THR Rough Hospital Stay

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Greetings one year out. I have had a lot of difficulties since my hip surgery close to a year ago, primarily related to mobility. Two months ago, I had a Vein Ablation on the same leg, uncertain how much that was related to hip surgery.

I have not been able to straighten my operated leg from after the surgery without significant pain. I have an appointment with my GP, since my OS continues to say the Implant is fine, so no problems should exist. I should take stock in Motrin.
 
@LoyalD so sorry to hear your recovery has not been an easy one! Sounds like you need to find another surgeon who will listen to you!
 
Two months ago, I had a Vein Ablation on the same leg, uncertain how much that was related to hip surgery.
Well, it's not but where were the incisions made? Did you have a vein strip or just superficial ties?

I read your thread right through and my impression is that you a) did far too much far too early b) were unable to get adequate pain meds and c) were setting your expectations far too high thus creating stress and disappointment.

You also mentioned tight hamstrings, shin pain and plantar fasciitis. Were you aware that these are all connected to one another? The hamstring muscles go way down into the back of the calf where they can transfer their inflammation to the tibialis anterior and posterior which in turn go into the foot and create plantar fasciitis. It's a bit reminiscent to the old song

"The foot bone's connected to the ankle bone,
The ankle bone's connected to the leg bone,
The leg bone's connected to the knee bone,
The knee bone's connected to the thigh bone,
The thigh bone's connected to the hip bone." (sorry - couldn't resist but it's true!)

I suggest you click on the image to enlarge it and get a better look

[Bonesmart.org] Rough Hospital Stay



So you can see that these three conditions were, in fact, all closely linked to one another.

Subsequently you appear to have been doing far too much - PT, exercises no doubt, early return to work etc., etc. All encompassed with an anxiety about taking pain meds 'too long' which in fact wasn't anything of the kind, and a general expectation that you were, somehow, responsible for your apparent poor progress which was actually pretty normal.

So now, the inevitable questions!

1. what's your pain like now? What are you taking presently (how much and how often, of course)
2. where about is your pain presently
3. what are your daily activities? That means work, shopping, house work and anything else that make you active
4. what exercises are you doing? I'd really love it if you would describe each one in detail including how many of each you do (reps) and how many times a day.
 
@Josephine , thank you for the questions you posed and taking the time to do so. I believe, after reading your opinion, you are spot-on. Disclaimer: You will recall I had my surgery on June 25th, and went back to my office job with a cane, five weeks later, part-time, then at Week 7, full-time, still with the cane.

In late-November, so 5.5 months from the surgery, my husband was diagnosed with State IV throat cancer, and life went crazy. I took over all physical needs at the house, including walking the Labrador 30-45 minutes per day off-leash (so no pulling), which hypothetically should be good right, since walking is one of the best recovery tools. I am responsible for walking the dog every day, usually get one day off if my husband is up to it; dog walker is not an option for us. Joe had 35 sessions of radiation and chemotherapy at the same time; again, absolutely all physical stuff at the house fell on me (dog, trash, laundry, etc.) Looking into what it would take for me to fully recovery went to the back-burner, for my husband's health crisis.

I just still have the massive acute pain under my posterior incision, which feels like a lump. For the past four months, I thought once my Saphenous Vein was ablated, it would fix things; no, not one impact. The pain runs down my operated leg's outside thigh, and my extensive, non-medical research says it is the IT Band.

1. Pain is always at a 3/4; I periodically receive Norco, which I take when things are really bad, but basically I take Ibuprofren 400 mg x 4 per day. I feel gross by the end of the day with so much Ibuprofen combined with the lack of full pain relief it provides. Undeniably, Norco works.
2. Pain is always at 3/4, at the end of a work day (again, office job so sitting), I am at 6, easily. I get up and walk all day, but my first steps are complete limping. I am physically exhausted when I get home from the pain and limping. The longer I sit, at home or work, the longer and worse the initial limping is.
3. Daily activities: Full-day's office job (though, get up LOTS, I never sit more than 10 minutes at a time), basic housework in between housekeeper's weeks, dog walk daily; I am not a person who sits.
4. I am not doing any exercises, only the extensive walking of the dog. Bought new sneakers to insure I was not walking in pre-surgery shoes. Same with my work shoes, all new; no heels anymore. Yes, I did all of the exercises early on, and as a result, I can easily sit cross-legged (actually feels good to do so), do clamshell lifts. Straigtening out the operated leg results in incredible pain under my incision site.

Josephine, thank you for taking the time to read through my history. In October, you will recall, I had debilitating shin pain and plantar fascitis and tight hamstrings; I thought all of this was related to the vein issue. I see, now, based on your images, that they are all connected. Which doctor should have figured this out? A year later and YOU are diagnosing the problem correctly, not doctors who see me!! As with just about everyone else on these Boards, my OS says the Implant is fine, so this residual pain, he feels, is not in his jurisdiction.
 
[Bonesmart.org] Rough Hospital Stay
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I went and found the above pain graph in another posting of Josephine's. The pain I describe is at L1BA, immediately under my incision site, and runs all the way down the L1BA column to my mid thigh. Periodically I get shooting pains in my groin, starting at L1B heading south to my pubic area.
 
@LoyalD remember to "tag" Josephine (like I just did with your user name) if you want her to see and reply to your post about the location of your pain.

You have had such a rough time and such inadequate care from your orthopedic team, from the get-go. This is not how it's supposed to be! And with your husband's cancer.......it's really all too much for one person. You have my deepest sympathy. You must be a very strong person to keep soldiering on through all this.

I wonder if you could see a pain specialist? At this point, a year after your surgery, it certainly seems like you would qualify as a chronic pain patient. And if you had a pain treatment plan that gave you consistent, daily pain relief, I wonder if some sort of body work (massage therapy, physical therapy, etc) could start working to solve the pain problem. It sounds like you have had just about no evaluation of your current pain. Maybe it is all muscular, or bursitis, or IT band problems, or tendonitis, or gait problems, or something else fixable. I don't know myself but I would hope with excellent medical care (which you have not had!) this might be amenable to treatment. At the very least you deserve to have a diagnosis!! Unfortunately it often requires becoming very pushy, persistent, asking for appointments and referrals, and it can take a lot of time to get the attention you need and deserve. But what if it could all be better? Just my 2 cents.
 
I just still have the massive acute pain under my posterior incision, which feels like a lump
It will do because that's the site of your deep incision. People have described it as feeling like sitting on a brick which I would imagine it very accurate! However, it doesn't usually last quite this long.
1. Pain is always at a 3/4; I periodically receive Norco, which I take when things are really bad, but basically I take Ibuprofren 400 mg x 4 per day. I feel gross by the end of the day with so much Ibuprofen combined with the lack of full pain relief it provides. Undeniably, Norco works.
Well to start with, it's not recommended to take ibuprofen 4 times a day - it should be more more than 3 times a day. But you'd be much better off taking Tylenol 1,000mg 4 times a day because it's about 60% better at managing pain than ibuprofen is and doesn't have any of the harmful side effects.
2. Pain is always at 3/4, at the end of a work day (again, office job so sitting), I am at 6, easily. I get up and walk all day, but my first steps are complete limping. I am physically exhausted when I get home from the pain and limping. The longer I sit, at home or work, the longer and worse the initial limping is.
I can only imagine. What a burden you have had.
3. Daily activities: Full-day's office job (though, get up LOTS, I never sit more than 10 minutes at a time), basic housework in between housekeeper's weeks, dog walk daily; I am not a person who sits.
Why 10 minutes at a time? If it;s to do with your job, okay. But if you're doing it in the impression that it's 'good for you' then stop it! With all you have on your plate, you need the rest!
4. I am not doing any exercises, only the extensive walking of the dog. Yes, I did all of the exercises early on, and as a result, I can easily sit cross-legged (actually feels good to do so), do clamshell lifts. Straightening out the operated leg results in incredible pain under my incision site.
Glad to hear you're not doing any exercising now. But the clamshells and other things like high marching, lunges and squats all help to create IT band issues.
In October, you will recall, I had debilitating shin pain and plantar fascitis and tight hamstrings; I thought all of this was related to the vein issue. I see, now, based on your images, that they are all connected. Which doctor should have figured this out? A year later and YOU are diagnosing the problem correctly, not doctors who see me!! As with just about everyone else on these Boards, my OS says the Implant is fine, so this residual pain, he feels, is not in his jurisdiction.
Well, technically speaking it's not his jurisdiction. To be honest (and I've never admitted this before!) a lot of this stuff I learned from my chiropractor as I've suffered from it myself and we talk a lot while he's treating me. This was one thing he showed me, how the ITB I'd had for ages then progressed on to issues in the hamstrings, then the calf muscle and finally into the plantar fascia. I didn't even know I'd got pain there until he started work on it! He's real a genius, that man! So you won't be surprised when I suggest you see if you can manage to see a chiropractor yourself to get the same deep massage I had. I know of no other way of to really get this treated.
 
@LoyalD
My, oh, my...you've had quite a difficult recovery! I see you are from Huntington Beach, CA. My surgeon and the hospital he works out of is located in the Orange County area. I'd be very interested in know which hospital you had your surgery at, if you don't mind me asking?
 
Mine was Dr. Mashhof out of Talbert Medical Group. Surgery itself was fine and the implant is fine too, with plenty of X-rays since the original surgery. That being said, my OS is not receptive to anything not mechanical, meaning soft tissue issues, he basically says he sees nothing.

Saw my GP this afternoon and he referred me to Neurology next Thursday.

Okay, I will head to the chiropractor, I adore her but she did not think I should have had the hip surgery, under her theory that everything can be fixed by natural remedies like chiropractic, acupuncture and healthy eating. But I will pursue the chiropractic route this week!
 
Greetings all. I am over a year out from my THR, Posterior, left hip. I continue to have pain with every step. I have been sent to yet another Orthopedist who has ordered yet another Xray. As I am not scheduled to actually see the Orthopedist until next Thursday, I am wondering if anyone can tell me what this excerpt from my Xray medical record means:

Status post left total hip arthroplasty. Prosthetic components demonstrate
scattered alignment without findings suggesting failure or loosening
identified. There is slight irregular lucency at the weight-bearing surface of
the acetabular component of the prosthesis which measures less than 2 mm in
thickness. There is standard bony and prosthesis alignment. No fracture,
subluxation, dislocation, or articular abnormality noted.

@Josephine
 
Josephine will need to "translate" this. I tagged her in your post.
 
Status post left total hip arthroplasty.

Prosthetic components demonstrate scattered alignment without findings suggesting failure or loosening identified.
"scattered alignment"? Not sure what that means but I think it's probably radiologist speak! It's the second half of the sentence that's important

There is slight irregular lucency at the weight-bearing surface of the acetabular component of the prosthesis which measures less than 2mm in thickness.
The term 'lucency' is a technical term for an area that lets X-rays through the tissue - 'radio-translucent - and as a result appears darker on the picture. In non-technical terms, it means there is a small area of poor bone stock or thin bone. But it's only tiny so nothing of concern.

There is standard bony and prosthesis alignment. No fracture, subluxation, dislocation, or articular abnormality noted
Interpretation - everything's okay! :thumb:
 
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