THR On the other side and now in the right forum

[Elosarabrab]

Maeve,mondo_caine, I sleep propped up with a backrest and lots of pillows. I can't lie flat on my back as it is uncomfortable. I sleep quite well like that.I have 3 months of it to put up with but I did it with the right hip and the time does go quickly.
Barbara

 

[Maeve]

Oh dear Elosarabrab. 3 months! You are very stoic!
Love to know where your Avatar/ tag comes from?
Cheers
Fran

 

[Elosarabrab]

Maeve Its my cat Quinn. My daughter got me the baileys tin one Christmas it had two miniature bottles and two glasses. He rested his head on it and looked so cute I had to take the picture.
Barbara

 

[C Mac]

A small question for my fellow hippies:
Is a heat pad any use for after exercise/ stretching? To relax the muscles?
I ice all the time but a couple of friends have mentioned heat.

I used ice in the early months after surgery. Eventually many months later I used heat. I do remember hearing some discussion about the whys and why nots of ice vs. heat some time ago and Poppet and Josephine could probably more directly answer your question.

Take care,
Cardie

 

[Josephine]

Heat is great for getting muscles to relax before stretching. But try it and see and then go with what works for you. That's always a good credo "go with what works"!

 

[Maeve]

Thanks@Josephine,
I have Hot/ Cold packs that work via freezer or microwave. Today I do Physio at my Day Patient Rehab...back to back Gym and Hydro. I am find ing the twice a week sessions great now I have a feel for what exercises and stretches are specifically helpful for my new leg length challenges.
Tomorrow when I do my own home program I will do the strengthening/ ROM program and the apply the heat pack before I do my stretches.
Thank you for such a prompt reply. This forum, and the knowledgeable moderators help immensely.
Now to a vexed question re medication.
I am on oxycontin 5mg morning and night with the plan to wean off. I think I will wean the day one first as have tried leaving the night dose and just taking Panadol at bedtime but I wake in the night with a gnawing dull ache. I think partly because I still can't sleep in any other position than on my back. So I seem to need that dose.
I have 5mg endone. I take one an hour before PT on days when I go to the Rehab. On days when I do my home exercises I take half morning and afternoon, before each session.
I also take Panadol on a needs basis...probably now only 4 max 6 per day.
Looking at my "drug supply" i only have enough medication to last until one week if I stay with 1xoxycontin, 1x endone per day.
Then I guess Panadol is the solution??

 

[mondo_caine]

Maeve, The sleeplessness is the worst thing part of the recovery. I have never been able to sleep on my back and now after 60 years to try and do it, and that to with a pillow jammed between my legs is tough. I roll on to my left side and doze off for a while but then I need to change position which means returning to my back and waking up. After a while I go back to the left side and the cycle goes on all night.

Still, as you say, all thing must pass and I hope to return to a normal sleep pattern in a couple of weeks

 

[Maeve]

Hi Josephine,
Not sure I tagged you properly in my early post/ conundrum.
Cheers
Fran

 

[sharonslp]

I couldn't wait to get back to being a side sleeper. And now, I start off every night on my side. And I wake up every morning on my back! I have no idea what normal is anymore.

Sharon

 

[Josephine]

I am on oxycontin 5mg morning and night with the plan to wean off. I think I will wean the day one first as have tried leaving the night dose and just taking Panadol at bedtime but I wake in the night with a gnawing dull ache.
I have 5mg endone. I take one an hour before PT on days when I go to the Rehab. On days when I do my home exercises I take half morning and afternoon, before each session. I also take Panadol on a needs basis...probably now only 4 max 6 per day.
Then I guess Panadol is the solution??

Why are you 'weaning off' oxycontin so early? You are only 4 weeks out and it sounds like you still need something stronger than Panadol (trade named for paracetamol). If your doctor won't prescribe you any more oxycontin or oxycodone (Endone/Percocet), then ask him for something simpler like codeine which is entirely effective for hips and far less of a problem. For a start there is no 'weaning off' required! But you need more than paracetamol for a few weeks yet.

Another thing - why are you finding it necessary to take pain meds before PT? If PT causes you pain, a) this is confirmation you still need something stronger than paracetamol and b) your PT shouldn't be that aggressive. Hips don't really need that much PT anyway.

 

[mondo_caine]

I couldn't wait to get back to being a side sleeper. And now, I start off every night on my side. And I wake up every morning on my back! I have no idea what normal is anymore.

Sharon

Since everyone who knows me says I am far from normal, I guess odd ways of sleeping are not going to be a problem for me in the long run.

 

[Maeve]

Thanks Josephine.
Unfortunately I am allergic to coedine. I am sure my Doctor has no trouble giving me another script for Oxycontin. I just thought I might not need it but I agree it's only early at one month so I will keep taking it while I need it.
Re the meds before PT. That is a mantra with orthopaedic people here in Oz. we are constantly reminded to take sufficient pain medication before Physio/ exercise sessions so we can do the required work.
As for PT and hips, the belief is that this is crucial to long term recovery. We must strengthen abductors and glutes in particular and it is a requirement to do an extensive series of exercises twice daily. The belief is that mobility will be compromised if the regime is ignored.
And this is not just my OS or my Rehab facility, it is across the board. The thinking is very different to that of the UK.

 

[Poppet]

Maeve, not so sure that 'it is across the board' here in OZ. I believe it is more of a surgeon by surgeon preference.

As for PT and hips, the belief is that this is crucial to long term recovery. We must strengthen abductors and glutes in particular and it is a requirement to do an extensive series of exercises twice daily. The belief is that mobility will be compromised if the regime is ignored.
And this is not just my OS or my Rehab facility, it is across the board. The thinking is very different to that of the UK.

With respect, not sure I agree with that philosophy. I had no PT other than the exercises in hospital, saw my surgeon at 4 weeks post and he said 'fantastic', my gait was perfect, I was walking without an aid and he said just walk, wasn't interested in PT, just walking. He was absolutely thrilled when I told him I had taken up Nordic Walking and told me that quite a few surgeons were taking the activity up themselves across Australia as they realize that walking with the poles, takes the pressure of the joints and yet one gets a cardio workout, in a gentle way which is difficult to achieve in the early weeks/months of recovery.

I would be very wary of taking pain meds prior to a PT session (were I to ever have one) because I wouldn't know where my boundary with the exercises were.

 

[Maeve]

Hi@Poppet,perhaps my take on the PT hips requirement is too broad a statement.
My OS strongly recommended I go to a Rehab facility as my underlying issue was congenital hip dysplasia and with that I had significant LLD pre surgery as well as atrophied muscles from birth and therefore I needed extensive therapy.
The rule of thumb/ mantra re meds before PT was the philosophy of the Drs, physios, nurses etc at this hospital. Patients at this facility were referred by many different OS Practices and all my fellow hippie patients were under the same regime.
So apologies for casting too wide a net. Those patients who go from the operating hospital straight to home may not have the same requirements and, as in your case just do the hospital exercises and perhaps continue these at home.
In the case of a straight forward hip replacement where there were no longstanding structural abnormalities that sounds a plan.
Sometimes the balance between keeping up the therapy and not overdoing it can be problematic. I think I have the mix about right now with lots of stretching, icing, heat pads where appropriate and remedial massage .Fingers crossed. :rolleyes:

 

[Poppet]

Sounds like you have worked out the correct regime for you Maeve, I am pleased

Just one point though regarding my own situation I had an extremely complex surgery, it certainly wasn't straight forward. I had AVN and the compromised femur had pushed the acetabulum completely out of shape and was forcing the head of the femur into my pelvis. I had to have multiple bone grafts, and reconstruction of the acetabulum. I also went into surgery with Chronic Kidney Disease caused by the NSAIDs my OS had me on. I had only 40% kidney function. I went into surgery with the knowledge that I may have to have dialysis. In any case, I spent 6 days in ICU, crashed twice, Hubby with me 25 hours watching me fight.. a day in HDU and then 5 days in my hospital room.

I had spent 2 years draped over a walker Pre surgery: had a severe trendelenburg gait. It was a miracle that I walked out of hospital at all even though I still have chronic kidney disease for life.. No wonder the title of my own thread says - I love my OS - and he knows it, lol

 

[Maeve]

You certainly went through a terrible ordeal@Poppet. It must have been very traumatic and I think it's wonderful how you keep such a positive outlook and help and cheer so many people on this forum. I tips my hat!
Going home after such an ordeal would have been a top priority . Keep well and happy!

 

[Poppet]

Thanks Maeve, yes, being positive is a plus. Wouldn't say I am a glass full girl all the time, but I try. Of course anyone who knows me on the forum knows that my cup will be overflowing when we retire Sept 2014..

BTW, I notice that your tags don't always work (I edited your post in Casey's thread to alert Jo) so here is a tip, make sure there is a space before you start the tag and just type in the @ sign immediately followed by their user name and you'll see a small box below and to the left of the posting area where the members user name will display. Sometimes there might be a very slight pause, but the member user name will appear.

it will show their correct name which you can click on -- then when you submit your post the member's user name/link will turn blue and send a message to them person, like this

Poppet

 

[Maeve]

Thanks Poppet!
Hope I got the tag right this time! Will remember the correct way from now on I hope!
Retirement is great! I'm a consultant in HR/ Compliance but now only work for one favourite client. Just enough work to add to the kitty for our Overseas trips. Worked very hard for many years so it's great to enjoy life after work. Movies, galleries, gym, lunches, trips away.......not at present though but this recovery will end soon and the social life will gear up again. Your time is not too far off!

 

[Josephine]

As for PT and hips, the belief is that this is crucial to long term recovery. The belief is that mobility will be compromised if the regime is ignored.

All evidence to the contrary! I can't lay my hands on any right now but there have been a number of studies over the years (in the peer-reviewed medical journals) demonstrating that thinking to be incorrect. It's not even correct for knee replacements! The conclusion being that best results are obtained from simply encouraging patients to go for good walks! However it does no real harm except over-enthusiastic use of some exercises can sometimes result in issues like trochanteric bursitis, ilio-tibial band and psoas syndromes, also low back pain.

 

[Maeve]

I'm with you Josephine re good walks being the best and I think your statement re over enthusiastic exercising hits the nail on the head!
Sooooo new strategy for me this week. Obviously I will continue the two day per week rehab visits but be very assertive about what I do at each gym/ hydro session....I think I know now just what exercises and stretches work for me. On the other days I will focus on walking!