THR Quad spasms THR

Naps

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Hi, having had my RTHR anterior, on Jan 3rd, I finally made it to the other side! Have to say that as prepared as I thought I was, I really wasn't.
Sorry for the length of my note, I just couldn't write anything before now.

Surgery was scheduled for the morning, OR ended up delayed for an hour. Was OK, as I was chillin' but boy, was I nervous. Luckily my husband was allowed to be with me until I went to the OR. After yet another body scrub, IV placement and signatures, I met my anesthesiologist and was wheeled into the OR. Before the spinal was done, I was sedated and do not even remember getting the spinal. Woke up in recovery- husband by my side.
After 2 hours in my room, doctor came by and then physical therapy came and got me up. I walked, with a walker, to the hallway and back- then sat in the chair for lunch. After lunch, back to bed and another PT session to do 13 steps up and down with a cane. For medication, I had Celebrex ( for 14 days), tylenol every 8 hours, aspirin low dose and tramadol every 4-6 hours. Staff was very helpful in providing new icepacks whenever mine melted, but I was not allowed to elevate my legs due to these compression things that were wrapped around my calves- they inflated in and out to prevent blood clots. They actually felt like a massage to me. I stayed until the next day, went home early afternoon.
Recovery: the first 9 days were quite miserable for me. Pain, bruising and swelling were intense. In addition to the above medication. I used a combination of the ice machine, "magic Gel hip packs" ( Amazon), elevation. The pain med was too strong for me, so I had to decrease the dose in half. It was making me dizzy, nauseas. cramping and unable to use the bathroom.(TMI?) For the bathroom issue, I originally started using senekot, then found out a daily bowl of raisin bran did the trick.
With the anterior approach, my bruising and swelling extended from the suture line, wrapped around my hip and down the butt. Very purple. The swelling began in earnest on day 3, and it was my entire thigh to a few inches above my knee, and the skin was very tight. The log leg like everyone said here. My surgeon had sutured beneath the skin, applied a clear water proof glue and no bandage was needed. Now, on day 12, the thigh swelling is almost gone. The incision is oddly swollen, kind of like a 4-5 inch bubble.
I do have tight swelling on the back of my hip, approx at the height of my incision line. Bruising is less now, turning yellow-green. There is sciatica-like pain when I try to sit on the commode- could this be from the hip swelling? There is also a feeling of a golf ball on that side when I sit on a firm surface.
I have not done anything besides rest, elevate, ice and do the isometric muscle squeezes the PT told me to do. If not for the posts here, I would have probably tried to do too much. Tomorrow is my first day out of the house and I have only gone up/down my stairs ( 13 steep) three times- very scary to come down them. I get up every 2 hours to walk to the kitchen, bathroom, etc. Not sleeping well yet as I am not a back sleeper, miss sleeping on my side!

One other question: how long does your surgeon have you wearing these thigh high anti-embolism stockings? Mine are so uncomfortable, I am thinking of asking if I can switch to the knee high ones.

Things that are helping me: I bought a wedge on Amazon, use it everyday! Did not get any swelling from just above the knee to the toes, as I had worried I would. A leg lifter I got on Amazon, used to lift my log leg in and out of bed, car etc. Get a rigid one, mine is 42" log. Grabbers: I found them at the Harbor Freight Store for 2.99 and have several through-out the house. Also got a clothes hook which also is useful moving your blankets over your legs.
Railings: my hubby put on the toilet. I had practiced getting up with the good leg, but didn't take into account that pain, swelling and general weakness would make me need the railing. Ice machine is invaluable, especially when lying down during the day and for overnight. During the day, I used "Magic Gel" hip packs, which I can get up and move around with. I also got a lanyard for my phone, as I was afraid if I fell down my husband would not hear me, or he could be outside.
Tomorrow is my follow up visit, I have a whole list of questions.

**Thank you to all who offer their advice and experiences to us,as Bonesmart truly is a place to go to share with people that "get it"**
 
@Naps Welcome to the recovery side! It sounds like you are doing well at this stage. And FYI I can't think of anyone who loved those compression socks! I know I ditched mine as soon as possible. Yes do ask your surgeon about getting the knee high ones ... or just doing away with them all together.

I'm sure you've seen these before but just for a refresher here's our recovery list of helpful things:

Hip Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary.
2. Control discomfort:
rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.
4. PT or exercise can be useful BUT take note of these
BoneSmart philosophy for sensible post op therapy
5. At week 4 and after you should follow this
Activity progression for THRs
6. Access these pages on the website
Oral And Intravenous Pain Medications
Wound Care In Hospital

The Recovery articles:
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
Post op blues is a reality - be prepared for it
Myth busting: on getting addicted to pain meds
Sleep deprivation is pretty much inevitable - but what causes it?

BIG TIP: Hips actually don't need any exercise to get better. They do a pretty good job of it all on their own if given half a chance. Trouble is, people don't give them a chance and end up with all sorts of aches and pains and sore spots. All they need is the best therapy which is walking and even then not to excess.
We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.
While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
 
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Welcome,
Everything you post here sounds totally "normal" so far, good luck with your post op visit and let us know how it goes. :)
 
:wave:Boy, those first weeks are tough...
and I didn't post for a while either.
I got a lot of pain relief from icing and found my swelling to be fairly minimal:ice:
Slow and steady...at this stage... gets us to where we want to be quicker.

Healing Hugs XXX
 
Welcome to the recovery side! Your update was a good one and sounds oh so familiar.
What a shame that the pain meds weren't as helpful as they could have been, it's a real balancing act.
But it now sounds like you are on the other side of that, with things looking up a bit!
Slow and easy does win the recovery race...
Congratulations on your shiny new hip!
 
Hi,
Now I’m at 17 days post op. Things are going slowly. Still a major problem is not being able to sleep at night; being unable to get a comfortable position. However at least twice a night for the last several nights I have experienced intense quadriceps muscle cramping. I had the anterior approach and the cramp starts at the top of the muscle all the way down to my knee. there is radiating pain also down the outer side of my shin.
Does anyone have this and is there any preventative measure or is there something I can do to prevent these cramps? They are very painful and wake me up and keep me up. Afterward, the muscle is very tender. Thank you for any suggestions
 
I had "charlie horses" off and on, I think magnesium supplement was suggested???
I'm sure you will get some advice, but those spasms do hurt.
Sleeping in the beginning is very uncomfortable and sleep is not continuous, it will get better.
 
@Naps Are taking any medication for pain relief? Sleep issues are part of this recovery. But if you are under medicated it can increase the problem.

Many new hippies complain of cramping. Muscles and soft tissues are recovering from all the trauma of the procedure. A heating pad on the area may help (but no heat on the incision yet). And as myglass suggested, magnesium does help both sleep issues and muscle cramps.

Here's a link to an article from our Library Magnesium is a star.

You will notice that I merged your newest post with your original recovery thread. For several reasons, we prefer that you only have one recovery thread:
  • That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
  • If you keep starting new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
  • Having only one thread will act as a diary of your progress that you can look back on.
Please post any updates, questions or concerns about your recovery here. If you prefer a different thread title, just post what you want and we will get it changed for you.

If you need an urgent response to a question, just tag a member of staff.

Many members bookmark their thread in their computer browser, so they can find it when they log on.
 
The muscle recovery is the slow part of the recovery. Cramps and other pains are pretty common, the sore muscles don't like being used. Nutrition is very important in rebuilding our bodies after a THR.
 
@Naps my memory finally got jogged enough for me to remember similar things to your quad cramps. Are you still having that? Ouch!

A bit of history-- I have had "growing pains" all the time since I was a child....

For both my hips I had calf cramping, not as bad as what you're talking about, but both times it sent me to ER concerned I was getting a blood clot. Both times it turned out to be under-medicating. I had an opioid/max dose tylenol plus Celebrex, and can't stand the constipation, so for both hips I tried to start weaning before the works got too stopped up. In both cases I had to up my med a little for a while longer.

Then from the second hip, between two and three weeks, a couple of mornings I "came to", just out of steep, experiencing a whole-body "stretch spasm". I'd wake up stretching, and my legs would get stuck contracted! It was not at all pleasant, and I had to catch myself waking up so I'd not do it. It's almost six years later, and I still can't stretch until I'm up and have the circulation moving more. I also get the "usual" calf/foot cramps that need not be associated with surgery. I was already taking a good magnesium supplement, so I tried a magnesium foam rub-on. I tried massaging my legs pretty deeply. I tried stretching. None of that helped, and the mag foam made my skin feel funny. I am not so miserable with these spasms these days-- I've found that exercise emphasizing intense use of entire leg including ankle and foot (not for you on that yet!!), plus not sitting too much, is helpful. Also, a major trigger is a rising barometer. I have no idea what that does, but it is unfailing. It I have cramps at night, when I go look at the barometer in the morning, it has swung up. I don't actually think these cramps have anything to do with my (anterior) THRs. And I sincerely hope NONE of this is in your future!

Edit: left out more of the good news re my own cramping! What started me on the road to fewer cramps was OTC "mild compression" stockings, 15-20mm compression. I found some not-too expensive knee-highs online, and wore them daily for a couple of years. Then I splurged on some "fashion tights", opaque winter colors. I absolutely love how the tights feel, and wear them often. They do not look the least bit elderly. In fact I wear them with boots and a short skirt! They are indispensable for long-distance travel, driving or flying.
 
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Thanks to everyone for your appreciated advice!
One question: I still cannot stay asleep for more than 2 hours, some part of my leg will start hurting and I need a position change or new ice. Do you think I need to start using the ice machine again ?, it will be 3 weeks tomorrow.

@zauberflöte
I had the cramps for several nights, none the past 2 nites though. Not doing much differently, am wearing my compression stockings during the day . They are thigh high, but I want to call the OS to see if I can change to the low ones for now. The cramps I have are so much more intense than my usual calf cramps. It's like my quad muscle turns into stone, leaving me very sore after it resolves.
Can you please tell me the link for the fashion tights you mentioned? I don't think I'll get approved for the low socks, so tights would be on my next ask. The thigh highs seem long for me, and they roll on the thigh and pinch me. Note that they are hospital issued.

PS: I've tried magnesium and have the usual side effects, so it is a no go for me.
 
@Eman85
IDK, I was using it every night, but when the quad cramps/spasms started the pad didn't cover the whole area. So I went back to the Magic Gel Hip packs. Somehow I didn't get back to the ice machine. I have it set up now, so I am going back to using it see if I can pre-empt the spasms. Seems like they are now located more around the incision than the entire quad. I guess that's progress...
 
@Naps keeping my fingers crossed your quad spasms are on the way out!

The website I purchased my compression legwear from is BrightLifeDirect.com .I spent a while last night looking for those tights, and they don't seem to have them!! :shrug: They have a "house brand" and the tights were part of the line. Dang! I'm glad I have a pair in each color lol!

There is a difference between these OTC compression items and the "TED hose" I had after my hips. The compression follows a different pattern over the leg. You have an appointment today? Or this week anyway? Ask if you have to keep wearing your hospital ones!

For my first hip I was issued a pair of obvious quality, but I hated wearing them. At my two-week appointment I begged the PA to let me ditch them. He agreed. Blessed relief! They had felt as though they cut off the circulation behind my knees. For my second hip I was issued a much cheaper pair, definitely shorter and smaller, hideously uncomfortable. I had a whole lot more upper leg swelling and it really hurt, and the codeine wasn't helping that part of the pain. About my fourth day home I made the executive decision to switch them out for the older pair, which I had kept. What A Difference! The huge swelling went down immediately. My understanding was that the more active you become, the less need for the stockings. My second hip, I had more mobility much sooner, for whatever reason. That hip had not been as bad to start with; perhaps that was it.

So definitely ask your OS or PA about that this week! You can probably also call their office and talk to a very expert nurse if it's anything like my OS!

I think that @Eman85 's comment "there's no time limit on feeling good" ought to be nominated for a Pulitzer for style and content, and a Nobel for sheer simplicity in the "advice" category!
 
@zauberflöte
Yes, mine have the graduated compression. They gave me an extra pair, but they must have upsized mine to accomodate the anticipated swelling, because I really need a size down. I also think that they helped with my thigh swelling. Although I did swell a lot, it didn't go to my knee and resolved quicker than I thought. 0I'm leaving a message with my OS team, to see if I can go to the lower leg ones. They have the graduated ones online.
 
Is it normal to have pain at night, I am 3 weeks and 3 days post op. Pain during the day controlled with Tylenol, quad is very tight!
Night time pain combination of spasms and then some pain along the outer leg, alongside the femur. Everything looks good- incision well healed, no drainage mild swelling of outer thigh as the day goes on ( from sitting I think).
Thanks!
 
Is it normal to have pain at night, I am 3 weeks and 3 days post op.
Totally normal. You are only days out of major surgery. Are you taking your pain medication as prescribed, around the clock? Try taking an ice pack to bed at night.
 
Pain doesn't know what time it is. Everything you did during the day comes home to roost at night. I iced continuously if I wasn't moving. My left had a real tenderness down the outside of my thigh for quite some time.
 
Happy One Month Anniversary, Naps!

If you’re still dealing with the spasms, consider Magnesium.
Magnesium supports the following:
Bone health
Healthy blood sugar
Cardiovascular health
Muscle relaxation and nerves
Promotes healthy sleep (falling asleep and staying asleep)

An article on Magnesium -
https://bonesmart.org/forum/threads/magnesium-is-a-star.20301/

I've also heard drinking 4-6 oz of Q-Tonic before bed which is a water that contains quinine may be beneficial in keeping cramps / spasms away.
Read the label as some of the waters do not contain quinine, but quinine flavoring instead.
@Naps
 

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