THR THR - One year on

Jan 2, 2023
United Kingdom United Kingdom
Day 1 - operation day. Arrived at 7:30 having followed all the pre-op instructions regarding antibiotic showering (5days), carbohydrate drinks (2 the day before, one on the day at 6am), fasting. A phone call from the hospital the evening before freaked me out because I thought they were going to cancel because of the weather (snow, ice, minus temperatures) but they were just checking I could still get there. Three bowel movements the evening before and another four that morning while waiting to go into surgery. I won’t need to worry about constipation for a few days.

Once in hospital I was dressed in a hospital gown, special knickers and little red socks with non-slip rubber strips and various doctors and nurses appeared to do obs, take blood, measure me for a zimmer frame, fit a cannula to the back of my hand, give me useful equipment like a shoe horn and a grabber, sign consent forms, draw an arrow pointing to my right hip and discuss anaesthesia.

Walked down to theatre behind the bed at about 11am, very chilly.

Sat on a bed with feet up in a kick stool while the anaesthetist felt about for the right place to insert the spinal block. Paracetamol into the cannula followed by an icy spray in my back that made me jump, then local anaesthetic injected around the site of the spinal block which felt like little tiny electric shocks, then the spinal which I didn’t feel other than a bit of pressure and my legs started to tingle and feel warm and I was helped to lie in my side I heard them say they were putting a sterile patch around where the cut would be and they must have sedated me at that point.

Came round in Recovery just after 1pm and couldn’t stop talking, no idea what about.

By 2pm I was sitting up in bed with a cup of coffee and some biscuits and inflatable cuffs on my legs.
A bit of a blur but late in the afternoon when the feeling had come back to my lower half I needed a wee and was helped out of bed and onto the commode. I had wet the bed as I was told I probably would but the special pad had soaked it up. I suddenly came over all faint and needed oxygen, an open window, fanning, a wet towel on my forehead and three nurses to get me back into bed. Low blood pressure. Fluids, antibiotics and oxycodone given via the cannula, paracetamol and ibuprofen orally.

My partner came in that evening to say hello and I spoke in the phone to my three children. Sent messages to friends. So far a bit of discomfort of the type where you’d adjust position but no pain.

A bit of a lack of appetite but trying to eat and drink something. Didn’t sleep very well, the regular obs, meds, inflating cuffs all contributing factors.

Day 2 - blood pressure still low and another fainting episode on the commode but a successful one later wearing oxygen. Physio came mid morning to do some bed exercises, standing exercises and a short walk leading to feeling faint again. Feeling hungry but when food arrives I pick at it. I made it to the toilet today with oxygen, still felt a bit faint and my hip hurt afterwards.

Was helped to do the blood thinner injection myself. Asked about tablets being a bit in the needle phobic side but my consultant prefers the injections which I will be doing for a month! A bit of reading, lots of napping, a wet wipe bath and my own pjs.

Day 3 - still feeling faint and sick every time I try to get up and threw up my breakfast. Anti nausea medication given and that helped a bit. Physio exercises. Managed the loo mid morning without fainting or sickness. Taken to X-ray to check position of implant. Short walk down the corridor and some more exercises. Lots of gurgling in my stomach suggests things are getting back to normal. Pain being managed very well.

Day 4 - cannula removed, managing bathroom and getting in and out of bed in my own. Walked the corridor in sticks instead of frame and did the stairs. All ready for going home. Nurses striking today. They totally have my support although in fact I haven’t been affected yet. Beginning to eat a bit more at mealtimes. Pharmacist brought a big bag of meds to take home with what felt like minimal instructions.

Getting in and out of the car is a knack but easier than I thought with the cushion in a plastic bag trick. Went straight upstairs for a lie down! Minus 10 degrees tonight so I wrapped up warm. Took codeine as well as ibuprofen and paracetamol but it gives me horrible dreams.The raised toilet seat is a godsend.

TOP TIP for at home. We have sofas everywhere rather than armchairs and I was contemplating buying an armchair. However, we have some rather old plastic garden chairs that we cleaned up, covered in throws with a couple of cushions, placed in different rooms and they have been brilliant.

Day 5 - at home. Not sleeping more than a couple of hours at a time. Still need the bathroom every couple of hours. Leg feels very heavy and a bit swollen and bruised but paracetamol and ibuprofen are enough to keep the pain under control. Doing my exercises three times a day and walking up and down the corridor in the house. A beautiful sunny day but icy. My appetite is returning, perhaps it’s the home cooking helping. Lots of naps. Finally had a bowel movement, the stool softeners helped. Then had three more during the evening! Dropped the codeine.

Days 6 - 9 stitches pulling a bit and a bit itchy, otherwise all good and similar to day 5 except now doing 20 of each exercise. Dry shampoo a godsend and strip washes. Haven’t ventured into the shower yet. Tailbone a bit sore from sitting in bed. Some visitors - niece, daughter, granddaughter - to break up the day.

Day 10 - the solstice - a bit of tidying up, exercises going well except for one which I need help with. Continuing with a jigsaw puzzle, reading, sleeping, walking. Made some lunch but needed help to carry it to the table. I have a shoulder bag I use for carrying stuff up and down stairs. Friends dropped in for tea and cake mid afternoon which was lovely but I needed a rest afterwards.

Day 11 - more friends visited. Managed all the exercises by myself today. Physio appointment and wound check. Getting in and out of the car and walking all went smoothly. All going well. Still only sleeping in short bursts, still needing the bathroom every couple of hours.

Day 12 - first proper walk outside to deliver Xmas cards and stopped to chat to a neighbour. My phone registered 350 steps. More of an urge to turn over in bed at night but I am sticking to the cushion between my legs, lying in my back rule. For some reason, snuggling my head into a pillow on the right side helps. My son arrived home from London for Xmas and my niece, daughter and granddaughter came over for an early dinner. I was tired when they all left about 7:30.

Day 13 - 498 steps. Ditched the ibuprofen today without any ill effects. Made vegetarian gravy for tomorrow. Lots of chopping and stirring. Needed help to carry stuff from one place to another.

Day 14 - end of week 2 - Xmas Day. 6 adults and one child. 791 steps registered. A lovely breakfast (croissants and buck’s fizz), a walk (not for me), a lovely vegetarian Xmas dinner), presents, board games, less work than usual for me. I even had a glass of wine. A very excited granddaughter. Spoke to my son in Vietnam who was in the process of booking flights home for a holiday here in May. Was very tired after a busy day and a bit sore so I added the ibuprofen back in.
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@Gloucestergal65 Welcome to BoneSmart and the other side of surgery. Goodness, you are very busy for so early out. Please do try and limit your activities and visitors - hard this time of year I know. Nap when you can. And at this stage, don't worry about how many steps you take during the day. You are healing - not training.

Here are some recovery guidelines for you:

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:
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

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.
Week 3 - still doing the exercises 3 times a day and getting out for a walk every day. Graduated from 1160 steps to 1254 steps a day and beginning to use reciprocal walking technique. Can manage with one stick at home to very carefully carry a cup of tea fro one room to another but mostly using two. Sleeping in longer chunks, not needing the toilet as often. Boxing Day visitors but very quiet after that. Occasional use of meds if needed eg for staples out and irritation of scar against clothes or shoulder pain caused by pressure on stick. When the shoulder pain came in I was out so I returned home pretty sharpish and quite painfully. The meds eventually helped it settle that day but in the morning it was so painful that I had to be helped to sit up. I had a good cry, started to take the painkillers regularly and over the next couple of days it has eased. I notice that I sometimes tackle the stairs unthinkingly and not following the recommendations, a sign of improvement in a way. Slept through New Year’s Eve although vaguely aware of fireworks. No partying for me this year. Enjoying watching tv, reading, jigsaw puzzles, chatting with friends and family, short walks, a bit of housework and cooking. It’s a bit like being on holiday. Except everything takes so long. Leg still a bit stiff and swollen. Scar still itchy but not irritated.
A big thank you to bonesmart and it’s contributors. I am now at the beginning of Week 4 and I have used this forum regularly to get answers to questions and for reassurance. You have been brilliant.
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I have a question. Not sure if this is where to ask it. I can hear my knees creaking when I do gentle squats. Does anyone know why? Is this a problem others have had? Is this a sign of arthritis in my knees?
I can’t answer that about gentle squats either, because I didn’t attempt them until much later into my recovery.
The knees experience stresses from this surgery, too. My knee and my ankle both were swollen and painful for at least the first maybe 3 months.

Would you be so kind as to post your surgery date with which hip was replaced?
Then our moderators will make you a signature that includes your surgery details.
It is a very helpful reference to others reading your thread.

You are doing well! Congrats! :yay:
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Part of the exercise regime I was given by the physio. I started the regime a few weeks before the operation. When I say ‘squat’ I mean a ‘mini squat’ as if sitting down and standing up again, but holding onto a rail or chair. I’ve been doing them since day 1 and have built up to 20 at a time, 3 times a day. There’s no pain, just a creaking noise from my knees.
I know you don’t necessarily advocate physio exercises but I had already been doing them before I found you, with no ill effects.
Not a criticism, just curious as to why you were doing squats, not sure how advantageous these are, that's all, and here we do not judge, you do what's within your comfort level, so I apologize if you feel offended in anyway.
Everything posted here are suggestions and experiences and most hips don't require anything strenuous to heal.
However, if these gentle squats are part of your recovery regimen and you are enjoying it then by all means do your thing.
@Gloucestergal65 It's my understanding that painless noise from joints can be from the release of little gas bubbles in the surrounding tissue. If that's the case, then the noise is normal. Some advise a more effective warm up to help eliminate it. Maybe you can start your reps with some shallower squats and see how that goes? Ask your physio about other warm up moves.
I enjoyed PT after my THR and continue the exercises by myself at home, more than a year post op. I found it really helpful both physically and mentally. I think the concern by some here, including myself, is that some physios push their patients way to hard and/way too fast, and some patients feel that they must comply. There are also hippies who feel the need to be PT all stars and push beyond what is good for recovery.
What worked for me is that if it hurt, stop. If it hurt later in the day or the next day, don't do that anymore/introduce it slowly later.
Listen to your hip, it's the boss of you for now :wink:
Thanks for the responses. I didn’t feel offended at all and I will continue the exercises because I know I can already do more of them for longer already and it is helping me to feel stronger. They are not at all painful and I don’t feel pressurised into pushing too hard. I appreciate your comments and all the advice I have received from this forum.
Noise from the knee joint usually isn't a good thing. Years back mine made noise which lead to surgery for cartilage repair and it had arthritis also. If doing squats be sure you have your butt out and toes can wiggle as all of the weight should be on your heels.

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