D-day quickly approaching

[chuckm]

Scott, one of the surgeons on this site remarks that on average hip resurfacing adds about 1/4" to one's height. I can't remember which surgeon but it's here somewhere. The sensation of the longer leg, however, is because the entire area is stiff from the surgery and the complex motion of the entire pelvic region takes some time to restore itself. My hip feels normal most days now but occasionally the next day after having played a soccer match it can feel a bit longer again. 

Three weeks was about the time that I had sudden improvement. That was also when I had my first follow up visit with my surgeon and that gave me lots of confidence to stand up straight on the new hip. Just push back at the earth and concentrate on using the new hip and not just the knee below.

Chuckm

[bosoxgordon]

I suspected that the new resurfacing would add a small length to my leg for the reasons you gave. I also am not sure how much bone is removed when preparing the femoral head. I would imagine the amount of bone removed would be close to the thickness of the femoral component. I suppose that is a question best answered by an actual surgeon. I will try to remember to ask Dr. Gross about that. I'm not exactly sure but I seem to remember that in the past couple years my x-rays have shown that my pelvis is a bit off balance and that very well may be because of my compensating for the arthritic hip. Now that the arthritis is gone I will have to adjust back to a more normal stance. That is what I'm telling myself at least.
One of the tough things about this recovery is that I'm forced to be much more physically inactive and it gives too much time to worry about all that can go wrong and question if this was the right thing. I had a friend ask me the other day if I would do it over again if I had the chance. I think he was trying to be encouraging by making the point that the pain is gone and it was a good thing. I had to be honest with him and say that I'm not sure yet. While I was bone on bone in my hip, my pain levels were not unbearable yet. I am still early in my recovery and still not back to where I was before the surgery. So, it's hard to say this feels like it was a good thing to do. I am still hobbling around like some old man and cannot do the physical work around the house that I often enjoy doing. (The lifting limitations are particularly hard to stick to)

In any case it is encouraging to see that folks like Chuck can play soccer after this procedure. I played soccer for years growing up and in college. I know how demanding that sport is on your body and I can't even imagine trusting my new hip enough to even try playing soccer again. It helps me keep the faith to know that I will in fact reach a point when I will trust my hip again enough to try something like that. Right now I'd just be happy to throw away this stupid cane.  :D

[tennisgirl]

Scott,

Dr. Gross told me it will add about 4cm and that your body will compensate.  I agree that inactivity will give you too much time to notice every little thing.  I can't remember when that feeling of a longer leg went away, but it does!

Try to watch the SEC Championship football game today in my hometown and see if Auburn can pull off another miracle play in the waning moments.

Mindi

[oldsoccerplayer]

One of the tough things about this recovery is that I'm forced to be much more physically inactive and it gives too much time to worry about all that can go wrong and question if this was the right thing.

I remember feeling the same way, but it's becoming more and more of a distant memory. I think I was at about the 10 week mark when I was able to say that even if I don't improve any further I'm better off now than I was pre-op. Up till then I was wondering if I hadn't just traded one set of pains & limitations for another. If my experience is anything to go by it does get better over time. I'm about 2 months away from going back to soccer and chomping at the bit. I feel strong enough having been exercising more and more aggressively but sticking to the 6 month restriction. Be patient and don't go too hard on yourself.

[Miguelito]

Scott,
I have read, and it was true in my case, that the point at which you are in less pain than pre-surgery is about six weeks. But that is really the approximate time where the surgical pain is less than the (now gone) arthritis pain. You are at three and a half weeks. The six week mark was spot on for me, but my hip was just destroyed before surgery, and yours doesn't sound like it was as far gone, so you probably shouldn't expect to be better than pre-surgery until a later date.
You just had major-surgery, actual, defined major-surgery. The recovery takes a long time. At six months you are still going to be unathletic. For me, that started returning at about a year.
I also am firmly of the opinion that young, active (particularly muscular) males have the toughest time for the month or so post-surgery. I think wrenching the femur through a thick thigh for a 40 year old male is completely different than doing so for an older person with less musculature.
You commented that you are not where you were before surgery. You shouldn't be. Try to pay more attention to the experiences of younger males post-surgery than the populace at large.
Be patient. You'll get their in the end.
Mike

[Miguelito]

Scott,
Just read a couple of your earlier posts. Of course people are going to look at a 40 year old dude with a cane. People's brains don't notice normal things that their brains are used to, but see a 40 year old dude with a cane out the corner of their eye and they're gonna look. Occasionally I find myself drawn to look at someone and I notice that it is because they are missing an arm or a hand.
I also noticed you mentioned that you feel you can't trust your hip. You shouldn't at this stage. That is why you should be using two crutches, one crutch, or at a bare minimum, one cane for any walks right now. Frankly I would be using the two for safety. Walk as normally as you can, but have the crutches in place, just in case.
Mike

[bosoxgordon]

Mike,

Thanks for the encouraging words. The whole crutches/cane schedule is and interesting topic. When I first talked with Dr. Gross and Lee Webb about when I could return to work (I am a pilot), they both said six weeks easily. I've actually talked with a couple other pilots that have had this done and they said they made it back easily. So, keeping that in mind, originally I was told to expect crutches for two weeks, a cane for two weeks, and nothing for two weeks. That would complete the initial part of my recovery. When I went in for the surgery Lee and Dr. Gross both said I should be off crutches in a week. They didn't specify how long I should be on a cane but I got the impression it was based on my comfort and I should be walking two miles a day by six weeks.
Interestingly there was another patient that had surgery the same day as me and he was told he needed to be on crutches for the full six weeks. I can only assume his hip was in much worse shape or maybe he had some issues with his bone density. He was a younger man but I remember he was limping pretty bad when he came in for his surgery. Anyway, my point is that it seems to be a bit of an individual thing. I do admit I have to force myself to take it slow. I've always trained myself to push through pain and go the extra mile. This is a case when I'm having to take a much more cautious approach and it feels strange to me. Sometimes it often feels like I'm being lazy or using it as an excuse to just sit around. Guess I'm getting cabin fever at this point.

[Miguelito]

Scott,
You raise an interesting point with your last post. I love Dr. Gross, but if there is one criticism I can make of surgeons promising aggressive recoveries, it is that they themselves have not had the surgery done. I think some of them (and not necessarily Dr. Gross, he didn't promise me anything) don't understand how hard the recovery can be. Those first few weeks are hard. They suck. If others have had a great recovery then I am honestly happy for them, but I think the fantastically easy recovery is out of the norm, and more likely to happen for older people who maybe have less muscle to cut through and a lesser expectation of functionality post-surgery. That is just my opinion. Anyone can feel free to disagree.
Mike

[Juno]

Mike, I just want to echo everything you wrote and tell you those were great words of advise. I so agree that each of us is individual and there are no canned recoveries. I think more of us err on the side of slower recoveries than not. This is true major surgery with side effects, real risks and months of recovery.

6 weeks was a good turning point for me too, but even then I was no where close to "my normal". I still get weird aches and twinges. I still stretch and work ROM / strength almost everyday --- it is getting better and stronger but I am confident it will take a full year.

Scott -- you are doing great! It's a struggle to remain positive -- especially when we are used to going all the time. I understand completely. We will help you get thru this part! (You all can all help me in three weeks when I'm going thru it!)

[bosoxgordon]

Thanks so much for listening and providing some great feedback and encouragement! I started this journey with hip OA about 2.5 years ago and I've been amazed at how helpful everyone out here and on the yahoo group have been. It's really amazing how vibrant this community has been over the years and how willing people are to help a stranger. I hope I can be a help to others now that I've "crossed over to the other side". It would mean a lot if I have a chance to pay it forward.

I would agree about your comments about how difficult this recovery can be. In particular I was VERY surprised at how difficult the first week was. I know everyone's experience is different but my first week was quite scary at times. I especially worried that I pulled the trigger too early on having the surgery. Like I've said before, while my OA was bone on bone I was still functioning pretty well. Don't get me wrong I still think I needed the surgery sooner or later it's just tough when I'm feeling like I've taken some really big steps backwards right now. I'm hopeful that I can get back to the gym and be more active than I've been in a few years.

I would also agree that sometimes the medical staff can be a bit too cavalier about the surgery. They do hundreds of these a year and it's all pretty much routine for them. This was my first hip surgery and it can be quite scary especially at my age. One of the reasons I've been trying to keep my posts updated on here is that hopefully someone in the future can read this and hopefully have a better idea as to what they may be facing. At this point many of the really bad physical pain is gone. I've found that now much of the battle is mental and emotional. It absolutely sucks being in the house this much and not being able to do something physically demanding.

By the way, how many of you were sick of hearing this from people? "Wow, your way too young to have hip surgery!" And then they usually follow up with a line of questioning that implies they don't think I really needed the surgery. LOL I can almost predict verbatim what people will say now. Anyway, it's always surprising how incensitive people can be with their reactions.

As far as my recovery pace is concerned I am really trying to keep my expectations in check. I agree that I have one shot at making this resurfacing work and I don't want to harm it by doing something stupid. Having said that, it's really hard to believe that I will be ready to fly again in three weeks. I do a lot of walking with my job and climbing in and out of the cockpit will be challenging. I'm trusting Dr. Gross because he was very confident I would be ready by six weeks. I've made some good progress by the three weeks mark but based on how I feel it's hard to believe I will be ready to fly again in just another three weeks. I do have to option of waiting a couple more weeks and I may do that just to be safe.

Anyway, I've gone on way too long (can you tell I'm getting bored trapped in the house?  :o ) thanks again for all the support.

[Miguelito]

Scott,

You had a tougher early go of it than I did, and I don't really know what a pilot's job entails, but I think the odds are good that you will be ready to work at six weeks. And if you're not, you're not. If you can wait until right around the six week mark to decide, that would be best. Absent any unusual setback, I think you would almost certainly be ready by eight weeks. But again, you are the one who decides that, based on how you feel.

In an ideal world everyone would get as much time as they need to get close to 100% before they return to work, so that they could focus more of their energies on their recovery. But I think you have a young kid or two. That, coupled with work, makes things more challenging.

All that being said, I suspect (and hope) that you are on the tail end of the tough times. You will still most probably have a setback or two, but my hope is that you will be pleasantly surprised in a week or two at how you feel. Just don't forget that this recovery is not strictly linear.

And watch a lot of TV. Distract yourself while your body heals.

Mike

[Miguelito]

Scott,

Just re-read your post where you mentioned climbing in and our of the cockpit. I imagine that there isn't a ton of room in the cockpit even in a widebody jet, but doesn't sound like that's what you are talking about? I imagine some cockpits are tough to get into (a fighter jet, for example!). At six weeks it would definitely have been significantly more difficult for me to climb in and out of anything than it would have been pre-surgery. I am not commenting on whether I think you can do it, I'm just saying would have been more difficult for me. In any case you can probably do it, just gonna be a hassle and an irritant.

I also have to admit that at 20 months it's tough for me to remember just what my hip was like at six weeks. Hopefully others right around there now can comment.

Also wanted to comment about your thinking that maybe you jumped the gun a little with surgery, so that you have that nagging doubt rattling around your cabeza. For that reason I don't (at least anymore) encourage people to jump into surgery. I tell people that they will know when they're ready. My first hip was ready. I really had no choice. In a two week span I had four separate days where I could not walk, and could only sleep contorted into a crazy sleeping position with my leg suspended in the air, and eight beers and half a dozen acetaminophen in me. But having gone thru that with my first hip, I am going to have the second hip done where it is around the stage where yours was probably at, because I know how bad the pain was with the first hip and I do not want to go through that with the second hip.

Reading this site over the last couple of years, I sense that most bilats do what I am going to do, ie pull the trigger a smidgen early on the second hip. I think this should be some comfort to you, that with the benefit of hindsight, most people waited too long with the first hip and would go back and have done it earlier. I clearly needed HR about 2-3 years earlier than I had it done.

Lastly, I encourage anyone who is under 45 (or 40, realistically) to explore surgery to have FAI/Labrum fixed prior to HR/THR. There are other options (than HR/THR) for people who are younger and have more than a little cartilage left. I don't see other options mentioned here often enough. Just know that post 40 your options narrow.

Mike 

[bosoxgordon]

Hello all. I'm sorry I haven't posted in a while. It's been busy around here with the holidays. I just wanted to let everyone know I had my six week check up last week. Everything checked out well and I've been cleared to return to full flying duties. I am glad I will be able to start flying again but I'm still not anywhere near 100%. I told Dr. Gross that I wasn't yet back to where I was before surgery. I am still in more pain and weaker than before. He said that since my pain levels were so low before the surgery he expects it will be the three month point by the time I'm back to a level I was prior to surgery. I'm optimistic and pretty confident I did it at the right time. However, I'm still impatient about how long it takes to heal up. It sometimes feels like I'll never be pain free again and the day to day swings get old. Just when I feel I'm getting stronger I will have a weak or painful day and I doubt my progress. I know it is to be expected but it's still discouraging at times. I'm doing the phase II exercises now and do feel myself getting stronger. I can sometimes feel when I push too hard. I was walking two miles a day on week six and getting a little sore. Dr. Gross said to maybe back off a bit for a while. So that is what I will do.

FYI I also found out that I got a 50mm implant size and it's at a 31degree angle. Lee Webb said that it looks perfect and I should expect it to last the rest of my life. Dr. Gross is very much more conservative with his predictions. LOL, he will NOT predict anything beyond what his research data actually shows.

Anyway, I'm hoping the aches and pains will go away as time goes on. I find that I'm quite stiff and sore after sitting still for long periods of time. It makes me wonder how I'll be after a couple hours in the cockpit.

[Miguelito]

Hi Scott,

Thanks for the update. Sorry you are still in significant pain. And everything you said about Dr. Gross computes with my understanding, FYI.

Try not to get discouraged. Recovery probably took longer than I thought in my case too; and being a Dr. Gross patient I was very conservative in my recovery. I know that at six months all I could do was hobble jog (if I had to run across a street). But at one year it was like someone threw a switch and athleticism started to return. I am now at twenty months and went skating yesterday for the first time since last winter and I was really surprised at how much better I was than I had been in years (even with the second hip deteriorating - nowhere as bad as first though).

Apropos of nothing, I also had a 31 degree angle.

I hope things improve more quickly.

Mike