My name is Nick Stam, age 53.
I had LBHR performed by Dr. William Hozack at the Rothman Institute in Philadelpha on May 7, 2008.
It was a great success, but not without a significant setback…
It’s now 10 months post-op as I write this story.
Let me back up in time. I have always been athletic. My sport of choice after playing football and running track in high school was Racquetball. I played from age 17 until 51 yrs old actively, at least 3x per week. I was always a top 10 player in all the clubs I joined, and I played in state-level tournaments for years. I also jogged 3-6 miles at least 3x per week very consistently for nearly 35 years. All of this conspired to help wear out my hips of course, combined with heredity.
During August 2006, I was jogging quite a bit, and one day I felt some serious spiking pain in my left groin. I thought it was a groin pull so I laid off for a few weeks. I tried jogging again, and the pain was just as intense. Laid off for a month this time, and tried again. Same horrible pain. After visiting my doctor, having multiple stretching sessions with a chiropractor, and finally consulting a friend who was an orthopedic surgeon, we discovered it was my hip joint wearing out. My ortho friend said it wasn’t terribly bad at that time, and if I could live with the pain to do so as long as I could stand it, because the alternative was hip replacement. I hobbled around for another year – got a cortisone shot in the hip which was little relief, and everyone always asked what’s up with the limp.
I finally went to another orthopedic surgeon in October 2007 who said I was the perfect candidate for a new procedure (in the US) called Birmingham Hip Resurfacing. He said he didn’t do it, but referred me to a leading doctor at the University of Pennsylvania Medical Center. I consulted with the U of Penn surgeon, and he said he preferred to do a full ceramic replacement. He didn’t care for the possible metal ion release of metal components. I said OK, and signed up for surgery just before Xmas 2007. During the waiting time, I was uneasy, and thought I still needed another opinion, and I wasn’t convinced that BHR wasn’t right for me. So, I cancelled the surgery and started doing more research. I discovered the Rothman Institute at Jefferson University Hospital in downtown Philadelphia performed BHRs, so I called them up stating my case. They had me speak with Dr. Hozack in February 2008. He was their BHR expert. He looked at my X-rays, understood my desire for an active lifestyle, and said I was a great candidate and that he could do a BHR in early May. I signed up.
After having the surgery, I was up and about the next day, walking the hospital floor with a walker with little pain – they inject the actual hip socket with some long-lasting pain killer, in addition to the normal pain medication. It felt better than I thought it would considering my leg was ripped out of it’s socket, ground down a bit, drilled, capped, and stuffed back into an new socket. And I had a 9 inch scar. Dr. Hozack likes to be sure he has full access to the femur and socket, rather than struggling to move aside muscles, ligaments, etc, and possibly straining them too much.
Dr. Hozack was absolutely great. He is an athlete himself, so he understands the desire to get back to a fully active lifestyle. As a surgeon, he’s a perfectionist. And he’s very concerned about his patients and makes sure to visit each morning. His OR assistants told me that my procedure went exceptionally well.
To start rehab, I did much walking with the walker at the hospital, I would do multiple sets of 10-15 very short squats, probably a few inches down and back up while holding onto the walker for support. So far so good. I was sent home three days after surgery. Got home, and about 4 days later got a fever – probably 100-101. It wouldn’t let up and a few days later – a week after initial surgery – the visiting home therapy nurse called Rothman Institute and told them they needed to look at the incision, because she thought it looked infected.
Sure enough, I contracted an infection from the hospital – I was the “1.5 out of 100 candidates” as I was sadly told by the attending surgeon Matt Austin (because Dr. Hozack was on vacation). So, Dr. Austin said he needed to re-open the incision, clean it out (called an I&D), and then test for the type of infection. It took a few days for the culture to grow, and they placed me on intravenous Vancomycin (a very powerful antibiotic) for those few days, until they could determine exactly what type of infection, and figure out the best drug to fight the infection.
It was indeed a staph infection, but it wasn’t MRSA. It was ultimately determined to be a “surface staph infection” and not deep in the joint (had a four inch needed stuck deep into the joint to extract fluid for the culture – that was FUN!). Thank goodness it was surface only, or else it could have meant serious problems if deep in the joint, with the worst-case being removal of the BHR components, months in a wheelchair, and then a full hip replacement because BHR could not be performed a second time.
I got to go home with my new friend – a CADD Prizm 6100 VIP portable pump, that would dispense Nafcillan for 1/2 hour periods every four hours into my vein via a PICC line 24/7 for six weeks! This wasn’t fun at all. Especially washing! But you learn to live with it, learn how to wash in the sink, or disconnect the pump, wrap the PICC line watertight in saran wrap and tape, while taking a shower holding your arm up and away from the water stream, etc. And you learn how to sleep on your back with the pump under a pillow by your side (because it’s a bit noisy in the dead of night and pillows muffle the pump) and you keep reminding yourself it could be much worse.
I exercised while wearing the pump, walked the neighborhood 1/2 mile every day with both crutches the first week , then single crutch the second week, a cane the third week, then no cane the fourth week. After four weeks on the Nafcillan, all signs of the staph infection had cleared based on weekly blood tests, but we stayed on the drug for the six week protocol to ensure the staph was gone. The chance of recurrence is very remote — much less than the chance of catching the infection in the first place, which was 1.5 in 100 at my hospital if you forgot 😉
During the last few weeks wearing the PICC line, I would disconnect for a few hours at night and head to the gym. I would walk on the racquetball court and hit the ball around by myself, moving pretty slowly, testing things out, bending, turning, etc. But nothing strenuous. I would do 10-15 minutes on the short stepper machine. It felt great.
After getting off the six weeks of Nafcillan, I would continually step up my routine each day. After 2 months post main surgery, I was playing racquetball very lightly. At 3 months, I was in front of my house running 7.25 second 40 yard dashes with my young boys. Yes, that’s slow, but I was actually semi-sprinting ! I asked the docs at Rothman if this was OK for me to do, and they said as long as it doesn’t hurt! By four months, I was probably at 80% of full speed at racquetball, with all the twisting and turning and no problems whatsoever! By 6 months I was near full speed on the court with absolutely no pain in the left hip. I’ve been playing racquetball three days per week for the past four months. I’m back to playing 3 out of 5 games – tough matches. My racquetball buddies can’t believe it, especially when they see the 9-inch scar. I work out on the Stairmaster and various other steppers and ellipticals, I’m lifting weights, and I’m actually pushing 350lbs on leg press machine without having the leg pop out of the socket! Amazing. Seriously, I find this incredible.
Now my right hip is starting to get sore, but isn’t slowing me down yet, and t’s probably a few years away from resurfacing. I wholeheartedly recommend BHR, and except for the staph infection, it’s been an amazing experience. My only recommendation – when you see a nurse or an orderly come in to handle your wound, make sure they wash their hands in your sink with disinfectant for 20-30 seconds. Do not let them touch you otherwise!