After running competitively in high school and college and then just for fun through my 20’s & 30’s, with mid-life creeping up my back, the thought of finishing a marathon by 40 turned into a obsession in June, 1994. After completing #1 in September, I went on to finish 30 in 20 states during the next 6 years, added trail running and felt the closest to God’s great creation during those Saturday 50 milers. Ultimately, I was able to complete 100 miles in 23 hours on a track in Pennsylvania during a Relay for Life event.
Running was a love that brought release from stress and kept my mind in top shape. My wife (32 years now ) used to think running would be the last love to go, long after her. Her prediction was incorrect; running is a faint memory while she continues to add joy to my life. Five years ago, my pain began inside the groin area with a continual tight IT band and hamstring on the right side. After trying Celebrex and other pain management, I decided to seek the advice of a pro. This particular ortho in PA looked at my x-rays in 2003, slammed the THR post on the table beside me and stated, “Within 2 – 5 years, you will have this done if you don’t quit running,” His time prophecy proved accurate, but I always believed there must be some other way at the young age of 48. Note: for the lovers of running, I have been told by five specialists that running may have accelerated the need for surgery, but genetics is the primary reason for my situation.
For nearly a decade, after logging 2,000 miles per year, my jogging slowly reduced to once a week for a mile or so and then to walking. It was as though I lost a very close friend, someone who had helped carry me through most of my adult life, encouraged me, blessed me, righted my world. It took two years to work through the lost. Taking its place, my much more distant friend, the bicycle, became my only avenue for serious exercise. After consulting with two other doctors and moving to NC, I found the alternative I was seeking – hip surface replacment. I devoured research about resurfacing, found very few individuals – even my personal physician – had heard about it. In my mind, I decided that when the time came, I would use the Birmingham and set out to find the physician.
Dr. Riyaz Jinnah at Wake Forest Baptist Hospital and NC Baptist Medical was found through google search disclosed at the wonderful surfacehippy website. After learning that they would accept my insurance carrier, a match was made. In July, 2008, I made my first visit to Dr. Jinnah. Even before seeing him, the x-ray tech told me I had come to the right place. I believe her words were these: “All we see from his patients is success after success.” It was a sign that I was in the right place. Dr. Jinnah took time to answer questions, explain what he saw in the x-rays and continued to solidify my decision. Since I coach high school cross country each fall, I needed to wait for the end of the season. November was the chosen month with the pre-op appointment in October.
This writing was begun on November 24, 2008, the 6th post-operative day. I was in no frame of mind to type my feelings and thoughts prior to today.
Pre-op: The staff was wonderful, informing me actions as they performed them, answering all my questions. The spinal insert is something I remember but have no associated negative feelings. With my legs numb, the wheel to the operation room was something like an amusement park ride – moving forward on my back with only half my body going with me. I was the second surgery of the day for Dr. Jinnah. I had chatted briefly with him in the pre-op and heard his voice in the operation room, saw the clock read 10:00 a.m. The next thing I know I was moving into recovery room.
Recovery: As the wheels of my gurney came to a stop in recovery, I saw the clock registered high noon. That meant the surgery was only an hour long considering the time of prep, opening and closing. The next hour in the recovery was wonderfully exhilarating. From the day I left the hospital as a baby in 1955, I had never been a patient – what a blessing from God. If I had known this feeling was going to be so heavenly, I might have sneaked in long before this. I experienced such a high: if they could package the feeling of coming out of the “Milk of Amnesia” combined with a spinal, the medical field would make enough money for all the research in the world without another fund raising event. Over the hour, it seemed I was irritating the nurse sitting beside me – could not get her into conversation. It didn’t faze me – it was such a feeling of euphoria!! When you have your surgery, enjoy this golden hour because there won’t be much of this in the days to come.
Hospital Room at WF Baptist: In the Stitch Center which is dedicated to ortho surgery patients, there are 16 rooms. Each room is so large, well decorated, with a 5-star hotel feeling. And the ward is SO QUIET. I was told by an orderly as he wheeled me to the exit x-ray that the rest of the hospital is crazy with noise and distractions until late at night. This is the best area of one of the best hospitals in North Carolina. The day staff was incredible, positive, competent especially a nurse named Kimberly (Kim). I emphasize the day staff. It seemed the sun was always shining on the day shift, but the darkest night fell over that area of the hospital at 7:00 p.m. The nurse assistant who attended my drain bags was a good guy, but the other two attendants seemed to be picked off the street for the night. I will spare the stories, but one snapshot is the fact that no one on duty could restart my IV that came out around 4:00 a.m. After two of them trying, they told me I had to wait for the day shift to come in at 7:00 a.m. Again, thank you, Kim, for your great service!
Surgery Day (Tuesday): Getting to my room at 1:00 p.m., I dealt with numb legs most of the day. With the numbness, I could not have done any PT on Tuesday. I took all the pain pills on schedule to keep ahead of the pain. Dr. Jinnah has the philosophy to stay ahead of pain – some given even before the surgery.
Day One (Wednesday): I took extra pain medicine 30 minutes ahead of my time with PT at the advice of Kim which proved to be wise. At 9 a.m. I was able to get out of bed, make it to the bathroom, sit in chair. With low blood pressure (90’s/50’s; much different from pre-op high of 160/100’s when my typical blood pressure is 120/80), I could not stay in the upright position long. As PT left, she told me she would expect much more when she returned (I sensed a devilish churl in her voice ). I told her I planned to do much more in the afternoon. At 2 p.m., she returned. She was so pleasant and encouraging (OK, I misunderstood her tone). She stated she was into slow walking as the unit staff had a big Thanksgiving meal and she felt like a stuffed turkey herself. By now, my blood pressure had returned to normal and I was able to walk down hall with ease, handled steps and toured an extra corridor before returning to room. As I passed the nurse’s station, the staff said I could go home and by 5 p.m., we were on our way for the 2.5 hour car ride home. After reading of other miserable car rides home, I was happy when it turned out to be better than expected. That night, sleep and rest were horrible. This proved to be a pattern of the next week: tolerable during the day, miserable at night. The first night I am not sure if IV fluid was catching up with me, but I had to use urinal or get up each hour to go to bathroom. I tried to use the portable urinal provided. Not to be graphic, but the numbness affected my ability to judge if I was done or not. After the second misjudgment, I got up each time. In my mind, I thought this was a good preventative method against blood clots.
Day Two (Thursday): I spent Wed night and Thursday on Tylenol 325 mg 2 – 3 pills at a time up to maximum daily dose of 4,000 mg. The day was one of the longest, one of the few days in my life when I did not see the exterior of God’s creation. It was with great difficulty that I had rest or comfort. Looking back, I should filled the narcotic prescription, but was making it – barely. (Having received the warning that narcotics lead to constipation and only experiencing this miserable experience a few times in my life, I figured the pain was less than my pure hatred for constipation. The narcotics seemed a way to delay a different king of pain and thus I avoided them. Whether this plan was the reason I did not have problems with elimination, it was a relief when 72 hours after surgery, I was able to get the system going in fine fashion.) I had little sleep, frequent bathrooms trips. Although at one stretch, I enjoyed 3 hours sleep just prior to sunrise.
Day Three (Friday): Another uncomfortable day with the minutes passing like hours and hours like days; another day without having the ability to go outside. According to PT instructions, did the walking up and down our hallway with my trusty walker. I was up often to get relief. Each night attempted to sleep in a recliner, or lie flat on a couch, then back to recliner, up then down. During the multiple naps this day, I had relief during my sleepy state, but at no other time. At 7 p.m., I threw in the towel, waved the white flag and asked my wife to get the narcotics at the local pharmacy. The prescription did not have the doctor’s phone number or address, and they would not fill it. Due to pain overtaking me, it was a very long night. Another note of this day: Dr. Jinnah’s philosophy is to get fluids out of the body so I had a drain tube that had been removed just prior to leaving the hospital. For the first two days, the hole in my leg had been consistently draining (W & Th) with my wife changing the pad every 5 – 6 hours. Today, the flow accelerated to a consistent drip, filling pads every 2 – 3 hours. We contacted the on-call doctor. He stated that unless I was filling a pad each hour, no problem. The nurse across the street told me the next day that there are pockets of fluid that let go. The drain slowed to nearly nothing Saturday.
Day Four (Saturday): Shortly after midnight, the pain seemed to come within the management stage. In the morning and early afternoon, I enjoyed watching the Raleigh Christmas Parade on television and then the Buckeyes clobbering the lowly Michigan Wolverines. My go-go nature would not have permitted this any other year. I would have been on the bike, working outside, then paying the price in pain for the rest of the day and the next. In my pre-surgery plans, I would be walker-strolling the local mall by today. In reality, the best I could muster was one trip to the mailbox down a very short driveway and a few walks up and back our hallway. The pain seemed within my limits, but still did not manage long periods of sleep over night.
Day Five (Sunday): First day since surgery where I enjoyed eating again. I noticed that through the entire first week after surgery, my body has not craved some of my favorites: ice cream, coke, cookies, sweets. My body greatly longs for and appreciates all the fruit and vegetables plus protein – chicken the first few days after surgery. Today, not being a beef lover, steak sounds so good. My loving wife served a great steak meal at noon. Never one to eat salt on anything except beef, I poured on the salt. Mid-afternoon, I took a longer walk along the front of our property and back. Shortly after coming in that afternoon, my leg swelled above the knee. In my study, I read a blog that said one fellow’s leg looked like a stuffed sausage. Mine was a partially stuffed. My wife believes it was the extra stress from over-doing the walk. I believe the excess salt contributed – attacking and attaching to the weakest area. Advice: stay away from salt added to food during your recovery. By day seven, the leg returned to nearly normal size with much bruising, but little swelling. The daytime pain is controllable, but at night it seems to nearly overtake me. On Friday night, the local pharmacy said they would complete the prescription because I might need it. They called and left message with the on-call and doctor’s office and would have it later in the day. When pain began to overtake me on Sunday night, my wife went to get it and they said no one had called back so they could not issue the pain pills. (Three days later, on Wednesday afternoon, local pharmacy called and said they now had the prescription. This will be an item I take up at my follow-up visit.) Another night of maximum dose of Tylenol with little sleep.
Day Six (Monday): Enjoying food more and able to move leg with greater ease. I have been diligent to do exercises and walk in the house. Getting up is easier and can do it without human assistance. Walk this afternoon is to the mailbox again and back. Had thoughts of going to mall for walk, but just not enough energy. Multiple cat naps. Nearly maximum dose of Tylenol but having longer time between doses – up to seven hours between pill pops and no more than 2 each time. Beginning to feel closed in. Administered the 5th of 7 dailys shot of Lovenox, blood thinner. Since the Mrs. did not want to give shots, I have no problem giving them to myself. The thought of blood clots versus a thin needle being inserted in stomach does not compare – only bruised myself once.
Day Seven (Tuesday): First day where I sensed that complete recovery may be possible. Stretches of nine hours between pain killer. Decided a trip to Target with my riding the motorized cart would be fun. Those carts are not fun, but the trip was great. The walk back to the car and then to the mailbox when we returned was refreshing. I have read multiple blogs where days are roller coaster like. Today, the whole day, I am on top of the coaster; not pain free, but very manageable. Comment: so many of us deal with real pain for so long, we have raised our tolerance level and the pain of recovery is less than the pain prior to surgery. Today, I spent considerable time at the surfacehippy.info website, watching the video’s of those successful. Read where some despise success stories. I disagree; being a believer in the Bible as God’s revelation to man, we are commanded to “rejoice with those who rejoice and weep with those who weep.” Each success story gives me hope that I too will one day have a positive story. I anticipate better sleep tonight.
Day Eight (Wednesday): My anticipation of better sleep proved successful. Enjoyed one stretch of 3 hours and two times of 2+ hours. Reduced Tylenol to one dose at 9 pm last night and not another until 8 am this morning. In advance of going out to eat with my mother who is in town and my wife, I took another 650 mg. The time out was a positive experience. The restaurant chairs weren’t made for the best positioning, but managed and enjoyed the time together. Walked through a grocery store before returning home. Spent the afternoon at surfacehippy.info website. Took the last of my 7 shot series of the Lovenox, then read the precautions (bleeding at the base of my spine???). Ignorance is bliss!!!
Day Nine (Thursday – Thanksgiving Day): Overnight, I spent most of the time awake. I rarely had trouble sleeping prior to my surgery date; even the night before the surgery, I had decent sleep. Since coming home, I remember only three stretches of three hours at one time. Last night, there was two hours, then one hour, then awake for two hours, then two hours sleep. I spent most of the two waking hours online reading at surfacehippy.info and checking out the side effects of Lovenox, the blood thinner. I only found one mention of difficulty with sleep, but numerous mentions of loss of bladder control. This gives me consideration of why I have had the constant struggle with having to urinate at least once every other hour since coming home. I suspect the blood thinner. With yesterday being the last shot, time will tell. With the loss of sleep, I anticipated a miserable day, but enjoyed another day of better strength. I took two short walks of about 200 yards each. When I read about those who are walking the neighborhood at this point, I remind myself that everyone heels differently and I need to listen to my body. This is the first day without any assistance from Tylenol. I am considering one dose of 650 mg just before lights out to help with tightness and slight pain. Considering going out early to Black Friday specials especially my favorite place: Sam’s Club as they are serving free breakfast.
Day Ten (Friday): The sleep was much better last night with one three hour stretch and quick to get back to sleep each time I awoke. The Black Friday trip was cancelled with a later day trip out of lunch and Walmart. At the daily dressing, there was only the slightest stain on the pad. For the first time, I wanted to see it so moved to the mirror and took a look. My wife is totally pleased with it, but probably wouldn’t be so excited if it was on her posterior. Prior to surgery, I saw that Dr. Jinnah has a video online where he performs a surface replacement done at WF Baptist in 2007. I thought about watching it prior to the surgery, but changed my mind. Sometime this weekend, I think I might take a look.
Lunch out was more enjoyable than two days ago. Restaurant chairs were not designed with the surface hip patient in mind. Afterwards, did some walking around WalMart, but it sent me quickly seeking the electric cart. I later took a short walk outside. It seems that this should be the end of the blog. There are set-backs in the future as well as more positive advancements. Today, I purchased an adjustment cane and tried it out. I am excited to think I will be transferring soon from the walker to my new beautiful blue and black cane. Someone told me I need to name it. Maybe I will call it Dr. J for the surgeon who appears to have done quite the work.
6 Month Update
As I approach the six month anniversary of my hip resurfacing, it is exciting to think about all the benefits that have come my way.
1) Freedom of movement without pain
2) Walks without pain and discouragement
3) Friends saying there is no limp in my painful gait
4) Sleeping seven hours straight without waking up due to pain
5) Sitting for hours without thinking about pain
Is the message clear? The lack of pain is pure pleasure.
Last Saturday, I decided it was time to trim the hedge in our backyard – ten feet high hedge that runs the length of the backyard. We are talking ladder work: up and down, down and up, up and down. Once when I was up high and in the middle of hedge (also 8 – 10 feet wide), I raised my hands as a victor – victor over pain. I anticipated problems with pain that night or the next day. Nothing! The next day is when a friend commented that it looked like I was experiencing full recovery.
Don’t tell the wife, but I have even jogged a couple of laps around the inside of a local track. In comparison when I used to run 50-70 milers, a couple of laps may not seem like much. But to one who had even given up walking last fall, it is sheer delight.
Kudos again to Pat for this site and encouragement to those who are still pondering whether you should “get it done” – get it done.
November 8, 2011
Three years ago, I was next on Dr. Jinnah’s list for hip surface replacement. If you read my experience log following the surgery, you know it was largely successful. It took one year before I felt confident strength to try jogging a 3-miler in a park. I worked up to it and the run was wonderful: to know that I could run if I needed to do so, and that without pain brought great joy, and a once-for-all release from the NEED of jogging.
After running most of my life and escalating during my 40’s to over 30 marathons, and50 & 70-mile ultras including a 100-mile run during a Relay for Life event, I thought I would never be released from my harrier addiction. Come on, you runners, you know it is an addiction when we must have it to feel satisfied. But, after I accomplished that Monumental 5K, I knew running was no longer something I had to have to live a fulfilled life.
On the positive side, I stay very active walking, biking, working in the yard, and all without pain. I have kept the weight off – one of the reasons I was running from all those years. Also, on the positive side, I don’t think about the hip.
The downside is that there was some nerve damage during the procedure with continued numbness from the outside of the ankle and moving up to the knee. It is not noticeable unless I have overdone it all. It is not unusual to walk 4 miles a day and not feel the numbness. Actually, I have to concentrate on the sensation to notice it, but this damage was the most difficult part of the recovery, the attributing factor to the pain I mention in my recovery log.
For those considering the surgery, I highly recommend it. It delivered me from constant pain during and following any walking or yard work to the renewed privilege of performing daily tasks without pain. I stated after the surgery that if I only had one year of relief, it would be worth it. Now, that satisfaction has tripled.
Many thanks to Pat for her invaluable website! It had been a long time since I visited it, but I remember visiting multiple times each day prior to the surgery and during recovery. The website was like a doctor-on-call with all the great advice and knowledge. Thanks to all the contributors who helped me through the process. I hope I don’t have to return to the site as a patient-to-be, but if I do, I know the website will again become a valuable tool in preparation for that second surface replacement.
2015 Update Seven years and counting!