My Hip Story:  Bilateral Hip resurfacing with Dr. Gross April 2012

 This story is turning into a huge novel.  I broke it down into sections where a person can read through the whole thing if they choose or just choose a heading that interests them.  I cover some of the basics that many other people have covered but also cover things such as food and entertainment sections.

My hips

This story starts around 2003.  I went to my parent’s farm and got out my father’s ATV.  I went to sit down and for some reason my butt seemed to stop approximately one foot from the seat.  It wasn’t that I was stopping due to pain; it was I just couldn’t seem to sit any lower, as if my hips never had allowed me to sit down.  I thought, well, this ATV has always been really small and I was older so maybe I just reached that magic age of getting older and had lost some mobility.  I returned home thinking about the ATV incident.  A week or two later I was using a hip press machine and noticed my knees would bow outward.  I watched another person use the machine and they were able to bring their feet to their chest while keeping their knees together.  I again tried and could not bring down the sled if I kept my knees together.  Then I tried a squat and also hit this “invisible” barrier in which I could not bend down any farther.  I was very active and had been playing very aggressive volleyball this whole time.  Sure I would be sore after a game or tournament, but I didn’t have any pain that would make me think something was wrong with my hips or back.  Fast forward to 2008.  I moved back home from Missouri to the Omaha, Nebraska area so I had a downtime from volleyball for several months.  As soon as I was situated I got back into volleyball but it was as though I had aged 10 years in a few months.  After the first game my hips were so sore I was limping the next day.  What in the heck had happened?  I kept playing but it was starting to take the fun out of it and after aggressive games I could be sore for 2-3 days.  I finally broke down and went to an orthopedic doctor.  He checked my range of motion in my hips and said, “You have almost no internal rotation in either hip”.  He took x-rays and told me both hip joints were shot.  He sent me to physical therapy but stated he wasn’t sure how much that would help my situation.  I started physical therapy and they worked on increasing the internal rotation of my hips, but it just didn’t seem to be working.  I’ve stretched out tight muscles before and with time you should start feeling looser.  The exercises and stretches seemed to aggravate my hips more than help them.  I went to 7 sessions along with doing the home exercises and stretches.  Progress was minimal and I just didn’t feel I was getting anywhere.  I wasn’t sure what to do, but then by dumb luck I broke my thumb trying out for volleyball.  After that healed I tried to return to volleyball and again my hips seemed to have age another 10 years.  I went to another orthopedic doctor in a larger clinic where they treated athletes and had more modern equipment such as digital x-rays.  He checked out my range of motion similar to the first Orthopedist and took x-rays.  He came in and told me I had severe osteoarthritis and femoroacetabular impingement or FAI.  What is FAI?  He explained how the neck of the femur was contacting the acetabular rim and that contact had created bony protrusions on the rim and on the femur neck which was limiting my hip mobility.  He was also dumbfounded as to why the other doctor had referred me to physical therapy as all they were doing was slamming those bony surfaces together, which explained why it seemed to aggravate my hips more than help them.  He told me my options were total hip replacement or total hip replacement.  What?  Surely there must be other options.  I had done some minor research before this visit and had read about hip resurfacing, so I brought it up.  He told me that hip resurfacing was initially the new trend but they were starting to see some data that they didn’t like so he didn’t recommend them.  He told me to try to deal with it as long as I could but there would come a day when the pain got bad enough that I would decide to get the THR.  He wasn’t mean or snooty about it, he just was advising me on what data he had seen and told me that he did not do hip resurfacing nor has he ever done it.  So back to the internet for more research.  I am only 38 and the one thing that seemed to be guaranteed was if I got a THR, I would need another one before I died.  Plus there were several restrictions on what activities you could and couldn’t do.  I didn’t expect to find something where I could go back to playing volleyball, but I wanted to at least be able to ride ATV’s and horse around with my son.  Meanwhile the hip pain kept increasing.  I was able to do fewer activities and noticed that even the simpler exercises such as using an elliptical machine was starting to bother my hips.  For some dumb reason the only exercise I could do besides walking was using the stair climber, but the motion seemed awkward and I noticed I was starting to get minor aches in my knees and ankles, also I was developing more and more pain in my Sacroiliac joints.  These joints are not designed to move very much, but with the restricted hip motion my body was trying to get motion out of any joints it could, so when I would bend over repeatedly such as picking up sticks before I mowed, I would get really sore in my lower back/SI joints afterwards.  I was also seeing compensation in my knee and ankle joints and realized if I let this go on much longer I could damage not only my lower back or Sacroiliac joints, but also the knee and ankle joints.

 Hip resurfacing

I researched hip resurfacing heavily and decided on using Dr. Gross due to his experience and the concept of cement-less implants made sense to me.  I started to email his surgical assistant Lee and ended up asking her a ton of questions.  She usually responded in 1-2 days and was able to answer all of my questions.  I wasn’t crazy about traveling all the way from Omaha, Nebraska to Columbia, South Carolina, but I decided if I was going to have major surgery like this done, I was going to go where I felt I would get the best care.  The logistics of an out of state surgery were very complicated.  I got a ton of information from reading other surface hippy stories and figured I would add my two cents to the mix.  I will try to speak just about what I experienced firsthand and my observations of the places I stayed, services used, etc.  I will also talk about some of the pains and how I reacted to them so a person can be better prepared.  I thought I was well prepared, but when it came down to the days after surgery I quickly learned that I did not learn enough.

 Hotel

I decided to stay at the Courtyard Marriott.  It is about 2 blocks from the front of the hotel entrance to the front of the hospital entrance.  I went round and round about which hotel to use.  I had it narrowed down to this one and the Clarion hotel which is closer to the airport.  I kept weighing the pros and cons of each.  The Clarion was farther away from the hospital, but it has shuttle service to the airport.  I figured I would still have to take a cab from the hospital to the Clarion, but then I wouldn’t have to screw around with getting a cab to get to the airport when I left.  The Clarion also had cheaper rates with my AAA card.  I think the difference was around $76 per night for 2 double beds versus $89/night at the Marriott, but the Marriott includes free breakfast and is right next door to the hospital.  I decided to go with the Marriott and I was happy with the choice.  Another factor was that my father was accompanying me on this trip and the Clarion had only king size beds for their handicapped rooms.  The Marriott does a ton of business related with the hospital and I ran into someone who had just had one of his hips resurfaced by Dr. Gross.  The staff are friendly, my room was clean and the hotel is close to just about any business you would need.  They had a small microwave and larger dorm size fridge in the room.  You get free breakfast buffet coupons.  They don’t have a full-fledged restaurant, but they do make breakfast each morning.  The buffet is a combination buffet and continental breakfast, so they had donuts, you could make your own Belgium waffles, on the hot portion, they usually had oatmeal and grits, scrambled eggs, biscuits and gravy, sausage and bacon, cereal, milk, OJ and coffee.  So overall not too bad of a buffet.  You will find out food is very important to me, so I will go into detail for those of you who enjoy eating as much as I do.  I checked in to the hotel on a Wed and stayed there until Monday morning and then will check back into a handicapped room on Friday and plan on flying out Sunday morning.  I requested a handicapped room with the toilet riser and whatever other handicapped accessories were available.  On weekdays they have free USA Today papers and Wall Street Journals in the lobby.  They also put out a tray of cookies each afternoon/early evening ranging from 3 to 5 PM.

 Flight

I really wasn’t looking forward to flying.  Unfortunately in my case there is no direct flight from Omaha, Nebraska to Columbia.  I even checked to see if there was a direct flight to Omaha from Charlotte, NC, but that also was a no go, so I was stuck with having to make at least one stop.  I chose to switch flights in Atlanta, GA.  I’m not sure if that was a good or bad choice.  I chose it because I didn’t want to chance having flights delayed by bad weather in the northern states such as Wisconsin or Michigan.  I didn’t realize how big the Atlanta Airport was.  On the trip down we flew in a Delta MD88 and then had to switch to a CRJ which is a smaller jet.  The MD88 has 3 rows on one side and 2 on the other.  The CRJ has 2 rows on each side and is noticeably cramped.  I purchased a Travel Pro Crew 8 22” bag for the trip and was glad I had something with wheels and a handle, especially at the Atlanta airport.  It fit in the overhead bins on the MD88.  I also had a laptop bag that I placed under the seat on the MD88 and was able to put it in the overhead bin on the CRJ flight.  For the CRJ they require you to check all “larger” carryon luggage, which included my main carryon.  It is not a full baggage check as you place it in a bin on the jet way just before getting on the plane and then pick up at a similar location at your final destination instead of getting it from the baggage claims area.  I booked my flights with Delta because they were one of only two airlines that connected in Atlanta and Delta was cheaper.  I signed up for wheelchairs on the flight home.  At first when I called Delta to talk to them about the flight they were talking about a “medical fare”.  This seemed good at first, but this is geared more towards people traveling for short notice serious medical conditions, probably more like cancer or organ transplants, where the procedure can change on short notice.  At first I thought I needed to get this to request the bulkhead seats, but this is just more for the ability to change ticket flight times/days without getting socked with change fees and doesn’t really apply to something like hip surgery where it is scheduled out several months in advance and unlikely to change.  I then tried to make the reservation but if I did it over the phone it is more expensive.  As you may tell I don’t fly much.  So I got off the phone and made the reservation for the flight down and back on the internet, chose my seats, and requested the wheelchair.  Then I turned around and called Delta back and requested bulkhead seats on the flights back due to a medical condition.  They transferred me to a nice lady who can then access all of those seats that are marked as unavailable on the seating charts and she was able to change my seats to bulkhead seats for the return flights.  I can still get bumped from those seats if someone comes on board that has a fused hip or someone with a service animal, but otherwise I will be in the bulkhead seats.  On the MD88 this means I will be able to stretch out my legs.  On the CRJ, I am still better off than the regular seats, but will still be severely cramped.

 Rental Car

The rental car situation was another complex issue.  I would need the car from Wed until Monday morning when I was admitted to the hospital.  I was going to rent from Enterprise at the airport but they are more expensive due to airport fees tacked on.  There is an Enterprise not too far from the Hospital but if you rent from the airport then they will charge you extra if you drop off the car at the other location, so I decided to rent from the Enterprise on 10249 Two Notch Road.  They are close enough to the hospital that you can return the car and they will take you to the hospital.  So I ended up taking a cab from the airport straight to the Enterprise location.  It takes about ½ hr. to get there.  I was not too impressed with this place.  I had reserved a standard size car and had on my reservation that I would arrive at 1PM.  I arrived there shortly after 1PM and after filling out all of the paperwork the sales guy took me outside and looked around and said, well, I have either a Jeep Liberty or a Ford F150.  The Ford F150 would cost more, but he would let me rent the Jeep for the same price as the standard since he didn’t have anything else.  The Jeep was returned literally while I was waiting in line.  What in the heck were they going to rent me if the Jeep hadn’t just come in?  They took the Jeep over and vacuumed it real quick and checked whatever it is that they check and away I went.  The next day the change oil light message came on.  No big deal, but annoying to see that message each time I start the vehicle.  Also a low tire symbol came on.  I took it back to Enterprise the next day and one of their employees came out and checked the tires.  One was slightly low so he filled it up, but the low pressure light did not go off.  I suggested it may be the spare that was low, but he didn’t think the spare was tied into the low light system and he did not even bother to check the spare since he would have had to crawl underneath the back of the vehicle.  Then he tried telling me that I would have to drive for a few miles before the light would go off.  I kept thinking to myself, if it was indeed the spare that was low, which was causing the low tire light to be on, how would I know if the other tires were low or picked up a nail.  He did tell me that I could come back tomorrow or stop by any Firestone Tire place as they have a contract with Enterprise, but the way they handled this situation just seemed to be lacking.  My father dropped me off at the Hospital at 9:30 AM on Monday and then took back the Jeep after I was out of surgery.  He then got a ride from one of the Enterprise employees back to the hospital.

 The layout of the area

You can find just about anything within 30 min or less of the Marriott.  It takes about 20 min to get to Dr. Gross’s Irmo office.  The directions he sends you are very good.  If you follow them to the letter it is virtually impossible to screw it up.  Most everything else is on Two Notch Road or just off of it.  I used Rabon Street whenever I wanted to get from the hotel to Two Notch Road.  They have about every kind of restaurant imaginable on Two Notch Road, along with Wal-Mart’s, pharmacies, car rental places, etc.  The farthest we travelled was to downtown Columbia to eat at Ruth Chris Steakhouse which took about 20 min.

 Pharmacies

Dr. Gross suggests using Long’s Pharmacy.  It is just down Farrow Road about 1 to 2 blocks from the Marriott.  I wasn’t sure whether to use them or Walgreen’s because I normally use Walgreen’s back home and they can easily transfer prescriptions through their system, so I went to Walgreens which is at the corner of Rabon and Two Notch Road.  The problem is some of the medications that Dr. Gross prescribed are newer and Walgreen’s did not carry adequate supplies of the pain killers.  Also, I was given two discount cards at my Dr. Gross visit.  One for the narcotic/pain killer and one for Celebrex.  The Celebrex discount card needs to be activated by calling an 800 number, so make sure you do this ahead of time to save yourself the hassle.  The discount card for the pain killer comes pre-activated so I was able to go to Long’s and get it filled there.  Most of the prescriptions are about a 1 month supply or less so there isn’t a need for refills, so in hindsight it would have been easier to just get them all filled at Long’s Pharmacy.  My Dexa scan was a little low on one of my hips so I was prescribed Fosamax which I just had Dr. Gross’s office call in to my local Walgreens back home since that isn’t crucial to take right away out of the hospital as the pain killers, and blood thinners are.

 Restaurants, Food and Movies

My favorite topic.  There is a shopping complex at the northern portion of Two Notch Road, about 15 min away.  They have a variety of shopping stores and a theatre.  The theatre is ok, a mixture of stadium and regular style seating.  It had smaller screens than I was used to, but the sound and picture was good.  Matinees run $7.50.  There is a Wendy’s across the street from the hotel and a Sonic on the same side of the street.  Both are within walking distance.  The Cracker Barrel is across the street and down several blocks.  Two Notch Road has many of the chain restaurants such as The Olive Garden, Texas Roadhouse, Outback Steakhouse, etc.  We went to Shianos one night.  They have pizza, pasta and calzones.  I’m not a huge fan of New York style pizza, but it wasn’t too bad.  We also went to Carraba’s which was pretty good.  I did find a very good ice cream place which made my day.  I wish I had found it sooner in the trip and feel cheated.  It is called Brusters.  Bruster’s, Carraba’s and Shianos are all down Sparkleberry Road which is off of Two Notch Road.  Bruster’s makes fresh ice cream and they have a variety of different flavors.  Some they keep on hand all the time and others they may just make once a week or once a month.  Like I said, I am kind of miffed that I didn’t find out about it until Saturday.  My favorite flavor was the key lime pie ice cream.  We also ate at Ruth Chris one night.  It is one of those fancy expensive places where everything is a la carte.  The food was good, but for one of those fancy places I thought the service would be much better.  Also, if you look at the Google map and drive down to downtown Columbia, Ruth Chris is on Senate Street, but the Google map did not show that some huge building breaks up Senate street, so it took us a while to figure out we had to go around this building to the other side to get to where Ruth Chris was, so FYI.  They have metered parking around the restaurant which goes until 6PM on weeknights.  Neither one of us had change so we had to go into a bar to get some.  I usually carry change in my normal vehicles back home and often have change in my pants pockets, but since I was putting everything on the credit card to make it easier to track for taxes, neither I, nor my dad had any change on us, go figure.  There were other places that we just didn’t get to.  One was the Puddlin Duck.  We found out about it on Sunday and they are closed Sunday and Monday, but I heard they have good food for a Pub and had good reviews on Google.

 Dr. Gross’s Office visit

The whole visit took about 3 hours.  I don’t know if things were just backed up or how we ended up spending that much time in there.  First I went back and waited a little bit to have x-rays taken.  Then I met with Nancy and she covered some medications that would be prescribed and had me fill out a pain questionnaire on the computer for each of my hips.  She also got me the packet of post 6 wk. exercises since I would not be coming back to the area for the follow up.  Then Lee came in and asked a few questions and did a motion check of my hips and was able to answer most of the questions I had written down for Dr. Gross.  Then someone came in with the Polar Care unit and showed me the operation and then brought in crutches and sized them for me and did a brief lesson on how I would be using them once I had the hip surgery.  Finally Dr. Gross came in.  It was pretty much like everyone else describes.  He is very patient and takes plenty of time to explain everything and anything you can come up with, a very rare trait for a surgeon.  I didn’t have too many questions, but my father was with me and was asking all sorts of questions and he took time to answer them all.

 The first surgery day

My surgery was scheduled for noon and I was supposed to be at the hospital to check in at 9:30.  I walked in with my crutches and polar machine and was greeted by the information desk people who knew who I was before I even told them.  They took the crutches and ice machine and then I went to admissions which was nothing more than having them copy my insurance card and driver’s license and filling out a few forms.  Then I was taken back to a prep area and changed into my gown.  They inserted my IV line and started the standard preliminary things such as taking vitals.  They drew blood to spin it down for the platelets which Dr. Gross applies during surgery to help stimulate bone/tissue growth.  About 4 or 5 people come in giving different speeches as to what they do, including the anesthesiologist.  They must have started me on the twilight meds right before rolling me back to surgery because I remember them rolling the bed out of the pre-stage area, but don’t recall anything past that point.  The next time I was somewhat cognoscente was around 3:30PM.  They had inserted a catheter after the surgery was done, so at least I wasn’t awake for that.  Thank goodness.  After staying in recovery for about an hour I was rolled up to my room.  All the rooms at Providence Northeast hospital are private rooms, which is good.  They have a recliner chair and a partial slide out couch so my dad stayed with me in the hospital the whole week to cut down on expenses.  They also put the polar ice machine pad on your hip right after surgery.  The spinal anesthesia provided a weird sensation.  I still could not feel either of my legs from the waist down and could not even move my feet or toes no matter how hard I tried.  It made me think of paraplegics and quadraplegics and how they can see their limbs also but cannot move them.  Slowly the anesthesia starts to wear off and I was then able to start moving my right foot slightly.  Since I was still numbed up I had no pain in my left hip that was operated on.  After the anesthesia wore off on the left side I still didn’t have pain, but more of an extreme stiffness.  The nurses are good about keeping you on the prescribed medication protocol.  All of the prescriptions that I had filled at Long’s and Walgreens pharmacies are taken after you leave the hospital.  While in the hospital you are basically given the same stuff but it is dispersed by the hospital.  I still found it weird that the most pain I had after surgery was from that dang catheter versus the actual hip.  Every time I tried to move or shift around the catheter that was attached to the leg would yank on you know what, which provided a little bite.  I was anxious to get the catheter out but was told that would not occur until Tuesday morning.  That night was a little uncomfortable mostly from the swollen hip area, not being able to move around too much, and from the catheter.  They brought in food around 5 PM.  I don’t know if I was just starved from not having anything to eat or drink since midnight or what it was but the food seemed pretty good.  I had lasagna, green beans, a dinner roll, grapes, tapioca pudding and ice tea.

 The 2nd day

Periodically throughout the night the nurse and nurse tech would come in to take vitals, administer pain pills, etc., but then there was a nice gap from about 2 AM until 4:30 AM where I was left alone until the lab lady came in.  I wanted to strangle her because she was the only one that turns on all of the overhead lights.  The nurse comes in around 7AM and I was anxious to get the catheter out.  I figured it was driving me nuts anyway, but if I were to do Physical Therapy any leg movement would be constantly tweaking that area.  At first she was going to remove it but then realized I was scheduled for surgery on Wed for my right hip, so she ended up talking me into leaving it in.  Dr. Gross showed up around 8 to 9 AM and I asked about the catheter and he said to have it taken out.  When they deflate the balloon you get a brief sharper pain with burning and then a quick intense burning pain when they pull out the hose, but believe me after a few minutes you will be glad that dang thing is out.  It burned to urinate the first two times after it was taken out, but after that things were back to normal.  Did I mention how much I hate catheters?  Next an Occupational Therapist showed up and instructed me on usage of the hip kit items and helped set me up to take a shower.  They have the hip kits at the hospital but I ended up calling the Medical supply place and paid for it ahead of time.  You have to mention this to the Occupational Therapist so you don’t get charged twice for the kit.  We ended up putting the portable commode in the shower so I could sit down.  I had packed underwear and work out short pants to wear while in the hospital but did not pack any t-shirts as I figured I could just wear the gowns.  If you are doing both hips, I would pack a shirt for every day except maybe Wed.  The day of the surgery you will be in the gown and they are better because you are hooked up to all sorts of equipment, but after they start taking all of that stuff off the next day, it would be easier to wear a t-shirt versus a gown.  At around 10 AM they took me down via a wheelchair to get an x-ray of the area.  Keep an eye on the person that takes you down.  I don’t know if she is a nurse or simply transports people around the hospital but she almost flexed my thigh greater than 90 degrees trying to put my foot on the foot plate, which we all know is a big no, no.  My legs were long enough that I just had to rest them on the calf pads and let my feet dangle.  At around 11:15 a Physical Therapist came in and had me walk with my crutches a little bit and then took me into their office where there were 4 other Dr. Gross patients.  They covered the exercises and then had us walk up and down a small set of stairs under their supervision.  After that they cut you loose to walk down the hall with the crutches if you so choose.  Throughout the day I seemed to get hit with tired spells and casually snoozed throughout the day.  I would also use the ice machine around every hour or if I felt the hip area becoming sore.  One thing to watch with the polar care ice pad is if it has been unplugged for a while the water can drain back into the machine and if you put it on fairly snug when it fills back up again it can actually be too tight and will have to be re-adjusted.  Out of all the motions or activities that I have done today the hardest seems to be getting into and out of the bed.  I just don’t seem to have full power or control over my thigh in that situation and it makes me somewhat curious as how it will be tomorrow after I have my right hip done.

 The 3rd day

My right hip was set for resurfacing around 9 AM on Wed morning.  I tried to find out when they would be taking me down to pre-op, but couldn’t get a solid answer other than they usually get a person 1 to 1 ½ hrs. beforehand.  I wanted to shower up before the surgery and decided to get up around 7 AM, but at 5 AM the “circus” comes in.  First the nurse tech will empty trash cans, take my blood pressure and temperature.  Then the lab lady comes in and of course turns on all of the lights in the room.  Next the nurse comes in.  So after all of that it was around 6 AM, so I decided to get up and shower.  I handled the night fairly well and was given pain pills around 10 PM.  I wasn’t sure if I wanted to take the pain killers or not, but they don’t want you to use the ice machine at night when sleeping. I was mainly just sore, more so versus pain, but I decided to take the pain killers and was glad I did because the soreness kept increasing after the ice machine was turned off and before the pain killers kicked in.  This also allowed me to get a better night’s sleep.  Showering wasn’t too difficult but I took the time to get everything set up such as moving the portable stool/commode into the shower, a couple of bath towels ready, the soap wash and my grabber thing.  I ended up showering standing up because my left hip felt well.  I had a gown ready and just gowned up instead of dressing because I would have had to take everything off in pre-op anyways.  Pre-op nurses ended up getting me around 7 AM so I was glad I got up early to take my shower.  They rolled me down to pre-op and I went through basically the same process that I did for my left hip on Monday.  I woke up in post-op around 11AM and stayed there for about an hour before being wheeled up to my room.  Once again I had a catheter in, but I was still numb from the waist down so it didn’t bother me too bad.  I started to slowly regain sensation in my left foot and leg first.  The strange thing was I had soreness at the front aspect of the right thigh.  My left quadriceps didn’t get sore until the next day.  I was more eager to take pain pills today with the level of soreness that I have in my right thigh.  At around 5:30PM a Physical Therapist showed up.  Dr. Gross had written I could take the catheter out after 6 hours post-op, so I decided to have the nurse remove it before I would do anything with the Physical Therapist.  Getting out of bed really sucked!  The Therapist was helping to swing my right foot /leg out while I was using the leg lifter to help move my left thigh/leg.  When I finally got to the edge of the bed and stood up I felt a shift or pop first in my right hip socket and then my left.  That freaked me out for a second or two, but I just stood there with the walker and did not feel any sharp pain, but still had the extreme soreness in my right anterior thigh.  Walking with the walker wasn’t too bad.  The physical therapist puts one of those belts around you to catch you in case you collapse.    I was able to walk down the hallway and back.  The physical therapist and nurse put a sliding sheet on the bed so it was easier to get back into bed.  They also put a pee bottle at the bed so I could urinate in that instead of getting up to go to the bathroom.  As sore as I was after getting out of bed the first time today and the hip popping I plan on using the pee bottle throughout the night to give both hips a chance to rest.

 The fourth day

Last night was a little rough.  The right hip and anterior thigh was sore most of the night, plus they put the compression sleeves on both thighs and legs again.  The rhythmic pumping motion doesn’t bother me too bad, but they make your legs sweat.  By morning the soreness in the right hip/thigh had subsided.  I was anxious to get up and shower because of sweating all night from the compression sleeves.  I was able to change how I got out of bed this morning and did not have the popping in either hip along with less soreness/pain.  I think that I rushed myself getting out of bed because the Physical Therapist was there.  This time I was by myself and took it a lot slower and analyzed how I was putting forces on my legs and hip area.  I did fairly well when I stood or walked but the hardest is still sitting down and standing up from either the bed or a chair.  Once again the 5 AM “circus” came in, so by 6AM I was wide awake.  I was taken down for x-rays of the right hip and then had another class with Physical Therapy.  It was the same information as Tuesday, but I was interested in seeing how I would handle their stair station, now that I had both hips done.  It gave me a little more pause, but I was still able to use the stairs fine.  They finally took off all the monitors and pulled my IV today which makes overall down time more enjoyable.  I am still using the polar ice machine.  I decided to just get one pad for the ice machine instead of an additional pad and a splitter.  This seems to have worked ok since I was able to just use it on the left side for the first two days.  I then concentrated it on the right side after that surgery, with a few uses on the left side.  I just found it hard to purchase another pad and a splitter for over $100 especially when this machine would probably just be used for 2 to 4 wks.  This was the day I started worrying about a bowel movement as I hadn’t had one since the first surgery.  I was told by one of the nurses that it takes on average 2-3 days after the surgery before a person would have a bowel movement.  I wasn’t sure how that ended up working out when 2 days later I had my right hip done.  Does that mean I was due for a bowel movement or does it tack on the days and extend it out to 4-6 days?  They had been giving me stool softeners each day but I had no desire to have a bowel movement.  If I attempted a bowel movement I just passed a lot of gas, but didn’t feel constipated per se, but it was on my mind since I was eating good at breakfast, lunch, and dinner each day.  Today I finally felt a tiny push and decided to take advantage of it and was able to get a bowel movement.  It was no easy feat.  Both butt cheeks are sore and slightly swollen so it feels as though the swollen butt cheeks are pushing closed my anus, so I ended up standing up and doing a slight push and then kept leaning back as though I was going to sit down, but never did.  I ended up “passing the football” as described by another patient while hovering over the toilet.  I was so elated to have finally had a bowel movement that it made it bittersweet when I noticed the bottom part of my dressing on the left thigh had rolled up slightly.  I ended up having the nurse replace the bandage because one of the functions of the dressing is to keep water out of the wound and with the edge rolled up, I could have gotten water up in the wound area.  I think the constant sliding into and out of bed got it rolled up.  It probably didn’t help that I always entered and exited from the same side of the bed.

Thoughts at this point

At this point I thought what could have I done better or what would I stress to a person having this surgery?  First, if at all possible lose weight if need be.  I dropped about 20 to 25 pounds before the surgery by exercising more and dieting.  I figured I would be using upper body strength to compensate for the decreased function in the lower body so I didn’t want to be hindered by any extra weight.  I would strongly suggest working on Tricep muscle strength because you will be constantly supporting up to most of your body weight especially when sitting down and standing up.  I ended up noticing bruises near both elbows due to supporting my weight on those areas.  The handles on the portable commode are made out of hard plastic and I think it was the cause of the bruises.  I would suggest wearing slick material short pants and avoid cotton.  They have a bed pad on the hospital bed and it is better to have slicker material to try and slide over that thing versus bunching it up.  Even with my slick workout shorts I still find myself constantly rearranging and sliding that pad around to smooth it out.  Don’t be afraid to use what is in the hip kit.  For some reason I shied away from using everything in the kit in the beginning but by the end I was constantly using the reacher and leg lifter.  I can lift up my left leg fairly well, but it still bites me in my anterior right thigh when I try to lift it up into bed, so using the leg lifter usually takes care of that.  I tried to stay up on swelling as much as possible along with getting out and walking a little bit.  I found I could make it half way down the hall and then would feel an increase in soreness in my hips.  I would simply stop for a few minutes and let the soreness subside and I was good to go for another length of walk.  I would then follow up the walk with the ice machine and would always elevate the foot portion of the bed to at least heart level.  Also be mindful of how much flexion you have in the bed.  At one point I had the head portion elevated along with the foot portion and stayed in this position for over an hour and when I went to get out of bed it felt as though the muscles had shrunk or tightened up making it difficult to stand up fully erect for about 30 seconds.  The one thing I quickly stopped using out of the hip kit was the sponge on the stick.  The plastic stick is so weak that it just didn’t seem to do a good job of anything.  The Occupational Therapist had advised me to use the sponge and wrap a towel around it to dry the lower legs/feet.  The problem is you have to get all the soap rinsed out of the sponge and if you have ever done that you know how long and many times it must be rinsed, squeezed and re-rinsed.  What ends up working much better, for me at least was using the grabber thing.  The bar is stiff metal and I could grip a wash cloth with it to wash my legs and feet and then rinsed and dried it off and used it to grab a towel to dry my legs and feet.  Just be careful not to poke yourself with the grabber. 

 The Fifth Day

It doesn’t take long for patterns to develop in a hospital.  One pattern was that the nurse tech would come in around 2 AM and check the ice and water in the polar pack, take my blood pressure and temperature and basically make a huge noise and racquet.  Then at 5 AM the full “circus” would come in starting with the lab lady, followed by the tech, followed by the nurse.  When all was said and done they took up about 45 min to 1 hour and left you wide awake at 6 AM.  I was mentioning this to the night nurse and she said I could bypass the 2AM check if I wanted to and if I needed the ice machine filled or anything else I could just buzz her.  That worked out great because I was able to sleep almost right up to the “circus” and then they must have coordinated because they all came in at the same time.  It was really loud, bright and annoying, but it only lasted 10-15 min and then they were all gone and I was able to get back to sleep.  I finally ended up getting up around 7:20 that morning.  I knew they brought breakfast around 8 AM and I wanted to shower before that.  Once again I ran into the catch 22 where if you stay in bed longer and get more sleep then you will also be that much stiffer when trying to get out of bed.  I pushed it a little harder I think because of wanting to get the shower done before the food arrived.  I hobbled into the bathroom, did my normal urination into the pee jar and then I started to get a wave of sickness.  It was the beginning of a vaso-vagal reflex, which if you have ever had one they suck bad.  It is like a combination of the feeling you get just before passing out combined with waves of nausea, combined with perfuse sweating.  I have had about 4 in my lifetime and knew I needed to sit down quickly so I plopped down on the raised commode and waited for the waves of sickness, nausea, light headedness and sweating that I knew were on the way.  I was able to control my breathing which seemed to decrease the waves of sickness.  Normally there isn’t anything I can do other than ride it out and wait for it to get over.  Unfortunately just about when the episode was over I felt a bowel movement coming on and due to pushing for the bowel movement it re-triggered the vaso-vagal attack again.  I’m not sure how long this cycle went on, but I was definitely catching up on any bowel movements I had missed over the last 4 days.  I would guess it may have taken 30 min or more because soon I heard a knock at the bathroom door from my father wondering if I was still alive in there.  I made sure all the vaso-vagal attacks were over and then showered, but still didn’t feel quite right.  Most mornings I have a good appetite, but just the thought of the food tray coming was making me queasy. I also felt dehydrated and wondered how much water I had been drinking.  I figured after having the largest bowel movement in my life that I should be feeling great, but I wasn’t.  I didn’t even try to get into bed but rather sat down in the recliner and told my father to eat what he wanted to from the breakfast tray as I was not hungry at all.  The nurse came in with the standard ton of pills to take but I had her get me a saltine cracker and took that with some water and waited for 10 min or so just to see how my stomach would handle it.  It seemed to go ok, so I took the pills and then napped in the chair off and on for several hours.  Usually I am chomping at the bit to get up and do some walking, but not that day.  Dr. Gross stopped by, which he did nearly every day or maybe it was every other day to see how I was doing.  The nurse also brought discharge paperwork as they usually discharge you around 11AM.  It was weird, because for the last 4 days I had been trying to get a rough idea when they would discharge me on Friday and could not get even a remote time period, but then when it came around it was, “oh, we usually discharge around 11AM”.  They did say I could stay longer and even eat lunch if I wanted to, but I was feeling better and wanted to get over to the Marriott again to see what type of handicapped features the room had.  Also, even after my morning sickness fiasco, I was suddenly craving a Wendy’s hamburger.  Another concept or question that we couldn’t seem to get answered until the point of was how exactly I was getting from the front door of the hospital to the front entrance of the Marriott.  They have these “transporters” in the hospital whose sole job seems to be moving patients from one area to another.  Each time a transporter would roll me down in a wheelchair to radiology for an x-ray versus a nurse or nurse tech, and when you are discharged a transporter rolls you down to the outside door of the hospital.  She then asked if we were going to get our car.  What car?  We had returned it to the rental place when I was admitted to the hospital.  She then contacted security and they come over with a minivan and then it takes you the 2-3 blocks over to the Marriott.  It makes sense to do it that way, but for some reason we just could not get anyone to tell us that is what would happen when we left the hospital.  Maybe we weren’t asking the right questions.

 Handicapped Marriott room

This room is similar to the one we stayed in before the surgery with two double beds.  They had the toilet risers already in the bathroom.  The tub should be interesting.  It will be a higher step into it, but it does have a ton of bars to hold onto.  We tried to get the king bed handicapped room as it has a walk in shower, but another handicapped person beat us to it.  I thought a King bedroom wouldn’t work but my father said he didn’t have a problem sleeping on a roll-a-way so we tried to get the room. The Marriott staff is real good about getting us extra towels and pillows if needed.  I definitely made sure I took the pee bottle from the hospital as for a guy it is so much easier to just use that and dump it into the toilet rather than messing around with sitting down on the commode and getting the shorts and underwear down.  I had just thought about standing up and urinating, but with the raised commode over the regular toilet I decided that I wasn’t that eager to test my accuracy.  I was a little worried about getting into the hotel beds, but it turns out they are as high if not higher than the hospital beds were so that has not presented any problems so far.  When it got to the point of actually trying to get into the shower I was surprised how complicated it turned out to be.  At first I thought I would just be able to pull my leg and lift it up and over the tub edge, but this put me too close to the 90 degree rule and my hip was eager to let me know this would not work.  Then I thought I would keep my whole thigh/leg straight and use the leg lifter from the hip kit and lift it up and swing it over the tub edge.  This was a complete failure also.  What ended up working for me was facing the back of the tub and bending over slightly grabbing the back wall with my right hand.  Then I was able to bend my left leg and slightly lift my knee at the same time which allowed my foot to just clear the top of the tub.  I was standing on the bath mat towel with my right leg straight and ended up spinning the towel very slightly which also shifted my leg over the tub.  It was probably a riskier mover since if the towel suddenly slipped out from under my right foot I would have been in big trouble, but it was the only technique I could find that worked.  I thought that the shower would make me feel better, but instead it was awkward, as I had gotten used to the hospital shower and now everything was changed up again.  After the shower I had to think about how I got into the tub/shower and then reverse it to get out.

 The sixth day

Friday night was rough.  It seemed like I was up every 2-3 hours to go to the bathroom.  I hated getting up but at the same time looked at the alternative which would have been a ridiculous amount of stiffness if I had slept the whole night through or just stayed in bed and used the pee bottle.  I seemed to be waking up now in the mornings with a general feeling of crap.  I don’t know how else to describe it.  I took my shower using my new found way of getting in the tub and went down stairs to the lobby for some breakfast.  The smell from the buffet practically made me nauseas.  I quickly looked for something that would be fairly easy on my stomach and decided it doesn’t get much blander than plain Cheerios and milk. I only ended up eating half of the little box as they were not going down well.  The thing that seemed to calm my stomach the most was the milk.  After just drinking the rest of the carton and sitting there a while I started to feel better.  I had my father bring me another little carton of milk and a cake donut.  This also went down easier than the Cheerios did.   My flight was leaving super early the next morning so I grabbed another carton of milk and this time some frosted Mini-Wheats to take back to the room since we would be leaving well before the buffet opened on Sunday.  I went back to the room and worked on my exercises and then hooked up the polar pack and took a nap.  I usually awake from the nap/icing feeling the best I do all day and this was no exception.  I was hungry enough that I ordered a calzone from Schiano’s and later that night had Sonic without any problems.  Our flight was scheduled to leave Columbia at 6:30AM.  With the drive time, getting up, showering, airport security, and unknowns, we calculated we would have to get up at 3:30AM.  I don’t even know why I attempted to go to bed, because I couldn’t sleep thinking about the flight the next morning.

 Going Home

I ended up calling the Deluxe cab company the prior day and told them I needed one of their mini-vans and I would need it at 4:30 AM at the hotel.  There was a 10% coupon I had printed off from their website and used that for the trip.  The driver was actually early, which worked out fine because I had gotten up early due to not sleeping, possibly from the thunder and lightning that was outside.  This particular mini-van had leather or vinyl seats which worked well.  I was wearing slick workout/warm up pants and they slid like ice on the vinyl seats making it fairly easy to get into the front seat.  Make sure you have the driver lay the seat back down and also lift up the left arm rest.  When I got my ride from the Hospital security van I was sliding myself in and everything was going fine until I hit the left arm rest.  Also everyone wants to help the cripple get in the van, but you have to tell them to back off and that you will instruct them at a certain point.  People naturally reach for your arm to help stabilize you, but this screwed me all up.  The only help I actually needed was after sliding my body in at an angle I needed just a little help lifting up my feet/legs so I could swing them into the van.  The ride was very uncomfortable to the airport.  I took an extended release and a regular pain pill right before leaving the hotel.  I figured I would want them to have kicked in by the time I was on the plane, but started to wish I had taken them earlier so the cab ride wasn’t so bad.  The cab dropped us off at the airport.  There were Delta representatives outside and I was greeted with, “another Dr. Gross patient?”  I guess they must see their fair share.  The Delta guy was helpful and got me checked in and one of our bags checked.  He then helped us through security.  What a pain in the ass.  They ask if you can stand but the Delta guy told them no way because I had both hips done so this bypasses me past the x-ray body scanner and brings me over to a pat down area.  In hind sight I probably could have stood in the scanner which would have cut down my security time by 5-10 min.  The poor TSA guy wanted to know what I could and couldn’t do such as lifting up my legs/thighs, etc.  He didn’t seem to know how to approach me and I wondered if he was new.  He ended up swabbing my hands and down the back of my shirt, along with a supervisor coming over to check his work.  Like I said, if you can stand up safely and comfortably in the body scanner, do it.  The Delta guy helped take off my shoes, and laid out my laptop and everything for the x-ray scanners.  You could tell he has done this a thousand times.  I almost forgot, I did have a brief moment of panic when I first checked in downstairs with the Delta crew because the lady asked if I was able to use the stairs to the plane because it wasn’t at a jet way.  I looked at her like she was smoking crack.  I told her no way considering the stairs have a high step up and it was raining outside.  I talked to her about the jet way and asked about some lift thing they had mentioned when I made the medical/bulkhead seat reservations.  That seemed to make them panic a little.  I couldn’t figure out why until one of the agents asked, “Hey is our lift still broke?”  Well, suddenly a jet way opened up, so all of the passengers on that flight could thank me for the ease of using a jet way versus the plane’s stairs out in the rain.  About the only good thing of being all gimped up is that you get to board the plane first.  I had checked my carryon bag because we decided to carry on my laptop bag, the polar care unit, and then my father’s two carryon bags.  I put all of my medicines into the lap top bag and the short acting pain pills into my coat pocket.  I wanted to make sure that when I arrived at Omaha that I would have the essentials from the trip.  My father had re-packed the polar unit back into its original box.  This did not fit in the overhead bin on the CRJ plane from Columbia.  The flight attendant took it and stowed it back in the plane somewhere along with my crutches.  I worked my way into the seat on the CRJ plane and instantly thought this was going to be a long flight.  The flight itself was only 30 to 45 min, but when you add the time from when you board to when you actually get off the plane it could be closer to an hour.  I may have boarded first but I got off last so they could get everybody off quickly and the flight attendant could retrieve my crutches and polar unit from wherever it was that she stowed them.  The Atlanta airport transporters had a wheel chair thing ready for me when I got off the plane.  It was a young Indian woman that would be helping me.  She had swung out one of the hand rails so I could enter from the side, but with a double hip resurfacing you must use both hand rails and it was another case of people trying to help the cripple, but making things worse, plus with her accent I could barely understand her but finally I got across the point that I would need to step in front of the wheel chair and use the hand rails to lower myself in.  She got me over to my connecting flight.  I was looking forward to sitting in the larger seats of the MD88 aircraft versus the cramped CRJ from Columbia to Atlanta. I got seated and there was a world of difference in the seats, leg room etc., but there was something wrong.  My hips, legs and back were killing me.  I just couldn’t shift or get comfortable.  I started thinking how long it had been since my last pain pill.  The short acting ones could be taken every 4 hrs.  Had it been long enough?  The hell with it, I was taking another pill.  I wished I had asked Dr. Gross or Lee about how often I could take the pain pills on the flight home.  I would ask them if I took a short acting pain pill and an hour later my hips were killing me could I take another.  Or find out what the maximum you can take in a period of time without getting into an overdose situation.  After taking the pill I was about 90% more comfortable within 10 min.  I should have taken it before boarding the CRJ flight.  Needless to say when my hips started to ache again 2 hours later into the flight I didn’t hesitate to pop another pill, which made the flight much more enjoyable.  I had requested a wheelchair at Columbia and Atlanta, the two places it allowed me to when making my flight reservations.  You would think if a person needed a wheelchair, they would have one for you at your final airport destination, but alas I had to wait for one at Omaha.  I was feeling stiff again, but did not have the aching pain in the hips.  I could tell my legs did not like the long periods of sitting and they were both noticeably swollen.  I was so drained by the time I got home that all I could think about was taking a nap.

 The end/final thoughts

I could go on talking about adapting to home life and so on and so forth, but I see this thing has morphed into a 15 page giant.  Hopefully I covered some of the things other people didn’t and showed how my thought processes helped and hurt me along this whole journey.  When I re-read this I thought how I could have been so stupid on some things, but when you are in the middle of it, every common sense thing seems to fly out the window.  I am nowhere near fully recovered yet but I already feel I have made the right choice and have no problems whatsoever recommending Dr. Gross, his staff and the entire process he uses.  My last thought:  I wish there was a Bruster’s ice cream place in Omaha, Nebraska.