November 29, 2016
I have about a week before my surgery next week. I’m a 49 year old female, born with hip dysplasia. I’m an avid rower and a cyclist and I’ve had bone-on-bone arthritis for at least two years. I was able to ride and row all season, and even got in one of each over the holiday weekend, which I’m happy about.
If it weren’t for this site I’d be having a hip replacement, I’m sure. I’m most looking forward to being able to stand, walk, and sleep without pain. Oddly enough I can row hard and ride hard easier than I can just stand around. The weight bearing is a killer.
December 7, 2016
Everything went well! I ended up with general anesthesia because the anesthesiologist did not like the idea of regional, even though Koen was ok with it. It worked out fine.
Food was exactly as described by I’m really not hungry so no big deal. I’ll see Koen tomorrow I hope. He said he doesn’t visit people the day off because they are all drugged up.
I was surprised that they don’t let you get out of bed the day of surgery. Hope that’s the protocol snd not just for me.
My lower back was hurting and the back of my hip some, but not in the hip. The morphine seems to be doing its job. I wonder when they tske you off the IV?
December 9, 2016
Coming up on 48 hours and seeing good progress. Got the IV out yesterday morning, pain pills are working fine, lower back not bothering me anymore.
Yesterday started using crutches, walking and stairs. Today we go to the hotel!
December 10, 2016
Feeling a little better every day! I may switch to Tylenol today and take codeine at night. Last night I got better sleep, and was even able to alternate from back sleeping to side sleeping (with the pillow).
I have PT with Lynda at 12:30, and may finally venture outside to walk a block to the coffee shop, we will see!
I’m so glad I read on here about “log leg”. That is exactly what it feels like and so strange! Knowing that it lasts about a week is very helpful. Even that is a bit better though.
December 12, 2016
So, I’ve been lucky enough to have slow and steady progress with strength and walking. Yesterday was pretty bad, because I started to have major stomach problems from the anti-inflammatories. This happens to me sometimes, and I forgot to bring my Celebrex, which I’m kicking myself for. I just figured they would have an alternative, but Jan (the nurse) just told me to stop taking them. So I feel generally better today, but a bit more pain and stiffness in the muscles, which makes sense since I don’t have any anti-inflammatories. He’s going to bring me some Celebrex tomorrow. No major issues wiht the hip, though.
The big news today is, I get to go to one crutch! The PT watched me walk and said as long as I’m indoors where the floor is even, I can just use one crutch. This makes life so much easier!
Every day Linda, the PT comes for half an hour. She does basic exercises, everything from stuff in bed, to walking sideways to (if you can imagine) tiny walking lunges. Just the tiniest. She watches and gives feedback, it’s pretty straightforward. Apparently hydrotherapy isn’t offered unless you ask for it. I’m going to do hydrotherapy with her once this week, just so I have some guidance for what to start with when I’m at the pool back home. Jan, the nurse, also comes every day. He brings his bag o’drugs, checks the incision, changes if you want, and answers questions. This was helpful because I would have been really reluctant to go off the NSAIDs except that he clearly thought it was no big deal.
Two things I’m wondering about. One is the anti-inflammatories. They are used to prevent heterotopic ossification. Based on my readings, this occurs often, though less in women, and often HO happens with no limit in ROM or symptoms. NSAIDS can lessen it, but there seems to be come discussion about whether NSAIDS might also inhibit bone growth that’s needed to have the device grow into your joint. So there’s a bone balance it seems. Some things can promote bone growth, which you need for the device to implant, but if it happens too much, you have bone growth in your soft tissues, or heterotopic ossification. The consequences of too little bone activity are a loose acetabular cup or femoral component, and potentially the consequences of too much are HO. So to me it seems like if you don’t take the NSAIDS you save your stomach, probably have a zero net sum game between HO and loose components, but you do lose some in terms of managing pain and inflammation. So far I haven’t had much swelling in my leg, but if one did, that would probably also be a factor. There also is some question about whether NSAIDs limit muscle growth, which you really need, because your glutes and probably some other hip muscles have been out to lunch for quite a while, and building them back and getting them firing is a key part of your recovery. Koen de Smet’s theory seems to be that surgical technique also plays a role, so, once again, if you have an experienced surgeon it might matter less. The bottom line for me was, the surgeon isn’t adamant, the benefits over the risks aren’t all that clear, I’m also female so even lower risk, and I was on them for the first four days so I’ll go with fewer medication rather then more, whenever I can.
The other gray area is related to the hip precautions. Standard hip replacement precautions include annoying things like not having your hip at more than a 90 degree angle, not crossing over the midline, and a few other things. The 90 degree precaution make just sitting in a normal straight backed chair quite challenging. So the issue is, most hip resurfacing surgeons follow those precautions to some degree. Two of the 10 most experienced surgeons, de Smet in Belgium and Su in New York, do not. Su actually argues that the build up of scar tissue that can restrict motion is more likely than a dislocation caused by not following the precautions. It’s generally agreed on that dislocations are much less likely with hip resurfacing. Here it’s even more confusing, because the PT is VERY strict about the precautions, but Dr. de Smet was just as clear that they aren’t necessary. Interesting. Su actually goes so far as to give clients stretching exercises to do that specifically break the precautions.
December 20, 2016
Well, tomorrow is two weeks. I’m walking about 2-3 miles a day on one crutch and it’s fairly comfortable. Pain at night has gotten less, and I can tell that I’m getting stronger with the physical therapy exercises. I can do the sideways walking without the crutch, but regular walking I really need it, although I’m not leaning on the crutch much, just using it for a little support. I really want to make sure I have a normal gait before I stop using it, because I’m able to get around quite a bit with it. Going up stairs using both legs is going just fine, which is great, because I have stair at work and at home.
I’m still very tired, and trying to honor that, working short days, getting into bed early, and making sure I get good rest. I’m sleeping better which is also helpful. I can sleep quite comfortably on my un-operated side with a pillow, which is what I used to do before so that’s great.
The bizarre muscle cramping seems to have stopped. I used to have intense groin and hamstring cramps when sitting or walking. I haven’t had one of those in a couple of days, so those muscles are probably getting over being mad at me.
I am having a lot of groin pain in the psoas region, which I know is a thing that happens, and I’m still really not able to lift the right leg without great difficulty. Getting in and out of bed is easier, but driving a car seems like a week away at least. Fortunately, I live in a walkable neighborhood, and have no trouble walking to work and other places around here.
I’m sitting a lot more since I left Belgium, which causes some low back pain, but I assume that a lot of things will resolve one the hip gains even a little bit of ROM.
I’m looking forward to getting rid of my dressing tomorrow, and to getting off the blood thinners and compression stocking next week! These little benchmarks are helpful.
I’ve been not worrying about the 90 degree thing for just sitting and other basic moves, but trying to respect it for dressing and picking things up off the floor. I might be a little more flexible with it after three weeks. De Smet wasn’t wrong, you kind of can just pay attention to your body and it lets you know what is ok and what doesn’t feel right.
December 31, 2016
Well, I about about three weeks and three days out from my right hip resurfacing with de Smet. Things were moving along well until the last few days when I seem to have come to a stand still. I can walk quite comfortably with the one crutch, even outside and walking more than I would have been able to before surgery. But when I try to walk without it, everything gets inflamed and the limp is not pretty.
I know it’s still early, but I’m wondering if people have suggestions for other ways to measure progress towards a crutch free existence when it’s too early to actually be crutch free? It’s quite amazing, people comment on how well I’m walking with the crutch, but now that I’m putting less weight on the crutch, I’m struggling to know that I’m making progress.
I still have some pain in the deepest part of the incision, but otherwise the pain is good, just taking a couple of tylenol here and there. Getting closer to putting on my right sock, too. And I started driving last week. But feeling a little bogged down this week. I’m also having significant pain in my front hip flexor/psoas, which I think is common for folks. I had a lot of trouble with that area before surgery so I’m not surprised.
I’ve also noticed that several people on here have mentioned that when they have had trouble after surgery and have emailed de Smet, he has not been responsive. What have others experiences been like? He was so responsive before surgery, but even when I emailed him for a simple receipt for my surgery so I could submit it to my insurance company, I heard nothing back. I’m a little nervous about being stateside without any reinforcement.
January 13, 2017
February 1, 2017
So, eight weeks today!
I went up to NYC to see Dr. Su. Dr. de Smet did not reply to my last email asking about when I could start cycling. I feel like once you are done with the surgery he is not as responsive. So I wanted to have someone who had me in their patient system I could also use in case I needed a revision.
He said I was doing great for 8 weeks. I asked him about the limp, he watched me walk, and said that’s glute strength. The interesting part was, he said the glutes aren’t really healed until three months, so you may not be able to get the strength you need until after that. This was very encouraging for me. The limp I have is like the one I had before on my very best day, and there’s no pain at all, so I think it’s just going to take a little time and I’m ok with that. I’m not going to worry too much about pushing glute strength for another month.
On another note, I did a one hour spin class yesterday and it was awesome! No problems at all!
March 10, 2017
Yesterday working with my trainer (who has a PT on site) we thought my psoas was acting up, but he had me do some specific moves and said the movement that made it hurt indicated that it was indeed a hip flexor but not the psoas, so quad stretching and such are recommended. Some people have psoas problems if the device is not properly placed. With an experienced surgeon this should not be an issue.
March 29, 2017
I’m at about four months, having only had one hip done.
It is taking me forever to do squats, but I’m making (very) slow progress. But still, it’s progress. I’ve been working with a trainer for six weeks, and the PT there said I made good progress. But my right leg is still SO much weaker than my left.
Standing on one leg is a joke, but it’s better. I still have a limp. I CANNOT do even ONE clamshell.
For about two weeks, BOTH hips were crazy tight and painful, and then it was gone.
I was having a pinching on the front of the hip, top of the thigh that I thought might be psaos, but the PT watched me and said it was actually the quad, which I guess is better.
Progress has been so slow, but it’s progress. I went from only being able to do squats at the very top of the range (because I would shift to one side) with the assistance of the TRX band, to being able to do a pretty deep (for me) squat with no help, and not shift to either side.
My standing on one leg exercises are better, but it’s still not pretty. My romanian deadlifts with handheld weight are getting closer to looking like actual deadlifts.
What I mean to say is, lots of random tightness, pinching, weird aching muscles, but a lot of it seems transitory, though some of it is hanging in there. (Four months and not one clamshell, really?)
I think improvement looks different after this kind of major surgery. I try to focus on the little improvements. They aren’t the kind I would see if strength training and not recovering from surgery, but it’s still progress.
My old PT told me two things to try for psoas release. Basically you do a bridge, with a pillow folded between you knees. Do 10, then do 10 with the band around the outside of your legs. In other words ten bridges pressing in on the ball, and 10 bridges pressing out against the band. That seems to be something you can try to get the psoas to calm down a little bit.
November 16, 2017
I’d say I’m 90% of the way there. Lingering issues include:
- My external rotation on the right (operated) hip is MUCH better, but it’s still not the same as the left.
- My hip flexor tendons (ilio-psoas most likely) are still touchy. They get very annoyed if I do too planks, and especially planks with one leg.
- My right glute is still struggling to come back online. It’s much better, but it’s an uphill battle.
Had a few times where my proprioception really felt off, almost like my leg wasn’t connected. A couple of Feldenkrais sessions really helped this, or if my gait seemed off.
Today I had the first of three ART (Active Release Therapy) sessions, so please I can report back on whether that was helpful as well.