Location: St. Louis, MO
Surgery Date: Jan-19, 2013
Surgeon: Dr. Edwin Su
Hospital: Hospital For Special Surgery – New York City, NY
“And in the
end, it’s not the years in your life that count. It’s the life in your years. “Abraham
like a phoenix from the ashes of shattered dreams.”
For the better part of 30 years a pretty significant
portion of my life was spent playing soccer. The “beautiful game” as they call
it – was many things to me. It was a way to stay fit without “working out”. It
was a way for me to vent stress and enjoy the camaraderie of friends. I loved
the challenge…..the competition. As I got older – I continued to
enjoy playing regularly. After Sunday morning games I’d spend the rest of the
day laying there – stiff and sore – but satisfied nonetheless. I loved it…..I
identified with it and never thought I’d quit. It was a big part of my life.
Then I got married, started a family and launched a new career. Life was
GOOD….balanced. Then….quite unexpectedly….I was told that I was suffering from
severe osteo-arthritis. And for the better part of the next 8 years it
gradually wore me down. I couldn’t accept that eventually I was going to have
to deal with it. Joint replacement was for old people. I had a high
tolerance for pain and I was going to put that off as long as I could. And the
pain just got worse and worse….
I started played soccer at age 8 after moving from Houston
to St. Louis. I went on to play in high-school, college (SIU-Edwardsville) and
competitively into my 40s (I’m now 45). That’s me in the picture above getting
some air against the Air Force Academy back in 1988. At 38 I first noticed a
mild pain in my groin during warm-ups prior to an over-30 match. I assumed it
was a minor groin strain – but it did feel a little different. As time went on,
the pain just wouldn’t go away. After an initial MRI showed excess fluid in the
joint – a doctor prescribed Celebrex. It seemed to work well enough – although
it eventually gave me some serious stomach pains. I continued playing – but it
soon became apparent that the issue wasn’t going away. So I went to see an
orthopedic surgeon – my biggest fear being that he’d aspirate the joint to
remove the excess fluid. But I found that the situation was actually much worse
than that. He said I was suffering from advanced osteoarthritis in BOTH of my
hips. In his opinion I misshapen hip joints to begin with and after many years
of soccer – I was left with little to no cartilage and bone spurs. Then he
basically read me my fortune. He said I would soon require total hip
replacement (THR) in both hips, that I would most likely postpone it longer than
I should, have the surgery only when the pain became unbearable, and then kick
myself for waiting so long. In retrospect – it was rather prophetic. This
really knocked me for a loss. I’d always enjoyed a wide range of physical
activities – soccer, snow skiing, jogging, biking, hiking and scuba diving.
Those were the things that I lived to do. I certainly had no intention of
giving them up. The thought of having hip issues, much less having to consider
hip replacement in my 30s – was simply unfathomable at that point. I
walked out of the doctor’s office stunned and depressed.
My father, who overcame many major challenges in his life –
was diagnosed with Multiple Sclerosis in his mid-30s. Now 71 and confined to a
wheelchair – I didn’t have to look far for inspiration on how to deal with the
challenges I was facing. My Dad is my hero. He never complains – never
lets his condition bring him down or those around him. My Mom has been his
faithful caretaker for many many years. Life certainly has not been easy for
them. So there would be no feeling sorry for myself. Everyone has their cross
to bear – this would just have to be mine.
At the time my pain level was low enough that I would
continue playing 1-2 times a week. But I sadly informed my soccer buds that I
was coming down the stretch on my farewell tour. Then I ruptured my achilles.
The sensation felt like someone gave me a swift kick to the back of the leg. I
rolled over directing a long stream of expletives at the nearest opponent about
5 yards away. He said he hadn’t touched me but I didn’t believe him. I limped
over to the sideline just wanting to get back in there and get some payback.
But that wasn’t happening. I limped around in denial for a month before I
finally went it to see a doctor who confirmed that my achilles was indeed
ruptured. With my hip issues and now an achilles rupture – I figured that
certainly spelled the end of my playing days. After getting my achilles fixed
the pain in my hip took center stage once again.
I visited one of the leading hip replacement surgeons in
the area and in his opinion I was ready for a THR. He also said that I would
wait too long and told me to call him when the pain got bad enough. In the
meantime he recommended cortisone injections for short-term relief. So for the
next few years I endured a series of very uncomfortable cortisone injections
about every 10 months. The injections were not fun. They were delivered thru
the groin of all places. Can you say ouch? Did I mention I don’t like
needles? But as uncomfortable as they were – they did provide enough relief for
me to forget about my hip….for a while.
A few years later I had a cortisone injection that failed
to provide any relief whatsoever. Up to that point all of the injections were
performed in a hospital using x-ray guidance to ensure they got the shot in the
right place – avoiding all of the major arteries in the area. However, the
doctor said he could now deliver the injections quickly and conveniently in his
office using ultrasound guidance. Everything went well enough with that shot –
but after a few days it was clear that I wasn’t getting any relief. I suspected
that the doctor didn’t get to the right spot using ultrasound. So I asked for
another with the old reliable x-ray guidance – but the result was the same – no
relief. So I went back to the doctor and he explained to me that it’s pretty
common for cortisone injections to eventually lose their effectiveness over
time. Well…..no one had ever told me that one before!
Stem Cell Therapy
Around that time I ran into an old soccer buddy of mine who
told me about an experimental procedure he’d recently had done on his knee with
tremendous results. This new regenerative procedure utilized a combination of
Platelet Rich Plasma (PRP), Adult Stem Cells, Lipo-Aspirate (Fat Graft) and Bone
Marrow Aspirate (BMA). The procedure was not FDA approved (and not covered by
insurance). I met with the doctor, discussed my condition and course of
treatment thus far. He started by telling me that cortisone injections might
provide relief – but they can also significantly accelerate deterioration the
joint. He was up front in telling me that his success rate with hips was not as
high as with knees. He gave me a 50-60% chance of benefitting from the
procedure. If it didn’t work he suggested that I might be a very good candidate
for hip resurfacing. So without any better options at the time I went ahead and
had the procedure done in Nov of 2011 with a second round in Jan of 2012. My
total out of pocket cost was approximately $5,000. Although the true objective
of the procedure (new tissue growth) typically takes 6 months or more – I did
experience an immediate reduction in pain. Like cortisone shots the relief
lasted about 10 months – then the pain came back in spades. Stem cell therapies
offer a lot of promise for the future and perhaps someday they will benefit
those suffering from osteoarthritis of the hip. But for now it was
unfortunately just another dead end.
I was frustrated. It seemed like such a simple ailment.
Given all of the recent advances in modern medicine – do we really not have a
better option than sawing off your femur and inserting a device with a 15-year
average life-span? How many replacements would I have to endure over the
balance of my life?
Getting Serious About Hip Resurfacing
At this point I was pretty fed up with short-term fixes and
reached a point where I was ready to give serious consideration to a longer term
solution – total hip replacement or this procedure few knew much about – hip
resurfacing. Shortly after beginning my research in Nov-2012 I stumbled onto
the SurfaceHippy website. Wow! What an absolutely amazing resource!
Everything in one place! The more I read – the more excited I became. Hip
resurfacing appeared to be a perfect fit for me. I continued my research on the
procedure for the better part of 3 weeks. Without Surface Hippy who knows how
long it would have taken me to fully understand this option. I probably would
have gone with Total Hip Replacement (THR). After a few short weeks – I was
convinced and for the first time in many years excited! I was
particularly encouraged after reading the story of Neil Richardson.
Neil was a former soccer jock (close to my age) who had a
great experience with hip resurfacing AND went back to playing soccer!
Unthinkable! I really wanted to know how Neil was doing years later. I reached
out to him via e-mail and he responded with nothing but great things to say
about his resurfaced hip. Neil confirmed that he had indeed gone back to
playing soccer. Wow! The remote prospect of playing again someday got me
pretty fired up. I would be absolutely thrilled just to get back on the field
to play even a little soccer to stay in shape. But before I’d go that far I’d
make myself commit to an extensive rehab, dropping some weight and making a
serious effort towards getting fit again before I put a toe on the pitch.
However, the hope of playing again someday – now that was a goal that I would
have no problem working hard towards!
Approach, Device & Surgeon Selection
From there I researched the pros & cons of the various
approaches and devices. In the end I determined my preference was a posterior
approach and the Birmingham Hip Resurfacing (BHR) device. The BHR had the
longest track record of proven success. From there I drew up a list of doctors
that utilized that approach-device combination. Initially the list had more
than a dozen doctors on it. Because I travel a lot for business I’d accumulated
frequent flyer, hotel and rental car points providing the ability to affordably
travel to be treated by the best surgeon I could find. I went thru the list,
evaluating each physician and spent a lot of time reading patient testimonials.
There were in fact a few doctors in St. Louis who did hip
resurfacing – however, it didn’t seem to be a focus area for them from what I
could read. Neither had performed more than a few hundred resurfacings and the
leading surgeon in the St. Louis area was unfortunately on medical leave due to
health issues of his own. So it didn’t take me long to decide that I would be
travelling out of town to have the procedure.
After a lot of research my first choice was Dr. Edwin Su at
the Hospital for Special Surgery in New York City. Initially I’d avoided New
York City assuming the overall costs would be higher and Dr. Su landed at the
bottom of my list. But after researching at least a dozen doctors in depth – he
quickly climbed back to the top of the stack. I was very impressed with Dr.
Su’s experience and clear commitment to the hip resurfacing procedure. Dr. Su
has performed more than 2,500 hip resurfacings in his career – and was clearly
one of the leading specialists in the US. The patient testimonials on Surface
Hippy had nothing but great things to say about him. In addition, the Hospital
for Special Surgery was ranked number 1 in the US by US News & World Report for
orthopedics with an incredibly low rate of infection (.4% for hip procedures).
Dr. Su also had a very well organized website that provided answers to all of
the questions Pat recommended on the Surface Hippy website for evaluating
surgeons. So now the question in my mind was – how long would I have to wait?
Fortunately it would not be long!
I contacted Dr. Su’s office in mid-Nov 2012 to get things
started and the first thing they asked me to do was to send them current
x-rays. A few days later Dr. Su contacted me to confirm that I would be an
excellent candidate for resurfacing……and they had an opening in the schedule on
Jan-19th, 2013 – about 60 days away. So I jumped at the opportunity
and booked my procedure.
Two days prior to my surgery date I flew to New York City
with my entire family unit in tow and went to the hospital for my clearance
physical and lab work which took a few hours. On surgery day I got to the
hospital at 10am. At team of nurses came in, got me into a surgical gown,
prepped my hip and put in my IV. They wheeled me into a cold operating room,
transferred me to the operating table and put some warm blankets on me. The
anesthesiologist came in, injected something into my IV line and knocked me out.
Not sure what time I woke up but when I did I was
surprisingly clear headed and pain free. Dr. Su came to visit and said that
everything went very well. The procedure took about an hour and a half. I
noticed that while I was knocked out they had inserted an epidural and gulp – a
catheter – which I’d anticipated. Contrary to my initial fears neither was a
big deal. They gave me a pain management device that allowed me to activate
additional doses of pain medicine as needed. I believe the pain medication they
gave me was called Veriflex by Baxter Labs. Unfortunately I suffered an
allergic reaction to it – which left me itching from head to toe for the better
part of the next 24 hours despite efforts by doctors and nurses to counteract
the reaction. After surgery, they kept me in the recovery room where my wife
was able to visit with me for a few hours until about 8pm – then transferred me
to a patient room. The first night I was comfortable, alert and stayed up
until about 2am reading a book. I wanted to be really tired so that I wouldn’t
have any problems sleeping on my back that night. I slept fairly well the first
night and slept off & on till lunch time the following day. A physical
therapist came by for my first PT session which was simply getting out of bed –
taking 3 steps forward, then 3 steps back with a walker. The therapist would
drop by 2 more times that day. On the second visit I walked out of the room,
down to the nurse’s station and back. Post-op they had me on a liquid diet
which was fine. Lots of juice, broth soup, soda etc. On my 3rd
visit that day I walked down to the family visitation room on crutches to visit
with my wife and kids. On the morning of day 3 they finally pulled the
catheter, epidural and IV in the morning and I was allowed to start eating some
solid food. The therapist came back and said that everything was going very
well and that if I could walk down to the therapy room on crutches and go up and
down the steps (4-5) without any trouble I could go home that day – which I did
without any problem. They then gave me a series of oral medications – Percocet
(for pain), Colace (stool softener), coated-aspirin and Pantoprazole (a proton
After discharge from the hospital I moved over to the
Homewood Suites in Edgewater, NJ. The staff was great and the hotel had an
excellent view of New York from across the Hudson. That night my wife helped me
into bed and I decided to try sleeping on my non-operative side with a pillow
wedged between my legs. I figured I’d likely stay in that position for the rest
of the evening. Then shortly after midnight – the fire alarm went off and we
were instructed to evacuate the building via the stairs. Our room was on the 6th
floor. I used 2 crutches to get over to the stairwell, handed them to my wife,
and then used the handrails on both sides to swing my way down to the main
floor. I had to assume the alarm was legitimate – but it soon proved to be a
false alarm. So….if you have to stay in a hotel after your surgery – be sure to
ask for a room on the first floor.
The next few days were pretty uneventful at the hotel.
Five days after the surgery I went back in to see Dr. Su for a final checkup
before flying home. He again confirmed that the surgery went well and I had no
cartilage left in my hip. He said my bone density was very good and I was a
perfect candidate for the procedure. I would begin physical therapy in about 2
weeks. So 6 days after surgery – I flew home to St. Louis.
Things progressed much quicker than I had expected. A week
after surgery I went to using one crutch. The first week or so at home I woke
up a few times a night when the pain medication wore off about every 4 hours.
By far, the toughest post-op maneuver is getting on and off
the toilet. I didn’t purchase the $75 raised toilet seat they offered to sell
me in the hospital – but that’s one piece of equipment to consider. I was
eventually able to perfect my mount & dismount without too much difficulty –
primarily by straightening my operated leg and using my upper body and
non-operated leg to get upright.
I went back to working on the 28th without too
much trouble – from home. It might have been a bit early but things were busy
and I didn’t want my workload to pile up while I was out. I spend most of my
time on the phone and in front of the computer anyhow – so resuming work was not
such a big deal for me. It certainly would have been nice to have an additional
week off to focus on rehab-recovery.
Attended church with my family then went on to brunch to
celebrate my Mom’s 70th Birthday! It was there that I took my first
public unassisted steps – no crutch, no cane. I was proud to be able to walk
slowly to the brunch buffet and back without my crutch. At this point I felt
ready to switch to using a cane.
Since returning home I’ve been doing all of the exercises
recommended by Dr. Su, a few additional exercises recommended by my physical
therapist and in addition I have been walking about a mile a day on the
treadmill in my bedroom.
I’ve since run out of Percocet and have transitioned to
Tylenol for pain. Pain level at this point is quite manageable. It is a
different sort of pain compared to the arthritis pain I’d been suffering for the
past 8 years. That pain was gone almost immediately after waking up from
(3-4 Weeks Post-Op)
In my job I often commute to the Chicago area – once or
twice a month. At this point I felt good enough to resume travel. After a just
a few days with the cane – it was pretty apparent that I didn’t need it
anymore. The only issue was that at this point I still couldn’t put on my own
shoe or sock. I took off on the trip anyway confident that allowing some extra
time in the hotel I’d figure it out. I didn’t take long and here’s how I did
it. I stood at the edge of the bed, facing the bed, put the knee of my operated
leg up on the bed and then leaned forward until my heel was approaching my
butt. From that position I could easily reach back and slip on my sock and my
shoe. No big deal! Everyone in the office was shocked to see me back so soon –
walking better than before the procedure. Full days in the office were tiring –
but it was good to be back.
I’ve been going to physical therapy once a week and it’s
been going well. I do my exercises once a day on my own nearly every day at
night and ice down afterwards. Once I’ve mastered one exercise and start to
feel cocky they come up with something else that I really struggle with. I’m
pleased with the progress but realize I’ve got a long way to go. But I am
really enjoying being active again – without the chronic pain. I feel great and
I’m starting to make progress towards dropping some weight. I’m really looking
forward to this fall which will be at the 8-9 month mark. Can’t wait to get
back to golfing and maybe, just maybe – a little soccer. We’ll just have to see
how it goes!
My quality of life has definitely improved. I feel
happier, more hopeful, less controlled by the arthritis. Like everyone says – I
too feel that I might have waited and suffered too long. I guess it was truly
hard for me to imagine that I’d wake up from the procedure and that old familiar
pain would be gone – but it was. I’m very grateful to those who have helped me
on this journey: God – for carrying me over the last 8 years, for Pat and the
Surface Hippy Website, Dr. Su, my wife and family for their support and
encouragement. My future again looks bright, full of hope and possibilities.
I’m re-energized and looking forward to taking better care of myself, getting
active again and living without pain. For those of you considering hip
resurfacing – there’s hope and I wish you well on your journey!
Can’t wait to provide an update on my 1-year anniversary!