THR Recently Had LTHR w/Anterior Approach

[lambo]

@lalo

Wow. That sounds like quite a bit to deal with. I am getting worked with just the hip and I can only imagine adding a knee on top of it. Good luck on your progression and I will keep your situation in mind when I need a little perspective.

 

[AndyH99]

@lambo Hi, my progression over the first three weeks has been steady baring one minor mishap. I'm finding my recovery is pretty close to the activity schedule in the reference library, so increasing my walking distance on my crutches, doing odd bits around the house and upping my PT levels slightly. I'm hoping over the next week to work further on my leg and hip flexor strength along with my single leg stability so I can progress to a single crutch in the not too distant future. Outside that I'm taking it carefully and one week at a time.

As far as a return to work goes, I work in the IT industry so I can work at home when ready and phase back in going to the office over time. However, I'm fully expecting to be out of action for at a minimum 6 weeks, potentially longer given the challenges with energy drain, mental focus and independent mobility. So whilst I'll do some research and training stuff when able the real graft will have to wait.

Hope that helps


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[Jaycey]

@lambo glad you joined us and congrats on that new hip.

Regarding returning to work at 3 weeks - I would not advise this as it is way too early in your recovery. Recommended is anywhere from 8 - 12 weeks and then a Phased return to work. Why so long - well you are still in major healing mode at 3 weeks, probably still taking heavy duty pain meds. Then there is the Energy drain for THRs. Give your body a good chance to heal from all the trauma.

I'll leave you with that reading others have referred to. Do come back and ask any questions - we are here to help!
First are the BoneSmart mantras ....
- rest, elevate, ice and take your pain meds by the clock
- if it hurts, don't do it and don't allow anyone - especially a physiotherapist - to do it to you
- if your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again
- if you won't die if it's not done, don't do it
- never stand when you can sit, never sit when you can lie down, never stay awake when you can go to sleep!
- be active as much as you need to be but not more than is necessary, meaning so much that you end up being in pain, exhausted or desperate to sit down or lay down!

Pain management and the pain chart
Healing: how long does it take?
Chart representation of THR recovery
Dislocation risk and 90 degree rule
Pain and swelling control: elevation is the key
Activity progression for THRs
Home physio (PT)
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?

 

[Josephine]

Hi and welcome to BoneSmart!

So I am on Day 7 and I definitely not pain free. I assure anyone considering an Anterior Approach for the reason of it being less painful to be wary that it is still painful. Morphine every day

It always makes me chuckle when people are surprised at the post-op pain. Anterior or otherwise, it's still major surgery and the comparison between an anterior and any other approach is not measured in day but in weeks! Unfortunately it's easy assumption that the 'less painful' bit is in comparison to other approaches. This is unfair to most people because they don't generally have any idea what the other approaches feel like. So they are left with notion that 'less painful' means in a few days. I think it's such a shame.

However, you are discovering from other member's posts that this isn't quite as bad as you thought and you will be back on your feet very soon. And yes, you need to keep up with the pain meds for a while and to allow things to settle and heal. Do read the articles Jaycey posted for you and take good note of them.

And finally, here's a tip that will get you back on your feet quickly: Hips actually don't need much 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.

 

[lambo]

@Josephine and @Jaycey

Thank you for the responses and the tips. I am completely on board with the recovery processes that you have posted and due assure you that they have already been very useful. Thank you for taking the lead on this forum.

 

[CricketHip]

Hi @lambo! I read your progress reports and you sound like you are doing well. Will be looking forward to reading your updates.

 

[zauberflöte]

@lambo I had anterior, and the pain post op was so much less than a gyn abdominal surgery in 1989, the dark ages of being a hero in pain!
I too felt that charlie horse-- my entire quads, and my calf too. That pain was worse than any other.
My very early recovery may have been a little faster than some others', but it was still 12 months before I felt fully confident.
On the next hip, I am not going to do any PT that engages the hip flexors, none at all for months!! Reason? I have a lingering plague of tendonitises from activity post op first hip, and I never once was asked to do a straight leg raise! Once burned twice shy, that's me!


My phone sent this using BoneSmart Forum, clever phone!

 

[lambo]

@zauberflöte

Man, yesterday I had a slight relief with the thigh pain. Today, my wife and I went out for a few hours, I even brought a cooler with ice packs to ice, and the pain is back. How quickly my body tells me when enough is enough. At home on the couch elevating, icing and resting!

 

[Suzette]

I too had terrible thigh/quad pain on the right side. It appeared as soon as the epidural block wore off, the leg was rock hard swolen and hot . I had never felt pain like it and dont fancy having that pain again either!! My left leg has been fine compared to the right. Same surgeon same day, just a different leg....it was worse than the a ceasarian section i had once. A while back though

It still aches and it drives me mad, but mine is 'just' .... Soft tissue muscle pain, with tight muscle bands in there too that I hope will eventually repair itself and I need to help it along by building some muscle up to help support everything.
We will come out the other side one day

 

[Elaine F.]

@lambo Hope today is a better day for you.

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[Jaycey]

Today, my wife and I went out for a few hours, I even brought a cooler with ice packs to ice, and the pain is back.

Very early days for you! The good news is what seem impossible one day is very easy another. Recovery is all about finding your limits, stepping back and then trying again. You'll get there!

 

[lambo]

@Jaycey
So true. Last night the thigh pain was back with a vengeance. What was getting around nicely early on in the day, which was what encouraged me to leave the house in the first place, quickly turned very painful in the evening. And it is so weird; You would think that most pain we feel would be right at the point of major trauma but this pain was all the way down my thigh, maybe 2.5" above my knee. It was like a line of horizontal pain.

 

[Jaycey]

but this pain was all the way down my thigh, maybe 2.5" above my knee. It was like a line of horizontal pain.

This is because the move your leg in all sorts of contortions to dislocate your hip. Lots of trauma to all areas. The back of my knee hurt worse than my incision area post RTHR. Turns out they evened up my leg length difference so lots of stretching. Ice and elevate - lots! It's the swelling and trauma that is causing the pain.

 

[AndyH99]

@lambo The one that made me laugh was the large purple bruise I had on the sole of my foot, all the leg ones made perfect sense given I'd watched the video of the op prior to going in for mine but I still haven't worked out how the sole of my foot got the bruise.


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[copsham]

Hi @lambo
11 days out from op. Wishing that everything will settle down and the pain will get less.

@AndyH99
That bruise can be produced by stretching the foot much too far back. That bruising was a symptom of my Lisfranc foot injury. You do not have any other foot symptoms do you?

 

[AndyH99]

@copsham Hi, no - no other issues or symptoms and the bruising is mostly cleared up so I'm hoping it was just another strange occurrence - I say another as I also managed to get hair dye on the sole of my foot when dying my wife's hair once - through a sock and trainer! Just another "normal" day it seems. Thanks for the thought though, appreciated.


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[copsham]

Whew thats a relief!

 

[lambo]

Everyone,

I am now 14 days out from surgery and things are looking up. In home PT with a therapist is going great. I have only had 4 sessions but I am noticing daily that my normal physical movement tendancies that I would consciously shy away from due to pain are unconsciously taking place again. I have noticed this in activities such as getting in/out of bed, getting in/out of the car, crossing ankles while sitting in a chair, and even crossing my ankles while laying down in bed without crossing my knees. I assure everyone who reads this that I am in direct communication with my physical therapist about all these movements.

I think I really lucked out with the therapist that is perscribed to me. He really understands what it means for a THR patient to take it easy and to listen to my body. He doesn't push me into any exercises that I tell him will be uncomfortable for me. At this point in my recovery I am I have transitioned to a single crutch and am walking as normal as possible w/o pain. Certainly, this is all done in moderation. I am surely not walking far distances yet. The furthest I have had to walk is into a hospital and down to the medical record room. I would probably chalk it up as 0.5mi. My to-go ice pack was quickly utilized after that trip on the ride home!

I really feel like the first 1.5 weeks were really hard on me physically and mentally. I felt like the pain I was feeling would never leave my body and was getting me real down and out about the whole situation. With that I really stayed true to icing, elevating, pain meds and rest. For anyone who reads this, I literally iced probably 40 mins on and 1.5 hours off for the first 9 days. This was done while getting up approx. at 7 and getting into bed at 10-1030. Also, I did not allow the icing to cause me any pain to my skin. It was extremely cold but I never allowed it to be painful. I can honestly say for the first 11 days I iced, elevated and rested and did not get off of the couch except for bathroom, eating, PT and ice pack refills. It was true boredom being on the couch but I do know it is the immediate reason why I am feeling like I am turning a corner in my activity level.

Sorry for the long post but I am feeling a little tired and am going to go lay down for a bit.

Cheers!

 

[AndyH99]

@lambo It sounds like you have your initial recovery phase really under control with some good support for the PT. Good luck and long may it continue.


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[Suzette]

Hi @lambo that's great you are coming to the end of, what I thought, was the worse bit, the first 2 weeks..... I also did not move from the lying down position....

have a great rest x