Bilateral THR Replacement accomplished!

[gershom]

Thursday and Friday last week were interesting and challenging days. I suddenly felt totally deflated and exhausted. I have my own business and work from home, and have been attending to odds and ends since I arrived home after surgery. But not Thursday and Friday. My body felt about 100 pounds heavier than it is, and I could not focus on anything. I simply did my PT the requisite number of times and slept. Sleep would last about an hour at a time, followed by a period of irritability. I'd walk around the house for a while, grab a glass of water or piece of fruit, and then crash again.

This all lasted until about 6AM Saturday, at which time I got up, brewed a cup of coffee, and got back to work. That lasted until about 2PM, at which time I crashed for a couple of more hours. I then took a shower, and my wife took me out to see a Purim play at our synagogue, then dinner with friends. All that time I could feel myself coming back to life. Today I felt extraordinary good! I took a mile walk around the neighborhood (no assistive devices), did my PT, and got a lot work done. I took a catnap, and felt refreshed afterward.

The feeling of artificial hip stiffness is vanishing. Walking and moving around is beginning to feel normal. I no longer require the sock donner or shoe horn...I can even tie my own shoes. To be sure, I am adhering to the basic movement restrictions to mitigate dislocation, but my physical therapist says that I seem to be past that. He said be cautious, but expects that my doctor will release me from those restrictions this Thursday (four weeks from surgery).

As I think about it, my surgeon's parting words at the hospital were these: "You are going to hit a point where it seems like a huge step back after much forward progress. When it happens, don't worry about it. It's normal." I had almost forgotten that; when I brought up the Thurs-Fri fatigue to my PT, he reminded me.

Indeed, healing and recovering from such major surgery is a long process. I have to remember to be patient, and to understand the advice that the medical team gives...not just hear the words.

Thanks again to all here for your terrific encouragement, sharing, and candid feedback. I will soon return the favor with updated pictures of my badges, which my wife says have turned from ominous to sexy.

 

[gershom]

I thought I would pass on a simple way to prepare for your recovery at home. As we all know, we need a "lift:" Some additional height for the toilet and chairs, to mitigate the risk of dislocation and make it easier to get up. I thought about this before surgery and decided to create simple, custom modifications to some of our furniture, to make recovery a little easier for me.

Below is an example. I chose a kitchen chair with arms on it, which the literature said would be beneficial. I then added about 3" to its height with a few lengths of PVC pipe and caps from the local Home Depot. I secured these to the legs with simple set screws, so as not to damage the existing wood. Note that I also did this to a living room recliner in my downstairs living room, and to a living chair upstairs. Just enough, just in time!

Total cost per chair was about $20.

 

[gershom]

This post is related to my bilateral THR, but it may be considered a little off-topic regarding my recovery. Moderators: Please feel free to move it as you deem appropriate.

I clicked on the "YouTube Subscribe" link below, and was treated to a great testimonial video:
"Bilateral Total Hip Replacement Surgery Patient Story (Richard Warner)."

Like Richard Warner, my Bilateral THR were done with the Zimmer configuration, ceramic-on-ceramic. About half way through the video, Mr. Warner announced that he and a number of other Bonesmart folks are going to run the Honolulu Marathon in December, 2013. So I am pondering this with both great interest and apprehension, maybe even astonishment.

My hips were likely destroyed, in part, because of excessive marathon running. I mentioned before that over a period of 8 years, I had run about 20,000 miles (....no exaggeration). I have a certificate from the Navy attesting to 10,000 miles over four years. Today I view that kind of intense and sustained running as simply irresponsible and reflective of exercise addiction (in my case). While I am delighted to get my life back with new hips and intend to resume a good exercise program, I would never think of running another marathon with the prostheses. I have enough of an engineering background to be at least suspicious of the ability of the implants to sustain the kind of training necessary to run a marathon (even a conservative preparation program). I would speculate that the interface between bone and metal was not designed to sustain that kind of pounding, and then there are fracture risks to the ceramic components as well. From what I have read, the forces required to install the ceramics carry great risk of fracture, and so I speculate that the constant pounding of running would carry similar risks. Perhaps I am wrong, but I am surely curious.

So can someone (perhaps Richard Warner) point me to the Zimmer stats and medical references that would suggest that marathon running is a prudent thing to do with such artificial hips? What are the plusses and minuses, risks and rewards? I am simply having a hard time believing that marathon running is advised after BTHR. I would appreciate any input. Thanks!

 

[gershom]

Today is my four-week follow-up appointment with the surgeon. I'm hoping to get the okay to drive and looking forward to starting outpatient physical therapy. My in-home PT added some exercises and resistance elements to the basic group that was prescribed post-op. I no longer need the sock donner, as I'm able to get my shoes and socks on, and even tie my shoes, without assistance. I have no pain and discontinued the Tramodol HCL two weeks ago. I can walk comfortably unassisted for up to about two miles. I would say that I am close to 80% in range of motion. I continue to use the reacher/grabber device for certain situations, to continue mitigating risk.

I still experience a small bit of swelling at the surgery sites, and I ice them every night before bed for at least an hour. Sleep remains a bit interrupted, not from any pain, but there is some discomfort and restlessness. I am sleeping on my sides, which is the most comfortable (with a body pillow), but it seems that after about two hours or so I experience some discomfort or restlessness. I have found that getting up and taking a walk around the house helps, and I am able to get back to sleep. I suspect that this, too, will pass.

I am looking forward to this next phase of healing, regaining flexibility and strength, and enjoying a normal, pain-free life.

 

[bottomshollow]

Gershom! There are members here who would kill for your phenomenal recovery! But I have no doubt that they are all quite happy for you. At the rate you are going now, by 12 weeks you'll be feeling as if you never had surgery at all.

Keep up the good work and keep us posted. We care.

 

[ByGosh]

Hi Gershom, I've been reading your recovery and want to congratulate you on doing so well. It's heartening to the rest of us who are still facing surgery. I'm going this Mon for BTHR, and feeling pretty nervous. I hope that I can make a smooth recovery, too.
The picture of you and your wife is beautiful. She's very pretty.
Keep up the good work and keep us all posted as you continue your nice progress. Take care.

 

[gershom]

ByGosh - Best wishes for a smooth and uneventful surgery. Wishing you all the best in recovery. Keep us posted!

 

[smrt2run]

I was just reading through your thread and came across your anecdote about using the urinal on the toilet because of swelling. Ill second that haha

 

[ByGosh]

Hi Gershom, Thanks for the good wishes. It's finally over! Today is day 5 post op. It wasn't a walk in the park, that's for sure. The surgery was Mon. and I went home Thurs. It's been a challenge. I had the usual hospital course, I think. My hemoglobin and hematocrit dropped pretty low, and I'm feeling very weak and tired out now. I was borderline for a transfusion, but this surgeon prefers the body replenish itself naturally, so I wasn't transfused. The biggest problem now is the awful feeling of being dreadfully weak and my thighs are starting to swell. I was told to expect this because I had drains in the first 2 days that are out now, and I'm on Coumadin which encourages leakage into the tissues. No one has said what to do for this really. It's hard to elevate the whole thigh, and it seems that elevating the lower leg may not be so effective, as I've been doing that. Also trying to ice more. Any suggestions? I'm getting up every hour, doing some ankle pumps, and buttock and quad squeezes.
How are you doing? Hope you're still sailing along nicely. Take care.

 

[gershom]

Hi BiGosh -
I was in similar shape following surgery with regard to blood count...borderline for transfusion, but the doc decided not to. He had me take iron and other supplements, and things stabilized eventually. I did not have drains after surgery, but I did have a lot of swelling from the surgery sites to my knees. Keeping the legs elevated was key, using layered pillows as it says in the literature. I was about 25 pounds up in fluid after surgery and it took some time to return to pre-surgery weight. I just had to be patient and endure all those trips to the bathroom...endless peeing!

I continue to improve, now on the second phase of PT exercises. I have much to recover in terms of strength and flexibility. I took a trip to see my grandkids last weekend, which included a 5 hour car ride. We stopped every hour so I could stretch and walk around. It wasn't terribly comfortable, but I got through it. I was quite exhausted after arriving and had to nap in between activities with the kids. Then today was a full day with family celebrating a nephew's milestone - which included a party and even a little dancing. Again, stretching and walking frequently were necessary.

I've been told that it will be upwards of a year before I feel completely normal. So I'm taking it a day at a time, doing what I'm told. Gratitude, patience, a positive attitude, and a sense of humor all seem to help. The absence of the old persistent osteoarthritis pain is enough to keep me smiling and optimistic.

So hang in there and know that it only gets better. Sometimes it seems like two steps forward and then one backward. But the net is forward and positive.

Keep us apprised...all the best.

Gershom

 

[ByGosh]

Thanks for the kind reply and encouraging words. I'm glad that you had a nice visit with your grandkids. 5 hours in the car would tire anyone out. And I believe that it could take up to a year to recover from this. I feel like I'll never be the same - but I wasn't "the same" before surgery anyway, with all of the pain and limitations that came on so suddenly. So if I can get rid of that osteo pain, I'll just have to adjust to whatever my new hips feel like and can or cannot do.
Anyway, I'll have to learn how to write on the post op side now, so that I don't keep bugging you . But your recovery story hit a cord with me because I exercised alot, too, and was in good shape going into surgery. (considering I had limited wt. bearing activity for 6 mos prior, although I was still swimming daily). I was determined to sail through all of it, but of course that's not the way it works. Your posts have also been very informative, and you're sort of like a role model post op patient!
The swelling has gone done significantly since yesterday. I don't know why - an inch less width in each thigh. They almost looked normal today. But I had a 100 degree temp last night, 99.2 today, so I'm nervously monitoring that now. And some kind of new wt. bearing pain has cropped up in my right thigh, which I'm also very concerned with and hope it's not the start of some infection, or something awful. I know that I've forgotten to adhere to the precautions every minute. It's so natural to just do things, and move and reach to get something. I hope I didn't goof anything up! I don't have a guardian angel spouse watching over me like you did. (Lucky you. I wish I could hire her to be my coach for a few weeks! ). I'm the nurse, and my husband is sort of overwhelmed by my degree of immobility, weakness, needs, etc. I'm the one who takes care of everything here, and now I can't, so it's difficult.

Anyhoo - take care. Keep up the good work. Talk to you later.

 

[gershom]

ByGosh-
In the first couple of weeks, I had several episodes of "OMG what did I do?" Then my wife or my PTist would remind me that I just had major surgery, not unlike a bad car accident where a couple of leg bones were severed. It might have been done by a skilled surgeon, but your body doesn't know the difference. Surely, keep an eye on any fever/indication of infection, and report it to your doctor/ case manager. But I found that pain and restriction here and there were regular occurrences, and that I needed to take my time, follow advice, and relax. Breathing exercises as taught in meditation are very helpful. And taking pain meds when you have pain is important.

Short story: In 2008 I had back surgery (laminotomy at L4/L5/S1). As the anesthesia was wearing off, there was a drug complication and I could not receive any pain meds. So I spent the next 8 hours or so doing abdominal breathing and meditating. It was uncomfortable at first, but eventually the pain subsided. It was an interesting experience that taught me something about patience and just letting things flow. I've certainly applied that experience to this surgery. (My point here is the breathing, patience, and general mindset...I am NOT suggesting no pain meds!)

Hang in there. I hope your elevated temperature is nothing serious. Keep us apprised, and hang in there.

Gershom

 

[Josephine]

Gershom, I reduced the size of your picture so it can be seen better.
Generally about 600pixels wide is better suited to forum use.

 

[gershom]

I had an interesting conversation with my PTist today. I related to her that I am able to sleep for about an hour at a time at night, at which time I begin feeling uncomfortable. I have to get up and walk around for about ten minutes, after which I can fall back asleep. The pattern then repeats. I am not experiencing pain, just stiffness and discomfort of sorts.

Her response was that this is normal. I am just under six weeks since bilateral THR. My body is still trying to figure out what these foreign objects are, and the normal response is inflammation and some fluid build-up. Getting up to walk increases circulation and, generally, helps resume the healing process, moves fluid, and helps things to calm down. I'm good with that. Patience, assurance that his is normal, and cat-naps as required, seems to do the trick. In time, I'm sure I'll be sleeping through the night.

 

[gershom]

Gershom, I reduced the size of your picture so it can be seen better.
Generally about 600pixels wide is better suited to forum use.

Thanks, Josephine. When I posted the photos, I tried to resize them using the "handles" that appear, but that doesn't seem to do it. Are you saying that I need resize the original before posting? Please advise...I don't want to clog up the forum with huge bitmaps!

 

[gershom]

My new walking mantra, as I attempt to break the old habits of osteoarthritis:

Hips and pelvis are not the same
Hips and pelvis are not the same
Hips and pelvis are not the same
....

 

[gershom]

I walked the mile to PT today. Had a great session. Them my physical therapist told me that I should not exceed a mile of walking per day just yet. Yes, I eventually walked back home.

 

[ByGosh]

Congratulations, Gershom! A mile? Each way? I can hardly believe it. Good for you, keep up the good work.

 

[BarbaraR]

Wow, 2 miles!

 

[Kim22]

gershom congratulations on walking 2 miles yesterday. How are you feeling today?