6 weeks

So, my surgery was 6 weeks ago yesterday. Things are going well. I no longer have to sleep with a giant pillow under my knees - I can lay in any position, I walk with only a barely noticeable limp, I can drive a manual transmission, I have been riding my bike to and from work - 10 miles total, I have started some strengthening exercises for PT which feel good, and I no longer have the precaution of avoiding flexion past 90 degrees although I don't yet have the flexibility to go much beyond that anyway.

My incision scar still has two little scabby sections on it and I can't go in a pool until those are gone. I have some pain occasionally on the outside of my leg and at my knee which my therapist and I think is related to recovery of my IT band, but that is improving. My range of motion is still pretty narrow. It's good enough for walking and cycling, but it's still difficult to pull on my shoes.

The therapist I am seeing is good. I thought twice about not even going to PT and just putting a plan together by myself, but now I am glad I didn't.

One month post-op roundup

At one month after the surgery:

• I never use crutches or a cane. 
• People say I don't even limp. I know I do, but walking does feel almost back to normal.
• I still have to sleep on my back with a large pillow under my knees, but I can get pretty comfortable lying, up a point, on my non-operated side.
• My PT consists of the same in-home exercises I was assigned upon being discharged from Swedish, but I do 20 reps of each instead of 10. Most days I don't actually get my assigned 3 three sessions in. I also go to the gym a couple times a week and do weighted upper body exercises.
• I am seeing a therapist twice a week who is mostly doing soft tissue work to smooth out the scar tissue and relieve trigger points.
• I can't quite drive a manual transmission safely. I drive an automatic VW van to work each day, which has a comfortable, upright sitting position.
• Pain level reaches a max of 3, mostly when moving in and out of bed or changing positions in bed (it's mostly my hip flexors). Most of the time, pain is around 0.5.
• My left leg is still functionally longer. I think this may be lessening and I think I have noticed other changes, such as a greater symmetry of my hips, that might indicate my pelvis is re-orienting itself.
• My scar has not quite closed up to the point where I could go swimming.
• I occasionally flex my leg greater than 90 degrees, such as when putting my socks and shoes on. But it never feels stressed and I believe there is no danger of dislocation.
• I can pretty much move around the house to be able to do everything I want to do. Shower, kneel in front of the stove to light a fire, carry in firewood or move other slightly heavy or awkward things around, etc.
• I still see improvement daily.

Bike ride!

M and I went for about a 4 mile ride along the Coastal Trail today. I used the Salsa Mukluk I bought off craigslist last spring and have barely ridden since. Before taking it out it, I dished the rear wheel a few mm to the non-drivetrain side to alleviate the chain rub that this vintage of Mukluk is known for and then I rearranged the spacers on the steerer tube to maximize the height of the handlebar. That's 4" of spacers in the photo there,

which would probably feel pretty ridiculous if you hadn't had hip surgery about 4 weeks prior. For me, it was very comfortable. Aside from a recumbent, a fat-tired snow bike might be the perfect bike for this stage of the recuperation. They are stable, built for long days in the saddle, and have easy gearing. When I picked the bike up I was surprised the previous owner hadn't cut the tube down a bit, but now I am glad he didn't.

The riding itself felt pretty good. My left foot seemed to float around a bit on the pedal, as if I was not pressing down the whole time and keeping good contact, my knee did not track in a vertical plane as it went up and down, and I had a bit of achiness in my lower thigh and outside knee. Still, it was very encouraging and I will be doing more from now on.

Post-op gear

This post is about the materiel I assembled to help with my recuperation. The oddest thing about getting everything together was that I was not absolutely certain the hospital would not provide me with crutches until I got down there and started to talking to people. One would think that with a several thousand dollar procedure that they could just throw those in. Not so. The only swag you go home with is the chunk of metal in your body.

First off, was a binder I received from the Swedish Orthopedic Institute called 'Joint Journey - Your Guide To Hip Replacement Surgery', which was moderately useful, although I should have just read it more closely before the surgery. I remember getting home afterwards and leafing through it going, "Huh, I didn't know that."

I got some regular ole crutches from Salvation Army for $7:

Clearly some people can't be persuaded to not purchase more expensive uber-ergonomic crutches, but for the time that I had to use them, they worked fine.

I found an adjustable height commode on craigslist for $15 being sold by the recipient of total hip replacement. Go figure:

As I learned when researching a new toilet we installed downstairs, the height of standard toilets these days is an inch or so higher than they used to be, so if you have a newer toilet and something like a counter nearby to help lower yourself slowly onto the seat, you might not need one of these at all. You just want the security of something like a bar or the counter and you need to make sure you can sit there without your leg bending past 90 degrees, which is the widely accepted limit to avoid dislocation. Your hip flexors are going to be pretty sore so you probably won't even get close to that for while. I ended up using this for about 2 weeks. You have to take the seat and lid off your toilet to make it fit.

I bought a shoe horn (I think this is the best kind) which at 3 weeks is still useful, and a sock horse which I did not find useful at all. There were a few times I had to have M help me put a sock on, but after a few days I found I could do it myself:

• Stand sideways to your bed or another surface that is about at knee height
• Keeping your thigh vertical, bend at the knee and put your foot on the bed behind you.
• Externally rotate your leg so that your foot now extends beyond the bed and a little behind the leg you are standing on.
• Hold your sock open with your fingers in one hand (on the same side as the leg you are standing on), twist and reach behind you, and get your toes in the opening of the sock. 
• Put your foot back on the bed and flex your foot to near 90 degrees.
• You should now be able to pull the sock up over the rest of your foot. 

Too much detail? Sorry, this isn't Twitter.

The reacher we got to help me reach...I don't know what..was likewise not useful. I'm thinking it might come in handy to retrieve lego pieces that have fallen behind bookcases.

For his recovery, my brother made this bad-ass cane from an old pool cue:

It's a little too pimpy for my tastes, but it has come in handy. That's a shifter knob on top with 3 different modes of LED illumination. Why in the world anyone would design, build, or want such a thing is proof to me that civilization is in a Romanesque decline. But a friend of my brother's was blinging out his truck and offered it to him. Turned out to fit perfectly on the top of the cane.

Finally, the one thing I acquired which brought me more relief than anything else was a pair of compression shorts with pockets for holding ice packs. For a few days after surgery, ice will be a great balm. The easier it is to keep in place, the more you will do it, and the better you will feel. These shorts are awesome for this. Not to mention that compression is good for reducing swelling and bruising.

They are made by 110% PlayHarder, which is great name for people using them for injury or surgery recovery to make fun of. For example, on my third day post-op M and I were outside our hotel taking a walk. I was moving slowly and cautiously on my crutches but I felt pretty good so I suggested that we circumnavigate the entire block. M asked, "Are you sure!?", to which I answered, "Well, I am wearing my compression shorts. 110 percent, baby!". It went on like that for a few days.

Welcome

Hello and welcome to my blog. Here is why I am writing:

That is a Birmingham Hip Resurfacing device I had installed in my left hip 3 weeks ago tomorrow by the inestimable Dr. James Pritchett in Seattle, WA.

For myself and for those who may be interested, I will try to use this blog to record my progress.

I currently walk with a slightly gimpy gait but I am not using crutches or a cane. I did use ski poles on a slightly-more-than 1 mile "hike" over the weekend.

I didn't have the BHR installed because of some kind of extreme body modifcation fetish but because, in my mid-40's, I started to develop osteoarthritis, presumably because of a condition called femoral acetabular hip impingement, or FAI. It all started with finding difficulty in sitting cross-legged. In the end, about three years later, when they opened me up, they found "severe arthritis and bone-on-bone contact". 

I had consulted with a handful of knowledgeable surgeons, in Anchorage, where I live, and elsewhere, and no one recommended arthroscopy or a total hip replacement. Two offered that I should reduce my level of activity and perhaps start walking with a cane and then get back in touch in another 15 or so years when I would more properly fit the profile for a THR. But with two young kids, now 7 and 5, and the wild expanses of Alaska barely investigated by myself, I knew I would not be content with that prescription. Plus, as I lost range of motion in my hip, my lower back started to try to take up the slack and was not succeeding. Something needed to done and the various forms of therapy I had employed had run their courses.

Hip resurfacing was familiar to me because my brother, one year younger, had both of his hips resurfaced nearly four years ago. It was great that someone I trust had already done the research and come to the conclusion that the best option was HR. I didn't have do as much on my own and every time I second guessed myself, I just reminded myself of his decision. So, at 3 weeks, things feel great. I improve daily and have no concerns.