December 23rd (Post Op Day 4)

In morning, breakfast then an hour of land PT with Marc at 9:30 am – ½ hour per leg. He has me lay on back in bed. He starts with a several minute light rubdown of thigh – not deep tissue or muscle, but designed to increase blood flow, using talcum powder. Next ankle flexes, then quad compressions – press back of knee into bed, hold for 5 seconds and release. Repeat. Marc then takes leg and works on range of motion. He bends leg, with calf parallel to bed and gently works thigh toward 90 degree angle with hip. No pain, but gentle stretching, increasing range of motion. Then, bending other leg at knee with foot on bed, I do a straight leg raise with leg he’s working on, and push down against his resistance. He says most people cannot do that exercise this early. I move to other side of bed and he repeats with opposite leg. Next, I lie in middle of bed and move both feet toward outside in a V. Marc then gradually increases the base of the V, again working on increased range of motion, with incremental stretches – not to the point of pain. Then, sitting on edge of bed, raise lower leg against resistance Marc provides. Next walking in Villa with Marc watching gait – even strides, rather than little short steps with bad leg and longer steps with good leg (easier to do right with bilats, since there isn’t a good leg), natural pace: one — two, one — two, torso straight, rather than hunched over, easy and limber, vs. stiff and constricted, movement. Most of this is coming pretty naturally – feels so natural, and great, to walk without a limp (as long as I have my crutches, that is.) Next stairs, up and down large entry way flight – probably 30 steps. Use one crutch and handrail, holding second crutch parallel to floor with crutch hand. No problem. Walk some more in hallway then back to room. Do abduction – holding door frame, extend one foot as far as possible to side. Back to center. Do other foot. Back to center. Repeat. Hard at first. Then calf stretch and back stretch. Last is groin stretch. Sit on corner of bed with one leg on either side, extend legs out, then lean back and raise arms over head. If any of those muscles are tight, you feel the stretch. Lunch, brief rest, then an hour of pool PT. Same as before, only I can do faster bicycling. Find out from PT that Kani cannot come today, but maybe tomorrow. Italian restaurant again with fellow patients for dinner. Koen says I can walk tonight, but Lynn brings wheel chair for backup. Walking goes fine without need for wheel chair.

December 24th (Post Op Day 5)

Breakfast, then PT at 9:30 am. Same as before, but today I get to do stairs one at a time. Right crutch and left foot down, then left crutch and right foot down. Very easy and natural. On the way up, it’s right crutch and left foot up, while pushing off with the left crutch still on the stair beneath, then left crutch and right foot up, while pushing off with the right crutch. (This is a bilat technique, so don’t use it if you’re a uni.) Mark gets ice-bag to use at night to help with stiffness. Go for walk outside and find neighborhood pharmacy, grocers, bakers, then walk a ½ mile in small park down the street. Feels great. No pain. Still blows me away. Christmas eve buffet with the DeSmets tonight. Kani gets sprung from the hospital this afternoon. Good food. Good company. Good hips.

December 25th (Post Op Day 6)

Marc is here as usual at 9 am even though it’s Christmas day. Same routine, but a bit more resistance and practice stairs without rails. Goes great unless you do same crutch, some foot, then bad things happen, especially if you’re coming down. Note to self – opposite crutch, opposite foot. (Bilat note only – unis do it different!) Christmas lunch of goat cheese salad, roasted rabbit, roasted vegetables, warm cherry- applesauce, and individual assorted mini-desserts that defy description. Walk outside in the park. Left overs for dinner with the DeSmets.

December 26th (Post Op Day 7)

Morning PT, with more reps, more resistance. Walk in the park in later morning – maybe a mile. Lunch, then a walk on the sidewalks where my crutch sunk on one of those uneven cobblestones and I felt a sharp painful pull. It seemed OK later although there was still a trace of strain, so I iced it when I got back. Pool PT added in straight leg raises, where the PT supports you laying lengthwise in the water, holding onto the bar, and you go down with your leg, then do a straight leg raise, alternating legs for bilats. (Unis do operated leg only for most of these exercises.) I asked Gaetana, Koen’s wife and the Villa nurse this week, about the muscle pull that evening when she came to change my bandages (it’s so hard to know what’s ‘normal’ and what’s a potential problem…) Gaetana got Koen who was roaming around the Villa somewhere, and he spent a half hour with me. Koen said that I was doing more than he wanted me to do and said I needed to slow down. He spent a lot of time teaching (when you stumble 800% or 8 time your body weight can go onto your hip; unused muscles also have unused proprioceptors that have a poor sense of where the hip/body is in space; the only thing that rebuilds bone strength is time, the highest risk of neck fracture is the first 6 months and some ways to decide what is ok to do or not – listen to your body, if it hurts, don’t do it; do less, not more; etc. He explained that the need to slightly shave the neck of the femur on both hips to allow full range of motion in my surgery, also increases the risk of femoral neck fracture. He then explained that because of this he wanted me to use two crutches for 6 weeks to minimize the fracture risk. (I was the only one with this protocol in my group.) Hip looked fine he said, but slowing down is most likely to keep it that way. Koen reminded me I was only 1 week post op. So…. I took easy the remainder of the day. Note to self – less not more.

December 27th (Post Op Day 8)

Normal routine. Breakfast, hour of individual land PT, walk, lunch, rest, pool PT. Sleeping in 2 hour stretches by now. Sleep fine in all positions, although using the pillow between legs can be time consuming if you want to switch positions. Stiffness tends to wake me up. Can put on support hose by laying on my back in bed, sliding heel to butt, slipping hose onto foot and pulling up to ankle, then I’m set to sit up and pull it up without breaking 90 degrees. Bilats have a harder time with autonomous functioning initially, as there is no good leg. Bilats are only 2.9% of the total procedures done by Koen, with the vast majority single hips, and the initial days are a bit intense. It’s great to have a fellow bilat, Kani, to share experiences.

December 28th (Post Op Day 9)

Continue with gradual increase in reps and resistance in individual PT. Walking is easy and natural and stride is good. Very little weight is on crutch – mainly for balance and to protect hip. . I went into the city center today on a sunny, clear, blue skied day and was able to see much of the old city. They have newer trams, so access on crutches wasn’t problematic. I walked through the most famous church in Gent which is huge with all marble floors and many stairs. I never would have made it pre-surgery and except for needing to rest once due to a bit of residual weakness, I had no pain or soreness. I continue to be amazed at the lack of pain. Pre- surgery, if I was standing or walking for any length of time, I was always scouting out the nearest bench or chair. Now, I need to get up and walk every half hour or so in order to stretch out the stiffness. I use two crutches all of the time – it’s an easy rhythem now, don’t rush, and rest when I’m tired. My stamina is surprisingly good.

December 30thd (Post Op Day 10)

The 3 hour excursion yesterday was fatiguing, but I had only minimal stiffness this morning which was remarkable. Koen and Marc both say to listen to your body, if you are sore, do less. Koen says do 75% of what you think you can do. I slept for a 4 hour stretch last night. If I walk a bit when I wake up, the stiffness goes away and it is easy to fall back asleep. No stiffness during land PT, and I took it easy during more strenuous parts of pool PT due to yesterday’s excursion and mile plus walk today. Meds consist of Clexane (40 mg injection daily for 21 days, with 80 mgs. the day before, day of and day after flight home), Biofenac (anti- inflammatory used to prevent/reduce heterotrophic bone growth), and pain meds as needed. I used only morphine epidural first 36 hours post surgery and two Tylenol tablets since then. No swelling or bruising of incision or of hip or leg. Incision is almost healed, although Gaetana or Koen check the incision daily. I do injection myself.

December 31st (Post Op Day 11)

Marc did hour of land PT. He added resistance to the abduction exercise (moving each leg out to the side from a standing position, then back to center.) Koen came to change bandage today and spent a ½ hour reviewing x-rays with me. Wow. I see now why he wants me to take it easy. He basically rebuilt the acetabulum cups so that they are where they should have been in the first place, but it involved a lot of bone removal from my pelvis. The slight shaving of the femoral neck corrected any chance of impingement, so that full range of motion is achieved. No wonder everything feels so different – my hips are normal for the first time ever in my life. Kani gets outdoor roaming privileges today and we go for a walk to the neighborhood store to celebrate. Tonight, a New Years Eve buffet with the DeSmet family – great food and company as usual, but neither Kani nor I last until midnight. He heads for bed at 10 pm and I last all the way until 11 pm. Wake up briefly at midnight to the New Years Eve fireworks – takes me a few minutes to remember it’s not Beirut and there’s no war, and a few more minutes to settle my heart rate back down. I wish my hips Beste wensen voor het Nieuwe Jaar, change position and go back to sleep.

January 1st (Post Op Day 12)

Marc has a well deserved day off today, but Koen lets Kani and I use the pool to do the water therapy routine which feels great. Kani and I go for a walk in the park, then later after a New Years Day luncheon, I take a tram to the Old City to see the city lit up at night. It is spectacular, but a lot of walking. I feel like I can walk forever, but I don’t because I’m doing less than I think I can. Back for left overs with the DeSmets and an enjoyable round of family games. Kani and I try the cork toss into the bucket, but pass on musical chairs. New Year. New Hips. New friends. Life is very, very good.

Take care, Michelle bilat 12/19/06

BHR DeSmet Madison, WI writing from Villa Cento Passi, Gent, Belgium

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Bilateral – 12 days out

I am a 51 year old woman, small framed (5’2″, 115 lbs.) with
congenital dysplasia and arthritic deterioration secondary to the
dysplasia in both hips. My right hip was worse than my left on x-
ray and had more limited motion. My left hip had more pain. Both
hip sockets were too shallow and angled problematically for my
anatomy. I was referred to Dr. DeSmet from a US surgeon due to the
complexity of my hips and the need for simultaneous bilateral
resurfacing. I spent the 3 months prior to the surgery pre-habbing
with a PT that had some experience with resurfs and during that
process, through a combination of pool work, Pilates, core training,
upper body conditioning, carefully orchestrated lower body land
strength work and balance work, went from being unable to stand at
all on my right leg, to standing easily (if painfully) on either leg.

December 18th (Day minus 1)
Spent yesterday recovering from jet lag from the flight from
Madison, WI to Gent, BE. This morning, went to the Villa Cento
Passi for pre-surgery work-up. Had blood drawn (5 tubes), chest x-
ray, hip x-rays on brand new, state-of-the art x-ray equipment,
fitted for post-op surgical hose, pre-op blood thinner administered –
Clexane (enoxaparinum), EKG, meeting with cardiologist reviewing
EKG and health history. Spent ½ hour + with Dr. Koen DeSmet
discussing all results. He sketched out for me on the x-ray what
the plans are and answered all my questions. (At this point of pre-
surgery jitters, the basic question could be summarized as, “Are you
sure this is really a good idea!?!”) Entire process took 2 hours,
with no waiting for anything. Amazing. Then lunch at the Villa,
unpacked in my room (able to just leave things as they are as I’ll
return to same room once released from the hospital. The room is
spectacular). I am #3 on the surgery schedule.

HOSPITAL STAY: December 19th (Surgery)
Taxi waiting for 5 minute ride to Jan Paflijn hospital at 7am. By
7:20 am, I am admitted and looking for ward 2-B. I have a 2 bed
room. I get gowned, scrubbed (they used to use special soap pre-
surgery night and day, but no longer do as results of study showed
no difference in infection rate. Infection rate for Koen at this
hospital is a very low ½ percent (0.5 %) with zero percent (0.0 %)
antibiotic resistant, MRSA, or C-diff infections. ) Next, shaving
and blood draws (x2). I’m feeling protective of my blood – seems
like everyone wants some these last 2 days. I hang out, getting
nervous with the waiting, reviewing the question of the day, “Is
this really a good idea? Maybe I should have just done one?” I
have no hesitancy about my surgeon as I have nothing but excellent
recommendations for him and the connection feels good. He appears
highly confident without arrogance – a nice combination for a
surgeon, explains clearly and without hurry, smart with a sense of
humor and skilled hands. I remind myself that pain level and
limited mobility necessitates surgery, everything has been carefully
researched and I’m in the best shape I could be, so I need to just
relax and trust. I don’t actually relax, but I am impressed with
my reasoning. At noon, they come and wheel me away. In the pre-op
area, they insert an IV, then to the pre-op part of the recovery
room, where the anesthesiologist puts in an epidural morphine device
into my back for pain control post surgery. Hurts a little, but not
bad, and it’s over quickly. He tests it out and exchanges the
morphine pump for a less finicky variety but the epidural tube stays
put, so no problem for me. I ask about pre-op antibiotics for
mitral valve prolapse (a benign heart condition that increases
potential for heart infection) as instructed to do by the
cardiologist, and they confirm that I have a broad spectrum
antibiotic in my IV. At 1 pm, they wheel me into the frigid (think
Alaska in mid-winter) operating room. (Koen has been studying bone
temperature and infection rate – he keeps the operating room cold to
lower potential for infection.) Bart (Koen’s nurse assistant) says
hello. They transfer me to a operating table and everyone works on
a limb – putting TEDS on right leg (left hip goes under the knife
first), disinfecting things, checking IV flow, then anesthesiologist
says my hand will sting and I’ll gradually feel sleepy, both
accurate predictions. I wake up cold. People sliding x-ray films
under both of my hips. Sit up to help them. Bad idea. Everything
goes dark. Wake up again to blood pressure cuff. Move to look
around. Everything goes dark again. Wake up to more blood pressure
taking. Warmer now. Special blankets with a heat hose underneath.
Much better. No pain. I wonder if Koen didn’t do the surgery.
Then I see the inverted V shaped wedge pillow strapped between my
thighs and I think that is only used for total hips, and sit up to
ask if they did a total hip on one or both hips. All dark and wake
up to more blood pressure taking. 65 over 45 – they don’t like the
reading. Everyone else, one by one, leaves recovery. I don’t sit
up anymore, or I figure I’ll never get out of there. Finally, at 9
pm, they spring me from recovery as BP is up to 70 over 50. Dr.
DeSmet said that surgery was very difficult, as the anatomical
complications were more severe than they appeared on x-ray, but
successful bilateral resurfacings. No need for blood transfusion.
I’m happy, in an out-of-it sort of way.

December 20th (Post Op Day 1)
Wake up early, early morning, believing I am in Beirut and hospital
is being attacked. Nurse assures me that I’m in Belgium — no war.
Good news. (I was an exchange student at American University of
Beirut in 1976 – 1977 when Israel attacked and civil war was in full
swing and was in hospital for short time after injury during an
attack – surgery/morphine/different country must be triggering those
memories.) Drink lots of water – supposed to stay hydrated. Wake
up an hour later. Throw up lots of water. Not so good. Sit up.
Fall back. More blood pressure taking. Pillow strapped between my
legs is a hassle. Nurse says it stays where it is until Dr. DeSmet
says it can go – maybe 2 or 3 days. Bad news. Night passes with
intermittent dozing, nausea, dizziness, vomiting, nightmares and war
dreams. Nurses excellent – kind, competent, reassuring. Nurses say
no more water until stomach settles. Good plan – the hell with
staying hydrated. (Forgot that IV was taking care of hydration
anyway.) In morning – no breakfast, can’t even keep fluids down
yet. Bed bath with nurses. Tubes are a hassle – oxygen, epidural
with morphine pump in back, IV, catheter and drain in left hip
(single hips don’t have tubes – only bilats.) Throw up as rolling
back and forth activates nausea. PT comes with pulley and thigh
band to raise leg to bent position, then lower, flex ankle, press
back of knee cap into bed and hold for count of 5, then release and
repeat in sets of 10. ½ hour per leg says PT. Dr. DeSmet comes.
Removes evil pillow – yes! My hero. Says surgery was even more
complicated than it appeared on x-ray, but everything looks great.
Required slight shaving of femoral neck to insure full range of
motion on both hips and extensive restructuring of acetabulum.
Says nausea/dizziness is probably due to either anesthesia reaction
or morphine reaction and it will pass — eventually. He leaves. I
throw up after 3 more leg pulls. PT takes away pulley. Says
tomorrow will probably be hardest day as they remove epidural with
morphine drip. Bad news — today is no picnic. Oh well – nothing
to do, so might as well just deal. Alternate dozing, vomiting and
dizziness for several hours. Fall asleep. Wake up at 3 pm. Sit
up. No problem. Feel good. Drink Belgium version of 7 up – no
problem. Live dangerously and eat saltine cracker – no problem.
Life is good. PT comes back with pulley. I start hauling leg –
watch my room mate and realized I’m doing it wrong. Must have
gotten instructions wrong this morning. I do what she does. Haul
up leg. With knee in bent position, extend leg fully and point toe
up and lower for 5 repetitions. Lower leg. Flex ankle. Push back
of knee into bed for 5 seconds. Relax. Repeat. Do 1//2 hour each
leg. PT come back – says those are advanced exercises – room mate
is 3 days ahead of me and only had one hip. Oops. PT says I can’t
try walking until all the tubes come out tomorrow morning. Room
mate teaches me Dutch – says I should be able to say Merry Christmas
in Dutch understandably by Christmas 2007. Dutch is not easy. Her
English is excellent, and we have a fine time together. Arm is
swelling. Doctor arrives and examines arm. Says IV has
infiltrated. New IV is inserted. That one infiltrates too. Note
to self – next life, get bigger veins that don’t roll. I suggest we
just leave the thing out and I’ll drink lots of water. No go.
Third IV installed. So far, so good.

December 21st (Post Op Day 2)
Wake up often in night. Whisper to room mate. She’s awake too. We
commiserate. Sit up – – get dizzy. Nurse comes. More blood
pressure taking. Feel like I have to go – can’t be — have
catheter. Sensation builds. Nurse examines catheter. Bag is
blocked. Works on it for a half hour. Bag fills with 1 liter.
Relief. At 7 am, all tubes come out. Amazingly easy and no pain.
Takes 5 minutes. PT arrives with leg hauling equipment. I ask her
about walking to bathroom. She says after exercises I can try. I
haul happily away for an hour. Discover I don’t need pulley – can
lift and extend leg without help. Do exercises without pulley. PT
says that’s not usually possible. I keep waiting for pain to come –
never does. PT lets me sit up – no problem, no pain, no
dizziness. Stand up – no problem. Then walk with walker to chair –
maybe 6 feet. No problem. Life is good. I eat lunch sitting up in
chair. After lunch, we make grand bathroom excursion with walker.
Then back to bed. PT comes back at 3 pm for more leg hauling. Do
exercises without pulley for an hour. PT lets me try crutches.
Right foot wants to turn inward a little – she says concentrate on
keeping it straight. Left crutch with right foot, right crutch with
left foot – a rhythm develops. Walk to end of hallway and back.
Right foot is behaving itself. Back to bed. Dr. DeSmet comes. I
ask about leaving hospital tomorrow. (I was scheduled to stay 4
more days.) He inquires about dizziness. I say I haven’t had any
in a long time. He smiles and says 3 am last night isn’t so long.
Seems long to me – must be a matter of perspective. He says if I
keep progressing, no dizziness and can do stairs tomorrow, I can go
to Villa tomorrow morning. Alright! Life is very, very good. PT
takes me for another walk before dinner. Up and down hall without
problem. No pain. Simply amazing. No pain. After dinner, walk
down hall with Dave to visit Kani who had surgery one day after me –
good to see him. As I’m standing at end of bed talking to Kani, I
realize I need to be in bed – now. Maybe earlier than now. Bed
seems to be a long, long way away. Tell Kani I have to go and head
out, cross country, to my room. Make it. Life is good.

TO THE VILLA: December 22nd (Post Op Day 3)
Stiffness during night wakes me up every hour or so, but most times
can fall back to sleep. Heels hurt even with heel protectors. Use
pillow under calf as well, and all is well. Crutch to B/R for teeth
cleaning and washing. Change into real clothes and pack. PT comes
right after breakfast. More leg exercises. Room mate says stairs
are easy compared to first hallway walk. PT comes for walk and
stairs. Right leg behaves normally now without any effort. My
knees are next to each other and my feet point straight ahead.
Amazing. Stairs are easy. Up one flight. Down one flight. Back
up again. Life is good. 10:30 am – Hugo arrives to take me back to
Villa. Use crutches pretty easily now. Back to Villa, settle in,
then 3 course meal for lunch. Short rest, then pool therapy.
Special waterproof bandage keeps wounds dry and sterile. Forward
walking, large step forward walking, 90 degree knee raise step
forward walking, 90 degrees with large steps forward walking,
sideways walking. Backwards walking (harder for me initially).
Then exercises – 90 degree leg raises, side abduction against water
pressure then pulling back to center, soccer kicks. Running in
place, then running in place with some bounce. Stretches – calf,
quads, groin muscles. (Bilats do both legs, unis operated leg.)
Bicycling holding onto rail at side of pool, with legs straight out,
using cycling motion to keep body at water surface, slow, then
gradual increase with some 1 minute intervals of hard cycling (they
don’t let me do hard the first day.) Koen stops by pool to check on
how things are going. Bandage change and shot (Clexane – blood
thinner) after pool. Plan to go out to dinner with brother and
other patients. Run into Koen in the elevator – he stays OK for
dinner out, but wheel chair is better than walking. After dinner,
say goodbye to Dave (my brother)who heads back to his home early
tomorrow morning. On my own now, but a couple from my town and Kani
are here, which definitely adds to experience.

Part II to Follow.

Take care,

Michelle
bilat 12/19/06 BHR DeSmet
Madison, WI
writing from Villa Cento Passi, Gent, Belgium

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Bilaterals: Gear Reviews and Other Tips

Kani and I are two weeks out from simultaneous bilateral hip resurfacing
courtesy of Dr. Koen DeSmet in Gent, Belgium. We are set to spend
tomorrow night at the Sheraton located 30 steps from the Brussels
Airport, with flights to our respective homes (Madison, WI and Hood
River, Oregon) scheduled for the following morning. We both were on our
own most of our surgery time. So while we still remember them,
here’s our tips:

* By far the most useful, in fact imperative gear item, is a good
grabber, essential if you are on your own, but very useful even if you
have a companion. If you have to travel, buy a folding one. Walgreens
has a folding grabber for $9.99. You’ll use this thing to dress,
pick things up, reach for things, pick up dropped crutches, and many,
many other things, especially your first few days to few weeks depending
on your recovery process. Grabbers rule. *
The next most useful gear item, is a sock putter-onner. Both Kani and I
preferred the 3 fingered variety with blue nylon on the inside and terry
cloth on the outside. We even managed to put TEDS on with this model.
*
A long handled shoe horn is a good thing if you have shoes where the
heel gets caught going on. My variety was plastic with a horses head on
the other end ($2 at a local shoe store.) In addition to it’s
duties with shoes, the stiffness of the plastic shoe horn let me get the
TEDS OFF again. Bring shoes you don’t have to bend over to adjust.

* If you’re doing surgery alone, or returning to being on your
own, practice putting TEDS on and off with your gear and make sure the
gear works for that purpose if your surgeon has a TEDS protocol. An
extra pair of TEDS is a good thing if the protocol is a 24 hour one or
you will find people studiously avoiding being around you and your TEDS.
* A Leg Lifter isn’t much use for a bilat. When you need it is
during the time you can’t lift either leg and the legs need to move
in unison, which the leg lifter isn’t able to do. Neither Kani nor
I found the long handled washer much use either. Neither one of us had
a dressing stick and we didn’t miss it. * Next in the Gear
Reviews, we cover crutches. By all means, if you are going to be on
crutches for a while, try to get forearm crutches with forearm circles.
Don’t use armpit crutches. You may need to put a lot of weight on
your arms for a bit and the forearm crutches are much more stable and
don’t mess up your shoulders. The model with forearm circles are
way useful, don’t fall, and just hang nicely from your arm when you
go to open a door, use a key, wash your hands, etc. The “Euro
Style” open back elbow crutches are not nearly as useful for longer
use. Most bilats use crutches for 4 to 6 weeks, so the arm band ones
may be well worth investing in. I got mine on Ebay for $30. * The
frequency with which you drop items is inversely proportional to your
ability to easily pick up the items. You will drop a lot of things
early on. * You will never have your grabber and will need to go
find it. Consider attaching it to your crutch as you won’t forget
your crutches early on. * Don’t ever drop both your crutches
early on if you are alone, like say in the bathroom. You absolutely
cannot pick them up again. One crutch dropped is usually recoverable
using crutch number 2. You will also get good at picking up a wide
variety of things with your crutches since you won’t have your
grabber with you. (See above) * Everything takes longer –
dressing, eliminating, walking, bathing, tooth brushing, etc., etc.,
etc. Just roll with it and don’t get frustrated. * The taller
you are, the more important it is to pre-prep your house, putting lower
things up where you can reach them without breaking 90 degrees, getting
a toilet extender, etc. If you’re 5’2″ or below, that’s
not much of a problem. Small and light is an advantage initially with
bilats. * Never, ever go down stairs using two crutches (i.e. going
down stairs without a handrail) using same crutch, same foot. Bad
things happen. It’s opposite crutch, opposite foot. Once you get
the rhythm of this, it goes well. * Use crutches as long as you need
to in order to walk without a limp. If you are still limping, you still
need crutches. Give it time. It’s easier to not develop a limp
than to get rid of one. * Try to work with a good physical therapist
before surgery working on balance, strengthening your weaker leg (if
you’re a bilat, you’ll have one), and on upper body strength.
Also, try to lose weight if you need to — it will help a lot. * In
the elimination tip department, the Rowland/Moran team offers three
tidbits for your consideration: (1) Kani says, if you’re using the
urinal at night, make sure that the bottom end of your bed is lowered
first or things slosh over, (2) Also from Kani, during your first bowel
elimination attempt, don’t strain too hard – it makes you faint,
and (3) from Michelle, if you feel like you have to go when you have a
catheter in and the sensation gets stronger, have someone check your bag
to see if it’s filling. If it’s not filling, the bag is
probably blocked. * If you’re not any good at asking for or
accepting help, either practice a lot before surgery, plan on a crash
course after surgery or don’t do bilateral surgery. You simply
cannot do this one without some help. * Bilats often get the
triangular shaped pillows (JEFs) used for total hips. Do not panic. It
does not mean you had a total hip. It means you’re a bilat. They
are, however, a drag, so ask your surgeon about getting rid of the thing
ASAP. * Do not compare your recovery with unis or even with other
bilats. EACH RECOVERY IS DIFFERENT. Say that over and over to
yourself. Each recovery is different. Slow and steady wins the race.
* Also do not compare one hip to the other. One hip/leg/foot will
always be worse than the other in some way. This does not mean that
your surgeon screwed up the worse hip/leg/foot. It means that each hip
is different. Love them as you do your children for their unique
strengths and problems. * If your epidural pain relief is only
working on one side, do not keep pushing the little pain button,
thinking that some will eventually slosh over to the other side.
Epidurals do not slosh. * When the nurse says, this will sting a
little, do not believe them. Substitute `a lot’ for `a
little’. However, it’s always over soon. * Post bilateral
surgery, you will notice a slight change in the way that days and nights
are structured. Each day will continue to have 16 hours. However,
nights, for the first few days post-op, have 32 hours apiece. If they
offer sleeping/pain meds, take them. You’ll still have lots of
hours to lie awake. * If you have very, very small veins that roll,
see if you can get them replaced before your surgery. It will save you
a lot of hassles. * Bring extra IPOD batteries and/or ear plugs in
case your room mate snores loudly. * Eat a lot post surgery. It
takes a lot of energy to heal. * Speaking of healing, take care of
your heels. Put a pillow under your calves with your heels hanging
loose, and consider a piece of sheepskin or something soft under them
(if you have a helper who can keep adjusting the damn thing, since you
won’t be able to reach it.) Heels tend to get quite sore from the
pressure of being on them and your back. * Drink alcohol lightly.
* Get a lot of rest. Do less not more. Do 75% or less of what you
think you can do. Listen to your body. Expect fatigue initially. *
Even if you have no swelling and no bruising and no real pain, you will
have lots of stiffness. Ice is great for stiffness. * Bring a really
good, very, very gentle and hypoallergenic lotion even if you do not
have dry skin or allergic reactions. The disinfectants they use are
strong in surgery and it does things to your skin that you wouldn’t
believe. And normal lotions just irritate it more. * If at all
possible, find another bilat to have surgery at the same time you do.
The mutual encouragement helps a lot, and definitely makes the
experience more enjoyable. * And finally, PICK YOUR SURGEON VERY,
VERY CAREFULLY. Simultaneous bilateral replacements are not easy, nor
short, surgeries and the more experienced your surgeon is in this
specialized type of hip resurfacing, the better off you will be. And
the more relaxed you will feel. Being certain that you picked the best
surgeon FOR YOU, does more than anything else to give you piece of mind
going into surgery and through the recovery process.

Hope this helps.

Take care,

Kani and Michelle,

Hood River, Oregon and Madison, WI, From Villa Cento Passi, Gent,
Belgium