Day 39
Not too bad.  I will continue to try and walk 3 times a day and be careful about yard work.  I am going to try to fix a closet shelf done all in standing in close quarters so that should be OK. I still have to be careful about hard landings as I found out coming down a step but that will ease with time.  Five weeks ago I didn't see how I could be at the place I am today.  The curious thing to me is the surgeon did hid thing and placed wires, a prosthesis, did an osteotomy and I will never see him from surgery until the day I am D/C.  My visit with him isn't until 10/21/2014.  I would think you would want to look at your handi-work to make sure things are OK.  What are you going to do.
I have not been wearing my TED hose because they are filthy dirty and I only have 1 pair

Day 38
I woke up without too much pain. I went out back and was trying to shuffle wood around and saw a gas can open.  I grabbed it to close it off and started to slide so I put out my crutch but I think it was on leaves and soft ground so I slowly tilted to my left uninvolved leg and slowly went down as there was nothing to stop my progress.  I popped back up but.....If I do this enough the odds are that I will eventually hurt myself.
I will gauge how much it is bothered as the day goes on and decrease or maintain my safe activity level.  There is so much to do around here and I want to do.  What I have to realize is this is my hip's last chance to do what I want to be able to do.  My fiancée is mad...again because of my behavior..  .  I took 3 "walks" with crutches today. The side does not feel good but who knows what is normal with this.  I attempted LAQ with 4 lbs and that was pushing it so maybe 3 lbs next.  I did some functional HSC using the recliner and that didn't hurt.  I did these after falling which did NOT hurt at the time.  After the exercises the leg did not feel right , like something was in the wrong place and the front, side, and back felt uncomfortable.  With time it hurts still b ut only if the leg is not perfectly straight ahead.
I shall focus on walking instead of working in the yard.  I think the pain pill made me a little grouchy but hey, maybe it is just me.

Day 36 & 37
The leg is still hurting more with increased WB.  I had hoped to be past here by now since I have been taking it easy.  The pain is localized and this always bothers me more but what can you do but try to move forward and don't repeat the mistakes of the past.  So I am on 50+% WB.
Had my regular physical and it was good.
The pain is decreasing again and I am being more careful with the amount of WB.  I did take 1/2 pain pill once during the day and once at night.  It is feeling good again within limits.  I did try to stain a wooden gate while holding onto the post and crutch.  Wow my left buttock was a burnin'.

Day 35
Forgot to inject Lovenox last night.  I fell asleep on the recliner and my fiancée slept on the couch next to me to be close .  She is such a sweetheart. I am so lucky to have a person like her in my life.  I slept until 6 AM at least.
There is some pain with WB but it is with WB and then isn't there.  I am trying to decide when to go to a crutch.
I have a pain pill on the side waiting for me.  The problem is it only hurts when I try to get up without enough bilateral upper extremity support or any rotation during WB & sometimes a little with straight walking.  I did too much and am now backing off.  Not taking the pain pill just staring at it.  My mind is finally clearing.
Tomorrow I'll find if my Coumadin level has changed any.  Don't hold my breath.

Day 34
Not a good start.  I woke up at 2:30 and never really got back to a good sleep.  I feel like I am hung over.  I know I am developing a cold as there is increased mucus from wherever and I am sneezing.  Who knows. I did do LAQ with 2 pounds which was easy then I did HSC with yellow theratubing. I will do more today along withng professional advice hip flexion just not SLR. Still no pain pills for at least 3 days.  It might help me sleep but I can't take it forever
OK so I may have overdone it.  I sprayed a deck with mildew spray and rinsed it while on crutches.  Yeah...here I go again.  There were moments when I put a lot of weight on that leg.  I went to the optometrist and got contacts to try afterwards.  I am feeling the posterolateral thigh some 4 hrs later.  Maybe pain med tonight
I was able to initiate 3 projects with a peer in Kentucky and am reviewing a paper by Chad Cooke on updates for evidence based tests for shoulders, an excellent paper
I am returning a book to the library tomorrow on the war
s between Sparta and Athens but it is from a perspective of an assassin who killed the hero of Greece.  I have another historical fiction novel on hold...Aztec
I am  giving professional advice to people in England, New Zealand, & Australia on a PT website..sort of cool

Day 33
Coumadin levels are actually dropping and are now 1.1;normal desired range is 2-3.  Eventually the home health nurse will not be coming and I will be monitored through the clinic in town which means we get to jump through their mngmnt attempts all over again.
The lateral thigh is sore but not worse with walking.  Today is paying insurance premiums and setting up medical payment plans to make it through.
Today is also my fiancée's birthday.
More a little later.
Tried walking with 1 crutch but that was iffy.  Most of the pain now is in the lateral and posterior thigh

Day 32
Sleep still is a bugger.  I woke up last night as I must have tried to flex my hip more than it should have.  I did not take any pain meds yesterday or last night.  I want the medications out of me.  Part of my nausea may be from this and part may be that I am pushing myself past where I need to sit down and rest.  I am recognizing those signs and responding to them now.
I took a shower using a transfer bench by myself today and shaved.  I figured if they can't get my blood to therapeutic levels and I am careful, I probably don't have to worry about bleeding out.
I crutched into the library to pick up a book around 3:30 PM and was exhausted and actually had to take a break.  I feel like I have been walking up Nevada Falls in Yosemite again.  What I have been doing is full weight bearing in stance and probably > 75% WB with crutches .  The side of my thigh is letting me know it is there and I am exhausted.  The cause is refreshing though.  So I have 2 books and a movie, several professional projects in the works, and a class I can do at home once the text arrives.

Day 31
No pain medicine last night and did OK.  My stomach is a little sour this morning so I took a Zantac.  I am putting more weight on my leg even though I am still using crutches.  I am going to try sitting in regular chairs with my cushion.  I am excited even though I know hip ABD is off limits per MD to let the bone reattachments heal.

Day 30
I woke up still 1/2 sick to my stomach feeling hung over.  I hate feeling this way . I realized at one point yesterday one of the nurses raised the bed and the room started to spin and she remarked it acts like vertigo.  When I move my eyes quickly-Bam.  I'm going to try and take a low dose Dramamine and see what happens.
My leg still has that one spot on the side that bothers with WB but how do you differentiate new from old pain after a surgery such as this.
No change in Coumadin levels.  I am now increasing my Coumadin levels AGAIN.   I don't think it will ever get to the therapeutic level. The surgeons office said to slowly wean off the crutches and no ABD for 4 more weeks and no O/P therapy.  He wants me to do what I do at home by myself and walk or ride bicycle.  Good news there.  So maybe I can begin a normal progression now.
I sat on a couch for a little while tonight and it was OK even though I had to modify my position.

Day 29
It is sort of a waiting game to find out what the abnormality on the x-rays is.  There is 1 specific spot on the side of my thigh just below the greater trochanter that is uncomfortable with weight bearing but that could be completely normal and unrelated to the "new"thing.
Ended up being a pretty bad day the rest o the day.  I got on a motorized cart at Costco to get some food with my fiancée.  ABOUT AN HOUR IN I FELT SOMETHING WAS JUST NOT RIGHT AND I BEGAN TO FEEL DIZZY, THE ROOM BEGAN TO SPIN .  Once we left I had no energy to fight it and had to give in to it.  My face went numb, my left arm number, I felt sick to my stomach and just wanted to die.  I chose this time to go to the ER.  I felt like I was falling and the world was spinning.  I can remember 1 time yelling for help because I felt so horrible.  They ran their tests & no PE and came down with the Dx of panic attack.  I'm sorry but I have never had a panic attack.  The 3 times this has happened , and only since surgery, they came relatively out of the blue when I was in no stress.  This time it didn't go away.  So no I do not buy their explanation.  If I thought that was what it was I would have no problem admitting it.  The rest of the day was in a drug stupor and I could barely make my way upstairs.  They did my blood test at the ER and it was only 1.258 for coumadin

Day 28
Well woke up with some discomfort.  It is more of a low intensity deep ache with a tad groin twinge.  Have to get ready to go to Richmond.  They discontinued the antibiotic and halved the Coumadin and I'll have blood taken today to see where things are
There is no change with being off the Rifampin 1 day.  If the insurance has not approved the Lovenox injections by tonight I have been instructed to go to the ER.  The Home Health nurse will check again tomorrow
Saw the implant and the myriad of wires surrounding the bone, where they performed the osteotomy & greater trochanter.  The immediate post-surgery x-rays look good but todays look like the wire has been squashed in places and the possibility of a compression or new femur Fx.  The progression is on hold until the NP can confer with the surgeon.  She wants 2 more weeks of home therapy if possible.
it's real ly depressing because I thought I was doing everything right for the most part.  I wonder if when I would support my leg in my hands to give some relief and got the pitting edema if the wire could have been distorted.  the appearance of a possible Fx didn't look good.  What can you do but move on and be depressed and hope it doesn't affect anything

Day 27
A relatively good nights sleep.  Again I think my leg was all over the place and at 1 point my knee didn't bend easily.  My buttock stung a little.  I watched a revision surgery on-line.  How they can differentiate structures when they begin to all look the same with the blood is amazing.  I guess hunters do that though when they field dress animals.
Tomorrow will be a busy day; driving up to Richmond to see someone in the surgeons office for the 1st time since surgery.  I want to get a copy of my surgical report but I know that makes people a little nervous.  I just like to know what was done.
Went to a meeting in a transfer chair with cushions and had no problems, meaning no pain med was necessary. My perspective today has changed.  I was telling a friend that the quality of my life is an inside job and external events, while they may produce stress, pain, or joy do not determine the quality of my life.....I do.
 The surgeons office called and they are stopping the 1 antibiotic and decreasing the Coumadin the next 2 days to 1/2 what it was.ns  The status of the injections is yet to be determined.  While the Coumadin clinic has said they have done what they need to continue, the insurance company is refusing and saying there is no prior authorization from them to allow continue coverage.
The surgeon's NP said they will have to initially monitor me more frequently for Coumadin blood levels.  She was surprised that the Coumadin clinic stopped home PT until they could establish a therapeutic blood level because of the DVT.  She said Dr. Jiranek would not have stopped it.  Unfortunately Dr. Jiranek was out of the country and someone else had to make the decision, right or wrong.
In the transfer chair I was wheeled through the grocery store again.
Tomorrow ought to be interesting
Ate dinner in the kitchen in the transfer chair.  I couldn't get close enough to eat with the plate on the table or lean forward so I ate with the plate in my lap. By 9 PM my hip had enough.  Most of the pain is centered in the posterior aspect of the joint and/or muscles

Day 26
Ah yes, a good nights sleep.  The RN came by and drew my blood and the outcome....no change on 15mg Coumadin and double Lovenox injections.  In their infinite wisdom they have upped the Coumadin to 20mg/day.  I am getting a little frustrated in the lack of doctor communication at this time.  If they change my antibiotic now my clot time will probably go sky high.  I see the surgeons NP in 2 days.  They continue to hold me off PT until the blood viscosity is in the normal range.  I wonder if the Coumadin clinic and the surgeon's office even communicate.  I was going to wait to contact the MD office since I am going in in 2 days but the RN said she was going to call me but it I think  people should follow through with what they say and my fiancée was encouraging me to find out what the plan is
It has been a good day overall.  I was playing around while reclined and a little too much hip action in dancing.  I was being careful but a couple directions did not feel warm and fuzzy.
Took a pain pill as a precautionary  measure from my earlier experience.

Day 25
Not a great evening.  I have been up since 3:30 AM with aches and unable to get or find a comfortable position.  Some buttock pain, some calf pain, some thigh pain.  Took 1/2 pain pill at 8 AM.  Who knows why it is..too much WB yesterday, too much time on my feet even though I am only 20 % WB give or take.  Focus towards the positive and move way from this point but embrace the moment for what it is. OK I took another 1/2 pain pill.  I don't need to have the pain completely gone to stop taking medication but what sense is there to temporarily suffer also.  It just feels good to not have my mind just a little bit foggy.
I have been drinking Emergencee as Vit. C is very important in tissue healing and I am thankful my doctor recognizes that.  I haven't had much heavy protein so last night tried a meat upon meat pizza thinking it would fill me up and satiate whatever is missing.  Where is my head?  Didn't work.  Happiness no matter your situation , is an internal affair.
I go back to the doctor ( NP ) for the 1st visit since surgery on Wednesday.  I am a little worried because I literally fought the insurance company to pay for the entire 28 doses ( twice a day ) of Lovenox instead of the 20 doses.  Starting on Monday I will have 5 doses left.  Part is determined by the blood Coumadin levels.  Normally they stop you from taking Coumadin after 30 days so we will see what their gameplan is.
The hummingbirds still bring a smile to my face as I watch them feed.  It is like they have become family for me.  I am tired of photographing them but not of seeing them.
I have meditated the last 2 days as I have meant to but it took getting a portable CD player which I wasn't even sure they made anymore.  Thank you retro...Target, Walmart, Amazon, etc.
The leg ached most of the evening and I was adamant that I was not going to lose sleep and suffer again so I went back t a full 5mg, relatively low dose, before sleep and I slept and felt so much better.  I felt a little guilty in going back to pain meds but I needed it and it did what it was supposed to

Day 24
Woke up in some discomfort but as I mentioned yesterday I think I am moving more in my sleep.  I am still going to try and limit or not take pain meds today.  My spirits are up a bit but I am on my last Lovenox injection and some of my discomfort remains in the lateral calf muscle so I must contact the pharmacy again.  The surgeons nurse did not get back to me on Thursday or Friday regarding switching 1 of my antibiotics so my Coumadin level can be at therapeutic levels. She did say on Thursday she would get back with me on Friday for sure.  In the medical field you have to take responsibility for your care.  I f you wait for people to get back with you when they say or bill you a certain way.
Spent more of the day up on my crutches than in the chair and only took 1/2 pain pill at 4PM.  The day is not over yet but I am excited
The rest of the day went just as well

Day 23
I had some discomfort last night but figured out that I was rolling slightly to my right side onto the surgical limb .  I corrected that and was OK but my leg straight out flat is still uncomfortable.  So I am going to try to go as long as possible without pain meds today.  It is feeling pretty good this morning
It is 3:10 PM and no pain meds.  The leg is a little stiff but getting up regularly helps that.  I have been able to actually exercise my brain on some studies which is amazing.  I just have to be careful not to overexceed my capabilities and use common sense.
So no pain med yesterday.  I must be moving more in my sleep as I am waking up in a little more discomfort.  Sex with my partner is becoming easier and less limited as long as my hips are elevated higher than my knees and they aren't together.
I need another pair of TED hose .  They give you 1 pair but they get dirty quick.
On reflecting back a day or two, my leg was hurting a fair amount when I fell but I was testing my leg  afterwards and SLR hurts no matter how you look at it.

Day 22
I had to take a pain pill about 5 AM as I must have had my leg out to the side or something because the lateral aspect is burning and aching a bit.  I am hurting for a shower but sometimes I want things when I want them and those helping me can't always be on my schedule.
I called the doctors office to ask if they would try a different antibiotic.  If I was off the Coumadinr chair  it would be a mute point but I suspect that since I had the clot I may be on it longer than next week.
So another day of recuperating.  I am going to try and go to a meeting today with a transfer chair and all so we'll see how this works.
One of my daily things is to blog, to take pictures of humming  birds on a feeder , and soon to take an on-line class for my National Strength & Conditioning Certification.  Mt head hasn't been clear enough up until recently.  Not working I am afraid of spending the money  ut I have to by December and when would I have the free time.  Actually the 1st hip replacement is when I studied for the exam.
So I went to a meeting as a friend drove me and I sat in the transfer chair.  After driving 10 min both ways and an hour there I was getting sore.  I've noticed with the pain medicine over time that my concentration is only good for maybe 5 min without wavering or drifting and in the mornings about 30 seconds.  It was good to hear other people talk.  My voice inside my head is old and echoes too much.  No information from the nurse, doctor, Coumadin clinic but I have to realize that I am not the only patient and must have patience to let them do their thing.
One scary thought the home nurse brought up is that most antibiotics have GI side effects of nausea or cramping and that would be difficult to tolerate too.  We will see what happens hopefully today as my PTINR = 1.5
I was rolled in Lowe's last night and feel like I had met my limit since I hadn't been out in a bit.  I guess that is the way I will increase my tolerance.  I don't know if I said it already but crutches make you mobile...often too mobile

Day 21
 3 weeks...had to take a pain pill this morning but I was not painfully stiff when I got up and stood.  To feel this was at 3 weeks is incredible relative to referencing my 1st surgery.  There is so much uncertainty but I have to remember, tomorrow is built on today.  I am in today and if I take care of today tomorrow will reflect that.  Perspective comes back in to rear its ugly little head.
A decent little day today as the weather allowed me to sit outside in the sun on a modified chair set up to accommodate a higher seat.  I have been able to walk in the yard with crutches and while it doesn't feel as good as yesterday before I fell, it isn't as bad as I expected and feared it might be.
The surgeon returns from his long absence so hopefully the issue of the antibiotic-Coumadin issue will be resolved and I don't have to feel like a pin cushion anymore.
The other issue is home nursing.  I have been very accommodating to them as I had nothing else to do but I need to take life back and the direct in the middle of the day apt has to stop.  I have to have my car taken in, I need to go to a meeting even though I will be in a transfer chair.  I will work with them but no longer be at their complete disposal since they call the morning of and split the day. If I am doing nothing that is 1 thing but I am not going to change schedules just to make their life easier.  In the medical field we act complacent like we have no choice.  All our choices are ours from the meds we take, the questions we ask, the decisions we make even if it runs contrary to that recommended.  There are consequences to our actions and as long as we are aware of those and base our decision on the best information at hand then we should rest well.
I did Not take a pain pill last night before going to bed. I think the amount of getting up I did during the day was good for me

Day 20
Surprise my leg aches...Getting as used to it as I can.
Today is rainy so sitting outside may not be an option.  What a drag. I can not entertain myself with mindless indulgence. I did get a book finally from the library so that will help.  I would recommend that hobbies, projects and the like are outlined so that when the pain decreases you can do something productive.  That is what works for me anyway.
Alright so I am feeling pretty much like an idiot.  My fiancée was very worried about me the last couple of days with the clot, the weird Sx of yesterday and all.  In spite of this and agreeing to let me not go to the hospital even though it is my ultimate decision, (all decisions have consequences 1 way or another), she was still OK with me walking in the back yard  even though yesterday she was adamant that I would do very little.  So I'm out walking in the yard with crutches , picking little tomatoes and spraying plants with a hand bottle of anti-fungal spray. I figured I might as well look in the front yard.  I saw a hose with a sprinkler on it and thought I would help by winding it up.  I had to lean forward with my leg out and rest on 1 crutch.  This lasted about 5 seconds before I fell on the ground on my left side.  As it was happening I thought this may not end up well and I was afraid to try and get up.  Somehow I did but I would assume it probably broke rules of what not to do.  I debated not telling my fiancée but it is becoming clear that I am either a much bigger idiot than I thought I was or am in total denial and I seem to have trouble regulating my activities.  I don't want to put her in the role of mom or warden but that is obviously what I am doing.  I gave up the crutches because they give me this freedom of movement.  It is fast and easy with them.
The hip is much more uncomfortable upon WB after sitting but I noticed that before the fall.  One thing I found out is that as they are continually increasing the Coumadin pills the insurance only pays per pill number based on the 1st Rx frequency and upon refill if the number has been increasing to keep the therapeutic dose between 2-3 then the refill comes early and the frequency on the new Rx should change to reflect the change.
So my leg does hurt more but since it didn't at the time I am hoping that no damage occurred other than soreness.  I am very disappointed in myself and how I could even fathom that that was any intelligent. Upon rising from sit to stand I feel a stiffness that I didn't before and it is a little uncomfortable but better in standing and "walking".
Two pain pills last night and 1 this morning.
The doctor returns from overseas so hopefully we can get the antibiotic changed and my Coumadin levels will stabilize.  In reflection I am only 3 weeks out and overall am doing well, much better than the anterior approach

Day 19
The day started off good with low level pain.  I was getting about using crutches in the yard and feeling decent.  The main calf pain from the clot is gone but it is still mildly tender to the touch. The home nurse came . and voila my Coumadin levels have not changed at all so now I am on 15 mg / day.  Now for the really weird part. 
The nurse was listening to my heart so I was breathing deeply.  All of a sudden I got really dizzy and slightly sick to my stomach .  After I told her this she said it was probably because I was breathing in through my mouth so I repeated this then I had the same reaction but more and my face felt slightly numb and I got very weepy.  This lasted for 5-10 min.  This was what I experienced when I tried using the walker to go around the driveway.  Now my oxygen and heart rate remained normal. After she left I got a call from my surgeons nurse who was strongly recommending I go to the hospital immediately .
I debated this for awhile because I didn't feel "right" but rationalized that what else could they do. The earlier lung scan was normal, I was on Lovenox for clots, and I hate spending 8 hrs in the ER not being able to eat or move.  So I did not go in but I promised my fiancée I would take it easy.
I tried sitting on a regular couch for an hour so I could sit next to my fiancée.  The problem with this couch is once reclined the leg part is too short for my legs, they hang off, and the lack of support is uncomfortable.
I ended up taking 2 pain pills before going to bed last night. Sleep remains my worse time

Day 18
I slept upstairs last night for the 1st time since surgery.  It was still uncomfortable sleeping but no worse than in the bed downstairs.  I did have a very wide pillow, one of those that are placed on the bed when it is made up but you're not supposed to sleep on, between my legs.  I was actually able to lie on my left side for 15 minutes without problems.
Yesterday I didn't take pain meds except in the beginning and end, even though at the end I did double up.  Wow, life is coming together.  Yes it hurts, yes my movement is limited, yes I developed a clot, but ....I am mobile, the pain is less and now it hurts nothing like my 1st hip replacement which was an anterior approach.  What a difference.
Everything was going pretty darn good with low pain levels around 2 then I decided to crutch into the shed looking for something to cut a rose stem.  I found that but I noticed and old bike pedal stretching out my fiancée's expensive bike chain.  I proceeded to life it 1 handed and realized this was a mistake.  Pain pill time.  I am really tying to do anything necessary not to take pain medicine.  My mind just doesn't feel quite right on it.  Maybe it wasn't before but now more so.  So I'm looking at budget and finances and everything that doesn't need to be done this minute. When I have nothing else to do I think everything can be done now but everyone does not go on my schedule.
I am becoming more mobile using crutches but am finding they are too quick at times and I have to quickly set them down.
I am a little afraid of going off the Lovenox because I am still on the Rifampin which metabolizes the Coumadin.  If I get a therapeutic Coumadin level , what is to stop it from the doing  the same thing ??  I have communicated this with the doctors and will do so with the Coumadin doctor today.
I tried the pillow between the knees and lying on my side but it didn't last long before I had to return to lying on my back.  I resumed a pain pill in the middle of the night

Day 17
After such a good day I was a little disappointed when I woke with more leg pain but some of that may come from the clot because some of it is below the knee.  It is impossible to secure the leg in a position that keeps it comfortable and keeps it from moving
I have the day to myself , sort of, as my fiancée had to drive a couple of hours to pick up her son from a Youth Conservation Corps camp.  She "arranged" for me to have several people to stop by to check in on me.  That is nice and all and the thought is wonderful but I believe it is unnecessary.
The distance this has created with my fiancée bothers me.  I'm grateful for everything she does but when I can't give back or do for her, or have regular physical contact I feel as if it takes something away, for me.  I need to get out of my head somehow and look at things in a fresh, new light but am not sure how to do that. I will discuss that with a friend later.  I missed my best friend while she was gone
I took a modified shower using the transfer bench and 1 leg hanging outside the shower.  I couldn't wash my toes on my right leg but other than that it was OK.  I found that if I stood up in the tub with my leg resting on the bench I could rinse easier. 
I am sitting outside with my computer, phone, pain pill, crutches and walker and the storm door propped open ready for the day.  I have my camera set up to take pictures of the hummingbirds when they come by to feed .
It was good to have company today.  I saw more in 1 day than I have in 2 weeks.  I was outside most of the day sitting and I took a pain pill at 8 and no more until 7:30 PM.  I even went to the store and carried a couple of groceries as I was wheeled around.  It was all good but now it is time for pain meds.
I realized that even if I think I am doing well on crutches I can get moving too fast for my own good and have to set down quickly.
I believe I am ready to try and go upstairs to sleep tonight.  Already put a 2nd bedside commode I picked up for free at The Restore Store over the toilet. One thing I noticed is that in the area of the incision the edema is so pitting that if I lean my leg against a rail of the chair or clasp my hands to support my leg I will get an immediate deep indentation that takes time to smooth out

Day 16
Slept in the recliner last night as I fell asleep watching TV and my fiancée didn't want to bother me.  I told her that because of events we are physically separate and sleeptime is the only time I get to feel her skin next to me.  This is important to me
The pain was at a very low level this morning and I expected it to be very stiff upon getting up but surprise!!  I went outside to sit for awhile then got up and with my fiancée went down 3 steps using crutches and the railing.  This was the 1st time in my yard since July 22nd.  Wow!  I could see the fungus on 1 of my aromatic bushes.  I picked a couple of grape tomatoes and jalepenos.  By this time the discomfort in the thigh had increased some so after going inside I used 1 crutch and a railing and went up & down the 13 steps to the upstairs.  It was time to recline but I felt so much better.
This appears to be a good time , regardless of the recent clot, as the pain is subsiding and I feel more normal.  My head is clearer, and I feel it is time to take a more active role in returning to function.  The shift in attitude and symptoms is incredible.  This is what I was hoping for.  Thank God
I can now begin to think of what I need to do down the road because for the 1st time since surgery, in my mind, at least, there is a down the road.
This is what I hope others will see during their 1st days or beforehand.  It takes time but the light is there.

Day 15
I woke up with less pain but I realized I cannot sleep with the leg straight out.  The minute I stood up the leg started throbbing which was a new sensation. The resting pain is less however.  My new procedure is to wake up and inject myself in the stomach with blood thinner, take my pills and to "take it easy".  I haven't figured out the parameters of taking it easy yet but Im working on it. 
I do need to consider more the feelings of the people around me.  Yes I am the one that is being primarily directly affected but those close to me are going through a lot too.  My fiancée was experiencing a lot of fear yesterday as they were scanning me for pulmonary emboli.  She was trying to be strong and when we found out there were none I needed to consider how that impacted her.  It is easy to become solely self-centered when I am going through the pain and disability but she is dressing me, feeding me, loving me through the hard times.  She has never said "No I don't have time for that".  That is selfless love and I would be better served if I could practice more of that.
This experience if you would call it that, involves a lot more than just the physical effects.  There are a lot of internal struggles, changes, attitude shifts that occur, and as I document what this experience is I am trying to include all of what I am experiencing.  Granted this is based on the personality characteristics of me before and other people may experience it differently. What I have come to find is that there will be some aspects that some people may be able to relate to and know they are not alone.  If that is the case hen at the worse they mat see that x weeks down the road there is also a difference, a change, and it does get better.  You know that academically but once you are in the "heat of the battle" so to speak it is hard for me anyway to have that perspective. 
OK enough of the ramblings.
Sitting does seem to be easier and I am able to tolerate for longer periods of time now. The pain is less now. The mobility except for walking is easier.  Set backs happen but nothing stays the same so it is good just to remember this.  I am ready to try more but have a slight delay due to the leg clot.  That is all it is.  Two weeks ago is history.  The only thing that still bothers me at this point is the fact that the least little hip angle change during hip flexion standing in my walker will produce immediate discomfort that limits me doing this at least the rest of the day.  This is an important movement and I need to be able to regain this.  It has to be the angle, or weight of the leg, because I can do it reclined without a problem assuming I haven't already tweaked it.
My last pain med was taken at 2PM and it is now 8 and yes it does hurt a bit more.  Once during the day I leaned to the side to pick up my dog and heard a pop in my hip which got my attention enough .
My family read my rambling on FaceBook about having to go to the hospital.  I didn't want to keep calling and complaining.  They did all call today and it was good to know they were there.  I took it easy today but I am worried about the hip stiffening up

Day 14
Two weeks ago today...I woke up in pain but decided to try and wait it out.  After awhile I had to get up and it is hard because my fiancée is sleeping and I want her to be able to sleep.  We went out to the back deck and drank coffee and sat for awhile.  I changed seats so I sat in the Transfer Chair with cushions and I felt I was able tolerate sitting time better.  A little while later I walked around our driveway with my walker & toe touch wt bearing.  I got 3/4 of the way around then just felt  lightheaded and tired.  I had to be wheeled back but I still felt I was making progress and there was hope.
I had therapy an hour later and we went upstairs with crutch and railing and fairly successfully.
I mentioned earlier I was having problems with my calf.  I called the local Doctor's Hospital to see if 1 sign of a clot in absence of any others necessitated my going in for an US.  The fact that I had to ask if I really needed to already answered my question.  I was asked to call the surgeon & I spoke with his nurse and she advised going in to get it checked out.  At 2PM I was having an US and lo & behold I have a clot in the lateral gastrocnemius vein up to the popliteal vein.  So now I have to double up on my coumadin and start giving myself Lovenox injections in the stomach to thin the blood.  The doctor from the Coumadin clinic said the antibiotic I was put on is metabolizing the Coumadin so it is not effective.  I am instructed to stop therapy, not massage the leg and to take it easy.  Then I was instructed to call 911 if I ever felt lightheaded.  I told her about how I felt with  exertion then I am informed I am to go back to the ER to scan for pulmonary embolisms.
The shock, the fear, the frustration of what else.  I had recently made the mental adjustment that things were getting better and there was hope in my mind that and I was going to not be a disability model and things would improve, relatively speaking and I felt I was slowly improving. This was as much as a mental setback as anything. However, there were some areas I felt that were beginning  to be improvement in and now I have to take a step back to take it easy.  I know it isn't forever but the last 2 weeks has seemed like 2 years already.
Tomorrow will come and this too shall pass but it is a lesson in powerlessness, or should I say relearning that I am powerless over many things in life

Day 13
As I try to sleep at night I try to reposition my leg because stationary positions cause my leg to ache.  I usually just do heel slides.  Around 4 AM in the middle of one of these I got that sharp anterior thigh pain.  It felt like something was twisted and would not "untwist". The pain was excrutiating until I could move my leg somehow to find a way to lower my leg to the bed without.  This was the 1st night I doubled up on pain medication in the middle of the night. I don't know if my knee was turned in or what as I couldn't see it in the middle of the pain and trying to find a way to get out of it.  I suspect that either my hip was adducted or IR.
I woke up still in pain like I had been beat up a little.  I doubled up on pain meds and 1 1/2 hrs later the pain was still at a higher level than previously.  Lifting my surgical limb during walking with the walker was still painful so I adopted a shuffling movement even though I was only putting 10-20% weight on that leg anyway.
I am ready for more good things to happen and for positive progression.  As I am typing I am realizing that my blogs of late are full of reports of bad news.  I am ready for this to change.
 With help of my fiancee, God bless her, I changed my scenery and was able to go out the 2 steps to the deck.  The secret for me is to use the crutches and her to get down the steps then switch to the walker as I realized in the beginning that I leaned strongly to my left to keep weight off the right leg. I sat in a chair with the egg crate cushion then in a Transfer Chair as I need to be able to accept/tolerate more weight on the hip/buttock.  I tolerated this for a couple of hours then came back to my Throne..the recliner. I realized that not only active hip flexion hurts but even more so abduction or movement of the leg out away from the body
We change how far back the recliner goes through the day & this varies the area of the hip that gets pressure.  I still took a pain pill an hr ago but only 1. I am keeping my fingers crossed as the day is going OK so far.  Another shower today and it never felt so good
My plan is to start meditating to sort of push the sensation of pain to the outer realm of  .  I have seen too much research & antedoctal evidence that it really works.  I didn't even try in the beginning as I was mentally scrambling for survival.
About 3:30 is all I can take outside and being without meds so came in and took two.  Meanwhile I  used some of my less pain filled time to start on a couple of projects that I can do a little at a time.
Began to discuss plan since my fiancée's 14 y/o son is coming back from camp.  There will be some impositions on everyone especially since he likes to watch TV & play videogames all day, watch, internet or listen to music all very loudly and I am sleeping downstairs for the moment. I assume I still will be spending the rest of my day hrs downstairs.  Fun,fun, fun . 
Began practicing steps for eventual return to bedroom upstairs.  I had a shower using my fiancée and transfer bench and felt like I was in heaven. 
I began to notice more of a pain in my surgical limb calf even at rest and it was tender but none of the other DVT (clot ) symptoms.  I hope this is just due to overuse of my calf due to not using full wt on my right leg.  I will assess this as the days go on.
I thought I would surprise my fiancée.  I was going to go upstairs without her help when she was in the shower upstairs. She used her radar mother ears and was not so pleased or happy...at all.
After my early misadventures that ended up in pain because I tried to push what I was capable of I told her I wouldn't do anything like that again.  It appears I am more self centered than I thought.  It never crossed my mind that she is scared because she cares about me.  I know I am bored and frustrated because I want to be tomorrow today but she cares about me and it is selfish not to consider her feelings too.  It is hard to ask for trust when I don't give her reason to trust me.  

Day 12
Well I an finding that today I am waking up in more discomfort than usual.  I immediately took 2 pain pills.  It took 45 minutes before the least little relief began in my recliner, my new buddy that has become part of my new world.  Now it has been 1/1/2 hours and the pain has dropped some.  I don't know whether to stop exercises for now , to call the NP or what.  I began to put my head in the future which I can control right?  I start thinking of how can I ever return to work in 3 months time being like this.  I'll never make it.
So I return to blogging and try to take some control over my life.  I realize, or pray, that in 3 months all of this will be behind me and I need to do what I can on this day.  I need to focus on what I can do not what I can't.  It is like the saying be part of the solution not the problem.   I also need to take stock of all the things my fiancée and friends are doing for me and be grateful and appreciative for all their efforts. Thank you impersonal computer screen for reminding me of this invaluable lesson that I will need numerous times.
I am caught up with my experience and will type more as the day goes on.
My PTINR  = 1.0 indicating that my blood is more prone to clotting. The Coumadin clinic nurse feels this is the result of the antibiotics I am also on
I found out in PT that my passive flexion is OK and pain-free so the muscle has to be fired up.  The game plan is to back off flexion if there is pain, ice it more over the next 2 days & try an interferential electrical stimulation unit I have for pain relief.
The "catching" in the front of the leg continues as the day progresses.  I tried going down 4 steps with help & assistive devices then was pushed down 1 block & back in a borrowed Transfer Chair.  What I found was that I had to repeatedly use my UE to lift to take weight off the right hip/buttock and was able to go down and back 1 block.  It was strange being out.
I continued with icing and tried use of a TENS for 10 min.  I'm not sure if it helped but certainly didn't hurt.  I will try when it gets more painful to see if I can notice change. I went outside for about another 1/2 hr to sit and waited out as long as I could before taking pain meds.  I used the TENS a 2nd time and placed ice bags on the skin.
As I was winding down the day I looked at my leg and noticed a "dent" with a lump of fluid pocketed on the outside of my leg.  It was a little disconcerting.  I realized that after surgery there would be swelling but it was strange how it was a discrete small area within the overall swelling.  I figured it would work its way out by tomorrow so didn't worry too much about.
  I continue to try and move the leg if I can do so pain-free.  I actually fell asleep in my recliner and felt relaxed for the 1st time. My fiancée tried to turn out the lights for me to stay there as she knew sleep was my Achilles heel and according to her I looked peaceful.  I decided it was more important to be next to her so I woke up and went back to the bedroom. If I knew what was to come I may have changed my mind

Day 11
I woke up as usual, in some discomfort, took 1 pain pill then an hour later doubled up on a 2nd one.
The sharp pains I experienced the day before really scared me and make me leary about testing the water with exercises again.
After the 2nd pain pill I did absolutely fantastic between 8AM - 1:15 PM.  I didn't take pain meds during this time.  My mind was decent enough to work on a crossword puzzle.  With help and the appropriate assistive devices, walker & crutches, I went down the 2 small steps to the deck & sat on a chair outside.  On the way down the 1st step I felt a twinge in the muscle on the front of the leg, the same one I felt the day before that bothered me.  Once I sat I forgot about it for awhile and upon going back inside I felt it again.
The scary part is not knowing whether this is normal, to try and work through it, to back off for a day , or to  just walk without trying to move it bigger and better within the prescribed range.  Once I begin to feel better I think it should continue linearly.  I remember telling patients that it is about the overall pattern of behavior.  They may have 2 major advances and be doing great then all of a sudden would have a "bad day" or set back.  In my experience as a therapist I have very rarely witnessed progressive, sequential nothing but blue skies kind of healing.  It is more like 2 good days then 1-2 not so good then 3 days and so on. 
I think we all want to "know" what every little ache & pain is and the truth is we probably never will.  The patent answers of "you had surgery" never was sufficient for me.  I want to know why, how,  why now, what if and too many questions pinging in my head to articulate
Back to the rest of the day.
The day progressively got worse from here. The sharp pain would increase everytime I lifted my right leg to swing it forward as I walked  walker.  I would "test" the muscle by trying to lift my knee to touch the walker horizontal bar as I had in my breakthrough day that I could do it without pain.  It became apparent & frustrating to find that it didn't get better and just go away.  Even reclining in the 1 chair that has my refuge could not get comfortable.  This bothered me. My mind went places it shouldn't without adult supervision, such as "Did I sublux the hip?"  Pain pills and hopefully sleep or just unconscious was my only solution at this point.  I could not solve or change things at this point

Day 10
Still waking up with the aching of the leg and unable to resolve how to preempt the pain other than doubling up on pain meds the night before 1st thing in the morning.
Sat in a transfer chair with W/C cushions for 20 minutes while someone came over to cut my hair.  Now I was almost looking human.
Around 4 PM I noticed a very sharp sensation of soreness/pain in the area of the posterior greater trochanter.  The way I would describe it is as if I had just received an injection of steroid or antibiotic in the buttock ( obviously had pneumonia before ).  This was a new sensation over the last 10 days so was worried that it might be a reflection of doing something not good to the leg.  I tried to comfort myself and say it is just using muscles that are "waking up".  This new discomfort was either accompanied by or just appeared at about the same time as another one that bothered me more.  As I would start to walk there was a sharp pain in the hip area of the rectus femoris or the main quad extensor and a secondary hip flexor.  It felt as if there was a pinch, like something was not moving smoothly and  it produced moderate pain.  I noticed that if I attempted to stand in the walker like I had been doing and lift my knee up to touch the lower horizontal bar the pain was reproduced.  Decreasing the stride length decreased the pain and appeared better with rest
Anytime I have new pain like these 2 I try to "figure out" what may have caused them assuming there is always an assignable cause.  Maybe I was not keeping on top of the pain, maybe I hadn't been moving enough, maybe I was in 1 position too long, or maybe this was back related somehow.  The pain was not to be figured out this night, however the old standby of doing less and using it less continued to work.
Prior to going to sleep I remembered that if I wanted I could take off the occlusive dressing I had worn since surgery as this was day 10.  I was a little nervous and there was only 1 area 2/3 of the way down the incision, that actually stung as I removed the dressing.  There was no drainage or oozing and the skin was not red around the incision.  It itched for about 1/2 hour and I left it to air dry overnight.  Double up on pain medication and off to sleep I went

Day 8-9 post THR revision

Day 8- 9
I realized all of a sudden that while lying in bed I could do heel slides much further than prior .  Wow! It was like a major victory.  Such a small but such a huge change 8 days out after surgery.  I also realized that I could hook my uninvolved leg under my surgical leg and move my leg in bed to reposition myself during the transfer from supine to sit.
Nighttime is still the dreaded time as the pain in bed in prolonged positions is not something I have been able to work out yet.  Pain upon waking is still a constant deep ache. I continue to double up on pain med before going to sleep and 1st thing upon waking.
Bowel Movements are beginning to return to more of a normal occurrence.
Today was the 1st day I resumed  modified sex, even though, a reoccurrence would be several days after.  It is sort of funny when I thnk how I "protected" my leg & hip with pillows. Why do I mention this?  This is about how life slowly returns to normal and what works and doesn't.
Today I noticed I could stand in a walker and lift my right knee to the lower horizontal bar of the walker.  Another WoW moment and very exciting for me.  Steps are slow but they are steps and I can't run until I can stand.
I took a shower  with helpusing a shower transfer bench with a dry walk through 1st. It was wonderful without the pain experienced during my attempt the 1st time after I returned home.  Is life retuning to normal slowly??I am actually beginning to feel human again.
Today I was able to straighten my knee, not fully, but without pain.  PT had me do isometric hip flexion

Day 4-7 of THR revision

Days 4-6 involved relearning an age old lesson that I can not and should not try to do things by myself, without help in times like this.  I don't like to ask for help.  I don't know if it makes me feel weaker or what but I feel powerless and want to reclaim some control over my life. Every 1-2 hrs I was getting off the couch to walk with a walker.  The 1st few steps the surgical leg would not move forward by itself and had to be carefully manually slid forward.  I continued with  regular use of the incentive spirometer.  I continued to try & do quad sets.  I was unable to straighten my knee from a slightly bent supported position.  I tried a modified shower using the bedside commode straddling the tub with my fiancée and walker.  This worked OK until the leg slipped because of water on the floor. I used to think the larger movements would be what would hurt the most. The fast attempts to either protect my limb by trying to keep it from moving or correcting bad positions are the ones that scare me now.  At this point I realize that if I relax while  the leg is being moved, as long as it is within the restricted ranges, life goes easier.
 I used crutches to descend 1 step to talk with a work person.  I must have stood there 5-10 minutes with minimal weight on the surgical limb. My thought was that I am limiting weight bearing so it shouldn't matter whether I use crutches or a walker.  I still don't know this is a flawed thought pattern but I do know that all of a sudden I needed to sit down quick.  This was a long resolving discomfort.
I missed the MD call in the AM as I had the volume on the phone down.  He left for a conference after my surgery so I had not talked to him since pre-op.  I felt like I wanted to talk to him but wasn't sure what I should or needed to ask other than to validate that there is good reason for my pain and that things would be better.
Tried to go down a step using crutches when I was alone because I thought it would be good to get a change of view...the problem is I didn't wait for help.  Hmmm, a recurrent theme?? Oh da pain!!!! It went OK until I started to lose balance then engaged muscles to try & stabilize.  That was the only time I "threw a fit" and threw a crutch out into the yard as I experienced frustration, fear, and pain.
At this time I realized that in trying to do more I was having 1 incident/day that produced lingering pain.  I needed to back off and let things calm down and heal.  This was an amazing return of perspective.
Up until this point I tried taking pain med only in response to pain.  Low pain then minimal to  no medication, significant pain and I would take a lot of pain medication ( as prescribed ).. By the time my pain was more intense it was too late and I would have to take more pain medicine and I found I was doubling up more often than I thought I should.
 Rereading through the literature I came across a section that stated to take pain medicine every 3 hrs religiously for the 1st 7-10 days.  I would take the higher dose before going to sleep because this is when the pain was the worse, on a day in day out basis.  Keeping on top of the pain is key.  I was relearning what they have told me from the beginning.  I don't have to do it differently and if I did I would get the results I got.
I got quite angry as I had not seen or heard from any home health and on day 5 post-surgery called to inquire.  I let them know that if I didn't see an RN today ( I was supposed to get clotting times since I was on Coumadin ) to start then I would request another agency.  The RN was not supposed to come in until 4 PM but she did change that to 1:30PM.  Once that had happened PT could now come in.  I felt that I shouldn't have to work so hard to get what I considered a basic service.  I needed some validation that everything was as it was supposed to be. 

The beginnng...

Ten days ago I had a posterior approach right hip revision with osteotomy.  The reasons for this . aren't really pertinent and will not impact what I am experiencing.   My purpose here is to hopefully provide perspective for anyone else going through something like this.  It is very difficult for me to think 7 days down the road when I feel as if I am withdrawing to deal with pain & fever & to merely survive.  I hope to provide a day by day progression through this process.  No 2 people will have identical journeys but there will also be similarities due to the nature of the procedure.

This is actually day 10  post right hip revision. The first 2 days were in the hospital and was as close to hell as I think I can be while on Earth.  I awoke from the surgery with nausea in the recovery room and had to be given medicine to keep from vomiting .  That worked well but the dampening effect on my HR & blood pressure came back to bite me.  I came out of the recovery room 2 hrs later than expected and my vital sign alarms kept going off so they moved me to a neuro floor as they did not have enough telemitry beds on the ortho unit.  The pain was incredible and because of the vital sign issue no therapy was sent up to see me.  It was almost comical as there was a poor lady that couldn't go to the bathroom on the floor so all night she would be yelling for help.  The poor staff on that floor had a lot of problems getting vein sticks so in my stupor I would guide them to more productive ones, or so I thought.

Day 2 I woke up without my surgical limb TED hose on and feeling hotter as the day went on.  I continually informed the nursing staff and numerous visitors that breezed through my room.  Once a nurse asked why my teeth were chattering.....My TED or a replacement never came and I continually was telling the nursing staff I felt burning up.  It is common to spike a post-surgical fever and up to a certain temperature is considered healthy but by the time they came back around mine had climbed to 103.5 degrees.  I still had to wait 30 minutes to get something and only because my fiancée insisted.  I had numerous people state the importance both before and after surgery of using the cheap plastic looking incentive spirometer. I remember 1 pre-op nurse say this will make the difference between having pneumonia & fever or not after surgery.
I was moved back to the ortho unit as my VS had stabilized.  I finally got another TED hose with persistent requests.  In my mind if my doctor wanted them I should have them.  Physical Therapy came up and we went to walk.  I don't know if my leg was stiff from not getting up Day1 or what but after Toe Touch Wt Bearing with a walker I could do no more than 10 feet.  That night I wanted to try to go to the bathroom even if I didn't have to so I could begin transferring, and to not become obstructed as I had after my 1st hip surgery. After my 1st surgery I was encouraged to eat but never asked and never did have a BM before leaving and I was not going to relive the misery of the vomiting and ensuing hip pain the day I got home.  The RN kept stating she was confused why I would want to go if I didn't have to but what can you say when you have already said it. It had to come down to the fact that I thought I should and the RN did not need to understand.
 Rather than waiting for me to lift and initiate turning my body in the direction I was getting out of bed and slowly lowering my surgical limb down easy, the knee was allowed to bend and the pain was incredible.  Then after returning to bed the surgical limb was quickly brought up and over with the same result.

Day 3 was uneventful for the most part.  I walked longer(30 feet), went up/down 3 steps, got drugs and left to come home and it is from here on that I hope may shed some light on how some of the things may come to pass.  It turns out I had unrealistic expectations and I am a Physical Therapist.  Revisions are different beasts and bone and muscle hurt no matter what you do or how much you make.
 Getting to sleep was the one part of this day I would rather forget.  I placed a 4 inch high 2 foot long step next to a 6 inch step.  As it works now, the right surgical limb is on the 4 inch-step with the walker in front of me and my non-involved leg is on the higher step to my left.  The goal is to slowly use the arms to lift and scoot back as someone slowly lifts and holds the surgical leg out straight.  Once the leg is supported by the bed then you can left the buttocks by pushing elbows into the bed and someone slowly brings the leg over , a little at a time.  It requires timing and does quickly get smoother.  The other is to find a chair high enough with enough padding and an arm rest so that 1 hand is on the walker and one lowering on the chair, taking care not to lean over at the waist.  There is no pillow placement that will feel better for all people all the time.  I have had to experiment with under heel, under calf, between and all combinations until I find one and todays comfort may not be tomorrows

I should be able to catch up to day 10 on the next blog then they will obviously be much shorter