7 Year Update – December 18, 2016
Seven years and three months post op for a Right BHR.
Have had no issues. Blood metals are now decreasing. Could not be happier. I wrote an article post op, seven years ago detailing my then short but successful journey. I am now back mountain biking and have no issue completing 60-70 km per ride.
My surgeon, Dr. Lawrence Kohan (Sydney/Australia) did an amazing job, and all of his forecasting has been accurate.
I highly recommend him and his anaesthetist Dr. Kerr for their pre and post operative care.
My new hip allows me to perform all of my normal activities well and I do not think about it ever.
It is now time to consider either a Partial or Total Left Knee replacement. Of course, I will be visiting Dr. Kohan and his team for this surgery. No questions asked. My best man has just had his second hip resurfaced by Dr. Kohan. His progress is amazing. He is three weeks post op, and is back on the building site. Just no heavy lifting or serious bending!!
A fantastic journey for me so far. Now a new one with the knee.
September 21, 2009
My name is David Mitchell. I now find myself four days away from have my right hip resurfaced with a Birmingham Hip Resurfacing device. Like others, my journey probably started some thirteen years ago when I was involved in a serious turbulance incident aboard a 747 aircraft en route to Tokyo from Cairns Australia. The incident itself was very scary, serious enough to put thirty nine people in hospital including some of the cabin staff. I suffered at the time, heavy bruising from my right armpit to my right knee, spinal compression in the dorsal region and a right hip. This required a month off work for recuperation. Things seemed to progress swimmingly, the occasional stiff knee and sore hip!! Fast forward nine to ten years. I noticed a slight click in my right groin and some stiffening of the gluteals in my right buttocks. Stretching and mobility exercises tended to help which enabled the daily two hour mountain bike rides. However, over time the stiffness became more and more prevalent requiring me to vist a physiotherapist (physical therapist in the US). A couple of weeks of therapy and back to normal.
Some two months later again I notice the stiffening returning. The Physio informs me that I need to keep the joint mobile otherwise I will be up for a hip replacement. A scary prospect for an otherwise fit forty five year old. More therapy, with no abatement of the increasing pain in my lower back, right hip and stiff gluteals. my Physio then suggested a visit to a othopeadic surgeon. My GP had some concerns and ordered some films. The report noted degenerative arthritis and a narrowing of the femeral space. Osteoarthritis!! My GP then referred me to a Orthpeadic surgeon who very quickly confirmed the report, listed some options but very quickly inferred that a BHR was inevitable. Again, at now forty six, I was very nervous and concened that I was being advised to have a form of hip replacement at such a young age.
A colleague of mine at work, who was a Physiotherapist in his past professional life, advised me to obtain a second opinion and referred me to Dr. Lawrence Kohan in Sydney Australia. Funnily enough, a friend of mine informed me that he too had the BHR procedure, further he had Dr. Kohan perform the procedure. He could not talk highly enough of Dr. Kohan. He also informed me that he was back running the sandhills at the six week mark post surgery. I could not believe this!!
A visit to Dr. Kohan was facilitated and I was promptly informed that I indeed have Osteoarthritis. Most likely the cause was a trauma as I was too young to suffer the level of arthritis present. At the time I could not think of such a trauma, no car accidents and no football! My surgery was scheduled for February 20th 2009. However, two weeks prior to the surgery I recalled the turbulance incident and informed Dr. Kohan. He advised that I cancel the surgey and investigate workman’s compensation as I was one of the crew aboard the aircraft.
It is now August 21, and I have been through the loopholes and minefield with this approach and have decided to finally have the procedure and worry about the legal side at a later date. Dr. Kohan has performed in excess of 900 BHR procedures. This is comforting given his track record. He also informs me that I will have no pain at all, as he and his aneathatist have developed a drug protocol that will eliminate all pain. Apparently, Dr. McMinn has also adopted the same protocol. I survive each day on a 50mg Diclofenac tablet and two Panadeine (paracetamol/codeine). Panadeine is an over the counter pain tablet in Australia, however, not available over the counter in the US. The mountain biking stopped about twelve months ago. To make matters worse, both knees are now displaying symptons of arthritis. I may have a long journey ahead, but will take each day as it comes. Reading the stories on this website is truly reassurance that there is a pain free future.
September 30, 2009 I am now 7 days post op. Wow, what a ride!! Dr. Lawrence Kohan and his anesthetist, Dr. Dennis Kerr in Sydney Australia performed my RBHR at 1030 on the morning of 24th September. I was in my own lounge room at midday on Friday 25th September, pain free, and suffering only mild discomfort.
I awoke in my bed at 1430 after the operation with a very clear head. No effects of anesthetic. My leg was numb from my waist to my knee and had a large ice pack strapped to my leg including a rolled compression bandage.
The nurses were administering pain tablets that included paracetamol, Nurofen and Tramadol. At 1730 Dr. Kerr administered a long lastong local anesthetic through a catheter placed through my incision and all the way to the BHR. This eliminated the discomfort and any other pain. This was again administered at 0230 the following morning and at 1000 when I was discharged.
Three and a half hours post surgery the nursing staff had me walking the corridor with a walking frame. I utilised this walker to facilitate the passing of urine three times throughout the night. I did not sleep particularly well but managed to achieve some five hours sleep. No morphine was administered.
Prior to discharge, a physiotherapist instructed me on the use of crutches and under the supervision of Dr. Kerr, had me walking, and climbing stairs using only one crutch. Further, I was given a booklet of excercises that I was required to start performing. They included foot paddling, thigh tightening, gluteal tightening, lying knee raises, hip abduction, knee extensions, standing hip flexion and standing hip extension
Friday afternoon I manged to walk to the end of my street and back (using two crutches). A distance of 500 metres. I slept particularly well on Friday evening.
Saturday afternoon (2 days post op) I managed to walk approximately 800 metres, but started to feel off colour at dinner. This continued through to Monday morning, but I awoke feeling great.
On Monday afternoon I managed to walk 1 kilometre with the aid of both crutches. Tuesday morning I was due to see Dr. Kohan for my first post op visit (6 days post op). My dressings were changed, and he advised that I keep the walking up and see him the following week. He further advised that I can walk with one crutch, a walking stick or nothing. However, I must ensure that I do not fall. On Tuesday afternoon I again managed to walk 1 kilometre but with a walking stick only.
Today is seven days post op and I managed to walk 1.5 kilometres with no assistance. However, I do take a crutch when I am in the shopping centre.
I am blown away at my progress. The only real issue is tight gluteals and quadricep. The pain I have had in my lower right back for the past two years has gone, and each day my left knee has less and less pain. My left neck no longer hurts. I have been religous with my excercises and look forward to increasing the distances I walk.
I have followed many of you through your procedures and recovery. I noted the many different issues that you have all experienced and read many of the blogs from the very qualified surgeon community. This website has certainly made me feel confident to go through with this procedure as my active lifestyle came to a screaming halt around twelve months ago. I know it is very early days for me, but if my short time progess is any indication I am very confident of my long term future.
The team that Dr.Kohan surounds himself with are both astute and caring. This includes his practise staff and the wonderful crew at the St. Lukes Private Hospital. They have all made this journey very easy for my wife and I.
For those of you who are still contemplating having this procedure do not hesitate. Make sure you are informed and confident with the team that will get you back on your legs. Finally, I cannot speak highly enough of Dr. Kohan & Dr. Kerr. If you think that is appropriate for you, come to Sydney and have Dr. Kohan get you walking again.
October 3, 2009 Well all was going swimmingly at the 8 day mark. Walking without any aids for approx. 1 – 1.5 km. However, on day 8 I bent down slightly to adjust my compression stockings and squeezed one of the discs in my very low back. This in turn has made both my groins very painful, limiting my ability to walk. My PT says that it happened as a result of my back and pelvis trying to realign after having the resurfacing.
A little heat teatment on the low back and some gentle psoas stretching has been prescribed for the moment. I would dearly love to take a strong anti-inflammatory but will not do so until I speak with my surgeon. I feel that this has really slowed my progress as I was enjoying being able to walk distances without aids. Now back to using one crutch just to help the groins.
Otherwise, the hip has been fantastic. A little tight in the right glute when walking, but nothing to be concerned about.
I feel like I am not doing anything for my rehab at present, the only good thing is the weather is very inclement!
October 7, 2009 Today is 15 days post op for my RBHR procedure. Yesterday, I visited Dr. Kohan to have the staples removed. All going well and the wound has healed great. My incision is some 25cm long, as Dr. Kohan had some difficulty dislocating the hip. He put this down to my robust physique. I’ll take that as a compliment!!
Am now able to walk unassisted, and am tracking approximately 2km at a time. I get a little sore in both groins, but was told this is as a result of skeletal alignment progress. No issues as yet, but will return to an office role in a weeks time. Dr. Kohan does not want me to return to my flying role until February next year as a precaution for DVT. I have to go to HKG to complete a project at the end of the month, so this will be the only time I fly, and the good doctor has precribed some Clexane injections for this journey.
I am “stoked” at the progress I have made. However, I have been religous in following the excercise guide, and restrictions that Dr. Kohan placed on me. No impingement pain, no hip grinding, no sore neck, back and knee. Just some stiffness in the groin. I will start having some massage to keep the surrounding muscles supple and then commence the weight loss program. Exciting stuff!!
October 13, 2009 it is day 20 post op today. I am loving my new hip and the new lease on life it is already affording me. Am able to walk unassisted 4km, and no pain meds what so ever. The only meds I now take are 300mg of Aspirin each day (for DVT prevention). I can stand on my feet all day tinkering with stuff in the garage and I do not get stiff or sore. Something that I have not had for three years. I am contemplating mowing the lawn this week. I will get the kids to lift the catcher as I am restricted to nothing more than 10kgs.
Am due back into the office on day 25 post op. Back to the stress and politics of the office. Not too worry. Will make sure that I get out in my lunch hour to take a long stroll.
I have had a visit to my Chiropractor, who I found out has referred more than 15 of his patients to Dr. Kohan. My chiro uses a very unobtrusive technique (no heavy crashing of the bones), and already my sore groins have disappeared. He has informed me that my pelvis was slightly askew as it was compensating for my diminished acetabular space. It was amazing how much difference I felt the next morning. I had very little feeling of “one leg too long” and I have not had sore groins since. I have another appointment in two days and I am looking forward to further progress.
The only real issue to talk of is the fact that after sitting for some time on a lower chair, my first two steps have a slight limp. Then it is full steam ahead.
November 2, 2009 I returned to work on day 21 post op. No crutches or cane. No problem negotiating our office or the people in it. All were caring and understanding as I did not sit for more than half an hour, got up, walked around and resumed my work. The first week back was tiring, and I probably would have benefited from only doing half days. However, I persisted.
Unfortunately, people started to take my recovery for granted as I scurried from one task to another with haste. My colleagues are now of the opinion that this type of surgery is easy and uncomplicated. The third day at work was a big scare for me. The lift in our foyer came down and the doors opened, However, the lift faulted and did not ground correctly. The lift floor was still some 10cm above the floor. As I enterd the lift, I tripped on my operated leg and fell into the lift and onto the floor. I jarred my left shoulder and operated side(RHS) groin. Needless to say my bosses were scurrying about concerned now that I am a liability being in the office. I do not believe I did any damage to the prosthesis, but am having a follow up X Ray on the 10th November. Time will tell.
Have been relatively pain free, however, have noticed the sore left knee come back and sore lower right back return. I notice that when I feel more lop sided the pain is more significant. After visiting my chiropracor the pain disappears and less lop sided. Hope this dissapates over time.
The thing I notice most is the walk from the car park to my office. It is up a slight hill. I no longer stop half way to adhust a tight and sore hip. I power up and grin all the way into the foyer. The past weekend was a busy one around the house. I mowed both the front and rear lawns, washed and polished the car, washed the dog and went to a bithday party on Saturday night. Too much. The following day was spent at a race track in the pits on my feet all day between 0830 and 1800. Had to go to work today for a rest!!!
My advice for what it is worth is to hit the brakes and enjoy your recovery. Don’t get over confident and attempt too much (as I did). I believe I could of benefited from a further two weeks off work, but I had to pay the bills. They are amounting!!
I have not used any meds since week two except the aspirin for DVT reasons. Have had the odd Nurofen when I over did things. eg. The past weekend.
Now the big task. After the go ahead from Dr. Kohan, I need to drop 10kgs. Back in the pool and some aerobic activity. Will keep you all posted from time to time. I wish you all the very best in your journey to pain free hips. There is definitely hope out there.
March 21, 2009 March 24th signals the six month milestone for my RBHR. The journey has been both exciting and challenging. I quickly read some of my previous posts and noted some of the issues I was facing. The first one that came to mind was the fact that my first couple of steps after sitting were with a pronounced limp. I am happy to say that I no longer walk with any noticeable limp.
I am now back to full duties at work. I am an inflight manager with an international airline in Australia. Dr. Kohan restricted my flying duties until I reached the five and a half month mark as a precaution for DVT. Last week I completed a fourteen and a half hour duty, only pulling up a little weary on the feet. I cannot say the same for the jet lag!! Am well and truly out of practice with that. (It is now 0300 in the morning).
I still have a sore low back on my operated side, but X-Rays have shown atrophy in my facet joints on that side. I continue with the stretching, swimming and regular visits to my chiro and feel that this is improving. My left knee no longer hurts!!
Dr. Kohan has given me the all clear to return to cycling but not yet mountain biking. His main concern is a fall and trauma to the femur on the operated hip. I cannot tell you how good I feel in comparison to pre surgery. People comment about the spring in my step and my upbeat and fresh demeanour. I did not realise how depressed I had gotten with my arthritic hip. This alone is worth the venture into surgery.
I would like to say a big thank you to Pat and all the site contributors. This resource has certainly given me all the options, much reassurance and the power to make very informed decisions. To those considering this surgical technique/prosthesis, make sure you are well informed. Seek experienced orthopeadic surgeons who surround themselves with clever and caring teams, and rest assured you are not on your own.