Name: Jeff Metherd
Location: St. Louis, MO
Surgery Date: Jan-19, 2013
Surgeon: Dr. Edwin Su
Hospital: Hospital For Special Surgery – New York City, NY
“And in the end, it’s not the years in your life that count. It’s the life in your years. “Abraham Lincoln
“Hope rises like a phoenix from the ashes of shattered dreams.” S.A. Sachs
For the better part of 30 years a pretty significant portion of my life was spent playing soccer. The “beautiful game” as they call it – was many things to me. It was a way to stay fit without “working out”. It was a way for me to vent stress and enjoy the camaraderie of friends. I loved the challenge…..the competition. As I got older – I continued to enjoy playing regularly. After Sunday morning games I’d spend the rest of the day laying there – stiff and sore – but satisfied nonetheless. I loved it…..I identified with it and never thought I’d quit. It was a big part of my life. Then I got married, started a family and launched a new career. Life was GOOD….balanced. Then….quite unexpectedly….I was told that I was suffering from severe osteo-arthritis. And for the better part of the next 8 years it gradually wore me down. I couldn’t accept that eventually I was going to have to deal with it. Joint replacement was for old people. I had a high tolerance for pain and I was going to put that off as long as I could. And the pain just got worse and worse….
I started played soccer at age 8 after moving from Houston to St. Louis. I went on to play in high-school, college (SIU-Edwardsville) and competitively into my 40s (I’m now 45). That’s me in the picture above getting some air against the Air Force Academy back in 1988. At 38 I first noticed a mild pain in my groin during warm-ups prior to an over-30 match. I assumed it was a minor groin strain – but it did feel a little different. As time went on, the pain just wouldn’t go away. After an initial MRI showed excess fluid in the joint – a doctor prescribed Celebrex. It seemed to work well enough – although it eventually gave me some serious stomach pains. I continued playing – but it soon became apparent that the issue wasn’t going away. So I went to see an orthopedic surgeon – my biggest fear being that he’d aspirate the joint to remove the excess fluid. But I found that the situation was actually much worse than that. He said I was suffering from advanced osteoarthritis in BOTH of my hips. In his opinion I misshapen hip joints to begin with and after many years of soccer – I was left with little to no cartilage and bone spurs. Then he basically read me my fortune. He said I would soon require total hip replacement (THR) in both hips, that I would most likely postpone it longer than I should, have the surgery only when the pain became unbearable, and then kick myself for waiting so long. In retrospect – it was rather prophetic. This really knocked me for a loss. I’d always enjoyed a wide range of physical activities – soccer, snow skiing, jogging, biking, hiking and scuba diving. Those were the things that I lived to do. I certainly had no intention of giving them up. The thought of having hip issues, much less having to consider hip replacement in my 30s – was simply unfathomable at that point. I walked out of the doctor’s office stunned and depressed.
My father, who overcame many major challenges in his life – was diagnosed with Multiple Sclerosis in his mid-30s. Now 71 and confined to a wheelchair – I didn’t have to look far for inspiration on how to deal with the challenges I was facing. My Dad is my hero. He never complains – never lets his condition bring him down or those around him. My Mom has been his faithful caretaker for many many years. Life certainly has not been easy for them. So there would be no feeling sorry for myself. Everyone has their cross to bear – this would just have to be mine.
At the time my pain level was low enough that I would continue playing 1-2 times a week. But I sadly informed my soccer buds that I was coming down the stretch on my farewell tour. Then I ruptured my achilles. The sensation felt like someone gave me a swift kick to the back of the leg. I rolled over directing a long stream of expletives at the nearest opponent about 5 yards away. He said he hadn’t touched me but I didn’t believe him. I limped over to the sideline just wanting to get back in there and get some payback. But that wasn’t happening. I limped around in denial for a month before I finally went it to see a doctor who confirmed that my achilles was indeed ruptured. With my hip issues and now an achilles rupture – I figured that certainly spelled the end of my playing days. After getting my achilles fixed the pain in my hip took center stage once again.
I visited one of the leading hip replacement surgeons in the area and in his opinion I was ready for a THR. He also said that I would wait too long and told me to call him when the pain got bad enough. In the meantime he recommended cortisone injections for short-term relief. So for the next few years I endured a series of very uncomfortable cortisone injections about every 10 months. The injections were not fun. They were delivered thru the groin of all places. Can you say ouch? Did I mention I don’t like needles? But as uncomfortable as they were – they did provide enough relief for me to forget about my hip….for a while.
A few years later I had a cortisone injection that failed to provide any relief whatsoever. Up to that point all of the injections were performed in a hospital using x-ray guidance to ensure they got the shot in the right place – avoiding all of the major arteries in the area. However, the doctor said he could now deliver the injections quickly and conveniently in his office using ultrasound guidance. Everything went well enough with that shot – but after a few days it was clear that I wasn’t getting any relief. I suspected that the doctor didn’t get to the right spot using ultrasound. So I asked for another with the old reliable x-ray guidance – but the result was the same – no relief. So I went back to the doctor and he explained to me that it’s pretty common for cortisone injections to eventually lose their effectiveness over time. Well…..no one had ever told me that one before!
Stem Cell Therapy
Around that time I ran into an old soccer buddy of mine who told me about an experimental procedure he’d recently had done on his knee with tremendous results. This new regenerative procedure utilized a combination of Platelet Rich Plasma (PRP), Adult Stem Cells, Lipo-Aspirate (Fat Graft) and Bone Marrow Aspirate (BMA). The procedure was not FDA approved (and not covered by insurance). I met with the doctor, discussed my condition and course of treatment thus far. He started by telling me that cortisone injections might provide relief – but they can also significantly accelerate deterioration the joint. He was up front in telling me that his success rate with hips was not as high as with knees. He gave me a 50-60% chance of benefitting from the procedure. If it didn’t work he suggested that I might be a very good candidate for hip resurfacing. So without any better options at the time I went ahead and had the procedure done in Nov of 2011 with a second round in Jan of 2012. My total out of pocket cost was approximately $5,000. Although the true objective of the procedure (new tissue growth) typically takes 6 months or more – I did experience an immediate reduction in pain. Like cortisone shots the relief lasted about 10 months – then the pain came back in spades. Stem cell therapies offer a lot of promise for the future and perhaps someday they will benefit those suffering from osteoarthritis of the hip. But for now it was unfortunately just another dead end.
I was frustrated. It seemed like such a simple ailment. Given all of the recent advances in modern medicine – do we really not have a better option than sawing off your femur and inserting a device with a 15-year average life-span? How many replacements would I have to endure over the balance of my life?
Getting Serious About Hip Resurfacing
At this point I was pretty fed up with short-term fixes and reached a point where I was ready to give serious consideration to a longer term solution – total hip replacement or this procedure few knew much about – hip resurfacing. Shortly after beginning my research in Nov-2012 I stumbled onto the SurfaceHippy website. Wow! What an absolutely amazing resource! Everything in one place! The more I read – the more excited I became. Hip resurfacing appeared to be a perfect fit for me. I continued my research on the procedure for the better part of 3 weeks. Without Surface Hippy who knows how long it would have taken me to fully understand this option. I probably would have gone with Total Hip Replacement (THR). After a few short weeks – I was convinced and for the first time in many years excited! I was particularly encouraged after reading the story of Neil Richardson.
Neil was a former soccer jock (close to my age) who had a great experience with hip resurfacing AND went back to playing soccer! Unthinkable! I really wanted to know how Neil was doing years later. I reached out to him via e-mail and he responded with nothing but great things to say about his resurfaced hip. Neil confirmed that he had indeed gone back to playing soccer. Wow! The remote prospect of playing again someday got me pretty fired up. I would be absolutely thrilled just to get back on the field to play even a little soccer to stay in shape. But before I’d go that far I’d make myself commit to an extensive rehab, dropping some weight and making a serious effort towards getting fit again before I put a toe on the pitch. However, the hope of playing again someday – now that was a goal that I would have no problem working hard towards!
Approach, Device & Surgeon Selection
From there I researched the pros & cons of the various approaches and devices. In the end I determined my preference was a posterior approach and the Birmingham Hip Resurfacing (BHR) device. The BHR had the longest track record of proven success. From there I drew up a list of doctors that utilized that approach-device combination. Initially the list had more than a dozen doctors on it. Because I travel a lot for business I’d accumulated frequent flyer, hotel and rental car points providing the ability to affordably travel to be treated by the best surgeon I could find. I went thru the list, evaluating each physician and spent a lot of time reading patient testimonials.
There were in fact a few doctors in St. Louis who did hip resurfacing – however, it didn’t seem to be a focus area for them from what I could read. Neither had performed more than a few hundred resurfacings and the leading surgeon in the St. Louis area was unfortunately on medical leave due to health issues of his own. So it didn’t take me long to decide that I would be travelling out of town to have the procedure.
After a lot of research my first choice was Dr. Edwin Su at the Hospital for Special Surgery in New York City. Initially I’d avoided New York City assuming the overall costs would be higher and Dr. Su landed at the bottom of my list. But after researching at least a dozen doctors in depth – he quickly climbed back to the top of the stack. I was very impressed with Dr. Su’s experience and clear commitment to the hip resurfacing procedure. Dr. Su has performed more than 2,500 hip resurfacings in his career – and was clearly one of the leading specialists in the US. The patient testimonials on Surface Hippy had nothing but great things to say about him. In addition, the Hospital for Special Surgery was ranked number 1 in the US by US News & World Report for orthopedics with an incredibly low rate of infection (.4% for hip procedures). Dr. Su also had a very well organized website that provided answers to all of the questions Pat recommended on the Surface Hippy website for evaluating surgeons. So now the question in my mind was – how long would I have to wait? Fortunately it would not be long!
I contacted Dr. Su’s office in mid-Nov 2012 to get things started and the first thing they asked me to do was to send them current x-rays. A few days later Dr. Su contacted me to confirm that I would be an excellent candidate for resurfacing……and they had an opening in the schedule on Jan-19th, 2013 – about 60 days away. So I jumped at the opportunity and booked my procedure.
Two days prior to my surgery date I flew to New York City with my entire family unit in tow and went to the hospital for my clearance physical and lab work which took a few hours. On surgery day I got to the hospital at 10am. At team of nurses came in, got me into a surgical gown, prepped my hip and put in my IV. They wheeled me into a cold operating room, transferred me to the operating table and put some warm blankets on me. The anesthesiologist came in, injected something into my IV line and knocked me out.
Not sure what time I woke up but when I did I was surprisingly clear headed and pain free. Dr. Su came to visit and said that everything went very well. The procedure took about an hour and a half. I noticed that while I was knocked out they had inserted an epidural and gulp – a catheter – which I’d anticipated. Contrary to my initial fears neither was a big deal. They gave me a pain management device that allowed me to activate additional doses of pain medicine as needed. I believe the pain medication they gave me was called Veriflex by Baxter Labs. Unfortunately I suffered an allergic reaction to it – which left me itching from head to toe for the better part of the next 24 hours despite efforts by doctors and nurses to counteract the reaction. After surgery, they kept me in the recovery room where my wife was able to visit with me for a few hours until about 8pm – then transferred me to a patient room. The first night I was comfortable, alert and stayed up until about 2am reading a book. I wanted to be really tired so that I wouldn’t have any problems sleeping on my back that night. I slept fairly well the first night and slept off & on till lunch time the following day. A physical therapist came by for my first PT session which was simply getting out of bed – taking 3 steps forward, then 3 steps back with a walker. The therapist would drop by 2 more times that day. On the second visit I walked out of the room, down to the nurse’s station and back. Post-op they had me on a liquid diet which was fine. Lots of juice, broth soup, soda etc. On my 3rd visit that day I walked down to the family visitation room on crutches to visit with my wife and kids. On the morning of day 3 they finally pulled the catheter, epidural and IV in the morning and I was allowed to start eating some solid food. The therapist came back and said that everything was going very well and that if I could walk down to the therapy room on crutches and go up and down the steps (4-5) without any trouble I could go home that day – which I did without any problem. They then gave me a series of oral medications – Percocet (for pain), Colace (stool softener), coated-aspirin and Pantoprazole (a proton pump inhibitor).
After discharge from the hospital I moved over to the Homewood Suites in Edgewater, NJ. The staff was great and the hotel had an excellent view of New York from across the Hudson. That night my wife helped me into bed and I decided to try sleeping on my non-operative side with a pillow wedged between my legs. I figured I’d likely stay in that position for the rest of the evening. Then shortly after midnight – the fire alarm went off and we were instructed to evacuate the building via the stairs. Our room was on the 6th floor. I used 2 crutches to get over to the stairwell, handed them to my wife, and then used the handrails on both sides to swing my way down to the main floor. I had to assume the alarm was legitimate – but it soon proved to be a false alarm. So….if you have to stay in a hotel after your surgery – be sure to ask for a room on the first floor.
The next few days were pretty uneventful at the hotel. Five days after the surgery I went back in to see Dr. Su for a final checkup before flying home. He again confirmed that the surgery went well and I had no cartilage left in my hip. He said my bone density was very good and I was a perfect candidate for the procedure. I would begin physical therapy in about 2 weeks. So 6 days after surgery – I flew home to St. Louis.
Things progressed much quicker than I had expected. A week after surgery I went to using one crutch. The first week or so at home I woke up a few times a night when the pain medication wore off about every 4 hours.
By far, the toughest post-op maneuver is getting on and off the toilet. I didn’t purchase the $75 raised toilet seat they offered to sell me in the hospital – but that’s one piece of equipment to consider. I was eventually able to perfect my mount & dismount without too much difficulty – primarily by straightening my operated leg and using my upper body and non-operated leg to get upright.
I went back to working on the 28th without too much trouble – from home. It might have been a bit early but things were busy and I didn’t want my workload to pile up while I was out. I spend most of my time on the phone and in front of the computer anyhow – so resuming work was not such a big deal for me. It certainly would have been nice to have an additional week off to focus on rehab-recovery.
Attended church with my family then went on to brunch to celebrate my Mom’s 70th Birthday! It was there that I took my first public unassisted steps – no crutch, no cane. I was proud to be able to walk slowly to the brunch buffet and back without my crutch. At this point I felt ready to switch to using a cane.
Since returning home I’ve been doing all of the exercises recommended by Dr. Su, a few additional exercises recommended by my physical therapist and in addition I have been walking about a mile a day on the treadmill in my bedroom.
I’ve since run out of Percocet and have transitioned to Tylenol for pain. Pain level at this point is quite manageable. It is a different sort of pain compared to the arthritis pain I’d been suffering for the past 8 years. That pain was gone almost immediately after waking up from surgery.
(3-4 Weeks Post-Op)
In my job I often commute to the Chicago area – once or twice a month. At this point I felt good enough to resume travel. After a just a few days with the cane – it was pretty apparent that I didn’t need it anymore. The only issue was that at this point I still couldn’t put on my own shoe or sock. I took off on the trip anyway confident that allowing some extra time in the hotel I’d figure it out. I didn’t take long and here’s how I did it. I stood at the edge of the bed, facing the bed, put the knee of my operated leg up on the bed and then leaned forward until my heel was approaching my butt. From that position I could easily reach back and slip on my sock and my shoe. No big deal! Everyone in the office was shocked to see me back so soon – walking better than before the procedure. Full days in the office were tiring – but it was good to be back.
I’ve been going to physical therapy once a week and it’s been going well. I do my exercises once a day on my own nearly every day at night and ice down afterwards. Once I’ve mastered one exercise and start to feel cocky they come up with something else that I really struggle with. I’m pleased with the progress but realize I’ve got a long way to go. But I am really enjoying being active again – without the chronic pain. I feel great and I’m starting to make progress towards dropping some weight. I’m really looking forward to this fall which will be at the 8-9 month mark. Can’t wait to get back to golfing and maybe, just maybe – a little soccer. We’ll just have to see how it goes!
My quality of life has definitely improved. I feel happier, more hopeful, less controlled by the arthritis. Like everyone says – I too feel that I might have waited and suffered too long. I guess it was truly hard for me to imagine that I’d wake up from the procedure and that old familiar pain would be gone – but it was. I’m very grateful to those who have helped me on this journey: God – for carrying me over the last 8 years, for Pat and the Surface Hippy Website, Dr. Su, my wife and family for their support and encouragement. My future again looks bright, full of hope and possibilities. I’m re-energized and looking forward to taking better care of myself, getting active again and living without pain. For those of you considering hip resurfacing – there’s hope and I wish you well on your journey!
Can’t wait to provide an update on my 1-year anniversary!