THR Wonkyhipoy Recovery<<

[Jaycey]

Following the recovery guidelines, it is suggested that on week three you start planning walks of 20-30 minutes. Well I am officially in week three as of today, and I do not see how this is possible.

All this is very general guidance. There is no rule that says you must walk 30 minutes at 3 weeks out. I know I was not able to do this that early.

My rule was walk half the distance you think you can do. When that is easy and pain free extend the distance - but only slightly. You will soon gain strength and more importantly confidence. Take any walking aid that helps you avoid limping. You do not want to get into the habit of limping again.

 

[Mojo333]

Part 2.
Wonkeyhipboy...unstapled.

Sounds like a poster out of the middle of a teen magazine

Balance too much with a day off little.
Hope you feel better soon.

 

[SurreyGirl]

I am just in week five and can manage 30 mins walking a day plus general movement around house etc. I am still using crutches on the walk but really concentrating on heel toe and not limping. If I take longer strides and start limping or balancing more on one leg I go back to shorter strides. I would rather take this slowly and get it right than speed up and develops bad habit. It is frustrating taking 2-3x as long as before on a journey I know well but it the thought of doing this pain free, easily and with no long term limping that keeps me going.

Good luck with your continued recovery and I am enjoying your posts and honesty..

 

[Layla]

Rough guideline, that's all. Some will lag behind you, some will blow past you.
Be patient and listen to your body. We all came to the party at different stages with varying pain levels
and different degrees of immobility. As Jaycey mentioned, always leave yourself enough energy for the return trip. Don't walk until you're feeling fatigued, you have to be able to get back to where you started.

A tip -
Try heel-toe walking when / if you're limping. Let your heel hit the ground first followed by toes.
It takes a concentrated effort but I believe you'll notice a difference. Give it a try.
A great weekend to you!
@wonkyhipoy

 

[dlp]

Sounds like you are doing good - as everyone notes, we all recover differently. I've had different results after both of my THRs - so even individually we can recover differently at different times. I'm feeling a lot better than after surgery #1, but even at 6 weeks, I still have moments where I get tired easily. Especially after concentrating on heel-toe walking

Nice muscle video - it reinforces what my favorite physical therapist was very fond of reminding me of. "Your body is a system" - a complex and interconnected system doing way more than you think every time you move.

 

[wonkyhipoy]

Hi all,

Update time. Well the last couple of days have been interesting, to say the least. On Friday I had my staples removed... 37 in total. Didn't hurt at all... which surprised me. My GP (who is awesome by the way... only had her since my daughter was born, but she has convinced me the female GPs are hands down netter then male GPs when it comes to bedside manner and projecting compassion) put steri-strips on the incision. It did not open up or anything, but she is a maternity doctor (in addition to being a GP), and said that in her experience (also was an emerg doc), in certain areas where you have a lot of movement (midsection, shoulder, knee and of course hip), there is a slight risk that the incision will open up when the staples are removed with activity. She said it was a very small risk, but why take any if you don't need to... so the steri-strips are just to support the skin for the next could of days.

Anyway, I did my first 30 minute walk on Friday evening. My house is on a hill, so there was flat walking, hill climbing and hill descending... a good variety. Did it with just a cane, and really just for balance support. I was tired, weak and sore when we got back, but it seemed to push me to the next level. Yesterday I moved around a lot, and started doing stairs in the normal fashion... meaning, using the op leg to go up and down. Really good strength, though the stabilizing muscles are definitely weak. At night, I went out for dinner (my first venture out of the house other than the grocery store event). I took a tramadol just so I wouldn't be in too much pain from sitting for so long. Dinner was great... no pain at all. When I settled down for bed (about midnight), I had a bit of aching, but not much.

This morning, another story. A lot of "all over pain"... some deep aching, some nerve pain. It honestly felt like the third day post op. I was rather taken aback by this pain. I popped some Tylenol and though on a couple of ice packs, and feel pretty good now (been up for a couple of hours), but still have some pain. I am not discouraged by this as it was something I kind of expected. Two days of a lot of activity... there was bound to be some soreness. Thus, today is a bit of a rest day for me... though I plan on doing another long walk... though not 30 minutes. I also plan on doing a workout today for my upper body, as all this laying/sitting around is causing a bit of upper body atrophy (not really of course,. takes much longer than a couple of weeks... more of a mental thing). I have a functional trainer (cable station basically), so I can do a full workout without putting any weight on my hip.

So things are going well. Two steps forward, one step back... such is the road to recovery.

Cheers

 

[Bchbum4evr]

@wonkyhipoy let me ask, on your busy two days did you ice and rest in between activities? I find that makes a huge difference.

I just walked about 1.2 miles, so now I'm icing and resting; we will be visiting our grandbabies later, so I will ice after before bed. Yesterday was a long day on my feet without icing (funeral, graveside and celebration after) and man do I feel it this am. Ironically walking seems to have helped.

Also, I think it was you mentioning how tender the area under the incision was. My PT has me massaging towards the trunk of body only, around the area to help make that less sensitive to touch. Seems to help me.

Good luck... keep it steady and slow.

 

[wonkyhipoy]

Hi @Bchbum4evr,

Yes, I ice often, and did so the last couple of days. My activity was simply higher .

As for a tender area, no that was not me. I had indicated that the bruising down the leg was quite tender, and the swelling around the hip. Oddly, the incision has never really hurt that much. But good advice nonetheless.

Cheers

 

[Layla]

In all honesty while reading your latest post I had a feeling it would end with pain.
Consider balancing out activity with lots of rest and ice.

The problem is we get overly ambitious then suffer later. At 17 days post op, a 15-20 minute walk once or twice a day is plenty. Couple that with some light household activity and it's enough. I don't know that I'd be tackling hills this early on either.

Exercising to the point of fatigue, soreness and weakness is counterproductive. Think of the trauma your poor leg endured. It needs TLC, not to be exercised aggressively. If we viewed these injuries (and it is an injury) as induced by a car accident, I think the last thing you'd feel is that you need to be putting your leg through a workout. Make any sense? I just don't want to see you in pain and sidelined in the ODIC, stalling your recovery.
I hope you're resting today and that you feel better soon. @wonkyhipoy

 

[wonkyhipoy]

Hi all,

Here is another update. Well, things seem to be progressing with ups and downs. After a good day yesterday I started experiencing groin pain when walking, specifically when stepping down. Had it again this morning, and took and Advil. Was gone most of the day but now is back. Not sure if this is significant or not. From what I have read on the forum, the groin pain is common, but after walking rather than during. Anyone who has some comments on the, by all means don’t hold back.

Other than the groin pain, I seem to be progressing well. I am able to walk a few steps without my cane, without limping... thought this tires the hip and quad out rather quickly, so other than the odd experiment here ant the, I do not do this often. Today was a movement day, so I went for a long 25 minute walk (long in terms of time... not so much I. Distance). Took frequent breaks (30-60 seconds) and it seemed to be both less painful, and less tiring... though the Advil may have had something to do with it also. Do some putting around the house including doing dishes, making lunch, getting up to let the dog out and in (which seemed like every 15-20 minutes ). All and all a pretty good day. Tomorrow is a rest day, so I will be backing things off quite a bit. Might do a smaller walk, and less putting. I think the groin pain is a sign I need a rest day... so I am going to listen to my body and take it easy. Might do an upper body workout on the cable station... super light on weight, and really just to make sure the sedentary life I am living at the moment affects my recovery.

Anyway, one thing I have noticed is I walk with less of a limp (actually no limp) when I put less pressure on the cane... using it more For balance than anything, but this also tires my hip/leg out faster. Going to PT on Thursday, so will get some guidance on using the cane properly. I am not going to lie... I hate the darn thing. I much prefer a single crutch. Not sure why the cane is considered a better aid... or rather a progression.

Well, that’s all for now.

Cheers

 

[wonkyhipoy]

Just an update to the update... This evening I noticed new bruising coming though on my upper inner hamstring / inner thigh area near the groin area. Perhaps the bruising is irritating the muscles in and around the groin like everywhere else. Guess time will tell.

@Layla, you had mentioned you got mysterious bruising on you leg 17 days out. I am 16 days out... so I guess I am part of that club now

 

[Mojo333]

Might do a smaller walk, and less putting. I think the groin pain is a sign I need a rest day...

That's what I had to do..one month or there is still lots of deep healing going on. I had a good bit of groin ache..more than harsh pain.
Icing the groin not too comfortable for me but did help.
No experience with the bruising but @Layla might add some insight?
This is in our library
https://bonesmart.org/forum/threads/groin-pain-good-hip.10308/

I'd say shorter walks...your hip will tell you (usually afterwards)
Hope today is a good day!

 

[Layla]

Hi
Some bruising did show up on my leg mostly in the area of my knee, right above and below my knee, on the outside, not inside. It was day 17 which I found odd but was reassured it happens. It was from my knee being jerked during surgery to dislocate my hip. Think of cutting up a whole chicken how you need to twist / bend the pieces to get them apart sometimes after you cut into it. I know that's graphic but sometimes being blunt is the only way to get an idea of the trauma our leg has experienced. That's why it needs TLC, not exercise. It needs to heal. And it takes a long time but its gradually healing day by day.

Ice any areas that hurt. In case you haven't read it elsewhere, Josephine recommends icing sessions last no less than 40-60 mins several times a day. At only 20 days out, you're in the very early days of your recovery.
Hope you have a good one!
@wonkyhipoy

 

[luvsibes]

Welcome @wonkyhipoy - I just read your posts and you are where I was at 3 weeks or so! I think when you are used to being active it's pretty challenging to pace yourself and not try to do everything we think we can do. I've learned over the years while being challenged with fibromyalgia/arthritis that just because I can doesn't mean I should! Pacing myself has been my mantra each day.

At about 3 weeks I was getting pretty antsy to get on with life. I was lucky to have great PTs who helped me slow down and moderate my exercise desires. Now, at 11 weeks, I'm doing very well and so much better than pre-op. I once again am at the "get on with life" mode and wanting to do more. Even though I'm pretty pain-free now (except for the darned scar area and nerve tenderness and slight swelling still), I can overdo if not careful.

I wish you a fast recovery and reminder that "slow and steady wins the race" in this situation!

 

[wonkyhipoy]

Hi all,

Up date time again. Thanks @Layla, @Mojo333, @luvsibes, @dlp, @Bchbum4evr and everyone else for all your comments and advice. Yes, I tend to be an active and fit person... though OA of the left hip caused me to gain 10 unneeded pounds over the last year... well that and eating like I was 20 ... so I tend to go a little squirrely just laying around all day (even with walks and PT exercises). I was a ODIC before I started . So the constant reminders to "go slow", "back it off when needed", and "rest" are greatly appreciated.

So where am I as of today. Pretty god really. As old pains from surgery go away, new ones crop up... which is of little surprise thanks to this forum. I find I am worse in the mornings now when I get up... and late in the evenings after dinner. The morning is easy to understand as I have been sleeping very solid since the first week. I no longer wake up just to take Tylenol, so I am quit stiff and sore in the morning. After an hour of icing (and after taking Tylenol), I feel pretty good. The evening is really just due to moving throughout the day. Pain is minimal when not moving... in fact, t I didn't move I would not need any pain killers at all. To be honest, even without the Tylenol, my pain levels are tolerable when moving, but I find my instinct is to protect the hip from pain when walking, which results in a limp. So I think it best to continue the Tylenol for now... though I will likely start to back off the dosage to 500 mg every 6 hours instead of 100 mg. Advil still works the best for me. I do not take it often as I have stated before, but I will today as I have my first outpatient PT today (more on that later). There is lots of ice in my future today

Speaking of ice, I finally had enough of the ice packs. While the are great (I have the gel ones), it takes 30 minutes before they are soft enough to mold around the hip. After that, they are only good for another hour or so. If I were just icing the hip, that would be fine, but I am icing all over to reduce the bruising. So, I finally broke down and bought a chryotherapy machine. Coldrush by Ossur. It is the exact some one I already have that sprung a leak (actually multiple leaks)... which I have had since 2011 (for my hip scope). I ordered it Tuesday and it came yesterday. These things are awesome. They apply cold to the entire hip area (especially with the special hip pad) and the unit stays cold for 6-8 hours. They are expensive ($350 CAD... $250 USD), but way worth it. If you have the funds, I highly recommend you get one (or a competitive product... there are many).

I am also starting to forget my cane everywhere. I was making lunch yesterday and wound up not using it for about 15 minutes. I see this as a good and bad sign. Good in that I am starting to get around without the stick, meaning recovery is progressing nicely... bad because clearly my memory is catching up with my age... I am only 42, but have been told its all down hill after 40. I am kidding of course.

Life has decided to though my recovery a little bit of a curve ball. My little one has caught a cold, so she is home with me today. Unfortunately, I am coming down with it too (I got it shortly after her). Such is life with a preschooler. My poor wife has also thrown her back out taking care of me and my little one. Going to be a tough couple of days for us I think. But we will manage.

Anyway, that's all for now.

Cheers

 

[Layla]

Sorry you had to catch a cold on top of all else.
Your poor wife, aching back, toddler and toddling husband.
You'll have to let us know how your post op appt goes today.
Wishing your household well!
@wonkyhipoy

 

[Mojo333]

Oh me stars...don't you know everyone had to take turns having problems.
You can't all do it at once
Hope everyone feels better (especially the baby..
Sorry you are Baby #2)

Not even a month so glad you are still taking it slow...all sounds very familiar.
It's gonna get good...just a little more time.

 

[wonkyhipoy]

Hi all,

Well time for another update. Well my little one's cold lasted but a day and a half... or at least the worst o it. As for me, it never really materialized. A little sore spot on my throat that went away in half a day. Typically I have a very strong immune response when it comes to colds. I have worked "germ exposed environments" since I was 16: restaurant kitchens (which are filthier than you'd think... even the cleanest ones), restaurant front of the house (waiting tables), and in the healthcare industry for 10 years. So i rarely get sick from colds... or anything really... maybe one cold catches me every couple of years... although this streak was broken when my little one first started daycare.... that is a whole other world of germs... lol.

Well, it has been a really good couple of days. The PT I have is very experienced and has worked with the complex joint clinic (which is where my OS is from) for many years (mostly with Dr. Masri, but also my OD Dr. Duncan). Anyway, he was quite surprise how well I was walking with the cane given the fact I am only three weeks post op from a posterior approach. He has encouraged me to not use the cane around the house when feeling strong, and to eventually only carry the cane outside. He did not give me a timeline for this, only saying it is dependent on ow I feel, and to back it off if it hurts. He didn't say this directly, but I got the sense from his tone that he thinks I will experience some increased soreness as I do more activity... which is in line with what everyone here has said.

He gave me a few new exercises and changes some of the ones from the hospital. Specifically, he modified the heal slides (sliding your heal towards your butt while lying on the bead), and the leg out exercise (sliding you leg out and back in). He said that these exercises can load the hip joint due to the resistance the ground/bed offer... even with a plastic bag (which I have not used since getting home). So instead, he wants me to use a large exercise ball (like the kind you sit on). This raises the legs much higher and provide a smoother action. He said the goal at this point is not to work the joint, but rather simply to move the joint and "lube it up". So far it has really helped in terms of loosening up the joint. For the leg out exercise (which he wants me to avoid entirely for now), I put both leg on the ball and move it side to side about 20-25 degrees each side... again, just to loosen up the joint.

He gave me two new exercises. Weight shifting (which was from the hospital), and squats. Not full squats... not half squats... not even quarter squats. Basically squat until my knee is just out over my toe (I have really long legs, so while for some this might be a quarter squat... for me it is more like an eighth squat). The point of the exercise is to activate the quads without activating the glutes too much. This is similar to the leg extensions with a roller under your knee... which you should never do by the way, and I don't mean just after a hip replacement... I mean ever... leg raises put a tremendous amount of pressure on your knee and are a non functional exercise... meaning, you rarely if ever do this moving in the natural world. Sorry, a bit of a rant from my weight lifting days. Anyway, the squats have shown me just how weak my quads are (I think as a result of the bruising).

Okay, so that is PT. So far very gentle, and fairly limited. My walking has increased day by day, but of course I have a tendency to over do it. What I find interesting is that 9 times out of 10 you don't know you have over done it until you body tells you later that day (rt the next day). I wish my body was equipped with traffic lights that would light up yellow and red as I got closer to the point of over doing it. Oh well, may be one day. Yesterday was a good example. Wen for a walk in the morning, putted around... ll without issue. Went out for dinner that night (my first outing in three weeks... thank goodness!) and had to wait 25 minutes for a table. There is a little strip mall near by, so I went over to kill time. No issues getting over there, or walking around. Was notified that our table was ready (text message), so needed to hustle back. I looked up and realized I was at least a 7 minute walk back. Now 7 minutes doesn't seem like much, but when you have already been walking around for 25 minutes... and are now a little tried and sore, a 7 minute walk seems very daunting. Plus, I only had 5 minutes to get back or I would loose the table... so I had to walk and a much faster clip. long story short, by the time I got to the restaurant, I could barely walk. Luckily, the pain subsided quickly while at the restaurant, but when I got home, I hurt. Iced with my machine for an hour and took some Tylenol... by the time bed time came around I was feeling better... but still sore. Fell much better this morning, but even after just a little putting around making breakfast and coffee, my hip started to hurt. Obviously, today needs to be a rest day!

Another thing that has caught me a bit by surprise... I did not realize how much I favor my op leg when standing. Not due to the surgery as it does not really hurt just standing with equal weight in each. But because I have spent that last 4-6 years putting most of my weight on my good leg. I first noticed it playing softball this season... standing out thin the outfield between pitches I realized I was literally standing on one leg almost the entire time. Even though my op leg feels good, if I am not paying attention, I inevitably end up standing almost exclusively on my good leg. This is a habit I have to break. On the plus side, my pre-op limp is essentially gone... I thought this would be a much harder habit to break... and it might be later on in my recovery... but I am thrilled is it gone for now at least.

The last thing I am surprised at is the amount of swelling still in and around the outside of the hip. With my previous hip scope, I had swelling for a long time, but after 3 weeks, the swelling was much less around the outside of the hip (hip pointer) by this point... though a lot of swelling in the butt cheek. With this surgery, the swelling on the outside of the hip is still very prominent. Certainly less than a couple of weeks ago though. It is fairly rock hard too... which is odd for me because most swelling I have had in my life has been of the softer squishy variety. This feels more like the goose bump you get when you hit your forehead really hard on something. It does not concern me at all... I expected this to a point, and it seems everyone on this forum has experienced the exact same kind of swelling (well, those with the posterior approach).

Okay, well that is a lot for now. Hopefully everyone else's recovery is going well.

Cheers

 

[luvsibes]

Thanks for the update. I'm at 2 1/2 months post op posterior. The only pain I have now is still around the scar tissue. There's still mild swelling and tenderness at the op site. It's not too bothersome and is still less pain than anything pre-op but I'd hate to bump the hip into anything or get bumped. I think it would hurt a lot in that scenario! Being balanced with both legs is new to me, too as I limped for almost 3 years getting progressively worse. My pelvis was tipped pre-op and I am not even and it's a joy to walk normal and learn to stand more balanced!

It sounds like you are doing well. The pacing yourself when you are an active person is a challenge. You are aware and listening to those who've gone before!

 

[wonkyhipoy]

HI @luvsibes,

Thanks for the feedback. 2 /12 months... I am so jealous. I hate waiting... I have never been a patient man. Just curious, for you when did the pain really start to subside... in terms of activity.

Cheers