Stephen Grinnell My Hip Replacement Journey Weeks 3 and 4
The last few days have been great, I have recovered from the long Journey. Its great not having stairs, but I have to practice steps this week as when I go home, I have no en-suite and I will have to use the stairs for the bathroom.
I need to evaluate my progress as the initial recovery has subsided and each activity, which was difficult a week ago, is easier now and its important to push. The InterX Therapy is working very well and the swelling is reducing and sitting is more comfortable.
I use a 6 minute walk test to evaluate progress. This is a test to record the amount of distance you can cover in 6 minutes. You can measure either by walking up and down a known distance i.e. 20m or track using a app on a smart phone. Steps also work, but a distance measure is best. I do this using my crutches and cover a distance of 407m in 6 minutes. I notice that I started too quickly and that my calf muscle in particular, was cramping as not used much for two weeks.
Using crutches or any walking aid reduces the load of your body on your lower legs so your muscles get weaker. The bigger muscles in your upper legs are used more when sitting and standing, but your lower calf muscle is used mainly for stability and balance, so gets weak quickly so when pushed and is the first muscle to get very tired.
This caused me to focus more on this area of my body over the coming weeks, doing more walking practice with short steps, lifting my foot and also walking on my toes like dancing. This helped in two significant ways, firstly, it helped reduce the swelling in my knee and also increased the movement and strength of my calf muscle.
Day 16, 17 and 18
These days were the last in Ireland and the focus was on doing normal things independently with crutches so that I could look after myself. Getting in and out of bed was much easier and I could reposition well. Shoes and socks, still needing help as I was following hip precautions. Needed only limited help with getting dressed and washed and had developed a system. The day walking and exercising was easier and I was able to increase the distance outside and my final 6 minute walk test distance was 529m. I was walking short distances in the house with no aids and small steps, I am also walking sideways to help my hip in the kitchen using the work surface if I need support.
Travel back to the UK. On the trip over initially I had to sit behind the driver as I could only get out and in the seat on the right side. Now my mobility has improved and the pain is minimal and significantly less swollen hip I can sit in the front passenger seat. I am also requiring much less help moving around. The trip to Dublin port was fine and boarding the boat was uneventful. I was much better on the boat and walked and enjoyed the crossing. The UK drive was long and I needed two significant stops to stretch out and move about.
Arriving home was great but needed the toilet and had stairs first. Managed well but noticed them straight away.
Day 20 and 21
Organising the house after surgery is important! Especially when you have been away to another country in your rehabilitation journey.
I have progressed well to this point, I can walk short distances without crutches and longer distances with a flow of walking with crutches. I am recovering very quickly now and need to evaluate and have a plan for next week as I am on my own. My wife and daughter are back at school and work so I am on my own so have to think what I will need and help required before they leave.
First day on my own, I have organised the obvious practical stuff with chairs drinks and lunch. I go through my exercises which are easier now and go out for a walk with my crutches. I aim to increase the distance in the morning so I can push later on without crutches. I am home and done everything, now I must rest so I can recover. I read and watch tv as people do, but I feel frustrated as I want to get better faster. At lunch I walk around the house without crutches and practice the stairs repeatedly to get better. I go out for another walk in the afternoon and get cramp again as I have pushed hard. I get home and rest while elevating my legs to help. On reflection, I need to structure more, I am naturally more impatient so likely to do too much, also I am conscious that I have progressed well and easy to plateau.
Lessons learnt from yesterday, I do more without crutches around the house and mimic normal life in short bursts. I do my exercises in the morning and after lunch but no extended walking. In the evening I focus on walking without crutches for six minutes quality not quantity and manage 490m which feels great. I have also altered my InterX treatment to focus on anti-inflammatory and accelerated healing rather than pain as that has gone it’s just fatigue.
Day 24, 25, 26
Repeat of the structure established yesterday and improved each day with six minute walk test results, 657m was my best, which was very good. I was tired as the focus of using this test was speed and extended gait, so it got me to walk properly and use the muscles and joints in the correct movement to re-educate post-surgery.
My range of movement and strength has improved significantly and most of the swelling has gone due to the interX treatment and importantly, no pain which feels great.
Days 27, 28
It’s the weekend and I have more visitors and I feel on show as it is ‘what can you do’ and ‘how are you moving’ etc. I still do exercises and the six minute walk structure as the benefits are obvious. A breakthrough prior to my return to hospital for physio assessment was that I was able to run for about 60m. Not like an athlete, but it felt amazing, it was not sprinting but it felt like it. People have commented why did I do that, it could cause a problem. Which is true, but I had worked very hard rehabilitating myself and the muscles and healing allowed me to do it.
A Great day today as I had rehabilitated enough to have a little run!
Hospital Physiotherapy review
Due to NHS waiting times this would be my first time I saw physiotherapy. They assumed I was in the incorrect group as I was able to walk and move easily without crutches. The goal after 4 weeks is one crutch and 6 weeks no crutches. Due to my progression, I did a variety of movement tests getting in and out of bed, stairs and extended walking. I am younger at 44 which obviously is a factor but I was not fit prior to the operation . I then went through the extended range of exercises which they use in the “Hip Gym” if you require additional physio or not rehabilitating well you can attend a 6 week programme. I passed all of the final tests easily for this programme. I was discharged from Physiotherapy support after my initial session.
Day 43My hospital consultant review was interesting as they had a look at my X-ray and remarked on a strange issue with my hips. The bone was regenerating around the implanted joint so essentially, my body had accepted the new joint