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Revision THR Triple Hippy- Revision smoothly over<

Mojo333

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-What if its not strain and something else related with the technical aspect of the operation? I don’t think so but what if...?
This is what causes all of us anxiety...but this is a very common complaint @sansabosa.
It is one of the reasons we caution about overactivity...and it IS easy to overdo. We have to work up to things slooowly. I learned the hard way a few times as most of us do. It's a dance ...we do a little bit too much - feel it, and have to back off...then try it again to a lesser degree.
Most probably it is iliopsoas strain but I am worried if it becomes chronic..
Most probably.:yes:
I get that because this is a revision, you are probably not confident yet that all will be well. All the more reason to give it extra time, in my opinion. I know you are ready to get on with life...but you will get there.
Sending good Mojo your way!:roseshwr:
 

Mojo333

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Josephine

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I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?
 

Josephine

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Here y'go then!

It would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are

1. what approach did you have for your surgery? Anterior, posterior, lateral? You can look here to see the various types THR approaches or incisions

2. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't forget to factor in other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness).

3. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

4. are you icing your painful area at all? If so, how often and for how long?

5. are you elevating your leg. If so how often and for how long?

6. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

7. are you doing any exercises at home? If so what and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)

Exercises done at home
- how many sessions you do each day
- enter exercise by name then number of repetitions of each
etc., etc.

Anything done at PT
- how many times a week
- enter exercise by name then number of repetitions of each
etc., etc.
 
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sansabosa

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@Josephine
Please find below my answers:
1. L-THR Revision 2 months ago is posterior (L-THR 20 yrs ago was posterolateral)

2. Pain level 5-6 since a couple of days

3. Post op first 3-4 weeks I was given the following:
Meloxicam (Zeloxim fort) 15 mg, twice a day
Paracetamol/cafein/codein (Geralgine-K) 500mg/30mg/10mg, twice a day
Tramadol (Contramal) 50 mg, once daily
Pregabalin (Lyrica) 25mg, once daily
I used the above religiously on time for the first 3 weeks and my pain level was 2-3
However, I dropped Tramadol and pregabalin 3 or 4 weeks post op and gradually decreased Meloxicam to once daily plus Paracetamol 500 mg once or twice daily between 4-7 weeks post op and I nearly stopped all since 1-2 weeks. However I have been taking Meloxicam once daily and Paracetamol 500 mg twice since a couple of days

4. The first 5-6 weeks I was icing for about 30-40 minutes religiously for every 3 hours during the day time, posterior area
The last 2-3 weeks, nearly none and I did not have pain nearly
Since a couple of days, icing every 2 hours for 30-40 minutes the groin area
Currently icing again

5. Elevating continuously while sitting

6. Activity level is low, no house work etc just walking in the corridor for activity purpose and counting my steps and in good weather 15 min of walking outside.

Started pool about 10 days ago, The first two visits was just 20 minutes of soft adaptation, yet the last one was more exercising, drills and cycling back and forth for 40 minutes, placed the physio rubber between my ankles and walked sideways. Probably overdid, the following day I had groin pain. I iced and rested for one day, it passed. The following day I had to sit upright between 9:00-16:00 for a meeting And the pain is back again. Currently I have not started work and have been working from home sitting in my recliner, elevated legs.

7. My physiotherapy was between the 3rd-6th week post op at home once or twice per week, total of 6-7 sessions which is over since 3 weeks by now.

I am not doing anything extra physio by myself
Just walking between 15-45 minutes of total/day, 1500-2000 steps per day in intervals..
Have been walking with 1 crutch post op 8th week

I hope the above helps
Looking forward to hear from you
 
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Josephine

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2. Pain level 5-6 since a couple of days
Okay .....
3. I dropped Tramadol and pregabalin 3 or 4 weeks post op and gradually decreased Meloxicam to once daily plus Paracetamol 500 mg once or twice daily between 4-7 weeks post op and I nearly stopped all since 1-2 weeks. However I have been taking Meloxicam once daily and Paracetamol 500 mg twice since a couple of days
Considering your level of pain, I would suggest you take a sensible dose of paracetamol which is 1,000mg 4 times a day at 6hrly intervals. The safe daily maximum is 4,000mg although you would naturally remember to subtract any paracetamol in any other medication you may be taking.
I further suggest you don't take any more Meloxicam as it is an NSAID which is a very poor pain medication and in addition, has several other unpleasant side effects
Medications: acetaminophen (Tylenol, paracetamol) and NSAIDs, differences and dangers
NSAIDs Diclofenac. ibuprofen increase risk of heart problems: new study

If the paracetamol is not sufficient to manage your pain, then you should consider taking Tramadol as well to the amount of 50mg 3-4 times a day. This can safely be taken with paracetamol.
4. The first 5-6 weeks I was icing for about 30-40 minutes religiously for every 3 hours during the day time, posterior area
The last 2-3 weeks, nearly none and I did not have pain nearly
Since a couple of days, icing every 2 hours for 30-40 minutes the groin area
Currently icing again
The wisest way of icing is 40-60mins and more than 4 times a day.
5. Elevating continuously while sitting
Make sure you are elevating correctly, like this Ice to control pain and swelling.
6. Activity level is low, no house work etc just walking in the corridor for activity purpose and counting my steps and in good weather 15 min of walking outside.
Good
Started pool about 10 days ago, The first two visits was just 20 minutes of soft adaptation, yet the last one was more exercising
Pool work is nice but it's easy to overdo it. Make sure you don't do too much.
My physiotherapy was between the 3rd-6th week post op at home once or twice per week, total of 6-7 sessions which is over since 3 weeks by now.
I am not doing anything extra physio by myself
Just walking between 15-45 minutes of total/day, 1500-2000 steps per day in intervals..
Have been walking with 1 crutch post op 8th week
Do make sure you adhere to this protocol:
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.
 
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sansabosa

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Thank you @Josephine
I’ll increase my paracetamol dosage. Indeed I’ve been icing longer intervals of around 40-60 min 4 times daily since 2 days...
I can’t figure out whether it’s the pool or sitting upright for a couple of hours caused this pain in the groin. Haven't been in the pool since a week now, kind of cautious...
Should I be worried and check with my OS?
Actually pain kind of dropped from 5 to level 3 after 3 days of complete rest, pills and icing...
 

Layla

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Hi @sansabosa
Wondering how you're doing?
I hope you're pain is easing. Let us know how you're feeling when you have time.
Wishing you comfort and a great rest of the weekend!
 
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sansabosa

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Thanks @Layla
I am much better now, pain has eased, it was muscle and oedema pain basically.

Today was my 3rd month post op visit. The OS found my Xray, muscle tone and ROM pretty well. I am still with 1 crutch/cane (at home) and he mentioned that you will drop it when you feel ready soon. Next check up is 3 months from now, at 6 month post up.
I raised him about the pain I had in the medial part of my knee, which has been going on for 6-8 years now and probably is the reason why I can not leave the crutch yet...My question to him was about which strategy to follow, whether to get unicondylar knee replacement and hopefully be hospital free for the next 10 years (?) or hang on until it is unbearable and I get TKR...
My frustration is that after all the osteotemies in childhood and younger ages of my life, I had my RTHR 6 years ago, LTHR 20 years ago at the age of 35 and now revision 3 months ago...while I am in ''repair and maintenance'' period, I want to get over with all the barriers and want to walk limitless, travel and enjoy the next 10 years of my life... My hips are now ok, almost ok in a couple of weeks, but I still can not enjoy walking due to the sharp pain in the medial section of my L knee and this pops up again since I started to become more mobile and not using analgesics any more.
The OS checked my eligibility for UKR with special Xrays and he said it is doable and up to me to decide when to have the operation.
Now I will reflect on it a while and then decide, probably listen to my body and see.

Any thoughts, experience sharing, suggestions are welcomed about unicondylar knee replacement soon after this recent hip revision...
 

Mojo333

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Hi my friend. I hate this knee thing is hanging you up.:console2:
Maybe you could get a start on the pre-op side of the knee groups and get some feedback?
You have done it all with such grace and optimism...I wish I could give you clarity about what is best.
I am still sending you all the best!
 

Layla

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Hi @sansabosa
It's good to read your muscle and edema pain has eased.
I'm really sorry that your latest recovery is being overshadowed by a knee issue.
If it's inevitable that you need a surgery to function normally and move forward without pain, I'd consider it, if I were you. You can always ask Josephine's opinion on an ideal time frame between your hip Revision surgery and the unicondylar replacement you're contemplating.
Wishing you comfort and also clarity in making a decision.
 

Layla

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Hi @sansabosa
Dropping by to wish you a Happy Four Month Anniversary.
I hope you've been doing well since you last posted.
Wishing you only the best as you continue healing.
Have a great weekend!
 
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sansabosa

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Hi @Layla
Thank you so much for thinking of me.
Indeed I am much better. However, revision surgery recovery has been slightly different than the standard THR, a bit longer. I am still walking with aid, with a small cane but I think this is normal for hips that have gone through numerous surgeries since childhood...
Spring is in the air, I believe I’ll be in shape by the end of 6 months post op
Thanks again
Happy Easter:flwrysmile:
 

Mojo333

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:) :-) (:So happy to see your update.
Continued best wishes as you travel this recovery journey!
Onward and upward:egypdance:
 

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