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Author Topic: 2 October 09 - Progress report/advice request  (Read 1929 times)

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Eurocard

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2 October 09 - Progress report/advice request
« on: October 07, 2009, 12:18:13 PM »
Hi All, this is a first post so firstly to say what a great resource this is and I hope to be able to contirbute in the future.

I had my surgery in the Bronovo Hospital in Den Haag, Netherlands on 2 October 2009.  Components were Zimmer 56 mm Femoral Component into a 62 mm Acetabular component on my left hip, they look huge on the x-ray!

Post surgery my Dr (Hr Steenmeyer) described what he had found; it seems that my hip had developed incorrectly following childhood trauma and had effectively been going bad for 39 years.  The trauma I suspect was doing a Full Back-Layout somersault over a car after it struck me in the small of my back when I was 9 years old.  At the point of my operation, when both knees were bent, my left knee would be 15-20 cm left of center.  Watching the path it would take when I cycle was hypnotic to say the least.

I think for the above reasons, in common with most people having a hip operation, all the muscles, ligaments and tendons in my left leg are now looking for their proper place to live under the new regime.

Day 1 Observations.  I stayed in bed all day and was not visited by the physio.  I did sit up, I did use the hospital bed to find comfortable positions and I did carry out exercises such as pressing my knee into the bed, pulling my toes towards my hip and clenching my buttocks.   I had very little feeling of pain (Drugs helping).

Day 2 Observations.  I stayed in bed the majority of the day.  I did sit up in bed to eat my lunch, however, after 30 minutes i felt very dizzy, blood pressure dropped and I had a rapid sweat drenching me.  I lay down again.  Exercises continued as for day 1.  The major area of weakness for me was a total inability to prevent my left knee falling inwards, the muscles and ligaments to do this having been dormant for many years. Pain Killers were paracetomol and deflenic (sp), although I did manage to get a morphine injection in the middle of the night (Probably not needed but wow, it was good!)

Day 3 Observations.  The day started as had the others, but I took lunch sitting at the table, having got there using a walking frame.  I was ok moving around using the frame during the day, and only found getting in and out of bed to be a struggle.  (I discovered that placing a plastic bag on the bed to ist on allowed me to spin into place much more easily!)

Day 4 Observations.  The volunteer from Physio was not around so I walked (with Fram) myself down to physio, was switched to saome crutches and walked my self back up to the ward. 

WARNING  At this point I was feeling good, little pain, fair degree of mobility.  Do not let this fool you, it is fair to say that I did to much that morning and paid for it

When I saw the physio at 3pm he pointed this out to me and told me to slow down, but that I could go home then, or in the morning.  Given his warning I decided to await the morning. Pain Killers Paracetomol, less frequent deflenic.

Day 5 Observations.  I was stiff when I woke, although woke is relative as I did not sleep much.  My leg was more swollen than on previous days.  I did a last session with the Physio who took me through the exercise regime once more and I was discharged from the hospital.  I think I did a little too much on my trip home and settling in which combined with the work of the previous few days meant my leg was definitely swollen by bed time.  Getting into bed at hoime was a breeze, my wife replaced the plastic bag with a silky quilty thing I have, with plenty of handholds around I was able to extend the left leg fully and lower myself onto it then slide effortlessly into position.  Pain Killer Paracetomol.

Day 6 Observations.  Today! 

Getting out of bed is a breeze.  I sit up, slide myself over the end of the bed, left leg bending to the floor then sliding until I am sitting at the end of the bed and can use the bed and chest of drawers to stand erect. (Ergopnomics working in my favour here).  The swelling in my legs has reduced significantly but I will take it very easy today.

I will have 1000mg of Paracetomol 3/4 times a day for a while.

I took a shower today with the wound wrapped in cling film, the  bandage stayed completely dry and I feel a lot better. we changed the bandage after and the wound looks clean and dry.  I am blessed that my wife is with me full time and is helping in every way she can.  Our 26th wedding anniversary is tomorrow and  will probably be spent at home, but I will be making it up to her big time in November.

I am fairly sure I have not anticipated everything ahead so I will scour this forum for information and anything I discover formyself I will post in this thread.  However, I am hate reinventing the wheel so will gratefully accept all hints and tips to speed recovery.  I do find setting myself goals helps me, so I am plannning a round of golf or two in the new year.  Until then my goals will be more nearsighted.

I would be most interested in responses from people who have had the operation recently so we can share our experiences real time as it were.  Nonetheless, I am acutely aware that there will be someone out there whose situtation almost certainly mirrors mine and there advice would be most welcome.

My most immediate question is:  What is the minimum amount of exercise that is recommended after you have 'over done it' for a day or two; and what is the yardstick that you would use to signal the 'back off dude, its time to take a rest day'? 







Eurocard

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Update
« Reply #1 on: October 15, 2009, 11:07:23 AM »
Progress has been good over the last week.  I am amazaed at the difference a few long walks can make.  I started Monday, at +9 days, and in just three days I have found an astonishing improvement.  I can honestly say there is next to no pain in my left hip area, even the wound hurts insignificantly.  I was taking Paracetomol for pain but have effectively stopped that now.  Last night lying in bed I felt so good it made me laugh, I am hoping the smile on my face is here to stay!

I can get by comfortably with one crutch, but take two for walks currently and probably will until Sunday when I intend to move to one for a whiled before considering walking unaided for any length of time.

Which raises the question, is it just a feeling of security that decides the point at which you move from two to one to zero crutches/cane?


obxpelican

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Re: Update
« Reply #2 on: October 15, 2009, 11:18:15 AM »
Progress has been good over the last week.  I am amazaed at the difference a few long walks can make.  I started Monday, at +9 days, and in just three days I have found an astonishing improvement.  I can honestly say there is next to no pain in my left hip area, even the wound hurts insignificantly.  I was taking Paracetomol for pain but have effectively stopped that now.  Last night lying in bed I felt so good it made me laugh, I am hoping the smile on my face is here to stay!

I can get by comfortably with one crutch, but take two for walks currently and probably will until Sunday when I intend to move to one for a whiled before considering walking unaided for any length of time.

Which raises the question, is it just a feeling of security that decides the point at which you move from two to one to zero crutches/cane?




A lot of doctors let the patients body do the talking, Dr. Gross basically said walk walk and then walk some more for the better part of rehab. 

When I was at your point I would put a crutch in front of me straight up and down and I would take baby steps towards it, that way I always had a crutch withing arms length.

You are probably pretty close to walking unaided, just be careful as a fall this early in your recovery can be really bad.


Chuck
Chuck
RH/Biomet U/C Dr. Gross/Lee Webb
8-6-08

John C

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Re: 2 October 09 - Progress report/advice request
« Reply #3 on: October 15, 2009, 11:25:18 PM »
The PTs ( and the doctor) that I worked with encouraged using two crutches for long walks, until there was no more limp. Even if you were putting very little weight on the two crutches, they preferred that you not use one crutch, since it does not encourage good walking mechanics, which is easier with two. Around the house and office, anything goes with the docs approval, since you are not really developing walking mechanics.
John/ Left uncemented Biomet/ Dr Gross/ 6-16-08
Right uncemented Biomet/Dr Gross/ 4/25/18

kb134

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Re: 2 October 09 - Progress report/advice request
« Reply #4 on: October 16, 2009, 03:44:36 AM »
Eurocard!
Congradulations man! That is one huge piece of resurfacing you got - I'm a good sized 6'1 athletic male, and I got Zimmer's Durom 50mm femoral component, and I believe a 56mm Acetabular Cup. That sounds like an incredibly stable hip you got there Mister :))
My advice: it is a different experience for everyone - rehabilitating faster or slower. I grew hasty when I would see Youtube Vid's of people walking on ice, without a crutch, only after one week post-op. It took me about 5-6 weeks to get off the crutch, which was also prompted by my PT - almost like being weened. But then again, I also had an allergic reaction to the Spinal that I was given for surgery and the post-op swelling continued for a couple of weeks ...
So, it is unique for us all. Just listen to your body.
A good piece of advice that I was given: "Do what babies do: Eat, Sleep, and Poop."
During this "new season," walk as much as you can. Rest when you feel like resting and so on and so forth.
Activity is good in that it has your body react and begin that process of generating/regenerating bone around the Acetabular Cup and the, in what can be found in many cases, the "thickening" of the femoral neck, as well as all the muscles and tissues that were affected begin to re-grow and/or adapt.
Remember, there is no rush. When you are able, get to a pool and begin water exercises that your PT will give you. Ofcourse, pay attention to all the sensations and ask any question you want to ask - you have a wealth of experience here that would love to be passed on!
Best!
 

Eurocard

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Re: 2 October 09 - Progress report/advice request
« Reply #5 on: October 16, 2009, 07:34:56 AM »
Thank you for all the advice it is most welcome. 

JohnC, I know what you mean about one crutch giving you a slightly abnormal gait, this is one of my concerns.  I have been doing as you suggested and taking more and more weight of the crutch as I walk so I may continue to do this for a while yet.  Last night was my longest outing yet and I must admit that both crutches were carrying a good deal of weight by the time I got home.

Obxpelican, baby steps is right, that is just where I am at the moment;  I will try and move around the house unaided a little more, but see myself a few weeks from walking unaided yet. 

Thanks for the congrats kb, I am not sure I can sense the size of the implant at all, although lying on my side I sometimes think I can.  It certainly feels stable though, I am only 5'8, so it is a big lump for me.  However, as the doc said, the hip had been growing wrong for a long long time.  After yesterdays exeertions I expected some stiffness/soreness this morning but all is fine.  So I am still smiling!

obxpelican

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Re: 2 October 09 - Progress report/advice request
« Reply #6 on: October 16, 2009, 03:12:48 PM »
You are doing very well, let your body tell you what is best... if you think about it when you put weight on the hip you are actually pressing all the pieces together.

I would be willing to bet those baby steps become regular steps in a week or so.  One thing, until you are sure you are 100% stable don't venture outside without at least one stick, like I said before, a fall at this point in your recovery could be really bad.


Chuck
Chuck
RH/Biomet U/C Dr. Gross/Lee Webb
8-6-08

Eurocard

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Re: 2 October 09 - Progress report/advice request UPDATE
« Reply #7 on: October 29, 2009, 11:30:17 AM »
4 weeks post op and I am walkimg, albeit with a limp.  I can get by comfortably with one critch, but when I am out walking I make sure I do stretcheds of 100 meters plus with the crutch off of the ground.  I notice that my left foot has its some tendency to flick inwards a little.  I do have some small discomfort in my lower back after extended walks, but all in all I am feeling ok.  I expect the limp to slowly fade away over the next few weeks and hopefully the left foot issue will disappear in time also.

Whilst the strength is returning throughout the leg I do still see areas of weakness, although in no case has there been no improvement in a particualr area. The weakest area is still the lateral balance at the knee.   I hope to get ito the pool over the next few weeks to help with recovery still further.

Thanks once again for the advice and support.


 

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