July 30, 2016

This forum was invaluable in my decision making process so time to give back. I am a 55 year old active male originally from the UK, but have lived in Orlando for 30 years. I am 6 feet tall and weigh 195 pounds. Back in 2012 my GP diagnosed my night-time left hip pain as arthritis - "You will eventually get to the point where you will need/want a hip replacement". Not a great diagnosis at 52 when you enjoy skiing, hiking, tennis,cycling etc. Over the course of the next 4 years the hip pain came and went on the left side - gradually getting worse and more frequent, especially in bed, which I always thought was weird as my weight was off my hips. Gradually the right hip also started to give me discomfort - in September 2016 I got a cortisone shot in the left side which worked great. Sadly a shot in the right side in November pre-ski trip did not.

A visit home the same month to the UK introduced me to the work of Derek McMinn via a close friend. My USA residence and insurance prevented me from going to 'the godfather' however, so I searched for US surgeons who had trained with him. That research led me to this forum - thanks Pat! Lots of reading and one too many YouTube videos later I realized the importance of picking the right surgeon over the device - I was intrigued by Dr Gross's approach, and very heartened by the reviews posted by his patients.

I sent my X-rays off in the mail and was pleasantly surprised to get a phone call at home on a Sunday evening from Dr Gross. He was happy to stay on the line for probably 20 minutes or so and answer every question I could throw at him. We determined both hips were bone on bone and that I was a good candidate in need of his expertise.

Let me state for the record that Dr Gross was not my initial choice of surgeon and I also went for a 3rd opinion to a prominent local ortho with no skin in the game. He liked the sound of no cement but also recommended a lateral approach rather than posterior. In the end I went for experience and reputation rather then the methodology or the device. The point is you WILL go back and forth on all the different elements that come into a big decision like this. I could find pros and cons on the mechanics, recovery time and a lot of other variables - the one constant was the record of the doctor in question.

Even though I was offered 2 ops just days apart we decided on a 6 week gap between surgeries. Literally not having a good leg to stand on didn't strike me as a good idea, and I also figured my wife as my primary carer would have a lot more to do. I drove up from Florida the night before my pre-op check and stayed at the Residence Inn in Columbia SC, right across from Providence hospital. Dr Gross's office is about 15 minutes from the hospital - my wife had flown in to meet me and we met the next morning in the lobby.

As many folk have stated it is a well oiled machine - paperwork, x-rays, a consult with Crystal to sort out your meds, a meeting with Lee Webb who is terrific and then the man himself. He's confident, not cocky, with a pleasant demeanor and again took as much time as I needed to go over everything. I got to hold a sample Biomet device and see exactly how it fit on a fake skeleton - it sounds silly but that really helped.

This is scary stuff without a doubt. Even the day before I had been second guessing my decision to go ahead - I had deliberately played golf 2 days prior so I would be hurting when I got there! I didn't want him operating on pain free hips - does that make sense? Lee also obliged by re-confirming that both my hips looked lousy on the x-rays and simply would not get any better over time. Weird but I needed to hear that - they were not going to regenerate carteledge and fix themselves.

Last stop at the pre-op meeting is to get measured for crutches, pick up your Polar Care Ice Cooler (love that thing) and your hip kit - a grabber, sock donning device, leg lifter etc. You will also make your appointment for your 6 week follow up exam.

The day of the op the hospital is a 2 minute drive from the Residence Inn parking lot - the hotel is great, the rooms are a good size and the bed and the toilet bowl are at a decent height. You will appreciate that on your return. Shower the night before and the morning of the surgery with the special antiseptic wash they give you
Providence Hospital is like a resort - a boutique facility with very well appointed private rooms.

Check in is efficient, then you are called and walked back to prep for surgery. The nursing staff are terrific and provide gown and slip proof socks and a groovy hat. The IV was inserted very efficiently (they give you a numbing jab first - a small sting nothing more). You will meet with the anesthetist and then get some Verced to relax you -  family can sit with you and then Lee will stop by. She confirms which hip by autographing it and adding a smiley face. I shaved my own thigh/hip/rear prior to arrival - they will though trim you up if required and slather your leg in an iodine-like solution.

While you are 'happy' on Verced the profusionist will draw blood to spin up in the centrifuge -  this is how make the platelet 'paste' they use to paint on your implant and in the incision to help healing. I didn't even feel them doing it - you are pretty out of it in a pleasant sort of a way. I remember being wheeled down to the theater, saying hello to the assembled crew and that was the end of that - no more memories of anything at all.  I received the epidural, but apparently was not as still as they like on the table, so ended up having general anesthesia which we were told afterwards is rare. Consequently my post op recovery time was longer and I had a little bit of a scratchy throat as they gave me a breathing tube.

You wake up with Polar Care in place and in no pain - and the staff are just wonderful. (Big shout out to Elise and her colleagues - all of them just as pleasant and caring as they can be) Choose your food from the menu carefully - do NOT wake up hungry like me and have 3 plates of dinner!! (More on that later)

Sleep on drugs was no problem - though you will get woken up regularly through the night as they check on you.
The next morning they wanted me out of bed walking (that would apparently have happened Day 1 if I had not had the general anesthetic) - first they remove your catheter - a very special feeling that lasts about 3 seconds. Putting weight on your new hip feels all wrong, it feels wobbly and you don't want to do it. Grit your teeth and little by little you will take a few steps. You will also get to pee (important so drinks lots of fluid) and eventually to shower if you want to, with a staff member on hand if needed. Your physical therapy class is the last thing you do before check out - they go over the exercise regime and show you how to negotiate stairs.
Discharge is typically the afternoon the day after surgery and you will head back to your hotel.

If driving try take a vehicle with plenty of space that you can get in and out of out of very easily - we have a Honda Minivan. Back at the hotel fire up the Polar care machine, take your drugs and order in. Sleep is pretty much drug induced that second night as well - though back sleeping is hard for a side sleeper. BIG TIP - take the hospital pee bottle with you - invaluable for a guy who can't get out of bed easily (sorry ladies) and you will use it at home. You probably won't poop at the hotel due to the effects of the anesthesia - your instructions include laxatives and stool softeners - do NOT - I repeat do NOT ignore the advice given on getting your bowels moving again post surgery.

After a reasonable might we checked out and headed back to Orlando - a 6 hour drive. The passenger side seats of our minivan go completely flat - I was horizontal, legs fully supported with a seatbelt on. I was also on drugs and watching DVD's so I have to say it was a comfortable way to travel for the most part. Getting out at the rest stops to stretch and pee is not much fun - your newly operated leg does NOT want to move - your carer literally needs to lift it for you and support it until it is on the ground -  it is like it belongs to someone else! You need to buy an INVERTER from Home Depot so your Polar Care will work in the car all the way home. Fill it with ice at the hotel and then replenish the ice as you go. We had also taken some ice packs to the hotel which we froze and used as back up.

Once home and you gather your thoughts the reality sets in that you have had a major procedure - there is bruising where they manhandled you in the operating theater to test your new hip. The incision (about 4 inches) is neat and has a raised almost rope like appearance - there is also an additional 1/4 inch incision where they put in a pin to test your leg length. When you stand your hip feels tender and a little unstable - however the bone on bone hip pain has gone! There was tenderness down the outside of the thigh where muscles have been moved around and also some groin pain which I was told is normal. Once you master the crutches getting around the house, including the stairs is not that difficult - just slow and quite tiring at first so go at your own pace.

After a couple more days I started to cut back a little on the meds - everything was going fine BUT I still hadn't pooped and it was day 5! What followed was literally the most miserable night of my life - way worse than anything to do with the procedure itself. I was evil to my wife and angry that more attention hadn't been paid to such a simple issue. Suffice to say second time around the coffee and the prunes were high on the priority list along with some meds to help things along.

The main challenges at home the first week are definitely dressing and showering - your carer will need to be in attendance much of the time. For the pain ice your hip regularly for an hour at a time especially after you've been on your feet. Walking is tiring and your wrists will hurt from the crutches. The raised toilet seat has been terrific as it makes sitting and standing much less difficult. Extra pillows in bed are great for between the knees - I could sleep on my good right side, but if my top left leg (the bad one) slipped in front of the lower one it was painful.
You will inevitably twist your bad led and frighten yourself that you have done something terrible - this happened to me twice. A momentary lapse of focus and I put weight on the bad leg and turned - ouch! Call the office if required but like me they will re-assure you that you have simply tweaked it in a painful way - no permanent damage. My new hip also 'clunked' occasionally which is freaky the first time - that is the best way to describe it. The pod of muscle your hip sits in has been disturbed and is 'looser' than before - once everything tightens up that sensation goes away.

Every week brings progress - I was driving after 4 weeks as it was not my gas/brake foot and able to go out with the family for dinner - just pick your table wisely. In crowds you are paranoid someone is going to bash into your new hip - protect yourself and fend them off with your crutch if you have to!

As the six weeks passed and my second op approached I again started to second guess myself. Would everything all go OK a second time? Was I pushing the odds? My right hip seemed to have stopped hurting - maybe I was just focused on the new left hip? Driving back up and repeating all the pre-op procedures was also a little strange as I knew exactly what was coming and in what order - everyone was just as nice though and Dr Gross was just as accommodating with his time.

The morning of the op I was definitely more scared than the first time and I think it showed on my face - at moments like this being able to remind yourself of the times when you were in a lot of pain is very useful - ask your family to remind you as well of what a grumpy person you are when you are hurting! Prior to surgery golf left me hardly able to walk.....and sleeping at night required me spraying both thighs with freezing cold numbing spray. That's no way to be going on with your life if you can fix it - and they can! Focus on the fix if you are nervous - pain free living is a wonderful thing.

The anethetist came around and was confident the epidural would work fine this time around, he simply upped the dose a little - he was right. The Verced did it's job, I don't recall a thing about the blood draw by the profusionist. I do remember being asked to sit up in the operating theater (I presume for the epidural) then lights out....no more memories. I woke up with what were now familiar feelings on my 'new' right side - all of a sudden my 6 week old left hip was now my good leg which took a bit of getting used to.

Post operatively everything has been pretty much the same - with ONE notable exception - I watched what I ate,I drank more fluids and I pooped on day 3 - and I have never been more grateful for anything, EVER!

I am currently 4 weeks in to recovery #2 - using one crutch if I have to, preferred over the cane which I find a little unstable. The left hip and leg feel great - no sign of a limp. Still a little unstable on the right side, but I now know that in a couple of weeks that will have passed. I hope to be driving in a couple more weeks (a longer lay off this time around as it's my driving leg) and then after the 6 week mark I am going to focus on strength, stamina and range of motion on both sides. Yoga, swimming and the eliptical machine at the gym - lots of walking and maybe I'll break into a jog at some point ....I hope so! I have NOT set myself a fixed time table - I shall just do as much as my body is comfortable with.Even though Dr Gross has told me I can resume activities at 6 months I have decided to be conservative and  wait 12 months before ski-ing - I would hate to mess it up after going through all this.

If you are considering bi-lateral I still think that if you can put 6 weeks in between the ops it's a good idea. My 6 week check up was also my pre-op for hip #2 - a two for one!

Looking back I am so pleased I have had this space age procedure - very few people have heard of it so spread the word! There are so many folk who should go this route over a traditional THR. I keep my x-rays on my phone so I can educate friends and family - and anyone who'll listen! Dr Gross and team were beyond wonderful and so far so good. The muscles around your new hip will tighten up and the limp should disappear - the difference is amazing. Be patient, we are all different and what I have described may not apply to your experience - I hope it does though, with that one exception!

I will update this log in a few weeks as I make more progress - in the meantime as my memories are very fresh feel free to shoot me any comments or questions.

SEPT 1ST 2016 UPDATE

It's now been 8 weeks since the second surgery (right hip) - I dumped the crutches for good a few weeks back and just take the occasional Tylenol when I get any soft tissue pain. I am walking 1-2 miles a day with a slight limp which I expect to disappear. My left leg/hip which is 5 weeks older feels great - solid and 'tighter' all around. I think that may have prompted me to overdo it on a couple of occasions at the gym and in the pool - my 'fresh' right hip started feeling tender and sore soI backed off the elliptical machine and just focused on strolling around the neighborhood getting my mojo back. Last weekend I tripped and fell over an ill fitting manhole cover - whoops......skinned knees and a pulled groin but no lasting impact on the hip thank goodness. I think I have concluded that to rush the recovery is foolish given all I've been through to this point so going to take my sweet time. Sleeping like a baby compared to before when the hip pain would either prevent me from getting to sleep or would actually wake me up. I show folks my bi-lat x-rays and still don't quite believe what's been done - the guy is a bloody genius!

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