Staging of Bilateral Procedures

FlbrkMike · December 12, 2010, 09:02:13 PM

Hello Surface Hippies.

It seems that there are two separate "Surface Hippy" sites, and I'm not sure what the deal is, but I don't really care. I'm getting some good info at both places. Is there a rule against "cross posting"?

After seeing three surgeons about my hip problems I've decided to try and schedule my bilateral resurfacing ASAP. Both sides look bad on the film and I have a lot of stiffness on both sides, but the pain is worse on the left side. So, I think I will go with the left side first.

I'm looking for informed opinions on the staging of the two procedures. If everything works out well I hope to have the first side done in late January. The question is how long to wait for the second side. I want to fly to Salt Lake City at the end of April for my nephew's wedding. My optimistic schedule would be to have the left side done in late January and the right side four weeks later in late February. This would give me two months to recover enough to fly for a couple of hours for this wedding that I do not want to miss. My wife will be available to do all of the driving, so I don't really have to worry about that.

Is this too aggressive of a schedule? Should I wait until after April for the second procedure? I'd really like to get everything done sooner rather than later and I figure that with a four week interval the recovery periods for the two procedures will overlap somewhat, reducing the total recovery period. But, is there a good chance that I wouldn't be ready to fly after two months?

Thanks in advance for any opinions.

Mike in Fallbrook, CA.

Pat Walter · December 12, 2010, 09:38:30 PM

Mike

Welcome to Hip Talk. I have the www.surfacehippy.info website which is a website that I started as a personal project and paid for all the costs. The Yahoo surfacehippy discussion group is not a free standing website - it is part of Yahoo and not owned by one person, but Yahoo. Many people post at both places, I don't mind. I belong to the Yahoo group, but don't post there much any more since my site keeps me pretty busy.

Each surgeon has their own protocol for bilateral resurfacing. Some do them at the same time, some separate them by a few days while other a few months. Much depends on what you want to do and what the doctor wants to do.

There is no way to predict your recovery. Some people take a long time while others a shorter time. You will only know as you go thru your post op recovery. 2 months recovery should be enough to fly. I had my resurfacing in Belgium and flew 8 1/2 hours 9 days post op to get home. I was still on two crutches for the flight. Normally, just one crutch walking - but airports are diffiuclt. Generally used wheelchair assistance coming and going. If you are not recovered enough for the wedding, you can ask for wheelchair assistance. Certainly at 2 months you can crutch around for a wedding. Hopefully, you will be off crutches by then.

Pat

EMP · December 13, 2010, 10:02:47 PM

Hi Mike-

I had both my hips done the same day. IMHO it's the best way to go if you need both done. One surgery, one hospital stay, one recovery period, and very important to me, one medical leave from work. From what I've read on recovery time, it's not much more than a single resurfacing. I was out of work for four weeks.

E

FlbrkMike · December 14, 2010, 03:54:25 PM

Hi Pat and E,

Thank you both for your responses.

E, I was wondering how hard you found it to get around for the first few days and weeks with both hips operated on. Obviously you can't compare from experience to having just one done but any insight might be useful. Also, I hear you need to avoid sleeping on the operated hip's side for some time. Did you sleep on your back? I usually sleep on my right side, and sometimes switch to my left, but am not comfortable on my back. I snore pretty loudly on my back as well.

Also, I'm a fairly large person. 6', about 235 and heavy boned. My doc said that he has done both at one time but prefers not to because it's a long and tiring procedure.

EMP · December 14, 2010, 09:26:26 PM

Hi Mike-

I'm not going to pull any punches, the first two weeks were tough. I was popping percocets like M&Ms. But after the first couple of weeks it quickly got much better. The first real improvement (in comfort) came on day 10 when the staples were taken out......all 84 of them. We're about the same size and weight. I'm 6'2" 245 lbs. You will have to get used to sleeping on your back because you'll have to stay off the incisions at least 3-4 weeks. I slept with my feet elevated which also helped swelling. But all told, the time goes fast and getting it over with way outweighs the small time of discomfort upfront. The percocets help........

E

littleb · December 14, 2010, 10:48:55 PM

One of the recommendations for all surface hippies is to have a recliner, I think it can be safely said that would be good advice for you. If you don't already have one and are not in the market for such a costly piece of furniture, I got a fold away model from LaFuma for under $200 and have no regrets. I still use it for my back on those sleepless nights. I couldn't sleep on my scar for months because it was so sensitive. I hope you don't have that problem.

DirkV · December 15, 2010, 01:36:59 AM

Hi Mike,
First of all, good wishes for successful resurfacings to get an active life back.
Second, I second Pat's comment that different surgeons have different protocols.
I had similar bilat problems, and like E, I too didn't want to take a year to rehab sufficiently to get back into some semi-serious athletics, only to repeat for the other side.
Finally, I'll tell you how it worked for me. I had pre-surgery appointments with 2 CA docs, who both suggested the same protocol. Both said that they could do, and had done, simultaneous bilat (both sides in a single operation). However, both also suggested that there is a very slightly minimized risk to do them separately. E.g., the risk of infection for a 4 hr operation is more than 2x the risk of a 2 hr operation. In my case, I had the operations done 5 weeks apart. I was blessed with successful surgeries and quick recoveries. I work from home, and was working after 1 week both times. For more details, I sent Pat a "hip story" at http://www.surfacehippy.info/hipstories08/dirkvandyke08.php .
To your question, in my case, I would have been able to undertake the activities you are planning at 2 mo after the 2nd operation. But again, surgeon's protocols differ, and after any major surgery, you would be advised to have things in pencil.
Best wishes,
-Dirk

fenceman · December 15, 2010, 05:46:23 PM

Hi Mike,

I second the recliner. I only had one done but even then you still have to sleep on your back. I couldn't sleep on the op side or hoist my leg up to sleep on my good side. Both positions were uncomfortable for a while until your leg heals. Good luck with your decision.
Bill

hernanu · December 15, 2010, 09:40:17 PM

Hi Mike, I had two done, one in Aug. 24, then the other two weeks ago (Nov. 29th). I allowed three months to go through PT for the left (worse) side. In both cases, I slept on my back with the operated leg elevated. It does prolong things by 3 months, but it worked for me.

Others here have had good success with having them done at the same time, or (as described in another thread) separated by three days.

In the end, though, it seems as though if you have a good surgeon, the path may vary, but the end result is generally good. It was for me.

newdog · December 15, 2010, 09:51:42 PM

hernanu,
Sounds like Dr. Snyder is a really good doc. Glad it worked out for you. The thing is you are done and it went well.

Steve (newdog)

FlbrkMike · December 16, 2010, 09:55:49 PM

Great story Dirk. Thanks for taking the time to post it.

I've had stiffness in my hips for just about as long as I can remember. I always thought that I was just not very limber and it was probably a sign of getting older. I used to work out religiously on my indoor rower, for about 15 years. One day a couple of years ago I felt a slight twinge in my left groin, like I had snapped back too hard on the pull, which turned painful the next day. My internist diagnosed it as hip flexor tendonitis. I went through a couple of months of PT, which always felt good but didn't help in the long run. That was the beginning of my downhill slide. Now, it's an adventure just trying to cut my toenails.

I also am seeing Dr. Ball and hoping to get on his schedule in January. I just need to get the medical clearance from my personal physician. Dr. Ball is the third orthopaedic surgeon that I've seen. I live in a relatively small semi-rural town in northern San Diego County. We have a small hospital here that's generally pretty good, and one orthopaedic practice with four docs, which I went to first. The doctor there told me that there are several stages of handling the arthritis. First is use anti-inflammatories. Second is to try steroid injections, which I did several times. When the pain and stiffness gets too bad it's time to consider replacement.

I went to a class for potential joint replacement patients (hip, knee and shoulder) at the hospital that's put on by the OS guys in town. Turns out they only do THR. A friend on my street had a partial done last year (BHR) which he told me about and I asked about it at the class. The doc putting on the class said that they don't do them and generally don't recommend them. I also noticed that at 55 years old I was about 20 years younger than the average age in the class.

That's when I started researching hip resurfacing online, and I found the two surface hippy sites. What a great resource they have been!! I also made an appointment with my friend's doctor, which was Dr. Chao in San Diego. Turns out that he's also the Chargers team physician. I noticed him on TV during a Charger game a couple of days after my appointment. He said that I was definitely a candidate for partial replacement. I also took my film a couple of weeks later to Dr. Ball. Dr. Chao seemed very competent, but in somewhat of a hurry. Also, he doesn't specialize in hips, but sports injuries in general. Dr. Ball specializes in hip resurfacing and seemed happy to spend as much time as it took to answer all of my questions. He even gave me his email address, and that of his scheduler, in case I had more questions. I really appreciated that extra attention and his obvious experience, and have decided to go with Dr. Ball.

FlbrkMike · December 16, 2010, 09:59:03 PM

Oh yeah, one more thing.

We have a recliner, which we originally bought for my wife when she was pregnant with our first child 21 years ago.

It's still in good shape, and the most comfortable seat in the house. I use it regularly to watch TV but sometimes it's hard to stay awake in it. I guess I'll be giving it some more use next year, which seems somehow very appropriate. Full circle and stuff.