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I began having some groin pain in the
summer of 2004. An avid gardener and horseback rider, aches
or pains weren’t uncommon and I didn’t pay too much
attention to it. In the fall, I went on a two week trip and
thought it would be a good rest for whatever muscle was
bothering me.
On the way home on the plane, it seemed that the groin
pain/burning was actually worse. It bothered me more and
more over the fall and into the holidays. In January I made
an appointment with my PCP to discuss why the pulled groin
muscle wasn’t getting better.
He asked me a few questions and moved my leg around a bit,
judging range of motion. He suggested an x-ray and sent me
off to the x-ray tech. About 30 minutes later he walked into
the patient room and said “You need a total hip replacement;
you are bone on bone in your right hip with significant
arthritis.”
Well, either he had the wrong room or was pulling some kind
of little joke as at 54 needing a THR was the farthest thing
from my mind. He showed me the film and pointed out the lack
of cartilage and rough surfaces. His advice “wait as long as
you can until you can’t stand the pain and then I’ll refer
you to an OS for a THR consult”.
I went home in denial and stayed there for several weeks. No
one in my family had ever had a hip replacement and I
couldn’t come to grips with the fact that at 55 I was going
to need one. I wandered about on the internet researching
total hip replacements and everything I saw confirmed that I
didn’t’ want one – anytime soon, if at all!
The spring of 2005 I found it becoming more difficult to
work in the garden. Getting up and down was hard and
painful. I began carrying something with me to help with
standing up. My ROM began shrinking and I found it
increasingly hard to swing my leg high enough to clear the
back of my horse. Sitting on either of my two, big broad
horses became increasingly uncomfortable and I began finding
excuses why I didn’t need to ride.
By summer I had run out of excuses and had developed a
pronounced limp with every step. The pain was constant and
sometimes significant. I reluctantly returned to my PCP for
the OS referral. I had the name of an OS that I had been
told by several friends in the medical community was the
best in the area. My PCP looked at the name and said “He’s
excellent, but it will take you a while to get in with him.”
I figured if I was going to have to have a THR, I’d better
seek out a good doctor and it was worth waiting for an
appointment.
I got in to see him in November 2005. I’d been having hip
pain now for over a year. I filled out all the forms and
waited, hoping that he’d have an alternative that might work
for a “younger” patient like me. He walked in the room,
stood with his hand on the doorknob and said “You need a THR,
I’ll have my girl put you on the calendar”. I wasn’t
thrilled with either – the “my girl” reference or the hand
on the doorknob. I started to ask him questions from the
list I had brought. He answered a few and then said that
“his girl” would give me a booklet that would answer all my
questions.
“Is there anything else for younger people”? “No”.
“Is there a new procedure coming that offers promise”? “No”.
“Is there anything else I could do to put this off for
awhile”? No”.
“Will I be able to ride my horses with a THR”? “We’ll have
to see”.
And, he left.
His assistant brought in calendar, but I wasn’t quite ready
(couldn’t walk, but still not ready) to sign on the dotted
line. She talked with me and I actually got more info from
her than I had from him. It would be a metal THR with a poly
cup. It would be uncemented. I would have to use a walker
for “a time” and then progress to crutches. I wouldn’t be
able to sit in a normal height chair (they had tall chairs
for sale) and I would need to sleep with a special
orthopedic “abduction pillow” strapped between my legs for
the first 6 weeks.
For some reason the strapped on pillow thing seemed the
worst to me. I’m fairly claustrophobic and the idea of being
strapped to a pillow at night spooked the beejeebers out of
me. I told her that I couldn’t make a date at that time, but
would call them. She told me that he was very busy and that
if I wanted him to do the surgery I needed to “get on the
list” right away.
I went home and talked to my husband about it and we had
another in a long string of arguments about whether I needed
to have the surgery or not. He was watching my world shrink
as I became more and more reluctant to do anything that
involved any amount of walking or physical activity. He
wanted me to do whatever I had to do to get back to enjoying
my life. I had run out of excuses and knew he was right.
Regardless of the concerns I had about how a THR would
change my life, I could no longer put it off.
I called the OS office and told them that I wanted to
schedule surgery. They said that someone would call me back.
I waited almost 2 weeks and then called them again. They
said they were very busy and someone would call me. A few
days later the scheduler finally called.
She asked me what hospital I preferred and offered me a
choice between two huge county hospitals – neither of which
appealed to me. I asked if the doctor had a preference and
she said that he did not. I found that surprising as I felt
thought that he’d prefer one or the other. I told the
scheduler that I preferred a Tuesday or Wednesday surgery
date and she told me that I would be offered the next
available date. If I didn’t want that date, it might be
quite some time before I could have surgery. It sounded like
a thinly veiled threat to me. She said that she’d check the
schedule and call me back. Another week went by before she
called back.
I was scheduled to have surgery on a Friday, Good Friday in
March – 4 months away. I told her I wasn’t keen on having
surgery on a Friday and especially not on a holiday weekend.
She said that was the appointment available and that if I
didn’t want it, it might be some time before I could have
surgery (sound familiar?). I asked if the doctor would be in
town that weekend (Easter weekend) and she said they had no
way to know what his schedule would be like 4 months from
then and it didn’t matter because he might not come to the
hospital on the weekend anyway. Feeling more and more that I
was being forced into a corner, I reluctantly agreed. I was
told that I’d get a packet in the mail with all of the
information and appointments that needed to be scheduled
with my PCP for pre-op tests and the Red Cross for 2
autologous blood donations.
I waited for another 2 weeks and nothing arrived. It was
almost Christmas and I was anxious to see the material so
that I knew what I’d need to schedule. I called the office
and was told that material was sent out when they had time.
It arrived shortly after the 1st of January.
Reading through the booklet “ Total Hip Replacement, A Guide
for Patients” didn’t make me feel any better. The
illustrations were all elderly people, stooped over canes
and walkers. I wasn’t thrilled to read the 12 week
precautions “ Don’t sit in chairs without arms, don’t sit on
sofas, don’t sit for long periods, don’t cross midline,
don’t sit in a bathtub”.
Next came the Avoids “Avoid skiing, basketball, contact
sports, running, jumping”. Not that I wanted to do those,
but at 56, I didn’t want to know that I no longer could.
I made all the very time sensitive appointments (blood must
be given 2 weeks ahead of surgery) all pre-op tests must be
within two weeks of surgery, but no more than 2 weeks before
surgery, pre-registered with hospital, and made the myriad
of arrangements necessary to leave my animals (dogs, cats,
horses) for the week I would be in the hospital. Every time
I thought about the surgery it made me feel sick inside –
sick with fear and dread of the surgery itself and of the
way my life would be changing.
About 6 weeks before the surgery I had a call from the OS
office regarding an insurance issue that needed my input.
When I called about it I was told that if there was any
“glitch” with my insurance I’d have to reschedule surgery
and there was no telling when I could get back on the
schedule. The “glitch” which they could have easily handled
was simply a mailing address problem.
A month before my surgery the doctor’s office called to tell
me that they needed to reschedule the appointment that I had
with the doctor for the Wednesday before my surgery.
Apparently they had made the appointment incorrectly as a
doctor visit instead of as a pre-surgical visit. They needed
to move the appointment to the previous week instead and
gave me a new appointment time. That appointment time
conflicted with one of my blood donation appointments, but I
was told that was the only time I could come into the office
and I would just have to reschedule my 2nd blood donation
appointment. I mentioned having some questions for the
doctor and was told that I would not be seeing the doctor at
my pre-surgical appointment “he didn’t have time for that”.
I had met this doctor for a grand total of <5-10 minutes and
felt the need to at least meet him a second time before
surgery to ask a few additional questions. “If you need to
see the doctor again, we will just have to cancel your
surgery and there’s no telling when we can get you back on
the schedule” – the same old “threatening” song and dance
routine.
Well, that was it for me. I said “I’ll have to think about
all this” and hung up. The next morning I called and told
them that I was uncomfortable with everything – the surgery
(holiday) date, the hospital and how I was being treated by
the staff. Again I was given the standard “no telling when
we can reschedule you” line and passed around among staff
members until I said simply, I am cancelling the surgery and
hung up. The office manager called back later and left a
message that it was important that I call her. I did, got
her voice mail and left an “I’m cancelling” message for her.
I felt better that night than I had in months. The huge
dread that I was making a mistake was finally lifted from my
shoulders and I knew I’d made the right choice. If I
couldn’t trust the people that the doctor surrounded himself
with, how could I trust him?
My husband was not happy. He hadn’t liked the interaction
with the doctor’s staff either, but his big question was
“What do you plan to do now; it won’t be long before you
can’t walk at all.” He had a point…
A few days later I decided to try giving Midlands
Orthopedics a call and set up an appt for a second opinion
with whoever did hips. They were not on my insurance but I
had had a knee injury repaired by one of their docs with
good success.
I called their office and asked who did hips. The
receptionist said “Dr Gross”. I asked to make an appointment
with him. She said “You’ll need to bring your films by to
determine if you are a candidate”. “Candidate for what I
asked? “Resurfacing” she replied. “What is resurfacing” I
asked. It was the first time I had heard the term. She
suggested I go to Dr Gross’ website and take a look. If it
interested me, I would need to drop my films by for a
consultation.
That night when my husband came in from work I had the
solution for his “What are you going to do now” question. I
was going to have resurfacing; IF Dr Gross felt it was right
for me. I just knew it had to be.
Dr Gross’ office called the following week saying that I was
indeed a good candidate and offering me an appointment!
About 3 weeks later I sat in his office with my list of
questions and a big lump in my throat. What if it wouldn’t
work for me?
The big day arrived and after a bit of wait, Dr Gross came
in the door, walked across the room, sat down and picked up
the paper. “Are these your questions” he asked? He went
through them one by one and then told me a number of things
I hadn’t thought to ask. He showed me my x-ray and discussed
why I would be a good resurfacing patient. He spent about 30
minutes in the room without once looking at his watch or at
the door. He made me feel that nothing was more important
than answering all my questions and giving me however much
time I needed to learn about the surgery and what it would
mean for me. I couldn’t sign up for surgery soon enough!
Shame on that “well respected OS”, who couldn’t be bothered
to tell me about a new procedure being offered for younger,
active folks AND the world class doctor offering it less
than 10 minutes away.
My surgery was scheduled for June 2006. When I thought about
this surgery I felt excited and at peace – how different
from the anxiety, fear and dread I had felt about the THR. I
still didn’t want to have any surgery (does anyone?) but I’d
come to terms with the fact that I had no choice if I wanted
to walk and continue on with my life.
I found dealing with Dr Gross’ staff the polar opposite of
my first OS. Each person that I talked to was kind and
considerate. While I was sure they had been asked and
answered each and every question a multitude of times, they
were always kind and considerate. I found dealing with Lee
Webb to be an epiphany in a time when just getting someone
alive on the phone was a challenge at most doctor’s offices.
When I emailed Lee (what a joy to be able to email a medical
question) I usually had the answer back in hours, often in
minutes! If I sent a message at 10PM, I often had an answer
by 11PM. Along with the answer to my question came obvious
caring and concern.
I began walking (hobbling) with a cane and found it to be of
great help. I could no longer walk more than short periods
without stopping. I used to be able to walk long distances
without worry, now I was resigned to limping from seat to
seat. I got and used a handicapped parking sticker and it
was a Godsend for those final weeks. I used to worry that
people would see me pull in and park and think I was
misusing the privilege. My husband said “Just get out and
start to walk and no one will ever think you are”. The week
before my surgery I went to a book store to stock up on some
reading material. It was difficult to hold my cane, stand up
and look at a book. By the time I had been there about 15
minutes I was exhausted with the effort of standing. When I
checked out the clerk took one look at me and said “Are you
OK?” That’s how bad it was. The pain made everything hard
and I was weary with the simple act of living.
I found great peace in the words of a wise resurfacing
patient who had gone before me. He said that I had done
everything I could do, researched the procedure, found a
highly qualified doctor that I trusted and made the best
preparations I could. Now it was time to let the doctor do
his job. I thought of that often in the last weeks before
surgery and found it to be very comforting.
The last 2 weeks when I had to quit taking anti-inflammatories
was terrible. There was simply no moment in time when I
wasn’t in pain. I couldn’t walk, sit, stand or lie down
without pain. The only time the pain lessened was when I was
in our hot Jacuzzi with a glass of wine in my hand. I spent
an hour every evening in that last week soaking in the tub
and looking forward to the end of this chapter of my life.
The day I limped into the hospital I was ready. I had
thought I would be afraid, but surprisingly I wasn’t. I had
somehow come to terms with the prospect of the surgery and
rehab and knew that whatever it entailed, it brought with it
the chance to return to a normal life.
I took my iPod Shuffle with me into pre-op, loaded with
music that made me feel calm. A quick trip to the restroom
to change into a gown and lovely hat and then into the bed.
A handful of pills arrived including meds for nerve pain,
general pain and nausea. An IV was started (after they
numbed my hand). Some blood was drawn for the platelet rich
gel that Dr Gross uses in the new joint and surrounding
tissue. My husband got to write NO on the “wrong” hip to
make sure that they would resurface the bad one. An
anesthesiologist came in and discussed the spinal anesthesia
and asked how “deep” I wanted to be. I told him that I
didn’t want to know a thing about it and he smiled and said
OK. I was asked if I wanted something to calm my nerves, but
I didn’t feel that anxious and listened to music for the
short time until I was taken to the operating room.
The OR was HUGE – much bigger than I expected. And it was
freezing cold. There was music playing and a bunch of people
doing various tasks. Within a few minutes of entering, the
anesthesiologist asked me to sit up and lean forward over a
pillow. He said I might feel some cold on my back and
possibly a slight sting. The next thing I remember is waking
up in my hospital room with my smiling husband by my side –
the very best medicine one can hope for!
My surgery was at 3:30 and it was around 7:30 before I got
into a room. I don’t remember recovery at all, although I’m
told I talked coherently to the nurses and my husband while
there. I don’t remember the ride up in the elevator to the
room either. I suspect that having asked to be rather deeply
“under” - it took me longer to climb back out into the
world.
I dozed comfortably that night. I had no pain what-so-ever.
When I moved around in the bed I could feel some discomfort
in my skin but there was no pain in the hip. Nurses came and
went, usually with a smile and comforting pat. The next
morning I woke up to a spinning room. My BP was low (not
uncommon) and I was very nauseous. So much so in fact that I
couldn’t even sit up. The urinary catheter (put in while I
was under anesthetic – what a kind and considerate action)
was removed without excessive discomfort. I was encouraged
to drink fluids to bring my blood pressure up.
The PT came in and suggested that I try walking. It didn’t
seem like a good plan to me, but hey, what do I know. I had
on the ubiquitous open-up-the-back hospital gown and the
nurse helped to put on a second gown, opening to the front
like a robe for my first walk. I stood up with a walker
(which is used for your first time up to be sure you are
steady on your feet) and got about 4 steps before collapsing
into a chair. No pain in the hip, but the room was flying
about and I had the good sense to tell the PT that I didn’t
want to try walking at that time. It is important to
remember that we are all different and what works well for
one person, doesn’t work for another. We need to listen to
our own bodies and respect what they are telling us. A few
minutes after reaching the chair I started vomiting and
vomited for about the next 10 or 15 minutes. As quickly as
it had started, the room stopped spinning and I felt better.
I headed back to the bed and drank some Coke in an effort to
bring my blood sugar up. About 2 hours later I was ready to
try walking again.
What an amazing feeling to stand up and take a step without
the deep, grinding hip pain that had been my constant
companion for so long. The groin pain was gone. Absolutely
GONE. My leg felt heavy and kind of “dead” (we laughingly
call it “log leg”) and it was work to move it – but when I
put my weight on it there was no hip pain. The first actual
“pain” I had was when I went to get back in the bed and had
to “lift” my leg into bed. That hurt! The motion of lifting
it was very painful, but the pain stopped as soon as the leg
was back in the bed. It was painful to lift my leg into bed
for the first week or so after surgery.
By afternoon I had walked the hallways a couple of times on
two crutches. Each step I took felt steadier than the one
before it and I was greeted by smiles from other resurfacing
patients making their way up and down the hallway.
The hospital food wasn’t especially appealing so I had a
Wendy’s hamburger and Frostie for dinner. It hit the spot.
That night I had to get up and down several times during the
night to use the restroom (all that water I’d been drinking)
and that was uncomfortable and difficult to manage. I
regretted not having the urinary cath the second night. I
should have called the nurses, but hated to and struggled to
get in and out of bed by myself. I wish I had had someone
stay with me the second night to help with getting the
equipment on and off for my frequent bathroom trips.
The second day a nurse showed us how to remove and reapply
the dressing and discussed the discharge orders. Around 1:30
we set off for home and it was a wonderful feeling to get
back into my own home and bed again. I did miss the triangle
which hangs above the hospital beds as that was quite
helpful in getting in and out of bed. I can see where having
a hospital bed with a triangle above it would be very
helpful for anyone having bilateral surgery as they won’t
have one good leg to push with.
All in all I was very pleased with the hospital. Everyone I
dealt with was kind and considerate. If I had to complain,
it would be that I wasn’t offered something more significant
for nausea control and that getting up and down by yourself
the second night (after the cath is removed) is difficult
and worrisome. No doubt I should have called a nurse to help
each time, but didn’t. That’s my fault, not theirs. Next
time I most certainly will. I had been told that if I wanted
to I could have gone home the first day after surgery. For
me that would have been a big mistake as the nausea and
dizziness would have been worrisome and more difficult to
handle at home. Although people from the greater Columbia
area and those who live within a few hours are often told
that they may be discharged after only 1 day – I strongly
recommend that everyone stay at least 2 days. Orthopedically
you are probably fine to go after 1 day, but just the
general recovery from surgery takes a little longer. If a
problem were to develop, I think you are better off in the
hospital than 2 or 3 hours down the road on your way home. 2
days in the hospital for resurfacing is a minor imposition
and worth the extra time for the additional care and PT.
I really enjoyed my first few weeks. Apparently a lot of
people are bored and restless but I lead a fairly active
life and the opportunity to just sit back and worry about me
for a few weeks was quite a pleasure. I had lots of videos
and books. I slept when I felt like it, read when I felt
like it and watched mindless entertainment whenever I didn’t
want to do anything else. Each day it got a little easier to
get around.
The only real problem I had was early morning (4-5 AM) thigh
cramps in my op leg. I’d wake up with the upper/front thigh
muscle knotted up and hard. It REALLY hurt. I’d get up and
hobble around on my crutches for a few minutes and it would
stop. I tried all sorts of different things, heat, ice,
elevation and nothing seemed to stop it but walking. It
bothered me most mornings for the first 10 days or so and
then simply stopped. I didn’t need much in the way of pain
meds, took Vicodin for a few nights and then switched over
to ES Tylenol. I took a Darvocet now and then if my hip/leg
ached a lot but it was no where near as bad as the pre-op
pain had been. I did have trouble sleeping, most people
apparently do. I started taking Halcion and took them for
about 10 days and then took Benadryl for another week or so
(it puts me right to sleep) and by that time the issue had
resolved. I never had problems with constipation that many
people have. In fact, strangely enough I had some fairly
severe diarrhea for about a week. I had decided to check in
with Lee Webb to see if I might have picked up an intestinal
bacterial infection and by the day I planned to call her it
spontaneously resolved without intervention other than OTC
diarrhea meds. I suspect it was a systemic “upset” and once
my system settled down after surgery it resolved.
For the first few weeks there were lots of unusual and
different feelings and sensations in my new hip. It had been
defined by pain for such a long time, that some of the new
feelings were surprising and worrisome. I don’t tend to over
react about myself (husband, horses, dogs, cats - different
story). I decided that unless I had PAIN or felt something
was WRONG I wasn’t going to get excited and contact the
doctor’s office. The two major concerns post resurfacing are
dislocation and femoral neck fracture. Both are catastrophic
events that won’t be mistaken for much else. That attitude
served me well and I went through the entire first 6 weeks
post-op without needing to contact the doctor’s office for
anything. I spent a lot of time in my zero-gravity recliner,
my favorite after surgery spot. I used ice on the hip off
and on during the first 10 days. I never had any significant
swelling.
I used two crutches for a week. I like the old, traditional
underarm crutches. Apparently many people prefer the forearm
type now, but I’ve had other orthopedic issues that have
required crutches and am comfortable with the under arm
style. If they are not adjusted properly they can cause
problems. I used 1 crutch for another week. I could probably
have gone to a cane, but I liked the support and stability
of the crutch. After that I went to a cane for about 10 more
days and was quite comfortable with it.
I began to drive at 2 ½ weeks. I tried in a parking lot
first, to make sure I felt that my leg was responsive enough
to be safe. I began driving myself to a local mall to walk.
It was very enjoyable. I’d walk awhile, sit and people watch
a while, walk some more and then have some coffee and read
the paper. I could walk more comfortably than I had been
able to for months prior to surgery. At about 3 weeks I
began walking at a local leisure center on a indoor walking
track. I was almost ready to give up the cane but still hung
on to it in public. The walking track was oval and I would
walk the short ends without the cane and the long sides with
the cane trying to match my strides with and without the
cane. After just a few days I was carrying the cane more of
the time than using it and when I began forgetting it around
the house I knew it was time to give it up.
I had not been able to tie my shoe or put on a sock in
nearly a year. It took me about 9 months before I could
comfortably do it after surgery. If I had gone to the gym or
pushed I’m sure it would have come back sooner. I was
satisfied to allow it to return in good time and it did.
Each person has a different recovery and much determines how
quickly it will go. Your pre-op condition, age, physical
fitness and “drive” all go into deciding how quickly you’ll
come back. If you expect to follow a certain pattern, you
may be disappointed to find that your recovery isn’t what
you expected. The best plan is to trust your body and allow
it to heal in its own time.
My only regret is having waited so long and given up way too
much of my enjoyable life to pain and disability. If I had
found resurfacing sooner, I’d have done it sooner. My other
hip is headed down that road and when the time comes to do
it, I’ll do it and get on with my life.
I’ve become somewhat of a local “hippie helper” for Dr
Gross’ patients offering local information and assistance
with the logistics of traveling for surgery. As a 30 year
resident of Columbia, I can provide info that makes the trip
easier for others and I love doing it. If you are
contemplating surgery or would just like to talk to someone
who has had surgery with Dr Gross, I’m happy to help you
anyway that I can.
Patricia Dukes
Columbia, SC
Dr Gross rBiomet 19June2006
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