I am 4 days post-op (in 4 hrs) and doing fabulous. We are all
different patients, but Mercy Mt Shasta and staff is the best hospital I’ve ever
been in and Dr Ure’s office staff is stellar. Don’t let the small town keep you
away. The hospital is the cleanest and pristine and nursing staff has a lot of
ortho experience. Here’s my story, but feel free to get back to me with
The more knowledge you have going in the more relaxed you will be. Their
pre-surgical joint class is an all-day affair but you get to meet the nursing
and therapy staff and they get to know you. It also included lunch, pre-admit,
lab work, and discharge planning. The staff is totally committed to you and
your care/recovery. They are fun and personal – I knew all about their
families, etc. by the time I left, and they mine. The OR nurse John Palmer
even took photos, at my request, of the surgery and made me a CD – way cool!
Don’t get me wrong, there’s a lot of work to do after surgery. For me, the
first 6 hours after surgery your spinal is still in effect so really no pain.
Thereafter, until 24 hrs post-op, was a bummer for me. Nausea/vomiting, feeling
comfortable in bed, etc. I only used the PCA (patient controlled analgesic) for
pain 4 times then went to extra strength Tylenol. I don’t do well with heavy
meds and I really didn’t need them. That has a lot to say about the surgeon and
his technique. Yes it’s uncomfortable, tender and sore, but not super painful.
At 24 hrs I had in-bed therapy and got out of bed and stood with a walker, but
that was it for the afternoon. At this point you are asking "was I right to go
through this?", but just wait until the next day – wow!
By the next morning I WAS A DIFFERENT PERSON. I had bed therapy and started to
walk with a walker, not very far grant you, but it really felt good to move your
legs. You are hooked up to 5 external devices that slowly are removed; mine by
the end of day 2. You have your incision blood drain, which is re-infused if
300cc or more is collected. I luckily only incurred 250cc’s – another feather
in the surgeon’s cap I think. Of course there’s your IV with antibiotics and
fluids, foley catheter, TED hose, and your calf-squeezers that apply continuous
massage via air.
By 48 hours I was taking short walks in the hall, with the walker, and got
outside for fresh mountain air and beautiful scenery. I enjoyed a tasty Chef’s
Salad (ask for it) that evening and began eating more, which really helps! All
the staff was surprised at my 24 hours of progress and I began preparing to
leave the hospital the next morning as long as I was released from therapy.
Cleared medically to discharge, but still needed the blessing of therapy, I was
able to SHOWER. Dr Ure uses sub-cutanious sutures with a telfa pad and
waterproof cover, another plus. I was sent home with extra supplies to change
the dressing if it did indeed get wet. I still cover it with a towel during
After showering I was up with therapy walking a much longer distance, with
proper posture, and clear to make the 6 hour drive home to Merced CA – whoohoo!!
It was comical getting in and out of the Yukon but the ride fairly comfortable.
The key was frequent stops, moving your leg, and iPOD tunes of course.
Once home it was very nice to have all your assistive devices already there and
set up. Here’s my list of have-to-haves:
Walker, reacher/grabber, sock aid (I took to hospital), shower chair, raised
toilet seat with handles, straight-back chair with handles, wet wipes, hand-held
shower head, bed tray, Standard Size reusable ice pack. Dr Ure’s office wrote a
prescription ahead of time so the durable medical equipment items could be
ordered and at home before I left for Mount Shasta.
Of course I have a LONG way to go but you truly see daily progress at this
point. Today I am walking-through my steps, actually a stride, with the walker
and can almost get myself in/out of bed – every thing is in slow motion and
takes forever to accomplish! You will definitely need help at home, not sure
for how long, so be sure that is in place.
That’s my story for now but will post weekly update on Surface Hippy and the
Yahoo Discussion Group 🙂 My husband was concerned initially by my location
selection, small town and all, but quickly got on board with my decision.
Without all the input from everyone on this and the Yahoo Board I could of not
made the right decision for me; my thanks go out to everyone who provided
information and supported me!!!
L BHR Ure 10/10/07
My 20-day update
I have been waiting for some dramatic change to occur but
realized that I’m down to a snails-crawl with improvements lately. I still just
take Tylenol but only a few time a day rather than every four hours.
I just can’t seem to get onto one crutch and cannot bear much weight on the leg.
Paul (my PT) passed along a weight-bearing exercise that should help – see below
if you are not aware of it yet.
As far as encouraging weight bearing on the surgical leg, try standing straight
and tall in your walker with hands positioned above the handles of the walker.
Use your hands on the walker ONLY as a safety net. Shift you weight slowly back
and forth from one leg to the other. As you shift your weight to your surgical
leg make sure that your hips and shoulders both move over the leg. This is what
occurs on your non-surgical leg. Look in a mirror if you feel you are
compensating. This technique allows you to confidently find how much weight you
can put on the leg. Using a scale under the surgical leg will allow you to
objectify the process. If you use a scale, make sure your non-surgical leg is
standing on a phone book or piece of wood equally as high as the scale so you
are standing on level ground, so to speak.
I can definitely tell if I over do it as my knee hurts like heck at the end of
the day. Also, if I sit too much, or at the wrong angle, I am uncomfortable at
night. I still wake up every three hours and am very stiff. I take a short
stroll and use the bathroom, then back to sleep.
I suppose I walk about 400′ or so at a time, during the day, but need to hit the
streets rather than just right around the house. I live on an acre lot so it
will be easy to log feet in the neighborhood.
It doesn’t hurt to sit on the toilet anymore, and I can do my morning routine,
including showering, alone now (as of day 14). Doug took me to the store
Saturday and it was still very difficult to get in/out of the Yukon. I was
thinking I might drive this week but that’s not happening seeing I can’t get
into the car alone; a downfall of an SUV I suppose.
I prefer the forearm crutches to the walker, unless I’m needing to move stuff
around then my big bag on my walker is the best.
Tips: Taking the dogs food, in a baggie to the bowl, works great. Keep the phone
with you in a bag attached to your walker or crutches. Even if there is no one
around to tie your shoe you can loosely tie the laces then use a long-handled
shoehorn to slip the shoe on. You should be able to bring the non-operated leg
up to tie that side 🙂
Each day I look for a little improvement and remember back to the early days to
reinforce that yes, I am getting better. Good luck to everyone, this is amazing
to say the least!
LBHR Ure 10/10/07
The visit with Dr. Ure was fun and informative. As a couple of you know I was
determined to walk into the appointment on ONE crutch and I did accomplish that.
The day before I just did it, and I suppose I was just chicken. As long as my
body alignment and posture is good it does not hurt AT ALL. As of today I’m
doing about 1/2 my walking on one crutch and the other 1/2 on two. When Dr. Ure
saw me he asked "when are you getting rid of the other one?" – he’s too funny!
I first asked Dr. Ure to explain what my OA looked like and how it had
progressed. The morning after surgery when he checked on me, I was feeling just
awful and couldn’t think of questions to ask. He said that the damage was not
bad, but average, and it made the surgery easier than having to try and repair
extensive damage if I had waited too much longer. The time was right!
The x-rays look perfect, beautiful I might add and made me smile. He pointed out
that there was about a 1/8′ gap between the cup and the bone, in just a small
portion, that will no longer exist once the bone grows into the cup and at six
week I do not need to observe the hip precautions – I’m going to work on tying
my own shoes 🙂
Regarding PT – at 6 weeks post-op I’ll be good to go. His office will fax the Rx
to the therapy office of my choice. I asked about aqua therapy and he was not
pro/con; again my choice. I feel I will only need help regaining ROM and
strengthening – pretty boring.
I have a dental cleaning in a few weeks and he recommends following the ADA
guidelines for antibiotic use, he thought a three-day dose, so I will be in
touch with my DDS. FYI the ADA guidelines are 2 years following hip surgery.
I shared with him how quickly the leg length is decreasing and since I started
using one crutch I notice very little; I’m thinking less than 1/4′. I wear
orthotics in both shoes, to help with ankle pain after a calcaneous fx many
years ago. If there is still a length difference in about two months the
podiatrist could adjust my inserts accordingly.
BHR ID Card: I asked about obtaining my serial numbers for the devices and he
said that is a VERY good idea in the event there would ever have to be a
revision, etc., as the surgeon would need to know what size the devices are. His
office can get me the information. Note: Denise in his office did fax me copies
of my device information.
My next follow up will not be for one year post-op. I will not need to
personally see him, but he would like an x-ray at a minimum.
On my way home to Merced I actually WALKED (with crutches) the Sacramento Zoo,
for two hours, with my daughter and granddaughter as I felt using a wheel chair
would be a step back. Thank goodness my 21 month old granddaughter walks slow,
and I really surprised myself. The hard part of the zoo was getting into the
little train that drove around the zoo, not to mention the tiny low seat – oh
I’m feeling so much better, more energetic, no Tylenol at all, back on my side
of the bed, sleeping on my non-op side, incision tenderness just about gone,
easier getting in/out of the Yukon, and I’ll be taking a test drive tomorrow;
I’m sure I’ll be fine (I was)! It’s hard to believe everything that has happened
in only four weeks.
Every two weeks just gets better! I returned to work about five-six hours a day
the week of Thanksgiving then will have four days off. Other than feeling
exhausted my hip is great. I noticed many more muscles that need improvement
after working in my desk chair and moving around – oh my!
I’m on one crutch exclusively and it’s great to have that extra hand free. I
ride the stationary bike daily for about six minutes and am increasing the time
daily; I love the way the muscles feel when they are truly working correctly.
On Thanksgiving day, feeling SO thankful for my new hip, I took several
unassisted steps – it didn’t hurt! My muscles still need more strengthening to
support me for any distance but it was good. I’m closer to tying my shoe and am
quicker moving around these days. Life is really getting better!!
I am now 4 month post-op and rarely think about my hip. What I didn’t realize
was how different my life had become pre-op. I am continually active again and
quick in my actions – that was not the case before my new BHR.
My ROM now exceeds the normal ranges and all the therapists cannot believe how
quick I recovered. Given they are use to older THR patients, and had not had a
HR patient before me, they are all on the bandwagon for the HR procedure! They
all have Dr Ure’s name now
The one area I continue to work on is putting more weight on the leg. Tasks such
as lifting a laundry basket, 40 lb dog food bag, or heavy objects, remind me
that I am still healing. I find daily exercise, in some fashion, absolutely
necessary to stay on track; if I don’t my hip will become stiff and noticable. I
continue to walk, ride a stationary bike, and complete my exercises learned
post-op and during therapy – this is a constant reminder of how far I’ve come –
it’s quite a motivating factor.
My husband Doug will head to Whistler in a couple weeks, this year without me,
but next year I’ll be skiing the glacier with him
Over the last couple of months I began to
occasionally have some mild groin pain and popping of the hip. I contacted
Dr Ure and x-rays were ordered. After nearly two months, and several phone
calls to his office for the results, Dr Ure finally contacted me.
Per his chart document he stated that the
x-rays “show components to be in satisfactory position and alignment without
evidence of loosening or other failure. There is, however, some mild
narrowing of the femoral neck.” He also noted “some degree of discomfort
with resurfacing is not uncommon in the smaller size ranges such as what she
has.” He instructed me to contact him if pain or discomfort increases.
4 YEARS – THE HONEYMOON IS OVER
The last two years have brought increasing
groin pain, instability, and popping/clunking on a regular basis. Two months
before my 4th anniversary I became so alarmed at
the consistent instability that I contacted Dr Ure as well as patient
advocate, Vicky Marlow, for direction. Vicky recommended x-rays and cobalt
and chromium blood tests, which I coordinated with my PCP. I found out that
Dr Ure had had relocated to Port Angeles, Washington, from Mt Shasta,
Dr Ure returned my call, and explained that
since my surgery it has become apparent that misaligned cups are causing
issues and that my smaller size is no longer a positive as once thought. He
recommended a surgeon in Los Angeles who enjoys “challenges” in the event I
needed surgery. I offered to send him my x-rays once received, and he
provided me with his email. That was the last I heard from him and I am
extremely disappointed at his unprofessionalism when he did not reply after
I sent my x-rays twice. It was obvious, from the x-rays over the years, that
there were problems from the day of my BHR, at year two, and year four.
After I had my x-rays and lab work in hand
Vicky had several surgeons review them for possible causes of my pain and
instability. The following are excerpts from the surgeon’s emails:
She needs a revision
ASAP before the neck on the femur breaks
Neck narrowing due to
high ions and there will be some acetabular osteolysis at revision. Yes,
early revision is indicated
inclination and version angles are high to start with. The cup appears
to have migrated
The causes of my
At the time my BHR was implanted the acetabular was prepared too deep
which left a void between the cup and acetabular. Sometime, during the
first two years, the cup tipped into a position of excessive anteversion
My revision surgeon, Dr Scott Ball, felt the femoral neck narrowing was
due to excessive wear of the device following the tipping of the cup,
causing metallosis, and subsequent osteolysis.