Left Hip Resurfacing - Professor Cobb Charing Cross Hospital 20th Feb 2019

[profcobbfanclub]

Hi, I’m a 50 year old male who has been the lucky recipient of what is for me a life changing left hip resurfacing implant.

Oxford hip score before surgery 19/48, 6 weeks after surgery 48/48. Smith and Nephew Birmingham Hip.

I’m just over 8 weeks post op as I write this and feel absolutely fantastic thanks to the amazing work of Professor Cobb’s team at Charing Cross Hospital, London and also the superb nurses, physiotherapists and everyone involved in ‘fixing me’. I’ve found Pat’s website very inspirational and reassuring in helping me with what at the time seemed to be a daunting decision to go ahead and become a ‘hippy’ myself  .

Now, armed with what I know, I wish I’d pushed to have my resurfacing operation far sooner as my quality of life has improved no end so I felt it time to share my story.

[profcobbfanclub]

Before the op ….

I’ve always been physically fit having spent all of my adult life practicing martial arts, running, ‘living in the gym’ etc. and generally looking after myself health wise. I’m very rarely sick, eat a varied diet and thought of myself as a fairly youthful 40 something. I’ve always had boundless energy and a sunny disposition and then this changed ….

Over the last 3 years I started to develop a progressively more pronounced limp and thus started a period of various investigation and tests, a foray into looking at trapped nerves, back problems, numerous scans (I’m sure this may be a familiar story to some of the people on this site) then my left hip was found to be the cause of my woes.

Bizarrely my right hip was pretty ok – a little bit of osteoarthritis but minimal. I won’t bore you with the details of my declining mobility but by the time I was ready for my op I couldn’t walk any distance without pain, had to shuffle up and down stairs and used a walking stick.

I still remained as positive and cheerful as I could but was on the verge of being in ‘real trouble’ physically. I was also working and as the sole breadwinner in my family was becoming increasingly nervous about being able to continue to support my wife, my 2 teenage sons and 2 lovely but energetic dogs.

By the time of the op the osteoarthritis was very bad and I had pretty much no cartilage, numerous bone-spurs and had developed cysts in the joint space some of which were quite sizeable (this showed up on a CT scan prior to my op).

[profcobbfanclub]

Damage limitation ….

For a considerable period before the op I made numerous lifestyle changes to help reduce the impact of my problems however as time progressed I knew that surgical intervention was inevitable and that small lifestyle changes wouldn’t provide a total solution.

I followed a regimen of cleaner living – tailored my diet to less inflammatory foods, drank less alcohol (none at all in the month leading up to the operation and afterwards) and cut back on caffeine, replacing my usual daily rounds of coffees with decaffeinated (strangely this had a far, far more positive impact than I expected it would).

A couple of other things that really worked for me to help ease my progressive pain were drinking sour cherry juice (it does have a high sugar content though), taking curcumin supplements (turmeric) and fish oil.

I also started using a sit-stand desk for work and a saddle stool and combined with more targeted exercises for brief periods I experienced some respite.

I knew however that I was slowly declining in terms of my mobility and fitness and started to feel down about it.

My muscles were starting to atrophy due to limited use and by the time of my op I had quite an imbalance between my weakened left leg, my overcompensating right leg and my posture was awful.

I tried foam rolling to alleviate muscle pain, paid a regular visit to a sports physiotherapist for deep tissue massage (which gave me short periods where I felt great before sadly going downhill again after a few days) and also visited a chiropractor (this was primarily for fascial release and also helped a lot but again short term). All of these things took the edge of my deteriorating state but were only staving off the inevitable.

[profcobbfanclub]

I also had a leg length discrepancy and was using orthotic inserts in my left shoe to balance me out but yet again this was only a minor tweak amidst the array of other adjustments I’d made to ease my situation – far from a solution.

I knew that I needed to be as fit as possible to assure a good recovery when my operation date finally came so I attended regular body pump classes and static bike cycling right up to the week before the op date. The body pump classes helped massively although I did need to tailor some of the exercises to compensate for my increasing decrepitude. The camaraderie and discipline of a regular (and importantly, low impact) exercise class helped me enormously and my class mates and instructors were very supportive. This combination really worked for me and given that I’ve been exercising for over 30 years went some way for me in helping to maintain a level of fitness, strength and flexibility. For anyone reading this please be careful if you aren’t already active – I’m not saying it’s for everyone.

At my pre-op checks at 2 weeks prior to the surgery it was interesting to recount all the lifestyle changes I’d made and I realised that most if not all of these things I’d continue into the future after the surgery once I’d been given the ok and followed the medical advice appropriate to my case. I still have another original hip to look after along with my newly enhanced one.

[profcobbfanclub]

The day of the op ….

I was one of a number of patients undergoing a hip resurfacing procedure on the day of my surgery and what struck me was our ages. Similar demographic – all male, mid 40s to 50s and all of us had been very active. Our stories seemed startlingly familiar although I was the only person with a walking stick and had there been a prize for decrepitude I think it would have gone to me!

During my pre-op consultation, one of the surgical team members gave me guidance on what to expect during the procedure and afterwards and said to me ‘after this you’ll hate us for a week then love us after that!’ More on that quote later but it struck a chord with me.

The procedure was performed by Professor Cobb’s team under general anaesthetic and from being given the initial anaesthetic pre-op it seemed like mere seconds before I awoke and was told ‘the procedure went very well’. I felt extremely hungry, a little thirsty and dry but other than that I felt surprisingly well. The thing that struck me was the pain had gone from my hip. I hadn’t realised how bad my pre-op pain had been as it had been a progressive build up but I felt great albeit nervous about moving too much until I’d spoken to anyone.

My operation was late in the day so by the time I’d been returned to the ward it was pretty much time to sleep and I didn’t get chance to try out my new hip until the morning. I slept reasonably well given the circumstances although given the level of observation and care this wasn’t uninterrupted. I was however grateful for the attention and felt extremely well looked after by a lovely ward team.

The next morning after breakfast I had x-rays taken and during the doctor’s rounds got to see my new hip in all its glory, was advised that the implant was perfectly in situ and that I was on the road to recovery but that I’d probably be in hospital 2-3 days.

[profcobbfanclub]

The unexpected ….

So, the next stage was something that I was quite nervous about despite what I’d read and been told about what to expect numerous times. I was to get up and use a frame, then 2 crutches and then if I managed this well enough I could progress to a single crutch.

What I didn’t expect was that when I stood up I felt surprisingly stable, so much so in fact that on the advice of the physiotherapy team I skipped the walker, moved straight to 2 crutches and within a very short period, managed to walk on 1 crutch and up and down the small set of stairs used to assess a patient’s readiness to go home!

I did go back to 2 crutches as I wanted to make sure that my gait and posture were maintained and even went for a short stroll around the hospital to say hello to my fellow ‘hippies’ recovering from their own operations.

After more tests and lots of attention from the ward team I was in the process of being discharged as they were so happy with my progress that they said I could go home to recover. I was leaving hospital 20 hours after I’d gone into the operating theatre and felt great.

I must stress that it was my choice to leave so quickly as I felt so good and the team were very strict on following protocol to ensure that I was ready to go and could be safely discharged.

By the time my family came to the hospital to visit me during the afternoon I was out of my surgical gown and back in my own clothes and sitting in a chair with my crutches ready to go home. They were amazed and fully expected to see me in bed looking a bit tired, with my drip still in and hooked up to a monitor. I don’t mind admitting I got a bit emotional at that point.

The ward team and the surgical team were great. I felt really well looked after throughout my short hospital stay and can honestly say that the whole experience was far better than I could have anticipated. I felt informed, looked after and fully prepared for my recovery. The fact that I had Professor Cobb’s team perform my procedure was very reassuring and I knew that I had been in the very best hands.

[profcobbfanclub]

Back home ….

I strictly followed the guidance I’d been given and as anyone else who has been through this knows, had to wear some delightful DVT stockings for a month post op.

I did suffer from some post-surgical swelling which was at its worst in the first 3 weeks and the need to sleep on my back at night with a pillow between my legs took some getting used to.

I drove my family mad with my obsessive and militaristic approach to food (I’d stocked up prior to my op) and certainly for the first couple of weeks was ravenous as the healing process kicked in. I ate very healthily – lots of beans, nuts and fruit – I was told fresh pineapple was perfect for bone growth so ate that daily. I was ravenous and during that period ate 5 full meals a day (2 breakfasts, lunch, early dinner and a supper) and did put on some weight but I figured that healing was paramount.

My sons laughed at their dad ‘twerking’ in the kitchen i.e. doing my regular physio-advised exercises and the dogs learned not to jump all over me – not an easy rule to enforce.

At 2 weeks post op my GP checked my surgical scar and gave me the ok. Then after my next physio appointment I started with gentle static bike again and slowly ramped that up. I also walked as much as I could with my crutches and increased this as the weeks progressed.

By the time I saw my physio again a few weeks later the crutches had gone and I progressed on to much more challenging exercises to improve my strength and to help safely rebuild muscle.

[profcobbfanclub]

Back to normal …

It was a wonderful feeling to walk into the hospital limp free and crutch free for my 6 week post op checks having driven there myself. I had a very positive discussion with a member of the surgical team and a reality check – more sage advice ‘Don’t go mad! You’ll feel golden and you are but no stomping (), jumping or impact activity. Take your time to heal properly.’ and he explained that the healing of the bone around the implant and the recovery of the muscles takes time and shouldn’t be underestimated.

So from the comment I was given on the day of my op, did I ‘hate the surgical team for a week then love them afterwards’ ? No I didn’t. I loved them from the point at which I’d had the operation!!!


I did have to contend with all the anticipated post-op challenges of swelling, minor pain and niggles (mainly due to those oh so necessary but annoying stockings!) and the need to be ever so cautious and get used to other people doing things for me at least in the first few days but I feel very positive about my new hip. A series of small victories over the first few weeks such as being able to put on my own socks easily, get in and out of the bath, trim my own toenails (gross I know but more gross if someone else has to do it for you !), drive, climb stairs normally, walk without crutches etc. has been very uplifting and it’s amazing how these unassuming activities take on greater significance when they have been such a struggle in the preceding months.

Now at 8 weeks post op, I’m enjoying the simple pleasure of walking normally again. I am slowly increasing my exercise levels in line with professional physiotherapy advice and I definitely won’t ’go mad’ as I want my shiny new hip to last as long as possible and I’m so happy to be ‘back to normal’.

Everybody who knows me and saw how I was pre-op is stunned by the change and I’ve lost count of the number of times I’ve heard ‘but how is this possible? You would never know you had had major surgery only a few weeks ago. It’s like you never had a problem. You are perfectly balanced’.

I’m back in the gym albeit taking it cautiously and this morning before I wrote this one of the very supportive class instructors said to me ‘So which hip did you have done again?’. The fact that she couldn’t tell - that put a smile on my face !

[catfriend]

Congratulations! Yes, much you wrote will be familiar. Nobody ever wishes they had waited longer, but done it sooner. That sensation of all that hip pain being just instantly gone is so hard to describe until you experience it for yourself. No DVT stockings for me, though, just one aspirin per day for the first month. Good luck with your continued healing.

[profcobbfanclub]

Thanks catfriend. Yes, I was on the aspirin for the first month as well as being told to continue with the stockings. I guess different hospitals and health authorities here in the UK follow different guidance. I've read that some people were prescribed much more serious anticoagulants in the first weeks after the op. I was also given 'no restrictions' guidance whereas some surgeons suggest no flexion beyond 90 degrees and no crossing legs in the first 6 weeks. Guess opinion varies but so far so good and it's worked for me - I am still ever so cautious though - probably not a bad thing so am taking what the physio tells me seriously and taking my time. Biggest problem I had was atrophied muscles but even that is starting to improve rapidly even such a short time after my op. I'm a very happy hippy 

[jimbone]

Congratulations are certainly in order- sounds like your recovery is doing outstandingly well.  Very few people I've talked with, including myself were putting on socks at 6 weeks without the sock tool and I was a good two month before trimming my toe nails.  My surgeon lifts all restrictions besides common sense at 6 weeks and I was walking a mile unaided by then but still felt quite vulnerable and let that feeling guide most of my recovery decisions.  If it hurt in a bad way, I knew I wasn't healed enough yet to do it.  If a controlled stretch felt challenged I pushed the boundaries within reason and found consistency one of the best allies.  I've heard of Dr. Cobb from the hip replacement forum when I was still considering that procedure and his reputation is highly esteemed.  That feeling of gratitude for the surgical and medical team is something isn't it?  I sometime think it a pharmacological reaction to something they slip into one of our drips, it is that pervasive.  I am grateful it hasn't worn off, I still remember the entire experience as uniquely caring.  You mention your back round in martial arts.  Does it involve taking falls and do you plan to continue at some point?  At 64 and bilateral I suspect it's time to hang it up but quitting all together rankles.  Wishing you continuing success.

[Pat Walter]

Very glad my website was helpful.

Congratulations on the new hip resurfacing.  So happy things are going well.
I appreciate, as well as many others, you posts to share your story.  The personal stories are so helpful to perspective patients.
Thanks again for sharing. I look forward to reading about your progress.  I wish you the best.
Pat

[profcobbfanclub]

Thank you Jim and Pat for your kind support.

Jim, my background was in kickboxing and kung fu so overall tough on the joints and I started in my early 20s. Not as much floor work impacts as if I'd been a judoka but I suspect this hasn't helped with the cartilage loss although I am blaming the running and everything else I've not been able to participate for some time due to life and work commitments so have passed the baton on to the next generation - my sons are both shodan in shotokan karate and they love it.

I don't expect to go back as I'm grateful to feel 'normal' so I'll stick to the more conservative weight training, cycling and walking that I've adapted to and enjoy the simple pleasures of walking my dogs with my family and just being able to lead a normal life. I've read so many stories about people who have done amazingly well post surgery and been able to do iron man triathlons and continue to perform in all sorts of athletics and martial arts disciplines. For them I have great respect but personally I'm happy to slow down - I know 50 is still very young but I am happy to feel so good and adapt.

I don't see this as being defeatist and sometimes I think, hmm, maybe  but then I remind myself how bad the last 3 years have been, contrasting with how I feel now. Also, I'm grateful that the rest of me seems to be ok joint wise and I plan to keep up the maintenance  .

I'm hoping my hip resurfacing lasts as long as some of the other people on this forum and if I do need to have the right side done at some point in the future then I'll proceed without hesitation.

Thanks for reading my story and I'll keep you all posted, Paul

[fastboy64]

Great story well written Paul.

I too am in the Prof Cobb fan club having received the ceramic H1 in September 2017.

I would say my hip has been pretty much perfect and letting me train and race full on from one year post op.

I like the Prof Cobb approach based on planning and precision - I am sure that is behind the quality of outcomes we are enjoying!

The best is yet to come for you!

David

[profcobbfanclub]

Thanks for the reply David. Absolutely spot on - the precision and planning aspect were very reassuring. A lovely chap too and what a great surgical team!

I was originally looking to participate in the H1 trial myself but rapid deterioration of my condition meant I had to drop out and opt for the more traditional metal on metal option at short notice. I had reached a point where I had literally seized up and could barely walk even with a cane.

I've been reading your posts in the run up to my op and it's been very inspirational stuff.

All the best, Paul.