2 Week R Biomet w/Dr. Gross

[Anniee]

Oxycontin, Lyrica, Tylenol and some other stuff - sounds like a good excuse to me!

Curt, I'm happy that you are doing so well!  I did have to think about how I walked for a while after my first surgery.  That felt a little weird, since I've been walking for many years without having to think about it, but I found myself limping a little if I did not think about not limping.  I don't remember exactly how long I had to do that - probably about 2 months. 

[curt]

       Had a good 6 week follow-up with Dr. Gross this morning (and then drove 7 hours back to Virginia Beach).  Cup angle was good, ROM standard, still a little weak in abduction, but all ok. 
       I used the opportunity to talk to him about MOM and cup angles, since there have been so many posts lately about the metalosis and implant wear,  and this is roughly what he said:

  He has had 7 total revisions (out of 2000+), with 2 cormet and 5 biomet.  All had high angles.  He stated that he has had no revisions due to wear with a cup angle less than 50 degree.  I wanted to act intelligent, so I asked what the exact optimum angle was? and he said: less than 50 degrees.  He was a little tongue in cheek, but said that measuring it on an xray, between the supine look after surgery and standing for follow ups and simply marking it on the screen were inexact to several degrees anyway.  All he knew was that ensuring the cup angle was less than about 50 degree virtually eliminates what was already a low .03 percent revision rate.
   As I mentioned in another post this evening, he did reiterate that he wants me to avoid too much flexion (over 120 degrees) and to remain careful about avoiding the movements associated with his dislocation of my leg.  He feels that it takes up to a year for all the soft tissue, ligaments and muscles to heal completely.

      Other than that, I plan on continuing my Hernanu exercises but on steroids until I am strong like bull! Curt

[John C]

Hi Curt,
Thanks for asking the questions, and bringing back the good info. I am not clear on one thing. Do the 7 revisions refer to those that were due to metal wear? I know that Dr Gross's record is very good, but I was pretty sure that the total revision rate is more up around 2% when you include all causes. From this I am guessing that the 7 revisions you mention to get to the .03% revision rate, just includes those due to metal wear issues, as opposed to other causes. Does that sound right?

John

[ScubaDuck]

John-

Are you referring to the revision rate (of failure rate) of the general population of 2%?  I would guess that Dr. Gross, like many of the experienced HR surgeons, would have much lower rates.  This then leads to an overall success rate of 96 - 98%.

It would be interesting to know how many other cases of fixing an acetabular cup that came loose or other fixes he has had.  I think this just refers to HR to THR revisions.

Dan

P.S.  His rate is actually less than 0.35% (7/2000)

[John C]

Dan,
I have not looked it up in awhile, but my memory is that he has a long term failure rate (meaning revision of any type, for any cause) of around 2%, which is very similar to Mr. McMinn and other top surgeons. I believe that his more recent results with the Biomet cementless is even better.

[curt]

       Sorry guys, spent the weekend away.  His 7 revisions he was quoting were for metal wear/loading only.  He didn't specify the symptoms or ion levels for metalosis.  But they were all just for metal wear.  He wanted to stress that he hasn't had any since they pegged the cup angle as a prime suspect.  Zero.  So his rate for metal wear was .03 percent.  Sorry bout the confusion.  Curt

[curt]

     The leaves are falling, falling, falling.  Spent two days picking them up and bagging them.  Got into it a little heavy and overdid it some.  Groin and outside of my hip are a little tender this morning.  I've gotten a bit paranoid since the surgery about any twinge being a pending dislocation, or any pain being my implant shifting or a fracture occuring.  I actually think that its mostly sore because I just used it, not because of a problem. 
      It has been so long since I've had pain that wasn't due to the hip being a mess, that I think I've forgotten what it feels like to just be plain ol' tired like a workout.  Hopefully with a little ice, rest and some alleve, I'll be back on track.  Lately I haven't been thinking too much about the hip at all.  It will be nice to get to the point (other than being amazed every now and then) when I don't think about it ever and worry about the other stuff like the barber asking to trim my ear lobe!  Happy holidays to all the New World yankees.  Curt

[hernanu]

I understand the paranoia, curt. It probably is sore because of that, just lay low until the pain goes away, it's probably the stabilizer muscles complaining. If I get that (the groin in particular), I wait until it's fully unsore (word?) to do anything ambitious since I don't want to overstrain a muscle that's lagging behind.

[Cantab]

Raking leaves!!! YUK :( Part of the reason I scheduled my operation in Nov, I knew I couldn't rake this year, and also shovel snow.  "Sorry Hun I just cant risk the injury."  Seriously though it is wierd that I can't wait until next year to do it without the hip OA pain the last few years.   

I've gotten a bit paranoid since the surgery about any twinge being a pending dislocation, or any pain being my implant shifting or a fracture occuring.  I actually think that its mostly sore because I just used it, not because of a problem.

Just  a few days out of surgery I feel this every time i move awkward or feel the ligament/tendons catch a little when I move the leg.  I think this is always in the back of our mind, I'll learn to live with it, fear can be a good thing to keep you out of a bad situation.  Good luck with the leaves Curt., you probably don't have to worry about much snow though

[curt]

    I have undergone a sort of epiphany about my recovery.  I've been concentrating on the physical and I think, for me at least, its really mostly mental.  The physical meaning pains and aches, progress with walks, daily activities, time on the treadmill, strength and weakness, etc.  I've been consumed with these things because they seem measurable.  I compare myself to the others on this site (I'm slower or I'm faster); I compare myself to my previously fit or crippled self; I wonder why I stagnate and stop improving or why it hurts or aches depending on the day or activity.
     Then I started to just try and feel good.  About anything.  Not so much how I'm doing, but concentrate on the positive things that remind me this is all worth it.  Going any amount of time - minutes, hours whatever - without thinking about my hip; just being glad to be out for a walk - even if I start to limp a little; sleeping for any stretch of the night (not counting old man pee); looking at my spare tires and not getting depressed, but making a plan of action to take care of them too.
      I've decided to keep it mental, and I mean the happy, grateful mental.  I can't run right now, but at least I can walk and that's pretty good, considering.  I think I'll copy Boomer and do a Costa Rica or some other reward.  Its been a long year or more being in the dumps and thinking about the physical, so send me some mental up juice instead!!

Curt (no I'm not drunk...yet)

[Luanna]

Curt,
Affirmations really work. The mental part of training at the Olympic level is huge. The athletes spend about 40% of time at the Olympic Training Center working on visualizations and affirmations. Seriously! That fact made me sit up and take notice.

So - here's a start: I am healing well and at a good pace. My body knows how to heal itself. I visualize myself (activity you love - example: skiing down the mountain) gracefully and fully confident that my new hip is fully integrated into my body and working perfectly. We are pasting up one affirmation per week on the refrigerator right now.

Well - you get the idea.

Luanna

[curt]

Luanna, I like it!!  I have a new one too..."I had bad hips, but great bone density!!!"

Curt

[Kiwi]

Curt, What I did pre-op was write up & stick on a 'vision' (white) board, a high level view of all the activities I wanted to achieve in the first year post op. I gave myself what I thought to be very achievable targets that I could tick off as the year went by. It's really motivating for me and gives me a lot to look forward to. There's a lot missing but this give you an idea.
I'm just past 6 weeks & have ticked off ALL the 1-6 week personal targets! Felt good.
I also wrote reminders for myself, in amongst the targets (listen to your body etc... which I didn't do so well on a couple of occasions).

Looks something like this;

1-6 Weeks:
Lots of walking
Bed, chair, standing exercises
Driving by week 6
Walk a mile by 5 weeks
Let it settle
Slowly build up
Listen to my body
Ice, ice, ice
Books, DVDs
Exercycle
start swimming
Ditch crutches
Start working from home
6-8 weeks
Change to more strengthening exercises
2 months
Fishing - surfcasting only
Walking
Swimming
New exercises
Increase ROM
3 months
Walking
Swimming
Exercises to target golf
4 months
Take boat out?
Biking
Golf - chippin only
Exercises
5 months
Driving range
Walking
6 months
Golf
Get exercises that target squash & tennis
8 months
Diving
Fishing
9 months
Tennis doubles
Start hitting squash ball by myself
10 months
Length game (squash)
Tennis singles
11 months
Squash doubles
12 months
Squash singles
LISTEN TO BODY
Get check up X-rays
Feedback on Surface Hippy

As I say, I think these are quite conservative targets, but that's what re comended & this approach seems to be working for me so far.
I just need to check in with HQ (aka my lovely wife) & get a pass to do it all the now  ;)

[curt]

      Those all look great.  It appeals to my competitive nature to have goals, measure and time.  I'm sure I'm not alone in that most of us got here using training programs, workout schedules, etc.  There have been quite a number of surprises during the recovery that have made me harumph or be pleasantly surprised.  I would never have believed how much I would notice the loss of that deep hip ache upon waking from surgery.  I would never have believed how WEAK my flexion and abductor muscles would be this late in the game.  I would never have believed how cathartic and helpful a site Pat's would be for me.
     I am going to keep my recovery basic from here on out:  1.  work on staying postive about the smallest of successes as well as the great big ones; 2.  stop getting overly concerned about each tiny twinge or pain -  most of which is probably the good kind; 3.  start assuming that wherever my recovery takes me day to day, that's exactly where Curt is supposed to be; 4.  simply hope it works and lasts for the rest of my life!

Thanks for the support, Curt

[Kiwi]

I think that's why I like this approach too, Curt - I'm competitive & goal driven.
Also agree that you have to celebrate & reflect pre Vs Post op all the small & large achievements. I'm really noticing much more comfort just sitting & getting in and out of vehicles. I used to cringe every time I did this as my hip flexor would grind & the last two weeks before my op send shooting pains down to my knee which would then completly lock up. This no longer happens. I can already walk further without pain than I could pre op etc etc.
Just last night I crossed my leg without thinking & had gripey, pulling sensation in my groin, it's been painful ever since. My wife was more worried it than me! I just know I have to take it easy today. I'm taking the approach that this is a lifesytle change for me & the rehab work will go on for years. My hope is that I'll be fitter & stronger than ever as a result.
I like you new approach.

[Aerial]

My yoga teacher always says "I love myself why I try".......how powerful!  Keep trying a little more each day and love yourself for taking a leap of faith when you feel ready, no matter how small!