John Bria’s Hip Resurfacing with Dr. Su 2007

RBHR January 9, 2007 Dr. Su

 Fri Jan 19, 2007 10:30 am

I am happy to report that as of 5:00 PM, Tuesday afternoon, January 9, 2007, I am the proud new owner of a Dr. Su installed right BHR at the Hospital for Special Surgery in New York. Dr. Su sent me home on Friday morning, January 12, with the following instructions: bilateral support for three full weeks, weight as tolerated, no restrictions. On Saturday morning I took my first walk, which was as sweet a stroll as I have ever had. Each day I feel better and stronger, but because of swelling, my backside, which on a good day might be the size of Vermont, grew to the size of Texas, and is now receding to its original boundaries. I am ecstatic at these early results of Dr. Su’s magnificent work.

I realize I have failed to introduce myself to the group, so let me add my lengthy particulars to the data base for anyone who is interested. My name is John, male, 56, 5’9", 160lbs. Because I have been lucky enough to work at home since 1973, I have had a very physical existence. I am a life-long tennis player (played in college), started running in 1969, started adult cycling in 1980, did a lot of rock and ice climbing during my forties, and have played a lot of hockey, platform tennis, roller bladed, XC skiing etc. I like to maintain my property which involves chainsaw work, rebuilding stone walls, splitting wood, plowing the driveway, shoveling all of the walks, heavy-duty transplanting of shrubs and everything else that goes with keeping an old house together.
 

As of my surgery, I was cycling only, having given up all else over a period of about 5 years. – although I did spend some time standing on the tennis court this past summer. A year ago, I was able to do the Mount Washington Bicycle Hill Climb Race, although I was way back in my age group – more like survival for me rather than a race.

Like many others in this group, I first noticed a pain which I thought was a pulled groin muscle, and my first quick steps on the tennis court became very slow. I ignored the pain, and decided to run the Adirondack Marathon on five weeks training (three of which were the taper down) and then decided that 10 marathons would be a good goal, but made it through only 5.

I consulted a local OS who said he specialized in the "rehabilitation of runners," not sure how he meant that, who informed me I had low grade arthritis and to keep the mileage down. My hip sometimes would lock-up with a 9 on the pain scale when I stood from a chair or in mid-stride during a run and this did not seem very "low grade" to me, so on the advice of a bilateral THR friend of mine (who won two National 45+ Court Tennis titles with his THR’s) I saw Dr. Michael Maynard at the Hospital for Special Surgery. Dr. Maynard saw that I had a torn right labrum and thought he could give me some years with arthroscopic repair. So, in August of 2003, Dr. Maynard removed torn cartilage, a bone chip and a cyst from my right hip, but found that the injury was very old and that the flapping torn cartilage had created a huge hole in the good cartilage. His conservative and realistic opinion was 2 years before a THR. As it turns out, I pushed it to 3 ½ years and resurfacing. Without Dr. Maynard’s good work, however, my hip would have been replaced three years ago.

I actually did have an October date for a THR with Dr. Paul Pellicci, a New York grand master who has done many happy people in my neighborhood, but in the middle of September, I found this great group, and after 30 seconds of research, said, "Whoa," and called Dr. Su. Thank you group.

A little more about Dr. Su’s concern for his patients: When he came to see me just before surgery, he gave me the opportunity to back out if I was not sure. And I was so nervous, my wife had to hold me down as I said I’m out of here. He does not push the patient. He is calm and thoughtful, and I stayed. As it turns out, there was not a bit of cartilage left in my joint.
Again, thank you to this group.

John RBHR Dr. Su Jan 09 2007

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On Monday, February 12, I saw Dr. Su for my five week post-surgery x- ray and follow-up, and I would like to add his recovery guidelines for those first 5 weeks and for the next three months to the wide- ranging database of recovery protocols. I have posted a few times before, but as a reminder, I am a 56 year old male with high-mileage on my hips.

I took my last serious painkiller 61 hours after my surgery, on the morning I was leaving the Hospital for Special Surgery. Dr. Su sent me home with instructions to use two crutches, weight as tolerated, for three full weeks, no restrictions on sitting, sleeping and hip angle, two aspirin a day, showering okay immediately, no TEDS. The first morning home, I did my first crutch walk for less than a mile and gradually increased the distance each day. On day 11, Dr. Su told me I could walk up to three miles, start on the stationary bicycle, set for no resistance, and start some light stretching.

At three weeks, I began using a cane, could have used it far sooner, but was following Dr. Su’s instructions, continued to walk twice each day for at least 3 miles total. Had a physical therapist come 3 times a week, did my hip exercises each day, and rode my stationary bike at a cadence of 90 and a heartrate of about 85.

At my 5 week visit, Dr. Su and Todd, the therapist, spent a lot of time with me watching me walk, thoroughly checking my range of motion, showing me exercises to improve it and answering my numerous questions. They advised that the cane was no longer necessary, but have it with me for long walks. Dr Su wrote a prescription for out- of-the-house physical therapy – 6 weeks, 2/3 times a week, and during my first session today, I worked with light weights and the Elliptical. Will walk, do yoga Warrior Poses and ride my bike later this afternoon.

I asked Dr. Su when I could start the following activities, and he replied, "now," or when I am ready for most of them.

Stationary Bicycle with resistance, and out of the saddle, standing up on the pedals – now

Road Bike – if I am sure I will not fall – now

Splitting Wood – now Carrying Firewood, up to 30 lbs. – now

Shoveling Snow – now Driving tractor to plow driveway – now

Tennis – easy swinging, hitting balls – now, but no running or impact motions

Yoga – now Pilates – now

Rollerblading – now, if I do not fall

Dancing – now, but do not step on wife’s toes

Rock Climbing – now, no backpack, do not fall, send photos

Running – maybe in 3 months to six months

Kayak – carrying 17 foot, 35 lb. boat, wait until the spring Forgot to ask about riding my old BMW motorcycle

Here are his two most important admonitions:

About running, Dr. Su specifically warned me that the impact from running would shorten the life-span of the resurfacing device.

About re-establishing my range of motion, Dr. Su said I had a window of opportunity of 6 – 8 months to achieve it, afterwhich time good results would be difficult.

I hope there is something of value for someone in this post, because I have taken so much of value from everyone else’s experiences in this group.

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I want to clarify a few things from my earlier post about recovery guidelines. There seem to be many different paths to recovery, some slow, some fast, and one must remember that we must work within the abilities of our own bodies and that the prize is not won after a few months, but after twenty years when we still have our shiny hips in good working order. Is it important to be out front in the first lap of a twenty lap race?

The "do not fall" caveat is major, and not to be easily dismissed. So, although Dr. Su said the road bike is okay, I will not ride with anyone else or in unusual weather conditions until I have had much more time to heal. During my adult years, all but one of my bicycle crashes has involved another cyclist, usually a good friend or family member, and poor communication. And my better judgment says leave the rollerblades in the closet until the summer. On the other hand, how many times have I tripped and stumbled within the "safe" confines of my house?

By achieving my range of motion within a 6 – 8 month time frame, I believe Dr. Su meant the range of motion of a healthy normal hip, not the ROM of my cranky old hip which at its best when it was young, had problems. So, I am hoping for better range than I have ever had in my right hip. It took me years of sustained effort to run that hip into the ground, but recovery seems as if it will need even more effort – of an intelligent sort, and proper care and feeding to make it last.

For those who know their yoga poses, my in-home therapist gave me some "stretches" which resembled Warriors 1 and 2, and I have added Warrior 3 and Tree Pose. I had to stop yoga three years ago, every pose was unhappy, but this new hip has my body smiling again.

I am off to Cambridge, Massachusetts, in the morning to see my grandchildren. Shortly before my surgery, young Isabelle – 2 ½ – was out for a walk with her parents when she suddenly broke into a bow-legged wobble. When asked what she was doing, she replied, "This is how Grandpa walks." Not any more, sweetie.