THR There and back!

[SurreyGirl]

Lol, I know of someone else who's supposed caretaker did the exact same thing. What bad timing for the second shot! She ended up caring for him instead of getting the help she needed.

I came here to respond to your questions about MLD from another thread.. as @Mojo333 stated earlier to you, elevation has a lot to do with getting things moving, fluid wise. But you can also stimulate your lymph nodes that are located in your abdominal around and in your groin area.

Here's the sequence:

****
Take deep breaths.. deep, as in breathing in to a count of 3 or 4, whatever is best for you. hold it for another count of 3-4, then blow out completely, still using the count that's comfortable for you. A series of at least 6 of these could help get your excess swelling to move. To ensure you are taking proper deep breaths, place your hand on your naval and watch while taking in your breath, if doing this properly you should see your hand move up.

Then, as you slowly breath out, to the same count of either 3, 4 or 5 gently press down and slightly upwards with the palm of your hand.
Do this whenever you feel up to it during the day or night. The more supine that you can get in the recliner or bed, the more effective this can be.. you have lymph nodes located in your groin and sitting up too much can cause a restriction of the lymph flow.

You can, after the breathing, place your hands lightly on your upper thigh, right where the crease is in your groin and lightly stroke upwards towards your naval.
I did this quite a bit post op and while it takes a while for the body to wake up and respond, it will and it will help get the swelling moving.
The reason this can help is because many of our lymph nodes are located in our abdomen. Our breathing combined with moderate pressure over our naval can help to "prime" our lymph system.

***********

Additional notes: you can reach down to your knee and lightly stroke upwards your groin after doing the steps above. Then lastly, gently pump the back of your knee in a rolling, upward motion towards the trunk of your body, using all 4 fingers of your hand and NO fingertips pressing in..

This can be effective if done daily.. use light pressure, no deep pushing. This isn't a no pain no gain thing.

I hope this helps!!

****

I am screenshotting this. Brilliant!

 

[Layla]

Great update. Happy One Month Anniversary!
I hope you have a wonderful weekend!
@nasruddin

 

[nasruddin]

5 weeks - tomorrow visit with PT.
After surgeon visit I decided to ramp down my other pain reliever, NSAID ibuprofen, because he released
me from prescribed dosage - now "as needed".

So I ramped down over a few days to nothing, And slowly ramped up to a little bit of pain.
It's enough to be noticeable, & start affecting my walk again. It seems to subside (not completely) after
I start walking. This pain seems deep, & more towards where I think the ball / socket is, rather than
trochanter / IT (those being more typical for me).

I haven't changed activity level much - I actually did next to nothing but sit over the weekend aside from
2 short dog walks, no PT, no extra walking. I did do one day of cleaning which didn't seem like much at the
time but the garmin watch counted it as a 10k steps day, over my limit. I am experimenting a little now that
I have no limitations - I did a 10-min slow exercise bicycle trial at the gym, & a very short pool walk
(just a couple laps) - no problems at the time.

[I had already stopped using acetaminophen a week ago - I had been using that for a LONG time and figured it was time to stop using it.]

It seems like a little regression and/or a little pain would be normal for right now. I usually will ice and elevate
for a few minutes no matter what after any reasonable exercise, like those dog walks. I'm debating with myself
whether to let it ride for a day or two, or to pick up one of the pain meds (probably the aceto) again. Idling for
a few days didn't seem to make a difference.

 

[Mojo333]

@nasruddin

did next to nothing but sit over the weekend aside from

....

2 short dog walks, no PT, no extra walking. I did do one day of cleaning which didn't seem like much at the
time but the garmin watch counted it as a 10k steps day, over my limit. I am experimenting a little now that
I have no limitations - I did a 10-min slow exercise bicycle trial at the gym, & a very short pool walk
(just a couple laps) - no problems at the time.

At only 5 weeks, really is alot.... You sound like you are doing really well, but, as I found out, you can expect delayed complaints due to angry still healing soft tissue.
Patience is prescribed in large doses.
After 1 month, I was ready to move this recovery business forward...
- Unfortunately, it takes the time it takes
Sticking with the icing after activity really helped me.

 

[springs12]

I can tell you that I felt this way at 6 weeks. I haven't taken meds in weeks aside from some muscle relaxants at bedtime, but that has mostly been because my back is really struggling now. At my 6 week, I was told to still take it easy and start with a 5 minute walk in the water, hang out for 5 more, and then walk again for 5 if I felt okay. Then I have gradually worked my way up, and now nearly at 9 weeks, I am almost to 45 minutes of constant walking in the water. I am just starting to feel more comfortable without the cane, but I still carry it around. I feel like there is no shame in using it, and there is no rush to stop if it allows me to not limp so the proper muscles can strengthen. Limping creates compensations. My biggest struggle is sometimes I get sharp pains in the front/groin area when initially walking, but I attribute that to weak hip flexors. It subsides after walking. My back is my other struggle as my lumbar and sacrum are not loving this change. I also do my PT exercises bc they seem to help my back. If my back is hurting, it causes me to limp as well.

I cried at my 6 week bc I didn't feel like I was overdoing it, but they told me to take a step back, begin water walking and get some soft tissue work done. They were right. Nearing 9 weeks, and I feel much different. Kinks are still being worked out. My body is still adjusting. But, I am excited to see where I will be in 3 more weeks.

My advice is not to be overly eager to get back in the game, and stop and evaluate your body and take baby steps. When you look back, you will see the progress and will not have suffered trying to get back to life too quickly. You got this.

 

[Layla]

Hi there, I am sorry you feel like you've regressed some.

I haven't changed activity level much - I actually did next to nothing but sit over the weekend aside from
2 short dog walks,

You may not have changed your activity level much, but whatever you are engaging in may be too much at this point in time for you. The day of cleaning this past weekend that involved 10k steps was a bit ambitious, but sounds accidental. Also, it never seems to hurt, until we stop. This makes it more difficult to determine how much activity our recently traumatized leg can handle.

I am experimenting a little now that
I have no limitations - I did a 10-min slow exercise bicycle trial at the gym, & a very short pool walk
(just a couple laps) - no problems at the time.

Wondering when you did this in relation to the 10k step day because all of the activity combined may be why you're feeling as though you've regressed. The surgeon may have said you have no limitations, but clearly we do because our body is in healing mode for quite some time and unfortunately it doesn't take much for healing soft tissue to become inflamed and cause swelling and / or pain.

You can ice for more than a few minutes, so if you're hesitant to start taking the acetaminophen, try icing for a longer period of time, several times a day and see if it brings you some relief. Wishing you comfort and a nice rest of the week!
@nasruddin

 

[nasruddin]

That "angry still healing soft tissue" can be a hard customer!

The 10k cleaning day was definitely an oversite. There were a couple days between the gym/pool day & that.
It's surprising what water exercise can do to you - it seems innocuous at the time but you move
differently in water & the muscle work is different.

Good data for negotiating with the physical therapist tomorrow.

I'd like to give my metabolism a rest from the NSAIDs and tylenol ... giving this a day or two.
If the pain doesn't abate then I'll re-think this idea.

 

[benne68]

I'd like to give my metabolism a rest from the NSAIDs and tylenol ... giving this a day or two.
If the pain doesn't abate then I'll re-think this idea.

Rather than completely stopping all pain meds, you should consider cutting back slowly. It's much hard to make our bodies go "cold turkey" and pain can really interfere with the body's ability to heal.

I would suggest either reducing your dosage, or extending the time between doses. Try that for a few days, then cut back a bit more if you don't have a big increase in pain. Alternatively, you could cut out the NSAID and just take the Tylenol for a week and see what happens.

Good luck. Let us know how it goes.

 

[Hipopapotamus]

Great to hear how well things are going

 

[nasruddin]

Well let's see. I think I will finally start the PT today - it's not much different than what I was doing (but ...
the arrival of the inevitable clamshells, although really, really conservative ones). More on that after I actually
do it again (outside the clinic).

I kept having hip pains during the week, slowly subsiding, but not subsiding fast enough.
Also quite sleep disruptive.

So experimenting with a little ibuprofen before bed, starting last nite. Subjectively, my sleep was much better
and walking had no probs this morning. Objectively, the electronic devices complain about how bad that
sleep was. I'll repeat the experiment a few more days and see if this discord settles down. I think poor sleep
is starting to interfere with general healing.

I always worried in the past about ibuprofen, about how it could cover up an injury and allow you to make
it worse. I'm not sure that applies so much here. The injury is what it is already & my walking/exercise program
is mostly conservative. I don't think I'm likely to hurt anything. A 10 mile hike or leg day at the gym would be
another matter. Not today.

(There are other reasons to be wary of ibuprofen, & the digestive ones I have also experienced a bit
of in the past month - never before.)

 

[Layla]

Hello and a Happy Sunday to you!
This is your recovery to navigate as you see fit, but I hope you don't mind a few words of caution.
Clamshells can be especially hard on the IT band. Please keep in mind that it is not necessary to exercise your injured hip to promote healing. The controlled trauma sustained through THR will heal on its own. Often though, we're impatient and want to move the process along. In doing so we run the risk of struggling with pain and setbacks stalling the healing process. The best therapy for recovery is walking, but not to excess. Start slowly, increasing time and distance incrementally in an effort to keep from overdoing it and you will reap the benefits of a successful recovery.
Have a great week!
@nasruddin

 

[nasruddin]

Trying to keep it balanced - a little ROM, a modest amount of walking & water work. I figure that if my perception of pain or need for ibuprofen goes up I’m over the line & otherwise I’m ok to do whatever it is I’m doing.

The problem for me is that reactions to exercise are delayed by hours or a day.

I m not too sure about the mini bridges or mini clamshells but PT’s advice to just try a couple each time seems reasonable - so far.

 

[Hip4life]

@nasruddin At just 6 weeks out, you are doing so much more than the average bear. Lol. These ups and downs are going to be with you for a while as those soft tissues really do take time to completely heal. Healing can continue through a year or more, all be-it in less and less dramatic form. It is going to take them longer if you stress them more than they are able. As you have discovered, it sometimes doesn't show up for a day or two later. Patience sometimes is the hardest muscle to train right now. There really is no need for strength training any of these muscles and you run the risk of tendonitis if pushed too far. Just a cautionary tale as you are the captain of your recovery.

I also wouldn't get too concerned about the sleep quality right now. It is always disrupted by major surgery, drugs, change in routine, and the aches and pains that occur with the stiffness of newly traumatized tissues. If subjectively you feel like your sleep was okay, then go with that. All of this will right itself in time. The information from our various devices is just a small piece of the puzzle and they don't know the complete story right now.

You sound like you are doing very well and are on a normal recovery path. Just give yourself a little more time and gentleness and that will hold you in good stead. Blessings for continued good healing.

 

[nasruddin]

I feel I am very fortunate. Great surgeon, great team, work done at a center of excellence, great home care.
So far no real problems. Lots of learning and relearning, for better and worse.

I am watching a friend go thru knee surgery recovery and does that ever look like a real marathon.
Same background (different surgeon though). They are kind of depressed by the slow recovery
(I think they are probably "on schedule" so far.) We hip patients may have it a bit easier, in general.

 

[Layla]

Glad you're doing so well. Sounds like you are very pleased with all. You're blessed.
Happy Two Month Anniversary! I hope you have a great week.
@nasruddin

 

[nasruddin]

How can it be three months!
Everything is so different.
I can remember the pain, the lack of mobility, and the last few really bad weeks ... and then it was done.

I have learned that chronic pain is like a steady drain, a tax on your resources. Once it's relieved, or reduced, you can find a whole lot more energy you must 've been expending on coping.

Good news - the slow but steady PT & gentle yoga I have been doing seem to be paying off. I am mostly pain free - I notice some discomfort when I test some range of motion things, or stand a lot (like, hours). The pain I had in the outer trochanter or along the IT area seems to be mostly gone.

My walking gait is much better

I can generally do anything I want

I was able to participate fully (mostly) in our bird migration survey - I couldn't quite do what I used to do, but with some help and some rigging up of rolling carts I was able to cover it, & we really needed it, we had a very heavy migration season that is still winding down.

Some works in progress -
Squats. We are working on this slowly and gently in PT, & I think it helps, but I hate them. It's clear the left (operated) leg lacks a lot of strength it needs.

Range of motion while a lot better is still lacking on left side

Still some numbness on upper / outer left thigh - it's always changing. I think I continue to recover some nerve sensation there, I guess this just takes a long time (& I don't know what the endpoint will be).

It's really hard to get that last part of the walking gait corrected. I think I really need to keep on this, because I think the asymmetric walking was hard on the right side & I have some plantar fasciitis-like symptoms on the right foot.

I have been "prescribed" gentle hiking on irregular terrain, but it's been hard to get to because of the survey work (altho I get a little bit of it there anyway). I hope I don't run out of good weather before I can do more.

I've been continuing acupuncture but I'm not sure of its effect at this point - I'm hoping that at least it helps with general healing and system improvement. Can't hurt.

At a friend's recommendation I went to see her craniosacral therapist - expensive, but I definitely notice things from it. It's even a little quantifiable - I can see the relaxation response in my fitness watch. In the last session, for instance, I noticed an immediate improvement in my forward fold range of motion the next day. Therapist notices a lot of lower back tension and reduced mobility which is most of what he is working on with me, altho that last session was focused on the left hip and thigh (he thought we were far enough along in healing that it was appropriate). As I said it's expensive and skepticism is warranted but I suggest people in recovery consider trying it.

Now that I have a little time I'm going to look for some kind of feedback mechanism for walking gait (there are things for running but often they don't work properly or at all for walking). If anyone has any recs I would appreciate it. I have sort of fixed the gross limping most of the time but I need something else to get more refinement.

So far so good - grateful to be living in this age of miracles.

 

[CricketHip]

Wonderful update! I agree about living in the age of miracles.
So happy for you and in fact for all of us!