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Bilateral THR Surgery Complete - 2/24/2015

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@lando622 So happy you are getting the extra help at a rehab facility. Reading through your thread I completely agree about the hospital staff being lame on the icing. Had I not kept asking for it I would have never had it. I learned about it from reading this site prior to surgery. I am still icing. I did go to a class that was required by the hospital prior to the surgery. Learned all about the assist devices and they sold a "hip kit" after the class. Included long handled sponge, reacher, and the sock aid. The hospital did a good job explaining the process. After the surgery I had to be very proactive to get what I knew I wanted during the recovery. Thank goodness for this site to research before the surgery. Keep getting better. I'll try to keep up!
 
Rehab is going well and I'm able to navigate steps and walk with my walker. I didn't realize how off my gait must have been as walking straight/normal is challenging. My doctor's assistant mentioned that it appears my legs were different lengths; if true, that may explain why it's harder than I thought to walk straight... Years or a lifetime of walking and compensating won't be overcome in a couple days.

Today feels like a huge turning point in terms of progress. Healing slowly but surely, doing great with exercises and biological systems are back on track.

I feel a bit of guilt as there are some really hurt people in the rehab area. Many are very advanced in age, too. I'm so fortunate to have done whatever I did to need both hips done now and not 30 years from now.

I am looking forward to going home soon and being with my wife and kids. Though my rehab experience at the facility has been worthwhile and I've learned a lot, I'm ready to go home.
 
"Years or a lifetime of walking and compensating won't be overcome in a couple days." Keep that firmly in mind as you go through the recuperation period!!!! All of the muscles in your body are going to have to get readjusted to properly situated hips - and yes it does take a while .... or longer .... to get that done! As for legs being different lengths - way, way, way too early to tell if that is a problem! Particularly with BTHR the most likely thing is the fact you were limping on bad hips for an extended period of time and now do not have to do that but the muscles have not yet caught up with the happy new hips. When you see your surgeon next (probably at 6 weeks or so post op) xrays may be taken of pelvis and new hips - that should show if pelvis is even. I felt like my legs were different lengths for about 2 months or so but xrays showed pelvis was nice and even and my OS assured me that leg length differential was not an issue for me - and he was right!

One question/suggestion - Do you have new shoes or are you wearing old ones? If you're wearing old ones - please get new ones or have old ones resoled!!! It really helps to have brand new bottoms on shoes when recuperating from hip surgery! The old ones will have the worn pattern of your limping time etched into them - and that does NOT help muscles get back to the way they are supposed to be.

Hope you get to go home soon! Best place to finish recuperating :)
 
djklaugh,
Great info and advice. Thanks for taking the time to draft that.

My doctor's assistant asked about my legs being different lengths pre-surgery based on x-ray measurements at our pre-op appointment. I have all the confidence in the world that my legs are the same length post-surgery.

I'll take a look at my shoes. My running shoes tended to wear evenly along the centerline of the shoe with a bit more wear in the forefoot. I always thought they were good but when one buys new tires, it's good practice to spring for an alignment as well so everything wears evenly. Great tip, thanks!
 
@lando622,
Your posts are making me so happy and positive. You sound like you are in a good spot and moving in the right direction. I'm counting down my surgery date for my Bilateral April 8th. I hope to stay in the hospital at least 3 days. They said a bilateral was out in 1 day I could be 2. I like the idea of 3-4 days.
I will have a PT area set up in the house and will walk outside bedroom to get to kitchen instead of split level house stairs. We live on a hill and lots of stairs. I would like to go to PT rehab but would miss my young son too much. I feel I can do it at home. I will be alone most of the day when I get home from hospital. What do you think? Can you manage on your own after 6 days? I have surgery Wed and husband goes back to work Monday. Someone will bring my son home from school and my husband can make dinner when he gets home.
I guess just need to make a command center with all the things I'll need.

Well keep us posted an your day to day recovery. It is very helpful. Bilateral seem to be a bit different than getting 1 done so your input is great.
Can I ask how old are you?



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Cat,
I'm 45 and in the Coast Guard...apologies as I thought putting my vital stats in my profile made them visible to all. I'll update my signature so others can see it, too.

Until my hip issues developed this past fall, I was very active. I've always been around great people in the CG and fitness was a high priority at all my units, especially my last one where for the past three years, we did some mix of SPEED, crossfit, Tabata, etc five days a week. Laying in my rehab bed typing this, I am pretty sure that I was way off in thinking that I just had some workout soreness that I nededed to work through (sarcasm).

I feel my bilateral procedure (anterior approach) is the way to go if one is a candidate for it, and I'll answer your questions the best I can based on my experience over the past week.

For an anterior approach bilateral procedure, all that I've seen and experienced indicate one can expect a two-day hospital stay. If you do one hip at a time by the anterior approach, you may get one day in the hospital. In my case, it was understood that I'd be there two days though two people in my treatment circle dropped hints that I might actually leave the day after my surgery (told me that "you might leave today" the day after my surgery) That isn't advisable in my opinion, and it certainly was not going to happen on short notice.

Taking into account that everyone's insurance is different, mine has coverage for inpatient rehab and a doctor friend recommended taking that route if I could because of the bilateral component leaving me with two weak sides. I'm glad I listened to him and that my wife was assertive in pushing it since the hospital's admin care staff initially opposed my going to rehab...briefly, the surgical staff felt I should go and they won out.

For me, this was the best option. Our house is on the market due to our pending summer transfer and there are a host of other logistical challenges with going home right away. The inpatient rehab is much more comprehensive than my two 15 minute visits with the hospital therapist, and I've learned many useful tips and tricks that I didn't know at the hospital. Hospital session on day 1 after surgery was get on my walker and hobble down the hall to the stairwell where I struggled up and then down two flights of stairs. Same thing on day two, but I struggled up and down three flights. They deemed me suitable to go home and there was no briefing, PT plan, etc...just go home and someone will contact you.

Within my first half hour at inpatient facility, I was given much better/clever ice packs for my legs (you will need lots of ice), a more comfortable bed, a reaching stick and a sock tool. Getting caught up on pain meds mercifully happened relatively soon after.

So this is now Thursday night after Tuesday AM surgery.
I get evaluated on my status/progress Friday AM and start rehab for real Friday afternoon. Everything takes a lot more effort than one would hope: moving around the bed, around a room, going to the bathroom, cleaning yourself (can't shower due to having to keep bandages dry), doing rehab, eating, etc.

I'm kicking butt in rehab but I have to...though I'm middle-age, I'm the "kid" here and there are some very frail and very injured people. I feel a tinge of guilt to "only" have two replacement hips and I go about my therapy the best that I can. While some of these exercises could be done at home with at-home care therapists, this is truly dedicated to making people better. There are no responsibilities or distractions and if anything goes wrong, help is here.

A few final observations...general anesthesia hits me hard. I woke up from surgery feeling like a million bucks, but as that wore off it wasn't exactly a nice transition to my pain meds as the staff took the "every four hours as needed" to mean "don't offer it unless he asks for it." I ended up behind the pain curve for longer than I should have. Now, I'm on the staff about pain level 7 every four hours.

Another issue with anesthesia and pain meds for me is, to be polite, a herculean irregularity. At both the hospital and the rehab place I guzzled water, I take metamucil and stool softeners twice a day; at rehab place I've had at least 6 prune juices in 2 days, including two coffee cup size hot prune juices, coffee with breakfast daily and a contraband "Smooth Move" tea (thanks, honey. I won't tell). All that prep and effort finally got things started but the big-toe size result wasn't what I was hoping for. Over the past day, it seems to have evened out. Maybe more detail than anyone wants, but my intent is to drive home the point that recovery is a full-on effort for at least several days. Its hard to take care of anyone else or do anything else. You need to focus on you so that you don't extend the harder initial period longer than you might otherwise experience.
Also, if you're taking pain meds every 4 hours, for about an hour of that time you may be loopy, tired, ADHD, etc. I wouldn't advise having any deep responsibilities until at least you're off or have greatly reduced your pain med schedule.

I'll wrap this up by saying that in my opinion, 6 days out is too soon to turn back into Supermom or Superparent. You certainly can help out but there may very well be times you need help and if you're the only one around, it's a challenge. Maybe a very carefully chosen family member or relative can help you out.

Good luck in your preps and considerations.
 
@catdemar @lando622 Hi there - I just wanted to chime in and say that I'm going to be having bilateral anterior approach THA on 3/16, and I cannot wait! Landon, it was really helpful to read your insights. I've also chosen to go to an acute rehab facility after discharge from the hospital. I'm glad to hear that everything is going so well for you!

Regard,
Theron
 
drgnfly,
Good luck with your upcoming surgery. Hopefully, the next couple weeks fly by and you're on the other side.

How did you come to the decision to go to an inpatient rehab center afterward? It'd be good to compare notes on that topic as it's an option I don't see many taking.

While we have the benefit of youth on our side, recovery still needs to be taken seriously and requires an active participation and focus. There are enough new parts installed that we have to really pay attention to every move we make during the initial recovery period. Good luck!
 
Hello @catdemar
Your long wait will soon be over. Like me you use Bonesmart to the full. We are lucky. I am 7 weeks post op and would be concerned about you being alone after 6 days. Can your husband go back to work for just a few hours a day? Have you got someone else to be with you.

The problem is the unpredictability of all aspects e.g.. I had no issue with pain took my paracetamol every 4 hours which kept it under control BUT had extreme tiredness just slept, went to bathroom, slept, took medication, slept, had a little food and I went on with this for about 10 days. Well anyway you know the positives of recovery as well as the problems from Bonesmart.

Any way, thinking of your "control centre" in easy reach if you are on your own:
Medication, in easy reach, with note of what was taken when
Alarm clock to alert you to next medication due
Water to drink, prune juice and similar to try to avoid constipation,
Snacky type of food
Mobile phone handy( i found having a little light bag for it over the shoulder helpful then it is always with you in the critical days)
Laptop/TV/radio/DVDs or what ever you prefer plus remote controls
Tissues, moisturising cream, lip salve (my skin got very dry post op)
Work out how you will open the door to visitors, warn them that you might take a while to reach the door!

Your son might be shocked by it all, my little grandson was (aged 4). He kept wanting to make me better, wanting me to put an elastoplast on it and hated seeing me laying on the sofa. After 10 mins of asking, he was asking again "is it better now" At least your son is old enough to understand that you will be a lot better in a few days!

The first few weeks are demanding but you really do turn little corners and it is very encouraging when you achieve little things and big things like At week seven, the week one and week two experiences really are history and the rewards are great!

I was so so scared. I describe myself as having a hospital phobia. Amazingly I got through it all as will you. I thought I would be nearly back to normal after 2 weeks, crazy idea! I got very tearful post op which could be a reaction to general anaesthetic or to the feeling of vulnerability or not being in control BUT it is "do-able" and that time of early recovery which is complex physically and emotionally does not last long. At 7 weeks post I am just about to go for a walk along the sea front, very windy and sunny, but it is such a relief to do something "normal" again.

I just want yours to be over and done with as all this waiting is not good, other than to prepare practical things.

Karen
 
Sorry @lando622 just realised that I have highjacked a thread that is not Catdemars will try to repost on hers. Apologies
 
copsham,
No worries...she asked some questions here and both you and I provided some input back to her...hopefully, our info helps her out.

You're spot-on about all the different sleep periods. I've been treating my last 6 days since surgery as one long day with periodic bits of sleep breaking it up. I find that I take my meds, feel tired/loopy about an hour later and nod off for about 20-30 minutes of hard sleep. I wake up, shift around the room a bit, get a drink of water, and crash hard again. I definitely would not choose to try and be the primary caregiver for someone else.

Typing these responses on my small tablet, I nod off often and have to make all kinds of edits. Being in charge of someone else, driving, etc all have to wait for a bit in my case.

Have a good one!
 
Today was great for rehab. I did a bunch of exercises that tested the new hips: sets of air squats down to 90degrees, balancing on foam blocks, walking on foam beam, stairs, ramps; walking with a cane, I went over gravel, dirt, uneven grass and concrete; worked on exercise bike, did side shuffling, marching. I'm hoping I can work thru the bad mechanics that I developed relatively quickly in continuous PT.

Then, the surprise of the whole surgery to me, the night nurse brought me a powered icing system that I can rotate between legs as much as I want and the best part is there's no spillage or mess. The doctor in charge of my care here showed up today for the first time since I came in...he had food poisoning on Friday and today was his first time back and seeing me. The Charge Nurse wrote a request based on all my issues getting ice and trying not to spill melted ice in my bed every day. Wow, that was VERY good of them and it is awesome for my healing.
 
drgnfly,
It's the DonJoy Iceman Classic Cold Therapy Unit and a quick internet search shows it can be found for $150.

However, as this can put a deep freeze on tissue if not used right, there are all kinds of notes and warnings stating that this is to be used under a doctor's care only. Prescription is supposed to state how long it is to be used on what areas of the body.

Probably easy to overdue it with this machine, but it seems to me that this would have been ideal during my initial post-op hospital stay.

The trauma of the surgery would cause swelling likely no matter what, but this certainly would better keep up with it than those lame break and shake disposable ice packs.
 
drgnfly,
As I was prepping for my release tomorrow, the topic of "what happens to the cryo-therapy unit?"came up. Care Manager said it stays in the hospital, but Discharge Nurse said it goes home with me as it is no longer sterile.

I will get a copy of the doctor's order for it in case my insurance company gets billed and wants me to pay for it.

I really think you'll be ahead of the game if you have this in your post-op hospital room. Good luck!
 
Hey everyone,
Lounging on a Friday evening with my legs propped up by a foam roller (on top of a pillow) behind my knees and my cryo therapy unit icing down my swollen lower body.

I came home mid-day Wednesday and it was the ideal time for me after 2 days in the hospital and 6 days in inpatient rehab. My preferred pharmacy didn't have 2 out of the 3 meds I was prescribed, but said they should be in the next morning. Since the one they did have was a pain med, I figured it was OK. Worst night of my recovery by far.

The next morning, I picked up one of the two remaining meds (blood thinner) and pharmacy said that they would know later in the day if my remaining pain med (Oxycontin) would be in the following day. Determined not to spend another night like the previous one, I got my scrip back from the pharmacist so I could take it to another pharmacy we are affiliated with. Got my final pain med without a hitch and though it's taken once every 12 hrs, it makes all the difference.

At home, stairs are taller and toilets are lower than at the rehab facility. It's great to be home again and I'm walking a lot more (and a lot better) than I did in rehab. I'm waiting on some admin to catch up so I can continue outpatient rehab.

My lower body is noticeably swollen despite all my efforts with icing. My legs feel like I have a cellphone on each thigh. My wife and kids have noted that my color seems more pale (slight anemia noted in hospital despite me receiving pint of my own blood back after surgery).

I notice a fair amount of swelling in my feet and I'm sporting some thick cankles (yikes!!!). I seem to be bruising easily on my right foot, too.

Overall, I feel great. Keeping the dreaded constipation at bay and I'm doing very well. My body fatigues easily which lets me know when to dial it back a bit.

Looking forward to a great weekend. Hope all of you have a good one!
 
@lando622 The swelling is pretty SOP for bilateral hips and while the icing :ice: and elevating ("toes above nose") does help it takes a week or two for it to totally go away. Unaffectionately known as having "log legs" :snork:
You may also notice your legs looking like they are bruised all the way down to your feet. But it does not feel like a bruise - ie: doesn't hurt if you press on it. That too is fairly normal and according to my OS is from blood seepage during surgery and will be reabsorbed. There is a lot of tissue trauma associated with this kind of surgery and a lot of healing to do including growing new bone around the implants. So yes you are going to feel fatigued for a while - just go with the flow and take naps when you need to. :sleeep:

I had one side that was noticeably more swollen and bruised looking that the other - my OS said he did that leg first then I got flipped over (lol I am so glad I was out like a light through all of that!) so he could do the other side. So the first side was downward and I was lying on top of newly invaded flesh and newly repaired hip for the duration of the 2nd surgery so gravity and pressure made that leg a bit more traumatized.

It's good to hear that you are home and doing well! Hang in there - you will see as you go along that all of the above is temporary and you will improve as time goes on. It's really a revelation to go back and read your thread a year or so after this surgery and see how very far you have come :yahoo:
 
Deb,
Thanks for your insight! I'm afraid to go back and read any of my posts, especially the early ones as they may be pretty medication-induced ;-)

Getting better every day...
 
Hello @lando622
any more info on your recovery? would like to know how you are doing.
I am getting nervous. have 3 more weeks until i go in.
Hope you are doing well.
 
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