THR My Story (long)

[Jaycey]

@dw152 The recommended time off work post THR is 10-12 weeks and then a Phased return to work. Of course everyone recovers differently and you might be able to get back to it sooner. But a major roadblock for some is Energy drain for THRs. It's real and you can't fight it.

 

[trailrunner]

My doctor told me 6 weeks if I have a desk job and am working from home. She also said that we'd re-evaluate. I trust her that she's not trying to rush me back. But if she doesn't give me a note saying I need more recovery time after 6 weeks, that may limit my options.

I told my work that I'd be out for 6 weeks. My (temporary) boss asked if that was maybe 6 weeks out of the office and could I work from home after 4 weeks? I said no - the doctor said six weeks. I'm at the point in my life and my career that I will not rush back. I did that once when I came back the day after foot surgery, but I won't make that mistake again. I'll take as much time as I need.

I will add that this is the busy time of year for us, and there is a lot going on. I'll do my best to prepare my coworkers to cover while I'm out, but after that, I'll focus on me. I'm also being considered for a promotion. My time away during recovery may complicate that and could cause me to lose out on the promotion, but I really don't care. My health is my priority.

 

[nasruddin]

You should be able to get your surgeon to go over the tech details - mine did (also Kaiser).
It was an interesting experience - we went over a demo implant - you might be getting a little pink ceramic
ball in your hip as the replacement - CeramTech.

As for sizing, he said they have racks of different sizes (I'm envisioning shoe racks with different sized parts).
We didn't get a chance to see the inventory.

Mine said he could correct a lot of turn-in/turn-out and leg length but he is wary of perfecting it - your
body system is set up to certain angles and lengths and drastic changes could be counterproductive.
Some of this variance is natural - he has some himself (ie one leg turned out (externally rotated) a bit
more than the other).

I think shoulder replacement is more like knee replacement, PT has to happen right away, yes?
I know someone who DIDNOT do their PT after shoulder replacement & never recovered full ROM
(perhaps because of that - but it was a bad problem). With hips we are hearing to let the PT go or go
way easy for a few months.

 

[dnhTX87]

One of my cycling group guys is having his second hip done in about a week. He came back great from his first hip about two years ago. He was/is a runner, cyclist, triathlete etc. he didn’t slow down much after his hip. I did a knee about 1-1/2 years ago, and got stronger after surgery as I was not favoring the injured joint. I won’t hesitate having my second knee done later this year. I rode 2500 miles last year (2022) after TKR surgery in mid November 2021.

 

[Hip4life]

Your question about "how do they align everything?" intrigued me. I'm a science/medicine nerd. So I went back to my op report remembering the surgeon had mentioned something about that. As I understand it, there are trial components they can try (trial reductions) until they get the perfect fit and alignment: like femoral heads and necks. The summary listed my final components. The one that I had remembered was "high offset" Polar stem. I always figured that was used to help re-align my new hip with the old one. I never questioned it, because it all seemed to perfectly function in real life. I'm sure your OS would be happy to explain those technical aspects. My OS seemed rather proud in explaining them. In any case, I find that stuff fascinating as well.
@dw152

 

[trailrunner]

Your question about "how do they align everything?" intrigued me. I'm a science/medicine nerd. So I went back to my op report remembering the surgeon had mentioned something about that. As I understand it, there are trial components they can try (trial reductions) until they get the perfect fit and alignment: like femoral heads and necks. The summary listed my final components. The one that I had remembered was "high offset" Polar stem. I always figured that was used to help re-align my new hip with the old one. I never questioned it, because it all seemed to perfectly function in real life. I'm sure your OS would be happy to explain those technical aspects. My OS seemed rather proud in explaining them. In any case, I find that stuff fascinating as well.
@dw152

Thanks for the explanation! This is all just a curiosity to me. As I said, I'm sure some smart people have figured all of this out, and once a surgeon has done it a few dozen times it becomes mostly routine.

Fortunately, I'm pretty average height so mine should be straightforward. A friend of mine has had both hips replaced, and he's a very tall guy. I imagine they might have had to order some special hardware for him.

I have a few more technical questions, but I'll save them for a later post, or I'll save them for my doctor if they are out of place here.

 

[EalingGran]

Mine said he could correct a lot of turn-in/turn-out and leg length but he is wary of perfecting it - your
body system is set up to certain angles and lengths and drastic changes could be counterproductive

My surgeon said he could restore my natural alignment with a pkr or fully straighten my leg with a tkr.
I had a very valgus leg ( over 20 degrees) due to collapse of the lateral compartment with OA.
I had a pkr and my leg is now almost straight with just minimal knock- knee matching my other leg. This seems to suit me as my pre- op sciatica ( from spinal stenosis) has thankfully gone.

 

[Roseanne]

@dw152 relate to so many things you have posted. Initial shock and grief realizing that the hip had to go. I got a second opinion from another doctor who referred to the surgery as being barbaric. But also said the success rate was off the charts. Taken a long time to get my brain around the whole process. I saw my surgeon today for a pre-op appointment with surgery scheduled for this Thursday July 13th. Asked him how they keep from having all sorts of splinters from getting into the body when they saw off the bone. He said they irrigate the wound throughout the surgery and that chips from the bone should not be a problem. He didn't sugar coat the fact that post surgery pain will occur. I am still in shock that I need this surgery, but the hip pain is crippling me and destroying my quality of life. I have been active and focused on health my entire life. This diagnosis came out of nowhere. Like so many others I thought it time it would heal itself. Instead, it got worse. I have felt like I was 90 years old hobbling around on my cane.
I am very fortunate to have a supportive husband with a strong medical background who will be with me thru it all. Plus a very sweet 3 year old granddaughter sleeping in bed next to me as I write this. I want to be able to pick her up again, play with her and not feel excruciating pain when I do. So, onward and upwards.

 

[trailrunner]

Well, I'm now one month away from my surgery. I think about it every day.

I've had several dreams so far about the surgery. One of my dreams, I woke up and thought the surgery was complete. In another dream, I was awake during the surgery, and sort of calmly monitoring the procedure. When it was over, I politely asked the anesthesiologist "aren't you now supposed to give me something to make me have amnesia so that I don't remember any of this?"

I'm currently now on an extended work trip. About the only exercise I can do from hotels is running. I've had to travel a lot over my career, and have usually enjoyed running in a new place, especially when I can find a trail. Yesterday I found a nice trail nearby, and ran there. I got lost and added an extra mile to my run. My hip was a little sore during the run and then later in the afternoon, but I'm glad I did it.

I went to a social event at my tennis club a few weeks ago. All my friends were asking about me, and it was sort of sad to hear all their stories about the tennis club, and to hear about the classes I used to enjoy. Same for my running friends. It's a bit hard to deal with when I have built my life and identity around being active. Oh well. I have to deal with it.

Right before I received my diagnosis back in March, I was active, playing 30 hours of tennis a month, plus some running and pickleball. Now I'm down to about one third of that. Between now and the surgery I have a couple of hikes and bike rides I want to do, but I also have a lot of things to take care of around the house, and work is going to be busy. I'm going to be busy right up until the surgery, which is maybe good to keep my mind off of it.

When I get back from this trip, I'll also start having a series of pre-op appointments. I have prepared a list of questions for my orthopedic surgeon. I have a right to ask questions, but my list is a little long, and I'll admit that some of my questions are just to satisfy my nervous curiosity, so I'll try to filter them down to the meaningful ones. I'm trying to strike a balance between being informed yet not be a pain the butt to her.

Enough rambling for now.

 

[Caison113]

Hi @dw152 — sorry to hear those stories, but most of us can relate to having to bow out of activities due to our nagging hip. I mean, it was down right embarrassing sometimes when people would look at me as a fit, “young” guy and I can’t go on a hike or had to get subs for my remaining tennis games in the season. But now, 5 months out of my 2nd hip surgery, I’m back to where I was 10 years ago and even better in terms of range of motion and flexibility. Sure, I’m not really 40 years old as my body will tell me, but my hips are sooo much better.

Just know that this surgery really has a high success rate, and you being fit will go a long way in your recovery. The first week or two sucks as you have to use a walker and lay flat a lot, but you will see incremental progress and be thankful for each one! I remember those similar worries and anxiety — I even found myself trying to talk myself out of the surgery the night before (and then I woke up at 2am in pain from the hip, haha). As with most things, the anxiety about the thing is often worse than the actual event.

Enjoy your remaining few weeks as much as you can and get your answers and then you will just have to “trust the system.” We will be here for you!

 

[Lupyhippie]

I think life in general, but especially surgery on our bodies is all about managing expectations. I see so many on here that are just insistent that they go back to the exact same activities in the same way. I’ve chosen over the 4 years since THR 1 and elbow injury, and knee injury and now OA in the other hip that I need to just be kinder to this ol body that has served me so well over the years. It’s let me have tons of fun and after I repair it again, I can do more fun things for the rest of my life. Maybe not the same things but I can find new ways to be kind to this awesome vessel I live in. I’m now choosing to seek out new opportunities with sometimes new social groups. I need to be more patient and kind to this ol body that has served me well for so long. And we can keep doing activities that I might even like better. So expectations are no longer part of my mindset. I treat my body like a favorite relative, or a new puppy and she I turn will reward me with even more time and new experiences. Sometimes we are our own worst enemies. Don’t do things to yourself that you would not push onto a good friend. We aren’t Olympians. We are normal folks wanting to live happily ever after !

 

[Charlie33]

Hi @dw152 — sorry to hear those stories, but most of us can relate to having to bow out of activities due to our nagging hip. I mean, it was down right embarrassing sometimes when people would look at me as a fit, “young” guy and I can’t go on a hike or had to get subs for my remaining tennis games in the season. But now, 5 months out of my 2nd hip surgery, I’m back to where I was 10 years ago and even better in terms of range of motion and flexibility. Sure, I’m not really 40 years old as my body will tell me, but my hips are sooo much better.

Couldn't have said it better than @Caison113. The self image of a young, athletic guy and recognizing we all have to age gracefully is a challenge in and of itself without hip replacement lol! Fortunately at 8 months I am doing things now that I have not done in 10 years, and lately refer to this surgery as 'miracle surgery'. Everyone feels preop anxiety, but know you will do very well given how active you are going into game day!

 

[Layla]

Hi dw152,
It is difficult to get surgery off of your mind once you've scheduled it, the clock begins ticking loudly it seems.
Perfect example...you're even dreaming about it. To me it was like a mourning process. A long goodbye to a natural body part. I cried silent tears in bed the night before my surgery, thanking God for my natural hip and all of the years it served me well. I was able to sleep afterward. Looking back, it was a sad and fearful time, but losing that pain and getting back to life makes it all worth it. If you're unable to engage in the activities you love afterward, as an active person, you will find new physical activity to engage in. It will all work out and we'll be here to support and encourage you through it all.

I have built my life and identity around being active

You can still be active afterward also. Some do still run. That is a topic you need to discuss the pros and cons of with your surgeon.

In an effort to shorten your list of questions for the surgeon, bring any questions here that you eliminate, if you're comfortable doing so, if we can offer any opinions or advice based on personal experience, we certainly will.

I hope the next month flies and I wish you comfort and peace of mind as you wait.

 

[trailrunner]

Perfect example...you're even dreaming about it. To me it was like a mourning process. A long goodbye to a natural body part.

Wow - this is exactly what I'm feeling! I thought I was over reacting and over thinking, but maybe these thoughts are normal.

So here's my weekend update. I was out of town last week, so for exercise I was running. I took it easy and only ran every other day, but after a week and a half I was starting to be in more pain each on each run. I think I found my limit. When I finished my trip and got home, I went for a bike ride, and I was struggling. I did a route I've done many times, and my time was the slowest time all year. I'm really only pedaling with one leg, and I think my good leg is getting tired of doing all the work. I went for a hike yesterday. It wasn't overly long or difficult, but was I was pretty sore the entire time, and I was hobbling around yesterday afternoon. When I hike, all I think about is the surgery, and I find myself looking forward to when the hike is over because I'm in discomfort. I'm also reaching the point where I can't get my sock on by myself without cussing up as storm. I think I'm reaching my limit on what I can do in my present condition.

I told my work colleagues what I was having done. One of my colleagues follows me on IG, and she is a fellow hiker and always interested in my hiking photos. When I told her my problem was in my hip, she asked me "how can you hike with that problem?" I said "it hurts, but I'm just not going to do nothing. that's not possible for me."

Although it may sound like I'm doing a lot, my activity level is about 1/3 of what it used to be. Just tennis alone I was playing 30 hours a month plus my other activities before my hip sidelined me.

In an effort to shorten your list of questions for the surgeon, bring any questions here that you eliminate, if you're comfortable doing so, if we can offer any opinions or advice based on personal experience, we certainly will.

Thanks. Most of my questions are related to details of my procedure (which approach, what materials, what drugs and medicine will I be taking afterwards). I'm going to avoid asking questions about recovery, because everyone is different and by reading this site, I've gotten a good feel for the general recovery process.

One question I have is how do they control bleeding? Do they only cut the skin to get into the hip, and skin doesn't bleed too much? Seems like once they open up my body to get to the hip, it would just be a bowl filling up with blood. Sorry if this is a morbid question. I've performed exactly zero surgeries in my lifetime.

 

[djklaugh]

@dw152 Surgeons control bleeding very carefully! And no the hip capsule is not filled with blood - blood is contained in veins and arteries. Surgeons are very careful not to cut arteries ( those bleed a lot) - small veins do get cut but those are cauterized to stop the bleeding. For hip replacement surgery the blood loss is usually quite small - it is not typical for one to need a blood transfusion during or after such surgery. The skin is cut, the muscles under the skin are moved aside, and the bones of the hip are exposed. IF you are really interested you can find films of the actual surgery on YouTube ( not recommended unless you can tolerate some rather gruesome pictures). Also you can find cartoon depictions of the surgery also on YouTube - a lot easier to look at IMO.

Surgeons are very carefully trained - and have years of doing these surgeries - and one of the major precepts of any surgery is minimize blood loss! Most TV/movie medical shows are not terribly accurate.

 

[trailrunner]

@djklaugh Thanks for the explanation. Just to be clear - it's not something I am worried about, I'm just curious. I have confidence that smarter people than me have figured all of this out.

Whenever I cut something like a finger or hand, it seems like it bleeds a lot, so I just have it in my mind that a larger, deeper cut like hip surgery would involve more blood. One of the things I remember about my shoulder surgery 30+ years ago is that the doctor told me I did not need a transfusion, so I guess that's been on my mind since then.

I've seen the animations of the surgery. I sort of enjoy those - up to a point. If I'm watching a YouTube video and they start to show the actual surgery, I have to stop it. I just can't handle that. I have a lot of admiration (and thanks) for people who can.

 

[Jaycey]

@dw152 to give you some further peace of mind, I take blood thinning medication for a heart condition and had no issues with bleeding during my ops. The team watches you throughout the procedure. You will be in very experienced hands!

 

[trailrunner]

Yesterday I realized something during my hike. One of the reasons I have extra anxiety about my upcoming surgery is that the last time I was in a hospital was April 2020. My mother had caught covid and unfortunately passed away. Even though we were in the thick of covid at that time, the hospital allowed me to be with her all afternoon on her last day (which I appreciate very much). My surgery will be at a different facility, but the surroundings, the equipment, the bed, the monitors, and the staff in their scrubs will bring back those very painful memories. I think this has been in the back of my mind since I first realized that I was going to have surgery, but I only now realized how this has been affecting my feelings about it. I probably sound like a basket case, but when I need to be strong I will be.

 

[Jaycey]

@dw152 So sorry you lost your mum during covid. I too lost my mum to that horrid virus and could not be with her when she passed.

I probably sound like a basket case, but when I need to be strong I will be.

No, you don't sound like a basket case. You sound like someone who is still grieving. I totally get it!

Please keep in mind that the hospital environment for orthopaedic procedures is totally different than the intensive care area used for treating covid. It's a much happier place, since most patients leave the hospital relieved of all the pre-op pain and looking forward to getting back to an active life.

Your mum would want you to have this surgery and get back to doing what you love. She will be with you in spirit!

 

[Layla]

Aww, this is heartbreaking. I am very sorry for your loss.
Thankfully you were able to be with your mom on that sad April day.

Hospitals can be depressing. Even if visiting due to the birth of a baby, my anxiety goes up upon walking through the door. You're also missing and grieving the loss of basically your first love, your precious mom. Our moms are the one we run to for comfort and the one we always counted on to be there in sickness and times of crisis. I am sure you're wishing you could hear your moms loving reassurance before and after surgery. While we're no replacement, please know you'll always find encouragement, support and hopefully some comfort here. Having experienced this surgery...We Get It! No one could have convinced me this beforehand, but after surgery, I thought if I only knew that it was way easier than I imagined I could have saved myself the despair.

The medical team in pre-op prep are great. They know how you're feeling and I found them to be reassuring, gentle, caring, and they kept the conversation light, peppered with some humor. I sensed their confidence in doing the job they were trained to do, and what they do best. For them, it will only be another day on the job. They want the best possible for you and will work toward that outcome.

You don't sound like a basket case, you are experiencing real and normal feelings that the majority of us felt. You will get through this and life on the other side will be sweet! Try to focus on losing the pain and getting your life back when your thoughts drift into the bad place. See if it helps....hopefully it will somewhat.
Wishing you peace of mind.
@dw152