June 19, 2015
Thanks to all the people who’ve contributed to Surface Hippy. Here’s my experience. I’m a 56 year old man, and I’m scheduled to have bilateral resurfacing with Dr Gross June 22 and June 24, next week. I flew to Columbia 2 days ago, and had my preoperative appointments yesterday. I’m staying at the Courtyard by Marriott, which is right next to Providence Hospital where the surgeries will take place. Everyone has been very nice and I feel well taken care of. Yesterday, I met Nancy, Dr Gross’ office nurse, Lee, Dr Gross’ nurse practioner, Dr Gross, and Amy, the coordinator for joint replacement at Providence Hospital. I also went to the Longs Pharmacy (walking distance from the hotel, although I drove) and picked up my prescriptions. I also received my Polar Care ice machine and hip kit, and I brought my own crutches. Dr Gross was engaging and candid in answering my questions about resurfacing. He also was in no hurry to go anywhere until all of my questions were answered. I was a little concerned about my bone density, because it’s on the lowish side, but he felt it was adequate and reassured me, saying it was in the normal range. I also told him I wished there was even longer-term outcome data, but he said by the time that is available, there are usually newer, better treatments. I hadn’t thought of it that way before. Somehow, that made me feel better, knowing the data was pretty good for a relatively new treatment.
I feel ready for these surgeries. I’m not too apprehensive. My hips first stated bothering me 16 years ago, although it was minor, superficial pain at first that I thought was a soft tissue problem in the lateral hips. It didn’t stop me from doing what I wanted to do (running, biking, swimming). 6 years ago, I learned that I had about 1 mm of joint space left in the lateral hip, bilaterally, and was advised not to run, jump, or take my hips through extreme ranges of bending and lifting. 4 years ago my hips worsened. I had developed lateral knee pain, and the therapy for presumed IT band tendinitis seemed to make my hips worse. I lost the ability to cross one knee over the other and bring my knee to my nose, and walking became more painful. I had steroid injections bilaterally which helped for 3 weeks on one side and 6 weeks on the other. Since then there’s been a gradual worsening of range of motion and pain. I’ve been able to ride a bike around town and use a stationary bike and a Stair Master. But the intensity has gradually decreased to the point were I’m using the very lowest levels, or even no level sometimes (just turning the pedals on a Life Cycle without turning it on). I still walk my dog slowly for about one mile, but I can’t keep up with my family when we’re walking outside. I walk slowly with discomfort, sleep poorly (usually 2-3 hours at a time), kind of fall into chairs and pull/push myself out of them, and often hold onto something when I bend over. It’s taken me a while to convince myself that I really need this, because I can look and feel pretty good when I’m sedentary, just sitting around, but now I’m convinced and I feel ready. I’ll let you know how things go. Thanks again to all the people who’ve contributed to this site.
June 23, 2015
Post op day 1
Dr Gross felt the resurfacing of my left hip went well yesterday. The spinal anesthesia worked great. They gave me some Versed in the preop area which helped me to relax and perhaps to forget as well. The last thing I remember was transferring from the gurney to the operating table. I don’t remember them placing the spinal anesthesia. Then I woke up in the post op area as if I were waking up from a nap. I was alert and had no nausea. There was slight, superficial pain over the upper front corner of my left hip, but it was pretty mild. Soon they took me up to my room, and as the anesthesia continued to wear off, I began to have moderate aching at the front of my left hip and thigh. They gave me a short-acting narcotic by mouth for that and the pain resolved. But it took 30-40 minutes before I started to feel relief. Since then I’ve been comfortable taking the regularly scheduled Oxycontin, Celebrex, and Tylenol. I’ve been on a regular diet since surgery.
I worked with a physical therapist in the afternoon. (My surgery had been at 9 am, for which I arrived at 6 am.) The therapist gave me 4 exercises: 1. ankle pumps (pointing and dorsiflexing the foot), 2. isometric contractions of the whole leg and butt while the leg is straight, 3. short arc leg extensions (with leg resting on a flat surface and partially bent because of a rolled up towel under the knee, one contracts the quadriceps muscles and straightens the leg), and 4. heel slides (starting with the leg straight on a flat surface while one leans backwards or lays flat on one’s back, one slides the heel in towards the body while the knee bends, then slides the heel away from the body until reaching the original starting position). The ankle slides were the hardest for me because it hurt the quadriceps muscles from my hip down to mid thigh to do them. I ended up using my hands under my thigh to help lift my thigh as I slid my heel towards me. Then the therapist and her helper helped me out of bed, and I walked to the end of the hall and back, using a front wheel walker, while she held my Foley bag and he pushed my iv pole.
I slept reasonably well on my back with my feet elevated, though I’m usually a stomach or side sleeper. They woke me up 4 times, twice to take vitals, once for a blood draw, and once to give medications. My room is set up for a single patient, and I believe the rest of the rooms on this floor are as well.
In the morning my Foley catheter and oxygen (delivered with nasal prongs) were discontinued. An occupational therapist came and worked with me to shower and get dressed, using a front wheel walker and a raised toilet seat (which was used as a chair for me to sit on while I showered). After that, I worked with the physical therapist, reviewing the exercises from the day before, and walking with crutches along the hallways. At 11 am, I attended a class with other resurfacing patients where we reviewed the 4 exercises we had learned, and learned how to go up and down stairs safely. Then I practiced walking with crutches back and forth along the hallways. That’s it. Tomorrow I get the right hip resurfaced. It will be interesting to find out how to sit down and get up from a chair, and how to go up and down stairs with 2 newly resurfaced hips. I’ll let you know how it goes.
June 24, 2015
Post Op Lhip day 2, Rhip day 0
Getting to surgery today was easier because I was already in the hospital. All I had to do was wash the surgical area with their special disinfecting soap last night and this morning and then wait for the preop nurses to come bring me down. I already had an iv. They only needed to draw some blood to spin down to make platelet-rich plasma to apply to the implant sites.
I remembered a little more this time. Today I remembered transferring to the operating table and then being helped to sit up so they could place the anesthesia line. I remember thinking to myself, “Don’t break the 90 degree rule.” Then I went to sleep. After the operation, I woke up earlier in the recovery room than I had after the left hip, and I felt groggy, but not nauseated. Everyone taking care of me in the hospital has been very nice.
Going back to square one with recovery and precautions after the right hip resurfacing has made me appreciate the progress I had made in just 1 day following the left hip resurfacing. On post op day 1 with the left hip they discontinued the Foley and the oxygen, and they saline locked the iv so that I was much more mobile. I felt a little stronger and more coordinated, so I was able to get out of bed by myself and go to the restroom and practice walking up and down the halls. Occupational therapy helped me learn how to shower and get dressed. Physical therapy promoted me to using crutches, and I could walk to the nursing station to ask for help instead of using the call switch. The physical therapist did work with me this afternoon, after the right hip resurfacing. We practiced the 4 rehab exercises that she had given to me, and then we walked up and down the hall, using a front wheel walker. It was harder getting out of bed with 2 weak legs, so she raised the bed to make it easier. Tomorrow we’ll try lowering the bed and try again.
I decided to preempt the pain that I had experienced after the left hip resurfacing by asking for a narcotic medication soon after I woke up from anesthesia in the recovery room. They gave me some iv dilaudid, and I’ve been fine. No moderate pain like the first time. I’ve been comfortable while taking my regularly scheduled meds (OxyContin, Celebrex, and Tylenol). I’m not sure when we’ll stop the OxyContin. (Oh, my mistake. I did get Celebrex at some point, but it’s not part of my scheduled meds. I’m getting Mobic instead. )
July 1, 2015
L Biomet (56 mm) post op day 9, R Biomet (54 mm) post op day 7
Bowel and bladder issues began to resolve the day after discharge and are now fine. The travel day home was long. There were travel delays due to weather and 2 missed connecting flights. My poor wife was walking pretty far and sometimes fast on a slow to heal sprained ankle with a walking boot as we raced across Dulles to try to make a flight. She was also developing what we later found out was an infected corneal abrasion which was also quite painful. It took 16 hours for us to get home, finally arriving at 1:30 am. But we made it. I called ahead for wheelchair assistance at large airports like Dulles (Washington, DC) and San Francisco, and that was helpful.
My legs started swelling about post op day 3, first the thighs, then below the knees, and then the feet. It was pretty impressive. It’s resolving now, but not yet completely. I’ve been up on my feet probably more than is advisable, but I need to do things like cook and clean the kitchen because I take care of our house. I haven’t violated any of the hip precautions, I’ve just been up more and reclining less than the ideal amount. I use the Polar Care about 3-4 hours a day while reclining in a Lazy Boy chair, and I try to get my feet up even higher, above my head, for about 2 hours a day. But I might spend 5-6 hours now standing in the kitchen or doing something elsewhere in the house. I started out doing less, and this is where I am now. I do things slowly and carefully, but I do them. I still use 2 crutches most of the time, but I can use 1 crutch for a short distance if I need to carry something. I can even take a few small steps with no support, but I don’t do that very often. I’ve learned how to reach the floor without using my reacher. It’s similar to putting your un operated leg behind you when bending over. With my feet apart, I reach for progressively lower things to hold onto in front of me while walking my feet backwards, until I’m low enough to reach the floor. It’s often easier than bringing a reacher around with me, and I don’t break the 90 degree rule. I’m down to using a half dose (50 mg) of the extended release narcotic (Nucynta ER) along with Mobic and Tylenol. I’ve experimented with taking none of the extended release narcotic, and I found I’m more comfortable talking some for now. I can feel things shifting around in my hip sometimes when I move, but nothing is audible, and the feeling is no more than I had been experiencing in my natural hips for the last year and a half. Overall I’m feeling pretty well. Things get a little better and more normal feeling every day. The heel slides, which I had to do initially by putting my hands under my thighs and lifting up, I can now do without that extra assist. I walk around the house and around our cul de sac, but I haven’t actually gone out for a “walk” yet. I might try that this afternoon. Thanks to everyone who contributes to this site.
July 9, 2015
Last Thursday as I started my outside walking program, at post op days 10 and 8, I noticed that my left foot was a bit toed in. I had been told in the hospital not to let my foot curl in, but to straighten it out. My right foot alignment seemed perfect and I was concerned that maybe something was wrong with my left side. I straightened my foot out as I walked, so that my toes pointed straight ahead, but this but a strain on my lateral knee cap and lateral left hip. It wasn’t a severe strain, but my left leg definitely felt different compared to my right leg which felt supple and strong. The next day I decided to try a gentle stretch aimed at the internal rotators of my left leg. But I also started an isometric strengthening exercise for the external rotators of my left hip, not knowing at the time that the external rotators are cut and then repaired during the resurfacing operation. (I still don’t know the details of what is done with them.) I also continued to externally rotate my left leg as I walked, so that my left foot would point straight ahead. The strain on my left knee resolved and I was feeling pretty good except for a mild strain at my left lateral hip. I sent an email to Lee, but not soon enough for it to be answered until Monday. Over the weekend I advanced my walking program so that I was walking about 1/4-1/3 mile up to 3 times a day. On Monday morning I was feeling good enough that I walked perhaps 1/2 mile with 2 canes instead of crutches. My walking felt easy except for a mild strain in my lateral and sometimes medial left hip. My leg swelling had largely resolved by post op day 10, but I still had some persistent ankle and foot swelling which was moderate on my left and mild on my right. Then I read an email from a hip surgeon, saying that there was little to gain and potentially much to lose in being active too soon after surgery. He said that too much activity could turn the perfect resurfacing into a THR. This got my attention. Soon after, I got Lee’s response that I should not rotate my leg, but just let it go where it feels most comfortable, and that the alignment would improve as the muscles got stronger. I had stopped using pain meds on Monday (of this week) and my left lateral hip definitely felt irritated. I was also concerned that the persistent left ankle and foot swelling was a sign that I had injured something in my left hip. I wondered if I could have caused a stress fracture in the femoral neck or torn the external rotator repair. This was a bad feeling. So I changed what I was doing. I stopped my walking program and spent the next 3 days mostly on my couch with my feet up above my head and the polar care going every other hour. The pain in my left lateral hip resolved but my hip feels a little sensitive like it was stretched or messed with. The swelling in my left ankle and foot was stubborn, but today it’s been reduced to some slight to mild swelling behind the malleoli. Lee sent me an email that it would take a major injury to disrupt the external rotator repair, and I’ve heard that femoral neck fractures are not common these days. This is encouraging, and I feel fortunate that it looks like things will be ok. But I’ll tell you, I’m in no hurry to advance any of my activities anymore. What I mainly want is healthy, functioning hips. I hope there are no complications. The lessons for me from this are be patient, ask questions first before acting, listen to your body, and don’t overdo.
By the way, I asked Lee for clarification on how much walking we should do, and she said to aim for a total of up to 1.5 miles/day by week six. I was headed far beyond this at the pace I had set.
July 31, 2015
It’s been 5 weeks since my surgeries. My left hip continues to recovery slowly compared to my right one, but I think there has been some progress since last week. I think there is less stiffness and soreness across the trochanteric area, I can stand longer without my lateral hip starting to ache, and there is less swelling in my left foot and ankle. Sometimes I can stand as long as I want (a couple hours) and sometimes it’s more sensitive. Sometimes I don’t feel much stiffness/soreness at all, and sometimes it’s a bit more. I’ve also noticed that there is stiffness posterior to the trochanteric area whenever I take a step up with my left leg. And I’ve begun to have some soreness in the lateral hamstrings where they insert into the knee. It’s hard to be sure exactly how things are going because I need to compare how I feel now to how I felt several days ago. There’s not a dramatic change from day to day.
I’m walking 1.5 miles/day with 2 crutches. My left hip feels like it needs this support. Inside the house I’m comfortable using 1 crutch, and I use 1 crutch outside for short distances like walking around our cul de sac. My hip will warm up after about a 1/2 mile and feel better. I can walk a few steps without crutches with sort of a waddling gait. I tried walking (about 1/2 mile) 3 weeks ago using 2 canes, and that felt ok, but that was before I became more concerned about the stiffness and soreness in my lateral hip. Since then I’ve stuck to crutches.
My right hip feels great. I have a follow up appointment next week. I hope to find out what’s up with my left hip. If they tell me it’s ok, then I’ll feel better about challenging it more.
August 20, 2015
I’m now 8 weeks post op. I’m still using a cane, but I’ve begun transitioning away from it. I do without it for at least half of my indoor walking. During my outside walks, I frequently pick up my cane and walk 10-40 yards without it. It doesn’t feel like I’m hurting my left hip to walk on it for short periods, but I have a slight limp. The left lateral stiffness and pain have improved. The left lateral hamstring aching has resolved. My left hip flexors are very weak and painful when I try to do the supine straight leg raise. I still can’t lift my left leg into the air without significant pain, so I do this exercise in the standing position to make it easier and avoid aggrevating what’s hurting. Dr Gross gave us 2 strengthening exercises to do: straight leg raises in the supine and sidelying positions. The sidelying leg raises have helped my left lateral hip feel better. My right hip continues to feel great.
The stretches Dr Gross gave us (reaching for our feet while seated in a chair with knees apart and feet together, hip flexor stretch-which I’ve modified, adductor stretch-which I’ve modified, and quadriceps stretch) are helpful in reducing stiffness and pain. I’ve also been doing hamstring stretches. My left (lateral and anterior) hip is still achy when I get up from having sat for a while, and my left adductors ache too. But this improves after I’ve walked a little. I still use my arms to stand up from a seated position. I try to ice my left hip (lateral, anterior, and adductor origin-not for the squeamish) 30-60 minutes a day, which helps reduce pain and stiffness.
We’re allowed to flex our hips past 90 degrees now. The main restrictions we have are no extreme hip flexion (such as squatting), no crossing the legs at the knees, no running or jumping, and no lifting more than 50 lbs routinely.
My left hip is improving, but more slowly than I would like. Still, I can imagine weaning off the cane in the next 2 weeks, and moving on to things like walking up stairs foot over foot and riding an exercise bicycle.
September 4, 2015
I traveled from California to have bilateral resurfacing with Dr Gross. I was in the hospital on Monday, with surgeries on Monday and Wednesday, discharged to the nearby motel on Friday, and flew back to California on Saturday.
For my surgeries, I flew United which I don’t recommend. They fly you past Columbia to Washington DC (Dulles), and then fly back to Columbia, so the travel time is longer than on an airline which would go more directly through Atlanta (like Delta). On my return trip to California, there were thunderstorms in DC which delayed my flight out of Columbia. I ended up missing my flight from DC to California and had to wait 6 hours for another flight. It ended up taking 16 hours to get home. That was a long day.
When I went back for my follow up appointment, I flew Delta. The flights were shorter and there were no delays. Some people recommend flying in and out of Charlotte and driving to and from Columbia.
I had 2 experiences with bulkhead seating. In the first, the bulkhead (the wall in front of me) went all the way down to the floor. This gave me no room to stretch out my legs in front of me and was miserable. I ended up switching to a regular economy seat, and that was much better. If you are tall, be careful about choosing a bulkhead seat. (I’m 6′ 4″.) In my second experience, the bulkhead didn’t come down all the way to the floor. It stopped about 2 feet above the floor, which gave me lots of legroom. That was very comfortable.
October 2, 2015
I’m 14 weeks post op. and my left hip is starting to feel like a real hip, like it really supports me. I still may hobble a bit after getting up, and I still have times where there is stiffness and soreness, but I also have times where I don’t feel any pain or stiffness, and where I actually feel somewhat agile and strong. I was turning and changing direction in the kitchen one day this week, to the right and left, and felt no pain, weakness, or limitation at all. It reminded me of how I used to feel prior to the onset of hip pain. I put on my parking brake (once) without lifting my leg up with my hands, and I went grocery shopping and could move normally and independently of the cart. (I still used the cart to help me get down to the lowest shelves and then get up again.) For the first time since my hips started hurting, my left hip has started to feel soft, cushiony, and comfortable again around the joint. I’m also starting to use my legs more when getting out of a chair or sofa, and I was able to put my socks on (with some difficulty) while sitting on the sofa or bed (instead of on a low seat). Another thing that’s getting easier is turning from face up to face down when I’m on the floor. I don’t have to be in an extended, lying down position. I can turn while my hips are flexed by putting my weight on my hands.
I’m still just walking, stretching, and icing. My continuous walks are now 30 minutes (at a 20-22 minute/mile pace). My stretching has ranged from 70-100 minutes, but is usually 90 minutes or less, and I’m icing my left hip for about 30-40 minutes.
November 7, 2015
I’m now almost four and a half months post op. I don’t mean to give too much information, but just to give you an idea of how long it can take to regain certain abilities, it’s only been since this week when getting dressed that I can balance on one leg and step into my pants with the other, bilaterally. Also, in the last week I’ve finally been able to lift and pull one ankle up and rest it above the opposite knee so that I can reach my feet while I’m standing to wash and dry them without needing assistive devices. OK, enough of that.
My continuous walks are now about 50 minutes, although I usually walk my dog, letting her sniff and pee, for about 20 minutes, before switching to a non-stop mode. So my total walking time is about 70 minutes. I’ve found at this point that it doesn’t really matter whether I walk 50 or 60 minutes continuously. My hips seem to be able to take the extra time. My daily walking total has varied between about 3-5 miles. I’m not as concerned now with knowing my walking speed or exact distances. I can keep up with people walking at normal speeds, and I can walk for as long as I have time for right now without my hips getting sore. So I’m pretty content. I expect to keep improving as I keep rehabbing, and eventually I’d like to be able to jog a couple of miles, hit tennis balls, or shoot basketballs. But if the most I could do was to regain normal walking ability and walk for as long as I like, then I would say that these operations were worth it. And I feel like I’m close to achieving that.
I’ve added using an exercise bike and Stairmaster to my routine during the last 2 weeks. I’ve needed to limit my time on the bike to no more than 25 minutes to avoid having left lateral hip pain after riding. The Stairmaster was initially a bit challenging, but feels more normal now. I usually do one or the other or a combination of both for about 20 minutes at the lowest level of resistance.
I’ve missed several days of icing and although my hips might be a bit sore in the morning afterwards, they warm up and feel good after an hour. I may experiment with icing vs no icing to see what difference there is. I’m still stretching for about 90 minutes, and my flexibility continues to improve.
My hips are starting to even out now in terms of pain and performance. My weaker left hip is more flexible and so is able to handle faster walking speeds more smoothly than my right hip. My left hip has fewer minor, off-and-on aches now than my right hip when I’m walking, and the left anterior hip no longer gets fatigued. My left hip doesn’t ache while driving, and the right hip, as it loosens up, aches less and less. My left hamstrings and quadriceps are tighter than in the right leg and take up to twice as much time to stretch out to a comparable end point. Stretching out feels good again, like it used to prior to my having hip problems.
November 21, 2015
Tomorrow I’ll be 5 months post op for my left hip. Although I continue to walk my dog for about 30 minutes/day and walk instead of drive for short trips close to home (for up to a mile and a half one way), I’m spending less time walking now and more time using the exercise bike and Stair Master. I guess I’m transitioning back toward my old exercise habits. Walking is so much fun again though, that I choose it whenever I can over driving. The last two days, I’ve used the exercise bike and Stair Master for 30 minutes each, mostly at the lowest resistance level, at a cadence in the 60’s to 70 on the bike, and my hips feel fine. I’ve also stopped icing my hips because I’ve been tired or busy in the evenings, and also because the weather and house are colder at night now. My hips feel a little sore in the morning when I get up, but after that, I don’t really notice it. This coming week, I may try to add back some strength training, mainly upper body. I might wait a little longer, to see that my exercise bike and Stair Master routine is going well, before trying the straight leg raises again. I can drive for a longer time, about 25 minutes, before my right hip starts to ache, and the aching is less that it used to be. I can wash and dry my feet and put on my socks more easily that I could before, although the easiest way to put on socks is still by sitting on a step stool, with my knees to the side, so that my feet are automatically within reach. I may have minor aches, off and on, in my lateral and anterior hips while walking, but nothing that makes me stop. I also have less stiffness, just a little, when I get up after sitting for a while, and getting up from the couch is easier. I think that’s it. I hope you all are well!