comments on LTHR

[Guest guest]

I received lots of helpful advice and encouragement from list members and

the archives on the way to a recent THR operation (June 15), and want to offer

some feedback -- hoping some of it might be useful to others.

I posted a few messages this spring. The gist was that I was a little

skeptical about getting a hip replacement any time soon. I've had arthritis in

the right knee and foot (big toe) for several years. 6 or 7 years ago began to

feel intermittent pain in the left hip and assumed it was more arthritis. When

it became persistent enough to be a real nuisance, went to an orthopedist who

took x-rays and said it was arthritis with AVN, and prescribed an NSAID

(Celebrex, which didn't work for me) and physical therapy. Got some not very

helpful second and third opinions before going to a surgeon recommended by my

secretary who was the first (of five I tried over the years, all told) who

really seemed to know what he was looking at. He said my hip was shot, would

need a replacement eventually, but could get probably get by for a few more

years with NSAID (Vioxx, which did work for me, though only at 50mg) and a cane,

and that I would know when I was ready. I was 51 at the time. One concern then

was that metal / plastic prostheses typically lasted no more than 15 or so

years. I asked him about ceramic and he said " ceramic breaks. " This was just

after ceramic had been approved for use in the U.S. and then 'recalled' because

of frequent cracks, a design flaw which was fixed shortly thereafter.

I went back to him a couple of more times, about once a year, as the pain

became more constant, my limp more pronounced, more dependent on a cane, but was

still reluctant to get the operation. I had days with no serious pain at all (as

long as I took my meds) and since I have a sedentary job (teaching and

research), work mostly at home or in my office on campus, mobility is not a

major issue, though I was getting out of shape since I couldn't walk fast or do

much yoga, my main forms of exercise.

What I was most afraid of was losing the ability, even for a few months, to

bend and to sit on the floor, which for lack of elevated shelf space is where I

keep a good portion of my books. What persuaded me was that I was losing too

much sleep to pain.

My window of opportunity was limited to early summer, start of the one long

break in the academic year, so I went to the surgeon in March to schedule an

operation for June. Was advised I'd be back on my feet in no time, biggest

problem would be sticking to the restrictions long enough to heal properly. He

said he would do a ceramic prosthesis, non-cemented.

Checked into the hospital at 6:30 a.m., wheeled into the OR an hour later,

spinal, a horde of doctors descending on me to insert IV's and a tube " into the

bladder " (so I was told, via the urethra, I only later realized), numbness, out

cold, woke up in the recovery room some hours later, at one moment hit by

intense pain, extreme heightened perception, sure something was really wrong,

asked nurse to check the morphine drip, turned out the IV was leaking. Once that

was fixed was back in blissful fog.

Spent the next 3 days in hospital, enjoying the luxury of constant attention

(first time overnight in a hospital). Best part not even having to get out of

bed to urinate. Worst was constipation. After a couple of days was offered a

choice of Milk of Magnesia (worried about when it might kick in), suppository,

or 'fleet enema,' new experiences all. I opted for the suppository, did it

myself, no real effect. Solicitous nurse then insisted on administering the

enema (was later informed by attending physician in rehab that dignity is

something you can't hold onto in a hospital), it worked well.

I got 2 or 3 hours of physical therapy in the operating hospital and was

walking on axillary crutches when discharged to rehab. Had a choice of

'sub-acute' (nursing home with rehab facilities) or 'acute' (rehab hospital). My

surgeon told me I'd go crazy in the former. Had several options, chose the Rusk

Institute in Manhattan so I'd be close enough to home that my daughters could

visit. Stayed for 12 days, 3 hrs / day physical therapy. Only drawback was that

roommates were mostly recovering not from surgery but from strokes and worse,

felt badly being so far ahead of them, tried to help by running errands

(bringing french fries and real coffee from the cafeteria, etc.) in my

wheelchair, and interpreting aphasiac requests for the nurses.

Discharged from rehab hospital 4 days ago with loftstrand crutches, used one

of them at home for day one, but not since, just a cane when I go out walking,

about 2 miles a day now. Zero pain in operated leg (now the same length as the

other, so no limp). Follow-up visit to surgeon tomorrow a.m.

After-effects: calf muscles very stiff in the morning. Get tired easily but

have trouble staying asleep for more than a few hours at night.

[Guest guest]

Welcome back! Glad you are doing well. I was wondering how you made

out with the surgery.

How are you doing with the restrctions? When you feel good they are

hard to follow, but we must be careful.

Sue - 4 weeks post op THR revision.

>

> I received lots of helpful advice and encouragement from list

members and the archives on the way to a recent THR operation (June

15), and want to offer some feedback -- hoping some of it might be

useful to others.

> I posted a few messages this spring. The gist was that I was a

little skeptical about getting a hip replacement any time soon. I've

had arthritis in the right knee and foot (big toe) for several years.

6 or 7 years ago began to feel intermittent pain in the left hip and

assumed it was more arthritis. When it became persistent enough to be

a real nuisance, went to an orthopedist who took x-rays and said it

was arthritis with AVN, and prescribed an NSAID (Celebrex, which

didn't work for me) and physical therapy. Got some not very helpful

second and third opinions before going to a surgeon recommended by my

secretary who was the first (of five I tried over the years, all

told) who really seemed to know what he was looking at. He said my

hip was shot, would need a replacement eventually, but could get

probably get by for a few more years with NSAID (Vioxx, which did

work for me, though only at 50mg) and a cane, and that I would know

when I was ready. I was 51 at the time. One concern then was that

metal / plastic prostheses typically lasted no more than 15 or so

years. I asked him about ceramic and he said " ceramic breaks. " This

was just after ceramic had been approved for use in the U.S. and

then 'recalled' because of frequent cracks, a design flaw which was

fixed shortly thereafter.

> I went back to him a couple of more times, about once a year,

as the pain became more constant, my limp more pronounced, more

dependent on a cane, but was still reluctant to get the operation. I

had days with no serious pain at all (as long as I took my meds) and

since I have a sedentary job (teaching and research), work mostly at

home or in my office on campus, mobility is not a major issue, though

I was getting out of shape since I couldn't walk fast or do much

yoga, my main forms of exercise.

> What I was most afraid of was losing the ability, even for a

few months, to bend and to sit on the floor, which for lack of

elevated shelf space is where I keep a good portion of my books. What

persuaded me was that I was losing too much sleep to pain.

> My window of opportunity was limited to early summer, start of

the one long break in the academic year, so I went to the surgeon in

March to schedule an operation for June. Was advised I'd be back on

my feet in no time, biggest problem would be sticking to the

restrictions long enough to heal properly. He said he would do a

ceramic prosthesis, non-cemented.

> Checked into the hospital at 6:30 a.m., wheeled into the OR an

hour later, spinal, a horde of doctors descending on me to insert

IV's and a tube " into the bladder " (so I was told, via the urethra, I

only later realized), numbness, out cold, woke up in the recovery

room some hours later, at one moment hit by intense pain, extreme

heightened perception, sure something was really wrong, asked nurse

to check the morphine drip, turned out the IV was leaking. Once that

was fixed was back in blissful fog.

> Spent the next 3 days in hospital, enjoying the luxury of

constant attention (first time overnight in a hospital). Best part

not even having to get out of bed to urinate. Worst was constipation.

After a couple of days was offered a choice of Milk of Magnesia

(worried about when it might kick in), suppository, or 'fleet enema,'

new experiences all. I opted for the suppository, did it myself, no

real effect. Solicitous nurse then insisted on administering the

enema (was later informed by attending physician in rehab that

dignity is something you can't hold onto in a hospital), it worked

well.

> I got 2 or 3 hours of physical therapy in the operating

hospital and was walking on axillary crutches when discharged to

rehab. Had a choice of 'sub-acute' (nursing home with rehab

facilities) or 'acute' (rehab hospital). My surgeon told me I'd go

crazy in the former. Had several options, chose the Rusk Institute in

Manhattan so I'd be close enough to home that my daughters could

visit. Stayed for 12 days, 3 hrs / day physical therapy. Only

drawback was that roommates were mostly recovering not from surgery

but from strokes and worse, felt badly being so far ahead of them,

tried to help by running errands (bringing french fries and real

coffee from the cafeteria, etc.) in my wheelchair, and interpreting

aphasiac requests for the nurses.

> Discharged from rehab hospital 4 days ago with loftstrand

crutches, used one of them at home for day one, but not since, just a

cane when I go out walking, about 2 miles a day now. Zero pain in

operated leg (now the same length as the other, so no limp). Follow-

up visit to surgeon tomorrow a.m.

> After-effects: calf muscles very stiff in the morning. Get

tired easily but have trouble staying asleep for more than a few

hours at night.

>

>

[Guest guest]

Hi, Sue

Thanks for this message.

The restrictions _are_ a nuisance but I'm following them. Went to surgeon

for follow-up x-rays and checkup yesterday, his main concern was that I stick to

the restrictions till end of week 6 post-op to be on the safe side. I'm still

using a cane when I go outside, mainly for balance, indoors walking around fine

without it (and pain-free except for a little stiffness in the hip mornings).

I asked doc whether _all_ restrictions are lifted after 6 weeks; he said

yes. I was concerned because I've been advised (by a visiting nurse, and some

notices on this list) that it is better never to sit cross-legged, for example,

or get into a shallow bathtub, after a THR. Apparently that would be an

exceptional case.

Otherwise, surgeon prescribed a weekly dose of residronate sodium (Actonel),

something usually for osteoporosis, to promote growth of bone around implant. I

haven't seen any references to this on the list and wonder if it is a new

tactic.

Re: comments on LTHR

>

>

> Welcome back! Glad you are doing well. I was wondering how you made

> out with the surgery.

>

> How are you doing with the restrctions? When you feel good they are

> hard to follow, but we must be careful.

>

> Sue - 4 weeks post op THR revision.

>

>

> >

> > I received lots of helpful advice and encouragement from list

> members and the archives on the way to a recent THR operation (June

> 15), and want to offer some feedback -- hoping some of it might be

> useful to others.

> > I posted a few messages this spring. The gist was that I was a

> little skeptical about getting a hip replacement any time soon. I've

> had arthritis in the right knee and foot (big toe) for several years.

> 6 or 7 years ago began to feel intermittent pain in the left hip and

> assumed it was more arthritis. When it became persistent enough to be

> a real nuisance, went to an orthopedist who took x-rays and said it

> was arthritis with AVN, and prescribed an NSAID (Celebrex, which

> didn't work for me) and physical therapy. Got some not very helpful

> second and third opinions before going to a surgeon recommended by my

> secretary who was the first (of five I tried over the years, all

> told) who really seemed to know what he was looking at. He said my

> hip was shot, would need a replacement eventually, but could get

> probably get by for a few more years with NSAID (Vioxx, which did

> work for me, though only at 50mg) and a cane, and that I would know

> when I was ready. I was 51 at the time. One concern then was that

> metal / plastic prostheses typically lasted no more than 15 or so

> years. I asked him about ceramic and he said " ceramic breaks. " This

> was just after ceramic had been approved for use in the U.S. and

> then 'recalled' because of frequent cracks, a design flaw which was

> fixed shortly thereafter.

> > I went back to him a couple of more times, about once a year,

> as the pain became more constant, my limp more pronounced, more

> dependent on a cane, but was still reluctant to get the operation. I

> had days with no serious pain at all (as long as I took my meds) and

> since I have a sedentary job (teaching and research), work mostly at

> home or in my office on campus, mobility is not a major issue, though

> I was getting out of shape since I couldn't walk fast or do much

> yoga, my main forms of exercise.

> > What I was most afraid of was losing the ability, even for a

> few months, to bend and to sit on the floor, which for lack of

> elevated shelf space is where I keep a good portion of my books. What

> persuaded me was that I was losing too much sleep to pain.

> > My window of opportunity was limited to early summer, start of

> the one long break in the academic year, so I went to the surgeon in

> March to schedule an operation for June. Was advised I'd be back on

> my feet in no time, biggest problem would be sticking to the

> restrictions long enough to heal properly. He said he would do a

> ceramic prosthesis, non-cemented.

> > Checked into the hospital at 6:30 a.m., wheeled into the OR an

> hour later, spinal, a horde of doctors descending on me to insert

> IV's and a tube " into the bladder " (so I was told, via the urethra, I

> only later realized), numbness, out cold, woke up in the recovery

> room some hours later, at one moment hit by intense pain, extreme

> heightened perception, sure something was really wrong, asked nurse

> to check the morphine drip, turned out the IV was leaking. Once that

> was fixed was back in blissful fog.

> > Spent the next 3 days in hospital, enjoying the luxury of

> constant attention (first time overnight in a hospital). Best part

> not even having to get out of bed to urinate. Worst was constipation.

> After a couple of days was offered a choice of Milk of Magnesia

> (worried about when it might kick in), suppository, or 'fleet enema,'

> new experiences all. I opted for the suppository, did it myself, no

> real effect. Solicitous nurse then insisted on administering the

> enema (was later informed by attending physician in rehab that

> dignity is something you can't hold onto in a hospital), it worked

> well.

> > I got 2 or 3 hours of physical therapy in the operating

> hospital and was walking on axillary crutches when discharged to

> rehab. Had a choice of 'sub-acute' (nursing home with rehab

> facilities) or 'acute' (rehab hospital). My surgeon told me I'd go

> crazy in the former. Had several options, chose the Rusk Institute in

> Manhattan so I'd be close enough to home that my daughters could

> visit. Stayed for 12 days, 3 hrs / day physical therapy. Only

> drawback was that roommates were mostly recovering not from surgery

> but from strokes and worse, felt badly being so far ahead of them,

> tried to help by running errands (bringing french fries and real

> coffee from the cafeteria, etc.) in my wheelchair, and interpreting

> aphasiac requests for the nurses.

> > Discharged from rehab hospital 4 days ago with loftstrand

> crutches, used one of them at home for day one, but not since, just a

> cane when I go out walking, about 2 miles a day now. Zero pain in

> operated leg (now the same length as the other, so no limp). Follow-

> up visit to surgeon tomorrow a.m.

> > After-effects: calf muscles very stiff in the morning. Get

> tired easily but have trouble staying asleep for more than a few

> hours at night.

> >

> >

>

>

>

>

>

[Guest guest]

Be careful and go slowly. Stop if you have any pain! Make sure you

have stong muscles. They are what protect the hip from dislocating.

My doc wants to wait 3 months before he lifts the restrictions. I

will have a hard time keeping them. At 4 weeks post op RTHR revision

it is hard. Before the revision I crossed my legs all the time and

use a low bathtub.

Good luck.

Sue

> > >

> > > I received lots of helpful advice and encouragement from

list

> > members and the archives on the way to a recent THR operation

(June

> > 15), and want to offer some feedback -- hoping some of it might

be

> > useful to others.

> > > I posted a few messages this spring. The gist was that I

was a

> > little skeptical about getting a hip replacement any time soon.

I've

> > had arthritis in the right knee and foot (big toe) for several

years.

> > 6 or 7 years ago began to feel intermittent pain in the left hip

and

> > assumed it was more arthritis. When it became persistent enough

to be

> > a real nuisance, went to an orthopedist who took x-rays and said

it

> > was arthritis with AVN, and prescribed an NSAID (Celebrex, which

> > didn't work for me) and physical therapy. Got some not very

helpful

> > second and third opinions before going to a surgeon recommended

by my

> > secretary who was the first (of five I tried over the years, all

> > told) who really seemed to know what he was looking at. He said

my

> > hip was shot, would need a replacement eventually, but could get

> > probably get by for a few more years with NSAID (Vioxx, which did

> > work for me, though only at 50mg) and a cane, and that I would

know

> > when I was ready. I was 51 at the time. One concern then was that

> > metal / plastic prostheses typically lasted no more than 15 or so

> > years. I asked him about ceramic and he said " ceramic breaks. "

This

> > was just after ceramic had been approved for use in the U.S. and

> > then 'recalled' because of frequent cracks, a design flaw which

was

> > fixed shortly thereafter.

> > > I went back to him a couple of more times, about once a

year,

> > as the pain became more constant, my limp more pronounced, more

> > dependent on a cane, but was still reluctant to get the

operation. I

> > had days with no serious pain at all (as long as I took my meds)

and

> > since I have a sedentary job (teaching and research), work mostly

at

> > home or in my office on campus, mobility is not a major issue,

though

> > I was getting out of shape since I couldn't walk fast or do much

> > yoga, my main forms of exercise.

> > > What I was most afraid of was losing the ability, even for

a

> > few months, to bend and to sit on the floor, which for lack of

> > elevated shelf space is where I keep a good portion of my books.

What

> > persuaded me was that I was losing too much sleep to pain.

> > > My window of opportunity was limited to early summer, start

of

> > the one long break in the academic year, so I went to the surgeon

in

> > March to schedule an operation for June. Was advised I'd be back

on

> > my feet in no time, biggest problem would be sticking to the

> > restrictions long enough to heal properly. He said he would do a

> > ceramic prosthesis, non-cemented.

> > > Checked into the hospital at 6:30 a.m., wheeled into the OR

an

> > hour later, spinal, a horde of doctors descending on me to insert

> > IV's and a tube " into the bladder " (so I was told, via the

urethra, I

> > only later realized), numbness, out cold, woke up in the recovery

> > room some hours later, at one moment hit by intense pain, extreme

> > heightened perception, sure something was really wrong, asked

nurse

> > to check the morphine drip, turned out the IV was leaking. Once

that

> > was fixed was back in blissful fog.

> > > Spent the next 3 days in hospital, enjoying the luxury of

> > constant attention (first time overnight in a hospital). Best

part

> > not even having to get out of bed to urinate. Worst was

constipation.

> > After a couple of days was offered a choice of Milk of Magnesia

> > (worried about when it might kick in), suppository, or 'fleet

enema,'

> > new experiences all. I opted for the suppository, did it myself,

no

> > real effect. Solicitous nurse then insisted on administering the

> > enema (was later informed by attending physician in rehab that

> > dignity is something you can't hold onto in a hospital), it

worked

> > well.

> > > I got 2 or 3 hours of physical therapy in the operating

> > hospital and was walking on axillary crutches when discharged to

> > rehab. Had a choice of 'sub-acute' (nursing home with rehab

> > facilities) or 'acute' (rehab hospital). My surgeon told me I'd

go

> > crazy in the former. Had several options, chose the Rusk

Institute in

> > Manhattan so I'd be close enough to home that my daughters could

> > visit. Stayed for 12 days, 3 hrs / day physical therapy. Only

> > drawback was that roommates were mostly recovering not from

surgery

> > but from strokes and worse, felt badly being so far ahead of

them,

> > tried to help by running errands (bringing french fries and real

> > coffee from the cafeteria, etc.) in my wheelchair, and

interpreting

> > aphasiac requests for the nurses.

> > > Discharged from rehab hospital 4 days ago with loftstrand

> > crutches, used one of them at home for day one, but not since,

just a

> > cane when I go out walking, about 2 miles a day now. Zero pain in

> > operated leg (now the same length as the other, so no limp).

Follow-

> > up visit to surgeon tomorrow a.m.

> > > After-effects: calf muscles very stiff in the morning. Get

> > tired easily but have trouble staying asleep for more than a few

> > hours at night.

> > >

> > >

> >

> >

> >

> >

> >