THR Six Weeks out from an Anterior Hip. Where Should I be?

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@HippyHelen You sound like you are doing great. I agree with Beachgal that 8 pounds is nothing to get concerned about. As your activity increases, that will slip off. I hope your transition back to work goes smoothly; I am sure your co-workers and students will be very supportive. Have a great 1st day tomorrow and remember to take a break when you need it! :)
 
@cthipster @beachgal @MajorHeidi @Poppet @lovetowalk @muckingabout

Hi Everyone. Been a way for a little while. I think because I have a sense of moving backwards. I am almost 12 weeks out now. It's GREAT to sleep on my operative side and at my 8 week check up my OS was happy (in fact asked if I wanted the other one done in 6 weeks!). But then I went to a wedding about 3 weeks ago, outside park venue, but did not anticipate the 5 hours of uneven grass. Since then I feel like I'm at a standstill. Most days I do my PT. I try to walk at least 1/2 mile day. But I became very tired after that wedding and I'm wondering if any of you had similiar feelings of going backwards. I've even had to nap more since then. I also feel very depressed. Sometimes my naps are long. I don't know what I would do if I had to return to work right now.

I'm traveling in the middle of September, out of the country, two flights (one in a small plane) and I'm thinking "How on earth could I have thought that would be OK!!". The big positive with the trip though is I will likely spend hours in ocean water which was the only time I didn't hurt before surgery.

So like I said...and like the name of my thread....."I'm 12 weeks out; where should I be?" Hitting the gym like a maniac? I keep telling myself I'm going but then don't....makes me feel pathetic. Walking 3-4 miles per day? I don't know! Should I not feel tired like I do? My pain medication intake is probably 1 Narc/ 4 times week. Alleve 2x week (I wish I could take more alleve but I can't tolerate NSAIDS. I also feel like I am really really stiff in the morning and upon the first step when I get up from sitting. I often walk like a penguin (I know this is bad) so I'll pick up the cane....and stairs are still really really hard for me if they are steeper pitched. Am I expecting to much? At my 8 week OS followup I felt better than I do now.

So you guys have bucked me up before and made me feel normal.

And hey muckingabout! Hows it going!?
 
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@HippyHelen I didn't write to you in my thread because I knew you started school friday and you were gearing up for it....last thing you need is my garbage...

This is what @cthipster wrote me when I was really down and I'm reading it again.


@lee0605, congrats on being 8 weeks out. Since you and I sound a bit alike, I'd love to share some things I learned when I had my first hip replacement in April 2013 and how I'm applying this hard-gained knowledge to hip replacement 2, which I had done 16 days ago. I was a three-sport athlete in college (field hockey, ice hockey and lacrosse) and am a highly competitive and A+ type personality. The first time around, I kept pushing myself, as I felt I "should" be doing this or that, and in the back of my mind, I thought, "I was an athlete. No pain, no gain." As a result, I would overdo it and set myself back. I also had a lot of down days, as I was not meeting my own expectations and standards, as well as the bar that was set by friends who said they were doing amazing things at two weeks, etc. I remember seeing my surgeon and saying I was kind of down because I seemed to be behind the curve and that everyone I knew who had hip replacements were doing this and that so much earlier. He confirmed I was behind the curve and also that my friends had reconstructed memories. He told me he would have patients telling him they were doing xyz at two weeks when he was looking at the file and seeing they did it at five weeks. That made me feel better.

Fast forward, this time around, I have taken it easy and the only thing I'm listening to is my hip. If I think I should be walking a mile, I will walk 1/2 a mile. I have been doing the exercises they gave me at the hospital, but I only do one set of 10 at a time, 3-5 times a day, spread apart. I am doing no formal PT (my surgeon believes that it does more harm than good at this point, as people push too hard) and am just walking in the neighborhood or park. I rest a lot and am not doing any work from home, as I did the first time. I am enjoying the time off.

Guess what? Since I relaxed, my recovery is going *much* better. At the hospital, I skipped the walker and went straight to the cane. I went off all narcotics at 14 days out, and I can walk around the house without a cane and go up and down stairs normally. I only have had one depressed day. While I may start adding the meds back in when I start exercising more, it feels fine right now. The old me would want to push my exercise regime much farther, but the new me says what's the point? Slow and steady wins the race.

Even though you're a couple months out, honor yourself by slowing down a bit. Do half of what you think you "should" do. If you're having pain, cut back. Take tomorrow off and just do your activities of daily living. You will thank yourself later.

Best wishes!
 
@lee0605 Do not worry.....
I found a post of mine to you when I was at 13 weeks:
I am at about 13 weeks out.
I still feel stiffness when I stand up from sitting. this goes away about 10 steps into it.
I hope this abates; some say it can take 6-12 months for it to do so.
I go on multiple walks per day , usually doing 3 miles. Sometimes I add in a 30 min stationary bike, and/or
go to the pool for PT/water aerobics/breaststroke laps.

I am now at about 19 weeks or so.....
I still feel stiffness upon standing , though it has let up 'just a tad'. I am positive it will continue to decrease in small amounts.
I have a FITBIT flex and try to do at least 10000 steps a day, which is about 5 miles or so.
But, Note: important! This is not all at once. I do maybe three structured walks of varying amounts like 1 mile, 1.5 miles, 1.25 miles, or 2 miles......per day; and the rest is incidental stuff that adds up.
I don't jog, and probably will not do that again due to risk to the implant. Why risk it?

I feel that my recovery is normal and okay. Many people have stiffness, and for many it does go away in time.
I think it will for you, too.
 
Thanks so much @MajorHeidi . Your posts were the first ones that made me feel I was recovering within normal limits. That fitbit flex sounds like a good idea. It just came to me as I strolled in my driveway that I have been taking my dogs with me on my walks and he does tend to pull of in different directions occasionally. I think I tend to walk a little faster when I walk with him which might not be so great for me. Another thing I recalled was that last week he moved around me quickly and I pivoted with a planted foot....even though my OS said no probelem with this at my 8 week checkup. Don't judge poor Dingo. For a 14 year old dog he has more energy in his paw than I have in my whole body. Thank you for your help and I recall the post you referenced.
 
And @MajorHeidi , I would love to run again but looking at another surgery, the left, and considering the amazing implant I have, I wouldn't risk it either. I hope I can be OK when I travel. I is almost like upscale camping. Fly to the middle of nowhere and then drive to the middle of nowhere. At least 4-5 hours to the nearest hospital. A little nervous.
 
@lee0605 - just need you to know you are in my thoughts and prayers. Woke up this morning wanting to go back to bed. I was so tired yesterday. Very hard getting back in the groove. I don't know what I'm going to do tomorrow when my college course starts. I is a late course 7:40 -9:40. I'm thinking I may need to catch a nap on those days, but am fearing getting so stiff that when I do have to go it will be uncomfortable. I have been feeling soreness in the operated thigh even after sleeping and if it doesn't go away or diminish will be calling the Dr. I am still using the cane for stability. Today is my last PT appt. The PT is suggesting I get an order to work on the other side and also to get a shot. I got a shot the day of surgery and am thinking it is too soon for another one yet. Have a good day!
 
Hi Lee, I am a week behind you. What you describe seems normal to me and sort of describes how I feel, too. We are not going to an outdoor evening wedding in Vermont because I know the coldness and uneven ground will cause a setback. Going to running camp in NH was good for me because there was a lot of walking on uneven terrain. Most of the waking was in short amounts and a lot of 3/4 mile flat walks. Twice I did two miles. After the first two mile walk I slept two hours! It felt good. Our housing was up a short and steep hill which caused ankle tendon issues at the end of two weeks. Lots of ice, rest, compression, etc. now the ankle is feeling better. It didn't help that camp was followed up by yard work at our place in NH. Now it is back to PT and the gym. Like you, my body tells me when I have done too much.
Driving my car is a bother. I have never had an automatic, but the clutch is annoying now because of the angle of the leg so I am going to buy an automatic. It will be better in NYC, Baltimore, and Washington traffic. When we are in Florida the five speed isn't needed anyway. Like you we are always on the go either in the car or on a plane.
I find the more I think about the hip, the more annoying it is. I am tired of worrying about being ok or not ok! I am finally at the point where I am beginning to be glad to be titanium. Just beginning...
Today is the first day of school. I was a school principal. One of the reasons I retired was that 12 weeks rest for my hip would have been impossible. So now I am doing short walks multiple times a day, weight machines and free weights (not heavy), and the bike. Almost ready to get on my road bike on the bike path. Almost ready for spinning again, but will modify. My OS does not like spinning and I think he is nuts.
I have a tiny bit of stiffness when I stand up, too. I think that is mostly mental for me. I just don't trust myself yet. Unfortunately there are really no guides as to what to do and how much to do. The only certainty is that if you overdo it the hip or some other part will complain. So eat well, be gentle on yourself, do less than you think you can, and try not to worry. Oh, and keep an ice pack handy. To me, you sound normal. At least you sound like me.
Even though I am not happy about having a titanium arm and hip, I am incredibly grateful for them. We have a good coaching friend with serious cancer and one in a wheelchair following serious back surgery. Life has been good to us and eventually we will get better. Twelve weeks out isn't that long after what we have been through and how long it took to get us there.
Happy back to school and back to work, Be Well.
 
@lovetowalk - thanks for putting it in perspective as we really aren't that far into rehabilitation.
 
@lovetowalk I don't know how important this wedding may be to you but my daughter was married in a garden setting less than a week after my hi fracture/replacement. I used a wheelchair for the day. This helped me avoid the dangers of uneven ground, prolonged standing (which I couldn't have done then in my dreams!) and the hustle of bustle of so many people possibly bumping me, etc. They are not terribly expensive to rent.
 
@lee0605, I'm glad my previous post provided some encouragement for you. I think you are doing great! I experienced my first hip replacement as a series of hills, plateaus, and valleys. Up and down but always going upward. It would drive my crazy, as my expectation was that it should just be an upward trajectory. If you expect the ups and downs, then you're not really going backward. You are just have more time to enjoy the terrain that's unfolding in front of you.

If you are tired, you should rest. Since you are taking a big trip in a couple weeks, reserve your energy. Walk enough to move the joint but not enough to keep you in a state of continuing fatigue. It sounds like the wedding wrung you out, and you may still be playing catch up. Get a great book, relax, and enjoy it. I started the Outlander series by Diane Gabaldon ... if you start those, they will keep you busy!

I am five weeks out and am definitely doing lots of hills and valleys right now, as I find my limits. I tried to go back to work last week (after a month on leave) and totally crashed after four hours last Monday. As in almost passing out and fainting at work. It took me a couple days to recover from that episode. I did a few hours works here and there last week but was very careful. I am also doing work here and there this week but am being very careful. I go back full-time next week, and it's going to be intense. If I can't do a whole day, I will leave. After almost fainting at that meeting, everyone is handling me with kid gloves. Kind of funny. Maybe it worked in my favor.

In mid-September, we will also be taking my oldest to college for her freshman year. 15-hour drive, lots of moving in, flying back. I'm not quite sure how I'll get through that -- the emotion of a child leaving the nest has been quite high I've discovered -- but I figure I will just need to get out of the car every hour and walk around. You should too when you travel. If I'm tired, I will sleep. You should too. The trip sounds wonderful, so I hope you don't worry but instead decide with your traveling companions what you will do when you get stiff, tired. And of course, be careful. I'm sure your companions will help you if you feel unstable. Maybe it's not a bad idea to consider a portable wheelchair if you are sightseeing and the area is flat. You could get wheeled around if necessary.

My hip is good and not good. I have shooting pains down my operated leg, and my knees and ankles hurt on both sides. These are side effects of walking weird and not being able to stretch. I take a painkiller at night if necessary, and I know these aches and pains will work themselves out over time. I also have an appt. with my kinesiologist, as he can take care of the muscle pain quite expediently. I experience my hip pain and stiffness going up and down is also a hills and valleys type of thing. It takes the worry out of the equation.

Hugs to you. You really are doing great, and your body is telling you what you need to know (rest).
 
Hi @HippyHelen

You sound aweful and scared. I think you may need a fellow Valley person to commiserate with at some point this week. Let me just say that as far as your PT goes I think you're doing to much. I think @MajorHeidi 's thread will help you alot as well as @cthipster 's. They kind of make you feel better about not being way ahead of where you should be. Also the articles from the moderators did me good last night as I too am feeling depressed. Wow! both of us at the same time although the tension you are feeling certainly cannot help. Will your OS give you a benzodiazopine which would act as a calming agent and a muscle relaxant? Knowing your OS office I might consider asking the PA or OS. Anyway call me if you need a should to cry on. I haven't figured out how to make my phone ring more than 4 X but if I miss you I will get back to you as soon as I see your name on my phone.

I can feel such tension in your post and I'm so sorry you are feeling this low. And 8 pounds! With our limited ability to walk and exercise this is nothing. cthipster tells the stories of her up's and downs.

I think you are pushing it to hard with PT. Walking is the best, as everyone here says. I was discharged from PT at 6 weeks. Apparently had a PT who saw where I was not how much my insurance would cover.

Hang in there my friend,
Much love and concern,
Lee
 
Dear @Josephine I was hoping you could help me. I know you have heard just about everything...

I am almost 12 weeks out and was doing really well. I was trying hard not to overdo things as recomended by so many folks on this site, napping and mostly walking my dog for exercise (0.5-2.0 miles per day). I was doing balance exercises and basically some of my PT. About 4 days ago I started to have pain that has started me limping again. I don't know what I did or overdid. Could it be from walking the dog too fast? Sitting in a too hard chair? I still have the ability to abduct the leg well and move it forward. It is moving it to the rear where my range of motion seems to be affected and I feel a sharper pain than I have felt before.

I also feel a slight tingling occasionally at the bottom of my foot. Very very slight. My foot is not swollen ever. I'm kind of freaking out as I was moving forward well...I thought (this really gets me tense)....I was about to start going to the gym and increasing my activity.

Have you heard of this type of thing before? People suddenly having symptoms that haven't been there before? I have had to take pain meds when I had been off them almost completely and the same with the cane which I haven't used since week 6. Unfortunately what works for me best, the NSAIDS like Aleve, I can't take because they interact with standing meds I take. So I can only take them 3X/week max. I ice as much as I can. Sleeping on the operative side doesn't seem to bother it at all and in fact seems to alleviate the pain. But now when I am standing and walking I am reaching for furniture and using the cane. I feel frightened and demoralized. I was doing so well. Have you heard of people having a sudden bunch of steps back? I was wondering if @cthipster @beachgal and @MajorHeidi had had similar experiences.

A sudden move backwards? Back on the cane after being off of it? Maybe I wasn't exercising enough? I am way over my normal weight by 40 pounds and I know this is not good. Is my chair to hard? I don't know. I sound stupid here. But I hope you have some insight you can offer me. Thanks Josephine
 
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@cthipster Thanks again for your last post which I will bookmark and read again and again. I know passing out isn't good but it does sound like it worked in your favor! Your posts seem to be the ones that make me not freak out. And I will get that book series. As I said in my post to you minutes ago. I get very scared. My job as a jail nurse or any time of nurse is just not possible now. It is this part of your post that I feel like

My hip is good and not good. I have shooting pains down my operated leg, and my knees and ankles hurt on both sides. These are side effects of walking weird and not being able to stretch. I take a painkiller at night if necessary, and I know these aches and pains will work themselves out over time. I also have an appt. with my kinesiologist, as he can take care of the muscle pain quite expediently. I experience my hip pain and stiffness going up and down is also a hills and valleys type of thing. It takes the worry out of the equation.

Hugs to you. You really are doing great, and your body is telling you what you need to know (rest).


It seems that you really are doing so much so soon after a posterior approach. You must be very strong of body and mind. And all the things you have to do with work and family. I get tired just reading it. My trip is to take care of my home which is in the very middle of nowhere. Two plane flights and a very rustic property. That's putting it lightly. There are barely paved roads anywhere. I will need to be very very careful. Frankly I'm scared. I wish I didn't have to go but I must maintain my one room shack (but it's beautiful). I am scared that it would take at least 4 hours or more to get to an American hospital. My husband gets frustrated with me, espeically right now when suddenly I am needy again. I think this makes me tense as well. I don't wish you pain at all REALL REALLY but the shooting pains make me not feel so alone. The tingling at the bottom of my operative foot makes me scared. Maybe I should just stay in bed for a few days.

Thank you so much for sharing your trials and tribulations. Hugs to you as well. Thank you
 
and @cthipster and @beachgal I still cannot walk stairs really without completly holding on to the railings. I can only if the stairs are really pitched low. Is that where you guys are at? I'm sorry I'm asking for so much.
 
Don't be sorry for asking questions!!! That's what we're here for!

While I may not be able to tell you exactly what is causing you to have pain now, I can say what it is not.

It is not from sitting in a hard chair.

It is not from exercising too little.

It is not from being 40 pounds overweight.

What it may be is too much exercise for where you are in your healing process. I suggest you try scaling back your exercises and walking for a week or two and see if that improves things. Continue to ice whenever you can for as long as you can even if you don't see swelling.

Have you tried taking Extra Strength Tylenol? You would need the full dose of 1000mg taken every 4-6 hours with no more than 4000mg in any 24 hour period. Be sure and count any other sources for acetaminophen in that 4000mg total (cold and sinus meds, allergy meds, etc.). Do that for 2-3 days along with the reduced activity.

I'm betting you will feel better. Remember, recovery is rarely a straight line. Most of us go backwards as we push more toward a normal level of activity. Feeling pain is your body telling you it's not ready to go there yet.
 
Dear @Jamie Thank you for your response. I am trying to "figure out" what I did (or didn't do). This morning I pulled a muscle in the opposite groin (which also needs replacing). And I get to feeling increasingly anxious which can't help a thing. I will continue to ice. I can't take tylenol excessively (except for fever or whats in the vicodan 3-325) because of the standing meds that prevent me from taking Alleve (which works great but can make me gain 10 pounds of water in 2 days). I'm relieved it's not my chair/exercising to little/to much or being overweight.

I have found myself getting more and more depressed and try to (often) remind myself how very lucky I am to live in a time I am able to have had this surgery. Maybe I also get tense because I think my husband thinks I should be further than I am. After all I was discharged less than 24 hours after the THR.

Thank you for your note. I know I will read it many times today. And ice!
 
Maybe I also get tense because I think my husband thinks I should be further than I am. After all I was discharged less than 24 hours after the THR.
Oh @lee0605 - this says a lot! Please don't let anyone tell you how far you should be in your recovery. Each and every recovery is different and frankly those miracle "I'm in no pain and can already walk unassisted at 2 weeks" recoveries are just not the norm.

It doesn't matter what approach was used - recovery is recovery and it takes time. Read this thread again and please share it with your husband Healing: how long does it take? This one too: Chart representation of THR recovery. And while you are at it - ask your husband where he got his medical qualification. Sorry if this sounds harsh. But this kind of thinking is just so counterproductive to recovery.

And your comment about getting discharged so early - perhaps more proof that this does not work for everyone. In any case you were not discharged healthy - you were discharged to recover. Big difference but often confused.
 
@lee0605, first BIG HUGS. You are certainly not alone, and I am grateful for Bonesmart. We can all support each other.

When do you come back from your cabin?

Your body is giving you information. Thank goodness for that. It speaks! If you listen, what is it telling you? What I hear from reading your words is that you should back off on your exercise for a couple days and see if the pain resolves itself. And if you need your cane and pain meds, by all means use them. They are like the tools in your garage. If you need that wheelbarrow to lug stuff around, do you feel shame for using it? :)

A tingling feeling may imply that there is some nerve impingement and perhaps caused by some soft tissue dysfunction in that place you are feeling the new pain. Giving the muscle some rest and maybe alternating heat and ice will help calm the muscle down.

So much of my aches and pains have been soft tissue-related and related to the trauma of surgery and different biomechanics after surgery. Those kind of issues are resolvable without further surgery in most cases. And soft tissue expertise is usually outside of the realm of the orthopedic surgeon. Does it help ease your mind to think that your new hip is all well and good? Have you had follow up xrays, which satisfy both you and your doctor, and do you not feel any debilitating pain in the socket itself? That should be reassuring.

On Friday, my OS released me from all hip precautions. On Saturday, I promptly did a 20-minute yoga routine and went to the gym for the first time and did 2.5 miles on the elliptical. I was so glad to stretch and do what was part of my normal routine. After the workout, I was swinging one leg back and forth and then the other back and forth, a typical rehab move which I waited to do until 6 weeks out. I immediately felt some snapping in the operated hip, and today there is a slight clunking in the operated hip. By the end of the night yesterday, I was hobbling around and ended up icing both sides and taking Tramadol. This morning I am stiff.

So, note to self: I overdid it, and I need to do nothing strenuous for the next few days. Maybe I should wait another couple weeks before I go back to the 20-minute yoga routine. It's good to stretch, but maybe my muscles are not ready to stretch that much, and I need to wait. My operated hip feels fine other than the slight snapping and clunking, so I know it's okay. I also know that I had snapping and clunking after overdoing it on the first hip replacement, which completely freaked me out, but that it will resolve itself if I cut back on the exercise. Yes, body, I am listening!

@lee0605, I want to affirm for you that being kind to yourself will aid your recovery. Worry and stress manifest themselves in the body and go to the weakest part (your hip). Your muscles will contract under stress, which causes pain. They say that living in the past causes depression and living in the future causes anxiety and worry. If you can live in the present with no judgement of where you should be in your recovery, you may experience relief. I am sending that intention your way.

That said, it's very natural to have ups and downs in your recovery and very natural to have emotional ups and downs. If you are sad or anxious, you are doing well by acknowledging the emotions, as you have done here, and then letting them go.

We are walking beside you.
 
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