Left for surgery at 7:30 am – forecast of snow had us on the road earlier just in case. Uneventful ride to Newton-Wellesley however.

Arrived at N-W at about 9:30 checked in for the surgery, and waited till about 10am for the first papers to sign, then was taken to the pre-op room. Pre-op room – typical stuff, IV (why she put it in my right arm is what I’m wondering), doctor Hanmer came by, signed my right hip. Everyone always asked which hip. Anesthesiologist came by. Looked like things were a little ahead of schedule – Doc had done one resurfacing already with the same team, so everyone was practiced up.

Headed to OR around 11:45 or so (I think) – had some nice drugs for the journey. Operating room was way larger than I thought it would be, and very bright. Could tell I was about to lie on a peg board, was all covered with stuff. That’s the last I remember until the afternoon….

According to Wendi – stitches were being finished up at 2:31 pm, and I was in post op around 2:50 pm. Don’t really remember much there, them taking the O2 mask off, Wendi coming in to say hi. Then transport to the room – I remember seeing the PT Dave and saying hi to him on the way to the room. The nice people at N-W were kind enough to make sure I got a private room so Wendi could stay with me. Woke up some more, and noticed I had a Fentanyl patch on for pain, and a catheter for injection medication directly to the operative site. I had no catheter for wound drainage (and they utilized steri-strips and dissolving stitches). Oh, and an ice bag against my hip. Dinner was brought in, around 5:30 or so and I was cautioned to eat slowly. Since I hadn’t eaten in 20+ hours, I was kind of hungry. Downed the soup slowly (that felt good on my throat, which no doubt had a tube inserted during surgery). Started in on the turkey and dressing – was tasty! About 6:30 started to not feel well, about 6:45 got the sweats and everything, and thought I should take a nap. Woke up around 7:10 pm with a bunch of hospital staff scurrying around me. Turns out I had passed out, and thrown up – everyone was concerned, I was apologetic. Doctor was asking a ton of questions, code was called, all kinds of stuff. It was decided the Fentanyl patch had to go, and further testing required.

First was an EKG – it took like 18 points of measurement. There was a bit of a normal/abnormal reading, so a CT scan of my chest was ordered. Of course, my current IV was too small for the CT scan contrast material necessary. So a new IV was needed, now in my left forearm for the CT scan, then switch the main IV over that stick (I was also stuck while I was out for a blood draw as well in my left arm). I thought I might get a mobile CT unit (do they make them?), but no, I had to be moved to a new gurney. Out comes the sliding board, which they got under me and slid me over to the gurney using the sheet and board (not a very comfortable process). Down to the CT scan (it’s now probably about 10pm), of course, have to be moved to the CT bed cause I’m about to be shoved into a little donut hole. The tech (Bob) tests out the IV to make sure it’s good, he says the process will take about 15 minutes. The contrast goes in, feels cold in my arm, but warm in other parts (like I wet myself in Bob’s terminology). CT scan is done, and I’m moved back to the gurney and eventually back to bed. It’s about 11pm now, and somehow I couldn’t sleep. I got to kiss Wendi happy new year, then wandered off to sleep.

January 1, 2009 Jan 1, 2009 Thursday After a fairly decent night sleep resident comes in, checks the wound, and injects pain meds in the catheter, then, breakfast arrives. I am able to eat some, and am feeling a little better, although still groggy. I’m able to utilize the plastic urinal this AM, so I’m relieved (no pun intended) that no catheter is required here.

The PT, Dave, comes in, and we’re going to try to me up and walking around (it’s now around 10 am). I was given an oxycodone for pain a little earlier, too, and a resident ortho had come in and injected meds in my site catheter (this is a common practice in Australia, and Dr Hanmer brought it to N-W after his study there). After some horizontal exercises to get things going, it’s time to sit up.

So, I’m able to sit up, and get stable there, after standing though, I started getting light headed, and dizzy. Not good, so I laid back down, an everyone kept an eye out for a little bit. I guess I don’t do well with narcotics, plus there was still some stuff in my body from the day prior. I will take a nap, and try in the afternoon again.

Around noon time, I started feeling a lot better. And after lunch felt much better, I guess all the meds from the previous 24 hours were finally processed. Still utilizing urinal bottle, not a great process. PT Dave came by in the PM, and I was able to get up and walk around the room with the walker. He thought that was good for the day, I guess he was still nervous about me passing out.

I did notice, at some time, that during the surgery, they wrapped me around the hips with one of the large elastics they use for abdominal surgery, this compression was actually comforting to me.

One of Dr Hanmer’s associates came by as well during the day, and checked in. Of course, I got stuck in my right hand for more vials of blood. It was also decided to utilize Ultram for pain control. This worked way better than the other stuff. Of course, vital signs are checked fairly often, and in the evening the first round of pills came by – vitamins (iron, C, B), Tylenol, Coumadin, Senokot, and an Ultram. Hard to get a full nights sleep, with the urinal, nurses, and things going on.

I’m surprised at how sore I am. I didn’t expect that. Not sure why, as it’s an invasive, manipulative surgery. I thought I’d have more muscle strength I think. My quads and hamstrings feel OK. It’s the groin and hip flexor muscles that don’t work right now. Not much swelling, either, which surprises me (maybe I’m peeing the swelling out, and I’m laying down mostly.

January 2, 2009 Jan 2nd, Friday.

Felt pretty rested in the AM, which is good because it was a busy day. First off, got stuck for more blood, still in the right hand again, then meds in the catheter, and catheter removed and dressing changed. Then, Dr. Hanmer came by, and we talked about the surgery a bit. I was a little longer in surgery cause of my size, and the fact that I have very hard bones. They took an in-process x-ray to make sure everything was seated correctly prior to sewing me back up. He said everything went well, though, and expected that with PT I would be able to go home on Saturday. I suppose I’m about 12 hours behind, what with the fainting and later in the day surgery. I might have been able to go Friday evening otherwise.

Then it was down to the Utrasound dept to check for blood clots. I was able to get up on my own, and get over to the gurney (I know they make portable ultrasound units, I guess they want me to get up and move around). The UT took awhile, and was not comfortable, as she was pressing on my sore legs, and somehow, I had to get my knee up in the air for her to get the underside. Luckily, had the exercises from previous day to fall back on, and was able to get my knee up, and hold it there for her. Back to the room, and decided to sit in the “lifeguard chair” instead of getting in bed. The Occupational Therapist came in, and went through the various tools they provide (the sock installer is cool). Got up checked out the commode, and went to bed.

Dave the PT came in. Horizontal exercises, then got up on crutches and walked down the hallway a bit. Groin and hip flexor very sore, and can’t lift my knee up when vertical. Definitely didn’t expect that. Pretty tired now. Went back to bed took a little nap, and had some lunch.

In the afternoon, Dave came back, did more exercises and got up, did a complete circuit around the floor. Feeling stronger, but still very weak. Was able to take more normal step though. The evening was uneventful, pills, vitals, and urinal useage. Had one IV removed, since I had pulled it out anyway. Haven’t been hooked up to the drip since the morning. Drinking plenty of fluids.

January 3, 2009 Sat Jan 3

Potential move out day! After giving yet more blood (I tried to talk her out of it because I wasn’t hooked up to the IV, but she didn’t want to hear it). Dressing was changed by a resident, then breakfast. This morning I felt rushed. The PT came in and we went over, did the stairs, and I was cleared to leave. The discharge process wasn’t smooth, and I didn’t expect that. I was given a script for meds I wasn’t on (the patch and oxycodone) and then they brought in a wheel chair that wasn’t suitable. One of the PT’s helped out with that. I used the regular toilet instead of the urinal though, before leaving. Since it was a Saturday, was very quiet around the hospital. Getting into our vehicle was a bit of an experience. Having long legs doesn’t help much. Uneventful ride home, we thought we’d be able to get a Utlram script called in, but couldn’t cause it was a weekend. The nurse on duty felt really bad, and we could have turned around and went back to get the script form the hospital (the resident was in surgery at the time of discharge, so I couldn’t get one prior to waiting). We decided to continue on – it’s a long drive! Got home, and immediately went to bed, very tired, and very sore. Was thinking might have left a little early at this point.

We decided to fill the oxycodone for pain relief, and only take half a tablet to avoid the dizzy side effect. This would work until we could get the Ultram. Was a pretty quiet night Saturday.

Overall, very happy with the folks at Newton-Wellesley. According to Dave, they’ve done 800+ BHR procedures, so that’s good, but the staff was upbeat, helpful, and caring (a bit of a fumble on discharge, but overall they were great)

January 4, 2009 Sunday Jan 4, 2009

Visiting nurse came by today. Checked me over, everything seemed to be OK. Was showing Wendi my incision and explaining things, changed the dressing, this didn’t sit so well with me, and started making me feel faint, so I went back to bed. I was on Tylenol, senokot and aspirin. Was able to move around the house a bit and get in an out of bed with Wendi’s help moving my leg around a bit. Still doing my exercises 3 x per day as well. Hard to move my leg laterally, and lift it up. The quad exercises are not a problem, and hamstrings are ok, too. Still very sore, and noticed more swelling today.

Talked about the pain meds, she was going to send something to the doc as well (I had called and left a message over the weekend

January 5, 2009 Monday Jan 5, 2009 The Doc’s office called, apologetic about the pain meds, and is going to call a script in. I’m going to try to work today. We have a home office, so it’s not a far commute. Was able to utilize the height adjust on the office chair to keep the 90 degree rule from coming into play. Feel pretty tired, but able to get some stuff done. Feel a rumbling, hey – might be able to put the new commode into use (they delivered one to the house Saturday PM). Using the commode wasn’t as easy as I hoped, but everything worked out in the end (no pun intended again) – very much like baby doo-doo though.

The PT came by the house, and we went through the exercises, and she added a couple more ones in the standing position. So I’ve got more to do now. Noticable swelling in my hip, and thigh down to my knee. The best news of all – a shower today! Was able to get into our stand up shower (the 4” sill was a bit of a problem, but was able to crawl over it with my toes). That definitely felt good.

Wendi is spoiling me with gourmet meals – high protein, high in iron, and spices to help with swelling and such. Moving around much better on crutches, still painful to move the leg laterally (groin muscle is still sore to the tough). The weird thing is I twitch when I fall asleep, which tweeks the hip muscles sometimes, not comfortable. I’m trying not to take the Ultram, but have found it necessary after lots of activity.

January 6, 2009 Tuesday Jan 6

Visiting nurse came by, everything a go – said to leave off the dressing. Have lost one steri-strip along the way apparently. Still doing all my exercises, and working. Still noticeable swelling. Was able to get on the scale out of curiosity. I weighed 221 (at surgery weighed about 212). That’s allot of water weight! Up and around on crutches, getting easier to move in and out of bed, too. Senokot keeps working as well!

January 7, 2009 Wednesday Jan 7 No scheduled visits today. I thought I’d try making coffee in the morning for us (latte’s). That was too much standing, didn’t make it through, but an A for effort. Feeling stronger. Getting knee pain every once in awhile as well. I’m feeling like a slug – Wendi doing all the housework (including using the snowblower!).

January 8, 2009 Thursday Jan 8 No visits again today. I was able to make coffee, too, but felt very tired this morning, tried to not take an Ultram last night, and probably wasn’t wise. I’m getting around better, and was able to take a few steps without crutches. The exercises are getting easier, too. Noticed my calf was more swollen today for some reason. Keep moving the legs! I’m probably sitting to much, although I try to lay down for a bit mid day, and walk around, too. Have tried not to take Ultram today, but needed it at night.

January 9, 2009 Friday Jan 9 PT visit today. Added more exercises, and made existing lateral moves a little more difficult (took away my cheat sheet). I’m getting good ROM with the horizontal knee lifts, and have more standing exercises to do. They are starting to fatigue my left leg while doing them, too. Still hard to stand for a longer period, makes me tired, my cardio work at the gym is not going to be easy when I go back! Getting stronger as well, feel like I have more energy today, although by 4pm got pretty tired. Was a longer day today, though. Weighed in at 213. Still swollen in hip and calf, but knee is better.

January 10, 2009 sat jan 10 Feeling allot stronger today, haven’t taken any pain meds except for Tylenol earlier today, have been able to sleep on my left side with a pillow between my knees. It’s nice to be able to sleep in a different position. I may stop with the Senokot as well, I eat a high fruit diet anyway, and not taking much pain killer, can’t see the need. Doing exercises this afternoon – I was amazed at the height I was able to get on straight leg lifts. They’re painful, but I could barely get a half an inch this morning on them, and now I’m a good 8 inches off the surface! Also, can walk with minimal assistance with Crutches. Now’s when I really have to watch and don’t over do things, or break the 90 degree, middle crossover or inward rotation rules. Definitely feeling restless as well, hard to watch Wendi have to do everything around the house, including the 6 inches of new snow we got overnight.

January 11, 2009 I'm 11 days post-op. I was going to post from the hospital, as it had Wi-Fi, but I didn't feel up to it. Anyway, some history.... 44 yrs old 6'2" 210-215 lb male, very active. I started feeling pain in the right hip about 5 years ago, but I could "pop" it back into place, and it felt ok. Started feeling worse, went to an ortho about 3.5 years ago, and he prescribed anti-inflamatories. I took those for a bit, and it was on and off pain for awhile. about 1.5 years ago stared becoming more consistent, and went to a different ortho (we lived in the Pacific Northwest at the time). He said I needed a total hip replacement. I figured, he's a surgeon, that's what they do, that's what they're going to recommend (kind of like taking your car to a mechanic, there's always something to fix). I didn't want a total because of the life cycle, and everything else (and my dad has had bi-lateral replacement, and the first one dislocated). Moved to the east coast, and it got to the point, where putting on socks and shoes and doing things around the house was painful. I could still function, but was affecting my lower back and knee (the ITB was as tight as a drum). I read where a Dr Arnot had a synvisc fix for awhile (I've noticed, he's a hippy now). and thought that might be an option, did research, and found Dr. Hanmer at Newton-Wellesley Ortho Assc. in MA (we've moved to east coast). And went to see him, he suggested the resurfacing, we said ok, and the surgery was scheduled for Jan 21, 2009. Luck would have it, we got moved up to Dec 31, 2008, and I'm now post op, and getting around fairly decent.

February 29, 2009 Day about 38…. Had to look at the calendar and figure out the days – I can’t believe the difference between day 1 and now! Graduated from in-home PT to out-home PT week 3 – of course, had no strength in my leg at all during the testing @ PT office. Have all kinds of exercises to do - but I kept the “initial” ones in addition to the ones added on. Don’t need to do that. Graduated from a crutch to a cane end of week 2 as well. Still a bad limp, and can only lurch around without the cane, and not very far.

With the PT, my leg is getting stronger – it’s weird, one day I need help to do side raises (laying down), then all of a sudden I can do them on my own. That’s cool. Way easier to get in and out of the car. Decided to take a trip to Costco, end of week 3 – that was a long day, but just really tired when I got back home. The cart is like a walker, so it wasn’t to bad.

Had a snow storm (well, another one) during week 3, and I decided that I was going to snow blow. Figured as long as I was deliberate in my movements, and was aware of which way my hips and feet were pointed, things would be OK. Since there wasn’t ice, just snow, had good grip and the snowblower is kind of like a mechanical walker. Felt good to be able to contribute some more. I’ve mastered the “golf ball” pick-up to get things off the floor. That sock tool is excellent, but I’m not using the grabber much.

Week 4 Have been at the gym walking the treadmill and light elliptical as well. had the follow up doc’s visit. X-Ray’s were excellent, he was pleased. Said I was cleared to drive! And the only movement I had to be really careful of is inward rotation. Other than that keep it at 80% ROM (yeah, right), and let the hip dictate activity level. Drove home, and had a bad pain in my knee of all places. Seems to be fairly consistent with driving up till now (over ½ hour in the car). Learned that no muscle or ligaments were cut. If they had to be moved, he either separated muscle fiber or cut them loose from the bone, then re-attached them. Said that as long as the incision is still pink, there is healing going on in there, when it turns white, things are pretty well healed up. Almost gave me the go-ahead to try skiing when I was walking good without the cane, but, he being a skier, decided not a good idea, and said to hold off until the 3 month follow up.

End of week 5 – feeling much stronger. Although, still no stamina. Have many exercises to do, and do them at home and the gym. Was glad I opted out of a trade show that would have required long travel and 2.5 days of walking. I would have been not able to do that.

Into week 6 now – can walk a bit without the cane, and not much of a limp. When the muscles (and lower back) get tired, though, need the cane. Which happens fairly quickly. At least I can be a help around the house now – loading dishwashers, brewing beer , that sort of thing.

March 3, 2009 I'm almost 9 weeks, and I'm still getting stronger there - straight leg raises (laying on back and side) with ankle weights attached and clamshells with weight by the knee. My PT said to be real careful with the machines because they can use the quad more than the abductor - same with the side leg raises, need to engage the glute first (tense). Getting stronger - but that is the weakest area for me.

November 16, 2009 I'm at almost 11 months - and learned that I needed to keep doing the PT excersises - in additon to the normal gym workouts. I thought (incorrectly) that if people are skiing at 6weeks(!) things should progress rapidly. Not true, there's allot of soft tissue to heal, and it takes a LONG time.

I also realized I was still favoring the operated leg when picking things up, and all that, so I've concentrated on getting that leg more supportive when doing daily activities. I guess it get's habitual with the pain before, and the requirements after surgery.

January 3, 2011 It's been two years plus a couple of days. Hard to believe - it's gone by pretty fast. The two year check-up looked good, doc said I'm pretty much the prefect candidate. Questioned a couple things on x-ray (angles and what not) - and he explained things pretty well - force loadings, etc. Have been skiing and building stone walls and other labor around the house. Periodically I get achy, and sometimes minor cramping, but it goes away. Overall I'm able to participate in life way more fully (and pain free) than prior to the surgery - and that's the object I would imagine.

 

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