Hip Replacement setback.

[DrJack54]

So started a thread several weeks ago re hip replacement.

Currently 10 weeks post op.

All was going very well. 

No pain and while progress was slow it was steady. 

Was just doing corridor walking routines every day using one walking stick with arm rest. 

Amounts to about 3km per day.

 

So yesterday morning woke with pain that is worse today.

Basically can walk (with stick) very short distance. Also painful even when sitting laying etc.

 

I have flight to Oz next Tuesday.

Going to my doctor on Sunday.

 

Finally my question...

Has anyone in similar situation had a cortisone injection.

It's not an option I would be happy about but apart from cancelling my plans not sure what else I can do.

Edited August 19, 2022 by DrJack54

[DrJack54]

Another question.

Thinking I will need wheelchair to get to hospital.

Is there private companies that do this or even the hospital? 

My hospital is PHYATHAI 1.

[essex boys]

Hi Drjack, I’ve had a cortisone injection in the knee for pain relief, it worked well and dulled the pain but it was only good for about a week. 
I don’t know anything about wheelchair assistance in the hospitals here, but I’m guessing if you turn up on crutches that the hospital would get you a wheelchair ( my friend here in Khon Kaen went to a private hospital, he got wheelchair assistance and they charged him 100 baht for the privilege of being pushed in it) good luck with it all hope it goes well and have a good flight.

[The Hammer2021]

The airports organise a wheelchair  for you. You will  also need a fit to  fly certificate

[metisdead]

I had a hip replacement on my left hip 4 years ago.  Since April I have had persistent pain in my left leg upper thigh area.  The doctor diagnosed the problem as hip tendonitis, he did give a steroid injection back in April and a week later prescribed a weeks worth of some steroid pills.  My main problem has been after sitting down then standing up, the pain kicks in.  I use one of those forearm crutches to get around.  Sometimes the pain eases but it always comes back after sitting down and standing up.

 

It got worse and worse about 9 weeks ago while I was in the USA, as I didn't have health insurance coverage there, I didn't get any medical assistance there other than my forearm crutch. 

 

When I returned to Thailand and visited the doctor at the hospital where I had my hip replacement, the doctor diagnosed it as calcification hip tendonitis, he didn't know what to say regarding treatment, gave me a steroid injection at the time and he prescribed Norgesic and Celebrex  I decided to visit the therapy department at the hospital and I was having ultrasound therapy 3 times a week for a couple weeks.  Then they added laser therapy after the ultrasound.  That went on for a couple weeks then they upgraded my therapy to shock wave therapy and electric shock therapy, it got a bit better. 

I was advised to do some exercises, maybe this will help:

 

https://www.verywellhealth.com/hip-tendonitis-exercises-5119249

 

The therapy people advised to more or less do this: RICE therapy (Rest, Ice, Compression, Elevation).  They didn't really get into the Compression part.  In the local drug stores, you will see all sorts of wraps for ankle pain, elbow pain, wrist pain, back pain, but not much in the hip area.  I found this on Walmart online while in the US:

 

 

If your problem is in the upper thigh area, you may find that hip wrap will help. I have found that wrap to be really helpful. I use it all day, take it off before bed. I still have a bit of pain when standing up, at least my leg pain is no longer holding me hostage. 

 

As you said, you have pain while sleeping, maybe you should not lay on the side where you had the hip replacement, mine was on the left side, I was advised to sleep on my right side with a comforter between my legs.

 

Hope this helps!

[DrJack54]

22 minutes ago, metisdead said:

Hope this helps!

Very helpful at the same time scary.

Thankyou 

At the moment my pain is constant and severe.

Came on quickly .

Rehab going well then bang.

Perhaps infection.

Next step to get to hospital.....some how

Edited August 19, 2022 by DrJack54

[Lorry]

5 hours ago, DrJack54 said:

Another question.

Thinking I will need wheelchair to get to hospital.

Is there private companies that do this or even the hospital? 

My hospital is PHYATHAI 1.

You can call the hospital and ask for an ambulance. 

Cheaper: book a London taxi through their "cabb" app. Tell their call center about the problem. 

Once you arrive at the hospital,  the hospital has a wheelchair for you.  Usually free.

 

At airports,  you can ask for wheelchair assistance. Call your airline, it's free, but must be booked in advance. 

Ask for WCHS, not only WCHR. WCHR means you may be able to climb stairs. WCHS is wheelchair to the door of the plane, inside the plane you must use your crutches. 

You will be asked for a certificate of fitness to fly. Have your doctor write one. 

[Lorry]

4 hours ago, metisdead said:

you should not lay on the side where you had the hip replacement, mine was on the left side, I was advised to sleep on my right side with a comforter between my legs.

Yes.

Most definitely.

[DrJack54]

3 minutes ago, Lorry said:

At airports,  you can ask for wheelchair assistance

Thankyou for your help. 

I won't be flying next week.

The pain with this set back is severe. 

My fear is that it's result of infection. 

[Lorry]

5 minutes ago, DrJack54 said:

Thankyou for your help. 

I won't be flying next week.

The pain with this set back is severe. 

My fear is that it's result of infection. 

If it's that bad you can go to the hospital tomorrow. 

They can do x-rays, blood work, and they may be able to call your doctor in. That wouldn't be unusual in this kind of private hospital. 

And if they really think it's infected they can start antibiotics. 

Edited August 19, 2022 by Lorry

[Sheryl]

37 minutes ago, DrJack54 said:

Thankyou for your help. 

I won't be flying next week.

The pain with this set back is severe. 

My fear is that it's result of infection. 

It coukd be and in that case cortisone is contraindicated. 

 

If on the other hand it us due to tendinitis then vortisone might help.

 

You should not wait till Sunday. Call hospital for ambulance and go now.

[dddave]

From the symptoms the OP describes, I'm wondering if it could possibly be SCIATICA.

I had an attack of Sciatica a year ago and much of what the OP describes: severe pain sitting, standing and even lying down is what I experienced.  I suspect I brought my own case on by improperly stretching my back.  Perhaps the OP, in coping with his recovery aggravated the sciatic nerve somehow.  

 

Edited August 19, 2022 by dddave

[DrJack54]

22 minutes ago, Sheryl said:

You should not wait till Sunday. Call hospital for ambulance and go now.

Going Saturday morning. 

Can't wait till Sunday.

Fun times. 

[DrJack54]

Just for anyone curious about cost of ambulance...

I live 65baht taxi from hospital and the ambulance was 5000baht so I went with first option.

 

BTW never been on a Saturday previously..... clearly a day to avoid if you have choice.

 

[metisdead]

On 8/19/2022 at 10:00 AM, DrJack54 said:

Basically can walk (with stick) very short distance.

 

If you only have 1 of those forearm crutches, it might be a good idea to get a second one. I have 2, I don't use both of them all the time, only when the pain level is high, then I use both of them to get around which helps a lot. 

[lopburi3]

7 hours ago, DrJack54 said:

BTW never been on a Saturday previously..... clearly a day to avoid if you have choice.

Indeed school children off and many parents not working so Sat/Sun are no go if you have the choice.

 

At any rate hope something has been done for your pain.

[DrJack54]

12 minutes ago, metisdead said:

 

If you only have 1 of those forearm crutches, it might be a good idea to get a second one. I have 2, I don't use both of them all the time, only when the pain level is high, then I use both of them to get around which helps a lot. 

Yes I have 2. 

I went for the walker to 2 sticks and then 1.

So the doctor dismissed infection as expected with no redness or pain when pressure applied, no fever etc.

His opinion is that I have over done the walking.

Recently doing sections holding the one stick away from ground. 

Anyway had a shot in arm and other meds which just amount to anti inflammatory and pain suppressors. 

Return tomorrow to see my doctor who assisted head surgeon. 

Doctor today seems to think I will be fine in few days.

Perhaps bit tight for Tuesday night flight. 

BTW Ta for your very detailed post earlier. 

[DrJack54]

2 minutes ago, lopburi3 said:

At any rate hope something has been done for your pain

Day and Night.

Sitting comfortably now. No pain at all, however I'm stationary.

Yesterday was severe (at least on my pain scale. 

Ta for well wishes

[DrJack54]

This post is just for anyone looking for any first hand experiences re hip replacement recovery.

 

So back to hospital today to see doctor that assisted with the surgery and he wanted x-ray, ultrasound, blood tests.

Without going into the details the ultrasound found hematoma (large) in area of hip joint and in turn putting pressure on the muscles.

Not aided by the fact I take anticoagulant due to previous DVT and PE.

 

So admitted into hospital only for blood transfusions which into final bag 3am as I type this. 

 

One of the suggested causes for this to occur 10 weeks post op was over doing the exercise.

Indeed I was pushing it in preparation to family visit Oz.

That is all off now as Rest is the recommended course of action.

Over detail but for those facing hip replacement slow and steady as she goes.

Folk are always interested in cost so for this one night in the flash private room is 5k and then of course will be all the additional costs such as meds etc.

On the positive side this is my first night in a bed and zero discomfort. Previous two nights spent in chair at home.

Bed two painful.

No meds today so onward and upward.

Again thanks for helpful posts. 

 

 

[chubby]

yeah, this is the problem with saying anything without full assessment of a person .

medical history, meds, age, should be disclosed as a start, but then is what it is.

 

so are they going to incise and drain the hematoma ? anticoagulants are high risk meds

 

hematomas in upper legs can sometimes calcify fwiw

Edited August 21, 2022 by chubby
s

[DrJack54]

17 minutes ago, chubby said:

yeah, this is the problem with saying anything without full assessment of a person .

medical history, meds, age, should be disclosed as a start, but then is what it is.

 

so are they going to incise and drain the hematoma ? anticoagulants are high risk meds

 

hematomas in upper legs can sometimes calcify fwiw

Thanks.

They haven't indicated anything other than rest when I'm back home..

Hope not too many more chapters in this book.

[dddave]

OP

A friend who had hip replacement in Bangkok several years ago found the best support device for walking was a "Trekking Pole".  They look like a ski pole.  They are very light weight and also fold into 3 sections so easy to tuck into a shoulder bag or backpack.  Their advantage is the handle has a sturdy strap and if you place your hand correctly into the strap, it provides solid support with much less strain on shoulders and forearms.

I have arthritic knees and on bad days, need support assistance.  At my friends suggestion I purchased a trekking pole and it really is superior to the cane I was using.  Because it folds-up so easily, it's much easier to deal with when sitting somewhere, not having it constantly falling to the floor.

https://www.lazada.co.th/products/yunhw-aluminium-trekking-pole-stick-i2861944958-s10440606542.html?clickTrackInfo=query%3Atrekking%2Bpole%3Bnid%3A2861944958%3Bsrc%3ALazadaMainSrp%3Brn%3Aae00a5d94032840481620cc017cc0d5e%3Bregion%3Ath%3Bsku%3A2861944958_TH%3Bprice%3A299.00%3Bclient%3Adesktop%3Bsupplier_id%3A100190895676%3Basc_category_id%3A3485%3Bitem_id%3A2861944958%3Bsku_id%3A10440606542%3Bshop_id%3A2116795&search=1&spm=a2o4m.searchlist.list.i40.61ba510b2fCOoP

Edited August 22, 2022 by dddave

[DrJack54]

10 minutes ago, dddave said:

OP

A friend who had hip replacement in Bangkok several years ago found the best support device for walking was a "Trekking Pole".

Thanks for advice.

Will look into it.

I was using one walking stick with arm rest....going great guns.

I'm still in hospital and had some results from blood tests. One was my INR is 7.1.

Should be 2-3. 

Hence the blood after too much walking. 

This is not a lot to do with hip replacement itself but some separate medical conditions that obviously in my case has caused an issue. 

 

[crouchpeter]

22 hours ago, DrJack54 said:

Thanks for advice.

Will look into it.

I was using one walking stick with arm rest....going great guns.

I'm still in hospital and had some results from blood tests. One was my INR is 7.1.

Should be 2-3. 

Hence the blood after too much walking. 

This is not a lot to do with hip replacement itself but some separate medical conditions that obviously in my case has caused an issue. 

 

Are you on Warfarin, with a clotting time like that? I don't think the new anti-coagulants are as bad as Warfarin.

[DrJack54]

9 minutes ago, crouchpeter said:

Are you on Warfarin, with a clotting time like that? I don't think the new anti-coagulants are as bad as Warfarin.

Spot on. 

I will be using Xarelto moving forward. In Oz it's part of what we call PBS and cost largely paid by gov. 

Expensive here of course. 

 

I'm back home now and it's just a reset. Setbacks not all that uncommon. 

Already improvement and was able to sleep last night.

Onward and upward as they say. 

Edited August 23, 2022 by DrJack54

[Boomer6969]

In a case like that one MIL would send me to the Wat to train in levitation.

[crouchpeter]

2 hours ago, DrJack54 said:

Spot on. 

I will be using Xarelto moving forward. In Oz it's part of what we call PBS and cost largely paid by gov. 

Expensive here of course. 

 

I'm back home now and it's just a reset. Setbacks not all that uncommon. 

Already improvement and was able to sleep last night.

Onward and upward as they say. 

I believe Eliquis, (apaxiban), is the best of these new anticoags.. $6+ per month in Oz. for us. Approx. 5,000 baht p/m here. But if you can't get home every 6 months, India has a generic, called Apigat.  Aud $150,with postage, for 3 months supply. Warfarin is a pia. Stop 1 week before surgery, and always problems with clotting levels. So unless they've given you a pig's heart, go with Eliquis. As an aside, I was going to Oz in April, but couldn't make it because of the pain. Have my hip replacement surgery on Tuesday. Fingers crossed!

[DrJack54]

2 hours ago, crouchpeter said:

Have my hip replacement surgery on Tuesday. Fingers crossed!

Keep folk in the loop.

Hip replacement very common and many have to deal with it.

Post op for me zero pain.

I just had bit of bad luck with setback.

Tonight my flight to Melbourne goes without me but not a big deal.

Good luck with your procedure. 

[Lorry]

On 8/22/2022 at 11:48 AM, DrJack54 said:

INR is 7.1.

Oh.

You were lucky that your hip "warned" you about this problem.

Could have easily resulted in a life-threatening hemorrhage somewhere else. 

[Sheryl]

6 hours ago, Lorry said:

Oh.

You were lucky that your hip "warned" you about this problem.

Could have easily resulted in a life-threatening hemorrhage somewhere else. 

Absolutely. Had you kept up with regular lab tests? Might you have been given medications (e.g. antibiotics) that interact with warfarin?