June 12, 2011
Well, things could not have gone better. Dr. Su said the bone density was good and he just had to clean out a couple of small cysts. The whole process was incredibly efficient and literally pain free. There was only one glitch in the whole thing, they had way over-booked the rooms and I had to spend 8 hours in recovery. There were some people who had to stay there overnight. That was the only place they dropped the ball, but they dropped it big time. It was rather surprising they were so poorly organized there when every other step of this experience was probably the most efficient thing I have ever seen. However, they did bend over backward to compensate for it all, which also shows that they are willing to be accountable for the entire process.Dr. Su is so real. No God complex, completely straightforward and just a really nice guy. He spent time with me pre-op and allowed me to ask all the questions I wanted. All of the HSS staff here are incredibly nice and attentive. I really haven’t had any pain, per se. The only discomfort is sitting in the bed on the wound. It doesn’t hurt, it is just annoyingly sore, like if you spent hours and hours sitting on a cement bench or something. They cut me off of the epidural this morning and gave me oral Percoset. That stuff ROCKS! No pain at all, not even sitting on the wound. PT starts today later on in the morning and I am anxious to get up and move around. I really feel amazingly good. I am just getting tired of laying on my back all the time. Thanks everyone for the well wishes. No matter where you are in the country, if you are considering resurfacing, I strongly urge you to put Dr. Su and HSS down for serious consideration.
June 12, 2011
Dr. Su called me in my room today from his home to check on how I was doing. He really is a great doctor. He remembered everything about our pre-op conversation and said he put the device in specifically to my build, lifestyle and goals. He didn’t know the exact angle of the placement but said he would measure it on the post-op x-rays tomorrow and let me know. He said he is much more focused on the cup placement in relation to the overall mechanics of an individual’s hip system as a whole rather than a selected number. He also said my acetabular cup is a size 60! I’m 6’4″ so I guess that makes my hip socket pretty big. I forget what he said the femoral component size was, something like a 54 or 56.
June 13, 2011
Dr. Su said I needed to be very careful the first 3 months and then SLOWLY build athletic activity back up during the period between 3 and 6 months. Barring any unforeseen complications, he said I can run at 6 months.I have already decided to be on the conservative side and not even think about running until WELL AFTER the 6 month mark. My plan is to get past the 7 or 8 month mark and then, when I get out and walk, inject a minute or two of easy jog every so often. From then until the year mark, I will just do a little more running and a little less walking as time passes until I am back to running the whole workout. I did a bunch of walking around my hospital floor today. It was really great to periodically get up and move. Learned climbing stairs with the forearm crutches too. I really like those type of crutches. For me, they are much more natural feeling. I should be released tomorrow and will spend another week at the Belaire. Truly, this has been much easier than i thought it would be. It’s not exactly a party, but my shoulder arthroscopy was more difficult as far as recovery goes. And the staff at HSS is really incredible. I really couldn’t ask for more from them.
July 13, 2011
Nothing other than literally “working on my stride” (see below). I always qualify my fast recovery by saying that I am a freakishly fast healer and, probably more significant, I was fully mobile and active all the way up to surgery. I think that is the biggest thing. Most people needing resurfacing aren’t so fortunate and are in so much pain that they can’t do much beforehand. I was keeping in what I call “Half-Ironman shape”. I was swimming 7500 meters per week, riding 100+ miles per week and (up until a few months before surgery) running 15 miles per week. The running was a bit painful for the last couple of years, but nothing that stopped me. It started to get worse late last year and so I stopped running on land and started deep-water running to prevent trashing the bone right out of being able to get it resurfaced.Regarding the walking and stride – I could pick up both my crutches and take a few steps at a time by day 3. It was sore and I was favoring the operated side, but I could do it. I was tempted to push it, but decided to work with the two crutches and focus on walking dead even with them so I wouldn’t create a habitual limp from the start. Two things about this I feel are important. First, use forearm crutches. You can walk much more naturally with them than the underarm type. Second, just like with good running form, push you pelvis under you and line up your shoulders with it. Do not hunch forward with your shoulders onto the crutches. Then you “walk light” on the crutches. You just touch them to the ground at your sides at the point of full bearing on the operated side and make sure you are walking dead even. It only takes just a tiny bit of weight onto your arms to help the operated side through the full step and takes just enough of the load off to allow you to walk straight and even. Then, as you get stronger each day, lighten the load you are putting on your arms to the edge of where you can still walk even. I worked very consciously at this every day, every walk. After a couple of weeks, I went to one crutch or cane when I walked for another week. Same thing here except you are now bearing more weight on the operated side. I kind of transitioned during that week by using 2 crutches on long walks and the cane for everything else. When I was on the cane, it was the same drill. You walk with proper posture and make sure you give enough weight to the cane to allow an even step on the operated side, but not so much that you are leaning over to the side or depending upon the cane too much. If you can’t do that, go back to the crutches until you can. DO NOT FORCE YOUR RECOVERY. No one else’s timetable is the one for you. Feel what your body is doing and act appropriately. Your timetable may be 2 or 3 times longer or it may be shorter. Your body is sending you constant updates. Tune in and listen. At week 4, I was using nothing. Long walks make the operated side a bit tired (3.5 miles), but I am up and down stairs without problem and completely functional without any devices. They are put in the garage rafters. The payoff for this came yesterday when I went in to get my follow-up x-rays to send to Dr. Su. I am at 4.5 weeks and the tech was asking me all about the device and procedure. As we walked a very long hallway back to the front of the facility, she was about 8 feet behind me and said she couldn’t believe that it was just over 4 weeks and I had absolutely NO limp at all. She said there was no way to know I had this done last month by the way I walked.
April 16, 2012
** Disclaimer: I am not a doctor, I don’t play one on TV. My statements are a combination of personal pre-op research, my own rehab and a HUGE dose of opinion based on my own deductions. I think there is a lot of interpretive gray area all over the theories of proper rehab.That said, there are certain constants I believe hold true for all patients: 1. Fact: The acetabular cup has been press-fit into the hip bone. There is no glue. The knurled back allows for bony in-growth over time. This is the “glue” that will hold it in place so that it can withstand the pressures of activity. The key phrase here is “over time”. Bone growth is slow. During the first 6 months to a year (depending on what surgeon you ask), this bony in-growth is not complete and, therefore, not a completely solid bond. My Opinion: Significant pressure on this cup (what I have referred to as “torquing”) early on can make it move in the socket. I think of it as gluing something and then twisting the parts before the glue is dry and it comes loose. Not only is the glue probably not going to ever permanently bond the two pieces because of this movement, they are now misaligned, and probably going to continue to move around, preventing any future bonding. You now have a permanent failure of the mechanism. 2. Fact: During the surgery, the femoral vascular system is temporarily disrupted. Over the next (approximately) 3 months, the bone density of the upper femur, including the femoral head, weakens as the body rebuilds the supply damage within the femur. The theoretical peak of this weakness is supposedly at the 3 month mark. From month 3 to month 6 (or month 12, depending upon what surgeon you ask), the density slowly gets better and better. Some of the research documentation suggested that in many cases, the density after one year was actually better than before surgery. I believe that they attributed this to a higher level of activity post-op than pre-op for those who were significantly immobile before surgery. Moderate impact (AFTER THE HEALING PERIOD) keeps bone density up. My opinion: Pretty much the same as #1 – Any high pressure on the femoral head when it is in this weakened state could subject it to breakage. This danger is two-pronged. You also can engage in activities that risk trauma (falling off a bike or while skiing) during the “weak” period that will snap the femoral head off like a toothpick. This I know as a good friend of mine did exactly that. A very light fall from a bike at about 3 months and it snapped. So, what exactly is the right amount of effort to get the muscles and body back while not risking the device or the femur? From what I can gather, nobody knows. And I am sure we have all heard the tired cliche “Listen to your body.” It’s not the body I don’t trust, its the mind drowning it out with a lot of “I want, I want, I want” whining. Face it, we are all a bunch of overgrown, spoiled 5 year olds who want what we want…NOW! I think there are obvious no-no’s of high impact that we have all heard. If you don’t know what these are, you haven’t done your homework and need to stay after school to catch up with the rest of the class. Personally, I didn’t do anything that put a high resistance on the joint: leg weightlifting, hard bike resistance, any upper-body weights that put twisting leverage on my core. I strongly feel you should not put either hard pressure nor leveraged twisting on the joint in the healing period. There are two points I’d like to make here: 1. I know from over 30 years of strength training that you can fully work you soft tissue (muscles) without having to use huge weights that put a lot of pressure on the joints. High reps with very low weight taken to muscle fatigue is very effective. 2. YOU ARE NOT TRAINING, YOU ARE HEALING. I think that this point is being missed by many. Yes, this operation is so you can get back to doing everything – AFTER YOU HEAL. Nobody said you can do everything as soon as you check out of the hospital. If you insist on acting like a spoiled 5 year old and do something impulsively stupid, your hip will punish you like an angry nun in catholic school. Everyone must do what they feel is right for them. Personally, I gave up some overall fitness and did a very conservative rehab to give myself the best chance of success with the device. I realized that all I had to do was face the fact that it is all ego. I have been in Ironman shape for over 20 years, and I didn’t want to lose that. Boo Hoo. Once I got over myself and this whole B.S. about tying a good deal of my identity to my fitness lifestyle, I realized that I wasn’t losing that lifestyle. I was moving through a phase of my lifestyle that required the same amount of discipline it took to get there in the first place. And I would work with both my body and my common sense so that I could achieve this goal just like all the other goals that came before. If ever a cliche fit this situation I think this one does: “Train smarter, not harder.” Best to all my fellow hippies. Please take care of yourselves.
April 18, 2012
As is obvious in my posts on this thread, I couldn’t agree more. Even though I did have the OK to run at 6 months, I waited to 7 months to even do little 100 yard jogs during my long walks and still do not do any run segments longer than a half mile or so at a time during these long walk / jog sessions, and I am coming up on my 11th month. I will emphasize I am still very focused on how everything feels and overly cautious about how much it gets pushed.Although I am doing a 70.3 triathlon on my first year anniversary, I GUARANTEE I am going to be doing this EXACT long walk with some jogging short distances interspersed during the run segment of the event. It will be a fun swim and bike with a nice stroll after that to the finish line. I want to get back into the mix but I will not be “racing” any time soon. It is unfortunate that there really isn’t some sort of consistent protocol that new hippies could use as a dependable guide for safely getting back to impact activity.