August 20, 2021

I am a 62 year old male. I have been very active all my life. My main physical activity is long distance cycling both on the road and on the trails here in Northeast Ohio during March to November. During November to March I hike in a wooded area and hike 5-6 miles per day. I have been cycling since 1982 and a normal year of cycling mileage will range during a slow year at 4,000 miles and my good years, over 9,000. I have 4 bikes, a 1995 Bike Nashbar Tandem, a 1998 Trek United States Postal road bike, a 2000 Trek Mountain Bike and my 2014 Pinarello 65.1 Dogma road bike.

This will be a multi-part series and I will take you up to my 6 week post-op follow-up (I see the staff on August 27th, in one more week, but who’s counting, me).I will then post updates for this series when something that I think might help others comes along during my recovery.

I hope this helps others if they are thinking about surgery, are in the middle of recovery or working up to that 1 year post-op anniversary.

Osteoarthritis Diagnosis/Treatments

I was first diagnosed with Osteoarthritis of both of my hips about 3 years ago after I saw a Rheumatologist for the first time and he took X-rays of both hips. My Dr started me on Celebrex twice a day and after about a year I started getting Cortisone injections in my right hip. About a year later, I started getting Cortisone injections in both hips. The injections would start working after 3-5 days and I would mostly be pain-free. The injections would last about 4-6 months. I knew that the injections would only work for so long and that eventually I was going to need hip surgery.

My Introduction to Birmingham Hip Resurfacing

I decided in October of 2020 during my Cortisone injections in both hips that I would begin exploring my options for hip replacement. In January of 2021, my daughter’s boyfriend, (he knew about my ever increasing pain with both of my hips) told me about a podcast by Joe Rogan, on a particular podcast, Joe Rogan had the wrestler, The Undertaker. I watched the episode and listened to how The Undertaker had the procedure Birmingham Hip Resurfacing (BHR) done by a Dr in New York City. I was intrigued and began investigating about this procedure that I had never heard of before.

I began my research on the web, read all I could find, including the website surfacehippy.info. By the way, a great website and many people contribute their experiences of BHR and answer questions of newbies that are apprehensive at the procedure.

It Sounds Like BHR Might Be For Me?

My next task was to find a Dr near me that did the BHR and I found Dr Peter Brooks at The Cleveland Clinic. I went to his website and reviewed all I could about the BHR procedure. During the review of his website I kept thinking, Am I eligible for this procedure? I know the procedure is normally done for males, younger, active and I fit 2 out of the 3, but was that enough? I went to make an appointment on The Cleveland Clinic online portal and then I chickened out. It was March my son was getting married in April and I had an appointment scheduled for another round of hip injections and I told myself, if the hip injections don’t work this time, I will schedule an appointment with Dr Brooks. I still had the doubts has to whether I would be eligible and then I started thinking, If I’m not eligible for BHR and the injections don’t work, what will I do next? I kept thinking if I end up having a Total Hip Replacement, my cycling days would probably be over and cycling has been a big part of my physical and mental health for over 40 years.

My son was married in April, the last round of hip injections did not work and when we got back from the wedding in New York City I made the appointment with Dr Brooks. By the way, after we got back from the wedding we found out that we were are going to be first time grandparents (a grandson). Another reason to get these hips fixed so I can keep up with our grandson.

My First Visit With The Staff For Dr Peter Brooks

I had my appointment with Dr Brooks staff (the staff was very nice). I showed Phil the PA my X-rays originally taken 3 years ago by my Rheumatologist and he showed me a CT Scan I had of my pelvic area for another health issue that was taken a couple of years earlier. Phil showed me the latest X-rays taken before my appointment. The pictures did not lie, in 3 years I had gone from a little bit of space in both hips to absolutely no space in my hip joints. I found out that I was indeed eligible for the BHR procedure but because I had the Cortisone injections in April I was going to have to wait 3 months to have the BHR procedure. My BHR procedure was scheduled for July 16, 2021. I hate waiting, but I also hate that I could no longer do the things I loved to do, I had already stopped cycling in April because it was painful while riding and then I was unable to move the remainder of the day because of the pain. I had always told my family that if I could no longer cycle, that it would be time to have surgery, so it was time.

Pre-Op

I did all the pre-op testing on July 1st, had my pre-op talk via telephone with Dr Brooks on July 6th and everything was a go for July 16th. Dr Brooks told me during the phone call to give him a year and he would have me back on the bike.

I decided after that comment by Dr Brooks, if he wants me to trust him to get me back on the bike, I was going to do everything I was told by the surgeon’s staff, the physical therapy staff and the occupational therapy staff to make sure that my surgical outcome was the best it could be. I was given a notebook with all the steps about the procedure leading up to the surgery and after. I read that multiple times leading up to the surgery so that I followed all the guidance.

Two weeks before surgery day I was told to discontinue all meds and supplements. That meant that I was no longer permitted to take my Celebrex but could continue taking my Tylenol. You have no idea how much a med works until you have to go off of them. The two weeks pre-op were very painful because I was no longer taking Celebrex and it truly was helping me with a lot of the pain.

Surgery Day

My son came in from New York City (our daughter is a Nurse Practitioner and had just started a new job a few weeks earlier and was unable to be there) to help me and my wife by getting us to Euclid Hospital where the surgery was to take place. We entered the hospital, me limping in pain, while walking in to the surgery center I thought to myself this will hopefully be the last time I have pain in this hip. The preparation in the surgery center went great, the staff was excellent.

I thought I would be a nervous wreck, I had not had any surgeries for 25 years, my last one was a biopsy for my Hodgkins Lymphoma in 1996 (another big health hurdle, I was told by my Radiology Oncologist that I would never ride a bike at the level I was riding pre-cancer, I proved him wrong, just a hurdle). I was calm knowing that this was going to be another hurdle that we were going to get through and that I would be without pain after my recovery. I did not even need anything to calm me down before surgery.

They ask you to write NO on your non-surgical hip before surgery and they check multiple times to make sure they know which hip they are working on. I decided that I was going to write “No, Next Time” on my non-surgical hip knowing that if all went well I would be back in approximately 4 months to have my 2nd BHR.

OPERATING ROOM

They rolled me into the operating room, moved me from the bed to the operating table. They introduced all the staff that was in the operating room at the time. I told them “ALL OF YOU, HAVE A GREAT DAY”. They had me sit on the side of the operating table, someone kept me from falling as they asked me to lean forward, someone put a mask over my nose/mouth and I saw the anesthesiologist with some large needles and he said “I’m going to put you out now”. That was the last thing I remember until I woke up in the PACU.

PACU

The PACU nurse was also excellent. This part was a little hazy coming out of anesthesia and I’m not sure how long I was there. My family said the surgery lasted about 1 hour and I was in the PACU over 2 hours. When I woke up in the PACU, the nurse introduced herself and I asked her if I had received the BHR or did they have to do a THR, she said I got the BHR and I cried. I was so happy that the BHR was successful and that my cycling days were not numbered. I had a spinal block, so the nurse in the PACU kept trying to see if I had any feeling in either leg, I didn’t. At one point I started shaking and they gave me some meds and the shaking dissipated. X-ray came in and took an X-ray of my hip, it was hard to keep from shaking. I kept saying I was cold and they already had me wrapped in warm blankets and even had something warm on my head. At one point the nurse took my temperature and said I was overheating from the warming blankets and she removed the one from my head. I eventually started getting some feeling in my legs and it was time for them to move me from the PACU to my room. I asked the PACU nurse if I could have a room with a view of the lake (Euclid Hospital is directly on Lake Erie). I was mostly joking but the PACU nurse asked someone and it turned out that I had a private room with a lake view.

Moved To My Room

Once in my private room with the lake view is when things got busy. I had a lot of different people come into the room, so many I don’t even remember everyone that came in over the next few hours. A few were the nurse taking care of me and the Nurse Practitioner that talked to me about the pain medications, my son, my daughter (my wife was alternating with the kids to visit). I had not eaten since midnight the night before, it was early afternoon by the time I got to my room. My son had ordered food for me, the NP wanted to give me half a pain pill, warned me about taking it on an empty stomach. By then the spinal block had pretty much worn off and I had pains in my upper leg and I wanted to take the pain pill but didn’t. The food took over 2 hours to come and after about an hour of waiting on food and having so much pain I took the pain pill anyway. Big mistake. Physical Therapy had come into the room, wanted me to stand up, I stood up and my blood pressure tanked and she ordered me to lay back down in the bed. Then my food was finally delivered and the odor from part of the meal made me feel sick to my stomach and my daughter got me a bed pan as I vomited, My son and daughter got the nurse to come back in and she gave me a shot of Zofran and a different pain med into my IV and things started to settle down. I eventually had a little bit of my meal (not the turkey that made me sick to my stomach!).

My wife and son left about 7pm after I started feeling better. My daughter stayed a couple more hours. I started getting my pain pill every 4 hours and the pain was pretty manageable. Don’t wait too long between pain pills, take them the first few days, the pain can be pretty awful and if you wait to take the pain pills it can take 30-60 minutes for them to kick in, do you really want to be in pain, not me.

During the late evening and through the early morning of day 1 post-op, it consisted of taking vitals, taking pain pills, Zofran and me eating saltines, graham crackers and drinking lots of water to keep from getting sick again. During one of my pain pills the pain pill wasn’t working and I started having a lot of pain. I found out later that I had dropped the pain pill in the middle of the night when I tried to take it and we didn’t find it until the next morning when they were getting me out of bed for PT and OT.

At first daylight, I wanted to make sure that I got some breakfast as soon as possible before they started PT and OT because I did not want a repeat of surgery day post-op. I couldn’t get food ordered and so I texted my wife (we live an hour away from the hospital) and asked her to see if our daughter (she lives about 20 minutes from the hospital) could bring me a McDonalds Egg McMuffin and a small Orange Juice. My daughter showed up with 2 Egg McMuffins, OJ and a large bottle of water (our kids are the best). I ate the food and was prepared for pain meds and PT/OT but PT didn’t show at 8am like I was told and I did my OT early morning and had to wait until after 1pm for PT.

Time To Go Home

My wife and daughter drove to my house in my daughter’s car. My son and I drove to my house in my wife’s car. It’s an hour but it seemed like 4 hours because I was having pain and could not get comfortable in the passenger seat.

When we got home my wife, son and daughter went into action.

My daughter began to put my meds post-op and my supplements that I was taking before surgery into my pills cases, I have one for am and one for pm and then I do my meds/supplements two weeks at a time. My daughter made my wife a spreadsheet that she printed out so my wife could chart when I took my meds so she could keep track, especially for my pain pills because they were every 4 hours and did not work with my am/pm pill cases.

We have a step-in shower in the basement and a tub shower on the 1st floor (ranch) and I thought I would be able to get into the tub-shower but discovered during PT that raising my leg to get into the shower was not going to happen. My son had ordered a shower chair, a sprayer shower hand extension while I was still in the hospital from Amazon and it was there when we got home. My son went to work putting everything together so I could take a shower. Post surgery, moving down the stairs with a crutch, using the walker to get into the shower was a new experience. We used plastic wrap to cover the bandage to keep it dry and I sat down on the shower chair to take the shower using the hand shower extension. A new experience as well but I felt so much better getting that shower.

We also discovered after getting home that my bed or the guest bed would not permit me to get in and out of either of those beds (one was too high, the other was too low). My son and daughter brought up a twin bed from their youth that we had saved in the basement and put it together in the Living Room for me to sleep (it was just right).

My 6 Week Schedule For Recovery

Make sure you have one or more people available to help you during recovery. Do not think you can do this by yourself? I do not care how strong you are. This procedure will humble you as far as thinking you can do this alone. I had my kids and wife there for the first couple of days to help get the daily schedule figured out, getting through shower issues, med schedules and sleeping issues. You have to remember that you are healing, you are on pain meds and your mind will not be working as usual. You will need someone to help you and you better take advantage of the help to get you through the recovery process. In my case my wife was the one taking care of me during the recovery process. This is 6 weeks, she needs a break too, she will have errands that needs to be run and you can’t be left alone so you don’t do something stupid to jeopardize your recovery. We had 2 of our neighbors that came over when my wife needed to run errands, they just “Tony sat” and really we just talked and they helped when I needed something during the few hours my wife was gone. This extra help is especially important during the first 2 weeks, really as long as you are on pain meds, after that you should be able to get around enough to take meds and go to the bathroom without help.

For the first week and half post-op, my schedule was get up at 8am, get a good breakfast fixed by my wife, take my meds at 9am, do my Physical Therapy at 10am. At noon, get a good lunch fixed by my wife, take my meds at 1pm, do my Physical Therapy at 2pm. At 4pm, get a good dinner fixed by my wife, take my meds at 5pm, do my Physical Therapy at 6pm. After a couple of days I started going out front and sitting in a sturdy chair and initially once an hour (eventually twice an hour) I would walk down my driveway and then back up approximately 75 feet each way using the walker trying to get muscle tightness out of my operated leg. I would sit out front until it was time for lunch, meds, PT.

The first 1-4 weeks post-op, I had issues with pain and tightness in some of the muscles of my upper leg. I am sure it was because of this surgery. I have not watched any videos on how exactly this procedure is done. I do plan to watch the videos, once my 2nd hip has been operated on, I would rather not know until after the 2nd hip is done. I thought I would post some of my observations with the muscle tightness pain, maybe someone can tell me exactly why I had issues with these particular muscles. I had pain and tightness in my Vastus Lateralis Muscle from the top of my knee to my hip and Sartorius Muscle and Rectus Femoris Muscle (I could have the wrong muscles, I’ve never had an anatomy class, I’ve never asked by Nurse Practitioner daughter her opinion). Each week of Physical Therapy the pain and tightness has subsided. I believe the biggest gain was when I started doing the 2 week post-op exercises below. At 5 weeks post-op I still have a tightness, almost like there is a large wad under the skin but that has subsided over the weeks (I notice it during the Hip Abduction/Adduction exercise) and I’m sure will eventually be gone.

My physical therapy done at home consists of the following exercises, I started with 10 reps and added one each day until I reached 30 reps, these are done 3 times per day:

   Circulation Exercises (I continue to do these through my entire 6 weeks, unless told at my 6 week follow-up I will see if these can be discontinued)
      Ankle Pumps
      Quadricep Sets
      Gluteal Sets

   Physical Therapy Exercises (I started these day 1 post-op, at home, I continue to do these through my entire 6 weeks and plan to continue doing them 1 year post-op)
      Short Arc Quads
      Heel Slides
      Hip Abduction/Adduction
      Lying Down Helping Your Knee to Your Chest
      Sitting, Bending Forward, to Touch Shoes, Socks, and Feet
      Exercise Bike (you would think a guy with 4 bikes would have a way to do this, but I did not, so, I did not do this exercise)
      Seat Knee Extension

   Physical Therapy Exercises (I started these 2 weeks post-op, at home, I continue to do these through my entire 6 weeks and plan to continue doing them 1 year post-op)

      Hip Abduction (standing)
      March in Place (standing)
      Hip Extension (standing)
      Forward Leg Raises (standing)

I stopped taking the pain med 1 1/2 weeks post-op and my schedule got a little more flexible but I continued to do my PT three times per day and I do my walks in the driveway using the walker.

At 2 weeks post-op, I added 4 more PT exercises to help with Range of Motion. I also began doing most of the PT exercises on my non-operated leg, at least those that don’t require me to put more than 75% of my weight on my operated leg. This was hopefully to help strengthen my next leg for surgery and to help support my operated leg by having more flexibility/strength/Range of Motion in the non-operated leg. After a few days I had to discontinue the exercises for my non-operated leg, I was getting too much pain, felt that it was making that leg weaker and I need as much support as I can get and so for now, I have stopped them. I did notice while I did these exercises of the non-operated leg, that my operated leg has so much more Range of Motion with the BHR and that my non-operated leg has limited Range of Motion and is not as stable as my operated leg.

At 5 weeks post-op, I still do PT three time per day and do my walks in the driveway using the walker and I am looking forward to my 6 week post-op appointment with the surgeon’s staff and hope that my X-ray shows that everything is progressing nicely. I am hoping that I can get off the walker/crutches for this hip and I can start driving again.

My Post-Op Recovery From 6 Weeks Post-Op For The Next Year

I have my 6 week post-op appointment, Friday, August 27th. The following is what I hope can happen from 6 weeks post-op until my next BHR on my left hip happens 4 months post-op of my first hip. Yes, my 1 year anniversary of my first hip will be uneventful because the clock will start over after my second hip is done so my 1 year anniversary of my 2nd hip will be when things can get back to normal.

At 6 weeks post-op, my plan is to walk approximately 3/4 mile around my allotment, once per hour eventually building up to twice per hour for next two weeks.

At 8 weeks post-op, I then hope to get on my mountain bike and ride the same 3/4 mile around my allotment a few times per hour eventually building up to approximately 5 miles (6-7 times around the allotment).

10 weeks post-op, I was told pre-op that at 6 weeks post-op I will be permitted to ride 15-20 miles and won’t be able to ride more than that for 1 year. I have a favorite, mostly paved trail, that I like to ride that is 18 miles out and back so I will be doing that for that 1 year. Remember I said hopefully 4 months after the first hip I hope to have the second hip done, that means that all the clocks start over again, so it probably will be 2023 before I’m back to riding my long distances again but that’s ok, I am following Drs orders and put my faith in him to get me riding again because it has been an important part of my health through the years.

Time To Go Home

When we got home my wife, son and daughter went into action.

My 6 Week Schedule For Recovery

My physical therapy done at home consists of the following exercises, I started with 10 reps and added one each day until I reached 30 reps, these are done 3 times per day:

My Post-Op Recovery From 6 Weeks Post-Op For The Next Year

At 6 weeks post-op, my plan is to walk approximately 3/4 mile around my allotment, once per hour eventually building up to twice per hour for next two weeks.

Where I Am At Today

I am 5 weeks post-op.

Most of the surgical pain and tightness are gone. The daily schedule is routine now but look forward in a change soon.

One thing I forgot to mention before was that I was told that my surgical steri-strips would start to come off around 2 weeks. I did not have any come off until week 3 and then only a few fell off. I waited until end of week 4 and I was able to very gently remove the remaining 13 steri-strips. This made life much easier once the steri-strips were gone, with showering, PT exercises, putting on clothes and sleeping.

I am anxious for my 6 week post-op Dr visit on August 27th. I want to see the x-ray of my hip 6 post-op and hope that everything is as it should be, I can get off the walker/crutches and start to get back to a somewhat normal life knowing that there will be a few limitations during this next phase of recovery.

I also hope to schedule my 2nd BHR for later this year. I hope COVID-19 does not delay elective surgeries.

I have lots of questions for the surgical staff as to what I will be permitted to do up to my 2nd BHR knowing that the clock will start again for my recovery after the 2nd BHR.

August 27, 2021

6 Week post-op follow-up:

I got my 6 week post-op x-ray of my new hip (BHR), the PA (Phillip Golnick) said everything looked good.

He said he would show it to me after he whisked me out of the exam room and took me out in the hall to see how I walked without aid. He had me go up/down the hallway a few times. At first it was weird, I hadn’t put full weight on the operated leg for 6 weeks, my head was telling me no, don’t do it, but after a couple of laps of the hall I was feeling better, still weird.

Phillip said I was doing great for someone that had surgery 6 weeks ago.

We went back into the exam room and he showed me the x-ray, yep, looked good to me too.

We then discussed what I could and could not do on my new hip and he answered all the questions I had accumulated over the last 6 weeks.

I won’t go into the do’s and don’t but I’m happy to just have some normalcy back and I’ll deal with the limitations and appreciate the things that I am now permitted to do.

He said that my Physical Therapy can include the standing exercises (Hip Abduction, March in Place, Hip Extension, Forward Leg Raises and he added one new one, Side-Lying Hip Abduction. After doing all these exercises for 6 weeks it was strange to not do a bunch of exercises that I had done 3 times per day.

I received my list of post operative BHR guidelines.

Phillip then asked if I had any more questions. I said, when can we schedule my left hip BHR? He said 4 1/2 months, I asked, Is that from 6 weeks post-op or surgery day? He said surgery day. That was good to hear, that means I could have the surgery in late November or December. He said he would have his scheduler call me to setup the date of my 2nd hip BHR.

I then left the Dr office without any aids and walked from the office to the parking lot and eventually to where my wife had parked the car, far out in the parking lot. She said I thought you would call me to pick you up. I said I wanted to walk all the way without any aids.

I received the call from the scheduler to schedule my 2nd BHR before I could even get out of the parking lot and I am scheduled for Friday, December 10, 2021 with a note that if someone cancels for Friday, December 3, 2021 I will take that slot. We have picked Friday surgeries because our daughter can help get us home on Saturday just like the last time when our son and daughter helped. We know what the drill is at home and this time it should be much smoother. Our son may not be there because he will have a newborn baby, hopefully by the end of September and I’m sure momma and poppa will want to stay with the baby.

I plan to start doing my neighborhood walks tomorrow morning (before it gets too hot) instead of my driveway walks that I’ve been doing for the last 6 weeks. I hope to build up my distance and endurance over the next 2 weeks, after that I will do the same but instead of walking I will ride my mountain bike around the neighborhood building up my distance and endurance.

That’s the 6 week post-op update. I will update as warranted with anything that might be of value to those considering BHR, recovering from BHR and those looking forward to 6 week post-op and beyond.

By the way, my operated hip has so much more strength and range of motion than my non-operated leg and that is encouraging and scary. I need to keep my non-operated hip going until December 10th.

November 9, 2021

It’s been 2 1/2 months since my 6 week post-op and I am now one month from my 2nd BHR on December 10th.

Since my last post.

My rehab 6 weeks post-op was walking for two weeks around our allotment, walking about 2 miles per day. The next two weeks I was riding my mountain bike 4 miles per day.

At 2 1/2 months post-op, I have been riding my mountain bike on the improved trails alternating riding and walking on a paved trail at our local park every other day. I have been riding my bike 15 miles per ride and walking 4 miles per walk.

I continue to do my PT each day, twice per day.

I continue to “baby” my un-operated hip and look forward to my next BHR (not looking forward to the first 2 weeks but after that it went as expected after the first 2 weeks)

We lost our 15 1/2 year old Yorkie, Sophie, on September 23rd and we have been slowing getting used to not having her around. She was blind and having seizures about 5-6 weeks apart starting in February and her last day with us she had 12 seizures in a 2 hour period and with heavy hearts we decided it was time for us to let her go.

We became first time grandparents on October 2nd when Alexander “Alex” was born. We get a FaceTime visit each day with Alex.

We made our first airplane flight since COVID-19 started on October 21st, going to New York City to see our grandson Alex. (I had no issues going through TSA Security. I was scanned going out and coming back using the full body scan.)

My operated leg still performs as expected and my un-operated leg is not as painful as it was before my first BHR. I am guessing it’s because i am not compensating for the pain of both hips hurting. It’s enough that having the 2nd BHR will be welcomed and look forward to getting the next one done so I can continue my rehabilitation.

I now have the added incentive to get through my rehabilitation so we can make visits to New York City to visit our grandson Alex (and his mom and dad too). I am hoping that by February 1st I should be able to make the trip.

I will give updates after my 2nd BHR and I hope that it’s pretty much a repeat recovery as the 1st BHR.

Hip Resurfacing at Surface Hippy

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