December 30, 2016

I had bilateral HRA surgeries with Dr. Gross on December 12th and 14th of 2016, and am approximately two weeks and several days post surgery. I want to share my experience to others, and especially to those prospective patients considering this procedure. When my arthritis got to the point of affecting my daily activities of normal life last Spring, I began an inquiry to what my options were. I had pretty much resigned myself to the eventual total hip replacement surgery, and was rather saddened by the fact that I was going to have to retire from any of the sporting activities I used to enjoy. Before 2016, I had really never heard of hip resurfacing. Initially I did recall some of the bad press, and believed it was more or less an experimental procedure. Not until I landed on this very website, one that proved to be crucial to my decision, did I realize that there was an option for me - if you have realistic expectations, and choose your surgeon wisely. I'm still way premature in terms of assessing the ultimate outcome of my decision, but currently I couldn't be more happy that I made the right decision. I probably should have done this years ago.

Quick background: 54 year old male who has been living with OA for probably 15 years. I was still active in some sports (beach volleyball) right up to the very week prior to my surgeries, but was really having a hard time simply walking, so my sporting "game" was getting rather sad. My friends started to call me "the cripple" (all in good fun). Unaware that I could have benefitted from the HRA procedures years ago, I let both of my hips deteriorate rather severely. In my mind, I always thought that if I kept working through the pain and lack of motion, I could stave off any eventual serious debilitating effects of OA. By last Spring however, I realized this thinking was wrong. So after reading about individuals' stories here, and opinions of surgeons (two of the most vital and unmatched aspects of this website), and not to mention some frustrating hurdles to climb with insurance, I chose to undergo bilateral HRA with Dr. Gross in South Carolina.

So keeping in mind the primary audience of our stories should be those who are living with OA, and who might be considering hip resurfacing, I will attempt to detail what I consider most of the important details and concerns, which include all of the positive as well as the challenging aspects of the surgery and recovery. This site is a very positive and strong advocate of HRA (which is great), but it will only continue to be a respectable resource if both the good and not-so-good aspects of the procedures can be discussed. Fortunately, at this very early juncture, I pretty much have only positive things to say about my experience.

First things first. In my experience, the bilateral HRA procedures are something that you can undergo with perhaps at the most only a mild to moderate amount of pain and discomfort. With the exception of only one setback, my recovery would have otherwise been not very challenging at all. Keep in mind everyone has different pain thresholds and recoveries, but I would only consider myself merely average in terms of these traits.

The one issue I had post-op was probably very similar to what another poster here named Quig experienced with his bilateral surgeries earlier this year. It may have been a reaction to the spinal anesthesia, and the fact that bilateral patients have to undergo double the dose. What was kind of strange was I didn't have any adverse reaction of any kind up until the very minute I sat down in the car to drive to the airport on Sunday (had surgeries on the previous Mon, Wed). There was this moderate throbbing at the back/base of my skull, and the only slight remedy was to keep very still, and hold my head up with my fist. The pain began with the car ride, and continued with the 5-hour flight to California home (lasted about 7 hours). It wasn't terrible, but did make for an uncomfortable time. I'm merely speculating at this point since the problem began when I first had to sit upright in the car, but I think I could have made the problem worse by not getting off of my back more and sitting upright in the chair at the hospital/hotel (this is something the nurses and therapists try and get you to do). So that was truly the only challenging aspect of my experience. Wait, I lied. I would be less than honest if I didn't mention one other milestone that I endured that was a little rough - taking your first "big potty" :-). That was an hour and a half of my life that I wouldn't want to go through again. I don't know if it would have alleviated matters, but I would advise patients to ask the medical staff to give you all medications and advice to make this eventual event easier to endure. And, perhaps I should have been a little more conscious of my post-op meal choices, lol.

So, the above two issues were the real only tough times I had to go through. I don't want to minimize what is still considered major surgery, but everything else at this point has been relatively easy to accomplish.  My next post will highlight what you can expect during the surgeries, and for the two-week period after. And I can't end this first post without saying that while I'm pretty certain a majority of the physicians and medical staff who are recommended here treat their patients with respect and professionalism, you couldn't be treated any better by Dr. Gross, his staff, and the hospital personnel (nurses and therapists). Even my wife commented on how friendly everyone was.

January 3, 2017

I'm about 3 weeks out from bilateral surgery, and everything is going even better than I would have expected. My last post dealt with the only moderate hurdle I had to overcome. This post will detail what to expect for the first two weeks during and after the surgeries. I'm writing about my experience with bilateral surgery as performed by Dr. Gross and his staff, but anyone considering bilateral hip resurfacing surgeries could find this info useful.

Day One:
I was admitted into the hospital at around 6:00 AM (Providence Hospital in Columbia, SC. Very nice looking place). You'll sit around for a bit filling our forms, but soon you will be entered into the pre-op area where they will start an IV on you, and get you dressed. Nothing too special there, but be prepared to sit there for a while. You will talk with the anesthesiologist and Lee Webb who assists Dr. Gross. You will then be wheeled into the surgical room. If you look around you can see some of the devices used, and the other thing I remember was it was very cold in the OR. It's now time to go to "sleep". The anesthesiologist will have you sit up, and he will put the sedation meds in your IV. It only takes about 2,3 seconds and it's "lights out". Dr. Gross uses a spinal and sedation (not a general). For me, as I believe for most patients, you're completely out.

So the next thing you remember is waking up in the recovery room. One of the benefits of not having a general anesthetic is you won't feel that groggy. For me, it felt like waking up from a long nap. What you won't feel however, is the use of your legs. You won't be able to move them for about 30-45 more minutes. Expect to lay there on the recovery room for another hour or so. I didn't experience any pain during that time.

I was wheeled into my hospital room that afternoon, and everything was unremarkable for the first day. There wasn't much pain (you will be on pain meds), and I slept much of the night. Note that you will have to sleep on your back. I normally don't, but I didn't have any problems.

Day Two:
This day was very similar to the previous day. Eventually, the physical therapist will arrive and the goal is to get you walking a little bit. The first thing that is noticeable is when you attempt to slide you operated leg to the side of the bed, it won't move. You'll have to wriggle it a bit, and eventually it will slowly move to where you want it to go. The therapist will help you stand and this was a little difficult at first, but once you do it a couple of times it's not too bad. You'll use a walker first (then crutches) and the first couple of steps on the operated leg feel strange. But every step you make gets easier. Getting back down in your bed is similar to getting out. Just be patient.

Later in the afternoon they will help you walk down to a hip class where you will see other patients. You should notice that it's even easier to walk than the first time. Getting in and out of the bed/chair is still a little tricky. The exercises they have you do are all straightforward and easy.

Day Three:
This is the day of my second hip surgery (left). In terms of the pre-OP it was almost identical. Except there was a little delay after I was wheeled into the OR, and I got to listen to some nice classic rock-n-roll music the staff was playing in the OR. I believe I have seen a movie or two where this happened. The post-OP period was very similar to the first surgery for the first hour or so. Then things got a little more difficult in the afternoon and evening. As far as pain goes after both hips have been operated, it's really not too bad. I'd give it a 3 or so (out of 10) on the old pain meter. What was different than the first surgery was it was definitely harder to sleep. I only got some intermittent sleep that night. Again, I used the pain meds as frequently as allowable, and this helped to reduce pain and to help you sleep a little.

Day Four:
Days 3 and 4 are definitely the toughest (if you don't experience the "headache" issues I had on the trip home). The occupational and physical therapists will again get you to get up and start walking. This time it's far more difficult without the use of a good leg. Just be patient. They will be there to make sure you don't fall (they will stand behind you, and have a belt around you for the first couple of trips). The first time you try and move your legs off the bed, try to stand up, and sit down will be hard. Even though they said I had bad form some times, I felt that using my arms helped a lot while standing up. And remember that each time things get easier. Another piece of advice which may have contributed to the pain in my head/neck on day 6. Try and get out of your hospital bed on days 4 and beyond and sit upright in the chair that's in your room. The staff encourages you to do so. I think this might assist in reducing some of the effects of the anesthesia in the days to come.

Days Five, Six
As said above, every time you get up and walk it gets easier. They will probably get you moving around on crutches by now (to me they seemed more useful than the walker). They should also get you to take a shower. Don't feel like you've regressed if the shower is more difficult than you would have expected. The warm water makes you a little more dizzy.

I stayed at the hotel 200 yards from the hospital (For Dr. Gross patients, I recommend this). When I was discharged, it wasn't very hard to get into the car. Just put the seat back as far as it goes, and slant the chair back all the way too. Get your butt as far back as far as it can in the seat, and swing your legs around. It was a lot easier than I thought.

Days Six through Fourteen - Quick Observations.

These days will show great improvement, and you should really been over any tough portions of the procedures.

- I never had much swelling, and unlike many here, I didn't find the Polar Ice machine all that useful. I used it for the first days after each surgery, but never used it afterwards. I know that icing helps overall though.

- As far as the flying went, besides the headache issue (that I'm speculating is not completely common), the trip home would have been a piece of cake. I flew coach, and didn't have any pain or movement issues while flying for the 5 hours home. I did take the pain meds right before boarding to be safe.

- I went off the crutches probably on probably day 10 or so. Everyone's different. I don't know if my continued sporting activities and weight training right up until the days before the surgeries helped in this regard. For me, all the weakness/instability went away on both hips right around day 10.

- Others have mentioned this, but as you start walking you will notice some days are easier than others. Don't feel like you're regressing. It's probably a sign of soreness from the day prior.

- And by the second week, I felt that in terms of simply walking, sleeping and some of the normal activities of daily life, I'm already better than I was before my surgeries. I'm back at work too (desk job). There is some minor residual pain around the surgical sites, but all the other pain of movement I had experienced is completely gone. So I am very content at this point for sure!

January 14, 2017

Just a quick note on the one real issue I had post-surgery - the spinal headache. After doing some "extensive internet research" :-), this is definitely what I experienced. I incorrectly attributed the headache to the spinal anesthesia medication, when it turns out it is actually due to the leakage of your spinal fluid. I know others who have experienced this on this website have already specified the true cause.

The medical literature on the internet claim that roughly 40% of patients receiving spinal taps will experience some level of spinal headaches with various symptoms (dizziness, nausea, ringing in the ears) which includes neck stiffness/pain and aversion to light/sound that got me. And I guess bilateral patients would therefore up their odds since they have to undergo two spinal taps. And the literature also states that people don't tend to get the headaches until 3-5 days later, when they sit up or stand (lying down usually makes the symptoms go away). So that explains my story. I was on my back pretty much the entire time, and as soon as I had to sit upright in the car, the symptoms began.

I don't know what a patient can do to prevent these. I actually don't know if Dr. Gross allows any options for anesthesia, but an alternative like general anesthesia might bring about a whole new set of rare but serious risks perhaps far worse than the headaches. New patients should ask Dr. Gross about their options (if any). There are procedures for treating serious headaches which involve injecting your own blood ("blood patch") to stop the leakage (again, I don't know if Dr. Gross or other hospital staff performs these). I would also ask him if sitting up for periods of time soon after surgery would help prevent the symptoms, or bring them on faster so they don't occur at inopportune times, for example when you're traveling home on a plane (which happened to me).

One option I can  think of for patients who are closer by, and are driven to/from South Carolina, is to make sure your passenger seat reclines all the way back in a flat position (not all cars can do this). The literature claims the symptoms basically disappear when you are able to lay down. My personal story can attest to this. When I got home, and was able to lay down, presto! I felt normal again.

February 9, 2017

It has been two months since my bilateral hip resurfacing surgery with Dr. Gross. I just wanted to leave a quick update. I'm basically doing great, without any real issues to speak of. Here's some quick observations dealing with the 3 week post surgery mark to my current 8 week milestone.

While I'm more than satisfied with the steady progress, the first thing I've noticed is the pace of the progress has slowed down compared to what occurred to me during the first 2-3 weeks. In the first couple of weeks, you could see significant improvements almost on a daily basis. Now, and for the last couple of weeks, the improvements seem to be measurable as each week goes by. Note I'm not complaining or anything, but one needs to set their expectations accordingly.

Similar to above, the last several weeks are a little different than the initial post-op period. After about week 2, I noticed most/all of the pre surgery pain while walking quickly went away. I thought maybe this pattern would continue to a point where I had no pain or soreness. But of course, with the additional walking, exercises and stretches, I've found that I get a little sore now and again, especially on days after I push it a little harder than normal. After getting up from sitting for a while, I will experience a soreness and unsteadiness a little bit similar to how I felt pre-surgery. However, after then walking a few steps, things magically are almost back to normal (which never occurred pre-surgery). Again, things are *far* improved compared to pre-surgery, but there is still a lower level of soreness. I went back and read stories of others and was reminded that this is normal. I guess I thought I would have some sort of miraculous recovery, which is pretty silly. :-)

Then again, I am truly so much better than I was before, and continue to remind myself how lucky I am to have decided to have this surgery done, and to be patient at this still relatively early juncture. Actually, my range of motion is already far superior to how I was earlier. I can now pick things off the floor with ease, and can seemingly walk unlimited distances, and don't wake up in the middle of the night due to hip pain. Oh, and I believe I was becoming slightly "bow-legged" over the last couple of years due to my bad hips, and this has appeared to have gone away (look in the mirror and my legs look straighter now). So I guess I should count my blessings!


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