THR Valentine’s Day LHR Anterior

[Layla]

Hi Valentine,
How are you doing on this two month post op surgery date? We haven't heard from you since the dislocation post above. I hope you're doing okay... Please let us know when you have the time.
Hugs and best wishes.
@Valentine

 

[Valentine]

@Layla , Thank you. I am doing ok. My follow appt was rescheduled to this coming week because both xray machines at the dr office went down. I have been laying pretty low. I haven’t had a lot of pain but my os feels weaker than prior to the dislocation … and I am super scared of it happening again. I was just starting to get my gait back and go caneless a little here and there when it happened, but now I am back to cautiously using the cane. I feel very conflicted between being still and healing vs moving around to build muscle and bone. I have mostly decided to be still until I go back to the dr and get new images. I think maybe it happened because I am so flexible, combined with a heating pad that night plus an unfortunate movement. My husband is concerned about the angle of the cup - but I guess we will know more on Tuesday. I am unsure what movements are ‘safe’ (had anterior approach and anterior dislocation)

 

[Valentine]

I go to the doctor this afternoon for my follow up, but I am in a bit of a panic and could use some advice/words of experience. Since I had the dislocation and trochanter fracture 2 weeks ago, I have been ok… but not necessarily feeling progressively better. I would say it knocked my mobility back 2-3 weeks. When I first got home after the dislocation, it didn’t hurt (high pain tolerance) but the muscles were weak and maybe sore, which the dr said was normal. Inflammation lessened then I had a few random days of slight pain intermixed with days of no pain. Fast forward to yesterday, I went to the post office and was uncomfortable with some light pain then and throughout the afternoon. I like to bend my legs a lot when laying down or reclining and this week, that has been less comfortable on my left side. Now, I have woken up in the night to use the bathroom and notice the top of my incision (which has looked great) is sore, has a red spot and is leaking clear fluid! I am panicking. I have graduated back to regular undies from my boxers which could have irritated the skin but have not done anything remotely strenuous (and have actually been concerned I am not moving enough which I was going to ask about today). I have been fortunate to have always had good health but have regrettably let my fitness decline terribly the last five years. Am I going to hit another unlikely statistic and find out I now have infection? Surface or interior? Quick refresh- left anterior hip replaced 8 weeks ago with small femur split repaired at time of surgery with cerclage then dislocation with greater trochanter fracture (chipped off) 2 weeks ago. At my appointment today, I was going to find out if a new xray confirms the new fracture hasn’t moved (ie no fixation surgery), then mostly ask questions about what movements to avoid and for how long. Sorry this is a bit of a disjointed ramble, just worrying.

 

[myglasshalffull]

All of these concerns are valid & certainly concerning to you.
Happy you have the appt today & can relieve some of your worry.
I had small fracture after my surgery & no idea if it happened during or after surgery, just was told at 6 week post op that there was a small fracture & I had to be on lwb for next 4 weeks in hopes of the fracture healing, if not more surgery. So you know I kept myself very close to home & did only what was necessary. I have an acquaintance that dislocated a couple of times and that was in forefront of my mind for sure. Fortunately fracture did begin to heal on its own.
As far as an infection they will do blood work more than likely today at your visit.
I wish you the very best with your appt today.

 

[Valentine]

@myglasshalffull thank you so much for your reply. The dr didn’t give me lwb instructions, but my body has been telling me to lay low (and his nurse did tell me to lay low when she called to reschedule the appointment due to xray being down). I never went back to sleep after I woke up to discover this and now it feels like a bad dream. So, I have many questions- (1) you had a trochanter fracture too, right? Was it chipped off? (2) Did your friend with dislocations end up having them resolve? Need surgery? How many? Early days only? And (3) Yes, I am SO glad my appt is today and I’m sure they will draw labs. Question- wouldn’t they have routinely checked that when i was admitted for the dislocation?

 

[myglasshalffull]

Yes, small fracture in trochanter. No clue how it occurred. I was on vacation in Virgin Islands when the surgery had to be performed so my surgery wasn't here so no idea if the surgeon who performed surgery missed the small fracture, or if fracture occurred during the surgery. Then back home I was assigned an OS here who of course didn't want to touch me let alone get involved in more surgery! They are all afraid of getting sued, it's very sad. I ended up changing OS last year around this time because I didn't feel "heard" just "handled."
My friend who dislocated had two one was when she was working in her garden other was bending over to tie her shoes & that was couple years after her initial surgery. So with that in back of my mind I'm still careful!
I would figure blood would be checked but who knows, my son is ER nurse & he told me they are so short handed so who knows.
Let s know what happens today.

 

[Valentine]

@myglasshalffull Oh, wow! That must have been scary to need to have surgery while away from home! I spent so much time choosing a surgeon and the thought of having to travel post surgery is just daunting. I am glad that it seems you have it behind you. I am a rule follower and have certainly tried to follow instructions and will probe dr for more detail going forward.
Goodness- your poor friend. A few years after, I would fully expect to be able to tie my shoes without giving it a second thought. I am very flexible- was still sitting criss cross applesauce not all that long ago. By week 3 post op, I could do shoes and socks myself and bend straight over to pet the dogs. I am not doing those things since dislocation because everything feels off but I am going to have to probably really change the way I naturally move going forward.
Yes, understaffing and lawsuits are unfortunate. I feel like at the hospital they were pretty ‘on it’ but I am also pretty trusting. My biggest fear at the moment is the raw spot on my incision. It hurts- but it is also where the leg bends. My legs were out straight while sleeping (on my back), but a lace strip may have rubbed it wrong. I will definitely let y’all know what he says today. I want to head on over in hopes they would see me five hours early haha.

 

[Valentine]

@Freyagirl I just saw your post that you had a similar wound issue this weekend. I am so glad that yours is ok and I appreciate that you shared that. I am hoping to hear the same this afternoon!

 

[Freyagirl]

@Valentine I hope your incision is fine as well. I have the same issue with my undies rubbing on a bit of the incision and usually wear smooth boxers. One section keeps getting red but so far not opened up. I am laying low until that section has a better seal on it. I hope your appointment goes well.

 

[Valentine]

@Freyagirl -thank you very much. Now that the sun is up, I feel a little less worried, but i don’t like that it opened. Definitely back to the boxers! (Wondering if they make tummy control loose-leg boxers? haha)

 

[Eman85]

You had anterior approach THR so they rotated your femur in the direction of your incision so they could work on it after dislocating the joint. That is the movements that you would want to avoid as that's the direction that would be most likely to cause problems. That is why posterior has known restrictions for 6 weeks as we tend to move in directions that put strain in that direction in normal movements.

 

[Valentine]

@Eman85 Thank you! My brain has a hard time translating that. The dr pulled out a hip model this afternoon and went over it a bit. I just have a mental block but I am not ‘doing it wrong’ so maybe that’s ok .see notes to follow. Layla, Freyagirl, myglasshalffull, mendogal - my appointment went well today. The dr was very sweet and spent about an hour with us explaining things well. Still processing but the quick summary is that he wants me to take an antibiotic for the wound but isn’t terribly worried. He said it has something to do with the stitch dissolving, an absess maybe.

He said the new fracture is in same spot, no surgery (unless I fall or something). The vertical fracture from the surgery isn’t showing, which is good.

We talked a little bit about the dislocation and why but he said no way to know for sure. He said it’s normal for it to still be sore and to lay low and baby it for now.

He spent a long time going over xrays and ct scan with my husband (career in orthopedics so knows all the technical stuff) all about angles, retroversion, etc and he feels like everything is where it should be at sizes and angles and placements he likes and can’t see anything he could do to change it that would help. He went through some common ‘corrections’, none of which I need and all of which would likely cause problems. My husband agreed with what he said.

He said there are 2 diagnostic things he can do- (1) get another ct scan but this one of the whole femur to see the exact position of the stem. We are going to do this. Option (2)- he can put me under and then under flora move my leg into all positions to see what it does. He said he did this for 2 patients in 12 years (one was inherited) bc they were so fearful of it happening again. Neither one dislocated when he manipulated their leg or later. My husband, the dr and I decided together that we would want the ct scan first and think about doing this later (or not). He said that he does not see anything that would lead him to think I will dislocate again.

That’s all I can remember right now but it was reassuring!

 

[mendogal]

You have an excellent, caring surgeon there! I'm relieved there's some clear answers and a plan for a CT.

 

[Valentine]

@mendogal , me too! Thank you for your kind support!

 

[Layla]

I am happy to hear your surgeon was willing to spend the time he'd did with you as a couple. Having a husband with a career in Orthopedics must feel comforting during this time as you're able to rely on his opinions and understanding. Thankfully your surgeon was willing to slowly go through the x-rays and CT Scan with hubs.

I'm glad the visit was reassuring, hopefully providing peace of mind. Please stay in touch and know we're always here for you. Thanks for the update, Valentine.
@Valentine

 

[Nini]

Sounds like you have a wonderful team between your husband and surgeon!

 

[Valentine]

@Nini yes! I am very thankful

 

[Eman85]

With my Rt I had a spot in my incision that was odd, turned out to be an internal stitch that worked it's way out. It all healed up just like the rest of the incision.
I didn't dislocate but at 3 mos with my first THR I did a real major league overdid and it was a major setback and was like starting my recovery all over again. It set me back at least 3-4 weeks and took a lot of sitting and icing to get back where I was.

 

[Valentine]

@Eman85 well, it seems like you are doing great now so that is encouraging. I feel like this has set me back about that same amount. I feel conflicted about activity. I really feel like I have been a slug since surgery and especially since dislocation. I feel like I need to start getting out and walking. I am just going to try to just be patient and wait until after my ct scan and follow up from that- both of which should be next week.

 

[Eman85]

Actually I had a really big overdo back in Jan and thought I damaged the implant. I'm still working on getting back from that.