RA Gram's Hip Resurfacing with Dr. Lammens 2015

I just officially joined this website today (two weeks post-op for Birmingham Hip Rresurfacing), although I browsed the site for the 18 months or so prior to surgery to understand what BHR was all about (versus total hip), what expectations should be, what doctors were recommended, etc. My Kaiser Permanente healthcare plan does not do BHRs and was recommending Total Hip Angioplasty. However, the head of orthopedics in Denver, Dr. John Gargaro, had performed a few BHRs prior to joining Kaiser so I spoke candidly with him in October 2014. Based on that conversation, I felt a BHR was still a strong candidate for me so I made several appointments with well-regarded hip surgeons in January (for consultations) and switched insurance plans to Anthem BCBS in January so I could visit the surgeons. I visited Dr. Brian White of Western Orthopedics (does not do BHRs, but is known for advanced hip procedures), Dr. James Rector of Boulder Orthopedics, and Dr. Peter Lammens of Panorama Orthopedics -- all from the Denver area. The preconceived notion was to get a BHR from Dr. Rector (well-regarded on this site), but to talk to Dr. Lammens (a relative unknown on this site) for another opinion, and to talk with Dr. White on the outside chance there was a procedure I was overlooking - there was not! Dr. Rector was professional and experienced with 1200+ BHRs to date (as of Jan 2015). I then saw Dr. Lammens and was surprised to learn that he had 1100+ BHRs (as of Jan 2015). I liked his straight-talking demeanor and his hospital was closer to me, so I opted for him. Very happy so far.

My background: 53 yr old male, extremely active in sports, high-level amateur sponsored racquetball player, sponsored backcountry skier, mogul/bump skier, mountain biker, hiker, snowshoer, non-technical mountain climber, etc. 5'10, 200 lbs, pulse in high 40s, blood pressure low 120s over mid-70s. Thought I pulled a muscle in a racquetball tournament about 5 years ago. After two years I had it looked at and was diagnosed with FAI - a condition in which an irregular-shaped femoral head can cause cartilage tears, which it did. At my age (late 40s), my only option was a total hip replacement and was advised to ward it off as long as I can since it probably would not last long with the type of sports I do. Another year later and I was feeling pain whenever I ran or walked, though I could still do all other sports, oddly enough. After another year, hiking, snowshoeing, climbing, etc. were out of my repertoire also due to back, thigh, hip pain. I skied just once last fall and found it painful. I continued to play racquetball 15+ hours a week but paid for it dearly. My game had diminished, my movements and mechanics were awkward, and I was starting to develop pains elsewhere for compensating for my hip. In the last several months, if I played at a high level, I limped for several days. That was the deciding factor.

My surgery with Dr. Peter Lammens of Panorama Orthopedics (Golden, CO) could not have gone better. Surgery was performed at OrthoColorado hospital (Lakewood, CO) and it is an absolute top-notch facility.

April 1-15, 2015: Played racquetball or squash every day. Almost wondered why I was having surgery done!
Thursday, April 16, 2015: Came out of surgery about 5:30 pm, out of recovery room about 6:30 pm. Plenty of drugs and felt fine, but woozy. Did the walker thing around the room about 11:30 pm and was surprised at how easy it was.
Friday, April 17, 2015: Did not get much sleep (lots of people to check on you in the hospital!), but felt good the next morning. Moved from my private bed to a reclining chair once the catheter was removed. Ate a full breakfast - not because I wanted to, but because I was under the impression that was one of the "check boxes" that needed to be checked before they would discharge me. Met with occupational therapy that morning. Walked to the therapy room on two crutches, walked back on just the cane. No problems with steps, clothing, restroom, etc. I was discharged around 1 pm. Then the meds wore off! Seriously, that night I wondered if I was premature in getting out of the hospital as I was in a lot of pain and felt far less mobile than previously. I took 12-hr Oxycontin, but I had to urinate roughly every hour all night long. Getting in and out of bed was very hard and painful - made worse because I was hooked up to an ice-therapy machine that I had to disconnect from each time!
Saturday, April 18, 2015: decided to forego painkillers. Did not like the side-effects. Used two crutches during the day, did two flights of stairs, did not sleep well at night. Did finally shower!!
Sunday, April 19, 2015: Switched to one crutch. Did 5300 steps, 8 flighs of stairs, slept a little better. Did not get up every hour to urinate, but slept fitfully.
Monday, April 20, 2015: Switched to cane. Did 9125 steps, 4.12 miles (cumulative - walking around house, etc.), 7 flights of stairs. Went back to 12-hr oxycontin at night. Only got up every 2-3 hours, but got better sleep overall.
Tuesday, April 21, 2015: Enlisted the aid of my 79-yr old father to purchase load, and carry a used reclining chair. Chairs in our house are either Victorian (think straight-backed, uncomfortable) or Mid-Century Modern (think comfy-looking, but low-slung and impossible to get in or out of). Absolutely sick of being on my back in bed. Recliner was a godsend. Was able to even cat-nap a little.
Thursday, April 23, 2015: One week post-op: Felt pretty darned good overall. 15,650 steps, 24 flights of stairs, 7.1 miles - but that included several walks, one of which was 1.25 miles with cane.
Wednesday, April 29, 2015 (yesterday): Eliminated my cane entirely. 17.400 steps, 33 flights of stairs, 7.85 miles, including a 1.75 mile walk. Had my ~2 week follow-up appointment. All is well, cleared to drive.
Thursday, April 30, 2015 (today): Back at work full-time (had been working from home about 4-6 hours/day until now). Activity stats are super-lame because I don't have the luxury of taking off for a walk whenever I want. Try to get up periodically. Glad to know that my Aeron office chair at work is far more comfortable than my antique wood desk chair at home!
Future: I am still observing the 90 degree rule, no crossed legs rule, and midline rule until told otherwise. I Intend to play golf at 6 weeks (not competitive) and get back on the racquetball court (again, not competitively) after my June 5 follow-up appointment. Hope to start hiking in mountains after that also. Intent to compete (very competitively) in a racquetball tournament in August -- just shy of 4 months post-op.

My observations:
- Because I was active until the day of my surgery, AND because I did not wait to have surgery until I could no longer walk at all, my muscles never atrophied. I have to believe that has really been a huge factor in the speed of my recovery.
- I also have to believe that my surgeon was largely responsible for my quick recovery by doing a perfect surgery. He told me I was the ideal candidate, came in at exactly the right time (just hitting bone on bone) and my muscle tone and bone density were excellent, so it made surgery easy.
- I suffered through a lot of pain, but am dedicated to a speedy recovery. I may have left the hospital one day too early and I definitely stopped taking pain meds too early. I should have continued pain meds during the day and dealt with the side effects (dehydration, constipation, slight headache). Now that I am back at work and driving, pain meds are not possible during the day, but I also would state that my pain is manageable without them anyway. I am very stiff from sitting.
- I found the rehab exercises to be insignificant compared to my overall activity level. I have worked hard to walk, climb stairs (including our winding basement stairs in our Victorian), to walk the dog, etc. I have been entirely self-sufficient at home since just a couple days after rehab - including cooking, loading/unloading dishwasher, keeping my ice therapy machine topped up, etc.
- I strongly recommend an ice therapy machine. I purchased mine at the hospital for $175 (DonJoy Clear3). I looked at the $3000 GameReady machine (which is actually prescribed by Dr. Rector in Boulder), but was not willing to spend that much. However, I still ice my surgical site all night, every night, so the $175 was well worth it. It cuts down on swelling and helps to manage the pain.
- I had gained about 15 pounds in the year prior to surgery due to slightly decreased activity level and I am slowly losing weight during recovery now so believe I will be at my normal weight 6 weeks post-op.

Overall, I found this website to be an incredible resource. Reading about other people's experiences was fantastic. It gave me a sense of what a long, short, and average recovery would be, and really gave me incredible insight into the surgical procedure itself. Going into the surgery, I felt very knowledgeable about how the surgery would be peformed and what to expect. Mostly, I felt very encouraged about all the positive attitudes and positive stories. I do not think I would have gotten beyond the metal-ion level scares and moved forward with a BHR without this website. Most advice was directing me to a total hip and I was simply not comfortable with that, given my lifestyle.


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