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R THR Part Deux

Discussion in 'Hip Replacement Pre-Op Area' started by inthebeginning, Mar 7, 2019.

  1. inthebeginning

    inthebeginning graduate
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    Here we go again. Right THR back in September of 2013 which went extremely well. I walked out of the hospital, cane held above my head, 24 hours after the surgery. I 'ran' a marathon, that's 26.2 miles, on an elliptical on my 6 month surgery anniversary. At my one year check-up, the doc said," See you in six years!" I was ready to go!

    Started riding the bike more and more and stayed active with the kids, life was great! I even made a huge change in my nutrition in 2017 and by eliminating gluten, dairy and sugar I lost 60 pounds! I figured the hip would become a permanent memory. Wrong.

    There had been a few moments through the 5½ years that the hip would remind me that it was Titanium, ceramic and plastic. I live in Colorado and the weather can get pretty crazy. The old hip was becoming quite the barometer! I knew if the forecast was calling for a big snowstorm or other prolonged low pressure weather, I would keep the Advil handy. About 6 months ago, those little reminders were becoming more and more frequent.

    Getting that right foot up to pull on socks and shoes is sometimes as painful as it was pre-THR. I saw my primary care doc and asked about some PT to see if we could figure something out. It was presenting like hip flexor tendonitis. A few weeks of PT and no real improvement. My therapists finally said, get some pictures to make sure there isn't something else going on.

    Sure enough, the stem is very well seated at the base. The top half, not so much. My Ortho said he hasn't seen this much, and he does ALOT of hips! He thinks that the bottom end being so well fixed in place caused my bones to figure everything was good and stopped growing bone around the upper part of the stem. Now we have a loose stem. I always though I had a couple of screws loose, but not my hip! :loll:

    So, here we are again. I've thrown my name in the April Rainbow basket because I'm not waiting to get this fixed. I'm only 52 years old and need to keep up with a 12 and 15 year old!

    Thanks for listening!
     
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  2. Mojo333

    Mojo333 FORUM ADVISOR Forum Advisor

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    :wave: and welcome to Bonesmart!
    I am sorry you are having to get this hip redone but you sound positive and I'm sure you will do well. You sound like you have done well with lifestyle and nutritional changes to keep yourself healthy.
    Might I give a few thoughts for this time around.
    My first concern comes with frequent use of NSAIDS.
    Josephine told me early on in my recovery Tylenol was a better choice.
    I am constantly reading confirmations through research that NSAIDS are not a good choice for recovering hip patients.

    FYI - an excerpt:

    http://journals.sagepub.com/doi/full/10.1177/0300060517732697
    Postoperative drugs
    Painkillers are frequently used by patients with hip osteoarthritis. In our experience, most of these drugs are represented by nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs are the least safe of painkillers in terms of osseointegration. NSAIDs impair the osseointegration process of titanium implants by inhibiting cyclooxygenase-2. This results in decreased levels of prostaglandins, which are important in promoting inflammation and supply of bone-formation cells. Therefore, we suggest choosing acetaminophen (paracetamol) for mild to moderate pain and opioids for severe pain in patients following total hip replacement.

    I was a big fan of ibuprofen but steered away from it in recovery.
    It can take up to a year and beyond for full healing so this may be aggressive activity especially now for revision.

    This is NOT to say either of these things led to your revision, just some things to ponder and would like to see this be your Forever hip!! :ok:
    It's natural that when we feel up to things, we want to go full throttle...but slow and steady will win this race and you have lots of support and encouragement here.:flwrysmile:
     
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    Last edited: Mar 8, 2019
  3. inthebeginning

    inthebeginning graduate
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    I want to say I did stay away from the Ibuprofen for at least 2 years after the surgery. Only used it on really bad days for pains other than the hip. Once I lost the weight, I didn't need it for much of anything because many of those 'old man' aches and pains went away since grains are inflammatory and were causing many of those anyway. It wasn't until about 6 months ago that the hip started acting up...I can't really say how long the thing has been loose, but the film doesn't lie.

    Thanks!
     
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  4. Mojo333

    Mojo333 FORUM ADVISOR Forum Advisor

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    I'm glad you've decided to face this development straight on...attitude can mean so much for recovery.
    I hope you have a good weekend @inthebeginning :yes:
     
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  5. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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  6. inthebeginning

    inthebeginning graduate
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    I do remember and am aware of all the issues and risks with these. I am also a heart attack survivor so I always run meds through my cardiologist first.
    Here’s the big question, first THR I went under general, I am thinking regional this go around.
    Tell me what you think.
    Thanks as always!
     
  7. Jaycey

    Jaycey SUPER MODERATOR Moderator

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    I am certain they will tell you no NSAIDs. I took them for years and now have cardiac issues.
    The alternative to GA is a spinal with sedation. I highly recommend this. No nausea or groggy feeling in recovery. And no, you do not have to stay awake with a spinal. Just tell staff you don't want to see or hear anything. You will be in a nice, comfy sleep.
     
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  8. inthebeginning

    inthebeginning graduate
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    Oddly enough, I sort of want to... I heard a story from the hospital that did my first and will do the revision of a man that stayed awake and actually had them roll in a labor mirror from the maternity ward so he could watch!! Not to sure about that, but I may want to start awake.
     
  9. Jaycey

    Jaycey SUPER MODERATOR Moderator

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    Some surgeons don't allow this but your's might. Just ask. Be warned, it is a very noisy procedure!
     
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  10. Mojo333

    Mojo333 FORUM ADVISOR Forum Advisor

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    :flabber:
     
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  11. inthebeginning

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    So I have heard! I’ve watched a few YouTube videos as well.
     
  12. inthebeginning

    inthebeginning graduate
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    Just had 6 cc's of fluid aspirated this morning to check for infection. Doc said the fluid appeared normal just by visual. We will have to wait up to 2 weeks for the full workup. Nice shot with the needle in it! You can see the space around the top of the stem quite easily in this shot as well. Wiggle, wiggle.
    aspiration.jpeg
     
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  13. Mojo333

    Mojo333 FORUM ADVISOR Forum Advisor

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    :fingersx: all is clear!
    Wishing you comfort as you wait.:angel:
     
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  14. inthebeginning

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    Just read most of my pre and post-ops threads from the first go around in 2013. I sure did start out in a pretty dark place back then. Of course the news that I needed a replacement was very sudden. I never knew that my hip was going bad!
    As I read through my hipstory, I am taking diligent notes so I can plan out the next three weeks of pre-covery as well as recovery after. I have made a milestone chart to measure against. I will try not to force myself to attain the same milestones, but I think I can! It's been 5.5 years but I am in better shape now and 60# lighter on the scale.
    Most of all, I will keep coming back to this awesome place to get daily affirmations from all of the success stories here at Bonesmart!

    Thanks in advance!
     
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  15. Layla

    Layla FORUM ADVISOR Forum Advisor

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    Happy Tuesday!
    You're going in well prepared mentally as well as physically.
    Weighing 60 lbs less and being in better physical shape certainly can't hurt moving toward surgery / recovery.
    I agree that BoneSmart is a great place for support, advice, encouragement and commaraderie. Thanks for being a part of the forum! Your contributions are greatly appreciated.
    Enjoy the rest of the day! :SUNsmile:
    @inthebeginning
     
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  16. inthebeginning

    inthebeginning graduate
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    Cardiac Clearance appointment today. Good to go! In fact, I was supposed to have my normal 6 month visit in June. They pushed it back to October since my ticker was in such good shape!
    I guess it didn't hurt that I rode the bike 16.5 miles this morning!
     
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  17. beachlily

    beachlily senior

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    16.5 miles! Impressive! You’re going to be my “ hip goal “ ... now I better get on my bike.
     
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  18. inthebeginning

    inthebeginning graduate
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    Have my surgical pre-op appointment today. Sooooo many questions. Even though I’ve been through this before, its still different this time.
    3 weeks tomorrow!
     
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  19. inthebeginning

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    :headbang::headbang:
    Advised at my pre-op that I can expect ‘a couple weeks’ of partial weight bearing after my revision. That is NOT what I wanted to hear.
    On the bright side, I have already picked up my temporary handicap parking permit that gives me that option for 90 days. I also confirmed that they will be able to return my old parts after surgery!
     
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  20. Jaycey

    Jaycey SUPER MODERATOR Moderator

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    Bummer! Sounds like your surgeon is fairly conservative. Oh well - just part of the process.
    So are they committing to give you the old implant. Would not happen in the UK!
     
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