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My experience with a bilateral hip resurfacing with Dr Edwin Su.
I am 52 years old and on January 3, 2011 I had surgery to repair
both hips. I have been physically active my entire life, and
exercised 3 to 4 days per week including both cardio and weight
training. I played ice hockey in college, and continued to play
competitively until age 30. I enjoyed running outdoors, and loved
riding my bike regularly. I am an avid skier, as well. All of this
came to a screeching halt with what seemed at the time to be a
simple muscle strain, but turned out to be arthritis in both hips.
I had begun to notice what I thought was a muscle strain in the
groin area, in the fall of 2007. I was not sure what was causing the
pain, but is was uniform on both sides, and I went to a few doctors
who thought I had overdone my weekend warrior routine. I was told to
rest, and I did, but it did not get better. I went to a chiropractor
who actually took an x ray and told me that my pain was because my
back was out of alignment so he began a painful process off
adjusting me. The adjustments were incredibly painful, as he turned
my on my side, and adjusted my hips, actually accentuating the pain.
Finally, I went to see an Orthopaedic specialist, and actually
brought the x ray from the chiropractor with me. This was almost one
year later. The specialist put the x ray under the light, and in
about 5 seconds (literally) told me that I had arthritis on both
hips, pretty advanced, and referred me to a specialist. I went to
see several specialists, first of whom was Dr. Hozak at the Rothman
Institute in Philadelphia,
Dr Hozack was detailed and very informative. Basically, he told me
that the damage was to the point that I had to have both hips
repaired. He focused on hip replacement, and I was not familiar with
resurfacing at this point.
After my consultation with Dr Hozak, I was pretty sure the only
question was when not if. He told me that the question of timing
would be primarily based on when the pain was too much and when my
lifestyle was impacted beyond which I could no longer physically do
what I wanted. He was completely right.
My goal at this point was to delay the surgery for as long as
possible, and try and manage the situation.
In the interim, I worked with Dr Matt Lorei from Bryn Mawr PA, near
Philadelphia on preventive methods and pain tolerance. Over 18
months, we did 2 injections of cortisone, which really made a
difference for me, in lowering the inflammation and reducing pain. I
exercised and stretched, and tried to strengthen the muscle group
surrounding the injured area. It may have helped, or maybe just
thinking it helped was good for me. I even explored using Synvisc,
which is artificial synovial fluid and approved for use on the knees
in the US, but not hips. It is however approved for use in hips in
Europe and has shown some success in prolonging the usefulness of
damaged cartilage, but it is better (apparently) for those with less
advanced arthritis.
Anyway, advance to early 2010 and I knew I had finally reached the
state that Dr. Hozak suggested I would. The pain, as well as, the
reduced activity level were just too much and I was ready to do
something. Dr Lorei introduced me to the concept of resurfacing, and
was promoting the resurfacing procedure for me. He compared and
contrasted it to replacement in great detail, even sketching out
several pictures for me, depicting how the procedure would reshape
my hips, and eliminate the pain points, while restoring mobility. He
told me I should do both hips, but suggested that his protocol was
to do one at a time.
I then embarked on research and quickly determined for myself, that
if I really was a candidate for resurfacing, for all the reasons
that are well documented on Pat's website and others, that was the
procedure I wanted to have. I also decided that I wanted to do both
hips at the same time if possible.
Since I split my time between NYC, and Philadelphia, I searched for
specialists in both locations. After visiting several doctors, I
discovered Pat's site, and began to really learn about what was
important when selecting a surgeon.
A colleague who is a cardiologist, told me that one should think of
your surgeon as a mechanic, in that the more procedures they
perform, the better they become. Essentially, go for the doctor that
has had the opportunity to learn from experience and familiarity.
Although that may seem obvious to everyone, it really drove me to
find someone that has had significant experience, especially with
bilateral procedures.
In November 2010, I decided to go with Dr Su at Hospital for
Special Surgery in NY. He clearly performed the resurfacing many
times, including a significant number of bilateral procedures. Also,
although different people prefer different styles of communication
from their doctors, for me Dr Su was perfect. He is direct, concise,
and does not waste time. If you come prepared, he is clear with his
communications and extremely efficient. He seemed to know what was
important (for me) and what was not. In addition, I sensed his
confidence immediately.
We scheduled the surgery for January 3, 2011.
Well, here we are, January 3, 2011. No backing out now. I have
checked in to the hospital, they have scrubbed me, asked me a
million questions, had me sign my name more that signing up for a
mortgage, and asked me my name and birthday at every opportunity. I
will pick up the story when I am in recovery.
They took me in on schedule at 1100am, right on time. For those of
you that have never had surgery (like me) it is pretty strange. The
thing that I did not realize was how cold the operating room was.
They prep you and then put a warm blanket on you and then take you
into what seemed like a freezer. This was the point of no return.
They take you off the gurney, and put you on the operating table,
which was kind of a scary looking table. Then it was good night.
I woke in the PACU ( post anesthesia care unit) around 300pm, and
felt remarkably fine! They kept me there overnight which is protocol
for bilateral surgeries. I did not feel any pain, but of course I
still had the epidural hooked up to me. I do recall feeling pretty
stiff. They were constantly putting ice on the incisions. I slept a
lot. On January 4, in the morning they moved me to my room, and then
shortly after, Dr Su came and told me that the surgery was a success
and everything looked good. What great news. He told me the PT would
be by later and get me up and walking. At this point, I still did
not really feel pain, but the stiffness was very apparent. Still
lots of ice. When the PT came, and they sat me up, she asked me how
I felt. I told her I felt a bit light-headed. Bummer for me, as she
said " you are not ready to walk yet" and left. Be careful what you
tell them, as feeling light-headed is natural when you sit up, but
she did not want to walk me because of that. I was disappointed
because Dr Su told me over and over again that getting up and moving
was really important. Anyway, minor setback. Try again tomorrow.
Another minor setback was the catheter. Once they removed the
epidural, and I began taking painkiller orally, they wait about 8
hours and take the catheter out. In my case, perhaps it was a bit
too early, as the effects of the epidural had still not worn off,
and I could not relieve my bladder. They had to put it back in late
that night and that was not very comfortable, but at least I could
relieve my bladder again. Don't let them take the catheter out until
you regain your feeling.
January 5, day 3 was a good day. I was feeling remarkably well, and
they walked me with the walker twice. They also took the catheter
out for good and all was fine. Still lots of ice, still minimal
pain, just pretty stiff.
Thursday January 6, and they have cleared me for discharge.
Everything looks good, I am walking pretty well, up and down the
hall with the walker. They advanced me to crutches, and showed me
how to use them on stairs. Time to go home. I must say, although
this was the first time I was in a hospital, so I may not have much
to compare against, the experience for me was very good. The staff
were very helpful, seem well trained and most importantly for me,
are very nice people without exception. I hope all hospitals are
like this, but I felt like I was in a premium hotel, more than a
hospital. I am very pleased with HSS. Even the food was good.
It's January 7, and I am home and determined to make great progress
in my rehab. Dr Su told me to shoot for eventually walking a mile.
Not sure if this applies to everyone, but it is my goal. I will walk
indoors for now, as the weather is brutal and lots of snow. I
measured the hallway in my building and each lap ( up and back) is
about 180 feet, so 14.5 laps is 1/2 mile. My goal is 29 laps, or 1
mile, but obviously not today. Today, with crutches, I walked 8
laps. I am icing the incisions regularly to keep down the swelling.
The swelling is pretty bad. Anyway, ice will help reduce the
swelling, and I am using it liberally. Also, the PT visited today,
and gave me a bunch of flexibility exercises. These are really
helpful in working off the stiffness that I have been complaining
about. They are all pretty standard strength and stretch routines.
Followed by lots of ice.
January 8 was a minor breakthrough day. I walked twice, in the
morning 8 laps, and in the afternoon 4 laps, and I feel like I am
using the crutches more for stability and less for weight bearing.
Also, I have been laying on the floor on my stomach, and although I
don't think I read about this anywhere, it provides incredible
relief from laying on your back in the bed. Also did the PT routines
on my own.
January 9 did 10 laps in morning and 10 laps in the afternoon. Felt
pretty good, although the PT told me that the right leg is lagging a
bit, and pushed me to try on "walk better than longer". Today was
also the first day I felt "pain" and it was in the right leg, and
muscular along the incision, not in the joint. It is amazing that
the constant pain I have had in my joints, are not apparent. Anyway,
the PT showed my what seemed to be causing the pain in my right leg,
and when I walked properly, and used good form ( tighten my stomach,
don't lean over, post my butt), the pain began to dissipate. Good
news. January 10 and 11. I continued to increase my walking and was
up to 14 laps. I also began to walk outside, which really tired me
out. Slept well after that.
On January 12, 9 days after surgery, I had my first visit back to Dr
Su. He said my progress was great, he took the staples out, and he
encouraged me to walk with one crutch instead of 2, and really
pushed me to do much more stretching. He gave me a list of stretches
that i am working on. It feels great to work on these motions. I
took the day off from walking, as I was pretty tired from the dr
visit, so I rested. I jut felt like I needed it.
Today is Sunday January 15, and I am pretty settled into a routine.
I walk twice a day, using one crutch alternating from left to right.
I try to walk once inside and once outside. I always ice after
walking and stretching. I am no longer using the hyrdocodone
painkiller/anti-inflammatory and have switched to Advil 200mg 3
times a day. The pain that I felt a few days ago in my right leg is
gone. Still a bit stiff, but the stretches are significantly
increasing the flexibility. Tomorrow is 2 weeks.
Michael Green
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