Left resurfacing Conserve plus with Dr De Smet

[hernanu]

All sounds normal and good progress. Get using to triggering those metal detectors. I've done it at airports and a courthouse.

[whyme]

Two weeks yesterday...  Lots of positives:
No swelling down the leg.
Walking ~2h a day, 5-6km, one crutch.
Doing PT exercises 2 x 30-40', gradually increasing reps and intensity.
I stopped taking painkillers 6 days ago, so I'm only on the mandatory antiinflamatories and heparine shots (1 week left).
Sleep got better, I turn on the good side sometimes, which helps.
Moving around better, less sensitive to little turns and twists.

Still, there are few niggles and I have some doubts:
The "good" hip is getting increasingly sore...
The scar area is still a bit swollen, no idea when to expect this to disappear. It gets worse towards the evening, and "resets" during the night. Ice does not seem to make much difference.
While walking I lean a bit towards the good side, finding it difficult to take pressure off the crutch.
I cannot sit for too long, and the hip feels a bit "rusty" when I start walking again.

Anyway, I'm quite happy, I expected things to be a bit more difficult but can't complain so far...

[whyme]

Forgot to mention, every night I'm having a few spasms (2-4 times) on the operated leg, and sometimes on the other leg, has people experienced this too?
It shoots from the lower back and goes down through the leg, lasting 1-2". In the early days it could be a bit painful as the hip area was much tender. I guess this is a natural way of "exercising" the muscles, as since the operation I don't move much in bed.

[oldsoccerplayer]

I think that's pretty good for just two weeks. I had some of those symptoms, like not being able to sit for a long time and feeling 'rusty' when I got up. I found that the rusty feeling went away after I walked for a couple of minutes.
Being able to sit for longer is a mixed blessing. If you do a desk job like I do you can get so immersed in your work that you forget to get up and stretch every so often, which even healthy people should do. The post-op soreness served as  reminder to take periodic breaks so there's a kind of silver lining there.
I've also experienced a pinching sensation in my lower back in the non-op side. I have mild arthritis there but I think it's more likely to be the body readjusting to a normal posture after a couple of years of compensating for the pain on the other side.
I found these aches and pains are worrisome but so far none of them have persisted more than a few days at a time.

[whyme]

Hi all,
I'm 4 weeks post surgery today (Wow!), I've been checking the Hip Talk daily but haven't posted about my particular journey for a couple of weeks.

Here are the positives:
So far I feel it has gone very well, with steady progress and no setbacks.
There is no pain in the operated leg, but of course some stiffness or discomfort at times (more towards the evening).
I walk ~2h per day in two (sometimes three) sessions, generally covering 8-10km, using just one crutch since week two.
Also I do some PT exercises ~2h per day (increased repetitions and sets overtime, but not intensity).
And started on the static bike, built up gradually up to 15'/day (~60 rpm, no resistance), this is just to gain mobility gently.
Since a few days ago, I can walk around the house unaided, but with a noticeable limp.
Mandatory medication stopped a week ago, and since then I haven't taken anything at all.
The hip is less sensitive to little turns and twists.
The wound looks very neat and shows no signs of issues.
Sleep is alright, I wake up a couple of times when changing posture, but got into a decent pattern.


And here are the doubts (probably all normal, but would like to confirm):

- Sitting for long is not comfortable, particularly during the second part of the day. It seems no matter what chair or sofa (maybe there are better chairs?). This worries me slightly as my job involves sitting in front of the computer for long hours.

- The only pain I have is on the opposite side (in the rib cage), and also the lower back, surely because of the crutch, but I find it difficult to control and apply less force with every step.
The unoperated hip also complains at times, again due to overuse (particularly when doing the standing PT exercises).

- Around the wound it's always bulky, like if I had a gel pad under the skin. In the evening it feels more tight (or "hardened"). Will it take weeks or months until this disappears?

- I don't use much ice (between 1-3 times a day), but when I do it doesn't seem to make much difference, is this the general feeling?

- Still having spasms down the leg (actually, it could happen in both legs) during the night, generally when changing posture. Is this something others have experienced?

- Since ~2 weeks ago I feel really tired when I wake up, but after a few minutes I'm fine again.

- I believe using one crutch after four weeks is fine, but wonder what has to be done or happen so the limping without aid goes away. Is it that the gluteus is too weak yet?
If I tight the gluteus there is an uneasy feeling that tells me to not do it...

- I haven't visited my local Physiotherapist yet, but probably should go to make sure I'm not getting bad habits or muscle strength imbalance, but at the same time I'm a bit worried as try to avoid forcing mobility too early?

[luann again]

I think most of your concerns are quite normal. I am the gal with a C+, too. I am going on 3+ years since surgery and am still "recovering".  Still have some soft tissue aches and spasms at times. Seems to improve a little every day. Be patient and don't dwell on worrying too much this early in the game ( even if others on this site seemed to have recovered much faster!)   Everyone is different. Thanks for all the updates.  Sounds to me like you are doing well! Ask your Dr about any issues that really concern you. Lu
 

[hernanu]

Hi all,
I'm 4 weeks post surgery today (Wow!), I've been checking the Hip Talk daily but haven't posted about my particular journey for a couple of weeks.

Congrats! Around four weeks is when you start feeling independent and stronger.

Here are the positives:
So far I feel it has gone very well, with steady progress and no setbacks.
There is no pain in the operated leg, but of course some stiffness or discomfort at times (more towards the evening).
I walk ~2h per day in two (sometimes three) sessions, generally covering 8-10km, using just one crutch since week two.
Also I do some PT exercises ~2h per day (increased repetitions and sets overtime, but not intensity).
And started on the static bike, built up gradually up to 15'/day (~60 rpm, no resistance), this is just to gain mobility gently.
Since a few days ago, I can walk around the house unaided, but with a noticeable limp.
Mandatory medication stopped a week ago, and since then I haven't taken anything at all.
The hip is less sensitive to little turns and twists.
The wound looks very neat and shows no signs of issues.
Sleep is alright, I wake up a couple of times when changing posture, but got into a decent pattern.

All good activity, good progress. Seems like things are going well. If you need something to help any discomfort, don't avoid taking it, it's not a long term thing.

And here are the doubts (probably all normal, but would like to confirm):

- Sitting for long is not comfortable, particularly during the second part of the day. It seems no matter what chair or sofa (maybe there are better chairs?). This worries me slightly as my job involves sitting in front of the computer for long hours.

Remember what you had done. The muscle capsule about the hip was either cut or stretched. Your hip was removed from the socket, reinserted and then the capsule rebuilt.

You have several things going on:

• The most important is that the bone is both healing and annealing itself to the devices.
• The muscles, both large and small are healing.
• Your body is recovering from blood loss and general insult to the area.
• The nerves are probably slightly inflamed and irritated.
• The incision is healing.
• You are recovering from the effects of anesthesia and pain medicines.

There are probably more, and yet we all have made it back to our general lives, and some of us put a lot more stress sitting on the joint (luann with her cutting horses, BILL with motorcycles, a slew of us bicycling, etc.) than a sitting at a desk can do.

I am amazed at the recovery powers of my body, having experienced exactly the same issues as you.

I had trouble sitting longer than 15 to 20 minutes on anything early on.

So I stood, walked, in general moved around. I went back to work at 5 weeks both times, and both times I had to get up at that interval to be comfortable. I suddenly became a popular, man about town (or the office), since I was walking around talking to people.

Did wonders for my popularity. Plus I worked the crutches for sympathy like there was no tomorrow.

I noticed that I was actually able to stand longer than I could sit. It was a kick, since that hadn't been the case for seven years.  I went to Jazz clubs and stood around with my one crutch just looking cool. 

The kind of chairs at bars were actually the longest to get used to, and I finally noted (in one of my posts) the feeling of accomplishment on being able to sit for three straight hours at a club during a massive jam session without pain.

It's a process and will take its time, but that's where we have to be patient. It will be a pain until it's not.

- The only pain I have is on the opposite side (in the rib cage), and also the lower back, surely because of the crutch, but I find it difficult to control and apply less force with every step.
The unoperated hip also complains at times, again due to overuse (particularly when doing the standing PT exercises).

At four weeks, your body is confused, untwisting itself from years of being twisted and in shock from no longer being 'wrong'.  Your new hip is ready to go more and more and will put more stress on the other hip, since it is now rarin' to go.

It works itself out.

- Around the wound it's always bulky, like if I had a gel pad under the skin. In the evening it feels more tight (or "hardened"). Will it take weeks or months until this disappears?

Once it's possible, you want to work on this. One of the things we want to do is to discourage the formation of scar tissue. light massage around the area or on it once fully healed is what I had, then as tolerated, I started using the foam roller on the area to make sure it is released as much as is possible with that.

Some folks here have used active release techniques (ART - http://www.activerelease.com/ ) to good effect once their body was ready for it. It's something I'm actually considering in case there is something I've missed at three years.

- I don't use much ice (between 1-3 times a day), but when I do it doesn't seem to make much difference, is this the general feeling?

Nope, most find that ice helps quite a bit. Your body is healing and inflammation works against that. The more ice that is applied, the more support you give your body to lower that inflammation.

- Still having spasms down the leg (actually, it could happen in both legs) during the night, generally when changing posture. Is this something others have experienced?

I did, I believe others have as well. I found that if I hydrated more, drank a lot of water, it both helped my walking (more trips to the rest room) and kept the spasms at bay.

- Since ~2 weeks ago I feel really tired when I wake up, but after a few minutes I'm fine again.

Just normal recuperation, I think.

- I believe using one crutch after four weeks is fine, but wonder what has to be done or happen so the limping without aid goes away. Is it that the gluteus is too weak yet?
If I tight the gluteus there is an uneasy feeling that tells me to not do it...

You just need for the muscles to get stronger. They will, but you want them to get stronger and not learn how to limp. Which is why you want to use the crutches as long as needed and consciously practice good walking habits. If you're limping then you still need support.

- I haven't visited my local Physiotherapist yet, but probably should go to make sure I'm not getting bad habits or muscle strength imbalance, but at the same time I'm a bit worried as try to avoid forcing mobility too early?

I was doing at home PT by the end of the first week, went to outpatient PT by four or five weeks. My surgeon has a PT service that he refers patients to, they are well acquainted with hip patients, although I was the first HR they had done (and excited they were!). They were very conservative and did not demand stretching or strength exercises that went against my surgeon's limitations.

In the end, you are also the limiting factor. If something doesn't feel right, you put a stop to it. I found, as an example that at eight weeks I could do many exercises, but had trouble with walking on the treadmill - I told them and back to the bike I went. No problem, but everyone is different. Some THR patients had no trouble with it.


It all sounds normal, you are making good headway.

[whyme]

Thanks Hernan and Luann,

I asked the questions just in case, and to share the experience so others can relate; from your feedback it all looks pretty normal, which is reassuring.
My perception is to be recovering faster and better than anticipated, but I keep alert for any signs of overdoing things.

The worry about sitting was more about the short term when I'm back to work.
I also find astonishing that it feels more comfortable standing than sitting, which had never been the case before...

Yes, it's probably time to start visiting the Physiotherapist.

Regarding massage, foam roller and Active Release Technique I'll try to do without them for now as long as progress is perceived, but will reevaluate pending on results.

I have a similar feeling regarding mobility: being hypermobile I probably don't want to force it back too quickly, as it will happen eventually anyway... For example, now at 4 weeks I almost can reach my toes already, not breaking the 90 degree rule (still, I don't do it).

[whyme]

6 weeks post surgery today!

Things keep going well, progressing steadily, haven't suffered any setbacks or major problems. Every now and then there are niggles that last for a few hours or a couple of days, then I tend to worry a bit, but so far all go away eventually.

I'm still using one crutch to walk, but not indoors. The limping has diminished now, so I walk freely maybe 20-25% of the time, and use the crutch the rest. I think I will be ready to ditch it in 1 week or so.

Regarding exercises, they are focused on gaining strength, but the gentle way: low intensity, high reps (20-25) or less reps but hold 5-10", low angles. I don't do any stretching or exercises to specifically force mobility.

A typical daily exercise routine:
Walk x 2: total 2-2.5h, 8-11km. I might reduce this gradually to 1-1.5h once no crutches are needed any longer.
Static bike x 1: total 30', 65-70rpm, lowest resistance (around 35 Watt).
Hip exercises x 2: total 2h. (Glutes, quads, calf raises, toe raises, standing hip flexion, squats low angle no weight, lunges low angle no weight, abduction standing, standing leg forward and backward, lateral lunges, step laterally).

If I had to mention 'buts', they would be: sitting for long is still unpleasant, particularly in the evening; the area around the incision is bulky (like having a gel pad under the skin as mentioned in a previous post), and gets harder as the day progresses; and can't sleep on the operated side, I tried but is uncomfortable.

Overall very happy and hopeful, fingers crossed!

[hernanu]

All of that sounds very good. The bulkiness of the incision will come down, but I did begin to work on it, gently massaging to preclude scar tissue becoming set in.

You're doing things right, good hard work and care.

[luann again]

Good news. So glad things increasingly are getting better. You still have a long way until full recovery so be patient. Sitting a long time should keep getting better. That "start up" after sitting and then walking stiffness should keep getting less and less. I think it took me somewhere between 6 months and a year to completely disappear.
Chin up!   Lu

[whyme]

9 weeks post surgery today! It's going well, here are some notes:
- Between weeks 6 and 7 I put away the crutches. This was a gradual, natural transition.
- Restrictions were lifted after week 6: leg can bend over 90 degrees, toilet seat riser removed, no more pillow between the legs during sleep. I can cross the legs (but I don't).

- After week 6 I visited a local physiotherapist, following up once a week since. Initially he kept most of the routine, gradually adding harder exercises and removing easier ones. Daily exercise routine right now:
1 long walk (1h+, 5-7km)
1 x Hip exercises (1h): bridge on heels, "clam shell" abduction, leg abduction (lying on the side), leg extension, calf raises, toe raises, standing hip flexion, wall squats, lunges, squats low angle, standing walking, abduction standing, lateral lunges, lateral steps on stepper, front steps.
1 short walk (30') + Static bike (30-35') + Cross trainer (up to 10' now).
Is hasn't been easy to put the time (3-4h/day overall!), but it's worth as I can see the progress. In the coming weeks I will have to compress the schedule (less time, more intensity).

- Regarding "sporting" activities, the surgeon says I can start cycling outdoors, swimming, cross trainer (elliptical machine). Running after 3 months. However, this is on a "feel" basis and must happen gradually.
I don't feel cycling outside yet for a while (don't want to fall!) and will wait few more weeks before swimming. About running, as much as I like it, I'll postpone the internal debate (should I, shouldn't?) at least until 6-9 months out. There is no rush.

- Mobility is good for daily life as-is. I've recovered ~80% of my range of movement and not doing any stretching at all. Being hyper mobile helps here...
- Around week 6 I discovered the famous "clunking"! For me it's like a sudden shift. No pain, discomfort or noise involved, just feels weird.
- No pain getting in and out of the car! This is great, after 4-5 years used to those few dreaded seconds every day...
- Is not comfortable sleeping on the operated side, so I don't.
- The incision area is still bulky and numb.
- I can sit for longer before the discomfort kicks in.
- Some days I can do without ice therapy in the evenings.

- The non operated hip keeps complaining more than usual. I want to hold on for a few years before resurfacing it, but is hard to tell. At this point the operated side (still tender and weaker) almost feels better than the "good" side...

Sorry for the long note!

[hernanu]

Wow, nice recovery. Keep it up, all that work pays off.

[oldsoccerplayer]

The non operated hip keeps complaining more than usual.

I felt the same for a while (still do sometimes). It might just be the non op side getting used to a normal posture after spending a lot of time compensating.

[toby]

Whyme,
You are making great progress but as Pat says..it's not a race.
Interesting that Dr De Smet allows running at 3 months (my surgeon said 3 months too). However, I took the McMinn advice and waited a year.
Also, you stated..- 'The non operated hip keeps complaining more than usual. I want to hold on for a few years before resurfacing it, but is hard to tell.'
I hope I don't regret saying this but..my right (non operated hip) showed severe OA too at the time of my HR. Probably numerous years of overcompensation for my dreadful left hip.(stupidly I ran until the last year). I was ready to go Bilateral, my surgeon said that after the HR and being properly aligned that the deterioration in my right hip might cease. He was absolutely right after almost 4 years I don't get a twinge!
Hope it's the same for you.
Toby

[lgbran]

Why me ,
So reassuring to here of your progress since your HR. Another vote of confidence for this technique. I'm 4 days away from my surgery and was worrying about the inactivity post surgery. However if I can make progress like you have I will be wrapt. All the best with your ongoing speedy recovery. Keep on updating

[whyme]

Thanks guys for your comments...
Regarding my recovery regime, is just to give an idea but it works different for everyone. And the devil is in the detail (i.e., duration, speed, intensity, repetitions, angles, progression over time...).
Note that I feel niggles and discomfort on a daily basis and doubts creep in occasionally, but as long as there are improvements, it's ok for me.

Igbran, I'm only new on this, it's more reassuring hearing from older hippies after years!

Toby, I hope you're right about the other hip. However, it already has moderate OA, and I suspect there is labral tear (since a while ago), that won't help. My surgeon says this can't be predicted: sometimes it lasts longer as things get balanced after surgery on the worse hip, while others it wears out faster because the patient becomes very active...

[whyme]

Hi,
I'm 3 months post op today. Overall, very satisfied!
One major improvement is that I can sit for long hours now, and only at times feel some discomfort. And rarely use the ice packs.
Getting in and out of the car now is perfect.
I can walk any distance, or stand for hours.
The operated side is almost as strong as the other one, except on two areas: the hip flexors (psoas?) are clearly weaker, and adductors too. This is quite normal my physio says.

So progress continued, but not at the initial rate as I hit some collateral issues:

- Once back to work, I could not maintain the activity levels after 2-3 weeks. So progress slowed down.

- The knee on the operated leg complained for 3 weeks starting week 9 or 10, on the internal side, hurting mainly while walking, but I concluded it was due to increased intensity in some of the hip exercises.

- Once that went away, last week the same knee started to complain right in the middle (patella), again probably due to more intensity in some of the hip exercises, but mainly caused by the static bike in the gym (which I can't fit properly to my geometry as I would with a road bike).
So I had to stop a few days.

- Got a cold 4 days ago. That wouldn't bother me before, and would soldier on (both in terms of keep doing exercise, and to let it cure "naturally" no matter how long it takes), but not now. With colds/flu/sore throat (probably I've 3-4 episodes per year) I've a tendency to pick up sinusitis or chest infections (maybe once every 4 or 5 episodes), so I've been worried and tempted to reach my surgeon for advice, but I haven't yet.

Question: Should we be more vigilant with infections than before for a few months after surgery, or for life, or better not to worry at all?

Areas I expect improvement in the not distant future:
- Sleeping on the operated side. I rarely lay on that side, and when I do it's almost face down rather than lateral.

- Hip flexion is good in terms of angles, but definitely there is a discomfort in the groin at times. So I'm not getting stronger there because I can only exert this muscles very mildly. It's only 3 months, and the physio says it's quite normal, probably due to removal of osteophytes there, and the bone is a slower healer.
What's people experience on this?

- The right hip keeps bothering, we'll see when I properly begin the sporting activities (for now, I've just been doing rehabilitation really).
As I said on a previous post, at 3 months I'm clear to run, cycle outdoors and swim, but I won't even think of running for at least 9 months, or cycle outdoors for 6 months or so. I will start swimming once I recover from this cold.

[whyme]

Hi, 4 months report!
First, the issues... There are a couple of things still bothering me:

1) Groin discomfort with hip flexion (rather, when extending the leg after hip flexion). Is this normal, any advice or actions I should take? Would swim help?
This appeared around 2 months ago and doesn't go away.
Walk, cross-trainer, static bike are all fine ... Just when flexing the hip more than 30-45 degrees, regardless of weight or resistance.
My surgeon says problems in he groin are mostly down to overdoing or too much forced flexion exercises and recommended to reduce that and take anti-inflammatories for 2 weeks.
However, I struggle to find where I'm overdoing.
The physio noted the groin is the only weak area left now (compared to the other leg), so I should be working on it, but I don't know how so it doesn't aggravate the symptoms. Maybe work on very low angles (<30 degrees)?

2) Sleep on the operated side is still uncomfortable, although it got a bit better lately. Is this common?

On the positive side, I feel much better than before surgery, and can do things not possible before without pain. That's a success and I'm grateful.
I expect further improvements and be able to retake sporting activities gradually from now.
The exercise routine has been cut down significantly, but still manage to do something (hip exercises, walk, cross trainer, static bike) 4-5 times a week for 1h or so.
The ice packs have been at rest for 6 weeks or so.
I don't do any stretching (mobility is good) or massage on the hip area.
Last new year's eve I danced (well, most wouldn't call that dance...) under the influence for a while and felt great the day after!

[Miguelito]

Sounds like you are progressing nicely. I can't really comment on the groin. I still get twinges very occasionally.

I can't remember how I was side sleeping on op-side at four months. I'm gonna guess that it was 50/50 if I could at four months. If you are not there yet I am sure you will be soon.

I really just wanted to weigh in that, in my opinion, four months is still in the early stages of recovery. Your incision is healed, but there is still healing going on (I imagine). I didn't push it in rehab, but I didn't really start feeling athletic until the one year mark, but then it came on quickly. Even at that, I was a far better ice skater at 20 months than at one-year. So my point is just that full recovery from this surgery takes a long time, so you can expect a lot of improvement going forward. I personally would hold off on any real sporting activities for a bit longer, certainly to six months. Again, just my opinion.

Mike