One week post THR - on the rollercoaster

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One week post-op left THR – first of all I need to thank my consultant Mr Phillip Roberts and his team who have been faultless. I write this hopefully to reassure any people about to go in for their surgery and I am more than happy to answer any questions at all.

Day zero (Friday) – The consultant and the anaesthetist came to see me at about 9am to discuss things. I was first on the list due to my misshapen femur and pelvis making a more complicated procedure than usual. We agreed on spinal with a cannula in my wrist to administer sedative (diamorphine) as required. At 11am we met again in theatre and 10 minutes later was in a lovely relaxed sleep. 90 minutes later still I awoke in recovery still very happy and comfortable and was transferred to my bed. As I had no pain at all I declined oxycodeine  and just had paracetamol and nefopam coupled with an intravenous antibiotic and fragmin injected into my tummy to keep the clots away (injection every day for 28 days ). My blood pressure was 90/55 so it was decided that I shouldn’t try getting out of bed today. After going to the loo  normally after the op my bladder changed its mind and went into retention so I had to have a catheter fitted. Also two drains, hydraulic DVT socks, oxygen pipes, cannula. Wound site about 175mm long with approx. 20 staples.

Day 1  (Saturday) – I awoke after a very comfortable night and still no pain – however at about 9am pain began to grow steadily and I asked for the oxycodeine and ibuprofen to be added. Mr Roberts popped in to see how I was at around 10am. At 11am the physio came and got me out of bed with the intention of taking me to x-ray. At the foot of the bed I became very nauseous and dizzy and nearly fainted which prompted the physio to get me back into bed sharpish. The pain continued through the day and proved difficult to get back under control ( probably varying between 5 to 8 out of 10) but by bedtime I was comfortable again. Bad news x-ray now shut till Monday. BP 100/65. Another shot of intravenous antibiotic.

Day 2  (Sunday) – I slept quite well even though on my back and enjoyed a good breakfast. The physio came at 9.30am with crutches but with having had a scare the day before he only walked me around the bed and back. I happily returned to have a nice day in bed. Until the consultant arrived at 4pm and put a bomb under me by telling me that the first days recovery post-op are his biggest indicator of the ultimate level of function of the new hip. He explained that all the muscles work, the joint is secure and will hold full body weight and the wound unlikely to open up. All I had to do was get up and walk. Following this I started getting in and out of bed at least every hour even through the night for very short walks ( tubes everywhere ! – the nurses were lovely ) BP 100/65. Final shot of antibiotic, hydraulic socks and drips removed, still on oxygen to try to lift BP.

Day 3 (Monday) – Wow everything happened so quickly – more physio showing me the exercises to do at home, off to x-ray (amazing pictures ! ), more physio to do the stairs test, a visit from the anaesthetist and consultant Mr Roberts who walked with me 40m up and down a corridor and discussed the success of the operation and  I was discharged by mid afternoon. BP 110/65. I hadn’t realised my last allowed dose of oxycodeine was Sunday night and so dropped to 30mg codeine instead. The weather was horrible on the way home and although only 5 miles home and following all the frenzied activity I was cold to the bone and in some pain ( level 4-5) Getting in and out of the car was quite easy though.

Day 4 (Tuesday)  -  Nice to be home. I managed the stairs quite well and pain was back under control. Steady progress today. A flat spot at around teatime ( 4-5pm) when I became very tired and pain up to around a 4-5. Off to bed not too bad really.

Day 5 (Wednesday)  -  Slept 2-3 hrs at a time with visit to the loo to keep legs moving each time I awoke – not too bad. Pillow beneath my knees and a firm foam pillow at the foot of the bed to rest my feet against. Spreads the weight quite nicely. Off to physio this morning at the health centre. He has added two more exercises – laying on my back

1.       Press back of knees firmly into the bed ( not great at this )

2.       Leg raise 200mm from the bed surface ( achieved zero mm )

Never mind stuff to work on. Back home – another flat spot around 4-5pm. First walk outside today probably about 50m there and back.

Day 6 (Thursday )  - Feeling good today. Almost all the swelling in my hip area has now gone and hardly any bruising left either. 500m walk along the street. Pain levels generally good. I have come so far in a week I am amazed. I have started to do stupid things like set off across the room without my crutches before remembering. My sports physio ( an old schoolmate ) messaged me today to warn me to take it easy for at least a few weeks as this is the time when problems can be encountered by trying to push too far too quickly. Point taken I am just doing the exercises set by the physio and a short walk each day. Leg raises are now achievable but still hard and also pushing foot out to the side and holding is quite hard – Lots to be working on but so far so good.

 

So all in all a rollercoaster ride this week but feeling like I am moving in the right direction. Please don’t hesitate to ask any questions as I got such a lot of great support from folk on this forum I am keen to help others also.

Paul

4 likes, 31 replies

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  • Posted

    Hi Paul

    Pleased to see you are doing so well. But don't rush things it's not a race. Be kind to yourself as well as those blinkin exercises you need to rest too.

    Don't give up the drugs they keep the stiffness away especially paracetamol I'm still taking them 10 weeks in.

    Keep it up!

    Julie

    • Posted

      Hi Julie - sound advice. I would definitely discourage trying to 'push' things. Also as I have discovered to my cost over the last few days pain control is the key - it takes ages to get back under control once it arrives. (No heroes here !)

  • Posted

    Dear Paul

    Excellent news and very interesting to read the detail. Just go at the pace you are comfortable with. I cannot recall doing any exercises, just lots of walking!

    Cheers Richard

    • Posted

      Thanks Richard - my consultant agrees with you. He says hip muscles are designed for walking therefore the best exercise to get back to full mobility is walking. Poor Physio has to do something though !
    • Posted

      Walking is very important, but so is physio.  There are many muscles surrounding the hip, legs and lower back that need strengthening.  We tend to forget about the inner and outer thigh & hip muscles when all we have to do is walk. 

      As you know I'm over 7 months post op.  I've been walking (briskly) each night and feel really good with no pain.  The other night my husband and I had this bright idea to climb a steep hill close to where we live.  I was very careful going up - no problems at all.  BUT, coming down my husband came running behind be yelling 'watch out I can't stop!'...... he was joking, but I didn't realize that at the time.  Instinctively I quickly stepped to the side (while trying to control my spead coming down the hill) to move out of his way.  It was then that I remembered those inner muscles that we tend not to use often.  I came limping home and immediately put ice on it.  Luckily no damage! 

      PT will get you in complete shape.  And I've found that we may have to continue those strengthening exercises for a while.

  • Posted

    Hi Paul, congratulations on your progress so far! Glad to hear it's mainly going well for you. Remember to take it easy. I took all my hospital prescribed pain meds for the first fortnight, and then gradually reduced them. There's no point in suffering!

    All the best, Judith

    • Posted

      Hi Judith - lovely to hear from you. The only med I have reduced voluntarily is codeine as it does upset ones tummy somewhat. I now chop the 30mg tablets in half and take with paracetamol every 6hrs. Ibuprofen sandwiched in between but only 3 doses a day of this. This combination seems to have settled my tum nicely and not taking movicol anymore to move things along.

      Hope you are feeling fit and well

      Paul

  • Posted

    Wow, thanks Paul.. You sound like it's going phenomenally well for you!

    I'm scheduled in for the right replacement on the 16th March, varying degree of nerves, fear and excitement. It's good to read your success, thank you.

    If I may ask, what if anything could you have prepared more for?

    Thanks again

    Caron

    • Posted

      Brilliant question Caron !

      Physically I have struggled to do the leg raises the physio asks me to do - so i might practice these pre-op to get some muscle memory going.

      Around the house I have found that the worst thing to happen so far is letting my crutches drop to the floor and having no means to retrieve them. This is easily solved by having a grabber at each point in the house where you stop and put your crutches down. The lounge, bathroom, bedroom,kitchen/diner. So that is 4 grabbers - well worth the few quid each for the extras.

      I might also ring occ health and see if I can have another perching chair as these are very useful as adjustable height and with cushion experimentation easily my favorite sitting place. I want one upstairs too for the office.

      Have a selection of raising cushions to experiment with post op. My combo is a memory foam wedge designed for car seats on top of a memory foam shaped pillow.

       Do a list of five minute jobs to get out of the way this week. That cobweb in the corner, the picture still sitting waiting to be hung, favorite books at a reachable height on the bookcase.

      Good luck with your op Caron - its not as scary as you think I promise

    • Posted

      Yes, I really liked the perching chairs! Ended up with 3, because a friend gave me a couple. Had one at the kitchen table, one in my study and one for sitting in the garden. ( It was summer.) Hope you're having a good day today.

  • Posted

    Glad everything has gone well,don't rush take each day as it comes. Feel I have turned a corner today cooked Sunday roast and done some shopping,I am 8 weka tomorrow on my secon hip,it's been a lot slower with this one and my body has told me to slow down x

    • Posted

      Hi Jill

      Well done you - what time are you carving the roast ?

      How long between operations were you ? My second is planned for 7 weeks from now. I can understand the body getting a bit fed up with all the extra work fixing stuff. I guess the period of inactivity following op.1 weakens the muscles on the second side too.

       My stitches total in the last 5 months is over 100 now due to a couple of unforseen problems I had before Christmas so I know where you are coming from.

      Keep it up Jill

      Paul

  • Posted

    Hi Paul 

    its been really good being able to read a day by day diary I'm waiting on a date for my op believe it's in march im really consurnd about the whole thing I'm not good with pain at all and I don't have a lot of support when home so hearing your experience is opening my eyes pls keep it up x

    • Posted

      Hi Karen

      Thank you I am really glad it helps. I wouldnt worry about pain as it really is controllable. ( especially if you have good tollerance to morphine ) My only problems have been due to the dizziness I get when on opiates so because of a need to get up and about I initially tried to avoid them.

        I have had a friend on here who has gone through the op just a few days ahead of me and we have been updating each other on our progress/feeelings etc daily and it really has been reassuring and helpful. I will always reply if you pm me on here as I know how frightening this whole business gets sometimes.

      Best of luck for a date in March

      Paul

    • Posted

      Hi Paul 

      thank you for replying I've now had all my equipment delivered and bed sofa raised so I'm guessing it's soon rolleyes not sure how I'm feeling about it would you recommend if possible staying on one level of house until more steady and less pain and is it really a case of more rest helps or keeping on it helps I know may sound silly lol x 

    • Posted

      I worried about going up and on my crutches, but really the stairs are not as bad as you expect. Just the first few days are hard work, after that, gets a bit easier. You shouldn't need to be all on one level.

    • Posted

      Hi Karen

      I agree with Judith stairs arent too difficult, they are an area where you can have a fall though so I try not to go up and down more than a few times a day. Let your body tell you how much is good - I do think getting up and moving around every hour or so is a good idea though in the early days even though you will probably need help each time you get in and out of bed. Dont be afraid to keep buzzing the nurses. After 3 or 4 days I could coax my legs in an out of bed myself by hooking the good foot under the operated leg and gently pushing/pulling it across

      It all gets real when the stuff arrives doesnt it ! You will be fine though

      Paul

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