THR New hip 3/7/12

[Josephine]

Talked to nurse and Home PT and no one seems too concerned and agrees it was a subluxation.

Er excuse me? They said it was a subluxation but they weren't concerned? What kind of cowboy outfit is that? Don't ever let that PT touch you again, will you? And certainly follow your instincts like when you said you felt it was "a big switch".

The cramp was from your prosthesis being partially dislocated and, by the sound of it, more than a little. I think you were lucky it didn't come right out. You should report this to your surgeon very soon and take care you don't abduct your leg to that degree ever again.

However, in the short term, just rest the leg and let the muscles settle down and recover and you should be okay. Just mark it down to a near miss.

 

[Orthodoc]

I would agree that you should talk with your OS. I know that if you were my patient I would want to know about this so I could examine you, and possibly take some x-rays. The pop could have been several things, from scar tissue, to a suture popping, to relocation from a subluxation,etc... It is possible that an event like this could be singular, without recurrence, but your OS will best be able to advise you. Please let us know what he/she says.

Orthodoc

 

[Poppet]

Calling Cathy, @VThereandnow, how are you doing my good friend?

 

[VThereandnow]

Thanks for input @Josephine and @Orthodoc With all due respect I really feel it was the foot cramp that started the whole freakish thing and my body twisting and straining to try to deal with it that forced the subluxation, if that's what it was. ...and I did talk to the triage nurse on my doctors team and yes, they did say since it popped back in to just take it easy but if there was increased pain beyond soreness from the event or trouble weight bearing to call back. When I talk to my docs right hand nurse tomorrow when she calls to tell me how much Coumadin to take after bloodwork, I will make sure she has the info to tell the doctor since she deals with him daily.

I am ok since it happened, a bit more sore in the thigh, but that is from my lack of judgement around listening to the PT instead of myself. I think I've come to terms with the event, but wanted to know if SOMETIMES it can just happen once and never again. Like I said, no crystal ball, but was scared after all this, that this was a precursor. ...and only time will tell.

Thanks again all, I appreciate your time
Cathy

 

[Josephine]

With all due respect I really feel it was the foot cramp that started the whole freakish thing and my body twisting and straining to try to deal with it that forced the subluxation

But that's what happens when a hip dislocates - the patient gets all those muscular spasms.

 

[calikat]

Yikes! That sounds scary Cathy. I am glad it went back in. Keep us posted as to what you Dr.'s office says.

 

[Orthodoc]

wanted to know if SOMETIMES it can just happen once and never again.

Yes, it is possible. See my previous post:

It is possible that an event like this could be singular, without recurrence, but your OS will best be able to advise you.

Orthodoc

 

[Jamie]

I wouldn't risk it....I'd have the surgeon take a look just to be reassured that all is okay.

 

[djklaugh]

@VThereandnow Hey Cathy just checking in to see how you are doing. I hope that you are doing well and what ever that spasm thing was now is sorted out and no longer a concern.

 

[VThereandnow]

Thanks Deb @djklaugh and so sorry for the delayed response. I have not been on the site much. I know myself and know it is hard for me to not compare to others (though I understand the logic of not doing it), so I needed to stay away to take care of myself emotionally. I hope you are doing well. You remind me of the energizer bunny. Hip, shoulder etc and you just keep on going

First, there have been no other bizarre incidents. Took me a week to feel comfortable again, but that was because I was now putting meaning to every little physical feeling. Had my post op a few wks ago, and of course all looks good. When he said "the X-ray looks great", I now know that does not mean much haha. My X-rays looked great all along. Really only time will tell. I keep talking to my hip and saying " I hope you are doing what you are supposed to this time", meaning grow in properly. It takes 12 wks for that initial bone growth to happen so hopefully it is happening.

Still much better than the first surgery in initial recovery but now at 7 weeks out, I feel like the honeymoon is over and the reality has set in. It is going to be a long haul for me. Back in the pool 3x a week, once with my PT and the other X on my own and another day on land with my PT. Progress is very slow. My glute min and med, from the whole experience, are extremely weak and hard to get engaged. Before surgery, when I was trying to figure things out I did have some muscle tests done and they are working, just very weak. I do worry though about them ever truly coming back, but I have to just keep believing they will or I would not have the energy any more to keep trying to get better after all this. I am still using a cane and do not see me getting off very quickly. I know I feel better than before surgery with the loose cup, but I feel a bit worse as I do more, some in my hip, and then my back. I still have my LLD, though it is less than before, and since he wants me to not do anything about that for a while, my back is hurting a lot these days. Can't really tell how much is from limping and how much is just because it is screwed up from things. On that front, I am working on losing some of this weight I put on as I know it will help my back issues. Again, a slow process but in my case everything is going to be slow but hopefully steady.

Trying to get back out in the world again. Went back to my meditation group last week (doing the home meditation has helped me tremendously) and my Brazilian drum group on Monday. It was nice to be welcomed back by everyone and felt good for my soul to drum. Now the big challenge for me is to keep the faith and keep doing things to keep my spirits up. It is hard to be doing the same things and expect different results, but like I said, if I don't believe , what do I have? In reality I have been pretty positive, though it was a sore morning so this note does not fully display that.

Guess my signature still holds true and I just need to surrender to it

 

[djklaugh]

@VThereandnow ((((((Cathy))))) It's wonderful to hear from you! And I'm so glad things are looking up for you. It does sound like a lot of work and slow progress - but slow and steady does win races And yes your siggy does hold true!!

The meditation group and the drumming group sound wonderful! I love drumming myself though I do a Native American style. One of my friends from when I was working use to be in a marimba band as the drummer and it was always such fun to watch and listen to the group! Yup drumming - any music - is good for the soul

 

[Poppet]

Hi Cathy, @VThereandnow so pleased to get an update from you. Come back occasionally when you feel like it.

Take all the time you need to build up your strength, your job right now is to relax and recover. Recovery is hard work - but you're not alone. Not a day goes by that you aren't thought of and wished well. With your courage and determination, you will win this battle both physically and emotionally my dear friend xxxxxx

 

[sharonslp]

Cathy, at one time my glute muscles were dead. Not weak, not playing possum; the word my doctor used was dead. But after 3 months of PT, they all perked right up. Yours will too.

BUT BUT BUT BUT BUT.....
At 7 weeks out, you are still so fresh and new. Please don't make the mistake that so many of us make, and in that push to have PT get you strong again, you end up creating new soft tissue issues. IT bands, bursitis, nerve impingements, and so on. You've read enough here to know what all can become a problem. More often than not, it was avoidable by just slowing it down in the beginning. I know....that's not your style....but think about it.

I hear you saying you are still limping. If you are using your cane, and getting adequate pain meds, then your gait should reflect that. Are you still medicating? Do you maybe need to tweak your pain med regimen to get more effective relief? Getting the gait normalized will go a long way to helping your back problems.

Take care, friend. Just want to hear that you're getting the recovery you were hoping for.
Sharon

 

[VThereandnow]

Thanks women. You've got some good points Sharon ( as usual). I actually did cut back pain meds rather abruptly but then got back on track with tramadol in the morning and regular scheduled Tylenol thru the day and if I need more than that I take it. ...and I have gotten much better this 2nd time around at laying down when I need to and taking it more easy at home. Of course the polar vortex weather has helped me not feel like running around. I am not in the crazy pain I was before surgery. I don't think I am doing too much, in fact my PT has been with me from the very beginning and is actually fairly cautious. I guess I was fooled by the beginning of my recovery. After surgery I was feeling no pain in my back (it was glorious) when walking with walker, being on oxy, having the anterior approach etc. It makes some sense that I now would be feeling the effects of my LLD on my back and the activity in my hip. After my past experience (loose cup, early subluxation) I have to keep myself from making meaning of certain pains when I get them. It is almost like a little PTSD, but not really, but you get what I mean. I keep thinking something is wrong, then have to pull myself back and be in the moment.

Thank you Sharon for talking about you glutes (sounds odd lol). That is encouraging. In fact I was telling my PT (Beth) so we kind of tested a bit yesterday and noticed that when doing certain things, having my hand on my side, we could actually finally "feel" some engagement. I am going to have to learn how to focus in and celebrate the small gains, as mine won't be leaps and bounds, and I need to be ok with slow and steady. Also, we are going to take a separate day for Beth to look at my back reports, scans etc, to see if there is something else I can be doing along the way to help my back, and make sure we are not doing things to hurt it. I like this plan, because even though she knows I have degenerative stuff in my spine, she has never really seen the actual reports or the specifics.

It is kind of weird this time and great, that there are certain body things that are so much better than last time because of the anterior approach that it kind of tricks me into thinking other things should be coming along quicker. At my post op he told me not to compare to a regular anterior surgery and that even though they were not replacing the stem, my recovery would be slower but ahh the mind still plays tricks on me. I keep saying to Cheryl I don't know where I am supposed to be as far as recovery. She says "you are where you are, and that is where you are supposed to be". Another wise one right? Lucky I have that reality check right here at home.

Thanks again all, I truly appreciate your feedback and your time listening.
Cathy

 

[Z15]

Cathy,

I think you can piggy back Cheryl's wisdom with your signature tag line for an end to end perspective...

You are where you are, and that is where you are supposed to be....Everything will be all right in the end, and if it is not all right, then it is not yet the end

We keep working on things and hoping for more forward steps than otherwise, but the otherwise is gonna happen to all of us. Perhaps you need to check your progress QUARTERLY so as not to get wrapped around the little sideways movements that we all "enjoy".

I'll keep monitoring your status my friend...

Z

 

[Poppet]

Slow and steady.... Me too!

 

[calikat]

She says "you are where you are, and that is where you are supposed to be".

I love that!

 

[VThereandnow]

Hey my old peeps, Let's recap shall we? And fill u in on new fun happenings
@Josephine (bottom in red surgeon recommendation)

3/2012
INITIAL THR (posterior)
3/4 inch LLd, & Much much struggle
Unresponsive Surgeon

7/2013
NEW SURGEON

9/2013
nuclear bone scan showed loose cup
Research, Another opinion, Confirming Loose cup
Stem is properly placed and not loose

12/2013
Revision surgery to replace ball and socket (anterior)
Try to get more even leg length
2wks out muscle spasm with PARTIAL DISLOCATION

Otherwise, Initial recovery very good, much better than 1st surgery

5/2014
Recovery going great, cept for glute min & med
Can't get off cane though otherwise feeling great
(PT, land &water, anti-gravity treadmill, biking etc)

6/2014
Pondering muscle tests as glute min/med totally not coming back

6/2014
PARTIAL DISLOCATION (pivoting-day after some gardening)
Took me to the floor :(
friends jamming pillow between legs popped it back in

7/2014
Finally felt comfortable resuming activities
PARTIAL DISLOCATION (standing, not even sure if I was pivoting this time)
Was somewhere I could support myself, and eventually it Popped back in

Back to doc (mine out of town, saw someone else)
PELVIC CT
Atrophied glute min/med & fatty infiltration starting on glute min
Shows cup properly placed, bone grown in well
2 screws partially sticking out the back of my cup

8/2014
SURGEON APPT/ RECOMMENDATION/EXPLANATION
Would have thought muscles would have come back by now, they have not, cup is absolutely properly placed, verified by scan. Having shorter leg length and weak muscles causing slippage. He is recommending CONSTRAINED ACETABULAR LINER. Feels I would have good results as my cup is not malpositioned and he would only be replacing liner as cup is grown in solidly. Most fail because surgeons are trying to use ring for wrong reasons, such as trying to compensate for badly placed cups. He assures me this is not the case. Why have muscles not come back? Could be because I walked around so long with the long leg and loose cup, could be they are just over stretched now. Sometimes they just don't come back even when there was not as much initial trauma as I had. Will they ever come back? Maybe, maybe not, but they have not up to this point, it is going on 8 months and now I have instability. He feels it will keep happening and wants to do something before it comes all the way out and damages something else.

Yes, I do know there are ups and downs to the locking ring, and yes I do know that much instability is caused by improper placement of appliances, but it is also many times due to muscle weakness. I do know I could just keep trying but I will tell you, when it pops out it is totally nightmarish and yes, I do know he is a surgeon and surgeons suggest surgery. I must say though that this being my 2nd surgeon, I really like the guy, trust him and feel he does his homework etc. I probably will get another opinion but wondering what people know about the locking ring. Mine will be

Any thoughts on the locking ring would be appreciated- the revision cup I have is DePuy Pinnacle Gription -please be a bit gentle so as not tip me over the edge where I am tetering
Cathy
(And thx for reading)

 

[Jamie]

It's so nice to hear from you, but I'm terribly sorry that things are still challenging for you! I think Jo is your best bet for advice and I see you've tagged her. She should be along soon. In the meantime, I'm sending you hugs as you move forward with this decision. You say you thoroughly trust this surgeon, but you might consider getting another opinion anyway just to be sure this is the best option.

 

[djklaugh]

Ye Gads, Cathy! I am so sorry things have not been going well for you! I think of you often and have been wondering how you were doing .... and so hoping to hear you were off doing fun things! Hopefully Jo will have some positive input for you ... and I will be sending up prayers and sending you good vibes!