Dean's Bilateral Hip Resurfacing with Dr Gross

[djganz]

Hi,
Thanks to all the people who've contributed to Surface Hippy. Here's my experience. I'm a 56 year old man, and I'm scheduled to have bilateral resurfacing with Dr Gross June 22 and June 24, next week. I flew to Columbia 2 days ago, and had my preoperative appointments yesterday. I'm staying at the Courtyard by Marriott, which is right next to Providence Hospital where the surgeries will take place. Everyone has been very nice and I feel well taken care of. Yesterday, I met Nancy, Dr Gross' office nurse, Lee, Dr Gross' nurse practioner, Dr Gross, and Amy, the coordinator for joint replacement at Providence Hospital. I also went to the Longs Pharmacy (walking distance from the hotel, although I drove) and picked up my prescriptions.  I also received my Polar Care ice machine and hip kit, and I brought my own crutches.  Dr Gross was engaging and candid in answering my questions about resurfacing.  He also was in no hurry to go anywhere until all of my questions were answered.  I was a little concerned about my bone density, because it's on the lowish side, but he felt it was adequate and reassured me, saying it was in the normal range. I also told him I wished there was even longer-term outcome data, but he said by the time that is available, there are usually newer, better treatments. I hadn't thought of it that way before. Somehow, that made me feel better, knowing the data was pretty good for a relatively new treatment.


I feel ready for these surgeries. I'm not too apprehensive. My hips first stated bothering me 16 years ago, although it was minor, superficial pain at first that I thought was a soft tissue problem in the lateral hips.  It didn't stop me from doing what I wanted to do (running, biking, swimming). 6 years ago, I learned that I had about 1 mm of joint space left in the lateral hip, bilaterally, and was advised not to run, jump, or take my hips through extreme ranges of bending and lifting. 4 years ago my hips worsened. I had developed lateral knee pain, and the therapy for presumed IT band tendinitis seemed to make my hips worse. I lost the ability to cross one knee over the other and bring my knee to my nose, and walking became more painful. I had steroid injections bilaterally which helped for 3 weeks on one side and 6 weeks on the other. Since then there's been a gradual worsening of range of motion and pain. I've been able to ride a bike around town and use a stationary bike and a Stair Master. But the intensity has gradually decreased to the point were I'm using the very lowest levels, or even no level sometimes (just turning the pedals on a Life Cycle without turning it on). I still walk my dog slowly for about one mile, but I can't keep up with my family when we're walking outside.  I walk slowly with discomfort, sleep poorly (usually 2-3 hours at a time), kind of fall into chairs and pull/push myself out of them, and often hold onto something when I bend over.  It's taken me a while to convince myself that I really need this, because I can look and feel pretty good when I'm sedentary, just sitting around, but now I'm convinced and I feel ready. I'll let you know how things go. Thanks again to all the people who've contributed to this site.


Dean

[lizardly]

Your story sounds like mine: from very active to barely active, but not looking too shabby when I choose my activities. You are further along than I am, though, I haven't decided what to do, so please continue to tell your story.


Best of luck.

[Pat Walter]

Good luck Dean.

You are in good hands with Dr. Gross and company.

Pat

[einreb]

Good luck Dean.

You are in good hands with Dr. Gross and company.

Pat

Yep!


It may sound crazy, but I actually have fond memories of the surgery experience with Dr Gross.  There will be ups and downs, but its good to know that the longer term trend will be towards pain free as you recover.

[JHippy]

Yep, very familiar story. I had my left done with Dr. Gross 6 months ago. It's amazing what we get used to. It'll be tough in the beginning but that soon passes. You're going to be very happy. Dr. Gross and staff are amazing. Keep us posted.

[China Lady]

Dear Dean, you will be a very, very happy man in 6 month time!

[karlos.bell]

  Good luck Dean. I hope all goes well for you. kind regards K

[djganz]

Hi All,    Post op day 1


Dr Gross felt the resurfacing of my left hip went well yesterday. The spinal anesthesia worked great. They gave me some Versed in the preop area which helped me to relax and perhaps to forget as well. The last thing I remember was transferring from the gurney to the operating table. I don't remember them placing the spinal anesthesia.  Then I woke up in the post op area as if I were waking up from a nap. I was alert and had no nausea. There was slight, superficial pain over the upper front corner of my left hip, but it was pretty mild. Soon they took me up to my room, and as the anesthesia continued to wear off, I began to have moderate aching at the front of my left hip and thigh. They gave me a short-acting narcotic by mouth for that and the pain resolved. But it took 30-40 minutes before I started to feel relief. Since then I've been comfortable taking the regularly scheduled Oxycontin, Celebrex, and Tylenol.  I've been on a regular diet since surgery.


I worked with a physical therapist in the afternoon. (My surgery had been at 9 am, for which I arrived at 6 am.) The therapist gave me 4 exercises: 1. ankle pumps (pointing and dorsiflexing the foot), 2. isometric contractions of the whole leg and butt while the leg is straight, 3. short arc leg extensions (with leg resting on a flat surface and partially bent because of a rolled up towel under the knee, one contracts the quadriceps muscles and straightens the leg), and 4. heel slides (starting with the leg straight on a flat surface while one leans backwards or lays flat on one's back, one slides the heel in towards the body while the knee bends, then slides the heel away from the body until reaching the original starting position).  The ankle slides were the hardest for me because it hurt the quadriceps muscles from my hip down to mid thigh to do them.  I ended up using my hands under my thigh to help lift my thigh as I slid my heel towards me. Then the therapist and her helper helped me out of bed, and I walked to the end of the hall and back, using a front wheel walker, while she held my Foley bag and he pushed my iv pole.


I slept reasonably well on my back with my feet elevated, though I'm usually a stomach or side sleeper. They woke me up 4 times, twice to take vitals, once for a blood draw, and once to give medications. My room is set up for a single patient, and I believe the rest of the rooms on this floor are as well.


In the morning my Foley catheter and oxygen (delivered with nasal prongs) were discontinued.  An occupational therapist came and worked with me to shower and get dressed, using a front wheel walker and a raised toilet seat (which was used as a chair for me to sit on while I showered).  After that, I worked with the physical therapist, reviewing the exercises from the day before, and walking with crutches along the hallways. At 11 am, I attended a class with other resurfacing patients where we reviewed the 4 exercises we had learned, and learned how to go up and down stairs safely.  Then I practiced walking with crutches back and forth along the hallways. That's it. Tomorrow I get the right hip resurfaced.  It will be interesting to find out how to sit down and get up from a chair, and how to go up and down stairs with 2 newly resurfaced hips. I'll let you know how it goes.


Take care,


Dean

[JHippy]

Sounds like all is going according to plan. Good luck with round 2 tomorrow!

[lizardly]

So far sounds good. Wishing you the best tomorrow.


I am also curious how you are going to get around with both hips operated on.

[MattJersey]

JHippy's mental game might be useful reading at this stage Dean, as I imagine you'll have some nerves. But every reason to expect it to run like the first.


A few weeks where it is uncomfortable and the odd tweak where you'll think you've done something (but haven't) will pass and you'll be looking forward rather than back, and I would expect to read stories of your delight on here at six weeks, 16 weeks etc etc.


Good luck, hope it goes as smooth as número uno.

[djganz]

Post Op Lhip day 2, Rhip day 0


Hi,


Thanks for all of your supportive and kind replies. I did read JHippy's article/post and found it helpful.


Getting to surgery today was easier because I was already in the hospital. All I had to do was wash the surgical area with their special disinfecting soap last night and this morning and then wait for the preop nurses to come bring me down. I already had an iv. They only needed to draw some blood to spin down to make platelet-rich plasma to apply to the implant sites. 


I remembered a little more this time.  Today I remembered transferring to the operating table and then being helped to sit up so they could place the anesthesia line. I remember thinking to myself, "Don't break the 90 degree rule."  Then I went to sleep. After the operation, I woke up earlier in the recovery room than I had after the left hip, and I felt groggy, but not nauseated. Everyone taking care of me in the hospital has been very nice.


Going back to square one with recovery and precautions after the right hip resurfacing has made me appreciate the progress I had made in just 1 day following the left hip resurfacing. On post op day 1 with the left hip they discontinued the Foley and the oxygen, and they saline locked the iv so that I was much more mobile. I felt a little stronger and more coordinated, so I was able to get out of bed by myself and go to the restroom and practice walking up and down the halls. Occupational therapy helped me learn how to shower and get dressed. Physical therapy promoted me to using crutches, and I could walk to the nursing station to ask for help instead of using the call switch. The physical therapist did work with me this afternoon, after the right hip resurfacing. We practiced the 4 rehab exercises that she had given to me, and then we walked up and down the hall, using a front wheel walker. It was harder getting out of bed with 2 weak legs, so she raised the bed to make it easier. Tomorrow we'll try lowering the bed and try again.


I decided to preempt the pain that I had experienced after the left hip resurfacing by asking for a narcotic medication soon after I woke up from anesthesia in the recovery room. They gave me some iv dilaudid, and I've been fine. No moderate pain like the first time. I've been comfortable while taking my regularly scheduled meds (OxyContin, Celebrex, and Tylenol).  I'm not sure when we'll stop the OxyContin. (Oh, my mistake. I did get Celebrex at some point, but it's not part of my scheduled meds. I'm getting Mobic instead. )


I look forward to tomorrow, and to the possible discontinuation of some of my lines.  Thanks for all your help.


Take care,


Dean

[MattJersey]

Amazing Dean, two major ops and you're already up on your feet. Well done. You guys who have two done deserve respect, it is no small undertaking dealing with one!


It's now just a matter of time, discipline with the exercises, and avoiding overdoing it. I hope that time passes quickly and easily for you. Best wishes.

[djganz]

L Biomet Post-op day 3, R Biomet Post-op day 1


Hi,

Today was notable for low grade fever, urinary retention, and overdoing the rehab exercises.


Last night there was a fair number of staff coming in to see me throughout the night, similar to the night after I had the first (L) hip done, which made sleeping more challenging. But they were all doing their jobs to keep me safe, so that's alright.


I had a fever throughout the day ranging from 100.1 to 100.7. Dr Gross didn't seem too concerned when he rounded in the morning.  I did more of my incentive spirometer today. Not sure what the source of this fever is. There's no drainage from the incision sites. I know there can be a whole host of reasons for post-op fevers.


After the first operation, I had some delay in being able to pee normally again. After the second operation I had more delay. I only voided about 235 ml by myself today after my Foley catheter was discontinued early in the morning. So finally, my nurse in-and-out cathed me and got 400+ ml with a residual of 21 ml. I hope this resolves itself, because I was planning on being discharged to the hotel tomorrow. Maybe the catheterization will help bring my fever down.


Early in the morning, I was doing my rehab exercises in bed. And I think I did them too many times, because I was sore and stiff at the side and front of my hips the rest of the day, though this did improve with rest.


I was able to get up and down for sitting today better than yesterday, but it's still difficult. I think I might need to use a front wheel walker to get home with. It's much easier to get up from a low seated position with a walker than with crutches.



That's about it.  Again, everyone here has been extremely nice.


Take care,


Dean

[djganz]

L Biomet Post Op Day 4, R Biomet Post Op Day 2


Hi,


I was discharged from the hospital today by about 11 am. My right leg strength was good enough today to be able to get out of a low chair using only crutches (thus avoiding mortifying my 13 year old daughter if her dad had had to use a walker going through the airport).  My fever resolved. And my peeing, while not yet normal, is headed in the right direction. I had one last PT session, where I worked on rising from a chair and going up and down stairs, and I was gone.  Dr Gross, his team, and the hospital staff were all very good. It was a good experience.


Tomorrow there'll be stairs to negotiate going in and out of the first aircraft. I'll probably need to go before or after everyone else, but I think I can do it. I called to get a wheelchair assist between planes when we get to Dulles, outside of Washington, DC. That's about it.


Take care,


Dean

[djganz]

Addendum to today's note. I had a moderate amount of nausea today after discharge after I ate a sandwich and lay down on my back to take a nap. The nausea developed during the nap. I haven't had a BM since the first surgery. They've done a good job of managing postop pain, but this afternoon, I considered my GI issues to be my number one concern. I was also a little concerned about my progress returning to normal voiding again. These problems sort of reinforce each other, because I tend to drink less when I know I'm retaining more urine, and that in turn probably makes my constipation worse.   I think tonight I'm going to go without the long acting narcotic. I also need to get a stool softener. I took our rental car back a few days after I arrived here to save on that expense. (With 2 hips done I ended up being here about 10 days.) But returning the rental car has made it more difficult to get to things like the pharmacy or grocery store. I sat up for a couple of hours and that has relieved my nausea. I also voided twice this afternoon/evening which was nice and will give me more confidence to keep drinking fluids.
Dean

[MattJersey]

[size=78%]Dean, sounds like you're going through a tougher patch right now, but you will get through it. I was pretty ill for first two days post op, with nausea, and was worrying a lot. Thinking minute to minute, more negatively, instead of big picture and positively (since i was in personally uncharted territory). Not saying you're there, but I empathise with your situation, and if you do find yourself worrying hopefully you can take some comfort from what others have been through already. It does pass, it takes a little while, but only a little while (trouble is time seems to slow down!) and you will soon be on the right, bright side.[/size]
[/size]
[/size][size=78%]Hang in there, your body will sort itself and stabilise, be that overnight or in a couple of days, or a week.[/size]


[/size][size=78%]I'm eight weeks post discharge today, and it is all a distant memory, I can only think positive things about my position now, and it is continuing to improve. (I would say my hip is, overall, now better than pre-op, even while I continue to develop new ROM, strength etc. Walking normally is pain free now, no limp. I'm not back to golf yet, but I'm swimming more than pre-op, walking as much as pre-op, gardening, and all without reaction, and pain free overnight.)[/size]
[/size]
[/size][size=78%]In a week's time you'll be better, and another week, better again ... Rinse and repeat.[/size]
[/size]
[/size][size=78%]Best wishes.[/size]

[djganz]

L Biomet (56 mm) post op day 9, R Biomet (54 mm) post op day 7


Hi,


Thanks, Matt, for your encouragement. Glad things are going well for you.


Bowel and bladder issues began to resolve the day after discharge and are now fine. The travel day home was long. There were travel delays due to weather and 2 missed connecting flights. My poor wife was walking pretty far and sometimes fast on a slow to heal sprained ankle with a walking boot as we raced across Dulles to try to make a flight. She was also developing what we later found out was an infected corneal abrasion which was also quite painful. It took 16 hours for us to get home, finally arriving at 1:30 am. But we made it.  I called ahead for wheelchair assistance at large airports like Dulles (Washington, DC) and San Francisco, and that was helpful.


My legs started swelling about post op day 3, first the thighs, then below the knees, and then the feet. It was pretty impressive. It's resolving now, but not yet completely. I've been up on my feet probably more than is advisable, but I need to do things like cook and clean the kitchen because I take care of our house. I haven't violated any of the hip precautions, I've just been up more and reclining less than the ideal amount. I use the Polar Care about 3-4 hours a day while reclining in a Lazy Boy chair, and I try to get my feet up even higher, above my head, for about 2 hours a day. But I might spend 5-6 hours now standing in the kitchen or doing something elsewhere in the house. I started out doing less, and this is where I am now.  I do things slowly and carefully, but I do them.  I still use 2 crutches most of the time, but I can use 1 crutch for a short distance if I need to carry something. I can even take a few small steps with no support, but I don't do that very often. I've learned how to reach the floor without using my reacher. It's similar to putting your un operated leg behind you when bending over.  With my feet apart, I reach for progressively lower things to hold onto in front of me while walking my feet backwards, until I'm low enough to reach the floor.  It's often easier than bringing a reacher around with me, and I don't break the 90 degree rule. I'm down to using a half dose (50 mg) of the extended release narcotic (Nucynta ER) along with Mobic and Tylenol. I've experimented with taking none of the extended release narcotic, and I found I'm more comfortable talking some for now.  I can feel things shifting around in my hip sometimes when I move, but nothing is audible, and the feeling is no more than I had been experiencing in my natural hips for the last year and a half. Overall I'm feeling pretty well. Things get a little better and more normal feeling every day. The heel slides, which I had to do initially by putting my hands under my thighs and lifting up, I can now do without that extra assist. I walk around the house and around our cul de sac, but I haven't actually gone out for a "walk" yet. I might try that this afternoon. Thanks to everyone who contributes to this site.


Take care.


Dean

[djganz]

L Biomet (56 mm) post op day 13, R Biomet (54 mm) post op day 11


Hi,


My legs haven't looked swollen for about 3 days.  My feet are still swollen, but not as much as when my legs were swollen. At that time, my feet sometimes didn't look like feet. Right now, after I take a shower and walk around, my left foot is moderately swollen and the right one is mildly swollen. But both are getting better every day.


I'm still using the long acting narcotic. Initially, I was taking 4 tabs a day, 2 at night and 2 in the morning. I tried tapering to 1 at night and 1 in the morning, but that was too fast. I went back to 2 at night and 1 in the morning, and I slept better. I may be able to reduce the dose again soon. Come to think of it, I haven't taken my morning dose today and I'm feeling fine.


I'm doing my 4 exercises twice a day and walking about 1/4-1/3 of a mile, at an easy pace, 3 times a day now. I'm still using 2 crutches for outside walking. Inside I can get away with 1 crutch or leaning on countertops or walls more often now. But I still use 2 crutches most of the time. I can take a few cautious steps with no support, with sort of a waddling gait.  I might do this to reach my crutches after standing up. I'm thinking of trying a cane or maybe 2 canes. I can stand up and put my legs up on the sofa armrest much more easily now. Sitting can be somewhat painful in the areas under or around the incisions. It's not the incisions themselves that hurt, but the tissues underneath. But I shift positions when I'm sitting to help with that.


I'm using the Polar Care unit about 2 hours a day now, once in the morning after doing my exercises and walking, and once in the evening.


One thing I'm a little concerned about is my left foot alignment. It seems to be a bit toed in compared to what I remember. I've started a couple of gentle exercises that I hope will help with this. I've also sent an email to Lee, asking about it. Has anyone else had any issues with foot alignment after resurfacing?  Hopefully, it will all work out.  That's it for now.


Take care,


Dean

[DeviceGuy]

Dean, interesting that you mention the pigeon toe issue.  I have noticed a toe in on both my feet after both hips being done.  The left has been doing it for 6 months and now the right at 9 weeks.  It bothers my wife more than me.  I have to be concious of trying to walk with the foot straight or they flop inwards.  Recovery has been great and it causes me no pain.  My muscle tone is not what it was, obviously, so I figured that was affecting the alignment.  I'd also be interested to hear if others have had this issue and if it resolved once muscle tone and activity levels increased.