Blinkys Hip Resurfacing with Dr. Gross 2015

[blinky]

Hard to top yesterday's success. Just know it is continuing unabated, now with just dietary help.


I went off the narcotics. A day without them felt pretty good, so I didn't take one at night either and it didn't make much difference. I slept fine and while I didn't feel great when I woke up, I didn't feel so bad that I regretted my decision.


I still feel worse in the morning. Swollen from no ice, meds almost worn off (Mobic), blood sugar low, stuck in one position all night. And I am ready for my morning coffee, of course. It is fair to say that I am always at my worst first thing in the morning, even preop. I revive after some coffee, a little food, and some ice. I feel best after lunch fwiw. I crutched around the house for about twenty minutes, but in two installments this time. I am able to sit at the kitchen table for longer periods.


Left leg is still better than right. Right seems more swollen. Right knee is still wanting to collapse in, but I am  able to control it better.  The official exercises are pretty easy to do. Walking is the challenge. I can feel I don't have the full range of motion and control over my legs when I do the correct four point crutch walk. When I first get up and when I pee in the middle of the night (poor H!) I don't worry about correct crutch walking; I just get where I need to go. I am stable to just stand, and have to remind myself that I need my crutches to turn around or change directions. I feel good enough to park them against the wall and have been tempted to push against the walls and take little steps to turn around. (okay I have done it; probably shouldn't)


Mentally fuzzy so I am happy with TV.


Pro tips: 1) H has me wear a belt of his for the difficult maneuvers we make, like bathing or middle of the night peeing. He saw the PTs using a belt to help stabilize patients and decided it was a good precaution. He can grab the belt if I slip or start to fall and lower me to the floor.
2) when people offer to help, ice is a great and easy thing to request.
3) carrying things with crutches is going to be a challenge. I am almost ready to attempt it. I have a bag I can put things in and sling around my neck. I can put a travel coffee mug or a water bottle in a front pouch and then carry drinks that way.


Cats take turns sleeping with me, which is sweet.


I really want to go outside. Maybe today.

[jd]

I'm surprised you found no difference with the narcotics at night. The last narcotic I stopped was a single 50mg Nucynta ER at night, since it lasts roughly 12 hours, it really helped with the aches that developed by morning and enabled me to sleep in a little more (since, as you said, the Mobic is wearing off and you've been stuck in the same position all night). I did however still stop it relatively quickly and substituted benadryl for awhile to knock me out for longer.

I think it'll feel really good to get outside! Even if you just walk a block or two, slowly, of course with your crutches. I say go for it! I found that I really liked getting the fresh air outside (although I'm not sure where you live and it might be very cold now!).

Good luck and keep us updated!

[blinky]

Benadryl is a good idea. I had my first night of not sleeping well. It wasn't the pain, it was not being tired enough and being stuck in one position. I took a wonderful one hour nap about noon and I guess that was a mistake. The cats, who normally don't sleep with me at night, have started to now, and one of them is so fat I have to move her off me. She can be next to me but not on me.


I will be ready to give up the recliner for sleeping. At first it felt so good, now I feel stuck in one position all night. Maybe try bed n a few days? I will have to put a pillow between my legs in case I roll over, which I wanted to do last night.


But in good news:


More time up yesterday, sitting, walking, doing more for myself. On crutches with no free hands, I have to figure out how to move things from place to place, even something as simple as a glass of water. The first few days home I was happy to just ask H to bring me stuff,  now I want to do it myself. I am using the grabber and the crutches to reach things. I have readjusted the location of my ice, for example, and unplugged it when I got too cold. I am lucky in that a friend made me a bag to carry things around. I have reached the stage where I am ready to use it. I can put a few light weight things in the bag and change locations.


How long will I be on crutches? I am thinking two weeks. I will be good at it by then. Then one crutch, but probably needing two for big treks, not a walk per se, but if I went out to eat or were in a stressful, new environment and wasn't sure what would be in store for me.


Left leg feels good. It went first and enjoyed the expert care of the hospital nurses for more time than the right leg, which was more on its own. Preop the right leg was the better leg, and so I think now I make that leg work harder out of habit. Right side seems more swollen. I feel like my strength is pretty good. Those leg bends/heel slides are easy. I did a few at night when I couldn't sleep just to change position and it felt very natural. I also noted that I could let my knees fall apart more. I am afraid to let them just go, but the swelling is down enough that I am not locked in a parallel knees position.


Progress!

[jd]

Progress is great.

Reading your reports I am very frequently reminded of how useful having one good leg was! :) The good news is, once you're done, you're done. I still have another maybe hip one day.

I'd definitely try the bed. I had to use a lot more than one pillow between my legs when I first started trying to lie on my side. I'm guessing you won't be able to tolerate being on your side for at least another week, maybe more, but it's worth a shot once it's no longer scary to roll over and you have the pillow(s) there.

Being able to carry things also feels great. I found it hard to be so dependent on help from others since I am usually very self-sufficient.

Keep up the ice and exercise and thanks for continuing to share.

[blinky]

One week out.


What a difference.


I woke up feeling pretty good for a change. Slept better since I didn't nap. I had a late snack right before I went to sleep and I think  that helped even out my blood sugar; it wasn't so low when I woke up.


Yesterday was a good day. I did my exercises, crutched around, and spent even more time sitting up at the kitchen table and receiving guests. (haha! I had more company than I expected yesterday.)I am doing more small things myself, like getting up to let cats in and out, get a drink, get a snack, small stuff, but stuff I didn't do the first few days at home. I think  today will be pretty quiet since it is the weekend. I hope to watch a lot of football in the recliner.


A few recovery thoughts:


I am going to wear simple, over the head dresses. I can manage that by myself, and it is warm enough here to dress that way. I can put a sweatshirt on top if I get cool and wear slip on shoes---we don't need socks here.


I am eating to heal. That means protein at every meal and lots of fruits and vegetables. With H here and lots of casseroles in the fridge, I can manage to eat pretty well. He works from home and has good control of his schedule which helps. He does leave me for big blocks of time, a few overnights coming up and daily for a few hours, though, which means I have to figure out how to manage on my own. My appetite is still pretty flat, but I am trying to eat more and more often to feel better. More even blood sugar throughout the day seems to help.


Left leg is still ahead. Less swollen, fewer niggles.


Bath time is pretty hilarious. We are lucky to have a very large walk in shower. We put stacked lawn chairs in it for me to sit on. (We fought about that. I wanted to go buy a super stable potty chair and use it as a shower chair. H wanted to MacGiver it.) H dons his "wife washing outfit", basically some ratty running shorts, and acts as my spotter for the operation. He is super paranoid about my falling, and I wear one of his belts as a safety harness, an idea he got from watching the physical therapists. Not very romantic, but pretty funny. (He will be gone for a few days later on in my recovery and I think  I will get my way and buy that stable potty chair...)


Thinking about how different I feel today compared to last week at this time. Off narcotics and don't need them. GI issues resolved. Crutching confidently around. Getting up and down smoothly. Icing, but can go iceless. I need crutches to move, but can stand without them. I can take a few little steps without both of them---being wobbly in switching my weight from foot to foot is my issue. The first week was the hardest part.


For people traveling, after I had overcome the constipation and was weaning off narcotics, was the big turn around point. Should I have spent a few more days in Columbia? Maybe. It would have been easier to get home Wednesday than Sunday. However, being home also contributed to my feeling better and getting over my GI issues. I had my coffee, my food, my schedule.

[blinky]

No real complaints. I didn't sleep well again and I blame the cats. The fat one has learned to lie next to me not on me, but the little one wants to be on my lap. When I leave the recliner this won't be an issue because they won't follow me to the bed. (I hope.)


The mental fog is lifting. I am not in such bad shape,but I have an inability to plan. I can take c are of my own immediate physical needs, which I guess are a lot right now, but struggle to tack up nonphysical needs to my mental to do list. Like I can know that I need to take meds, eat, get iced before H gets busy, but have trouble remembering that I need to pay the electric bill or check that website for Xmas gifts. We aren't talking high level thinking here, just non healing thinking. sigh. I do manage to complete these tasks, but what I could focus and do in an hour it takes me longer to do. I will be distracted and it takes me a while to come back on task.


I don't have any real pain, just a host of little niggles. Constantly changing niggles at that. Both bandages are off, for example, so I am hyper aware of sensations on my right flank. It feels different, not bad. The right side is more swollen, and I am aware of more swollen shins so less flexion on that side. Then I ice and both sides are the same again.


Most of the niggles are due to swelling I think.


I am on two crutches but can see one crutch in my future. I can take few tiny crutch less steps to even myself up, like when I stand up from the breakfast table and reach for the crutches against the wall. No hurry. I plan on being on two crutches all week.


A mother's observation: older son came home from college to check on me. I was thrilled. He was tentative with me, a little wary, at first. Physically gentle but also a little distant and reserved. I was surprised by his reaction, but after thinking about it, I believe it is because he is seeing his mom, who never gets sick and always handles everything, as mortal and vulnerable. (Mom who has coached him through long endurance events, running next to him when he hasn't paced as well she she has.) He is a big boy, a scientist, he knew all about the surgery, but I think  emotionally it was a shock. We did settle into our old, easy relationship when he saw I was okay. After dinner he was back to teasing me about my robotic stair climbing and getting out of washing dishes by being on crutches.

[jd]

Thank you for continuing to share with us Blinky.

The fog you describe is why it took the better part of 2 weeks for me to try reading a real book vs just playing on the internet and watching TV. Even TV took a little while for me as my brain dealt much more easily with the ADD of the internet!

Niggles will slowly and surely get better thankfully. Sounds like you're on top of the icing to control the swelling which is great.

Looking forward to sleeping in a real bed again?

Thank you for sharing the story about your son too. It's funny that you mention robotic stair climbing. Stairs are the only way the vast majority of people I run into notice anything is up now! Normal walking has become close enough to normal that people just don't notice unless they know, but put a staircase in front of me and I'm going at 1/3rd normal speed (only good leg stepping up).

[blinky]

I appreciated all the stories from those who went before me. It was useful to hear about the little but troubling problems and to see a timeline of recovery.


Excellent night's sleep. I woke up fuzzy headed, but just from lack of coffee. I am still letting H do things for me, but am supplementing much more, like putting the milk back in the fridge and refilling the sugar bowl. I can see next week being more self sufficient. H will be out of town some this week, so I have to line up a string of friends to drop in and check on me. I have a "I've fallen and can't get up" text group. Now to remember to carry my phone. I have to get out one of the boys' hoodies with a pocket and wear that.


Walking feels great. I am walking outside now and am just loving it. PreOp walking was something to be endured. Now I embrace it. [size=78%]I am enjoying movement again. Just small stuff to be sure, but I find myself swinging around the house is a more playful way.[/size]
[/size]
[/size][size=78%]Son showed me all the great stuff our smart TV can do. Who knew? He also recommended some shows for me. H made him do dishes, which was funny. Normally I just do all that. I can tell H is ready for this to be over. [/size]
[/size]
[/size][size=78%]I forgot to take any Tylenol yesterday. I did notice it. Late in the day I was thinking I was more sore than before. Not ready to give that up yet. [/size]
[/size]
[/size][size=78%]Right side still more swollen. It functions fine when I [/size][size=78%][/size]walk[size=78%][/size][size=78%] or do the exercises.  The incision [/size]isn't[size=78%] as pretty and is more numb. Two thoughts on that: 1) I think  my brain focuses on one area of hurt at a time, maybe [/size][size=78%][/size]hyper focuses. Left side has some limitations and swelling, but I ignore them because the right side is shouting louder. 2) I am trying to be cool about it. I am so early in recovery, a lot can change. I know from reading other bilat accounts that an uneven recovery is normal. (and is it so uneven? one hip is ahead of the other by two days) I don't have a lot of experience with stitches and surgical healing, but from what little I do have, I know there will be large changes.[size=78%]

[/size]Counting the days until those scabs heal. I miss the pool. [size=78%]

[blinky]

How did I mess up the formatting? Forget everything I said about improving mental clarity!

[Snowbound]

My hips didn't heal the same rate, the left side was slower to recover and always seemed to be a couple of days behind the right. The left caught up after 2 or 3 weeks except for numbness. The right side is good but the skin around my left incision running down to the outer knee is still numb (but slowly improving).


Now with rehab (I'm 9 months out) the left side isn't bad good but I still get some muscle pain on the right side, mainly with the upper hamstring. This isn't surprising, my right hip was the "bad" side prior to surgery. The problem seems to be mostly a muscle imbalance, my quads and abductors (which have been very tight years) are overpowering my weaker hamstrings and adductors. This tilts the pelvis forward and over stretches in my upper hamstring. The tight abductors has also made me somewhat knock kneed, so I've been focused on strengthening the hamstring/adductor muscles and cutting back on the quad exercises.

[jd]

Funnily enough, the last piece of my scab came off after the 4-week minimum that Dr Gross specifies before swimming, so I wasn't allowed to swim until yesterday. Hope to go for a swim this week though!

[blinky]

Oh no! Those scabs better fall off faster than that. I guess I could heal more slowly due to being older and due to blood thinners?


So yesterday I walked without crutches. It was only a few steps and it was an accident, but I did it twice. I was up, had the crutches parked against the wall, and I just automatically took off. I got a few steps away, remembered I couldn't walk yet, went back and got my crutches.


Very encouraging.


No pain, no wobble, I felt completely normal and natural. My brain remembers how to walk!


In general yesterday was a good  day for movement. I am up and out of chairs better and more often, move things around by myself (putting things away, picking things up), got up to pee in the middle of the night without calling for H to wake up and help.


My right hip feels much better. I can't say the two are even, but I don't notice such a pronounced difference.


I am obsessing about my incisions now that the bandages are off (okay not really obsessing, but they are getting more attention). They look fine, but there is some numbness and mostly I cannot stand for anything to rub them. I mean that in a relatively OCD way, like I may not be normal. (I do tend to worry little ouchies, like want to keep touching a mouth sore with my tongue.) I have been wearing large men's boxers, cotton, well washed and worn. As the bigger ones got dirty, I was wearing the smaller ones, mediums, and discovered my intolerance for touch. Solution? (Well, besides frequent laundry to keep those favorite three pair of underwear in play) I next day ordered five pair of men's silk boxers. I can't wait!


Functionally I am doing very well. My hips are working better all the time. I will be curious to see how different I will look: the scars, my hip shape and size. I am sure I am still swollen, but I seem hippier than I used to be. I am not bothering to wear my own pants so I can't tell how much bigger I am.

[Debcoco]

Blinky,
I really appreciate you documenting your day to day struggles/victories.  Just so happy that all is turning out so well for you!  We are all cheering you on :)
 

I think you've mentioned this before, but I cannot remember.  Did Dr. Gross use a Birmingham hip for your resurfacing or a similar device?  Is he still using the BHR?

Deb

[blinky]

Thanks! It is good therapy for me, too.


Dr Gross uses a Biomet device described on his website. He was not affected by the withdrawal.


So yesterday I probably did too much. It was predictable. H went out of town and so I was off leash.


Now, recall he works from home so he has been around much of the time, just is normally around much of the time. He has been leaving me for big blocks of time since the start. He went to hear one of son's concerts on Monday when we got back, for example. He typically is gone for three/four hours sometime during the day. The Monday he was gone, I set up a series of babysitters for myself. For this trip, I also set up a series of people to pop in and check on me. A good friend spent the night.


Okay, so I had too much company. Too much sitting up and not icing. Too much walking. It rained all morning and I was dying to get out when it cleared. I busted out, with a friend saying "not by yourself you don't" and racing over.


I was ready to collapse in the recliner by the end of the day. And ice.


Today I am revived. And have been getting into more trouble, learning how to move with one crutch and using the kitchen countertop....


The boxers came!

[blinky]

I will add that some of this caution is probably excessive. I am bilateral, so more constrained the first week, but I can get up at night by myself now. I can stand and fix food for myself and use a bag to transport things from place to place. The fear has been falling and being alone. I have my "I've fallen and I can't get up" group text list of people who live close by, but we worried that at night I might not get an answer. What if I fell on the way to pee in the middle of the night? If I hadn't fainted due to low bp, this wouldn't seem like as real a concern.


I do need help with the ice machine, but could fill bags with ice by myself.

[Paul_D]

Hi Blinky,


Firstly, I enjoy reading your journey :)


I am fascinated by the use of ice machine and the differences that you (and most Dr Gross patients) have versus what I have experienced under Dr. Bose. There seems to be some big differences in how the surgery is performed as our recoveries are extremely different? For example I only had minor swelling in the first week after operation only after walking where ice was needed. After this I cannot find a use for ice. My incision was without any scabbing yet I read people are peeling it off. Also Dr. Gross imposes the 90 degree rule where Dr Bose imposes no restrictions. I see the recoveries differencing a lot and yes we are all different but surely we had similar surgeries??


I am now 3 1/2 months out and now walk without a gait and as far as I need to go - Yippee!! I am amazed by how fast recovery was and feel like I did 10 years ago already. Cant wait to the 6 month period to go up another notch :)




Br,
Paul

[JHippy]

@blinky: Sounds like you're doing great. Very happy for you.

@Paul_D: I actually did ask Dr. Gross (really just out of curiosity) why other surgeons don't have the 90-degree restriction. He said (paraphrasing) 'I don't know what other doctors do. I do close up the capsule really well. But I definitely don't want you bending past 90 degrees until 6 weeks.' Fair enough, haha.

[Paul_D]

@JHippy - Although I was free to bend as I wish I still observed the rule just in case ;) I have been extremely careful in recovery until recently where I am now starting to push the boundaries a bit more :)

[jd]

I think that there's also a lot of patient to patient variation and associated caution.

For example, in my case (also Dr Gross) I only had very minor swelling, all in the hip area (no lower leg or even down to knee type swelling at all), but ice was still extremely helpful for managing pain. I would argue it was the most effective pain management tool I had (more so than the drugs) through the first week.

On the scab, I definitely didn't have a big scab I was peeling off, but there was a very small thin layer of scab on pieces of the wound that were a little hard to see, but felt hard, and eventually came off by themselves / went away. Think more nail clipping size :)

On the 90 degree rule, I think any surgeon who uses the anteriolateral approach doesn't have the restriction because the capsule wasn't damaged in that direction (but as always, there are tradeoffs). Not sure which approach Dr Bose uses, perhaps he's just figured out he doesn't get dislocations. One thing I did notice in Dr Gross' interview on this site was that he hasn't had a single dislocation in his data after the 2009 breakpoint (and low single digits ever). Oh well, only one more week for me until I hit that magical 6 week point!

[blinky]

Interesting discussion. I did get the impression that there was an excess of caution in some areas. The PTs, for example, also told me not to cross the midline with my legs (i.e. no ankle crossing, but also more difficult for me to use one foot to scratch the other) and not to toe in. Dr Gross was less concerned with those movements, but did insist on the 90 degree rule. I think he worries about people who feel too good and go out and do too much. Like with respect to my list of exercises, he told me not to add to them: no extra reps and not to add weights. Just do them as written!


I am not terribly swollen, but I am not yet my normal shape. My feet were a little swollen on the trip home, but I did fit comfortably in my shoes. I think my thighs were swollen, but maybe I am just fat. Maybe I notice the change in my hips more since I am a woman? I mean that both in a structural sense (i.e. maybe I am different) and aesthetically (I am more sensitive to a change). I do still notice a difference in the two legs. Right leg swells more and is the leg I choose to elevate if I can only raise one of them.


Really good day yesterday. With H gone I had some time and opportunity to do things on my own. This does raise the question of whether I should let on that I can now clear the kitchen table and stand long enough to do dishes.


I am crutching about 3/4s of a mile at a time. I should probably leave it there awhile. Our weather is beautiful and it is a treat to be outside.


Getting out has given me back my appetite. This is another mixed blessing. Because I am eating more I feel much much better. I wake up more steady and don't fade out in the afternoon. But I am still pretty sedentary and the holidays are coming up and I do like to eat and, well, you get the picture.


Finally took a trip in the car. Everything and everybody has come to me up until now. I was able to not fold myself into a smallish sedan and endure about a half hour drive each way. Sat up through a meeting and was reasonably focused (volunteer stuff). To make this trip work I took a bag, grabber, two ziplock bags of ice, and crutches. This was a trial run for the big drive to Thanksgiving. Looking ahead, I think the one worrisome variable will be finding handicapped restrooms on the road. Do most restaurants have them? Chains do I bet. Do large gas stations?