Category: Patrick’s Reports

It’s been one year, to the day,  since my right total hip arthroplasty was performed.  What I’ve learned:

1.  95% of my life is infinitely better than before surgery.  Pain and limping are GONE.

2.  My hip will never be “perfect” again.  I can still provoke discomfort with rigorous activity, especially planting, heavy weight-bearing (e.g. moving furniture), pivoting, etc.  This does not concern me.

3.  I can run.  In fact, I’ve missed one day of running in the past 2 months.  I run between 2 and 8 miles/day, many of them VERY slowly (like 10:00/mile slowly).  When I realized that running was possible, I set some goals:  3 miles @ sub 6:30 pace and a single mile at sub 6:00 pace

4.  Several weeks back, I ran 3 miles in 19:10, and 2 days ago, I ran a mile in 5:45.  Mission accomplished.  However, I still think there is room for much more improvement.

5.  I realize, as we all should, that running MAY jeopardize the longevity of my implant.  As such, I consciously and knowingly choose to run.  I am accountable for this decision.  I own it.

Best wishes to all the other HipRunners!… (Click Here to View Full Post and Comments)

I’ll keep this brief:

• Getting my hip replaced has been SOOOOOOO worth it.  Gone, gone, GONE are the days of hip/groin pain and limping.  It is such a joy to function all day every day (working, hobbies, activities with my kids, etc…) in the absence of pain, I sometimes forget what a miracle this has been for me.
• Running is progressing, albeit SLOWLY.  On average, I’m running about 5 miles, about every other day.  Any more, or more often right now, just hurts.  It’s a difficult to describe pain, but it just hurts.  I think I’ve read from some others here that they experienced this too, and that it usually feels better at ~1 year.  My longest run since surgery has been 7 miles and I did manage a 6:52 mile one day.  Again, thank God for the elliptical.  I do this for at least an hour on my non-running days.
• Worst experience so far was climbing out the rock jetties in Destin, Fla. to go fishing.  It’s basically maneuvering about to the end of a 1/2 mile stretch of huge boulders.  My leg hurt for a week after that.  The reward was worth it though.  Check out what I caught (on 15# line, to boot):

… (Click Here to View Full Post and Comments)

• For large stretches of nearly every day, I am completely pain free.  As stated many times before, I thank God nearly daily for this.  Work is great–enjoyable again.  Everyone says I look better (that is, like I’m not in pain anymore) and that my limp is GONE.
• I’m running a bit, every other, or every third day.  Longest run was 6 mi, fastest mile was 6:40.  All of the other workouts (haven’t missed a day since post-op day 3) have been on the elliptical.  That’s probably the way I’ll live out my days:  ~60/40 elliptical/running (so as to lengthen the life of my bearing, thereby preventing premature osteolytic failure of my “parts”).  I am really curious to see whether or not I can be competitive again while approaching it in this way.  I’m in no hurry, and it is my opinion that anyone who is in a hurry, or “gung-ho” after THA is simply unwise.
• Lastly, for those of you who’ve not had the operation yet, my advice is: please do not expect perfection.  When you really need it, THA is absolutely life changing.  Every day is SO much better than what I was going through prior to November 2013.  I still have a few odds-N-ends, however, that aren’t quite right.  The left-sided sacroiliac pain that I developed from limping so bad, and some right-sided medial thigh soreness/tightness are the 2 main issues that remain.  These do not, however, prevent me from functioning or working out at a high levels.
• Thanks everyone for continuing to contribute to this illuminating and helpful website!

• I ran 4 miles this morning @ something like 8:40/mile.  Mile 3 was 8:09.  The only issue as far as I can tell is a little tightness in my R (affected side) inner thigh.  Perhaps this is due to surgical healing, weakness, being out of shape or some such not-really-worrisome issue.  Or, perhaps it’s something not good.  I’ll need to keep a close eye on this.
• The hip generally feels GREAT.  Again, I thank God numerous times/day for this miracle.  The limp is gone, gone, GONE.  I could walk 100 miles if I wanted to, with no discomfort whatsoever.  Also, have pitched a baseball a little, and have been doing all kinds of odd exercises (pull-ups, pushups, yada, yada, yada) with no problems whatsoever.
• Every time I ask my surgeon if it’s OK to accelerate my activity, his simple response is “enjoy it”.  My acetabular shell needed to be implanted in an odd position, so the only thing that he said I must not do (for now) is a big, fat FADIR (flexion, adduction, internal rotation) maneuver.  Kind of like you’d need to do to shave your ankle, which, fortunately, I don’t do.
• I’ve taken ibuprofen/tylenol on a couple of occasions since surgery for (of all things) SI/low back issues on the opposite side.  Starting to fade now though.  Anyone else have this?
• A bit of advice:  Don’t think the daily improvement and the “super high” that goes with it will last forever.  For a while after surgery, every day will be noticeably better than the previous.  It’s almost euphoric.  Then, you’ll crash.  The improvement curve flattens out, and you don’t notice it daily.  For me, at about 7-8 weeks, this disappearance of daily improvement left me in a dysphoric, nearly depressed state.  This will probably hit you, too.  It goes away.  Look for improvement from one week to the next, and remember how $hitty you felt, and debilitated you were prior to surgery, and push on.

Happy New Year to everyone!… (Click Here to View Full Post and Comments)

• The switch has flipped.  I am really starting to see why I was wise to get my hip replaced.  1 hour elliptical/day.  Minimum of 2 miles  walking with the pooch/day.  Stairs, bleachers at my son’s basketball game, washing the bottom of my foot, crossing my leg while sitting, sit-ups, pushups, blah, blah, blah….all the things that tortured me for the past 2+ years are now done….PAIN FREE!
• I’ve gone from constantly thinking “how much ibuprofen do I need to use today to do some of the things I would like to do”, to the point where I nearly don’t even think about my hip anymore.  I haven’t taken ibuprofen now in 6 weeks and, despite being active again, feel no need for a single mg of the stuff.
• Despite feeling like I safely could do it today, I will attempt a little jogging on December 10–6 weeks from implant date.  To the best of my knowledge, that is when effective osseous integration of the components is likely to have taken place.
• I can see now why a lot of the contributors on this great site have a flurry of posting activity, followed by rarely being heard from again.  When your problem is fixed, and your pain goes away, you simply don’t think about it anymore.  Other than helping others who are in the shoes we once wore, there is no need to keep “hip discomfort” in the forefront of our thinking anymore.
• If you have debilitating hip pain that you and your physician(s) are fairly certain stems from osteoarthritis, and it has not improved after “trying everything” for months and months, and….you find “take it easy and use a bunch of motrin the rest of your life” to be an unacceptable pathway, I strongly encourage you to seriously consider total hip replacement as a definitive and completely effective solution to your problem.
• Please interpret everything I said above in light of the fact that I am only 4 weeks out, and still flying high on my first few days in years that I have been able to live my (active)

Recovery

• Ditched the crutches on POD 3.  Walking at least 2 miles/day.  Elliptical at least 20 min/day.  OK’d by surgeon, and I in NO WAY feel that this is pushing it too much at present.
• Pain not completely gone yet.  90+% of the wicked OA pain is gone, surgical pain, tightness still present, but diminishing daily.
• For every minute of activity, I still feel that I need ~2 minutes of “couch time”, hence:
• I am glad that I do not have to return to work for several weeks
• My surgeon is pretty liberal on all the “hip precautions” stuff and couldn’t care less if I carefully sit in a low chair, reach down to straighten out my sock, lay on all sides in bed, etc, etc, etc.  The only thing he said was “just don’t do anything heroic and stupid, like a deep squat with you legs externally rotated.  You’re smart, don’t do things that are obviously stupid”.
• I have no plans to jog even a single step for many, many weeks.

Hip Replacement Redux (as of today)

• This operation, though not horrible, is not a cakewalk
• Expect some unexpected things.  example 1:  I had a foley catheter issue (my own doing), that resulted in pain, orders of magnitude worse, than anything else related to this operation (short lived, though, fortunately)  example 2:  crazy levels of itchiness at my wound site, that was worse than the pain for a few days  example 3:  very impressive night sweats which are now diminishing
• Be in super shape going in to this, even if it means wrecking your old hip and causing a lot of pain in the process.  You will be glad you did this, trust me.
• You’ll feel some feelings of apathy, inertia, and helplessness in the first few weeks after surgery.  These are OK and normal, I think, but DO NOT let these feelings prevent you from getting your azz out of bed, or off the couch, MANY times/day and doing things for yourself.

I am by no means an authority on hip replacement and the best strategies for recovery, … (Click Here to View Full Post and Comments)

Night sweats.

Everything is going great.  Today better than yesterday, pain under control, no fevers, good appetite, #2s, the whole 9 yards.

In the hospital, and now at home, I am DRENCHING the sheets all night long.  To the point where I had to switch beds last night.  Bizarre.

Anyone else have this?… (Click Here to View Full Post and Comments)

Post-op day 2.

It is like a switch flipped between yesterday and today from “bad” to “good”.

Walking around a lot, mostly with crutches, but my surgeon, this morning, said absolutely DO lose the crutches for several stretches/day and simply walk.  I’ve done this this morning.  Scary but it WORKED.  My surgical site hurts but I’m pretty sure that the wicked pain that prompted this operation is gone.

Surgeon also said “just move and live life, don’t be going to the gym in 2 weeks and blasting all the specific muscles that you think you need to strengthened–people who do that simply set themselves back.”… (Click Here to View Full Post and Comments)

Had a spinal.  No issues.  Back in my room.  Feel fine, other than a burning, painful butt cheek.  Check out my femoral head.  How I “ran through” this, is beyond me.… (Click Here to View Full Post and Comments)

T-10.  10 days until showtime.

• Hip is as bad as ever.  Nearly constant Nasty, stabbing pain.  For some reason, bad at night.
• Intermittent ibuprofen, will have to discontinue in 2 days.
• Pulled a 41:00 5-mile treadmill run outta my a$$ this morning, including a sub 7:00 last mile.  I haven’t run anything even approaching 4 miles since February.  Pure torture most of the way, but I guess this is in tribute to my beloved right hip, which will take a trip to the pathology lab, on its way to the incinerator, in just over a week’s time.
• I’m not ruling out one last 10 miler between now and the 29th, as my Fall “marathon”.  We shall see.
• Some would say I’m an idiot–if I can be doing this kind of work, I have no business getting a hip replacement.  Wrong.  I need it and am getting it.

Officially booked for R THR 10/29/2013.  I could have done it yesterday, but I don’t want to miss fishing on the north shore of Lake Superior on 10/24.

I’ve been exercising a lot in hopes of bouncing back quickly.  Lots of aerobic stuff and strengthening.  Thank God for my True elliptical trainer.

The pain seems to have accelerated–it’s just at a ridiculous level now.  Despite being really nasty, it helps put my mind at ease in letting me know I am doing the right thing.

My biggest fear:  I get a sweet new hip, all goes well with recovery….and my pain doesn’t go away.  Anyone care to allay this particular anxiety?… (Click Here to View Full Post and Comments)

Since I want to be as fit as possible going in to surgery, I asked my surgeon “is there any reason I can’t be really active, use some ibuprofen, and beat the crap out of the joint even worse than it is, heading into surgery?  Is there any downside to that?”

He said “no, just make sure you’re off the ibuprofen for 5d prior to the procedure.  Your joint is going in the sh**-can.  It is irrelevant what you do to it at this point.”

I’ll probably have to do elliptical for an hour a day, the last 3-4 days.  I will not be able to run at all without the NSAID.… (Click Here to View Full Post and Comments)

• Saw my friend, the joint replacement specialist today.  He gave me plenty of time and answered all 11 questions I had in a caring and unhurried way.  There is very little chance this hip discomfort will ever get any better.  Hence, I see no reason not to proceed and get the hip replacement.
• I will get a titanium femoral component and ball, with a highly crosslinked polyethylene cup.
• If I don’t have pain, he told me I can walk as much as I want, with no assistance or devices the day after surgery.  Pain likely indicates a cracked femur, so you need to take it easy if you have that, so it can heal.
• I asked him:  If all goes well and I recover nicely, are there any things you would like me not to do?  His answer was:  No.  Do what you want.  Would you buy a sweet sports car after retirement and let it collect dust in the garage?  Use the damn thing.
• Hoping to get it booked on 10/29/2013.

 … (Click Here to View Full Post and Comments)

• I am a 47 yo anesthesiologist, and have been an avid runner (~3000 miles/year) for 20+ years.  I’ve completed 58 marathons with a best of 2:33, and I ran 2:46 in May 2012, at the age of 46.  At this time, I noticed I was needing quite a bit of ibuprofen around my major runs to get through “groin pain”, which became even more localized to the right groin, and right hip.
• In August 2012, after 700+ days of not having missed a day, I finally had to “give up the ghost” and take days/weeks off in an attempt to make the right hip/groin pain go away.  This was met with no success.  In fact, all areas of my life were becoming affected.  For example, everyone noticed my limping, and attempting to ski was pure torture.  Still, I held out hope that through some miracle, like every other running injury I’ve ever had, it would simply….GO AWAY.
• No such luck.  Fast forward to March 2013.  At work one day, I approached my friend and colleague, an orthopaedic surgeon.  Upon hearing about my ongoing struggles, he ordered a simple hip x-ray.  His email next day said “moderate OA, and obvious cam deformity”.
• To make a long story short, I was referred to his colleague, a hip preservation specialist (he trained with the guy from Vail, and the other guy from HSS, so I have no doubt that I was in the best of hands).  He informed me that it was pretty obvious that the cam deformity had already done significant osteoarthritic damage, but that there was some chance that cleaning out the joint and labrum, and removing the deformity (osteoplasty), could (with a protracted, meticulous, low activity recovery phase) get me to a relatively pain-free state, but that my activities–for the rest of my life–would need to be tempered (e.g. no running for exercise purposes, among other things).  In other words, I had femoral-acetabular impingement (FAI), which had already done significant damage.  The surgeon clearly informed me that if most of my discomfort and limitation was from the existing osteoarthritis, the