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Author Topic: The things I didn't expect in the post op period  (Read 8703 times)

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andybc

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  • Right BHR November 25 2010 Sarah Muirhead-Allwood
The things I didn't expect in the post op period
« 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!

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


halfdone

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Re: The things I didn't expect in the post op period
« Reply #1 on: December 03, 2010, 11:48:43 AM »
 :) 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

ReneeP

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Re: The things I didn't expect in the post op period
« Reply #2 on: December 03, 2010, 01:45:59 PM »
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
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muzza

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Re: The things I didn't expect in the post op period
« Reply #3 on: December 03, 2010, 04:25:18 PM »
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

andybc

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Re: The things I didn't expect in the post op period
« Reply #4 on: December 03, 2010, 05:33:01 PM »
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

wayne-0

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Re: The things I didn't expect in the post op period
« Reply #5 on: December 03, 2010, 06:26:49 PM »
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
11-7-08  Bilat/Dr.Ball/ASR

ReneeP

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Re: The things I didn't expect in the post op period
« Reply #6 on: December 03, 2010, 06:47:08 PM »
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
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obxpelican

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Re: The things I didn't expect in the post op period
« Reply #7 on: December 03, 2010, 06:58:45 PM »
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


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

halfdone

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Re: The things I didn't expect in the post op period
« Reply #8 on: December 03, 2010, 07:11:46 PM »
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

Pat Walter

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Re: The things I didn't expect in the post op period
« Reply #9 on: December 03, 2010, 09:29:12 PM »
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 
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obxpelican

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Re: The things I didn't expect in the post op period
« Reply #10 on: December 04, 2010, 09:42:35 AM »
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
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toby

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Re: The things I didn't expect in the post op period
« Reply #11 on: December 04, 2010, 02:42:15 PM »
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
LHR Adept-Prof Cobb-30-1-10

sfinrecovery

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Re: The things I didn't expect in the post op period
« Reply #12 on: December 08, 2010, 11:56:32 PM »
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

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Re: The things I didn't expect in the post op period
« Reply #13 on: December 09, 2010, 08:50:00 AM »
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

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Re: The things I didn't expect in the post op period
« Reply #14 on: December 09, 2010, 10:12:49 AM »
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.

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Re: The things I didn't expect in the post op period
« Reply #15 on: December 09, 2010, 07:01:14 PM »
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

jjmclain

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Re: The things I didn't expect in the post op period
« Reply #16 on: December 09, 2010, 09:19:15 PM »
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

andybc

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  • Right BHR November 25 2010 Sarah Muirhead-Allwood
Re: The things I didn't expect in the post op period
« Reply #17 on: December 13, 2010, 05:55:00 AM »
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






jjmclain

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Re: The things I didn't expect in the post op period
« Reply #18 on: December 13, 2010, 07:27:15 AM »
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!!!!

BerkeleyGirl

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Re: The things I didn't expect in the post op period
« Reply #19 on: December 19, 2010, 12:24:25 AM »
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

 

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