THR On the road to recovery after RTHR

[acbelmar]

Hi Emily,
I'm so sorry you are feeling so bad. I also have a numbness in my feet and they feel cold...I'm sure it was from the operation. I had the shin pain prior to my operation and haven't had it since. If you are worried then you should contact your Dr. Are you taking the meds that were given to you? I go with Jo ...the pain meds are part of recovery and thinking that they aren't needed can make recovery more miserable than it needs to be. I don't think relying on them makes you any weaker than someone who doesn't take them. We all have different pain levels and I don't believe we should suffer while healing..as far as I'm concerned we all deserve medals!!!

 

[emily76]

Thanks, I've only been given paracetamol and ibuprofen and I wear a patch with low level but constant supply of coedine. Maybe I need more? I'm taking what I've been prescribed. If no improvement I'll contact doctor tomorrow. Xxx

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[BarbaraR]

emily76, what are you taking for pain? The hospital I went to has a pain management dept. and I was able to call them when I had a problem. Does your hospital have that? I'm guessing it's evening where you are-- make sure you've been taking your pain meds on schedule, ice your hip and rest it, and call your doctor in the morning. There's no reason for you to suffer! Please let us know when you're better. XO

 

[sharonslp]

Emily, at one week out, it sounds like you are simply way under-medicated. Tylenol and ibuprofen are adequate for maybe a month from now, but with the pain you are describing I can't picture them doing much Most of us come home from the hospital with something like vicodin or oxycodone alternated with something like tramadol. (Not sure what these are called in the UK.) Our instructions usually say to take one or two every 4 to 6 hours.....and in the early days that means two every 4 hours. A codeine patch is not going to do it either. Please do call your doctor as soon as you can, and insist on stronger meds. They may make you very sleepy, and that serves to keep you resting, which is what you need a whole lot of right now.

Once you get the pain under control, you keep it that way for as long as it takes to get you past the early stages of healing. After a few weeks you can start to drop one pill every 4 hours, and then every 6 hours, and then maybe start skipping one dose a day, and so on....giving each change a few days to see how it works. It's much too early to know if you are having any unusual pain that is a sign of a problem, because at one week, EVERYTHING is still very painful.

And yes...with a toddler to care for, the odds are that you are doing way too much too soon. Are you able to get any additional help with childcare until you get past this stage?

Please please please call your doctor or the hospital. You don't need to be in this kind of pain.

Sharon

 

[Queenie]

Oh bless you Emily..............it's a tough old journey this one.

Well, luckily for you, you've found this forum which I believe will help you get through and answer a lot of your questions and worries.
It definitely sounds like you have nerve issues to me. These are totally normal by the way. I had nerve and muscle cramps/spasms for a few weeks after my op. The pain was worse than the surgery pain. I found taking magnesium(good for nerves)together with a B vitamin complex(for absorption) helped tremendously. In fact the spasms practically disappeared after a few days and I only got them at night if I moved after being still for a while. My doctor also prescribed 2mg of diazepam which help with nerve/cramp pain.
If you read over other people's threads you'll see that a lot of people suffer with aches, twitches, cramps, numbness, swelling......the list goes on. But Emily I promise you this is all normal. Your body has been through major surgery and its going to take a while for it to settle and be less grumpy. The best advice is REST, ELEVATE and ICE ICE ICE. A packet of frozen peas(wrapped in a dry cloth or kitchen towel) will do the job nicely. 20mins at a time or whatever you can manage is absolute bliss. It's scary because no one tells you how it's going to be and once you've left the hospital you feel very much alone and vulnerable. This is normal too!! You are only 7days out Mrs! I agree with acbelmar....Give yourself some credit. You are very brave dealing with this AND a little person.
The sleep issue is a problem for most of us. Sleep deprivation is a form of torture in some countries!! You do eventually get used to sleeping on your back though(I'm a side sleeper usually). I know you have a toddler to look after but you really need to grab sleep when you can otherwise you'll get exhausted. Is there anyone who can take your little one off for a few hours so that you can nap in the day?
As Josephine will tell you, no need to fret about the lack of PT. Hips sort themselves out. As long as you are doing basic exercises(the hospital must of given you some.....if not there are plenty of links on here), and getting up and out of a chair/bed periodically then you are doing plenty for now. You need to be kind to your new hip and rest mainly in the first couple of weeks. Plenty of folks on here have done too much too soon and regretted it.
This is my 2nd THR and I've always said that I'd rather give birth! BUT, time flies and before you know it your body is healing and you are able to do more and more each day. You've just got to go with it and take it easy. Don't be a martyr and over do things. Ask for help and don't feel guilty about anything. This time will pass and soon you'll be the one dishing out all the advice to the newbies. You'll be on the mend with a wonderful, shiny new hip!!
In the meantime don't be afraid to post all your worries and fears on BS. There will always be someone to help you.

You are not alone Emily.

Lotsa love

Queenie xxx

 

[Cindy B]

Hi emily76,

I'm so sorry to hear that you are in so much pain. Are you taking your pain meds around the clock, icing & elevating like everyone has previously mentioned? I can only say that is what I did and was very comfortable at 7 days post-op. I was sent home with Vicodin (hydrocodon) and it did the trick.

Do you have enough help to care for your child? Most of your time should be spent resting. Read Josephine's link titled Activity Progression for THR to ensure you aren't overdoing it. I truly hope your pain subsides and will say a prayer for you. I know how bad it feels as they didn't control my pain adequately my first night after surgery and I was in tears!

Best wishes & keep us posted...hugs!

 

[Firebrand]

Emily - it doesn't hurt to phone the ward and ask them what they think about the pain. There is little point in suffering in silence.

 

[emily76]

Hey everyone, hope you're all doing well. Just a wee update. The terrible pain in my legs has eased off a lot and flares up when I overdo it or when I compress the back of my leg, if I sit on a hard chair for example. The doctor says it's normal and my last some time. He has given me a short course of diazepam to help relax which is helping.

The dressing came off today and the stitches snipped at the ends, plus the tape has been removed.

Although I feel a bit achy and some discomfort I still cut believe I had major surgery les than 2 weeks ago. The toddler issue does bring challenges but we are coping, with help!! Emily x

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[Mbone]

@Pudfin I can't sleep either.... Not even a nap...,. Any suggestions?

 

[BarbaraR]

Mbone, can you take Benadryl? It helps me sleep.

 

[Mbone]

Yes I can but it does not make me sleep! I'll try it again!

 

[BarbaraR]

Oh, I hope it helps. Not sleeping is awful.

 

[Queenie]

Mbone

I have had sleeping issues from day one. It's downright torture!! Have you tried herbal sleeping tablets? We have 'Kalms' in the UK. Totally natural, the active ingredients being.....Valerian, Passiflora, Wild lettuce, vervain and hops. Not sure what the equivalent is called in US. Might be worth a try.

Hope you get some zzzzzzzz soon.

Queenie xxx

 

[CDP]

Hi Emily - good to read your update and see things are improving. I had quite bad muscle spasms, especially at night, in the first few weeks following surgery and was prescribed Diazepam to help counter them. It worked a treat and certainly helped me relax and sleep better too.

Keep the updates coming.....................

 

[emily76]

@Pudfin I can't sleep either.... Not even a nap...,. Any suggestions?

So sorry to hear about your sleep issues. The only things that have helped me are a foam wedge to sleep with and the diazepam which is helping with the leg pain with added bonus of helping me sleep. Good luck, it's pretty tortuous when you can't sleep. Xx

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[designergirl]

I hope your pain issues can be resolved soon. It does sound like you need more meds at this early stage. My sleep isn't perfect, but I'm napping a lot to make up for the interrupted night sleep. The extra pain meds do help you get back to sleep. When I got the script at the hospital, I literally got out the calculator on my smart phone and did the math to make sure I had meds to take every 4 hours until I see my OS on March 14th. I wasn't leaving without enough meds. I hope you can get the pain sorted out. Sending prayers your way Emily.

-Susan

 

[Josephine]

it's seven days post operation and I feel worse now than immediately post operation. The pains which started in my leg last night have gotten worse and getting up and down is so painful it takes my breath away. And when sitting I just can't get comfortable with it. It shoots right down my leg and the pain is in my shin and ankle and I keep getting a numb foot/pins and needles in my foot. I've only been given paracetamol and ibuprofen and I wear a patch with low level but constant supply of coedine. Maybe I need more? I'm taking what I've been prescribed.

Exactly what are you taking dosage wise? I expect you are prescribed 1-2 codeine 30mgs 4-6 hrly, yes? Then take 2 tablets 4hrly. You will only need to do this for a couple or three weeks and then things should start to ease up a bit. You might also put ice packs on your hip and anywhere else it hurts.

The lack of physio is most definitely money related and because there is a thought that people recover so quickly that it's not needed! Not my opinion obviously but that's how it is. I am due to see my practice nurse Friday so I'm going to ask about physio. In my case it was a little more complicated as I had my surgery a long way from home under a different NHS trust so no automatic referral to local physio.

No, it's not money related. Lots of surgeons don't order physio as hips tend to do pretty well with the exercises at home. And they also have a way of sorting themselves out over time, so don't worry about it. Walking about the house will be about the best exercise you can do as well as lifting your leg out/up sideways when you are standing at the sink.

But what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc.?

You should also read these articles - I think you need the information within!
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
Activity progression for THRs
Home physio (PT)
Post op blues is a reality - be prepared for it
Myth busting: on getting addicted to pain meds

 

[emily76]

Thanks Josephine, I have read all of articles and 're-read them. They have been very helpful.

In terms of the physio, as you say some os don't order it but this is partially because the physio element isn't commissioned for hips in all areas. As you say this is because most people do well without it. Commissioning decisions have been taken in some areas that because people can do well without it then it saves money not to offer it. I'm a commissioning manager for the NHS and queried this closely with my colleagues. It's not saving money to the detriment of patients but it is no longer routinely commissioned in all areas.
I am taking all medications prescribed, this consists of the trans-dermal patch which delivers 10 micrograms per hour of Coedine, I do not take oral 30mg as it hasn't been prescribed. I add to the patch 1000mg of paracetamol and 50mg diclofenac 3x a day. When I have the nerve pain I top this up with 2mg of diazepam. When i get the nerve pain it is incredibly painful but short lasting, otherwise I'm doing pretty well with minor achy pains around my groin and the inevitable twinge in the incision site.

Activity wise I'm pottering round the house. I have full childcare support at the moment but this has to be balanced around the demands of my son who wants his mummy. I cannot nap whenever I feel like it, but I do go to bed every afternoon when he sleeps and I sit as much as possible other times. I make tea and toast etc but not yet progressed to cooking full meals. My son does demand attention which doesn't help the tiredness, but I always knew this would be a challenge.

One thing I do find hard is managing the anxiety I feel whenever I get a twinge or different pain, it makes me scared something is wrong, but I tell myself this will pass.

It's an up and down journey and I'm so very tired but on the plus I can't believe I had major surgery two weeks ago and my hip feels so amazing compared to before.

Emily x

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