THR Alice N's Recovery Thread

[Alice Nutter]

I think I may be in the ODIC, but I'm not quite sure what exactly I'm overdoing. I have quite sharp pain and weakness whenever I stand up, from sitting or lying, and usually it goes away as I start moving. I have been walking either with a cane or without anything inside the house.

I found the walker unhelpful quite early on and a couple of days ago I moved back up from the first floor to my upstairs bedroom,13 steps. So, I have definitely been going up and downstairs more for the last two days. I have been walking between one and three miles per day according to my Oura ring (a kind of Fitbit but ring-shaped), some of it outside on uneven ground because that's all there is around where I live, and I NEED to get outside in order not to go crazy. I use hiking poles outside.

I have been doing either lying down PT or standing PT twice a day. I live on my own, but my adult children were here until two days ago at my beck and call. Therefore, I am doing more around the house now, but there is a lot less to do when it's only me and my two dogs. Just regular stuff, loading & unloading the dishwasher, some laundry, cleaning and lighting the wood stove etc. None of it hurts particularly while I am doing it. I'm very careful about positioning myself correctly.

I am taking Tylenol and occasionally Ibuprofen; Tylenol seems to help more. I'm not sleeping well, but that has been the case for many years, and I have learned to compensate with naps. I'm retired, so that's not a problem. And I can sleep on either side. I spend probably a couple of hours a day at my desk with no particular discomfort, but getting up and down from it is a bit of an ordeal. If my cane isn't handy, I'm relying on furniture for the first few steps. I know I should move every 30 minutes or so, but sometimes I put it off because it's going to hurt.

This afternoon I go to my first outpatient PT session, which I'm looking forward to because he knows me and my lifestyle well and I did pre-hab with him, so I will have a chance to discuss all this. For the first three weeks I had in-home PT twice a week, but while they were very competent they didn't seem particularly interested in what I was experiencing, more in checking me off their boxes. And I checked all the boxes. They told me I was doing great. At the first post-op appointment with the surgeon's assistant, he told me I was doing great too, but I don't feel I'm doing great. I did for the first ten days or so, but now I feel a bit stuck. My intelligent brain tells me that if the sharp pain & weakness wear off when I get moving, it must be soft tissue stuff, but my lizard brain is worried that I might have a micro-fracture or an infection. There's no sign of infection at the wound site, and swelling is minimal. I am longing to get back to swimming, but the surgeon said not for another three weeks.

THR January 22nd. Reasonably fit 66F. Plenty of pre-hab including swimming for 30 minutes every other day for the last six months before surgery.

 

[sistersinhim]

Welcome to Bonesmart, @Alice Nutter! Am I correct in assuming that your surgical date was January 22, 2024?
Which leg was it?

You are very early in your total recovery, and it is completely normal to have pain and stiffness for a few months, so I think you are doing just fine.

Here is some reading to help you manage your recovery:
Hip Recovery: The Guidelines

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 the 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

6. Access these pages on the website

Oral And Intravenous Pain Medications
Wound Care In Hospital


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 the 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 the member’s history before providing advice, so please post any updates or questions you have right here in this thread.

 

[benne68]

Welcome to BoneSmart, @Alice Nutter! Glad you found us.

Please read through the articles that sister shared with you. At only 3 weeks into this year-long recovery, what you are experiencing is normal. Your body has barely begun to heal from the trauma of surgery.

my lizard brain is worried that I might have a micro-fracture or an infection.

I remember how scary some of those sensations were as I was recovering from my first TKR two years ago. The surgical team really doesn't prepare us for this recovery and we go into with unrealistic expectations. As you read through others' recovery stories, you'll see that all of with TKRs have felt what you are experiencing now.

I found BoneSmart right before my first TKR and the advice here really helped me through it. I'm following the guidelines again this time around.

Please keep coming back and let us know how you are doing! We're here to help!

 

[Jules1956]

Hi, I had a LTHR on 17th January so a little bit in front of you. I have had exactly the same thoughts/ worries as you. I am going to my first PT appointment on Thursday. I am 67 years old and still working. I dont think i am overdoing it but I still get pain getting up from sitting. I have been doing my exercises and walking outside , I do about 5K steps a day. Maybe we are expecting to much to soon!!

 

[Alice Nutter]

Point taken about overdoing it, y'all. I have dialled back on the walking on uneven ground stuff - my dogs can fend for themselves - and upped the PT and icing. MY PT guy agreed with everybody here. By the way, when I said walked up to 3 miles a day, that was total - not in one walk. Even I'm not that dumb. So far on the new regimen, the results seem to be positive. I am also thinking harder about how I walk, rather than how far - the PT guy also pointed out that I was getting knock knees and since the knee on the right side (my THR was on the left) is already damaged I don't need to go any further down that particular road.

 

[mendogal]

Your PT was perceptive - and whatever was happening with your right knee will change in some way now because your new hip essentially "reset" your entire structure. So attention to posture and the shifting of weight as you walk will be important.

 

[Sdfoxy1]

Hi Alice. My surgery was on January 25th so I’m right there with you. I’m 60 female. I could never dream of walking that much. The most I’ve done is 2000 steps in a day. My knee just feels like it won’t bend when I walk and it’s so cumbersome. I went off my pain medicine bc I thought I didn’t need it. Well I thought that bc it was doing a good job. Back on and feeling somewhat better today. I have a PT that give me pretty hard exercises and pushes a little to much. He is a wonderful guy and our neighbor but thinks a little pain is necessary. I actually didn’t swell afterward and was able to walk a bit better when I got home. So I’m still unsure about that part. The best part is the full leg ice compression machine you get at the end of the session lol. My Rom is 95 passive and 105 when he’s doing it. Extension is 0. I’m trying to stay positive it’s so early on. I had a hip replacement a year ago on the same leg. Since the knee was bad it has not gotten strong so we are working at that also. He said I could live a perfectly normal life at the extension I’m at now but I haven’t been able to walk upstairs naturally for about 10 years so I would like for that leg to get stronger. Sorry for blabbing so long. I will follow all of your posts. Since we are so close together it will make me feel better. Shawn

 

[Sdfoxy1]

Ps. I’m in West Virginia.

 

[benne68]

I could never dream of walking that much. The most I’ve done is 2000 steps in a day. My knee just feels like it won’t bend when I walk

Just FYI: Alice had a hip replacement, not a knee replacement. That's why your experience is so different! That said, 2000 steps/day is great for barely 3 weeks post-TKR!

 

[Sdfoxy1]

I could never dream of walking that much. The most I’ve done is 2000 steps in a day. My knee just feels like it won’t bend when I walk

Just FYI: Alice had a hip replacement, not a knee replacement. That's why your experience is so different! That said, 2000 steps/day is great for barely 3 weeks post-TKR!

Thanks got on the wrong forum. Again. lol

 

[Alice Nutter]

Hubris. I was doing so well, I thought - off the walker, off the cane, doing my PT religiously, and I got complacent. So two days ago I ignored yours and my PT guy's advice and took the dogs for a longer than usual walk, in snowy woods, on uneven terrain. I had my spikes on, I had my hiking poles, it was great to be out, when ouch ouch ouch. Sciatica. I just about made it back to the house. I knew what it was immediately - shooting, electric pains running up and down the leg into the toes. It may be piriformis syndrome, it may be something to with pelvic realignment, but in any case what I am dealing with has to be dealt with. I have dropped all the exercises and the walking, except around the house every twenty minutes or so, I am alternating ice and heat which seem to help a lot, I am downing Tylenol and/or Ibuprofen and I am trying to rest. And I am trying to learn the lesson. Apart from that, my hip really doesn't hurt much any more; it's just my pride and my optimism that are dented.

 

[Layla]

I am so sorry to read this. You're definitely in the ODIC (Over Did It Club) and you realize why. All you can do is nurse yourself through this episode with lots of TLC, then proceed slowly, with caution. Halting the PT and long walks, especially on uneven and likely slippery terrain is a wise move for now. I do hope you find relief soon. Stay in touch and let us know how you're doing.

Please notice that we have merged your latest post with your original recovery thread. Having your recovery information contained in one place will make it easier for you to reflect back on. It is also helpful for those stopping by to be able to review your history before advising or commenting. Please post any updates, questions or concerns about your recovery here. I also edited your thread title to highlight your current concern, just as you titled it in your latest post. Hugs and best wishes!
@Alice Nutter

 

[myglasshalffull]

You cannot "exercise" your new hip into recovery. It takes awhile to be able to walk any distance or do other types of physical activity.
This is a marathon recovery not a sprint.
There will be days when you feel all normal & then you will overdo, been there, done that, bought the tee shirt!
So relax.
Ice & rest, take your time to recover.
I wish you the best.

 

[Alice Nutter]

LTHR, 66F. I posted in my recovery thread about sciatica putting in its most unwelcome appearance four weeks after my operation.

I have had a few days feeling mightily depressed, and now am starting to emerge, not from the pain, which hasn't diminished, but the despair, which has.
I am lucky - the sciatica does not impact my sleep, and I can sit without too much discomfort. So there's that. It's walking/moving that's the problem - the burning, shooting pain from foot to hip which BLASTS me every so often, to the extent that I stop and gasp, and am apprehensive every time I prepare to move. I do not know if it's piriformis syndrome or something else (an impingement?) that is causing it.

What I do know is that even before the sciatica I had pain deep in my upper left buttock after the operation every time I got moving from sitting, lying or standing still, a pain which disappeared after a few steps. I don't know if the two are connected, but I suspect they may be.

I have my second post-op appointment with the surgeon's assistant tomorrow, and I have alerted the office to the problem so that it's in my patient notes.

What I would like to know if is anybody on this forum has any suggestions on how to manage the condition? Obviously I am no longer doing any of the PT exercises I was being so diligent about, which worries me because I am losing strength every day. All I am doing is walking around the house and occasionally pottering on the flat land just outside, so I get a bit of fresh air. I am using my cane consistently; the walker does not relieve the pain at all and I find the slightly hunched position uncomfortable. I live on my own, have an upstairs bedroom. I have a good support network.WhatI

 

[Jaycey]

@Alice Nutter I had piriformis pain post LTHR and have on-going sciatica nerve issues. I found gentle hamstring stretches from a seated position eased this. In fact, I still do these daily. If you put your chin to your chest while doing these it gives you a very nice stretch. Start very gently - your hamstrings may be very tight.

 

[Jaycey]

You will notice that I merged your newest post with your original recovery thread. For several reasons, we prefer that you only have one recovery thread:

• That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
• If you keep starting new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
• Having only one thread will act as a diary of your progress that you can look back on.

Please post any updates, questions or concerns about your recovery here. If you prefer a different thread title, just post what you want and we will get it changed for you.

If you need an urgent response to a question, just tag a member of staff.

Many members bookmark their thread in their computer browser, so they can find it when they log on.

 

[greeneyedjan]

I had TERRIBLE sciatica afterwards, it put me back in the hospital for almost a week. I cant take corticosteroids, and thats what they usually use to control the inflammation. It eventually calmed down, but it was the worst pain I was ever in. Hopefully yours will be better soon without the post op trauma that I had. Im almost a year out ( MArch 2023) back to skiing, and most days forget I even had the surgery ( although I know at some point I will have to do the other hip :(

 

[Layla]

So sorry you're having such a rough time one month post op.
I hope you have an insightful visit with the PA tomorrow, your concerns are understood and you receive some helpful suggestions. Let us know how it goes.
Have a great weekend!
@Alice Nutter

 

[Alice Nutter]

Sadly the visit with the PA yesterday was quite the opposite of insightful. All he could say after looking at the X-rays was that the hip was just fine, and to ask the PT guy (whom I see on Monday again) for some exercises. Oh, and to take Ibuprofen, like I wasn't already. He showed no concern, no interest at all in fact. I'm mulling over whether to call the office on Monday and complain. Okay, I understand, they do hips and knees, and they know about hips and knees, but the fact is that this happened subsequent to hip surgery, is in some way related and is problematic, to say the least. I expected at least a "if this persists call us back and we may have some suggestions." In the meantime, I go round and round the ground floor of my house on my walker and swear every so often....No significant improvement so far, but at least (so far as well) it hasn't worsened.

 

[mendogal]

Unfortunately there are ortho surgeons who are skilled mechanics with no interest in the soft tissue problems. Since they create the culture in their practices, their PAs often are the same.

Your primary care provider may be your best "next step".