THR My New Left Hip

[Legseleven]

Great report @JusticeRider and so useful for others already nor contemplating this replacement journey. Please do keep us posted. I agree with you on many issues too.

 

[EalingGran]

A really helpful report.
I too hate opiates- although for me it is that my guts just seize up for days and days and POTs makes me more sensitive to medications.
Amazing that you could drive so early. This really does sound encouraging and easier than knees.
Don't know if you have Apple TV but I really recommend the new season of Slow Horses.

 

[JusticeRider]

Thank you @EalingGran I’ll check out Slow Horses!

I remember that you have POTS also, and if I remember right, some hypermobility too? The POTS can be really troubling…I don’t know about you, but it caused me some pretty significant memory issues, to the point I was starting to worry I had early onset dementia or something else really dire. Turns out it was just the lack of blood flow to my brain! The high doses of electrolytes I now take daily have made an incredible difference. They’ve helped with the fatigue and faintness as well. I had no idea previously that POTS could cause issues with memory. Have you experienced any of that?

This past Wednesday was 6 weeks since my THR! I feel like I’m making good progress. I’ve been almost completely aid free indoors for several days. I’ve also started walking outdoors with my hiking poles. They offer less weight bearing than the cane, but I’m ready for that now. I also feel like my posture is much better using the trekking poles and I feel like I’m more even in my stride. I’m up to a mile with a rest in the middle.

Walking still doesn’t feel effortless, whether indoors or out. I have to think about my form all the time and how everything is moving and feeling. It still kind of feels ramshackle and awkward, not smooth. But when I see myself in reflections, I look like I’m walking normally! So I guess it’s alright. And I know it will start to feel more and more natural.

I’ve started very carefully cutting back on the Tylenol. I’ve been taking 4,000/day for several weeks and I’d like to give my liver a little relief. With the caveat that I still need to keep the pain levels low and keep progressing. So far, I’ve cut out my wee hours of the morning dose, and gone from two tablets down to one at bedtime. So far so good! I will keep my two daytime doses the same for now and then we’ll see.

We’re having friends over for a Piesgiving celebration next Saturday. This will be my first time hosting a dinner at my place since my surgery, but I think I’m ready. I’m going to make a Basque cheesecake with a cranberry coulis, and provide some easy appetizers. Friends will be bringing both sweet and savory pies. So excited! These friends are the best kind, and they will understand if I need to hook up my machine while we visit

 

[EalingGran]

I had no idea previously that POTS could cause issues with memory. Have you experienced any of that

I had some brain fog around the menopause but my HRT patches seemed to solve that. I can still get dizzy and a bit faint if I don't manage my POTs properly with lots of fluids/ electrolytes. But generally I know how to handle it. The biggest change as I have got older is that I am much more sensitive to alcohol. Anything more than a single glass of wine can really shoot my pulse up to 130 plus. Also if I am ill in any other way my pulse can go haywire. When I had septicaemia it shot up to 160 plus.
I used to faint a lot when I was younger but I guess I just recognise the signs more now. I am also a lot more careful getting up.
How does your POTs affect you and how was it picked up? It is still underecognised. I have had it since my teens but in some people it seems to come on later in life, often after a viral infection.

 

[EalingGran]

We’re having friends over for a Piesgiving celebration next Saturday. This will be my first time hosting a dinner at my place since my surgery, but I think I’m ready. I’m going to make a Basque cheesecake with a cranberry coulis, and provide some easy appetizers

That all sounds amazing! Enjoy! What makes a Basque cheesecake different?
I much prefer easy entertaining with appetisers/ nibbles to formal dinner parties these days. It's more about the company than the stress of cooking.

 

[Legseleven]

Ooh. Basque cheesecake, wonderful. Do try it @EalingGran although it’s definitely not healthy food. As a treat, delicious

 

[Layla]

Piesgiving. Now that sounds like a fun idea!
Happy that you're excited for this and hosting kind understanding friends will be a joy. Try not to go overboard with any cleaning / prepping before your get together so you're present and not in the ODIC on Saturday. That would be my luck, I'd overdo the prep and be stuck in a chair icing "on the day".
Happy Sunday!
@JusticeRider

 

[JusticeRider]

@EalingGran I’ve also had POTS since at least my teens. But I didn’t get diagnosed until last year! Long story short, I just thought everyone fainted from time to time So I never mentioned it to my dr’s. The only reason I finally did is my symptoms seemed to be intensifying last year (fainting more often and for no obvious reason). My PCP sent me to a cardiologist and they had me wear a heart monitor for a week. When that showed a slightly elevated heart rate in general and lots of heart rate ‘spikes’ I was diagnosed with the POTS. It sure did explain a lot! Brain fog, fatigue, memory issues, fainting, heart racing, migraines, ice cold hands and feet, numb hands and arms, etc. And since my heart rate was spiking at night, I never felt rested in the morning.

Almost always when I first stood up from sitting or lying down, I would get a wave of fatigue that shortly passes. On bad days, I would see stars or feel suddenly woozy upon standing. In the past, I would faint if: I was hungry, I was hot, I was sick, I was dehydrated, I was low on sleep, I stood in one place for too long, etc, etc. And after surgeries, always. My doctor told me she had never fainted in her life and I was amazed! Since I’ve been taking the high dose electrolytes each day, though, my symptoms are much improved! @EalingGran what kind of electrolytes do you take?

 

[JusticeRider]

@Legseleven sounds like you are familiar with the basque cheesecake! Yes, sooo rich and decadent! It is probably a whole day’s worth of calories in one slice, but as a special treat, so lovely. @EalingGran it is a crustless cheesecake with cream in it and you sort of scorch it so the outside is firm, brown, and deliciously carmelized and the inside is sort of fluffy, creamy, and smooth. The middle puffs up as it bakes and as it cools, the middle falls and creates that denser. creamier center. I’m experimenting by making a drizzly cranberry sauce to top it with.

@Layla it is for sure a risk hosting a get together! So easy to overdo. As a special treat, we actually had a house cleaner come yesterday! The house looks amazing and now we have to keep it that way for a week We were just joking, don’t touch ANYTHING!’ Haha. Hopefully I can just give everything a quick wipe down and my husband can vacuum and that will be the extent of the cleaning.

The nice thing about the basque cheesecake is that I won’t have to make a crust! I was going to make an apple pie, but as we all know, ‘easy as pie’ is a ridiculous expression and making pie crust is a LOT of work! So this should be much simpler.

For appetizers, I’m going to buy some deviled eggs from my favorite deli, get some gerkins, olives, and giardiniera, and some nice cheese and crisp bread. Chuck it onto a platter and away we go! Hopefully I can keep the prepping and activity to a reasonable level and as you said Layla, just enjoy my company! And since we will be at my house, we can ‘retire to the parlor’ -aka the living room- to visit and I can make use of my recliner and ice machine as needed.
Hopefully it will be a lovely night all around!

We will be having our regular Thanksgiving on the official day at another couple’s place and bring a couple of special dishes to prepare and share with them. Hopefully by then I will be able to make myself comfortable in ‘normal’ chairs for an evening. Anyone have exciting plans for the holiday coming up??

 

[benne68]

This sounds like a great plan, @JusticeRider. As my sister-in-law often says when she does a store-bought spread instead of cooking, "I didn't make it, but I did make it happen!"

 

[EalingGran]

high dose electrolytes each day, though, my symptoms are much improved! @EalingGran what kind of electrolytes do you take?

I don’t take special electrolyte solution packs every day -as I am OK generally these days so long as I drink lots of fluid and take some salt with my food. That is so long as I sleep plenty, avoid high carb heavy meals, exercise carefully ( pilates- nothing too vigorous) and largely avoid alcohol. But if it is hot, I am travelling or I notice my fitbit telling me that my pulse is going a bit haywire- then I will take some sachets of diorolyte/day until things settle.
It's basically the BoneSmart mantra of listening to your body-especially when you have one that is a bit different from the usual standard. It is interesting what you said about cold hands and feet. I have extremely bad peripheral circulation and my daughter has full blown Raynauds syndrome. I am sure there are links between POTs, Raynauds and hypermobility syndromes that we are only scratching the surface of understanding.
Good luck with learning to live with POTs. It is an unpleasant condition but not really dangerous.
I saw a consultant cardiologist recently with my husband who has mitral regurgitation and will probably need heart surgery in the next couple of years. We were asking about travel restrictions (he has been told he can't travel above 8,000 feet). I mentioned my POTs and he said it is a real nuisance that can definitely affect life quality but it doesn't affect life span and I can do anything I feel capable of.

 

[AllNat]

I remember that you have POTS also, and if I remember right, some hypermobility too? The POTS can be really troubling…

@JusticeRider, I admire your and @EalingGran's guts in managing such a condition, especially while recovering from joint replacements, for which "Don't fall!" is such an important instruction to follow.

I’ve been almost completely aid free indoors for several days. I’ve also started walking outdoors with my hiking poles. They offer less weight bearing than the cane, but I’m ready for that now. I also feel like my posture is much better using the trekking poles and I feel like I’m more even in my stride.

When you're walking aid-free, do you have any limp? I feel as though my "slight Trendelenburg gait" is getting slighter, and I can take a few steps without feeling any sway/swing, but it certainly returns, particularly if I'm feeling tired.

In terms of posture, I try to keep in mind a mantra I took from "The Marvelous Mrs. Maisel" TV show, when the main character's manager would remind her "T*ts up!" every time she walked onto the stage.

Walking still doesn’t feel effortless, whether indoors or out. I have to think about my form all the time and how everything is moving and feeling. It still kind of feels ramshackle and awkward, not smooth.

Right?! It's situations like these that make me wish I could remember what I felt as a child, when I was learning new skills such as walking and talking. What was I thinking of as I took those early steps?

With the caveat that I still need to keep the pain levels low and keep progressing.

Is the pain from your incision, or from all of the activity that you're doing?

I’m going to make a Basque cheesecake with a cranberry coulis,

I had to look this dessert up, and it looks fabulously delicious! Now I just need an excuse to make one...

The nice thing about the basque cheesecake is that I won’t have to make a crust! I was going to make an apple pie, but as we all know, ‘easy as pie’ is a ridiculous expression and making pie crust is a LOT of work!

I agree 100%. There's not much that makes me cry as an adult, except emotional moments in films and TV shows and watching a pie crust fail.

I much prefer easy entertaining with appetisers/ nibbles to formal dinner parties these days. It's more about the company than the stress of cooking.

Absolutely! My family's embrace of the potluck concept has greatly lowered the entertainment stress level.

 

[JusticeRider]

@JusticeRider, I admire your and @EalingGran's guts in managing such a condition, especially while recovering from joint replacements, for which "Don't fall!" is such an important instruction to follow.

AllNat, the falling is the scary part after joint surgeries! It’s terrifying, honestly. I almost always have some warning, but the only thing to be done is to lie down. Sitting is not enough, I will still pass out. I must lie down, but once the black out starts, my body just kind of stops working. So there’s not always time to get to a bed or a couch and get myself laid down. But one cannot just get down on the floor after a joint surgery! It’s quite a pickle. I’ve had some horrible close calls and also had to yell for my husband to come and save me. Once I’m already going out though, I can’t even yell. My voice just won’t come out. It’s dreadful.

I was home alone once, after my first FAI and labrum repair on my hip, and started to feel faint coming out of the bathroom. I knew I had to get to the bed, but when I was almost there, suddenly my crutches wouldn’t move. It was like they were glued to the floor. I could barely see through the black and I couldn’t understand why my crutch wouldn’t budge. I was terrified to realize that it wouldn’t move because my muscles were no longer responding

It took everything I had in me to fall forward onto the bed. It hurt my hip and I hit my chin on my crutch and cut my lip. But at least I made it into the bed and didn’t fall onto the floor. There was no real damage to the hip, it was just extra sore for the next couple of hours. But it truly felt like a nightmare. It sounds dramatic, but it really was one of the scariest moments I’ve had.

It turns out surgery is a trigger for this, at least for me, so this has been a problem after all of them. That was the biggest reason I stayed at the hospital an extra day and a half for this last one. I really don’t know what we can do when it happens at home.

Luckily, when all the joints are working, I will feel it coming on and just immediately lie down wherever I happen to be. It can be very embarrassing but otherwise manageable

 

[JusticeRider]

I am sure there are links between POTs, Raynauds and hypermobility syndromes that we are only scratching the surface of understanding.

Yes, you are absolutely right, and they are learning more all the time, fortunately! I hope there will continue to be more research into these connections. Reynaud’s also runs in my family, although I don’t have it myself. I also have autoimmune disorders in my family, and there’s another possible connection with lots of overlap.

My cardiologist explained the link between EDS or hypermobility and POTS this way (paraphrasing): because the hypermobile person’s tissues are extra stretchy, including the blood vessels, there is not enough tension to maintain pressure in the blood. Instead of being pushed through, it’s more like a lazy river just sluggishly meandering its way through the lax blood vessels. This causes issues in circulation. The blood begins to pool in the abdomen, causing a lack of blood flow to the extremities, including the brain (hence the faintness, brain fog, cold hands and feet, etc). Then, the brain tells the heart and the heart speeds up to try to push the blood through to where it’s lacking. Hence the spiking heart rate. Fun stuff!

It's basically the BoneSmart mantra of listening to your body

Funny how that applies to so many things!

 

[JusticeRider]

When you're walking aid-free, do you have any limp? I feel as though my "slight Trendelenburg gait" is getting slighter, and I can take a few steps without feeling any sway/swing, but it certainly returns, particularly if I'm feeling tired.

In terms of posture, I try to keep in mind a mantra I took from "The Marvelous Mrs. Maisel" TV show, when the main character's manager would remind her "T*ts up!" every time she walked onto the stage.

I did have a little of that sway right at first, although I was able to correct it. It will still happen once in a while when I’m tired if I don’t notice it and fix it.

I love this reminder and I love The Marvelous Mrs Maisel! There’s no way I will not think of this now every time I walk!

It's situations like these that make me wish I could remember what I felt as a child, when I was learning new skills such as walking and talking. What was I thinking of as I took those early steps?

It really does feel like learning all over again. At least as adults we used to know what it feels like though! Meanwhile, we may have to waddle around like toddlers at times.

There's not much that makes me cry as an adult, except emotional moments in films and TV shows and watching a pie crust fail.

Ha! Yeah…that moment when you’re trying to oh so carefully lift the raw crust you just painstakingly mixed and rolled out into the pie dish and the whole thing just cracks right in half. Or you’re trying to get the texture right, and you just keep adding water ‘a few drops at a time’ because it still seems too dry, and then you realize you’ve overworked it and now, and after all that, it’s just going to be tough and dense and not flaky at all.

OR you spend ages making the crust, the filling, crimping the edge just right, and baking it for over an hour- the whole thing looks absolutely triumphant…but then as you’re taking it out of the oven, you accidentally bump the edge and a big chunk of that perfectly golden brown fluted flaky crust breaks right off. Ugh! I’m practically tearing up just thinking about it!

I had to look this dessert up, and it looks fabulously delicious! Now I just need an excuse to make one...

Make it! Make it now! No excuse needed

 

[JusticeRider]

Is the pain from your incision, or from all of the activity that you're doing?

Just general soreness. A little stiff and achy first thing in the morning. Can get a little ‘hot’ feeling after pt or a longer walk. I can move wrong in some random way and irritate it. Often it’s a knee or a foot that actually hurts. Mostly I feel the Tylenol is more of a preventative, but there are times things do get a bit sore and I look forward to my next dose.

 

[EalingGran]

was home alone once, after my first FAI and labrum repair on my hip, and started to feel faint coming out of the bathroom. I knew I had to get to the bed, but when I was almost there, suddenly my crutches wouldn’t move

That is so so scary. I am really glad this surgery has been a bit easier. Thankfully I haven't had an actual blackout now since 2019. We were travelling and I had missed lunch. I ate a largish meal and all the blood must have pooled in those lax abdominal vessels- I had virtually no warning and keeled over.

My cardiologist explained the link between EDS or hypermobility and POTS this way (paraphrasing): because the hypermobile person’s tissues are extra stretchy, including the blood vessels, there is not enough tension to maintain pressure in the blood. Instead of being pushed through, it’s more like a lazy river just sluggishly meandering its way through the lax blood vessels. This causes issues in circulation.

That's a really interesting and useful way to understand things.

 

[EalingGran]

Just general soreness. A little stiff and achy first thing in the morning. Can get a little ‘hot’ feeling after pt or a longer walk. I

That all sounds really positive. You are doing great!

 

[JusticeRider]

I ate a largish meal and all the blood must have pooled in those lax abdominal vessels- I had virtually no warning and keeled over.

Oh @EalingGran that is so scary! No warning…ugh! Were you hurt? Did it cause a scene? Not important I know, but still, these things can be a bit embarrassing. I hope you weren’t hurt though.

I’ve really only had a one or two times over the years where I had no warning, but generally I’m fortunate enough to know when it’s coming on. The idea of just collapsing is frightening!

 

[EalingGran]

No warning…ugh! Were you hurt? Did it cause a scene? Not important I know, but still, these things can be a bit embarrassing. I hope you weren’t hurt though

Fortunately I was sitting at a table in a restaurant and I just slumped forward. It was a bit embarrassing but I was OK.
I do worry about falling and I can really sympathise with you feeling vulnerable after surgery. I don't seem to be triggered by anaesthesia or opiates thankfully, although I hate the gut stasis.