nausea, day after right THR

@wmh9860
As the veteran of far too many surgical procedures, including several hip replacements/revisions, I can say that nausea after a block wears off is not uncommon, especially if one is taking NSAID's or pain meds.

It takes at least 24 hours for the drugs to metabolize out of her system, maybe longer if she is not eating much. Anesthesia always messes with my body's thermostat, but I don't know if that is common. If this persists throughout today, you might want to call the surgeon's office for antinausea meds. Other ways to help are making sure she is well-hydrated (water, ginger tea, ginger ale, even regular Coke) which helps dilute the drugs left in her body and flush them out. Tiny, easy to digest meals or snacks, and especially food with her NSAID's can also help.
I wish her a quick and uneventful recovery.

Thanks so much, The Dr called here today to ck on her and also one of the care team members called. He was amazed she wasn't on any pain meds and advised her to try the nausea meds he prescribed. She started taking the anti inflamatory/swelling med today and it has helped. She seems much better tonite. PT comes to our house tomorrow. Thanks again, Mike

One week after THR. She is doing great, never took any pain meds except Tylenol. Doing home PT for 3 wks, then going to out to PT (Rush). She's weened away from the walker 90%, only use it when she will be doing a lot of walking and or tired. Sleeping a lot but getting better. Does stairs by herself one step at a time. Her only problem is weakness in the leg. She has been in pain for 6 months with it being pretty bad right before surgery and gradually lost strength to where she could barely lift it a couple of inches on her back with a lot of pain before surgery and seems weaker now. She's doing heelslides-pillow crunches between knees-back arches-supline sliding leg back and forth-supline knees up dropping leg to the side She still cannot lift her leg to get into car by herself and it's tough getting into bed. At nite she is starting to get pain/tingling pretty bad sometimes going down her leg where to swelling is dropping to and cannot get comfortable so she gets up and walks around. She is comfortable in the recliner with her leg elevated to help with swelling (not a lot and the discoloring has started and dropping down into her leg). She has none of the pain she had before surgery, just pain form the swelling and incision but getting better. Dr and PT say she's doing great but we are concerned about the weakness. Any thoughts/ideas?

If she was weak before surgery from non-use or favoring the leg, it will just take a little longer to regain it. The fact that she can go up and down the stairs tells me she is doing really well!
I'm thinking it was probably 4 weeks after most of my hip surgeries before I could lift my leg into my car without "helping" it.

What she needs to do now is follow her therapy plan and ask the PT for some strengthening exercises appropriate to her stage of healing. Sometimes it it easier to start with walker or counter supported leg lifts while standing and "marching" while seated on a firm chair to get it moving. Lifting a leg off the bed really is hard - ask anyone who has been bedridden for a week how much loss of strength happens.

Now, about the swelling and tingling - both normal. One way to reduce the swelling is really elevate her legs - for 1/2 hour or more a couple times a day. You can use a stack of pillows, a wedge, lie on the floor with legs on a chair... You may have to assist her and the PT can show you how. This inverted position drains the fluid from the legs back toward the abdominal cavity where it is excreted.
Tingling - the nerves in her leg and hip are unhappy, having been moved and possibly bruised or damaged during surgery. When nerves wake up, they tingle, maybe feel like stabbing or burning. Depending on the amount of trauma, complete healing can take from a few months to a year. Any part that must regenerate does so at 1 mm per day, or about one inch per month. And, the way the brain works, the pain may be felt anywhere along the nerve, not just where it is healing. Just one of those things!

Please congratulate her on her great work so far! It does get better, and soon you'll be trying to keep up with her!

THANKS, HOME THERAPY WAS JUST HERE AND SAID THE SAME, THANKS AGAIN

Hi, Karen, my wife, has been getting some nausea and always tired, worse since yesteryday, she just started feeling bad yesterday afternoon and has been laying around since then, very tired and nauseous, no appetite, doesn't feel like doing therapy, other that that she's doing great, strength is coming back a little each day, she can get into the car and in and out of bed better, just using her cane now, she never took and nausea meds since she didn't have any or it was very mild until now, should she start taking the Zofran (for nausea), she only takes one Rx from surgery (meloxicam 7.5 tablet for swelling/inflammation),
she takes alendronate sodium 70mg tablet for Osteoporosis ,
metoprolol-succinate 50 mg capsule as a betablocker
atorvastatin for cholesterol 10mg tablet
levothyroxine 75 mcg tablet for under active thyroid, and vitamins and fish oil and calcium, maybe there is some interaction from meds. Thanks, Mike

Trying the Zofran is a good idea, especially if it will help her to take some liquids and a little food. The longer she goes without them, especially with all the meds she uses, the worse she will feel. Can you tempt her with a popsicle? Pedialyte makes some that could help maintain the electrolyte balance in her body. Ensure also make some supplements that are clear, and usually tolerated in small sips even with nausea.

Also, she might still be tired from the surgery, and possibly was trying to do too much too soon (a common issue.) Or she might have caught one of the many summer viruses now circulating.

OR she might be developing an infection. You could check her temperature and inspect her incision for any signs of redness or swelling. If she has a fever or you see any increased redness, call the surgeon's after hours number or your primary - this piece would be nothing to mess around with.

If all seems well, maybe just coddle her for a few days - recovery from joint replacement is a marathon, not the sprint we wish to believe it should be.

Good luck, please let me know how she is doing later today or tomorrow.
Sue