Thank you so very much for your website – I’m grateful for
the quality and organized delivery of the information available here – I plan to
return to the site in just a few minutes, provide a donation, and buy a fun
t-shirt. There is nowhere else to go for the comprehensive information,
authentic real-life stories, and descriptions you and your contributors provide
I’m scheduled for unilateral hip resurfacing in just a few days, the 23rd of
September, and have been surprised to find so little about Dr. Thomas Vail or
UCSF (University of California at San Francisco) on your site. I selected Dr.
Vail as my surgeon given the number of resurfacings he has performed (+/- 400),
his research and development with De Puy and experience with other implants,
because he uses computer guidance to place the femoral component, the
department’s reputation – which Dr. Vail heads, and my impression of the man. I
interviewed 5 other resurfacing surgeons – all very reputable and many well
liked on surfacehippy – and researched all of my arthroplasty options, studied
the issues with cobalt-chrome ions, in-vivo wear studies and many implant
mechanical studies and comparisons, etc.
At the end of the day, I opted for a long-term bone salvaging technique,
performed by an experienced and affable expert in the field, rather than a
"Jimmy Conners" hip, and came to question the concept of "minimally invasive":
in other words, I’ve invested in my future revision – if necessary – vs. any
short term rehabilitation gratification. Icing on the cake was that Dr. Vail
works essentially in my back-yard (but I would have traveled anywhere in the
world) and with a few modifications with my participation in my HMO provider, I
was able to have my insurance cover just about everything that UCSF provides.
Nevertheless, now just a couple days before my procedure, I’m worried about the
process. I’m 52, previously an avid triathlete (50-60 pounds ago) and have put
off arthroplasty for way too long – very painful degenerative osteoarthrosis in
my hips now with terrible range of motion and significant weakness: I cannot do
a standing squat except in the pool or walk beyond the mail box. I’m an
emergency veterinarian who depends upon being on my feet for very long stretches
(16-18 hours) lifting, performing surgery, and bending/twisting much of the day
– this has become progressively impossible the past 6 months. I swim 3 to 5
miles a week now and see postoperative recovery from surgery as a way to
emphasize my lap-swimming workouts as I migrate back towards greater leg
strength and function.
Like I said, I’m worried: about possible perioperative complications, the effect
my recovery will all have on my wife and her caring for me, and what my return
to function will ultimately look like. At the same time I’m positive about
turning a spiraling downward trend around while loosing some weight with a
return to activities lost over the years (biking, backpacking, etc.). Having
some range of motion and comfort again will assuredly improve my sex life too.
I’ve realized that one of the most helpful features of your website comes from
hearing other stories about the resurfacing process and the experiences of
others: successes, problems/complications, description, and the comfort of just
knowing that other people have gone through this – I’ve derived a better idea of
what to expect. For this reason, and because of a palpable void regarding Dr.
Thomas Vail and UCSF, I’d enjoy giving back to this process to potentially add a
bit to a greater cumulative work on surfacehippy. So, here goes:
With my wife Lori we drove over a sunny Golden Gate – a good omen – to the UCSF
Medical Center. I had been swimming considerable more mileage than normal the
previous week and put more effort into core exercises/sit-ups and stretches. The
evening before surgery I had one last long swim and fin kick session and was
I was anxious but the anesthesia and surgical teams were
incredible at relaying a caring and confident demeanor to my process. Dr. Vail
asked if I had any last-minute questions before I received a touch of midazolam,
more for anxiety. Then I received a lumbar plexus catheter (kinda like an
epidural) that remained in place until 72 hours later when I was discharged –
through this catheter I had a CRI (continual rate infusion) of local anesthesia
which I could augment with a control button after surgery. I also received a
spinal anesthesia in the OR room listening to Reggae. The OR nurses knew how to
have fun while remaining very professional.
Then we were off to the races before I knew it but in a very
calm and well orchestrated surgical environment. My anesthesiologist asked how I
was doing after they dislocated my hip joint – I couldn’t feel a thing but the
concept was awful queasy so I asked for more happy drug – I received a fentanyl
cri and woke up in post-anesthesia very comfortable and Dr. Vail relayed
everything went perfect over the 90 minute process. He wondered how I could walk
at all with such bone-on-bone arthritis and the extensive bone spurs he removed.
There is a drain in my wound and as I accumulate blood in a reservoir they
intermittently filter this back into my iv to keep my red blood cell count up –
very cool set-up. It was reported that I lost only about 300cc of blood total.
Ultimately I was transferred to a hospital room and could already feel and move
my legs well as the spinal anesthesia wore off. Through the evening I could
tighten my butt muscles and quads on the surgery side pretty well and had good
flexion and extension of my ankles…I’m beginning to think that this is a piece
of cake – not the pain I expected!
Slept through much of the night despite hospital noise and activity, monitoring,
blood draw – had help from iv doses of hydromorphone (Dilauded), my femoral
nerve plexus block, and a urethral catheter which was removed in the morning.
Surgery service rounds and a dressing change at 6:30am. Started enoxaparin (Lovenox)
injections and TED stockings to help prevent clots. Met with physical therapist
who got me out of bed and walking down the hall with walker, then up a practice
flight of 4 stairs. She mapped out milestones and expectations to keep after.
As the day wore on the entire hip region began to feel terrible – pain scores
around 8 out of 10 ultimately, real sore: just a dull powerful ache with
tightness to the groin – I’d switched to oral hydrocodone 10mg with Tylenol (1
to 2 q4 hours prn) since they last much longer than the iv hydromoprhone. As the
night wore on I became very sore all over (myalgia) in association with a fever
which broke with additional Tylenol, I sweated enough to need a bed change. I
ate about a half sandwich all day – just no interest – and stayed on iv fluids
which made me pee into a bed pan every couple of hours. Dr. Vail came by twice
that day and reassured me that days 2 and 3 are the worse and that I was doing
fine, and that the fever is inflammation related from tissue/surgical trauma
since my blood counts were normal.
Out of bed on my own at dawn and walked around, then again with therapist who
organized home care options specific to my needs: elevated commode, grabber,
rigid leg lifter, and new walker. Very steep use curve of my "new" leg after
surgery but adductors and abductors of hip the weakest. Placing about 80% of my
weight on surgery leg as we walk. Only 4 of the Vicodan pills all day and
additional Tylenol. In and out of bed with stretching, sitting to read, and
experimenting with movement – my leg seems to have lost proprioception from
surgery and/or the lumbar plexus block that was removed in the evening.
Out of the hospital by 11am and on the road home. Stopped by our local CostCo to
pick up drugs called into the pharmacy: Lovenox (enoxaparin) as heparin-like
agent to prevent clots, Vicodan, 81mg aspirin, vitamins – I walked about a
half-mile I estimate in and out of store – slow and of course with walker.
Picked up food for lunch curb-side. Home to eat, a warm shower using my walker
for support, and a long nap in my own bed without disturbances. Woke up and
watched Netflixs for several hours with my very own beautiful sexy nurse…I
thinks that sex might have to wait a few more days.
Walked outdoors – with walker still – nearly 2 miles around the neighborhood and
to the park; 95+ weight bearing. I could not have done this walk before my
surgery. I forgot what an ambulatory workout feels like: sweat, clear lungs,
sports euphoria. Everyone says "I should have never waited so long" and of
course they are right! I’ve developed a rash from sweating into the Tegiderm
bandage dressing along with some swelling to the leg – some topical 1% cortisone
for the former and wearing my TED stockings for the latter. Using a cane in and
around the house and up-down my 18 stairs separating our two floors. Only a few
more days until I can get back into the pool.