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Pre-Surgey Hip Pain at Night Improved Using a Recliner?

gertie

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@VSlowLife It's good to be prepared for foggy brain but my guess is that you'll not need super heavy pain meds, especially if you have the direct superior approach or something akin to it. By day 3 I was just on Tylenol and I am no stoic. I was given Dilaudid in the hospital but at a low dose so I wasn't too foggy there either.

It's good to test-drive a rental chair. The one I rented this time had a lumbar support that hit me in the wrong place and aggravated my already annoying low back pain, which I think resulted from all the realignment post-surgery--and the footrest didn't completely support my long legs.
 

Eman85

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THR has it's pains but I never got the least bit groggy or foggy from the pain pills. For me it seems if I have enough pain all they do is kill the pain sensors and I don't have any other effects. At least that's how it was with Hydocodone for me.
 

VSlowLife

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@Steelmanpa You have me thinking of other options to manage the pain, thank you! I always run things past my local pharmacist before I change anything. When the pain goes to a five or more my teeth tend to clench.

My GP wants me to talk to a pain doctor about something to give me more long-term relief. I am hesitant to try tramadol again, since it was not easy for my body to titration off of it. My lidocaine patches don’t take the edge off now, either. I pushed myself too much this past week to try to get some things done, and now I am paying for it.
 

VSlowLife

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@Eman85 My leather recliner has no controls except using your legs and back, but it was very comfortable to sleep in. My mom is currently using it in her assisted living room. She needs her legs up in the afternoons. Glad your’s worked well for you. There are so many models out there. I am considering renting one, since I have a small home.

Wow, you are right, if you lose electric it will not work! We get nor’easters in the winter, and ice storms at times, so I have to think about that, even with a rental. I do not have a generator with a propane tank for an automatic transition. Hmm, I wonder if there is some kind of temporary battery pack, that could work in an emergency situation? Electric wheel chairs have a battery pack, I think. What a good point, but sorry it happened to you!

I have had 7 or 8 surgeries. Unfortunately for me, general anesthesia makes my brain somewhat unreliable for a week. Strong pain meds even at the lower doses, affect my memory. Maybe I metabolize some medicines more slowly than other people?
 

VSlowLife

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@gertie I do think a power recliner can be a good idea, too. I do have two upholstered dining room chairs with side arms for sitting at a table. I will just need to raise the seat with a few pillows or cushions. That will initially give me a little exercise for the quads.

I do not have a back porch couch, just wood outdoor lounge chairs which may be too low, based on which approach I end up with. I am currently looking for a couch that is 22” or more for the seat. So many are just 18 or 19” which are not appropriate when you have bad hips.

I have visited my local medical supplier. The medium chair just fits my leg length and I am only 5’3! I thought I could get a petite chair. I think I will bring a book to read next time to see how it supports my back. Thank you! I know Golden lift chairs have a lift recliner for taller people.

I forgot about less pain meds with the direct superior approach. I recall reading how well you have done in respect to that. I just want to cover my bases, because I have read, in some cases the direct superior surgeon may need to switch to a posterior surgery if something comes up during surgery. Something I need to discuss with the surgeon at the end of the month.
 
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gertie

gertie

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@VSlowLife Yes, my OS told me he would switch approaches if needed--thankfully he didn't need to! I'm lucky to have a daybed on my back porch and that's where I nested these past months. You were wondering what would happen with a power chair in a power outage. The rental I got had a battery backup pack--the fellow who delivered the chair said it would probably only work to get the chair out of recline mode one time--but that's all that's needed really--something to keep you from being trapped. So, something to ask about. Might be a standard feature.
 

VSlowLife

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@gertie A daybed is raised up, so a very good place to recover. That is an option I will consider, rather than my pillow top mattress. @Eman85 had mentioned a power outage happened to him while he was in his recliner and the provider had not provided a back up. It’s good to know it is possible to have a back up to be able to get out safely if needed.
 

Steelmanpa

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@VSlowLife The thing to remember is the body is dynamic and things are in a constant state of flux, so some medications both OTC and Rx may be more or less effective due to a variety of things..
 

Ptarmigan

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Hi, @VSlowLife !

I am finding a great deal of success sleeping in my recliner post-op, and I found success sleeping with a body pillow pre-op. There are two subjects involved here: pain relief and sleep. They are related, but separate.

First, pain relief: When I began seeing my current PCP in November 2018, I had been taking Aleve for arthritis pain. He immediately recommended Tylenol. He said I could use the Aleve in addition to Tylenol to treat flareups, no more than 2-3 times a week. I got much better pain relief from Tylenol right away. (Note: I am unable to take Tramadol, because I have a bad reaction to SSRI/SNRI’s, so this is not a medication we considered).

The other things that helped me preop were icing and reclining. I am making a distinction here between elevation position (“toes above nose”) and reclining position (legs extended, back slightly reclined). I think the most important investment I made was in my icing machine, and I found a long icing session before bed provided me with enough pain relief to enable me to fall asleep. It was my ability to spend nearly all my seated time in a recliner position that helped me control pain by getting the weight and pressure off my bad hip. Sitting in a typical chair resulted in joint aching after 30 minutes.

Second, sleeping: Although I have an adjustable bed, I was unable to adjust it to a position that worked for back sleeping or even resting without pain. What did work for me was using a body pillow, sleeping on my non-op side, and wrapping arms and op leg around it. When I rested that op leg on top of the body pillow, I found a way to unweight the joint, and keep it in a neutral position, which minimized pain. I will go back to bed when I am ready to side sleep again. In the meantime, however, I am successfully back sleeping in the recliner, which is invaluable.

The recliner has a lever (it’s not powered) that controls the raising and lowering of the feet, and tilts it back a bit to correctly position the back when the feet are up. The lever is conveniently placed where I can reach it without twisting and isn’t too stiff for me. Once the feet are up, the recliner can also extend out and flatten, lowering the back angle until it approaches zero gravity. It requires some muscular effort to do this - either a push with the foot of the non-op leg or a helping hand to adjust it. I have access to both, so it’s working fine for me. The other feature the recliner has is substantial padding, so it feels like a welcome embrace.

We’ve been using recliners as “real” furniture in my family for a while now, in part because we’ve all recuperated from something in a recliner (even a nasty upper respiratory infection, where we controlled bad overnight coughs by sleeping upright), and in part because we enjoy a home theatre experience. I have ordered several pieces of “motion” furniture from LazyBoy - the variety of color, style, and options available is impressive, and the prices are moderate. LazyBoy recliners are also very available used, for an significantly better price. I strongly recommend an outing to sit in the chairs yourself, as you cannot tell from a picture how the chair will feel, and that’s crucial.

All that said, if I had had a posterior incision instead of an anterior, I would have needed to adapt my recliner to an entirely different set of restrictions. I think @mainegirl1 is 100% right when she points out you need to know what your approach will be in order to plan for post-op. I tried to plan for all contingencies, as I did not know for months which approach I would have, and I found it to be frustrating and ineffective.

Wishing you well!
 
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VSlowLife

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@Ptarmigan Thank you so much for your thorough review! I really appreciate it and I know others will, too.
I am seeing my first surgeon of 2019 tomorrow. I have been getting ready for that appointment. Will write more later.
 

Mojo333

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Please let us know what you glean from your appointment tomorrow @VSlowLife
I know it's an anxiety producing proposition, this hip replacement business...but truly, it gave me my life back!
 

VSlowLife

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@Ptarmigan I am so exhausted and so many things hurt from making this trip today that sleep is escaping me. I think I will end up with a recliner, even if it is a rental, because the bottom line, the surgeon said today, is there is a danger of the femur braking, especially since I am close to osteoporosis as a result of the parathyroid tumor which plagued me until this spring. It does not matter which approach as it can happen in any approach. This surgeon suggested a dual mobility head (Smih and Nephew) and a mini posterior approach @Mojo333, too.
He said my x-ray was about as bad as it gets. It confirms how much worse I have been feeling from that hip. Instead of one bone cyst I have several. I am sooo bone on bone!
BecauseI have a lumbar fusion he did the EOS standing and sitting full body x-rays to measure the pelvic tilt. Less radiation than a CT Scan and used in pediatric patients. He has been one of the published researchers working on THR for lumbar fused patients. He says there is an algorithm that has been developed to try to get the best angle insertion of the acetabulum in lumbar fused patients. There is a consortium of four hospitals nation-wide working on perfecting THR for lumbar fused patients.
I am glad he was so honest with me. I believe a fractured femur requires no bearing weight. I have used crutches in the past, and know I can survive using them.
 

Mojo333

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:wave: @VSlowLife
Sounds like you have found an OS that you can put your trust in and who is looking for a great outcome despite your extenuating issues.
This is so helpful...trust in my surgeon alleviated much anxiety on my end.
I had a recliner...lived in it for much of the first month, and love it still today.
Your hip situation does indeed sound dire so now we move from should I do this :what: to Got to get this done :yes:
I think you will love your new hip!:happydance:
 

VSlowLife

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@Mojo333 Yes, my hip situation is not good, for sure and I am glad to have found a surgeon to say “ Yes” to surgery for the right reasons. I am learning about the Smith and Nephew dual mobility system. @Elf1 mentioned to me that she was considering a dual mobility system, too, and her surgeon was willing to use one, but she heard they may not be easy to pop back in should it dislocate and require surgery. She did not have a specific source she could recollect. Would Josephine know more since they have used dual mobility hips for decades in Europe? I have read in general, that dual mobility hips are recommended for lumbar fused patients.
I am have a second opinion soon.
 

Mojo333

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Jo just had a knee revision surgery so she's been away from the forum, but I will certainly forward your concerns on.
I think if the dual mobility hardware is somehow more difficult to reposition in the case of a dislocation, my take away would be to make sure I was ready to undergo the initial recovery period with the utmost of patience.
I wanted my new hips to get good and settled before I pushed them to perform and didnt fall into the bragging rights pool of how quick I could drop recovery protocols.
It has served me very well.
 

Mojo333

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He has been one of the published researchers working on THR for lumbar fused patients. He says there is an algorithm that has been developed to try to get the best angle insertion of the acetabulum in lumbar fused patients. There is a consortium of four hospitals nation-wide working on perfecting THR for lumbar fused patients.
This surgeon sounds custom tailored to your specific needs. Would you mind sharing his name and location with us. We love to have these resources to pass on.
I am have a second opinion soon.
Sounds like the EOS xrays were quite conclusive...is there a reason you dont want the first OS doing the surgery?
 

VSlowLife

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@Mojo333 Thank you for responding. I hope Josephine has a healthy recovery.
It seems that there are more components in a dual mobility hip, so it is not easy to pop it back in like a traditional hip. I believe @Elf1 needed to sign a paper acknowledging this, if she had decided she strongly wanted the dual mobility hip.
The surgeon I saw, said I would have no restrictions after surgery. I believe he told me he removes one tendon and separates the muscle fibers of the gluteus maximus during a mini posterior surgery.
I agree with you about being cautious and careful, despite what the surgeon told me about no restrictions. How do I know my femur won’t fracture and then I have a few restrictions? I would rather be prepared and not worry about it.
To that end, I ordered a two motor tilt chair today.
I will have it next week and plan to start sleeping in it to see if I can be more comfortable sleeping and resting before surgery. This surgeon is booking at the end of November. I may pre-schedule my second hip, too. Thank you so much for your advice!
I am trying to get an appointment with the allergist he wants me to see. While I was infusing vancomycin for my spinal surgery, I became itchy around my head and ears. They told me that was an allergic reaction. Vancomycin is a broad spectrum antibiotic that this surgeon uses to close the wound. Another doctor along the way, mentioned if I was infused too quickly, that can cause that reaction, too. So I need to find out if I am really allergic. I do not know what they came up with as an alternate for the spinal surgery twelve years ago. I also have another antibiotic allergy that gives me red dots for a week.
 

VSlowLife

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@Ptarmigan I wanted to let you know I took your advice and ordered a two motor tilt chair today.I will have it next week. Since there is the possibility I could end up with a fractured femur, either during hip 1 or hip 2 surgery, it made sense to be prepared and relax about it.
Would you mind telling me the name of your ice machine? You sound so happy with it pre and post surgery for pain, either I will rent one or buy one. I have no idea how much they cost.
 

Elf1

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@VSlowLife didn't have to sign anything about the dual mobility implant, was just a conversation between the OS and I.

I'm curious like @Mojo333 and wonder why you're getting a second opinion when this doc Seems to be everything you've been looking for? Just curious.
 

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