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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.
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