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THR Wide Awake - Mailman Chases Dogs Away

I've garnered a lot of no nonsense knowledge from Eman..I remember when I was in my early recovery days and said I went to big box store and grabbed one of those riding carts and he suggested using shopping cart in store.
He's stayed and continued to help new members.
Thanks Eman!
Mailman you seem to be coming along nicely. Just listen to your body. It lets you know when you overdo, even now when I think I'm superwoman I need a day to just chill.
 
I'm don't feel normal yet either but I'm either getting close or I'm getting senile because I've been forgetting to grab a cane when i head out for a walk.

More seriously though, pertinent point you make about your insides becoming more flexible the more active you are. By your insides you mean your muscles? I identify much of the discomfort I feel as muscles that are either waking up or resisting new demands placed upon them as I walk more and more each day and with a more optimal gait. During rest they tighten but Instead of icing now instead I might change position slightly or get up and walk. This might seem like a bad idea because that hurts but after a very short time that pain disappears. With pain I try to identify muscle, bone, nerve or other tissue. Even drugs go to work differently on different component of an organism so I do think this kind of understanding can be useful to reduce pain.

Another example in pain reduction without drugs was the exercise of doing the surgery wide awake yet pain free. The pain component was not even bodily. Numbness from the waist down was 100 percent. Any potential pain or discomfort was completely psychological, simply put it was fear. Proving that to be a mirage put it to rest not only now but in the future.

I've been wondering why some people recover more quickly than others. I'm not satisfied with just saying everyone is different. That is more of a truism than anything useful. For what it's worth I think that understanding musculature is as important as understanding loss of cartilage. There apparently is not always a direct relationship between x-ray diagnosis and presence of pain and discomfort.

When I hear about bruising behind the knee and knee pain and loss of nerve sensation on the top of the thigh following surgery I also wonder about how much a surgeon's skill and expertise determines the post op experience.

I also hear from people that don't particularly like their surgeon. How unfortunate! The way I see it, lack of personal connection, empathy and caring cannot help but prolong recovery and create unnecessary pain. Psychological and emotional pain surely interacts with physical pain to make what is perceived as physical pain more severe. It's one total experience. Conversely, empathy, sympathy and personal relationship and support, for example as engendered here at bonesmart, reduce pain.

So while not yet back to 'normal' I want to take the opportunity to reduce pain and suffering by taking a deeper dive into it.
 
@Mailman You bring up a lot of interesting thoughts... and questions that are complex to answer. There are many factors involved in why one person seems to heal faster than another person - age for one. Children and young adults heal faster than elderly people do. That's just basic physiology.

Just for an example - a broken bone. Smaller bones usually heal in 6-8 weeks but large bones such as the femur or tibia can take up to 20 weeks to fully heal. With hip replacement one part of the healing process is growing new bone around the implants - around the stem that goes into the femur and around the socket that is attached to the pelvis. And one can not hurry the healing process! Bodies heal at the pace inherent in their personal physiology.

Another factor for hip replacement is how long it took to get from first twinges of a deteriorating hip to actually going into an OR and having the joint replaced. If that interval was a lengthy one the muscles in both legs and also the back get stress by having to move in not natural ways for the duration .... and that get progressively worse over time. So the longer the interval, the longer the healing probably will take. I've been coming to BoneSmart for over 12 years now and it does seem to me (anecdotally) that folks who have a sudden need for hip replacement (from such as a skiing accident or bad fall) rather than slow deterioration from arthritis seem to get healed up faster.

Different folks also have different tolerances for pain and limited mobility. Pain tolerance is really a very individual aspect. And those folks who are very active in their lives tend to have lower tolerance for the limited mobility part of things. It seems like we here some times have to metaphorically "sit" on some folks ... I think we need a theme song to play in the back ground -- such as Seventy-ninth Street Bridge Song by Simon and Garfunkel -- "Slow down, you move to fast, gotta make the morning last".

I also think that folks who have a realistic, general understanding of the healing process and have a nice large store of patience do better than those who have been given unrealistic expectations by either their surgeons and/or friends, family, coworkers. Just about everyone has heard some story of how so and so's 2nd cousin's husband's uncle had a miraculous return to extreme skiing 3 weeks after hip replacement at the age of 92! Total fiction of course.

You, sir, are not even 2 weeks post op from major surgery! I sincerely hope your recuperation proceeds as easily and as problem free has it has been going .... and is going to take more TIME!
 
Mailman said:
There apparently is not always a direct relationship between x-ray diagnosis and presence of pain and discomfort.
Click to expand...
This is definitely true - I had to fight (argue) to get my first hip done - the pain was an intermittent deep ache that at times was so familiar that it was almost comforting. The reason I went for the op was the reduced mobility and increasing instability from the joint. The NHS uses pain as the guide for referral but once I got to see the surgeon he agreed that the reduced mobility along with the x-ray was sufficient justification.
Mailman said:
I also hear from people that don't particularly like their surgeon. How unfortunate!
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I would say that this and trust in your surgeon is very important. Mine has a particularly blunt / brusque manner, impressing upon me that it was my decision to go ahead with major surgery, not his. He would tell me all the details and likely implications but would not advise me what to do. I trusted him to the point that I sought him out for my second hip replacement and have taken his advice in finding an ankle surgeon.
 
The great thing about bonesmart is that for folks like me who had no clue about hip replacement and no thought out plan to have hip surgery I found my answers here and encouragement here.
I wish I had the opportunity to find the right surgeon, buy all the items needed to help in recovery, etc. But I didn't, I fell and fractured my hip.
Mailman you sound like an engineer??? My son is an engineer and he needs to explore every avenue of how things work, why they work that way, etc. Just curious.
Nothing wrong with investigating why some heal quicker than others, I think a lot of it is individual and how much you want to get back to being independent. I wanted to get back to life ASAP but my body had to take time to heal. I had to take the big patience pill and be happy with small victories in the healing process. And there are unexpected setbacks along the way. I was extremely active prior to my accident. Not a sit around type person, but life had a different plan, not sure what that plan was but here I am.
It will be 2 years in February for my replacement. I enjoy reading everyone's individual journey and hope to be voice of some experience and reason.
You are someone with great curiosity and investigate all options. You decided to be awake for your surgery, again, all individual decisions we make or decisions that may be forced upon us through no fault of our own.
I enjoy reading your posts, gives me pause to think about all of the options out there.
Stay well and I wish you a wonderful day!
 
@djklaugh I appreciate you sharing your perspective and taking the time to explain it in detail, especially the physiology of healing. Learned a lot.

I don't mind being reminded to slow down either. I'm plenty happy just being able to walk as easily as I can already. Actually my goals for recovery are rather modest. Given that I'm 74, I don't aspire to go rock climbing or downhill skiing or even clean my gutters again and I promise not to even use a step ladder for at least 6 months.

I do admit though that I am eager to get completely off of all medications as soon as possible.

Having busted the myth that the surgery itself is anything to fear, in preparation for the repeat performance with the other hip my subsequent goal now is constructing a personal reality where a THA recovery is not much more than a relatively short term inconvenience, given the long term advantage for the rest of my life.
 
@djklaugh : Staff has continually suggested I slow down. The past three days the weather here has been very beautiful and I've been doing a lot of walking outside, carrying a cane but not using it much, walking slowly enough, stopping to rest if tired, being careful. I've reduced pain meds down to 1 Aleve tablet per day. So I think meds cannot be masking pain enough to allow me to be doing too much unawares. Besides walking there's not much other physical activity. I still mostly rest, recline, elevate and ice.

Saturday I walked 1.1 miles, Sunday 1.8 and today Monday, ( which is my Day 13) I walked 1.8 miles again, which took about an hour, a fairly leisurely pace. In general I feel progressively better each day for the past week, pretty much in a straight line. Will likely continue increasing the distance though I don't have any particular goal to meet. I do still have some discomfort but what was feeling like muscles beginning to cramp unless I readjusted position or stood up and began to walk (although quite uncomfortable at first).. all that is diminishing.

Given all this do you still think I need to slow down?

I have surgeon followup in another week so can discuss in greater depth with him then, but meanwhile is there any potential problem you see in what I am doing?

I do understand that I am really just beginning recovery and that I won't be fully healed for many months yet.
 
Mailman said:
but meanwhile is there any potential problem you see in what I am doing?
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I don't see any problem with your approach. You just need to understand that walking 1.8 miles only days out of surgery is not the norm.

Keep listening to that hip. It will quickly tell you if you have over stepped. Avoid twisting or heavy lifting for now. New hips hate this.

Enjoy that shiny new hip!
 
Sounds like you are going slow and still resting and icing so as long as your body is cooperating you are probably good to go.
I was off meds very early, hated opiates, took extra strength Tylenol as needed.
I had to stay on walker for extra month due to still having small fracture but I was able to cook, make bed and do general light housekeeping.
I'd walk around my dining table 10x's in one direction then change! It was winter here when I was recovering so no going outside to walk although I did get to grocery store with my partner.
Other days I just rested.
Only you know how your body feels.
 
@Jaycey wrote:
"Keep listening to that hip. It will quickly tell you if you have over stepped. Avoid twisting or heavy lifting for now. New hips hate this."

Thx. I've found this to be really good to advice to keep in mind at all times. For example my body is averse to any sleep position except flat on my back with both legs raised on the lounge doctor. This would normally be my absolutely least preferable way to sleep all night but I don't fight it. It's obvious I have to sleep that way each night for now. I wake every couple of hours but that provides an opportunity to grab a fresh ice pack so all good.

Same with walking. Body in charge. I just have to listen to my limits. But this provides an opportunity to pay close attention to the mechanics of walking optimally, of which YouTube tells me there are conflicting opinions, for example about heel strike.

I try to have no expectations about how progress will come. I'm completely aware that recovery is a long haul. I'm a walking talking experiment. We all are. In a way I'm just trying to keep myself (and my wife) entertained until it's finished.

Fortunately she isn't sick of all this yet.
 
@myglasshalffull You wrote:
"Mailman you sound like an engineer??? My son is an engineer and he needs to explore every avenue of how things work, why they work that way, etc. Just curious.
Nothing wrong with investigating why some heal quicker than others, I think a lot of it is individual and how much you want to get back to being independent."
-------------------------------------------------------

I'm not an engineer but I do think like one, primarily to provide a better outcome for myself and others, by considering what factors may be determining the speed of my own recovery.

In my case I was so disabled before surgery that I really could not walk without heavy reliance on a cane even to move around the house. So on Day 1 of recovery I was already far better off than I had been for months, easily walking freely around the hospital with reliance on a walker only to ensure I didn't fall. From Day 1 I didn't need any help getting into or out of bed.

I was extremely HAPPY and POSITIVE after I had attended my own surgery wide awake and from that had a sense of ACCOMPLISHMENT and also FREEDOM from FEAR. I had an overwhelming APPRECIATION and GRATITUDE for my surgeon and everyone in the OR, who by being present, I had a personal, although fleeting relationship with. I had a strong desire to continue their effort on my behalf with whatever I figured I could contribue. As far as I could see this would be to continue with minimal drugs and maximum walking (as my only physical activity), as well as maximum rest, icing and elevation, as per this website.

Today its been two weeks since surgery on Wednesday October 18th. Here is a breakdown of pain killers vs walking distance for my first 14 days. Note that I only took a single dose of opiate in the recovery room of the hospital. None after that, although I filled the oxycodone prescription which was written "as needed", just in case.

I think that the relationship of these two elements of pain relief and walking tells a story. My goal was minimum use of pain killers but also minimum time to full mobility measured in nothing more than the ability to walk greater and greater distances unaided. In the following chart Pain Killer % is the percent of Tylenol and Aleve that I took relative to what I was prescribed for each day for the first 6 weeks, which was 3000mg Tylenol plus 1000mg Naproxen (Aleve), per day. For the first 3 day period I am NOT including whatever drugs were packed into my wound because I don't know what they were. Regardless I do believe they account for me being completely pain free during this first 3 day period.

Days Pain Killer % Total Miles logged during period listed
--------------------------------------------------------------------------
1-3 50% 0.52 (all on day 2)
4-7 50% 0.45 (avg 0.11 miles per day)
8 75% 0.15
9 25% 0.36
10 60% 0.64
11 25% 1.10
12 0% 1.81
13 0% 1.80
14 0% 0.99

Today is Day 15. I don't expect to need to take any more Tylenol or Naproxen (Aleve). I 'm going to cut back some on the walking for the next few days as the weather outside is rainy and cold and I think it will do me good to ease off a bit.

I hope all of this is useful to someone.
 
@Mailman that is great ! I’m 2 days ahead of you. For the past few days, I’ve been forgetting to take my Tylenol, because I don’t have any pain.

It’s chilly here and we have a freeze watch tonight. I started using my treadmill. I love it. I walk so much better on the treadmill than with the cane. I’m keeping it to intervals of 10-15 minutes. I also resumed my upper body workouts, but in a chair. Day by day and moving in the right direction.

Very impressive mileage you have. So glad you’re having a good recovery.
 
@dnordo220 I think much of the credit for what so far is a good recovery should go to my surgeon. I think he was very expert and also very careful in performing the surgery. When I removed the bandage a few days ago I was surprised to see that the incision measured only 3 inches. Hard to see how he managed a THA with only that small an incision.

There are some sensations that I can attribute to the femur and acetabulum healing but i believe that much of my discomfort now is from ordinary exertion. Muscles waking up, working in new ways together. To some degree this extends to the musculature on the non-operative side.

Great that you are able to work out and expand your activities. Don't know what comes next and maybe this is a good sign but frankly I'm getting a little bored with what has been a rather limited daily routine.
 
@Mailman I had cabin fever so bad last week, I can definitely relate to the boredom, I guess I’m glad I’m working.

I had some fun zaps today, nerve ending sparks. lol.
 
Recovery can be tedious especially for anyone that is used to being active.
I resorted to Netflix, and books.
It was winter here when I was recovering so made it easier to just "chill."
But by late March early April I was bored as well.
 
Day 19
I took two days off from walking and just spent it resting and sleeping as much as possible, still only on my back with lounge doctor and frequent icing. Did me a lot of good.
Now with a fresh start I realize that after 5 years relying on a cane, I am learning how to walk properly again. I strongly recommend taking a deep dive into this!
Plenty of you tube videos available or just go to any park and watch kids play. See how they go in a moment from standing to slow walking to fast or to a run in one continuum effortlessly, gracefully with a spring in their step.
It took me a day just to coordinate the swing of my arms with the opposing leg but the progress is rapid and fun with a new and perfectly functioning joint.
 
Regarding heel strike- if this is done with a straight leg then although it avoids using muscles that may be very weak and uncoordinated I think that heel strike is a very counter productive strategy. A slightly (at least) bent knee and properly balanced engagement of all the muscles in the entire lower body is required even if done very slowly and cautiously at first.

I found it quite difficult to get everything coordinated correctly at first but memory from childhood comes back to help and it didn't take very long at all to get up to speed.
 
Checking in. 3 weeks after THR. Zoom followup meeting yesterday with surgeon.

I know it will take months for bones to regrow and heal sufficiently to not have to worry about overuse or misuse but today I’m walking normally, at a normal pace as I showed him here:

walking video 11-07-2023.mp4

drive.google.com drive.google.com

It's peculiar in a way watching this little video over and over again mesmerized and in some disbelief, as if I'm still the guy who ended up needing a cane to even get from one side of the room to the other. Until 3 weeks ago.

Next stage of recovery: recover the life of mobility I let slip away.
 
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Your gait looks so good and especially for so early out from surgery! Keep on walking. :) :-) (:
 
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