THR Sheila-Seattle's Recovery Story

[Sheila-Seattle]

My THR was on January 6. You can read my story on my blog at http://s2cycle.com/sheila/total-hip-replacement/

Unlike most THR candidates I was not bone-on-bone but had some arthritis starting around a 7 year old injury where I broke my femoral neck and had it pinned. So my surgery included removing those pins first. My surgeon said I could've waited a few years but I wanted to do it when I was healthy and also because of Covid.

I found this forum to do a reality check on where I am at one month. Here's my progress report:

I'm doing pretty well overall and have an in-home PT who's been giving me progressively difficult assignments.

I'm 71, healthy and active. I was walking 10+K steps a day up until the day before surgery. I was also doing yoga 3x week. Our new tandem bicycle has finally arrived and my hope is to be able to start riding again by sometime in March or early April.

I never took any oxy for pain and moved from the walker to a cane at about 10 days. I was showering with no problem by myself.

The in-home PT gave me more advanced exercises than the standard post-op set including: hamstring curl, leg extensions, toe raises, clamshells, and most recently squats to name a few. I did them daily along with the 15 minutes of walking followed by ice/elevation every two hours. Once I got on the cane I started to walk on our flat roof and progressed from 1000 steps a day for a week to 2K then 3K.

I still need the cane or I limp which is discouraging me. I'm currently able to raise the leg to my other knee, laying on my back which is one of the hardest things I do. At first I could barely raise it. The other hard thing I do is stand on my right foot for a full minute.

Last Thursday I told my PT that I was discouraged that I have some pain pretty much all the time (4ish) and he suggested that I remember I'm only at 3 weeks and my body needs to heal before I work it so hard. He suggested I take a day off now and then and alternate my walking days with my PT days which I've been doing since then.

I do understand that it's just been a month and that we are ALL different. But I have no basis to understand how I'm doing. I didn't think I was over-doing it and I don't want to "under" do it either so that I can progress well without injury.

My friends who I consulted with pre-op about their experiences said they were walking without aid by about now which I think is part of why I'm discouraged. In fact I'm probably progressing quite well. They were both under 60 so a decade younger than me. Since I was so active I had high hopes for more progress.

I'm also curious about the numbness around the incision areas. There's a pretty large swathe of skin that feels weird. I've heard that it will lessen over time and may or may not go away.

I'm curious to hear your observations and thoughts. Thanks.

 

[Pumpkin]

@Sheila-Seattle
Welcome to BoneSmart, glad you joined us!
At 4 weeks you are doing great, try not to compare yourself to anyone else. Most of us forget how challenging joint replacement surgery is, and give overly optimistic stories about our recoveries.

With your pain at a 4ish you are probably over doing, you could add an OTC pain medication, and cut your exercises back by 50% and see if your pain improves.
You are not unfit, you have been injured, needing time to heal, once your hip heals your strength will be there.

The numbness around you surgery site will diminish with time, as your nerves heal and you become used to the sensation.

You'll notice that I have moved your newest post and started your recovery thread. For several reasons, we prefer that you have your own recovery thread:

• That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
• With your own recovery thread, you will see the posts and advice others have left for you.
• Having only one thread will act as a diary of your progress that you can look back on.

So please post any updates, questions or concerns about your recovery here. If you prefer a different thread title, just post what you want and we'll get it changed for you.
If you need an urgent response to a question, just tag a member of staff.
How to tag another member; how to answer when someone tags you

Here are the instructions on finding your thread, How can I find my threads and posts?Many members bookmark their thread, so they can find it when they log on.

 

[Pumpkin]

Here is your copy of the Hip Recovery Guidelines, the articles are short and will not take long to read.

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

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Activity progression for THRs​

6. Access these pages on the website

​

Oral And Intravenous Pain Medications​

Wound Care In Hospital​

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 the 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 the member’s history before providing advice, so please post any updates or questions you have right here in this thread.

 

[ForumUser]

Hi Sheila,

Congratulations!

You sound on track! We all heal differently - for a while range of different reasons, so don't let someone's experience drive your expectations too much. (here's my thread from 2019 second THR - https://bonesmart.org/forum/threads/thr-a-doing-well.54206/).

My primary expectation from each hip replacement was to be pain free - and, to return to mobility. I continue to read many, especially men, who believe their lives will be the same - ie weight lifting, squats, running, etc - when, it may simply be too much to ask of the replacement joint.

So, those things I found especially helpful:
- elevate and ice (absolutely be doing this at three weeks!)
- light stretching etc while lying down
- walking as much as possible, but not TOO much - your body will tell you
- notice - no mention of PT at all, most believe PT is not helpful during early healing
- you will notice in my bonesmart thread that I overdid it (again, most common among men, duh); don't do this - it will set you back

Finally, work really hard on not limping - perhaps use the PT time for this by asking others to walk behind you and tell you which way you are leaning, how much, and when you are fixing the lean and limp - don't forget, this is all normal - and, just something to focus on.

 

[Schaargi]

Hi! I can give you a couple of highlights that my experience and participation have given me.

Last Thursday I told my PT that I was discouraged that I have some pain pretty much all the time (4ish) and he suggested that I remember I'm only at 3 weeks and my body needs to heal before I work it so hard. He suggested I take a day off now and then and alternate my walking days with my PT days which I've been doing since then.

Yes, you are doing too much, which is likely why you have pain, and will likely hinder your progress. My PT insisted that I take a day off every week. My day is Mondays. Also, she has me alternating days so that I don't do all the exercises every day. It gives the muscles time to recover and heal instead of hammering on them every day.

Also, stay on the cane or any other walking aids as long as your body needs it. It will help your body heal correctly instead of forcing your weight on a muscle that isn't ready for it, which will cause problems with your gait in the long run.

It's much better to under-do it than overdo it. If you overdo it, you will injure yourself and set your healing back. Almost all of us on this forum have done this and it stinks when you have a setback. Hope this helps!

 

[Sheila-Seattle]

Great input you guys. I already feel most welcomed and reassured.

Chris I saw I was supposed to start my own thread after posting and was investigating how to move it so THANK YOU for that and the helpful links and comments.

It's interesting about the no-PT approach. I'm so reassured to take it easy and not push. THANKS!

 

[Jaycey]

@Sheila-Seattle Welcome to BoneSmart!

Sometimes our more active members have problems differentiating between training and healing. Pre-op you probably exercised to build strength and fitness.

Post op exercise is not that at all. It's all about gaining your mobility in preparation for further strength training.

toe raises, clamshells, and most recently squats to name a few

These are strengthening exercises and I can tell you from my experience - new hips hate these! Toe raises put pressure on the new joint. And clam shells are for core stability - not hips. Squats are also strengthening.

Read the recovery guidelines again and maybe reduce the amount of PT you are doing. Walking is the best exercise for a new hip and it will help you gain the strength you need to transition from the cane.

Finally - never compare your recovery to any other recovery. Literally every THR recovery is different - even on the same person.

 

[Sheila-Seattle]

Thanks Jaycey. That makes sense. I was surprised to hear my surgeon poo-pooing PT but I'm starting to understand what you all are saying. So instead of cutting back my walking, cut back my PT! And since I was already a Fitbit step counter that's such a natural way for me to see progress.

 

[djklaugh]

@Sheila-Seattle Welcome to BoneSmart! In addition to the excellent information/advice you've already been given I'd suggest also walking around your home without shoes if possible. I found doing that helped a lot after my hip replacements to get to walking without a limp. Also check the bottoms of your shoes. If you are wearing shoes that got a lot of use before your surgery, the wear pattern might be keeping you walking in an old limping pattern. If shoes are really worn down at heels and soles then either get those replaced or get new shoes

 

[Jaycey]

I was surprised to hear my surgeon poo-pooing PT but I'm starting to understand what you all are saying.

Aggressive PT post op is a now a bit "old school". Most of our members (including me) found all it did was cause more pain and lengthen the time we needed walking devices.

There will be plenty of time for strengthening once that hip is fully healed.

 

[Schaargi]

Hi @Sheila-Seattle!

You had asked some questions about yoga on another thread, so I will answer here.

At one month, you need to be super careful. One month is about the time everyone seems to gain confidence and overdo things.

As for yoga poses and stretches, I tried things very tentatively at first. I tried little bits just to see if I could do them, modified them to make it easier, and didn't hold any pose. After trying one or two poses, I would wait a day to see if anything hurt the next day (when aggravation often shows up). Painstaking, I know. Don't try too many different poses in one day because if it hurts the next day you won't be able to tell what made it hurt.

As I mentioned in my other post, chair yoga is a great start. You would be surprised at how many benefits you can reap from chair yoga. I had no idea! Visualizing the poses while breathing through them gave me much the same refreshed feeling at the end of the session as ever. My favorite is Happy Yoga with Sarah Starr. When I started, I only tried half the poses and the rest I visualized and breathed. It was fantastic.

So, try your favorite poses one by one, don't push it, if you can't do it, close your eyes and visualize it. And be aware of any restrictions your doctor has given you. It will come!

 

[Pants]

Your doing great. Welcome !!!!

 

[Sheila-Seattle]

Schaargi thanks for all the yoga tips. Helpful.
Besides yoga the other thing I've been searching about is scar treatments. I'm seeing lots of recommendations for Bonesmart Active Skin Repair. But it 's sounds like that's meant for wound healing. Since I'm a month out I'm guessing maybe not so much. Trying to figure out what, if any, oil or treatment would be advantageous. Thanks for any insights.

 

[Jaycey]

@Sheila-Seattle No need to put anything on that scar. Just let nature do its thing. The scar will fade to a very thin line.

 

[djklaugh]

@Sheila-Seattle as Jaycey said there's really no need to put anything on the scar. And my surgeon told me not to put any thing - not even ordinary lotion - on the incision sites for at least 6 weeks. The incision may look healed but until the inside is healed there is still a risk of getting an infection.

 

[Sheila-Seattle]

I thought I'd add a little one-month update. I've only been on the forum a couple days but in that time a lot has happened. I think the combination of having backed off on the walking and PT for the last week, and celebrating my one month anniversary with a massage plus the support on the forum has finally helped me turn a corner. I'm on the brink of walking without my cane. I had just said to my husband that it seems like any day now I'm going to just leave the cane behind without realizing it and then I read that's exactly how it often is for people. I'm not going to rush it. But it's the first time it's even felt likely or possible. Yesterday my in-home PT came and did a one month assessment. He was very pleased with my progress and said I was not a fall risk and my glute medius is much stronger. I've stopped doing the exercises that BoneSmart nixes. I can stand on my operated side foot and balance for a minute. So that means I can put pants on without sitting down! PROGRESS.

 

[FCBayern]

Coming right along @Sheila-Seattle! Forgetting my cane is exactly what happened to me. I had been in a big box store (pre-covid) and had put my cane in the shopping cart. When I got to my car I loaded my stuff, left the cane in the basket and drove away. Realized what I had done at my next stop and when I went back there it sat still in the cart. That feeling of turning the corner is always wonderful.

 

[Sheila-Seattle]

Some new questions mostly sparked by poking around in the forums.

What is the 90 degree rule please?

I saw a tip about walking heel toe to help eliminate limping. I'm on the brink of letting go of the cane but still limp some w/o it. Is it better to work on losing the limp while using the cane or without it?

I looked up cycling and found a great post about how to start back to i but it was by a TKR person. I messaged him and he suggested I post and ask because for me with THR/A it might be different. I have an upright spinning bike (not recumbent). Basically he was saying start with no resistance and take it easy. He also had something about saddle height in there.

I'm now in the process of weaning off the Extra Strength Tylenol which is all I've been taking. Sleeping pretty well. I tried to sleep on operated side and did for a bit but it just feels too awkward with so much numbness there still.

Thanks for any insights.

 

[djklaugh]

@Sheila-Seattle The 90 degree rule means not bending your operated on leg more than 90 degrees. So no bending at the waist to pick some thing off the floor. Not every surgeon imposes this restriction. And if it is imposed by your surgeon it is only in place for about 6 weeks. If you doctor has said nothing about this then probably he did not think it was necessary for you.

As for bike riding of any kind -- when is your post op visit with your surgeon coming up? You should ask him at the visit OR call his office and ask to speak to his nurse or assistant to discuss this. Every one is different and heal at different rates. Thing is your hip tissues and muscles are still healing outside and inside. It takes about 6-8 weeks for new bone to grow around the implants and you need to be cautious not to torque your hip suddenly.

Sleeping on the operated side may take a while to feel comfortable. When I first tried after my hip replacements it felt like I was laying on a brick! But now it just feels normal and I sleep on my side every night with no problem. Started feeling ok about 3-4 months after surgery. You can try sleeping on unoperated on side - try putting a pillow between your knees to help top leg not move too much.

 

[Sheila-Seattle]

thanks Deb.

My surgeon gave me NO restrictions! So I guess I won't worry about that 90 degree thing. I'm already been doing forward bends (legs straight and touching my toes from standing). No Problem.

I don't see my surgeon until Feb 23 which is 2 months from surgery. I could ask my nurse navigator but I think I'll first check with my in-home PT next Thursday. I imagine slow and easy is key.

Helpful to hear your story about sleeping on that side. I've been sleeping on my other side with a body pillow that I've been using for years. I just like to alternate sides. I'll be more patient!

Personal question - I see you had "bilateral ThR". I've never heard of someone having both done at once. It sounds challenging. Or am I reading that wrong?