Hi. First of all, I would like to thank everyone who has provided information on this web site. It has been extremely helpful as I researched the implications of a BHR. My name is Bill, and I live in Little Rock, Arkansas. I am 59 years old, a CPA, and a former Open Division racquetball player until last November when the pain in my left hip became intense enough to cause me to stop playing. In the 1970s I was in a wreck in the jungles of Haiti which almost took me out. One of the injuries was a dislocated left hip, and I was 18 hours away from medical aid. I was fortunate to ultimately receive care at a fairly primitive hospital in Port-Au-Prince by a Haitian doctor who had trained at Johns Hopkins in the U.S. A team of surgeons was flown in from the U.S. to evaluate my situation, and they concluded that the Haitian doc had done everything correctly, even setting my leg back in the socket. I will forever be grateful to him. A Lear Jet ambulance was brought in to fly me back to the U.S., and I went through a period of recovery through the Campbell Clinic in Memphis. Long story short, I recovered and got back on the racquetball circuit. However, the docs told me that I would ultimately need a hip replacement. Many years passed, and I had no trouble with the hip and did not have to have a hip replacement. Fast forward to the summer of 2010 – hip pain started, I began limping, and I could no longer compete athletically by November. I knew what was coming, but I put off getting it evaluated because I was approaching my busiest time of year. In May 2011 I scheduled an appointment with Dr. Russell Burton, my family doc, who ordered x-rays and reviewed them with me. He immediately pointed out that the cartilage was gone in my left hip, and I needed hip surgery. I told him that I wanted to use a well-known doc at OrthoArkansas for the hip replacement (I had never heard of BHR), but Dr. Burton explained what a BHR is, and suggested I consult with a different doc at Ortho Arkansas who does the BHRs. I got an appointment with Dr. John Yokum at Ortho Arkansas, who evaluated my situation and concluded that I was a candidate for BHR. I can’t say enough good things about Dr. Yokum. He has done many BHRs, all without problems. He is extremely competent, and earned my confidence immediately. He has a straightforward, honest and efficient approach to his medical practice, and I trust his skill and advice. We scheduled the BHR for June 22. I conscientiously did the pre-op exercises that they instructed me to do. (These exercises are very important in building your leg strength in preparation for the surgery, and I highly recommend that anyone facing a BHR or total hip replacement seriously follow the pre-op exercise program that you are given.) In the weeks leading up to the surgery, OrthoArkansas gave me the opportunity to attend a class regardinge hip surgery in order to learn what to expect, but I declined. I believed I had done enough research by then to have a good handle on it. I probably could have picked up some additional good information from the class, though. The day of the surgery (June 22) arrived, and my wife (Kathy) and I drove to Baptist Hospital in Little Rock and I checked in at the Admissions desk. Check in time for me was 11 a.m., with surgery scheduled for 1 p.m. Baptist Hospital has a very caring and compassionate culture, and everything was handled with the goal of making me comfortable and keeping us informed regarding what to expect. (Someone from Baptist had previously contacted me at home, and we had already taken care of all the insurance paperwork, etc., so there was very little of that sort of thing to do when I checked in.) They escorted me to the pre-op waiting area, and shortly thereafter escorted me back to a pre-op bed for prep. Kathy was able to stay with me the whole time. The nurses took vital signs, shaved my left hip, and generally visited with me regarding the process. The anesthesiologist came by for a visit to let me know what to expect, and we discovered that we have several mutual friends. He was a great guy—in addition to being extremely competent, he was also quick witted and a lot of fun. The operating room nurse came by to introduce herself, and then Dr. Yokum visited to let me know what to expect. The personal, caring attention from these individuals went a long way toward easing my anxiety while I was waiting for the clock to tick down to launch time. At 1 p.m. they came to take me to the operating room. A nurse turned a dial on my IV, and I don’t remember being wheeled out of pre-op. I awoke in recovery, groggy as expected, and took some sips of water. In and out for a while, no pain, but stiffness and soreness. I don’t really remember being taken to my room, but I regained my senses pretty quickly thereafter. Dr. Yokum had told Kathy that the surgery was a success, although it took him significant effort to smooth out the rough spots in the hip socket. I had excellent and constant attention from the nurses on every shift. They were very personable and attentive, and genuinely cared. I had no catheter, and I used the walker to go to the bathroom. It was pretty amazing that I could actually walk within a few hours after surgery! Had to go slow and be careful. Used the plastic urinal that they left by the bed once during the night when I didn’t feel like getting up. Around 4 a.m. on June 23 Kathy assisted me in getting out of bed and I took the walker out into the hall and walked around a little, just trying to see what it felt like (not sure I was supposed to do that…). There was no pain in the hip joint, but again, stiffness and soreness. I was taking oxycodone. Physical therapy started that day. Walked down the hall to the PT room, and the therapists coached me through various exercises. I also began walking more in the hall with the walker. Wasn’t easy, but I could do it. Had PT twice on June 23, and again the morning of June 24. They gave me the utensils needed to help pull my leg up onto the bed, put on socks and shoes, etc. I was scheduled to stay in the hospital until June 25, but on June 24 I asked them to discharge me. At that point they were just bringing me meals and pills, and I figured I could do the PT at home. One of Dr. Yokum’s partners visited with me (Dr. Yokum was out of town), and agreed to discharge me. Kathy drove me home. Home physical therapists started visiting once a day, and I also did the exercises by myself a second time during each day. Used the walker for around three days at home and then shifted to a cane. Very important –the physical therapists don’t necessarily know what a BHR is, and they are trained to do PT as if you had a total hip replacement. My PTs thought I was supposed to use the walker for 3-4 weeks, so I had them call the doc, who said “get him off the walker now and put him on the cane.” No bowel movements from Thursday through Sunday after the surgery (anesthesia and pain medication will do that!). Took a stool softener and drank some prune juice on Sunday and everything kicked back in on Monday. I really appreciated the raised toilet seat extension with handles on each side! Today is Saturday, July 9, 2011. I’m 17 days out from the surgery now. I discharged the home PTs earlier this week (on Tuesday), since all they were doing was watching me do exercises that I know how to do. They did not recommend outpatient physical therapy for me, because they said I was motivated enough to do it on my own. I started back to work half-days on Wednesday, July 6. Drove myself the 11 miles to my office building downtown. Probably should have asked Kathy to drive me to work that first day – it was pretty tiring, but I managed. I’ve felt stronger every day since then. I’m planning to go back to work full time on Monday, July 11, and plan to be flying to meetings in Kansas City later this month. Bottom line: I’m really glad I had the BHR, and I am very grateful to Dr. Yokum, Baptist Hospital and the staff and nurses. I can’t think of anything that I would have wanted to be different. Recovery is slower than I expected, but I’m pretty impatient by nature. I can go up and down stairs with no trouble, foot over foot, and I’ve started using my treadmill for additional walking exercise. 5 minutes first day, 10 minutes second day, and today I’m going for 15 minutes. I can walk without the cane, but I’m not yet comfortable doing so. I’m still really favoring the left hip, and I’m conscious of trying to shift my weight properly when walking. I’m not there yet, though. I’m ready to start taking the border collies for walks in the woods at night again, and it’s frustrating that I can’t yet do that. Thanks again to everyone for providing great info on this site! It really helped me, and I hope the information above about my experience is useful to others who are considering a BHR.
One Month Progress Report
I had a one-month checkup on July 22, and thought I would provide a progress report.
June 22 – BHR on my left hip (Smith and Nephew device, femoral head cemented)
June 24 – Discharged from hospital
June 25 – Home PT started
June 27 – Stopped using walker and started using cane
July 6 – Started back to work. Also started driving again. Home PT stopped, and I started doing PT on my own twice a day
July 11 – Walked ¼ mile w cane
July 12 – Walked ½ mile w cane
July 13 – Walked 1 mile through woods and down street with Annabelle and Jasmine (border collies) w cane. Have walked 1 mile w cane every night since then.
July 22 – One month checkup. They took x-rays, and Dr. Yokum said everything looks good. I discussed the following with Dr. Yokum:
· I have no pain, but still some soreness when I get up if I sit too long at my desk. Primarily in the muscle that leads from the interior of the leg into the groin. That’s normal, per Dr. Yokum, and will progressively decrease.
· I’m having trouble sleeping at night, probably because I’m more conscious of some “achiness” when lying in bed. I rarely get over 3-4 hours of sleep. I’ve been taking Ibuprofen, which helps a little. He said this is normal and should decrease over time. Take a pain pill if it is too annoying.
· Can I stop using the cane? I’ve had no trouble doing leg lifts for the last couple of weeks, and I can walk without the cane, although with a slight limp. He said my abductors still need to strengthen some more, but I can stop using the cane when I feel confident without it. He said the limp should correct itself. I think I could do ok without the cane now, but only for short distances before the leg muscles get tired. I’ll probably go a few more days with the cane and see how I feel. Keep doing the abductor exercises. Also keep doing PT exercises twice each day.
· Do I have to continue to follow ROM restrictions? Yes, through 12 weeks, just to be safe. No crossing the legs yet, watch the 90 degree rule, etc.
· What about lake activities? Boating, wave runners, etc.? He said driving a boat on the lake at moderate speeds is ok, if I can safely enter the boat leading with my non-operated leg (which I can do). Wave runners are probably not a good idea yet because of mounting/dismounting issues. Wait till after 12 weeks.
· He was surprised that I had been walking a mile every night since July 13. He said it would be better if I walked on flat surfaces, and not up and down hills. Darn, I have to deal with hills. I’ll be careful. I could use the treadmill, but Annabelle and Jasmine want to walk every night.
· Come back for another checkup in 2 months.
I think I feel better after the checkup, probably because Dr. Yokum said everything looks like it’s supposed to, and I’m making progress. I’m impatient, though—maybe losing the cane in the next few days will help.
Still can’t put a sock on my left foot without using the “sock utensil” they gave me when I left the hospital, since I can’t cross my left leg yet. Otherwise, I’m pretty functional. I’m flying to a meeting in Kansas City next Tuesday—it will be interesting to see if I can get through the metal detector at the airport. I’m guessing probably not, because I’ll bet they’ve got the sensitivity turned up pretty high.
Kathy says if I have to keep using the cane for another couple of weeks, she’s found one in the shape of a pink flamingo that she’s going to buy me. I told her I would rather have one that turns into a sword…