Uber Alan's Bilateral Hip Story: Dr. Gross - Right (3/16/09) and Left (3/19/09)

[landaq007]

I am inviting Alan out to Pgh to cut my grass this Summer  Grin

I am so glad that Alan has a surface hippy to compare notes with.   Thanks so much for paying it forward to Alan.

Like I always say this is the best hippy support site in the world......maybe the universe.


Chuck

It is my pleasure to pay it forward -- and it is comforting to be able to!!  That is an open invitation to anyone, anytime  :)

I still have pain and discomfort when I first stand up after sitting for any length of time.  I definitely feel my right leg is ahead of my left in recovery.

Alan, my left was ahead of my right, so during the "cane days" I was taking the pressure off of my right with the cane as the left was more normalized.  I practiced easing off of the cane in my hallway here in the house -- simply pacing back and forth slowly allowing more weight transfer onto the right leg.  It was a very exaggerated transition at first and little by little it strengthened up.  Now I walk without the penguin-like lean I had become accustomed to pre-op. 

Another MAJOR milestone to me has been the ability to go back my bed to sleep and out of the recliner.  I naturally toss and turn all night so at first it was very uneasy.  I tried it the first time and went back to the recliner because it was as you described it "lying on top of a hardball under my hip.  No way I could sleep that way." 

I thought I was going to have to sleep with my feet off the end of the bed but after a couple of weeks I had wired a routine of pillow-between-knees and the occasional pillow-under-knees while sleeping.  Now I don't even notice it anymore and am no where near as conscious of damaging something since Dr. Gross & Lee gave me their blessing at the 6-weeks post-op visit.

I would like to see you post an update to your post in bilateral stories about the significant events that you have experienced since your previous post.  Always good to know what to expect next.

Thank you, I will update the post with the different milestones I have experienced!  Heehee  ;D  Cutting grass being up there on the list! Just in time for spring down here in Atlanta!

Let me know if there is anything else I can help with,

Tim

[MarilynRS]

Hi --  this is my very first post.  I've been reading on and off for a month or two.  It's my new hobby, usually late at night after I've got my kiddles tucked in to bed. 

Anyway, thanks so much for your posts.  I was thinking, back maybe in January and even into February, that maybe I would have my hips re-surfaced (I need bilateral) during spring break.  I had been thinking about Dr. Gross as one of the possible surgeons I would like, with an uncemented femoral cap. 

But I didn't get it all arranged  for Spring Break.  There's so very much to learn.  So much to process.  But my courage has been building as I read all the stories.  I need lots of stories.  And thankfully I have discovered this site. 

So now, Alan, I am cheering for you ! ....and for my original idea of doing it over spring break.  I could have been at 10 days post-op as well.  Oh well.  There's April or May or June.  But no later than June.  Thank you to everyone who posts -- the good, the bad, the ugly !   I want to be informed, know the questions to ask, learn what wonderful outcomes I may hope for. 

Thanks,  Marilyn :)

[obxpelican]

Marilyn,

Welcome to Pat's forum.  We have the best posters in the whole world here, maybe the galaxy.

You have come to the right place, we now have 2 experts in bi-lateral surgery now so just ask your questions away.  When possible post them publicly as everyone learns from questions and answers.

If you pick Dr. Gross you're going to be ok as he's one of the best.


Chuck

[uberalan]

Chuck,

I am getting there, slowly but surely.   I go back to Columbia for my six week check up on May 1st.

Alan

When can you stop by to see my lawn?   

[obxpelican]

Alan,

You do realize he has an out of town 6 week protocol?  I did it and it was fairly straight forward, I got x-rays locally and was seen by a physical therapist who filled out his questionaire.

Just a thought anyhow.  The big part of the 6 week checkup is to check the x-rays and ROM.

Chuck

[uberalan]

Marilyn,

Welcome to the forum and thanks for your comments.  I am glad you are finding some value in these post.  I did the same late night reading of the information on this web site.

As you read the post here, you see who are some really fine surgeons that have mastered hip resurfacing.  I figured I was going to only have one shot at this and I wanted one of the masters.   I don't think you could wrong with Dr. Gross, especially if you want to go the un-cemented route.  All it takes to get the ball rolling with Dr. Gross is to email Lee Web your x-rays and Dr. Gross will call you back in a few days and discuss your surgery.  

You will need someone with you in Columbia and the first week at home after the surgery.  My wife being a school teacher drove us to target spring break.  She used family sickness leave for the hospital week and spring break for our first week home.  She went back to work this morning.  My in-laws are spending this week with us if I need some help during the day.  I think I could probably manage on my own, but it is reassuring to have someone here.  

I was in your same position in regarding regretting that I didn't schedule the operation over Xmas/New Years Holiday.  My original target was to be at six months by summer, but we just couldn't get it done.    However; we have had such bad weather in Jan and Feb, had I had the surgery in December, my recovery would have been some what hampered by not being able to walk outside.  Even waiting to the middle of March, the weather is still causing problems with the blizzard last week and two more snow storms predicted for this week.  Of course, with the help of my in-laws this week, I can always travel to the nearest mall or COSTCO to walk around, which I will probably do today.

When I scheduled my surgery in January, Dr. Gross was booked a couple of months out.  Once you set the surgery date, his front office will start working on the insurance pre-certification, which in my case took about a month.  In my case finally scheduling the surgery was a major milestone.

Good luck and keep us informed of your progress and feel free to ask any questions.

Hi --  this is my very first post.  I've been reading on and off for a month or two.  It's my new hobby, usually late at night after I've got my kiddles tucked in to bed. 

Anyway, thanks so much for your posts.  I was thinking, back maybe in January and even into February, that maybe I would have my hips re-surfaced (I need bilateral) during spring break.  I had been thinking about Dr. Gross as one of the possible surgeons I would like, with an uncemented femoral cap. 

But I didn't get it all arranged  for Spring Break.  There's so very much to learn.  So much to process.  But my courage has been building as I read all the stories.  I need lots of stories.  And thankfully I have discovered this site. 

So now, Alan, I am cheering for you ! ....and for my original idea of doing it over spring break.  I could have been at 10 days post-op as well.  Oh well.  There's April or May or June.  But no later than June.  Thank you to everyone who posts -- the good, the bad, the ugly !   I want to be informed, know the questions to ask, learn what wonderful outcomes I may hope for. 

Thanks,  Marilyn :)

[uberalan]

Chuck,

I do realize he has a out of town six week protocol.  They gave me a choice.  I am planning to combine a business trip to the east coast with a checkup in his office.

If that doesn't work out, I may utilize the out of town protocol.

Alan

Alan,

You do realize he has an out of town 6 week protocol?  I did it and it was fairly straight forward, I got x-rays locally and was seen by a physical therapist who filled out his questionaire.

Just a thought anyhow.  The big part of the 6 week checkup is to check the x-rays and ROM.

Chuck

[uberalan]

March 30, 2009:   Post Op Day 14 (right) Day 11 (Left)

Hard for me to believe it was only two weeks ago that I had my first surgery.  My wife returned to her teaching job today and left me in the company of her parents.  I have adapted to life under Dr. Gross's three restrictions: (1) Don't bend greater than 90 degrees, (2) Don't cross my ankles and (3) Don't turn my toes inward, by mastering the tools in the assisted living kit. I can even use the sock installer.  I feel pretty self sufficient, but it nice to have their some company on the walks, knowing if I hurt something and can't make it back to the house, someone can go back and bring the car to rescue me.

This morning's walk was nearly 1/2 mile and I felt really good.  I focused on stand tall and reducing the pressure on the crutches.  I am still amazed how after walking it is so easy to take a nap.

This afternoon the wind made walking outside brutal,  so my father-in-law and I went over to Sears Grand to walk in doors and oogle the tools.  It is hard to tell how far we walked but my left hip began protesting, so I called it good.  This evening the pain continued so took a Vicodin.

All in all a good day.

[MarilynRS]

Thank you so much, Dave and Chuck for your kind replies :)

I am wondering a few specifics, with the 90 degree limitations (on your legs to torso).  Those are only for 6 weeks, right? 

What I'm wondering is how is it possible to even get in or out of a car at all without violating that?  I've watched by legs now with both our taller van and with our shorter little car.  I can't see how it can be done in either for sitting or for getting in and out.  Can you go a little past 90?  What kind of vehicle seems to be easiest to make this work?   

How was flying -- the whole airport experience, skinny-ing through plane aisles, etc?  Would it be better to schedule additional days post-op, at a hotel or such, before endeavoring to fly?  Also, I know flying can increase swelling in legs even "normally."  Was this an extra problem after your flight home?

OK,  enough for now.  And thanks again,  Marilyn

[uberalan]

Sorry I have fallen behind on posting, so this will catch up through yesterday.

March 31, 2009:   Post Op Day 15 (right) Day 12 (Left)

Weather today was nice and I took two long walks on crutches.  I am concentrating on reducing the downward pressure on the crutches.  I am still suffering what others are calling "start-up pain" after sitting for any length of time.  It is not from the joint, but from tight knotted muscles.

On the second walk of the day, I am feeling pretty frisky and push the distance by walking to the tennis courts before turning back.  This is probably 3/4 mile.  The last quarter of the way back is slightly uphill and I am feeling in both legs.  I fell some joint pain in my left groin.  I think I may have once again over-done it.


April 1, 2009:   Post Op Day 16 (right) Day 13 (Left)

April Fool's Day, which is appropriate for me.  I had a pretty rough night and took some Vicodin due to pain in the left  hip.  I obviously had over done it the day before.  When will I learn?  I decide to shorten my distance on the walks today.


April 2, 2009:   Post Op Day 17 (right) Day 14 (Left)

I had a better night and took things easy during the morning.  Last night's snow melted by early afternoon and my wife accompanied me on a late afternoon walk.  We took one of the new paths that had just been opened.  Bad decision the path ended in a muddy spot about 20' wide.  In retrospect, we should have turned around, but I thought I could negotiate the mud and uneven ground on the crutches.  It was not a pleasant experience, it would have been very easy to slip and hurt something.  However,  I had to be extremely careful and take very small measured steps to get across the muddy spot without the incident, but afterward I felt exhausted.

April 3, 2009:   Post Op Day 18 (right) Day 15 (Left)

I spent most of the morning on the phone with our IT support folks trying to make the VPN into the corporate network work.  My plan is to start trying to do some work from home next week.  Sitting for nearly four hours at the computer, I noticed my legs had become quite sore and stiff. 

In afternoon the weather was beautiful, but another snow storm was expected in the evening.  I took a long walk around the lake with my wife and in-laws.  My legs felt significantly stronger and I for several long flat stretches, I carried my crutches.  What a miracle!  Two weeks ago I was having trouble walk a couple hundred feet in the hospital.

Whether it was walking without crutches or sitting at the computer for nearly four hours, I noticed my calves and ankles had became very swollen.  So it is another intimate evening with the Polar 300's wrapped around each hip/thigh and keeping the "toes above the nose."

[uberalan]

I am wondering a few specifics, with the 90 degree limitations (on your legs to torso).  Those are only for 6 weeks, right? 

Marilyn,

Correct it is for the first six weeks.

What I'm wondering is how is it possible to even get in or out of a car at all without violating that?  I've watched by legs now with both our taller van and with our shorter little car.  I can't see how it can be done in either for sitting or for getting in and out.  Can you go a little past 90?  What kind of vehicle seems to be easiest to make this work? 

To me getting in and out of the car is still difficult.  The only two vehicles I have ridden in are my wife's Lexus R330 and my father-in-laws Honda Pilot, both of which are mid-size SUV's and the seats are on slightly above my rear when I stand.  They require a slight get-up to get-in, which I think is preferable to having to get-down to get-in.  Also wearing slick pants are helpful as it makes turning in the seat easier.  It is the combination of raising my legs while twisting around that makes it so difficult for me.  I have gone slightly past 90 degrees when getting in or out, but it hasn't been a problem. My car is a low slung Eclipse Spider Convertible and that might take me well past 90 degrees, so that will have to wait until after six weeks.

How was flying -- the whole airport experience, skinny-ing through plane aisles, etc?  Would it be better to schedule additional days post-op, at a hotel or such, before endeavoring to fly?  Also, I know flying can increase swelling in legs even "normally."  Was this an extra problem after your flight home?

I wrote up my experience about the flight from Charlotte to Denver in the "Pre-op Aniexty thread" reply #56 over in the Hip Resurfacing Topics section.  It was probably the worst part of the whole experience, but it was not as bad as I thought it would be.  If you can, I would strongly recommend flying first class and reserving the first row/bulk head seats.  We flew Air Trans Airlines and their "business class" was about half the cost of the other airlines flying between Denver and Charlotte.

As far as boarding and de-boarding the plane:  the Sky Cap wheeled me down the jetway to the door of the airplane and the wheel chair was waiting on the jetway when I arrived.  So I only had to "crutch" my way from the aircraft door to the first row.  This was probably only about 20' and I really didn't have to travel down a narrower row of the economy section.

The only problem was at Charlotte, the jetway was not adjusted correctly and there was quite a step up into the airplane.  Fortunately the PT crew at the hospital had worked with with me doing steps and stairs.  I had gone up and down two full flights of stairs at the hospital the day after they did my second hip.  However, if the height difference between the jetway and the airplane had it been any higher it may have been a big problem, but I am sure they could have adjusted it.

I had significant swelling on my right leg, calve, ankle and foot on the flight from Atlanta to Denver.  In fact, the swelling became so uncomfortable, I had to take both of tennis shoes off.  It was a pretty long day. 

I asked Dr. Gross and Lee Webb the same question you asked about whether staying over a few days at the hotel before traveling home.  Neither of them encouraged me to do that.  Dr. Gross said it might be a hard day, but with the pain meds it would be doable.  He was correct. 

I was much more comfortable being at home than in the Courtyard Inn for two or three more nights.  I don't think putting the flight off two or three days would have made much difference with the swelling.  I have had some swelling almost every day since returning home.  If I had it to do over again, I would still have flown home on Sunday.

If you don't have a car available while at the hospital, you may need to give some thought about how to get to the hotel from the hospital.  We stayed in the Courtyard Inn, which is pretty much in the parking lot of the hospital.  We didn't have a rental car, so inquired at the front desk to see if they had a hotel shuttle that could pick us up.  They don't.  Apparently there are some concerns over insurance liability and in the past some of the hotel staff may have picked patients up using their own private autos.   The hospital doesn't have any provision for this either.  So, my wife asked about borrowing a wheelchair from the hospital, promising to bring it right back.  However, my nurse wouldn't let her.  Instead, he said he thought some fresh air would be good for me and he would take me outside in a hospital wheelchair on his break.   He wheeled me over to the hotel on his break.  He didn't have to do this, but I found the staff at the hospital to be very accommodating. I had a great nurse.

[MarilynRS]

 :)  Alan, what a great story about the nurse.... old fashioned helping  :)

I appreciate you sharing some of the travel details.  I am still wondering, since I would be traveling from a smaller town in Oregon, which would entail at least two additional airplanes and airports, three stops total.  But I'll cross that bridge when I get there. 

I'm actually wondering about scheduling a week at a beach hotel, say Myrtle Beach -- sort of like what I've read on this site about Dr. Bose stories and the stay in India at a beach resort.  (Anyone know about the beach towns?)  And, since I have three children at home, (15, 11, and 7) it's also hard to imagine truly getting to rest once I'm back home.  At a hotel, I could conceivably take my morning walk while maid service is cleaning our room, then tell them all to go exploring with dad for some hours while I rest again!

Could you walk, unassisted by canes, etc, before your surgery?  I have waited so long that I am currently walking with 2 canes.  It's just one more reason though that I think I may as well jump in for a simultaneous bilateral re-surfacing.  I just sort of wonder if my recovery could possibly be as good as so many shared here.  On the other hand, I doubt I would be walking any worse -- I can't even take more than a step or two without the canes now.  So the recovery would only be about amount of pain, not being able to drive, etc.  Things like grocery shopping are already exhausting.

Thanks to all the Surface Hippys.  It's great to have a forum to talk hips.  I feel like a broken record to myself.   So many of my thoughts revolve around hips !!  femoral caps, acetabular components, cemented or uncemented, bone density, joint registries, blood clots, doctors and various options, and on and on.....   By the way, are you cemented or uncemented femoral cap?

Continued great recovery to you !!  Marilyn 

[uberalan]

One footnote to my previous post about entering/exiting from my wife's mid-size SUV.  We went to the mall to walk on Saturday because of bad weather and I paid attention to the extent of the angle between my legs and torso:  at no time did I exceed 90 degrees either entering or exiting.  I am about 5'10" before surgery.

:)  Alan, what a great story about the nurse.... old fashioned helping  :)

I appreciate you sharing some of the travel details.  I am still wondering, since I would be traveling from a smaller town in Oregon, which would entail at least two additional airplanes and airports, three stops total.  But I'll cross that bridge when I get there. 

I'm actually wondering about scheduling a week at a beach hotel, say Myrtle Beach -- sort of like what I've read on this site about Dr. Bose stories and the stay in India at a beach resort.  (Anyone know about the beach towns?)  And, since I have three children at home, (15, 11, and 7) it's also hard to imagine truly getting to rest once I'm back home.  At a hotel, I could conceivably take my morning walk while maid service is cleaning our room, then tell them all to go exploring with dad for some hours while I rest again!

Well given that you have a much longer flight and one additional plane change, it might be better to divide the trip up.  We spent the weekend in Charleston and that is very interesting place to visit.  I wished I had been able to walk more, but we did take a bus tour.  The first week after surgery was my hardest weeks and I don't think I would have really enjoyed a resort type of environment over just a nice hotel room, since I was pretty limited to how much outside walking that I was able to do.  My kids are all grown so I didn't face the responsibilities that you do.   My most miserable night was Saturday night in the Courtyard Inn, even though we had arranged for a handicapped room.

Could you walk, unassisted by canes, etc, before your surgery?  I have waited so long that I am currently walking with 2 canes.  It's just one more reason though that I think I may as well jump in for a simultaneous bilateral re-surfacing.  I just sort of wonder if my recovery could possibly be as good as so many shared here.  On the other hand, I doubt I would be walking any worse -- I can't even take more than a step or two without the canes now.  So the recovery would only be about amount of pain, not being able to drive, etc.  Things like grocery shopping are already exhausting.

I was getting to the point of needing a cane had I put the surgery off any longer.  I had developed a very bad limp and tried to limit the amount of walking.  I had been pretty physically active up until last January, so I had experienced only a year of atrophy.  In the last couple of days, I have been carrying my crutches on long portions of my daily walk.  During these "free walks" my wife has commented that I no longer have a limp.  This is less than three weeks after my last surgery. 

Each of us recovers at different rates, but you are bound to see some improvement within just a few weeks after your surgery.    I am so glad I had both hips done at the same time.  That first week was rough, but I have healed so quickly, the extra pain of that first week was worth it. If I had done only one, I would still be having OA pain and be facing another surgery and recovery.  I don't think I would really but that much further along if I had only had one done.

Thanks to all the Surface Hippys.  It's great to have a forum to talk hips.  I feel like a broken record to myself.   So many of my thoughts revolve around hips !!  femoral caps, acetabular components, cemented or uncemented, bone density, joint registries, blood clots, doctors and various options, and on and on.....   By the way, are you cemented or uncemented femoral cap?

I obsessed with all topics about resurfacing while waiting for my surgery and this site was great for providing information to feed the obsession, but also for preparing me mentally for the surgery.  I am still very interested in the topic, since I want to do all I can to make these new hips last a lifetime, but I can feel some of the obsessiveness being replaced with ideas and aspiration of the activities that I will be physically capable of performing in the future.

I should update my signature line.  I choose to the go the un-cemented route.  I have complete trust in Dr. Gross and he feels it is better, although he  will do either.  It is one less complication in a pretty complicated procedure.  Once the bone grows into the prosthesis it should be stronger.   However, it puts added importance to the first six weeks of the recovery period, where about 85% of the bone growth into the prosthesis occurs.

Let us know how your surgery goes and don't be shy of posting how your recovery goes for others' benefit.

[MarilynRS]

Thanks Alan.   :)    Did either of your femurs show much deterioration in the x-rays?  I am still waiting to hear, but wonder if that factor in mine (the deterioration) would allow an un-cemented cap, as I have heard from back from a couple of other (also very experienced) surgeons that such a procedure might be very risky for me.   It will be interesting to hear and get to ask my questions....  then ultimately I will have to decide which way and with which surgeon to proceed.

Keep up the good walking !   Marilyn

[obxpelican]

Marilyn,


If you send Lee or Dr. Gross your x-rays they can usually tell if if you're a good candidate for HR with an uncemented cap.  I had cysts and I was bone on bone and probably my next step was a wheel chair because the best I could do was around 50-100 yards at a time and Dr. Gross was able to perform my surgery.

Dr. Gross has a great article here http://grossortho.com/forms/Uncemented_femur_handout_9_2008.pdf about uncemented femoral caps, bear in mind that the acetabular cups and total hip stems are all pretty much uncemented devices.

Dr. Gross is arguably one of the best hip surgeons in this country as he takes on very difficult surgeries, read some of Dr. Gross's other patients about how they were treated both by his staff and at the hospital.  Dr. Gross's protocol is well thought up and leaves his patients pain free post-op on day one and with very little discomfort from then on.  I was never in more pain post-op than on my worst day pre-op.


Best of luck to you.


Chuck

[uberalan]

April 30,2009  Post Op Day 45 (right) Day 42 (Left)

Hard to believe it has been six weeks ago today that Dr. Gross and Lee Webb performed the hip resurfacing on my left hip.  I actually flew back to Columbia, SC today and have my six week post op exam tomorrow. 

I have had a great recovery with really only one bump in the road.  A couple of weeks ago (4/13) I was feeling so good and the weather was just excellent that day, I went for a walk with my wife and way over did the distance, probably walking close to 3 miles that day.  By evening my left hip had become tremendously sore and I was having some pretty intense deep stabling pains.

This was the most severe pain I have experienced during or after the surgery.   I was somewhat alarmed and feared I had messed up the hip joint or even fractured the femur, so I called Dr. Gross' office.  Lee had me go to a local hospital for x-rays, which I emailed to her.  The x-rays looked fine, the hip mechanics were in good condition and there was no sign of a fracture.  Lee had me ice and elevate the left hip and take it easy for a few days and then to slowly begin back with the PT. 

My left hip is better but still sore. If I walk too far, I feel a pain under my incision that feels like something (i.e. ligament or muscle) is being stretched at a certain point in my stride.  It responds well to icing, so I assume some of the soft tissues are still inflamed.

Other than that, my recovery has gone well.  The bone-on-bone pain from the arthritis  that has been my constant companion for the last couple of years is gone and so is the severe limp.  Even with the soreness in my left hip, I am much better off than before the surgery and I know I will only will improve.

I will post a summary of my 6 week post op exam tomorrow.



Alan

[Todd]

Allan,

It's great to hear about how much better you are getting around.  Just wait.  The improvements you see in the next 6 weeks will be better yet.  Once we resign ourselves to the fact that this is a long steady recovery rather than a sprint, it becomes easier to accept the minor setbacks from overdoing things on those days we feel so good!  Keep healing.

[obxpelican]

Hey Alan,

We've been wondering where you've been.

Hey...... we want to hear the good with the bad, even if it's because you were bad   ;D

Hope all goes well with your exam.


Chuck

[uberalan]

Allan,

It's great to hear about how much better you are getting around.  Just wait.  The improvements you see in the next 6 weeks will be better yet.  Once we resign ourselves to the fact that this is a long steady recovery rather than a sprint, it becomes easier to accept the minor setbacks from overdoing things on those days we feel so good!  Keep healing.

Todd,

You are so right about the "phase change" in thinking required.   My little incident opened my eyes to the long term and I have backed off trying to force my recovery to happen faster.

Alan 

[uberalan]

Hey Alan,

We've been wondering where you've been.

Hey...... we want to hear the good with the bad, even if it's because you were bad   ;D

Hope all goes well with your exam.


Chuck

Chuck,

Sorry to have dropped off the radar screen for a while.  I made this mistake of offering to telework from home 2 to 4 hours a day.  My employer took me up on the offer, but suddenly the 2 to 4 hours became 6 to 8 hours and by the time I did my twice per day PT and walks the day was pretty much gone and I was too tired of sitting in front of the computer to post.

My post op check up went very well (see the next post) and I return in person to the salt mines tomorrow.

Alan