Having read with much interest the reports of others who were someway down the track, I thought I would weigh in with an overviewreport of my own first year.I am a male living in Melbourne Australia, and first realized that Ihad OA around 2000. It became a bit painful doing leg presses atthe gym (so I stopped), and I started getting pains in my rightthigh, even going down to the ankle. One doctor thought it was astrained tendon, but a few months later it had not healed so I wentto a sports medicine doctor who sent me for an x-ray and diagnosedOA. He discussed treatment (exercise, physiotherapy, painkillers)and that it was possible that surgery might be needed down thetrack, with the options being THR, or the newly introducedresurfacing – of which he knew little (this was 2000).For the next 5 years I limped along, on physiotherapy, Vioxx,paracetamol/codiene, and glucosamine/chondroiton. All these workedto some extent and I no longer had referred pain. However, in thesecond half of 2005 things went downhill rapidly and I came to thepoint where I couldn’t go on – painkillers did not work properly,and at night I was waking up with pain every 1-1 1/2 hours,shuffling around and sleeping another hour on the recliner, thenmoving to the couch etc.I researched the internet on possibilities and decided thatresurfacing sounded very promising (although I had not come acrossSurface hippies at this stage). My x-rays showed complete loss ofcartilage in both hips, multiple cysts and so many osteophytes thateach hip looked as though it was surrounded by a milky cloud. Thewoman who took the x-rays exclaimed “my God, how can you walk!!”. My sports medicine doctor had no problem in referring me forresurfacing and commented that he would go that route himself if hewere in my position. Andrew Shimmin, the surgeon that I went to, isvery experienced in resurfacing, having done about 500 over 7 years(up to Dec 2005). At my initial consultation with him on 29 Nov2005 he went through the advantages of resurfacing (retaining anintact femur, much more stable joint, more rapid recovery, greaterrange of activities following recovery, easy conversion to THR ifthe joint failed at some future time), but cautioned that bone cyststhat could be seen in my X-ray could be deep enough to makeresurfacing problematic – in which case he would need to decide inthe operating theatre to do a THR. He also cautioned that whether Icould stand both hips being done in the one operation could only beseen in the theatre, and he would do one hip and then decide whetherI could go on for the second.I went for it as quickly as I could. Surgery for a bilateral BHRwas scheduled for 14 December 2005 at The Avenue Hospital inMelbourne. I went into hospital in the afternoon of 13 December asI was scheduled for surgery at 10am the next day. I was in the theatre for about 4 hours, under a general anesthetic.Although Andrew Shimmin said later that he had thought it touch andgo as to whether I could sustain resurfacing (i.e. because of the poorcondition of the hip surfaces), it turned out fine on both sides.Evidently I coped well with the operation and did not need atransfusion. As my red cell count dropped from 14 to 10 (whateverthe units are) I was put on iron supplements for the next 3 weeks.I spent the first night in the close monitoring room, before movingto the normal room the day after. It was quite an experience to wake up with tubes going everywhere.There was one into my nose to supply a flow of oxygen. A salinedrip going into the back of my left hand. Two drainage tubes comingout of small incisions to the front of the main incision on eachside, and a catheter coming out of the place that catheters come outof.As I had both hips done it was the second day after the operationbefore the nurses tried to get me out of bed. Two attempts in themorning were followed by success in the afternoon. The next day Itook a couple of steps with a walking frame, and two days after thatmoved to forearm crutches – much better than the frame. The woundshealed well with no infection, and over the course of the first weekI learnt to get in and out of bed myself, have a shower myself andcommence physiotherapy. While in hospital a physiotherapist visitedevery day and taught me exercises to do on the bed using a board andlittle rolled up socks to put under my heels to enable my feet toslide. I’m glad that my upper body strength was sufficient to fullyraise myself from the bed using the dangling triangle. It would havebeen very difficult if I couldn’t do that……. The staples came out on day 7, and I was allowed to go home on day8. I think that the final test (that I passed) was showing that Icould self inject the Fragmin that I needed to take for 20 daysafter going home. While Andrew Shimmin had said 10 days in hospital,the hospital itself expected me to be there for 8 days. I think thatAndrew was being conservative, so I would feel good if getting outin 8 days, but not disappointed if it was a bit longer than that. Pain? No pain!! The hospital had made clear that all pain relief upto self administered morphine was on offer, but I didn’t need that.Took panadiene forte for a couple of days, then dropped to straightpanadiene, more as a preventative rather than because I reallyneeded it. After I had gone home there was really no need forpainkillers of any type.The worst thing about hospital was the food. I did not enjoy theexperience of taking a bite of a rissole which gave me gas. Gasblocked by constipation is no fun! Eventually I was able to work itthrough by using the motorized bed back to raise myself up, andlower myself down many times, enabling the gas to work through thesystem.When I got home I made steady progress each day. I was careful to dothe sets of exercises that I was given by the physiotherapist beforeI left the hospital, and got a new series of exercises after amonth. It really was remarkable how, at that stage, I could tellthe difference between the two legs when doing my exercises. Myright hip was the first one that went, and so over time I favoredthat side. Though the left deteriorated at the end, there was stillmore residual muscle on that side. I could tell that the exerciseswere reviving muscle on the left, while starting from a lower baseon the right. At 3 weeks my wife took our daughter to relatives on the south coastovernight, so I took the opportunity to drive into the city (about20 minutes). Getting into and out of the car needed care but was OK,and driving was no problem at all! My wife was not impressed whenshe found out…By 4 weeks, I could walk around the house without crutches –although I did still use them when walking from one end of the houseto the other. Andrew thought that I should use the forearm crutchesfor a bit longer so I tried persevering for another week or so, butit is difficult when you just feel that you do not need them. Up to the 4 week mark I still had to sleep on my back, which createdproblems in that I woke every 1-2 hours and had to stretch my legsbefore getting back into bed and having another stint. But therewas no pain in the joints as there was previously. I startedsleeping through the night, and at about 5 weeks I could lie on myside. Such luxury to sleep through the night, wake in the morningand just doze off again for a short while, with no pain and nopressure to get up!!Andrew Shimmin and the physiotherapist were very keen for me to dohydrotherapy, so I went to the local indoor heated pool and saw anexercise therapist for a program which I started at about the 5-6week mark. That really did help and I would highly recommend poolwork.I went back into the gym at about 8 weeks, and have continuedthroughout the year to go to the gym four times a week for about 45minutes followed by another 40 minutes work in the pool.I returned to work after 7 weeks, and felt no difficulty in that atall (I work in a city office job).Flexibility has been something that I have been working on, andthere has been gradual improvement. At 8 months I could cut my owntoenails with difficulty, cutting some skin in the process. By 10months the extra bit of bend was there to make cutting my owntoenails easy.I felt that for the first 6 months I was engaged in rehabilitation.After that it has changed to general fitness and toning work. Ifeel no restrictions now in what I can do. On 12 December 2006 I had my 12 month checkup with Andrew Shimmin,which included x-rays. The implants look absolutely fine, and therehas been good bone ingrowth into the implants. Carefully making nopromises, Andrew implied that he could see no reason why the BHRsshould fail, i.e. he could see no reason for me to ever have arevision operation. Now that is something that I want to believein!! Of course, things need to be kept in balance. Over the first6 months I was so keen to keep up my calcium intake (to promote boneingrowth and maintain my good bone density) that I drank copiousamounts of full cream milk – with the result that my cholesterolwent too high. A change to low fat milk was indicated (sigh).Was resurfacing the right thing to do? Absolutely!! But if youhave got this far in this lengthy report I’d just like to make afinal observation. To me it seems that there are three criticalstages facing someone who is coming to a decision that surgery isneeded. The first stage is deciding what sort of operation to have, and whoshould do it. These are decisions that should not be left toothers. If you are at this point do NOT become swept away by thesystem or surgeons’ own choices. If you want resurfacing, go to aresurfacing surgeon, do NOT go to a surgeon and ask “what can you dofor me?” The answer may be “Come in next Wed and I’ll do a lovelyTHR”. The second stage is the operation. You have picked the surgeon, andnow you have to trust in him (any female resurfacing surgeons outthere?).The third stage, and where you are back in control, is therehabilitation stage. I think that we do not focus enough on theimportance of this ongoing process. Exercise and diet is neededthat promotes healthy bone growth and the strengthening of ALL themuscles around the hip area. Strengthening of the hip capsule isneeded, as well as strengthening of all the muscles around it.Varied exercise is needed, in all directions, not just repetitiveexercise in one plane e.g. walking…. So, merry Christmas to all and a Happy New Year. Let us hope thatthe rain comes tonight and put out those bushfires that arethreatening so many settlements in the High Country. Our thoughtsare with them and the brave firefighters.CheersRoss bilat BHR Shimmin Dec 05PostscriptOn 26 December 2006 the Melbourne “Age” reported on page 1 “This was the Christmas miracle – or at least, the Australian bush version. For three weeks, locals and firefighters have sat trapped, ringed by fire, alone and vulnerable at the top of Mount Buller. Day after day, the bush burned in the valley below, the flames making charge after charge up the slopes, fanned by hot winds.But then, at Christmas time, it happened. The winds eased, the prayed-for rains came, and the fire threat abated. On Christmas Day itself, it snowed. A miracle. Lightly at first, but stronger as the day progressed, coating the mountain-top in an unseasonable white blanket. As it snowed outside, those on top of the mountain sat down to Christmas lunch, and relaxed for the first time in more than three weeks.