Sunday, July 12, 2009

50 mile bike ride!

I was signed up for a bike race yesterday - my first. I had done quite a few running races prior to my surgery. I love the adrenaline and the drive to finish with a personal best time. Since running is out of the question I hope cycling can replace those feelings.

I got to the race and found out the 20-mile group only had two other people and it seems like this event was more of a ride than a race. There were also groups for 200K (metric double century), 100-mile, and 50-mile. After some discussion with the race/ride director I decided to connect with another group and just go until I felt I needed to turn around.

Well, I ended up doing a 50 mile ride! The hip did very well. I never had any hip pain at all during the ride. My quads were a different story. They really burned on the hills! I was afraid I would be very sore and stiff after finishing, but other than some general soreness in my both legs there was no problem at all.

This was the first time I've ridden with other people and it is so much better and easier than riding by yourself. The drafting technique really works. I even took my turns pulling the group. Averaged 18 mph for the entire ride, so I was really pleased with that as well.

The morning after I'm not very sore but do have some soreness in the glute around my incision. It's just soreness so I'm not concerned. I'm honestly shocked how well the hip is doing. Prior to the surgery I couldn't even run 40 minutes without my leg being so sore I would have to use my hands to help lift it. What a difference this is now!

I still have to listen to my body as I continue training, but I'm extremely pleased how well it has reacted.

Friday, July 10, 2009

12 weeks post-op

Finally made it to 12-weeks post-op. This is the de facto time period that most surgeons, including mine, allow hippys to perform most all activities (with a few exceptions) and begin to regain the mythical lost flexibility.

I can now officially do things like play golf, ride my bike on the road (oops, already been doing that) and flex beyond 90 degrees (been doing that, too). I have been doing most things I have wanted to the past few weeks, even though some things I wasn't really cleared to do. I have never felt like I pushed my body too hard, so I haven't been concerned about overdoing it too much. I had a bad hip for so long I know the signs to look for.

I don't have much of a limp anymore and most days I really have no limp at all. Some days I am a little sore and it comes back but by and large I'm walking better than I have in ages.

The biggest things for me are fitness and flexibility. I graduated from riding the bike on the trainer to riding on the roads a few weeks ago. I haven't ridden a bike for any period of time since I was a kid, and I never really rode a road bike, so this is all new to me (not to mention I have a new joint).

I don't consider myself a health nut but I am probably a fitness nut or even an aerobic nut. I love the feeling after a hard aerobic workout. I was totally hooked on running before my surgery. Now I'm getting totally hooked on cycling. I've always had strong legs and I now have the best aerobic capacity I've ever had. Seems like a perfect mix for cycling. Of course I'm still doing a lot of learning, but I'm looking so forward to becoming a better rider.

The other big thing for me is flexibility. I've had over 23 years of limited flexibility. With this new hip I'm working on getting that flexibility back. I've been slowly working on it the past few weeks and get gradually better each day.

I can easily put on socks and tie my shoes now. Doesn't sound like a big deal unless you can't do it. In the months prior to my surgery after virtually any run I couldn't lift my right leg without using my arms to assist. You should have seen me try to get into a vehicle. Already I have no problems lifting my leg after a hard bike ride.

I can almost do a full hamstring stretch but not quite there yet. I want to be able to pull my knee up to my chest but can't do that yet either. I need to find a therapist who can help with this, because I'm not sure I can do this myself. I have to keep on top of this or I'll never get the full flexibility back.

I still have some soreness and really expect it for many months, even up to a year. This was a major surgery and even though I've made what I feel is tremendous progress, it will take time to get back to normal.

I probably push myself a little too hard at times but I feel it's better for me to stress the joint a little to stimulate improvement.

I have my first ever bike race tomorrow. I'm only doing the 20 mile option. I could do more but being my first I thought it best to be conservative. I'm nervous but excited. Hope it all goes well.

Guess I need to go dust off the clubs now.

Wednesday, June 24, 2009

20-mile ride turns into 30 miles

I tested my leg on a longer bike ride yesterday (at least longer to me at this point), although it was unplanned. I ventured out of my subdivision onto the main road into my subdivision which is quite a busy road versus the roads behind the subdivision which are not well-traveled.

I went after rush hour to limit dealing with much traffic. I only planned on being on the main road for a short distance, less than half a mile, before going to some back roads for a good ride.

I had a plan in mind for the route. It was an out-and-back with a loop on part of the trip. Somewhere along the way I got on the wrong road and ran into a dead-end, which meant a lot of backtracking to get back on the right route. My original plan was for 18-20 miles, which would have been about an hour and fifteen minutes. My little miscue turned the trek into an hour and fifty minutes and 30 miles!

This was more than 30 minutes longer than any ride I had done on the trainer. The good news is I made it through the ride physically okay. I was a little sore but I had expected that if I had stayed on my original plan, because the roads around here have a lot of hills to deal with.

I'm ready to go again!

Friday, June 12, 2009

9 weeks post-op

It's now been more than 9 weeks since my surgery and my hip feels a little better each day. Some days are riddled with soreness, but I'm rehabbing hard so it's to be expected.

I've been spending most of my rehab time on the bike (on the trainer), riding 5-6 days a week. I've gone as long as 1:15 so far and that was work! Felt good to do, though. Some days are just easier recovery rides.

Two days ago I finally rode outside for the first time! I was a bit nervous, because I have never ridden a bike on the road while being clipped into pedals. I primarily stayed on my neighborhood street and kept doing loops, which is .9 miles. It also seemed like a good idea at the time to try tackling the hill that leads into my subdivision. It was almost a bad mistake, but I made it. The hill is fairly steep, around a 15% grade and a 1/4 mile long. I used to run it all the time, albeit slowly, but didn't figure it would be as hard on the bike. I got about half way up into my easiest gear and still struggled. I finally made it, though, and now I at least know what it takes for that hill.

Yesterday, I decided to go behind the subdivision where we have some fairly untraveled, but hilly, roads. Only scary part is the short patch of dirt road that I have to go on which has a downhill spot to start and uphill to finish between the pavement sections. My main concern is just being able to get out of the clips quickly if I need to bail. These pedals add an entire new element to cycling, but the benefits are great. I ended up with a good 16 mile ride, so it was a good day.

I am sore today from these two days of riding. I'm actually going to take a pain pill. This is a good thing, actually, because I worked muscles hard enough to stress them. I'll just do an easy recovery ride today.

Friday, June 5, 2009

7 weeks post-op

I'm now a full 7 weeks from my operation. Hard to believe it's been this long. I seem to get a little better each day. There is some pain and soreness but I can tell things are healing. I've been working really hard but have had an especially good week.

I worked my core and legs hard on two days, harder than I have worked since the surgery. My arm strength feels like it's finally back to where it was, or certainly very close. My weight has been down to between 151-153 the last couple of weeks, even though I feel like I'm eating more.

Cardio is my favorite work and I've done something every day. Three days of cycling (indoors on a trainer) and two days on the elliptical. I'm up to an hour on the bike! For not having rode a bike in many, many years, I feel like I'm picking it up well. The hour gets me about 15.75 miles. It's certainly not earth shattering but I'm very pleased. I can't wait to get out on the road and see how it translates.

I will say this. Riding for that long sure makes my butt bones hurt, or more technically - the sit bones. I've never really rode a road bike for any length of time so this is totally new to me. I've tried to get the seat post and seat adjusted correctly but it still hurts. I have a new seat ordered so hopefully that will help.

Oh, another small milestone. I'm finally done with taking aspirin every day for blood thinning. I'm in good enough shape and have been active enough that I don't think this was really ever an issue, but I was following doctor's orders. So, as of right now I'm free of scheduled medicine. That feels great. I haven't had a full pain pill all week. I have taken Tylenol a few times but not the hard stuff.

Taking a long road trip this weekend so it will be interesting to see how I hold up during the trip. I've had problems and pains on long trips for as long as I can remember but hopefully this will start to improve.

Saturday, May 30, 2009

Updated scar photo

Since I'm at 6 weeks post-op I thought I'd take an updated photo of my incision scar. It's amazing the progression from a week after surgery. If you can stand the horror, I made a collage. Click here.

6 weeks post-op report

I've been so busy working my job, working around the house and rehabbing lately I've neglected to post. I suppose that's a good thing.

Since the last post I've been to see the surgeon for a checkup and to do my first post-op x-rays. He said the x-rays looked great and was very pleased with how the implant set in.
He didn't lift all restrictions. Wants me to not ride the bicycle outside, play golf, go beyond 90 degrees, and other similar activities until 12 weeks. He did say I could slowly start working on the range of motion but he didn't want me testing it very much until 12 weeks. Otherwise, I'm free to do anything I want while using pain as a guidance. No more cane, which I haven't used much anyway.

I'm actually breaking the rules just a bit, because I can tie my shoes now but just barely. I stretch as much as possible with my arms and upper back trying to keep as close to 90 degrees as possible. Funny thing is, how I'm tying my shoes now is all I could do pre-op, so I know it's only going to get better.

I tried to be a really good patient and follow the rules to the letter, but that's difficult for me with this kind of stuff. I figure if you use common sense and let your body guide you things will be okay.

Saturday, May 16, 2009

Physical therapy

It was suggested that I note the steps of my physical therapy. That's a great idea. I'm sure I'll forget what I've done if I don't do this, so here goes.

First PT session was one week out from the surgery and then 2x per week for the following two weeks and then one final day on the fourth week post-op.

Session 1 (see attached photos)
1. sitting hamstring stretch
2. standing calf stretch
3. quad flexion (towel or pillow under knee with downward force)
4. knee extension (lying down will pillow under knee and extend lower leg upward)
5. hip adduction (squeeze pillow or ball with inward force)

6. hamstring strengthen (pull heel into surface)
7. heel slide (lying down pull knee toward chest close to 90 degree)
8. trunk stability (tighten buttocks)
9. standing heel raise (flex calves)
10. standing hip abduction (first session only move leg out 6-8 inches)

Session 2
1. Everything from session 1
2. standing knee raises max 90 degrees (use table for support if needed)

3. standing squats (use table for support and keep trunk vertical, squeeze buttocks on each stand)

Session 3
1. recumbent cross-trainer (10 minutes) (Click here to see the type of machine)

2. single leg press operated leg (10 minutes) (started with 60 lbs and moved to 75 lbs which is half my weight - was not to do more than half my weight)
3. recumbent bike (10 minutes)
4. hamstring strengthening (10 minutes) (this was done by sitting on a stool
(see picture) with 20 pounds of weight attached and pulling myself around the room - it really works well)
5. standing knee lift
6. squats
7. electrical stimulation on quads (15 minutes)

Session 4
1. Same as session 3 except no bike because I was doing that from home now
2. knee extensions on a weight machine (10 minutes - sessions with operated leg only and both legs)

Session 5
1. Same as session 4
2. Elliptical (10 minutes)
3. resistance backward walking (10 minutes - this was done by using a strap around my back that was attached on my front to a pulley weight system. I walked slowly backward and then slowly forward. I don't recall the exact weight but it was a comfortably hard weight, meaning safe but beneficial)
4. same as #3 except walking sideways
5. single leg step-ups (30 reps using the operated leg and holding a handrail for balance)

Session 6
1. Same as session 5
2. lying leg abduction (lying on non-op leg and raising op leg 6 inches - 10 reps x 3 - therapist told me to be very careful with this and not rush it - it was hard and painful, especially at first)

Session 6 was my last at the therapist's office, so I've been doing quite a few exercises each day at home. I generally alternate days on the harder exercises. Here are the examples of what I'm doing at home. I don't do each of these every day. I mix them up and alternate days with some, for example I won't bike ride and do elliptical in the same day.

1. stretch hamstrings and calves
2. standing knee lifts with 10 lb ankle weight
3. standing reverse knee extension with 10 lb ankle weight (works hamstring)
4. knee extensions using ankle weights or a bench/weight machine
5. standing side adductions using weight machine for resistance
6. walk 1-2 miles
7. lying leg abductions
8. core and upper body work (arms, shoulders, abs, back)
9. elliptical (up to 20 minutes per session now, increasing intensity and hope to be 30 minutes soon)
10. bike riding indoor on a trainer (essentially a stationary bike, up to 45 minutes now - working on increasing intensity and hope to be to 60 minutes soon)
11. leg press alternative (i don't have a leg press on my home machine so I simulate a leg press by holding onto a surface with my hands and squatting on one leg - I can control the weight/force with whatever I'm holding onto with my hands)

That's about it. I will modify and evolve as my body lets me.

Friday, May 15, 2009

4 weeks post-op

I can't believe it's been a month since the surgery. It has been quite a journey so far, from barely being able to move the first day at home to doing multiple exercises per day.

The first week post-op I was spending the vast majority of my time on the couch, even working with my laptop. I was barely able to sleep and was running a fever every night. I also developed a rash on my back, which appears to have been a heat rash due to spending so much time on my back. Also had my first physical therapy session and there wasn't much easy about it.

By the second week things were getting better each day. The fever was gone. The rash was finally clearing up (thanks to cortisone cream). Two more trips to therapy and new exercises. Got the staples removed and the surgeon said I appeared to be healing well.

Week three saw much increased activity at therapy and at home. I had moved to just a cane at this point. Most of my walking around the house was without any assistance, but any longer distances still required some help. I was able to ride my bike indoors on a trainer, like a stationary bike, and also work on the elliptical machine. For the first time I started to feel somewhat normal again. Certainly felt good to sweat with a workout!

The therapist turned me loose after my first session in week 4. It was nice to be able to start doing my exercises at home. The improvements continued to get better and better each day. Still stiff and sore after extended periods of sitting or sleeping but even those moments are improving.

So, that brings me to today. I've yet to have a really good night's sleep, but I am at least getting a few hours a night with the remaining hours being fairly restless. It's just still difficult to get comfortable.

The days are pretty darn good. Once I get the day started I don't experience much pain or discomfort. I'm getting in good exercises and try to do a little more each day. Today, for example, my exercises have consisted of leg extensions with ankle weights focusing on the quads and a different move focusing on the hamstring, 20 minutes on the elliptical, walked 2 miles and upper body/core work.

I can't wait to see what the 4 weeks brings.

Thursday, May 14, 2009

I can drive again

As of today I can drive again according to my surgeon. I've actually already driven some due to necessity and there was no issue whatsoever. I guess the doctors are understandably nervous about patients being able to react quickly to the demands of traffic. Perhaps I've healed quicker than most but other than some discomfort getting in and out of vehicles I've had no trouble driving.

I work from home so I don't have to drive a lot but it's nice to be able to go somewhere when I need to and not be dependent on others.

Tuesday, May 12, 2009

45 minutes on the bike

A new milestone today for me. I did a 45-minute workout on the bike (indoors on a trainer). I have been doing 30 on the bike and 15 on the elliptical but now that I'm going to be doing all my exercises at home I wanted to change the days when I do the elliptical and start working more on riding the bike.

Luckily, I do have a TV to watch while I'm riding on the trainer, so I won't get extremely bored. Also, I keep the workouts interesting by starting in an easy gear and riding for X minutes and then going through harder gears and so on and finally work back down to easier gears to cool down.

Hopefully by the time I actually get cleared to ride outside I'll have a good feel for how the gears work and understand what gear to ride in based on the situation. The thing I love about the trainer is that it simulates the road well and allows me to use all the gears and feel what they would really feel like on the road.

One thing I've got to get used to is the sore butt. Dang! I do have a couple pair of padded cycling shorts but I need some more, since I'm riding almost every day. So, some days (like today) I wear running shorts and fold a small towel to sit on. That only helps so much. I may have to look into a more comfortable seat.

Yet another thing to buy.

Turned loose from physical therapy

I've been improving every day. I'm really pleased with my progress and apparently so is my physical therapist. At 3 1/2 weeks post-op (yesterday) he gave me one final new exercise and said he trusted me to continue working hard but he also trusted me not to over-extend myself (literally and physically).

The latest exercise he is having me do is a lying leg abduction, which is just like the standing one I've already been doing, except (obviously) lying down. I lay on my non-operated leg and with both legs fully extended raise the operated leg a few inches and then bring it back down.

I've been doing this standing up since the first week post-op and have been getting better at it each time. There really is no pain doing it when standing and I can extend probably 60-70 degrees now.

Doing this lying down is a totally different story. There is so much more leverage against the hip and muscles on the outside of the leg, such as the IT band. This is where the bulk of my incision is so it's no surprise that it hurts.

I'll just keep working it and it will get better.

Friday, May 8, 2009

A bike tire beat me

Speaking of the new bike. I'm new to cycling so I'm learning a lot. One thing about me that can sometimes be a curse is that I over-research just about anything I'm going to do or purchase. When I was researching trainers I read about how they just eat tires. Because of this there are special tires created just for trainers. The one that gets the best reviews is the Continental Ultra Sport Hometrainer tire. I knew this would be a necessity given the amount of time I'm going to have to spend on the trainer before I'm allowed to ride outside. I did ride with my stock tire once while I waited for the Conti to arrive and I was shocked how much rubber came off the stock tire.

Of course I didn't want to keep changing tires when I rode the trainer, so I had to buy a cheap wheel and a cassette (that had to match the stock one). I was so excited when the tire arrived because I wanted to try it out. Did I mention cycling is expensive? Even with high-end running gear it wasn't nearly as expensive.

I haven't changed bike tires or fixed a flat since I was a kid. It's probably been over 25 years. Of course I watched some videos online to make sure knew how to put on the new tire correctly. Boy do they make it look easy! What a nightmare.

So I tried to do a test first without the tube. I should've realized right then and there that this was not going to end well. I got my trusty multi-tool which has two tire levers with it. I finally coaxed the tire on and was already frustrated.

I worked and worked and got the tire off. I was really worried about getting the tube and tire installed without creating a pinch-flat, which is caused by using a tire lever. There is an art to this.

Before trying to put the tube in I wanted to check the wheel for any abrasions, then I noticed something. All the spoke holes were uncovered and the edges were sharp. I thought to myself, "won't those cause a flat?" So I did what I do best - hit google. Sure enough, my new wheel doesn't have something called rim tape. What? Why in the heck did the wheel not come with this.

Of course I had never heard of rim tape so I surely didn't have any lying around. Surely I can use some other tape, like electrical tape. I got some and put a couple of layers on the wheel, being sure to stretch it a bit to fit the narrow wheel correctly without covering the bead.

I did some more research after getting the tape on and found out that electrical tape wouldn't work very well and I needed real rim tape, which is most common in the form of a cloth tape. So, my tire would have to wait. I went to the local shop and picked up some Velox tape, which I read repeatedly was the best.

I installed the rim tape and gave my first shot at installing the tube. I got the tire and tube on about 80% and then had to resort to using the levers. I knew to be careful not to pinch the tire. Sure enough I promptly pinched it and heard "hiss." Yep, flat #1.

I removed the tire and got to practice using the tire patch kit. Test number 2. I got the tire on and it seemed to have worked. Sweet! It appeared to be holding air, so I installed it on the bike and did a test ride. It worked great.

The next day I went out to do a ride. Yep. Flat. Dammit!

I did not want to be defeated by this thing, so I gave it another shot with a new tube.

I worked and worked to get this new one on right. In the process I broke one of my tire levers. Crap, this is not going to turn out well. You pretty much can't do this with just one, so I found some little flat tool in the garage that was shaped like the tire levers. Only problem was it was all metal, so it would do some damage to the wheel. So, I wrapped some tape around it and gave it a shot.

With the new tool and the one remaining unbroken tire lever I was eventually able to get the tire and tube on. I was as careful as I could be but the fit is so tight it's dang near impossible for me to do this right. I just hoped it had worked.

I aired up the tire and let it sit for a few hours. It seemed to be okay. Maybe it worked?

I got up the next morning. Yep. Flat. Son of a ...!

Well, I know when I'm beaten, so I gave up and took it to the local shop. Even the guy at the shop had a hard time with this tire. He said it was a really tight fit but he felt like he got it installed correctly. He also commented that I was smart for getting that tire for my trainer. Hey, the googling paid off :-)

Ever pessimistic, I didn't install the tire until it had made it through a night holding air. I woke up this morning and it still had full air in it. Yeah! Went for a 30 minute ride today and it worked great.

It's the little things in life that make you happy.

Better every day

Work is kicking my butt right now, so I haven't even had time to update this blog in the evenings.

I am now officially 3 weeks post-op and my hip feels better each day. I'm walking with just a cane now, although around the house I rarely use anything. I am careful to try to walk properly without a limp, because I'm wary of muscle memory causing a permanent limp.

I've also just been taking one pain pill a day, but there have been times where I should've taken another. Unfortunately I'm falling a bit into my pre-surgery habit of dealing with pain and soreness. I've got to learn to take medicine when I'm hurting - at least for these first few weeks.

I did use ice for swelling for the first time this week. I've done it a couple of days. Don't know if it's helping any or much but it's the right thing to do. I'm sure it's going to take several more weeks for the swelling to go away regardless.

The workouts at PT have been kicked up a notch each time. This week was a recumbent cross trainer, leg press, leg extensions, elliptical, stationary bike, hamstring pulls, step-ups, and resistance side steps. It is wearing me out! ... but totally worthwhile. It feels great to get in these good workouts.

Also, I've been riding my bike on the trainer almost every day plus some elliptical after. Today I did 30 minutes on the bike and 15 on the elliptical. I felt incredible afterward. I can't wait to get out on the road.

Looking forward to continued improvement.

Saturday, May 2, 2009

Rode my new bike for the first time

As mentioned earlier, my OS cleared me to start riding a stationary bike for rehab. The only caveat was to use pain as a guidance for how much I could do.

Last week I purchased an indoor trainer so I could use my own bike as a stationary bike. I got a Kurt Kinetic Road Machine fluid trainer. This thing is awesome.

I also purchased the cadence sensor for my Garmin Forerunner 305 so I could track my workouts. I used this heavily when I was running, so I thought it would be easiest to continue using it instead of buying a whole new computer for the bike. It won't track watts (power) but it will do speed and cadence, and when I ride outdoors it will map my rides, so I'm sure this will be more than adequate for a while.

The first hurdle was figuring out how to get on the bike, given that I have certain rotation and angle rules I have to obey on my right leg. I was able to get my right foot into the pedal clip and use the bike top bar for leverage and swing my left leg over the seat. That worked fine and kept my right leg correctly positioned.

I also had to tilt the handlebars back toward the seat so I wouldn't have to lean over too far to hold onto the bar and change gears. This enabled me to not break the 90 degree rule between my hip/thigh and torso.

I wanted to take it easily (obviously), so I figured 10 minutes, 15 max would be more than sufficient for the first time. It felt great starting off. These fluid trainers are cool! I started off in a mid-gear, big chain ring and 14 or 15 on the cassette.

After about 5 minutes, I figured I would be able to do 15 minutes. I wanted to move to a slightly harder gear for 2-3 minutes just to see how it felt. At about 8 minutes I was starting to sweat. This was great! I love working out and have really missed it. Even though this wasn't a big workout it certainly got the endorphins moving.

At 10 minutes I switched to a lower gear, don't even remember which, but definitely harder. My speed increased a little but the cadence felt about the same. I did that for 3 minutes and then cooled down.

This felt like a major accomplishment to me. Not only giving a good workout for my hip but being on a nice ride on my new bike for the first time. Bikes are much better than when I rode them years ago!

I was grinning ear to ear.

Thursday, April 30, 2009

New exercises today

Had PT right after meeting with the OS (to get staples removed). It is conveniently in the same building. I got to do lots of new stuff today. All the exercises the PT had me do to this point were stretches and muscle contractions.

Today he had me start with some sort of sitting machine that had steps that worked like a stair climber. Did that for ten minutes. Next was leg press with only my operated leg. Started with 60 pounds and moved to 75. Did that for 10+ minutes.

After that he put me on a short rolling chair that he attached some ankle weights to and he had me pull myself around the room for a while. That worked the heck out of my hamstrings!

Then I got to get on the recumbent bike for 10 minutes. It felt great! No pain at all.

Last thing was a contraption to electrically stimulate my quads while having me flex the quads each time it cycled. That felt weird but really kind of neat. I'm sure many of you have had that done. I've had a similar thing done to my back before but that was much more painful. Did that for 15 minutes and I was a bit tired.

What a day. Felt great to do some real work. I'm sure I'm going to hurt tomorrow but it will be worth it.

Got the staples removed

I'm exactly two weeks out from my hip replacements. Saw the OS today to get my staples out and do a status report.

He was very pleased with how the incision has healed and how I am feeling.

He gave me clearance to start elliptical and stationary biking. I just have to use pain as a guidance and don't break any of the angle rules. Oddly enough he doesn't want me swimming for another 3-4 weeks. Don't know why. Maybe something to do with being able to easily get into bad angles?

I can go ahead and switch to a cane. Definitely happy about that.

Still have to sleep on my back or non-op leg with pillow between legs for another 2-3 weeks. I used to always sleep on my operated leg so this is really causing me sleep issues.

I can finally drink again. I need a beer and some buffalo wings or pizza.

Doesn't want me to drive for two more weeks, which is fine. I work from home so just mainly need to go to PT.

Great meeting from my standpoint.

Also, I have a few pictures to share. I was able to get a picture (with my phone) of the x-rays taken by my GP (second image) a couple of months ago when I didn't know what was going on with my hip. Also, for reference I have the one from 1988 (first image), about 8 months after the surgery to repair my hip.

In the latest x-ray on the right you it shows where the extra bone and scaring virtually wore away the cartilage in the socket, especially on the edges. This is where most of my pain was coming from. The bones had no cushion to absorb and lubricate the impact from any activity. It's difficult to believe I ran a marathon in this condition.

Also, the second x-ray shows a faint line near the bottom that the OS drew to determine the leg length discrepancy so he could fix it with the prosthetic. It's nice to be level now :-)

I also put together a small collage of my scar as it's progressed so far. The total scar is 11 inches with 9 of that being the most recent (he cut through the existing scar). Interesting to see the progression as it heals.

Sunday, April 26, 2009

First real test of the new hip

Not much to report on Friday. Another good day. I did go to see my GP about the fever and cold or allergies that seem to be afflicting me right now. Unfortunately nothing conclusive either way. More than likely allergies based on the symptoms and pollen activity in the area. He was concerned about my fever even though it's continued to be low. He gave me a prescription for some antibiotics. Hopefully that will help clear up whatever is going on.

Saturday was the last day for the OxyContin, Celebrex and blood thinner shots. I still have Lortab for pain and have to take aspirin for 6 weeks to replace the blood thinner shots. They are really concerned about blood clots these days. Much different than the past surgeries I've had.

Saturday was also to be a big day. The Komen Race for the Cure for northwest Arkansas was scheduled for today. I was originally signed up for the elite race but the hip replacement canceled that. My wife and our dog Bella, however, were signed up for the first ever Bark for the Cure. This was a chance for people to bring their best friends out to support a great cause.

We had decided
a few weeks before surgery that if I was able to I would come to the event so I could at least watch. I love animals and really enjoy taking Bella out in public. It's good therapy for me and my wife and Bella just loves it. She definitely gets a lot of attention.

We left the house at 7 am. The Bark wal
k started at 8:30, but the elite race started at 7:30 and the regular (big) race started at 8:00. They were expecting 18,000 people this year, so we were worried about parking. The saving grace for us was that the Bark walk started at the PetSmart store instead of the Pinnacle Promenade entrance area where the other races started. We were able to park reasonably close, and come to find out we could have gotten closer but we took some of the first spots we saw just in case there wasn't anything further in.

We walked to the starting line and that's where we were going to setup a chair for me to hang out. The walk was probably 300 yards or so and by far my longest since the surgery. Of course I had both crutches and took it easy, careful to watch my form.

There were so many dogs there already. It is just fascinating to see them all and how they interact. Like I said, Bella gets lots of attention from both people and other dogs. She is a harlequin Great Dane, so she's tall, large and uniquely colored. She's our first Dane and is just a fantastic dog. We love seeing other Danes, too, and luckily there were a few there today.

The walk started a few minutes late but not bad. They announced over 900 dogs registered for the walk! That was amazing, especially for a first time event. It was a lot of fun for me just to watch.

I heard an announcement that the finish line was at a different location.
Uh oh! It wasn't far, probably about the same distance I had already walked. I felt good so I decided to go and try to meet my wife and Bella at the finish. I made it over there and apparently the Bark walk was much shorter than we expected. They had already finished! By the grace of God they found me accidentally. They were about to be on their way to find me at the start line.

It made sense
where the finish line was because it was located at the main vendor fair for the entire Komen event. We decided to walk around for a while. I still felt okay but was tiring. It took an hour or so to make it through all the vendors. The Promenade was vibrant! It is such a beautiful shopping area and really needs to do more large events like this. Just a perfect venue.

A lot of the dogs and owners from the Bark walk were doing the same thing we were. I'm sure the participants from the main even
t were wondering where all these dogs came from :)

Where the Bark walk ended there were treats and water for the pooches. Bella got a drink of water and a couple of treats. We met up with our friends and their dogs Phoebe and Gabe, a Pomeranian and a Golden Retriever. They had doggie ice cream! Bella got to lick clean one of the containers and it was obvious she loved it. She loves real ice cream, so doggie ice cream would be no different.

Our friend went to get Bella
a container for herself. It was just a small cup but it was frozen. Our friend tried to soften it up a bit by squeezing the container. Unfortunately the entire bit of ice cream popped out of the container and onto the ground. Bella quickly grabbed and ate the entire thing in almost one bite. A few minutes later she promptly threw it up :) She probably got a brain freeze from all that cold at once.

The funniest thing we saw all day was a chocolate Lab in a pile of ice. So
meone dumped a whole cooler full of ice onto the walking area for the dogs to cool off with. That puppy, which was probably 4 months old, was adorable to begin with, but he jumped into the pile of ice full on. He had all fours spread out with his belly fully onto the ice all the while trying to eat as many pieces as he could. He was soaking wet by the time it was all over. He didn't want to share the ice with other dogs! Looked a lot like those cute puppy commercials where the food is spilled on the floor and the puppy just lays completely in it. It was great and made everyone laugh.

Before long it was time to go home Bella and I were both worn out. We made the long walk back to the vehicle. I was not in too much pain, just extremely tired.

We made it home and in a short while I had some lunch and then took a nap. I made it through a big step on the road to recovery.

Thursday, April 23, 2009

Still running a fever

Again had a low fever through the night and woke up at 99.5. I've had a headache when I've woke up the past few days as well. I figure I either have a cold or allergies flaming up. Things are starting to bloom around here and it is likely allergies that is bothering me. I have stuffiness in addition to the headaches. Of course I'm scared to take any medicine in addition to all the drugs I'm on from the surgery. I took Lortab shortly after getting up and the fever and headache were gone in a short while.

While I was at PT this morning I received a voice mail from my OS's nurse. She was calling to tell me the lab results from yesterday were in. Luckily my PT is on the second floor of the building where my OS's office is. Good timing on the voice mail, because I just stopped by to see the nurse on the way out after PT. She happily smiled and told me everything was clear. No infections and no sign of pneumonia trying to start up. Whew! I asked her if it was okay to take something for the allergies or cold and she said yes and recommended I see my GP to make sure I take the right thing. Perfect. I'll go see the GP tomorrow and get this figured out.

The rash on my back seems to be getting better. Put some more Benadryl on last night. It seems to be working. There appears to be no more spreading and what does exist has started to dry up and heal. The pink spots around my incision haven't gotten any worse either, so hopfully all this stuff is fine and will just go away.

Not much more to report. It's been a full week since surgery and other than a couple of scares I'm extremely pleased with how everything has turned out. I'm glad it's almost Friday and there are no home baseball games for the Hogs this weekend. The Komen Race for the Cure is the big event. I was signed up to run in the elite race, but of course that was before I knew I'd be getting a new hip. My wife and Bella will be taking place in Bark for the Cure, so I'm going to try to go sit and watch. Should be fine and fun.

First PT Session

Had my first physical therapy session today. Apparently PT for hip replacements varies widely, I supposed based on things such as the surgeon's preferences, patient's age and condition, insurance policies, and other things. Some patients have to do PT before they are released to go home. Some are sent home and have inpatient (in-home) PT for weeks before being allowed to even ride in a car to go to outpatient PT. Certainly confusing but regardless, I was to attend outpatient PT the week following my surgery and go 4-6 weeks and continue on my own at home at PT's discretion.

All went well. Mostly straight forward type exercises and stretches. Only thing that was uncomfortable was swinging the leg out to the side a few inches, well almost a foot, and then back in. The therapist said that would be hard but we would progress a little farther out each week. That was the primary exercise that he wanted me to be extra careful with.

The therapist wants to be on crutches or at least a cane for 4 weeks, even if I'm feeling good walking. Said it's critical to have support there if it's needed, which obviously makes sense. Also said he doesn't expect to see me more than another week or so, as I can do everything at home and he doesn't believe I'll need motivation to actually do the work.

Learned a few more dos and don'ts and he showed me which muscles were affected by the surgery and how. That was nice to see diagrams and hear it explained. He has always worked with many of my OS's patients, so I felt really comfortable with his methods.

Anyway, nothing earth-shattering. If anything, I can do a little more than what I thought already.

Wednesday, April 22, 2009

First scare

Yesterday afternoon my back was itching. As I reached back to scratch it I noticed more bumps than I had previously noticed. A couple of days ago I felt like I had a couple of small pimples. I had my wife look at them and that's what they looked like. Okay, no big deal.

Well, when I scratched yesterday and felt more of them my stomach knotted up a bit. I went to the bath room and pulled up my shirt and looked at my back the best I could. Sure enough, probably 20 or so little dots. They were really small, not inflamed or red in color but they itched like hell. Crap! I'm officially freaking out at this point.

Of course my incision starts itching at this very moment. It's kind of like when you see a spider then a little later you feel invisible spiders crawling around on you. Maybe it's a sympathy itch. Whatever it is I scratched it, careful not to hit the staples. There were no little dots anywhere around my incision so I figured it was still okay.

I checked on it a couple more times and around my incision had developed clusters of pink spots. Double crap! I'm really freaking out at this point, because I figure I've got an infection and my implant is in trouble! Yeah, sometimes I overreact. I calmly called the nurse and left a message. A short while later the doctor's office called and told me I had an appointment for Wednesday (today).

I called my wife to bring home some Benadryl. After reading and asking some questions on it seemed to be a prudent thing to do and shouldn't cause any trouble. I didn't scratch the rest of the day. After some calming messages from the folks on bonesmart and my wife, I was in good shape and not as worried anymore.

Last night I had the best sleep I've had since the surgery. Bella didn't need out during the night and I was able to sleep the entire night in the bed (vs having to move to the couch at some point due to sleeplessness). It felt great!

Quick start to the day. Some coffee. Catch up on news and message boards. At some Kashi Go Lean cereal - great stuff!

Oh yeah, also checked my weight. 154. Sweet! Right where I've been for the past couple of months. I figured I had gained some weight since I haven't been able to be active lately. I can't wait to get healed. I can't stand being sedentary for very long. My appetite is way down from when I was running, though, which is a good thing, because I was eating a LOT.

Worked until my dad came over to take me to the doctor. I can't drive yet.

Didn't have to wait long to see the doctor. I really like it there. People are friendly. My doctor and his nurse are just wonderful. They always answer all my questions even when I know they are super busy.

The surgeon checked out my rash and thought it might be heat rash but he didn't know for sure. Wasn't concerned as it relates to my hip. He wants me to use cortisone cream and see if it gets better.

He checked my incision area to look at the pink spots. He definitely was not concerned. He said it looked like abrasions from either where I scratched it or something the tape caused. Said my incision area looked good and he was happy with it. It has developed a nasty looking bruise though. Man, is it ugly! He was not surprised, though, and I really didn't figure he would be.

He was slightly concerned that I've had a low-grade fever every night. He wasn't really worried since it's been low, but just to be safe he ordered a chest x-ray and lab work. Yes, I had to get stuck with a needle again and pee in a cup again. Oh, well. I had that done immediately upon leaving his office. They will call me as soon as they get the results. Hopefully that will be by tomorrow.

My hip is actually feeling pretty darn good. I only use one crutch around the house for the most part. It's totally sufficient and I can carry things easier that way. I've been working on walking without a limp to train my muscles correctly. The pain meds must really be working or I'm used to pain.

My PT finally starts tomorrow and I'll see the OS again next week to get the staples removed, so he'll be able to check things again soon.

Tuesday, April 21, 2009

Second day back to work

Since I'm not doing official PT until Thursday I did some simple exercises on my own. Just basic flexes. Also walked around a bit on the crutches. I'm feeling it a bit today but not too bad.

Made it through the night in my own bed without having to move to the couch, which was a nice thing. Only got up twice to go the bathroom. Did wake up a few times but was always able to get back to sleep. Didn't take any pain pills through the night. Probably should have because I'm still running a small fever, 99.6. I know this is not very high but it's happening every night. Took two Lortab when I got to see how fast it will break, because I need to have a good understanding of what's happening when I talk to the surgeon or nurse next.

Going to do some more exercises today. Want to walk a bit more and work on form. I have done that much. I've just been walking to get around. Need to make sure I train my leg muscles to walk properly. The surgery lengthened my leg about 3/4 inch to make it equal length with the left leg, so I 'm dealing with that difference. I'm sure it's going to take some getting used to. It certainly feels different. I also have some extra tightness down the back of the leg because of the muscles being stretched. The OS said that would happen and it would feel uncomfortable for at least a few weeks.

It's day two back at work. I'm working on the couch again. It was certainly comfortable enough yesterday. I'll be ready to get back to the desk at some point, but I'm sure that position is going to be uncomfortable for any length of time.

Looking forward to a good day.

Monday, April 20, 2009

Post-op, Day Five

Had another interesting night sleeping. Slept a good couple of hours and then had to pee. Dang! Shortly after I got up Bella got up and ate and of course needed to go out soon. My wife let her out and I was having trouble getting back to sleep. Rather than keep her awake, I decided to move back to the couch again.

I had the longest sleep since the surgery, over 3 hours. Woke up, watched a little TV and slept again for a while. Checked my temp and I was running a slight fever again. Highest I checked was 100.3. Woke up for good, made some coffee and read some things online. I was going to return to work today (I work from home) for the first time since surgery. Mondays are full of conference calls, so I knew I'd be on the phone for a while.

I made it through the calls fine and through the day fine. Took a few breaks to rest and made sure I took all my meds. I really hate giving myself the shots with the blood thinner. Only five days of those left.

Talked my OS's nurse today to get a few questions answered.
1. Don't need to take iron pills but won't hurt. My blood counts will get back to normal.
2. Had a dentist appointment scheduled this week to get a permanent crown installed. Found out I need to cancel that for a while and will need to take antibiotics before I see the dentist next. I didn't realize how dangerous dental work could be if you've had an implant, but the risk of infection is high. Luckly I read the warning labels on my medicine yesterday or I wouldn't have known this.
3. The fever isn't a major concern right now but if it gets above 101 then I need to watch my incision for changes and contact the OS. It's been below 100.5 so far and the incision looks fine and isn't sore. I guess some fever is normal after major surgery because of how hard the body is trying to heal itself, and it's made worse by being active during the day. My fevers have all been at night. Just have to keep an eye on it.
4. Asked about the dizziness I experienced and they weren't concerned.

So good, so far. I'm too much of a worrier and I think all the information available to read online makes it worse.

Made my PT appointment but couldn't get it until Thursday. I was hoping to get in tomorrow . I'll just do some simple things at home in the meantime. I'm ready to be healed :)

It's been a good day and I'm feeling better each day so far.

Sunday, April 19, 2009

Post-op, Day Four

Had a rough night sleeping. I crashed hard for a couple of hours early last night and then woke up several times through the night. I came back to the couch so I wouldn't keep my wife awake. Overall, I got several hours of sleep but not more than hour and a half at a time. Still ran a slight fever but my thermometer was not working, so I don't know how bad it was. It was gone by the morning.

Had a pretty good day. Just rested and read. Spent a lot of time on the message board reading and researching everything I could about hip replacement recovery. I've learned so much from there it's incredible.

Figured out all my drug schedule. I don't like doing all this but it all is there for a reason. Here is the list of things I have to take.

Lortab - (for pain every 6 hours)
Fragmin - (a self-administered shot to the stomach once a day for 7 days and then 81 mg aspirin once a day for 6 weeks for anticoagulant)
Celebrex - (once a day anti-inflammatory - 1 week)
OxyContin - (once every 12 hours - 1 week)

I can definitely feel the effects of the drugs. I'm scared to death of screwing up. I've watched too much CSI over the years, so I think the smallest mistake will kill me. As long as I follow the instructions I'll be fine.

Late afternoon I was finally going to get a real shower. My wife helped me through this. She covered the dressing with Saran Wrap and waterproof medical tape to keep it all dry. We have a large walk-in shower so it was easy with little risk of falling or tripping. She helped wash my legs. After the shower she changed my dressing. I just about passed out from being dizzy. I hadn't eaten anything in a while and I had been on my feet the longest since being at the hospital, so I wasn't too worried. I laid on the bed while she finished with the new dressing. It felt so good to be clean.

Had a great dinner, vegetable beef soup made with brisket that I smoked a few weeks ago. It is OUTSTANDING. The second time we've had it. Something about the smoked brisket flavor and the spices my wife puts in the broth just make it incredibly tasty.

I stayed awake all the way until bedtime. I thought not taking a nap would help me sleep better. On to day 5.

Saturday, April 18, 2009

Post-op, Day Three

I slept extremely well for several hours and woke up when the CNA came in to check vitals and see if I needed anything. I was hungry again and she brought me a snack a little later. Did I say how much I liked the night nurses? They rocked! I ran a bit of a fever again but it never got bad and broke again before morning. I guess it's a bit normal after surgeries, especially if you're active during the day. My body was sore and working hard to try to heal itself. That at least sounds logical and I think I've read something to that effect.

I slept on and off again during the night. I was really sore from walking the previous day. The nurse gave me another small dose of morphine before the shift change, thankfully, and I took another nap before breakfast.

I need to digress a bit. This was the first time I've ever had a catheter. I know some people have to be attached to these things permanently and that is a horrible thing. I would never, ever wish for that. That being said, it was nice to not have to worry about getting up to go pee or use a bed pan. Pretty amazing, actually. I never even had to think about it. Liquids got in the bladder and they went out. In layman's terms, of course. I would love to be able to use something like that in front of the TV on football weekends :-D

Anyway, my catheter drain box and overflow bag filled completely up overnight! I was drinking a ton of fluids, mostly water and some Sprite Zero. The CNA got a kick out of it. I was very well hydrated and the urine was virtually clear as water at one point. I was very cognizant about hydration when I was running a lot, so i was proud of this ;)

Pretty good night overall, a bit restless, but not as bad as the first night. The RN came in to change my dressing and remove the blood drain. The first night there was a lot of blood that drained from the incision area. The second day and night. Almost none. Not even measurable. When she pulled the tube out it was an odd feeling but not bad. This one was installed a couple of inches from the incision. For my previous surgery it was installed right at the incision but with a bigger tube. That one actually hurt. This one didn't. Felt good to get it out.

Breakfast arrived soon. It wasn't as good as the first morning but it was still good. Bacon, eggs, cinnamon roll, a banana and cheerios. The eggs were bland, but the bacon and cinnamon roll were awesome! I sliced some of the banana in my cheerios and put too much milk in so cheerios were flying everywhere, but it was good. I was nice and awake and ready to tackle the day.

Went through the final nursing change of my stay. Two totally new nurses given it was the start of the weekend. Both seemed very nice and friendly and I found them to be that way the entire duration of the day.

The OS came by during his rounds and was pleased with my status and progress with walking the day before. He said I could go home this afternoon after another round with the therapist. Woo hoo! This was what I was waiting to hear.

Since I was being released I also got clearance from the OS to have the IV and catheter removed. I wanted to get up and move around some more under supervision on the crutches, but it was so difficult with all that equipment attached.

I asked the RN if she had talked to the OS yet. She had not, but said she would go find him or read his discharge notes. In a few minutes she returned to remove my equipment! The IV was easy. She just unhooked it and left the needle in just in case I needed something else before I left. Then came the catheter. The moment I was most scared of. The prep-nurse had told me I would have a catheter installed but since my pre-op vitals were good they would install it while I was knocked out. The removal was a different story.

The RN told me about the balloon feature that was holding it in place and how she would relieve the air pressure and do a quick yank and that I would get an uncomfortable feeling for a few seconds. Yeah, right. Just uncomfortable. I was scared to death of what this was going to feel like. She showed me how she was letting the pressure out and then with no noticed just yanked! DAMN! It was extremely uncomfortable and felt like a whole bunch of urine came out.

She took care of emptying the tank and when I looked down not a drop was to be found. It just felt that way. I felt fine in just a few minutes. All things considered it was worth it. Only thing left was I'd have to prove that I could urinate normally on my own before I could be discharged. That would not be a problem, as I would later prove.

I was able to move myself to the bed to get the catheter removed and then back to the chair on my own with the nurse watching. I was feeling great at this point! Genuinely, great! I sat in the chair and read cycling magazines and waited for my wife to arrive.

My wife showed up mid-morning and that put another smile on my face. We just waited around for the therapist to show up. Pretty boring, but we had plenty to read.

The therapist arrived and took me for a walk around the floor. I went probably 3x the distance I had gone the day before with very little pain, but certainly weakness. Before the surgery I had a difficult time believing I would actually feel like this but I did. The pain was mostly, if not all, muscular. My hip seemed to be operating well. The therapist left and all that remained was lunch and being discharged.

We talked to the RN to see if my wife could get my prescriptions, so she could go pick everything up before I was discharged so I wouldn't have to wait in the vehicle. The RN obliged and my wife left.

Lunch arrived (albeit a bit small) and I ate quickly, like normal. It was spaghetti and a salad and a piece of chocolate pie. The spaghetti was okay, but bland. Salad was good and the pie was great. Yum! Now, I just had to wait.

Oh, I got permission to go ahead and dress in clothes and get out of the gown. I got to use some of my new tools to reach down without breaking the 90 degree rule. Took me a few minutes but I succeeded. I felt really proud, like a child riding a bike without training wheels.

Oh again, reverting back to the catheter moment - the nurse had left a bottle that I had to pee in to prove that my bladder was working. By lunch I had filled it up completely and even had to go in the toilet after that. Did I mention I was drinking a lot of water? The nurse was shocked, and of course laughed when I told her I thought things were working okay.

My wife showed up soon having got my prescriptions filled and eaten lunch herself. She brought me some of her leftover lunch, Chick-Fil-A nuggets! I couldn't turn those down. Best fast food chicken to be found! Now, just wait, wait, wait.

A little over an hour later the RN showed up with my discharge papers. Woo hoo! I signed some papers and they wheeled me out to the vehicle. 20 minutes later and I was home.

My wife got me settled in and I was pretty much down for the rest of the day. She is such a fantastic caretaker. Words can't express how good she is to me. Day 4, upcoming.

Friday, April 17, 2009

Post-op, Day Two

Surgery day went extremely well for me and I was as happy as I could be. I can't even explain how excited and relieved I was to have this surgery. I've been in pain, sometimes significant, for 23 years since the accident that originally broke my hip. I believe this is a new beginning for me that will allow me to be active for many years without daily pain.

As I mentioned in my previous post I was given some morphine to start the night off. That was a great relief and let me sleep well for a couple of hours. I was in-and-out of sleep the rest of the night. Partly because I just don't sleep well anyway, partly because the nurses checked on me every couple of hours, and partly because I was in pain. I also ran a slight fever and the Vicodin did help break it.

After the morphine I received Vicodin a couple of times. It wasn't very helpful, at least not very quick acting. I still made it through the night okay and was pretty wide awake by 5am. The CNA brought me some black coffee which really hit the spot. Breakfast wasn't until 7, but that tided me over and I watched TV and surfed the internet on my wife's Dell Mini, which is a great little machine. I used the heck out of it thanks to the hospital's free wifi.

Breakfast arrived right on time and it was fantastic. Cheese omelette with some ham bits sprinkled on top, a biscuit with gravy and a piece of sausage, and some fruit. Some milk, juice and coffee to wash it all down. The food is great here. Not at all like previous hospital stays. Bravo WRMC!

I went through a nursing shift change (7 to 7 is the shift). The current RN told the new RN that the Vicodin wasn't working well for pain and that I would likely need at least one dose of morphine during the day. I heard the conversation. Remember this for later.

The OS came to see me during his rounds. First time I had seen him since the surgery. He was happy with how the surgery went. Said everything fit well and he expected the implant to work great for me. He said that he had a heck of a time dislocating the hip, so he was happy with the fit. In a total hip replacement, when the implant is installed the surgeon puts the new hip ball into the new socket, checks rotation and then dislocates it on purpose to make sure everything is installed correctly. It's quite disturbing to watch. Here is a video of an entire procedure almost identical to mine in case you're interested.
It's very long, but some key points are between minutes 6-10 where the cut and cauterization take place. Around minute 14 is where the first part of the hammering occurs. At minute 19 is where they bore out the socket where the prosthetic socket goes. Around 23 is where they begin hammering in the implant. The hammering goes on for 15 minutes or so and then they fit the hip back into the socket and then dislocate it to make sure it fits and moves correctly. They then put it back in and then stitch it up. It's just very disturbing how seemingly standard power tools are used to cut, shape and fix your bones.

My implant I now have is a Wright branded cobalt material metal-on-metal (metal head and metal socket). This allowed me to have a much larger head, which is harder to dislocate, wears better and longer, has better range of motion and is more suited for very active people. The ball he installed is 44 mm versus something like a 22 mm traditional head. Here is the site that shows what I've got in me. Oddly enough it's called the Big Femoral Head :-)

He also expects me to recover well given my age. Told me I could go home tomorrow depending on how well the therapy went today. Said the only concern he had was I lost more blood than he liked. Again because of my age, he wasn't too concerned, but he was going to prescribe iron pills for me. Said I should be able to return to fairly normal activity in 6 weeks and also can start stationary cycling then. I could begin cycling outside after 3 months, but only in the neighborhood until I got comfortable.

My wife called about 8:30 to check on me and then she took Bella to day care again and then came to see me. I was very happy to see her. I love my wife very much and can't express how well she takes care of me. It made me smile just to see her.

We just chatted for the next couple of hours. The occupational therapist came by to explain my limitations and how I would be able to perform daily activities, such as dressing, picking things up, limitations on movement, etc. He brought a set of tools for me to use, including a grabber to help reach and pick up things, a hook for general use, a long shoe horn, a bath scrubber with a long handle, and a thing to help put on socks. I'm not to bend past 90 degree angle, so I can't dress like normal. I knew all this was coming, so no big deal.

Finally, the physical therapist showed up. His whole purpose was to see how good I could get along with assistance. He brought a walker with him similar to these. This was the first time I had been off the bed since the surgery. The therapist helped me get down and settled correctly on the walker. I had to use one for months when I originally broke my hip, so I knew how to use it already. I was able to walk down the hall and back. It hurt pretty bad and I had a bad limp, but I could tell the pain was muscular and not the hip implant. It felt strong already!

The therapist was happy with my work and suggested we try crutches for the afternoon session, which I was more than happy to do. Walkers are very cumbersome but crutches or a cane are much easier to deal with. The therapist left and I rested. Lunch eventually came, thankfully, because I was hungry.

Shortly after lunch I had some surprise guests, a couple of very good friends. They brought me a bag full of magazines to read, which was very thoughtful. We chatted for a while and it was very pleasant and certainly lifted my mood. Just another example of the quality of friends I have.

Next, I had to visit with the "case manager" assigned to my hospital stay. She is the person to make sure I get everything I need when I'm discharged, things like prescriptions, setup of physical therapy, purchasing crutches or other tools, etc. She was fairly friendly but seemed more intent on telling me what would be best for me rather than listen to my concerns. I felt a bit like a child being scolded a bit but it probably wasn't as bad as I perceived it. Anyway, in the end everything was fine and I was all set for whenever I could go home.

I have neglected to mention that I asked the CNA for pain medication around 9 or 10am and she said she would let the RN know. It's after lunch at this point and I have yet to see pain relief. A little while longer watching TV and reading. Pretty boring but I was worn out by all the activity.
I asked again for some pain relief and the CNA was surprised the RN had not come by yet. She said she would contact her again.

The therapist showed up a little later with the crutches for my second walking session. This went really well. The crutches were definitely a good fit and allowed me to get around better than with the walker. The therapist was surprised how well I was walking and so was I. My research had led me to believe I would be able to walk the day after surgery but I was skeptical. After this session I was grinning ear-to-ear.

I got back to the room and was understandably tired and in pain. I rang the nurses bell and asked for more medicine and told the CNA that I had not had any pain medicine since 5am. She didn't know what was going on but promised to get it resolved. A little while later the RN finally showed up with pain medicine and of course she brought Vicadin instead of morphine. Remember the conversation she had with the previous RN? Yeah, the one where the other RN told her that Vicadin wasn't working well for me. At this point I'm frustrated and hurting so I wasn't going to turn anything down.

I don't know why this nurse didn't give me any meds earlier in the day and then why she wouldn't give me morphine or something else besides Vicadin. She wasn't particularly friendly and had a bit of a strange personality, which was unfortunate because all the other nurses were absolutely fantastic and extremely helpful. Oh well, I wasn't going to let it upset me anymore. In about an hour or so I started feeling some relief and I knew dinner would be coming soon which would help me feel better, also.

Shortly after dinner arrived, I had some new guests. My parents showed back up and shortly after that my brother arrived and brought his wife and two boys, my 5-year old and 16-month old nephews. I was excited to see everyone but I'm not sure my nephews knew what to think. The 5-year old was fascinated by the catheter and the normally outgoing 16-month old suddenly got very shy when the nurses came in to switch shifts. I had a nice visit with everyone for probably an hour or so. They all left to go eat and it was time for me to start winding down.

My parents had been nice enough to pick up Bella from day care and drop her off at our house, so my wife was able to stay with me all day. That was great for me to have her around all day. She stayed with me a little while longer until the night nurse gave me some morphine (yay, finally!). I got sleepy very quick, so my wife left me for the evening.

Day three report coming soon.

Thursday, April 16, 2009

New Hip Installed

I had my old hip removed and new hip installed on the afternoon of the 16th. The preceding posts explain the reason for it, so I won't rehash all of that.

On the 15th I was able to eat normally until midnight. I had to give up NSAIDS (anti-inflammatory) and aspirin for the week prior to keep blood from being too thin, and no alcohol 24 hours prior, although I stopped having any drinks a week prior, also. With a fairly major surgery I felt it prudent.

I continued elliptical work almost daily until the 14th. I figured I needed to stop and let my body rest at least a couple of days. I just hope I don't gain any (or at least much) weight during the recovery period. I'm not necessarily a health nut, more of an exercise nut, so this period of sedentary activity during recovery is going to be rough but it's worth it.

I was anxious all night on the 15th. I had a good dinner and slept pretty well until about 4am and then I couldn't get back to sleep. I got up and read some things online and got a few last minute work things taken care of. Didn't have to be at the hospital until 10am, so I had plenty of time for last minute prep.

My lovely wife took Bella (our Great Dane) to doggie day care. I showered and had to use some special soap called Hibiclens which is an antiseptic. I had to use the whole bottle, which was an effort because there was enough to wash an elephant. I even had to sign a form that stated that I bathed correctly and used the whole bottle. I felt like a kindergartner being told to eat my veggies. Anyway, I did that correctly and then finished packing my bag and was ready to go.

Only about a fifteen minute ride to the hospital. A little dreary and cool and I was finally getting a bit nervous. Not really nervous about the surgery itself, because I've had two previous surgeries on this hip. I just wanted everything to go correctly.

Got to the registration area, signed in and paid my share of the bill that insurance was not covering. My insurance has been great so far. Hopefully there will be no complications with all this, because it is quite an expensive surgery. My share reached my out-of-pocket max of $1,250. Well worth it to have a good leg again.

Only had to wait a few short minutes before the prep nurse came and got me. My wife had to wait in the waiting area until the prep nurse was done. I put my gown on and the process started. The nurse was my age (37) and was the first of many over the next few days to ask why someone so young was having a hip replaced already! She took some more blood and then started my IV. She also gave me some drugs to start getting me relaxed. Then she prepped my hip by shaving most of my leg and then washing and coating it with iodine. She also put TED stockings on my legs and some automatic air wraps to help with circulation for the next few days.

When prepping my hip she noticed a couple of blemishes, either pimples or ingrown hairs, one on my butt cheek and one on my leg a few inches from my previous incision scar. They were almost healed but any kind of nick, cut, abrasion, etc., near the incision can lead to a cancellation of the surgery due to the risk of infection. I knew the blemishes were back there but thought they were far enough away not to cause a problem. She said they were indeed close enough to cause a cancellation but they looked almost healed so there was a good chance the orthopedic surgeon (OS) would be okay with them. So, she circled them with a marker and called the OS to let him know that he needed to look at them. She told me they were more worried about fresher active wounds and these were closed up well, so that made me feel a little better but I was nervous until I saw the OS.

She finished the prep work and was ready to allow my family in to see me until it was time to go. Of course, I had to pee, so she helped me get down the hallway with IV in hand and butt cheeks exposed. You really have to leave modesty at home when you are admitted to a hospital. I've been through it before, so it's not a big deal to me. Besides, I've worked hard to get myself in shape, so I don't mind showing off a little. Ha ha. :-p

My wife, mother and father all came in and were able to chat with me for about an hour. It was nice and helped pass the time. I really have very loving and supportive family and friends. I'm the type of person to feel guilty about receiving any kind of help on anything, but this week I had to leave all that behind. I'm very blessed with people who care about me and it's been more than obvious throughout this entire process.

At 12 noon it was time to go to the next step. The prep nurse started wheeling me over to see the anaesthesia folks. On the way the nurse stopped and got me another warm blanket. That was great! I went into another area and saw four different people related to anesthesia. I had to answer another round of questions and then got my first tiny dose of anesthesia. Starting to feel good at this point. I was set for general anesthesia but they threw a curve ball at me. They asked if I wanted a spinal block which would help a lot with the pain. I had heard the term but wasn't really familiar with it. They explained how I would get a shot in the back and when they found the right nerve my leg muscles would start twitching. Sounded painful but I remember how much pain I had in the previous two hip surgeries, so I was all for it! I gave them the go-ahead and they found the right nerve almost immediately. They were pleased and I was too because it didn't hurt too much. I then met the primary anesthesiologist. Just a few more minutes wait and they wheeled me into the operating room.

I remember being wheeled in and parked and that's it. I've always had a bit more recollection but this one was almost none. I woke up and it was done. Holy crap! I couldn't believe it. I was groggy coming to but felt much better than in the past. I guess everyone did their job great, because I was in much better shape than even when I just had my screws removed. I had to stay in recovery for a bit and then was taken to my room.

My room was on the seniors floor. I was probably the youngest person by 40 years! Needless to say every hospital employee who came in was surprised to see someone so young. I had a great room but was still too out of it to realize.

So, backup in time a bit. My wife was given an ID number for me which would display on a monitor in the waiting area with my status. Apparently, the status never changed to show that I was ever in surgery, so when they went to get her to tell her my surgery was finished she didn't even know I had gone in! She thought I must have been delayed for some reason. She even asked the front desk people to check on it and apparently they were rude and wouldn't help. An unfortunate blemish on an otherwise fantastic few days at Washington Regional. The same lady wasn't real friendly when we checked in either, so it wasn't a surprise. Anyway, after the nurses got my bed setup they allowed my wife and family in.

I was in some pain but not horrible. I was fairly coherent at this point and had some nice conversation. I was freakin' starving because I had not eaten since 8pm the previous night, around 33 hours. With all my running the past 18 months I was on a steady 2,800-3,000 calorie a day diet. My body was going to have to eat something! The RN asked if I felt like I could hold something down, like a light snack and some juice. I told her I was ready for a full meal, and it happened to be just about dinner time, so they brought in a full meal. The nurse told me to take it slow and she left. I promptly began wolfing down everything. Nothing slow about it. Not on purpose, I just felt good and was very hungry. Didn't feel nauseous at all. The meal was turkey and dressing with gravy, a roll, some veggies and a dessert. Pretty darn good meal.

My wife had to go pickup Bella from day care while I was eating, so she did that and my parents and my brother stayed with me. She made it back to the hospital and was happy that I ate something. She also stopped and bought me some reading material. Mostly cycling magazines and books since that's going to be my new hobby (instead of running) when I recover. My parents and brother stayed a short while longer and then left for the evening. My wife went to the cafeteria to get something to eat and she brought it back to the room, so we were able to visit some more.

I was starting to hurt pretty bad so the nurse gave me some morphine (yay!) and my wife left soon after so I could get some rest. I slept GREAT for a couple of hours but woke up at some point and wanted a snack. The CNA and RN checked on me at various times during the night. They were both awesome! The CNA found a nice snack for me, turkey sandwich, Baked Lay's, and applesauce. She even warmed up the sandwich for me. She was my favorite new buddy :)

That wraps up day one, although technically some of this leaked into day two ;)

Sunday, March 29, 2009

So, I'm getting a new hip

I finally got to see the ortho doc this week, actually two of them. The first reviewed my case and performed an exam. He felt like I would likely be a good candidate for a hip resurfacing or replacement. He said an athroscopy was an option but likely wouldn't be much relief. He recommended I see a hip specialist ortho. I was able to see him the following day.

The hip specialist performed his own exam and went into more detail on my options. He was very thorough in describing the options with pluses and minuses on each and what he felt would be the better option. One option is to do nothing and continue to live with pain.
The weight-bearing portion of the femoral head (ball) and acetabulum (socket) essentially has no cartilage left due to excess bone growth from the break years ago and the severe arthritis that I've dealt with over the years. I've unknowingly had bone-on-bone grinding for quite some time, and because of this, the pain is only going to get worse. He said he could give steroid shots that would likely limit or eliminate pain for 2-3 months at a time, but it's really only a mask and wouldn't allow me to get back to an active lifestyle.

The next option is an athroscopy where a surgeon would shave off the excess bone and remove the damaged cartilage. The problem is there would really be no cartilage left over, and there isn't such a thing as artificial cartilage that could replace the removed, damaged cartilage. So, in effect the arthoscopy would be of minimal help and further surgery would have to occur at some point anyway.

That left options of hip resurfacing or a total hip replacement (or arthroplasty). He said either option would be a good choice for me. The resurfacing leaves more original bone in place and the main risk is that the femoral head could break. Judging by my x-rays he said the break had healed well and strong and would take the resurfacing nicely. The one problem he saw is that my right leg is about 3/4 inch shorter than my left due to the break. He said the resurfacing hardware could potentially add maybe 1/8 to 1/4 inch but no more.

That led to the discussion of total replacement. He said he could fix the length discrepency and I would still be able to live an active lifestyle. Fixing the leg length would also likely help some of the lower back problems I've had over the years due to my overcompensation of the leg lengths. At that point it was a fairly easy decision to decide on the total hip replacement.

I have done a lot of research over the past month and felt comfortable with either solution and in my heart knew I was going to have to have the resurfacing or the replacement done at some point. It might as well be sooner rather than later, because the pain has been getting worse each week. Medicine helps, but only so much.

The bad part. My running career is pretty much over. While the doctor said I could potentially run again, the risk of causing damage to the impant is greatly increased. The same goes for pretty much all high-impact activities like tennis, basketball, etc. He did say I would have no problem with lower-impact activities such as cycling, swimming, golf, etc. A few weeks ago when I felt things were really getting bad I had already given serious thought to switching to cycling. The fact that I can safely get into cycling after I've healed and completed rehab makes me happy. The thought of living a sedentary lifestyle is sad, so I'm more than happy to focus my efforts toward cycling when I am able.

While I would really love to run again and I'm going to miss the sport terribly, I would rather be able to use both my legs later in life without pain.

Thursday, March 19, 2009

Unable to Run - Hip Pain Revisited

After the marathon I took 4 days completely off and then slogged through 2 miles. I took it extremely slow and it still hurt but wasn't unbearable. I felt better afterward, though. Took a couple more days off and slowly ran four miles. Didn't hurt near as much and I was starting to feel better. Keep alternating days off and short, slow runs for the next week and then started building back up.

This seemed to work well, but since the latter stages of my training and certainly after the marathon I began having more and more trouble bending my right leg at the hip after runs. After the marathon I could barely reach down to untie my shoes. I just assumed my hip trauma (see previous post) was just not happy with all this running. I have lived every day of my life since the accident with pain in my hip, so I really just blew it off. For the most part, once I started running I really didn't have much pain - many times I had no pain while running. The pain was always after I finished. It would go away, sometimes with the help of ibuprofen, sometimes that wasn't required.

I generally ran 40-48 miles per week from December through mid-February. The after-run pain had increased enough to start being a concern, but I thought it was likely muscular in nature so I decided to take a week off from running. I did continue my fitness by doing elliptical work.

After the week off my hip felt a lot better but soon went back to feeling how it did in the prior couple of months. I decided to just deal with the pain and tried to ice my hip as much as possible and do more stretching. Last week after a speed-work run I felt worse than I had in years. It was painful to put much pressure on my right side and my hip was really hurting.

The next morning the pain was still evident, so then and there I decided I had to stop running and go see a doctor. I do not enjoy going to the doctor which is part of the reason I procrastinated so long.

I saw my GP last Thursday and explained the situation and he took x-rays. I knew there wasn't a whole lot he was going to tell me, but I had to see him before I could go to an orthopedic surgeon. The x-ray did show that part of my hip appeared that it is likely grinding against my pelvis. Just great. The area that appears to be grinding is at the head of the femoral neck where the new bone grew over the previous break.

The grinding does make sense as the problem. It could cause bone spurs and cartilage damage, which appears to be technically caused by
Femoroacetabular Impingement (FAI), which I have never heard of but the description and symptoms sound like what I'm experiencing. I fear there is a stress fracture on the hip, pelvis or both.

My appointment with the ortho doc is not until next week, so I've been stressing worrying about what this is going to be and what it's going to take to fix it. I want to get back to running. That's my main concern. Maybe it's just rest, but I don't figure that's going to be the answer. I'm thinking best case will be an arthroscopy where the extra bone is broken off and damaged cartilage removed. Worse cases would be either a hip resurfacing or a total hip replacement. I hope whatever the decision is allows me to run again and be able to tie my shoes without pain.

The doctor told me elliptical work is okay for the time being as long as it's not hurting to do so. I've been doing elliptical every day and I'm not any worse. I'm also prepared to do water jogging but I hope I don't have to resort to that. I have to do something to keep my cardio up or I'll go crazy and probably gain weight.

Only 5 more days until I get some answers.