Hemi-Arthroplasty Advice required on behalf of a part wheelchair MS user after a hemi hip

[Scaredycat10]

I had a new knee a year ago so I am au fait with the wonderful advice on this forum, although I was on the Knee forum.

My husband has Secondary Progressive MS and had a fall ten days ago and had a hemi-arthroplasty ten days ago. Prior to the fall, he managed to shuffle a bit with the aid of his FES device. We have a through floor lift and he used a scooter upstairs. Sadly due to its design, I don't think that will no longer be of any use.

Wonderful nursing care in an NHS hospital and a successful op[ but I'm slightly concerned about the physio provision. He can't stand yet and although he's been declared medically fit, he won't be discharged to a rehab unit until the medics are happy he will be safe but what I'd like advice on is when do 'early days' and 'baby steps' stop being 'early days' etc? I am totally in the dark here as his mobility was severely compromised prior to the fall so am I expecting too much? He can't straighten his operated leg and is having problems with the other. He is so weak from all of this and has gone from a determined to walk a bit man to one who is really dispirited.

I am so concerned we're looking at a wheelchair permanently even around the house. The main query is, am I being a bit paranoid in wanting his own neuro physio to go in and access him or should we leave it to the hospital physios and slowly slowly does it. I worry his legs will lose whatever power they had,

 

[Layla]

Hello and Welcome to BoneSmart. Thanks for joining us!
I will leave our Recovery Guidelines for THR as the info is also applicable for Hemi Arthroplasty recovery, which can be just as long, if not longer than a Total Hip Replacement recovery. Both recoveries can take up to a full year, even longer for some.

I am sorry your husband is feeling discouraged. Hopefully he gains more strength with each passing week, making him feel more hopeful. I feel it best you raise your concerns with your husbands surgeon and care team and make decisions based on their advice. I wish your husband comfort and you patience, peace of mind and wisdom to make the right decisions as his loving caregiver. We're here for support when you need us, please know that.

HIP RECOVERY GUIDELINES

As you begin healing, please keep in mind that each recovery is unique. While the BoneSmart philosophy successfully works for many, there will be exceptions. Between the recommendations found here, your surgeon's recovery protocol and any physical therapy you may engage in, the key is to find what works best for you.

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

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

Activity progression for THRs​

The recovery articles
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 that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.

 

[Layla]

If interested, Here is a link to others that have experienced the same procedure - Hemi-Arthroplasty

 

[djklaugh]

@Scaredycat10 Does your husband have his FES device in the hospital or is the physio using one with him? If not it might help him to have it since it has helped him at home.

 

[Scaredycat10]

Thank you Layla, I have read the posts you linked to but unfortunately, no one was starting from the same very low mobility base my husband was. That of course doesn't mean they won't be helpful going on so I will keep them bookmarked.

djk
Yes, he has his device with him but it hasn't been working.
The FES nurse is talking me through, on the phone, all the possible scenarios and yesterday, she had me put the device on my leg to see if the trigger switch under the inner sole of his shoe was working.

O.M.Goodness...was it working!!! I literally let out a scream!

The foot trigger switch , is weight triggered and he can't straighten the leg [it was the operated leg/hip which has the FES device ] and so can't weight bear and so can't trigger the device!

Last night he was back on oramorph as his leg is now uncontrollable in bed [wasn't before the fall] and is at strange angles and hurts his hip.

He is going to talk to the hospital physios today [I have asked before if there's a splint or something which can keep the leg in check but nothing has come of it] about the total lack of control he has and I am speaking to his own neuro physio this afternoon to see what she says. She isn't NHS but every now and then, he has a series of funded sessions so she's our private physio but occasionally NHS funded so there's a tenuous link between private and NHS.

He really is the most positive wonderful man and has 'put up' with his progressing disability with such stoicism [He had cancer last year and the treatment although successful, progressed the MS]. I won't use the over used words depressed/mental health but right at this minute, he is getting very dispirited.

He is definitely in the right place as opposed to a private hospital as the staff are beyond wonderful and so caring. I cannot fault for one second the care he's getting and he's better in a very small bay rather than a single room etc but there comes a time when he is just one in a long line of needy patients and the physios just don't have enough the time to spend on each one as they would like.

 

[Layla]

Aww, you two certainly have been through a lot. It's an amazing gift for your husband to be able to remain positive through the adversity he's faced and concerns he is dealing with currently. Bless his soul! I pray things begin looking up for him allowing him to feel more encouraged and hopeful about his recovery. Big hugs to both of you.
@Scaredycat10