Four month update

[DirkV]

It's amazing how time drags when you are going through some of the rough spots during recovery, and with the luxury of time passed, how quick it seems.
I just came back from my 4 month followup (4 mo after the second surgery). All surgical concerns got a good report. It was actually a bit of a letdown in that there wasn't more hard data. The xrays confirmed that everything is looking good, but it seems that the xrays are useful in showing if there is a problem, but they do not show, for example, that bone growth into the acetabular cup is 65% complete or anything like that. Don't get me wrong, it was great to get a good report, but I was surprised that the larger percentage is subjective "I'm feeling good; getting better and better; ROM acceptable; etc." The xrays are more to corroborate that recovery is going well (everything in place; no apparent problems, etc.).

It was also interesting to realize the difference in perspective between physical therapist and surgeon. I've been going for therapy for the past couple months or so, once or twice a week. I'm glad that the therapist's goal is complete recovery. When comparing my current status against that goal, there is still a long ways to go. Strength is still missing, and the even bigger challenge is ROM. I wasn't super big into stretching pre-surgery, but it wasn't too long ago, only 3 or so years, that I was playing hockey, so I know what my ROM was before arthritis really hit, and I know that I am still a long, long ways from where I was a few years ago. The Phys Therapist also thinks that ROM needs lots of work. But the surgeon gingerly moved the legs around, checking for specific ROM measures, and was very happy.
It really brought home to me the idea that the surgeon's definition of success is a well placed prosthetic, and it's up to the patient to decide whether recovery is defined as walking, working around the house, low-impact activities, or being able to do things like play hockey or singles tennis or skiing black diamond runs, etc. etc. So I'm glad that I'm working with a Phys Therapist who defines recovery as getting back to a pre-op, non-arthritic state.
Don't misunderstand, the surgeon is supportive of returning to a higher level of physical activity; but it struck me that from a surgical standpoint the operation is already a success, while I still have a long ways to go in terms of muscle recovery and ROM before I reach my goals.
And If I don't take it to that next level, the surgery certainly is already a success. I'm much better than before the operation: I wanted to be able to go on (fairly strenous) hikes with my family and not be left behind, to be able to shoot some hoops with my son and not be sore for the next day after taking a few semi-quick steps for a rebound, to be able to keep riding bike. I feel like I've already got those things now. I didn't allow myself to think that I'd play hockey again (even gave away most of my gear), but the way the recovery is going, now I want to give it a try.
So now it's the gradual plateau stage of recovery. It's funny that a surgery can make you measure your life by toenail clips. I don't think I'm getting much better, but every time I clip my toenails, it's easier than the time before.
I do have a few concerns. As mentioned, ROM, ROM, ROM. I know from reading on message boards that this comes gradually over a year or more, and my surgeon also stated that people report big gains even up to 2 yrs post op. My left side (done last) is a bit more of a challenge in this regard, but it is making progress. I also have a bit of that clunking in the left hip. It's infrequent and getting more infrequent and more and more at the extremes of ROM. I expect that it will go away sometime in the first year, as is the case with many who have this issue.
I’m still setting an event goal of riding 111 bicycle ride Tour de Tucson in late November (no time goal, just finishing). If any hippies are interested, I’d be glad to help coordinate ( I live in Phoenix area).
Keep lookin up,
-Dirk
Bilat ASR, 02/08, 03/08, Dr. Ball.

[Pat Walter]

Hi Dirk

Recovery does take a long time and it is gained in small steps.  4 months post op is still early in a complete recovery.  As you realize it takes over 1 year for the body to completely recover.  It is great that we can be so active early on.

I imagine you have read about others that are now playing hockey again.  I think if that is your goal - you may get back on the ice again.  I hope you can.

Meanwhile, glad to hear you are doing well.  The ice will always be there waiting for you.

Pat

[CITY2SOUTH]

Dirk,
That was an awesome post. It makes me want to go out and start PT. It is not in my doctors protocol to have PT after hospital discharge. I had my 6 week check up 2 weeks ago and like your 4 month, dr was very happy with ROM and xrays showed nothing moved. My next appt. isn't for another 10 months.
 I have routine exercises to do and walk,walk,walk. I've added in swimming,elliptical and even rode my bike around the neighborhood. Riding the other day for the first time really showed me how stiff I was. My flexibility increases daily as well as my stamina.
You sound like your doing awesome and don't sell that hockey equipment just yet. Just give yourself time. I plan on skiing black diamonds by NEXT winter. I'm not rushing it. I'm just glad I had the surgery and didn't put it off for years like sooo many people do. I thank Pat for introducing me to Hip Resurfacing everyday, maybe not in a email or post but in my mind ya know. I was just about to schedule THR when I stumbled on this site. So we need to be greatful for what we do have even if it's not where we want it to be just yet.
As for toenail clippings try taking polish off, cutting, filing and then reapplying new polish every 2 weeks. Now that's a workout..
P.S. I met a great guy in the hospital that had 1 of 2 hips done same day as me, then the other 2 days later...I can't imagine the challenges you guys have. One is hard enough. I'm hoping to never need the other done. Only time will tell, for now it's good.
Take care,
Lisa
Uncemented/Biomet/Gross/6-23-08

[xocy]

Hi Lisa, THAT WOULD BE ME! 

Dirk, I think you are right, we get to a certain point of satisfaction and quit. I'm 7 weeks out and have been a real slacker the past week. My goal is to be better and more active than I was 2 years ago. I will kick my self in the butt tomorrow and get back at it. Thanks for a good post. Very motivational.

Mike
Bilateral
Dr. Gross
L 6/23/08 R 6/25/08

[stevel]

Great to read your comments about the perspective of a physical therapist and a surgeon.  Somebody said to ask a hospital orthopedic surgical nurse and a physical therapist regarding succcessful hip replacement or hip resurfacing.  I heard from our local physical therapist (who everybody raves about) that if I need to have my hip resurfaced - go to an East Coast surgeon.  I heard from my hairdresser who had her hip replaced by a local orthopedic surgeon, who is the best (of 4 local surgeons).  She heard from a hospital orthopedic nurse (who must work with all 4 surgeons), who he best is (e.g. lowest complications).

The dilemma for me as a prospective  hip resurfacing patient who must travel out of town or out of country is to sift through all the hype, opinion, bs and facts to choose what is best for for me.

[ahershberger]

Steve:
In response to your last post:  I don't know where you live but can't imagine you'll have to go too far for good results. 

I live in the Kansas City area and it didn't take me long to find my surgeon: (Dr. Scott Cook, McMinn trained in '06 and done well over 170) In fact, a friend of mine who worked for a dentist that grew up in this area and was extremely up to date and knowledgeable about the medical community and she was one who got me the name of my surgeon. 

By the way, I was first referred to an in network ortho by my family doctor.  He wanted to do a THR (I am only 46)  Then after talking to a doctor friend sought out another opinion (the 2nd) which is the physician I learned more about resurfacing from.  He however had only done 5 by himself so I then kept asking around since I didn't want to be part of his learning curve.  I also found out that our high school varsity basketball coach had it done last summer and I called him and he used the same surgeon as me. I also searched the physicians on the BHR website and my surgeon is listed. 

So keep going and ask those who know about your (surrounding) medical community.  It could pay off.

[dgm]

Thanks for the great post - it is funny to base progress on clipping our toenails (or painting them as the case may be) but it is so true.  I just reached the 6 months post surgery mark last week and am still a little frustrated by range of motion (or lack thereof).  I try to tell myself that I had very little ROM by the time I had surgery and it will just be slow regaining it.  I'm definitely not taking being pain free for granted - I can barely remember how absolutely miserable I was - but want to continue to see progress.

I, too, have reached my goal of being able to play with my kids, hike and not be chewing motrin like tic-tacs and ride my bike but I'm not where I used to be physically. Guess it comes with time.  Dr. Rogerson said I could plan to ski again this winter so that would be a benchmark, but I have to admit I'm a little nervous about it.

Thanks for letting me know i'm not alone!
Denise