Decided to get the resurfacing done, and now the wait begins..

[Johnster]

Greetings all,
I'm 52, and about 8 years ago, I got the bad news that the pain in my left hip was OA.  Since then I've been trying to keep as active as the pain will allow.  I used to be very active in martial arts, racquetball, weightlifting etc.  Now I go to the gym 3 times a week, ride a stationary bike 3 times a week, and generally try to not let the my limp be too obvious.  I've been to see 3 different surgeons in my area (Ontario, GTA) and all 3 said I'm a good candidate for resurfacing.  I've decided to go with Dr. McCalden at London HSC, and have seen him several times for status updates.  About 2 years ago he told me that when I decide to go ahead with the operation, to let them know and they'll schedule it.  I had pretty much decided to go ahead with it as now my other hip is starting to give me some problems, when last week I got a call from his office; they had a cancellation for late January and wanted to know if I wanted to go ahead with the operation then.  After much discussion with my wife, I decided to take it.  Ironically, my hip has lately been causing me relatively little pain, but last years winter was hell.  Walking in snow turned into a nightmare and I am anticipating that this year will undoubtedly be worse.   

I know everyone else here has been through this, and I'm interested in how you handled the wait.  On one hand I'm relieved to have made the decision, but of course since my hip isn't really bothering me right now my impulse is to say that it's premature, but everything I read says that success rates are much higher when this is done sooner rather than later, and I KNOW that the pain will return.  I've researched Dr. McCalden as thoroughly as I can, and all reports show that he is very good at this, (Dr. Schemitsch of St. Mike's was also an option, and he's moving to LHSC in January, so it looks like that hospital will soon be the only place to get a HR done in Ontario) but I cant get the recovery out of my mind, and of course the chance that he may get in there and decide that he has to go with a THR.  How did everyone else handle the wait?  Was the pain really terrible for you leading up to the operation or did your body play tricks on you as well?  How did you handle all the nay-sayers who say that HR is crazy and I should go straight to a THR?

Thanks for reading, it helps immensely to be able to ask questions of those who have been there before!

Cheers

[blinky]

Welcome and good luck.


I had exhausted all my nonsurgical options---PT, shots, chiro---and was going downhill. Walking was slow, stair climbing was avoided, carrying heavy items was limited. I could still swim and spin pretty vigorously, but started making the kids carry their own laundry upstairs. By the time I got to the point where I was thinking surgery, my left femoral head was in dodgy shape. Don't wait too long.


I waited three months for surgery. When I set the date I was pretty darn sure this was what I wanted and this was the doc I wanted, but I still took the time to back up and fill in my research and get more comfortable with my choice.


The other thing I did was train for recovery, tried to get in the best shape possible for the operation and the aftermath. That meant cleaning up my diet and lifting weights. I didn't care about losing weight (and didn't lose any) but focused on lean protein, dairy (for the calcium for my bones), and lots of fresh fruits and veggies. Some of my activities got limited due to the state of my left leg, wanting it to last long enough for resurfacing, so I lifted just upper body weights and swam, emphasizing pulling with paddles.


The time dragged at first, then sped at the end.


About whether you will wake up with a THR. Ask your doctor. How often has he had to convert mid way? Why? How likely is it in your case? I worried about that, too, especially since the left hip was on its last days. Dr Gross assured me he could do it, and I trusted his years of experience, but I still feared I would be that first case in x years in which he had to convert.

[Kingrob]

Your story is very similar to mine. I ride the stationary bike for my cardio as well. I hate the stationary bike, but I can't really do anything else for my cardio. I am not in much pain day to day if I don't do much - tired of living like that. Imagine if you went back to the full schedule of activities your were doing 10 years ago. What kind of pain would you be in then? We learn to adapt and sometimes forget how limited we really are.

What finally made me get this done is the limp I have is now starting to bother my knee. Fortunately I think I am getting this done in time since my knee does not bother me now that I stopped doing just about everything. I am not in any pain sitting or lying down. I cannot walk or stand more then 5 minutes without it starting to hurt. A 30 minute walk is about my limit before I need to sit down. Who knows how fast this is going to deteriorate. I don't want to schedule this when I can't walk. Imagine how bad the wait would be if that was the case.

People where you are from must be a lot more educated on HR than in the US. I have to explain to people what the difference is between a HR and THR. Nobody I have talked to has any knowledge of the bad reports on this procedure - I would have no desire to explain to them the reasons for some of these poor results either. I have researched this and it is what I am doing. I don't care what anybody else thinks. To me you have very little to lose by getting an HR, if it fails you get a THR. The reward of a successful HR far out ways the cost.

I have been waiting 3 months to get this done and I feel like my life is on hold. My surgery date is 11/25/15 and can't wait to get it done. Don't have any real advice on the wait except stay busy and get in as much cardio as you can. There is no stopping time - January will be here whether you like it or not.

Good luck

[gasyz]

I was in a similar situation as you aswell, slowly doing less and less sport etc.I got my BHR a few months ago(sep 5th)and couldn't be happier with it so far.If you look at my other posts you will see that I've also had problems with other people accepting my resurfacing and to me I'm in the same frame of mind as you,the BHR is worth a go.If by some small chance it does fail then I'm back to square one and a THR (which is still a option).I think to most people metal on metal dosn't sound as good as the new fangled ceramic and poly this that and the other technology.Good luck with your upcoming op and the rest of your active life.

[PMac]

Greetings Johnster


Taking the decision to go for it is the biggest step and obviously the right step! What I did to prepare was to get as fit as possible as Blinky has said, spend the time preparing for your recovery as you will be amazed how much easier it makes thinks. I am far more mobile a week after surgery than I had expected to be. Also get all those little jobs done that you won't be able to for a while afterwards.


You've done your research and chosen a surgeon you are happy with so don't fret about that and start convincing yourself there is someone better out there, I did that yet went with my gut feeling and my surgeon was absolutely brilliant. Any surgeon will tell you there is a very small risk you could wake up with a THR but the chances are that small I wouldn't let it bother you. Mine explained he'd only had to do it once in 12 years which equated to less than 1%, but he also reassured me that if it did happen it was the gold standard of THR and was the best money could buy due to my young age.


No real stigma here in the UK but you know your stuff and done your research don't let uneducated people get to you!


Good luck mate

[oldsoccerplayer]

Johnster - I don't think second-guessing your decision during the waiting period is that unusual. First, remind yourself of how much it hurt when you were in pain. Second, silly as it may sound, if there are certain activities or movements that you know trigger the pain, do them every once in a while (gently) to remind yourself why you are doing this.
Also consider the side-effects of not going ahead. Being in pain makes you irritable and can affect your relationships with friends, family and colleagues. One of the very welcome unintended consequences of getting my hip done was the improvement in my attitude to myself and others.

[djganz]

Hi Johnster.  Like many others here, I was essentially in your shoes. My activities and function had declined gradually over years. I had gone from running, biking, and swimming to riding a stationary bike at the lowest level of resistance or no resistance at all. Walking became something to just endure, and it was slow. I did my best to mask my abnormal gait, and I don't think I had much of a limp, but a PT was able to see instantly what was going on and point out my abnormalities. I felt pretty good when I was sendentary and standing didn't feel particularly painful, so I didn't think I really needed this operation. I put it off for years.  I think I was worse off than I thought. Now I'm 5 months post op, and life is much better!  Walking is fun again, and I can walk as far as I like. Standing feels great. My posture is erect.  No more pelvic tilt. I feel buoyant and energetic. I'm more engaged and happy with people, especially while standing.  These things alone have made resurfacing worthwhile, but I look forward to more improvement. 


I would be reassured by your surgeon's past success. Like Old Soccer Player said, take time to remind yourself of why you are doing this. Do what you can to prepare, physically and logistically. If you think there's any chance you may need some help during your recovery, then arrange for that now. I don't understand those who would say to have a THR instead. The data and case histories here seem to indicate that resurfacing is preferable. Maybe surgeons who only do THR's feel threatened. How about letting the naysayers know that after one year (or whatever limits your surgeon uses) there will be no restrictions placed on your activity? Can they match that?  Good luck!!!

[surfhippy]

Hey Johnster,

I'm 54 and am almost 8 months post-op, and I have to agree with everyone about being in good shape before your surgery to make recovery that much easier. I waited 7 years before having the procedure done by Dr. Gross. Like you, I was hesitant, and was experiencing times of relief that made me rethink my decision, but I knew the pain would return, as it did. I'm an avid cyclist, mountain biker, and surfer, and this condition was really cramping my style, and performance. I had outpatient surgery and due to good bone density, I was full weight bearing on my new hip right out of surgery, was on crutches for a week, then a cane for a week. The next few months were fairly easy doing PT, with exercises, stretching, and a lot of walking. It will change your outlook, you will be more engaging, you will be happier, and you will wonder why you waited so long...like everyone else. You will be a new person with a new found energy. Don't think of how long until your surgery date, it will be here sooner than you think. I'm now mountain biking, and surfing with no restrictions (or pain). Good luck and keep us posted!

[Johnster]

Hi Everyone, sorry it's taken me so long to reply (I have two very young children and they keep me pretty busy).  I've been reading each contribution to this thread and I have to say it has been immensely helpful.  There have been several points raised that I have to say resonated very strongly with me, and hearing the perspective of others who have had to deal with the same issues has really helped me be more at peace with my decision.  Thank you all. 

On a side note, I am wondering how many of you had an epidural as opposed to a full anesthetic?  I've elected for the epidural as I am very leery of the effects of anesthetic, so what was your experience?  I'm hoping to be able to bring in an MP3 player just to help drown out the noise and provide a distraction, what did everyone else do?

Thanks again!
John

[petemeads]

Hi Johnster, I had a spinal injection rather than an epidural, you go completely numb below the waist for quite a long time but stay wide awake (but with happy drugs) to hear the sawing and banging. The smell of burning flesh was not as bad as I expected, probably due to the effective airflow management of the operating room. I was asked if I had brought any music to listen to but I did not bother, hoping the surgeons own would be acceptable (jazz or classical) but the drugs definitely made the music and general chatter seem very quiet - taking your own makes a lot of sense!
The benefit of no general was instant appetite once back in my room - I was starving!

I think the epidural option allows sensation to return quicker to the lower limbs, maybe better if they expect you to start walking on your first day - no way I could have done that.

Cheers,  Pete

[Gazza2]

Hi Johnstor,


   I had a spinal injection  (IS that the same as n epidural) and was wide awake during the operation. My report is here


http://surfacehippy.info/hiptalk/index.php?topic=4536.msg43895#msg43895


If you are comfortable with what the surgeon is going to be doing (Drilling, reaming, cortorizing etc. then I think the spinal/wide awake is good as you don't have to battle the post operation grogginess from the anesthetic.


It is good that HR is still being done regularly in Ontario fully covered under OHIP, also good to here that there is a hospital doing regular HR in SW Ontario.


Your operation will come around in Feb, and if you were like me you will continue have second thoughts right up until the operation.  After a couple of weeks you will wish you had not waited so long.

[blinky]

Spinal here, but given something, that Michael Jackson drug, and some Versed, so I don't remember any details of surgery. I woke feeling great, quite refreshed. First leg, spinal lasted a long time and I didn't get to walk the first day. Second leg, the spinal was much lighter, and I could move my legs a little bit in recovery. Leg two was more what the doctor liked.

[jd]

Like blinky, I had a spinal but was absolutely not awake for the surgery (and that's my recommendation unless you really want to be).

Spinal vs epidural: spinal is an injection, epidural is an iv into the spine (stays in).

So, I had sleepy/amnesia drugs (but not general anesthetic) through an IV, then into the OR, move onto operating table, sit up for spinal, don't remember a thing after that. Similarly to a general anesthetic I just woke up in the recovery room, but it was a much easier recovery than when I've had general anesthesia in the past.

[Saf57]

My recent experience was exactly the same as JD,s, and that's what I would recommend, although the surgeons have their own preferences. I know that Dr. Marwin would not permit the patient to be awake, thus the spinal plus sedation. It's way better than general, which I had in the past. I personally would not want to be awake during this type of surgery, but I know there are some on here that were, and found the experience interesting.

[Debcoco]

I guess I'm in the minority as I had general Anesthesia and had no problems whatsoever.

Deb

[Gazza2]

As I said if you are comfortable with what the operation entails staying awake is fine. I had watched several videos of the operation so I knew what was going to be done. I saw it like flying, I knew the principle but had no control over what was going to happen so just tried to relax and in a strange way savour the moment as a once in a lifetime event. I spent most of the time discussing hockey with the anesthetist during the operation.


A couple of memories:
I recall all I could really see was the anesthetists monitor showing all my vitals,  a couple of times during the operation my oxygen level dropped and the anesthetist asked me to to take a few deep breathes and get my oxygen level back-up (Over 90 I think).
When the surgeon fits the acetabular cup and the femur cap they really hammer them in (I mean really hammer it) with the spinal I could hear the impact but felt the very slightly delayed shock wave as it came up my spine where my senses were still alive - very surreal.

[PMac]

Spinal injection with sedation for me, I have no memory of anything after being wheeled down. Admittedly I was a little nauseous in the evening but by the following morning I was absolutely fine. Personally a couple of hours of feeling rough was much preferable to being awake during surgery!

[Snowbound]

Just the spinal for me, I wanted to stay alert to hear what was going on and I found it fascinating. The grinding and hammering was a bit weird (sounded like I was at the mechanics shop) and you can feel lots of tugging and pushing on the pelvis but there was no pain. I asked to see one of the joints before they popped it back in but they didn't go for that.


My surgeon is French (I had the surgery in Ottawa) and it was interesting to hear them talk during the surgery. There were about 7 of them and they went seamlessly back and forth between english (for medical talk) and french (for chatting).

[imgetinold]

Johnster,


I actually ran four pain-free miles the day before my surgery.  Talk about second guessing the decision.  However, the reason I could do that was because I had done nothing active the previous 7 days. 


It really boiled down to whether or not I wanted to be sedentary.  If the answer to that was yes, then I could have put it off.  But, of course, the answer was no.

https://www.youtube.com/watch?v=ZXsQAXx_ao0


- Andy