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Struggling with pre-op pain

Discussion in 'Hip Replacement Pre-Op Area' started by nonny, Jun 17, 2017.

  1. nonny

    nonny Junior Member
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    I'm having total right hip replacement on August 16th, but I am really struggling with pain that radiates from my hip to glut, groin, piriformus, knee and calf. It's almost like sciatica.

    Recently had a routine visit with my rheumatologist (I have rheumatoid arthritis) and he gave me a six day course of methylprednisolone that helped, but pain returned as I tapered. I'm on injections of methotrexate and Humira for RA. I take celebrex and one oxycodone every day. The celebrex helps a little; the opoid gives me a good three hours of pretty much total pain relief. I have a shiatsu massager that helps and I sleep with a pillow between my legs. Used to go to pretty intense yoga 4 hours a week, but can no longer.

    I still take care of 3 year old and 1 year old grandchildren. I struggle but love caring for them three days a week. It doesn't seem to matter if I'm resting or active; indeed, the pain is a bit better if I'm moving. Sleep has suffered because of the pain. Can anyone offer any other tips for this stiffness and pain. Some days I can barely walk. Can't wait for the surgery! I'm excited to have a new hip as I obviously waited way too long!
     
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  2. Jaycey

    Jaycey Moderator Staff Member

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    Unfortunately as you are finding pre-op pain is very difficult (if impossible) to control. There are no meds that will touch this. The best advice I can offer is to limit your activity. Avoid any lifting or pushing and certainly don't do things like moving furniture. This will all ease post op but for now there is just not much that can be done.
     
  3. Horseshoe

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    Pre op pain is tough, use ice 40 minutes at a time, crutches or a cane to keep weight off the sore hip and don't lift or push anything.
     
  4. kayak59

    kayak59 Senior

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    @nonny Have you tried Lidocaine patches? They got me to my surgery along with Gabapentin.
     
  5. JennyHipcakes

    JennyHipcakes Junior Member

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    I'm sorry you are having so much pain, and have several weeks to go before surgery! :sad: It sounds like you are already doing a lot of good things to cope with your pain. I have the best relief from ice for my right hip (my surgery is coming up soon!) but maybe alternating ice and heat would work better for you. The sleep issue is so annoying, as I have also been awakened by my hip pain. Maybe you could ask your doctor if you could take Tylenol-PM. It's good for pain and sleep, sometimes, or your doctor might have a better idea.

    One of my problems is that I over-do it on the good days, then feel extra painful that evening, into the next day. It's so tempting to just do normal activities when I am not in pain, but boy, the price is sometimes steep! I wonder if taking care of the grandkids is too much for you right now. Even though they make you happy and you love them, maybe you should cut down on that work, at least try a week off and see if it makes a difference? I don't know, that might not work out for your family, but with surgery coming up, it would definitely be a good idea to take it easier.

    Let us know what works for you!
     
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  6. dougie0216

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    @nonny I do not have RA, but I completely identify with the pain radiating down the leg. Before surgery, my after-dinner routine was pelvic tilts, pelvic tilt crunches, piriformis stretches, yoga poses, tramadol, flexeril, Lidoderm patches, I bought an adjustable bed, calf sleeves, knee sleeves, whirlpool baths, Ice and cussing. One night it was so bad I just cried.

    All of the above simply did not help on bad nights. On some nights I just did not sleep. I dreaded being in a vehicle for over 30-min. I could not even ride my bike after Feb.

    The pain started above my trochanter at the base of the glute, went down into my quad, disappeared into my knee, came back out under the kneecap, ran down the outside of my lower leg between the shin and calf, then split and went around both sides of my ankle, across the top of my foot and on really bad nights I had pins and needles on top of my big toe. Some times it would start about 5" above my ankle and radiate both directions. Other times it would start under the glute and shoot down the leg. Some days it never went away at all.

    I had a physical therapist friend tell me that it wasn't sciatica because it didn't originate at the L5. Whatever.

    The pain was basically at the unbearable level from Christmas till June 01. I probably averaged 3-4 hours of sleep and was functioning (barely) at a pain level of 7+ for almost six months. My personal physician asked, are you experiencing stiffness in the am? OMG, stiffness?!? He's a young guy. I won the bet with him. He said it was my back, I said the hip. The X-Ray showed a very bad hip, and no issues below L3. I won, he referred me for surgery.

    I empathize, but that pain was gone when I came- to after surgery on June 01. My pain level after surgery was less than when I arrived. The discomfort after surgery was nothing compared to the nerve pain pre-surgery.

    I had the exact same symptoms before LTHR in 2013. This year, I was just so busy and had too many responsibilities to have surgery before June 1. Now I have two months off:yes:

    There's is hope! Hang in there!
    I hope you can find some relief. Looking back maybe opiates would have helped, but that was a boundary I wasn't willing to cross. After surgery, yes please.

    Best of luck.
    Doug
     
  7. JennyHipcakes

    JennyHipcakes Junior Member

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    Wow, thanks for sharing your story @dougie0216 - I am so glad your surgery was the ticket!! I have the "spear through my hip" pain at least twice a day. It's like I am scuba diving and a spearfisher mistakes me for prey and shoots a spear that enters under my right butt cheek and exits through my right groin.

    Can't wait for my second THR 6/27 when I can relate to your recovery success! It's inspiring to me, Doug. Thanks, again.
     
  8. nonny

    nonny Junior Member
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    Thanks for all the replies to my pleas! If nothing else, it helps me to know I'm not alone. @JennyHipcakes I will definitely try the PM medicine in TylenolPM. (Can't take tylenol as I already take an NSAID.) I will try the Lidocaine derm patches, too. Good ideas.
    And, Jenny, yes, I am also a person who overdoes it if I'm having a better day. I can so relate.
    @dougie0216 What you've described is precisely my pain! I can so relate to it all. And I have had a couple of those "just cry" episodes usually in the middle of the night. Excrutiating. My rheumatologist asks me, "How long does your stiffness last in the morning?" Try -- all day -- and with pain!
    I have stopped my yoga classes which makes me angry and frustrated. But I will be back and can still do some poses at home, but it's not the same as a powerful Vinyasa class. My piriformis is especially "angry." I will be back.
    @JennyHipcakes I will be sending only good thoughts your way on June 27th. And @dougie0216, you are now my inspiration! Hope your recovery is going great. Jenny and I will be just like you. My surgeon tells me I will have a fantastic recovery as I am not overweight, yoga practitioner, active, eat right, etc. That's my plan. (Surgeon looks about fourteen, but I like him a lot.)
    On a final note, I want to stay with the babies; my pain is the same no matter what I do or don't do. I limit sitting on the floor, hauling car seats with babies in them, and other walking more than a half mile, etc. I'll make it to August 16; only 57 days to go! Happy Father's Day to all!
     
  9. kayak59

    kayak59 Senior

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    Hope the Lidocaine patches work for you, @nonny . What I realized was happening, along with the pain from the actual damage, was my muscles, particularly the quad and others in the thigh and hip area, was that they were cramping. The Lidocaine really helped with that -- and of course -- also helped me sleep. Best of luck!
     
  10. nonny

    nonny Junior Member
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    @kayak59 You know, you may be correct about the cramping, especially the piriformis. After a while, you can't put your finger on which pain is causing the next spasm or cramp. You feel as if your body has betrayed you. I'm hoping I'm just like @dougie0216 and my hip is causing all these other issues. I never know with the rheumatoid arthritis. I'm going to have to look up trapeziectomy. I wish you well on your recovery and hope you are back in your kayak and outside hiking, etc. soon.
     
  11. kayak59

    kayak59 Senior

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    @nonny I had a trapeziectomy and removal of a big bone spur from the base of my right thumb on Friday. You can follow my thread under Other Joints if you wish.
     
  12. nonny

    nonny Junior Member
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    Hi @kayak59. I will! Looked up trapeziectomy so now I have some knowledge. I wonder if your psoriatic arthritis attacks your joints as the rheumatoid attacks mine. I think it's an autoimmune disease, too. I feel lucky there are now some orthopedic answers to address some of the joints. My hips are a combination of osteo and rheumatoid. I am lucky that my hands are hanging in there so I can still downward dog, plank etc. in yoga. Some degeneration, but holding on. I did take up knitting when diagnosed about ten years ago, which I feel has helped my hands (and my psyche). At the very least it can't hurt. Going to your thread now. Speedy recovery to you.
     
  13. kayak59

    kayak59 Senior

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    @nonny Yes, psoriatic arthritis (PsA) is also an auto-immune disease and related. It attacks the joints in the same way. My Mom and grandmother have RA. I asked my doc how do we know what is being caused by osteo and what by the PsA and she said there is no way of knowing. Given my age and the fact that I've never done high impact activities, however, she thinks it is more the PsA. I have been getting cortisone shots in the thumb joint for years now. That and occasional use of braces (including the Push brace which is great!) has kept me going. A lot of people say shots in the hand are really painful. My doc freezes the area instead of using Lidocaine and I would say its more of an acutely uncomfortable feeling rather than pain. Its a really small area to insert a foreign substance but it does work!
     
  14. nonny

    nonny Junior Member
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    I have pretty aggressive rheumatoid arthritis that I feel I'm successfully battling. My orthopedist showed me my xrays of hips and showed me typical osteo arthritis and pretty typical rheumatoid nodules that have grown on my hip. So he said it's both. I'm so glad the surgery has worked for you. It's awesome what they can do to help now. Hope you have some lambswool or other natural fiber (angora or llama or cashmere or mink) to tuck under that plastic.Think knitters (I have all those but I'm in Boston). I was thinking that might work for you.
     
  15. maggie23

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    Hi Nonny
    I have RA and I am due to have LTHR on the 4th July. My RA is controlled by RoActamara (Tocilimud) sorry the spelling is incorrect. I am allergic to methotrexate, I think Humira is another form of RoAcamara. I have a monthly infusion which helps a great deal. Injection did not work for me. The pain is less for the RA but my hips are just so bad.
    I understand that you want to continue to look after the grand children, I work every day even when I know I should be resting. Work keeps me going, a reason to get up and keep going.
    The pain I have is a mixture of RA and Osteo in my hips and back.
    I am sorry that you have so much pain. The pillow between the legs helps for a few minutes between tossing and turning.
    Keep reading because you will pick up a few things that will help until you have your op and after. As an RA person I now ice to reduce the heat in my hips and legs.
    Wishing you all the best and keep reading because it helps to know your not alone and most of all the love everyone will share with you to keep you going.
     
  16. GrannyC

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    One thing that will help a lot I think is using a cane and I know someone else already mentioned it. You probably already know it but you use the cane on the opposite side from the bad hip so if your right hip is bad, put cane in left hand. It really helps take the pressure off the joint and decreases the pain. Some people don't want to be seen with a cane but it sure beats the pain that comes with every step with OA. The waiting is the hardest part, especially when you are in so much pain. I wish you all the best.
     
  17. dougie0216

    dougie0216 Graduate

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    Use the cane. I'm a prideful male, and I used a cane prior to both hip replacements. It really does help take the pressure off. Opposite side, remember.
    I also I have the hour-glass shaped leg pillow and a memory foam wedge to tilt my pelvis. Whatever it takes.
     

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