BILATERAL HIPS 12/13/17 COMPLETE! ANY GUIDANCE APPRECIATED!

[surratt]

Awesome Blinky...ive read your entire thread and post!  I can very much relate to your two week experience.  Its weird in the last 3-5 days ive gotten so much better its crazy.  Im at the two week mark today actually and im able to walk short distances with no assistance, like you said it feels week and unstable but i can do it.  No longer getting exhausted or light headed.  Im doing lots of pullups and dips as well as forearm exercises for my upper body...band stuff as well.  Keeps my mind healthy more than anything i dont like feeling sedentary.


Im not sure how much i should be trying to walk on crutches bc you hear so many people try to push the walking and their results arent much better than the people who chilled.  So im trying to find a middle ground, make sure i gou outside on crutches every day to move my muscles around but not try to kill myself.  From what ive gathered its all about letting your body heal itself this first 6 weeks.


Taxicab confession...i shouldnt have but i drove yesterday bc i had to make a quick trip.  Prolly not the best idea at 2 weeks bilateral but i used 2 feet and it felt fine.  It was a short distance and it did feel good to get out of the house but my girl was pissed when i told her that lol.


Thank you for all the words and input guys its a huge help

[surratt]

little update...tomorrow will be the three week mark for my first hip.  Man Im feeling great, i just got done crutching outside about .6 mile.  Im putting less and less weight on the crutches at this point...i could have walked alot further than .6 but im trying to not go crazy and gradually build up.  Not really experiencing a ton of soreness afterwords either.


My exercises they gave me are boring as hell at this point.  Im doing lots of pullups dips and forearms exercises to try to keep my upper body in decent shape.  Im breaking that 90 degree rule wayyyyyyy too much lol.  Not terrible but sometimes my feet itch or something and i reach past.  I cant wait for the 90 degree thing to be over.  What is the danger of that anyway?  Is it dislocation or just tearing muscles?


Im walking alot around the house not using my crutches...its a super gimpy and very slow walk but its nice to be able to carry stuff without making 50 trips.


Similar to blinky i think at about the 5 week mark ill head to the gym and start trying to swim and hitting the sauna that I miss so much.  My 6 week check up Im going to drive up to see Dr.Gross ,  man i cant wait for that.


Also I know im not suppose to and my girl gets pissed but i drive to the store and do small trips.  the way my pedals are setup i dont have to lift my leg to change pedals i can just pivot on my heal or drive with 2 feet. 
probably not the best idea but i dont feel my driving ability is hampered, but i do keep driving to a minimum.


Im eating good food but im simply eating too much!  Sitting around the house all day i just munch too often.  I was 182 before surgery... 3-4 days post surgery i was 200 pounds from all the swelling and now 3 weeks later im at 185-186 and its hard to keep my weight under control.  At the 6 week mark with swimming and using the elliptical and bike it will be easier to keep the weight down.


anyway thanks guys for the words and getting me past that first 10 days full of uncertainty...it feels like smooth sailing from here

[surratt]

anyone ever experience lower back pain and stiffness during the first 6 weeks.  i have no issues as far as my back health but i feel like being unable to stretch my hamstrings and back due to the 90 degree rule have left my lower back a bit tight.  i just started doing a couple of stretches that may help but i cant wait until week 6 where i can start stretching more and doing more exercise.


I have an inversion table i use as well that gives me lots of relief but im not using it the first 6 weeks.  Ill discuss it with Dr. Gross at the 6 week mark but im willing to bet he says leave the inversion table alone until the 6 month mark.


Also my walk without crutches is way better... I use no assistance around the house now but i do notice im still going side to side to compensate for hip weakness and ive noticed me oblique side muscles are sore from that.... walk is slowly getting better though

[John C]

Hi surratt. I am willing to bet that your low back is doing its job right now, which is too protect your hip area by keeping you stiff and somewhat immobilized in the surrounding area. Our bodies evolved for tens of thousands of years before the invention of casts and splints to protect an injuries area while it heals. Our bodies do this by making the area around an injury stiff and sore enough that we don't do anything stupid and overdo it. I would suspect that as your body heals, it will ease up on the stiffness and soreness around the area, including your low back, so that you can start moving and regaining motion again. The rehab process is constantly treading a line between letting the pain and stiffness protect the area from further injury, and finding subtle movements that are safe and beneficial. It sounds like you are doing a great job with that so far.

[blinky]

Hmmm, I didn't think of myself as having lower back issues until pretty far out, like a year and a half out. My observant PT, however, pointed out that my SI joint was weak and noisy on one side about six months out and she worked to fix that.


I did notice some strange lower ab weakness a year out when I discovered I couldn't do some lower ab exercises like mountain climbers very well. (Two years out I can do them.) Maybe that's part of what you feel? Some subtle ab weaknesses? Hip flexors and psoas are traumatized by the surgery and by the time you spent compensating with a bum hip, too.


The real lower back stiffness and weakness I didn't feel until I was doing a lot of walking and standing (of all things). When H and I were exploring new cities, walking everywhere, going to museums, standing and staring at exhibits, at the end of the day my back would be very stiff. This was as recently as a year and a half post op. That has gone away, too.


I'll agree not to push too hard this early. Let yourself heal. Yes, do keep a list of weaknesses and watch how they improve or don't improve. Some stuff goes away on its own, some new stuff pops up when you think you are fine. You can ask Dr Gross about them at your check ups. At three-four weeks, I wouldn't worry about lower back stiffness.


(Something to look forward to: I was so excited to bend over at six weeks. I envisioned myself sitting on the floor and picking things up off the floor with ease. Ha! I was still stiff and weak. Yeah, I could do it, but it wasn't pretty. Lee had to coach me on getting down on the floor.)

[surratt]

yeah i think you guys are right....i actually feel a bit better today just doing those stretches.  Also not being able to do any ab exercises likely contributes. Over the years ive found that hamstring flexibility has alot to do with lower back stiffness and like John said the body compensates in ways when things arent working right so its really not that big of a deal.  But im super excited to hit that 6 week mark so i will be able to attack this more with exercise and stretching.


Ive got one little stubborn scab that is keeping me from getting in the pool.  It is the size of a dime and taking forever to fall off.  It feels healed underneath so i think im going to pull that badboy off and apply bactroban, hopefully it will be ready at the 5 week mark for the pool.  (will be at 4 weeks on friday)


I know you arent suppose to pull scabs but i read that sometimes they can actually slow the healing process and it can be appropriate to remove it.  At 3-4 weeks out i feel its pretty healed under it.  Im ready to start swimming next week so Im going for it.


As far as walking...I crutched 1.4 miles yesterday and .2 was without crutches.  Not really sore after it either or super tired.  So my goal is to be able to walk a mile without crutches at the  6 week mark so I made a chart where every day I add .1 mile to my over all walk until i get to 2 miles then i add .1 every other day to my walk without crutches.  The idea being i slowly get to walking 1 mile at the 6 week mark. 


Lol if you reference my earlier posts I didnt see how i could possibly walk a mile at 6 weeks but things are healing very fast at this point and now it seems very reasonable.

[rickgassko]

Hey Surratt - I was in there with you for PT class, got my left hip done the same day you did your first surgery.  My wife and I were thinking of you and it's good to see the progress.  I'm 4 weeks tomorrow and it's been up and down but generally moving in the right direction.  At 3.5 weeks for no apparent reason I started "clunking" and could feel some movement so may post to the "clunking" thread to see what others' experiences have been.


Dr. Gross's office says it's totally normal and the implant hasn't moved, so I'm trusting them.  I'm also excited to get in the pool and have one last scab that I'm dying to lose so I can swim!


Hang in there. 

[surratt]

Rick!  Yeah buddy same here with the clunking and shifting.  I felt that as I started moving more as well, but after reading and talking with Nancy everyone has that issue early on just due to a compromised hip capsule and surround muscle.  Mine is actually getting better and from what I read its gone for most people after a couple of months which makes sense. 


I dont know about you but that first week or so was rough as hell lol.  Im glad I did both at the same time though bc the worst is over now at almost 4 weeks.  I would be in the pool already but my left hip still has a little scab left so im going to wait a bit longer.


Keep me updated as to how you are doing, its nice to stay in touch with someone who is literally going through the exact same thing I am at the same time.

[John C]

Just a note on clunking; I had a fair amount of it in the first few weeks, and at the time it was hard not to be concerned. Dr Gross and Lee both assured me that it was common and normal, and that it would go away with time. As usual, they were right. In my case it did not magically disappear overnight, but was a gradual process. It was much less after six weeks, only during certain movements or stretches for the first year or so, and now only happens very rarely with certain stretches. To quote Dr Gross; "It must go away, because patients stop talking about it after awhile".
In my experience there were two variations. In the beginning I think that the muscles and joint capsule do not do their job of keeping the two articular surfaces in constant contact, so they separate and "clunk" back together until the muscles and capsule heal enough to regain constant contact. The other clunk is a much more subtle feeling that takes longer to go away; it feels like the two surfaces make a very tiny slip against each other and "clunk" into a new contact point. I think that it is because the metal surfaces are not quite as perfectly frictionless as a natural hip, so the two metal parts sometimes bind slightly before sliding into a new position against each other. It is very subtle, rarely happens, and is definitely not a problem.

[surratt]

At week 4 Im able to walk about .3 without stopping using no crutches, ill finish up the walk with crutches at around 1.5 miles.  Im still limping and compensating without crutching, Im wondering with you bilaterals that had them done at the same time, at what week did you notice your limp had diminished?


Also im finally able to go swim this Tuesday so im excited....im wondering also if leg extensions and curls are a good idea at week 4-5.  its not putting any stress on  my hip so i dont see how it could hurt.

[surratt]

going to get my first swim in tomorrow...any tips on what type of workouts to do or what type of swimming is best for someone 4-5 weeks out like myself?

[surratt]

also im trying not to worry about it seeing as though its week 4 but my right side I noticeably feel more pain in when walking, a sharp type of pain thats hard to pinpoint.  Im limping more on that side and I have to compensate in the walk.  The pain was worse in that side from day 1 as well.  I may be pushing too hard bc i feel an ache type of pain after my walks so im going to rest it a day or two.  Just wondering if anyone experienced that in a bilateral

[blinky]

That's funny, my right leg feels worse, too. It did from the beginning. Lefty was more messed up, so once it was fixed the relief was amazing and a huge contrast. Righty was messed up, but shouted down by the left leg, so I really didn't notice it. I wouldn't worry if they don't feel the same, but do let your poor right leg have a break. The slower leg will set the pace.


Swimming! At last! For your first swim, start modestly. I think I swam 400m of free, then did some pulling, maybe some pool walking. As I recall, my legs felt pretty alien at first, much to my surprise. But the swimming came back quickly.


The harder part was the logistics! I had to think how to change clothes by myself and how to get into the pool. I brought the grabber and wore easy to change out of clothes. Thankfully, the head of the gym offered to help me if necessary. I didn't need her help, but she popped her head in to be sure I was okay. Do you need to go up and down a ladder? That may be more awkward than you think. Since you can't bend 90 degrees yet, just pulling up on the side is not allowed.


I think you can do it. Bring your sense of humor and be ready to improvise. You will feel so much more normal once you can swim.

[surratt]

lol yeah im pretty sure a ladder is the only way out I didnt even think of that.  Im breaking the 90 rule more often than I should at the 4-5 weeks.  I dont go far past it but I do break it. 


I miss the sauna so much too so i cant wait.  Cant go today bc we got snowed out!


Yep its funny bc my left hip was the worst preop now the right hip is the one lagging behind.  Im sure the left leg is laughing at the right.

[surratt]

little update for people wanting to reference what 5 weeks in on a bilateral is like.  I am no longer using the crutches or walker around the house at all.  My right hip muscle is weaker than the left and i limp still as im walking compensating but i can walk at a fairly normal speed.  Lol Im still cheating at the grocery store with the scooter bc its fun but Ill likely quit that this week.


Im driving every day now going to the gym and even though you are suppose to wait 6 weeks I feel fine.  Im not the best swimmer so i get tired after just a few laps but it feels great to push my heart rate for the first time in 5 weeks.  I sauna 15-20 minutes a day and do side walks and stuff in the pool.  Im also lifting weights again but I avoid any exercise where im placing extra weight on my hips, so mainly machines and stuff but it feels great.  Also they tell you not to do sit ups but im doing crunches on the crunch machine bc it doesnt stress my hip area.  Also Im doing 20 minutes of the bicycle a day making sure to set it so I dont break 90 degrees and at no resistance, just to move my joint around and legs.


Ive gained  5-7 pounds just sitting around, ive been eating healthy food just too much, around 2200 plus calories a day so i cut back and now the exercise is helping me check it. 


Im doing my 6 week check up driving back to SC soon and Im excited so I can start stretching more and try to see if I can do the ellipitcal but im guessing that will be hard at this point.


Im ecstatic with my progress although I was anxious in the beginning but things are going great an Im ready for the next stage

[packman]

I’m very interested to hear what Dr Gross and Lee Webb say about your exuberance, and training routine.  Please share their insights.
I commend you for the enthusiasm and the desire and fully understand your apprehension to weight gain and inactivity. I chastise you on setting expectations for others as everyone is different on listening to their body and what’s the hurry syndrome. Some people have different pain thresholds than others and cautious approaches seem to be the advice of many on this forum.

[surratt]

For sure, reading all of the different stories on here for sure, everyone is different.  Some people do little to nothing some do too much and Im not sure where Im falling in there.  Maybe Im doing too much?  I feel great and I dont feel like Im stressing my hip in any way so Im trying to just listen to my body and go off of what Ive read people doing on this forum.  I did start hitting the bike 1 week earlier than Dr. Gross recommends but like i said im not breaking the 90 degree rule and its no resistance.  Other than that Im not breaking any of the 6 week rules.  Last time I spoke with Nancy she said just to follow the basic guidelines and listen to your body, as far as lifting weights, Im not actually lifting anything, everything is light and high reps and on machines as to protect my hip. 

[surratt]

Packman Ill run all this by Nancy again and see what she thinks, what are you seeing in your opinion that you think i need to back off of as an experienced Dr. Gross patient?

[surratt]

Drove up to Columbia to see Dr. Gross for my 6 week check up.  Everything is good and Im cleared to start the second phase of recovery which is exciting.   I had a huge list of questions of things i can and cant do and as always he was more than willing to just chat with me for like 20 minutes. To sum it up he basically said use common sense and listen to your body and push it at a rate you are comfortable with.  I told him about my inversion table and he said just wait until the 6 month mark.  Honestly I think it would be fine to go half way down which still gets a good stretch, I may try that and just wait 6 months to go fully inverted.


At week 5 I started doing the stairmaster and bike at the gym as well as swimming, Ill also be adding the elliptical.  Today i did 15 minute low resistance on the bike and 6 minutes on the stairmaster and 6 on elliptical. Im also swimming, so ill be doing a combination of these for the next 4 months or so for cardio and increasing resistance as I go.


I specifically wanted to know about body weight squats which he said were fine just dont go deep.  He also said its fine to do box squats with light weight and gradually work the weight up.  Leg press the same, just dont go deep.  Dont go deep is the running theme, but its exciting that I can slowly start building leg strength back.  Also he I wanted to know about hyper extension and low back raises, he said that was fine. 


He said there is no risk of hip dislocation as long as the legs are straight so hamsring stretching is fine, ill be trying to get my flexibility back in my ham strings which also helps with lower back stiffness. My goal is to be able to touch my head to my knees again, Im a long ways off from that so Ill just keep stretching every day.


Doing those leg lifts to the side are the hardest, those muscles are very weak.  I feel those muscles the most when walking, I can physically walk a mile at this point but its hard on those muscles so they need a ton of work. 


Im excited to see where I am 6 weeks from now being able to work on those weak leg and hip muscles, also working on my flexibility.  People werent lying when they say the time flies, Im sure the next 6 weeks will go even faster.


I downloaded a free app to learn spanish and have been working on my guitar and catching up on shows ive wanted to watch so I actually love the down time.  Although Ive gained 6-7 pounds so I need to lose that weight.

[blinky]

Glad you got a good report and also happy that you can expand your range of activities.


Do continue to be cautious. You are going to feel much much better and be tempted to do many stupid things. Don't forget that your femoral neck is vulnerable to fracture and will be more vulnerable at three months than it is now. (in part because you are going to feel so normal...)


Those leg lifts will get easy. It is so funny looking back at how hard they were at six weeks. Walking sideways in the pool will help strengthen those sideways moving muscles.


Looking forward to more good reports!