THR Terrible muscle pains

[YogaLesley]

Hello, I had my right THR on Wednesday 29th September and haven't been out of bed yet! Pain has beem horrendous, same as before only worse! Sooo depressing. Although wound is sore, I expected that but all the muscle spasms and aches, particularly around knee and below calf have been dreadful, still the dreadful dire toothache and crampy feeling. Problem has been my BP has been very low, also blood count so yesterday they decided to give me two blood transfusions which I think has helped. They didn't want to get me up in case I fell. So have had no proper physio and now they are off for the weekend! I suppose the nursing staff will try and get me up today ( desperate for the loo) but feeling depressed because so many people said pain changed and mine hasn't except for the worse. Surgeon says hip x-ray is good but as my leg was short they had to pull and sttech muscles which is why they hurt so much. I keep crying because they all look so puzzled when I try to explain the pain. ( And to think I was worried about getting back to yoga! Now some pain relief is only aim!). Has anyone else experienced anything like this?

 

[Jaycey]

@YogaLesley Yes, I experienced the same post RTHR. You get pretty man-handled during the procedure. But if they lengthen your leg - OUCH! That pain was worse than normal post op pain.

Are you taking pain medication? You might be under medicated.

Also, ask for an ice pack. If they look at you funny tell them physio has ice packs. Icing does help ease this.

The good news is that by the time I was discharged all this pain eased. Hope you get relief soon!

Here are your recovery guidelines:

Hip Recovery: The Guidelines
We are all different, as are the approaches to this recovery and rehab. The key is, “Find what works for YOU.“ Your doctor(s), physiotherapist(s) and BoneSmart are here to help. But you have the final decision as to what approach you use.

1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:

rest​

elevate​

ice​

take your pain meds by prescription schedule (not when pain starts!)​

3. Do what you want to do BUT

a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you​

b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​

4. PT or exercise can be useful BUT take note of this BoneSmart philosophy for sensible post op therapy
5. Here is a week-by-week guide for Activity progression for THRs
6. Access these pages on the website

Oral And Intravenous Pain Medications​

Wound Closure​

Pain management and the pain chart
Healing: how long does it take?
Chart representation of THR recovery

Dislocation risk and 90 degree rule
Energy drain for THRs
Pain and swelling control: elevation is the key
Post op blues is a reality - be prepared for it
Myth busting: on getting addicted to pain meds
Sleep deprivation is pretty much inevitable - but what causes it?

BIG TIP: Hips actually don't need any exercise to get better. They do a pretty good job of it all on their own if given half a chance. Trouble is, people don't give them a chance and end up with all sorts of aches and pains and sore spots. All they need is the best therapy which is walking and even then not to excess.

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.

 

[YogaLesley]

Thank you Jaycey, it is encouraging to hear I am not alone in having had such muscle pain. I was on morphine twice a day(12 hour tabs) and IV paracetamol, with liquid morphine occasionally for breakthrough pain. But today they have finished the morphine and put me on 2 normal paracetamol instead of the IV. I can still have oral morphine in between if I feel I need it. I am not too bad on the paracetamol if I stay still but if I try to do any exercises other than ankle pumps and circles, the muscle nerve pain starts screaming again. I don't know whether to ask for oromorph, or try and stick it out. Paracetamol doesn't seem much considering I was on Tramadol/paracetamol before I came in. Don't want to serm like a wimp!

 

[Jaycey]

Ask if you can have Tramadol/paracetamol again. For many this is a very effective combo. I was given Gabapentin while I was in hospital. It works very well for nerve pain. However they won't let you have it going home.

You are not a wimp and you should not try and push through any pain. Getting control of the pain is key to increasing your mobility.

 

[YogaLesley]

(I don't seem to have got the hang of posting as I thought I had already posted a reply but here goes again!). Thanks Jaycey, it is good to know that i am not alone in experiencing such muscle pain. I have been on 12 hour morphine tablets twice a day and IV paracetamol about 4 times a day with occasional doses of liquid morphine for breakthrough pain. However today they have taken me off morphine and the IV paracetamol and I am now on ordinary one gram paracetamol 4 times a day I think, with the option of oral morphine for breakthrough pain still. I am not too bad at the moment on the patacetamol but have just had some oral morphine as I found that when I did the on- bed exercises, it was causing the pain to start off again. I am not sure if I am being a wimp having the extra morphine or if I should try to push through the pain. Just paracetamol doesn't seem very much, especially as I was on Tramadol and paracetamol before the op.

 

[YogaLesley]

Whoops, I had posted it after all. Why couldn't I see it in my thread before??!!!

 

[Puggles]

I'm so sorry you're suffering so much! Maybe I'm not seeing it, but
you haven't mentioned ICE !!! You need constant ICE !!!

I keep crying because they all look so puzzled when I try to explain the pain.

Um, I don't understand why they'd be "puzzled"----they should
be completely understanding that after such a major surgery,
a patient is going to be in horrible pain/ crying.

I don't like that they haven't gotten you up because they're afraid
you'll fall. They should know that you NEED to walk around--
you REALLY need to, and they should be prepared for **IF**
you should fall.

I am not sure if I am being a wimp having the extra morphine or if I should try to push through the pain. Just paracetamol doesn't seem very much, especially as I was on Tramadol and paracetamol before the op.

No--- you are NOT a wimp---you had major surgery! Please try not to be so hard on yourself!
And no one expects you to "push through the pain" at all.
I hope that they can tweak your meds ***AND KEEP BRINGING YOU ICE *** to make you more comfortable!
(( hugs ))

 

[Eman85]

It sounds like they really had to do a lot of stretching of your muscles, and if they did any lengthening that would just add to the trauma to your soft tissue. I wouldn't worry too much about any exercises or missing out on any physio. At this stage for most of us ankle pumps would do. Why push through the pain? There's no progress in healing if you're in pain. Ice is great but I see most in the UK don't use it.

 

[Magsmom]

YogaLesley

you are NOT a wimp! Getting this done loving hurts and it’s hard. I’ve watched videos of actual hip and knee replacements - your body is really “manhandled” as someone mentioned here. It’s like carpentry work. Plus they have to cut through muscles etc just to get to your hip.

it sounds like you’re in the UK? I’m sorry they don’t seem to be working on a pain mgmt program for you. In the hospital here in NYC where I went, it’s #1 top priority.
even though you feel terrible, I think it’s important to advocate for yourself. I’ve gotten good at rattling cages when needed. If someone won’t cooperate ask to talk to their mgr. Yell if you have to. If it gets results who cares that you raised your voice. Or have someone else like a friend or relative do it for you. Or ask if your hospital has any pain mgmt specialists and that you want a consult.

there are so many options that can help. Gabapentin is great for nerve related pain. Flexeril or Robaxin are muscle relaxants and help the spasming tight muscles. (Btw I’m not a doctor and this isn’t medical advice. Simply sharing my experience with this).
Now that I finally got off the opioids (oxycodone for me) I use Tylenol (same as paracetamol I think) 2x day and alternate w Naproxen (nsaid) 2x day. I throw in a Robaxin as needed. I also make sure to take a stomach helper (Nexium, Protonix etc) to provide some protection from the nsaids.

all the best to you - it’s truly a one day at a time thing. Progress isn’t linear and though it feels horrible now, you WILL get through this

 

[YogaLesley]

Gosh you are all so kind I am crying again but thank you all so much. Yes I am in the UK in Wales. My main nurse is lovely and has said she will ask the doctors about other pain management. But when they switch over at night, sometimes there is miscommunication, like last night, when I had been told I could have IV paracetamol, she insisted I had tablets, and that my oromorph had been cancelled!! She showed it me and someone had written 'see next sheet' but she didn't have one. I insisted though and eventually after speaking to someone else, she agreed I WAS listed for it!! A bit worrying but hopefully she won't be regular! We are very lucky with the NJS here as I could not afford to pay for this snd the treatment is usually very good but I have to say the admin and continuity side of things can be a bit haphazard!! Most people I know don't seem to have had any problems which is why I felt uncertain. Things are easing a tiny bit and I have been up 3 times to WC and also sitting in a chair today. I like the idea of a muscle relaxant Magsmom, I will ask about that. Constipation is a problem too at the moment and laxatives seem to go to the other extreme! I will feel a lot more comfortable when that eases though suspect, knowing my own system, that may not be till I get home. Anyone lovely to feel you are all there.

 

[YogaLesley]

Sorry, of course I meant the NHS not NJS!!!

 

[JulieH]

@YogaLesley I had LTHR in Manchester in August. While the surgical team were great, the nursing care on the ward was very random and entirely dependent on who was on duty. I don't know about your hospital but at mine, even the good ones forgot to bring toilet paper with the bed pan, then generally brought paper towels instead when asked - they were closer. I do wished they'd go back to the large but cold bedpans hospitals used when I was a child instead of the virtual dustpan you get now... they're too small
As for constipation, I was given lactulose which is more of a softener and worked really well. Maybe worth asking about it.

 

[Magsmom]

Ughhgghhhhh the constipation is just awful, right???
here, wmy hospital uses a 3 step “model” an suggest you follow at home
1 start w sennekot and colace (softener). Twice a day. If that doesn’t work……
2 Miralax - white powder that truly dissolves fully in any fluid. You won’t know you’re drinking it. It’s pretty effective with few if any cramps.
And …if SOS still needed …… go to:

3 milk of magnesia - cherry flavor. Gross to drink but it’s like a shot glass so 1-2 gulps and you’re done. This WILL work. Guaranteed. Some slight discomfort but really not bad. Worth it to get some action going. When I took it I stayed near a bathroom just in case.

Also water water water. Fluid is Essential. Fruit w lots of water in it too. Melon, citrus, grapes, pears (great fiber), pineapple.
To get me to eat more, my husband makes up a bowl for me and puts a little whipped cream on it! He’s the best. I also tried drizzling w coconut milk.

good luck!!!

 

[ReluctantHippy]

Hey Lesley I’m in the same country as you! I’m SO sorry you’re suffering, you poor thing. I have mine in a week (private) and I’m terrified. I really hope you feel much better very soon

 

[YogaLesley]

Hey Lesley I’m in the same country as you! I’m SO sorry you’re suffering, you poor thing. I have mine in a week (private) and I’m terrified. I really hope you feel much better very soon

Reluctant hippy, don't be too put off by my experience, I seem to be unusual in the excess pain I have had, I have just been told by the care assistant that a lady in the next ward is managing on just paracetamol. On the other hand a lovely American doctor I saw yesterday said my pain management wasn't 'what it should be'! Don't be afraid to ask what your pain management plan is, i.e. what you are going to be on and when you can have it. There should be something for breakthrough pain too which you need to ask for when you need it as they won't volunteer it. My US doc also agrees with me that I have a secondary problem which is either nerves or muscles, so they are trying me on amitriptyline for nerves first. I think the trouble in the Uk as someone else said, is that the quality of care is quite random snd depends who is on shift. Continuity isn't always a strong point. However as you are going private, that should be a lot better. Having said all that, I AM getting better and may go home tomorrow. Day 7 is very unusual you will probably sail through and be home day 2 or 3,4 at the latest. I waited too long for the op and Covid prolonged it, hence the problems I think. Good luck xxx

 

[ReluctantHippy]

Well thank you for being so kind to reassure me. I just thought what a lovely woman trying to make me feel better when she’s the one in recovery. Must be a Welsh thing! Thank you. I wish you nothing but happiness, light and healing xxx

 

[YogaLesley]

Day 8 and finally got home yesterday, after mix- up with medications, no MST (12 hour morphine tablets) and no oromorph ( liquid morphine for breakthrough pain), just my old tramadol/paracetamol tablets which had never been discussed at all! Eventually after pointing this out, it was corrected, dr who prescribed hadn't even seen me! But my lovely New York doctor put it right!!!! I left, an hour late, one hour car journey home quite uncomfortable. Lovely to get home, partner had lit the stove, chair had raisers fixed and is much more comfortable than hospital chair. But I felt whacked having done quite a bit of walking several times round the ward. Best thing though was managed to get my hair washed - partner stripped off and got in bath and I just leaned over bath a little way using our grab rail and he used shower head to wash my hair.!!!!! Now that's love !!! Bliss !!! I got to bed about 8ish and had a tricky night having to go the loo a lot and pain coming back every time. Today felt a lot more pain but thought maybe that was because I did quite a lot relatively yesterday? Have taken all meds and the awful muscle/nerve cramps are just beginning to subside 3 hours in (11 a.m UK). Uncertain about too many isometric exercises, especially for thigh as they seem to make pain worse, perhaps I'll leave them for today and let things settle down? Guilt plays such a big part in all this, that you are not doing as much as other people, still have pain, even with meds, so not feeling as great as everyone seems to think I should be feeling!!! Am I alone in this?

 

[subie2021]

I'd bet my front teeth that you aren't alone in your feelings about recovery!
It's easy to get caught up in a sort of competition mindset in regard to how much we can do and how soon we can do it.
But remember, this is *your* recovery, no one else's. Who is there who is so important that we need to impress? You can't really control your body's reaction to traumatic surgery, the pain killers, and post op activity. In my opinion, it's a go with the flow thing most of the time - if I'm sore or tired, I rest. I do my PT exercises but push very gently. It took me years to fall apart to this extent, so I don't expect to put it all back together in a few weeks.
There are days I can do everything the PT asks, and days when I tell her enough is enough. No sense in overdoing it just to be compliant or tough, as the case may be, only to be set back by pain and sit around in misery for days on end.
Best wishes for a comfortable and complete recovery. You - and we all - will get there eventually

 

[djklaugh]

@YogaLesley From what you've written here it sounds to me like yesterday was rather an ODIC day (Over Did It Club)! Plus you are just one week out from having MAJOR surgery. Who is this "everyone" of whom you speak??? Did any of them have a hip replaced? Even if yes were they your age when that happened? I would bet they really have nothing to compare with what you've been through.

So - take it easy in body and mind. Ice, Elevate, take your pain medications, and REST!!! As for the exercises you were given in the hospital -- do them when you can but not so vigorously as to cause you more pain.

Expect to feel tired - expect to have some pain that will lessen as time goes on. Expect to have less interest ( for a while) in your usual activities. These too shall pass. Nope you are not alone!

 

[YogaLesley]

I am having similar problems, I have literally 'lost my thread'!!! How do I find it? I can find some of my comments on other people's threads but not my own! Help