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I am at home, recovering from hip replacement surgery. Am 84 & WEAK.


Use a WALKER. Hence NO Exercise possible.


THANKS


Joanna

Make it routine to drink 48-64 oz of fluids daily, & add a stool softener (OTC docusate). Sounds like you need a laxative now. Miralax is ok but works very slowly. ExLax works for me. Once you have a good BM, repeat the above: drink fluids, stool softener add fiber eat pruned or 4oz prune juice warmed up 30 seconds in a microwave.
Add veggies to your diet. Keep moving (get up and walk hourly)
Cut down on the narcotics - alternate a narcotic pain pill with acetaminophen or ibuprofen (ask you doctor which one according to your history.
The most harsh laxative, imo, is Magnesium Citrate. A Fleets enema works well too. Mineral oil works for some folks as well.
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Reply to Shane1124
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I hope you live in a largish area where they have physical therapy and occupational therapy that comes to your home and is NOT part of a home health agency. You can qualify if it has been awhile surgery. Or maybe if it is right after. My Mom just finished a few months of therapy to get her stronger again. Just sitting made her week. She uses a silver fold up and a Drive Medical nitro 4 wheeled walker at home. Bigger wheels allow Mom more stability. ? If your eligable for a second walker. She has what is called an european style with flat metal instead of those rolliaters.
We were referred to Fox rehab. It's in the north east and some south coast. It does not use your medicare home health limits. Just medicare.
Their number is 877-407-3422 for all their places. We live in Atlanta. They may be able to referrer you to someone in your area.
After hip surg you should have had rehab and if a more recent surg, not be this weak.
As for the other problem, without knowing meds and medical history I can't even make any recommendations. You need to call your physician and there are several ways to go and he would know best.
I pray you are keeping your weight up but not gaining too much. Nutrition is so important to get back in shape.
Take care,
Be careful
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Reply to Zoey662Brisco
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Same issues after knee replacement. Pain meds plus iron supplements after surgery caused issues. PT will be getting you moving faster than you think.
Drinking lots of water, add some of the fiber one products to your diet, raisin bran cereal. Add some fruit like apple slices.
Don't know specifically about hip surgery, but my PT had some exercises that I could do in or around a chair or in bed. All movement helps.
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Reply to Gracie61
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Imho, if you're on pain medication(s) for your hip replacement surgery, those alone are going to cause constipation. Imho, you should follow up with your physician. He or she may want you to attempt to get moving as is the protocol for hip replacements. However, you must tell your physician that you're on/using a walker.
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Reply to Llamalover47
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I had my hip replaced 6 months ago and was asked to walk daily to decrease blood clots, give my leg exercise and to keep my bowels moving. I took stool softeners for few days and got off narcotics quickly which are really bad to constipate. Are you drinking enough water? All of these things will help. Are you having home health com several times a day to check on you or are you past that period? You don't say how far out you are from the hip replacement but usually HH is ordered for the first 6 weeks where a PT comes to encourage exercise and check vitals, changes, changes the dressing etc. It would help to know more.
You may also be weak if one you aren't moving, two not eating enough protein. My doctor said I had to have at least 60 grams of protein a day for the bone to heal adequately. Healing takes a lot of calories and energy from the body. So I would eat a greek yogurt in the morning; have either cottage cheese or tuna for lunch (chicken would be good too) with veggies and or fruit, and a good helping of meat for dinner. I also had Ogain Protein drinks which have lots of proteins if I needed to supplement. Let me hear back from you and tell us if you do these things.
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Reply to Harpcat
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Excuse me.

Less than two hours ago I was sitting in front of a lady who not only uses a walker but has had a stroke, too, and she was showing me the exercises the Community Stroke Team has given her to do. I hadn't seen her for a while, about ten days since my last visit, and in that time she has gone from being afraid of her trolley running away from her to, right in front of me, pushing up on her toes to stand tall and strengthen her leg muscles evenly. Her lower legs are much less swollen, I have only this evening realised that she is actually taller than I am, and she is so proud! Clients can't see me grinning from ear to ear at the moment because of the surgical masks we all have to wear, but I promise you that's what I was doing.

So to hear you say that no exercise is possible because you use a walker, you're 84 and you're weak? Get stronger! Make a start!

Do you have support from physical therapists, or any care assistants visiting you at home?

The constipation meanwhile is enough to discourage anyone. If you're taking prescribed pain relief, you should also have been prescribed a laxative to counteract its effects on your gut. In any case, though, there are many gentle ways to relieve it, because with a sore hip you don't want to be coping with anything too violent and, er, sudden.

Lots of people find dried fruit (raisins, figs, apricots) helpful; there are products like Lactulose which draw water into the gut and soften the stool that way; and of course there are many over the counter remedies too. Have you already tried any of these?
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Reply to Countrymouse
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Pain medication often causes constipation of you are still taking those. Too little fluid and too little fiber in your diet also contribute to constipation. Ask your doctor for a prescription for Senna or try an OCT medication like Senekot.

You must have internet since you are using this forum. Look for "seated or chair exercise" videos online. There is a great variety ranging from gentle (and seated) yoga to routines that focus more on cardio or strength. Try out a few to see what style and level you like. You might find the upbeat music on some of them will encourage you and cheer you

Even people who cannot walk at all need to move and exercise the parts of themselves that can still move. If you are still having PT follow up, do the prescribed exercises. These have been specifically designed to rebuild strength.
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Reply to RedVanAnnie
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You have a lot of good advice here. I agree that you MUST keep moving. That alone will help your bowel problem. Besides that, you must keep moving or you will be a cripple the rest of your life.

For myself, if I get constipated all I have to do is eat a large serving of greens, like spinach, turnip, and mustard, cooked with some bacon or salt pork. yummm. In my case I am sensitive or allergic to onions or garlic. If I don't mind the other reactions, all I have to do is go out for Mexican Food and no constipation.

Mainly, drink a lot of fluids and walk. I believe the old wives tale that walking pulls and moves your abdominal muscles and that moves the BM around. I wish I could be more delicate saying this.
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Reply to MaryKathleen
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Please may sure to drink plenty of fluids, eat a lot of fruit and veggies, and consider taking fiber supplements. Be aware that narcotic pain medications can cause constipation but usually goes away once the medications are stopped. NSAIDs do not cause constipation.

I know you use a walker, but you need to get exercise as much as possible. I hope the doctor has prescribed in home physical therapy. You will definitely benefit from therapy and following their advice for activity.

PS I an an RN and this is a problem we address all the time.
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Reply to Taarna
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The only thing that worked for me after hip replacement was Phillips Milk of Magnesia. I tried everything else with no luck, but a dose of M of M did the trick brilliantly.

I used a walker for the first week after surgery.......I was told if I didn't walk I wouldn't heal or recuperate. Why can't you walk with YOUR walker? I graduated to a cane the following week, and then I was walking on my own after that. I think if you don't move your body, you're going to be in a world of hurt, my friend. Do a little bit each day to regain your strength.......it's THAT important!

Wishing you the best of luck!
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Reply to lealonnie1
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I love Activia, it supports gut health, billions of live active probiotics and it works well for constipation. It may take a few days, but works rather quickly to become regular and it taste great. Regular or sugar free options are available. Brother has severe constipation due to meds , takes this on daily basis and solves bowel problems. My mother and I take it and no problem with regularity. I dislike taking pills, powders or any type of medication for bowels so this works great for me and the rest of the family. Other posters gave some good advice, depends what you think would work best for you. I would check with your doctor, meds might be causing constipation and he/she might have a better option for you.
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Reply to earlybird
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If you’re on pain meds, I’ll bet that’s what’s causing this.
if so, ask your MD about scaling them back, or they give you a new prescription for a pill that’s a smaller amount of opioid with aspirin. The opioids cause serious sudden constipation. If it’s opioids causing this, diet changes are not gonna matter. You need a stool softener if it’s opioids causing this, and NOT a stimulant laxative.

Colace (docusate sodium) is a stool softener & is a gel capsule.
It is not a stimulant laxative, which ExLax, Dulcolac, Senokot are.

I had knee surgery last fall & put on Vicodin (Hydrocodone /Acetaminophen), first 2 weeks at 10mg/300mg, then lowered to 7.5mg/300mg, then 5mg/300, along with Colace at day 3 post surgery at twice a day for first 2 weeks. Opioid constipation is not - ime - not at all like regular constipation. The opioid seizes & dries up your intestines so screws up your overall digestive system. Stools get like lil rocks. Colace adds to & works to get your body’s water into your intestines to get stuff moved more comfortably from your intestines and into your colon.

Colace abt $20 for 30 100mg gel caps. $12 for 10. There’s a generic too.

Did you get a Breq Ice Cube? These are amazing as they keep Swelling & inflammation down and less swelling / inflammation = less pain. The drawback to Breq is that they need to be refilled with ice every day or other day & you’ll have to have someone bring you ice and have freezer space to store it. But it’s amazing machine. I think Medicare covers it if it’s placed on you after surgery so that you are leaving the hospital with it on you. It’s put into surgery costs.

Honey, I know it’s painful, but you have to move. There are passive exercises you can do seated Or laying in bed. You have to move and get weight bearing on your hips and start extending your range of motion. The orthopedic surgeon practice should be able to email you or snail mail you a printed out exercise guide. Are you scheduled to get physical therapy in the future? Like once Covid concerns are lessened where you are. If not, contact othopedic office to get that referral done. MediCARE covers post hip surgery PT. There are mobile PT probably waiting for stay at home orders liftedd to start scheduling patients, so imo you want to get put on someone’s list. Move and stand as much as possible, build up your time standing shifting weight from 1 leg to another. Find an activity to set as your own personal long term goal. Good luck.
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Reply to igloo572
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lealonnie1 May 13, 2020
Amen to all you've said, esp the moving around part. I was in such pain before THR that it was hard to get around. But afterward, that pain was GONE and little by little, I got back to good BY walking. First with a walker, then a cane, then on my own.
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Constipation is very uncomfortable. I will not give you list of remedies, the internet is your friend here. I will tell you that it is more of art than a science, and you need to find what remedies work for you, each person is different. The only recommendation I have is to find a progressive approach to resolve the problem; meaning that you start with something less harsh and use something stronger if the first “something” does not work readily.
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Reply to Ricky6
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Warmed up prune juice with a capful of Metamucil every night.

If you are truly, painfully backed up--an enema to get things going may be necessary--but it's doubtful you could administer one to yourself.

STAY HYDRATED!

Also, if you can, look up 'abdominal massage for constipation'. There are several gentle massages you can do for yourself that help 'wake up' the bowels. As you do the massaging, you FEEL stuff moving. You may likely still need an enema and/or the metamucil--but to get things moving.

And if you are able to get about with a walker--you should be moving about as much as possible. My mother BEGGED for hip replacement, the dr made her promise she'd be compliant--and sadly, she went from using a cane to being 100% reliant on a walker. He was furious with her and has since refused to do her 2nd hip, as she would then be bed bound for life.

Use it or lose it!

Good luck--my chemo made me constipated to a degree I couldn't even believe.
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Reply to Midkid58
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Have you tried a stool softener such as Solace? Warm prune juice? Increased fiber? Another option is Miralax which is often recommended by physicians. It comes in generic form as well. Increasing your fluid intake might help too. I would stay away from bowel stimulants suck as Ex-lax and Ducolax. They cause cramping and they are not good for the GI tract. Keep in mind that narcotics can cause constipation. Hope something works.
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Reply to Peanuts56
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Often it is the pain medication that can be the cause of the constipation.
There are stool softeners that you can use.
Products like Benifiber, Metamucil can help. As does Mirilax and Milk of Magnesia.
There are herbal teas, Smooth Move is one that I used once in a while for my Husband. He was on Senna daily as well but on occasion had to resort to one or more of these other solutions.
Prunes, prune juice both "tried and true"
Hospice also suggested a mixture they called "The Bomb" 1/4 Cup prune juice, 1/4 Cup orange juice, 1/4 Cup Milk of Magnesia and you heat that and drink that. Heating it is key for it to work well.
If this continues you might want to talk to your doctor there are prescriptions that can be used or if at all possible cutting back on the pain medications as soon as you possibly can. AND you need to talk to PT about getting more active, the more active you are the more your body will function better and "get things moving along"
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Reply to Grandma1954
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This is pretty common after surgery. You've gotten some good suggestions from this forum. Hopefully, you have spoken to your PCP (or better yet a nurse) about this as they may have helpful hints also.
It is particularly important that you get that new hip moving. It's ok if you have to use your walker (did you use one before the surgery or is this a new issue) but it is vital that you walk. Much depends on the type of insurance you have (traditional Medicare is the most generous in this situation) but you should have qualified for acute (or inpatient) physical therapy immediately after the sx. You should also have had some therapy after you returned home; a lot of times it is outpatient but if you don't have transportation to their site, that is difficult and that's where you need some type of home physical therapy. If this was not mentioned or offered to you upon hospital discharge, call the hospital and ask to speak to the social worker who was assigned to you in the hospital (if you don't remember, don't stress - let them figure it out). I believe you have a grace period after discharge to schedule home therapy.
Good luck in charging through the uncomfortable pain, the seemingly mindless and endless exercises. Push back the thought that it would be much easier to just sit in this chair and grab a pain killer. My friend put her head down and kept going with her exercises and minimized the pain killers. She's a bit younger than you at 82 but..... in four months she has amazed her doctor and is back to riding her horse!!
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Reply to geddyupgo
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igloo572 May 13, 2020
She was goal oriented and focused on that goal, it was get thru this so I can saddle up.
Makes a huge difference.
My mom had rotor cuff surgery at 89. Her goal was she wanted to be able to set & style her hair. House cleaning, laundry, visting family, going to church... could care less about. All about Those netted hair rollers that have twisted brush inserts & pink pins to affix them. She had a can of AquaNet rolled around a towel she used on her dining table to do her at home exercises. Come hell or humidity she was using those frickin’ rollers and using spray. Surgeon & PT, OT were amazed.
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Many medications can have this side effect, especially those given for pain and nausea. Calcium supplements can block things up too, so ask your doctor or home health nurse what you can cut back on. Go easy on those laxatives!!!
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Reply to Bigsister7
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I had 2 knee replacements in my 70's. Vicodin was necessary to relief pain after surgery. It causes severe constipation in most people. thankfully friends had warned me about this problem. I discontinued the vicodin 7 days after surgery. Also, i sprinkled a lot of freeze dried ground flax seed on my shredded wheat and any other breakfast foods.I am 86, healthy, med free, and pain free.All hydrocodone is dangerous, constipating, and damaging. However, it is necessary after surgery.Ground flax seed is a very healthy additive to promote digestive health and to lower cholesterol in a safe healthy way.People so unfortunate as to be on blood thinners should not take it, however.
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Reply to BobbieSena
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I had exactly tIhe same problem with my bowels after my hip replacement surgery. Nothing helped. Finally after five weeks, out of desperation, I put on latex gloves and pried a few bowels out. After that, it took all day to get rid of all of it. No more problems after that.
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shad250 May 13, 2020
TMI
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I would get a good probiotic and start taking it daily.

To help keep your bowels regular you can do a vitamin c bomb, like 10k milligrams and that can cause a good flush. I would also talk to your doctor about adding a magnesium supplement to your diet. This helps keep things regular and 80% of Americans are magnesium deficient, which leads to a whole host of problems, including constipation.

Keep moving that hip to ensure the best results possible.
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Reply to Isthisrealyreal
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Daisy9 May 13, 2020
Most doctors dismiss the idea of vitamins, supplements, and natural medicines, and will not approve of taking anything except drugs. I take magnesium citrate along with my daily calcium citrate to aid in calcium absorption, remain regular, and add additional magnesium to my diet. Plain magnesium will cause diarrhea, but if constipated, will even out the problem. (Remember to drink plenty of water each day! and try to get as much exercise as possible.) Start with 200 mg magnesium with each meal (or an additional tablet the first day) until regularity is established. From that point on take one tablet with each pain med. Isthisreallyreal's suggestion to take a probiotic is great. Btw, do not trust vitamin or mineral supplements purchased at a big box store, as many brands do not actually contain what is listed on the label. Purchase from a reliable vitamin store.
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Fleet as seen in the commercial
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Reply to shad250
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Joanna
Exercise as in walking, is very good to help the bowels get going. Plus it helps your hip.
Just increase a bit each time. Make sure you get up several times a day and walk a little further each time. Drink lots of water and that will help all systems as well.
I hope you feel better real soon.
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Reply to 97yroldmom
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Epsom salts also work if the above recommendations are not available, or if you've tried and they're not working(very strong, but sounds like that's what you need). Two to four teaspoons in a full glass of water and make sure you're near the toilet with plenty of TP for the experience. It works fairly quickly, usually starting in about an hour, so don't take it before bed or you'll wind up in the bathroom for most of the night. This is NOT a long-term solution; a very strong/potent laxative that can quickly lead to electrolyte imbalance if used too frequently, but it sounds like you need a strong and quick resolution to your plumbing issues. It used to be called " Go Lightly", and we would give it to patients in a gallon jug to drink as bowel prep the day before a colonoscopy. That name is obviously an oxymoron. It's not a gentle or pleasant experience, but it will clear out your bowels; please make sure to drink A LOT of water. Pain medications, as mentioned above, are notorious for causing constipation. If left untreated, constipation can become serious and even fatal. How long has it been since you've had a BM? Are you passing gas? This is a good sign, as it indicates that your system is somewhat active.
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Reply to gemswinner12
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Try to cut back if you are still using opiates. Make sure you are getting plenty of fluids and lots of fruits and veggies - prunes or prune juice is a good place to start (just think of them as medicine). Remember if you've added a fiber supplement like psyllium you MUST take it with lots of fluids or it can have the opposite effect. There are lots of OTC laxatives but Miralax is one that our doctors recommended post surgery, it's gentle and can be taken indefinitely if needed.

And do try to do your rehab exercises and walk as much as possible, you need to work that hip!
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Reply to cwillie
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our doctor has my wife on Metamucil but we buy Sam's Member's Mark Fiber Capsules, (100% natural psyllium fiber) 5 capsules per day to start.  we don't like the powder.
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