THR Now POST-op

[cannygirl]

I haven't had the concentration or energy to post yet but my journey so far:
My surgery was nearly a week ago and I was well cared for with appropriate pain meds given when I needed. This was a a very different experience from 3 years ago when I had a TKR where, despite being written up for strong opiates, I was not allowed to request them until the point at which they should be given (eg 4 /6 hourly) when there was invariably a long delay and a search for the nurse with the keys to the drug cupboard! I have been discharged with 2 sticks and 2 toilet raisers. Since returning home I have bought a grabber/dresser hand and a gadget to pull on compression stockings. My husband is trying hard to do 'total care' but it is difficult for him as he has not experienced any disability and finds it difficult to imagine....and I hate to keep asking for things. This morning it took me 2 hours to shower and fully dress on my own using all my gadgets. Exhausting but successful. I have slept almost all day since!

I have an urgent question: I find the night time so painful and uncomfortable. I am using Oramorph at night as it worked in hospital but
a) I am not sleeping and am restless - waking every hour,
b) still in pain mainly in my lower back and in the knee of the operated leg (this may be referred pain but is persistent.)
c) my sister lent me a large, heavy pillow to allow me to lie on my side
but I do not know if it is too soon to do this. I am alway on my side when sleeping but am unsure of the best advice on this.

I am seriously dreading another night and wonder about staying in my recliner instead.
any help please?

 

[djklaugh]

@cannygirl Alas sleep issues seem to be the norm after joint replacement at least for the first week or two. I think you would be OK to try the big pillow and see if that does help you sleep better. I know quite a few other members here have used similar pillows with good results. If that does not help then try the recliner.

Are you elevating and applying ice or cold gel packs to your new hip? It might also help to spend a half hour or so icing and elevating just before going to sleep.

It's really good to hear that other than the sleep problem you are doing well

 

[cannygirl]

Thank you Deb,
I will try the ice, elevation and side pillow tonight and see if that improves the night.
So far, I haven’t experienced anything like the pain of the TKR for which I am profoundly grateful

 

[Jaycey]

You might be more comfortable in your recliner. Many of our members spend the first weeks sleeping in their recliner.

Sounds like you might be under medicated at night. Do try icing and elevating. I took an ice pack to bed every night during the first weeks. Ice is a natural pain killer.

Here are your recovery guidelines:
Hip Recovery: The Guidelines
We are all different, as are the approaches to this recovery and rehab. The key is, “Find what works for YOU.“ Your doctor(s), physiotherapist(s) and BoneSmart are here to help. But you have the final decision as to what approach you use.

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 this BoneSmart philosophy for sensible post op therapy
5. Here is a week-by-week guide for Activity progression for THRs
6. Access 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.

 

[cannygirl]

Hi Jaycey
I felt SO relieved to get your response. ...rather as if a load was taken off me and I could breathe again. I’d forgotten just how much you made life bearable when I was in a real mess with my knee. Thank you so much. Tonight in the recliner will be a relief. I’ll remind myself of all the advice tips.
thank you, thank you

 

[JohnWilky]

I was reluctant to sleep on my side ( well documented) and waited till I had post op appt ( 8 weeks ) with surgeon before clearing it with her for direction , which I got the go ahead.
Sleeping on your back is tough , just very uncomfortable as is just relaxing .
But the great news is cannygirl is that all passes ( 11 week today ) and you will be stretching out soon enough, follow the fantastic , brilliant caring sensible advice from Bonesmart experts and you won’t go wrong.
I don’t brush my hair without referring to Bonesmart
Good luck C it will get better day by day .

 

[cannygirl]

Thank you for your encouragement and there is hope out there

 

[BellaMac]

I'm glad you are home and doing well!!!!

 

[cannygirl]

Hello, Good Morning from a very relieved woman. Last night was better: I stayed in my recliner, took a little more medication with a bit of trial and error. I woke hourly until 4am but didn’t panic and read a book. Then I took 50mg Tramadol after which I slept for 3 hours. Thank you to all for the patient advice and encouragement.
Today, I will need to pace myself as I have my 2nd CoVid Vaccine at the community hospital. I think this will use all my energy for today and I am not quite sure how this will work with my limited mobility

 

[Layla]

Hello and to recovery. Congrats on your new hip!
This early into recovery you may have some ups and downs. Overall hips are said to be an easier recovery than knees, I hope that thought brings some relief. Wishing you comfort as you begin to heal. I look forward to following your journey.
@cannygirl

 

[BellaMac]

Great information and support here. Congratulations on your new hip and a virtual hug to you.

 

[BarbyDoll]

Welcome to the recovery side! Sleeping can be a challenge. I have never been a back sleeper, so I was relieved when after my first hip surgery when my in home PT said I could roll over onto my side if I had a pillow between my legs. I needed to be careful to keep my legs together and not roll the operated leg too far forward. But for me it has made all the difference in being able to sleep at night. I also have a recliner, and many people are able to sleep well in their recliners. I don't know if it's the type of recliner I have, but I can sit comfortably but wasn't able to sleep in it at night. Go with whatever works.

 

[cannygirl]

I also have a recliner, and many people are able to sleep well in their recliners. I don't know if it's the type of recliner I have, but I can sit comfortably but wasn't able to sleep in it at night. Go with whatever works.

Hello, the last 2 nights I have slept in my recliner and made makeshift adjustments to give a longer leg length and some back support. Although I have not slept a full night, I have slept much better, not able to roll over which I was trying to do in bed. I think I am also more able to choose 'not to sleep'! I don't want to disturb my husband in bed, so just toss and get upset. In the recliner, on my own, I have chosen to read when I wake up or listen to a podcast until I feel able to try to sleep again. This has take the pressure off.

 

[cannygirl]

I do need a little more guidance. As I said I am sleeping a bit longer. Last night after icing and elevating, I took my Oramorph (managed to get the correct dose) and went to sleep which was bliss despite being on my back. Then when I woke about 3 hours later, I did a loo-stop and then read but decided I could try not taking any more medication. I did get back to sleep but have had much more pain all day today despite regular meds.
Question:
How do I know when I should reduce meds? I thought I was being wise at the time.

I so appreciate this forum with the mix of expertise and genuine encouragement

 

[cannygirl]

I don’t brush my hair without referring to Bonesmart

I love it John! I forgot just how great and normal and human the Bonesmart community is. I can genuinely relate here.

 

[Celle]

How do I know when I should reduce meds? I thought I was being wise at the time.

It's still a bit too soon to start reducing medications. The time to start reducing is when you start forgetting to take a dose until after its scheduled time, and don't suffer any increase in pain.

When the time comes to wean off pain medications, this is what Jamie suggested:

"Here is a suggested schedule for cutting back on prescription pain medications. Stay at each level for 3-4 days or even longer if you notice the pain symptoms increasing. This schedule assumes you are starting with one pill every 4 hours before beginning the reduction process.

1 pill every 6 hours and 2 at bedtime
1 pill every 6 hours and 1 1/2 at bedtime
1/2 pill every 4 hours and 1 1/2 at bedtime
1/2 pill every 6 hours and 1 1/2 at bedtime
1/2 pill every 8 hours and 1 1/2 at bedtime
1/2 pill every 8 hours and 1 at bedtime
1 pill if you are really doing something active during the day and 1 at bedtime

It is usually better to wean off these meds over several weeks, not several days. But.....if you are still having pain, then your body is healing and you still need pain relief. And in this case, I would discuss your pain management with your GP instead of your surgeon."

 

[cannygirl]

My recovery continues:
I guess I’m always impatient and this includes all the issues - decreasing meds too quickly, increasing exercise too quickly etc. This is partly influenced by my busy husband saying how well I am doing and I hear this as his need to see me functioning normally again! I find it so difficult to be dependent on others.

Just now - I find my worst time of the day as getting showered & dressed: I have to use a stick in the shower as we have no grab rails. Then the struggle to get all my clothes on and finally the compression socks ..the gadget for pulling on socks does work but the battle is long and hard. After more than an hour of this struggle, I am absolutely exhausted and feel as though I have run a marathon. Am I alone on this? Does anyone have tips that might help?

 

[djklaugh]

@cannygirl Those compression socks are a pain in the everywhere! And alas there is not (to my knowledge) any easy way to get them on. Yes the sock helper does help a bit but the struggle is real! Check with your surgeon's office to see how long you need to continue to wear them. I remember ditching mine after only a week or two.

Don't let hubby or anyone else persuade you to over do it - that club is way too easy to gain admission!

You are not "dependent" on anyone - you just temporarily need some extra help while healing from MAJOR surgery! 10 days post-op is way too soon to be doing too much!

 

[cannygirl]

Unfortunately I had a PE nearly 50 years ago following a ruptured uterus - so huge caution is taken postoperatively and I have stockings and blood thinning injections for 4-6 weeks! It is a battle I need to continue for a while yet!
I’ll just try to remember to choose to understand that I need help rather than being dependent. I am such an independent person

 

[Schaargi]

@cannygirl

Oh my gosh, I HATED those socks and had to wear them for at least 4 weeks, maybe more ( not sure-it is a bit of a blur now). My surgeon was insistent. I am now headed for another surgery and the first thought that came to my mind was those awful socks.

My husband was not helpful, either, not because he didn't want to-- he tried really hard-- but he just couldn't anticipate my needs and was quite clueless I had to tell him exactly what I needed.

Showers were exhausting so I did not shower as often. Maybe sponge baths in between full on showers? I did a lot of sponge baths-- Dove has body wipes that smell wonderful. I figured out how to wash my hair in the sink. When I took a shower, I dried off, but a bathrobe on, and rested in bed for a while before tackling the rest.