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[THR] On recovery journey

Discussion in 'Hip Replacement Recovery Area' started by cheermom, Oct 13, 2018.

  1. cheermom

    cheermom junior member
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    Hi All,
    I saw a link to this site on another site. I wish I had found you all before!

    I just had my surgery on Thursday (10/11) Total left hip replacement, anterior approach, using Stryker Mako robotics. Anesthesia was a spinal block and some sedation. I was a bit anxious about not having general anesthesia, but it actually was wonderful. Was up and walking just an hour after post-op with the PT since there was no groggy/loopiness from general.

    So far, so good. Went home about 24 hours after start of surgery. Very little pain and up and walking well with a walker. Stairs are no problem. Hope to move to a cane by week's end. Pain managed effectively with Tylenol and Celebrex. PT cleared me in hospital that I did not need home PT and will move to outpatient PT immediately.

    Looking forward to learning from all of you on how to make the recovery as fast, efficient, and painless as possible!
     
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  2. Barbaraj

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    Wow, @cheermom, glad to hear you're doing so well so far. I worry that you might be a bit overly ambitious with the desire to return to work at 2-3 weeks, but anything is possible so if that's motivating for you (while not setting you up for depression if it doesn't work out) then good for you. I'm just over 2 weeks and doing pretty well, but the one thing I simply didn't anticipate was how exhausted I feel (the dreaded energy drain) which is more of a factor than pain for me. But keep reading others' posts; there is a wealth of information here on the forum. Best of luck to you!
     
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  3. cheermom

    cheermom junior member
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    Thanks for the well wishes. My FMLA paperwork is for 6 weeks off work, but I set my goal at 3 weeks with my surgeon. If it doesn't happen, that is still ok with me. I like to set the bar high to see if I can hit it but also am realistic that I may not reach it. Heck, staying off work till after Thanksgiving would not be all that bad. I can work on all my Christmas crafts in the meantime. :)
     
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  4. Going4fun

    Going4fun member

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    Congratulations on your surgery. It's great that you're asking about how to best take care of yourself and your hip ... so I hate to have to say this ... there really isn't anything you can do to speed up your recovery ...

    The soft tissue has to heal ... and yes anterior surgeons disrupt a lot of soft tissue ... and the device has to fuse with bone and there is literally no speeding that up ...

    Returning to work in 2 to 3 weeks ... wow, I'm a bit surprised your surgeon said that was a possibility. I am four weeks out with a relatively easy recovery ... and ... well ... I'm glad I have leave for 12 weeks! ... Healing is energy depleting ... and your concentration will be off ...

    The problem with returning early is that you'll come home exhausted ... but worse, you can actually impede your recovery by moving too much too soon ... Walking is the best way to naturally move ... and build up flexibility and all of that ...

    Now if you have to return, you have to ... make sure that is absolutely a have to ... as opposed to an "I don't want to burden others" ... or "I don't want to ask for more time."

    Oh ... and OK, you want to avoid slowly down your recovery, be really cautious about pt ... Too many PT practitioners actually give people too much to do ... and that can set back your recovery.
     
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  5. Jaycey

    Jaycey SUPER MODERATOR Moderator

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    @cheermom Welcome to BoneSmart!
    Unfortunately there is no rushing this recovery. Your hip is now in charge. Listen to it and you can't go wrong. Try and push and you can indeed set yourself back.
    You are just out of major surgery. I would not assume you will be up to doing this at only 3 weeks out. You need to factor in energy drain and focus on healing versus activity.
    Hmmm... has your surgeon actually had THR? I've had 2 and there was no way I could have gone back to my desk job this early. Please reset your expectations. The recommended time off work post THR is 10-12 weeks and then a Phased Return. Sure, some return earlier. But there is no predicting how you will react to this surgery.

    Here are some guidelines that might help you through this recovery. Note the articles on Activity Progression, How Long does Healing Take and the Chart on THR recovery.

    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
    5. At week 4 and after you should follow this

    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.
     
  6. cheermom

    cheermom junior member
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    Thanks for the encouragement. 3 weeks is just a goal that may or may not be met. My surgeon is on board, so we will go with it. If I don't make it and need to take the full 6 weeks off (he said 2-6 weeks for work return) I am ok with that. Love my PT. She said to just do my exercises at home, no need for a home PT, and then start outpatient at 2 weeks when cleared to drive to fine tune gait.
     
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  7. cheermom

    cheermom junior member
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    Thanks Jaycey for the suggestion. But I would never question someone else's surgeon's competency just because they were different than yours. My surgeon only approved a max of 6 weeks off and is confident I will be ready to go far sooner than that. So, at this time, no resetting of expectations. The surgeon knows his stuff and the times his patients recover.

    I was lucky enough to have a very experienced hip replacement surgeon in my area. He is one of the main surgeons for the US Ski team. He definitely has the knowledge! While I am not a top athlete, his experience in bringing elite athletes back to competition level makes me willing to believe in his predictions and his recovery protocols. I have high goals but reasonable expectations. I have had several very intense surgeries, so am familiar with how my body responds. His recommendations are a return to work within a max of 6 weeks post op. If it takes longer, well, so be it. Naturally, this prediction was for me and for me only based on my surgery and anatomy. I would never recommend basing one's recovery protocol on someone else's surgeon's predictions for a stranger.

    I am not here to debate my surgeon's competency nor his recovery protocol and knowledge. I am a bit surprised at the negative post questioning my surgeon and his competency. Maybe this forum is not for me.

    Mods, please remove my account. Thanks!!
     
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  8. Lski

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    Sorry you are disappointed in everyone’s responses. They just want you not to set expectations too high. I was out at 3 weeks on a day trip to the yo celebrate my daughter’s sweet 16. It was a stretch walking to the waters edge. We went to Wildwood NJ. I had forgotten the distance from the boardwalk to the water was so far. I really over extended myself on a trip to the bathroom and needed 2 days of complete rest to recover. That said everyone heals at different rates. Cheer competition shouldn’t be too much walking, more sitting. Bring along a comfy chair with back support and a 2nd one to restelevate if needed. You’ll know if you have the energy for it when the tome comes. I hope you stick around. This website has been very helpful. The staff is super knowledgeable and responsive and also very supportive of your hip recovery.
     
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  9. Layla

    Layla FORUM ADVISOR Forum Advisor

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    Hi, Welcome to BoneSmart. Thanks for joining us!
    I echo all those before me in regard to your anticipated return to work. I don't think you're going to find anyone here that will tell you how you can recover fast.

    If by setting the bar high, you mean targeting your desired timeline, I understand wanting to move forward.
    But if you plan to get overly ambitious with PT and pushing yourself in different ways to meet that goal, I fear you'll crash and burn. If you haven't read the Recovery Guidelines yet that Jaycey left...below is an important paragraph -

    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.

    As you realize, this was major surgery. Your flesh was cut, your bone sawed, your femur reamed out. Power tools were used. Healing takes time and we can't rush it no matter how much we want to, or how hard we try. There are many here who can testify to the setbacks they've suffered trying to push things along.
    Energy drain hasn't hit you yet.

    I have a high pain threshold, myself and luckily experienced a rather uneventful recovery. With that said, I can't imagine returning to work at 2-3 weeks. Here is an article on the suggested Phased Return To Work -
    http://bonesmart.org/forum/threads/phased-return-to-work.5696/

    It's unfortunate that you're at a risk for infection. I'm sorry. I hope all works out in your favor and you're able to take the time and get the rest your body needs to heal and work optimally to ward off infection. It's depleted now and in a weakened state fighting to heal. And it is healing. I hope you're able to take it slow and help the process along.

    Stop back often, we'd love to follow your healing journey and offer support and encouragement along the way.
    I hope you have a peaceful weekend!
    @cheermom
     
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  10. 1stSurgery

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    :what::shrug::what::shrug:
    I'm confused!?

    But I hope @cheermom you make a fast strong recovery all the same. This is a very supportive group here, they only want to protect you from being disappointed later if you don't make the 2 week mark for work. Since most of us here have been down the road past that 2-3 week mark now once or twice. Best of luck!
     
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  11. cheermom

    cheermom junior member
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    Thank you. I believe I stated numerous times that I am committed to the 2-3 weeks but am realistic enough to know that things happen and I am ok with that.

    Apparently, I am finding that my surgeon's recovery protocol is a bit different than the norm and is a different approach than some prefer, but it is one I am willing to try. But as I said, I did not go into this as a highly trained elite athlete, so do expect my recovery to be a bit slower than a highly trained Olympic skier. But I do trust my surgeon with the goals he has set for my recovery. Everyone should do what is recommended by their surgeon and what is best for them.

    Goal #1 completed - 48 hours post op, by walking every hour, .25 miles completed with walker.
    4 week goal (surgeon set) - 2 miles independent walking
    6 week goal (surgeon set) - 4 miles independent walking
     
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  12. Barbaraj

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    @cheermom, I personally would LOVE for you to stay on this forum so we can all follow your recovery. If you are able to achieve the goals you've laid out about we'd all be THRILLED (albeit a bit jealous!) I'd love to read about a wildly successful and accelerated recovery as you've described--it would give us all hope (and maybe we'd all be demanding your surgeon's name and contact information). I think there are absolutely tons of folks out there who have this surgery, who never find this forum, and maybe are able to recover as speedily as you've described and with minimal/manageable discomfort. I think one of the moderators reminded me of this when I was reading some of the posts and was pretty shocked and scared at how long and difficult some of the recoveries appeared to be, and worrying that mine would be equally tough.

    My recovery has been fairly easy so far, just over 2 weeks but only using Tylenol in the morning when I get up usually, and trying to find a good mix of activity and rest (plus icing) that will speed my recovery along as quickly as possible. I said early on that a good recovery is what I hoped for, and if I actually had one, I'd like to post about that as perhaps it would give others some hope as they start out on their recovery journey. Of course, I know something could happen and I might have a giant setback for one reason or another. But reading about folks who have a good recovery so far, like you, is really inspiring to read. I think any comments about your recovery taking longer are just because folks are concerned about you, worried that you are getting your hopes up too high only to have them possibly dashed when it doesn't work out. But should you have the goals you've set above? Absolutely, and if it works out there will be a ton of folks cheering you on! Please stay!
     
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  13. cheermom

    cheermom junior member
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    Thanks! And I will not be disappointed if I have to admit in 3 weeks that the recovery isn't working out quite as expected and I am still using my cane. :old: But for now, I will trust my doc's judgement that I will be back to normal in 6 weeks or less with his recovery plan he set for me.

    I understand everyone has different recovery rates and none are wrong. Everyone recovers in the time that is right for their particular body. I hope noone takes offense that my surgeon has apparently set a rather aggressive time table.

    Around here, 3-6 weeks is the norm for recovery. Maybe because there are so many elite athletes training. One friend (an elite cyclist) had his done, was off all aids within a week and back training on his bike within 3 weeks.

    Another friend had one hip done late summer outpatient, other hip 2 weeks later, also outpatient. He is at 100%. Expectations in my neck of the woods is max 6 weeks, although everyone's mileage varies and setbacks can unfortunately can occur.
     
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  14. SurreyGirl

    SurreyGirl post-grad

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    Welcome to the other side and your surgeon sounds amazing! I truly hope you meet his goals and that his expectations are realistic for you. I am assuming you are athletic, an ideal weight for your age and very fit!

    My Os is somewhat of an opposite to yours and, because I am rather overweight, warned me to expect a tough recovery. Getting there now I think but it has been a classic sqiggle rather than a straight line in the Recovery Route!

    Don’t go, this forum is very useful and friendly. In adddition there is a wide variety of recovery experiences here so plenty of useful info from fellow hippies...
     
  15. cheermom

    cheermom junior member
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    Not sure if this is normal, but my week 1 exercise protocol is:

    Getting up and walking minimum of every hour, preferably more if tolerated, only using walker if necessary to prevent falls. But trying to walk independently.
    Glute, ankle and quad excercises, both laying down and sitting, ie: leg lifts, marching in place, etc. - 3 sets of 15 reps 3x per day. Knee extensions are killing me, lol.

    Week 2 will add in the standing exercises (squats, side leg lifts, front leg lifts, and some others) and core strengthening exercises.

    I am overweight and have not exercised for awhile due to the pain before surgery, so this schedule is a bit daunting. But I am determined :) I am so amazed at how much better my gait is already. Last week I was longingly watching people walk effortlessly while I lurched around, but I am so amazed that I am now one of those people with a regular gait. Have to work a bit more on my squeezing my glutes as I walk as I still have a little bit of a limp, but it is so much better.
     
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  16. Jamie

    Jamie ADMINISTRATOR Administrator

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    @cheermom.....I hope you'll reconsider about staying with us here on BoneSmart. The robotics used on your surgery are some of the newest technology and they do show promise in allowing more precise bone cuts and less manipulation of soft tissue. These are things that can contribute to an easier recovery. I would like very much to read more about your recovery, so please do consider staying and reporting on how you do.

    For now, I'm going to leave your account in place if you don't mind....
     
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  17. SurreyGirl

    SurreyGirl post-grad

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    I too would love to follow this. My OS insisted on the Posterior Approach as refused to do Anterior on overweight patients! So your operation is very up to date compared to mine :)
     
  18. cheermom

    cheermom junior member
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    Thanks so much, I would love to stay. As I read more posts, I see how friendly and encouraging people are here.

    I apologize for over reacting to the post asking if my surgeon had ever had TBH himself, questioning his competency. Post Operative sensitivity?

    I purposely sought out the Mako robot approach and was ever so lucky to have one of the more knowledgeable surgeons using it in my area. Pure luck on my part! So far, I am incredibly impressed with my capabilities 48 hours post op. Of course, I have nothing to compare to, and I am still in the beginnings of recovery, but very happy with the results so far. Not sure if it is normal to just do a spinal and not general anesthesia with a THR, but after having numerous abdominal surgeries in the recent past, I am relishing not being in that general anesthesia fog that persisted for days after the abdominal surgeries.

    Now off to make dinner for the family.
     
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  19. Jamie

    Jamie ADMINISTRATOR Administrator

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    @SurryGirl....don't beat your surgeon up too much about him not wanting to do an anterior approach if you are overweight. That is one of the risk factors and he was putting you and your wellbeing first. In reality, anterior patients are only slightly ahead of posterior approach (if at all) in recovery and both are at the same place after about 3 weeks.

    @cheermom....Actually spinal anesthesia is very common for both hip and knee replacements.
     
  20. SurreyGirl

    SurreyGirl post-grad

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    Thanks Jamie! I am definitely a “slow-mo” when it comes to recovery but it is what it is.... my OS, in the short meetings with me, was very clear about why in my case he preferred Posterior so I was happy with the decision. He is very experienced and has a good reputation notwithstanding a very dour bedside manner! He admits he does not normally operate on obsese people...

    And @cheermom I had the spinal too (made up my mind about that literally outside the operating theatre) and very glad that I did. I bet your family appreciate you cooking for them but DO allow them to spoil you in the few weeks you have off!
     

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