June 20th, 2016 THR

[blinky]

Ask your doc at your follow up. I bet he will have some ideas on when and how to come off.

[LMS]

I don't see him until the 22nd unfortunately.  I think I'll call his office.   


Well the staples are out... and that experience really caught my attention.  I thought my husband was exaggerating but nope... it felt like being stung by nasty little wasps with knives.

[LMS]

Today, I finally felt like getting out of my pajamas & actually get dressed. 


I'm back to using a walker for my outdoor 5 min walks.  My right hip was regressing while my left was progressing, which in turn started to affect the left.  I've also been using my cane to alleviate the stress some of the exercises were putting on the right hip.


I'm also pleased that I've been keeping slowly losing weight.  I've been averaging a pound per week since I received the phone call on May 4th.  So that's good for the hip.    I'm at 154.2 lbs.

[LMS]

Seems the weight loss was really because I hadn't been eating much.  My appetite came back a couple of days ago, no weight loss since surgery according the scale now.


Depression though...    I thought my periods of crying were because of the narcotics.  I've been off them for 4 days now totally. I had slowly weaned myself off.  At night I am "wanting" them, so antsy.  I know it'll take time.  But the crying & emotions.  I'm already on an antidepressant as well (that was working very well before surgery).  It's a struggle I wasn't expecting.

[blinky]

I am sorry to hear you are feeling depressed. I understand that is pretty normal post op. Recognizing it is half the battle. 


The end of the weight loss, yeah, sorry about that, too! My experience was similar. No appetite and so an easy initial weight loss (once the swelling went down), then feeling physically good and eating my way back up again.

[LMS]

I keep telling myself that it will pass, just keep looking at how well my hip is now compared to pre surgery.  I cry at everything.  I also have a history of major depression but the current medication my doctor had put me on 3 years ago, was literally a life saver.  So I was taken aback when it returned regardless of still being on the anti depressant.


My husband has been amazing & so have my two sons.  They are so supportive.  My husband takes me along on all his errands to give me change of scenery.


So today is week 3.  Both hips are sore, I'd say from mild to moderate.  With the left, I know it's healing pain but the right, it's OA pain.  I last took a Dilaudid last Wednesday at 4 am & took extra strength tylenols when needed.  That's when the right hip pain became a constant.  But even then, I don't take it often, only when rest doesn't take the edge off.  I had a follow up appointment with my GP regarding my iron today & asked for some Tylenol 3 to take when the pain refused to go with the extra strength tylenol.


My GP's nurse was mentioning that I was walking quite well, so that was nice to hear.  I keep apologizing for walking at a snail's pace.


Tomorrow I take my last blood thinning meds, Xarelto.  Yay!


I've increased my walking time to 2 driveway circuits, still with the walker because I'm getting the sharp groin pains in the right hip.  I've landed sharply on the operated hip a few times, which is not good.
Physio keeps improving, which is comforting.  I can't wait to start the next phase which will be at the hospital
 but am scared to plateau & regress like last time.  But... this time should be different since the hip has been replaced.  I'm supposed to start next week but haven't heard back yet as they are short staffed & 14 people were ahead of me.


And the weight has come back down... talk about yo-yoing!  But I'm sticking to drinking water & only eating when I really am hungry & no junk.

[LMS]

Today so far is really not a good day.  The pain in both hips will not go away, unless resting & worsens when I go for my walk.  I had to cut back by half.


My right hip keeps clicking, not a mild click but a very strong one several times a day & the left (new hip) feels so tight around the joint, it feels like I have a tightening band going around the thigh in that upper area.  It was always there post surgery but today it's uncomfortable even at rest.  So much for weaning off the pain meds.  So I gave in & took a Dilaudid & an extra strength Tylenol.


I don't want to depend too much on the meds since I get an acetaminophen headache if I'm on it too long & I've been having a constant mid grade headache for a few days now that will not go away.


I don't want to go back on the Dilaudid though.  The GP I saw on Monday gave me a prescription for Tylenol 3 but only 30 pills.  I'm not too sure which is best to take at this point.

[LMS]

Yesterday was 4 weeks post op & tomorrow is 1 month post op.


Again, one week passes by quickly & progress continues right after I think I'm going backwards. 


The pain shifts in the same area of the hip but you feel that it's a different.  Doesn't make sense until you go through it.  But the tightness around the upper thigh area/near groin, is lessening which is great.  The surgical area is healing nicely.  Still pulls & hurts (like it's tearing) at times.


I'm still using both the walker & the cane.  I've tried a few times to walk without but no can do yet.  Which is fine.  We've noticed I'm still using my right side to compensate, so I walk at an angle.  And also that my left leg is 1/2" longer.  Not sure if the surgeon can do anything about this but it's ok if I have to wear an insert in the right shoe, as long as it won't affect things.  Being pain free is far more important to me & resuming living life than a tiny issue like leg length discrepancy.


I can go up & down the stairs normally (with cane & bannister assistance for support).  Physio at home is almost on par with the unoperated hip.  Lower back pain is still there, my SI joints  need to be released.  Still no hamstring pain in the left leg which is heaven!


I finally have an appointment to go for physio at the Riverside hospital.  It's next Wednesday, a week late but that's ok, they are swamped.


My depression seems to be improving a little but my husband has asked me to rehome my draft horse which I do not want to do.     I finally was able to walk over to the barn to say "Hi" to them.  I hadn't seen my "girls" in 5 weeks.  But I didn't go in their paddock with them since I was by myself.  I was afraid of getting knocked over or losing my footing.


And today, I did a little bit of work in my shop.  I assembled small signs for a client.  So I'll continue doing a little simple job per day & slowly work my way up.

[horse doc]

Keep looking for the silver lining if you can.  It sounds like your body is just slow to adapt away from protection mode. 

As for leg length, you still might just be crooked.  If you can, look at yourself in the mirror in your birthday suit and see if your pelvis is level, then compare legs....

[LMS]

Slow & steady wins the race.     


I'm at week 5 & things have improved even more.  The pain is much less than 7 days ago.  Today, I put in 30 min of work at my work table (prepping vinyl for vehicle lettering) & when I was done all the easy stuff, I thought to go get a drink in the other room... 10 steps on I realized I'd forgot to grab my cane.  What an awesome feeling!  But I went & grabbed it, I'm only going to do that again when the PT tells me it's ok.


I saw my surgeon on Friday & he reassured me that what I'm going through is normal, to take things slow & let the muscles & other soft tissues heal.  Compared to the day before surgery, I am so much further ahead ROM & pain wise.  I am ecstatic!  I did forget to ask him to check the leg length.  But yeah, it is 1/2" longer.  The PT will help me learn how to walk with the length difference, I'm not too concerned.


For the past couple of days though, I have been really hyped up & excited about starting physio on Wednesday & that if it all continues to go well, I can start playing with my horses again at the 3rd month mark (So Sept 20th is marked on my calendar to get ready to sit in the saddle) and have made a goal to go off property & ride.  Regardless if it's my horse or someone else's trusty steed.  10 years is long enough to wait. 

[LMS]

I had my evaluation appointment at the Riverside hospital rehab department this morning & it was great!


My PT happens to be the same one that held the class I attended.  She is so lovely.   


So, according to her assessment, I'm am doing quite well, which was great to hear.  We went through all the exercises I am currently doing so she could make sure I was doing them properly, which I was.  Heck by now I should be with 33 years of doing physio under my belt.  Lol!  And all those ballet classes & my training & years of experience as a therapeutic riding instructor help too.  [size=78%] [/size]


[/size]She assessed my ROM, watched me walk with & without the cane.  I am to continue using the cane (which is a-ok with me)


We talked about my long term goals & expectations with recovery & what I would like to return to activity wise.  Some, of course are discouraged & usually, in a perfect world, should not be done ever again.  Which is fine with me.  I picked the ones that were most important to me, let her know what level I was at at my prime before the hip put a kabosh.  I told her it would be nice to get back to that level eventually if possible.


We talked about realistic timelines to achieve these goals.  Working together.   


So, yeah, today was the evaluation only & next week, the 6 week mark, we start physio.  I am to continue my current home physio until she says otherwise.

[catfriend]

 I have a 10mm leg length disparity, a similar disparity to yours. In my case at least some of it was pre-existing, as I had previously been advised to use a heel lift on one side to alleviate my symptoms. (Advice which I ignored because I didn't believe it.) Once I started really walking after surgery the disparity caused me a lot of pain on the right side of my lower back. I read that most people get used to small disparities over time, and Dr. P concurred. I initially used a Dr. Scholl's gel pad on my short side when on walks, but not anytime else. This helped alleviate the back pain from the walks, but was no panacea. At nearly six months I gave up and ordered real orthopedic heel lifts from Amazon. I use them in most of my shoes. These make a huge difference. The back pain from the leg length issue is gone. So, if you can't adjust after a few months, try the heel lifts on the short side. It's like night and day.

[LMS]

Thanks. 


We discussed the discrepancy & until the 6th month post op, I am to leave it alone.  If there is still a difference, then yes, I'll be getting a lift. [size=78%] [/size]

[LMS]

I was so proud of myself, Monday was my 6th week post op, so driving & water restrictions lifted.

I`m allowed to go in the water but no swimming yet.  Driving was a bit tough, making the hip area seize up.

We took the weekly update video of my walking & was putting together a comparison one to a year ago.  What a huge difference!  I was also able to do 40 ft without the cane, walking just as well with or without.  But then I received a call that my mother was having a stroke.  She lives an hour away from me so my brother called 911 & stayed with her until I got there.  They sent her home 10 hrs later & I`ve been staying wither since then, driving her to appointments & making all the necessary calls because she was in the middle of moving.

I went to my physio appointment (1hr drive into the city) & 3 exercises were added:  lying on un-operated side, lower leg bent, pillow between legs, upper leg straight, you do abduct lifts.  Then, the clam exercise & the reverse (foot/lower leg goes up, knees together).  Well with helping my mom out & these new exercises, my lower back is killing me & the sciatica is back with a vengeance.  Which of course is affecting my walking.  I'm back to taking 2 extra strength advil + 1 Tylenol 3 twice a day. 

I was hoping to go in the pool but it hasn't been up kept.

[LMS]

I`m still at my mother`s, looking after all her affairs regarding her stroke, moving et al.  She`s showing a slow progress which is very encouraging.

My hip on the other hand, it aches so much.  I can`t walk at all without the aid of the cane, so I`m still taking twice daily 2 extra strength ibuprophen & trying to keep it at 1 Tylenol 3.  I ice it for 10 min (hip area, side of thigh & lower back) after every physio session.  So 3X a day.   

I had physio at the hospital on Wednesday & the lower leg `abduction` (sitting, from the knee, you bring your foot away from center line) ROM has improved slightly.  Others are still the same.

We added another exercise now that the anterior movement restriction has been partially lifted.  Standing up, bring the surgery leg back, straight, in order to start stretching the front of the hip joint.  That hurts.

While meeting the stroke clinic doctor & team at the TOH Civic campus (for my mother), we were given a sheet of workshops for people who live with chronic conditions, in the Ottawa area.  If it`s ok with Pat, I`d like to put their info on here, so that people on here that are living in the Ottawa, Ont. (Canada) area can have a place to call for support.  Online is free for all residents of Ontario, Canada.

Living Healthy Champlain Workshops
www.livinghealthychamplain.ca
Toll Free: 1-877-240-3941

They have workshops you can go in person or online.

[Pat Walter]

Hi

It is always OK to share helpful information.  That's what this group is for.  Sharing stories, suggestions and helping each other.

Good Luck.   Pat

[LMS]

Thanks Pat. 

I forgot to mention, this is for self management for chronic physical & mental health conditions, whether it`s yourself who is afflicted or a loved one/patient & you need the support.

For Ontario residents interested in the online workshops: www.ontarioselfmanagement.ca

Having lived with chronic pain, other issues (physical & mental) since I was a teen, I'm going to check this out.  I think it's a great idea, especially for people who feel so overwhelmed.

[LMS]

At physio today we added weight to the leg curl machine (up to 2lbs), added an exercise like the reverse clam but while sitting & finally... the stationary bike.  The first minute was painful but then the next 2 minutes were great, so we added another 2 minutes. 

I was given the ok to do, in moderation, to start using the stationary bike (5 min at a time) & leg curl machine at home.  Or substitute the later with 2lb ankle weights.

This hip capsule is very sore & achy so I continue icing it & taking strong ibuprophen with Tylenol 3.  Seems like the pain/ache is more localized & the old muscle pain I had pre surgery is still slowly going away.

When at the doctor`s after physio, I asked to be weighed & I`m now down to 149 lbs!  I am so thrilled that I`m still on track with losing 1 lbs per week. 

[LMS]

Forgot to do an update last week...


So last Monday, 10 weeks post op, I was absolutely ecstatic when finally, after I don't remember how long, I was able to shave my legs without straining and... I washed my whole foot!  Woohoo!  I haven't been able to reach my foot & without pain.  I have to do it standing up, lift the knee, grab the lower leg (like a hug) & hold it up just high enough so I can reach the foot & wash it... I was so giddy about it & was telling everyone about it. 


Wednesday's physio was another good one.  My ROM has finally improved since my assessment 5 weeks ago.  Yay!  Abducting the leg no matter which position, is still painful around the joint.  And pain now seems to stay around the capsule of the joint.  Hamstring & glute pain is no longer a daily thing, it's now a normal thing whenever there is pain or ache.


I still have to watch out what I do because I will pay for it later on in the day & the next few days.


So... new exercises are: pelvic lifts, walking longer, standing on the operated leg without support & walking without the cane for short periods.  I have 2 weeks to work up the reps & length of time.


Funny how the basics, each step, has a purpose for the next step.  You think "Pah... push through it, how hard can it be" & the body sits you back on your butt when you don't take your time & follow through all the steps, even though they become mundane, they have a purpose as a building block for success. 


We're finally done moving all the stuff out of my mother's house.  I can now step back a bit & go at the pace I should be going for a successful rehab.  Unfortunately, I had no choice but to do things/push to get everything moved out.  So many things ended up not getting sorted but just boxed & stored in my hay shelter (thank goodness it was empty).  With my husband & boys' help, we'll sort through all the boxes at a slower pace I can manage.  And hopefully I can finally start staying home in the next weeks to come so I can start using my exercise equipment for rehab instead of only when I'm at physio.


Today I might put my dressage saddle on a bale or barrel & see if I can straddle it.  Eventually, I'll try the western saddle.


Anyhoo, in a couple of weeks, at the next physio session, if all goes well, I'll be discharged from physio & sent on my own to rehab.  I'll be writing up a list of questions & potential goals I want to achieve & the PT will go over it with me & advise me with a plan.  I'm excited.

[LMS]

Woohoo, what a great day today! 


Today I was able to rake grass & load up the big deep wheelbarrow heaped right up twice (someone else went & dumped it).  Did a lot of smaller piles that also had junk in it.  And I weeded a small flower bed.  I can feel it, the muscles are working & there's no pain.  I'm sure I'll be tight tomorrow.     But I took my time & lots of breaks.


I even raked up the loose hay on the barn floor & gave it to the horses, no pain.


And I sat astride a shavings bag to see how the hips would fare & no problem.  Tomorrow I'll try straddling a med sized barrel & see how that goes.


Man oh man it felt good to accomplish SOMETHING close to normal & not feel any pain except for a few twangs in the untouched hip.


Hey... I only used my cane half of the time today... Booya!