New hippy - Dr. Pritchett, April 1, 2013

[trgcfrg]

I took the plunge and had my right hip resurfaced by Dr. Pritchett in Seattle on Monday, April 1 (I wanted a little comedy ). This board has been critical and a huge help for me to make my decision, and your stories have really helped me know what to expect. I've decided to keep a detailed blog of my experiences (see my signature line) to help others know what to expect from this surgery, especially what surgery with Dr. Pritchett is like. I have scheduled to do the left hip on May 20th, so I'm going to be relatively aggressive with getting this over with (I'm spacing surgeries seven weeks apart, Dr. Pritchett minimum is six weeks).

Surgery day went better than I expected. I was sedated when they did the spinal anesthesia, and didn't wake up until I was heading to the recovery room. I was able to walk around my room with a walker with PT, but threw up both my lunch and dinner that day. Next time I would insist on more aggressive nausea management before the surgery.

Day 2 went well, and I successfully walked the hallways and stairs with my crutches. I was also able to shower and dress by myself and ate all my meals without any nausea. I was discharged from the hospital around 2 PM, and was able to use crutches to get into my house, my bed on the second floor, etc. Unfortunately, around 5 PM my leg muscles really started to tighten, even with consistent icing. I was in much more discomfort by the second night.

Night #2, my first at home, was rough. My mom woke me up every few hours to take my pain meds. At 12:30 AM I decided to take my full dose of pain pills (I had been taking one pill every three hours, this time I took two). When my mom got me up at 3:30 AM, I had got out of bed to go to the bathroom (pretty rough getting in and out of bed still as our bed is really high). On my way back to my bed, I started to get really dizzy and light-headed. I stopped, set my crutches down and held on to the bathroom counter to keep myself upright. My mom saw I was about to faint, and called for my wife and dad to help. Luckily, they were able to ease me back gently to lay on the floor so I didn't have a hard landing or hurt my hip.

Once my dad helped me back in bed I ate some snacks (banana, club crackers, water) to get my strength back. I decided to stick to the one pain pill level that was working for me earlier. Day #3 I've continued to have significant tightness in my hip and leg muscles, and I'm trying to stick with the icing and my PT exercises the hospital gave me. My wife also got me a hand-held urinal so I can maybe avoid having to go to the bathroom as much in the middle of the night.

Any suggestions on what I can do for the leg tightness / pain? Any ideas what to do to avoid fainting in the middle of the night?

Thanks!

Jeff

[Baby Barista]

Hey Jeff...

Fellow Seattlite and 38-year old Pritchett hippy here. All of your recovery sounds pretty similar to mine. Except during both of my surgeries, I got sick on the fourth day and ran a very high fever for about six hours.

Now about that leg tightness. For my first BHR, it was super tight. When it got so bad by day 6, I called Dr. Pritchett and he told me to massage my leg as hard as I could tolerate it, multiple times a day. The trouble was, I breathed on my leg and it hurt... so I couldn't put much pressure on it.

With BHR #2, I started massaging the hell out of my leg immediately after surgery and kept it up the next several weeks. I didn't have near the tightness as I'd had with the first surgery. I think it was directly related to my massaging.

So, if you can tolerate it, start massaging. Follow each session with some ice. Hopefully it helps!

[evant]

Jeff

Congratulations on the first of your hip resurfacings by, from what I've learned from this site, the brilliant Dr Pritchett.

Maybe you could avoid the dizziness by not attempting to visit the bathroom in the middle of the night - try using a portable bottle (or two - it's a little worrying when you hear bottle number 1 getting close to the top!) for the next few nights. I did this for a few nights until I felt more confident.

The leg tightness is unpleasant. I tried to counter it with the pain medication and hot water bottles (wrapped in a light towel to prevent scalding) placed on the painful area - I hadn't heard of anyone else doing this but my partner suggested it and it did help me get through it.

Be extra patient with yourself as the next few weeks unfold. Your family understand you've been through a big operation and will help you.

Good luck.

[hernanu]

Hey Jeff, congrats first and most.

One other thing to add to the good advice already given. I hydrated to a fare thee well. Always had a mug with water, sipping on it.

Did prompt more bathroom visits, but on the whole I think it let me get back to normal quickly. At your time, I think you're still getting rid of the surgical anesthetics, so the more you help things along, the better.

Your body is also actively trying to heal, so the more pure H2O you get, the better. Sounds like you're icing, I think more walking also helps get rid of the wooden leg. I got up and rambled about the apartment often. It also built up my battered walking confidence.

Good luck, sounds like a pretty standard recuperation.

[trgcfrg]

Thanks, all for the great advice. I tried massaging my leg and got more aggressive about icing yesterday and that seemed to help with the tightness. I haven't had any more issues with dizziness or falling down at night since I pared back my pain meds, and I am also eating snacks at night to keep my strength up.

Today (day 4) was slightly better than yesterday, both in terms of leg strength and less muscle tightness. I'm also making it a point to get up and walking around more during the day, which again seems to be helping get things stretched out. It also didn't hurt to have my first post-surgery bowel movement (sorry for TMI  ).

[trgcfrg]

I'm a week post-op, and my leg strength is definitely improving. I've gone out walking with crutches most days, and I'm able to go further each day. My big issue right now is that my hip is still very swollen. I haven't noticed  much improvement on this in the last few days even though I've been icing and resting regularly.

I had been hoping to be back to work next week, but I'd need the swelling to subside first. When did the initial post-surgery swelling start to go down for you?

[hernanu]

I had significant swelling, it didn't go away until about two weeks or three along. I don't remember how quickly, but the bruising followed it out the door.

Not long. I think the icing and activity helps, you're trying to get the body to remove fluid. Drinking water also helps, counterintuitive, but getting the plumbing working well helps get rid of the excess.

Don't worry about TMI, we've all been through it.

[PattyM]

Hi,
I am 3 weeks post op back at work.!! My swelling was severe even though I iced quite a bit.
My swelling started to go down the second week and looks pretty normal now. slightly
bumpy or swelled around incision. Keep drinking plenty of water and keep moving. It will
get better. It's still early, take it easy!!
Patty

[Dan L]

Jeff;

Congrats on your new hip, the first couple of weeks can be challenging. 

The tightness?  Answer for me: Zanaflex, (muscle relaxer). I used it the second time around and it made a huge, huge difference.  With it, far less pain meds (benefits in less fuzzy head and in your digestive tract) and when combined with ice, the second recuperation was much easier than the first where I took the pain meds more and dealt with the side effectsm of those. 

Move as much as you can, do stay ahead of the pain (you wont heal as well/soon if you are in pain), and ice, ice, ice.

Best regards for a smooth recovery and keep us posted on your progress.

Dan

[Tin Soldier]

Congrats on the hip.  Since it's been a week since the original post, I suspect a lot has changed.  Hopefully you've gotten into a more stable and comfortable routine.  All I can offer is to use a lot of ice.  I agree with Hern on the fact that keeping busy (going to the bathroom and doing other things) aids in recovery. 

[trgcfrg]

7 week update:  It's been a few weeks since my last update. I'm doing well overall, and am pleased by how quickly things seem to be healing. It's amazing the improvement from one week to the next in this early phase. Some more details about my recovery:

I've been surprised by how little pain I experienced during this recovery. I stopped taking the serious pain pills on day 4 and stopped taking even Tylenol a week later. The swelling finally did start to go down about 1.5 weeks after surgery, but it was closer to three weeks before it was gone altogether. I was able to return to the office at 2.5 weeks, and have worked full-time since then. I was down to a cane at 3 weeks, and stopped using it at 5 weeks (my PT suggested I needed it until then due to some limping).

From week 5 to week 7 I've noticed a big difference in muscle strength. Just in the last week I'm able to walk almost any distance without getting tired or feeling sore. I'm able to distribute my weight between both legs evenly without pain (took until almost week 6), and I no longer feel like my operated leg is longer than my other leg. I've also noticed a big difference in strength walking up stairs normally (i.e. skipping steps). At week 5 I could do it with significant effort, but now it's almost normal.

Going forward I still have a ways to go on range of motion (I just got off 90 degree precaution last week), and I still have stiffness when I stand after sitting for a while. By the end of the day I still feel a little sore, though that's getting better. My muscles are still a little tight, and I feel a pinching or pulling sensation when I extend my leg behind me too far while walking (i.e. with a long stride). Overall I would say that while people say my walking motion looks normal now, it still doesn't feel normal to me for the above reasons. Any feedback on when you started to feel totally normal when walking?

I'm encouraged so far in my recovery, but now comes the next step - I'm getting the left side done on Monday (5/20). I'm not sure that I'm ready to start over again, but I am glad to get it over with and get on with recovery. Wish me luck!

[John C]

Here is one thought on your walking issue. Very often in hip arthritis there is an issue called "flexion contracture", meaning your body tries to keep the hip in a slightly flexed position all the time as a defense mechanism. If this were the case, it would be tough to get your leg flat on the floor when lying on your back. This contributes to the the classic limp because the leg cannot extend backwards without pulling the pelvis with it. After HR surgery, this flexion contracture almost always goes away, but the involved soft tissue has been shortened for so long that it takes awhile to stretch them back to their normal condition. My guess from your description is that before the surgery, your flexion contracture would not let your leg swing back far enough to feel the stretch that you describe now. Now that the contracture is going away, the soft tissue will need to stretch out to allow a normal stride. I would expect this to happen within the first three months if you pace it well.
Sounds like you are having a great recovery.

[evant]

You're doing brilliant Jeff - good luck for tomorrow.

[podgornymd]

It sounds like you are doing great. I dont have much to add since i am only 4.5 weeks out but your recovery sounds very similar to mine. I am glad you gave us an update b/c i was getting discouraged b/c i am still with a slight limp but your post made me feel better about it.I hope i get the same results at weeks 5-7. Good luck with your other hip.

[Arrojo]

I'm encouraged so far in my recovery, but now comes the next step - I'm getting the left side done on Monday (5/20). I'm not sure that I'm ready to start over again, but I am glad to get it over with and get on with recovery. Wish me luck!

Good luck to you!!