THR Over the first hill...ready for the rest

[Layla]

Hello and Happy Wednesday to you!
I hope the week is going well so far.
Stopping by to wish you the best at your appt with the OS tomorrow.
I hope you leave there happy and reassured. Please update us if you feel like sharing. We're here for you.
@kfisher119

 

[kfisher119]

I had my post op with my surgeon today. He says the hip looks great and is healing fine. I can drive but two more weeks before I’m allowed back in the pool.

I was a little distressed by my x-ray. It’s clear that my pelvis has a pretty dramatic tilt. He says this is from muscle tightness that developed due to compensation pre op and readjusting post op. I asked about the SI joint and knee pain and he was hesitant to reassure me that this would resolve. He wants me to see a spine guy. I got weepy. I wanted to be the patient that could tell him he was amazing and had given me my life back. Worst case, I hoped he’d reassure me that it would all settle out with more healing. Referring me on to someone else was so disappointing. Has anyone one else had significant SI pain during recovery?

 

[CricketHip]

Yes, I did. In fact, I think many of the members had some SI joint pain post op.
In my case, my lovely Chiropractic Dr. has helped me immensely. I am about 3.5 months out and just recently she is seeing movement where it should be, everything on that right side was locked up.. whatever that means. I don't know if you have ever been to a chiro Dr., but it's important, as in everything, to find a really good one that does gentle adjustments.
On the positive side- at least you can get a check up with the spine guy and rule some things out, right? It's still very early on in your recovery, please try not to worry. My knee was still bothering me at 4-5 weeks, too. Now it's fine.

BTW- I've found this to be the case with my OS, he's very quick to refer me to the "spine guy."

I am sorry you are so worried, I hope you can get some answers soon.

 

[kfisher119]

@CricketHip i know you’ve mentioned living in the Philly suburbs. I live just outside Allentown. Wondering if you had a Rothman doc. Pm me if you’d prefer.

 

[Layla]

Good Morning and a Happy Friday to you
I'm sorry you were distressed by the visit with your OS yesterday.
I hope CricketHips commentary offers you some reassurance. Don't lose hope, it's certainly way too early for that. This recovery biz can take time and I'm sure you'll get there, so chin up. Brighter days are on the way.
Have a lovely weekend!
@kfisher119

 

[kfisher119]

@CricketHip I had been thinking about a chiropractor. I do have a good one, very gentle. She also practices acupuncture. I think I will call her and ask her opinion. Perhaps even a stim treatment would relax these muscles a bit. I just wasn’t sure if that was the right thing to do this soon. OS did suggest stim or ultrasound therapy might help the knee. Thanks for the suggestion. Good news is, now that i’m off aspirin for blood thinning they will let me take ibuprofen. Helps much more than Tylenol!

 

[Mojo333]

In fact, I think many of the members had some SI joint pain post op.

Me. I was really nervous to having any adjustments made but I've never been to a chiropractor or know what to look for in a good one.
I have been going to PT for this issue and tight hip flexors were definitely in the mix for my issues.
Some targeted stretches and exercises have been Really Helpful!
I am considerably further out from hip replacement than you. So I would also "exercise" caution.

 

[kfisher119]

Thank you @Mojo333. I agree this is a “proceed with caution” decision. I will just start with a consult. I’m thinking more about stim or ultrasound therapy for starters. She also does acupuncture which might relax things a bit. I know she will not be aggressive in any way.

 

[kfisher119]

Today I tied my right shoe by myself! It was a stttrrreeettcchhh, but I did it!

 

[Mojo333]

Today I tied my right shoe by myself! It was a stttrrreeettcchhh, but I did it!

Hip hip hooray!
It IS the little things...

 

[CricketHip]

Ahhh, that is good news that you have a Chiro Dr that yo know and trust. She will be a good start in pursuing the back issues.
Good on you about the shoe strings getting tied!

 

[Layla]

Great news on tying your shoe!
All of those milestones feel so good.
May there be many, many more.
A great Wednesday to you!
@kfisher119

 

[kfisher119]

Here we are at week seven. Overall, I think I'm doing well. I'm off all prescribed medication but taking the max ibuprofen allowed per day. I'd say I'm about back to the discomfort level I was experiencing pre-op. I never had the excruciating, grinding joint pain so I also didn't experience what others describe as immediate relief. My hip would really hurt or I'd occasionally feel that sense of leg collapse when I did a lot of walking and was quite weak climbing stairs. But my day to day pain seemed more associated with extreme muscle tightness. I was so tight in my lower back and through my hips that I couldn't easily reach my feet to tie my shoe and my range of motion was compromised. I couldn't get my leg over a bicycle seat. All the muscles that serviced my hip got tighter and tighter on the right but the left is very flexible. I did develop a significant limp the led to a significant knee pain.

So at seven weeks of recovery my incision looks great but it still tender to pressure. I'm still limping quite a bit but not using any support (cane) unless I'm out of the house for awhile. I have the pain/tightness in the lower back and hip flexor and the knee and my SI joint, knee and lower leg are still achey a LOT. I feel like I've overcome the recovery pain but haven't progressed much past where I was in August.

I'm back to a lot of normal activities but trying to hold off on anything too strenuous. I've had to be back at work the last week and a half due to staffing issues but I'm not officially back full time. A full day at work is exhausting and I go armed with ice. I've had a couple of days where I was on my feet for an extended periods of time. My husband wanted to do a shopping trip to an outlet mall which was exhausting. HE was the one shopping and I was the one looking for a place to sit and pass the time. I also went to an afternoon workshop that had me on my feet for 3 hours that was followed by a 2 hour meeting. That was a little easier on me that the shopping trip but again...exhausted and aching like mad by the end. I know...ODIC!

I'm still finding it best to sleep in the recliner with ice. Sleeping on either side pulls too much on the incision, even with a pillow for support. I've always been a stomach sleeper but if I try and lie face down my hip flexors are in agony. The pulling is extreme over my pelvic bone. I can feel that they are just SO tight!

At my follow-up my OS was still against any therapy but I'm feeling like it's a necessity. At the very least I'd like to have my mechanics analyzed and get some guidance on safe stretching. I'm cleared for the pool as of today so this weekend I think I'll head to the gym. They have a therapy pool, very warm for arthritics. I'll try doing some water walking and gentle stretching and see how that goes. I've been given no guidance as to what to avoid to minimize the risk of dislocation. I'm wondering how much I'm at risk 7 weeks out.

Please don't read this as whining, it's really not. It's just the facts. I know I'm progressing slowly, I guess I'm just confused as to what to do next. I have such hope for one day waking up to a pain free day. I can't remember the last one. Just trying to find the right balance between resuming normal life and more (getting out on those hiking trails) and staying out of the OCID.

 

[Calgal]

You sound amazingly good for week 7! The pool walking sounds lovely and I think it will help loosen up those tight muscles. I did have several PT sessions weeks 2, 4, 6, 8 and 12 where they looked at gait and gave me some simple stretches. I wasn't really diligent but kept walking and then at 3 months (with PT approval) started weekly private sessions with a Pilates / physiotherapist. She has gently helped me gain strength and better equilibration and I'm still working with her after 7 sessions. I was really stiff through lower back and pelvis and she helped me loosen all that area immensely. Will continue through the end of the year I think as my glute muscles are still very weak. It's a long process to regain strength and balance. Don't push too hard, it backfires!! You'll get there. Take it slow and steady. Good luck!

 

[Elf1]

@kfisher119 you sound pretty good for 7 weeks, this is definitely a marathon, slow and steady wins. I would suggest that you use your cane more as you state you're still limping quite a bit. Assistive devices really do help and if you aren't already doing so try heal toe walking. Start with your heal hitting the ground then rolling up onto your toe and push off from there, hope that makes sense. It's also helpful if you can do it in front of a mirror sometimes so you can see and correct yourself if you need to.

 

[CricketHip]

I think you sound right on track. There are a few more ups and downs waiting for you.. sorry but it's true!
I agree with what Elf1 said, please reconsider your limited use of the cane. I know it's a pain to keep track of but it seriously will help you with walking without the limp.

I didn't take your update as whining at all. You were stating the facts. I read some positives, too. You coped with helping out at work, and you are cleared now for the pool!

Since your surgeon didn't do much in regards to explaining the dislocation risks, I think I'll leave you the link that takes you to our forum nurse 's wonderful explanation in regards to the risks.
You may have read it but maybe it will help to see it again. Take care and have a great weekend, I think you are doing so well!

Dislocation risk and 90 degree rule

 

[Layla]

Hello and a Happy Saturday to you!

I'm still limping quite a bit but not using any support (cane) unless I'm out of the house for awhile.

As both Elf and CricketHip have mentioned, it is advised you use the cane until you're no longer limping.
A tip -
Try heel-toe walking when / if you're limping. Let your heel hit the ground first followed by toes.
It takes a concentrated effort but I believe you'll notice a difference. Please give it a try, if you haven't already. Using the cane while you still need it, and you do, may relieve some of that tension you're feeling in other areas.

My husband wanted to do a shopping trip to an outlet mall which was exhausting. HE was the one shopping and I was the one looking for a place to sit and pass the time.

That kind of takes the enjoyment out of the shopping trip. I'd go with my gut and if I felt an activity may be too physically taxing, at any given point, I wouldn't engage. There will be a time for shopping when you're walking more confidently unassisted, feeling stronger and are more energized. Major surgery definitely takes the wind out of our sails.

I know you realize your return to work feels premature. Twelve weeks is advised with a Phased Return - https://bonesmart.org/forum/threads/phased-return-to-work.5696/
I understand that's not feasible for all and you may not have a choice. Please take every opportunity to do what you need to do to be comfortable while there. No extended standing, or sitting. Bring ice packs to store in a community refrigerator, or a small cooler desk side if you feel you could benefit from using one while there. Hopefully your colleagues understand that you've experienced major surgery and are conscientious and understanding in regard to your needs.

I also went to an afternoon workshop that had me on my feet for 3 hours that was followed by a 2 hour meeting.

That's a bit much for this point in recovery. Three hours on your feet followed by two hours of sitting, likely on an uncomfortable office chair, must have felt exhausting.

Please take it easy in the pool this weekend. Some water walking and gentle stretches sound relaxing and a bit therapeutic but it's easy to overdo it in the water and not feel it until later.

At seven weeks, you're still early days into your recovery considering you hope to have this implant in place for life. You're doing well but I think you could scale back in the areas mentioned a bit longer.

Wishing you comfort and a relaxing weekend!
@kfisher119

 

[Layla]

Happy Two Month Anniversary!
Hope you're doing well.
Have a wonderful rest of the week!
@kfisher119

 

[kfisher119]

It's thirteen weeks post op and I thought I should probably check in. I am improving but not where I was hoping to be. I'm trying to walk regularly and getting in about a mile a day. I have a friend who had a double knee replacement 8 months ago and she recommended someone to me who is helping her quite a bit. He was an OS but now has a small private gym. She told me he works her hard but it has helped her recovery tremendously. So I have been there twice and I like it, I like finally exercising regularly. But it does not seem targeted to my complaints. His philosophy is that muscle needs rich blood flow to heal. So I do a series of exercises with very moderate resistance but with speed and repetition to increase my heart rate. We shall see. I feel good working out even though it is challenging.

I'm still having pain along the long muscle that runs parallel to my lateral incision. It hurts most from the lower end of my incision scar down to my knee and it hurts most when I first start walking after sitting. It has a hard time bearing weight for a number of steps so I have a serious limp every time I get up. With movement, it seems to work itself out until it becomes fatigued, then I'm walking funny again. I'm consciencious about the heel/toe walking but there's still a limp and my stride is quite short. I almost feel like I'm taking baby steps.

Overall, I think I'm better but when I stand and take those first 10-12 steps my husband will always ask why I'm not getting better. I have no answer.

Still sleeping in the recliner often well iced. I have tried sleeping in bed but I cannot get comfortable. Sleeping on the incision side applies pressure which hurts and sleeping on the opposite side really stretches and pulls at the incision even if I use a pillow to prop my knee. I still have a lot of tightness in my lower back (SI region) and my right hip flexor.

To those who've been there, how does this sound. My OS doesn't "need" to see me until March.

Unfortunately, my 91 year old mother just fell and broke a hip last week. It's the second one. She does not live near me so I'm not fully apprised of how she's doing. My sister keeps me up to date on the phone. Because of her age, she's sometimes confused. I spoke with her the day after her surgery and she didn't complain of pain but she had only been up to stand once. She was moved to a rehab hospital yesterday after hip replacement surgery. I wish I was close enough to see her and help her.

 

[CricketHip]

Oh gosh, I am so sorry to hear about your mother. That has to be so very difficult for you, living further away. Are you able to see her over one of the holidays coming up? We have had a few members talking about their elderly parents with fractured hips and they seem to recover well. I wish this for your mother, too.

Your exercise program sounds a little strenuous to me, are you certain that isn't the reason you are still having such discomfort? Not trying to sound negative but it sounds a bit worrisome to me.
The muscle you described sounds like it's the Iliotibial band? Does that sound familiar?
You can get very inflamed there and I'm wondering if you would consider backing the exercises down a bit?

As for not seeing your OS until March, I don't see mine until I am at 6 months post op. They all seem to vary with their philosophy on the follow ups.. I saw the PA at 3 weeks and that's it.
I would have liked to have seen him at 3 months but apparently he's not missing me like I miss him.

I hope you have a good holiday and sending your mother and you some good healing prayers.