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[THR] Westy's Hip Recovery Thread

Westy

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Hello everyone, I had THR on June 27, 2019 at 7:30am. Surgery lasted 2 hours, and Doc told my wife, I was in the top 10% of the worst cases he's done. Apparently I was loaded with a ton of osteoarthritis and bone spurs. His average time for surgery runs 1 hour and 15 minutes.

When I was moved from recovery to my regular room, I was in a world of pain. I have all kinds of issues with opiates. My body rejects them for all intents and purposes. The nurses trying to do their job gave me Diluadid. I had a bad reaction to it and was crawling out of my skin. Several haze filled hours went by, and my pulse got down to 35. Then they tried morphine, with the same reaction. next they tried oxycontin, and again, no success. By this time it was about 4 in the morning the next day.

I was so uncomfortable, I told my son, who stayed with me, no matter what, we're outta here today (Friday) I stopped the nurses from giving me anything else for pain and just dealt with it. I was in a haze, so I'm not sure of the timeline, but I did some walking with a walker and attended a PT class, which I pretty much slept through.

Next I vegged out until the early afternoon PT class. When the time came for that, I pleaded with the head of the class to get me discharged. She made me walk 300 feet and back on a walker. Even though it hurt like a I got 'er done and 2 hours later I was home.

Since being home, I was able to somehow manage to use Norco for the first 7 days. It helped but the pain was still very bad. Now I'm 3 days free of narcotics today. Again, I've been in a haze, so pardon me if my timeline is off.

My biggest issue now is excessive swelling way up the joint and my incision is still oozing a fair amount of blood. I attribute that to the Eliquis. I've been doing my PT steadily and go for staple removal and my first post op visit mid week.

This is already long in the tooth, sorry about that. More later.
 

Layla

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Hi Westy :wave:
Welcome to BoneSmart and Recovery! :welome: Thanks for joining us.
I'm really sorry you had such an awful start. Thankfully things have tapered off for you.

I'm wondering if you've been in touch with the office of your OS since you mentioned your incision is oozing a fair amount of blood? I really feel you should touch base with them on that as they may change your dosage, or put you on something completely different for blood clot prevention. Please contact them. I would guess that a PA is on call over the weekend.

Following you'll find the Recovery Guidelines. Please read them thoroughly as I believe you'll find the information beneficial.

Stop back often, many will be here to offer support and encouragement as you begin and continue on the journey.

Wishing you comfort and a peaceful Sunday!

Hip Recovery: The Guidelines
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:
rest
elevate
ice
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 these
5. At week 4 and after you should follow this
6. Access to 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 the at each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice. @Westy
 
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Westy

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Hi Layla, I've had in home health care nurses since getting home. They've been wonderful to work with. Doc actually left for vacation after he finished up his surgeries on the 27th. I did speak with his PA who had me stop the Eliquis for one dose. That helped, but here we are again. Doc is back, so I've got an email into him, via MyChart.
I appreciate your comments, very helpful.

Thanks
Westy
 

Mojo333

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Sorry about your rough first days...thank goodness All Temporary.
Ice and ice and more ice...:ice:
Healing vibes coming your way @Westy :console2:
 

Josephine

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And don't do any PT or exercising! Hips don't need it. Read the articles Layla left you - ALL of them!
 
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Westy

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Hello Hip People :)

Well, I may have some trouble in river city as the saying goes. My incision is and has been red for a while. I saw the Doc's PA today and he said to watch the area for spreading of the redness, as it may indicate a possible infection. It never dawned on me while there today to ask to see the Doc for a "more qualified" opinion. 100% my fault.

If I may, I'd like to ask some questions, after giving you all some brief background on the last several weeks.
My recovery has been slow. Getting off the narcotic (Norco) so soon was a bad move. My pain levels were still way too high when I made the Tylenol only call. Bottom line, I went back on the Norco 10-325 and have been taking 3 to 5 per 24 hours, depending on pain level. The bulk of my pain is now concentrated in the joint, along with the lower center of my left glute (cheek) :) I also experience tenderness in the front center portion of my quad.
The swelling under the incision is still there, but has gone down.

For the record, my procedure took place 4 weeks ago, tomorrow, or June 27th. Is it common to still have pretty high pain levels in the area's described, this far out from surgery? The pain comes and goes and does respond to the Norco very well. I've been able to get some decent sleep over the last week or so, which is a nice change from early on.

My biggest concern and question has to do with the "possible infection". I've already done 1- 7 day course of Cephalexin and it's obvious that didn't help (the redness is still there). I have not had a fever above 100 since a few days after surgery. in fact, it's been constantly below 98.6 for weeks. The incision does feel slightly warm to the touch and there is some distinct swelling under parts of it. Again, it has gone down, but it's still there.

If I do indeed have an infection, does this mean I'll have to undergo this entire procedure again, or is it just a skin infection? I can't seem to get a clear answer from the PA. One time he said it's like dealing with cellulitis and the next time he says I'll need another complete procedure, where they open me up and clean everything out, put it all back together and sew me up. UGH!!!! I'm being 100% honest with you folks. The hospital portion of the recovery, once I was back in my regular room was a complete disaster. The overkill with the narcotics was ridiculous and made me think i was about to die. I couldn't wait to get outta that place. I know I'm getting ahead of myself, but i honestly don't know if I could take another night in that hospital with the drug pusher nurses.

Final thing is this. They insist that I do P/T at the outpatient facility. I had my first session last Friday and by the time I was finished, I was both sore and swollen again. That seems counter productive to me?? I've been doing all my home P/T exercises and sticking to them very rigidly. I've read that many of you don't do the P/T and while I'd love to be in that club, the doc's PA is pretty insistent on it.

Any comments or suggestions on my issues would be most appreciated. I'm placing a call to the Primary tomorrow to get in and get his opinion and a blood test to wee where my white count is. I also plan on seeing the Surgeon ASAP to get his take and some clarification on what exactly an infection calls for.

Thanks HIP people, I appreciate all of you

Westy
 

Fiona444

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Hello @Westy i am sorry you are having such a tough time. With regards to possible infection i think i would be demanding to see the surgeon. Im sorry but not sure what a PA is?

I am not sure I would do the PT either if i still had pain like you describe. Although my physio is keen on me doing exercises she did stress not to do anything that hurt.

I am sorry i dont have much advice for you but i am sure someone more qualified will be along soon to help. Wishing the best for you and some answers very soon
 

Mojo333

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Oh, I dont like to hear that you are worrying about possible infection.:unsure:
I'm placing a call to the Primary tomorrow to get in and get his opinion and a blood test to wee where my white count is. I also plan on seeing the Surgeon ASAP to get his take and some clarification on what exactly an infection calls for.
Exactly what you should do, in my opinion. Please let us know and I hope you get in quickly.

I've been doing all my home P/T exercises and sticking to them very rigidly. I've read that many of you don't do the P/T and while I'd love to be in that club, the doc's PA is pretty insistent on it.
So say you did...and don't.:nah:
Again, my opinion. First things first..

Will be thinking of you and hope you get encouraging news.:fingersx:
 

Eman85

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As far as your recovery pain it sounds like you got the "you'll be all better in 3 weeks" brochure written by people that have no idea what this surgery really is. I'm not a big fan of PA's or PT's, just my opinion. As far as infections go that would be #1 on my list as far as getting an answer. As far as PT goes I'd call in sick, I'm betting if you continue you will hurt more.
 
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Westy

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Thanks Fiona, Mojo, and Eman. I appreciate your responses. You are going to love this, because it's pretty close to direct from a comedy. I wrote my surgeon and his PA late last night. (via an APP which allows direct email contact, called mychart) I was looking to get in for another appointment either today or tomorrow in order to have my surgeon evaluate and comment on the redness around my incision. I don't think I've said it here, but I never saw my surgeon after the procedure. He left for vacation on the 27th of June, right after he finished his final surgery of the day. I've not seen him in either of my post op office visits either. I get the PA (physician assistant for whoever asked) who's a nice guy, but I'm, well, a bit skeptical. But, that's just me. No disrespect to any PA's here. anyway, back to the letter i wrote last night. I got a response this morning, and guess what, my surgeon is out of town until 8/6. LOL This man likes his time off. The PA is fairly certain I'm worrying about a non event, but to be safe, he gave me another round of Cephalexin. <smh> He also offered to see me again.....HUH?? LOL Anyway, I've taken the advice offered here and cancelled my P/T for tomorrow. Frankly, I'll take the word of real world patients who've been through this every time over that of someone (the PA) who never has. I know I've been kind of quiet on my thread, but I read the forum often. The amount of information folks share here is invaluable and I thank you all very much for this wonderful resource.
I'll check back in and update the thread in a week or less. Have a great weekend everyone, and thanks again for the responses. I appreciate you.

Westy

PS i seriously am not demeaning or looking down on PA's. Being older, I'm just having a hard time getting use to the whole PA thing, which is happening everywhere in our area. Like I said, my PA is a super nice guy and is trying his best to do right by me. Maybe I need to have more faith in the whole system?
 

Hipster64

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Hi Westy: I get where you are coming from about PAs. My PA, who assisted my OS in surgery, came to see me every morning in the hospital. The first day post surgery he insisted on putting me on a narcotic in the Percocet family, which I refused-Percocet has made me loopy in the past and my mom had opiate issues so I was leery about taking them. He prescribed them to me anyway and told me to expect an 8 PM discharge that night. Well, I ended up vomiting the entire day and stayed an additional day in the hospital. I also was scratching like crazy that following day because my body was so itchy. The nurses deemed the drugs were the cause and demanded the PA switch me to Tramadol, which I have been on ever since. I have to see him tomorrow so this should be interesting.

Regarding PT, I do the exercises with the therapist but that's about it, unless the therapist asks me to practice using my cane or walk outside on non-therapy days. After reading people's posts on here as well as the recovery articles, I decided that I am not becoming a recovery warrior and risk overdoing things.

Best wishes on your recovery, and keep us posted!
 

Eman85

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I'm very fortunate with my OS. Great communication both with patient portal and telephone. During surgery they called my wife 2 x and then immediately post surgery the OS called her. Then he came in and saw me in post op and showed me my post op x-ray.
There was a Dr. opened a clinic here in my town, cash only no insurance. I called to make an appointment and she answered. One of the questions I asked before I made the appointment was are you a real Dr.? She replied that she was and that was a very good question. We got along just fine. I've been down the road with almost Dr.s, I'm done.
I never had redness or anything like it around the incision. I would be concerned like you are about infection.
 
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Westy

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Good evening folks,

Well, it seems the Cephalexin may indeed be working. The redness has subsided a great deal and that has me in a better frame of mind. Today marks 33 days since my surgery. The main thing that still has me concerned, I still have what I would describe as a fair amount of swelling at the top of my incision, and it wraps around to the front middle at the very top of my thigh. I've been icing like a pro, as suggested here. I also took my first dose of Meloxicam, 15MG once per day, today. This is supposed to help with swelling. Even though I'm getting around good, I'm still reliant on the cane about 90 to 95 percent of the time. I do experience "soreness" at the top of the thigh back into the left glute at the bottom. All the other swelling I experienced in the first week or so is now gone.
I read a lot and in doing so, I get mixed signals on the remaining swelling. I'd say it's gone down a great deal in the last several weeks in the specific area I pointed out. However, the fact that some is still there and I can see it, has me a little worried. I never use to worry about anything, but this darn surgery has really changed that. :)

I read that swelling can last for months. I'm just a month out, so I'm trying to relax and do my in home P/T and icing. I did start walking on the treadmill a few days ago. It took me 15 minutes and 43 seconds to do a half mile yesterday. Oh man, prior to this darn surgery, even with a bum hip I could easily pound out a 7 1/2 to 8 minute mile while jogging. Granted, it hurt afterward, but this is like starting over. Sheesh!!!!!

I guess I'm looking for some comments on the swelling from you wonderful folks. My Doc isn't back until 8/6. If it gets any worse, I'll see my Primary Care Doc right away. But, like I said, it seems to be getting better, based on where it is now compared to just 2 weeks ago. Thanks for any comments in advance, I appreciate all of you.
BTW, I'm in my mid 60's, so I'm not a young man. LOL I know my age has something to do with my healing. That's just an FYI. Prior to surgery I was in fair, not great shape, certainly not how i was 15 years ago. LOL
take care, folks.

Westy
 

Jaycey

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@Westy All that you are experiencing sounds totally normal for only one month post op. Please reset your expectations on this recovery. This was major surgery. You are not going to bounce back to activities until that hip heals. The slow and steady approach works every time. Keep icing and elevating. Still early days for you.
 

Mojo333

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:wave:Happy belated one month hipversary.
One month out is prime time for post op blues and cabin fever and generally...I'm ready to be be back to normal time.
It IS a hurry up and wait period.:bored:
You do a bit more, things are still healing...things swell..and it's back to the position.:ice:
All very normal and unfortunately it's your body that's in charge.
It will keep getting better, so keep the faith.
Well worth it in the end.:yes:
 
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Westy

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Thank you for the words of encouragement @Jaycey and @Mojo333. My OS is back from vacation on 8/6 and I was able to snag an appointment with him on the 7th. This will be the first time I've seen him since 6/27. I really like him, but he is a man of few words. :) I'll follow the suggestions, and keep on truckin. One day at a time, but it is a bit frustrating. Have a great rest of the week, and thanks again. I really appreciate this forum and all the contributors.

Westy
 
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Westy

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Greetings to all my supportive Hippie friends,
It's been forever (well, it feels that way) since I've posted here. I am exactly one week shy of being 4 months post op. I was doing fairly decently for a while, and things were coming along. About 4 to 5 weeks back, I started to feel more pain at the very upper joint, and the left hip/leg has become weaker than it was back then. I went to the OS (who as it turns out, is one arrogant, nose in the air, .....) I can't stand being around the guy for more than a few minutes. It's funny, when you first see him, he's pretty cool and has a bit of a decent personality. Then, as soon as they suck you in and get your money, BOOM, the real personality comes out. LOL
Anyway, believe it or not, prior to last Wed., I only had 1 post op X-Ray. I kept asking for them to do one on my post op visits, but they claimed it wasn't needed. Finally, last Wed they did one. Everything is still exactly where it's supposed to be, BUT, "There is evidence of heterotopic ossification" per the OS and the written X-ray results which came in tonight. I've been in a lot of pain and complained to him many times, all to no avail. His standard answer was, you'll be better in a month. Grrrrrrrrrrrr!!!!!!
He prescribed a week's worth if Prednisone 20Mg to help with the swelling at the top of the joint and ordered two MRI's. One for my Lumbar Spine, which i had yesterday, and one for my hip. The one for my hip requires a special machine, and the first available is in very early November. Meantime, I've also got pain in both of my "sit bones" which obviously I don't know the medical name of.
I did some reading up on this heterotopic, and it sounds like a revision may very possibly be in the cards. Based on the short reading I've done, it seems there is no cure for this??? I am so angry, because the OS never mentioned that this was a common risk with THR. I really dislike this doctor too. Is it possible or practical to go to a new OS, or is that not good? Does anyone here have any idea if the type of new hip he installed in me could have caused this HO?
The pain level is high enough to keep me up all night long about every other night, and this guy didn't offer any pain killers. I'm at my wits end, and hoping one of you veteran hippies can shed some light on this whole deal.
I hope everyone is doing great and enjoying life. So far, I have to say, electing to have this THR surgery is the single worst decision I've ever made in my life. Prior to it i was in a lot of pain and had somewhat limited mobility, but at least I wasn't facing uncertainty like I am now. BTW, side note, the Lumbar Spine MRI was to check for nerve impingement as I've got herniated L4 and L5 which was all settled down after two shots of cortisone and whatever else they use. The hip MRI is to rule out torn soft tissue and whatever else. Thanks everyone, I appreciate all of you.
 

Mojo333

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Hi Westy. So sorry you are dealing with this.
I pulled up articles here on Bonesmart and it actually is lengthy and alot to sort through but I'm seeing treatment options - however I don't know timelines involved post surgery.

I am so angry, because the OS never mentioned that this was a common risk with THR.
My surgeon did not mention much in the way of prospective complications either.
I really dislike this doctor too. Is it possible or practical to go to a new OS, or is that not good?
Being confident in your OS's course of action going forward would be important...perhaps after your test results you could decide?
Does anyone here have any idea if the type of new hip he installed in me could have caused this HO?
I'm not seeing this in what I've looked through...there are some listed potential reasons but this doesn't appear to be one of them.

Certainly think he should be able to prescribe something so you can get some relief while you pursue answers.
Can you approach your GP about this?
 
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