My John Antoniou resurfacing story

[Jed]

I first heard of hip resurfacing back in 2002 when my brother-in-law had one done in England. At the time I had no hip problems so his descriptions, whilst fascinating were purely academic. Yes hips were fine then. Knees, that was different â€" had cartilages removed from both 40 years ago, before the days of the arthroscope, and had a ruptured ACL 15 years ago, been bone on bone for some time, so I had always imagined myself an inevitable candidate for knee replacement.  But funnily, knees have never restricted my from hiking, cross country skiing, or trout fishing. Then, about 3 years ago, something started catching in my right hip, everything became increasingly painful, even driving. Moderate arthritis quickly became severe, and the once active, fit, outdoor loving, optimistic 56 year old became a miserable, short tempered cripple. I looked into the possibility of hip resurfacing here in Nova Scotia, and the only surgeon who did it gave up because of a high failure rate, and he tried to dissuade me , citing metal ions, allergies and the large number of revisions.
I was pretty disappointed. I know several people with THR and they all are disappointed that they had to compromise their life styles much more than they were initially led to believe. Meanwhile my brother-in-law was hiking up mountains, downhill skiing, horseback riding as if there was no tomorrow. And I asked myself, what would happen if I was 5 miles up a trout stream, in the middle of nowhere, and a THR dislocates? And what if we go back to Fiji, where my wife is from, and I have to sit on the floor?  No I was not yet ready to make excessive life-style compromises, especially since we have the technology and skills needed to minimise such compromises. Yes resurfacing had to be the way to go. The question was how do you access it?
A local doctor friend mentioned about a fellow in Montreal who does resurfacing and gave me the name of one of his patients who lives nearby. He had a wonderful experience. And so I contacted the office of Dr. John Antoniou at the Jewish General Hospital in Montreal and luckily managed to get an early consultation, back in October 2008. He confirmed the all too obvious state of my hip and assured me that given my age, health etc I was a good candidate for resurfacing. I was really taken by his quiet, confident demeanour as well as by the efficiency of his assistant, Maria, who made all the arrangements which are a little complex given my out-of-province status.
Four months later, after a little jab in my spine, I could smell the cauterised flesh, hear the reaming and hammering, as my new ASR prosthesis was installed to replace my worn out hip. Now the two days before that, I was a nervous wreck. I have never experienced anxiety like it. The irreversible nature of the procedure, the potential side effects and complications that run through your head, replayed over again and again. Yes I knew the odds were heavily on my side but I just could not shut out that “what ifs”. So in the recovery room with my long suffering wife, as the sensation slowly returned, and I found I could move my toes and feet it was all a huge relief. One of the operating team informed that the femoral head was a little misshapen, and that the leg was one cm shorter than the other, but they corrected for this. Was also told that the post op x-rays looked really good. More relief.
For the next few hours the morphine pump kept me pain free, if stupid. An intense thirst crept over me, which I heartily slaked. This coupled with the intravenous, introduced a considerable volume of liquid, but , despite my best efforts, the old body could expel none. I did not know of this inconvenience associated with spinal anaesthetics and morphine, and neither had I experienced the delights of a catheter. I found out that night.
Day one after the surgery I was quite nauseous. The dinner of the night before came up and the nurses administered some anti-nausea drugs. These made me even more light headed. I had a good book to read but could not concentrate with all the drugs in my system. In the afternoon, the physio came around to get me up walking. Very pleasant, indeed cute, but she was barely up to my elbow when I stood. Took a few hesitant steps with the walker and then she asked my to sit in the chair beside my bed. I did this dutifully but the sweat rolled down my brow and I started to feel weak. I told her  I needed to lie down and she inquired as to whether I could get up. I thought I could but I did not trust either myself or her ability to catch me if I fell. So a few burly orderlies were press  ganged into the room. Just as well as no sooner had I stood,  I was out cold, as if from a Mike Tyson left hook to the jaw. I remember the pain in my hip, and voices, panicking, but it all seemed detached, as though happening to someone else. The blackness dissipated and I found myself again in bed, indeed no sooner was I horizontal, and the blood flowed back to the head, and I was fine. Not an unusual occurrence I was told, especially given the morphine and anti-nausea drugs. So that was it, out with the drip and just some tylenol and advil for the pain.
Next day was much better walked 4 times along the corridor, and with the aid of a suppository managed a good crap. Despite my now clear head, I couldn’t help feeling quite overwhelmed. I thought of the entire system that made my new hip possible, the skill of Dr. Antoniou and his surgery team, but also the nurses, the orderlies who washed me, the floor cleaners, the food providers, the administrators who fast tracked the paper work, indeed the whole integrated system  of specialisations all of which had to function flawlessly for a good outcome. A veritable united nations of a system, featuring individuals of every race, from every continent. Indeed as this realisation washed over my I actually cried. Me, a cold, rational economist, overtaken by emotion -  overwhelmed, tired, but incredibly relieved and thankful.
I left hospital on day five, once the physio had determined that I could comfortably manage stairs without passing out!   I remained in a hotel in Montreal for another 5 days, looked after by my lovely wife, until my staples were removed and Dr. Antoniou gave me the all clear to fly home. The wound was good but continued to weep in one spot until day 8, the day before the staples were removed. Dr. Antoniou said the x-ray was great and there were no restrictions on my activity. Wonderful news, especially given my earlier fainting episode which left me with that awful feeling that I might have damaged something .
Tomorrow it will be 3 weeks since my surgery. My exercises are progressing well and I can finally do straight legged leg raises (something I could not do before the surgery given the arthritis pain). I can walk a fair distance now, perhaps a mile, with one cane. Every day my wife takes me down to the university ice rink where I walk around the concrete path above the seating. There is still too much snow to walk outside, indeed we had 2 inches of freezing rain yesterday which kept us inside.  Still get tired in the evenings, and am pretty well wiped out by 7 pm. Some days are better than others but the trend is unmistakably upward.  Take no painkillers, except the solitary aspirin which I take once a day as a blood thinner,  after finally packing in the Lovenox injections. Can’t walk without the cane, and when I do walk, I get some mild pain in the incision site and sometimes around the hip. Hopefully this will go away soon, along with my cane.
Must say I was very thankful to come across this website. Learned a great deal.  It’s great to read of other folks’ experience and to find out that what I have been going through is not unusual but mirrored in the experience of others. That is a great relief. Good luck to all surface hippies.

[Grimbo]

Good to hear from you Jed, that was an interesting read.

I passed out the day after my op when I moved from the bed to the chair and worryingly I also passed out the next morning doing the same thing!

I had never fainted before in my life! It was a weird experience! They told me it was common after an epidural.

I look forward to reading more from you.

Graeme
5/12/08 LBHR Mr Green, Sunderland, UK

[Jed]

Grimbo, yes it is a little disconcerting when you pass out. I did it once before, after I ruptured my ACL, and the doctor who was piloting the sled which crashed to cause the  problem, stuck a needle into the joint capsule to drain away the blood that was producing a scary swelling. Eyes rolled back and I was out. I guess being horizontal, enjoying the trauma of surgery, the loss of blood that goes with it, and the irritation of the vagus nerve, all combine to make one quite vulnerable. The day I passed out in Montreal, a woman also fainted and her heart stopped, so she had to be resuscitated (code blue panic). Thankfully she was fine too.
So you had your new hip in December, how are you now?

[Grimbo]

I had my op on the 5th of December 2008 so I'm at 13 weeks tomorrow.

I had a fairly slow recovery (based on what I read here) and a couple of unrelated problems (knee and foot problems) set my recuperation back a few weeks.

Right now, I feel like I'm starting to come out the other side! I've put on a lot of weight since the surgery so I'm trying to lose that as well as regaining my leg strength. I'm currently doing half an hour vigorous exercise on the machines in the gym every day.

My main goal is getting back to playing inline hockey (which I did 3 times a week)... I'm not allowed to play until June (6 months), but I hope to be able to put my skates on for a gentle skate in a few weeks.

[Jed]

Wednesday March 4 was my 3 week anniversary. celebrated by taking my first, hesitant,steps without a cane. Quite a struggle. Yesterday was a bit better and mangaged about 80 yards. However, I was even more tired than usual in the evening. Exercises are progressing well, and, lying on my unoperated side, can managed a few lateral leg raises now. Would love to walk outside, but another damned snow storm is howling. When is spring finally going to come?