THR Recovery Diary

[ldk]

The surgery went well today.

The physical therapists were surprised that I was able to stand up on my own. They will be giving me walking exercises with a walker tomorrow.

There is still pain in the groin area, which might have occurred because they strained my tendon during surgery when positioning my leg. The necrotic bone was removed and replaced with a Johnson & Johnson total hip replacement. I don't feel any pain from the bone anymore, which was on the right side of my right thigh.

All of the pain now is near the groin to the left of the anterior incision site, which is stapled and taped up with bordered gauze. The incision is around 6 inches long.

There were two anesthesias, one injected in the spine to numb the lower torso, and a general anesthesia through an IV. I do not remember any of the surgery.

The spinal anesthesia gave me an allergic reaction with itchiness all over my body, making me want to scratch everywhere. Benadryl was administered to relieve the itching.

A Scopolamine patch was stuck behind my ear to relieve nausea.

There were a couple of antibiotics applied prophylactically, Vancomycin and one other. A MRSA swab test after surgery was negative.

The medical bill was huge at around $9000 USD. I'll probably take out a hardship loan from my 401(k) to pay it.

 

[myglasshalffull]

Welcome & happy surgery is behind you. Groin pain is quite normal now, I still experience a little groin pain when I overdo.
Keep us posted on your recovery.
Well wishes!

 

[Mojo333]

Welcome to the Healing Side...

I'm impressed that you left such a detailed and clear headed post this early out. Members awaiting THR will find this helpful and inspiring.

My early posts were a mess

I'm leaving your hip recovery guidelines below....
Each person has their own unique recovery experience, and listening to your body is the easiest way to recover but you should find these guidelines a big help.

HIP RECOVERY 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

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 medstototo
Sleep deprivation is pretty much . inevitable - but what causes it?

Nutrition is of paramount importance. Available here are dietary tips, nutrition basics and additional food supplements. These articles are both general advice on food and specific guidelines aimed at people both pre- and post-surgery.

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.

 

[mendogal]

Good to see you on this side!!!!

 

[benne68]

Welcome to recovery, @ldk.

Glad to read that everything went well with your surgery and you were up and walking post-op.

When you are feeling up to, do read the articles that Mojo shared with you above. The information really help me with my recovery and I'm sure you will find it helpful too.

 

[Layla]

Congrats on your new hip!
I hope they are providing you with ice. It should help with the swelling and pain.
Stay in touch through updates. We'd love to support you as you're healing. Safe travels home...if you haven't been discharged yet.
@ldk

 

[ldk]

I had postop urinary retention for the first 24 hours, and they had to use a straight line catheter.

I was able to regain urination yesterday afternoon as the anesthesia wore off, but my pain level is now 9/10 instead of 3/10 as it was yesterday when I could walk without a walker. Now I need two guys to lift me out of bed. Just moving my legs off the edge of a bed is a huge exercise with loud groan pains.

All of my joints -- both hips, lower back, both shoulders and elbows are in extreme pain with the slightest movement. Only the knees, ankles and wrists seem to have been spared. I'm on oral pain medication but it doesn't help much.

 

[ldk]

What's strange is that it took over 24 hours post-op for the anesthesia to wear off, yet I could walk around fine with it (no dizziness, vertigo or balance problems). It might be due to the combination of spinal injection and general anesthesia. Now I need two guys to help me walk, and today was originally going to be the release day. I don't think Vicodin is enough for this pain, which is 9/10. if I could self-administer Dilaudid, I would.

 

[Mojo333]

oh my stars...
I am sorry you are hurting.

I had a few hours of some pretty rough pain until they got my pain meds tweaked.... Be that wheel...keep squeaking with the nurses and let him confer with the doctor.
I hope things level off soon.

 

[ldk]

How to assertively express your pain and request relief without coming off as a junkie or a potential liability?

 

[cold_brew]

Sounds awful but know that it’s going to be temporary. Power thru the first week or two somehow and when you look back it’ll all be a blur.

 

[cold_brew]

If you are at 9/10 they should be changing *something* about your pain meds??!?!?

 

[Mojo333]

I would probably state that exactly...
this is post-op pain -
"Look, I don't want to come off as a junkie, but the medication is NOT keeping my pain under control and it is not just uncomfortable, it is Extremely Painful.

 

[ldk]

The anesthesiologist and surgeon did not tell me to expect it to take 30 hours after surgery for the anesthesia to wear off, so I wasn't prepared for the urinary retention or the 9/10 pain level 1.5 days after leaving the OR.

They should have told me what to expect and how long it would take, or used less anesthesia so that it wouldn't take 30 hours for it to wear off, and so that nurses could attend to the pain immediately after surgery rather than me having to beg them for narcotics on the third day after surgery.

 

[mendogal]

There is a lot of variation in how long anesthesia effects last and it's hard to predict for any given person.

Having said that, I agree 100% that we are often not given important information about the immediate post op period.

You shouldn't be discharged until your pain is under control and an appropriate discharge pain med is ordered.

 

[ldk]

I looked perfectly normal -- almost too good -- yesterday morning, and was able to walk without a walker and without a lot of pain. The surgeon looked at me and said I could go home yesterday, but I told him my ride wasn't available and that I wanted to stay until today. The physical therapist acted a little surprised at my performance, but was helpful. I didn't feel "high" on anesthesia.

But I had urinary rentention which built up slowly the night after surgery until I had to ask for a catheter. Then later yesterday, urination slowly returned to normal, but 9/10 pain occurred all over the body to where I needed men to help stand me up straight out of bed. Once I was standing up on my feet, I could walk by holding hands or by using a walker.

 

[ldk]

The surgeon should not have encouraged my discharge yesterday, especially with the clue that the urinary retention that I and the nurses told him about meant that the anesthesia hadn't worn off yet. I had the catheter inserted at around 5 am yesterday, and still couldn't urinate until late yesterday afternoon.

"You want to leave tomorrow?", he asked around noon, almost like he was penning a discharge in my charts. I said "yes", not knowing about the 9/10 pain until hours later.

He only prescribed Vicodin (hydrocodone + Tylenol) to take home. He is off today, so I will have to ask his Physician Assistant, but they are hesitant to prescribe opioids and the laws are different everywhere.

 

[djklaugh]

@ldk Here's a (humorous) pain scale for you: https://bonesmart.org/forum/threads/new-kind-of-pain-scale.52544/

 

[ldk]

Since the surgeon is off today, I was given three options:

1. Leave immediately, since the hospital already has the discharge papers written by the surgeon yesterday when I did not feel like leaving because I was still unable to urinate. Take Vicodin at home. Call the surgeon's office next week if I still have pain.
2. Spend the night, getting pain medications and vitals checked regularly, and get more exercise with the walkers to acclimate myself. Take Vicodin at home. Call the surgeon's office next week if I still have pain.
3. Wait for another physician who can administer IV pain medications in the hospital, but who can't really do anything else over the weekend.

I have chosen to go with #2, since it's more convenient than #1 for whom is picking me up, and because #3 might get very expensive, and it can't do much over the weekend except relieve pain, which is reasonably enough controlled with pills if they are taken often enough.

 

[mendogal]

I think it's a prudent decision.