1st Hip Resurfacing with Dr. Pritchett

[DonFromCT]

I am writing this to share with others in the hope that it may help some.  I have gotten so much by lurking and reading before my surgery. 

I'm going to create an outline structure and fill things in as I have the time. 

1) Introduction, description of my condition. 

2) Psychological and emotional issues pre-op

3) Surgical experience. 
I am now 4 days post op and am over the hardest stuff. 

The morning of the surgery I got to the Swedish Institute at 5:35 and was checked in within a few minutes.  I was helped by a nurse who was FANTASTIC.  She was my primary point of contact for all of the pre-op time.  She was kind, gentle, and put my IV in using lidocaine.  It was painless!! 

Dr Pritchett came in and we confirmed what hip he was operating on.  He initialed that leg, we chatted for a couple of minutes and he left. 

Time started to move quickly.  I looked at the clock and realized that we were getting close. 
The nurse anesthetist came in and we talked for a while.  I told him a joke an orthopedic surgeon friend of mine had said which was the guy doing the anesthesia is the only real doctor in the room.  ha. 

Next thing I know they are wheeling me into the OR.  I am given some Versed to relax me.  Needed to be awake to assist with feedback in setting up the spinal block.  All was going well and then . . . .

. . . I woke up in recovery.  Very strange.  But good. 

Pain was moderate.  I felt great and wanted to get moving.  But when I sat up my blood pressure crashed so I eventually ended up waiting an extra 90 minutes before I was ready to stand. 

During this time I was assisted by a FANTASTIC nursing staff.  I drank 2 - 20 oz bottles of Gatorade and 6 small cups of cranberry juice.  I produced 2.5L of urine!!!.  Wow.  At one point I had to ask for a second jug.  Ha.  During this time the nursing staff was always attentive without hovering.  The level of attentiveness was perfect.  I never felt like I was wanting. 

Being able to urinate while still in bed released a bit of stress that I was feeling post-op. 

Eventually, I did my PT and OT, my wife arrived to take me home.  The policy at Swedish is still no visitors.  The new written policy to allow helpers when needed.  I thought I was going to be able to finesse this with my wife.  But no go.  Then I saw a woman who was 85 and having a procedure that day.  She couldn't do ANYTHING for her self.  So her daughter stayed.  She deserved to stay.  I just had to suck it up and finish the day on my own.  Not a big deal. 

My spirits after surgery were MUCH better.  Prior to surgery, I had a lot of anxiety.  Now, it was a done deal.  All that was left was to do the work to get better. 

My experience with the Swedish Institute for Orthopedics was excellent.  We all pick our doc based on research, but tend to give less consideration to where the surgery is happening.  I knew Pritchett's credentials when I decided to go with him.  But knew little of the Swedish other than their low infection rates.  I was blown away by the quality. of the nursing. 

The ride home in an Uber Comfort was excellent.  When you are pathetic looking people are extraordinarily gracious.  ha. 

We took the escalator up to our VRBO rental Condo and I had a decent day with not too much pain. 

That night I slept well.  I did the entire night on my back. 

1) Day 1 post op.  The first full day after surgery was ok.  Pain, wasn't too bad

Days 2-7 post op -

I spent 8 days post op in Seattle in a VRBO.  By the way.  I can not recommend enough the benefits of getting a nice place for your stay. For the first few days you are essentially house bound.  It is nice to have something more than just a hotel to live in. 

I was also determined to eat well and not put on weight during my recovery.  So having a kitchen was key.  We were very close to the Pike Place Market, so my wife and kids went down every day and got fresh meat, fish, and veggies for lunch and dinner. 

Days 2 and 3 were probably the most difficult.  I got some swelling in the hip and upper thigh and had a fair amount of pain.  I pretty much took the Oxycontin every 6 hours all day and night.  I could actually put weight on it painlessly.  It was moving it laterally or forward that caused the pain. 

I had no ability to lift my leg at all.  It was as if my hip flexors were not firing, not even a little.   

Days 4-7
Gradual lessening of pain.  I was off of Oxy during the day but still needed it to sleep at night.  The main problem is that I am normally a side sleeper and was only able to sleep on my back.  After a few hours on my back, my back would actually start to hurt.  But I couldn't really shift.  So I just laid there, awake, in pain.  Unless I took oxycodone. 

Day7 I flew home to the Boston area.  My lovely wife got me a non-stop flight in 1st Class so it was about as good as it could get.  Every 45 minutes, I got up and walked around for 15 minutes, then reset my watch to go off in another 45 minutes.  I was up a lot.  But by the end of the flight even with all the walking and even doing calf raises while I was up, my shin, ankle and foot swelled up an alarming amount.  Very strange. 

I was home by late afternoon and spent the evening on the couch with my foot elevated.  By morning it was much better. 

17 Days Post-OP

I have been walking every day for the last 6 days.  By walking I mean walking while using my crutches.  I move the crutches forward and take 2 steps, repeat.  Over the last few days I've been using the crutch to support me less and less. 

I've also been able to go longer.  1 week ago I did .66 miles and felt no pain or soreness during or after the walk.  Today I walked 1.86 miles!!!!  I feel great.  I've never felt any pain during or after the walk.  Actually, I do get a little bit of pain for the first 5 minutes.  Then everything warms up and relaxes and no pain for the rest of the walk. 

MOTION IS LOTION!!

I've been a bit negligent on PT.  I didn't call my guy until this week and he won't be able to fit me in until next week. 

My hip flexor is much much stronger than immediately post op.  I'd say I'm up to 25% strength.  It sounds like nothing, but it means I can at least lift my leg into the car or into bed.  Which is huge. 

This all would be much much more difficult if I was overweight or out of shape.  Getting up from the couch for the last 17 days has essentially been putting the surgical leg out in front of me and doing a single legged squat.  Getting into bed originally required me to drag myself up kind of walking on my hands. 

One question that is really burning in my head now, that maybe someone can answer is at what point can I stop using crutches.  My hip abductors are too weak to really stabilize my full weight.  So if I try to walk without the crutches, my hips shift to the bad side when I weight that foot.  Obviously this is a question for my PT. 

Pain is really a non-issue.  If I move it outside of where it wants to move, I get pain.  If I do my stretches I get pain.  But when I'm just living my life, I'm pretty much pain free.  I do get some transient surges of pain.  But they are a 2-3 on the pain scale and only last for a few seconds. 

Sleeping is still difficult.  Its actually the most difficult thing overall regarding this operation.  I still can't comfortably sleep on my side.  So I'm on my back until roughly 2 am, then I get up and walk around the house a bit on crutches, pop a couple of Advil and go back to bed. 


4 Weeks Post-Op

I have been walking (with crutches) for the last couple of weeks.  I've been averaging about 1.5 miles on each outing with my longest walk a bit over 2 miles.  I felt fine the next day with no more discomfort than usual. 

Rather than transition to 1 crutch for longer walks, which I can do, I've decided to stay with 2.  I prefer the symmetry of 2 crutches and it seems to help me maintain a proper gait. With that said, as time goes on, I put less and less weight on the crutches.  I'd guess I'm putting less than 50 lbs on the crutches now. 

I also rode the exercise bike at my PTs office.  It was great.  Just for 10 minutes, but it was great.  I have a triathlon bike on a trainer at home and was also able to use it for 10 minutes this afternoon. I felt great after.  I'll see how I feel tomorrow and adjust from there.  I felt stronger going up stairs right after riding.  Like the bike got more of my glute to fire. 

I am still having difficulty sleeping.  Primarily because I am not comfortable on my side and lying on my back all night causes back pain for me.  So I have to get up a couple of times per night. 

My Psoas (hip flexor) is still "angry".  It was angry before surgery because of bone spurs.  Its angry now, even though the bone spurs are gone, because of the trauma of surgery.  Its really the only source of ongoing discomfort at this point. 

In general, my hip is happiest when I am upright and using it.  I feel far better 1 mile into a walk than I do 1 hour into sitting on the couch.

3 Months.

Its been 2 months since my last update.  Things are much better with one complication.  I have some heterotopic ossification.  It doesn’t look like its going to be a big issue, but my orthopedist and I are watching it. 

At my last report  roughly 1 month post op, I had just gotten on a bike.   At the time I was able to make about 30 watts.  Prior to surgery I could make 500 watts in a sprint and maintain 200 watts for 20 minutes.  Within a week of my first ride I was making 100 watts.  By 2 months post op I was able to make 160 watts for 20 minutes.  Essentially, with respect to cycling, I’m now fully healed. 

Riding a bike is a wonderful thing for me because I am “good as new” now on a bike.  It’s wonderful.  All of my numbers above are from my bike on a Wahoo Kickr bike stand.  About 2 weeks ago I started riding outside.  That is even better.  Today I rode 5 miles, swam for 30 minutes, then ran 5 miles home.  After something like that, I don’t have any soreness or pain.  Like I said in my previous post, my hip seems to be most happy when I’m using it. 

I’ve started doing squats while using a TRX band for stability.  Actually, in general, I’ve hit the gym pretty hard.  Adductor, abductor machines are the most difficult.  I’m working with like 15 lbs still.  Where as on a leg extension my surgical leg is nearly as strong as my other leg. 

In general I’m finding the little muscles more difficult to get back into shape than that larger muscles.  My glutes are now as strong as before surgery. 

Other than my psoas, which is still traumatized from the surgery and I can’t really work it hard, my biggest weakness is internal and external rotation.  I am VERY weak there, despite gently working it every day. 

Regarding pain.  My joint pain is gone.  But my psoas still hurts every day.  This feels like a groin pull.  It kind of sucks, but again, its happiest when I’m moving.  I’m sitting on the couch now and have been for the last hour and its a bit of a bother.  But while I was riding my bike or swimming breaststroke its fine.  If I try to swim with a flutter kick, my psoas gets annoyed quickly. 

I’ve been working on my flexibility also.  I am finally at a point where I have more extension than before surgery and about as much flexion.  Perhaps a bit more if I keep my knee rotated in, but a bit less if I rotate it out.  Either way, steady progress is nice. 

Mentally and emotionally, I’m in a great place.  I have nagging anxiety about ongoing recovery but every time I push the envelope (just a bit each time) my body reacts well.  Every time I’ve pushed, I’ve been happy I did.  So its been very encouraging. 

As far as hiking and walking.  I’ve pretty much stopped walking the neighborhood.  Its boring.  I’ve been hiking 2-3 times per week.  Typicall 3-4 miles with a 10 lb weighted backpack.  When I come to a hill, whether its up or down, I will repeat it twice on every trail.  Hiking is proving to be great exercise for my psoas. 

I hope this is helpful.  I’ll check in again soon. 

6 Months Post-Op

Hi all,

A lot has happened in the last 3 months.  All is going well.  I'm continuing to progress. 

I'd say In am 100% in every day life.  I can ride my bike as fast as I could before, I can swim, water ski, etc. 
The big news is that I started running last week.  The first day I did a walk/run about 45 seconds of each.  I had no pain and no discomfort the next day.  So I upped things a bit each day. 

Yesterday I ran 2 miles with no discomfort either at the time I was running or today when I woke up. I'm thrilled. 

I've been careful to not run until I've warmed up the joint.  I typically walk for 5 minutes and do some "high knees" before running. 

The only issue I ave is that if I am sedentary for more than 30 minutes, I'm stiff for a few minutes when I start moving again.
If I stay active it is PERFECT.  or nearly so. 

If my resurfacing intents me to stay active, I guess that is a good thing. 

The heterotopic ossification is not bothering me.  Its on the outside of my hip so it may at some point cause problems.  But for now I've got my fingers crossed.  I need to reach out to my local hip ortho to see if he wants another X ray at 6 months to track it. 

I'll write more soon. 

[jimbone]

Congratulations Don on the successful surgery.  I can't agree with you more- the Swedish Ortho Clinic has a fantastic staff and handles the patients with extraordinary care.  I was fortunate enough to have both my hips done there in 2018 by Dr. Pritchett and both times went as smoothly as your own experience.  You didn't mention the warm air paper tent they set up around you while prepping you for the operating room- I'd already been given a mild sedative and drowsed off and on for an hour before going in.  Good medical reasons for it but I just found it so comforting.  The pre surgical nursing staff showed a great sense of humor and readiness to address any concerns and the entire surgical and post surgical team carried the day.  The next few months as you recover and regain your strength free from OA pain are going to be some of the most exciting and gratifying you may ever know.  Great days ahead- best wishes.

[Pat Walter]

Congratulations on the new hip resurfacing Don. Thanks for starting to post your story. The personal stories are so helpful for people learning about hip resurfacing, as you know.
So happy for you and Thanks for sharing your story. I look forward to your future updates.
Pat

[packman]

Good post and congratulations - I am a few years past both of my hip resurfacings, but do remember the painful recovery of rebuilding the stretched muscles. I found a lot of people had so much easier recoveries from THR and did not quite understand. Your decision for resurfacing will pay dividends. I hardly think about my hips in my daily activities.

[catfriend]

I hope you continue to do well. I am about six weeks ahead of you on my second hip resurfacing by Dr. Pritchett. After my first resurfacing I had the same orthostatic hypotension issue as you when I stood up for the first time. I did not have that on my most recent resurfacing.

[DonFromCT]

Thank you all for the kind words. 

I got a LOT out of being able to read other peoples' stories, so I want to give back and leave a story for others who may be doing this in the future. 

Added this to the main body in the first post.  . 

Days 2-7 post op - I spent 8 days post op in Seattle in a VRBO.  By the way.  I can not recommend enough the benefits of getting a nice place for your stay. For the first few days you are essentially house bound.  It is nice to have something more than just a hotel to live in. 

I was also determined to eat well and not put on weight during my recovery.  So having a kitchen was key.  We were very close to the Pike Place Market, so my wife and kids went down every day and got fresh meat, fish, and veggies for lunch and dinner. 

Days 2 and 3 were probably the most difficult.  I got some swelling in the hip and upper thigh and had a fair amount of pain.  I pretty much took the Oxycontin every 6 hours all day and night.  I could actually put weight on it painlessly.  It was moving it laterally or forward that caused the pain. 

I had no ability to lift my leg at all.  It was as if my hip flexors were not firing, not even a little.   

Days 4-7
Gradual lessening of pain.  I was off of Oxy during the day but still needed it to sleep at night.  The main problem is that I am normally a side sleeper and was only able to sleep on my back.  After a few hours on my back, my back would actually start to hurt.  But I couldn't really shift.  So I just laid there, awake, in pain.  Unless I took oxycodone. 

Day7 I flew home to the Boston area.  My lovely wife got me a non-stop flight in 1st Class so it was about as good as it could get.  Every 45 minutes, I got up and walked around for 15 minutes, then reset my watch to go off in another 45 minutes.  I was up a lot.  But by the end of the flight even with all the walking and even doing calf raises while I was up, my shin, ankle and foot swelled up an alarming amount.  Very strange. 

I was home by late afternoon and spent the evening on the couch with my foot elevated.  By morning it was much better. 

17 Days Post-OP

I have been walking every day for the last 6 days.  By walking I mean walking while using my crutches.  I move the crutches forward and take 2 steps, repeat.  Over the last few days I've been using the crutch to support me less and less. 

I've also been able to go longer.  1 week ago I did .66 miles and felt no pain or soreness during or after the walk.  Today I walked 1.86 miles!!!!  I feel great.  I've never felt any pain during or after the walk.  Actually, I do get a little bit of pain for the first 5 minutes.  Then everything warms up and relaxes and no pain for the rest of the walk. 

MOTION IS LOTION!!

I've been a bit negligent on PT.  I didn't call my guy until this week and he won't be able to fit me in until next week. 

My hip flexor is much much stronger than immediately post op.  I'd say I'm up to 25% strength.  It sounds like nothing, but it means I can at least lift my leg into the car or into bed.  Which is huge. 

This all would be much much more difficult if I was overweight or out of shape.  Getting up from the couch for the last 17 days has essentially been putting the surgical leg out in front of me and doing a single legged squat.  Getting into bed originally required me to drag myself up kind of walking on my hands. 

One question that is really burning in my head now, that maybe someone can answer is at what point can I stop using crutches.  My hip abductors are too weak to really stabilize my full weight.  So if I try to walk without the crutches, my hips shift to the bad side when I weight that foot.  Obviously this is a question for my PT. 

Pain is really a non-issue.  If I move it outside of where it wants to move, I get pain.  If I do my stretches I get pain.  But when I'm just living my life, I'm pretty much pain free.  I do get some transient surges of pain.  But they are a 2-3 on the pain scale and only last for a few seconds. 

Sleeping is still difficult.  Its actually the most difficult thing overall regarding this operation.  I still can't comfortably sleep on my side.  So I'm on my back until roughly 2 am, then I get up and walk around the house a bit on crutches, pop a couple of Advil and go back to bed.

[catfriend]

The answer to when you can stop using your crutches is.... whenever your body is ready. There is no magic date. Expect those hip muscles to stay weak for a long time. They get stronger bit by bit, but it takes time. As you get stronger expect to transition from your crutches to a cane. You're probably on the verge of this now. How long you need the cane also depends on your body. As those muscles get strong enough to support your body you will feel the need for the cane less and less. But you will notice that when you start walking without the cane you will walk like a penguin. This is because you're still building those muscles back. To build and maintain a better gait it's better to stick with the cane a little longer than you might think necessary. This is especially true when taking walks, plus it also helps to keep fatigue from setting in too soon (and it makes a handy stay-away-from-me tool). Everybody heals differently, so just go with what your body says.

Don't worry about delaying the PT. After my first resurfacing I started PT a little over three weeks after my surgery date. There is still so much healing going on at this point that they didn't have me do much more than the exercises I was already doing. It seemed like a waste. When I started to get more out of PT was when I was a little further along in my healing. At that point I knew what my deficits were, and had better goals. After my second resurfacing on March 1 I made the decision to not start formal PT until later. I waited until mid April, after my 90 degree restrictions were over. It was the right decision for me. I'm getting more out of it, plus I'm back to swimming. The two combined are really moving my recovery ahead.

[DonFromCT]

4 Weeks Post-Op

I have been walking (with crutches) for the last couple of weeks.  I've been averaging about 1.5 miles on each outing with my longest walk a bit over 2 miles.  I felt fine the next day with no more discomfort than usual. 

Rather than transition to 1 crutch for longer walks, which I can do, I've decided to stay with 2.  I prefer the symmetry of 2 crutches and it seems to help me maintain a proper gait. With that said, as time goes on, I put less and less weight on the crutches.  I'd guess I'm putting less than 50 lbs on the crutches now. 

I also rode the exercise bike at my PTs office.  It was great.  Just for 10 minutes, but it was great.  I have a triathlon bike on a trainer at home and was also able to use it for 10 minutes this afternoon. I felt great after.  I'll see how I feel tomorrow and adjust from there.  I felt stronger going up stairs right after riding.  Like the bike got more of my glute to fire. 

I am still having difficulty sleeping.  Primarily because I am not comfortable on my side and lying on my back all night causes back pain for me.  So I have to get up a couple of times per night. 

My Psoas (hip flexor) is still "angry".  It was angry before surgery because of bone spurs.  Its angry now, even though the bone spurs are gone, because of the trauma of surgery.  Its really the only source of ongoing discomfort at this point. 

In general, my hip is happiest when I am upright and using it.  I feel far better 1 mile into a walk than I do 1 hour into sitting on the couch.

[jimbone]

Good going Don- you're right about the need to exercise and maintain motion for healing and getting the nerves/muscles "talking" to each other again.  About 6-8 weeks after each procedure I noticed even a little bit of indolence let things slide back too quickly and wondered if I was going to need to spend the rest of my life in a gym 12 hours a day.  Once if re-established a good set of core strength, regained some flexibility and had stronger responses in  the rotators it began to build on itself to where the gains didn't fall off so quickly.  Hope you continue to enjoy your recovery.

[DonFromCT]

3 Months.
I've also added this to the original post. 

Its been 2 months since my last update.  Things are much better with one complication.  I have some heterotopic ossification.  It doesn’t look like its going to be a big issue, but my orthopedist and I are watching it. 

At my last report  roughly 1 month post op, I had just gotten on a bike.   At the time I was able to make about 30 watts.  Prior to surgery I could make 500 watts in a sprint and maintain 200 watts for 20 minutes.  Within a week of my first ride I was making 100 watts.  By 2 months post op I was able to make 160 watts for 20 minutes.  Essentially, with respect to cycling, I’m now fully healed. 

Riding a bike is a wonderful thing for me because I am “good as new” now on a bike.  It’s wonderful.  All of my numbers above are from my bike on a Wahoo Kickr bike stand.  About 2 weeks ago I started riding outside.  That is even better.  Today I rode 5 miles, swam for 30 minutes, then ran 5 miles home.  After something like that, I don’t have any soreness or pain.  Like I said in my previous post, my hip seems to be most happy when I’m using it. 

I’ve started doing squats while using a TRX band for stability.  Actually, in general, I’ve hit the gym pretty hard.  Adductor, abductor machines are the most difficult.  I’m working with like 15 lbs still.  Where as on a leg extension my surgical leg is nearly as strong as my other leg. 

In general I’m finding the little muscles more difficult to get back into shape than that larger muscles.  My glutes are now as strong as before surgery. 

Other than my psoas, which is still traumatized from the surgery and I can’t really work it hard, my biggest weakness is internal and external rotation.  I am VERY weak there, despite gently working it every day. 

Regarding pain.  My joint pain is gone.  But my psoas still hurts every day.  This feels like a groin pull.  It kind of sucks, but again, its happiest when I’m moving.  I’m sitting on the couch now and have been for the last hour and its a bit of a bother.  But while I was riding my bike or swimming breaststroke its fine.  If I try to swim with a flutter kick, my psoas gets annoyed quickly. 

I’ve been working on my flexibility also.  I am finally at a point where I have more extension than before surgery and about as much flexion.  Perhaps a bit more if I keep my knee rotated in, but a bit less if I rotate it out.  Either way, steady progress is nice. 

Mentally and emotionally, I’m in a great place.  I have nagging anxiety about ongoing recovery but every time I push the envelope (just a bit each time) my body reacts well.  Every time I’ve pushed, I’ve been happy I did.  So its been very encouraging. 

As far as hiking and walking.  I’ve pretty much stopped walking the neighborhood.  Its boring.  I’ve been hiking 2-3 times per week.  Typicall 3-4 miles with a 10 lb weighted backpack.  When I come to a hill, whether its up or down, I will repeat it twice on every trail.  Hiking is proving to be great exercise for my psoas. 

I hope this is helpful.  I’ll check in again soon. 

[PalmettoGolfer]

Don, when did you find out about the heterotopic ossification?  Is it something you felt was wrong and had it checked or was it found during a normal checkup?

Just curios, I'm just over 2 months in, and I worry about every little pain and strain.

Heck, just about the only I don't worry about is the constant (almost) clunking.  Although that's starting to get on my nerves a little   ;)