THR September 1 2025: a new right hip to match my left

[Deni444]

Don't be hard in yourself... The Codeine makes me incredibly emotional, ridiculously so. When I said to my husband that I was considering dropping the morphine in favour of Codeine because of the sleep side effects, he went white as a ghost and said, Oh no... Do you think that's a good idea! Maybe you could discuss a medication change. They all have side effects but I've been pretty good on the oramorph. My head is my head... Until I get too little sleep.

 

[Deni444]

I'm about to rush out but... With hip #1. I was pretty much elevated all the time in my recliner.

 

[Tuppence71]

The Codeine makes me incredibly emotional, ridiculously so.

Ah, I didn’t know it could be the codeine. I am definitely not myself. Last time I was able to stop taking the opiates not long after coming home, just continuing with paracetamol; maybe I’ll start thinking about easing off them now. The pain is really just stinging / soreness around the wound: so long as I ice plenty, get enough rest and don’t do anything dumb* it should be manageable.

* The big challenge: not doing anything dumb.

 

[Tuppence71]

Oh - and another question for the hive mind:

Last time around I had a cemented post, but this time the surgeon managed to slip in an uncemented post. He seemed quite pleased with himself as I, apparently, have very thin bones (which is why the first surgeon opted for cement). Could this be why my leg feels weaker / more bruised? Is the act of inserting an uncemented post a bit rougher on the body?

 

[Deni444]

I'm afraid, I know very little about uncemented. I did a search but still not too clear. My very, very limited understanding is that they take a little longer to establish a strong bond because instead of cement the bone needs to adhere to the prosthetic. I thought there were generally, slight different precautions... I'm just guessing though.

Let's ask @Jamie

 

[Jamie]

Deni444 is right that an uncemented implant must have time for an ingrowth of bone into the porous surface of the stem. There usually are no special restrictions, though. Because the hip is a weight bearing joint, you usually have enough pressure on the joint to encourage growth. The uncemented stem is “press fit” which means it is a very tight fit. It’s not like it will move around while the ingrowth is taking place. But…you do want to avoid overdoing things with iyour new hip so activity should be limited to short walks every few hours. Try not to compare this hip with your previous one. No two hips are ever the same.

 

[Tuppence71]

Try not to compare this hip with your previous one. No two hips are ever the same.

Thanks. I do keep reminding myself just to let go of all my expectations. But I made the mistake yesterday of looking at my previous thread, and things were SO different. And I know my husband / family had assumed I’d recover in the same way and made plans on that basis - I feel as if I am disappointing / inconveniencing everyone by not making it all look as easy as I did back then.

I am on a different road, but I know it gets to the same destination. This time I am taking the scenic route rather than the ultra-fast expressway. I should stop and enjoy the views.

Plus, I imagine that I am on course to win some sort of national award for the greatest number of sudoku / Wordle puzzles completed over the course of one hip recovery.

 

[Newhip_Pol]

Good grief @Tuppence71 I can't believe you are beating yourself up about slow recovery when your op was only five days ago? Haven't read your first hip thread but that recovery must have been miraculous! You have already told us that some things are easier and better this time around.
My second hip recovery was slightly slower than the first, not sure why but I was almost five years older! We got there in the end and by 12m I could forget about hips and focus my worries on the ankle. Both hips are now amazing and coping well with partial weight bearing for the ankle recovery.
Remind yourself (and your relatives) that you have just had major surgery on the largest weight bearing joint - the one that is crucial for stability and balance. Slow and steady - you can definitely do this.
Best wishes.

 

[Tuppence71]

I know you are right @Newhip_Pol. And I do feel a little bit better every day. I knew that hoping for two recoveries like last time was asking way too much (it was a bit miraculous) and all things considered I’m still doing ok. I just overthink when I am lying awake through the night….

 

[Deni444]

I may not always sound like it but on a personal health level, I'm prone to overthink things too. I've found it useful to focus on the day at hand and respond accordingly resisting the temptation to plan out the week in my head in concrete. It's not all bad news on this journey. We tend to dwell on the horrible days but in my experience we get surprisingly good days too. Although you are finding week one a challenge, it's no guarantee that week two will be as challenging. Good days/bad days, good weeks/bad weeks. I've even known mornings to be completely different to afternoons. It may just surprise you and be good. When you read the threads, you get an idea that it's all very unpredictable and sometimes seems to defy logic.

I think as double hippies we have expectations of being better prepared but the reality, it's the first time all over again. I'm a very glass half full rather than empty type of person... Rather than feel bad and focus on this hip giving you a harder experience, maybe try flipping it around and think it's fortunate your family only have one difficult journey, not two. Both could have been hard. You all benefitted last time, that's a lovely gift but not the norm. Just keep gently explaining to loved ones, that this time you are experiencing closer to the norm. Explain that taking it easy now and letting your body dictate the agenda should pay dividends for a smoother recover in a few weeks time. Annoying but any plans you made can hopefully be postponed on the basis of a change in anticipated circumstances. You'd do so without a thought if you unexpectedly broke an arm or leg... You could try making, 'change of plan... Hip said no' a bit of a humourous but serious motto and I'm sure loved ones will sympathetically fall in with the reality that this time you're hurting a bit more and struggling a bit more.

You're doing great... This is just temporary and before the blink of an eye you'll be past the initial post surgery trauma stage.

 

[Tuppence71]

Thanks @Deni444 - TBH, I think I’ve not quite shaken off whatever chemically-induced type of depression hit me in the immediate aftermath of the surgery. I may not be flying through this first week like last time, but I’m not that bad. I need to find something better to do with my mind than cycle through negative thoughts.

It also only occurred to me an hour or so ago that following a bout with a horrible nerve condition called brachial neuritis about 10 years ago, the muscles in my left arm are only about 70% as strong as my right. I never think about it because it doesn’t really make a blind bit of difference to my day to day life. (I don’t do that many handstands, usually). But of course, this time around it is my left arm taking more of the weight on my sticks. So of course I feel weaker and a bit less steady. When I notice my left arm wobbling, it’s not necessarily that my hip is a lot less strong, it’s that my arm can’t bear my weight quite as easily. Hey, maybe this is a chance for me to finally build those arm and shoulder muscles that wasted away back up again! A double win.

But enough about me. I hope you’re feeling OK today, and your wound is benefiting from being out from under the dressing.

 

[myglasshalffull]

Good question. I combined both but I have to say I was more comfortable just lying flat. I say do what makes you feel the least amount of pain & get your rest.

 

[Deni444]

All good my end Tuppence! Good spot, regarding your arm strength. Just a bit of extra effort can make a difference post surgery. I must say, my arms are looking trimmer than they have in years... I think we deserve the bonus

 

[Layla]

Plus, I imagine that I am on course to win some sort of national award for the greatest number of sudoku / Wordle puzzles completed over the course of one hip recovery.

Love that you keep your sense of humor, Tuppence.

Remind yourself (and your relatives) that you have just had major surgery on the largest weight bearing joint - the one that is crucial for stability and balance.

Great point from Newhip_Pol!

What helped me realize I was making progress was to pick a day of the week and on the exact same weekday, every week, reflect back in thought, or writing, and realize the progress I was making, even if it felt slow, or stalled at times.

Recovery has it's own pace and can be influenced by many things such as age, since our body changes over time, the strength of your muscles and even how you've adapted since your first THR three years ago. And since I mentioned that Happy (very soon to be) Three Year Anniversary!!
Trust that with time and care your strength and stamina will return, and if it matters, I think you're doing really well for only five days post op.
Happy Saturday!

 

[Tuppence71]

Hi @Jamie - I think the bed pain I get is more my body telling me that it isn’t ready to be in a certain position yet, rather than something I need to medicate away. If I lie on my back, legs out straight, my hip actually feels fine, and I can doze off for a couple of hours. But I’m not someone who normally sleeps on their back; I find it really uncomfortable and always wake up with backache. So then I start trying to find ways to prop myself safely on my side and that’s when I hear from my hip.

I could put a pillow beneath my knees to try to relieve the back ache - but if I sleep with my hip flexors bent they will be seized up by the morning. (I learned this the first night I was home, when I was in terrible shape come the morning). Maybe I should get up and move around when my back gets sore, rather than try to fix it with a new sleeping position? I know it is only a matter of time until I can comfortably prop my right leg on my bolster and sleep on my side….

I’ve been alternating paracetamol (1000mg) and codeine (30mg), taking each every six hours (so a dose of something every three). Mostly I’d categorise my pain as fairly low level discomfort - unless I do something too demanding.

 

[Tuppence71]

@Jamie If I take it very easy, I have very little pain. If I try to push things - walk around for too long, ask my right leg to bear more weight than it wants to - it hurts.

I suppose I’m a bit uncertain, because I was told by my surgeon ‘no precautions, but listen to your body, and if it hurts, stop’ (the surgery was posterior, so no precautions was a surprise). So I am struggling to differentiate between ‘pain that is telling me to adjust my medication’ and ‘pain that is telling me to back off’!

 

[Jamie]

I think you need to look at your pain medications differently. There are many reasons for post-op pain. Obviously the main one is the pain associated with surgical trauma and the tissues directly related to your incision area. But pain medications are also a benefit for for your overall body that is still experiencing recovery from that surgical trauma. This can manifest in a variety of feelings that can include restlessness, pain or discomfort in other areas of the body, mood problems, and what you're describing as not being able to get comfortable when trying to sleep.

If you're not taking anything at all for pain, I suggest you try taking paracetamol 1000mg every 6 hours for a day or two and see if that makes it easier for you to get comfortable in bed. It won't hurt you and it just might enable you to get the rest that is so important to your healing process.

However, if the hip pain is pretty immediate and centered directly in the incision area, then you are probably right that it's too soon to try and sleep in that position. In that case, you might try a heating pad on the small of your back to help counter any back pain.

 

[Deni444]

I suppose I’m a bit uncertain, because I was told by my surgeon ‘no precautions, but listen to your body, and if it hurts, stop’ (the surgery was posterior, so no precautions was a surprise). So I am struggling to differentiate between ‘pain that is telling me to adjust my medication’ and ‘pain that is telling me to back off’!

Jamie provided a really good explanation of the different types of pain. Maybe I can help to put it into perspective in relation to 'precautions', if I share how I approach the difficulty (uncertainty) you describe.

Similar to you, I had a posterior surgery and have no precautions. I was maybe more fortunate, in that they did a pretty good job of walking me through it in hospital. They described the potential stress on the new hip, using the examples that are often the restrictions applied for 6 weeks.

They explained that instead of being given fixed restrictions, I was to approach certain activities and posture carefully and cautiously. I was to avoid any activity that caused a noticeable difference in comfort level or pain upon performing it. Or an increase in pain or discomfort immediately (30 minutes) following the activity.

They used the example of the 90 degree restriction traditionally fixed for a number of weeks. These can include but are not limited to...
not bending the hip beyond 90 degrees, not crossing your legs or ankles, and not twisting the operated leg or waist.

Personally, this is how I approach 'no precautions'. I understand that bending beyond 90 degrees potentially puts stress on the healing hip and therefore I must be particularly mindful doing any activity that could potentially involve a bend near, on or beyond 90 degrees.

Here's an example, using toilet height. When precautions are in place, we often are advised to use a raised toilet seat for 6 weeks because it prevents us breaking the 90 degree restriction. Personally, despite having no fixed precautions, but being cautious and mindful... I was aware that my hip feels uncomfortable if I use my toilet without a raised seat, it does feel a little more upset immediately after the activity. I therefore use a raised seat. Not because I'm told to by my surgeon but because my hip tells me it isn't comfortable without one. Essentially potentially telling me it is feeling the stress we want to avoid inflicting on our new hips. I know others are perfectly comfortable without a raised seat. We're all different.

My personal measure of 'back off' pain. I know how I feel when standing about to position myself on the toilet. I monitor any twinge or uncomfortableness in the hip region that wasn't detectable before I bent down. I feel a significant difference, I Back off.

My personal measure of take more medication pain is similar. A comparison of what I feel when I take medication compared to what I feel without it. As Jamie explained, pain is experienced and perceived differently by different people for all kinds of reasons too diverse to list. Pain in a general sense is subjective. Personally, I think I may have a high tolerance. Maybe I've experienced chronic pain for a long time and my brain processes it s little differently compared to someone who hasn't experienced chronic pain. Just a thought for illustration, rather than science. My average level of comfort within 4 hours of medication when sitting or laying in a given position can rapidly decline. I experience a relentless uncomfortableness, in any position. I become very fidgety and restless. I personally based on a measure of normal for me am interpreting this restlessness as pain. This is when personally, although I'm reluctant because of side effects, do take a small dose of the medication I've been prescribed for breakthrough pain. In my mind that's exactly what's happened. I've got an average level of comfort when taking my scheduled medication. When my comfort levels go very noticeably above and beyond, I'm calling that breakthrough pain.

I Do hope you may have found some of that useful in terms of clarity. We are all different though. Personally, I always find a real life example helpful. If you haven't keep asking!

 

[Tuppence71]

Thank you for such thoughtful and considered responses @Jamie and @Deni444

Pain is such a hard thing to define, isn’t it? When I was younger I had epilepsy, and had a lot of nasty accidents and injuries as a consequence. It used to be a bit of a (not very funny) running joke that the universe had dealt me a bad card with the seizures, then felt guilty so gave me a very high tolerance for pain in order to help me deal with them. I also used to run marathons - and a large part of that is training your brain to ignore a lot of physical discomfort (particularly if, like me you are not an especially good or fast runner, so marathons take a VERY long time). And then over the last 8 years or so I’ve lived through the deterioration of first my left and then my right hips, trying my very best throughout not to let my failing joints stop me doing the things I loved. So I think I have a rather strange relationship with pain…..

I am taking my meds (paracetamol + codeine) as @Jamie suggested when I first came home from the hospital. I don’t have anything for breakthrough pain (although I could, I suppose, take an extra codeine, as the packet does say ‘up to 60mg 4 times daily’ and I am only taking 30mg). Really for me though, I get the best relief from ice and elevation.

Thanks for the personal insight on how you’re handling the lack of formal precautions, @Deni444 . My hip seems to have no problem with 90 degree bending, but is very quick to shout out if I twist and I’m very wary of crossing my legs. Won’t it be amazing in a few months time when we’re not constantly scanning our bodies to assess how the most basic movements feel?

The sleeping pain if I move towards side sleeping, is definitely hip-focused, and close to the surgical site, so I am fairly certain it is ‘back off’ pain. I wasn’t sure if I could use a heat pad for my back, given that there is so much inflammation in my body right now - but that sounds like the best solution. That said, last night was a bit better - it was 3.30am before I woke up for the first time, so I did get about 5 hours before getting restless.

I’m going to keep your posts in mind as I move through and see if I can come to a better understanding of my pain levels / patterns. Have a great Sunday, you lovely, wise people.

 

[Deni444]

I am taking my meds (paracetamol + codeine) as @Jamie suggested when I first came home from the hospital. I don’t have anything for breakthrough pain (although I could, I suppose, take an extra codeine, as the packet does say ‘up to 60mg 4 times daily’ and I am only taking 30mg). Really for me though, I get the best relief from ice and elevation.

@Tuppence71 Glad it was somewhat helpful. Fascinating pain history you have there!

Just coming back to confirm that what you mentioned you could do regarding the extra Codeine is exactly how I managed #1 hip. I used that range of prescribed dose as a back up, particularly useful during the night when maybe pain takes more of a hold as we become sleep deprived. It really is quite a balancing act, especially taking side effects into consideration. In reality before long I was off the Codeine all together.

You're doing great... It's all just temporary