Stephen Hip Resurfacing with Dr. Callander 2012

I'm 58, super active, and live in the Lake Tahoe area. Among other activities I've run for 35 years and that, combined with other activities and some suspect genes (thanks Mom) led to the deterioration of my hip. I got the OA diagnosis in September, had to stop running in November, and scheduled surgery for March 27, 2012, at the end of the ski season. That way I would have a new hip in time for our glorious (but short) Tahoe summer.

Pre-op I worked on upper body strength, and concentrated on bar dips - you spend a lot of time lifting yourself out of chairs after surgery. I also worked on balance with a bosu ball and an Indo board. I tried to keep as active as possible leading up to the surgery and walked 5 miles in San Francisco the day before surgery.
 

February 14, 2012

After being diagnosed with OA in September, I began exploring my options and came across this terrific site. I have read and understand what is involved in resurfacing, but what is particularly valuable is all of the insight and feedback from others who have gone through the same thing.

I am 6 weeks out today from my surgery with Dr. Callander in SF. I am working on putting together a realistic work out program for recovery. While I realize that I will need to feel my way, I am thinking of the particular exercises that have worked for others. I am 58 years old and have been mega active for the last 35 years. I bike, run, lift weights, compete in triathlons, hike, paddle board, and ski downhill and cross country - in fact I scheduled the surgery to coincide with the end of the ski season, and to provide a sufficient recovery period before the start of the next ski season. Up until I was forced to stop running in mid-November I had my BF in the 7% range; it is still in single digits.

I have a complete weightlifting gym at the house, with Olympic barbells, a full set of dumbbells, and every machine exercise you could imagine. I have a treadmill and a spin bike, as well as a road bike, TT bike, and a mountain bike. I also live on the edge of a forest and have access to tens of thousands of acres of open land.

So it appears that walking is the primary initial activity. I haven't seen much mention of the treadmill, perhaps because of the need to stabilize with crutches or a cane. I don't see a lot of reference to an exercise bike, although I have adjusted mine to not go beyond 90 degree of leg lift.

March 28, 2012

I'm home. While it feels like I was kicked by a mule, the pain and
ROM are improving each day. My foot points straight for the first time in years! I'm off the pain meds for now - I went off them at about 24 hours post-op - and the PT will be here tomorrow. It still feels all a bit surreal, but I am looking forward to each day.

April 3, 2012

One week post op today. Walked 3.6 miles over 3 walks. PT had me off any assistance around the house yesterday except for stairs, but that was a bit much so I went back to the cane today. Still doing a few minutes at a time without assistance, and trying to balance the muscle soreness. Every day gets better. My next goals are to do away with crutches and the cane completely, and get back on the exercise bike and to upper body weights. The target for that is next Tuesday, based on the rate of recovery to date.

I think another call-out is due to Dr. Callander. I was in very good physical shape going in, but I think my recovery has to be due, at least in part, to the relative lack of trauma caused by my surgeon.

April 10, 2012

2 weeks post-op today. Progress has been steady, never as fast as I want, but steady. I've tried to do a little more each day, either in walking distance or in reducing use of walking aids. It's worked pretty well, as I've only had 1 day where I woke up more sore than the previous day, and I just backed down my activity a bit.

Today is actually a big day for me, because I had Dr. clearance to start on the exercise bike and do light upper body weight training. I was on the bike before I digested breakfast and the bike went really well. I did 15 minutes at the lowest resistance, then I alternated 4 sets each of 12 reps with a 100 lb flat Smith machine bench press and 8 reps of body weight chin ups. I then went back and did another 15 minutes on the bike. When I got off the bike I was walking better than I have at any point since the surgery. I expect things to tighten up a bit during the day, but I still see a net positive from the bike.

In summary I am off walking aids within the house, and am using a cane to walk outside with brief periods of no aid. The criterion is my gait - I will walk without aids as long as I can without limping.

To those who haven't had the surgery yet or are still in the early recovery stage I wanted to mention depression. I am an incurable optimist, but this is a tough surgery. There are times when I wonder if I will ever be free of pain again. Last Saturday my wife and I went over to Squaw Valley just to enjoy the weather and listen to a little music. A friend asked my wife if I was skiing on the new hip yet. Her reply was "Are you kidding? He can barely walk." That was tough because it was a beautiful day and I couldn't be out on the slopes. That night when I went to bed I took a close look at myself in the mirror and I can see the affects of pain in my face. I got in bed and I wanted to cry - I was so tired of being in pain. The next morning I got up and felt the best yet, so I put the optimist face back on. I know I will get through this - primarily from reading all of the stories on this site of people who have had this surgery and have fully recovered - so I know it is just a matter of time.

April 11, 2012

Day 15 and my leg feels the strongest to date. Could be the bicycle, I'm not sure. Ironic as last night was the stiffest I've felt to date.

Stiffness - I'm fortunate enough to work out of the house but I'm a 1 man show with deadlines so I was back to work part time on day 3, and full time on day 6. The most difficult thing has been sitting at my desk. I try to periodically move around but it still contributes to stiffness. I just need to deal with it.

Pain meds - an interesting story. I stopped all pain meds 24 hours post-op but about day 8 I was pretty sore one afternoon and decided to take 2 pills. Almost immediately my wife's shirt began changing colors and I fell asleep in the recliner. I then got up and went to lie down in the bedroom. I became aware of something going on in the great room and got up to investigate but my path was blocked by a black cloth. There were three people there doing some sort of modification to the fireplace. I went back to bed and my wife started talking to me. I couldn't see her in the pile of bedding so I had her put her hand up and I grabbed that just so I knew I wasn't hallucinating. I then had a very earnest conversation with her until I woke up as she came into the bedroom, back from her daily 7 mile run. The worst part was I spent 4.5 hours hallucinating and the pain meds only lasted for 4 hours, so my leg felt no different then when I took the pills! No more meds for me.....

April 17, 2012

3 weeks post-op today. The recovery is still gradual, but continual. I've been off all walking aids for a week now, and the 90 degree restrictions were lifted today. The potty chair is in the garage and all the pillows from all the chairs have been put away. I feel so much......shorter.

This past week I added the spin bike and some light upper body weight work to the routine. I started with 15 minutes at no resistance, and have worked up to two 30 minute sessions at a moderate resistance, about 60% of what I used to do pre-op. I've also gradually increased my weights, to where I am doing 4 sets of 12 reps of 140 lb flat Smith machine bench presses, and 4 sets of 10 reps of body weight chins, nothing approaching failure yet, but enough to get me breathing a bit harder.

At my level of recovery that is about as hard as I want to push the bike and the weights. Yesterday I got just the slightest light headed and nauseous, which indicates to me not to push any harder. I also felt some fatigue in and around the hip joint for the first time.

I alternate the hard days and the easy days, with the bike, weights, and a shorter walk one day, and then several longer walks with the basic rehab exercises the next day. I feel stronger, and my leg feels better, on the mornings after the hard days, but I still feel the need for a break between those days. While walking has been undoubtedly beneficial, I still feel that the spin bike has accomplished more in terms of strengthening the leg. The combination of the two is dynamite.

The last 3 nights I've been able to sleep more on my side, and this morning felt pretty good on both sides.

The biggest issue I am still dealing with is weakness in the glute and hamstring of the operated leg, and stiffness in the upper leg and glute after sitting for any length of time. My instincts tell me I'm doing enough on the exercise front, and I just need to wait for further healing.

For anyone contemplating this surgery, 10 days ago I couldn't imagine ever walking properly, and pain free, again. The last 10 days have convinced me that I will now achieve that goal, and sooner rather than later.

April 24, 2012

Four weeks post-op today and a bit of a breakthrough. While the healing process has been gradual, every day has started out pretty good, with a slight increase in pain and stiffness during the day. Yesterday I did a 5.25 mile hike in the woods, with no increase in pain or stiffness. No real increase in stiffness through the balance of the day either. It's a little thing, but this whole recovery is about little things.

Another interesting thing about yesterday's hike was for the first time I felt some fatigue in my quads and hamstrings, just a little bit, but it was in BOTH legs, with no real difference in feel between them.

I liken this recovery to the large pile of snow on the north side of the house that accumulates through the winter from the snow blower. As it begins to warm the pile begins to melt, and every day it is just a little bit smaller. The area of pain and stiffness around the incision (because the hip no longer hurts) is just a little bit smaller each day. Of course the snow is long gone and the stiffness in the hip is still there but you get my drift.

While I've increased the mileage on my hikes I've kept the balance of my exercise at the same level, with two 30 minute sessions on the spin bike at 60% of my pre op resistance level and light upper body weights, alternating days with hikes in the woods. This Friday I see Dr. Callander again and I have a list of exercises and activities to go over with him. I will stick to his recommendations as to when to begin certain activities with the exception of running - he has patients starting jogging at 3 - 4 months and I'm going to wait a full year.

On Saturday we are leaving for a 15 day cruise out of San Francisco to Hawaii and back. We stumbled on to cruising awhile back, and after several years of saying "it won't work for us" we gave one a try with terrific results. The biggest plus for us is that we actually relax - like many people we used to come back from vacations more tired than when we left. Since all the stress is removed - the driving, where we are going to stay, where we are going to eat, what we are going to do - we actually relax.

Our approach to a cruise is to work on our fitness. We usually figure on 4 - 5 workouts a day, beginning with an hour long run - which is now a walk for me - a cardio session, a weight session, some pool work, and another walk. We enjoy the cruises with a lot of sea days as we have no distractions from those activities. In between workouts we eat - like we do at home - but we have always lost weight by the time we get back.

This cruise is a little different because we set up the timing of it to coincide with my rehab, thinking that at 4.5 weeks post op I would probably still be on crutches or using a cane. I've been off both assistance devices for 2 weeks now, so instead I will look forward to getting a slew of new activities to try from Dr. Callander.

Looking back on the four weeks since surgery the progress is pretty amazing. Initially I had to wonder whether I would ever walk normally again, or if the pain would ever go away. I can confidently answer yes to both questions now, although I'm not quite there yet - I can see the light at the end of the tunnel. To all of you that had surgery after March 27 hang in there - it does get better!

May 22, 2012

8 weeks post-op today. We did our first three road bike rides this past week, and the bike fitness is coming back quickly. Yesterday we did our first big climb, with 30 MPH cross-winds posing a real challenge. No issues at all with the operated leg - it actually felt stronger than the non-operated leg.

We also paddle boarded on Lake Tahoe for an hour and a half on Sunday. I had some concerns about falling off my race board because of poor balance but it was again a complete non-issue. Saturday we hiked a 2.5 hour stretch of the Tahoe Rim Trail. At one point I felt some mild tightening in the operated leg but that went away before the end of the hike.

No soreness and any stiffness after sitting goes away in about 3 steps.

Upper body weight training is now full tilt and I am nearly back to my pre-op poundage's - maybe another week.

So at 8 weeks I am doing everything I was able to do pre-op, with the obvious exception of running and avoiding any impact. While the recovery will seem slow when measured day to day, every day builds on the previous day so you are always getting better.

As I've mentioned before, the better your pre-op fitness the quicker you will recover from this operation. IMHO, the two keys are to push yourself within your capabilities - never to the point where you are more sore the next day than the previous day, but always pushing to what you are capable of - and balance work that recruits the stabilizer muscles. The bosu ball helps in this regard but walking on uneven terrain, like a trail instead of a paved path, also helps quite a bit.

As I've also mentioned before you may have doubts early on about whether you will EVER walk normally again. The operation fixes your hip but leaves your muscles and tendons in your leg starting over from scratch. You WILL recover and YOU will walk normally again. Think of it as that one class you dreaded but you had to take to graduate - you just get through it and when you are done you are home free!

May 29, 2012

9 weeks post-op today and had the biggest test to date - yesterday we did a 12.5 mile hike along the west shore of Lake Tahoe. Not a very difficult hike as it had very good footing the whole way but like all hikes in the mountains it is rarely flat, but meanders from lake level to maybe 200' above the lake and back down.

No hip or operated leg issues. I am tired, but my whole body is tired.

As I look back at it there is some difficulty in separating the benefit of exercise from the natural recovery process, but these are the three exercises that have helped me the most:

1. Walking. Initially on the street until the balance and stability came back, and then on the trails, where the uneven footing brings more of the stabilizer muscles into play.

2. Deep knee bends. Walking up steep hills revealed the lack of strength in the operated leg. I started at 5 weeks doing assisted knee bends, using a bar to assist me down and back up, and then at 7 weeks went to unassisted with my heels on a 2 x 6 to keep my back as upright as possible. Leg strength came back pretty quickly.

3. Riding the road bike. Started this at 7 weeks and the endurance aspect plus climbing seems to leave the greatest fatigue in the legs, but feels the best after recovery the next morning.

June 22, 2012

I'm nearly 3 months post op, and have resumed all of my previous activities with the exception of running and heavy weight training for legs. I still feel the occasional bit of discomfort at the incision mark, but it's not really pain and quickly goes away.

So I was carrying our paddle boards down to the shore of the lake on Tuesday and my wife commented that I was swinging my hips as I walk - the last bit of forward leg extension was coming by moving my hip forward instead of my leg.

Yesterday I did a 5 mile hike while concentrating on my gait and realized that both hips - operated and non-operated - were a little tight. By concentrating on my gait I was able to get a normal leg extension with no waddle and had the tightness worked out by the end of the walk.

I am still paying attention to it and I realize that I've gotten into a bad habit. It's quite easy not to waddle, but for now I need to think about it.

As so many others have commented your muscles need to be re-trained to walk normally, because we haven't been walking normally for years. Just another thing to pay attention to.

July 27, 2012

4 months post-op. To a large degree I don't even think about the implant anymore. The momentary stiffness I felt after sitting for a long period went away at about 12 weeks, and there really aren't any issues anymore, save one.

I've got very long legs - I have a 37" inseam. As a result I have relatively poor leverage - my leg muscles are a long way from their fulcrum point. I have always relied on weight lifting for leg strength in other activities, like hiking and biking. I can't do that now, and won't be able to do that for some time.

On Sunday we did an 11 mile out and back hike that included 1300 feet of elevation gain in the last mile and a half. That left me pretty fatigued in both legs. That is a factor in recovery - not pain, not stiffness, not ROM, but just less strength because of the inability to train legs with heavy weights. That will come back in time, but it's still quite a ways off.

There are no complaints though - zero. I did a very similar hike one year ago, and I was limping so badly at the end I didn't know if I would make it back. This was after several doctor visits but before I got the OA diagnosis - I didn't know what was wrong with me. Now there is no limping and no pain. The heavy weight training will resume at some point, I just have to be patient.

September 28, 2012

2nd run this morning. I followed the same route I did Wednesday - it's probably 3 to 3.5 miles - but this time I ran nearly the whole way, and just walked in a few places. I felt fine - no soreness, stiffness, or swelling.

Cardio has really taken a beating in the last 10 months though, and it doesn't help that I'm running at 6200' elevation. What's odd is that it's a real struggle for the first five minutes or so, and then my breathing gets much easier. On my way back from this run I ran up a pretty steep, pretty lengthy hill, and my breathing was easier than when I ran down the same hill to start the run. Don't really understand that.

One thing that I feel is a handicap is my inability to train legs with heavy weights. My doctor has cleared me to do squats with up to 50 lbs, but that isn't enough weight to really fatigue them. I figure another 6 months at 50 lbs and then I'll start adding weight. That will help with the running.

I am doing a lot of other exercises for the legs including, biking, hiking, and pedal kayaking. In the last few weeks I've added a slide board and a Skier's Edge machine every other day, and that has to help with the strength.

Plans for now are to build up the run to maybe 5-6 miles, 3 times a week, over the next 2.5 months. I'll then switch over to cross-country skiing for cardio, snow gods willing, and start running again in the spring. While I don't have any concern about running that much on the new hip, I am paying attention to the old hip. The x-rays show considerable deterioration in the cartilage there but I don't have any pain, and just a very slight reduction in ROM to the side, not enough to bother me. In any event, simply the fact that my body is moving up and down when I run now, instead of lurching from side to side, has got to help everything on the non-bionic side. And if I have to get the other hip done at some point in the future at least I've been able to run again. No complaints.

March 27, 2013

Hard to believe it's been a year already. All I can say is my new hip is probably the best part of my body, considering the rest is so damn old! Just got back from a 4 mile run and have a 22 mile mountain bike ride scheduled for Friday - my first mountain bike ride since the surgery. Had my best ski season ever, although I am hoping that by calling a premature end to the season we will get some desperately needed late season snow and extend the season.

Really, no complaints at all. Surgery was not fun, recovery was less fun, but being completely pain free and back to all my old activities makes it totally worth it.

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