Right BHR - Cleveland Clinic March 2011

[phillwad]

Who am I? â€" Very active male who in the last 12 months has done a number of endurance (100k and over 9 hour) mountain bike races, a cyclocross bike series in the fall and full cross country ski season.  Following a regular physical 18 months ago my doctor and I put together a plan that included more stretching and strengthening my core to overcome some hip range of motion issues and soreness.  I also lost some weight â€" 20lb.  At my next physical, Jan 2011, commented that I had not seen much improvement, especially in range of motion and soreness.  So we took an X-Ray and it became obvious â€" bone on bone for both hips, significant flat spot on my right hip (so that is what the “clunking” sound was!!) â€" stretching was not going to change much. Doctor recommended investigating both THR and Hip Resurfacing

My Goals â€" With active kids and wife in the house the goal was to find a solution that gave me the best chance of returning to the active adventures us as a family enjoyed.  Bike about 5,000k a year, relearn how to snow plough and learn how to skate ski for cross country skiing (Iam the slow poke in the family as I continue to “classic” ski).  Recovery timeframe was less important

Research â€" Looking at both possible solutions/procedures.  Fortunate to have a friend who had BHR back in 2001 â€" yes must have been one of the “original” in the US and then he had the other hip replaced 2005.  He has returned to his full sports activities without restrictions.  Spoke to some friends who had THR and listened to what they had to avoid.  Another friend had THR on both sides and is a very active â€" read wickedly fast â€" cyclist.  So I knew with the right opportunity getting back was possible.  Decided that BHR was the way for me.  Looked in to the different Doctors and fortunate that Dr Brooks works at Cleveland Clinic â€" 45 min drive from home

Surgery March 18th 2011 â€" Had my right hip resurfaced and spent 3 days post op in the hospital, even got a room to myself â€" must have been good!  Tough to get the pain meds and sleep in the right balance.  Limited PT in the hospital â€" basic how to do some exercises and how to use crutches (maybe 3 hours total).  I have the fancy inflating socks on for 2 weeks.  Surprised how much it hurt being driven home, especially going around corners.

March 21 â€" March 31 â€" Set up bed in the den to limit the up/down steps. Sleeping continues to be the biggest issue â€" the quality is marginal â€" so I have to take a nap most afternoons.  Cut back on the oxycodone, now at half original dose from when I got home. it was 10 days post op before first bowel movement and it is nanoseconds from deciding to pee and peeing about half the time.  Walking with crutches for 30 min a day outside, will extend that this weekend to 45min.  Range of motion exercises twice a day.  Most are OK but I do not have the strength to do side hip extensions while lying on the bed without help.  I should be sending back the inflatable socks this weekend.

Next Steps â€" 2 weeks post op - increase the types of exercises I can do, then 6 weeks post op have my check up and hope to leave without the need for crutches, finally plan for the left hip sometime this summer.  Dr Brooks insists on a year post op before returning to “normal” activities

Glad to share

[Pat Walter]

Thanks for posting.  Great to hear you are doing so well.  You will have a great summer with that new BHR.  Keep us posted on your progress.  Cleveland Clinic is great - I received a new aortic valve there last Aug.  You will recover from your BHR much quicker than if you had open heart surgery!  LOL   Been there and done both - will take the BHR any time.

Good Luck.

Pat

[hernanu]

Sounds like a typical good experience. I also had problems with the side leg raises, the PT told me that it was normal, your muscles basically had to remember how to move the same way again. Within 30-40 days I was doing 30 side leg raises with 5 lb weights on my ankle, so change comes fast. Just stay faithful to your PT and walking, you'll do well.

I had my first procedure done in the summer, and that was a very good experience, since you can walk whenever you want to, don't have to worry about ice and can put shorts on during walking, avoiding problems with the incision or swollen areas.

Congrats on a good outcome, as a bi-hippy I can tell you that having both done when you need them is such a relief. It is awesome to be able to do everything you want just about.

[phillwad]

Hernanu - Thanks for the encouragement. 

Yesterday I got off the pain meds at 2 weeks post op - that's a good feeling - just on aspirin for blood clots.  Had a good walk yesterday.  Today I walked for 70 min - good long strides and distance covered.  It felt good but the crutches in the arm-pits hurt and I am not even leaning down on them!  I will do the stretching/toning exercises twice today which will include the extra exercises I can include being 2 weeks post op.  This will be a full day.

We also set up my daughters bike on the trainer in the basement yesterday.  It has a step through frame so getting on is easier.  I expect to get sometime on that in next few days as an alternative to range of motion exercises.  I love riding a bike so it will be good to get back on one - Cheers - Phill 4-3-2011

[newdog]

Another feel good story. Good for you!

[phillwad]

Update April 9, 2011 - three weeks post op

Things are going well, yesterday I had a good long 3+mile walk in an hour, clunk clunk clunk with the crutches!  Range of motion exercise is improving and it is looking like the snow plough turn in of my right foot has realy improved....but we have no snow left!  Just a prep for next year.

Sleeping is better but I still struggle to lay on my surgery side.  Not yet sleeping through the night - so a nap in the afternoon helps.  I can sit on a regular toilet seat now.  Have been getting much better up/down stairs - all signs of improvement

Back to work, not full time but 5 to 6 hours a week.  Still restricted on driving until after by follow-up in early May

[phillwad]

Update April 25

Still on crutches - I have my 6 week appointment on May 3rd and hope to get off the crutches then,  Been doing lots of walking and managed a couple of 5mile walks last weekend - all good except when my boot lace came undone and I needed help to tie them back up - there was no benches to sit down on.

I set up my daughter's bike - step through frame - so I have been riding when the weather is bad or it is dark.  Try to do 60 min of walking/riding each day.  The range of motion exercises are still being done for 90 reps - 3 sets of 30 - getting boring and I am ready to branch out a bit and do some different ones after my meeting with the Dr on May 3

I am putting my own socks on, sleeping back in my regular bed and back at work full time - but still with no driving

Spirits are good

Cheers - Phill

[danebuxbaum]

Hang in there. I traveled 900 miles to have surgery with Dr.Brooks back in July of 2010.
I am walking pain free now and the only difference between my new side and my other side is slightly less ROM (very slightly) and a tendency to lower back soreness especially on the surgical side.
Understand that I have had arthritis for 20+ years and at age 57 it ain't gettin any better, so I am not surprised that the rest of my body would continue to deteriorate. Brooks is a good man and really believes in the surgery. My debate at this point is whether I should spring for the bucks to fly back to Brooks for my one year follow-up, or have it checked out locally and send him the x-rays like I did for my 6 week check-up. You will continue to get better, and better. Have patience.

[phillwad]

Danebuxbaum

I was lucky when my regular Dr knew about THP and HR and refered me to a couple of local doctors who specialized in both.  At that time I did not know the experience that Dr Brooks had and he was only 40min away.  Thanks for the encouragement

Cheers - Phill

[phillwad]

6 week â€" update
Well my surgery was March 18th, 2011 and I recently had my 6 week follow-up with the physician’s assistant,   Walked in on my crutches and walked out not needing them â€" Great news.

I looked at the x-ray and asked what “angle” my socket was at “perfect” came the reply.  The PA pointed out how they know etc and it looked good to me â€" we could not agree on the “angle” but it was “perfect”.  I have a 54mm ball â€" close to the largest of 56mm â€" must be a guy thing!! Some different exercises to do to strengthen the external hip muscles and I can get back on my regular bike.  Here is the only down side currently â€" only 15 miles or 1 hour at a time for the next year Ahhhhhhh!!!!!!  The Dr wants the bone to fully recover.  On my first day with out crutches I remember looking down the airport having to go to D10 â€" Wow that was a long way with a back pack and a roll on suitcase!!!

I have now flown a number of times since the check up â€" the pat down is “intimate” as you can imagine when the wand goes “off” â€" think where the hip implant is..  Using the full body scanners works and I do not need a pat-down â€" used them 4 times.  I take aspirin 2 days before and 2 days after flying â€" lots of ankle curls etc while flying.

Cheers - Phill

[newdog]

Good news, phillwadd! My surgeon also said "perfect" so I really didn't care about the angles. Maybe I'll ask him next year when I go back for my one year recheck exactly what the angles are.

[phillwad]

Update - I had my second hip resurfaced in Aug 2011 and so I am now one year past. 

Recovery I think will never stop, stretching to increase range of motion, core exercise to improve the support of the hips and fittnes to take advantage of the both new hips.  I will probably not go back to karate but I am back to riding hard and looking forward to cross cuntry skiing again this winter - I want more snow!!

[hernanu]

I agree, the core exercises are part of what I do now. I've joined a yoga class and am working on stretching at home fairly religiously, just enjoying the increasing ROM... Good that you've got skiing in your sights.

[lycraman]

I agree, the core exercises are part of what I do now. I've joined a yoga class and am working on stretching at home fairly religiously, just enjoying the increasing ROM... Good that you've got skiing in your sights.

Hernanu - how long after your op did you start doing the yoga? I would love to do that but I would be so scared about the hip!  I was investigating starting doing yoga when all my problems started and my ROM began to plummet.

[hernanu]

Just now, at two years.

It was never a goal of mine, though so it just became something I would do in time, I'm sure I could have gone back earlier and if would have been a benefit.

You might want to check Aerial's posts, she is very involved in yoga, and was able to go back in good time (and very happy about it). Remember, though that she was very active in it and her body was probably well attuned to it; it's like doing anything new, if you've not done it before you need to step slowly and especially if you're recovering still.

I did go back to very light stretches as allowed at PT at three months or so, just to get the muscles into the plan. I started doing systematic stretching (very carefully) at about six months or so, deeper stretching at about 9-12 months, and am now doing all of the stretches that I did before.

I still have not regained the ROM I had when I was training the most, but am really not that far away from it.

[lycraman]

Brilliant, thanks.

I know exactly what you mean about taking it easy, especially if you've not done it before.  I was just starting when it all went bad!

Looks like I'll be leaving it for a couple of years. I have to say though that I am seeing improvements in everything day by day.  I nearly got my laces tied today!

[phillwad]

Stretching is something I added to my work out schedule.  Not sure I do "yoga" but I look at websites - find new stretches and will spend 50 min 2 or 3 times a week just stretching.  I think this is both needed for the hip recover and also because I am 'older' now and it is a very important part of reducing the risk of other injuries. 

If there was 2 things I would suggest to everyone - CORE exercises and stretching - both can be hard work and will make me sweat.  This morning I did a series of CORE exercises using a big ball - great for all those little muscles that are needed to keep balance

There are a bunch of great youtube videos taht help select exercises, especially at 7:30 min for our hip recovery

http://www.youtube.com/watch?v=s1Nus8QnY04&feature=relmfu

[fenceman]

Glad to hear you are doing well Phill.  I will have my right hip done by Dr. Brooks this Dec. after he did my left 4 yrs ago.  I also live only 45 min South from the clinic.  What did you think about the Euclid Hospital?  I had my original done at the main campus of Cleveland Clinic.  How many days did you stay at the hospital?  How would you compare your second one to your first? 

Bill

[phillwad]

Euclid - I had a room with a view of the lake - so I watched sail boats.  I was in 3 days.  Recovery for each one was about the same - I had trouble sleeping, plenty of pain but manageable with the right meds.