The things I didn't expect in the post op period

[andybc]

Hi BG,

You have my sympathy. I was largely stimulated to start this thread because the post op pain was so horrendous. Quite unexpected. I commented that most people either had very high pain thresholds or very poor memories! A few people say they didn't get much post op pain, but this is definitely the exception and not the rule.

I think what you're getting is the norm. It's thoroughly miserable for the first week for many, if not most, of us. My pain didn't really resolve  before day 10. Even now, at 3 1/2 weeks post op I still can't fully weight bear without quite a lot of discomfort. Again, I think that's normal. Acutally, when I'm out walking it's much better. Seems to be worse making short trips around the house. Even now, I get good days and bad days. But generally it gets better each day.

I presume you're not on any medication which would make your headches worse? I was on Rivaroxaban, an oral anticoagulant that gave me migraine-like headaches.

The pain around the hip region and leg will get better, I'm sure.

As regards the incontinence, that's one of the reasons I was very keen to avoid a catheter. It's more of a problem for girls than boys and it will clear up. Maybe, just get a sample of urine checked, though, to be certain you don't have an infection.

Keep smiling.

Andy

[ReneeP]

Hello all,

I am 6 days out from a revision to a THR after my BHR cracked the neck of my femur at 3 weeks post op.  Recovery is a little different than the first time around.  I must have lost more blood this time.  I got up the night of surgery to use the commode, and as I got up to get back in bed, I passed out and fell on my hospital floor...on my knees.  Thankfully, my hip was fine.  They determined that I was very anemic and I had a blood transfusion that made me feel a lot better. 

I do feel a bit more energetic this time than I did at this point last time.  They left my socket and just switched the BHR to a large MOM THR.  They said my recovery will be easier this time.  I definitely have much less swelling, and barely any bruising.  I think I'm sleeping a little better this time too, although I do take percocet and tramadol at night to help with the achiness and discomfort.  It makes me sleepy which I'm sure helps.

As far as incontinence goes, I haven't had a problem, really.  But if I wait too long to get up, I do feel like I have to "run" to the bathroom before it comes out.  The first couple of days after surgery though, things were SLOW.  I would sit on the commode for what seemed like a long time, waiting for things to start flowing.  I assume that was from the spinal.

Everyone hang in there...we'll all get better eventually.  I think we're all just impatient to get back to our normal lives...I know I am!  Then again, I'm trying to appreciate this rare opportunity to rest and relax from my job, raising 3 kids, and taking care of a sick husband.  These hip surgeries have their pluses and minuses!

Renee

[Merkley5]

Hi BerkeleyGirl - I have been thinking about you since your surgery date and hoping all went well.  Thank you for your post as the information that is provided by all of you who post about your surgeries and recovery are so appreciated.  I will be having surgery with Dr. Su in Jan.  Good luck with your continued recovery and I hope your pain becomes more controlled.  Take care and let us know how you are doing when you feel you are able.
Debbie in Chico

[andybc]

Welcome back Renee!

Your positive spirit is an inspiration. No point in feeling that in the supermarket of life, you've picked the trolley with the wobbly wheel - but....take your recovery gently this time. As you say, it's a rare opportunity for you to relax.

Best wishes for a speedy recovery.

Andy

PS I still think your pain threshold is miles higher than mine!

[sfinrecovery]

Hey, Berkeley Girl, great have a another SF CPMC patient!.  I am six weeks out and the pain I had before, for many years, has now subsided.  The remaining pain is that of strenous PT (muscular) and the incision healing.  Of course, the ROM is still an issue, but I am sure with plenty of biking and muscle stranthening, it will improve.

Patience has been my biggest challenge, knowing that this TAKES TIME.  I am not the best at counting on people or asking for help, so it has been a very humbling process.  I still cannot do full weight bearing due to a bone density issue caused by some particular circumstances, so it has taken longer to heal.  Still on two crutches while I am outdoors, but try one at home.  I still cannot drive since my Iliopsoas and Rectus Femoris are so atrophied, but in the healing process.

Planning ahead was my biggest priority, getting the home in gear, stocking the freezer and getting help set up surgery - the emotional support is so important, and one person in particlar has been the best.   And yes, having another someone every other day to do household shores (sp) has also helped - I do not have to worry about laundry, dishes, etc.

Following doctor's protocol has been important as well... easy does it.  The one thing I should have done is donate blood in case for a blood transfusion.  I had some challenges around that...

I should better get out and abouts and go to the gym and ride the bike, as I try to do every day when I do not have PT... getting those joints moving.  Keep on healing, you and all of us!!! Juan

[BerkeleyGirl]

Hi everyone. Thanks for all these kind words! It's especially good to hear that this is normal -- both the pain and impatience with it. There is this impression out there from the "pain-free" stories (those amnesiacs and tough guys) and the promises of pain meds that you'll simply need to REST, that's all, and walk and do your PT if you're doing that... not struggle with the pain and the sleeplessness.

I've had people at my house frequently, and the phone ringing like crazy, all of which is wonderful (I feel loved), but it's been pretty exhausting. Only yesterday did the pace slow down. I feel asleep at 9pm, woke at midnight for 2 hours, then slept til 11am! I think my body was finally saying, "aaaahhh." I actually slept well. I've been sleeping on my side since Post-Op Day 2 (the hospital propped me up).

Last night I discovered a trick: use a long pillow (king size) between your legs, not a short one. And use the slickest sheets you have (not flannel). Have a firm mattress but plush mattress cover. Don't wear clothes. (Or, I should say, a la Marilyn Monroe, wear only Chanel No. 5.) Last night I was able to roll from my back to my side -- even the surgical side! -- and onto my stomach throughout the night. Try lying on your stomach; it's heavenly and your leg just stretches out behind you, feeling extended and rested. If you bend up your non-surgery leg, it's almost like lying on your side.

Juan, I also didn't donate blood, because of studies showing that women who donate up to a few months before their surgeries tend to have a higher need for transfusions during surgery. I didn't need one during surgery, but the day after surgery, my low blood pressure got really really low... 74/45 or so! (was I alive??). I was nervous about a transfusion, and of course the docs have to lay out all the risks. But when asked, they said they would do it; and they do them all the time. So, I have some generous person's hemoglobin in my body now.

Makes me determined to donate blood, to "pay it forward," when I'm through with all this.

Juan, was your surgeon Dr. Gilbert, or Dr. Callander? Or someone else?

It's encouraging to hear that for some of you, the pain started to get better after Day 10. I'm on Day 8 now.

There's an interesting new book out there, by the way, on pain: "The Pain Chronicles." It's a science journalist's investigation into pain -- its cultural history, medical history, biological basis, etc. -- told in the context of her journey to address her own chronic pain. It doesn't take a moralistic position either way in the pain debates. Helpful reading!

BG

[andybc]

ANOTHER MILESTONE AT 4 WEEKS

Well, two milestones actually.

Particularly welcome as yesterday wasn't so brilliant as I'd overdone it a bit recently and was in some added discomfort.

Yesterday morning I got up at 6 to watch the eclipse of the moon. Let the dogs out and the moon was shining brightly in a cloudless sky. Went back upstairs to change into warm clothes. Only one sock, though as I didn't have the nerve to wake up my wife and ask her to put it on for me. Went back into the garden with a cup of coffee and promptly stood in some dog doodoos. Undaunted, I sat in a chair to watch the spectacle. As the foot untainted by dog poo gradually froze, the clouds came up and covered the moon! Still I did see about a 70% eclipse which was spectacular. Given that I was in some pain I unashamedly watched the tv, ate chocolates and drank red wine for most of the day. Watched several old episodes of Nip/Tuck, The Guns of Navarone, Brigit Jones Diary and Oceans 13 for the umpteenth time. The depressing thing is, it was one of the best days I've had for ages!

Anway, back to my milestones. Post op assessment very good. I can now drive!! Brilliant. Also, 90 degree rule no longer applies. Am going to have ceremonial burning of raised toilet seat!! Guess if I was French, I'd celebrate by putting the raised seat on a comode, driving out to the nearest motorway and taking a dump by the roadside waving to passing motorists. Being British, I celebrated rather more sedately and took a gossip mag into the toilet to catch up on what the A list celebs have been up to over the last 4 weeks so I can now have a more informed, if less meaningful, discussion with my daughters who seem to have an encyclopaedic knowledge of these things.

I have been told I can now fully weight bear, but will probably use a stick for a while longer but I really do now appreciate being pretty much pain free.

To all of you in the more immediate post op period, you have my sympathy but it really will be worth it in the end.

To Pat - this website has been of immense help and support to me and countless others. Thank you so much.

Andy BC

[Pat Walter]

Andy

Great post - glad to hear you are progressing so well.  Hope you have a great Holiday without the toilet riser!

Berkley Girl - glad things are slowly progressing for you.  It takes time for things to heal.  Not sure how long it takes a cell phone to recover after being in chicken soup!  Happy Holidays.

Pat

[jjmclain]

Pat, Merry XMAS to you and again thanks for such a wonderful site!!! Andy, thank you for once again making me laugh!!!! I am now at 6 weeks and was taken off crutches at 4 weeks (and allowed to fully weight bear) and taken off the 90 degree rule. I was also allowed to swim! The pool is also great for therapy!

What a difference these last 2 weeks have been! You will see a lot of progress now that you have been taken off the restrictions. The first day off the crutch I was like a baby learning to walk! But by the next day, things were better and now I am walking better than I have in years. When they said I didn't need the crutch anymore, my husband took it away...best thing, only way for my muscles to start getting strong again.

Good luck to you and I look forward to your next post!

[johnmarken]

Andy,
Thanks for starting this thread. I had thought of doing something similar for the same reason but never did, now its nearly 3 years later. I was one of those who was utterly surprised by the pain level of my hip resurfacing posterior approach. I probably fall into the more extreme category. I am now mostly happy with it and enjoy a fairly athletic outdoor life, but it has been a struggle at times and a lot of deliberate work.

Post OP PAIN kept me in the hospital for a full three days. Much more than I expected. I did not walk successfully at the hospital till just hours before discharge because I could hardly move at all and the amount of opiate required caused my blood pressure to plummet when I tried. I was fairly laid up as you for the first 10 days at home. POINTER: I slept on a recliner for three weeks. Much easier to get out of to hit the can than from a bed! I highly recommend it. Started using the bed at 3 weeks and found it difficult to find a good position to sleep. I had to make sure to put a pillow between the legs or I'd wake up suddenly with a twang if i moved wrong by mistake.

Illiopsoas/groin pain: When the required 6 or 8 weeks of no 90 degree hip bending thankfully passed and I started PT, I was discouraged at the amount of pain experienced with mid-line movement. The general stiffness was not too difficult to get past with regular work but sharp pain with mid line movement lasted a good year. I'm still careful. I think starting Yoga at one year was a huge help. I know its not recommended but it has been amazing and I am a regular practitioner now. Early on i was determined to get back on the bike and into the hills by spring/summer so I was pretty good at consistence at the gym. It took three months post surge to have the flexibility to start riding the trainer but I was able to start bike commuting and doing longer rides carefully at 4 months. I got that mid-line twang fairly often then. At six months I was doing century plus riding so I can't complain too much about progress once things started going. The mountains had to wait a bit longer till I could lift my knee higher without fear of that twang though.

WEAK EXTERNAL ROTATORS: That was also a real disappointment and continues to dog me some. I had hoped to get back into climbing right away but had to delay for another year.  In addition to the mid-line psoas issue, my ability to keep my leg under me on hills (inner twisting motion like a soccer kick) was very compromised and affected balance too much. That made me quite sad. Such difficulty is in the literature as a common result but I didn't know to look for it (yes competent retro studies with valid stats). But with a lot of work in the gym and outside I have made enough progress to do some scrambling and snow climbing over the past year. I'm cautious, aware of reduced ability but I think I'll get there.  Its an ongoing project for sure.

Over all its great. I am in far less pain than before surgery and certainly a lot more functional than where I had gotten to. I'm glad I did it. I've done three STP (200 miles from seattle to portland) rides including a single day 200mile ride, many other rides,  and am now getting into the mountains on a regular basis though cautious with the more technical climbing. But man, it didn't come without some pain and work!

A note about Yoga as I've read it is discouraged. I has been wonderful for my balance, motion, flexibility, piece of mind. Instrumental in taking it to the next level. I can't say enough. I did wait nearly a year to go to class but was stretching on my own. I think I have a pretty stable joint. I don't know if it was the method resurfacing with posterior approach sparing the capsul or what. Pritchette said I could do just about anything after the 90 degree prohibition as pain would keep me from doing anything I shouldn't. I just follow my senses. If a motion feels too strange or hurts I back off a bit but eventually try again and reap the benefit. I suppose its YMMV.

[BerkeleyGirl]

Could others share their experience with yoga?

I practiced yoga for 15 years and was fairly high-level, but I believe that hyper-mobility combined with weight-bearing while the hips were torqued was what triggered my osteoarthritis... I do recall some "twangs" that were probably slightly dislocations, never diagnosed or adjusted, and I think it just wore down from there.

I'm afraid now to do yoga, afraid to do anything that would pop the hip out. I'm only in early recovery so obviously wouldn't try for months, but Andy mentions that yoga is discouraged. Is that in general and over the long-term?

Thanks,
BG

[resurface]

BG, as far as Yoga

I am seven months post op (May 6, 2010) and I started back at Bikram 4 weeks ago.  No issues.  Like anything, need to listen to ones body.  I was never at a high level but I find some benefits.  I find it unlikely that yoga alone led to your hip issues. I find that many of the single leg poses help with my rehab.  Anyway... get back on that horse but take it in steps.

Good luck.

[BerkeleyGirl]

An update: Yesterday, 19 days post-op, I walked up and down my block MOSTLY WITHOUT CRUTCHES AND WITHOUT MUCH LIMP! I carried the crutches, of course, but found it quite easy just to walk. I tired quickly, and tiring means sloppiness in gait (my operated leg tends to roll in without its old hip-capsule musculature), so I mostly am using a crutch or cane as it continues to strengthen. Still, very encouraging!

Pain definitely still there -- still wakes me at night aching, and is worst by far in the morning -- but there's a gradual lessening. This really is a long recovery; I can tell I'll be working on strengthening abductors etc., and very carefully improving range of motion, for many months ahead. And of course taking extra care to prevent falls... I've never really liked downhill skiing anyway...! But beginning to see a light at the end of the tunnel.

I've studied Buddhism on and off for years, and I'm trying to use this experience of facing limits and mortality as a "practice" for appreciating the things of life even more. I've always been very strong and carefree, seeming much younger than I was (47), traveling everywhere, kind of like a 20-something guy in some ways -- the "live forever" attitude. Welcome to reality. My father's death last week has added to the sobering note. It's been quite a year.

I've also experienced a great increase in community -- friends helping me out post-surgery in my newly-adopted Bay Area region, sisters coming together around my father's death, and these online forums as well as offline connections through them. The stuff that life is made of. Happy New Year, all.

BG
RBHR Gilbert 12/10/10

[ABC2]

5 1/2 week update:
I can now put both socks on  :)
Another milestone.

Having said which, the startup pain is still very uncomfortable as is walking without a stick. With a stick, I have almost pain free walking though.

Funny business this. Pain pre op was bad, but far worse, albeit different, post op. So milestones are measured in how much less pain you get compared with the considerably more pain that has resulted from the operation.

To cap it all, half way through our family New Year's Eve dinner, I was struck down with a stomach bug and saw in the NY on the toilet (which at least I can now sit on with only minimal discomfort (had no discomfort in this respect pre op!)).

Anyway, I am ever the optimist and greet the New Year with a glass half full and bowel half empty. No point in sitting around feeling that in the supermarket of life you've picked the trolley with the wobbly wheel.

I'm not one for New Year's resolutions as I've never achieved any (nearest I got was in my twenties, when I resolved to give up smoking and masturbation. By March I was down to 20 a day, but still smoking as much.) However, this year I will pay more attention to my health, that's for sure.

Have just read inspiring post by someone who is skiing only 4/12 post op. Now that's what I call a sucess.

I still get quite a bit of pain whenever I do too much physio, so am going to heed the wise words of Pat et al who always emphasise "listen to your body". The trouble is that I don't really like exercise for the sake of it. Am happy to train to ski and play tennis etc, but just going to the gym (and I have one at home as one of my daughters is a fitness trianer), sucks as far as I'm concerned. If I'd listened to my body over the years, I'd now weigh at least 25 stone!  The moment I start in the gym, I hear my body saying "stop this and go and get a glass of wine". Many years ago, I belonged to a club called "joggers anonymous". Our principle was that the heart had a certain number of preallocated beats to last three score years and ten, so there 's no point in speeding up your heart rate and using them up prematurely. So if you felt like taking exercise, you phoned someone on the list and they would talk you out of it and go for a beer instead. I think most of the members have died now......

Seriously, though, rehab seems to be a compromise between pushing yourself and being sensible. At my age (60), the latter takes precedence.

Whenever I'm feeling sorry for myself, I read through various posts on this board. They range from those whose progress, like mine, is a bit slow and therefore reassuring to those who really inspire.

Thank you all for sharing your experiences. I can't tell you how much help it has given me.

So, to Pat and all of you, my very best wishes for a healthy, happy 2011.

Andy

[ABC2]

PS ABC2 is formerly ANDYBC. Somehow lost my id in the ethernet.

[PDJ]

Andy, this is very funny and very, VERY accurate! I had mine done November 29 and am having some issues the same, notably that stupid toilet seat! I had to use a jug when doing a number 2 as both bits didn't fit! I had a lot of post op pain and I still get a fair bit but am starting to get greater mobility. This morning, I was 3 inches away from putting my left sock on for the first time, which is a target I have set myself. It is funny how little can mean overdoing it though. I walked up the road with my daughter a week ago - it's about 500 metres or so to Sainsburys and had to get a taxi back as I couldn't manage! That was it for 5 days as I had no energy left at all. I find myself needing a nap most days and sleeping better at nights now but in some odd positions! I am pretty optimistic about my recovery - knee pain has been my biggest hindrance but that is improving now too. Cricket in May is my target but we will see. Being a fast bowler it could be tricky but I will ask advice and see what the docs say. Get well soon, everyone.

Paul.