Revision THR Suki Gets a Revision

[Thedogtales]

Suki,

The heel/toe has to do with what part of your foot hits the ground first with every step. When I limped, my foot on my bad hip side would just sort of clump down - the whole foot at one time. Now when I step out, my heel touches the ground first. Then as I continue through the step, as my weight goes on the ball of my foot, my heel is lifting up and I finish the step pushing off my toes. Its a rolling motion from the heel to the toe.

I'm trying to picture what you mean by "tripod". . . . Are your legs far apart and the cane is front of you rather than to your side? Because of the time you wear the abductor brace which I assume kept your leg further out from the center of your body, maybe you need some adductor exercises to build up the muscles that bring your leg in to the center of your body. If I'm doing the exercise where I lift my leg (or slide if I'm lying down) to my side and then back, I concentrate on the muscles on the outside of my thigh (abductor) when lifting to the side and then the muscles on the inside of my thigh (adductor) when bring my leg back.

At any rate, I don't always listen to everything my hubby says!!

Sally

 

[Josephine]

Definitely not on a white line! Just normal walking, normal spacing and pacing.
It's also normal walking when you stick your foot forward and strike the ground with the heel first
Then as you move forward, you naturally transfer your weight through the foot as it rolls over from heel to ball of foot and then to toes and the other foot is already rising off the ground
By the time the first foot gets rolls on to the toes, the other one is already prepared to strike the ground with the heel, and so on

 

[Suki]

Thanks folks. Your input, as always, was helpful. I asked my PT why we were not doing any work on my gait and she indicated strength and ROM were priorities, and gait would normalize with increase to those and time. I also saw my surgeon today and he told me to ditch my cane, as he felt reliance on it would delay strengthening and gait improvements. He watched me walk and said it looked good to him, for where I am in recovery, and that I will see further improvement in my gait as I begin to trust the hip more. He did recommend I carry the cane on long walks for awhile more, but only use it when I tire.

Suki

 

[Suki]

So, today was a bittersweet achievement. I am 10 weeks post-revision to my LTHR. As I live in Alaska, and we had record snow and ice this year, I was pretty home bound from December through my May 7 surgery. I was in an abductor brace and doctor forbade me walking outdoors. I longed, all winter long and through my surgery, to recover enough to take my two sweet boys--Buddy, a huge black lab, and Sammy, a middling to large golden retriever--on a walk along our favorite route. Lots of things for the boys to sniff and beautiful scenery for me to soak in. I focused on being able to do this daily walk, I daydreamed about it really, throughout my wait for surgery.

Well, today, I made that walk, all two miles, with my Sammy dog. It was as beautiful as I remembered, I was so thankful to have the mobility and strength back, the sun was shining, the air sweet with clover and lilac....but I will never again share this walk with my best friend Buddy. You see, I lost Bud the week after my surgery. It wasn't that I expected him to live forever. But boy, do I miss him. He would have loved today! But I celebrate this beautiful July day, my other best friend Sammy and his patience with my slow pace, and hope each of you still in recovery soon have a day like this to do what you most want.

Suki

 

[bottomshollow]

Lovely post, Suki. Happy you had Sammy to share this day and the beauty of nature with. I'm fortunate to have many lovely days with my cats following me around as I replenish the seed and nectar feeders for the birds and scatter corn and peanuts for the squirrels, then retire to the screened in porch to bird and squirrel watch together.

 

[Debbie_joints]

So, today was a bittersweet achievement. I am 10 weeks post-revision to my LTHR. As I live in Alaska, and we had record snow and ice this year, I was pretty home bound from December through my May 7 surgery. I was in an abductor brace and doctor forbade me walking outdoors. I longed, all winter long and through my surgery, to recover enough to take my two sweet boys--Buddy, a huge black lab, and Sammy, a middling to large golden retriever--on a walk along our favorite route. Lots of things for the boys to sniff and beautiful scenery for me to soak in. I focused on being able to do this daily walk, I daydreamed about it really, throughout my wait for surgery.

Well, today, I made that walk, all two miles, with my Sammy dog. It was as beautiful as I remembered, I was so thankful to have the mobility and strength back, the sun was shining, the air sweet with clover and lilac....but I will never again share this walk with my best friend Buddy. You see, I lost Bud the week after my surgery. It wasn't that I expected him to live forever. But boy, do I miss him. He would have loved today! But I celebrate this beautiful July day, my other best friend Sammy and his patience with my slow pace, and hope each of you still in recovery soon have a day like this to do what you most want.

Suki

So sorry for the loss of your dog Buddy, but you know, I bet he was walking right there with you on your first trip out there with Sammy. So glad to hear you are doing better now.

 

[Thedogtales]

Buddy was a lucky dog to have someone love him so much.

 

[rider1960]

How bittersweet--you finally get to take your walk and Buddy isn't there to share it with. But, he does sound like he had a wonderful life with you and couldn't have been loved more.

Glad Sammy was able to enjoy the celebration walk with you.

Congratulations!

Dorothy

 

[TracyW]

What a touching post Suki. It must be beautiful where you live and Sammy must have had such a good time today. I'm sure the Buddy is with you in spirit watching over your recovery and new good health. Pets have such a way of knowing how we feel . . . you were both lucky to have had so many lovely walks amongst the lilacs. It's good to hear you are doing so well in your recovery.

broken link removed: https://www.smileycentral.com/?partner=ZSzeb001_ZNxpt631YYUS

 

[Elle11]

Oh, Suki, my eyes became so wet when I read your post! Our animal companions are so dear, so beloved. Oh, gosh, a lab...is there anything sweeter???! I am sorry that your Buddy was not with you on this amazing milestone day, but as Tracy and Debbie said, certainly his spirit was with you. I am so glad you had such a beautiful walk. The lilac is only now blooming??!!! Wow! More wonderful walks for you, my dear!

 

[jazz6661]

Suki - I am so sorry for the loss of your dog. I went from having 4 cats, 1 dog and 1 tortoise to only the tortoise left. All my cats lived long lives and my dog died way too soon but we will both have our memories of them to get us through. I'm so glad that you were able to have your walk with Sammy. I agree with everyone else - Buddy was there with you too - I'm sure you could feel his spirit. Hugs!

 

[Suki]

Hi folks

I am almost 11 weeks post LTHR revision. As a reminder I also have a RTHR. I also have OA in knees, with future TK replacements predicted, though managing well right now. My recovery has gone very well after the first couple of weeks of feeling like a train wreck ;)--- Bet lots of you can relate!

I was able to ditch the cane at 6 weeks and walk a little more each day. Currently doing 2 miles or so daily (while walking an 70 pound golden retreiver---yay for Sammy and me!!). I was able to descend stairs normally around the same time though still have a little "heave and lift" going on when climbing stairs foot over foot. Definitely need the bannister to aid me in climbing. I don't limp, even when tired, but my revised leg wants to angle out--as though I am still in the abductor brace--a little like Chester in the old Gunsmoke TV show--and more so when tired. If I consciously think about it I can bring the legs closer together. Others now think my gait looks normal, but it feels wrong. Like my legs are spread too far apart and the joint is tense rather than loose and easy while striding. Coincidently I find I still cannot slide my revised leg inward when laying down. The signal doesn't seem to travel from my brain to my leg. I CAN lift the leg and thus bring inward---just cannot slide it. I am also unable tie my own shoes--I cannot bring the revised leg's ankle to the opposite knee and I cannot bend enough even with my foot on a stair, nor can I raise the leg high enough to rest the foot on a chair, in order to get to those dang laces. Shaving my legs is also a challenge because I can't get the foot up onto my shower stool or the toilet...None of these things were an issue for me prior to revision. I was able to sit in "Indian" pose, get up and down from the floor, kneel..though squatting required heaving myself back up by way of countertop or other support. I could sit with legs crossed, or with one leg underneath me. I can't do any of those things now.

I am still under doctor ordered hip precautions---no crossed legs, or inward toes, or more than 90 degrees angle. I am not yet allowed to squat ( and couldn't even if I were allowed), or kneel...originally figured all of these restrictions would be gone at 12 weeks but PT suggests some will be life long. I don't see my doc for a couple of weeks yet so am hoping for some advice or information on whether any of the above sounds "normal" and will improve, etc.

I don't require pain medication on most days, and on the days when I do it is generally due to achiness in my back or knees. The hips don't hurt.

So, with all of that, my specific questions are as,follows :

1-My knees are stiffer as is my "good" hip. I think because of the 5 months in brace and associated inactivity including the past 10 weeks postop. Can anyone suggest exercises that are gentle but may assist me in regaining ease and flexibility?

2-Do any of you have suggestions on how to best increase hip flexibility in the revised hip? My PT has worked on strength and ROM (being able to attain 90 degree flex) and increasing stamina but has not focused at all on the flexibility allowing me to tie shoes, shave legs, etc. I have only 1 session left with her so not sure how much help I can expect on this issue, as I surmise her focus is directed by doctor's instructions?

3-Are there more long term concerns with revisions that require adherence to long term hip precautions? Am I to be forever limited in flexibilty and ease of movement and forced to a stricter attention to movement? Is scar tissue and stiffness of the joint a help in holding everything in place?? I have read that revised hips are less satisfactory than original THR in strngth, movement, etc., and that once a THR dislocates the risk of future dislocations, even after revision is greater. Is any of this factual? Or is this info associated with older studies and experiences, before use of the larger balls?

I am hoping that those of you with revisions will offer suggestions and information and I also hope Jo might weigh in, as she has so much ortho experience.

Thanks for reading this post and for any help or ideas you might provide.

I am so grateful this technology/medical solution was open to me. Overall I feel as though I have my life back. Now it is about enhancing the gift I have been given.

Regards,
Suki

 

[Elle11]

Hi Suki,
I just read your post about hip revision and I see all your concerns. I do not have answers to your excellent questions, but here are a few thoughts

That is amazing that you are doing so much walking and that is supposed to be the best exercise ever. Very good! And with no limp-wow!

I have a strict regime of all those stanard bitty exercises they gave us (from ankle flex to leg lifts) and although they seem geriatric-like, they really do strengthen the hip and increase ROM. So, don;t give those up!

Yes, the restrictions are destressing, but I am at a loss to see why they would be life long if you are already so fit (inspite of the OA, including knee problem.) You are seeing your doctor in a few weeks, so hopefully you can get clear direction from him. I can image how frustrating it is not to be able to shave and tie your shoes (well, no, I don;t image, that's my reality, too!) and I would realy tak to the PT about that if your restrictions are goign to carry on a bit more.

I will be interested to hear what Josephine; has to say to your questions above and in paticular why you can't do the foot slide.

You said "I cannot bring the revised leg's ankle to the opposite knee". Should you even be attempting that yet? That kind of goes against the "cross-over" rule, as you are not quite 3 months out.

Finally, I would suggest finding a good yoga teacher (Alaska is full of them), particularly someone who does yoga therapy (not the leapers, jumpers or pretzle people!)

Suki. good luck to you. SOunds like your Golden Retriever is one of your best therapsts!

Warmest,
Elle

 

[Jaycey]

Suki if you are still under restrictions you should not be trying to tie your shoes as you describe. Please wait until you are off restrictions before trying this. Then just keep working on it. I had to work for months to have the strength and ROM to do this. But with time and a bit of patience you will get there (leg shaving and all).

In terms of lift time restrictions I have only two - no parachuting or bungee jumping. In other words I do pretty much what I want and what my body allows. Your OS may tell you otherwise. But it is a decision you need to make. I think alexthecat; had the same experience and I am sure she will confirm she is living life to the fullest again. Please don't worry about revisions - once your restrictions are lifted you can get on with life.

 

[TracyW]

Hi Suki,

I agree with Elle, you seem to be doing very well for 11 weeks post op. How long does your doctor expect you will be in the brace? I can understand how your gait feels wrong because the brace is a layer, that even if very thin, is a presence between your legs as you walk.

No 2 recoveries on the same body are the same. I think you will find a new normal once you are out of the brace and able to exercise and stretch more fully. It’s frustrating I know, but try not to imagine the worst, as our bodies are magnificent and capable of healing beyond other’s opinion. At 12 weeks on a original RHR I can just barely put my ankle on my opposite leg (cleared for me by OS). As for tying shoes, removing the brace will help that process (do you have elastic laces?) and for shaving legs, I found a great contraption on Amazon that helps extend the razor so you don’t have to bend down so much.

As for PT, can you call your doctor to see if you can extend your sessions? Maybe she can come back after the brace is off? I think you should call him and get some answers now rather than waiting. Knowing is always better than not knowing or guessing.
I admire your perseverance in pushing through this recovery. You imagined all your great walks with your Sammy and did it! I suspect that once you are able to walk without the brace that your knees will loosen a bit to make those walks more enjoyable. Yoga therapy sounds like another great opportunity as well as swimming if you have a facility in your area.

Keep posting, I’d love to hear what your OS says about the brace and your extended recovery. Stay positive, not even your doc knows your body as well as you do. With as determined as you are I can’t imagine your recovery will be very successful especially over the next few months, my PT told me 6-8 months and I’ve read up to a year for the full results of your revision.
Keep the faith and hug your puppy for me!
Tracy

 

[Jamie]

Your threads have all been merged into this one, Suki !

Please continue to post your questions, concerns and updates here as you go forward in recovery. Thanks for letting us know we needed to do the merge for you!

 

[Josephine]

I don't limp, even when tired, but my revised leg wants to angle out--as though I am still in the abductor brace and more so when tired. If I consciously think about it I can bring the legs closer together. Others now think my gait looks normal, but it feels wrong. Like my legs are spread too far apart and the joint is tense rather than loose and easy while striding. Coincidently I find I still cannot slide my revised leg inward when laying down. The signal doesn't seem to travel from my brain to my leg. I CAN lift the leg and thus bring inward---just cannot slide it.

It's quite probably due to the wearing of the brace. If you can do it when laying on your back, then it's not anatomical, just stiff muscles and probably a little bit of habit.

I am also unable tie my own shoes- Shaving my legs is also a challenge
I am still under doctor ordered hip precautions

Then why are you doing these things? You shouldn't be!

1-My knees are stiffer as is my "good" hip. I think because of the 5 months in brace and associated inactivity including the past 10 weeks postop.

Yes!

2-Do any of you have suggestions on how to best increase hip flexibility in the revised hip?

You can't beat walking but not to excess. A 10-20 minute walk twice a day will be good.

3-Are there more long term concerns with revisions that require adherence to long term hip precautions?

No!

Am I to be forever limited in flexibility and ease of movement and forced to a stricter attention to movement?

No!

Is scar tissue and stiffness of the joint a help in holding everything in place??

No!

I have read that revised hips are less satisfactory than original THR in strength, movement, etc.,

Not necessarily. depends upon the reason for the revision and your ROM beforehand.

and that once a THR dislocates the risk of future dislocations, even after revision is greater. Is any of this factual?

Nonsense! Utter nonsense!

 

[Suki]

Thanks ladies for your responses. I appreciate your suggestions and comments.

I am lucky to have such a wonderful husband....he has been so very patient and supportive. He cheerfully shaves my legs for me and doesn't complain about the multiple times a day I ask him to tie my shoes. I guess I am just impatient in wanting full independence back for these sorts of simple self-care activities.

Jamie, thanks for merging threads. The name is perfect. Can we add the header "revision THR " category?

Elle, I think using gentle healing Yoga is a great idea. I worked with a wonderful instructor in years past and she is still active in her practice. I will call her Monday. And yes, my Sammy is a big help in keeping me moving. He is quite patient with my snail's pace and grateful for each walk we take. He and I both put on a few pounds over the past 7 months and with the walks he is starting to slim down again. Alas, not so fast for me.

Jaycey I will read Alexthecat post today. Appreciate the encouragement about regaining ROM and the info on the level of restrictions you were given. I think I could live without parachuting or bungee jumping ;).

Tracey, where did you find the razor extendor and what is it called? Looks like it could really help. And yes, I think I will ask my doctor for an extension of my PT to work specifically on the gait related issues. For clarification I am not currently using the brace but wore it from December 2 until my May 7 surgery ( except for a couple of days in late February before the 2nd full dislocation).

Regards
Suki

 

[Suki]

Jo

Thank you! You answers to my specific concerns are really really comforting. God bless the work you do for all of us hippies.

Suki

 

[Elle11]

Hi Suki,
I was so happy to read Josephine's response and hear that revisions have the same outcomes/restrictions as the original ones. Good for you! YAY!
Oh, my dear, let your sweet husband do the leg shaving and shoe-tying. These loving acts of kindness are good for husbands' souls and ours as well!
Great you have an instructor there that you like! Give her this article which wonderfully informative and talk to her in detail about your restrictions. Go very, very easily. You seem to have such high demands of your body, so make sure that you are super-cautious!
You take gentle care,
Elle