THR THR Posterior - Slowly Healing

[flamingoprint]

@flamingoprint I am still like that. I scan my area-even the kind of cushions that are on chairs-bc the cushioned ones feel much better-lol. I’m very aware of my surroundings & I certainly do not wish to be out Christmas shopping right now. Thank goodness most of that is taken care of. I think I’d have some serious anxiety.

After two weeks of going out without any aids and walking 'normally'(and having some quite scary moments in crowded places) , because of pain issue I've had to go out the last week with a stick (and a bit of a limp) - and the difference that makes is amazing! All of a sudden people give you space(and consideration) ..And start asking if you've had surgery! (No one except close friends realised before which felt a bit weird as I wasn't in a 'normal' headspace yet). So actually recommend taking a stick out for a while just for that.

 

[Layla]

Me too. I've been out a few times and get quite nervous in crowded places - people bumping you and stepping out without looking, children and dogs suddenly getting under your feet...Find I need to keep a bit of safe space round me.

Ladies, in these early months of recovery, which it still is, there is no shame in bringing a cane along and using it in stress inducing crowded places, even if you no longer are using it daily. It is a clear signal for people to steer clear of you and give you space, which we all naturally do if we see someone using an assistive device. It's not cheating, regaining confidence in yourself and your abilities post op is also part of recovery.

 

[Phoebie]

At my 4 month mark I flew to my son's house in Texas for a week or so. I was using a cane & was ok getting through the airports. As soon as I walked in the airport in Boston & they saw I was using a cane they asked if I wanted a wheelchair. No thanks, think I'll be fine & I have to sit for 4 hours on the plane so walking at that time seemed like the right thing to be doing.
See if you can get an aisle seat that way you can get up & move around a bit.
Hope you have a safe & wonderful time.

Thanks, I have booked Special Assistance because getting to the gates at Heathrow T5 requires the training of an Olympian. Also, I don't want to be standing for too long in queues. I have my own booth on the flight so I can use the bed if I want and get up and wander around without annoying people. I shall relish this level of luxury* as it is not a long term option.

*It is BA so the luxury is relative. Better than some but a lot worse than others. Crew is always lovely though.

 

[msart]

Uneventful day today, which is OK!! I had a GREAT day Sunday and I am thankful for it. I probably did too much Sunday but it was worth it-bc I felt so good!! I am hoping tomorrow I am going to feel good. I’m crossing my fingers that it’s every other day now. It’s cold here in Louisiana, and I don’t think my new hip is a fan.

One question for everyone-I have a dental cleaning coming up this month & my surgeon is calling me in some antibiotics. Any thoughts or advice on this? I am curious to if this is standard with a joint replacement or it is up to surgeon? This is my first trip to dentist with my brand new hip!!

 

[mendogal]

It's quite variable and ultimately up to your surgeon.

The American Dental Association in 2015 issued a statement that routine use wasn't necessary in most post-artificial joint folks; people who have had prior complications with their joint implants or are immunosuppressed should be considered for antibiotic prophylaxis by their surgeons.

In common practice, it seems like most surgeons are highly risk-averse and take a firm "better safe than sorry" approach - some for the first year or two, some forever.

It's definitely an individual physician-patient decision.

 

[myglasshalffull]

Re: antibiotics for dental work:
My ortho said first two years to use them when having a cleaning or any other dental procedure. Many say lifetime, others say none, so I did the first two years.

 

[Phoebie]

I have never heard of this and cannot find it in any of the literature I was given. That said, you have to beg for antibiotics in the UK. They are so concerned about antibiotic resistance through over prescribing.

 

[flamingoprint]

The surgeon who did my first hip (16 years ago though) told me I should always, without exception, have antibiotics with any dental procedure. My dentist refuses - and. I think their professional body (whoever that is,) took a decision on this and definitely won't give antibiotics if there's no infection.

 

[Phoebie]

And in the UK GPs cannot prescribe antibiotics for anything in the mouth. This is dentist territory. I found this out when three weeks into the first Covid lockdown I had a tooth infection. We had no dental coverage in the UK for the first 18 weeks of the pandemic. My GP refused to prescribe for my mouth. Eventually I tracked down my dentist - he was not allowed to open his surgery so he was decorating it - and he issued a prescription. Whew.

I just do not understand the association between having a hip replacement and needing antibiotics for all dental work. I would love to know the answer.

 

[benne68]

I am curious to if this is standard with a joint replacement or it is up to surgeon?

As you can see from the other replies, it depends upon your surgeon and your dentist.

In my case, my surgeon recommends antibiotics for any dental work during the first six months. My dentist, however, insists that his patients take it for two years post-op because he doesn't want to be at fault if someone develops an infection.

I recommend checking with your dentist.

 

[flamingoprint]

As it was explained to me, any infection that can enter your blood stream can then travel to an implant in your hip and cause infection. Someone correct me if I'm wrong but I think infection on/around the prosthesis is one of the main causes of THR failure.
Apparently dental infections are one of the most likely to enter the blood stream.

 

[flamingoprint]

That said, my first surgeon was adamant about having them and my dentist is equally adamant about not giving them!

 

[Hip4life]

The answer is fairly simple. When getting dental work, it's very common for small injuries to the gums. They are very vascular and doctors worry that bacteria can be introduced into the bloodstream. This is of course, is much more common in more involved procedures but could happen at any time. If bacteria does get into the bloodstream, and your body doesn't counter-man this, it could find a new home in the new joint replacement. The chances of this happening are low but not zero.

As above, every surgeon has their own protocol. My surgeons, even in the same practice, have ordered antibiotics for me before dental procedures ranging from two years to life time. This doesn't really bother me because it is only four antibiotic capsules 1 hour before the procedure. I figure four capsules every six months or so is not going to create a problem, so I don't hesitate in taking them. My dentist takes over the management of the antibiotics so it's very easy to make sure I have them before dental work. If this is a big issue for you, then I would discuss it with your surgeon and dentist, as you need to be comfortable with it as well.

 

[benne68]

Someone correct me if I'm wrong but I think infection on/around the prosthesis is one of the main causes of THR failure.

According to Hospital for Special Surgery (the leading orthopedic hospital in the world) the top three causes of "failure" requiring hip revision are:
1. repetitive (recurrent) dislocation of a hip replacement
2. mechanical failure (implant wear and tear – loosening or breakage)
3. infection
That said, THRs have a higher than 90% success rate.

 

[Morgan Le Fay]

@benne68 I can not WAIT!! This has definitely been a challenge, for sure. I am thrilled with these milestones lately.

@msart

I am SO happy for you!!
Congratulations.

 

[msart]

@mendogal, @myglasshalffull, @Phoebie, @benne68, @Hip4life, @flamingoprint
Thank you all for the responses on antibiotics for dental work. I have an unusual case all the way around. I’m in Louisiana and my surgeon in Texas-thankfully my Dr’s-dentist included has said whatever your surgeon says goes and we will call in. That said my surgeon recommends it. So my dentist is calling in for me. I am also on Cellcept-an immunosuppressant for my RA-rheumatoid arthritis, so I am sure that is included in his decision. I have always healed on schedule which is a huge blessing. I have read that people on immunosuppressants do have to take antibiotics for the rest of their life, I do not want that!!! I also do not want an infection in my blood, body or hip!! Prior to this surgery I had planned on having some extensive periodontal work, I have however tabled that for now. I can not handle any more trauma to my body this year. Thankfully not an urgent matter. Maybe a never matter!!

Interesting to me that the UK has completely different ideas on this topic. Things that make you go hummm…

 

[Phoebie]

I made the mistake of Googling this question and I now have 15 different answers. I was thinking that if it is to avoid infection then surely it could apply to something like a cat scratch or maybe if your pedicurist is over enthusiastic and breaks the skin etc.

@msart I agree that now is not the time for anything major. Enough! But you may think differently in a few months time. I am sure there becomes a point where our hips do not dominate our thoughts. I hope.

 

[msart]

@Phoebie the google dr we will all die if we google long enough. Crazy!!!

Agreed. And MAYBE there will come a time where our hips don’t dominate but right now & since I got home from hospital-first thing I think about is how will my hip do in this situation... Today it’s freezing cold & rainy & in Louisiana our bodies are already not accustomed to it and my new hip ( I’m actually thinking she needs a name) is really not a fan. I think the afternoon will be spent with my dog under the covers with Netflix. Oh what an exciting life I lead. I actually picked up a bottle of wine yesterday at the store-but have had zero desire to have a glass, maybe for Christmas.

 

[Phoebie]

I have been out and about again today. Sat having coffee with a friend at home this afternoon and when she left I got up and boy was I stiff. An afternoon of rest and now I am icing. My brain is willing.........

I love a glass of wine or cocktail, but I know what you mean, no appetite for it.

I mentioned the dentist thing to my friend today and she was not aware of the rules for hips but her mother is currently having treatment for cancer and her dentist was totally up and on it. Took all the details, made the preparations and any medications needed. I guess it is similar. I mean, that medical questionnaire they make you complete every time is pretty extensive.

I also remember getting antibiotic shots whilst in hospital. Nothing mentioned about afterwards. I shall stop stressing and just mention it to my dentist next time I go in.

 

[msart]

@Phoebie-twins!! I also did too much today, currently icing & elevating. My mind also-just wants to be there!!! My body just not ready yet-keyword YET!!

Yes! I had many antibiotics in hospital & even when I got home. But I also had a uti (probably from cath), so idk if they were looking at that. I don’t think or remember really if I had some at home-I was heavily medicated as I had to be to survive a 5 hr trip from Texas to Louisiana. Much of that and following week are a blur. My parents & friends have filled me in-lol.

Don’t worry too much about it unless u have a dental visit within first 6 months of surgery. And call ur dentist at least a week before, just in case they want them. From what I understand-some do & some don’t. So really who knows. Do ur best-all you can do. Hope u get some rest tonight-I may take 1/2 Benedryl tonight bc I had a long nap while it was raining so early this afternoon!!!