THR Wide Awake - Mailman Chases Dogs Away

[Mailman]

@dnordo220
I've left a message with my surgeon's office asking for guidance on how much walking would be a good target at my stage of recovery, not necessarily as a number of steps but more like should I go for more meds with more walking or fewer meds with less walking as I am doing now.
Looks like I had my procedure 2 days after yours so it's interesting to compare notes.

 

[Finallydone]

It's a race I'm running by running more slowly. What kind of race is that?

I think it’s called a marathon. Takes a different mindset and strategy than a sprint. Gratitude is always good.

 

[Layla]

Mailman,
Would you be comfortable going for a ten minute walk outdoors? Walking five minutes one way, turning around and going back? It's a good / safe way to start while waiting on a response from your surgeon. Many do this and then slowly increase their time and distance using their comfort level as their guide. We do not advise taking more meds in an effort to tolerate more activity, but see what your surgeon's office advises. I wish you a good day!
@Mailman

 

[Mailman]

The surgeons office replied:

"There is no real answer to this question as it's different for every person. We don't mandate a specific number of steps or distance. You have to listen to your body's limits all while working to ensure that you are progressing over time.

That's the key....progressing over time consistently. "

That makes perfect sense to me.. if I eliminate the first few days following surgery when I was so pain free I thought I was super recovery man and casually walked a half mile less than 24 hours after being wheeled out of surgery on October 18th at 4:15pm.

 

[Eman85]

Distance, speed and number of steps proved out to be a waste of time for me. With my second THR I came to the realization that regaining proper walking form was more important than the rest. I already knew how to walk and had walked millions of steps in life already, I wasn't training I was recovering. When I wrapped my head around that after my first THR my second was a lot more pleasant and productive. I would walk very slowly and purposely with good posture for short walks.

 

[Mailman]

No one told me that my wound had been packed with drugs to give me up to 72 hours of complete pain relief.
This would have been really good to know.

 

[Mailman]

@Eman85
I completely agree about walking with optimal form being more important than distance. I only included the steps to show how for the first 3 days I could do anything with my new hip, how immediately I could walk without a cane which I couldn't do before. It blew my mind but was short lived. Now on day 8 I wouldn't attempt what I did on day 1 but am making steady progress and am able to practice having a good gait, which was.not possible before the procedure.

 

[mature mama]

I too had next to no pain with my first three and both tkr but I think this was a result of my nerve block. It lasted a few days and I hardly needed anything other than Tylenol. I did not walk a half mile though. And I think only because these procedures were during the winter. My first hip was during a particularly cold and icy winter. I was reluctant to go outside and I am not normally a wimp.

Good luck with your walking.

 

[Mailman]

@mature mama thank you! Its good to hear someone had the same experience with spinal block, hardly needing anything more than Tylenol. I am very reluctant to take any medication so when the nurse in the recovery room gave me an oxycodone I refused at first. Then she gave me the lecture about staying ahead of the pain, and that when the spinal wore off I could go from 0 to ten just like that (and clapped her hands together loudly to drive home the point). So I took it and for the next few days didn't understand why I had zero pain, even though I didn't take any more oxycodone.
I don't find any support for your theory about a residual effect of a spinal block lasting days but will ask my provider at my followup. As previously mentioned by @Jaycey, the drugs inserted into the wound when they sew you up can last up to 72 hours, so that sounds more likely.

 

[mature mama]

My husband thinks I have a high pain tolerance but I think the nerve block got me over the first few days and made it all much easier. I have had both knees done and had heard these were very painful. Nope. They hurt less than this hip. I am grateful it made recovery so much easier.

 

[Eman85]

I had a spinal block and my tolerance for hip pain is pretty high, I put off replacement for over 30 years. With my first I got back to the room after surgery and felt great. Had lunch and the PT came to take me for a walk. Nurse asked if I wanted any pain pills and of course I said no I feel great. We walked a lap around the floor with me on the walker and I still felt great so why not do another lap? By the time I got back to the room I was drenched in sweat and could have folded that walker up like a gum wrapper I was in so much pain. First pain pill didn't dent it, rand for another and finally got some relief. Tore up my hero card and face reality. After that I took the pain pills and slowly went longer between them. I can put Tylenol in my pocket and it works as well as if I swallowed them, has no effect on me. I'd rather take the pain meds as directed then take NSAIDS.

 

[Mailman]

@Eman85 After reading your story I need to reconsider my strategy, re-examine my assumptions and start experimenting to see what actually works and what doesn't. Usually I try to just take no meds at all but I need to face reality as you were forced to do. I'm glad you found what works for you and have stayed ahead of the game.

 

[Hippie Chick]

I can have a headache. I can take something for it and get relief. I can opt to tough it out and endure it. Not taking something when I need it only impacts me and occasionally those around me if I am irritable. I am thankful that I do not normally have to take Tylenol so it still benefits me now. If you need pain meds to be comfortable at this point in recovery, I would take them. Ice and elevation are non-pharmaceutical pain relievers which can also help at this time.

 

[Mailman]

@Hippie Chick In my particular case I don't need to be comfortable. If my priority was to be comfortable, I would have experienced the THR asleep. What I needed in addition to a replacement for my "extremely severe" joint deterioration was two-fold,
1. to avoid drugs that can contribute to cognitive decline, esp. in older people already experiencing some memory loss, and
2. to face my fear of surgery head on (which turned out to be surprisingly easy)

Now that I am post op day 9, number 2 is resolved but avoiding drugs is still a concern. An unexpected fringe benefit of doing the surgery wide awake was that for an hour and a half I had the opportunity to hang out with the anesthesiologist and ask a lot of questions while the surgical team went to work on my leg. She had not much else to do other than monitor my blood pressure and heart rate after administering the spinal block. We hit it off well and had a good time together.

She also pretty much confirmed my thinking about pharmaceuticals and the various methods of anesthesia, to wit:

There are no drugs that are completely risk free or cost free. The ratio can be very low but it's always a cost-benefit decision. Her hospital there only had about 5 percent surgeries using general anesthesia.. only the ones like heart surgery where nothing other than general is possible.

A THA with spinal block alone without sedation is rock bottom in terms of risk of POCD (post operative cognitive decline). Propofol carries a risk of POCD.

Tylenol is more benign than NSAIDs in that they can ulcerate the stomach lining. That's why included in the pain prescription is another drug to counteract that. Opiates can cause problems with cognition, and the prescription also includes other drugs like Narcan just in case you happen to OD. For me it would be wise to avoid opiates if possible.

 

[Hippie Chick]

I think it is great that you were able to have the surgical experience you wanted. You have obviously put a great deal of thought and consideration into your recovery and pain management plan. I am glad that you have met your second goal and feel certain you will also meet your first. I look forward to hearing more about your continued progress and recovery!

 

[SurreyGirl]

Hi there!

Fir my first hip op I was on opiates for quite a while . I didn’t like the cognitive effects either.

This time I managed to come off them around 6 days after the op. I then managed on parecetemol with the morphine as back up although I only needed it once. I iced a lot more this time, rested up when I felt tired and did a fair bit of walking when I didn’t.

8 weeks out and I felt way ahead compared to my previous recovery.

Glad you are thinking things through and I agree the strong drug combo they give you straight after the op can lull you in to a false sense of security!

All the best with your recovery.

 

[Eman85]

Usually I try to just take no meds at all but I need to face reality as you were forced to do. I'm glad you found what works for you and have stayed ahead of the game.

I don't like to take any "drugs" including over the counter stuff but yes sometimes you have to face reality. I was more of a hero with my first then took the easier path with my second. I didn't have to refill my pain meds at all. Actually, I saw my pharmacist and they provided a kit to destroy what I had left. My area is known for pillbillys and homes have been broken into in search of pain pills. I've known people that have been overprescribed for an injury and they are not among us any longer. As long as you understand what and why you are taking something and remain in control there should be no problem.

 

[Mailman]

@SurreyGirl
Fewer drugs, more ice and elevation using the Lounge Doctor (highly recommended) seems to be the best path forward for me but unlike you I don't have anything to compare it to. So what you say gives me a lot of encouragement. Thanks for that!

it's day 10. After reading @Eman85 's story I'm going to start reducing my use of Tylenol and NSAIDs to the degree that it doesn't keep me from increasing the number of steps I log each day.

My surgeon insists on no PT for first 21 days at least and maybe never and instead to get both as much rest and walking as can be arranged comfortably, meaning definitely not to increase pain killers so as to walk more.

Still, recognizing that the road to recovery has many bumps and changes in directions, I expect it might become necessary to increase drug use at times.

 

[Eman85]

In my particular case I don't need to be comfortable.

In my case I found that being comfortable post-op was important. A good chair and an icing machine were the 2 requirements for me. I iced continuously if I was sitting or lying down.

 

[dnordo220]

Good morning @Mailman It’s day 12 for me. I am still taking my medication. Tylenol, Meloxicam, aspirin, gabapentin, Prilosec, and Colace. I am limiting myself to the pain meds. If I am experiencing throbbing during the day, I’m only taking one tramadol, last night I woke up after my ice was no longer cold and took a half of an oxycodone. I’m not going to stop my medication until they run out.

I’m surprise that you doctor didn’t give you a sheet to follow. my guide lists every medication and what its purpose is for and how long I should be taking it it tells me the time that I should be taking it and then on the bottom it has the optional pain meds and there’s a log every time I take when I login so I can see my progress.

I went on an unescorted walk outside today woo hoo! And I’m about to take another yesterday I had 34 minutes of exercise it was not planned, but I am definitely improving in my natural movements.

I stopped the walker over the weekend and started using the cane. I do not need the cane to walk, but I do bring it with me when I go outside for a walk when I walk I look like I’m in the marching band. lol

My thigh swelling is reducing every day, my ankle swelling is also reducing. I am attributing that to being a little bit more active and icing appropriately.

I actually feel really good today. I feel very close to normal. I can dress myself and put my own shoes on and do all those daily living activities that need to be done. I made my own breakfast. No one is home to help me and I feel pretty safe and secure.

With all that being said, I am still taking the necessary precautions and making sure that I am 100% aware that I had a hip replacement and then I have to be careful.

My advice to you is just follow directions. Don’t try to get ahead of it. Don’t try to beat it. It comes when it comes.