Advice, expectations, and reality

PRE-OP ADVICE

Keep in mind that my surgery was bilateral (on both hips at the same time).  Much of my advice, expectations, and reality are overkill for a single hip procedure…  maybe.

BHR, pre-op, left, website

Pre-op, left.

  1. CONDITION.  As early as you can, prepare your upper body for the workout it will get after surgery.  You don’t need to go heavy, just try to strengthen muscles in the wrists, arms, shoulders, and back.  A regular conditioning routine will also help with your post-op endurance.
    1. HINT #1:  Do push ups facing an armed dining chair (or similar chair), then sit in the chair and do sitting push ups.  You will need this muscular enhancement!
    2. HINT #2:  Practice using crutches:  balancing, pushing, and pacing.
    3. HINT #3:  Learn the physical therapy routine you will start the day after surgery.  These are exercises done in bed.  Practice days or even weeks before your procedure.  My physical therapist told me that many people “can’t find their muscles” after surgery, and my doing this helped keep my muscles toned and in the know, so to speak.
  2. NUTRITION.  If you are not eating healthy now, you better get started!  You don’t have to be a health-food nut, just eat healthy foods.  Cut out processed snacks, sodas, and most deep-fried foods.  Focus on protein, calcium, and vitamins C and D.  Eat regularly.  Take a multi-vitamin/mineral.  All this will be more important after surgery when your body is craving the nutrition it needs to heal itself.
  3. ATTITUDE.  Mental preparedness is a big part of the surgery day and post-op time periods.  It’s the hardest of things to manage, too, especially if you have mental health challenges (anxiety, depression, etc.).  Counsel with your pastor or a trusted friend.  Meditate – not the creepy yoga type but rather prayer, Bible-reading, and relaxing, reflective moments.  If you are worked up about surgery, tell your surgeon.  Seek to be at peace with it.

    BHR, pre-op, right

    Pre-op, right.

  4. TAKE PICTURES.  Pre-op and post-op pictures will show changes in what the surgical site(s) look like, how your posture can improve, and if any “deformities” are resolved.  My wife and I noticed less swelling, even compared to post-op surgery trauma to muscles.
  5. WORK AHEAD.  Depending on the time of year, you will want to take care of major chores or tasks that need to be done while you have no precautions.  Think ahead.  Also, stock up on ice, pre-bagged and ready to use.

SURGERY DAY EXPECTATIONS

  1. FAST.  You will be told to not eat or drink after midnight.  If you can’t make it that long, then you need to talk to your surgeon.  Fasting is a notable spiritual discipline as well as a practical physical discipline in the event of things like a weather emergency, outdoor crisis, unexpected travel, health crisis, etc.  Surgery is a health crisis!  Discipline yourself in fasting.  It will come in handy.
  2. LEAVE MODESTY BEHIND.  You won’t need it.  In fact, it will just get in your way.  As one who appreciates the benefits of therapeutic naturism, it didn’t bother me in the least to be as naked as I needed to be.  As one who enjoys practical naturism (like skinny dipping!), well, you can’t get more practical than a surgical experience during which being naked is not only expected but necessary, if not appreciated by all.
  3. LEAVE A LOT OF STUFF BEHIND.  Pack light.  A string pack with gym shorts, a tee shirt, and a few essential toiletries is all you’ll need – maybe a Bible and/or a book.  Be organized.
  4. DON’T SWEAT THE CATHETER.  My surgery, on both hips (bilateral), was about 4 hours long so a catheter was inserted after they knocked me out.  When I woke up, I really didn’t know it was there at first, and after I did know, it only felt a little odd (no discomfort).  When the nurse removed it later that night, I only felt a few seconds of slight, uncomfortable pressure that reminded me of peeing after I’ve held it for a long time.  Up until then, it really didn’t bother me nor did I have the urge to go.
  5. OBEY ALL INSTRUCTIONS.  This really covers everything else.  Just do what the surgeon asks you to do.  It will go a lot more smoothly when you cooperate.

POST-OP REALITY (especially for bilateral hip resurfacing)

THURSDAY.  My surgery was on a Thursday afternoon and like I said it lasted 4 hours using general anesthesia.

FRIDAY.  I basically had no precautions after surgery.  The few that I had were:  don’t drive, do take blood thinner as directed (aspirin), wear compression socks, no disco moves (really, the surgeon said that!), and take pain medication as needed which, by the way, I stopped when I got home.  I was standing and slowly moving back and forth to the bathroom just a few hours after I woke up.

Physical therapy started in the hospital.  I was able to walk around even more using crutches (at my request – I didn’t want to use a walker).  Occupational therapy also started.

SATURDAY.  PT worked with me on climbing and descending stairs.  I was generally walking around the room using crutches, without assistance.

SUNDAY.  I was discharged in the afternoon.  Two weeks of home therapy was ordered which started the next day.  I worked from home this week, as much as I could.

THE FOLLOWING SUNDAY.  I was back in church, on crutches, teaching my Sunday School class.  Week two of home therapy started the next day during which the therapist told me that there was nothing more he could do.  I had apparently “maxed” out the routine.  For his swan song, I asked him to guide me in safely getting on and off the floor, which he did.  After that, all my bed exercises became floor exercises.  I went to the office twice.

WEEK 3:  Outpatient physical therapy began with an evaluation.  Although I had started using a cane at home, I opted to take the crutches to therapy, which happened to be the last day I used them.  Tuesday morning, I voluntarily ditched the crutches and stayed with the cane.

I was now in the office full-time.  My home therapy routine continued without a break (except on Sundays) at home and in the office.  However, I was now doing new therapy exercises which were not as demanding as the first two weeks of home therapy.  But I was also walking a lot.

BEGINNING OF WEEK 4:  MONDAY.  My second outpatient therapy session was held, after which the therapist faxed my progress report to the surgeon…

…which now brings me to my one month follow-up, which was really just 25 days after surgery.


ONE MONTH FOLLOW-UP

As it turns out, my left hip was the worst.  The surgeon told me that muscles had tightened (became kind of fibrous) because of disuse or minimal use over time, even though I routinely stretched to keep muscles loose.  Imagine if I had not stretched.

At my one month follow-up (actually, at three and a half weeks), I had all precautions lifted (which weren’t that many).  I left the doctor’s office with no limitations on my activity other than “if it hurts, don’t do it.”

Physical therapy was continued, with an upgrade to doing more resistance training.

My next follow-up will be three months after surgery.


THREE MONTH FOLLOW-UP

At three months, I’ve been declared fully healed.  But I’ve still got a lot of strength and some range of motion to recover.  My surgeon told me that I could do anything I want.  I suggested things like bicycling, motorcycling, hiking with a full backpack, and the like:  No restrictions, but again, I’ll have to work up to many of these things, and also be careful with heavy lifting for a little while longer.

My next check-up is at the one year post-surgery mark.  By then I expect to have full strength, range of motion, and little or no soreness (yes, I’m still a little sore after exercise but considering the way the surgeon had to stretch my muscles, it’s really not that bad, like 0.5 or less on a scale of 1-10).

Physical therapy is now done.  I’m simply exercising, eating well, and doing anything else the surgeon has told me to do.  All three are keys to recovery.


EIGHT MONTHS OUT

I’ve suddenly realized that at the eight month mark from surgery, nearly all the pain and discomfort in my hips are gone.  I still have a little numbness on the surface of my left thigh but I’m getting used to it.

I’m catching myself doing things that I could not do this time last year or for that matter, in the last few years.  I’m lifting, working, moving, swimming, hiking, and contorting and things are great.  I expect the one year mark to be even better.


ONE YEAR FOLLOW-UP

Xrays, 3-2017, 3

One year, left.

By now, most of the pain is gone.  I still have a little discomfort but it is largely not associated with the surgery (more likely old age).  At my one year follow-up, x-rays showed that the resurfacing components are in perfect alignment and that all bone has healed nicely.

I have been told that I can do anything I want.  No restrictions.  I still have to take an antibiotic for a few years before I have any major dental work done, or other procedures (I had outpatient surgery on my left thumb a while back and although awake and talking to the surgeon the whole time, he still had an IV antibiotic administered since my HRA was less than a year ago).

Xrays, 3-2017, 5

One year, right.

Now that the weather is a little more hospitable to work in, I’m doing a lot of things outside that I couldn’t do before the surgery.  I can also ride my motorcycle and four-wheeler pain-free.  In fact, the list of things I can do pain-free is endless.  For the last numerous years, I’ve been writhing in pain in my hips with nearly any activity.  ALL of the pain is gone.

The only pain I have to look forward to is the inconvenience I’ll have when I go through metal detectors.  But if they insist, I’ll gladly show them my scars!

 

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