What to expect – One person’s early post-op THR experience

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In responding to Kaura's question about what to expect when going through a total hip replacement, I found many interesting and inspirational insights among member posts. Reply's to my responses included a suggestion to begin a new discussion. It’s now Wednesday, March 15, nine days after my surgery, and I'll start this discussion by including updates to my early (Day 4 and 5) posts, as well as a further update through today.

Of course, there's no one outcome … everybody's experience will be different.  But I found that understanding what other people did that contributed to their experience was helpful. I’d invite people to ask questions and comment on things that may have contributed to their experience with total hip replacement

Day 4 Post - I had a left hip replacement 4 days ago on Monday March 6th.  I'm a 60 year old male in decent condition. 5’ 10”, 170 pounds.  In beginning of February, I was diagnosed with torn hip-joint labrum and hip socket cartilage, arthritis and bone spurs, and total hip replacement was recommended (vs. arthroscopic hip surgery).   The surgeon recommended a ceramic ball and a polyethylene socket.  He went in through the front of the hip (anterior).  He said that anterior was less invasive and had a quicker recovery time vs going in through the side of the hip.

I was walking with crutches about 5 hours after the surgery and was cleared for discharge the same day.  I elected to stay overnight to be safe.  The next morning (Day 2) I went home and was fortunate to be able to walk without assistance, although I am using a cane to make sure I can focus on my impaired gait.  

On Day 3, I was in a lot more pain and began to experience more swelling.  Today (Day 4), I'm feeling much better and getting to spend a lot more time walking. I'm on two painkillers -- I'm now cutting back on both, and using the stronger of the two at night only.  So far so good.  

Day 5 Post - I tried going the day without painkillers and up'd the amount of time walking per hour and the quantity/intensity of exercises (leg lifts, foot pumps, etc). By late yesterday afternoon I concluded that I went too far too fast.  I began to experience a high level of stiffness and pain in my operated leg and found it more and more difficult to get up each time after sitting for more than 10 - 15 mins. [On the positive side, my painkiller "boycott" resulted in a muh-appreciated improvement in my constipation issues.]  

After an early dinner yesterday, I took 2 of the strong painkillers (5mg oxycodone) plus a prescription sleep aid and went to bed around 6:30 pm.  Woke up around midnight in pain and took 2 more pain killers and another sleep aid, which got me through til 5am this morning.  I got up feelling well rested.

I think I'm going to go back to taking the painkillers more along the lines that they were prescribed to see if that helps in facilitating the more aggressive daily "workout" routine.  For now, I'll still reserve the strong painkillers for overnight (2 oxy's every 4 - 5 hours or so) and the milder ones for during the day (1 - 2  50mg tramadols every 6 hours).

So far today, I feel like my progress is back to where I was around Day 2. Hoping that by the end of the day, I'll feel more like I've had 6 days of progress.  

Day 8 Update - Now beginning to feel that some breakthrough improvements are happening in the operated leg.  Beginning to consciously share walking load among both legs, giving the good leg a bit of a break. Now walking without assistance, but staying inside (wintry/icy outside last few days), practicing “perfecting posture,” sticking to routine for doing daily exercises.

Factors contributing to recovery so far include: 

·       Urgency – In 6 weeks, by April 17th, I want to be able to get back to the gym for full workouts and to be ready for spring outdoor cleanup

·       Time available - being semi-retired helps immensely.  Making your recovery your full-time job is priceless.

·       Medications – sticking to the prescribed medication routine, with a change in one of the painkillers due to a rash that developed.

·       Self therapies, including elevating leg like 30 mins each hour, and icing it several times a day

·      Daily exercise routine, that includes walking unassisted while practicing “perfect posture” and a corrected walking gait (about 10 – 15 minute about 5 times a day) and doing 2 - 3 sets of 7 doctor-recommended exercises per day:a)   Ankle pump - 10 reps, both directions, both ankles, occasionally hold for 5 seconds

b)   Quad press - 10 reps, press quad down, hold each Press for 5 seconds

c)   Glue squeeze - 10 reps, squeeze butt cheeks, hold 5 secs

d)   Heal slide - 10 reps, slide heel up toward butt, try to push knee bend

e)   Sort leg lift (calf lift) - 10 reps x :05 sec hold (pillow under thigh - raise lower half of leg)

f)    Sitting knee lift - 10 reps x :05 sec hold 

g)   Assisted straight leg lift - 10 reps 

Day 9 Update - Today, I felt very good.  More like myself, and getting my sense of humor back.  Getting around well with very manageable level of pain.  On the downside, I feel like I went too far too fast again by not paying attention to my swelling.  Went out for the first time since the surgery for lunch and spent way too much time with my leg not elevated.  I’m now dealing with a throbbing left leg and foot.  Hopefully icing my leg and keeping it raised overnight will help.

More to come....

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  • Posted

    Gary you are doing amazing well.

    I was lucky that I had lots of hips replacements within my family, also senior nurses, so was able to get lots of advice prior to surgery and after surgery, blunt and too the point advice, for what the surgery entailed, I was better prepared that most, for painkiller use, do not cut back on the OXY until you start to feel alot better, my cut off was about 14 days after surgery. Then stepped down to paracetemol.

    Sister who is the nurse said get in a supply of pear juice, for constiptation, very gentle, and not as nasty as prune juice, worked wonders for me, also orange juice alternative also not as nasty as prune juice.

    Fantastic that you are exercising as much as you are doing, I know you have goals but this getting well after this surgery is a marathon not a sprint I'm afraid.

    If you are feeling really brave and have a strong stomach watch the youtube video of your surgery, VERY ROUGH, and a real wake up as to just what they did.

    Best wishes for your future plans, slow down a little but I think you know that anyhow.

    • Posted

      Hi Lyn - thanks for the reply! I just watched the video and loved it. Interestingly, looks like they went in throught the front of the hip like they did with mine.  They suggested not taking the oxy because of a rash I got. They gave me Tyl #3 to go along with the Tram so I'm able to get the level of pain relief I need to progress with strentgth building and stamina.  Def will try the pear juice!  It  is very helpful to talk through with family and friends experiences they have had with their hip replacements.  Would have been very helpful if I knew of this (or any) site that has forums like this.  My struggle started back with trying to decide between arthroscopic surgery and total hip replacement.  So glad I choose this route.  Best of luck Lyn, and while I may not be slowing down, I will definitely slow my pace of acceleration!

    • Posted

      I'm taking every piece of advice that I believe will help so I picked up a couple bottles of pear juice today.  I am very thankful I've found this forum before my surgery.  

    • Posted

      you will find the pear juice very yummy, but don't drink too much, the hospital gave me about 1/2 cup with each meal, and then I continued that at home, kept me going even though I was on morphine, and that for me makes me vomit at one end and constipated at the other end. Thank goodness OXY seems to be tolerated by my system but again still leaves me constipated. 

      Best wishes for your surgery, you will notice the differences when you wake up, the pain from the old worn out joint has gone, but you do have pain and discomfort from the surgery, but every day gets better, uncle Bill my 80 yr old uncle, said about 2% a day, I agree, by the end of the first week you will really notice the differences, things are on the improve rather than getting worse as they do with a worn out hip.

    • Posted

      Lyn, this "when you wake up, the pain from the old worn out joint has gone. . ." has been one of the most encouraging posts.  thanks smile

       

  • Posted

    Hi gary, 

    Good to see you here !

    Wow !!!!  you are 10 days post-op and doing all that ??? Amazing !!!

    You already know that THR surgery is major surgery and eventhough you had the anterior procedure, there was still some cutting of bones, dislocating joint, the preparations to have the new hardware fitted etc...

    This is still so fragile and in the beginning stages of repair the damage done.

    Great summary too - 

    Most of us want to stop taking the pain meds too soon - so was I until my doctor explained that it is better to take them as prescribed to maintain level of comfort and move about ...

    Your body is letting you know that you are doing a wee bit too much, darling --

    It might also be better to use a walking aid for the following reasons:

    The purpose of the walker or crutches is to avoid a fall or sudden twist. Weight-bearing is safe immediately after surgery. But until the implants have grown into the bone, a process that takes 4 to 6 weeks, a fall or other sudden twisting force on the leg can risk implant loosening or injury to the leg. Reflexes take time to return, and narcotic pain medications can further dull the senses. That is the reason for learning to use an assistive device as long as necessary after surgery.

    Are you on any blood thinners? 

    Please keep us posted on your progress --- very helpful ...

    big warm hug

    renee

    • Posted

      Thanks for all your encouragement Renee.  Much appreciate your support.  I now do take my cane with with me at all times. The proper growth of the bone around the implant and really hits home when the thin about the possibility of what a fall or slip could do.  Somewhere along the line I heard that it was good to keep clumsy people away from you too, lol! They have me on 81 mg aspirin 2x a day for blood thinner.  It is amazing how the body can separate itself and "talk" to you.  My bruised and swollen leg reminded me of that.  I'm doing goog, taking it more cautiously, but still feeling progression.  Thank you for your support!

  • Posted

    I'd agree with Renee - just a little more caution would be a great idea!

    ?Like you I took to the hip replacement like a duck to water. I do have an ankle issue now, but the hip is perfect. And was from the start. No pain at all - nothing!!! BUT...

    ?As it says in Grahams reams of advice, the walking stick is not just for support. It is a warning for other people to be more careful around you. You don't want to fall or be knocked over - that small tumble or knock at the wrong time or at the wrong angle can set you back to pre-surgery! That simply isn't a risk worth taking.

    ?And I'd dump the "urgency" - it takes what it takes, and as you have already found out TWICE, more haste is less speed! Overdoing it isn't helping you. Although you will be much, much better by 6 - 8 weeks, and loads better by 12 weeks, take note - at your age, assuming reasonable fitness and good bone density for your age, it can take up to 18 months for full re-modelling of the bone! I'm 59, also in good shape overall, but have fabulous bone density (I know - they had to check it! - it's as good as someone half my age due to decades of weight bearing exercise) and I've been given an estimate of "about nine months" for full re-modelling, because I need this hip to become fully and totally weight-bearing for surgery on my opposing ankle (which they don't want to do until there is no risk at all to the hip).

    ?If you look at it that way, you can get back to normal life in several weeks, but STILL need to be just a little cautious for a good bit after that. For most of us that isn't really a big deal. "A little cautious" simply means not taking a silly risk and not pushing too hard too quickly. Patience is a virtue. Enjoy the fact that you can do so much more, but that doesn't have to mean that you pretend you are 21 again! Give yourself just a little space and time to be 110% secure in the knowledge that all is as it should be.

    • Posted

      Hi Beth - first, an LOL.  I just responded to Renee, above, and recalled my recollection of someone who told me that canes are also useful for keeping the clumsy people away from you. Thanks for that line ...  it makes people feel more comfortable when they see me walking around with a cane for the first time! Second, thank you for you very helpful thoughts regarding what physically is going on behind the scenes with my recovery ... ie, the new parts molding with and becoming part of my bones and body.  Not keeping that in mind when you feel like you making progress risks the a set back.  That 9-month timeframe seems totally reasonable, and makes sense using that as the time frame to know when can can rely on using your new hip as your primary hip. Slow and steady -- I do have the luxury of time.  Thanks Beth!
  • Posted

    You are doing well Gary. Very interesting to read your diary.

    Cheers Richard

    • Posted

      Thanks Richard for being here.  It's great to read throug all the posts and go back through and follow the other discussions, and I'm always appreciative of the members who say encouraging things that keep me wanting to stay in the loop here.  Take care - Gary 

    • Posted

      Dear Gary

      Thanks for your post.

      Onwards and upwards!

      Cheers Richard

  • Posted

    Hi Gary,

    I'm also aged 60 but female and am fit as have my own horse so do lots of riding and want to get back in saddle asap. I'm at 9 weeks post op and due to go back to work next week . I had to persuade the powers that be as they normally don't like a return to work until 12 weeks.

    However...i have to agree with what everyone else had been saying here that you have to be patient as you can't rush the healing processes. You need the pain meds to help with your exercises.

    I've followed all the instructions I've been given by the professionals to the letter and its worked. I've no pain or swelling, the scar is less sore as I massage it every day, I'm walking every day for 30-50 minutes. I can walk a mile in 20 minutes.

    Like you I have a goal that I'm desperate to achieve. I want to get back on my horse and ride. It's so tempting when the weather is good. But I'm not risking the progress I've made so far.

    As the saying goes "slowly slowly catchee monkey"

    Please don't try to rush your progress.

  • Posted

    So glad I found this forum and your post specifically Gary.  Thank you to all who contribute.  My THR (r) is in 2.5 weeks, the closer it gets the more . . . you know, just trying to learn and quell the nerves.  I am 61 yrs old in the US and must say I am getting lots of tips and tricks from y'all. 

    • Posted

      Thanks Kebra - So glad you found this.  If I found that this blog existed and read it BEFORE my surgery, I would have done things differently.  Can't say I wouldn't have had mistakes, but some of them were avoidable.  Best of luck in your surgery.  They all sure made it feel like it was going to be pretty routine (ie. they definitely have done this a few times and now know how to do it), and I am fortunate to feel so far that it was.  Spoiler alert - don't watch the you tube video of it til after lol.  I'm in the US too.  Look forward to hearing how you do and feel free to ask questions.  There's a lot of people here with a lot of varied experience that are kind enough to share their experiences to help you.  Best of luck!

    • Posted

      Hi Gary, what are some of the things you would "have done differently?" Just in case I have missed some of those posts.

      Also, I'm most confused by how long everyone is taking to get back to work.  I was told with my Right Anterior Hip replacement with a 'desk' job I could return in 4 weeks.  What am I missing here? I also thought I would be driving at 4 weeks....is my doc blowing smoke ?

    • Posted

      Dear Kebra

      It cannot be over emphasized that we are all different. It depends on so many things including how good your surgeon is, how positive you are, what condition you are in, how fit, your BMI, smoker, drinker and type of job and finally a certain amount of luck will come into it. There may be other factors I've missed out.

      Hopefully that may help you.

      Cheers Richard

    • Posted

      Hi Kendra - one thing I would have done different is to make sure I'm giving my leg enough time during the day to recover from walking around and sitting. In the second week after my surgery, I neglected to elevate my leg and ice it to keep the swelling down, and it blew up like a balloon -- thigh, knee, calf and foot. Just one aspect of going too fast too soon. I'm learning better that this all takes time. Plus, on the swelling front, I now wear a compression sock when I'm going to be up and about or sitting for extended periods (a lunch, a haircut, drive time ...). Regarding driving, I'm fortunate because it's my left hip that got operated on. Don't think I'd be driving at this point if it was my right hip.

      On your question about recovery time, my experience to get back up and walking has been pretty good. I'm now at Day 15 and carry a cane with me but don't rely on it anymore to support walking. I use a Fitbit to measure steps as an indicator of progress, and am now in 7000 - 10000 steps per day range (most smartphones have built in Health apps that can do that too -- just have to carry ur cell phone w you all the time). Beginning over this past weekend (Day 13 or so), I started testing my ability to use my operated leg to lead when going up stairs. I'm now starting to see my strength building for that.

      Like others have said, it depends on many factors. I think that by doing an anterior surgery (going in to replace the hip from the front va the side), you'll be favored for a quicker recovery. Going slowly so as to not incur setbacks, doing the recommended exercises every day and walking-walking-walking all will certainly help. For me, if I was working (I'm retired), I'm guessing that by the fourth week I would probably be able to get back to work in a "desk position" although I'd definitely need to reserve judgement on that til I hit that 4 week point. If you have some flexibility in ur job to take breaks to elevate ur leg, that would favor ur ability to get back to work too.

      Hope this helps! Look forward to continuing to hear from you as you near and get through your surgery. Best of luck!

    • Posted

      Gary, 

      I am 15 days post op for Hip Resurfacing and just wondered if you (or anyone else tbh) experienced the following,

      I am struggling to change my stockings on my operated left foot - in fact I can't remove them on my own or put them on myself. I  suspect this is normal and my physio is unconcerned (I am doing lots of walking and PT exercises) but was hopeful to be able to have more movement on my operated leg. I have made some progress tbh and just wondering if I a, expecting too much too soon.

      Cheers

    • Posted

      Hi PTBCAL,

      You shouldn't need to struggle with stockings. I'm at 10 weeks now and up until 6 weeks I used a sock aid which was brilliant for getting socks or stockings on.

      Regarding the amount of movement with your operated leg it comes back gradually. After I'd been for my 6 weeks review I was disappointed as I thought that once I was out of hip precautions everything would be back to normal. I was wrong as my muscles were so stiff even though I'd been doing all my exercises religiously.

      However now at 10 weeks I'm able to dress without any aids and movement is coming back slowly. I do stretching exercises night and morning and can almost touch my toes. Still not fully there yet as its a slow process but definitely feel more normal especially as I'm now starting back to work.

      It's still early days for you. Take your time and don't expect to much to soon.

    • Posted

      I agree with hippy. Now in my 3rd week since surgery, I still use the "sock aid," which is a device I wish I had known about months ago, back when my real hip started giving me pain and problems. If you don't have one, it's a must, both pre and post thr. It's also incredibly helpful in putting on a compression sock. Good luck!

    • Posted

      I have a couple of questions about the compression sock.  (1) has everyone needed them?  (2) when you say a 'sock aid' is helpful with compression socks what type of aid are you speaking about?

      I ask because long before my hip went out I needed compression socks for a short period of time.  To say they are HARD to put on with regular strength and mobility to me would be an understatement so I wonder what type of 'aid' people are using.  I've heard of the hook to grab socks, I've seen a plastic sleeve type thing with pully type ropes (like a jump rope).

      Thanks 10 days and counting till THR - can't wait.  Just had my syvisc injection in same side knee - trying to get that thing shored up before the operation.  

      Happy Thursday All 

    • Posted

      Any recommendation of a particular 'sock aid'?

      Looked at Amazon and there is so many with various positive reviews.

      cheers

    • Posted

      Hi kebra.

      In answer to your first question, I never had to wear compression socks. I was asked if I had any history of blood clots. I haven't so I had no socks. After the op I had foot pump boots on both feet to keep the blood circulating and I was sent home with anticoagulant tablets for 35 days.

      I got my sock aid from a mobility shop. It's a silky material inside so your foot slides in and out easily. The outside is terry towelling so your sock grips to it. You put your sock over it and slide your foot in. Then it has 2 long tapes which you use to pull your socks on. I'm not sure if it works with compression socks as I never used them.

      Good luck.

    • Posted

      I got a cheap and cheerful plastic one that cost about a couple of UK pounds. It has draw strings which makes it very easy to put my socks on with it. Makes a huge difference. I also bought a long shoe horn and elastic laces.

      Cheers Richard

    • Posted

      I've seen several recommendations for the elastic laces.  Sure wish I knew about those this past year.  I've wondered, though, are the elastic laces truly tight enough to be used in a 'workout' situation?  I know I probably can't run anymore - heck I haven't been able to for almost a year now but I do use elliptical machines where good foot support is important. 

    • Posted

      The Hickies ones are as tight as laces - they have various ways to make them tighter or looser to fit what you want.

      Sam

    • Posted

      I replaced my laces with the elastic ones three weeks ago and do not notice any difference just easier and quicker to put on.

      Cheers Richard

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