THR Yankee Recovery<<

[yankees100]

@Jaycey - is the side of my hip supposed to still be so tender? I had that symptom before the surgery and am worried about this too. How do you know if the hip replacement helped the issues you had prior?

 

[Jaycey]

Have you tried stopping the exercises and icing regularly. I wonder if you have developed bursitis. Let's tag @Josephine to get her input.

 

[Josephine]

I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?

 

[yankees100]

Admin, can you change my thread title to Yankee Recovery. Thanks!!!

@Josephine of course! Thank you!

 

[Josephine]

Title change done - great idea!

Here y'go then!

It would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are

1. what approach did you have for your surgery? Anterior, posterior, lateral? You can look here to see the various types THR approaches or incisions

2. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't forget to factor in other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness).

3. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

4. are you icing your painful area at all? If so, how often and for how long?

5. are you elevating your leg. If so how often and for how long?

6. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

7. are you doing any exercises at home? If so what and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)

Exercises done at home
- how many sessions you do each day
- enter exercise by name then number of repetitions of each
etc., etc.

Anything done at PT
- how many times a week
- enter exercise by name then number of repetitions of each
etc., etc.

 

[yankees100]

1. Posterior -about 10-11” incision

2. 3-4. Lean towards 4 when walking/activity. If I’m laying down the pain is less, only when I get a sharp pain does it go back up to 4. But even on the pain meds I still have pain.

3. I’m on 5-325 oxycodone. I was prescribed 4 a day prior to surgery for 2 years due to the hip issues I was having (reverse hip dysphasia that caused OA and bone spurs). I’ve weaned down to 3 a day. 1 at around 11am, 1 at 5pm and 1 around 5am. Ibuprofen 800mg 2x day. Gabapentin 300mg 1x day. Tizanidine 4 mg 1x day.

4. I’m icing the painful areas as much as I can get the ice packs refrozen. About 3-4 x day for 45mins-1 hour.

5. I am not sure I am actually elevating it. I lay down or sit on my bed while I work. I have a few pillows under my leg, but can’t get my hip above my heart.

6. Activity level is high. I’m cooking 3-4 times a week. Tonight I cooked and did the dishes. I do laundry, fold and put away. I vacuum. I have steamed cleaned my carpet on my hands and knees (was not painful). I sweep and mop. I pick up stuff off of the floor. I grocery shop, though only one big one with a cart. I go up and down the stairs 3-4 x day to get my breakfast, lunch and dinner.

7. Exercises at home
-not consistent with each due to pain level. See below for norm.
- heel slides - reps of 10 2x day
-leg pumps - reps of 10 2x day
-leg lifts - reps of 10 1x day
- glut squeeze - reps of 10 2x day
-backward leg lift - rep of 10 1x day
- marching- reps of 10 2x day
-heel toe raises - reps of 10 2x day
-standing knee curl - reps of 10 1x day
-1 short walk to stop sign a day. But the past week I’ve had a bad cold so only 1 wall the past week.
- squats - reps of 5 1x day (Dr wants me to work on doing 50!)

No PT - Dr. said just walk

 

[Mojo333]

Those exercises are definitely PT.
Oh my stars
Just walk is right.

 

[yankees100]

Today was a good day! Worked from home, did some laundry and vacuuming. Went out to dinner and now a date with my BFF ICE. Still got some sharp pains on my hip. But still a great day, forward progress definitely felt!

@Josephine am excited to hear your advice.

 

[Josephine]

2. 3-4. Lean towards 4 when walking/activity. If I’m laying down the pain is less, only when I get a sharp pain does it go back up to 4. But even on the pain meds I still have pain.

Okay, I see

3. I’m on 5-325 oxycodone. 1 at around 11am, 1 at 5pm and 1 around 5am.
Ibuprofen 800mg 2x day
Gabapentin 300mg 1x day
Tizanidine 4 mg 1x day.

Oxycodone: okay but if you are only taking three doses a day that means you are also only taking 975mg Tylenol (acetaminophen). You can take another 3,000mg during any one 24hr period and I suggest you do. Try taking 2 regular Tylenol (325mg) with each oxy and another 1,000mg at another time.
I also suggest you alter your timetable and take them like this

8am 1 oxy, 2 regular Tylenol (975mg)
2pm 3 regular Tylenol (975mg)
8pm 1 oxy, 2 regularTylenol (975mg)
2am 1 oxy, 2 regularTylenol (975mg)

total 3,900mg​

Ibuprofen - rubbish pain killer (so stop[ taking it) but very good at messing up your stomach Medications: acetaminophen (Tylenol, paracetamol) and NSAIDs, differences and dangers.
Gabapentin: about right
Tizanidine: is just a muscle relaxant. Doesn't affect pain

4. I’m icing the painful areas as much as I can get the ice packs refrozen. About 3-4 x day for 45mins 1 hour.

Then get more ice packs! And ice for at least 60mins and more than 4 times a day.

5. I am not sure I am actually elevating it. I lay down or sit on my bed while I work. I have a few pillows under my leg, but can’t get my hip above my heart.

LOL! You don't have to get your HIPS above your heart. Just your toes! Like this

6. Activity level is high. I’m cooking 3-4 times a week. Tonight I cooked and did the dishes. I do laundry, fold and put away. I vacuum. I have steamed cleaned my carpet on my hands and knees (was not painful). I sweep and mop. I pick up stuff off of the floor. I grocery shop, though only one big one with a cart. I go up and down the stairs 3-4 x day to get my breakfast, lunch and dinner.

Ye gods and little fishies! That is NOT the proper amount of activity for 6 weeks out! You really have to read this again Activity progression for THRs and follow the schedule I've laid out in there.

Exercises at home
squats - reps of 5 1x day (Dr wants me to work on doing 50!) - 50? Is he insane? Besides which, later your Dr said this "No PT - Dr. said just walk". So why are you doing all this? You shouldn't be doing squats at all!

not consistent with each due to pain level - I'm not at all surprised!

heel slides - reps of 10 2x day
leg pumps - reps of 10 2x day
leg lifts - reps of 10 1x day
glut squeeze - reps of 10 2x day
backward leg lift - rep of 10 1x day
marching- reps of 10 2x day
heel toe raises - reps of 10 2x day
standing knee curl - reps of 10 1x day
1 short walk to stop sign a day. But the past week I’ve had a bad cold so only 1 wall the past week.

This is all unnecessary and harmful! This is why you have pain.

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.

 

[yankees100]

Thank you SO much @Josephine !! I had no idea about being able to take more Tylenol. On it right now!

I’m seeing a pattern where at the end of the day the side of my hip gets that sharp pain. To the point I can’t get comfortable. Any ideas for comfortable positions for posterior incisions. I can’t lay on my side yet.

Thanks so much for the advice! I truly appreciate it! I can certainly tell I’m making slow progress, but I agree I think I’m still overdoing it due to thinking everyone around me probably think I should be better by now.

 

[Josephine]

due to thinking everyone around me probably think I should be better by now.

At 6 weeks? Nooo Waaay!

the side of my hip gets that sharp pain

Show me where that is using this chart

 

[yankees100]

Sorry I can’t figure out how to update the chart.

Sharp pain:
TL1B
VL1B
TL1F
VL1F

 

[Josephine]

LOL! It's not interacive! You just tell me the references exactly like you have done!

So like this?

This is Trochanteric bursitis


.

 

[yankees100]

That’s what Jaycey alluded to as well. And I’m thinking it is too due to the tenderness and sharp pain. I have another appt with OS on Wednesday, I’ll talk to him about it. But I’m the mean time this girl is scaling back her activities.

Thank you!

 

[Mojo333]

But I’m the mean time this girl is scaling back her activities.

Smart lady. Lots of trauma to get these prostheses affixed...lots of healing going on.
Hope all eases,soon

 

[yankees100]

So will the bursitis go away with rest? Or will something need to be done, i.e. antibiotics, cortisone shot or surgery?

 

[Josephine]

So will the bursitis go away with rest? Or will something need to be done, i.e. antibiotics, cortisone shot or surgery?

@yankees100 if you read the article I left you, you will find all the options in there

 

[yankees100]

@Josephine I’m editing my pain area on the side of my hip. Do you think this is still bursitis? I have an appt tomorrow, so I’ll ask him too.

L1BX is where I feel the pain is most tender. And it’s seems to me at the end of my incision.

Also, I see a lot of comments on glute pain. Is that a normal place to still be recovering at 6 weeks? Thank you!!

 

[Josephine]

L1BX is where I feel the pain is most tender. Do you think this is still bursitis?

Maybe. But it's more likely ITB (ilio-tibial band) issues. Not likely to be glutes there. And you can still be tender at 6 weeks.

Are you still doing exercises? ANY exercises? (including PT)

 

[yankees100]

Nope, no exercises. Cut back on activity too. Increased Tylenol.

ITB looks like the cause! I have pain in my thigh and a little in my knee, not bad though!

Should I do some of those stretches or is it still too early? Same with a massage, too early?