I thought I would post this because the vast majority of peoples' accounts suggest they sailed through hip resurfacing with no problems at all and it seemed just like a minor inconvenience for a few days!
Now I've delved deeper into the various postings of personal accounts, I realise that some have been about post op pain etc., but, for the most part they are either written by fantastically stoical people or those whose memories are slightly impaired!
I write this as one who is 7 days post op; very pleased to have had a BHR done, but actually in more pain now than I was before - which I didn't expect.
I'm 60, 5'11", 82 kg and moderately fit.
Maybe I should add that, even though I'm a doctor, I have found this site incredibly useful. I'm not an orthopod, I'm a radiologist. So although I know what's going on with the xray, what I knew about the practicalities of having it done was pretty minimal.
No need to reiterate making a good choice of surgeon. Most of us won't have the opportunity to choose an anaesthetist but I was fortunate to have one who has worked very closely with the surgeon for 10 years and can give the "lightest" anaesthetic possible so you're able to mobilise the same day of the op.
Anyway, here are a few suggestions/some of the things I experienced:
PAIN: Well, it simply isn't true that you wake up pain free after the op - unless you've had an epidural and that's going to wear off! You simply substitute one pain for another. I did have some IV analgesia for 24 hours but started getting side effects so stopped it. My advice is to take as much analgesia as you are offered and can tolerate. Even then, others seemed to have exactly the same pains as me, though. So, it's probably going to hurt more than you expect and in different places. The new pain is due to the soft tissue damage inevitably caused by the major surgery you've had. By and large it's not harmful and it's very reassuring to hear the physios, nurses and doctors confirm that. But it is ####### sore!
The pain I have is partly due to the fact that virtually all analgesia makes me throw up so I don't take anything other than paracetomol. Most of you won't have this problem. In fact, I've been in so much pain since an episode of septic arthritis in the hip following an arthrogram earlier this year that the pain itself isn't the major issue. It's the worry it heralds some sort of complication when you have pain even on partial weight bearing. Being medical, I really should be able to look at that logically, but it's psychologically quite hard.
The other killer movement is the straight leg raise. Most people seem to have this to some degree. Tensing your glutes at the same time is said to help, but not much in my case. It's mostly getting into bed that it hurts and the trick is to really shuffle back as far as you can on the bed and that, in itself, tends to straighten your leg out. Presumably the pain's coming from iliopsoas and it seems to resolve in most people but can take many months.
BOWELS: I'm very British about my bowel habits and take great pleasure in spending a couple of sessions each day in the bathroom reading papers, medical journals and magazines about the antics of A list celebs and the British Royal Family. It was actually the anaesthetist who told me constipation would be a problem but I didn't really take that seriously as, normally, I need laxatives like Iceland needs more snow. Indeed, had never taken one before. So I cheated and didn't take all I was offered. Big mistake! Well, probably. There are two types of laxative. One softens the stool - which I did take. The other stimulates bowel movement. I took some, but not all, of these.The main problem was that it was (and still is) really painful to sit even on a raised toilet seat. Also, they are far too small! I don't have a particularly big arse, but, frankly, there was more chance of the toilet seat disappearing up my arse than something coming out of it! I'm going to research designs further. This isn't rocket science. Anyway, I had two or three days of really unpleasant stomach cramps but am ok now. When you get home, though, you won't have the grab rails like they do in hospital. I have a bath one side and have put a chair the other which provides the additionally needed support. It still hurts to sit down. The bowel problem was particularly irritating as the King Edward the 7th Hospital in London, has an outstanding menu every day; there's also a very passable wine list. I might add here that this Hospital is absolutely gold standard, with wonderful nursing care and physiotherapy. Apparently, they've admitted cases with MRSA but never has one spread, which is amazing.
CATHETERS: Girls needn't bother to read this - it only applies to boys whose prostates are beginning to enlarge. If you have symptoms suggesting you may have trouble weeing after the op, they will threaten you with a catheter! Well, it's not threatening, of course, it's just good practice. But I hate any thing being inserted into me and was keen to avoid it. It will be done when you're under anaesthetic, though, so it won't hurt but it can be pretty irritating afterwards. Having said which, it probably beats the hassle, anxiety and pain of staggering out to the toilet to pee in the immediate post op phase. So if they say you need one, just agree to it, would be my advice. If you don't have one and used to have to take your time preop, it's going to take you a lot longer post op! (but only for the first day or so).
GETTING DRESSED: This is not easy. I preferred to spare the nurses the ordeal of having to help me, so I developed a technique of putting my shorts or jogging trousers on myself. While sitting, I put the good leg completely through the one trouser leg first; then, using a stick or crutch, manoeuvre the operated leg partly into the other trouser leg. With some relatively minor wriggling you can do this without hurting your hip. I then stand up and insert the upturned stick into the 2nd trouser leg and use the handle to manipulate the waist band to a height where I can grab it without flexing my hip too much. From then on, it's easy. Did have one awkward moment, though, when I was just completing the manouevre and a nurse walked in. You can imagine the scenario, with the handle poking forwards through the trousers..............
Oh, and by the way, shreddies (underpants) are just not going to go on if you have much leg swelling. I'm still going commando and anticipate doing so for some weeks more. I guess boxers would be fine.
LEG SWELLING: This can be a bit alarming but is quite normal. It will likely track down your leg over the next few days and your ankle and even foot will end up swollen and bruised. All normal and expected, but a bit disconcerting when you look in the mirror and see half an elephant man. Quite reassuring to see others like this in the hydro pool. I really hadn't expected quite so much swelling, though.
TED STOCKINGS: Not sure if these are called the same in the USA. They are really important to limit the risk of DVT and my surgeon has you wear them for a month. (Tubular bandages simply won't do the job properly.) They are totally impossible to get on/off by yourself. You need the help of a loved one, friend or neighbour - the last two might be one person, of course. If so, best wait till their spouse is out if they have one.....
Tip - put your foot in a plastic bag. Easiest if you are lying down, with your quads tensed to raise your foot off the bed, toes pointing down. Your friend/lover/neighbour then pulls the whole thing over the ankle and the top part up your leg, your toes going through the hole in the undersurface then the bag can be removed fairly easily; then pull the foot bit back down over the foot.
I've found a few times at night that they caused me intense irritation on the back of the heel but a bit of wriggling usually helps.
SLEEPING: A killer problem for me! I simply can't sleep on my back. I maybe get one or two hours of fitful sleep. I've tried every combination of pillows under my head and legs. If I take sleeping tablets I get a few more hours sleep but wake up with such terrible neck pain from the awkward position in which I've passed into a coma, it really isn't worth it. Also, I tend to snore like a pig if I'm on my back and my poor, long-suffering wife has quite enough to put up with, without adding that. Luckily I only need 4 or 5 hours sleep a night, but even so I'm becoming really tired now. I have, however, caught up on many of those recorded tv programs I've been meaning to watch for months and months. Don't think there's anything much I can improve on this until such time as I'm allowed to sleep on my side, which I think is about 3 weeks away.
TRAVEL FROM HOSPITAL: You probably all know the technique for getting in and out of the car. Sit in the front passenger seat with it pushed back as far as possible. Have the window wound fully down so you can use the door frame for a support. Try and keep your operated leg as straight as possible, grit your teeth and be sure not to flex your hip or rotate it too much.
I had a 1 1/2 hour ride to the airport and a 45 minute flight home. I elected to revert to two crutches for the journey, which was a good move. You're very stable on these and it also alerts those around you to the fact that you're relatively incapacitated. The journey was a breeze - except for the security check! Yes, the new hip will set off the metal detector, which no-one had told me. I work with the local customs officers at home xraying suspects for drugs so I never give the guys a hard time, however testing they can be in some airports. Usually in the UK they're pretty pleasant, unlike the USA where they seem to go on some sort of course where they learn to elevate rudeness to an art form. Anyway, it ended up with me having to go into a cubicle and show them my scar. I felt rather sorry for the two customs guys, both of whom seemed a bit squeamish when they saw the operation site.....and discovered I wasn't joking when I told them I wasn't wearing any shreddies!
I realise I've gone on at some length but I hope those of you who don't "wake up without any pain" or other problems will find it useful.
You are welcome to contact me directly if there's anything I can help with.
Andy BC
:) Great post Andy. You have described the ordeal perfectly. (I was also at KE7 - who was your surgeon?) I think the "bowel issues" are the worst. You are very shrewd to write this at 7 days as I hope that soon your own memory will become impaired, or at least selective, because your pain will have abated, you'll have figured out where to place all the pillows to get a good rest on your side, and feeling fairly human again you will conclude "It wasn't all that bad!" (PS I cheated and started sleeping on my side sooner than I was supposed to but please don't tell anyone.)
HD
That is a very good post, Andy. However, my experience is a bit different than yours. Once the spinal wore off, my joint pain was gone and all I was left with was muscular and soft tissue pain. Also, I was allowed to sleep on my side with a pillow between my legs while still in the hospital....I was able to sleep on my side much longer than I was able to pre-op. As a female, I wound up with a catheter post-op, in the recovery room, because I had to pee so badly that my blood pressure went up, but I didn't know I had to go. I swore I would never let them catheterize me, but at that point, I really didn't care and it saved me the hassle of having to get out of bed during the night after surgery.
My point is that everyone's post-op experiences are different. People who "claim" to have no joint pain don't necessarily have memory impairment, just a different experience. Some people have bowel problems, some don't. Some people have a catheter, some don't. Some people can run marathons 4 weeks after surgery, some are still on crutches, some are on a cane. Some people's surgeons allow them to sleep on their sides after surgery, some don't.
I appreciate your post because it does show another experience for those of us who don't have the quick and easy recoveries. Some of us have unexpected setbacks, some of us have major complications, and some of us sail through like it's nothing. It's important to share stories like yours because many of us went into surgery expecting a quick and easy recovery and it's a little disconcerting not to have that. But I don't think it's fair to criticize people who say their joint pain was gone after surgery...because it IS for some of us even after the anesthesia has worn off.
Renee
Top post Andy. Reminded me very much of some of the issues I had post surgery/ies. How soon we forget, or put aside those memories. The bowel and catheter problems were two of my most difficult issues. I might as well have been eating blocks of gorgonzola cheese for all the good the hospital laxatives did me. They had no effect whatsoever and I had to deal with it myself when I got home. Getting over that was the worst part of both my hip surgeries - horrendous.
Neil
Thank you for the kind words.
HD - I went to Sarah Muirhead-Allwood. Wonder if you did, too. I selected her as one of the best hip surgeons in the UK and, indeed, in the world. I knew, beforehand, that she's not one to sit and chat much at your bedside and that could be a problem for some. However, she has amassed a fantastic team around her and they can fill in the gaps she leaves. I also admire her for what she has achieved personally. For those who don't know, she has changed gender. I can't begin to imagine how much fortitude this requires for anyone, but to do it in that most macho of surgical specialities (orthopaedics) must require superhuman resolve. (I was tempted to ask "what's a nice girl like you doing in a joint like mine?", but thought better of it!).
Renee - I certainly didn't mean to criticise anyone so please forgive me if it came across like that. I think I probably didn't make it clear that in my case, too, the actual hip joint pain was gone. However, you describing "all I was left with was muscular and soft tissue pain" serves to confirm what I have always thought, which is that my pain threshold is embarrassingly low! You are so right when you say we have many different experiences of the surgery. I rather suspect we could all sleep on our sides with a pillow between our legs post op, but I certainly don't have the intestinal fortitude to argue with my surgeon over that one! Anyway, I'm sure your experiences will inspire many who may be wavering over whether to have the surgery and perhaps mine will reassure those who don't sail through it quite as quickly.
Neil - thank you sharing that I'm not the only one whose bodily functions were troublesome.
Andy
Hey Andy,
After reading your post which i thought was well done and very detailed i have some comments. First of all I was one of those pain free guys and yes I did have an epidural. Funny thing was I hated the feeling of not being able to feel my legs so two days after surgery when they took it out and the feeling returned to my legs it felt so much better and yes I had no pain. I never once pushed the button for more drugs. I had both hips done on the same day and the only feeling I could describe would be a charlie horse sensation, but it wasn't painful. What was painful was the way I was living pre surgery and that was 24/7 pain. I have never said that it was a breeze, in fact the first 8 days were very trying and after that it became easier and easier with each passing day. My memory is very clear with what I went thru pre and post surgery in fact it is something I will never forget. I am 2 yrs 1 month post op now and still pain free. Hope it stays that way.
Wayne
This is a good topic for a thread. I'd like to add something that I didn't expect after surgery. My first 3 weeks post op went relatively easily, other than the typical exhaustion and muscle/soft tissue pain, and by a little over 2 weeks I was walking around my house only using my cane about half the time, and doing some stairs with my bad leg...BIG MISTAKE!!! I hit 3 weeks thinking I was home free, and got hit with intense groin pain, and have been off my feet as much as possible all week. That threw me for a loop. I did too much, too soon, and now I've set myself back a bit. But I'm trying to learn from my mistakes and let my body heal without rushing it or overdoing it when it feels good.
Renee
Andy,
Great post, I enjoyed reading it. This at times has been an issue on this forum, the painless recoveries vs. the painful. I've thought about it for a while and what I can tell you is, I've had both kinds of surgeries, On October 1st 1983 I broke my femur up high, that night was one of the most painful things I've ever gone through. Post op when they put the plates and screws in was one of the more painful 24 hours I've ever experienced, I mean it was downright awful. My surgeon was an older man who was not aware of the technology available for pain relief and I suffered for it.
What you have read when you find someone who did not have much pain post-op are most likely those that had the epidural, most of them come out pretty well with not a lot of pain, granted we all had some pain, mine was more like a monkey fist throb but noting like my bad days, I was so bad pre-op that I was on pain killers for 3 months so I was pretty bad.
When you have major bone surgery the first 24-36 hours can be very bad, the way my surgeon does it is that he uses a lot of anesthetic directly injected in and around the surgical site, that along with the meds they inject for the epidural makes for a very good experience, you can ask my wife, when she came in to see me I was laughing and in a very good mood, I did not take anything for the pain till after a day or so. When I got up to walk the first day all I felt was a crunching/sucking feeling in my hip, no pain, in fact the nurses had to order me back to my room.
I think in the end we all need to understand each other, some of us did well pain wise, some had problems, most do not suffer much post op though I've talked to freinds who have had the surgery shortly after their surgeries and other than being groggy they were not suffering.
All of us are different, with different surgeries, different pain tolerances and in your case you chose not to have an epidural, that may have had a lot to do with your elevated pain levels. I've also read where the anesthetist failed to place the tubes carrying the pain killer close enough to the operated area.
I am sorry you've had more pain than most of us, the good news is that soon it will cease and you will eventually be pain free.
Keep us posted.
Chuck
Quote from: andybc on December 03, 2010, 11:15:17 AM
I thought I would post this because the vast majority of peoples' accounts suggest they sailed through hip resurfacing with no problems at all and it seemed just like a minor inconvenience for a few days!
Now I've delved deeper into the various postings of personal accounts, I realise that some have been about post op pain etc., but, for the most part they are either written by fantastically stoical people or those whose memories are slightly impaired!
Andy - My surgeon was Mr. Vickers, who coincidentally did the Queen Mum's hips with SMA. I expect to be going back to KE7 to have my other half done, but as my surgeon has retired I will be with someone else.
Good luck with your recovery - I hope you will get through it without any indecent exposure charges. ;) Like you I found the hydrotherapy pool at KE7 very helpful for initially regaining confidence in and mobility of the joint and I later did a lot of rehab/PT exercise in the water at a local pool which worked out very well for me.
HD
Thanks for your great post. It is very informative.
I don't think anyone has no pain after surgery, but hopefully, most doctors and hospitals make sure you don't feel the pain. Sometimes there have to be adjustments. I have a very clear memory of my surgery and did not take anything but a few Advil after leaving the hospital at 2 1/2 days. I have a lot threshold for pain and am not stoic - I hurt a whole lot when I have it, but did not have much. Mostly soreness from my incision. There have been quite a few people with the same expeirnce while others take pain meds for weeks or months. I just had open heart surgery 4 months ago and it was the same way. Some people have great pain while others don't have as much. I think a lot depends on the technique of the surgeon and how the treat pain. Just my opinion. In both my hip and heart surgeries I have very expiernced surgeons that had done more than 3000 hip resurfacings and 3000 valve replacements.
I don't think anyone is forgetting their pain, but they are just telling their stories. I hope that your recovery continues to go well and you will keep us updated. It is great for new people to read the detailed stories so they know what to expect - both the good and bad. Fortunately, most people are in the middle of a good recovery and pain control.
Good Luck.
Pat
For sure experience counts, especially when the doctor has over 1000 surgeries. The less digging around the surgeon does the better the result too.
In this day and age I think it's a crime that any patient would be in a lot of pain post-op. One of the first questions I asked Dr. Gross was about his pain protocol and he assured me it would not be an issue. I never had anymore pain than I had pre-op.
Chuck
Andy,
Brilliant post. Wonderfully British.. great to welcome you to the UK HR club.
I had my HR at KE7(prof Cobb)-my whole experience was outstanding in all areas. Undoubtedly an exemplary hospital, yes the gold standard. Also, the hydro/physio/protocol guidance booklet system-superb. Yeah the food..exceptional.
I did have swelling, but I honestly haven't taken or needed a paracetamol since day 4 post op. Luckily, too my other bodily functions remained as reliable as ever. Bet if I need the other hip resufaced (which is very likely) I'll really pay fror it!
I've every confidence that your result will live up to expectation.
Please keep us informed.
HD,
Check out Prof Cobb if you want the 5* of KE7 and a truly wonderful man and great surgeon.
Toby
Great posting, Andy, et al.,
In reading your excellent pointers, I am preparing my own to be posted later, when I am feeling better. For now, I am now 4 weeks post op after several months of reading your posts since June 2010. I must confess that I also did a LOT of research off the hippy site in terms of other experiences. My injury story dates 2 1/2 years ago, when I had a fall down a whole flight of stairs on my right hip. Although there were no broken bones, my hip sustained "unidentified trauma" for several months and unresolved pain regarless of PT. Since then, I have had two arthroscopies to repair "labral tear, bone spurs, debribement, etc.". The pain continued. Shortly after the second arthroscopic surgery an MRI determined that the femur head had developed avascular necrosis.
Hence the recent BHR in early November. My wonderful surgeon did more than a great procedure - he has helped me undersand the long way ahead due to chronic trauma and two interventions. His compassion and eagerness to educate me have been extraordinary... After surgery, I was in acute care for 4 days and the skilled nursing part of the hospital for another 7 days and had the best care.
Home now, I am weening off some of the pain medication and started PT this week. It has been very difficult to move through the recovery pain. The good news is that some of the pain I had for so long from the fall is better. Only the 10+ inch suture healing remains, along with a very painful groin pain diagnosed as athrophied Iliopsoas and Rectus Femoris. I am hopeful this too shall pass with plenty of care to develop flexibility and consequently bone density to assure proper recovery in the next 6 months. It has made my walking very difficult and I am looking at 6-8 weeks with crutches and subsequent cane until the bone density is surely improved. I have the feeling I am looking at a very conservative recovery period...
One of the things remaining are very painful cramps at night on the operated leg, regardless of any position I move into ( I am now allowed to sleep on my side with pillows between the knees)... has anyone experienced this? Sleeping on my back with that styro-foam pillow was aweful, but these cramps are keeping me up at night...
I will start posting as I feel better. I really do not desire this experience to anyone, and I am glad that we all have different recovery levels, many of them better than mine - for me, it has been a very difficult recovery with anxiety and painful depression...Again, thank you all for all your feedback!
Juan
Hi Juan,
I am 4 weeks post-op today from a LBHR. Although I have had no joint pain since the surgery, my night pain in my leg sounds a lot like yours. My operated leg is still bruised down the back (some of it I think is due to the fact that my surgeon requires coumadin in order to avoid blood clots) and still has some swelling, although each day is less and less. But I am a small person and really notice it! Days are great! I have never had a problem during the day when I am up and moving, etc. and I have tried to be as active as possible. My surgeon's protocol required 50% weightbearing with crutches for the first 3 weeks and then weight bearing with one crutch started a week ao. I've been walking with the crutches since the day after surgery. It sounds like some people though are allowed a lot more activity.
At night, I wake up and am very uncomfortable. It is the pressure on the bruising and swelling and being in one position. I was allowed to go on my side but with the leg feeling so heavy and swollen, that too is uncomfortable. I change pillows, positions, etc. so many times at night but still can't get comfortable for long. So I know what you mean.
I think everyone is different. I was in excellent shape prior to the surgery. I am a triathlete and fitness instructor. My surgeon did tell me that my muscle tissue was dense and my bone was strong. I am not sure how that correlates to the swelling, etc. but I do know they put your leg through a lot during the surgery.
Hang in there and things will get better as you are allowed to do more.
June
Hi Andy, I loved reading your post, it is an absolute hoot !! I was laughing out loud.
Why do we british call underpants shreddie's, the term always makes me laugh, people in the US must wonder what the hell we are on about.
I totally agree with what you are saying, I was told by quite a few that the pain disappears ( like magic ) immediately after surgery, not, in my case. My op was THR, I post on Total Hippy, but switch on to this one as it is a more used site, with more general info. I had my surgery at Nottingham City Hospital on 9th Sept, I had spinal not epidural. No probs with the surgery, catheter until the next morning when I asked to have it removed, I was up on a walker the next day, crutches in the afternoon, home on the 11th. I could not believe how quickly I got out. I fibbed in the hospital & said I had been to the loo, I knew from experience, no way would things happen that quickly, came home & ate lots of fruit & veg, senakot tabs & still had to buy something from the chemist ,similar to an enema, that sorted things ! I had to give myself blood thinning injections for 28 days, but didn't have to wear the stockings. Getting your leg into bed is as awkward as you described, I got cramps everytime,until the swelling went down,about a week after surgery. I used a dressing gown belt like a hoist to get my leg into bed.I refused opiate based painkillers & just took paracetemol, the pain was qiute bearable, but not gone like majic.
I am now 3 months post op, very mobile , good gait,everything going from strength to strength, I am however, still in discomfort, I think it is all muscular & healing, I am optimistic that I will be totally ok when done healing. The awful arthritic pain has, of course, gone, but even though I healed quickly on the outside, it seems to be taking a while on the inside !
Anyway just wanted to thank you for the good laugh
Linda.
Hi, June, it sounds like we are on about the same healing path weeks-wise. I went for my second PT session today and the PT said that the cramps may also be due to not elevating the leg enough (off the knee) while on my back, and encouraged using a wide pillow or two a little bigger than your hip width... will try it tonight. Fortunately my blood was thi enough (due to two and a half years of anti-inflammatories and did not need anti-coagulants nor drains (and only the inflatable stockings for three days).
Now that this great PT has explained a little more about the mechanics of my hip and legs I feel more compelled to really make this recovery my full time job. PT is extremely painful, but only because they are pushing the muscles and tendons from their athrofied stance. Maybe I will post later what is working for me... in the meantime, my days off PT, I should be doing a stationary bike for 10-20 minutes (as bearable) to get the circulation going in the joint and produce natural body lubrication. Best healing to all of us... one little step at a time (no pun intended)!
Juan
Juan,
I don't think I need the coumadin. I am active enough, nothing like what I am used to(but enough for just having major surgery), but walking up to 3 miles a day. Unfortunately, my surgeon requires coumadin as a precaution. I hadn't used the stationary bike or the spinner bike due to the 90 degree restriction I have. I tried sitting on a spinner bike and I got too close to my limitation. Maybe the stationary bike would be a better fit. I also have my tri bike on a trainer but that would definitely break the rule! I have found the PT too easy and not painful at all even when the swelling was at its worst. I've tried the pillows at night, but still wake up with the throbbing in my leg. I go back for my 4 week tomorrow and will let you know what I find out. I hope my 90 degree restriction is lifted and I can swim and/or get on a spinner bike at least.
June
UPDATE AT 2 1/2 WEEKS
Well, it wasn't until day 10 that the "post-surgical soft tissue" pain resolved enough for me to really appreciate that the pain was no longer coming from my hip joint.
I'd got a bit behind with the walking due to the weather being bad so, predictably, overdid it a bit and was quite sore the next day. Good lesson. I'd been discharged with a cane on day 5 and was told I could really just use the cane for balance, but realistically, due to a combination of discomfort and apprehension I'm probably still only about 85% weight bearing.
I now walk twice a day for about 1/2 hour each walk. The exercises are much easier - even the straight leg raise. Also I can now sit on the toilet relatively easily - yippeeee! Still can't enjoy the magazines yet so, ultimately, I'll have a lot of reading to catch up on. Don't want to risk falling off the perch just to read about Liz Hurley and Shane Ward. Am definitely thinking of coming back as a cricketer next time around, though.
Sleeping is really the only bugbear. Am just waiting for call from the clinic as I think they told me it was ok to lie on my side with a pillow between my legs. Am managing to get a bit of sleep on my back; last night was a record - maybe got about 4 hours.
Another milestone - put on a pair of shreddies today! I still have some swelling, however, and the shreddies are a bit tight in the groin crease which is where the femoral vein runs, so may revert to commando status for a bit. Can't quite face the hassle of getting everything off for a bit, though.
Talking of DVT risk - I'd been getting dreadful headaches at night which I thought were due to degenerative change in my neck and lying on my back but then I realised they seemed to correlate with taking rivaroxaban (oral anticoagulant); so I changed to clexane (injectable anti coag) - headaches now gone!
So I am now beginning to feel real benefit from the operation. I'm going to go a bit gently with the physio, however because, although I'm very much an optimist I'm also acutely aware of the statistics concerning complications such as fracture, dislocation etc and small though the risks may be I want to minimse them as much as possible.
I feel I could almost get back to work pretty soon but am booked out till the second week of January so I'll probably stick to that.
OK, off to remove my shreddies now.
PS just spoke with clinic. Fine to sleep on side with pillow between legs and no longer have to be fanatical in observing the 90 degree rule.
Andy
Love your posts...crack me up!!! I have had a lot of the same symptoms as you, but now that I have reached the 4 week mark and went off the blood thinner, things are much easier!!!!
Hi everyone. I'm 6 days post-op, RBHR, with Dr. Robert Gilbert in San Francisco. The surgery apparently went really well -- Dr. G said my 45/50 BHR was a totally perfect X-ray in terms of optimal positioning -- which I was VERY glad about because I'm female and was worried about the metal wear problems from problemmatic placements.
Dr. Gilbert isn't listed among the expert resurfacing docs, but he is one.... When I first saw him, he'd done 280 BHRs, and has been doing so many that now he's surely over 300. He said he'd had two failures (both fractures, I think) and they revised to THR with keeping the acetabular cup from the resurfacing. He's known at California Pacific Medical Center as a very talented senior surgeon, and he and his team were top-notch.
I'm recovering very well in terms of weight-bearing, ROM, strengthening overall, etc. I've had two problems, one expected and one not. The unexpected (I'll admit this here among all of you): initial poor continence. For about 3 days since they took the catheter out, I would have urgency to urinate and barely be able to hold it, or to start losing it just before reaching the toilet. I was dismayed about this until I realized that of course the bladder sphincter and related muscles are in the groin area, and my groin was bruised and swollen from the surgery, so (duh) these muscles and reflexes might not yet be online. It's gotten better, but it made the first few days rough because I would suddenly, very suddenly, have to go to the bathroom and yet had to stand up (the transition in what's difficult) and hobble to the bathroom. I can't quite yet sprint.... So, I've gotten a portable commode that I stand near my bed, and though I don't 100% need it anymore, it's very useful for nighttimes.
I hadn't read about this problem anywhere, and I wonder if other resurfaced women have had it.
The second problem is PAIN. I had a spinal, and though I was standing up (weight-bearing!) four and a half hours after surgery with no pain, the spinal soon wore off... and I haven't not had at least level "5" pain since. I was prescribed Vicodin, and though I've been taking slightly more than the Rx directions (which were a 7.5/325 ever four hours), the pain level sometimes creeps higher (to 7 or even 8, when I start to cry), especially in early morning and in late evening. It is exhausting. The home nurse told me on Post-Op Day 5 that a "5" level was not good enough, that it's better for healing not to have so much pain, and that I should call the doc. He was out, but another doc in the practice prescribed Percocet. Not much difference at all.
Part of the issue is that I've had on-and-off chronic migraines for many years, and my body is both very familiar with narcotics (unfortunately) and, since pain breeds greater pain sensitivity, I have a lower threshold. So they don't seem to be having enough impact. I've taken a lot more opiate meds for my migraines than I'm taking now for the hip, but I still don't just want to ratchet up without guidance.
I'm using ice nearly all the time, and that does help some, and my spirits are generally very good (I live alone but have had lots of friends visiting to help). I just wish I could have even a break from all this pain. It's Saturday night right now, and I won't be able to reach my doc til Monday.
I'm exercising reasonably, haven't injured it, generally doing everything right, it seems... and yet. The pain is in the bone and soft-tissue area, plus down the entire leg and also in the groin.
Sigh.
And I dropped my i-Phone into a bowl of chicken soup, but that was kinda funny. After fluttering through a bunch of screens (like fluttering wings), the phone seems to have survived....
Berkeley Girl
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
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
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
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!
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
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
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
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
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!
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.
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
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.
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
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
PS ABC2 is formerly ANDYBC. Somehow lost my id in the ethernet.
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.