THR Ausman gets a new hip!

[Ausman]

Hey fellow hippies!

So glad I found this forum. It looks like a wonderful place! I had a total left hip replacement on August 23, 2018, just over three weeks ago.

All things considered I think my recovery is going okay. I am able to walk now with a cane, and have mostly retired my walker. I can take short steps without my cane, and my THR exercises are going well.

What has me very concerned though is a bizarre pain in my left foot and ankle when I stand up from sleeping. I had the hardest time last week trying to describe it to my doctor's nurse on the phone. She was asking is it "shooting", "stabbing", "aching", "pins and needles". No, no, no, and no. I simply couldn't describe it.

This morning when I awoke, I laid in bed dreading setting my foot down, knowing what was coming. But I was determined to find words to describe what I was feeling and this morning I finally got it:

Picture a balloon being dangerously over-inflated nearly to the point of bursting. And all the while, the balloon is on fire. THAT is what I am feeling. My foot and ankle feels like they are burning and being inflated to the point of bursting. Thankfully this burning feeling lasts only for a minute or so.

I suspect now that I am indeed feeling my ankle and foot "inflating" with blood as I stand. But why the pain and burning sensation?

For the rest of the day, my foot and ankle feel "bone sore". The greatest pain is on the top of my foot. It is hard to describe, but it feels for all the world as though a heavy weight (picturing a bowling ball) had been dropped squarely on top of my foot. If I press in that area, it feels like every one of the metatarsal bones are bruised.

I am treating my foot and ankle with ice and elevating during the day, but not sure if that is making any difference. FWIW, standing during the day does not produce anywhere close to the full-on burning foot pain that I get when rising in the morning. So there appears to be a connection to how long I had been laying and how severe the burning pain is.

So, does this "burning and about-to-burst" sensation sound familiar to anyone? What about the persistent "bone sore" pain on the top of my foot?

This same area had a lot of swelling and black-and-blue bruising during the first two weeks, though the swelling and bruising are now improved. Yet these strange foot pains persist and if anything are getting worse.

I'll be seeing my doctor next Friday, which is my first post-op appointment. Personally, I think a month is much too long to go, and I plan to say so when I see them. Is this typical though?

Well, that's about all for now. Looking forward to getting to know everyone here and wishing you all speedy and full recoveries!

 

[Eman85]

Welcome. I didn't have much swelling even in the hip area, none downstream. Are you doing ankle pumps to keep the blood flowing? Are you elevating the leg? One of the things I was told to do was support the back of my ankle 25% of the time I was laying down or sitting in the recliner. As far as odd pains go I don't think anyone on here hasn't had numerous never before felt pains like we've had post THR. The knee pain is more common but they mess with everything from the hip down so foot pain is possible. As far as follow up appointments mine was at 2 weeks and 6 weeks.

 

[Layla]

Hi, Welcome to BoneSmart! Thanks for joining us.
It sounds like you're doing well, aside from the mystery pain. I can tag the Nurse Director, @Josephine to see if she has any ideas on the pain you describe. Otherwise, you may need to wait until Friday to see what your OS has to say.

Please read the Recovery Guidelines below as many will still apply. Pay special attention to the Big Tip -
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.

Stop back often. We'll walk alongside you offering encouragement and support as you continue healing.
A great week to you!

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 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​

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. @Ausman

 

[Ausman]

Thank you Layla! Yes I would appreciate Josephine's insights on this. Might my foot pains be related to some of the swelling and bruising that I still have in my foot and ankle? My doctor did not direct compression stockings, so I have not used those. But then I don't see a lot of mention of them in the threads I've read here either.

Thanks Eman! Wow that is amazing you had no downstream issues. Most of my leg was black and blue at some point during the first two weeks. Now the pretty colors have mostly faded and are pretty much just from my ankle on down.

Yes on the ankle pumps and elevating. But not all day and maybe I've just been on my feet too much during the day. And of course I'm not elevated when I'm sleeping, so maybe that is the problem when I awake? Did you do compression stockings?

 

[Eman85]

I used an ice machine and it was on me as soon as I reached the room post surgery. I kept it on me just about 24hrs a day at home for the first 2 weeks. I had very little discoloring at all, very light yellow near incision. I didn't elevate when sleeping and just sat in a recliner most of the time. At 2 weeks I could roll on my side to sleep. I didn't have any compression stockings, ankle pumps and 1 aspirin a day for clots.

 

[Ausman]

Thanks again Eman. Yep ice machine here too - Breg Polar Cube. Though we only knew about it since a friend of ours had used one. Never saw one at the hospital. Nice thing is that the hip pad can easily be used as an ankle/foot wrap as well.

 

[Eman85]

Same machine here, 4 frozen water bottles and swap them out with the other 4 in the freezer. Kept it going pretty much constantly. That was my parting gift from the hospital. I don't see how people can ice enough with ice packs especially if they are alone.

 

[Lski]

Welcome! I elevate at night & anytime I'm sitting & not driving. Try that to see if your ankle & foot are better in the morning.

 

[1stSurgery]

I really hope you are able find the cause @Ausman and can be quickly relieved of the added swelling and pain. I feel for you! I think you've described your symptoms very well and clearly. Keep asking questions and seeking answers and let us fellow hippies know how you progress.

 

[Jaycey]

@Ausman sounds like normal post op pain. You get pretty "man handled" during THR. Some of the bruising will be a result of this. Does icing relieve this feeling? Let's see what Jo recommends.

 

[Bionic]

@Ausman,
I didn't have much in the way of pain and I don't remember any bruising but I did get a swollen foot. I was wearing compression socks but at some stage the foot was so swollen I couldn't get my slipper on. The foot felt like it was being blown up. I never iced (naughty, naughty) not realising how important it is but elevated when I could. I think mine took a few days and gradually it started to go down. All is ok now so lets hope the same happens to you.

 

[SurreyGirl]

I had no compression stockings and my ankle used to swell up as soon as I put weight on it and eventually I could not wriggle my toes. In the early days I went to bed in the afternoon and rested up with leg elevated and ice packs alongside hip and on ankle. I also did this when going to sleep at night. It did reduce the swelling but it then started up again the following morning and was aggravated by walking. However this all diminished after three weeks and the ankle was almost back to normal by week 5. I can now wear normal shoes!

I felt very sorry for those that has the compression stockings as we had a heatwave in the uk and people were complaining so I was lucky.
The ankle was a nuisance and I hated it but it did get better.

I hope you get great advice from your doctor and that it resolves itself soon

 

[Josephine]

a bizarre pain in my left foot and ankle when I stand up from sleeping.

Ausman, tell me what approach did you have for your surgery? You can see the various options in here THR approaches or incisions

 

[Ausman]

Thanks Lski! I tried elevating last night in bed and it was just too uncomfortable. It was kinda bending my knees backward. (I don't have that problem elevating during the day in my recliner).

Plus I have been sleeping a lot on my non-operative side and anything to elevate made turning over not possible.

The good news is the extra elevating I did yesterday seems to have reduced my waking/standing pain a bit. That and I'm now making a point of doing ankle pumps anytime I wake during the night for several minutes and/or until I doze back off. I still have to be very careful not to stand too suddenly but hopefully that will improve with reduced swelling.

Thank you again so much!

Thank you SurreyGirl. Was there any of the burning sensation as your foot was swelling? That is what seemed to stump my doctor, but this morning was ever so slightly better.

Hi Josephine. I am embarrassed to say I don't know. I will find out and post back. Thank you!

 

[SelfHelp]

Which pad did use with your Breg Polar Cube? I see on-line that Breg sells a hip pad. I wonder if the hip pad is just their xl universal pad with longer Velcro?

 

[Ausman]

SelfHelp, I checked and the pad is the Breg Hip WrapOn. Part #04750. Not sure if it is the same pad, but it does seem adaptable to several uses. Hope this helps!

Hi Josephine I checked with my doctor and the approach used was the antero-lateral.

Does the approach my doctor used typically involve forced rotation of the foot or ankle during surgery? I am still trying to figure out the soreness in the bones of my foot and ankle and wonder if it might be the result of such use during my surgery.

Thanks!

 

[SurreyGirl]

Hi I got mainly a numb sensation in my ankle and toes and the ankle swelled quite a bit and it didn’t take much to aggravate it. However they got a lot better over the weeks. The burning sensation was my heel which did not like being in one place in bed and was like a pressure sore. Putting a small cushion under it to to raise it did help but for the first three - four weeks I had to ice the ankle as well a the hip and would stick an ice pack on it when sitting in a chair during the day too !

 

[Josephine]

Does the approach my doctor used typically involve forced rotation of the foot or ankle during surgery?

Not as a rule but it depends upon the skill of the chap on the end of your leg!

I used to do it for my surgeons quite a lot because they would jokingly say that I 'frightened the hip and made it pop out"! I know I'd been taught how to do it at a very young age by a man who in time, turned out to be a premier hip surgeon in the UK but he was a registrar at the time! But I've seen inadequately trained assistants make a right performance out of trying to dislocate a hip and holding the patients lower leg, even as low as the ankle, whilst doing it.

The point of this little story is that it does depend upon how they dislocated your hip, how easy it was and if it needed undue pulling and twisting to get it to come out. Actually you can never tell beforehand how easy or difficult a hip is going to be to dislocate during this surgery. So this just might be a reason why your foot and ankle are hurting. But I can tell you that it should settle down in time.

 

[Ausman]

Hi Josephine

I am not embarrassed to admit I got a bit faint reading this but thank you! I purposely avoided all graphic descriptions and videos going into this surgery. It never occurred to me that it might fall to some poor assistant to "draw and quarter" the patient. I think I would have been so out of there had I known that was coming LOL! Good thing I didn't!

But is it safe to say that somebody had to dislocate the hip, one way or the other? Sheesh I guess I thought they just sawed the thing out. Oh god, getting faint again.

Seriously thank you Josephine!

 

[1stSurgery]

With you on that @Ausman! It's fascinating to read objectively but I'm going in for right THR in 3 days and starting to feel like a chicken about to be deboned!! I too avoided all videos and accounts of the process beforehand but am fully interested to see it all after. The first time I heard about the dislo procedure I pictured some big beefy guy named Vinny being called in from the wings to shove yank push and pull. And then called back again to ram it back. Then I quickly erased that image from my mind. But reading this account...brought the chicken quartering into my mind and now... I feel like a chicken! In more ways than one.
But it is very interesting you gotta admit.
Wow.
(Chicken squawking sound effects here)