March 17, 2011

I will be needing a hip operation and was told that hip replacement would be my better option, or actually-only option; but a friend (male), who had successful hip resurfacing last year, convinced me that I should look into hip resurfacing. He also directed me to this site. I am from the New York area and have an appt. to see Dr. Su next week after waiting almost 3 months for the appointment. I understand it will be well worth the wait. I have been using this site to collect information and prepare my questions hoping to leave no stone unturned! Unfortunately, I have yet to run across anyone on this site with my condition. Here is my story:
I am a 53 year old female, 5’7″, and up until about a year ago, never had pain in my hips. I am active, used to be a runner, thin and strong. Even with my current hip pain, I still work out on an eliptical bike, work with weights, do a little yoga and continue with physical therapy exercises. I have been diagnosed with hip dysplasia-I believe it is mild as it’s never been an issue all my life. I also have spinal stenosis in my lower back, which I have been aware of for many years. I’ve learned to work with my back issues and never let it stop me from being active. Ten years ago I took certain measures to help my back and was essentially pain free for about 8 years. Then the pain came back soon followed with a pain in my left hip. No one can tell me which is the aggravator – the back or the hip. I was initially treated for bursitis, which I believe was present but is fine now. My groin pain is gone and I can get around better.

I cannot: walk long distances-both hip and back begin to hurt. Going up stairs is painful but not going down. I can do deep knee bends, touch my toes, sit comfortably, sleep pretty well, do light yoga moves. I am still very flexible.

March 27, 2011

I had my consult with Dr. Su and received the OK for hip resurfacing from him! I am delighted he feels confident that I am a good candidate. We discussed the metal on metal and release of metal ions into the blood stream, more prevalent with females, no way to be certain who it will affect, etc… so this is my big conern. My bone density test (I brought with me) indicated good bone density and my xrays were pretty straight forward – hip dysplasia more pronounced on the left then the right, and curently I am bone on bone on my left hip. I was expecting to wait another 3 months for the operation but a cancellation came through for April 14!! That’s ony 2 1/2 weeks away! I jumped on it-had to give up our family vacation to Bermuda though! Big dissapointment, but this really needs to get done. Needless to say, I am very nervous but feel I am in good hands with this surgeon and the hospital. This metal thing does have me concerned but feel I need to go this route before a total hip replacement.

April 25, 2011

I am-2 weeks post op and I suppose I’m doing OK. To back up a bit, I did something unprecedented after hip surgery-at least as far as I know and hear from the nurses. I had my surgery on Monday, was discharged on Thursday and on Friday, my family and I flew to Bermuda for the weekend for a quick vacation we had scheduled months before! This was a celebration for many life events in my family and I had worked so hard to find a great hotel at a great rate this time of the year. When I jokingly asked the Dr. beforehand if this was possible, he thought it was doable. Well, on Thursday he cleared me to go and off we went. Everything worked out beautifully and I felt it was the best thing I could have done for myself. We received VIP treatment atm the airport, the hotel, and from all the friendly and helpful people in Bermuda. This time of year it is not so crowded in Bermuda and the weather was glorious! Our hotel room was wheelchair accessible and so was the bathroom- much more comfortable then my own. We stayed at the Fairmont Southampton-highly recommend this hotel!!

Once back home, the work began. I started in on light PT from the visiting physical therapist and began experiencing discomforts that are probably normal but annoying. I developed and still have pain in my thigh, side of my knee, and back of the knee joint. My groin muscles give me a lot of problems and I fine that this holds me back from doing some of the important strengthening exercises. The most annoying is the clunking feeling I get with most movements. I know this is normal for some people and my Dr. listed this as something to expect until the muscles and tendons strengthen over time. Each day gets a little better, but I feel like I’m being impatient. I went in strong and ready and feel I should be coming out strong and ready. I feel like my leg muscles that once were strong and supportive have become weak and like jello and this is the reason for all my discomfort. My Dr. recommends using two crutches for 3 weeks, the PT says at 2 weeks or before, I could wean off the second crutch. I use the one to get around the house to do things so I have a free arm available and then go back to using two crutches when I get tired. The Dr. says walk, walk, walk, the best PT is walking. I have ventured out down the block and back but I am no where near a mile walk like some of you I read about. I am hoping this week things speed up for me and I can report back to say all my discomforts have disappeared!

May 8, 2013

I had my first done by Dr. Su – left resurface BHR and I am now getting ready for my second – right resurface BHR. This recent video he released is such perfect timing. Out of all the Dr.’s I’ve been too, he is the one I feel most comfortable with – compassionate, thoughtful, and very calming. He puts you at ease.

October 13, 2013

I am four days out from surgery on my other hip. My left was done 2 1/2 years ago; I thought I was good for another 5 years before my right went, but sometimes the body has other ideas!

In the coming months, I hope to use this forum to help and inform future and past surface hippies, just as this site has helped me tremendously and to also use this as a journal for myself. My first time around, I kept no notes. I felt helpless to comment when you would post questions and I couldn’t quite remember my details. What I do remember was leaving the hospital on a Thursday and on Friday, I was on a plane to Bermuda with my family for vacation/recuperation! ;D We had a family vacation planned, my surgery was moved back which almost collided with our vacation. My Dr. said if all looks good, you’re good to go! I was a very good patient! I got the VIP treatment the whole way there and back and all worked out well!

Upon my return from sunny and warm Bermuda, I came home to damp and cold spring weather. My at home PT began and I just remember walking around my block with crutches forever and taking it very slowly. I wanted no complications so I did everything by the book. My recovery was a bit slower than most due to on-going back issues. I had my left hip resurfaced but my left back side was and is my worst side which hampered recovery. I would like to share a short version of a lifetime of issues:

-I have always had back problems – pretty much all my life – never a problem with my hips.
I made aggressive steps to solve the back issues, but most medical help meant some form of surgery. I wasn’t interested so just moved through the pain, which became my normal. I’m very active and flexible – my yoga instructors thought I might be too flexible – I’ve been told that before.

-I’ve been exercising and running since the age of 12, used to swim, but walking was my favorite. I used to work in NYC and when everyone else was taking cabs, subways or buses, I would walk – no matter how long it took. I depended on my legs to get me everywhere.
-So, when I started having problems running and walking a few years ago, I was devastated. When I was diagnosed with spinal stenosis AND hip dysplasia, I went through a short period of denial.

-I developed arthritis in my left hip due to the dysplasia, the right seemed OK but there was a labral tear noticed on the MRI. It caused me no pain so we left that alone and concentrated on the left hip. It took a year for me to work through the system until I found the right Dr. to perform a hip resurfacing. My concern with a THR was dislocation. Since I was extremely flexible, even pre-surgery, I felt I would easily dislocate my hip.

-The surgery was done on 4/11/11. Due to the stenosis and what later showed were pinched nerves on both sides, it was difficult to do what PT required. Time moved on, I healed, put it all behind me and I became active and happy once again.

-Until my right went out December 2012. This time it was the slight labral tear that tore further that created excruciating pain. I still had cartilage but not healthy cartilage so nothing else could be done other than get a new hip. I chose to have the hip shot, which I understand is controversial, but it did buy me time.

So, here I am. I have spent the last couple of months just enjoying myself and having fun! 🙂 I discovered bike riding and have discovered new places because of riding! I still do yoga and my ROM is still incredible! Although, I can’t walk without pain and becoming exhausted very quickly.

Thursday I head to HSS, Dr. Su is my Dr. Now I’m nervous, of course, and just wish it to be over.
Once again, thank you all for your supported stories – I think this time around, I am more aware and prepared. Unfortunately, I have no plans to fly to a beautiful island to recoup!

Surgery time: 2:15pm, Thursday 10-17-13
My surgery was done at HSS (Hospital for Special Surgeries) Dr. Su, NYC

Once in recovery room, my husband was allowed in for short period to let me know all went well with the surgery – no surprises! Dr. Su also told him that I was a good candidate for resurfacing as my bone quality was good and muscle tone in great shape. I am female, mild dysplasia and 55 years old – not a great candidate on paper, so only the best Dr. with experience would do for me.

However, I had two post-op concerns: very low blood pressure and high pulse rate, and extreme nausea – nothing would stay down, not even ice chips. After 3 attempts at nausea medications and still bring up green bile, they called in the special forces! :-[ (pain management group). I was given a nausea patch to put behind my ear. Once the patch was in place, they started me on a liquid diet which soon progressed to soft, then normal diet.

I’ve been under anesthesia before, many times, and never felt sick. I was hooked up to the epidural drip and perhaps that wasn’t agreeable to my system. Guess I will never really know, but once I could keep food down I felt so much better and caught up rather quickly in PT.

The next issue was blood pressure and high pulse rate – they felt pressure way to low to be released. In recovery, it was sporadic, dipping below 90 (85/70) at times. (low blood pressure is normal for me, but they were not comfortable with it) I also had “the shakes” after surgery. I had this the last time and prepared them that this could happen again, so when it did happen again, they were quite aware and took care of that promptly.

In every way, I was healing rapidly and didn’t need to be there, I wanted to be released on Saturday. It was the low pressure that held them back. Finally was able to convince them and left Sat. afternoon, blood pressure 100/70.

Today is Sunday and have spent most of the day just resting, icing (using an icing machine), took my first shower, working on the swelling, and walking around the house with crutches. I feel very stiff, achy everywhere in left leg, pinching at the incision sight, but nothing abnormal. I’m using a localized lidoderm patch placed near the incision site to control pain, something different from 2 years ago along with all the other med scripts they send you home with.

Home nurse and Physical Therapy begin tomorrow. So, at this point, pretty standard stuff and uneventful — hoping it stays that way!

November 10, 2013

I am 3 ½ weeks post-surgery and all seems to be going well! This recovery seems to be progressing a lot quicker than my first. Here a quick rundown of my progress and struggles:

Progress:
First, I have no pain – best part of all!
Icing – stopped icing after about 1 week. There was very little swelling, much different from the first where I was icing for almost 3 weeks.

Crutches – gradually weaned myself off the second crutch. One crutch inside walking, two crutches outside. By 2 ½ weeks I completely lost the second crutch.

Driving – At 2 weeks, I was driving. Even though surgery was on my right hip, I felt capable of getting behind a wheel and in control. Started with very short distances and worked my way into light shopping.

Walking – by now I am walking about 1 mile outside and because we are nestled in the mountains, a lot of my walking is uphill. It doesn’t bother me, in fact, it’s quite invigorating! I am also using a stationary bike, low resistance for about 15 minutes and continue with the first stage exercises that most of us begin with.

Socks! – I was ecstatic when I found a way to get my own socks on! By wearing only the short ankle socks and using my grabber, I can slip on the toe portion of the sock, then reach around the back of my foot, grab the sock from behind, and slip it over my heel. It takes a little flexibility but you don’t break the 90 degree rule. I don’t have precautions but am careful with my moves.

Stairs – today, I seemed to have mastered the stairs, full weight, without the aid of the crutch!

Home PT – went well, but a lot of it was just a refresher from the first time. It did help, though, – finished until outside PT begins

Struggles:
Gait – will take a while to perfect. After the first surgery on my left hip, I never fully recovered a smooth walking stride. Two years later, the right hip went so that stopped all progress on my left. Hence, I will use the one crutch until I feel 100% before moving onto the cane. Unfortunately, my follow-up appointment isn’t until early December so I’ll be working on this on my own.

Because I was still working on strengthening my left hip when my right went, my left has been a bit overwhelmed. I do feel a bit of stress in that hip so I’m doing the best I can to try to strengthen it again.

Sleep! I know everyone struggles with this and I’m no different. Not that I feel any pain, just very uncomfortable and restless! I think when I do my exercises before going to bed, it helps – calms the leg (or tires it out – not sure). Lots of pillows is definitely a must! I’ve managed to get on my side and remain comfortable for a short period but it’s not long lasting.

Boredom! – Knew this would be an issue beforehand so I did line up a few small projects to work on after surgery. Well, they’re finished so boredom is setting in. I can’t sit for very long as standing and moving around is more comfortable which means more walking and exercising and hopefully a faster recovery!

Not an easy journey mentally but physically, I can’t complain – just hoping for steady progress forward with no setbacks!

December 10, 2013

I went for my 7-week checkup with my Dr. last week and he was impressed with my recovery. I’m a little late in posting this because after my visit that day, came home with a sudden, strange virus that hit me like a rock! I wonder if our immune systems are a bit compromised for some time after surgery-Ugh! Anyway, he felt I was way ahead with my progress, gave me the all clear to proceed with the next phase of exercises, and to continue listening to my body for instructions as to what it can and can’t do. Dr. Su does not have a one size fits all protocol that all should follow after surgery. He will give you the basic set of first stage exercises to work on and if they can be performed comfortably and correctly, move onto the next phase. He mentioned that all his patients have their own time clock and they should listen to that.

After surgery, I had permission to put full weight on the operated leg as soon as I felt comfortable to do so. Even given broad range clearance and limited restrictions, I still followed precautions just to play it safe.

I have mild dysplasia and I was curious how the cup was able to fit properly around the acetabulum if my bone wasn’t fully formed. He explained that he had to build that part up so the cup would fit securely. I think this is why we choose the best surgeons we can find to perform this surgery. I wonder if a less than qualified surgeon would take the time or have the skill to do this.

Before surgery, I worked very hard to keep my muscle tone strong and bone quality healthy. I exercised a lot, ate healthy (increased protein) and took my vitamins, especially Vitamin D and Calcium! I believe this contributed to a quick recovery.

My first surgery, I was not as prepared physically and hence, my recovery was a lot slower.

Dr. Su’s only restrictions is to refrain from running, jumping or carrying anything over 50 lbs for 6 months. He actually told me 30 lbs…maybe because of my age, gender, or simply I shouldn’t be carrying 50 lbs no matter what!

We discussed moving onto outside physical therapy and the possibility that I may not need it at all. Because I went through this once before, I know what I need to begin doing. I have begun the strengthening exercises and now I feel pain – good pain! I started working on those “clamshell” exercises and simply can’t do it! Hip Abduction – (side Lying) – negative!

So, even though my first two months have been smooth and quick, I can see the next few months will be rocky and slow! My own time clock alerting me to be patient.

December 27, 2013

I haven’t posted in a while so thought I’d give all an update on the progress of my setback.
Things have settled considerably but it took a lot of work to get where I am today. Through a little self-diagnosis, I believe I must have suffered a rapid onset of bursitis. At first my whole leg was in pain – groin, thigh, gluts, back and side legs. I remained on crutches for about a week, iced, rest and stretched as gently as I could. When the acute pain settled, what I could feel, and still have a little of, was intense tenderness, like touching a nerve, at the area where one would feel for bursitis. I do have occasional flare ups on my left and I would have to work through it, but never had it on the right hip.

What this has done is set me back perhaps 6 weeks whereas now I’m at 9 weeks. One exercise my Dr. suggested for bursitis is the “figure 4 crossing of legs” which is to sit in a sitting position, place your operated foot over the unoperated knee and gently press on the knee downward to flatten the leg. This is great to help with rotation and to relieve stiffness. At first I couldn’t even get my leg up, now I have it to the point where I’m working on flattening the leg to make the “4” shape.

Another helpful suggestion was the foam roller, which many of you have mentioned on this site. It’s extremely painful, and quite difficult to maneuver onto, but on the days I can manage it, I do feel some relief!

As I mentioned, I spent a lot of moments thinking of the moment that I moved the wrong way to cause all this. When my daughters where in for the holidays, I had a lot of help which I thankfully needed but they also pointed out a possible cause. The day this all happened, I started the elliptical bike I have in the basement – it’s old and wobbly and the movement isn’t what it should be. Both my daughters work out in high performance gyms and know the difference between a good machine 🙂 and bad machine >:(. They said my machine is a bad machine and gave me all the professional reasons why. They said they could feel pain and stress on the sides of their legs as well and couldn’t imagine me using this in my condition! I believe I must have pulled something which set this into motion!

So, lesson learned! My old elliptical machine heads for the trash! I hope this helps someone make good choices when it comes to using quality machines! I will begin outpatient PT in January for a few weeks to get this sorted out and then start in on strengthening exercises.

March 27, 2014

Just thought I’d give you a quick up-date on where things are with my progress.  Today marks three weeks from my surgery (hip wash and debridement) and as frustrating and disappointing this whole thing has been, I feel good, there is no pain and energy levels are good.  Of course, I felt fine with no pain before all this happened so all this is still a mystery!  I’ve spoken to the Infectious Disease Dr. and the culture they took after surgery never grew anything so, I’m not sure, good news, bad news. It’s still an unknown bacterium we’re dealing with – the IV antibiotic is broad spectrum.  He did share some positive thoughts on this, as slight as they might be, but I’m leaning on that right now.  I have to say that my hip and strength factors within my hip are much better.  Progress is speeding up within the last three weeks where as prior months before were a slow grind.  Right now, I feel like putting all this behind me, moving on with my life and never seeing another Dr for a long time!!  But I know I can’t do that!
I do a lot of hindsight searching,– What should I have been looking for, what signs should have told me to go to the Drs and ‘get this checked out’?  I’m not sure what my complaint would have been?  I had a setback in December, but we all have set backs; I rested, iced, went back to my crutches for a few days, then things began to improve in January, started PT, progress was slow but things were improving.  Quite frankly, I thought I had bursitis because I had it before, but bursitis is normally very painful.  I had an ache, right were bursitis would be.  The therapist thought bursitis and maybe tendonitis.  I had an ache, no fevers, no illness, my incision was healing/had healed beautifully.
I guess my point here is I wish I could pass on advice for the sole purpose of this website and everyone out there as to what to watch for when it comes to infections.  We discuss our progress all the time, the ups and downs and finally, for the vast majority, it all works out – we give it patience and time.  So, when is that not good enough?
I meet with the Infectious Disease Dr. and my surgeon three weeks from now, April 21st,  pic line will be done.  I have a whole list of questions to ask and I hope some answers to share – will give you a further up-date then.
Thank you for all your kind thoughts and support!
PS – I do want to say and stress that I love my new hips!!   I feel like I can walk like I’m 20 again!
Debbie

April 30, 2013

It’s been eight weeks since my surgical irrigation and debridement of my infected hip; two weeks ago ended my six weeks on an IV picc line.  I met with my surgeon, Dr. Su, and the ID Dr. on April 21st for a progress report and discussion on my options going forward. X-rays were taken and all looked perfect.   Dr. Su and I were on the same page – to continue with oral antibiotics for another six weeks with an undetermined ending date.  When I stopped the IV picc line, although relieved, I felt very anxious, like someone just removed my security net!  I felt exposed to whatever may still be lurking inside so when Dr. Su agreed to continue, I was very relieved!

I was suppose to meet with both at the same time but ended up in a discussion with the ID Dr. before meeting with Dr. Su.  He wasn’t too keen on continuing antibiotics but after talking with Dr. Su later, he came on board.  It’s important to have an ID Dr. on board with therapies going forward as they will be the one monitoring blood work, interactions with the antibiotics and making recommendations along the way.  After discussion with him, I’m not sure we see eye to eye on certain things which may leave me to look into a second opinion and/or another ID Dr.

The reason for the continuation of low dose oral antibiotics is because the infection affected my new metal hip.  Once they open me up and had a good look, it wasn’t good – infection deep into the hip joint.  My hip was dislocated to allow access to the acetabulum and surrounding tissues.  Irrigation and debridement was done more than once, pretty continuously.  Dr. Su told me later he never scrubbed so completely and thoroughly.  My implant was perfectly intact.  It’s amazing I didn’t feel all this early on and did not have pain.  I have a 50/50 chance of this returning.  When they cultured the fluid and tissue specimens to determine the cause, nothing grew back.  I was on antibiotics for two weeks before surgery which might suggest that this successfully rid me of the infection.  This is my theory which helps me to stay a little positive!  I have been on antibiotics that target no specific bacteria, but  broader spectrum – so far it’s done the trick.  The next six weeks, I am on Augmentin and Rifadin (generic-Amox TR-k CLV/Rifampin).  Rifadin needs to be paired with another so hence I’m on two.

I had a discussion with Spencer on this site who went through a similar situation with an infected hip.  He noticed early on that something just wasn’t right and caught the infection early – the infection never hit the hip.  Thanks Spencer for the emails and talk!

I wish I could share what it is one looks for when it comes to infections. Here’s a timeline of events and maybe an alert/alarm might help someone else be more aware of possible symptoms that I seemed to have been oblivious to:

October 17 – Right hip resurface and for the next 7 weeks, recovery was very quick and painless.
December 4 – Follow up with Dr. Su.  All looked great, X-rays perfect, ROM  good, incision healing perfectly.
December 14 – First set back.  Felt like I pulled something as I had been doing quite a bit.  Spent the next week relaxing, icing, back on one crutch for a week.  By the holidays, feeling better and worked through muscle issues.
January 8 – Began outside PT.  Although slower than I would expect, progress was being made.  Had difficult spots around the groin, tight and on the side of my hip I felt tenderness at the bony point and thought I was dealing with Trochanteric Bursitis, maybe tendonitis because the spot was so specific.  Maybe at this point I notice a difference in the look of both my hips.  My right looked ‘fuller’ than the left.  This, however, was nothing I would have worried myself over at the time, but I do reference back to this when searching for a beginning point.
February 16 – noticed a red ‘ring’ around incision.  Thought I had Lyme disease without the symptoms!
February 17 – Brought this to the attention of my PT.  She thought she felt some swelling.  Watched it for a day, redness around incision grew and it felt like ‘something’ was under the incision.
February 19 – Visited my family Dr., blood tests started and since there was an obvious sore on my hip, started me on antibiotics.  Notified my surgeon.  He was on vacation but began sending pictures of the incision to the PA.  In the meantime, more blood work done.  Everything was off, Sed rate and CRP high (important indicators, especially for surgeons looking for infection).
Feb. 26 – In to see Dr. Su.  He was perplexed by what he saw and also my state of well-being.  No pain, not even when the incision was touched and pressed.  Ordered MRI for that Friday.  Had to wait for insurance clearance.
Feb. 28 (Friday) – MRI
March 3 (Monday) – Dr. Su calls early to say there is fluid around joint and strongly suggested surgery that week.
March 6 (Thursday) – Surgery – irrigation and debridement, copious amounts of antibiotics both inside and out.  Four days in hospital.
March 10 (Late Monday) – released to go home.  Nurse comes in evening to start me on the picc line.

And today, I feel normal, walk without a limp, pretty much in a smooth fashion – my gait is perfect.  This is why I will stay on this course, fighting it off for as long as I can.