THR Six days post surgery<

Cathippy

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New hip last Saturday and was discharged Wednesday. Yesterday ok but upper leg now swollen with loads of bruising and thinking I overdid rehab and 20min walk too much.

Anyone else have longer operated leg. Mine confirmed as cm and wondering if this might cause more pain as very aware when I walk.

Looking forward to normalising my experiences and hearing how others cope.
Have worn out back too
 

Layla

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Congratulation and Welcome to BoneSmart and Recovery! :welome:
Thanks for joining us.

Please find the Recovery Guidelines below. There are many short informative articles that I'm sure you'll find useful. Consider icing for pain and swelling. If you're not already, please start several times per day for 40-60 minutes each session. It should help. There is an article on "ICE" in the Recovery Guidelines.

Following is the Big Tip which you will also find in the Recovery Guidelines -
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.

Stop back often, we'd love to support and encourage you along the way.
Wishing you lots of comfort and a great weekend!

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
5. At week 4 and after you should follow this

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.
 
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Cathippy

Cathippy

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Thank you for all the advice which I am planning to read. The right hip. May need left doing but hopefully some way off in future.
 

Pumpkln

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@Cathippy,
I noted your THR was last Saturday and added November 10, 2018 to your signature for you. If the date is incorrect let us know, and a moderator will up date it for you.

All the best for your recovery!
 

Eman85

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Are you icing? It's the best for swelling,bruising and pain. I didn't have any leg length difference but I do have a worn out back. The one thing about the recovery from the THR I got a chance for my back to rest and it felt real good.
 
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Cathippy

Cathippy

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I am icing now thanks. Use to manage back with walking pilates and movement so bit bothered back might have melt down at some point ...
 

Mojo333

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:hi: welcome and glad you are on your way to life without Hip pain.
All you need to do right now, is walk to the potty and walk where you gotta.
Slow wins this race.
Do take things easy. Your body is recovering...doesn't need to perform any more than necessary right now.
Healing hugs:roseshwr:
 
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Cathippy

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Struggling to sleep with fixed position and pain around knee at night !
Have lower leg compression stocking on. My leg above this swelled day before yesterday and around knee very swollen and bruised. Have large bruise come out right up inner thigh.
Started icing and elevating yesterday. How often please to reduce swelling and do I need to do less moving and physio till it goes down ?
Didn't sleep well at all night before last as pain meds just didn't work well enough.
Last night put leg on pillow after putting a deep freeze pain patch on back. After taking oramorph about 1 fell asleep for 6 hours. Hope all of these didn't breach precautions.
Feeling really emotional again this morning....no idea it would be this hard and would feel so on my own.

Any advice much appreciated
 

Ginny12

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@Cathippy

You are not alone, please try not to worry. I am sure that you will get lots of good advice soon. I am no expert but it does not sound like that you have broken any precautions. If it is any consultation i had my op coming up to a month ago and the most that i have slept is 4 hours. But that is normal apparently.

Please read Layla's info re icing and swelling above. No wonder you feel alone with emotional, perfectly normal albeit not very nice. In fact read all the stuff that the moderators have sent you, it really does help.

Hang in there it will get better. The first two weeks are challenging as so much has happened to your body. I was tired brushing my teeth! I am much better now and so pleased that i have had the surgery.

Warmest healing wishes
 

Jaycey

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How often please to reduce swelling and do I need to do less moving and physio till it goes down ?
I would stop all that physio and just walk around the house for now. You are just out of surgery and all you should be doing is resting. Ice and elevate as much as you can during the day. Sessions should be 45-60 minutes. If you have swollen or bruised areas other than your hip ice those areas as well. We get handled pretty aggressively during the procedure. Lots of angry soft tissues.
Feeling really emotional again this morning....no idea it would be this hard and would feel so on my own.
Read the article Layla left you about post op blues. Unfortunately its all part of this recovery. But please don't feel you are alone. You have a whole army of BoneSmart buddies with you through this journey.
 

Josephine

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Any advice much appreciated
I usually ask before posting these questions but given the comment above, here they are!

It would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are

1. what approach did you have for your surgery? Anterior, posterior, lateral? You can look here to see the various types THR approaches or incisions

2. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't forget to factor in other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness).

3. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

4. are you icing your painful area at all? If so, how often and for how long?

5. are you elevating your leg. If so how often and for how long?

6. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

7. are you doing any exercises at home? If so what and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)

Exercises done at home
- how many sessions you do each day
- enter exercise by name then number of repetitions of each
etc., etc.

Anything done at PT
- how many times a week
- enter exercise by name then number of repetitions of each
etc., etc.
 

Eman85

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You're not alone, plenty of people here that have been there and done it. You're a week in and have a ways to go yet, don't start getting impatient. I don't think you can ice too much, I used a machine and had it on continuous, even when I slept. I don't know what precautions or restrictions you have, I slept with a pillow between my legs.
 
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Cathippy

Cathippy

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1. Posterior approach

2. Pain levels
Daytime - soreness around buttock/scar area which can make sitting difficult
Some lower leg pain outside/front of leg
Was there prior to surgery and assumed possible sciatica in nature or due to limp
Can generally manage this pain
Nightime
Severe knee pain particularly left sided w
when lying flat in bed which can prevent sleep. Severe bruising in this area which spreads up inner thigh to top. Worst across top of compression socks.
Now using cushion under leg
Icing at night.
Still waking me even on morphine.

3 Pain meds: Co-codamol 30mg x2 4 times daily
Ibuprofen slow release 200mg x 2
Oramorph 5mg at night 2hrs after codeine

4 icing knee during evening for appx 40mins

5 Elevating 40 mins am and 60 mins pm

6 Being cared for so may do small tasks like make porridge or move cup. Walk round house.

Physio exercises see below
15 min slow walk outside

7 exercise
Walking round house hourly
Daily am on bed
Heel slides 8 to 10
Static quads 10
Hip abduction 5
Gluteal exercise 5 to 8
All done on bed and prior to surgery

Pm
Hip abduction 5
Hip extension and knee flexion stopped now
Calf raises 6
Mini squats 3

Have reduced activity over last 24hrs

Thanks for any advice Josephine or others
 

Josephine

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2. Pain levels
Daytime
Soreness around buttock/scar area which can make sitting difficult
Some lower leg pain ouside/front of leg
Was there prior to surgery and assumed possible sciaticac in nature or due to limp
Can generally manage this pain
Nightime
Severe knee pain particularly left sided w
when lying flat in bed which can prevent sleep. Severe bruising in this area which spreads up inner thigh to top. Worst across top of compression socks.
Now using cushion under leg
Icing at night.
Still waking me even on morphine.
Cathippy, I didn't need all this - just tell me your pain score numbers on the scale of 1-10 - like this

facial grimace scale.JPG
 
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Cathippy

Cathippy

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Swelling now reduced and make sure to pace myself. Can manage in day but finding night pain hard.
Minute I lie down pain in my knee starts.
Ice in evening if painful.
Take co codamol 30mg 30mins before bed after taking ibuprofen after tea.
Usually get off but wake few hrs later in agony. Take liquid oramorph 5ml.
Sleep after awhile but wake maybe 4hrs later. Take co codamol and try to sleep again.
Have used ice stick on patch too.
Is there anything else i could do ?
Thanks

Ps can see some improvement each day now ☺
 

Layla

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Hi, I'm sorry you're having a rough time.

Sadly, patience is key but hard to come by when your feeling off emotionally and in pain
Thankfully you're seeing improvement. Have you tried icing your painful knee? If no, I'd try it.
Icing is beneficial for both swelling and pain relief.

You may not agree, but sleeping for a stretch of four hrs straight is pretty good at only a little over one week post op. Especially if you're falling asleep for a few more hours after you take meds again.

I would advise against any physio.
Here is the Big Tip from the Recovery Guidelines in case you haven't had a chance to read through the articles yet -

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're here to support you through this. When you're feeling down, stop by, someone is always here to offer encouragement. Keep in mind this is only temporary, it truly is.

Ice for the time period, Jaycey, suggested. No less than 40-60 mins per session. With that said, I iced more often and really suffered minimal pain and swelling. I iced continually while I was sitting or laying down, even falling asleep with a large ice pack at night and grabbing a fresh one half way through the night.

Here is the Activity Progression from the Recovery Guidelines as a reminder and rough gauge of what you could be doing currently -
http://bonesmart.org/forum/threads/activity-progression-for-thrs.13187/

I hope today is a good day! :SUNsmile:
@Cathippy
 

Josephine

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2. Pain levels vary from 2 - 9 over 24hrs
Oh gosh - that's quite high but you are only 10 days out!
3 Pain meds: Co-codamol 30mg x2 4 times daily
Ibuprofen slow release 200mg x 2
Oramorph 5mg at night 2hrs after codeine
I don't recommend the ibuprofen as it's a very poor pain med and doesn't work very well as an anti-inflammatory after surgery.
Also the codeine in the co-codamol is not really a good pain med and neither is the oramorph - not for after surgery, anyway. I strongly suggest you have a chat with your GP and see if you can't persuade him to prescribed you Tramadol which you can take 50-100mg at a time every 6hrs and along with 2 paracetamol. It's a much, much better pain med. These are my charts I created when I had my surgery done. The first one on the left I used for the first 2-3 weeks and then I changed to the one on the right. But you could do what you wanted with them so long as you didn't exceed the 'totals' which are the daily maximums.

aa Tramadol routine 1.JPG
aa Tramadol routine 3.JPG


4. icing knee during evening for appx 40mins
5. Elevating 40 mins am and 60 mins pm
That should do very well.
6 Being cared for so may do small tasks like make porridge or move cup. Walk round house.
Jolly good - very pleased to hear it!
15 min slow walk outside
7 exercises
Walking round house hourly
Daily am on bed
Heel slides 8 to 10
Static quads 10
Hip abduction 5
Gluteal exercise 5 to 8
All done on bed and prior to surgery
Pm
Hip abduction 5
Hip extension and knee flexion stopped now
Calf raises 6
Mini squats 3
Don't do ANY exercises! None at all! I noticed that Layla, when she left you the guidelines, actually posted our BIG TIP, TWICE in that post. So did you not see it? Or either of them? Did you actually read her post?

Just in case you missed it, here it is again!
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.

What I mean by this of course, is that you could halve the amount of pain you are getting if you would just stop all those exercises!

If you are concerned about refusing to do therapy, you need to read this Saying no to therapy - am I allowed to?
 

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