THR Trying to recover Post OP Feb 10th

[Valinda]

I have had a very bad time with this. I have lupus which might have played a little part in it. Although my lupus has been very quiet for the last 10 years. I had the anterior surgery which I thought would be quicker to recover from and easier. I wasn't able to get up out of bed until the end of the 2nd day when they were able to figure out a combination of pain meds that would work for me. Turned out to be high dose Dilaudid and Morphine LA did the trick. But the pain was off the chart if they didn't keep it up. My whole thigh was/still is numb to the touch but extremely painful on top of everything and shooting nerve pain down my leg. I was able to go home, but I wasn't able to do much for several days. I felt lucky to make it to the bathroom and that's it. Then on the 5th day I woke up at 1am in terrible pain. There was a huge, hard bump, about 6 inches across, just under the 3 inch incision at the bend of my hip. Pain was shooting down my leg and no amount of pain meds helped. So my husband took me to the ER. They determined that the Lovenox, blood thinner I was injecting was causing a bleed under the muscle and causing pressure on all the nerve bundles there. I stopped the Lovenox and started aspirin. The big bump went down a bit after that, enough to get me out of extreme pain anyway.

I've had two in home PT visits and two outside PT visits so far. But so far they haven't been able to do much with me because of the pain, numbness and the big bump. I can't walk too much or else I get in too much pain. I use two crutches and try to put my foot down every now and then but it's really difficult. My right leg is now at least an inch longer than the other one, so that makes walking difficult as well. My pelvis doesn't line up anymore. Tomorrow will be 3 weeks since the surgery and I'm still having buyers remorse over it. I still have to get the other one done too! Right now I'm thinking NO WAY! I think I'll just keep walking on that collapsed hip. It's fine and dandy! And to think I wanted them to do both hips at once! I'm so glad they refused now. I can't imagine going through this with two hips at once.

 

[Jamie]

Valinda, so sorry you are having a rough time of it. Things will get better. It's important for you to be kind to yourself right now....to rest, ice, and take those pain meds on a regular schedule to keep the pain under control.

Here are our basic recovery articles for you to read. They will help you understand more about what you may experience in recovery. Please don't hesitate to ask any questions you may have and we'll be here to help and support you.

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
Activity progression for THRs
Home physio (PT)
Post op blues is a reality - be prepared for it
Myth busting: on getting addicted to pain meds

 

[jebrig3164]

Things will get better I had my right hip replaced a month ago and so far so good. Believe it gets better then I have my left hip replaced next month on the 30th.

 

[Healthyhip12]

Hi Valinda. Things will get better, but it will take time. Pain management is very important. My doctor seemed to think that a muscle relaxer is helping me control my pain better this time. Also I take Tylenol 650 mg 4 x daily as well as oxycodone. Remember our mantra that if it hurts, don't do it. It is hard when you get home and realize that you are forced to take it easy in order to heal well. Short trips to the bathroom are perfect. Your leg length will even out with the other hip surgery. I limped around with uneven legs for over a year. Hip replacement is an elective procedure so you don't have to do anything until you are ready. As for the bump, you need to be icing it as much as you can. Ice is a wonderful pain killer. I just got home from the hospital today and have a large throbbing leg to baby. Nothing planned except for trash TV, ice, long naps, visits to Bonesmart and elevation. Hang in there. Good things take time. Be patient and loving with your new hip. Thinking of you.

 

[Valinda]

Those links make me feel even worse. According to those charts and statistics from people most likely much older and harder to heal than I am, I should be walking with a cane twice a day for 10 to 20 minutes. I can't put weight on my leg yet! Three steps and I'm in pain. I can't sit down. I have to put all my weight on my other cheek in order to sit. My pelvis is all out of whack. Thank goodness for grab bars in the bathroom! I use two crutches because I can't get anywhere in the walker. I have to lift my right leg and crutch it just to make it to the bathroom. I'm 3+ weeks post surgery here. Even my PT is telling me that I'm not doing well. I am motivated. I have a high pain tolerance after all these years of dealing with lupus. I've even been through more surgeries than fits on a single spaced sheet of paper. But this is ridiculous. I'm putting way too much stress on my left hip that has AVN. Pretty soon I'm going to be in a wheel chair at this rate.

Here's my question. Are there different sizes of hip prosthetics? And if so, if they put one in that was too big would that explain all my problems? My new hip just feels wrong.

 

[grandma chris]

@Valinda I have absolutely nothing to offer except for my sympathy! It must be horribly disappointing for you to still be feeling so bad. @Josephine, is there some reasonable explanation for what is happening to Valinda?

 

[Josephine]

I should be walking with a cane twice a day for 10 to 20 minutes

Valinda, do remember that those targets are tp advise people who are doing too much that this is ALL they should be doing! It doesn't mean that's where you should be. There is no such thing as shoulds and oughts in this business. Everyone progresses at different rates for different reasons.

My right leg is now at least an inch longer than the other one, so that makes walking difficult as well. My pelvis doesn't line up anymore.

Well, that's why your legs seem to be unequal. Read this to understand more Leg length differential - LLD

Are there different sizes of hip prosthetics? And if so, if they put one in that was too big would that explain all my problems?

Yes there are but surgeons spend a lot of time making sure they select the correct size for their patients.

Tomorrow will be 3 weeks since the surgery and I'm still having buyers remorse over it.

A whole 3 weeks? Gosh, you are an impatient one! Recovery can take 3 months never mind weeks. Just remember how long you've suffered from this arthritic hip and then consider how unreasonable it is that you expect things to be a lot better in three weeks. (I know that sounds harsh but I'm just teasing really)

Now I have some questions to ask you:

1. 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 compare this with the bone-on-bone pain you had before surgery!

)

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

3. how often are you icing your hip and for how long?

4. are you elevating your leg, how often and for how long?

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

6. what kind of PT/exercises are you doing? How much and how often? (and detailed details would be appreciated, please! Reps, sets and session and all that)

 

[Valinda]

1. 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 compare this with the bone-on-bone pain you had before surgery!

I actually have AVN in both hips and my right hip collapsed back in Sept. So I didn't actually have the arthritic bone on bone thing. My pain sits mostly around a 5 at rest and if I move shoots up from there depending on what I try to do. Which isn't much.
2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often? I'm taking Hydromorphone (generic for Dilaudid) 2mg tabs. As prescribed I'm supposed to take one to three every 4 hours for pain. But in real life, I'm taking them when I can't stand it anymore. Mostly at night so I can sleep but that doesn't work too well for the most part. I was only given so many at discharge. I have to make them last.

3. how often are you icing your hip and for how long? I have a 3 inch incision site at the front and a 1.5 inch incision site at the back. Plus my whole thigh is numb with burning, stabbing, stinging pain. My husband keeps me stocked with ice and I rotate sites mostly all the time.

4. are you elevating your leg, how often and for how long? Mostly all day except when I have to go to the bathroom or just get up to try and stretch. Honestly I'm not pushing it. The pain is just too much. I do everything I can just to try and make it feel better.

5. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and
About the only thing I can do is go to the bathroom and get myself back in bed. I can manage to take a shower with a shower chair. Other than that my husband and daughter have taken over all housework etc. I try to do things but it's too much. And the pain pills only go so far. I can lay in a recliner and use a laptop. That's my activity level.

6. what kind of PT/exercises are you doing? How much and how often? (and detailed details would be appreciated, please! Reps, sets and session and all that) The Physical Therapist won't give me to many exercises at this point because she says that it's beyond what I can handle and she's right. I do the ankle flexes, a couple knee slides on the right side is about all I can handle. Maybe one or two, sitting on the side of the bed and lifting my leg if I'm having a good day. Beyond that the PT said not to try too much. She said if it hurts to stop. Well, it hurts all the time. Is that really usual for over 3+ weeks out? I'm 47 years old. Active. 5'4' and before surgery 130lbs., now 120. Apparently crying is like going to the gym. I'm loosing weight without trying. Another few weeks of this and I will have to go buy new clothes.

On another note: My PT said I should call my doctor and get in to see him asap. I did that yesterday but was told he was booked up and they couldn't get me in any sooner for my post op with the surgeon which was scheduled for the 27th of this month. So this morning I had my husband call and use his "man voice". A nurse called me back within minutes and asked for details of what was going on. She said that I definitely need to be seen sooner and she thanked me for calling and letting them know. (Thank you man voice!) So I now have an appointment for this Thursday first thing in the morning. Wish me luck! I'm hoping that he'll take the hip back. There is seriously something wrong with it. :'-(

 

[Healthyhip12]

I am so glad that you will be seeing your doctor! Good luck! I have had 2 hip surgeries now and the first one was much more painful and difficult than the second. I had to take twice as much pain medication the first time around and looking back, I probably didn't take enough. Making your pain pills last does not seem to be helping. I hope that your doctor will give you new prescription and encourage use until your pain is down to a bearable level. Pain at level "5" continuously is exhausting.

Also, the fact that your other hip is bad may be causing significant delay in healing. I never got off pain pills between my first and second surgeries and even had to increase my dose. By the time I had my second surgery, they really weren't helping. You are doing all the right things, so keep it up. Will be very interested in hearing what the doctor recommends. Hang in there!

 

[Valinda]

Thank you for your kind words Healthyhip12! That is the first encouraging thing I've heard so far. They haven't talked about when they will do my left hip but it's "inevitable" apparently. Right now I feel like even though that my right hip had been collapsed since Sept. I could have gone the rest of my life without this. I so regret doing it right now. And having to hold my leg up and walk on crutches is putting a huge strain on my left hip. I don't know how much longer it's going to last. I may just end up in a wheel chair before I do this again. I don't know how you go the courage to do it again!? You're amazing!

I've only seen the Dr. briefly a couple times. I first checked into his clinic to see his PA because he was booked 6 months out and that was the quickest way to get anything done. Most likely he'll pop in with an assistant say hello and leave his assistant to deal with whatever I have. That's kind of his MO. I kind of want to ask him to take this hip back before he can leave this time. We'll see how it goes.

 

[Josephine]

My pain sits mostly around a 5 at rest and if I move shoots up from there depending on what I try to do. Which isn't much.

This is your operated hip you are talking about?

I'm taking Hydromorphone (generic for Dilaudid) 2mg tabs. As prescribed I'm supposed to take one to three every 4 hours for pain. But in real life, I'm taking them when I can't stand it any more.
Mostly at night so I can sleep but that doesn't work too well for the most part. I was only given so many at discharge. I have to make them last.

I still need to know how much you are taking and when.

my whole thigh is numb with burning, stabbing, stinging pain. My husband keeps me stocked with ice and I rotate sites mostly all the time.

You still haven't told me how long you ice and how often?

Mostly all day except when I have to go to the bathroom or just get up to try and stretch.

That sounds about right.

About the only thing I can do is go to the bathroom and get myself back in bed. I can manage to take a shower with a shower chair. Other than that my husband and daughter have taken over all housework etc. I try to do things but it's too much. And the pain pills only go so far. I can lay in a recliner and use a laptop. That's my activity level.

Then don't try to do things! Is your doctor being mingy with the pain meds? Has there ever been any mention of you going to a pain clinic?

The Physical Therapist won't give me to many exercises at this point because she says that it's beyond what I can handle and she's right.

Yes of course - you said that before.

Is that really usual for over 3+ weeks out?

Hang on - in your signature you have "surgery March 26, 2012? When did you have your THR done? What date?

I'm hoping that he'll take the hip back. There is seriously something wrong with it. :'-(

If you are only 3 weeks out, your primary problem is lack of appropriate pain meds.

 

[Healthyhip12]

Oh darling, I so feel your pain. Getting AVN is so different from osteoarthritis. It comes on rather quickly and confines one to a wheelchair quite rapidly. Even though you are having a very tough time of it, I do think you did the right thing by having a surgical repair, unless you want to be confined to a wheelchair, which you have made very clear that you don't! That doesn't mean that you get to escape all those perfectly normal feelings of loss like anger, denial, resentment, bargaining, why me, etc. I can't tell you how many people have told me that I am too young for a hip replacement and how that makes me feel like I have made a mistake. The bottom line though is that my old hips didn't work anymore and I was barely hobbling around with a cane. One of my 80 year olds ( I am a nurse in Assisted Living) sent me a note that I must be very brave to work with all the pain. It made me feel awful as I am there to comfort them, not the other way around.

Each recovery is different and if you are having a rough time it can be hard to read those super success stories. The key is to take only the information that can help you and never compare yourself with others. You can't even compare one surgery to another because no two are the same. You also need to cut yourself some slack because of your lupus. Be kind to yourself. You are doing the best you can do. Bonesmart is a great place to get perspective. Hip replacement is huge and it takes 12-18 months to totally heal. It is a big time commitment, but worth it in the end. My doc even got on me for not taking my calcium and vitamin d - said my bones were mushy! So even after we heal we have to do exercises and have a healthy lifestyle to take care of the new hips.

I am glad you found us and I hope we can help get you through this difficult time. Sending you positive healing thoughts and energy. Can't wait to hear what your doc said.

 

[Valinda]

Thanks once again Healthyhip12! Just got back from the docs. The xray looks good. The incision sites look good. So they can't figure out why I can't put any weight on it or sit. So they gave me some long acting morphine and more dilaudid and tripled my nerve pain meds. The doc said to just push through it. Take the pain meds and walk on it anyway. No more, "if it hurts don't do it." So we'll give this a try. I've had a lot of pinched nerves from the bleeding at the front incision site so maybe that's it. He wants to see me back in 2 weeks and see if there is any improvement. Hopefully there will be by then! I'm going to Hawaii at the end of the month. Hopefully it won't be in a wheel chair!

And yes! Take your calcium! I take calcium tablets all day long. My bones are so bad after all the steroids and chemo I've had to take over the years, plus menopause 10 years ago doesn't do the bones any good. I also take Reclast infusions to try and build my bones up. I feel very lucky that they were able to put the prosthetic into my femur without having to wrap it in metal first because of the poor quality of my bones. Calcium is key!

 

[Healthyhip12]

I am so happy for you! I think most Bonesmarties assume you are medicating on a schedule and not withholding your pain medication. I know that it helped me a lot when I read my post op orders in the recovery room and saw 100% weight bearing for me. I then insisted I was medicated down to a level 1-2 so I was able to put 100% on my hip. So now you will have some good pain medication to help you, but you still need to slowly increase your activity and not overdo and continue to ice. You have a lot to look forward to. I love Hawaii. Aloha!

 

[Josephine]

I then insisted I was medicated down to a level 1-2 so I was able to put 100% on my hip.

@Healthyhip12 You found this a benefit? It's somewhat illogical to think that pain medications would have any bearing on the ability to weight-bear.

 

[dkirk0530]

Praying you can push through the pain! It must be somewhat of a relief that xrays look well and otherwise no issues. That would have really been worrying me.. keep us posted! Hope the new meds and nerve relief are the answer for you!

Diane

 

[Hoppy Nanny]

@Valinda. Sorry you are having so much pain..... But glad that your surgeon was able to put your mind at rest. I think perhaps your expectations were that at just 3 weeks you would be doing more... But I have to say that it took me until 6 weeks to come off two crutches and even then I spent most of the day resting. The trouble is there are some people who sprint along the first few weeks and then slow down and then others, like myself, who have a very slow, but steady progress. I'm at 6 months now and doing fine but it was slow going. Try and think long term..... And then you won't want to give your new hip back!!! I had one shorter leg and bad limp up until 12 weeks... All gone now...I only ditched my one crutch two weeks ago... But I got there in the end. Take it easy... It can be a longer journey than you thought.... But a worthwhile one. Take care... Chrissie xx
@Josephine.... Loving the 'mingy' word!!!!

 

[Healthyhip12]

Hi @Josephine!
For me, knowledge is power. Fear is very illogical, so I own that. Knowing that it was OK for me to 100% weight bear was crucial. I did not want to mess anything up! It hurt a lot to walk on my new hip and it still does. Taking my pain medications on time and routinely helps me as well as knowing that it is OK to put as much weight as I want on my new hip. I am a big believer in that your body will let you know what you should or should not do. I am also a chronic over doer. For months after my first hip surgery, therapists explained my left hip pain as favoring it over my operated side. Ultimately this was not the case. It needed to be replaced as well. Although I have found this second hip replacement much easier than the first, I am still frustrated with the pain, slowness, aloneness and drudgery of recovery. Very illogical considering that by summer I will be doing things I haven't been able to do in years. Catherine

Hi @Valinda!
Let us know how you are doing so we can cheer you on! I just got out of the house yesterday for the first time. It wasn't easy and I was so frustrated that I could only go a little ways. But I do consider even the tiniest step forward a success and my goal for today is to do what I did yesterday, but in two sessions ( the same amount of activity, but not all at once). If there is one thing I am learning, it is patience. Hoping your new pain meds are treating you well and that you have a lovely day. The most wonderful thing about Hawaii is the spirit of Aloha.

 

[Poppet]

Hi there @Valinda - have you read this article about bone health and nutrition..

https://bonesmart.org/forum/threads/bone-health.21754/

 

[Valinda]

I'm nearly 6 weeks post op now and I have nothing to report. Everything is still the same. No detectable improvement yet. Thanks Healthyhip12 for your continued encouragement and thanks also to Hoppy Nanny. That is also encouraging to hear from someone that had difficulties like this. I'm starting to think I'll never walk again. But I'll hang in there.