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Old 09-21-2008, 06:30 AM   #1
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Progress--7th week post surgery

Well--I'm hitting end of 7th week (49 days) post surgery tomorrow. Can anyone tell me what restrictions, if any, were lifted for them after 6-7 week mark? And, what things they were told they still shouldn't do after this time period? Just trying to figure out what is reasonable/usual.

I think I'm making reasonable progress with home exercise program. Will see doctor in 2 weeks for checkup and am wondering if he will actually give me some supervised therapy. I am still walking with a little limp but every day shows some improvement.

Right now I walk with a cane but around the house can walk without it. I started work last week and a few times started to leave cane in my office-forgot about it and had to go back to get it. I can walk a mile or more with my cane (heat and weather permitting here in Houston) and have had no problems in resuming driving a car. I expect I won't need a cane much longer but it does make me feel more secure outside and in crowds. I'm in no hurry to abandon it. (Unlike the walker, that made me crazy).

I still walk up stairs most of the time using one foot at a time, but it's getting easier to do regular stair climbing (foot over foot) when I walk upstairs. It's easy now to do regular stair climbing when going downstairs so long as I hold onto the bannister.

I still have not tried to sleep on my side but its getting really hard to stay on my back. I am sleeping better (hurricane and no power days aside) but still haven't had a truly restful deep sleep yet.

Anyway, I'm hoping when I see the doctor next he'll allow me to start working out at the gym--at least with stretching and other exercises. I'm starting a list of questions about what I can do and not do now.


Maggie

Last edited by Larimergirl; 09-21-2008 at 12:50 PM. Reason: put question at top of post

 
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Old 09-22-2008, 05:42 AM   #2
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Re: Progress--7th week post surgery

Hi, glad you are progressing well. I started sleeping on the unoperated side at 4 weeks. Am 8 and 1/2 weeks now and can go to sleep on both sides but will wake up in an hour or two with the surgery side aching and have to turn on my back and stretch out. Just be sure to put a pillow between legs to keep them from crossing while you sleep. I have found that I ache less at night if I put ice on the surgery site before bed. Just discovered this in the last few days so I will make an effort to ice everynight. I was doing this but had become lax because the surgery site did not seem to feel as hot at night any more so I stopped except for days that were harder.
I started sleeping on my side using a body pillow cuz the OS had told me I had to use that stupid foam Christmas tree for 30 days. I didn't even ask him- just got rid of it cuz I was reading that others did not even use it or got rid of it as soon as they got home. He hasn't released me from any restrictions- hasn't even mentioned it other than to say I am doing well and he is pleased. Just using good sense and listening to my body and reading alot. Could not possibly walk a mile though, but do well in the house as you say, without the cane. Did have those "soft bone" issues and was on tip toe weight bearing for 3 to 5 weeks. Not seeing OS again til December. Have violated the 90 degree rule a lot with bending forward, does not hurt and feels okay. Cannot reach my foot yet but can shave my legs on both sides. Am retired, age 61, so don't have to worry about work. Still afraid to try the tub but will soon. On the 5th week of PT and still walk with a "Frankestein shuffle" cuz the surgery leg is longer and am hoping it will settle. The more I walk unaided, the less muscle spasms I have had which is good cuz I have had a real problem with that- read in other posts. Hope this helps you a little.
Darlene

 
Old 09-22-2008, 06:15 AM   #3
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Re: Progress--7th week post surgery

I find that each doctor and surgery is different. My first 3 were very cautious while my last one was not. I was able to go to a cane as soon as I could stand it and without out in the same manner. I must admit it took me a few months as my hip tired easily.

Have you not had therapy yet? I started mine as in home therapy then regular therapy and was done by the 8th week with this last one. The one previous took nearly a year. I still do some of my at home exercises like quads and gluts when my hip is feeling stiff from muscle and scar tissue issues.

2 years later I still have pain sleeping on my side that was operated on, not sure, think it's scar tissue but it's tolerable. I am a side sleeper too. You should be able to sleep on your side at any time. In fact I was placed on my side with the last two while in the hospital you just have to be sure something is between your legs. I sleep with a pillow between my legs anyhow, have since a child as it's better for keeping your hips and spine aligned.

I had the foam piece for only a few days then a regular pillow while on my back this last time. I was shocked the nurses took it away, angry even because in the three previous I had it for months. Different doctor, different protocol this time.

The 90 degree rule isn't about pain, it's about potential dislocation, that rule on all my surgeries was very conservative and was months before I was allowed to exceed that.

Please discuss the leg discrepancy with the doctor you may need a temporary lift in your shoe. Sometimes it goes away, sometimes it does not. Left uneven you will begin to have lumbar problems and find it puts extra stress on the hip of the leg that's longer.
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Old 09-22-2008, 07:46 AM   #4
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Re: Progress--7th week post surgery

Thanks for the note. As for leg length discrepancy, I think maybe you are referring to Darlene's post since she mentioned walking with a frankenstein shuffle? I do not believe I have any significant discrepancy but am thinking my limp is caused by needing to lean less on non-operated leg. I felt a little unbalanced the first few weeks, but now seems basically ok. I will have to pay attention a little more to make sure I don't still feel operated leg is longer than non-operated leg. Dr. Told me at time of surgery that I might have a 1/4 inch difference.

As for physical therapy, I was surprised when doctor didn't order it. He said he didn't think I'd need it. I had worked out at gym three times a week plus swam in pool several times a week prior to surgery. So, was in pretty good physical condition overall. I plan to discuss it when I go to see him on Oct. 2.

Thanks for your comments

 
Old 09-22-2008, 12:11 PM   #5
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Re: Progress--7th week post surgery

Wow I am totally blown away, you had a THR right? No therapy? That's just insane! No matter how physically fit you are, you could be a marathon runner, they cut so many muscles that it demands some sort of therapy or exercises to bring back the strength of the glutes and quads and help in healing or being actually functional again.

My mother in laws dance teacher had his done few years aback, talk about being in great shape! You couldn't of asked for a better candidate. His dislocated within the first month and had to have an immediate revision. Everyone is different I spose.

I just don't know what to say to that! Are you able to to raise you leg while laying on your back without issue? Did they have you doing any at home exercises?
I'm completely dumbfounded!

 
Old 09-22-2008, 01:39 PM   #6
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Re: Progress--7th week post surgery

My Pop has had both hips replaced when he was in his 70s. He dismissed the PT that came to his house at 2 weeks both times. Said he didn't need it any more and was doing better then than I am now at 8 weeks post, age 61. He was in better shape physically before the surgery than I, and had been very active and able to work hard. I had sat at a desk and stood at a podium and walked from my car to the classroom and then around the room several times during the day for 20 years. When I retired, I went from having some stiffness in my hip and falling down inexplicably several times a year to having a pronounced limp and tenderness in the hip within 6 months. I was doing a lot of different physical activity which caused the hip to finish going quickly. I had no idea that my joint was all but gone when I went to the OS ostensibly because one leg seemed longer. I know now that it was because the arthritis was so advanced that the top of the femur was beginning to soften.
My PT told me that very few muscles are cut in the surgery I had, which was one of the posterior approaches, but that some large ones are split lengthwise to accommodate getting the replacement in. This in turn heals better than muscles being cut across. I think most of the OSs try to avoid cutting muscles across now at all costs.
You can feel it in the surgery site and hip if you are putting undue strain on the part that is healing. I was very agile before and feel that this is why I can now violate the 90 degree rule although earlier, I did not even try. I have just naturally begun to bend further and have been able to pick up something from the floor by bending the other leg and bending at the waist almost since coming home from the surgery. However, I have had to be very cautious about turning my foot inward as it seems to want to do this naturally at times and this does cause and uncomfortable feeling in the surgery site. My Pop says, now at 86, that he can do everything he did before except that arthritis has caused his back to go also and this hampers him some.
The OS did tell me, although he has told me very little, that if the joint is installed correctly, I have ceramic on ceramic, it is very hard to dislocate. He says that once it is locked in, even he has had problems getting the joint apart. Hard to imagine that when so many folks do disclocate although I think there are SOME movements, like pivoting, which would cause it easily.
Darlene

 
Old 09-22-2008, 01:55 PM   #7
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Re: Progress--7th week post surgery

Hi Kissa. I have a sheet of exercises I'm doing at home--about 7 different exercises. i can raise leg while lying on back, but not very high. I'm not sure doctor won't order some PT at next appointment and I will raise issue again. As I said, I was surprised he didn't require it when I first went home after surgery. I think i would benefit from it--particularly some stretching! Will keep you posted. Thanks for your comments

 
Old 09-22-2008, 08:16 PM   #8
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Re: Progress--7th week post surgery

Darlene:

I think you are right about current techniques cutting very few muscles. My surgeon told me that he was able to move many of the big muscles and had to cut just a few small, deep muscles. That may be why I didn't need supervised PT to date.

Do you have tenderness around your incision still? Mine is healing nicely I think--now its itchy but occasionally it feels tender. I think maybe I've bumped it a few times now that I'm in the office and sitting a lot more. I'm trying to get up and walk frequently, but have jostled against it quite a few times. I've noticed too that my glutes are sore. I suppose I'm finally using them properly for the first time in a long time.

Maggie

 
Old 09-22-2008, 08:31 PM   #9
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Re: Progress--7th week post surgery

Larimegirl,

That is really really strange that you doc didn't start you on PT, I haven't dealt with a hip problem, but just had a knee reconstruction/tibial osteotomy. Had the surgery on a Monday and started PT that Thursday. Anytime I've ever heard of anyone being operated on a joint, they've had to do PT to rebuild the muscles and get the elasticity back.

Good Luck with your appt.

 
Old 09-23-2008, 03:59 AM   #10
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Re: Progress--7th week post surgery

Hi Maggie,
My incision is still tender but most nights I can sleep on it especially if I have iced it right before bed. It has healed very nicely though with no problems.
The DO have to cut a couple of the smaller muscles but as you say, move the rest or split them.
Also have to get up and walk around a lot- try to do it at least every hour or it feels as if my surgery side is going to sleep. I get sore if I overdo and sometimes have to take it easy the next day.
Darlene

 
Old 09-28-2008, 07:34 PM   #11
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Re: Progress--7th week post surgery

Incision is feeling better. I've been able to sleep on non-operated side for short periods of time. Right now, knee on my non-operated leg is bothering me. I iced it tonight and that helped a little. I have a little cartilage wear in knee but not a big problem (it's been checked recently). I am wondering if most of my discomfort is from overuse. I still don't feel quite ready to give up the cane as I feel just a little off. As I think I mentioned in earlier post, doctor told me operated leg would be 1/4 inch longer than left leg and so I'm wondering if this is stressing the knee more than usual (i.e. usual being before surgery....). I am a little afraid that the problems with the right side affected the left....
Anyone had this kind of experience?

 
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