therapists in the field. The first visit yielded much of the usual talk about my deformed hip bones and a packet of information which soon became referred to as the “Little Book of Horrors” (really just the informed consent risk listings, etc.). Two years after the first visit I made a second visit to Dr. Hamilton trying to get myself psyched up for surgery as it really was a quality of life issue for both my family and me. There were some key changes that made me feel slightly more comfortable with the surgery, so I picked a date!

I kept the date (surprising, still) got a ceramic on poly bundle of hardware installed and am working my way back to “new normal.” It has not been at all what I’d expected as I was told by a number of people that once the surgical pain abated I’d be amazed at how good I felt. I didn’t know anyone who had actually HAD the surgery, let alone the dysplasia related conditions (shallow pelvis, leg length discrepancy).

It has been a long, slow haul with a lot of peaks and valleys, some tears and readjusting of expectations. I was on assistive devices (walker, crutches, one crutch, cane) until my follow-up at the surgeon’s office, five weeks post- op. My ex-rays were fine, my gait was a bit like a pirate’s, my feet ached, my knee felt swollen and my other hip was exhausted at the end of the day from bearing more than it’s half of my body weight. I still use the cane at times -- more than I'd like.

I am glad to be part of the list as it seems some of the other people here have similar experiences to mine and similar complaints during the recovery period as well. I’ve gotten more reassurance reading people’s experiences here than I’ve gotten from my surgeon or physical therapist.

Thanks for reading!
Take care,
Cardie
 
Hiya Cardie, welcome to Bonesmart! As you know you will find great support and information here, even though you have reached 13 weeks I dont doubt that you still need guidance and someone to talk to who's been through a similar experience

I am 11 weeks out and still feel like its early days for me

Take care

Tanny x
 
Hi Cardie,

Welcome to bonesmart and thank you for your story.

You're quite right to use your cane when you feel you need it. Like you, I would like to dispense with any walking aids. I will, but not quite yet.

You're only 13 weeks out from major surgery and I'm pleased that it seems to have gone so well. If I understand you correctly then you're still in quite a lot of pain - is that right?
 
Tanny & Cappy,

Yes, it is still the early weeks out from surgery. My expectations have been way too high -- I thought I'd walk without a limp by now, definitely be done with that cane and be much further on my way back to the usual events of my life -- driving kids around, multiple errands, yard work, exercising, sleeping comfortably...

I don't really have pain, at least not in a consistent troubling fashion. It's the reduced mobility of the joint which is having an effect on my lower back and knee. A few weeks back my PT suggested taking longer walks (you know, like further than the mailbox and back). I went too quick and then had a big depressing set-back, had to dial everything back again and am now back to rationing my activities. I cannot get up to speed and that is frustrating to me and my family -- puzzled looks when I say that I'm not going to the grocery store to get an onion b/c that will mean walking thru the parking lot, thru the store and check out and back thru the parking lot -- from the girl that went to the grocery store everyday in addition to other stuff like housework and yard work and other aimless wanderings!

My surgeon tells me that he thought and wished I'd be further along by now, but that maybe it's just going to take 6 months to a year for that to happen. I'm having PT twice a week, which I really like but it's always a bit of lottery as to whether that's going to get weird things aggravated -- like my knee, or swelling to my hamstrings, or the need for a 2 hour nap in the middle of the day to get dinner on the table!

Ok, sorry to complain so extensively....I think that infusion of patience that was given at the hospital has worn off! ;)

Take care,
Cardie
 
Cardie Hi and welcome! I would suggest you keep posting here and get the support you surely need. At your age with a family, I understand how anxious you are to get on with it already! Patience and time and good doctoring shoud bring all good things together. :cat-kittyandsmiley:
 
Welcome Cardie, sounds like we have a similar history, but I think from what you are saying you may have been more mobile pre-op than I was. Hang on in there it's early days still, it will all come good. Overdoing it is the easiest thing to do, patience is the hard bit. You'll get there :thumb:
 
Welcome to BoneSmart Cardie! As you have discovered we all heal differently.

I too assumed I would be up and running only weeks post-op. I am now 15+ months out and just seeing the "normal" side.

I (like you) waited a long time. I was not diagnosed correctly until a few months before my op so can't really say I was putting things off. But in any case, the longer you wait the longer it takes for things to settle.

Your limp will decrease and your mobility will increase. Just don't give up! It just takes time and patience - hard I know.

There is no timeline set in stone for recovery. Please don't let anyone tell you just where you should be in this process. Take things ease and work to rebuild those weak muscles. You will get there!
 
Hi Cardie,

I like you had hoped for a quicker recovery but I'm 6 months down the line and still have to use the crutch. I still have pain in my knee and back as my leg is still compensating. My limp has reduced but due to my very weak abductor muscles I walk pretty badly without my crutch as my muscles can't stabilise my pelvis to walk in a level way. It's called a trendelenburg gait.

It can be frustrating and difficult when people ask you why you can't do certain things, but keep sharing your experiences and you'll know you're not alone.

Keep up the good work!!
Jyoti
 
That's right, Jyoti. Those spectacular recoveries tend to go along with the ageing type arthritis. Those who've had dysplasic problems with the concomitant deformities will almost inevitably have a more complicated recovery as a result. Shame, that but that's the way it is.
 
Welcome to Bonesmart Cardie. We are from the same area and I have heard that Dr Hamilton is a very good surgeon at Anderson Ortho Clinic. Sounds like you are doing great. Listen to your body....You will get there.
 
Hi, Cardie....welcome!!! You will find many kindred souls here who are going through or have been through a recover similar to yours. It seems to be pretty common where there are congenital problems involved prior to surgery. But....it just means slower recovery. You will still reach your goal of better and pain free movement. Hang in there and lean on your fellow BoneSmarties when you need us. We're here for you.

I did detect a bit of information in your post that I'd like to clarify. You mentioned needing to take naps before getting dinner on the table. Naps are a normal thing for quite a while after surgery, so don't give that a second thought. But....you're getting dinner every night? Cooking other meals too? House cleaning? Other activities in addition to trying to go for walks? If the answer to htis is "yes," you could be pushing yourself a bit too hard for this early stage of recovery.
 
Hi Cardie,

I have something similar with shallow socket and a shorter leg. Oh and expectations that were to high. It's taking me longer than I thought to recover too. I am seeing week to week progress and while I am on crutches outside I can walk around the house now, a bit like a pirate too :). But no more hip pain!

Hang in there someday you will barely remember these days. Sounds like you are quite active.
 
Hi Everyone,

Thanks for the warm welcome and sharing of similar stories.

I do have a bit of the Trendelenburg gait according to my PT, Jyoti. However, when I read about and observed the gait online I wasn't sure that was fully my issue. I feel like much of my gait abnormality comes from the joint not having a full range of motion in the socket and when something gives way it is usually my knee and not my hip. I am working on those gluteus muscles though since those are supposedly what give rise to the Trendelenburg gait. I also have quite a bit of discomfort in my lower back at the sacroiliac joint which I also feel comes from the restricted motion at the hip which makes me utilize low back muscles more in walking. My stride is shorter on the operated side as well.

I had begun to work on my own healing theory since I felt as if I was a mystery to the doc and PT. Years ago I had adhesive capsulitis in my shoulder after an injury, so I decided that maybe that was what was going on in my hip joint due to the trauma of my surgery -- a gumming up of the hip capsule. My PT verified that the capsule was still in my hip and after reading one of the articles about the layers of closing at surgery from Jo, I saw that the "psuedo capsule" is closed with a dissolveable type suture and takes about 3-4 months to heal -- perfect, seemed to fit in with my theory on the joint! The shoulder took about a year to get back on track and so maybe the hip will follow suit!

On the idea of talking progressively longer walks (my PT's suggestion). After I did that one week and threw myself into a heap of swollen muscles, tendons and tears. I reminded myself that walking was not my exercise before surgery because of my leg length discrepancy (about 1") and that it was foolish of me to think that my surgery was going to make walking work for me like it does for a regular person -- not a miracle!! So, I had done the exercise bike and elliptical machines prior to surgery because they don't require impact or equal strides and when I get back up to speed I'll go back to those forms of exercise and hope they will work for ME!

Jamie, on the housework related projects -- there's a lot of slacking off on my part. My kids are teens so they get their own lunches and snacks, my husband does breakfast and some weekend meals. My family stepped in big time during the first month after surgery, now it's just been a bit more challenging because they expect me to be back up to full speed (those darn expectations, again!!).

Take care,
Cardie
 
Ah the expections of those "not in the know". Many of us have suffered this. If you are up and dressed and moving around friends and family quickly forget you are still recovering from major surgery.

Just keep reminding them that this was not "a walk in the park"! Can't tell you how many times I said that post-op!
 
Hi Cardie,
I agree with what you're saying. We are all different. I also have limited range and other issues and our histories and how our bodies deal with it will have differences.

At the end of the day, all I know is that i need to keep at my exercises and I should be losing weight ( not really happening at the moment :th_heehee:) and hopefully my body will slowly improve after all of these years of misalignment, leg length discrepancy, very limited range of motion and whatever else it has had to deal with.

We just need to keep the faith :thumb:
Jyoti
 
Jaycey is soooooo right!!! It is important that you not let "guilt" creep in. You must continue to communicate with your family and friends that you are still healing and need help. They may scoff and shuffle around a lot (teenagers are like that, you know), but it is critical for your well-being that you be afforded the time you need to heal properly.

If all else fails, have them watch a YouTube of the surgery. That usually gets 'em!!!:th_heehee:
 
''However, when I read about and observed the gait online I wasn't sure that was fully my issue''

If you googled Trendelenburg gait and saw the same video I saw then it was extreme.................I'm a 'TG' and just have noooo glutes at all - really difficult to walk straight unaided, however hard I try - but nothing really like the guy on the vid. I get sacroiliac aches and pains too - on the opposite side.

The hardest bit of recovery is being patient and not overdoing it. It's still early days.....
 
Hi Carlie and welcome! Sorry it took me awhile to read your thread, been having my own issues that have had me pretty self absorbed. Usually I jump right in but I've been a slacker of late, sorry :blush:.

This is by far the hardest most painful thing I have yet to experience in my 60 years! Unless someone has gone through it they can not even imagine the pain, physical and emotional, that is all part of this. And like you, it starts years before the actual blessed event for most of us.

That being said, there is no way to recover from the years of pain, walking wrong/odd, muscles being trained to do the wrong thing, etc. etc. etc. in a few days, weeks or in a lot of our cases, even months! Unfortunately, I think you are finding that out.

But you know what? That's ok. IT WILL AND DOES GET BETTER! I am 18 months and have had a terrible time, including a fractured femur that was missed that had to have a revision 2 1/2 weeks after the THR. I lived thru it and did improve.

I honestly don't think the inexperienced OS that did both my surgeries did them right though, so now, after taking a fall a month or so ago, I may be looking at another revision. BUT, I did feel pretty darn good for awhile, but probably not for a full year. And that was after all that I went thru.

So please be patient is what I am trying to say. You sound like you are doing awesome to me for just over three months. You sound like you are right on target. Please do not compare your recovery to anyone else.

We have all been thru different ordeals in our lives and we will all recover differently, some faster, some slower, but we will recover!

Hang in there Carlie, and drop in often for support. This is a magnificent forum for people going thru the various stages of recovery. Welcome aboard :wink1:!
 
Hi Everyone,

Thank you all for your replies of encouragement, reassurance, suggestions and sharing of your experiences - I do appreciate them.

I am wondering how others have dealt with their LLD (leg length discrepancies) especially those that had the dysplastic issues with LLD prior to surgery.

As I've been left to my own devices, I have been trying experiments with no lift, my old (3/8") lift and a little 1/4" heel cookie. Thus far nothing has conclusively felt just right.

My OS had suggested that I wear no lift and let everything stretch out fully and acclimate, my chiropractor suggest that I still need my full lift because my standing pelvic x-ray (which he took) shows my pelvis is off by about 1/2", my PT is very diplomatic and doesn't make a recommendation but offered me the 1/4" heel cookie to experiment with.

In conjunction with the LLD questions:

1. Why are the X-rays always in a lying position?

2. How can my X-ray at the chiropractor show that my hips are level but the top of my pelvis is so uneven?

I am about 16 weeks out from surgery and feeling like most of the swelling has settled down, but still having that low back/ SI joint pain.

Thanks for reading :)
Take care,
Cardie
 
Hi Cardie, sorry you are suffering from the low back/SI pain. I know that one well.

Since you are 16 weeks out I would suggest you get someone to measure you correctly to judge what degree of LLD you have now. Your OS is right, things will continue to settle and lengthen. But as Jamie told me during my recovery at 3-4 months out you should be able to get a measurement and may be able to use a lift.

Here's a good thread that shows how they should measure. I had a good podiatrist measure me and then had custom orthodics made with the lift included.

Does the chiro help with your back pain at all?
 
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