I start this story of my hip resurfacing from the hospital room the day after
my surgery. The road to this point was longer and more difficult than I had
initially envisioned, and I felt that others might benefit from some of my
experiences, as I have benefited from reading the input from others on this
excellent site.
First, a little background: I an a 66 years old – long in the tooth for most
resurfacings! But, sports and an active lifestyle have been an important part of
my life for as long as I can remember and my goal was to maintain this activity
level. Tennis in particular is my passion, and I compete regularly in singles
tournaments and league play. When not playing tennis, I ride my road bike, play
racquetball and enjoy walking & hiking. Therefore, when I experienced what I
thought was a groin pull in March of 2009, I was distressed that I had to layoff
these activities, but I figured the injury would heal with rest. Unfortunately,
it didn't. I wrapped my groin and started taking more ibuprofen but the problem
just kept getting worse. Finally, I went to my local orthopod and he confirmed
the diagnosis: arthritis of the right hip with bone on bone contact. He
basically told me to continue going as long as I could, then come back and have
a hip replacement.
After the diagnosis, I felt that I would have a year or two until surgery, so I
just upped my dosage of anti-inflammatory and pressed on. Unfortunately, even
going to prescription strength Mobic proved inadequate, and by November of 2009
I couldn't compete at all. Something needed to be done.
CHOOSING A PROCEDURE & FINDING A DOCTOR
When I first realized that a hip replacement was inevitable, I rather naively
believed that technology had improved to a point where hip replacements were
more or less routine and recovery to full mobility would be quick and easy.
However, as I researched the various procedures, it soon became apparent to me
that this was major surgery and there were many options, procedures, devices and
other medical decisions that had to be made, and they couldn't be made in a
rush. So I backed off my initial timeline and started exploring the options,
particularly resurfacing vs. THR. A good tennis player and friend had one of the
first BHRs here in NC when it was still experimental, and he had great results.
So, that was my first area of interest and subsequent research led me to this
helpful site. After studying this site and comparing the procedures, it seemed
clear to me that if I wanted to return to my active lifestyle, resurfacing was
the way to go.
Unfortunately, finding a doctor to do the resurfacing proved difficult. There
were no doctors in the Charlotte, NC area who were on the website referral list,
so I made an appointment at OrthoCarolina, the largest orthopedic group in
Charlotte. The first doctor I saw said he did no resurfacings on anyone over 55,
and even then, they represented only a small number of his total hip operations,
so I moved on. He did suggest another doctor in the group who might do it, so I
made an appointment with him. Unfortunately, the soonest I could get in was in
about 2 months. In the meanwhile, I went to another orthopedic group only to
discover that they did no resurfacings whatsoever.
Given the difficulty finding a surgeon locally, I called Dr Gross in Columbia,
SC which is only about 90 miles south of Charlotte. Dr. Gross said he would do
the procedure but that he did not accept Medicare, so that put him out.
Eventually I met with the second doctor from OthoCarolina, Dr. John Masonis, who
agreed to do either the resurfacing or a THR. He had been involved in a
resurfacing trial and estimated he had done over 100 procedures. I would have
preferred a doctor who was really "into" resurfacing, but he was a doctor with a
good reputation who had been recommended to me by several other athletes who had
their hips/knees operated on. Surgery was set for May 17, 2010.
I started getting cold feet as the surgery date drew near. I had stopped those
activities that were really bothering my hip in November, so not surprisingly,
by May the pain had lessened and I started second guessing my decision to go
ahead with this major surgery. But, I tried a couple sets of tennis and a golf
round the week before the surgery, and all the pain returned, so my conviction
returned as well.
SURGERY AND HOSPITAL
I had the first scheduled surgery time which supposedly is good, but I was not
excited to be on the road to the hospital at 4:30 a.m. for the 5:00 a.m. show.
But once I got over this obstacle, I was admitted quickly and sent to prep right
away. Certainly better than sitting around and waiting. In surgery prep they
started the antibiotic IVs and completed the other preliminaries. The
anesthesiologist stopped by to brief me on the spinal I would get. He told me
that I would be given a mild anesthetic which would enable me to be awake enough
to sit up for the spinal, but groggy enough that I wouldn't remember it. It
worked liked a charm. I don't remember the spinal, the catheter or the operation
at all, and I awoke in the recovery room with the operation complete. Shortly
thereafter I was wheeled to my room…..total time from prep to room: about 3 ½
hours. The doctor chose an anterior incision, so I had a long scar running up
the top of thigh to just above my hip bone. I also had a blood drain attached
and it drained for about 3 days.
I stayed in bed the rest of the day. Dilaudid was hooked up to my IV and could
be administered on demand by pressing a button. Initially, I tried to limit use
to one shot every other hour but the nurses assured me that it could be
administered more frequently. The first night was not very restful with the
nurses making frequent visits. Also, I was trying to sleep on my back, the
pressure cuffs where inflating periodically on my legs (to prevent clots) and I
had a bad case of night sweats….all pretty normal stuff. The next day I started
PT, learning to walk with crutches. The second night was better as the nurses
cut down on visits, I could sleep on my side and I was more generous with the
Dilaudid applications. The night sweats were still bad, however.
After some morning PT on the third day, I was released from the hospital and
headed home around noon. Since I live alone, my daughter arrived to help out for
the rest of the week. You're pretty helpless your first days back so a helper is
absolutely essential.
RECOVERY
My recovery was complicated by two factors: first, the doctor's orders dictated
no weight bearing for the first two weeks and 50% weight bearing for the second
two weeks. The second factor was that I live alone, and my daughter had to
return to work after the first week. While many friends provided food and ran
errands, and my sweetheart came over after work every day to make dinner, I was
nevertheless on my own during the day. I soon realized how difficult it was to
do everyday tasks when you are on crutches and one leg. Like, how do you carry
your morning coffee from the pot to the dining room table? Also, my bedroom is
on the second floor of the house and I had no downstairs alternatives.
In order to cope with life on my own during the day, I developed a few
techniques which I found helpful. My daughter bought a metal basked which
affixed to the walker so I had a way to transport articles and food short
distances around the lower level of the house. For getting up and down stairs
with the crutches, I found a large canvas bag which I could hang around my neck
to carry things I needed upstairs while still having my hands free for the
crutches/banister. I also took home a urine collection bottle from the hospital,
so I didn't have to go all the way to the bathroom when I had to go in the
night. Unfortunately, I then had to use my around-the-neck-bag to transport the
urine the next day to the toilet - not a very pleasant experience - but I guess
you do what you have to do.
I was somewhat confused by the non-weight bearing orders, given that all I have
read on this site indicates that most of the BHR patients are weight bearing
immediately. I tried to get a clarification on this from the doctor but the only
explanation was that this was “his protocol.” Everybody says “listen to your
doctor” so I tried to be compliant. I had regular visits from a PT, but given
the restrictions, all we could do is practice going up and down stairs and going
for walks with the crutches.
When I first got home, I was taking Percocet for pain. While it was helpful, it
gave me constipation that was resistant to all over the counter medication. I
tried them all: Citrocell, Ex Lax, stool softeners, Milk of Magnesia. Finally,
after a week, the pain from the constipation was worse than the hip pain, so I
stopped the Percocet completely, and 12 hours later, all was well.
I replaced the Percocet with Tylenol, but as week 2 wore on, the pain lessened
to a point where I would take the pills only once or twice a day. By the end of
week two I could tell that healing was well underway. I didn't need to take any
Tylenol, the night sweats were significantly reduced and I was able to walk
increasing distances with my crutches. I started weaning myself onto one crutch
while indoors but maintained both crutches for outdoor walking to at least
attempt to comply with the doctor's directive. The biggest problem at this point
was terminal boredom and cabin fever, although I was able to get out
periodically. It gave me new empathy for those who are shut-in permanently!
My doctor used the anterior incision procedure and then used internal stitches
and glue to seal the incision. Thus there were no staples to remove and I was
able to shower early on in my recovery. Healing of the wound was fine and
without pain, as if often not the case with staples.
By week 4 I was walking comfortably with one crutch, was able to get to the pool
in the neighborhood for some water exercise, and was practicing getting in and
out of my car. Since the surgery was on my right leg, I had to be sure I have
enough strength in the leg to lift the foot from the accelerator to the brake.
Fortunately, in my car the pedals are close together, and by taking off my
sandals, my heel moved smoothly to the brake. I eventually got to a point where
I was comfortable driving around the neighborhood and to the local grocery
store. Just this small measure of freedom was exhilarating!
By the end of week 4 I was off the Coumadin( and back on beer!) and was walking
with only a cane. I was frustrated by an inability to get clarifying information
of what I could and could not do under the “50% weight bearing limit” so I took
it upon myself to proceed at a pace I felt comfortable with.. On my 4 weeks
anniversary I went to the cane on and off and felt comfortable although still
limping.
My 4 week checkup with the doctor went fine. The x-rays all showed normal, and I
was basically cleared to do anything I wanted to do. So, I am dedicating the
rest of this month and next to regaining the muscle strength I have lost, losing
my limp and regaining some conditioning. At this stage, I'd say my progress has
been good and I am cautiously optimistic. I don't have pain in the hip but I
still have a pronounced limp and major range of motion problems. I had to have a
friend help with put on my sock for my first trip to the sport center. My goal
is to return to the tennis court by late Aug./early Sept. and to be competitive
by Oct. I'll keep this site posted.
In closing, I just wanted to compliment this site for the information and
support it has give me over this entire process. It was most informative and
helpful. If I can give back to anyone something more than I have already
written, please don't hesitate to drop me an email at rshipman3@carolina.rr.com
