THR Not sure if this is normal fatigue

[KathyD]

I am 7½ weeks post op. I went back to work at a sedentary job 3 days a week at 4 weeks post op. My commute is 70-90 minutes each way. I am doing PT but nothing too extreme.

I have been taking duloxetine for depression for about 6 months which makes me tired also. I am having night sweats. I am exhausted. Now that I look at this all written down, I can see why, but I don't remember being this tired when I had my first hip replacement 2 years ago.

 

[Layla]

Hi Kathy, Welcome to Recovery once again.
I'm sorry you're struggling, feeling down and fatigued. A Phased Return to Work at twelve weeks post op is what's recommended. Its understandable that for various reasons, all aren't able to take the full twelve weeks that's advised. I'm sure going back at four weeks post op from major surgery is contributing to your exhaustion. A 70-90 minute commute each way is a long drive. Many are uncomfortable sitting in a car that long this early into recovery. In addition, it can be stress inducing, which is also an Energy Drain.

Wondering if you've spoken to your OS, or a member of his team about your night sweats and whether it's a side effect of something you're taking?

PT is really unescessary as noted in the Big Tip from the Recovery Guidelines below -

BIG TIP: Hips actually don't need any exercise to get better. They do a pretty good job of it all on their own if given half a chance. Trouble is, people don't give them a chance and end up with all sorts of aches and pains and sore spots. All they need is the best therapy which is walking and even then not to excess.

Please read the Recovery Guidelines and pay special attention to the articles on Energy Drain and Post Op Blues.

Stop back often, we'll be here to offer support and encouragement as you continue to heal.
Wishing you comfort, some restorative rest and brighter days ahead.


Hip Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:

rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)​

3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.
4. PT or exercise can be useful BUT take note of these

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

Activity progression for THRs​

6. Access to these pages on the website

Oral And Intravenous Pain Medications
Wound Closure​

Pain management and the pain chart
Healing: how long does it take?
Chart representation of THR recovery

Dislocation risk and 90 degree rule
Energy drain for THRs
Pain and swelling control: elevation is the key

Post op blues is a reality - be prepared for it
Myth busting: on getting addicted to pain meds
Sleep deprivation is pretty much inevitable - but what causes it?

BIG TIP: Hips actually don't need any exercise to get better. They do a pretty good job of it all on their own if given half a chance. Trouble is, people don't give them a chance and end up with all sorts of aches and pains and sore spots. All they need is the best therapy which is walking and even then not to excess.

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice. @KathyD

 

[Eman85]

I wish I would have done more of a timeline documentation but I do remember a tremendous lack of energy and stamina. I didn't go back to work but just basic things around the house wore me out. I know I still had room for improvement at 12 weeks.

 

[Going4fun]

Sorry to hear of your fatigue ... you're back at work ... I'd say drop the PT ... Your movement at work (even in a sitting job) is your PT ... and a 70-90 minute commute each way ... that's pretty brutal on a hip in the first few months ... PT, early return to work and a long-commute---You're pushing things ...

Definitely drop PT ... Did you tell your surgeon about the night sweats? ... Don't know anything about duloxetine ... know a ton of people on other antidepressants ... but not that one ... which is Cymbalta right? I can't tell whether you think you are still depressed? ... Definitely report your mood to your prescribing doctor. Antidepressants, like all meds, have to be tried out, with dosages tweaked and adjusted (and sometimes medications changed) until you get to the optimal regimen.

I would be exhausted in your situation ... but I don't like those night sweats. Definitely report fatigue and night sweats to the surgeon, or the surgeon's nurse or PA.

 

[Debru4]

I think @Going4fun made some good points:

Not everyone can control when they return to work, or the distance their job is from their home. But you can control the PT and outside activities, so maybe you could look at that piece? It might the small thing that is tipping the scale.

I have only had one replacement, but I understand that every hip is different, so it sounds like all of the variables with this replacement are really slamming you. Kudos to you for being aware of how important it is to address depression---sounds like a visit with your doctor might be in order to see if your symptoms may be elated to meds, or to the replacement itself. That would probably be what I would do. Good luck.

 

[S00zd]

Hi Kathy. It sounds to me like you have an immensely tiring life at the moment and one which is likely to cause fatigue. That commute sounds hideous, by whatever means of transport and wearying in itself. Can you discuss with HR about doing fewer hours until you have recovered a little more? I'm amazed at you doing so much and I'm only a week ahead of you and just 2 years older, so you are doing really well-but also paying the price. i came on here for the first time only 2 days ago for the first time with a big string of issues and was greeted by many calls to "do less, back off" and already things are calming down for me!
Your GP would be a good port of call as regards you sweats and the medication. I suddenly developed night sweats in hospital until the penny dropped that I had abruptly stopped my HRT. Could there be any link for you?
Wishing you all the best and good to see you here. It WILL get better.

 

[Jaycey]

@KathyD Be sure and read the article in the list Layla left you on energy drain for THRs. It's real and you just can't fight it. Since you went back to work very early out you may have more problems due to the fatigue of that activity as well.

 

[KathyD]

Thank you all for your replies. It makes feel better - I thought either there was something wrong or I was just being a wimp. I can't control my job - I went back early because if I don't work I don't get paid so I could not afford to take more time off. I only work 3 days a week so I can rest in between more than I have been.

 

[Layla]

Hi @KathyD
Rest assured, the fatigue can happen, especially given your early return to work.
Our body's energy supply isn't limitless. So when we're in healing mode after major surgery
our energy will be used for healing first, not leaving a great reserve for all the other activity of daily life. It is completely normal to feel tired for quite some time. How long....most likely relates to your body's rate of healing. Making our best effort to get adequate sleep and rest is beneficial.
Our body does it's best healing while we're sleeping.

It's good to hear you are taking advantage of your free time by resting in these still early weeks of recovery.
It will get better!
I hope you have a nice week

 

[SaraK]

I agree with @S00zd that the night sweats could be hormonal related. I started having more issues with night sweats (and day sweats) after my second THR. Anesthesia and surgery seemed to affect me in what would seem like unrelated ways (much like pregnancy did lo those many years ago). It's at least worth a conversation with your internist to see if there could be a hormonal component and whether there might be a treatment to consider.

 

[Mojo333]

I thought either there was something wrong or I was just being a wimp. I can't control my job - I went back early because if I don't work I don't get paid so I could not afford to take more time off. I only work 3 days a week so I can rest in between more than I have been.

That's how I had to do it too
Just take all off time and do Nada!

Healing Mojo coming your way

 

[Josephine]

I went back early because if I don't work I don't get paid so I could not afford to take more time off.

That's okay - just make sure you don't do anything BUT the work those days.

 

[desertrat]

4 weeks is awfully quick to go back to work. I was exhausted the first 4 weeks and slept 10-11 hours a night and still needed extra sleep after that. I needed it and felt like it was part of the healing process. Fortunately I didn't have to rush back to work - I don't think I could have. Please rest on your days off like everyone else is saying. You're not being a wimp.

 

[KathyD]

Thanks, everybody. I was planning on going to the pool since I got the go ahead to get in the water 2 weeks ago, but now I think I'm going to put it off for another month or two. I am getting cabin fever since we have had so much snow here in the Colorado mountains (no avalanches where I am!) but there is a track at our rec center that I can walk on. I have today off, which is good since Thursdays are my busiest day with the longest commute. My hip doesn't hurt with the drive anymore except for a little stiffness. Thank goodness for car seat heaters!

 

[SurreyGirl]

My car seat heater is a hot water bottle!

I am now swimming again and find it really helpful and therapeutic. I still get stiff if sitting too much at work but am making progress. I think swimming is helping loosen things up. Walking too but I do pace myself if I get tired after work and driving..

You are only two months out so still have a lot of healing to do but it will all come eventually!

 

[Layla]

Happy Two Month Anniversary!
Glad to hear you can sit in the car comfortably. Long car rides can be really uncomfortable early on. I know I struggled for the first few months.
Enjoy the three day weekend and your walk at the rec center if you go.
Stay in touch.
@KathyD

 

[KathyD]

I walked a mile today at the rec center. It felt good - no pain or lightheadedness like the first time. We'll see how I feel tomorrow . I am getting serious cabin fever, though. I have finished sorting my clothes for Goodwill and I am tired of watching bird nest webcams (although the babies are cute). I do have a bunch of yarn stashed. Maybe I'll crochet an afghan.

 

[KathyD]

I forgot to mention that my hips have names. My brother started this. I was very anxious about my first replacement so he thought it might lighten things up if he gave my hip a name. He called it Helen. So I thought it only right that the second hip had a name. I called it Troy. So now I have Helen and Troy (instead of Helen of Troy)

 

[S00zd]

Doesn't that make you the wooden horse?

 

[Debru4]

It is hard to get into the "It's OK, and even can be fun to rest and not do much" mode. Just because our hip has slowed us down, doesn't mean our minds are there too. But when you think about it, what a gift to be able to sort clothes, watch webcams, and maybe even crochet some.

I have to admit I eventually got into that mode, and enjoyed it a lot---perhaps too much. Now that my hip is doing so well, I am having to remind myself to fire up, and get back into a bit more of the "doing" mode!

Glad to hear your walk went so well---by the time spring rolls around your hip should be ready to roll as well!