THR Newbie limping in on the pathway

[Autumn01]

Hiya all! So glad to find such a rich resource.

i be new to all this. baulking wide eyed with fear at the mountain before me. I am taking it step by step.

My left hip has conjential hip dysplesia. It went arthritic from roughly 2006 after a small running slip (but no fall). I managed to somehow keep running and slowly sink into arthritis till last few weeks when finally I struggled to walk and now finally diagnosed. I am now using a walking stick for support, taking otc pain killers when i have some shopping and other stuff to do. my heating pad is helping tremendously.

however my comlication is I am stuck in Greece thanks to lockdowns and a Mom (recently passed), who had retired here in Greece and had dementia and needed my help and presence. So its interesting to have this new thing thrown at me, trying to find a surgeon and deal with logistics with my family in UK…facing suspect fourth wave covid and more lockdowns.

the good side is, i have savings and can pay to go private to avoid years of backlogs both here in Greece and UK. I cant wait…its bone on bone now! Until august when my Mom passed, I had no option and no possibility for dealing with my increasing problems. She needed me. Lucky it lasted! Within weeks of her going, i am barely mobile!

because costs are half what they would be in UK and because I have grown to understand that the doctor’s technical skills here in Greece are top class, I am venturing to investigate Greece. I have worked all over the world for my career in IT pre retirement, so all this gadding about is quite normal for me.

the challenges are many….lack of language, lack of support, lack of knowledge….. when I was consulting the challenge was where to find a supermarket and identify milk (non Cyrillic), pay electricity etc

anyway. This too will pass and one step at a time the gordian knot will unravel. i have few years left and I would love to return to day hiking, overnight camping and if possible a game of sedate tennis!

So far i have found a top surgeon that operates both in Greece and UK. I have more discussions tomorrow to firm final date for November. It will be minimally invasive surgery. with my dysplesia i had no idea I had…..I am relieved this is still available to me! I have a choice whether to use the navi machine for cup placement positioning or just go with his skills. I feel the navi might be more for my comfort so have left it to him to decide! Its an extra 1.5k payment and different hospital. I need to decide if I should stay on my own and hire help in Crete where I still have an apartment I rented to be with my mom before she passed, or return to UK and be with my daughter. Since its winter it doesn't matter much ….unless the UK plunges into power failures and struggle with the food shortages that I am reading about! It's just a hindrence factor now i add to my long list for decision making. I am leaning on the return to UK because i can do some sewing to while away the hours. and because i will have all manner of conveniences available that I wont have in Greece for the winter months of initial recovery. And I will be less of a worry for my daughter! Since my doc has a practice in Coventry UK, there are no problems with additional prescriptions as needed. and I should anyway so my UK phone gets a reset and stops thinking I am out of country too long and applies all manner of extra payments and cuts my data..

meanwhile I am preparing! I have a walker, a walking stick….! My bed is high enough…UK bath is high and I am short, so if I go to UK, no showers there then!! I need to see about getting supply of ice. I will probably go for the instant cold bulk buy packs.

i have read and am reading….i get a short term advantage with the minimal invasive stuff but will still need to observe own body recovery ‘slow is good’ pathway. But then I figure if I can minimise muscle and ligament damage…its all good cause there is less damage to heal. but its up to surgeon and the joker card of fate while in surgery. Stuff happens they say!

Enough for now…. Just a peep to join up and both add my experience and take your advice.

later y’all!

 

[Autumn01]

i take aspirin as a blood thinner now as my circulation is poor, but I will stop nearer the time. I am at sea level so it shouldnt cause problems going without. There are other things that also act as blood thinners so I should research to weed them out and also cut out. very likely they will inject me with blood thinners after surgery, as I will be inactive anyway. Vitamin C acts to help stop bleeding so i aim to ask doc about taking that on day of surgery. Sometimes they let you pop your medication without water, so maybe he will allow a couple of vit C pills.

 

[Going4fun]

Don't get too invested in the "minimally invasive" label. Hospitals are putting that label on all kinds of surgeries. That's just a label. You will still undergo serious surgery and have a recovery process like the rest of us.

Just find a really good hip replacement surgeon, period.

 

[subie2021]

Not to mention no good surgeon goes in thinking "I'm going to open this patient up as wide as I can, and then mess with and disturb as much tissue as possible."
Almost all surgery is as minimally invasive as the surgeon can manage to get the job done.

 

[Autumn01]

Thank you! Point well taken!

i had a discussion with the surgeon last night and from one day to the next, the entire scenario changed hugely. sunday he mentioned I could fly back to UK for post operative period within two days. That had me immediately make plans for immediate surgery and not wait till kids have holidays to use to help me! Next discussion…its minimum 6 weeks plus all usual precautions and limitations…..no bending etc yadda yadda! AND crucially he said as a throw away sentence…i may have to let one tendon go! Say what?! I dont react..i take time to consider….but I hear perfectly well!

i reached out to him to find more info in superpath because I am alone, no help and collapsing congenital hip. So no option here…need total hip and soon soon!

so its the mini posterior approach!p he offered! To me the mini and the old approach is length of scar. Who cares! Make it my total body. I had my youth to show off my prettiness…i am becoming an androgynous crone…but with my eccentric colourful ways!! But cut muscle, cut tendon, dislocate hip…. All very dramatic and sounds like a fight between bone crusher and meat mincer! I am on the block with no one to help. Not going to end well!!

so as the saying goes, if you dont like the result, dont do the action. I dont like the result of this mini posterior. The meatmincer will win! i will cause me more damage by having to push myself a little more looking after myself.

Not going to happen. back to start line.

i did ask what happened to the superpath option which was the reason I reached out to him? Waiting for reply….

<sigh>. The plans of mice and men. <Sigh>

 

[Mojo333]

Hope you don't mind me lending my thoughts ...
but first, I'd like to say I can only imagine how hard it was caring for your mother away from your children during a pandemic (with all that has come with it) with a bad hip.
Thinking on my own recovery, I couldn't imagine having to make a flight the first 8 weeks in which time I was fully independent and the only support I needed from loved ones was mental and emotional.

Regarding the approach, you want a great surgeon who is and does what he does best.
Recovery lines with different approaches converge fairly quickly as we look at longterm recovery.
You deserve to have someone look after you in the short term, in my opinion.

Wishing you comfort as you make your decisions.
Strong independent folk (I consider myself one too) can struggle with the first weeks particularly.

Thankfully....all temporary.
Once you get that new hip settled, your world is yours again.
Then...like Lennie we can find our happy place...
An' have rabbits.... "...we'll have a big vegetable patch and a rabbit hutch and chickens. And when it rains in the winter,...we'll build up a fire in the stove and set around it' an' listen to the rain comin' down on the roof

 

[Layla]

I’m sorry for the loss of your mom.
You have a lot to consider. My only advice would be to be where you feel you’ll be most comfortable after surgery…and that may be near family members or friends that you can count on.
Wishing you lots of comfort as you ponder it all and firm up plans.
@Autumn01

 

[Autumn01]

Well i chatted to surgeon some more. I guess my reaction was hugely that i wouldnt be able to fly to be with my kids to recover and they have difficult period with work so cant take chunks off …I cant wait…so everything just became additional friction. He wont ok a 3 hour athens to london flight for six weeks. Real Big Bummer!

But I got to do what I got to do. Becoming an invalid is not the way I want my life to go. I have a choice, I walk my road.

i have firmed my date to 23rd…one week later…to allow my daughter to be able to fly down and pick me up from hospital and spend first 10 days with me.
after that ….. we will see.

at worst I will organise local takeout to deliver food to me and the expat community here is superb so I will be able to find someone who is in need of some cash to pop over and help me for an hour or so a day. Otherwise…hey…soup cans etc for another ten days it will be! i will pop my eyes out watching old favourites….i am eyeing ‘walking dead’… and maybe ‘greys anatomy’…its been years!

its a mini posterior with navi system….. stryker ceramic titanium implant…..i looked at the navi system online youtubes…. Very seriously interesting! i am crossing fingers the implant corrosion problem is now fixed! there are no active recalls i can find for this.

anyone who knows anything current…..let me know now please!

 

[subie2021]

I don't know if Mako and Navi are the same thing, but I had Mako robotic assisted surgery seven weeks ago, also with titanium and ceramic replacement parts and a posterior approach.
Recovery has been easy outside of being a bit out of it a few days post-surgical, meaning a bit weak and feeling off balance. I think that was all drug related. I appreciated the help of my daughter and DH for about 3 days but after that was able to function solo with a few aids like grabbers and sock aid etc.
I had log leg that gradually diminished with a few simple exercises, and some swelling that didn't bother me much except as it was absorbed I was making frequent bathroom stops.
My surgeon gave me restrictions related to to the posterior approach, no 90* bending, no leg crossing, abduction wedge or pillow for sleeping. Annoying, but not all that bad.
The minute my other hip goes bad, I'd be happy to sign up for the same surgery.
Good luck to you!

 

[Autumn01]

Hi Subie

Mako is the robotic US integrated system, it takes in body measurements and defines the strict parameters the doc can use and wont allow any deviation. So cup placement is very accurate. The doc explained that they would send my CT scan to US for the company to return the specific Mako instructions to feed into the robot for surgery.

the Navi doesnt need this. It is a hand held and computer based system which is not as defined as the Mako, but is just as good.

at 40% more in cost I suppose because of the CT scan and other propriatorey charges. I felt happier with Navi.

good to hear about your swift return to independence! Its really encouraging! I hope to do similar.

look i am not happy with the posterior approach, from what I read, it has its negative and those hit me the worse. Muscle and tendons are hit. It will take time for body to heal. Maybe much less time with new updated technical refinements than old conventional and I can only hope so. because i have dysplesia complication i am allowing that to dominate and not running about finding a surgeon to force anterior approach. I am more concerned about the surgeon having good visibility, doing a great job with what he finds and resulting for me in accurate cup placement.

any other approach actually feels like a short term short cut that will cost me dear long term with dislocations because of poor cup placement in a squiffy hip.

ugh! to abduction wedge! i havent yet got my post operative orders! someone is getting in touch to discuss all that stuff with me.

Looks like I wont get any sleep for a couple of nights! i guess I will be so uncomfortable not being able to shift to my preferred sleep positions, I will be totally distracted and wide eyed most of the first couple of night! the brace also doesnt look like it helps easy bathroom visits!

 

[Coddfish]

Hi @Autumn01
Just to reassure you a bit about the posterior approach. I had THR right hip 8 weeks ago with posterior approach, nice 10 inch long curved scar on the thigh. It gives the surgeon the best access for the operation, so you reduce the risk of nerve damage. It’s also a quick in and out (my operation took all of 50 minutes from when the spinal went in to when they wheeled me into the recovery room, and that included time to chat to the surgeon about what he had done). I suspect it’s no coincidence that I had no bruising, no swelling, and achieved a speedy recovery. 8 weeks on I am more or less back to normal. My surgeon separated through my glutes but cut (and repaired) my piriformis and a couple of minor tendons. It meant I had some weakness in my groin but that is gradually resolving. The risk of dislocation reduces fairly quickly and I didn’t find the restrictions a huge problem.
On some of your other points, I was advised not to fly at all in the first 6 weeks and not to fly long haul for 12 weeks. I definitely wouldn’t have been able to get into a shower over a bath, I was very grateful for my large walk in shower.

 

[Autumn01]

I delayed my op to 26 nov because i made a decision to upgrade myself to Mako pathway. i have given every possible assist for a good cup positioning outcome so if anything goes wrong, its not because i have savings but was scared to invest in my well being!

meanwhile I am taking things easy. I cant walk much anyway and I dont want anything going wrong. My heating pad helps a huge amount but nights are difficult because leg gets cold. Cranking up heat makes me overheat so that heat pad helps somewhat. Otherwise i am isolating mostly to avoid covid in case of delays, streaming series and dreaming of a good summer to come!

 

[Mojo333]

Hi @Autumn01
My heating pad was my go to leading up to my surgery, also.
Though nothing ever really touched that OA pain, heat was comforting...
Glad you are comfortable with your decision and hope the rest of the month flies by.

 

[Autumn01]

Hiya Mojo! My pain subsides! Maybe cause i am frying it! Its a fight between the sizzle of overheating flesh on bum and the dull ache of bone….

 

[Autumn01]

Hi All. I have a question. Doc here is proving non supportive. I am freaked out at the expected pain, don’t feel supported and don’t feel ready. Doc says …he will give me a script… paracetamol maybe anti inflamatories…I will be fine he says.

I sent word back via assistant I need to talk again about pain meds. Not happy. Don’t feel I will have enough ammunition to manage having read what everyone on here is taking and still in pain.
When I mentioned to him that I will take ibuprofen if he doesn’t give me enough stuff…he was horrified. They hate ibuprofen…all the docs have the same horror reaction here when you mention it. But then he thinks paracetamol enough.

I read ibuprofen 600 mg. can be taken with paracetamol because different organs process them.

But will it be enough?

I will be THR mini posterior, cut muscles, ligament … so facing pain.
I don’t want to delay but I am really worried.

 

[Mojo333]

When I mentioned to him that I will take ibprufen if he doesn’t give me enough stuff…he was horrified. They hate ibprufen …all the docs have the same horror reaction here when you mention it

My Surgeon prohibited NSAIDs like Ibuprofen for the first few months after THR due to studies showing it may interfere with bone growth.
Many hippys have found a tramadol/tylenol regimen to be very effective.
I took this combo early days...
Perhaps you can try to ask about it if the doctor is reluctant to prescribe stronger opiates.

Ice really was the best pain reliever for me along with maximum dosage of Tylenol.

 

[Coddfish]

@Autumn01 My surgeon / hospital prescribed paracetamol rotating with ibuprofen. The ibuprofen was effective, not sure the paracetamol did anything much. I didn’t have opiates after trying oxycodone and then codeine whilst I was in hospital - the former made me vomit and hallucinate, the latter just made me feel weird and spaced out. Decided I wasn’t having any form of opioid ever again after that (this being my first encounter with any of them). I didn’t find I had excessive pain, I just needed to ice my groin on a handful of occasions in the first 2 weeks.

 

[Jaycey]

@Autumn01 I was discharged from hospital taking only anti-inflammatories and paracetamol. My first THR was posterior as well. I wouldn't be too concerned about this. Staff will work with you while you are in the hospital to get any pain managed.

 

[Autumn01]

Thank you everyone. I dont want opiates.

I am stocked up with one box neurofen (ibuprofen) express…640 odd mg per tabled. I used two tabs of that already some weeks back, so know they work a full 8 hours per tab. I was really quite amazed. I will pop in and get another box morning.

I know there are products that bind paracetamol and ibuprofen together but I like the flexibility not to take if I am ok for a few hours.

And inform doc!

I sure wish I had explored some cannabis products for pain control. There just wasnt time. But knowing now I am aging and may need it in future, I will start investigating to find a brand with consistent high CBD.

I am hesitant on anti inflammatories and ditto on icing because they both prevent the body doing its work to clear the area out. They help for pain, but delay healing. I will be more inclined to do icing to lengthen medication out…so a 75:25% approach during the day. Icing reduces those chemicals in my body…so a healthier alternative.

On the other hand I have read the research on ibuprofen ‘maybe’, ‘might’, ‘could’ delay bone growth…but only a small % less according to published research. Since its only for 6-7 days, if that, i will take that reduced bone growth loss risk. I know ibuprofen stays in the bloodstream for 24 hours so cumulatively its a problem on kidneys…but I will try hard to mitigate and again…. Its only a very few days. People with problems take it daily for months and years. This isn't the case here.

All this in a country thats still steeped in tradition of antifeminism! The doctors are excellent, but they arent used to females and probably not even males asking questions of them. But here I am and here I draw my line.

 

[Autumn01]

Jaycey the reason i am more than concerned is that in May/june this year My mother was in Hospital in Greece with a broken femur. She had dementia so I had guardianship and was looking after her. She died in August. They first refused to operate and wanted to have her remain in bed the rest of her life…she was 84 yrs! They said her heart probably couldnt take it…but they handnt examined her and they knew it and i knew it. Then when i threatened with press they smartly changed, examined and operated…and then it was the battle with pain meds. Poor mom was in awful pain. It was paracetamol only 1000 mg twice a day. End of. No anti inflammatories, icing either. They refused to allow me to give her ibprufen. I was scared to intervene and land up losing guardianship over her. She suffered hugely! The doctors said it was only for 7 days and then the pain would stop. So thats their reason. The nursing staff of course defer to doctor! And not only that but they took pleasure in delaying her medication for hours.

And here I am now walking her path. Almost like karma!

UK has five year backlog and twice the price to go private there. The doctors here are far better but there are cultural problems. Their bedside manner is in dire short supply.