THR One hip done, one to go!

[craftdee]

Hi @bobbi AVN is Avascular Necrosis (also known as osteonecrosis and other names) It is the death of bone tissue due to a lack of blood supply.. it leads (or did in my case and I'm sure many others) to tiny breaks in the bone and the eventual collapse of the bone/joint. The hip is the most common joint for AVN, but the knee and shoulder are also often involved. It's more prevalent among youngish men, probably because trauma (such as a break or dislocation) is one of the main causes of the interruption of blood flow and youngish men are the ones that indulge in behaviours more likely to risk trauma! There are other reasons, alcoholism (not me) steroid over use (not me) SLE or Lupus or RA (testing under way for me) ... or the old "idopathic" meaning they don't' really know why (probably me!!) which accounts for about 15% of cases
There is a great article in the library regarding different approaches, here's a link, lateral is more closely related to Anterior, in that it disturbs less soft tissue giving a generally quicker and "easier" recovery with less restrictions, Posterior involves cutting (well separating) the gluteal muscles and cutting the capsule that protects the hip... more soft tissue to heal and why Posterior Approach THRs are more prone to dislocation (which is what the restrictions, or precautions, are designed to reduce the already low risk of) Sometimes you don't get to choose which approach you get, I had to have Posterior because it gives a better field of view which was needed in my case, you go with the best recommendations of your OS for the best outcome for you :cool:

 

[Jaycey]

Gosh @Getnfit , you are a real trooper! I am surprised they gave you blood thinners prior to surgery! That's a known complication alone! And yes - GA is SO much harder to come through. Hang in there my friend. At least it's all done and you can now focus on the healing.

 

[Getnfit]

LTHR December 1st, RTHR December 4th, home December 7th... What a ride! Felt pretty good after first surgery, but it's been quite the roller coaster ride since second surgery! I am realizing that pain management is crucial, not enough meds = major glute, quad and IT band pain, too much meds = nausea, weakness and dizziness. Today I think I got it right, one Percocet every four hours daytime, two Percocet evening, two Percocets plus Gravol before bed.
I've been doing plenty of physio because I have to walk to the bathroom every 45-60 minutes to pee! Drinking lots of water (with lemon and cucumber slices) is important to rehydrate after extensive blood loss. I am eating 5 small meals per day. I had a Holistic Nutritionist write me a list of top super foods to include in my diet to support better bone and muscle repair. Pain meds are essential to control pain and good nutrition is essential for faster recovery!
I feel like I haven't progressed much as far as physical accomplishments, still walking very small steps with walker. But I haven't regressed and I feel in better control. I am more positive and I know good things come to those who are patient! Looking forward to being able to walk pain free!


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[Gilly]

Wow @Getnfit I know you've heard this many times already but you really are so, so brave getting the both hips done so close together!! You've been in my thoughts. I'm glad its done and dusted for you and I hope have got the meds sorted as it's not good at all being in pain. Rest up well at home. Wishing you a speedy recovery and I look forward to your updates. Love your positive attitude..

Hugs...

 

[Jaycey]

@Getnfit at only days out of surgery you are doing great! Don't worry about what you assume is slow progress. You have just had 2 major surgeries. Slow and steady and yes, focus on pain management. The more the pain is controlled the more you can begin to get mobile. You are doing great!

 

[Getnfit]

I have a question... One week post-op double THR - I am a little bit concerned that this might be a permanent change... My hips are so freakin' wide right now, I have a thigh gap, I look like a Barbie! My back side has gone FLAT! It's like the surgeon re-attached my glutes to my sides rather than to my back :0( it looks and feels really weird! I understand that my body will be different but this is extreme! Did any of you experience this and did it get better with time? Did your bum go back to where it should be?


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[Jaycey]

My hips are so very' wide right now

Lots of post surgery swelling. Ice and elevate. All this will fade in time. Not to worry!

 

[Getnfit]

10 days post op two THR... Taking only Tylenol during the day and 1/2 a Percocet at night. I finally feel like myself again off the pain killers. I am standing, walking and kicking a bit more every day! Eating foods high in calcium with low inflammation index and drinking lots of water. Hoping I can start walking short distances indoor without walker or crutches by Monday.


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[MissMoo]

That's great news @Getnfit. It's amazing how everything seems to turn around so quickly. Hopefully a lot of that swelling has gone away now too. I had a similar thing at first but I think it was just because my butt was generally the lowest point (with my legs permanently elevated) and little activity meant my lymphatic system was on a go-slow.

Only throw those crutches away when you feel confident that you're walking well. I'm still on a single crutch and several people on here have said to be sure your gait is even before you walk unaided, to help prevent developing any bad habits.

Great that you're almost off the meds too. What is your plan to return to exercise - do you have any restrictions?

 

[Getnfit]

@MissMoo Thanx for your reply. Your right about making sure I don't start unassisted walking too soon and end up developing a limp, better to stay on crutches a bit longer and work towards a more natural gate. I just feel like I need to work on balance, I feel my legs getting stronger already, but it's the weight transfer from R To L and L to R that is a challenge. I'm going for physio on the 19th and hope they give me the ok for more extensive exercises. I'm a gym and yoga junkie and I can't wait to get back at it! My surgeon warned me to stay away from yoga for at least 10 weeks, which I will, but many of the physio stretches will probably be very close to some yoga poses anyways! The only exercises I do right now is walking with assistance around the house and in bed I do heel slides, bridging and leg extensions as well as seated (leaning back to avoid 90 degree bend in the hips) leg extensions. But I can't wait to start doing more glute exercises! I remind myself often that this is a journey, and I avoid focussing on the destination too much!


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[caroline2]

Hi, and I can only wonder if being a yoga teacher caused the hip joint damage? And you are so young. I exercised all my life, danced, walked miles, never was a runner, did some yoga but not heavy duty yoga, and my hip started to act up at about 70, had a RTHR at 72.... other hip thank goodess is good. My surgery side knee is worse since hip surgery, but I'm doing all in my power to save my knee. I never took any steroids in my life, so guess that saved me too for a lot of my life. I think I've read where the AVN is usually caused by steroid use. I had the anterior and left with some complications like nerve damage and some other stuff.... Hope all continues to go good for you......

 

[Getnfit]

@caroline2 Thank you for your post. The yoga isn't the cause of my pre-mature arthritis, I have congenital dysplasia. If I hadn't been so physically active all my life, yes the cartilage might of not worn out so soon, but I was unfortunately doomed with bad hip structure from birth. Yes I'm young at 47 and am a very fit woman, and I must admit that the recovery from these surgeries is the greatest physical and mental challenge I've ever faced. I greatly admire you, having gone through this at 70! I'm sure your fitness played a key role in your recovery too! It is so important to stay healthy and fit so that your body is at its best when your best is needed!


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[Jaycey]

better to stay on crutches a bit longer and work towards a more natural gate

Indeed! The sign you are ready to venture out on your own is when you start leaving your walking aids behind. Still early days - especially since you had two major surgeries within days.

 

[caroline2]

Thanks for your explanation Getnfit, I was fit for the most part and strong and get angry when I think of the nerve damage etc I'm dealing with 4 yrs post op. I put trust in the surgeon and now working with the mess....as I said in my post I think, some days, I could scream, cry and get very angry. And I can still hear my GP's words, "you could be in a wheelchair if you don't do the hip replacement".....so I'm not but who knows.... My issue was right groin was all crumbling bone/cartlidge when I saw the xray...... C

 

[hippo70]

Congrats on your recovery Getnfit. My wife is scheduled for left THR (anterior) in February. I don't want to hijack your thread but if I could ask a question - you are the same age, same condition (AVN from congenital dysplasia), she even did ballet when she was young but no yoga - What size ball did you get? Her surgeon has advised a smaller ball because of her shallow socket (if I described that incorrectly my apologies). Did you have leg length differences? Her left leg is 1.5 inches shorter now, which they expect to be even after. If so was that a problem?

She is scared to death, primarily of nerve damage leading the loss of control of her foot.
Thanks and continued success.

 

[Poppet]

Ditto Jaycey - best to stick with your walking aides and improve your gait at this early stage - you are doing so well

 

[Getnfit]

Hi everyone! One month post double THR, survived the holidays and excited by my daily progress! I can go up and down the stairs like a normal person, a bit slower, but only holding on to railing and only one foot on each step! Getting around the kitchen with no crutches, focussing on posture, lifting knees a bit higher than needed and maintaining my centre of gravity. Still using crutches for any walking outside the house. Finally sleeping 8 hours without having to get up to pee! I wake up middle of the night to flip over onto my belly, a couple hours later to flip onto my back again and usually spend the last hour of sleep on my belly again. I am so close to being able to lay down on my side with a pillow between my knees, scars are still just a bit to tender. My body shape has changed a lot, hips are much wider than before, but I guess that's the price I have to pay for the LARGER balls my OS recommended. Although my socket wasn't very deep (dysplastic), at 47 years old, I wanted to continue being active, so he recommended the larger ball (39mm) and socket to allow for a greater ROM AND lessen the risk of dislocation. He performed a lateral approach which left me with 6" scars. But he didn't use any staples, only dissolving stitches, which makes for much cleaner scars. My prosthetic hips are a combination of cross linked poly (plastic), ceramic and metal. I am now 1/2" taller, and my OS made sure that both legs were going to be a bit longer and match up! I could feel the left leg much longer after the first surgery, but everything felt even after the second surgery!

Getting both hips done 3 days apart has been quite an ordeal, but I have no regrets! The pain I had in both hips pre-op is gone! I no longer have pain really, it's just a question of time for my muscles to get strong again, for the scars to heal and for my range of motion to improve to allow me to stretch and get rid of the stiffness. It took me two years to actually accept that my only option was THR and now that it's one month behind me, I'm so glad I did it! Good luck to all you hipsters! Stay positive, eat well, rest lots, keep moving!

I do have one question for you double hipsters out there... Sex? When can we resume having sex? I realize that until I have clearance to "abduct" it might be best to wait. But just wondering when will it be safe to attempt love making again :0)



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[Gilly]

Hi @Getnfit Happy New Years to you!!!!

I have been wondering how you were getting on and it's great to hear from you and that you're doing so well and getting stronger. I find it hard getting my head around how you have coped having both done at once...So so brave...But it does get it out of the way in one go and no going back...I'm week seven, back to work tomorrow, yay so happy about getting back to normality...I know I will be tired but will get there..Having my follow up appointment Thursday so will be asking about the 2nd operation. I think I will give myself more time before I get the right one done.

You mention sex, that's a biggie for me too and will be discussing this with the surgeon...I'm not 100 per cent sure what we can/cannot do at this stage. What I was told prior to having the surgery was that it my flexibility will return and sex will be better after the replacement...


Hope you having a good day..

 

[cnydutch]

Gals it's been said "if it hurts, don't do it". My doc was that way, and i know it's different
with me being a guy, but, there are gentle ways to try and see how it goes. don't expect
a marathon and don't expect the earth to move, but, like everything else in recovery take
it slow and rebuild as you go..

@Getnfit you are a brave girl having those surgeries so close! congrats on your smooth
recovery! keep up the good work!

 

[Getnfit]

Had my 5 week follow up with OS on Wednesday! I'm cleared to start doing some "real" exercises! Let the hard work begin! Both THR are looking great and my ROM was quite impressive! I'm allowed to forward bend beyond 90 degrees and can now do abduction work to wake up my glute med! On Thursday my PT recommended I try walking with walking poles. Wow! They're amazing, I can walk with those sticks way faster than with crutches and yet they keep my in alignment much better than with no assistance! Can't wait to use them outside! Unfortunately it snowed overnight and I won't risk going out until the sidewalks are cleared! I also went on an upright bike for the first time yesterday, no resistance, but it felt very comfortable and my PT said my knee/hip alignment was fine. Give it another week and I will probably attempt a spin class! Yeah! Also did my first personal yoga practice today!!! Nothing fancy, but I was quite comfortable with Crescent Moon, Tree pose (easy version), Warrior 1 with Eagle arms, Toppling Tree, 1/2 Forward Bend and Chair pose. It felt amazing to breathe in every posture and achieve such a milestone! Anyone out there still afraid of THR, don't be, it's all worth it! Make sure you stay as fit and strong as possible, including upper body strength, right up to the day of surgery and recovery will be that much easier! 2015 is going to be a GREAT year!


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