I start this story of my hip resurfacing from the hospital room the day after my surgery. The road to this point was longer and more difficult than I had initially envisioned, and I felt that others might benefit from some of my experiences, as I have benefited from reading the input from others on this excellent site.
First, a little background: I an a 66 years old – long in the tooth for most resurfacings! But, sports and an active lifestyle have been an important part of my life for as long as I can remember and my goal was to maintain this activity level. Tennis in particular is my passion, and I compete regularly in singles tournaments and league play. When not playing tennis, I ride my road bike, play racquetball and enjoy walking & hiking. Therefore, when I experienced what I thought was a groin pull in March of 2009, I was distressed that I had to layoff these activities, but I figured the injury would heal with rest. Unfortunately, it didn’t. I wrapped my groin and started taking more ibuprofen but the problem just kept getting worse. Finally, I went to my local orthopod and he confirmed the diagnosis: arthritis of the right hip with bone on bone contact. He basically told me to continue going as long as I could, then come back and have a hip replacement.
After the diagnosis, I felt that I would have a year or two until surgery, so I just upped my dosage of anti-inflammatory and pressed on. Unfortunately, even going to prescription strength Mobic proved inadequate, and by November of 2009 I couldn’t compete at all. Something needed to be done.
CHOOSING A PROCEDURE & FINDING A DOCTOR
When I first realized that a hip replacement was inevitable, I rather naively believed that technology had improved to a point where hip replacements were more or less routine and recovery to full mobility would be quick and easy. However, as I researched the various procedures, it soon became apparent to me that this was major surgery and there were many options, procedures, devices and other medical decisions that had to be made, and they couldn’t be made in a rush. So I backed off my initial timeline and started exploring the options, particularly resurfacing vs. THR. A good tennis player and friend had one of the first BHRs here in NC when it was still experimental, and he had great results. So, that was my first area of interest and subsequent research led me to this helpful site. After studying this site and comparing the procedures, it seemed clear to me that if I wanted to return to my active lifestyle, resurfacing was the way to go.
Unfortunately, finding a doctor to do the resurfacing proved difficult. There were no doctors in the Charlotte, NC area who were on the website referral list, so I made an appointment at OrthoCarolina, the largest orthopedic group in Charlotte. The first doctor I saw said he did no resurfacings on anyone over 55, and even then, they represented only a small number of his total hip operations, so I moved on. He did suggest another doctor in the group who might do it, so I made an appointment with him. Unfortunately, the soonest I could get in was in about 2 months. In the meanwhile, I went to another orthopedic group only to discover that they did no resurfacings whatsoever.
Given the difficulty finding a surgeon locally, I called Dr Gross in Columbia, SC which is only about 90 miles south of Charlotte. Dr. Gross said he would do the procedure but that he did not accept Medicare, so that put him out. Eventually I met with the second doctor from OthoCarolina, Dr. John Masonis, who agreed to do either the resurfacing or a THR. He had been involved in a resurfacing trial and estimated he had done over 100 procedures. I would have preferred a doctor who was really “into” resurfacing, but he was a doctor with a good reputation who had been recommended to me by several other athletes who had their hips/knees operated on. Surgery was set for May 17, 2010.
I started getting cold feet as the surgery date drew near. I had stopped those activities that were really bothering my hip in November, so not surprisingly, by May the pain had lessened and I started second guessing my decision to go ahead with this major surgery. But, I tried a couple sets of tennis and a golf round the week before the surgery, and all the pain returned, so my conviction returned as well.
SURGERY AND HOSPITAL
I had the first scheduled surgery time which supposedly is good, but I was not excited to be on the road to the hospital at 4:30 a.m. for the 5:00 a.m. show. But once I got over this obstacle, I was admitted quickly and sent to prep right away. Certainly better than sitting around and waiting. In surgery prep they started the antibiotic IVs and completed the other preliminaries. The anesthesiologist stopped by to brief me on the spinal I would get. He told me that I would be given a mild anesthetic which would enable me to be awake enough to sit up for the spinal, but groggy enough that I wouldn’t remember it. It worked liked a charm. I don’t remember the spinal, the catheter or the operation at all, and I awoke in the recovery room with the operation complete. Shortly thereafter I was wheeled to my room…..total time from prep to room: about 3 ½ hours. The doctor chose an anterior incision, so I had a long scar running up the top of thigh to just above my hip bone. I also had a blood drain attached and it drained for about 3 days.
I stayed in bed the rest of the day. Dilaudid was hooked up to my IV and could be administered on demand by pressing a button. Initially, I tried to limit use to one shot every other hour but the nurses assured me that it could be administered more frequently. The first night was not very restful with the nurses making frequent visits. Also, I was trying to sleep on my back, the pressure cuffs where inflating periodically on my legs (to prevent clots) and I had a bad case of night sweats….all pretty normal stuff. The next day I started PT, learning to walk with crutches. The second night was better as the nurses cut down on visits, I could sleep on my side and I was more generous with the Dilaudid applications. The night sweats were still bad, however.
After some morning PT on the third day, I was released from the hospital and headed home around noon. Since I live alone, my daughter arrived to help out for the rest of the week. You’re pretty helpless your first days back so a helper is absolutely essential.
My recovery was complicated by two factors: first, the doctor’s orders dictated no weight bearing for the first two weeks and 50% weight bearing for the second two weeks. The second factor was that I live alone, and my daughter had to return to work after the first week. While many friends provided food and ran errands, and my sweetheart came over after work every day to make dinner, I was nevertheless on my own during the day. I soon realized how difficult it was to do everyday tasks when you are on crutches and one leg. Like, how do you carry your morning coffee from the pot to the dining room table? Also, my bedroom is on the second floor of the house and I had no downstairs alternatives.
In order to cope with life on my own during the day, I developed a few techniques which I found helpful. My daughter bought a metal basked which affixed to the walker so I had a way to transport articles and food short distances around the lower level of the house. For getting up and down stairs with the crutches, I found a large canvas bag which I could hang around my neck to carry things I needed upstairs while still having my hands free for the crutches/banister. I also took home a urine collection bottle from the hospital, so I didn’t have to go all the way to the bathroom when I had to go in the night. Unfortunately, I then had to use my around-the-neck-bag to transport the urine the next day to the toilet – not a very pleasant experience – but I guess you do what you have to do.
I was somewhat confused by the non-weight bearing orders, given that all I have read on this site indicates that most of the BHR patients are weight bearing immediately. I tried to get a clarification on this from the doctor but the only explanation was that this was “his protocol.” Everybody says “listen to your doctor” so I tried to be compliant. I had regular visits from a PT, but given the restrictions, all we could do is practice going up and down stairs and going for walks with the crutches.
When I first got home, I was taking Percocet for pain. While it was helpful, it gave me constipation that was resistant to all over the counter medication. I tried them all: Citrocell, Ex Lax, stool softeners, Milk of Magnesia. Finally, after a week, the pain from the constipation was worse than the hip pain, so I stopped the Percocet completely, and 12 hours later, all was well.
I replaced the Percocet with Tylenol, but as week 2 wore on, the pain lessened to a point where I would take the pills only once or twice a day. By the end of week two I could tell that healing was well underway. I didn’t need to take any Tylenol, the night sweats were significantly reduced and I was able to walk increasing distances with my crutches. I started weaning myself onto one crutch while indoors but maintained both crutches for outdoor walking to at least attempt to comply with the doctor’s directive. The biggest problem at this point was terminal boredom and cabin fever, although I was able to get out periodically. It gave me new empathy for those who are shut-in permanently!
My doctor used the anterior incision procedure and then used internal stitches and glue to seal the incision. Thus there were no staples to remove and I was able to shower early on in my recovery. Healing of the wound was fine and without pain, as if often not the case with staples.
By week 4 I was walking comfortably with one crutch, was able to get to the pool in the neighborhood for some water exercise, and was practicing getting in and out of my car. Since the surgery was on my right leg, I had to be sure I have enough strength in the leg to lift the foot from the accelerator to the brake. Fortunately, in my car the pedals are close together, and by taking off my sandals, my heel moved smoothly to the brake. I eventually got to a point where I was comfortable driving around the neighborhood and to the local grocery store. Just this small measure of freedom was exhilarating!
By the end of week 4 I was off the Coumadin( and back on beer!) and was walking with only a cane. I was frustrated by an inability to get clarifying information of what I could and could not do under the “50% weight bearing limit” so I took it upon myself to proceed at a pace I felt comfortable with.. On my 4 weeks anniversary I went to the cane on and off and felt comfortable although still limping.
My 4 week checkup with the doctor went fine. The x-rays all showed normal, and I was basically cleared to do anything I wanted to do. So, I am dedicating the rest of this month and next to regaining the muscle strength I have lost, losing my limp and regaining some conditioning. At this stage, I’d say my progress has been good and I am cautiously optimistic. I don’t have pain in the hip but I still have a pronounced limp and major range of motion problems. I had to have a friend help with put on my sock for my first trip to the sport center. My goal is to return to the tennis court by late Aug./early Sept. and to be competitive by Oct. I’ll keep this site posted.
In closing, I just wanted to compliment this site for the information and support it has give me over this entire process. It was most informative and helpful. If I can give back to anyone something more than I have already written, please don’t hesitate to drop me an email at firstname.lastname@example.org.