Sandy's 6/30/08 Surgery Update

[Eeyore346]

Hi All

I'm back!

All went really well. It's day 3. I just got home from the hospital a little while ago and I am amazed at how well I am doing. I thought it would be a lot worse. My knee hurt far worse then my hip. Even in therapy the knee hurt worse.

My incision is six inches long and goes across my butt check. I guess because of being overweight that's how they did it.

It hurts to walk. I have to take it slow. Therapy hurts a lot. The ride hiome was no picnic. But I still thought it was going to be so much worse. The most painful part of the experience was when the muscle by my hip decided to hurt (They figure it hasn't moved in over 10 years). So they put me on a muscle relaxer (Soma) I am on 2 vicodine every 4 hours and soma every 8. It has been plenty to take away the pain.

Thank you so much for all your thoughts and prayers. I'm going to go now as I am so tired.

Sandy

 

[westexas]

Sandy,
Thrilled you are home safe and sound. These first couple of weeks will be very testy and you sound like me...Had not really exercised or felt like it for five long years...The pain was unbearable... Just keep up with the pain meds and I am sure you will have plenty more questions to ask as the days go on...Just know I am an oldie but you have plenty of newbies to get you through these next LONG LONG six weeks....Patty

 

[Sofa King]

Sandy,

Glad you're home and all went well, and very glad you're not having as hard of a time as you expected!! I'm 25 days post op LTHR, and I haven't had the knee done, as you've had, so I can't really compare this to anything else. The only other surgery I've had was an appendectomy when I was 19 years old, and the recovery wasn't too bad, but I had no ability to eat or keep down food, so I dropped to a rather sickly looking 145lbs. (I'm 5' 11"). You mentioned above that you got a posterior incision, maybe because of weight. I didn't even know they did an incision on the front for THR? I'm about 240lbs now, (about 50lbs overweight than my ideal, 190lbs. for my height), and mine is kind of diagonally up my left buttock too, but almost 10 inches long. I guess that's why he opened me there too, being about 50lbs overweight. I've been 225lbs and up for about the last 8 years, and I'm sure that extra weight helped accellerate my avascular necrosis and femoral head deterioration. Once I'm healed and healthy again, I plan to start mountain biking again, (no more regular running or jogging), until I'm up to doing it 4-5 days a week, and at least 15 miles or more a pop, but that'll probably be next Spring. Likewise, I intend to drop back down to about 200lbs eventually. I want this prosthetic to LAST! Anyway, I bet you're tired! Get some rest and we'll holler atcha' soon.

~Dalton

 

[JudyS]

Sandy,
You go girl. I am so glad everything went ok for you. Especially glad it was not as bad as you thought. Get through about 3 more days. I feel the first week was the worst or about 6 days.
Thanks for posting to let us know. I have been thinking about you this week.
Sleep is a good thing

Judy

 

[MsCat62]

Sandy,
Welcome Home!!!! I'm so glad it all went so well and that it wasn't/isn't as bad as you'd thought. My prayers are with you.

 

[chaloo]

Sandy

Good to hear that all went well at the op. Take it easy for first two three weeks. You will feel fantastic in few weeks time.

Take Care

Jaz

 

[Josephine]

Incision has nowt to do with the patient;s weight but all to do with the surgeon's preference. Surgeons will choose to do the posterior, the posterior lateral (as I think you did, Dalton) or the lateral.

I'll try and post some pics but right now have to go and train a new mod for CF ...

brb

 

[rejoyce318]

I'm having an anterior (front) incision when I get my THR (left) this Wednesday. Surgeon's preference, b/c he'll push the muscles aside rather than cut into them. I found some animations & a webcast about that kind of surgery last night. Haven't heard of too many people from this forum talk about having had an anterior incision.

Joyce

 

[rejoyce318]

Glad you're home, Sandy!
Joyce

 

[Josephine]

Antero-lateral was the bench-mark incision for both McKee and Charnley (to whom you all owe a great debt of gratitude for devising artificial hip joints!). The surgeon I worked with 75-89 also used it but then, he was trained by Charnley so he would, wouldn't he!

Dislocation is not so much of a problem with that approach either. This is because in the posterior, the hip is (obviously) opened at the back of the joint and since the most common manner of dislocation is by posterior displacement, this approach obviously makes it easier to occur. The anterior approach, on the other hand, opens the joint in the front so it is much less at risk in the early post-operative period.



Here is the full posterior approach - right in the centre of the buttock. You can see how the femoral head is delivered out of the hip joint at the back by turning the leg inwards, knee moving towards the other leg, which is the position it moves into when you cross your legs or flex your hip joint at more than 90 degrees.



This is the antero-lateral incision. The blue dotted line is the more traditional one, extensive and curved, The shorter straight line is the more commonly used one nowadays as it is less intrusive. The femoral head is delivered out of the back as in the full posterior approach.

However, in this anterior approach, the head is delivered out of the front of the joint, by rolling the leg outwards. but because of the anatomy of the joint and the muscles surrounding it, rolling the leg outwards after this approach is not so risky as rolling it inwards with the previous approaches.

 

[Eeyore346]

Thank you Josephine for all the info. My incision is more swollen now then it has been. But my knee is in incredible pain. It is swollen to twice it's size. I believe they are going to have to do another MRI to see what is going on. I am sitting here now with ice on my knee and on my incision. Pretty bad, I have hip replacement, a six inch cut on my butt and all that really really hurts is still my knee.

They are opening the coumadin clinic this morning just for me so I can get my level checked. So that means a trip to the hospital.

Yesterday was definatly my worst day yet. But I did manage to sit outside for about 30 min. It was such a beautiful day, I couldn't resist.

So now I have made it to day 5!

Sandy

 

[westexas]

Bless your heart Sandy. I will be thinking about you...I came home on day 5. Had a five hour drive. Did good until day 7 and then had lots of minor problems. I do remember my knee killing me for awhile and very swollen, then it moved into my foot for awhile and then back to the hip incision. It will be rough seas then calm seas...kind of an up and down for many weeks. Just take each day as it comes and keep up with the pain meds and icepacks. It hurts looking at those pics but that is the real deal when it comes to hip replacement....Keep us posted....Patty

 

[Eeyore346]

Wow Day 5 and I have already been to Wal-Mart! I had to go get my coumadin tested at the hospital. We then stopped by the local Wal-Mart for iron and multi-vitamins (which my surgeon requires you to take) I saw some friends at the store and they couldn't believe how well I was doing. (I didn't want to tell them they should have seen my agony last night). I was in a wheel chair. But I do feel great today. I guess it is like everyone says... a couple steps back, a few forward, a few back, etc. I have definatly learned the main thing is taking your pain meds on time! I walked from coumadin clinic out to van and from van to house today. (It is a pretty far walk down sidewalk to my apartment.

Sandy

 

[JudyS]

Hi Sandy,
I remember the extreme swelling , as it was only a few weeks ago. Everyone here told me it was normal and would go away. I still thought mine was so unbelievable. It was both legs with the surgery leg a little worse. My kneecap seemed lost . My feet were not even recognizable.

I'm glad you made it to Wal Mart. I had a few Dr,. apts during week 2, but it took me until almost 3 weeks to get to a store. Sounds like you are doing wonderful. Take those pain meds. Lay around in bed.
Take Care
JUdy

 

[ceci1957]

Sandy, I'm so glad you're home and all is going relatively well. Remember we are all different and handle pain and surgery differently. Take it easy and don't rush to get better. I felt much better after a week, and after two weeks, I went to a bookstore. Now, that did wear me out, but it felt good to do it. Today I feel great and would return to work on Monday but the doc said I couldn't drive until week 4. Take good care of yourself and let others help you.

 

[Sofa King]

Sandy!

Sounds like everything with you is going mostly normal, as far as your pain levels, mobility, just at day 5, etc. I was still a 'miserable bear' on day 5, but those days are a distant memory now. (27 days post op, YAAAA...) We're all VERY glad to hear how you're doing, and that (hopefully), the worst of it is over. Of course, you still have a bit of the trail yet to go; you may be 'out of the woods', but 'not to the farmhouse yet'. Seems like you're spirits are up and doing well, and that's the MOST important thing! Hang in there Doll, stay on top of taking those pain meds, and you know you've got TONS of great support here... (Jo is priceless, ain't she?) Keep us informed!

~Dalton

 

[*gmac*]

Sandy-
Welcome back. I'm a few days behind at the site, we were up north camping. Haven't read all posts I'll try Sunday night. The one that caught my attention was your knee being swollen. Could that just have been the (temporary)byproduct of trying to separate your femur from your hip? Take care.

 

[rejoyce318]

Antero-lateral was the bench-mark incision for both McKee and Charnley (to whom you all owe a great debt of gratitude for devising artificial hip joints!). The surgeon I worked with 75-89 also used it but then, he was trained by Charnley so he would, wouldn't he!

Dislocation is not so much of a problem with that approach either. This is because in the posterior, the hip is (obviously) opened at the back of the joint and since the most common manner of dislocation is by posterior displacement, this approach obviously makes it easier to occur. The anterior approach, on the other hand, opens the joint in the front so it is much less at risk in the early post-operative period.



Here is the full posterior approach - right in the centre of the buttock. You can see how the femoral head is delivered out of the hip joint at the back by turning the leg inwards, knee moving towards the other leg, which is the position it moves into when you cross your legs or flex your hip joint at more than 90 degrees.



This is the antero-lateral incision. The blue dotted line is the more traditional one, extensive and curved, The shorter straight line is the more commonly used one nowadays as it is less intrusive. The femoral head is delivered out of the back as in the full posterior approach.

However, in this anterior approach, the head is delivered out of the front of the joint, by rolling the leg outwards. but because of the anatomy of the joint and the muscles surrounding it, rolling the leg outwards after this approach is not so risky as rolling it inwards with the previous approaches.

Thanks, Jo.
Joyce