THR Rt. THR Dec. 30, 22, N. Little Rock, AR

Sgk

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Hi - I unfortunately didn't read through all the instructions before, so now I'm starting my recovery thread here. I would like to also request to be added to the December Supernova group for December 30, for THR.
I had a left THR almost 19 years ago with my parents and family's help. This one is more difficult because I'm older and live alone. I had help from my sons until Sunday, and that was indispensible. Now trying to do all the right healing things and the information here has been most helpful. I've run across some contradictory information with what my friend who had 2 THRs recently had experienced - i.e., doing regular PT exercises vs. What I've seen here - waiting until later, so that's a little confusing. I've been really tired and have not been motivated to exercise other than the 14 stairs I have to go up and down to let my dog out and the normal work of getting around and doing things for myself. I'm curious to know how many weeks most people take off from work to recover? I have up to 12 available, but not sure if medically will need that many - my doctor will release me when to go back. My 1st postop appointment is tomorrow morning. Anyway, looking forward to interaction with this group.
Thanks!
 
All I can give you is my experience. With my LTHR I was trying to be a super achiever to start with and did all of the PT exercises at home on my own. I felt really good at 6 weeks and then began the overdoing it on a regular basis. Spent a lot of time undoing my overdoing. The with my RTHR I took the opposite approach and did little if any PT aside from walking and some stretching. I didn't have the overdo's and didn't have any setbacks. In the end the right did just fine and there was absolutely no difference in the end result.
As far as work goes I never went back after my 12 weeks and really don't see why anyone would go back sooner. Allow your body to heal and enjoy the outcome, which is why we go through the surgery to start with.
 
@Sgk Welcome to BoneSmart! I am glad you found your way here. Most hips do not need PT - walking really is the best exercise. Though if you limped on a bad hip for a long time you might need some PT to get the muscles around the hip back to working properly. For now elevating the leg and applying ice/cold packs will help reduce any swelling and help with pain control. Here is our list of post op suggestions and articles.

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.
 
Thank you!
I had my 2-week postop visit yesterday with my orthopedic surgeon's PA. He told me I don't need to elevate all night, I could just sleep flat. However, he did note that I didn't have any inflammation, so sleeping elevated all night every night could be why? I didn't see any time frames on elevation, so wondering about this.

Also, totally forgot to ask this: my son pulled me from a sitting to standing position a day or 2 after surgery (I was struggling to get up from sitting, he faced me and pulled me up - he's very strong from weightlifting) and I felt/heard what seemed to be a shift in my femur. We don't believe we violated the 90% rule or twisted anything. Had 1 other time it seemed I felt a femur shift when on my feet with my walker in my kitchen - within the next few days after that. Nothing since. I called the on-call # over the weekend - it was one of their nurses, who said it was just a fluke and if I didn't have pain from it, no worries. My xray and visit yesterday was good, so was this just a fluke at the beginning, and how would you explain this?
 
If you go on line and watch a hip replacement you will understand why you want your body to heal first before exercising. You cant strengthen muscles until you have healed and two weeks is certainly not long enough to heal from this major surgery!!!!
 
All I can give you is my experience. With my LTHR I was trying to be a super achiever to start with and did all of the PT exercises at home on my own. I felt really good at 6 weeks and then began the overdoing it on a regular basis. Spent a lot of time undoing my overdoing. The with my RTHR I took the opposite approach and did little if any PT aside from walking and some stretching. I didn't have the overdo's and didn't have any setbacks. In the end the right did just fine and there was absolutely no difference in the end result.
As far as work goes I never went back after my 12 weeks and really don't see why anyone would go back sooner. Allow your body to heal and enjoy the outcome, which is why we go through the surgery to start with.
Thank you for this! Your info makes me feel better about taking the slow road!
 
No idea on elevating, I never did any more than sit in a recliner never had my leg higher than my heart or any other elevating.
As far as your femur moving I don't think that's what you felt. I had a clicking or clunking in both hips and it was tendons settling in. If you dislocated others would tell you about it as you'd probably pass out. Best thing is don't get sloppy, pay attention to restrictions and take it easy. Keep resting and icing you've got a ways to go.
 
Thanks again, @Eman85 - again, that helps!!
 
Hi @Sgk ! I am so delighted to hear you have a 19-yr-old hip as well as the new one! Mine are going on 10 and 6, so they are no longer babies.

Re that PT-- I was like @Eman85. First hip U was obedient to my OS's protocol and did all my gentle little home exercises. I cannot tell that it did me any particular good except to give me something to do. The second hip I did nothing but walk. I cannot tell that it did me any harm, and being outside certainly is a pleasure. It's a very long recovery anyway, although you may find yourself feeling partly normal long before the 52 weeks are up.

I iced and elevated for many weeks. I wore ice 24/7 for a month for both hips, and kept my legs up as much as I could. After the month, I'd ice whenever it felt good, or if I had been sitting a long time or had perhaps overdone things a tad.

I'm glad you have 12 weeks available-- there were a few people on here with me who went back earlier than their bodies were happy with, and paid the price. Others were fine going back shy of 12 weeks but made sure they had plenty of ice at their workplace!

You spoke of feeling the femur shift. I had the oddest thing happen about a year after my first hip I'd had alot of trouble with my piriformis cramping up all the time. I was standing on a step unlocking the house door, with my op leg dangling off the step behind me. All of a sudden there was a sensation as though my leg were going to drop right off! (But no pain, just sensation) I was very very careful for a few minutes until I decided it was still attached and would stay so. Days later figured out that it had been my piriformis suddenly de-spasming, and what a relief that was, too!
 
I felt/heard what seemed to be a shift in my femur.
Many new hippies complain of popping, clicking or feeling like the joint is loose. Muscles, soft tissues and tendons were pushed away from the joint area when the implanted was placed. They need a bit of time to firm up around the joint.

Feeling tired is all a part of this recovery. Read the article post above on Energy Drain. It's real and you just can't fight it.
 
Thank you both @zauberflöte and @Jaycey ! Your comments and explanations are very reassuring. I have not realized until your comments that this is going to be more than a 6 or 12-week journey. My 1st hip seemed like it was a breeze, but I was many years younger and had lots of help. I can see this one will need more care and rest. Since I need the time to make changes to my career path (currently an adult ed teacher - ESL and GED, in a toxic environment - wanting to get into remote instructional design/elearning or proofreading, it's been a welcome break to have this time off. I haven't had this kind of time to just focus on healing and studying, so it's very reassuring to hear you all say that I'm doing recommended things. Also, my friend in NC has had a different approach with her OS of PT from the beginning, and she seems to be doing really well and has questioned why I'm not doing more physically. I told her about BoneSmart. She would like to know the source/validity of all the information provided on here. I can't seem to find anything to answer that. My doctor does seem to follow the same info here for the most part, though. My PA did recommend starting this next week with some standing leg lifts for each leg just to start strengthening the quads a little - but 3 sets of 10/day, nothing past a certain point, so seems reasonable. The other recommendations from day 1 have just been walking 3-4 times/day, ankle pumps, contracting thigh/bottom muscles which I do randomly. I also have a future of knee replacements needed at some point, so the bone-on-bone and osteophytes in my knees, I think, have made some of my movements and pain worse. So I do need to remember that I've got more going into this recovery than I did 19 years ago with the left hip! I do really appreciate all comments and advice, which have really helped me immensely with this path! I am a sharer of info and intend to do so with my experiences.
 
Only source I can give you is my experience and the fact that everyone on this board has had at least one THR. From experience and readings on here you'll see that OS now tend to steer patients towards the take it easy and heal approach, especially since most of us are shall we say pre-cell phone or pre-color TV generations. Most patients tend to seek the fast track like they're missing the Olympic THR team and they're not living up to the one week wonder recovery stories. All PT's seem to be trained in the no pain no gain you're going to miss the opportunity window mindset.
My take, I've been living in this body for over 6 decades and did all of the damage to it. Maybe I have finally started to listen to it, I'm a slow learner.
 
She would like to know the source/validity of all the information provided on here.
Our source is literally thousands of members who took the "slow and steady" approach (both hip and knee side) and very successfully recovered. The "no pain, no gain" approach is for people who are in training. You are recovering and have nothing to prove. Plenty of time for strength training once that hip recovers from all the trauma of surgery.
 
@Sgk I know your friend must be happy with her recovery, and yet maybe she doesn't really know that every hip is different simply because every person is different. Also, as many on here will tell you, each side of their body is different! Sure I have two bionic hips, but even this far out they behave differently. Part of that may be my other "structural deficits"-- right side SI joint is worse that left side, my career has made me a little lopsided so I use the halves of my body differently-- everyone has a difference somewhere.

There was somebody on with me in 2013 who was getting aggressive out-patient PT with lots of strengthening exercises. One day she was doing one of them which involved some movements while on her hands and knees up on the PT table..... and fell off. I don't remember what the damage was, but it was real. She didn't post after that, as I recall. That's definitely an outlier, but having something like that happen is pretty scary!

As we say of so many things...."It's a marathon, not a sprint!" Cheer your friend on and for yourself continue as you are. By next Christmas you will both be at the same point in your recoveries!
 
If you think about it any time you have an injury, say a broken foot or arm the Dr has you in a cast until it heals. The same goes for a hip. They sawed off your acetabulum to put in the new one and pounded a ball into your femur. With all that I think it is reasonable to let it heal for a bit before strengthening the muscles around it. We are really lucky they let us walk!! I think you are doing great with your progress. Keep up the good work!
 
@Sgk - Hi and welcome! My ortho said to me that I could recover from THR just as well on a desert island as I could in a room full of PTs with equipment (barring any complication of course). My advice is to get lots of rest, do your little mini-exercises to prevent clots, and then walk a slowly increasing amount. I took it easy for about a month and then began to introduce exercise in increments and now a year later, I'm doing better than ever at full speed.
 
Thanks, all of you, for making me feel so much better about the slow and steady recovery approach! I emailed my director to state my original optimistic plan of coming back to work after 4 weeks was now changed to the 12 weeks of short-term disability/FMLA. All of your posts to me have contributed to my comfort level in this, and I appreciate all of you for this! My doctor's PA also told me whatever I needed to do he would support - even if longer, so that makes me feel supported all the way! Meanwhile, I'm putting in lots of study time towards a new remote career path that will further add to a better lifestyle down the road.
I have a question on elevation - how long is it recommended to do - like weeks after surgery? I've continued to sleep on my couch with legs elevated all night. I have a "nest" with all my stuff on a double ottoman at head level, so this has helped me feel in control of my sleep position so I'm not able to change to side sleeping or cross my legs and it's been working well for all that. My PA told me last week I didn't need to sleep with legs elevated all night, that flat was ok. So wondering about opinions on this. I'm also icing every day as needed and will continue if I feel I need to. I assume everyone would agree about that also? Thanks!
 
@Sgk Ice and elevate for 45-60 minutes per session, several times per day. In time the need to elevate will taper off. Yes, it's fine to sleep with your legs flat if that is comfortable. Still early days for you!
 
As I said I never elevated, the only thing I did at my OS suggestion was to use a rolled towel under my ankle at times. I'd use it while reclining or in bed and it was to keep the muscles stretched in the back of my legs. only used it for 15 min at a time in early days. Ice if it feels good, why not?
 

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