March 25, 2009

I just turned 56 years old and am by no means a fitness model (and probably somewhat embarrassed about how little I have to show for how much I have worked out , but I have been physically active most of my life with running, biking, swimming, skiing, hiking, yoga and weight lifting. Well up until about a year ago, when my left hip suddenly became as sore as my right hip, which had become sore and stiff about seven years ago. I was able to compensate and refused to let it slow me down, but now every form of physical activity now hurts. I have become increasing less physically active with each passing month. I have delayed getting treatment this past year while relocating our household from the Washington D.C. area to Colorado. Maybe this delay has played in my favor.

Last February with my rapidly deteriorating hips, I went to an orthopedic surgeon and he diagnosed moderate OA in my right hip and slight OA in my left. He advised that someday when the pay became intolerable I would need an THR, but I should put that off as long as possible. I had heard something about “resurfacing” and ask him about it. He said it was pretty knew and he saw no benefits over the THR. By October, we were living in temporary quarters waiting for our new house to be finished and the pain had continued to get worse. I made an appointment with a Denver OS and his conclusion was I had severe OA in the right hip and moderate in the left. He had done resurfacing but told me I was a poor candidate for the procedure and he was only 50% confident that he could do the resurfacing and would know until the surgery was begun. He also wanted to wait at least three months between hips. I went ahead a rather hesitantly scheduled surgery for the middle of December. The more I thought about it the more I didn’t like those odds. This web site lead me to send my xrays to Dr. Gross and within a couple of days Lee Webb emailed me saying I was an excellent candidate for resurfacing. Dr. Gross called me on the phone and spent about 40 minutes discussing the operation. He suspected there was more bone on bone contact happening in my left hip than the X-rays indicated and said he could take care of both hips on the same trip to Columbia, SC. My recovery might be slightly longer, but once done I’d be pain free and not facing another operation and recovery. The pace and responsibilities of my project manager’s job make it very difficult to be away from work and extended period, and my wife is a school teacher and it is hard for her to be gone, so doing both hips during one trip was very appealing. I scheduled the operation for the middle of March the week before my wife’s spring break, so she could be with me for the operations in SC and then have the next week to be my nurse at home. Dr Gross operated on my right hip on Monday (3/16/09) and my left hip on Thursday (3/19/09). I was discharged from the hospital on Saturday (3/21/09) and we flew home to Denver on Sunday (3/22/09).

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March 23, 2009: Post Op Day 7 (right) Day 4 (Left)

My first full day home and my worst day of this experience so far! Swelling and pain and questioning my own intelligence. I did my twice per day PT exercises and walked on crutches about 400′ each time. My right leg is sorer than my left and is noticeably the more swollen of the two. Seems to be to types of pain happening. The first is an incredibly tight/twisted knot of muscles, almost like a constant muscle cramp. The underlying muscles are sore to the touch. My intuition tells me this tightness will get better with time. Funny thing is in different spots on the two legs: on the outside of my leg above my right knee, but on the left about mid thigh. The other type of pain is far more frightening. It is a sharp stabbing pain from deep in the groin and hip joint itself. When it happens, I immediately panic, fearing that I just fractured the neck of the femur. Fortunately it does last long. I guess I adjust to it when it happens. Chuck is entitled to an “I told you so!,” but part of my discomfort may have been trying to be a “hero” and avoid the heavy duty pain killers. I have read several post from other of Dr. Gross patients stating they didn’t need anything but Tylenol after leaving the hospital. I didn’t think I needed the vicodin. I decided I would not play “hero” tomorrow, use the drugs before the PT and hope things improve.

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March 24, 2009: Post Op Day 8 (right) Day 5 (Left)

Today was much better than yesterday, despite a fitful night full of self doubt. I arose feeling better than the day before. I took a long hot shower and worked on all the areas of residual adhesive tape from the hospital. The shower was wonderful. I felt good enough to sit a couple of hours in front of my desktop computer catching up on email. Before the morning PT exercise, I took a Vicodin and my morning walk was slow and probably about 600′. The air was crisp and the view of the fresh snow covered Front Range was inspiring. No comparison to how bad I felt on Monday. The swelling in the right leg is decreasing and the muscle pain doesn’t seem as intense. I did put on the polar packs and took a little nap courtesy of the drugs. Afternoon PT exercise seemed easier than this morning and some of the muscle stiffness seems to be easing. I increased my distance to about 800′ with some of it being up hill. I had a couple of those “joint jolts” during the walk, but decided I probably haven’t really fractured anything and perhaps they were part of the healing process. Overall a much better day and a much better attitude.

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March 25, 2009: Post Op Day 9 (right) Day 6 (Left)

Today was a break through day! I discovered I could “walk” using my crutches (i.e. Right crutch forward with left leg forward alternating with left crutch with right leg forward). This was so much easier than moving both crutches forward simultaneously. This feels so natural and my wife commented that I was “walking” with no detectable limp. It was also a very mild and beautiful day in Colorado and I was so pumped that I went double the distance from the day before (probably about a 1/4 mile) with this new form of walking. I went again that afternoon and increased the distance by another block or so. That evening, I even had enough energy left to attend as small group meeting in our neighborhood, where I sat for a couple of hours in a straight back chair. Assessment: I am clearly on the road to recovery! March 25, 2009: Post Op Day 10 (Right) Day 7 (Left) Blizzard day in Colorado and my bodies tells me I have over done it! I awoke with a different feeling in my legs. The “monkey’s fist” was still there and painful, but my legs felt dead. Overall, I felt hung-over and out of sorts. Just moving about the house caused my legs to tire quickly. I had felt this way years before when I was a runner on the day after a road race. So with the blizzard raging outside, I decided to take the day off and didn’t even make it to the computer to post. I need to learn to pace my recovery. We did pull the “super seal” bandage off the right hip incision. My scar is about 4″ long and it is not very pretty. Dr. Gross uses cement to seal the wound instead on stitches or staples. It will be interesting to see how it “cures out.” Assessment: It is easy to over do it on the road to recovery!

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March 28, 2009: Post Op Day 12 (right) Day 9 (Left)

Yesterday’s swelling has reduced significantly and the snow has melted enough to go for a walk. I walk about 1/4 mile on crutches with only minor discomfort toward the end of my circular path, which is up hill. I began consciously trying to reduce the weight I putting on the crutches. For the first time, I feel stable enough to shuffle around without the crutches in the house. One amazing discovery is while sitting I can spread my knees further apart than I could pre-surgery and when I bring them back together. My in-laws arrive to stay with me next week while my wife returns from work. They are amazed that I answer the door without crutches and question. I apply the Polar 300’s and take a Vicodin during the afternoon when I feel some discomfort and a little swelling in the ankles. I sleep the entire night in bed with my wife and briefly try rolling over on to my right side. Too much discomfort lying on my side for more than just a few minutes. I make a mental note to ask Dr. Gross if he and Lee were playing pool during my operation and lost the Q BALL. I have perfected my technique somewhat in getting in and out of bed without making too much noise. March 29, 2009: Post Op Day 13 (right) Day 10 (Left) This is the magical tenth day after the last surgery where so many patients report feeling a net gain in their recovery. I am feeling very good and my morning walk with my father-in-law is about 300′ further than yesterday. During the walk I pass a neighbor who was speaking to some friends sitting in a car in her drive way and she asks, “What happened to you?” I start explaining and suddenly a man jumps out of the car and runs over to me. He smiles and said “This is what you can look forward to being able to do in about three months.” He had a THR three months ago and I was impressed with his spryness. I tried to explain that I had had resurfacing instead of a THR and he said he had never heard of resurfacing. I still have pain and discomfort when I first stand up after sitting for any length of time. I definitely feel my right leg is ahead of my left in recovery. I plan to do a second walk to equal length before supper. It will be nice when the snow completely melts and I can have access to the numerous cross country paved trails in our neighborhood, but alas another snow storm is forecast for this evening and Monday for the Front Range.

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March 30, 2009: Post Op Day 14 (right) Day 11 (Left)

Hard for me to believe it was only two weeks ago that I had my first surgery. My wife returned to her teaching job today and left me in the company of her parents. I have adapted to life under Dr. Gross’s three restrictions: (1) Don’t bend greater than 90 degrees, (2) Don’t cross my ankles and (3) Don’t turn my toes inward, by mastering the tools in the assisted living kit. I can even use the sock installer. I feel pretty self sufficient, but it nice to have their some company on the walks, knowing if I hurt something and can’t make it back to the house, someone can go back and bring the car to rescue me. This morning’s walk was nearly 1/2 mile and I felt really good. I focused on stand tall and reducing the pressure on the crutches. I am still amazed how after walking it is so easy to take a nap. This afternoon the wind made walking outside brutal, so my father-in-law and I went over to Sears Grand to walk in doors and oogle the tools. It is hard to tell how far we walked but my left hip began protesting, so I called it good. This evening the pain continued so took a Vicodin. All in all a good day.

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March 31, 2009: Post Op Day 15 (right) Day 12 (Left)

Weather today was nice and I took two long walks on crutches. I am concentrating on reducing the downward pressure on the crutches. I am still suffering what others are calling “start-up pain” after sitting for any length of time. It is not from the joint, but from tight knotted muscles. On the second walk of the day, I am feeling pretty frisky and push the distance by walking to the tennis courts before turning back. This is probably 3/4 mile. The last quarter of the way back is slightly uphill and I am feeling in both legs. I fell some joint pain in my left groin. I think I may have once again over-done it. April 1, 2009: Post Op Day 16 (right) Day 13 (Left) April Fool’s Day, which is appropriate for me. I had a pretty rough night and took some Vicodin due to pain in the left hip. I obviously had over done it the day before. When will I learn? I decide to shorten my distance on the walks today. April 2, 2009: Post Op Day 17 (right) Day 14 (Left) I had a better night and took things easy during the morning. Last night’s snow melted by early afternoon and my wife accompanied me on a late afternoon walk. We took one of the new paths that had just been opened. Bad decision the path ended in a muddy spot about 20′ wide. In retrospect, we should have turned around, but I thought I could negotiate the mud and uneven ground on the crutches. It was not a pleasant experience, it would have been very easy to slip and hurt something. However, I had to be extremely careful and take very small measured steps to get across the muddy spot without the incident, but afterward I felt exhausted. April 3, 2009: Post Op Day 18 (right) Day 15 (Left) I spent most of the morning on the phone with our IT support folks trying to make the VPN into the corporate network work. My plan is to start trying to do some work from home next week. Sitting for nearly four hours at the computer, I noticed my legs had become quite sore and stiff. In afternoon the weather was beautiful, but another snow storm was expected in the evening. I took a long walk around the lake with my wife and in-laws. My legs felt significantly stronger and I for several long flat stretches, I carried my crutches. What a miracle! Two weeks ago I was having trouble walk a couple hundred feet in the hospital. Whether it was walking without crutches or sitting at the computer for nearly four hours, I noticed my calves and ankles had became very swollen. So it is another intimate evening with the Polar 300’s wrapped around each hip/thigh and keeping the “toes above the nose.”

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April 30,2009 Post Op Day 45 (right) Day 42 (Left)

Hard to believe it has been six weeks ago today that Dr. Gross and Lee Webb performed the hip resurfacing on my left hip. I actually flew back to Columbia, SC today and have my six week post op exam tomorrow. I have had a great recovery with really only one bump in the road. A couple of weeks ago (4/13) I was feeling so good and the weather was just excellent that day, I went for a walk with my wife and way over did the distance, probably walking close to 3 miles that day. By evening my left hip had become tremendously sore and I was having some pretty intense deep stabling pains. This was the most severe pain I have experienced during or after the surgery. I was somewhat alarmed and feared I had messed up the hip joint or even fractured the femur, so I called Dr. Gross’ office. Lee had me go to a local hospital for x-rays, which I emailed to her. The x-rays looked fine, the hip mechanics were in good condition and there was no sign of a fracture. Lee had me ice and elevate the left hip and take it easy for a few days and then to slowly begin back with the PT. My left hip is better but still sore. If I walk too far, I feel a pain under my incision that feels like something (i.e. ligament or muscle) is being stretched at a certain point in my stride. It responds well to icing, so I assume some of the soft tissues are still inflamed. Other than that, my recovery has gone well. The bone-on-bone pain from the arthritis that has been my constant companion for the last couple of years is gone and so is the severe limp. Even with the soreness in my left hip, I am much better off than before the surgery and I know I will only will improve. I will post a summary of my 6 week post op exam tomorrow. Alan

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May 1, 2009 Post Op Day 46 (right) Day 43 (Left)

I showed up at Dr. Gross’ office ten minutes early for my 09:50 AM appointment. They called me on the dot and took me back for two sets of x-rays. The first was from an overhead machine and the second was from a sideways machine that shot from the inner thigh outward. They had me fill out the patient hip survey. For normal and “at its worst” pain levels I answered 0 and 2 for my right and 1 and 4 for my left. Lee Webb tested my range of motion and was very surprised and pleased with the increase over the ROM before surgery. She also tested the strength of my legs by having me resist as she pushed and pulled on my legs. Again she was surprised and pleased with my strength. I assumed my left side would be much weaker than my right, but she said they were essentially the same. She then went over the phase two restrictions, which last until six months post op. Basically, I am not to cross my legs at the knees or above, avoid extreme stretching or bending until 6 months, no impact exercises like running, no bike riding due to the risk of falling and fracturing the femur (but an indoor bike is fine) and no contact sports. (I’ll have to postpone my post-op mixed marshal arts match for awhile.) But anythings else that is not prohibited is a okay as long as I ramp up with moderation. Next Dr. Gross came in and reviewed my x-rays. He said everything looked perfect. There was perfect symmetry between the left and right and the critical angle on each side was exactly 38 degrees. I told Dr. Gross, “You do very good work.” We talked about the soreness in my left hip and he said that I shouldn’t be alarmed that one side was healing different than the other. The mechanical parts are perfectly positioned and the bones show no fractures and with that the soft tissues will heal – eventually. I asked him if I might have pulled the internal sutures loose by overdoing the walking and he admitted it was possible, but even so the tissues would grow back together. At this stage, there is nothing to really do about the pain in the left hip, except just wait and see if the soreness goes away. He said to call the office if it doesn’t improve in the next few weeks. He said that if possible they would like to see me 1 yr post-op and if I couldn’t travel to SC, I could have x-rays and ROM exams done locally I thanked both Lee and Dr. Gross for the wonderful job they had done and told them how thankful I was that my life had been given back to me. I left their office about 12:15 PM feeling very happy with my decision to travel out of state to a doctor that I had found out about on a web site with a strange name about surface hippies. I was also glad I traveled back to SC for the six week post-op exam in person given the concern I had developed over the soreness in my left side. I had lunch and then drove the Charlotte airport arriving at around 02:30 for my 06:10 PM flight. I had a couple of hours to kill so visited the Carolina Air Museum that is located at the airport. I wondered about the exhibits and even crawled up into the cockpit of the DC-3 that is the museum show piece. I left when the museum closed at 4:00 PM and then realized an amazing thing. I had been on my feet walking around and climbing into the aircraft for an hour and half without having to sit and rest because of the OA pain and weakness!!!! May 2, 2009 Post Op Day 47 (right) Day 44 (Left) Saturday I began the new phase 2 exercises and could really tell they were doing something by the end of the day. I worked on doing the stairs foot over foot and then my wife and I installed two ceiling fans. She did most of the work on the ladder, but I made numerous trips up and down the stairs to my tools in the basement. Surprisingly on the afternoon walk I found that my left hip was not nearly as sore . Maybe it is healing after all. May 3, 2009 Post Op Day 48 (right) Day 45 (Left) The Sunday was the most amazing day. After waking up, I did the Phase II exercises, went to Church and had to park a good distance from the entrance and I walked in with no pain or soreness from the left hip. After church my wife and I went out eat lunch and then I did something with her I hadn’t done in ages, (no not THAT) but we went shopping. We spent an hour and a half walking through Sam’s and then spent another hour buying grocery store, walking each isle. All of this was on my feet and without sitting down. Before my surgery, I would just wait in the car while she shopped. Then we returned home and I mowed the front and back yard for the first time since May. We then decided to go buy a leaf blower and discovered Sears was having “Friends and Family” Sale from 6 PM to 9 PM. We went to buy the leaf blower and spent another 90 minutes walking around the store and also bought some patio furniture. When we returned home, I assembled the leaf blower and used it to clean off the grass clippings from the drive way and sidewalk. When I finished that and still had plenty of energy to get on the computer and make these posts. This has been the most amazing day. I feel like I have my life back and can do normal everyday activities that most healthy people take for granted. I don’t think I will ever take doing these normal everyday activities for granted. I have had no pain today. Seven weeks ago before my surgery, I would not have been able to do a fifth of what I did today. Miracles do happen to ordinary people like me.

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May 4, 2009 Post Op Day 49 (right) Day 46 (Left)

Today I returned to work after being gone starting 3/13. I took the crutches with me just in case, but kept them in the car, (they are kind of becoming a crutch to me if you know what I mean.) My coworkers were glad to see me. At the staff meeting they even gave me my own bullet point on the week’s significant events. Alan (The Terminator) Uber returns to work:

Some of my other coworker accused me of faking the surgery, just to be able to have a six week vacation. They said I showed no signs of having such major surgery just six weeks ago. I was so tempted to show’em my other “cheeks”, but now my scars don’t look all that bad and they are only 4″ long. I didn’t want a bullet point next week saying “Alan (The Terminator) Uber moons coworkers.”

Even though I had been teleworking from home, we have another email system that is only available in the office and I had over 1,100 unread emails waiting for me. Oh the joys of a “paperless society.” In the afternoon, I had to give a briefing to a visiting VIP at one of our other facilities that is so large you literally have to walk nearly a mile from the available parking spaces to the entrance. I had intended to see about getting a short-term handicapped parking sticker, but forgot about it until Monday morning. Anyway I negotiated the distance just fine, gave the briefing and walked back to the car. Probably close to two miles. Although I had intended to may be leave early, I wound up working an 11 hour day. I was tired when I returned home, but I was delighted that the hips had carried me through my first day at work without pain or problems.