Six week review and check up

[Asalisbu]

Six weeks out of a Bi-lat.  going in for my review.  Going to bounce a few things off them to make sure it’s normal.   Curious since this forum has been perfect at keeping me grounded any thoughts on the issues/frustrations i will discuss today, which are probably normal but I’m obsessive. 

-I can walk a mile with out crutches but that is it.  I definitely feel a smooth gait  compared to pre op but  it’s also not this beautiful easy experience.  It’s not pain so I keep going it just gets super tight in the groin and I guess sore for lack of a better term. The glutes catch on fire but that doesn’t bother me as much as it feels like I did 100 squats and let’s me know I’m using correct muscles to walk.   It’s those tedious little groin muscles that frustrate and between the two a mile is it.   Not itching to keep going at all.

-I’m back at work and start up pain is annoying.   It’s not pain so much as super stiff and I either have to waddle a few steps or grab a crutchto brace a few steps, any where from five to twenty steps before I get a “normal” walk.  It happens every time I am seated more then 40 minutes or so.  I have read that is very normal here but it’s one of my current obsessions.

-pants is not pretty but I can get them on unassisted.   Forget about shoes and socks.  I really really want to dress myself at this point.   Now that I am back at work I don’t have time for the tube thing and grabber games that passed the time when I wasn’t working.   My poor wife, me and my little ones all sit on the bed as she works her way down the line putting our shoes and socks on.  We have a good bit of fun with it but I really want to dress myself.   On the footstool I can just reach the top of my foot  with my fingertip which is progress. 

-I am rather rigid and black and white so I found the six week instructions slightly vapid for my tastes.   They are great about responding so no issues but what the hell is “no bending the hip into extreme flexion (eg squatting)”.  What’s considered extreme, 90 degrees, lower, higher?   Is squatting the only thing that puts me in extreme flexion (I think so right?). Granted it’s all rather moot right now since my mile walk is my peak physical performance at the moment but just in case I decide to rack a bar a do a couple of hack squats I need to be ready. 

- I can go to the gym.  Nothing more then 50 pounds.  What does that mean because I am definitely going back.   Can I do push ups pull ups dips body weight stuff, which is what I have in my head to start with.  I feel like a baby bird shoved out the nest at six weeks.... go take on the world but don’t do anything stupid until six months.  Maybe I have abandonement issues, maybe I could get a hug before being launched, I bet Dr Gross is a hugger. 

Blinky just gave perfect advice on another thread about this which has helped prep me.  Just because you are clear doesn’t mean it’s automatically going to be easy.   I will basically start trying light things and getting to the floor and if it hurts scratch it for a little while.   So I can get on the floor to do some stuff.   I have no idea how that is supposed to happen but I am going to do it one way or the other (minus being stupid about it.). 

All in all I do see many positive changes. Enough that I have no regrets at this point.   I get these moments where all the soft tissue  is relaxed and I really feel how nice it is to move and flow down the hallway.  As is repeated on here it just give it time to heal. 

[jimbone]

Asa-

Good, funny post.  Sounds like you are doing well and as expected, on schedule, in the right direction with a positive outcome in your upcoming future.  I had both done as well but they were 8 weeks apart so the recovery was likely a bit different.  1 mile at 6 weeks seems to be a good standard, although it took me 7 to get there unaided and without a bit of stretching in between.  I hear you about the groin discomfort- getting my adductors stretched and loosened has been and continues to be a challenge, same with the glutes but I have found hill climbing to be one of my favorite activities these days and getting a good burn going on there is something I now look forward to.  Squats: my nemesis.  Working with a good PT has been a help but we never pushed for too deep- beyond 90 degrees- for the first 6 weeks.  After that we worked to go deeper and I still struggle with that.  Your plan for the upper body work in the gym was mine almost to the T.  Just learned quickly how much strength I'd lost so it took a few weeks to regain most of it.  I held off getting on the floor/doing push ups until the 6 week mark.  Pretty much just let my sense of vulnerability be my guide- if it felt too scary I held off a week or two until I felt stronger.  It was a Red Letter Day getting my sock on without the sock aide somewhere around week 8-9.  Has to be done sitting on the stairs or propped up on the box spring and it isn't pretty but I'm working on it.  Same with tying my shoes- can bend over and do the left but the right needs a chair and contortions.  I hope to get there in time.
At 6 weeks I still had considerable start up difficulty and after 40 minutes in a chair or driving I still do- not as bad- but I don't pop up like my leg/hips are 19 anymore either.  I found 1 legged stands beneficial for that- working up to a 1 minute hold and come off it gingerly.  When I get up after sitting more than a few I plan on a good stretch and centering and the first few steps are cautious still at 12 weeks so sounds like you're doing well.  Congratulations.

[rag33]

Thanks for sharing. Really helpful since I'm onkyva couple weeks behind you. This morning I was freaked out because my hip was do stiff. I convinced myself I had a metal allergy when I was half asleep. Keep up the good work and the updates !

[karlos.bell]

Hi You are doing exceptionally well for a Bilat

[hernanu]

Six weeks out of a Bi-lat.  going in for my review.  Going to bounce a few things off them to make sure it’s normal.   Curious since this forum has been perfect at keeping me grounded any thoughts on the issues/frustrations i will discuss today, which are probably normal but I’m obsessive. 

Obsessive is good at this point. Get whatever answers you need - they work for you, not the other way around.

-I can walk a mile with out crutches but that is it.  I definitely feel a smooth gait  compared to pre op but  it’s also not this beautiful easy experience.  It’s not pain so I keep going it just gets super tight in the groin and I guess sore for lack of a better term. The glutes catch on fire but that doesn’t bother me as much as it feels like I did 100 squats and let’s me know I’m using correct muscles to walk.   It’s those tedious little groin muscles that frustrate and between the two a mile is it.   Not itching to keep going at all.

Not bad for the time you've put in. Make sure you are concentrating on the gait, any bad habits may persist and have to be unlearned. It's much better to be annoyed now than to re-train yourself.

Remember the groin muscles are not just weak, they were afflicted during the arthritis and need to come back to a normal walking style. Some may be atrophied, others overly developed and tired. Give them some slack. The strength and ease will come.

-I’m back at work and start up pain is annoying.   It’s not pain so much as super stiff and I either have to waddle a few steps or grab a crutchto brace a few steps, any where from five to twenty steps before I get a “normal” walk.  It happens every time I am seated more then 40 minutes or so.  I have read that is very normal here but it’s one of my current obsessions.

I'd use a crutch if it's a problem, or just plan on standing for a bit, contemplate the universe for five or ten seconds. Let people think you're a deep thinker rather than just waiting for your body to equilibrate. No reason to rush.

-pants is not pretty but I can get them on unassisted.   Forget about shoes and socks.  I really really want to dress myself at this point.   Now that I am back at work I don’t have time for the tube thing and grabber games that passed the time when I wasn’t working.   My poor wife, me and my little ones all sit on the bed as she works her way down the line putting our shoes and socks on.  We have a good bit of fun with it but I really want to dress myself.   On the footstool I can just reach the top of my foot  with my fingertip which is progress. 

I lived alone for both hips (I know you're a simultaneous bilat), so it was the tube or nothing. If you've got help, give them the tube - it'll be fun for them and faster for you. Again - use the fact that you're recuperating to give yourself a little time.  Who knows - even after you can do it yourself, the little ones may still want to do it for fun.

I wouldn't force the stretching. It puts stress on the smallest components, which include your hips. The resistance is from your big muscles. The flexibility will come, but you are still recuperating physically, so it's not like you are fully reconstructed yet.

-I am rather rigid and black and white so I found the six week instructions slightly vapid for my tastes.   They are great about responding so no issues but what the hell is “no bending the hip into extreme flexion (eg squatting)”.  What’s considered extreme, 90 degrees, lower, higher?   Is squatting the only thing that puts me in extreme flexion (I think so right?). Granted it’s all rather moot right now since my mile walk is my peak physical performance at the moment but just in case I decide to rack a bar a do a couple of hack squats I need to be ready. 

What I've heard (I didn't have the 90 degree limit) is 90 degree. Deep squatting is extreme flexion, I would think. I'd avoid the squats with weight for now.

Your hip bones are still growing into the device, let them do so without any excess stress being put on it. I waited for a good six months before any leg exercises with weights. I've modified my approach from pre surgery to now - pre I did 400 lb leg presses of about 24 reps, I now do lighter most times but more reps - about 250 for 90 reps.

My advice would be to let the bone fully mesh with the device, walk and do light stuff until that's done.

- I can go to the gym.  Nothing more then 50 pounds.  What does that mean because I am definitely going back.   Can I do push ups pull ups dips body weight stuff, which is what I have in my head to start with.  I feel like a baby bird shoved out the nest at six weeks.... go take on the world but don’t do anything stupid until six months.  Maybe I have abandonement issues, maybe I could get a hug before being launched, I bet Dr Gross is a hugger. 

I went back to the gym about two months post surgery (both times). I used that time to work with a trainer to blend my physical therapy routines with my workouts. Again, I did no heavy weights or anything that would cause me to drop from an elevation to the floor with impact.

Fifty pounds I would think (check with them) would be any standing holding a total of fifty pounds in extra weight.

Blinky just gave perfect advice on another thread about this which has helped prep me.  Just because you are clear doesn’t mean it’s automatically going to be easy.   I will basically start trying light things and getting to the floor and if it hurts scratch it for a little while.   So I can get on the floor to do some stuff.   I have no idea how that is supposed to happen but I am going to do it one way or the other (minus being stupid about it.). 

Very good advice. Pain is pain in this case, worth listening to - forget all the sports commercials about pushing through the pain.

All in all I do see many positive changes. Enough that I have no regrets at this point.   I get these moments where all the soft tissue  is relaxed and I really feel how nice it is to move and flow down the hallway.  As is repeated on here it just give it time to heal.

Ain't it fine?  At 8 years, I still get a pleasant feeling remembering the nastiness of the pain that's gone and evaporated.