I met with Dr. Chhabra and he answered all my questions (22 of them) I’m set to have right a BHR on 9-22-08. He has done over 50 now and I feel confident with him so I am going for it. I had some concerns about cemented vs. uncemented, as well as what type of THR if the bhr will not work. He said he had one where the end of the femur (ball) was too damaged and they had to go with a THR. He showed me the aborted implant with the end of the femur cemented on and you could see where they cut the ball off for the thr. I feel confident after seeing that piece that the cement will be ok.
From what I’ve read in here the cemented ones are holding up fine, and most of the doctors listed in here cement the ball side. Also I noticed its not like a loose fit, its more like a nail driven into a piece of wood. If the bhr will not be an option, the thr is uncemented metal on metal with the same larger ball (like a bhr) The fact that he can recognize when there may be a future problem was reassuring. He said I was his most curious patient.
Oct. 16, 2008
Well I am at 3 1/2 weeks out now and can use the cane, but am no where near walking without support, the people who can walk around at 3-4 weeks are studs !! “Walking” for me right now is rocking back and forth and taking 2″ steps. My teenager says I walk like a penguin (he only tells me this when he is out of arms reach ) Kind of thought going in that at 3 1/2 weeks I’d be further along than I am. Got a couple little issues. I have lots of pain on the top of my thigh when I raise my leg and there is a brand new knock in my knee that feels like a tendon hanging up and then snapping back, it hurts but not bad. That’s the good knee so I’m hoping that subsides. I’ve had a couple times when I have lost my balance and one time sitting up out of a chair that I put a lot of weight on it and I thought I must have moved the cup or cracked the neck because it hurt so bad, and always felt different after it happened, like something had moved, but since I’m not in a ton of pain (2 norcos every 10-12 hours) I’m assuming its all good and its just muscles. Bending my knees slightly results in an extra deep feeling clunk, and those muscles are just starting to work. Also have some rock hard knots in my upper butt cheek. I tried out walking around in chest deep water today and did some “circles”. The pool may be my new best friend, it felt great to be in the water again, almost like “normal” ha ha. So aside from a couple panic attacks and some un-cooperative muscles, I am inching forward. Bill.
Oct. 27, 2008
its 5 weeks today and it has gotten a little better after 3 days in bed. I can use the cane this morning but feel the muscles start to tighten up and burn after a few minutes. So its better but no where near where I was a week ago. Funny thing is, its not like I moved a certain way and then felt pain, I was having a pretty good day and then by the afternoon it was killing me. It must be a fine line between no problem and oops I did to much. I didn’t get any warning really, it was great all day , and then it wasn’t. Anyway I plan to take it easy for another week and not push myself or try to walk anymore than around the house, I feel like I can’t really “trust” it yet, like yeah it feels great now but if I walk a 1/4 mile who knows what’s going to happen ? The muscles on top of my thigh are like mushy Jell-O with a burning pain down deep, but numb to the touch on the surface. I can poke my thigh with a letter opener and not feel it, but if I push on it with my fingers, it hurts down deep. On the side and butt are rock hard knots. My 6 week follow up is in a week, I hope that is my “round the corner” time. I am looking forward to it so I can get a look at my x-rays, wondering what the alignment looks like and not knowing exactly what is in there makes a long day longer…(ha ha Right ??) I’m pretty sure the skeleton/framework is good, because last week when it was good it wasn’t too bad , but it will be nice to know it “for sure”, instead of being “pretty sure”. I know the muscles will come back sooner or later, just not as quickly as I thought. Hope I don’t sound too mopie, I’m an optimist I swear. “I’m not going to lower the bar but I think I need to put it farther away” Ha Ha no biggie, I’m only 49, I got lots of time. Thanks again for the replies and encouragement. B.I.L.L.
Dec. 3 2008
Got a message from my Dr., he said yes the angle is much steeper than he prefers, “I thought it looked ok after surgery but the last x-rays show the cup angle being very steep” “We can wait an see if there are problems 6 months down the road” If its wrong I’d rather not waste another 6 months wondering. I will get the x-rays, as well as get 3 or 4 other doctors opinions.
Feb. 24, 2009
Bill with the 65 degree cup here. Most of you know me but for those of you who don’t here is the short version. I was having a tough slow recovery after my right bhr 9-22-09. My cup angle is 65 degrees and was listed as a failure by one of the doctors. After lots of 2nd opinions ranging from leave it, to revise asap, to wait and see, maybe it will be ok, (so pretty much opinions that were all over the map) I was a mental basket case wondering what to do. After talking to one of the doctors on this site (Dr. Klug in Roseville) We came to the decision to run with what we got. My progress has really improved in the last 3 or 4 weeks and he was the first doctor to really spend some time going over my case and x-rays, the guy spent 45 minutes on the phone with me just today, Nobody else was willing to do that. And I am happy to report that while my progress was at a snails pace in the beginning, lately it has been improving steadily and am back to work full time and feeling stronger and more confident every week. He said if there are issues down the road he’d be happy to do a cup revision on short notice but has seen patients with worse x-rays do great, and any benefit would not be worth the extra bone loss in the pelvis. So anyway I feel like I have been a drama queen around here (Ha Ha) and it is a relief to just concentrate on pt and getting my life back. No pain meds for a couple weeks now after chowing several a day for the first 3 1/2 months. I don’t know why my recovery was slower than most, maybe I waited too long (8 years of hip pain) and my muscles and range of motion were next to zero, maybe because I am 35 lbs overweight, I don’t know exactly why, but it has turned around for me now and I can not find words to describe how relieved I am.
April 15, 2009
I’d update you as I approach my 7 month mark next week. I’m happy to report that it is starting to work very well and we have been doing things I haven’t been able to do in years. We have been riding bicycles and hiking on the weekends and I have even ridden my dirt bike around in the desert, and last week was able to stand up on a surfboard. My biggest problem right now is that while I am back at work if my employee flakes or quits I cannot get the work done. I have a pool service and repair business. I hire guys to do the weekly cleaning and I run the show and do all the repair work. My problem is about a month ago my main guy screwed off for about 2 weeks and I had to fire him, leaving me scrambling to save the business (lots of un-happy customers with pools that were ignored for 2 or more weeks) And while the hip is good enough to do repair work, I can’t do the route. The bending over, carrying heavy equipment in and out of the yards, twisting and turning while netting and brushing, bending over constantly, not to mention getting in and out of the car 30 times a day, the hips not there yet. I’ve been struggling the last 3 weeks and feel like I’m over doing it, but until I can find a reliable guy I have no choice. It’s been swelling up by the end of the day and I ice it every night but some mornings its puffy and swollen when I wake up so it never really gets to “recover”. Up until I had to fire that fool it was working great, and on the weekends after I give it some rest it feels fine as well. So I am happy, its coming along good.
Aug. 25, 2009
I had my 9 month X-rays with the new Dr. who told me “Everything looks fine” I asked about the cup angle (mine is about 65 degrees) and he said “Not all steep cups fail and any problems related to metal ions wont begin to show for a couple years, wait a year and then come back” I asked him what he was looking for on the x-ray and he said if the components start to show dark spots along the edge where it attaches to the bone then the bond is starting to deteriorate and a revision would be needed. He seemed to think he could do a cup revision only and keep the bhr. He also said Kaiser Permamente doesn’t test for metal ions because there is nothing they can do about it anyway, plus there is not enough data on what is or isn’t too high.
Feb. 29, 2010
Well I got my results back from the blood test, the Dr. gave me the #’s in ppm, and he said the levels were below normal. The cobalt was 0.005ppm and the chromium was 0.01ppm. He assured me that everything is wearing fine and the issues I am having are the results of the surgery itself and not so much the placement of the components, plus the fact that I have probably been overdoing it since about the 6 month mark when I went back to work full time. I don’t really know what the % #’s mean because there seems to be several different scales (parts per million, parts per billion, parts per liter etc.) but am still steadily improving so….there you go ! I am guilty of not doing all the pt I probably should have, and definitely guilty of overdoing it on a daily basis. Being a self employed pool man I never really had the option of “taking it easy for a few days” to let things catch up, it’s more like eat a couple vicodin and get my ass back to work so I can keep the house etc. Performance wise I am still making progress and although my hip feels doesn’t feel “normal” I am still improving slowly but surely, and am back to surfing, dirt bikes, hiking, bike rides, all that good stuff. These last 15 months have been an interesting time in my life and I am so glad I found this site to relate with others going through the same issues (Thanks Pat!)
I know now that I need to rest my hip for a few days every now and then. I know this because last weekend in the desert I completely brain farted, took my mind off the trail for a second and rode off a 6′ tall drop-off where the recent rains washed a section of the trail away. I ejected over the bars and landed on my left side, the result was the wind knocked out of me and bruised (cracked ?) ribs. Not being able to take deep breaths for a few days forced me to take it easy this week, and today my hip feels really good no pain and the puffiness and swelling has improved. Note to self: REST once in awhile! The hip held up fine and I am glad in some respects to have “Crash Tested” it, although I could have gone without the ribcage injury, that still hurts haha. My friends made me feel better by laughing at me and saying “Hey your leg didn’t come off” good friends right there…
So anyway here I am at 15 months out, I am back to my “normal” life for the most part (Wayne-O will argue the normal part) and am happy to be giving a positive report on this whole thing and plan to keep getting myself in better shape and knock on wood keep this thing for 20 years or longer. I’ll post some riding pictures in the motorcyclists thread when I get them. So while I’m not having the quickest recovery in here, I am happy and still improving, an for that I am grateful.
April 20, 2010
I am now at just over 18 months and was steadily improving until about 5 months ago when it started to become uncomfortable to sit. Since then it has gradually gotten to the point where riding in a car causes swelling in my butt cheek and the back of my thigh, and once it is swollen it hurts and starts to knock. If I’m sitting in the car and reach towards the floor it knocks several times co-inciding with pain. My Dr. (kaiser) says the x-rays look ok (well except for the 65 degree cup but ok as far as bone growth) They tested my blood and said the results were “Very low” : the cobalt was 0.005ppm and the chromium was 0.01ppm. I haven’t really found any solid info on what’s too high, and it seems like the other tests are not ppm, they’re pp-something else. (This info came via phone call but there is nothing about it in my patient history.) He said the problem is just from the surgery and has nothing to do with the implant itself. When I wake up in the morning it feels pretty good but by the end of the day it’s puffy knocking and sore. Walking is better than just standing, but sitting is the worst, I find myself leaning over on the un-operated hip and sitting completely crooked. I’ve been taking 1-2 vicodin 4-5 days a week, Some days it’s not so bad but other days I give in so I can work and or sleep at night. I have just started to investigate bursitis and wonder why my doc didn’t mention it because it sorta sounds like it may be it. I have been steadily exercising and can flex all the surrounding muscles nice and tight, but when I relax they just sorta go to Jell-O, like they’re puffy, flabby and bigger than the other side. I see my regular doctor on Friday, he wants to know why I and I quote “Still need narcotics” So what I am wondering is, Does that sound like bursitis or something else ?
April 17, 2012
3 1/2 Year Update
Just wanted to give you all an update on how it’s going at a little past 3-1/2 years. Here’s a quick recap for some of you newer guys and girls. Sept 08 got rt hip resurfaced, was having a slow recovery and at 6 months they (Kaiser) wanted to revise to a thr due to a steep cup angle. Several other doctors said it’s not that steep and to just leave it and keep an eye on the ions. 2-1/2 years out I was having some swelling and after extracting some milky sinovial fluid they wanted to revise again. 2nd and 3rd opinions said that milky fluid is a sign of inflammation that could be caused from over-use, and if it was failing the fluid would be almost black, take it easy for awhile and wait it out, so I did.
The last 6 months or so it has been good ! It still will get a little swollen and sore from time to time but I am a happy camper . Looking back I think there are a few things that held me back. In no particular order,
1. My incision is huge compared to pretty much everyone else I talk to, I think my doc cut through more muscles, tendons, and whatever else they need to get through to get in there than most others.
2. I also think I waited so long for the surgery that my muscles and range of motion were way behind where they should have been before the surgery.
3. My pt after the surgery was very limited. I discovered this by talking to a lot of people who did all kind of things for their pt that I never even heard of, I was given a list of some exercises to do but was pretty much on my own and clueless.
4. The cup is around 65 degrees and shallow, so my hip sticks out a little further on the right side and is slightly longer. (I believe) the muscles had to be re-trained to compensate for the slightly off-kilter geometry. I don’t know this for a fact, but it took me a long time before my foot pointed straight and I still have to think about keeping it straight, the natural tendency for it is to point inward, still fighting that.
5. As soon as I could I was back at work (cleaning pools) and never gave my hip any recovery time, just right back into the same routine that wore out the first one, and I started back on norcos so I could work all day and pay the bills. (Having this surgery while being self employed with no paid time off or disability dictated pushing through days when I should have rested) I am jealous of the people who get paid time off to recover, it would have been awesome to be able to concentrate more on pt, stretching and resting for 6 to 8 weeks without the pressure of having to make money. (I love being self employed and have no regrets about it, but not sweating work for a month or so would have been nice. That was my choice though, like I said no regrets)
6. I am overweight, since the surgery I have lost 12-15 pounds and can honestly say every pound off seems to help, I still need to dump about another 15 pounds. Besides dumping a few pounds, I also hired on another guy to help with the commercial pool cleaning, I still do a few but I don’t have to go full throttle for 8+ hours a day. Carrying the equipment, opening and closing gates with my legs, getting up and down and kneeling on concrete all day, and the constant pivoting was killing me.
I also eat better, take vitamins and try to drink a gallon of water a day minimum, and stretch nightly before bed, and try to get at least 6 or 7 hours of sleep a night (that seems to be hard for me, I don’t know why) Those are the lifestyle changes that seem to be helping. The things that still bother me are sitting for extended periods of time, standing still for any length of time, and lifting heavy things. I can walk almost all day, up and down hills whatever, but standing in a line for 15 minutes bothers it for some reason, I think it’s due to the different leg lengths, I’m constantly shifting my weight from one side to the other. I’ve lifted way more than I should lots of times (100+lbs.) and that seems to bother it so I don’t lift anything heavy if I can help it anymore, I feel like an old man but oh well. Other than those minor things I have been charging !
My wife and I just had our 25th anniversary and spent 3 days hiking in Yosemite and 2 days walking around San Francisco. It was a trip we had been talking about taking since before the surgery and finally pulled it off. We did Hearst Castle, several waterfalls in Yosemite, one of em (Nevada falls) was a 7 mile hike with a 1900′ elevation change, we did it in 4 hours ! Walked around Chinatown in San Francisco, rode on the outside of the trolley cars, and had a great time without being held back by my hip at all, (first time in 10+years)
Since the surgery I took 3rd place in a bodysurfing contest, and have been racing motocross or riding in the desert at least twice a month. We’ve been going on hikes or ride bikes on the non motorcycle weekends. All in all life has been pretty good lately, and I cannot tell you how good it feels to post something positive in here.