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THR SO many questions!

Puggles

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Hi there!
I LOVE this site, and have been reading for about 2 years. I love all the camaraderie, encouragement, and the information is so, SO helpful ! I have read MANY threads,
and learned so much; however, I have many questions about things I haven't been
able to find here.

By the way, I need BOTH hips replaced, and I have been too afraid, so I've put it off for way too long! Now, I can barely walk without crying, so I MUST do this!

1. I'm incontinent, and RARELY make it to the bathroom in time! For sleeping, I wear several
extra-absorbent diapers, and when i wake up, I am soaked. It didn't occur to me until
today that my incision will probably be saturated with urine while sleeping. I know that's not good, but also wonder if it'll cause infection?

2. I'm going to get a bedside toilet in order to not be soaked when I wake up, but---there
are going to be times I still won't make it. I can't constantly be cleaning my urine-soaked
incision, nor can I get up all night long, because then I'll be overly tired!

3. And, to make it worse---I recently had to start LASIX, because my regular blood pressure meds aren't enough. Lasix, makes my urine even less controllable.

4. If you were me, would you try to stabilize your BP and incontinence before you
considered surgery?

5. Not only is my BP too high, but my legs and feet swell terribly. I wear compression hose and try to elevate as much as I can while awake. The problem with the compression hose is that many times, I don't make it to the bathroom in time, so my hose get soaked, too. I do not
have the ability to change hose every single time!

6. While I sleep, my legs are over the heart level, and I wake up with NO swelling---it's great! But only a few hours later, they swell again.
But I'm scared about how surgery is going to affect all of this. Having my legs elevated
all the time will also be PAINFUL! I am completely overwhelmed about this! Just more
reasons why I've put this off for so long.

7. While in the hospital and walking with Physical Therapist, there will be urine leaks all over my room's floor AND the hallway. This is not only embarrassing, but more importantly---UNSAFE for other people in my room/ hallway! NO DIAPERS I have tried completely contain the urine ! I have tried SO. MANY. brands, and the higher quality ones are quite expensive.

8. I keep thinking that getting them BOTH done is probably best ! The surgeon I'm planning on using won't that, though. I realize MAYBE I could find another surgeon that would. Why not get it over with in one surgery?

9. I am very obese, which, of course---makes things even harder. I wondered if my surgeon / PA didn't push surgery because of it? Even though both hips are "bone on bone", they never really seem to want to do surgery. They offered yet another steroid injection (ugh, they don't help!), and physical therapy. I love PT, and know it would help, but now that I can barely walk and feel my hips are about to crumble, it concerns me that they didn't encourage surgery. I went ahead and just asked the PA if my weight was the reason, and she said no.

10. A couple years ago, I stumbled and fell twice, breaking my arm, and a few months later, a rib. This was when I was rushing around and NOT using my walker at all times. These falls and the resulting pain have made me terrified of falling!

11. Another thing that really bothers me is that even though I know having one of them replaced is going to help my pain A LOT, it will ONLY be on that one side. Walking weirdly with one good hip and one bad one doesn't seem like it will be very productive. I will still need a walker, and still have severe pain on one side. Doesn't it just make sense to get them both done at the same time?

IF YOU READ ALL OF THIS---thank you! Wow, I know it was VERY long! I appreciate
your time and look forward to your responses! THANK YOU!
 
OP
OP
Puggles

Puggles

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Oops, I forgot one other important thing---I have read SO MANY threads here about how delaying surgery only makes things worse, which sounds very true. I find
it weird that my PA/ Surgeon have never mentioned this, even though they know I've put this off for many years (the LEFT pain started around 2013). And now that I waited so long, my right is just as bad. Do you find it odd that they never encouraged surgery? Odd that they've never said delaying will only make it worse?

I once had a steroid injection (about 4 or 5 years ago), and that doctor even
commented on how "BAD" my left hip was. Should I stop worrying about why my current doc/PA have never said anything?
 

Missy45

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Hello! I think you will get directed to some good info from the moderators here. I just thought I might be able to add something about the incontinence. I don’t know why you need hip replacement, but if you have labral damage, I do know that weakens the pelvic floor in women and causes or worsens incontinence. I saw that you asked if you should get the incontinence under control before surgery. I wonder, though, if the surgery will help with that.

Just a thought! :flwrysmile:
 

Pumpkin

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@Puggles
Welcome to BoneSmart, glad you joined us! :welome:
I will try to answer your questions.
1) Incontinence, ask your MD for a referral to a womens health PT or OT to help tone and facilitate your pelvic floor, hopefully reduce the incidence on incontinence.
2) You may want to purchase the bedside commode now, to get used to it.
3) Talk to the MD who prescribed the Lasix, they may be able to adjust your dose.
4) Talk to your cardiologist about hip surgery, imagine your orthopedic surgeon (OS) will want your cardiologist to clear you for surgery.
5) Ask for a referral to an OT/PT (women's health specialist) to find out how to prevent wetting your compression stockings.
6) Pace how much you are elevated during the day, if you know how long after you are up, your legs start to swell, time it so you elevate before all the swelling has returned.
7) They will double you up, or you may have a catheter the first day.
8) You would need to be healthy enough to tolerate two surgeries.
9) There are a lot of considerations going into deciding or recommending surgery, they probably felt you were doing OK.
10) Fear of falling, use your walker.
11) You will need a walker regardless after surgery, sometimes getting one hip done eases the load on the other hip.

Sometimes surgeons and patients do not understand just how bad their hips are and how their quality of life has declined slowly over time.
In the reading below, you will find a score chart, you will see just how limited your life has become.

New BoneSmart members like you are in various stages of their journey to joint replacement. Making the decision whether or not to have surgery and preparing for surgery can be easier once you have done your research and know what lies ahead. Here are some tools that can help you decide what is best for you.

If you are at the stage where you have joint pain but don't know for sure if you are ready to have surgery, these links may help:
Score Chart: How bad is my arthritic hip?
Choosing a surgeon and a prosthesis
BMI Calculator - What to do if your surgeon says you're too heavy for joint replacement surgery
Longevity of implants and revisions: How long will my new joint last?

If you are at the stage where you are planning to have surgery but are looking for information so you can be better prepared for what is to come, take a look at these links:
Recovery Aids: A comprehensive list for hospital and home
Recliner Chairs: Things you need to know if buying one for your recovery
Pre-Op Interviews: What's involved?

And if you want to picture what your life might be like with a replaced hip, take a look at the posts and threads from other BoneSmarties provided in this link:
Stories of amazing hip recoveries
 

Going4fun

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Well, sure, the pain gets worse over time, and yes the recovery can be harder, but surgeons are quite wise, it seems to me, to not push people into surgery.

The psychology here is that recovery requires patient work and patience and experimenting ... and going through frustrating periods. It's smart to allow the patient to decide when to go for surgery. When my recovery was slower and more frustrating than I imagined, I couldn't just blame my surgeon. I wanted the surgery. I asked for the surgery, from this specific surgeon. There is a chance that the surgeon did tell you something like, "the pain is not going to get better." It's really hard to take in all that a surgeon says during consultation.

And lots of people like not having the surgery for ten years ... even if that slows them down. And "get worse" is a bit vague. You could go several years with the same pain ... and then at year 5, the pain gets exponentially worse. My mother held off on surgery for 30 years. And she kept moving and walking with a cane ... hyperactive ... somehow she had high pain tolerance and she was scared of surgery. She didn't even take Tylenol or any other over-the counter pain meds. "I'm not a pain person," she once said to me. Well when her hip was about to collapse, her surgeon told her she needed to have it ... and she did.

Replacement is an elective surgery, not required for living. Yes, very much wonderful for living well ... but not required for living.

You want to type out a list of all that you've said here ... print it out ... and show to your surgeon and your GP and all the various doctors ... Share EVERYTHING. And then let the doctors get on the same page as far as getting you in the best condition for surgery. Note: it is possible (I've seen it happen) that doctors looking at your goal of surgery ... can get more creative in finding good treatments. Not guaranteed of course.
 
OP
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Puggles

Puggles

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Everything from my posts above is still worrying me, and in the
last week, I am feeling utterly hopeless and am just wondering
I have MORE
issues than when I originally posted. Ugh !!

** 1. My right (dominant) hand and thumb are SO painful
when I wake up. My hands are what get me out of
chairs, and a LOT of my weight is on them when I walk
around with my walker. The acute pain usually goes away
after a while, but it tingles and is numb intermittently.

When we grocery shop, the cart acts like a walker---it's great!
BUT, my HANDS are what take most of my weight.


I had this same problem a few years ago, but it WENT AWAY!
I have several hand/thumb wrist splints that help a lot, most
of the time. I also do exercises/ apply ice, but that usually
doesn't help.

HOW ON EARTH will I recover from THR if my hand(s)
are painful, numb, and tingling?


** 2. I have bad headaches *almost* every. single. day. I do not
have the patience or desire to consult ONE MORE doctor
for this !!!! The other day/evening, I was headache-free, and
I celebrated !!! It was SO. NICE. to have just ONE DAY
of no headache, my hubby was thrilled for me, too!

Aside from constantly tight shoulders (gee, I wonder why? LOL),
adding to this fun is that now, I can hear my neck bones
CRUNCHING. The thought of going to yet ANOTHER doctor(s),
having more (PAINFUL!) X-rays and/or other tests is just
toooo much!

** 3. I recently learned that my obesity makes me higher
risk for blood clot/ pulmonary embolus.

Even *IF* I survived a pulmonary embolus, there are NO ICU BEDS or enough staff in my city !!! Is anyone else here worried about
this?


And even just being on a regular hospital floor, I am
terrified of not enough nurses, and/or new grads who don't care,
don't have experience, etc. Believe me, I've had some AWFUL
nurses in the past, so my concern is valid !


Changes since my original post:

**1. I DO NOT want to have them replaced at the same time
any longer! The surgeon I *thought* I
liked wouldn't, and knowing how hard it'll be with just
ONE hip, I don't think bilateral is the right thing for me--
ESPECIALLY now that I have the severe hand pain.

**2. I've read a few threads here about COLLAPSED hips.
I asked the surgeon (who I no longer want to see) about this, and he kind of shrugged
and said (very coldly) "you're bone-on-bone, they're ALREADY COLLAPSED".....he said it with "that" tone to imply it was
an absurd question.
I'd appreciate hearing from those of you who've been through this.
( @Jaycey ---I'm pretty sure you've been through this?)
Yes, I can google, but I want to hear from actual people who've
been through this. How do YOU define "COLLAPSED?"

**3. Annnnd, now my right knee is acting up. Once in a while,
it will be SO painful, I can barely walk. I can also hear crepitus.
Elevating my legs at night to reduce my VERY swollen feet and ankles
REALLY irritates my knee. HOW AM I GOING TO ELEVATE my swollen
feet, ankles, and newly-operated hip(s) if it hurts my knee???

If anyone read all of this, I apologize sincerely to your tired eyes! (hee hee!)
I think it's understandable now why I say I feel hopeless!
 
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Pumpkin

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Puggles,
You have so much on your plate, so many choices, and so much to consider.

For elevation, be sure your knee is slightly bent, knees do not like to be flat on the bed.
@Jaycey has experience with a collapsed hip.
Given everything going on I agree one hip at a time.
Pulmonary Embolus( PE) is rare, your surgeon will be sure you have preventative measures in place.
Do you have a history of PE?
Right after your THR you will be full weight bearing, suspect from your description your new hip will take some weight off your hands.

We all are nervous about our joint replacements, once it is done we wonder why we worked ourselves up in such a tizzy before surgery.

Be sure you share all your concerns with your surgeon and primary physician.


Things that helped me during my TKR recovery, and may help you with pre op.
Relaxation breathing
Adequate Pain control
Reading the forum and finding others with similar challenges
Calling a friend
Getting out of the house if possible
Watching comedy on TV

And do not forget to breathe,

Chris
 
Last edited:

Jaycey

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Here's an image of what a collapsed hip looks like:
Collapse.png


You surgeon is right - if you are bone on bone the hip is already collapsed. I'm not sure what you are worried about however. All this will be replaced with a shiny new implant.

The only complication might be a longer recovery due to habits formed pre-op. Correcting gait issues can be challenging. But a good physio will help you with this. Or, try our partner OneStep once you have had your surgery.
 

Layla

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Hello @Puggles
I‘m sorry for all of your issues and struggles. I can’t help but wonder if you’d consider scheduling surgery, several months out from now, with a nod from your surgeon and together with him, compiling a list of issues and concerns that he deems need attention prior to surgery? Then…formulating a plan to resolve what’s necessary so you‘re able to move forward, engage in and enjoy life once again. It seems in waiting, the list is growing as you‘re spinning your wheels in frustration, which is understandable, but seems to be crippling you. Possibly a plan of attack will help you stay focused with your eye on the prize of better health and physical mobility. Just something to consider…
Wishing you all the best.
 

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