March 21, 2019

Well, I took the plunge for the outpatient resurfacing by Dr. Gross earlier today.
All was a great success and happy with how everything went. Currently resting up on post op Day 1 at the hotel with pain controlled.

Just visited by the visiting nurse as well…just when I thought i couldn’t be any more impressed.

Five stars all the way around for Dr. Gross and team.

Here’s the story:

41 yo male with left hip OA mild to moderate symptoms and Fapreventing favorite activities such as weighlifting, running, and martial arts.
Symptoms of stiffness and during the job when I had to stand for periods of time.

So I first sought local opinions from various Orthopaedic surgeons, who initially offered either steroid injections, stem cell injections, or total hip replacement. Tried steroid injections and PT first, with limited and temporary improvement. Then fortunately the Ortho who did my injections mentioned the option of hip resurfacing since I’m relatively young.

So I began looking into it and first went to the HSS website to find Dr. Bryan Kelly, who I saw had expertise with FAI.
But I later discovered after the office called me back, that arthroscopic solutions were typically no longer viable once OA has set in.
They offered to send my information to Dr. Su, who does resurfacing, and I agreed.

His PA called me a while later and said I was a great candidate.

However, various life circumstances prevented me from scheduling the surgery at that time.
Later, when I revisited the option, my insurance has changed and I was back to the drawing board.
I again looked around and this time found this website and various other surgeons such as Dr. Gross, who seemed to have both long experience and many great reviews from patients.

I saw he also took my insurance.

So I sent him my info.

3 weeks later I got a call from him and told me I was an excellent candidate. He spent
Surprisingly, I immediately received a surgical date, extensive preop instructions, and a hotel reservation for me made by Dr Gross staff. I was impressed with the level of service already.

So I began preparations for setting this up, arranging plenty of time off work in advance , I took 4 weeks.
During the time leading up to the surgery, I did extensive research on resurfacing, with particular emphasis on various information found in this website. On advice of some on the site, I got into the best shape possible with the OA for the surgery.
I put emphasis on weight bearing exercises like squats, even though they were painful, since bone density is so important for the surgery. I also emphasized Hip adductors and abductors and Psoas on my gym routine.

The initial consultation went well and Gross answered all questions and was quite personable and down to earth. A well organized office routine. Also met Lee Webb, who also inspired confidence with her knowledge and demeanor.

When the date finally came, I reported to the surgery center at 6:30 AM.
About 10 minutes later, I went back to get changed, bring my polar care unit and crutches for post op.
They started me off with a cocktail of OxyContin, Tylenol, and an antacid. Then they had me change into a gown and they placed the IV and drew blood.

Lee Webb cane and asked if there were any more questions, then the anesthesiologist explained her side of the procedure, including a spinal anesthetic and propofol. They gave me another cocktail of IV sedatives in prep, then I woke up and all was finished.
Once I was awake enough, I ambulated on crutches with the therapist and then attempted to void. I did get nauseated at that point, so they took me back to bed.

They scanned my bladder and it was full. But I did get to void successfully a bit later after the nurse reminded of the the potential need for a straight catheterization.

So the trip to the hotel was uneventful and kept on top of the pain meds.
Had nausea again that first night after standing, but subsided eventually.
Did the bed exercises here and there and keeping up the schedule for post op meds.
Doing pretty well overall at the end of post op day 1, but will probably need to bump up the pain meds, as it increases toward post op days 2-3.

Wish me luck for a continued smooth recovery and rehabWell, I took the plunge for the outpatient resurfacing by Dr. Gross earlier today.

All was a great success and happy with how everything went. Currently resting up on post op Day 1 at the hotel with pain controlled.
Just visited by the visiting nurse as well…just when I thought i couldn’t be any more impressed.

Five stars all the way around for Dr. Gross and team.

March 23, 2019

Yesterday on Post op day 2, I noticed being more awake and able to ambulate several hundred feet on crutches. The 9 hour drive home from SC to Florida went surprisingly well too. Keeping the routine with the pain meds was very important, which helped keep a positive mood and do ankle pumps and quad/glute sets with minimal to no pain on the drive. I also was using portable ice packs and placing them near the incisional area for the ride, 1 hour at a time. (The kind you activate by popping them, so no ice and water messes in the car) I think not having an interruption in the ice therapy helped progress too.
I had elected to stay at the hotel for 1 additional day just to get over the hump on pain control, lingering anesthesia side effects, and movement. Glad I did. I also wanted to get a few doses of the Eliquis on board before a long car ride, as DVT or PE would foil the whole plan.
Got home last night by about 7pm and had a nice juicy roast beef sub, which I think my body thanked me for. I’m sure I needed the protein, calories, and iron for healing.
Today, my ROM continues to improve and I’m ambulating independently on crutches around the house. Not for exercise yet, just for necessities. Pain is virtually zero and I think I’m going to titrate off the narcotics completely by tomorrow. Still taking it easy with the polar care on as much as possible and there is really only minimal swelling.
Next item on the agenda is getting the bowels to move, which should be facilitated by the colace, movantik, fluids, prune juice, and increased walking.
Will keep posting on progress, and things are definitely moving in the right direction.

March   24, 2019

Post op day 4 and pain controlled with Tylenol and Mobic alone. No narcotics today.
Had a scary slip with the operated leg last night when crutch walking to bathroom, due to the crutch being inadvertently placed onto a hand towel that fell on my tile floor. Didn’t fall, thank goodness, but it did require a reflex contraction of my operated glute and adductors to stay upright, which was somewhat painful. I don’t think it caused any real problem though, as there doesn’t seem to be any undue soreness or pain today. Have to be real careful for the first few months to avoid disrupting any muscle or soft tissue repairs that are not yet healed.
Continuing ice therapy, fluids, crutch walking, and prescribed leg exercises.
Range of motion continues to improve today.

March 28, 2019

2nd of Post op Day 7 and still making incremental improvements in mobility.
Bowels we’re moving on post op day 4. So that’s no longer a concern.
Started walking with 1 crutch last night and today, taking it slow but doing fine.

I notice that the glute on the operated side is still slow to activate or incompletely activating? It feels funny putting more than 50% of the normal load on the joint when walking. So I still use the crutch to offload it some.

I’m thinking it will just take a little more time for that to normalize.

Had my first outside walk with one crutch, several houses down the street and back, with my wife walking along side me holding the other crutch just in case.
I’m now able to get in and out of bed without using the aid for lifting your leg, just taking time.
Continuing the simple hip exercises as prescribed.
Still zero pain.

March 31, 2019

Post op day 11-
Still getting around easily with 1 crutch. Definitely could go to the cane. Drove yesterday for the first time since pre-op and also walked 1/2 block. Was slowly progressing with walking distances over a couple days.
Today, I’ve noticed slightly increased swelling of the lateral upper thigh, and a little at the upper medial thigh as well. Also some mild soreness of the vastus lateralis.
So I decided to rest up today and do only minimal walking today, keeping it elevated with plenty of ice.
I guess this is my body telling me to slow down. It didn’t really feel like an unreasonable amount of exertion at the time though.
But I’m listening to my body anyway.
Glad I took plenty of time off work, so I have time to wait these things out.
Still no significant pain. Taking Tylenol morning and evening, Mainly for prevention and for comfort in transfers and necessary ambulation

April 5, 2019

Now 16 days post op.
Still using a cane to walk but seeing daily improvements in the ease and speed of walking.
Getting in and out of bed and shower is much easier too.
Still tricky to get a shoe onto the foot of the operated side, but that’s improving also.
Had another upper body gym workout, followed by the normal hip exercises for phase 1 and that all went well. Feels weird walking around the gym with a cane, but whatever.
I think I’ll be able to lose the cane in the next couple of days, the way things are going.

April 8, 2019

19 days out and noting continued improvements in walking, self care activities, and some early recovery of general fitness. I have a slight 4mm leg length increase from the surgery, and I started using an insert on the opposite shoe to compensate, which seems to help balance when walking. Had a machine based gym workout focused on chest, shoulders, abs, and triceps, taking great care not to do any weight bearing on the hip.
I even experimented with a few sets of bodyweight calf raises, thinking it could further help advance the walking. That went fine too. Won’t take it to any extreme though. Don’t want to have a dilemma confusing calf muscle soreness with potential DVT.
Tomorrow I’ll focus more on back and biceps, then hit some abs again. The crunch machine seems pretty good at this stage, since it’s easy to get in and out of, and doesn’t cause any stress on the hip. Already using the whole stack of weights again on that. Feels good.
Next early goal is to lose the cane, which hopefully can be in the next day or two.
Meanwhile, I’ve definitely been able to use the cane for many workarounds concerning multiple various every day tasks in addition to walking. Everything from helping put shoes on, closing car doors, picking things up or moving them out of the way, even getting dressed, lol. I’m sure I’m not the first to notice these other uses for it though.

April 9, 2019

20 days out-
Took my first unassisted outdoor walk today while carrying the cane, about 1/2 mile. Walked to the gym to kill two birds with 1 stone.
Not a fan of the the awkward waddling gait that I have without the cane, but at least I can manage without any pain. I’m sure the gait will improve as I walk more.
Continuing the upper body workouts, which Im enjoying.
Incision still looking good and healing.
I also tried some modified reverse lunges on the non operated leg using a wall to stabilize myself.
That went fine too. I need to be able to lower my body for certain work related activities to resume next week.

April 20, 2019

31 days post op today-
Over the past week, I’ve noticed significant further improvements on the speed and ease of walking. My wife has difficulty keeping up with me when she comes along now.
I still have a limp without the cane. So Im electing to still use the cane until my gait normalizes completely. The limp is also improving almost daily though. I don’t think I’ll have it for too much longer. We’ll see.
I walk 1-2 times daily about 1-1.5 miles. That seems to be the sweet spot, since more than that seems to still cause a little swelling and soreness in the quads and not speed up healing. I have to hold myself back somewhat. But it’s much more comfortable to walk now than it was preoperatively. No hip pain whatsoever. I still use the ice machine most evenings after settling in, mostly for prophylaxis and comfort. I also feel like it may still help promote healing on some level and may prevent swelling after long walks. It’s soothing anyhow, even in the event it isn’t helping otherwise. The incision looks great.

Still Regaining my upper body strength in the gym and expanding my repertoire to also selectively including some work with dumbells and barbells in addition to machines. Nothing that places any stress on the hip of course. But it’s a boon for morale to have such consistent progress.

Already thinking about the 6 week follow up visit with Dr. Gross. How time flies!

April 28, 2019

5.5 weeks post op-

Mostly Walking without a cane with mild residual limp at this point. The limp worsens beyond 1-2 two blocks if I’m not using a cane. But it isn’t that obvious for short walks, like within the house. The everyday walking around the house and office is pretty close to my post high intensity workout baseline that I had preoperatively. My walking speed is essentially at baseline.

Also, there is a soreness in the hip joint area that starts showing up on unassisted walks beyond a block. I feel it with each step I take, once it showed up. Not painful, but kind of a nuisance though. So I back off if I start to notice it. Usually rest or cut the walk short. I guess that will go away soon. Maybe it’s the uncemented implants telling me to Hilo’s back and wait longer for ingrowth.

There is a new issue that’s shown up though over the past week or so. It’s a twingy kind of ache radiating down the back of the thigh and also towards the back inner part. I notice it mostly when using my left hamstrings for something like moving myself forward in a rolling office chair or getting up from a low position without enough assistance. Today was probably the worst, since I got up out of my low slung sports coupe with some drinks in both hands and no free hands to help propel myself up and out of the drivers seat. When I stood up, I had a mildly painful twinge in the back of my thigh, just below the buttock. It was obvious that something was strained or at less stressed to its limit. When I got inside, I got into bed with the ice pad on and just completely rested it for a couple hours. Took a Tylenol just in case, which I had weaned off of about 2.5-3 weeks ago. I don’t feel it anymore. Guess it’s just one of those ways ones body reminds them not to outpace the healing process.

Otherwise Still use ice machine after workouts or walks in general, for what it’s worth.

The upper body workouts continue to intensify and I use a workout app to track progress.

The quads soreness issue hasn’t shown up in a couple of weeks. So that seems to be resolved for now. Once I start the next phase of exercises and up the intensity, I may see it again.

May 5, 2019

At 6.5 weeks at this point-
Noticing some small but noticeable improvements with modifying the side leg raise to standing position. May try again in lying position after my follow up appt this week.
Front raises aren’t an issue.

Also doing light elliptical, stationary cycling, and walking before or after gym workouts, and that’s probably starting to pay some early dividends as well.

Still have a mild limp, which varies in severity throughout the day. I think it tends to be worse as the day wears on, or after I’ve been sitting in one place for a while.

Pressing on…..
Have my follow up on Thursday

May 9, 2019

Today’s 7 week follow up visit went well. Xrays looked fine.
Strength overall continues to improve.
However, the one thing that is lagging is the abductor muscles function and flexibility, and persisting weakness with abduction.
So I’ve been doing a modified version of the side leg raises in the standing position since last week. I think the function is improving but very slowly. Dr. Gross saw the issue and gave me a reasonable strategy to continue the standing side raises for another week or so, then work up to the ankle weights in standing position, then finally doing them in the normal side lying after a few weeks.
Its this persistent abductor weakness is what’s causing the residual limp.
He also suggested that for people that are particularly muscular preoperatively, those larger muscles may be more traumatized and stretched during the surgery than if they were smaller or atrophied, which may lead to this kind of a scenario. Unfortunately in this case, I fit into that category.
So I guess I may have shot myself in the foot with part of my vigorous preop training. With original intent to facilitate recovery, Part of what I did was intentionally strengthen those muscles with lots of ankle weights and reps on side raises. Squats and lunges too.

So given these observations, I guess one might carefully consider which and how much pre-op exercises directed at this particular muscle group that one should really do, to help avoid similar issues.

Im not happy to have a delay in something, but I’m glad I fully understand the exact problem now and have a good plan of dealing with it.

And my progress in other areas is on schedule.

Will keep posting on progress

May 19, 2019

8.5 weeks post op-

I’ve been focusing on the abductor weakness with the standing side leg raises with/without ankle weights, and getting stronger gradually. I also gathered the courage to try them again in the side lying position positioning a pillow between the legs without weight for the last couple days and that’s improving mildly too. Can now get up to about 8-9 uncomfortable reps, but haven’t lost patience. I know it will take a little time.

Still doing the gym workouts with mostly upper body exercises. But I did venture off the reservation today and tried some lower body stuff cautiously with very light weights. Just leg extensions/curls, seated calf raise, and the rotary hip machine, which exercises the flutes without really loading the hip at all. And 30 min elliptical machine for cardio.
It was a far cry from a real workout. But it still feels like progress, since I’m slowly re-introducing more activities to then build on further.

Straight leg raises are pretty much where they were under normal circumstances, and could do as many ankle weights as I want with those.

I’m looking forward to seeing where I’ll be in another month or two. Hopefully back to full strength on the side laterals, which I think is the last real frontier on the early recovery. After that, it should be smooth sailing.

I can tell already the significant improvements on hip rotation exercises, as the hip feels like it glides smoothly through the movement, without any pain at all. Also if I stand or walk for long periods, no problem at all, which is another big improvement.

July 16, 2019

At 4 months, I’m doing light squats on the smith machine with less than 100 lb for 20 rep sets.
Started with assisted bodyweight at about 2 months.
I still feel mildly uncomfortable stiffness and soreness when I push it on abduction machines but it seems to be working itself out over time. I’m taking it slow and gradually increasing weights on both abductor and adductor machines, since I’m generally in the gym anyway. I’m at about 60% of the preoperative strength, when it comes to these groups. I could probably do more or go faster, but I don’t want to have a setback.
The limp was totally gone at about 7 weeks, but I was initially compensating by leaning over slightly toward the affected side.
Just a consequence of the temporary abductor weakness, which is now gone. I stand and walk as I always have now. Brisk walking is no problem at all.
My cardio is entirely 30min of either rigorous stairmaster workouts or stationary cycling. I take walks occasionally, but don’t have the time to get enough cardio in through regular walks alone, which would take at least an hour a day. That wouldn’t leave much time left for the gym workouts. Thankfully I get in a fair amount of walking day to day.
Can’t wait until the 6 month mark, when I’ll feel legitimately licensed to start pushing things more.

September 8, 2019

Just short of the 6 month mark at this point.
I’ve returned to all activities except running and weighted squats. But that’s mainly out of respect for the standard post-op guidelines. I can do body weight lunges and squats well, particularly squats. And I can go all the way to the floor each time easily. The lunges leading with the operated side are a little weaker than the other. But I think that’s eventually going to even out. I may start doing more sets/reps on the operated side to correct for that. I stretch and still do all of the previously mentioned gym and cardio machine workouts about 3-6 times week, I do still get mild soreness intermittently on the operated hip after a day or days of heavier use, but nothing requiring medication to deal with. I believe that may be because it is still internally healing. I just listen to my body and back off anything involving the hip whenever it seems sore. I just focus on upper body exercises more, or else just take a day or two of complete rest, for example. I’m looking forward to seeing what the ultimate end result will be.