THR My new hip!

[belweav]

@Sommers16 I loved your post as it is helping me with my recovery.
Your point of not trusting the new hip is something I went through with the healing of my right ankle from a trimalleor fracture. I took a while to trust the ankle once I could start walking and it is also why I don't think that way about the hip. I saw it move out wards in a way it hasn't in months.

 

[Sommers16]

Hello, BoneSmart friends! And thank you, @Cynthia777, @gullimac, and @Nana2-8 who have recently posted on my thread with such compassion and encouragement!

Since I've returned to working from the office full time I have become "unplugged" a bit from this warm and valuable resource and I have a lot of catching up to do.

My stamina for full time working has improved and my walking continues to improve. I am not 100% without the cane, but am getting there.

Improvements tend to come in whispers rather than shouts. I've never been through a comparable experience before where there has been such a mixture of both excitement and concern.

I still have a limp and I still have discomfort. But neither the limp nor the discomfort post surgery is the same as pre surgery.

Now when I stand after having been sitting, it is more about feeling stiff, and needing to warm up a second. Then, when I start to walk, I can feel some soreness in the quad muscles and hips from having been walking before. Initially, my steps take in that penguin or Charlie Chaplin looking side to side gait. I think it is technically called Trendelenburg gait, and it is caused by weak abductor muscles. It is getting better but is a work in progress. I want to be without the cane completely, but at times I feel like I need it, usually because of soreness, and sometimes for stability.

Before surgery, standing up and starting to walk was a challenge, but for a different reason, obviously, and with different sensations. Then, I would stand and need to pause a second or two. But in this scenario, it felt like the leg needed to extend, as if it were "caught" at the hip, requiring some time and effort to stand fully upright. Then when walking started, it was often painful, but more in an arthritis way than a muscular way.

All of this is truly nothing short of amazing, really. I know sometimes we delve into very specific topics and other times we discuss THR in a more broad overview sense. Both perspectives are needed.

The THR journey is different for everyone, but I find myself awestruck when I see the difference it makes in people's lives. As my walking gets more "normal" I find myself catching glimpses of my reflection in store windows, and I think, "That's me. I AM walking better. I did it! I can't believe it!" Now, no one is going to be offering me any deals to walk the catwalk to feature this fall's boot collection or anything, but that's fine. That walk isn't exactly a "normal" walk either. Ha Ha

When you've lived for years- in my case decades- walking a certain way because that's the way you physically are able to walk, and then to have THR, and have that functionality "reset" to near original specifications ... it is emotionally overwhelming in a good way.

At 45, I resisted the idea of getting an "after market" part and was terrified of the surgery. But each person has a point they reach where enough is enough. While the human spirit has a tremendous capacity to endure circumstances, eventually something has to give.

Now I am having moments-glimpses here and there of how the new hip is better. Of things I can now do. Of hints of what I might be able to do with more time and healing. I feel like my brain is working overtime to process it all- both the new physical signals it gets from a new hip that stands differently, walks differently, and feels differently- but also the processing of emotions that tries to reconcile the before and after. If you've ever seen a video of someone with a new hearing implant like a cochlear device who hears for the first time or for the first time in a while, THR reflection can feel like that. With THR, it definitely isn't that immediate or dramatic, but one day you feel yourself walking, almost "normal," and without the pain you've endured for years, and you think to yourself, "This is how it was supposed to feel. This is what normal is. This is better."

I am looking forward to catching up on everyone's progress, both the trials and triumphs. I just wanted to share where I am along the path and to encourage others that whatever you are facing with your journey today, it does get better, and it is worth it to try fighting for yourself.

Hugs & healing-
Sommers16

 

[Cynthia777]

What a great post @Sommers16! You always have such a wonderful way of expressing the challenges and triumphs we all experience during this journey. Look how well you're doing and you haven't even reached the three month mark! I just can't express enough how happy I am for you! Onward ho!!!

 

[Sommers16]

@Cynthia777 - Thank you so much! You are so wonderful!

This forum has been so helpful for those literally and figuratively walking the THR journey. It fills a necessary gap. Plenty of attention is given to the conditions and pain before surgery. And often in life we hear post surgery, after healing, of joint replacement patients saying they "wish they'd done it sooner." But what about the middle? What about the ups and downs of recovery, what that is like? And where do we go with our questions and concerns?

When I went to the joint class before surgery, the RN leading the session was frank and upfront and told the class, "We're getting people coming through who don't think this is going to be a challenge. And I'm just gonna tell you, it will be." Now, at the time, I felt like, "Geez, way to comfort the room!" Here we are, in pain and nervous, and that does not sound like encouragement. But now I get it. It's about managing expectations. And this forum has been so helpful in helping to get us from point A to point B. Thank you, "CC," for all of your help and support!

 

[Cynthia777]

The emotional ups and downs of this journey have actually been more difficult than the physical part for me. At three months post-op (2nd THR), I find myself still having low days even though I'm not in any pain. I'm usually a very upbeat person, but this journey has sometimes brought out the devil in me (so to speak)!
Somewhere online I read a study and it talked about making sure the patient was psychologically ready for this surgery. I can see why now. I just keep telling myself, "This too shall pass."
xoxoxo @Sommers16!

 

[Zelda]

Hi @Sommers16
I sometimes feel I could have written your posts but you put into words things I'm only half aware of. I have found the 6 week plus period of my recovery the most emotionally challenging and I really didn't expect it. I feel a little in limbo as the worst of recovery is over but I'm not quite ready for normal life yet. I find myself constantly trying to manage my own expectations, almost scared to hope and plan for a fully recovered future and sometimes that makes me feel like I'm being very negative. I just don't think I can deal with the disappointment if I'm too optimistic and don't quite get there. I still see people here abandoning their cane after a few weeks and I'm so jealous, even though I know my limp is evening out a little and I'm building stamina all the time.

Anyway, I really wanted to say thank you for putting all that into words! I do hope you continue to have more little triumphs and to share them all with us.

 

[gullimac]

The emotional and mental side of recovery are certainly overlooked. My own stubborness seems to cause me the most problems. I have tried to stay realistic about recovery, but I still bounce around all over the scale sometimes. This week has been frustrating with my left hip (yet to be fixed) giving me increasing problems. The right has been a bit sore too, with an uptick in activity level in the last two weeks.

We all seem to go through a lot of ups and downs I this journey. It is great to have a place to share our journey (the good and bad parts) with others going through the same thing (and preparing to go through it).

 

[Sommers16]

@Zelda & @gullimac (and everyone):

Thanks for your posts. I hope things are well and that somehow, just somehow, we are gentle and kind and patient with ourselves today. I'll let you know if and when I learn to master that consistently.

I am grateful for my progress. I'm already taking some things for granted, such as sleeping at night without arthritic pain waking me up. How quickly we forget what is better while focusing on what still needs work. I'm guilty.

This past week at my job, to honor someone's birthday, they had an Italian ice truck come out for a treat. So far, so good. A co-worker decided to shoot a video of us standing outside with our treats, however.

In the video, I manage to ignore the smiling faces and the rainbow of ice colors and the sweaty brow of the hardworking man on the truck and focus on one thing- me.

Specifically, watching me walking towards the truck. While I should, by all accounts, be grateful to be walking at all, and to be walking now almost exclusively without the cane, that critical voice inside says it isn't enough. I see my hesitant steps, my looking down to watch for hazards in my path, and the stiff, somewhat laborious limp.

I thought my walking looked better. I think at times it looks better than others. I don't think I've been deluding myself with glimpses of reflections here and there telling me how good I'm doing.

These days when I stand from having been sitting, I am stiff and it takes a few minutes for things to feel more fluid and natural. It's not the pain from before, but rather tightness and soreness. Again, coming from where I've been, it is an improvement. But it would be so helpful mentally to know this stage should last "x" amount of time longer and then here's what to expect after that. But there's no advancing through the book to see how things turn out.

As I watched the video, I thought, "Surely, I look better than that in real life." As if the video is somehow distorting the truth in the vein of "a camera adds 10 pounds." Only I've never heard, "You know the camera makes a person's gait less becoming. It's science."

As some kind of reality check I looked at other people- their faces, mannerisms and movements. And perhaps viewing them with a kinder, more accepting lens, thought, "Yes, that all appears rather accurate and normal." Which leads me to conclude mine must be a true depiction too.

I find myself wondering if this is as good as it gets. Or maybe I'm not being patient enough. And feeling guilty I struggle with just acceptance. And not celebrating more the already hard won victories.

I limped for years and years before the surgery. It is really illogical to think post surgery I would be gliding about as if on an invisible conveyor belt. I don't know how much more improvement to expect, but I am hopeful. And while I keep the flame of that hope burning, I am trying to concentrate on just here and now. Just being, and letting that be enough. Accepting that I am enough. That I am not anyone else, and I'm not competing with anyone else.

It's such a rob of today's joy to pick ourselves apart and to live with worry. I find I can stay in a "good" place mentally for bursts of time, but then stray away again and have to find my way back.

The other night, I swung my legs up and over to get into bed and it struck me how easy that was compared to just a few weeks ago. There is progress. There is improvement in quality of life. There is hope. And often in life, what you are seeking/focusing on is what you will see and find.

I hope each of you celebrates unique, special, awesome, one-of-a-kind, terrific YOU today. Just as you are. Right here, right now. Without comparison. Without condition. Just acceptance and peace and love for yourself.

I'll work on it too.

 

[Zelda]

I find myself wondering if this is as good as it gets.

I don't think so.
One of the reasons I continue to advocate for physiotherapy is that it gives you a continuing measure of your progress and a bit of reassurance. I feel like I've been "in recovery" forever now, with even the second May surgery feeling very distant and because of this I think I should be better by now. My physio's the one who keeps pointing how early it is and that the recovery timeline is over year or eighteen months not a matter of weeks. So keep that flame of hope going!

 

[Zelda]

It's just struck me wit you talking about stiffness - I only get stiff now when I've done too much in a day. I know you're back at work and I wondered if you're maybe not getting enough chance to rest?

 

[Sommers16]

@Zelda- it's hard to say about the stiffness and rest. I find once I get going, walking becomes easier. So while I believe rest and not overdoing it is important, for me it seems important also not to be too still for extended periods.

When I have been sitting or lying down and get up to go I have what looks to be called Trendelenberg Gait caused by weak hip abductor muscles. I feel stiff and rusty, like an old manual can opener.

Things have definitely improved since I had the surgery- I don't wish to lose sight of that or to be ungrateful. I'm just still recovering, and as you said, it takes time.

One specific example I can point to are the stairs at work. These aren't outside, but rather inside, between three floors.
I am challenged to walk up and down the stairs using each leg equally. It is easier and more comfortable ascending with the right (non-operated) leg, and pulling the left leg up behind, rather than each leg taking turns of pulling the weight up. I hope that makes sense.

If I go up the stairs with the weight on my operated leg it sometimes feels weak and unsteady like it may not support me. And I have to consciously correct for what my PT told me was a "kick stand" stance. You know how a kick stand on a bicycle works and looks? Sometimes I have my leg further out like that than needed on the stairs.

It's hard to determine in recovery what is okay to do until you can do better, and what shouldn't be done if possible, lest it become an undesirable habit. I think the operated leg should, by logic, feel and perform weaker than the other leg because A. It has been operated on, and B. The muscles weren't being used correctly in that leg prior to surgery.

@Zelda- I am reminded of the THR warriors like yourself who have had to have BOTH hips replaced, and I'm interested to know in that scenario if one hip feels like the more dominant, stronger one? Perhaps the one restored longer ago that has had more healing time?

Honestly, it's difficult for me to envision both hips feeling equal in comfort and strength. That hasn't been the case in so many years. But I do believe I have more improvement to come, and that keeps me going.

 

[Zelda]

I am challenged to walk up and down the stairs using each leg equally. It is easier and more comfortable ascending with the right (non-operated) leg, and pulling the left leg up behind, rather than each leg taking turns of pulling the weight up. I hope that makes sense.

It makes perfect sense because I've been doing it too, although with different legs. I'm right handed so historically I would go up stairs right foot first and then a reciprocal pattern. When my hips first started bothering that swapped - some days I could still do reciprocal but the left went first and others I would lead with the left for each step. I also did the kick stand thing - although I thought of it like a rollerblading or iceskating motion.

I went back to leading with the right leg not long after the RTHR but it's only very recently that I've been able to manage stairs with a proper reciprocal pattern and just yesterday I was very proud of myself because the shopping centre stairwells had just been painted and I had to go up two flights without holding on to a rail! But when I'm tired or the stairs are very steep, I go back to holding on and doing one step at a time.

My right, six month hip is definitely stronger than the left. It feels "normal' but lacking fitness. I can balance on it better and for longer, it can do more of the physio exercises well etc. but my left has had a better range of motion almost all the way through this process and is getting stronger a lot faster than the right one did. I too have weak abductors and I've had a series of exercises from the physio to work on this. It sometimes feels never-ending! I am absolutely determined to keep going though - I want to be fitter than I was before because the lack of activity had just made me so fat and sedentary without me really noticing. My physio sessions are almost up and I was thinking about pilates or yoga to keep up the strengthening process. Finding the energy to do that and work full-time will be the challenge. I honestly don't know how you managed to go back to work so soon!

I know there will be more improvement for both of us. If recovery takes a year to eighteen months, we're barely through the first quarter. There's still so much time to make progress!

 

[Sommers16]

@Zelda: thank you for sharing! I am so proud of you! Thank you for the encouragement. We are going to get there!

 

[Sommers16]

Hi, all! I'll be uncharacteristically brief-ish as I am at work. But it is because I am at work and going up and down stairs that I need feedback.

So going up stairs is hard if I am stepping reciprocally, using each foot/leg equally to pull my weight up to the next step.

I am having pain on the outside of my operated leg. I find that pulling my weight up on the operated leg is only possible if I am using both handrails and applying some weight onto my hands. And while this makes my walking upstairs with the restored leg in the lead possible, it still hurts.

The outside thigh muscle is so sore, and I can feel it running down the length of my leg on the outside.

I know healing takes time. I know it makes sense muscles would be weaker in this leg. But I'm "cheating" just to get up the stairs comfortably by making every weight bearing step up be my non-operated leg and just pulling the surgical leg behind it.

I don't know if my operated leg is saying, "You've got me inflamed from trying this and I need a break" or "Keep trying to use me this way because that's the only way to get past this stage."

I don't know what is going on. Walking on level ground is ok, other than some initial stiffness when I stand up, but putting weight on this leg going up stairs is painful. And it is impossible to do if I don't have handrails to press down on.

Has anyone else experienced this and may therefore have info/suggestions?

 

[msmo]

Hi @Sommers16 . I have trouble with stairs too, although my pain is inside of my knee and inner thigh. I'm working with a PT to correct the muscle imbalance and weakness with my inner quads and tight hamstrings. Might be worth it to get a PT assessment to figure out what's going on.
Best wishes
msmo

 

[Sommers16]

@msmo- thank you for your reply and best wishes for working through your stair challenge. I've been looking online and the answer to my issue isn't clear, but I am going to keep looking and asking.

 

[Zelda]

I know I still have quite weak hip muscles but I don't have the kind of pain you describe. Even my new gung-ho physio says that if something hurts in my operated leg I should stop doing it and find another way to gently strengthen the muscles.

I don't think "pushing through" the pain and discomfort is a good thing in this process. Can you avoid the stairs at work?

 

[Jaycey]

I don't think "pushing through" the pain and discomfort is a good thing in this process.

Exactly! Trying to push only results in a setback. My strategy was to try and if there was discomfort wait and try again another day. Build up gradually. For many of us it was months (years) of limping around pre-op. Muscles are not going to respond instantly. Just give it time.

 

[Sommers16]

Thank you @Zelda and @Jaycey! What you are saying makes sense.

Unfortunately I cannot avoid the stairs as it is the only way to access the floor I work on. When I first returned to work I was set up on the main floor for a few weeks, but I then needed to re-join my team in proximity on the upper floor. If the condition does not improve, I may move back to the main floor.

I think (?) this could be Iliotibial band syndrome, but I really don't know. Some articles I read sound like the kind of discomfort I am having and others on the subject don't. The Internet is a useful tool and also a land mine of anxiety for those with medical uncertainty. Ha Ha

For now I will be kind to myself and not feel so bad/guilty if I can't make it up the stairs by pulling weight equally with both legs. I know (logically, anyway) that healing is a process. But when you've started to see and feel progress in recovery, you just want more of that.

All gain, no more pain. Working towards this:

 

[Zelda]

I'm so glad I had to wait 12 weeks before I could go back to work. Be kind to yourself, @Sommers16 and if you can't cut out the stairs see what else you can (not!) do to give yourself a break.