Hip Resurfacing News

Smith & Nephew's strong profits beat expectations
February 2010

Smith & Nephew (S&N), the hips-and-knees maker, posted higher profits in the final quarter of last year after the replacement joints market stabilized.

The market suffered during the recession, but started to recover in the second half.

Traditional hip and knee ranges, like its Legion knee, did well, particularly in the US, while products designed for younger, more active patients, such as the bone-sparing Birmingham Hip Resurfacing System, were weak.

Younger patients were more likely to put off surgery than retirees because they did not want to take time off work or balked at the cost.

"Our largest business, orthopaedics, saw a good finish to a tough year," said chief executive David Illingworth. "Market conditions were a little less difficult than in the first half."

He said it’s too early to say when patients who deferred operations might have them done, and S&N is struggling to push through price increases as governments and private clients have tightened their budgets. But Illingworth was hopeful that the $12bn  global market for replacement joints would improve, with consumer confidence returning and unemployment now falling.

S&N expects revenues in orthopaedics to grow at the market rate this year after lagging in 2009.

Profits before tax rose to $175m in the fourth quarter from $162m a year earlier, with revenues 11 per cent higher at $1.07bn, helped by strong sales at the wound management division.

Analysts and investors welcomed the results, and the shares closed up 4.3 per cent at 660p.

Antibiotic Prophylaxis for Bacteremia in Patients with Joint Replacements by AAOS

February 2009 American Academy of Orthopaedic Surgeons

READ COMPLETE ARTICLE BY CLICKING HERE

This statement provides recommendations to supplement practitioners in their clinical judgment regarding antibiotic prophylaxis for patients with a joint prosthesis. It is not intended as the standard of care nor as a substitute for clinical judgment as it is impossible to make recommendations for all conceivable clinical situations in which bacteremias may occur. The treating clinician is ultimately responsible for making treatment recommendations for his/her patients based on the clinician’s professional judgment.

Any perceived potential benefit of antibiotic prophylaxis must be weighed against the known risks of antibiotic toxicity, allergy, and development, selection and transmission of microbial resistance. Practitioners must exercise their own clinical judgment in determining whether or not antibiotic prophylaxis is appropriate.

More than 1,000,000 total joint arthroplasties are performed annually in the United States, of which approximately 7 percent are revision procedures.1 Deep infections of total joint replacements usually result in failure of the initial operation and the need for extensive revision, treatment and cost. Due to the use of perioperative antibiotic prophylaxis and other technical advances, deep infection occurring in the immediate postoperative period resulting from intraoperative contamination has been markedly reduced in the past 20 years...

...Patients with joint replacements who are having invasive procedures or who have other infections are at increased risk of hematogenous seeding of their prosthesis. Antibiotic prophylaxis may be considered, for those patients who have had previous prosthetic joint infections, and for those with other conditions that may predispose the patient to infection. There is evidence that some immunocompromised patients with total joint replacements may be at higher risk for hematogenous infections. However, patients with pins, plates and screws, or other orthopaedic hardware that is not within a synovial joint are not at increased risk for hematogenous seeding by microorganisms...

...Given the potential adverse outcomes and cost of treating an infected joint replacement, the AAOS recommends that clinicians consider antibiotic prophylaxis for all total joint replacement patients prior to any invasive procedure that may cause bacteremia.

Dr. Barry Tannen (bilateral HR 12/18/08)

I am a 52 year old physician who had bilateral hip resurfacing with Dr. Su on December 18th 2008 at the Hospital for Special Surgery in New York. I had been diagnosed with moderate to severe osteoarthritis 3 years earlier and increasingly had to deal with the pain and limitations that this brought on. I am an avid tennis player who competes locally and in USTA tournaments and obviously my tennis game was greatly impacted, but so were ordinary activities of daily living such as tying shoelaces, etc.

My experience with Dr. Su, his staff, and the entire team at the Hospital for Special Surgery was nothing short of amazing. I left the hospital 6 days after surgery and was discharged to my 2 story home. My wife was terrified that I would be climbing stairs immediately, but it was no problem. I started outpatient physical therapy one week after being home, returned to work 4 weeks after surgery, and started playing doubles tennis in 8 weeks, singles in 12.

I feel better than I have in at least 8 years, maybe longer. I enthusiastically recommend HR, and especially Dr. Su who is an amazing surgeon in my opinion.

Emanuel captures tennis tourney

Temple Emanuel captured the recent Jewish Athletic Group (JAG) Tennis Tournament. Barry Tannen (left) and Mike Spivak hoisted their trophy. The duo overcame the father-son team of Richard and David Fischer of Cong. M’kor Shalom in the finals. Over 30 area players representing many area men’s clubs participated in this year’s event.

Hello, I am a 37 year old former (and hopefully again in the future) athlete who recently had my right hip resurfaced with Dr. Gross in Columbia, SC, having traveled from my home in Charleston, WV for the procedure. My story and this information is for those who are scheduled for or may be considering the procedure, I would like to pass along as much information and personal experience as possible for your benefit, as so many others have done on this wonderful website.

Would like to first summarize that so far I am completely satisfied and recommend the procedure 100%. Also, I wholeheartedly recommend Dr. Gross and his wonderful practice.

As of today, Aug 15th, 2009, I am almost to the 5 week mark post-op. From the moment I woke up from the surgery, I have not had any pain in my hip more than what feels like a muscle stretching or general tightness / stiffness. There is no trace of arthritic or bone pain. I'm not sure I had any expectiations either way, as I read lots of stories both ways - people that had problems and those that sailed through. It is hard to believe that there could be no pain, not with all the wrenching around that goes on in there. Dr Gross has videos on his website showing the procedure (ha, I couldn't bring myself to watch them until AFTER the surgery) - your hip is sliced through, dislocated, and then subjected to medieval torture devices and power tools! How can that not hurt later? But, for me, it doesn't.

I have to say, I was feeling very sketchy in the pre-op room where they start to work on you. Needles and pills everywhere, people coming and going, doing weird things to me. And then, wheeled into the operating room. Just like on TV, with everybody in masks, and the overhead light the size of one of those old satellite dishes. I don't remember much, but even in a sedated mode, it was scary. Then that's it – I was out. I have heard they ask you to count or whatever, but as far as I can remember, they snuck up on me.

The first 24 hours after surgery were the hardest, but even that was not too bad. Even had it been worse, there's not a lot of remembering due to the pain meds and the lingering sedation. I was told Dr. Gross does five surgeries a day, twice a week. Mine was on a Monday, at 9 am. That made me second in line that day. In my mind, that was great - that way he got to wake up and practice on someone else before hacking on me (ha). Seriously, though, I wonder about these things. Doctors are people too, I want them to have their A game when it's me under there. That was really my only question during my one and only office visit – "hey, Doc, you're not going to go out and get wasted the night before my surgery, right?" He said he wouldn't, just for me. Sweet.

Speaking of pain meds, they gave me vicodin that first day and I think I took my prescription two or two and a half more days after that. As I said, there never was any real pain from the surgery, but they kept saying "stay on top of the pain, if you get behind, it's harder to catch up". Well, at that time, I didn't know if some big pain wave was coming or not, so I took the meds. I really don't think I needed it. Hard to tell. The only thing that hurt was when they took the catheter out on the day after surgery. That was bad. Sort of like a vacuum cleaner hose had been up there all along, and got removed along with the catheter hose. There was this weird suction feeling along with the discomfort.

A physical therapist (PT) came and helped me walk that 1st afternoon of my surgery (a mere few hours after the surgery!). The walk was with crutches, but the crutches were for balance, not to take weight off the hip. I have read that they want you to put weight on the hip to help press-fit the devices into their respective slots. The most difficult part was keeping balance considering the lingering sedation. Mostly, though, I just laid there in the bed. The PT also said to keep moving my feet and legs. She gave some prescribed motions to do.

Providence Northeast Hospital is 1st class. Everyone that I came in contact with there was super. Also the food was not too bad. The hospital is yet part of Dr. Gross's well-established system that is wonderful.

I was told to plan for two nights in the hospital, but it ended up only being one. That first night sucked. The main reason is that it was hard to sleep with the O2 / heart monitor beeping all the time and the nurse coming in every two hours. Also, my heart rate kept going down too low, which would set off an alarm. I don't know what was worse, the alarm, or me wondering how bad it is to have a heartbeat low enough to set off the alarm. The low heartbeat was surmised to be me being in relatively good cardiovascular shape, along with lingering sedation effects. I still hardly slept at all.

At the consultation appointment prior to surgery, they asked (made?) me to buy this cold pack machine that is basically a little igloo cooler filled with ice water, attached to a pump, some hoses, and a bandage. I mention this because had I known it was going to cost so much out of pocket for the thing, I could have purchased one on eBay, brought it with me, and saved some $$. But I wasn't aware I would need this prior to the surgery and therefore didn't know to ask if I could have brought my own. Anyway, cold water circulates through the bandage. I was told to bring it to the hospital. After the surgery, they kept it on my hip and leg, circulating cold water constantly. When I left the hospital, it was sent with me, and I used it every 2 hours or so, including in the car on the way home. I think that was a big help to my quick recovery, by minimizing the swelling. I have read about people with bad swelling problems; I had none.

The next day, Dr. Gross stopped by my hospital room. He asked a few questions, and advised that I could leave later that day. I was all for that. Also, a PT came by and explained some of the disabled person tools like the sock put-on device, followed by another walk. I was able to stand and take a shower. I got a little dizzy in there, which I believe was due to the heat and lingering sedation and pain meds. Fearing possible fainting, I had to get out and sit on the toilet. Later that afternoon, I was discharged from the hospital. They make you ride a wheel chair out, but I could have definitely crutched out on my own power.

The second night, which was in a hotel, also sucked. The main problem was the whole sleeping on your back thing. The main mode of sleeping the first few nights is on your back with a pillow between your legs. You are allowed to turn over on either side, as long as the pillow stays between your legs. Well obviously, I wasn't going to lie on the operated side, and while lying on the good side, I was not confident in the ability of the operated side/leg to stay under control. That leaves the back-lying position. There's only so long you can stay in one position before muscles get tight, and general discomfort sets in. It was not a good night. In general, the confidence of sleeping on the good side grew, and by 7-10 days, I was in a routine of moving from back sleeping to the good side every 1-3 hours, with good sleep in between. It helped me to sleep in a recliner for a day or two before moving to my regular bed. One other thing that surprised me was that I had to pee every 1-3 hours through out the night. I surmise that it was a side effect of the catheter. That very slowly went away up through the 3 week mark.

Wanted to mention that that 2nd night I had a fever that got up to 101. I was somewhat nervous about that. It's hard to know in the moment if it's just temporary (it was), or if it's going to get worse. Make sure you have a thermometer with you.

On the 3rd day post-op, my wife drove me and our 2 year old daughter on the 6 hour drive back to WV. We have a CR-V, and I sat in the back seat with the front passenger seat reclined all the way back to give my legs room to stretch out. Could definitely have made it sitting in the front, it was just even better back there. The ice pack has a hand pump bulb thing, which I used to keep the cold circulating on my hip and leg. We stopped 2-3 times so I could get out and walk.

My walking progressed roughly as follows:
1->4 days - walking with crutches
5->20 days – walking with a cane or one crutch. Towards the end of that period, walked with a limp when not using the cane.
21 days -> now (34 days). Walking fine with zero assistance. Limp is almost completely gone.

Again, it seems crazy to me to walk, unassisted, with no limp, so soon. Most of the time, I have to keep reminding myself that I recently had hip surgery, lest I do too much too soon and risk damage to it. And really, my belief is that it would be hard to damage it, but I'm sure not going to chance it. Like on the stairs. I could walk up the stairs normally with no problems by 21 days. I catch myself taking two at a time on the way up (including with the operated leg!), like I used to do before the surgery, and have to slow down, since, who knows, that might not be good for it. Definitely one of the best gifts of the procedure is the "not-thinking-about-my-hip" mindset it allows, in contrast to before, where the pain when I walked consumed my attention.

Some background on my situation and events leading up to my resurfacing:

I am a former college basketball player, and have enjoyed continually playing basketball at a fairly high level up until this spring; when my hip pain finally forced me to stop. It began around 5 years ago as an occasional snap or click in there, and gradually progressed through tightness and stiffness to a slight limp in the past 2-3 years (people would ask "why are you limping?", and I didn't even realize I was). Couldn't pinpoint what it was, but last spring I knew something was really wrong. An X-ray showed "severe degenerative changes" (loss of spacing superiorly, osteophytosis), basically arthritis. There's not much positive in those adjectives "severe" and "degenerative". Was pretty crushed by that news.

Began my research on problems of the hip. Purchased a couple of books and eventually found Surface Hippy. Visited a recommended orthopedic surgeon here in Charleston, WV. He diagnosed arthritis caused by congenital (birth defect) hip dysplasia in both hips and recommended a total hip replacement in the really bad one, noting that the other one will require one in the future. There's another 30-something-year-old guy in my office with one of those and he's not allowed to run on it. I mentioned hip resurfacing to this surgeon and he noted that he didn't recommend it due to risk of femoral fracture and un-proven track record. OK, well, I have to think about this.

Was able to play basketball this past winter. Would basically take my daily Celebrex and supplement it with two ibuprofen before going out to play. By March, people were feeling sorry for me and saying I should stop. I would limp-run up and down the court. The weird thing was though, is that when I quit for good in April, it REALLY got bad. It went from a manageable limp in April to a "I can barely walk 2 blocks" severe limp by May. It was like the running and exercise had been keeping it loose. Got a cane; it was the only way I could get from my cubicle to the bathroom. Weirdly, though, I could still play golf. Would ride the cart up to my ball, cane my way the rest of the way, and then hit the ball. Lost 2-3 clubs worth of distance (due to not being able to push off with my right hip), but oddly, it didn't hurt my scoring. I theorize that I was now playing old man golf, where it's hard to lose any balls if you can't hit it far enough to get into trouble, ha!

Meanwhile, the more I researched re-surfacing, the more it was crystal-clear obvious that it was the thing for me. Active, young, good-looking (oh, well, 2 out of 3 ain't bad). It seems utterly ridiculous to cut off the top of your femur when there are other alternatives. There are so many other benefits, but if you're reading this, you're probably already educated as to those, so no wasting time re-preaching. How could I find out if there were any few orthopedic surgeons in this area that would do resurfacing? Call each and ask? I don't know, I guess I could have done that. Found one that was on the Birmingham Hip website and visited him. He had only done 8 procedures. I believe it is important to have someone with lots of experience at this. That's one thing that is so incredibly helpful about Surfacehippy - the doctor experience data. I cross referenced my insurance coverage with doctors that had significant experience (at least 100 procedures) within a 2 state radius and that gave me a manageable list to choose from. Ended up going for the high end of experience, which was Dr. Gross, and believe that was the very best choice I could have made. Will not hesitate to return to him when my other hip gives out. Definitely hope it is later rather than sooner, but I now have no fear what-so-ever about the procedure.

Wanted to also share some information about the financial end of things. Below is what I have experienced so far. I have Aetna Open Access (EPO) insurance.

1. At the doctor's office prior to my surgery, they suggested I buy the below items, but I am unsure whether I could have refused at the time:
a. Crutches (insurance doesn't pay for all of it) ~$15 copay with my insurance (you can bring your own if you have them, eliminating the need to purchase in the office)
b. Disabled person care package (grabber thing, long shoe horn, sock putter-on thing, and long sponge on a stick) $60
c. Polar ice pack. Mine was a Polar Care 300 model manufacturered by the Breg Company. It was $250 in the doctor's office. The reason I list it here is that these are on sale on Ebay for $70-$100. I would have bought mine there if I would have known.

2. Dr. Gross's office requires a pre-payment of $1,200 which is for having a Nurse Practitioner present during the surgery; they said most insurance companies wouldn't cover that. I paid that, and am still not sure if my insurance will cover that or not. There is also a prepayment of $1,000 for some people, if their insurance won't cover "minimally invasive technique". I did not have to pay that one.

3. So far, my insurance website says they've been billed a little over $51K. Thank goodness for insurance, right?! That is definitely a lot of money, but to me, it would have been worth paying whatever.

In closing, I am less psyched about getting back on the basketball court than I was before the surgery. It may have something to do with the thrill of just walking painfree being plenty of satisfying exercise at the moment; also it's summertime and golf season. Speaking of golf, I got the OK from Dr Gross's office to return to the links at about the 5 week mark, so that will keep me busy until winter. Knowing myself I'll be back on that court, though. Sweet!

That's all I have as of now, best of luck to you with your decision, and your surgery. You are on the right path!

I was not able to find anyone in Atlanta with a good track record doing resurfacings -- so a very big "Thank You" to SurfaceHippy.info and the fellow surface hippies on this site. 

I started having unbearable pain around November of 2008. I called Dr. Gross's office in December after speaking with Mike from this site who had a bilateral with Dr. Gross back in June. When I hung up with Mike I called Dr. Gross's office and on the first call had tentatively scheduled the surgery dates pending me getting the package together.

I got the package put together according to the protocol on Dr. Gross's website and Dr. Gross called me to confirm I was a candidate. I drove to Columbia from Atlanta on a Friday for my pre-op consultation and met with Lee Webb and Dr. Gross (about 3-3.5hr drive). I drove back to Columbia the following Sunday (Super Bowl Sunday '09) and got to the Courtyard Marriott in time to watch the game and get a good nights rest before Monday's surgery.

Monday was very smooth at Providence NE. I went in a bit early and was in pre-op in no time. The whole pre-op team was a lot of fun, the anesthesia team, the nurses... it was a positive environment. The surgery was the blink-of-an-eye kind of thing where I felt like I closed my eyes for a moment and then I am coming to in post-op with the post-op nurses.... to whom I am sure I probably owe an apology for some reason... and then after a while I am being wheeled up to the room for recovery. I was late in the day so the following morning the Physical Therapy team had me doing the exercises, and walking the hall for the first time on crutches. Then the Occupational Therapist showed me how to use the ADL (aid to daily living) kit. Those OT/PT folks were a lot of fun and very helpful to get me started on the way to recovery. The floor nurses were very helpful and good people, one of whom is a fellow Dr. Gross resurfacer!

Wednesday was basically a repeat of Monday. They wheeled me down to pre-op and started with the prep and again it was a very positive experience with the anesthesia team and the nurses and "vampirella" the vampire lady who loved my veins. Then in what seemed like a few moments I was coming to in post-op -- and probably saying things I shouldn't have been -- and then I was wheeled back up to the room. The PT/OT team had me exercising and up and walking on Thursday and then we did a little group PT session and practiced stairs on crutches and walked the hall a couple of times. I was able to shower on Thursday evening, standing up.

Friday after breakfast I did a little PT and then was discharged by 11am. I rode home to Atlanta and got out a couple of times to walk around a rest stop and stretch a bit.

The one thing I would do differently is wear the provided ice packs on the way home. It was cold the week I was in the hospital and some nights that ice felt pretty cold so I was not to fond of the ice. So I didn't use the ice on the way home.

Well I got very swollen. This is probably the one thing I was not prepared for from doing my research. Dr. Gross told me I would probably swell up and I didn't really know I would swell up so bad. I believe it may be normal, maybe not, but the entire length of my legs were enormously swollen starting on that Friday and increased through Sunday. So Saturday, Sunday and part of Monday I spent with legs elevated by a couple of sofa cushions with the ice packs running, laying on my back (for the most of the time) working to get the swelling down. I called Lee Webb on Sunday and she told me to elevate and ice and that the swelling was probably at its worst on that particular day -- she was right. On Monday (5 days post-op) the swelling had already started to decrease rapidly and I was feeling so much better.

Crutches: I was doing my exercises as prescribed and walking on two crutches until 9 days post-op when I felt like the crutches were holding me back at that point. I had shifted to one crutch at 8 days post op and it was a bit awkward so I decided to get a cane.

Cane: I shifted to a cane 9 days post-op and it felt more natural than the crutches. I was glad to be rid of them.

Ten days post-op: Armed with a cane, I went to the Kiwanis Club's pancake breakfast fundraiser and was amazed how well I could stand up in a very long pancake breakfast line inching around an elementary school cafeteria. I am sure most folks with hip pain can relate -- this would not have been possible pre-surgery. I would have had to sit down every two or three minutes to ease the pain. This is when it clicked with me how well the surgery/recovery was going.

Then I walked around Wal-Mart behind a shopping cart and picked up a couple of items. Then we stopped by Lowe's for a few things and I was able to walk fine with the cane. I just had to take it easy and slow getting in and out of the car so as not to break the rules prescribed by the PT team.

Eleven days post-op: Went to church. Walked in with a cane and everyone was wowed that I had bilateral hip surgery and was walking so well. I have to admit I have been pretty wowed by how well everything has gone -- and I thank God for all of it. And I thank Pat and all the helpful people on the surface hippy website and everyone on Dr. Gross's staff that were so welcoming and hospitable, and all of the folks at Providence NE hospital that were part of the process.

Thirteen days post-op: Getting in an out of the car is getting easier. I still have this pain that last about 20 seconds when I stand up after having been seated for a prolonged period of time. I believe this will pass with time and it is so minor compared to the pre-op pain I was having.

I am 34 yrs. old and am in pretty good physical shape. It turns out I had worn a large hole on my right femoral head approximately 3 cubic centimeters. Dr. Gross told me that if I had waited much longer I would have had to go with the THR -- thank God I called in time! He was able to graft the hole and "achieve an excellent press fit."

I hope writing this will help someone else benefit from my experience – since I received so much valuable help from folks on this site. Let me know if I can help with anything.

Thank you,

Tim

Bilateral - Dr. Gross
2-2-09 (R) 2-4-09 (L)
Biomet ReCap/Magnum

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June 12, 2009

Today I am 128 days post-op. I have done so well that I have been quite slack on updating this beloved group where it all started for me. I have no pain whatsoever in the hips. The "clunking" is very few and far between nowadays. I have a 5,000 s.f.+ garden that I have been actively working in every evening without any pain at all. Yesterday I strolled easily up the middle of a long flight of concrete steps to enter a building (without touching the rails)! If that sounds like a miracle to you then you are a surface hippy or a potential surface hippy! I have been back in the gym at a low to moderate level of activity as I wait for the six months to pass. I feel wonderful !!! I could go on and on about the things I can do with ease...

When I read the Wall Street Journal article on last Thursday June 4th, 2009 "Doubts Raised Over New Type of Hip Surgery" by Anne Tergesen, I was a bit disappointed with the negative tone of the article. Naturally, I fall into the "perfect" candidate for the resurfacing being young with strong bones, but I have heard prevailing positive messages from "less-than-perfect" candidates on this site and other places.

I'm sure you know how these things work in word-of-mouth: the old rule of thumb in business is "a bad experience gets talked about 11 times where a good one gets talked about 3 times". I believe it is the same with online reviews and ratings -- many times we only make the effort to put the bad ratings and reviews up so as to help prevent anyone else from having a similar negative experience. With this in mind I believe hip resurfacing's strengths outweigh the weaknesses or we would have a considerably more negative feedback on this site and others.

I felt like the article's title and subtitles set a dominant negative tone and the positives of the article were mediocre in comparison. Oh well... That article is why I said I better log back in and keep folks updated a little better.

Please contact me if you have any questions about the surgery or Dr. Gross or anything else I may be able to help with. In my case it became "no news is great news!!!" over the last few months, but know that I remain happy to help wherever possible! Do not hesitate to contact me!!

Tim

>Nov. 1, 2009

I sit in Chennai 4 days post op on my right hip, Birmingham w/ Dr. Bose.  Today when I seem to have gotten past the pain bits and am actually looking at my gait.

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>Nov. 15, 2009

I am breaking my return trip from Chennai in Munich for 6 days (enjoying German beer, bread and brats!).  18 days post op and did an easy 2-hour bike around the city's parks today.  Leg still a bit long but coming around.
 
Thanks for your work on the website and support!
 
cheerz,
 
stuart

I just had a right hip resurfacing from Dr. Thomas Gross in Columbia, South Carolina and wanted to provide some step by step information that could help future recipients manage their trip, hospital experience and recovery process in a more knowledgeable manner.   I am a nurse and that may give me a little different perspective that may be useful.  Anything I mention is only a suggestion and may not work for everyone, but the more information you have the better decisions you can make for yourself.   Some of this information will be applicable to people traveling to other Physicians and locations as well.

Airline Travel:  When booking your flight, talk with a reservations person and tell them about your surgery and need for a bulkhead seat for all legs of your return flight.  That will give you the easiest seats to get into and out of with crutches and the most leg room to reduce the flexion of your hip.  If you book these seats yourself you can get bumped from them for “priority” passengers who need them, as an online booking will not ID you as a priority person.  Be sure to confirm these seats when you arrive at the airport for a return flight.  Also, when you check in for your return flight, ask for a voucher for a wheelchair to meet you at your layover and give this to the flight attendant in the plane.  Another possibility is to use the “golf cart” transporters, but they may be difficult to get into and out of.

Housing & Transportation:  I had my procedure on Wednesday (hospital check in 9:30 am), so with a Tuesday morning (10:30 am) office appointment with Dr. Gross we arrived by plane Monday evening.  We stayed at and recommend the Comfort Inn on Bush River Road Phone (#803-798-5101).   This is for several reasons:  1) They have free shuttle service from the airport, 2) will take you back to the airport or car rental facility the next morning (if you do not rent a car upon arrival), 3) have very nice comfortable beds, 4) will come pick you up at Providence Northeast Hospital and bring you back to the hotel on your discharge day, 5) have ADA handicap rooms close to the front desk with elevated toilets (so you won't need a raised toilet in Columbia) and walkers in the shower (much safer than crutches),  and 6) shuttle you to the airport the following day for your flight home.  They also have an accommodative staff, as Vijay and Nick were very helpful, the usual free breakfast and wireless internet service.  My wife traveled with me and she slept in a fold out bed in the hospital, so we only needed a hotel before and after the surgery. 

Car Rental: We used Enterprise for car rental as their prices were competitive and they had a drop-off location Northeast and Southwest of the hospital where you can leave the car the day of surgery and they will take you to the hospital for check-in.  Be sure to clarify this arrangement when you rent the car.  That way you really only need to rent a car for one 24 hour period, to get to the doctors office, drive around for the day and get to the hospital the following day.   Your doctor office visit and surgery time may require a different schedule.

Office visit with Dr. Gross:  Give yourself 2 to 3 hours as it is a slow process.  The office is about 15 minutes from the hotel.  Be sure to write down all of the questions that you want to ask or you will inevitably forget some.  I expected Dr.  Gross to be all business with the number of cases he does and rush through the office check.  Instead, he was very personable and went out of his way to explain things clearly, showing models of the components and making sure that every question was answered completely.  He showed no inclination to leave the room until I was completely satisfied and he demonstrated his concern for his patients in other ways as well.  This is a big plus on top of his knowledge and skill.

Pre-Op in the hospital:  After checking you in, they will start your IV and draw blood for pre-op testing.   They will try to draw blood from the IV so you only receive one stick.  If the person starting your IV causes a lot of pain, ask for someone else to make the second attempt.   The IV should not hurt that much and some people are just better than others.  Request that they do not start the IV in you hand, wrist or bend of your arm as these areas will be painful and troublesome during your stay.

When they use hair clippers on your leg and butt (guys), be sure you  brush off all of the hair that is stuck to your body and they change the sheets on the stretcher so you don't take loose hair into the OR room for your surgery.  They will also put a blood pressure cuff on your arm, oxygen sensor on your finger and heart monitor patches on your chest.

In the OR:  After hooking you up to heart and oxygen monitors they will have you sit forward on the OR table and give you an injection in your back consisting of several medications.  This will be the spinal anesthesia that will numb you below your belly button for the surgery and reduce your surgical pain for 24 to 36 hours after the surgery.  I feel like this is safer than general anesthesia as is has the potential for fewer serious complications, and is one of the reasons I chose Dr. Gross.  This shot will just be mildly uncomfortable.  After you lay back down you may feel an odd sensation as they insert the foley catheter into your bladder, but you will be pretty well numb by this time.  Shortly afterwards they will give you drugs to put you to sleep, but will allow you to breath on your own.  You will not even know the surgery is going on.

In the Recovery Room:  When you wake up, they will be watching your vital signs closely for an hour or so until you go to your room.  You are going to feel some degree of numbness below the navel which is normal and you will have minimal pain in your hip area.  You will have a foley catheter in your bladder, this will be uncomfortable, but will allow you to urinate freely so they can watch your fluid status.   You will also have leggings that will inflate and deflate.  This is to help prevent blood clots from forming as your muscles are not working normally due to the spinal anesthesia.  They are a bit annoying but will be on for the first day and night, then off the next day.  From this point forward you have three leg rules-  1) do not move your leg to the midline (centerline) of your body, 2) do not rotate your toes inward, and 3) do not flex your hip more than 90 degrees.  These are essential as they help to prevent a dislocation of your new hip joint (very bad). 

In your room:  All of the rooms are private, have a fold out bed, and have wireless internet access so bring your computer to help pass the time.  The low level of pain is from the long acting narcotic in the spinal anesthesia and the oral and injectable drugs given by Dr. Gross.  He really does an excellent job here.  Saying this, one of the more common side effects is nausea.  Just drink water first and give it some time in your stomach.  Continue drinking plenty of fluids over the next few days as it will be very important.   Start eating slowly and don't chow down your first meal.  You may want to ask for an anti-nausea pill to prevent this from developing, or at the first sensations you have of feeling sick to your stomach, ask for one right away. 

The staff is good, as they take care of patients with this surgery frequently and you will have a nurse and a nursing assistant working with you.  They work two 12 hour shifts going from 7 to 7.  You will wake up with the cool pad over your surgical area that you picked up at Dr. Gross's office.  This is your best friend and is part of the pain control.  Use it regularly for the next 1 – 2 weeks.  The ice in the bucket needs to be changed about every 4-5 hours or it melts and the pad warms up.  Sometimes the staff forgets to change it, so if the pad feels warm to you, ring the call bell and they will be happy to fill it up.  If your surgery is done before 1 o'clock or so you may have Physical Therapy come and begin your exercises and walking the same day as surgery.   You will need to follow their directions at home, so follow their instructions carefully as their information is critical to your recovery.

Guys, your legs will be coated with a surgical soap that has glued all of your leg hair to your skin.  This will become itchy and uncomfortable, especially during the night.  The staff has a white cream that will melt the soap and free up your hair.  If you have a significant other staying with you have them use this with a wash cloth on your legs.  If you are alone, have the staff do this.  Trust me, you will be glad to do this.   

You will have the oxygen meter on your finger, this is to monitor your breathing in case the drugs in your spinal injection effect your breathing.  If the machine is beeping with every heart beat, ask them to turn the volume off as it is not necessary.   This noise will combine with other factors to keep you awake at night.   If your oxygen level drops the machine will sound an alarm and this is all that is necessary. 

Pain Medications:  The staff will regularly offer you Tylenol for you pain, take them.  They have basically no side effects and will be helpful.  There will be stronger pain medications for you as well that are related to morphine.  You want to take these stronger pain medications before the level of pain increases, or it will be difficult to reduce the pain.  Balance this out with not taking them when they are not necessary, as there are side effects that you do not want.  One of these is a slowing down of the bowels which are already affected by the spinal anesthesia. 

First Night:  We were awoken almost hourly after 1 am the first night, and I hope these steps will help minimize your sleep disruptions.  The staff will say that their job is to keep an eye on you and not necessarily let you get rest.  However, with some coaching you may be able to get them to minimize the wakeups and improve your care.  I strongly encourage you to ask your nurse to do the following:  at 10:00 pm when you have medications and vital signs due, have them refill your ice bucket at that time.  While taking your medications, firmly request that your nurse comes in to check you at the same time as the assistant gets your vital signs at 2:00 am and refills your ice.  Ask them to come in for the 6:00 am vital signs and ice refill when the phlebotomist comes in to take the early morning blood samples.  It was extremely annoying and unrestfull  when their visits were staggered.  Their excuse is that they need to check on you, but they can do this in a coordinated manner that provides better patient care.   

1^st Post-Op Day:  First thing in the morning they will take out your foley catheter.  It will hurt but only for a few moments.  Afterwards, you are going to feel like you need to urinate but it will just be a false sensation.  When you do pee, it will hurt again and feel difficult to get started.  You may also have some air burp out with the urine, which will resolve after a day or two.  This pain will decrease after a few more urinations and it will be normal in a few days.  Measure your urine (urinal for guys and hat for gals) for the staff who will be keeping track of this today.  I suggest you get up and go to the bathroom whenever you need to urinate as this movement is good for the body.  Get up only with help, as there is  an increased potential for falling and serious injury this soon after surgery.

Your hip and leg will still feel pretty good, I was amazed at how little it hurt.  Stay up in the chair as much as possible and follow the OT and PT instructions for your activity.  If you have work to do this is the day to get it done because the next couple of days will be more uncomfortable.   

Your digestive system and bowels are going to be messed up with the drugs you have received and this will be a problem for you over the next few days.  I did not follow everything here and my abdominal pain was much worse than my hip pain.  Don't minimize this complication.  Here are a number of suggestions that will help

(http://www.spine-health.com/treatment/back-surgery/preventing-constipation-after-back-surgery): 

·         Increase activity as soon as possible after surgery. Walking is an excellent way to help bodily functions return to normal, and also helps with healing from the surgery.

·         Limit use of narcotic medications (e.g. Vicodin, Tylenol #3, Darvocet, Percocet, Oxycontin) to just what is necessary for adequate pain control. Narcotics slow down bowel motility, leading to constipation. Consider switching to a non-narcotic pain reliever (such as regular Tylenol or extra strength Tylenol) for pain control shortly after surgery to reduce the risk of constipation.

·         Begin using a fiber laxative, stool softener, or combination product after surgery to reduce the risk of constipation, particularly if one has experienced constipation in the past.

·         Drink plenty of water and other non-caffeinated fluids (at least 40 oz per day), provided that the physician has not restricted fluid intake for another reason. Prune juice and apple cider (not apple juice) are also excellent natural laxatives.

·         Eat foods that are naturally high in fiber to stimulate the intestines. High-fiber foods include beans, whole grains and bran cereals, fresh fruits (such as watermelon, grapes), and vegetables (such as lettuce, carrots). Limiting foods that contribute to constipation is also a good idea, such as cheese, meat, and processed foods.

·         Eat small, frequent meals throughout the day, rather than large meals to aid in the digestive process. (Save some fruit for between the meals snacks)

Even with doing these things it may be until your 3^rd Post-OP day before you have a bowel movement. 

2^nd  Post-OP day:  Your hip is going to be more sore today, so utilize the stronger pain pills but only as needed.   Be up as much as you can in the chair, take a walk as often as you can, continue eating as before and drinking lots of water.  This was my most uncomfortable night, from abdominal cramping and pain, not the hip pain.  I did not follow all of the recommendations above and paid the price.  If you sleep on you back, put a couple of pillows under your legs to give you a little hip flexion to make it more comfortable.  If you sleep on your side, be sure to place a couple of pillows under your operative leg to elevate it and not allow this leg to approach the centerline of your body.

3^rd Post-OP day:  Your hip is going to feel stiff today, but don't let that slow down your exercises and walking.  These activities will loosen it up and help.  Other writers on this website have inferred about the difficulty of their first bowel movement and this is not to be underestimated.   Here are a couple of suggestions.  Sliding your underwear down to your thighs will keep your legs fairly close together and create more pain in the hip as you sit on the toilet.  For a more comfortable position, and to make it easier to lower yourself safely onto the seat, drop your underwear off of one leg completely so you can move your feet and knees further apart.  Find a comfortable position and try to relax, try not to strain, it will take some time and won't be pleasant.  If you feel light-headed lean back and let whoever is with you know so they can come into the bathroom with you at this point.  People have passed out and hurt themselves. 

Flight Home:  When checking in to return home, confirm your bulkhead seats.  Allow plenty of time for wheelchair travel and a full body search by the TSA people.   It is going to happen, so just accept it.  Some of the airplanes leaving Columbia will arrive at their destinations and park away from the terminals and lower the plains steps to the tarmac.  To prevent this, let the flight attendant know that you will need a ramp upon arrival, and they can make that arrangement.  They will not automatically put together a slow moving person on crutches with the need for a ramp. 

Home:  Pretty much continue what you have been doing.  If you start feeling like things are difficult, think of all of the young men and women that are returning from fighting in the middle east without legs.  Again, this information is from my personal experience (and hospital experience) and yours may be different.  I hope it will be of some help.

I had a RBHR by Dr. Brooks on February 25, 2009 at Euclid Hospital-Cleveland Clinic. It has been about 8 months since my surgery and I divided my experience into categories of chronological order. Before sharing my experience, I would like you to know that I am completely satisfied with the procedure and would recommend Dr. Brooks for anyone considering a hip resurfacing.

Background
I was diagnosed with arthritis in my right hip about 5 years before having surgery. At that time I was 46 years old, and was told that I need a hip replacement. I tried to maintain a high level of activity and control the pain with over the counter pain medicines. However, as the joint degenerated I modified my activities because of the hip pain and stiffness that would result. The degeneration of the joint was slow. People would ask why I was limping. I did not realize it because the slight limp became my normal gait. The limp and stiffness got worse overtime. About a year before my surgery, I could not walk more than a block or two before severely limping. My recreational activities were reduced and centered around weight lifting, golf, and the use of an elliptical trainer.

About a year before my surgery, a friend of mine was told he needed both hips replaced. I told him about Pat’s hip resurfacing website and we worked together to figure out the best approach. His hip pain was more severe than mine, and he beat me by about three months to getting an appointment with Dr. Brooks and having the surgery. I was able to observe his recovery before my surgery and that reduced some of my questions and anxiety.

I decided on a hip resurfacing because of my age and the level of activity that was possible after surgery. Once I felt comfortable in selecting hip resurfacing over a total hip replacement, the most important factor for me was to find a surgeon. I wanted a surgeon who has “seen it all” and did resurfacings on a regular basis. This website helped educate me (and my friend) and narrow down the search.

Initial Consult
I traveled about 180 miles from my home in Belle Vernon, PA to see Dr. Brooks. My initial consult was quite memorable. I drove 6 hours through lake-effect snow storm to get to the Cleveland Clinic Main Campus the night before my appointment. It is normally a 3-hour drive to Cleveland from Belle Vernon, PA.

Dr. Brooks took the time to answer all my questions and to explain the risks that were involved. As an engineer, I really liked Dr. Brooks’ knowledge of the biomechanics of the resurfaced joint. He was able to answer all of my “why” questions about the implant and resurfaced joint. At the initial consult, I met Phil Golnick, Dr. Brook’s Physicians Assistant. Phil was great – he patiently answered all my questions between the initial consult and my surgery, and the questions I had weeks after the surgery.

Surgery – 1st Day
The morning of my surgery, I was instructed to wash the right hip area with a scrub – something like a Phisohex. I liked the fact I was told to write NO on the left hip. I think that was for my own piece of mind – but some of the simplest things can be the most effective.

I don’t remember much of the operating room. When I transferred from the gurney to the operating table, I was asked to sit up and dangle my legs over the edge of the table. Looking around, the operating room reminded me of the PBS series Olde Yankee Workshop. Phil came up to me and held my shoulders and told me they were ready to start with the anesthetic. I looked down at the IV tube and saw a milky white fluid. I asked what it was, and was out before I heard the answer.

I was given a general anesthetic and epidural. When I woke from surgery, I was numb from the belly button on down. It took several hours to regain all the feeling in my legs.

The first day was the hardest, but it was not too bad. I was immobile with ankle cuffs that would inflate to move blood around my legs, my operative leg was slightly elevated, and the incision was iced. I had an IV, heart and O2 monitors attached to me. I drank a lot of water the first night thinking it would help flush the anesthesia out of my system - not sure if that is true but it seemed to make sense at the time. The ice helped to dull the pain and help reduce swelling.

I was not in any significant pain, probably because of the lingering effect of the epidural. Also, the nursing staff told me to take pain medications to stay ahead of any pain. So I asked for the pain meds that were prescribed and was given a pill every six hours. Unfortunately, I was not very groggy and did not sleep much after surgery – it was hard to fall asleep with all the equipment strapped to me.

Surgery – 2nd Day
The nursing staff wanted me to get out of bed and sit in a chair. I could put 75 percent of my weight on the operative leg. It was good to have someone around when getting out of bed for the first few times so you don’t fall. I was able to use a walker to get to the bathroom. There was brief, but sharp, pain in the operative leg muscles when I got up the first few times. I think it was due to stretching the muscles that occurred during the surgery. I started eating solid foods later the second day.

Surgery – 3rd and 4th Days
I begin moving around on crutches on the 3rd day after surgery. The physical therapy staff gave me several exercises to do while laying in bed to keep the blood moving.

The hospital staff also showed me how to administer the Lovonox injections. I took self administered blood thinners the same time each day for the first 11 days after being discharged. Injecting myself with a needle was not too bad because the needles are very fine. After I completed the series of Lovonox injections, I had to take one 365 mg aspirin about every 12 hours for the next month.

Dr. Brooks showed me that I did not have to be afraid of bending my operative leg. I was able to lay in bed with my back elevated, and move my operative leg almost to my chest.

The night before I was released, I got an ultra sound on my legs to check for any blood clots. Before I left the hospital, I received a prescription to get another ultra sound about 10 days after being released.

The day I was released from the hospital, the epidural had a delayed side effect. I began getting headaches after I sat up for about 10 minutes. Lying down or standing did not seem to bother me. Apparently, everyone does not experience side effects from the epidural and there are several ways to curb them should they occur. Since I was going home, I was instructed to drink caffeinated beverages – not tea – but something like double shot espressos for a few days. The headaches lasted about 4 or 5 days after going home. The caffeine helped reduce the headache pressure.

Since I had to be driven 180 miles, I asked for pain medications for the trip home. The PA turnpike can be a little bumpy in sections. Fortunately, I was in a SUV and brought several pillows to provide cushion for the drive home. I could also stretch out over the entire back seat which made the ride home comfortable. Also, I brought easy slip-on shoes and basketball tear away pants so I did not have any tight fitting clothing for the trip home.

The staff at the Euclid Hospital was great during my stay. They were always there when I needed assistance.

Post Surgery Recovery Up To 6 weeks
Dr. Brooks requires you stay on two crutches for 6 weeks. For about the first two weeks, I went for short walks. I increased the distance a modest amount each day, at first starting with a few hundred yards and increasing the total distance to about 1 mile at about 5 weeks post surgery. I was fortunate that I could take off work for 6 weeks on medical leave.

I continued to take the prescribed pain medications as I did in the hospital for about three days after leaving Euclid. I was not in any pain, but did not want to experience any either. I just stopped taking them and I was fine. After that, I took one prescribed pain med about a week after being home when I went to sleep. This reduced the discomfort from the 32 staples holding the incision.

I continued to take the Lovonox injections as prescribed. I also was instructed to take my temperature each day – I assume it was to help alert me if an infection started.

I could easily get dressed and put my sock on the operative leg without the aid of any device - it was a little tough at first. I was able to do most simple things (like cook and cleanup after myself) but it took about 3 times longer than pre–surgery. I bought an extended gripper to help pick up items, but never used it.

I did not opt for a surgical dressing to cover the incision so I could take a shower. I did the “bird bath” cleaning every day. I did not want to take a chance of getting the incision wet. It was a good feeling to take a shower a few days after the staples came out. While the incision was healing, I used an 8-inch abdominal bandage to cover it and change the dressing two times a day. Those bandages were not available at the local drug store. My friend ordered them in advance of his surgery and he had many left over. I used medical paper tape that can be bought at the drug store to secure my bandage to the skin. The medical paper tape did not irate my skin. I had the bandages so I used them.

My leg was bruised, probably because of the very strange positions it was placed during surgery and putting the implants into my bones. The bruising peaked about 7 to 10 days after surgery. It was looked much worse than it felt – although it was sore, it was easily tolerable. Taking the blood thinners probably made the bruising worse. I was never in much pain, but my friend prepared me for the bruising that would occur.

After being discharged from the hospital, I did not have any trouble sleeping. When I woke up in the morning, I would do some stretching exercises before trying to stand. I would take my time getting out of bed and did not rush since I had no where to go. I could not drive until getting off crutches.

6-Week Check-Up
My 6-week check-up with Dr. Brooks was in early April 2009. Dr. Brooks watched me walk without crutches, and I had a slight limp. Dr. Brooks suggested one more exercise for the leg. It was to lay on my non-operative side and raise my operative leg, 3 sets at 30 reps per set, three times a day. Initially I was too weak to lift my leg an inch, so I got the remedial version. That was to stand, balancing myself, and move the operative leg laterally. I did the standing version for about a week before attempting the lying version.

Dr. Brooks showed me the X-rays of my operative leg – about 3 or 4 were taken that day. Although I have no medical training, the hip joint looked like a perfect fit from every angle. Since hip resurfacing is elective surgery, it is so important to do your homework and find a surgeon that can make the implant fit just right.

Dr. Brooks indicated that for one year I could not run, jump, or lift any weight over 30 lbs. Basically, do not over exert myself. I had to wait another 6 weeks before playing golf, and had to take a cart for the first year. After one year, Dr. Brooks indicated he will re-evaluate my BHR and determine if all restrictions could be lifted.

Post 6-Week Check-up To 8 Months Post Surgery
About 4 days after being off crutches, I was walking up a flight of steps and pulled the quadricep muscles in the operative leg. It took about 6 weeks for that to completely heal. I continued to do the leg exercises and strengthen the hip muscles.

I had access to a heated therapy arthritis pool and found some water exercises on Pat’s web page. I did those exercises and walked around the therapy pool for about 3 weeks after getting off crutches. I did not ride a bike or do an elliptical trainer – I just walked everyday, rain or shine, trying to increase the distance. I bought a pedometer to monitor my walking distance and to make sure I did not over do it, take it too easy, or plateau.

For the first few weeks after getting off crutches and doing the leg raises, I did not feel there was any improvement since I continued to limp. At the time, it was a little frustrating. I visited Pat’s web page many times and called my friend often to compare my progress, and to find any morsel of information about recovery. I continued to do the lateral leg raises and it was very hard, straining to raise the leg and breaking into sweats for such a simple exercise that I now take for granted.

After about 5 weeks of being off crutches, I began to notice the leg was getting stronger and the limp starting to slowly resolve. I continued to walk every day as a strengthening exercise. There was some muscle soreness – in the buttocks and top part of the back of the thigh – but I continued to work the muscles – keeping in mind not to over do it. Throughout this time, the operative hip joint felt fine, just like my non-operative hip.

The slight limp began to diminish each day as the leg got stronger. It was not a step change, but a very gradual process that completely faded after about 4 months of my surgery. Throughout the recovery, I remembered that slow and steady wins the race and I made sure not miss an exercise set. I hoped that I would recover like one of those people that boast about extraordinary activities only a few weeks post surgery – but I did not. My friend and I recovered at about the same pace so I assume that my recovery must have been average.

I steadily increased my walking distance. July 4th was about 4-1/2 months post surgery and I went for a 5-mile walk. Over the next few weeks, I increased the walking distance to over 6 miles. Today, I don’t think about my hip surgery and I feel that I could do just about anything. But I’ll wait until February to see Dr. Brooks in hopes there will be no restrictions associated with my new hip.

June 30, 2009

I am here in South Carolina with Dr. Gross at the hospital. It is Tuesday today. I had the right hip resurfaced at 9am yesterday. Tomorrow, I will have the left leg resurfaced at 3pm. Thanks to all the folks who have published comments and given feedback on this site. It is incredibly useful for setting expectations and getting a feel for what is going to happen next. My thanks to all you great posters!

I am 44 years old, and am in good to great physical shape (except for the hip area!). I learned about Hip Resurfacing and Dr. Gross by doing a Google search when I was frustrated about "hip replacement and snowmobiling". Somehow I came across an individual who was a year out and bragging about being able to snowmobile again with no pain. What a funny way to hook into this site!

I learned about Dr. Gross from this site as well a ton of independent research. I called and talked to their staff and was impressed with how caring they seemed. In reading the blogs, I felt that Dr. Gross and his staff went the extra mile to make their patients recover well.

So I decided to sign up and go through the process. For me, my life felt like I hit a brick wall sometime back in October. I was limping for the past 8 years or so, but there was no affect on my sports, ROM, or anything else. I had pain, but medicine seemed to be the way to treat it. What was interesting to me

What was interesting to me was how the pain medicine doses became part of my life. Two alleves in the morning to get me started, maybe one before playing hockey, or maybe throw down a couple of Anvils. I was popping these pain killers every day. I do not think that was so good!

Then, in October, for the first time in my life, I felt that my ROM and strength in my legs was to push off, or stand up from the back of the skies, or do something I always had been able to do, was GONE! I finally decided to do something about it.

I met Dr. Gross and his staff in their office on Friday. I was impressed with how friendly, nice and caring his staff was. It might be something to do with the South as well… you all are a caring and wonderful group! I hail from Northern Michigan, and live now over in Northern Sweden!

Dr. Gross and I discussed in detail the results of my DEXA scan, which is a bone density scan. Because of my arthritis, I was a little low. If not for my physique, desire to do both, and commitment to take it easy, I think Dr. Gross would not have gone forward. Being a male 44 years old helped as well, but the bone density was a big deal. I was a -2.1 on the left and -2.3 on the right. Osteo something arthritis is -2.5. So I am not so good! But I am on a course to strengthen my bones (good tip for people to look at prior to surgery, have the DEXA done early). I take calcium and vitamin D daily as well as a bone strengthening prescription (forgot the name) once a week. So we decided to move forward!

My right side feels pretty good. I have been up and down the hall 3 times practicing a gated walk with the crutches. It is definitely stiff@! And it is definitely hard to maneuver out of bed turning the right leg to get into a standing position. Because of my Dexa, Dr. Gross has me on the slow progression PT. I am not to weight bear much (and little as I can) for 6 weeks. But… I willing to do that because I really want to get my life back and both sides were killing me pre Bilateral!

So…things are going well. The staff here is excellent at the hospital. I have felt very welcome and very cared for. Everyone has been great. This is truly a first class place. Tomorrow, I have to stop eating and drinking tonight at midnight, I will get stage 2 – the left side done! I will keep everyone posted. I am excited and nervous. After reading all the posts, I know the first 10 days are going to be tough! But I am ready, here, and willing to endure! We fly back up north on Saturday.

---

July 15, 2009

Well... I am now post op 2 weeks. I agree with previous post that the first week is tough. I would refer to it as more than tough. At least it was for me... wow! I will do a little memory recital here and get caught up to where we are today.

I had the second hip done on Wed late - I was the last surgery of the day. I had the good fortune to be very easy. The surgery according to Dr. Gross was straight forward and easy. As you may recall, I was a little low on my bone density - a negative 2.1 on the right and a negative 2.3 on the left. Dr. Gross had originally suggested I not do a bilateral. Upon our meeting, and discussion, we decided together to proceed with the bilateral surgery knowing my recovery would be under his slow program. More on this later!

On Friday, we were discharged from the hospital. The pain meds, coupled with what I assume was some device to dislocate my leg from the socket prior to surgery, made the bathroom a big nightmare. We stayed at the Courtyard on Friday night. My butt was so uncomfortable. Trying to go the bathroom was terrible. It does get better, but that first ten days are tough for men. Of course, I am a big baby, but that was no fun!

Courtyard was great. We had the handicap double room. My father had been with me all week. Having him to help was indispensable. You need someone to help you out for a couple of weeks.

On Saturday, we packed up and headed to go out of town from Columbia airport. I had to take two small flights to get home. One jump from Columbia to Detroit, and then from Detroit to Traverse City, Michigan. Having read the forums, I knew to take my medicines – the pain meds. In addition to Vicodin, I had something Dr. Gross gave me that was a 12 hour. I took that as well as brought the vicodins with me to use ,as well as the next 12 hour pill for when we were in Detroit. I also packed empty head ice packs. Those ice packs you can buy at the store that have a big screw off top, are meant for your head, and you can put ice in them with water. We carried these empty through security and had a vendor fill them with ice in Columbia. They were a HOT TICKET! And very recommended. Having one for each side during the flight, really helped me a lot. We refilled with ice in Detroit for the next segment. They were perfect because you can take empty through security.

Upon arrival home, I was a little swelled and took it easy. The hardest part was the bathroom. The pain killers act like a plug, and your butt feels like (and is) very bruised. Sitting on the toilet seat for 5-7 days was not pleasant. Cover your one eyed snake with a towel, and grip those side bars on one of those raised toilet seats your grandpa would use. You need both hands to hold your butt off the seat, since it hurts, which is why your one-eyed snake needs a blanket! Nuff said… And...Get ready to pass the football....

Once home, my father was diligent about filling the polar ice machines and wrapping my hips with those cool packs. They really helped with bruising and the swelling. They are like having a loud fish tank (as a bilateral you get TWO!) in your room, but they are worth it. By day 5 or 6 post op, after sleeping with ear plugs (trying anyway!) I pulled the plug on those babies and put them away! I needed some sleep.

Sleep has been tough. I am a roller. You cannot roll with a baseball in each hip! It is difficult, and just now possible, to sleep on the stomach. But still… it does not work like it should! Just takes time!

I have been really good about taking long walks. I am now post op almost 2 weeks, and enjoy going around the block on my crutches for a good 40-50 minutes. I also walk on my crutches everywhere when we go shopping and stuff. Because of my bad bone density, I am forced to keep the crutches for 6 weeks (doctor’s orders). That will be the toughest thing for me moving forward, as I am already able to walk around without them. Only good part is that you get lots of sympathy from people – everyone has been so nice and helpful. Bad part… for a guy that is single… not like having a cute puppy…!

My spirits are high. I feel good and the bones are getting stronger. I did push one day and took some family (day 12 post op) out on my boat. It is a big boat, so the wave impact was minimal, but still, because I was doing the driving, and standing a bit of time, my legs told me the next day I over did it! It completely wiped me out. I passed out and slept a day away the next day. Moral of the story… you just had major surgery dummy… take it easy!!!

Today, I feel great again. I am going to go out now and go for a long walk. I really like having done this in the summer. I don’t put on anything but shorts and I never have to worry about ice. I can walk every day and I am never too hot (that might be a living in northern Michigan summer thing!).

If I can help anyone else, please hit me with questions. This has been a wonderful process for me. I have NO arthritis pain. My wounds on my leg where the incision was made are healing great. I feel them but the feeling is like a cut healing on your leg, not arthritis deep pain. I don’t feel the new resurfaced components like I thought I would at all.

Looking back, and concluding this long rant(!), that first week is tough TOUGH TOUGH! It just gets stronger, easier, and better. I am so GLAD and so HAPPY I went and saw Dr. Gross. I owe it all to this website and the people who have contributed before me. I am really excited to keep improving, and in 6 months, be back to normal!

In March 2009 hip pain had significantly negatively impacted my life. Performing basic daily functions became extremely difficult. On March 10, 2009, I had hip resurfacing surgery performed by Dr. Kreuzer at Memorial Herman, Memorial City Hospital in Houston Texas. The surgery was remarkably "un-remarkable." My recovery has been quick and is near complete 6 weeks after the surgery. I live in a four story townhome and was able to negotiate the three flights of stairs to and from my bedroom beginning upon release from the hospital on March 13. As an exercise regimen, I climb 30 flights of stairs in my office building 4-5 times a week.

I am well pleased with the hip resurfacing surgery and the resultant enhancement in my life. I am looking forward to having resurfacing performed on the other hip in mid-May 2009.

Raeburn Marshall