She's Back -- Or Blazedog's Excellent Surgical Adventure

[blazedog]

Hello everyone -- hope all has been reasonably well with all of you.

As some of you know, I had a total hip replacement on March 8th but everything went really well -- (knock on wood) and no major or minor complications so far -- I see my surgeon tomorrow for the first follow up visit when I will be X-rayed but presumably no pain means that everything inside is as it should be.:)

Of course I am also on most excellent pain medications (Oxycontin and Percocet) :D :D

My surgery was done by a very new technique -- anterior approach on a very high tech table which enables the leg to be precisely positioned and also for frequent x-rays which are critical for this approach.

http://i72.photobucket.com/albums/i192/baguettebabe/PROFX_Table.jpg

The benefit of this approach is that no muscles are cut and therefore I have none of the onerous and scary restrictions most people recovering from hip surgery have as there is almost no risk of hip dislocation. I was up and walking the first day after surgery and on Saturday walked without the walker, crutches or cane under the careful eyes of my physical therapist. There is obviously some surgical pain and also muscle soreness and stiffness -- from having been twisted during surgery and also because in the months leading up to surgery the pain caused atrophy of muscles one's gait becomes "off" to avoid pain.

For anyone needing hip replacement, I can't recommend this procedure highly enough as the recovery is so much easier than for the posterior (more standard approach). The physical therapist told me I was doing better than 99% of his patients -- which he thought was due to the approach -- logical since no muscles have to heal together.

The worse part was lying in bed after the Foley catheter was removed and having to wait 25 minutes for a nurse to come to help me out of bed to the toilet -- and those elevated toilet seats aren't much fun either. Getting in and out of bed was impossible for me since I had lost so much strength in the lateral and abductor muscles which control lifting and moving the leg to the side -- essential to getting out of bed. Once I acquired a nifty little device called a leg lifter, I was good to go -- literally.:D

It was illuminating to view the medical system as a patient -- almost without exception, the individual personnel who I dealt with with were compassionate and competent but so overwhelmed by work due to financial constraints of the medical system.

My surgery was done at Cedars Sinai in Los Angeles which is one of the major hospitals in the US so I don't know how it translates to smaller hospitals but I would assume funding for support staff is a pretty universal problem. My experience was that the care was astoundingly good until there was no medical risk to me -- after that, one had to fend for oneself since the nurses and clinical partners (what the LPN's are called) are so short staffed, that they have to triage care.

In terms of medical outcome, my surgery and treatment was superb -- no infections, no complications etc. However, it is difficult to lie helplessly in bed desperately having to pee and watching the clock tick by.:eek: This is NOT the fault of the nursing staff as they weren't twiddling their thumbs. One of the nurses explained that it was a combination of not enough staff plus sicker patients which require more care -- i.e. since patients are sent home as soon as they are stabilized, most of the patients require more care -- a vicious circle and very hard on the nurses and the patients.

The food at the hospital was surprisingly good with lots of healthy choices -- for example a turkey/dried cranberry salad with Newmans Light Raspberry Vinaigrette which was pretty equivalent to a salad from Paneras. The matzoh ball soup was WONDERFUL -- but one would expect no less at a hospital called Cedars Sinai.:D

i fought to be sent to a rehabilitation facility rather than go home since I live alone. The food there was scary bad -- not just that it was bad beyond belief -- baked potato that was semi raw, library paste mash potatoes but also that it was so unbelievably unhealthy -- nobody should be eating that kind of food but it would be especially lethal to their residents. For example, my roommate was bedbound after knee replacement and was also diabetic -- She was being served high fat, white flour food -- i.e. Salisbury steak, fake mashed potatoes, white pasta concoctions which are the antithesis of what a diabetic should be eating -- and did I mention the food was beyond inedible.

Anyway -- I am back and looking forward to resuming my life before excruciating pain circumscribed it. The operation -- especially with the anterior approach -- is a true medical miracle.:)

[Krysia1031]

I was thinking about you because a family friend is having hip replacement surgery in a few weeks and all I could picture was your crazy little contraption.

Glad to hear things went well and you are recovering. Sorry to hear about the bad food. Maybe we should get the rehab center a subscription to CL. :D

[donleyk]

Welcome back! I'm glad to hear your surgery went so well.

How often do you have PT? Can you cook for yourself now?

Keep up the good work!

[LakeMartinGal]

Glad to see your erudite self back, Blazedog! I missed you. I think it's wonderful that this surgery can be performed, and that you have little pain with it! That bedpan mambo is literally a pain in the @ss, but you seem to have survived ok! My aunt has to have the second replacement of the same hip in a month, and I'm going to send your post to her daughter, to see if they can do this for her! :D

[Valerie226]

What a fascinating experience! Hope all continues to go well. Good to have your opinionated self back at the keyboard. Too bad about the bad food but around here rehab facilities are basically nursing homes, never known for healthy or interesting meals.
I've been reminded many times of your ordeal because that contraption puts me in mind of Pilates equipemnt..... or an old James bond movie.

[lindrusso]

I guess I missed that you were going in for surgery. Glad to hear that everything went well and that they are developing new and better ways to perform this usually debilitating surgery! That's quite the contraption! :)

[Kay Henderson]

Delighted to hear things went well and that you are back with us! Keep us posted on how things are going for you.

Kay

[Hammster]

Glad to hear it went well and you are having a relatively easy recovery.

Welcome home. :D

[ErinM]

And if anyone wants to play orthopedic surgeon...you be the doctor!

http://www.edheads.org/activities/hip/index.htm


You can also do a knee replacement, and as well as a virtual hip resurfacing!

Glad to hear your recovery is going well Blazedog!

[honeygirl1971]

Blazedog, I'm so glad everything went so well! What an amazing advance in hip replacement surgery! I hope the rest of your recovery goes equally well! Glad to see you back here again too!

PS I was born at Cedar's Sinai, and my mom told me the food was excellent way back then too! ;)

[funnybone]

I don't remember hearing of your surgery. Glad to hear you are doing well.

[stacy7272]

I'm so glad to read that everything went so well! Did you have any students work on you? Since Cedar Sanai is a teaching hospital it seems that is something that happens all the time.

I had my two kids at Cedar Sanai and with the first one the person stitching me up was learning. Boy did she do a terrible job! It took 40 minutes and it took over 6 weeks to heal!

With my second I asked for an epidural and the nurse was going on and on about the wonderful doctor who was currently on that does the epidurals. He's the best! You should have seen her face when the doctor walked in with a student! :eek: My heart sank. Luckily, the student did perfectly. It didn't hurt or cause any bad side effects.

And yes, my foodie niece, who is now 16 but was 10 at the time, still talks about the wonderful food she had there when she was visiting me! :D

[lindrusso]

I had my two kids at Cedar Sanai and with the first one the person stitching me up was learning. Boy did she do a terrible job! It took 40 minutes and it took over 6 weeks to heal!

Oh ouch!

Don't they have cadavers for that kind of practicing?? I know they all have to start somewhere, but please don't let someone do stitches until they have perfected it somewhere else please! :)

[Wendy w]

Good for you Blaze. Take care of yourself. Cedars is a good hospital.

I just had some surgery myself. I'm on week 5 with 3 more to go. The time is flying. Take care of yourself.

[colleency]

Welcome back ! Glad to hear it went so well. My mom's partner had an awful time with her hip surgery last August. She's still recovering from it! (There were oodles of complications.)

[SDMomChef]

Glad to have you back on CLBB and good to hear that the surgery went well and that you are having a fast recovery!

[misskitty100]

Welcome back!

[blazedog]

Thanks for all the good wishes -- my physical therapist just left and I walked down the hallway twice without the walker -- once with my hands above my head.

I know that there was a student of some kind working with the anesthesiologist as she was the person who put the intravenous tube in my arm -- that went reasonably well. There was probably a student working along with the surgeon as a young woman came in to see me one morning and introduced herself as having assisted my OS.

I had spinal but had asked to be oblivious during surgery so my last memory was being moved onto the operating table when they must have hit me with the good stuff :D and then waking up in the OR when it was all over -- I was evidently trying to move a mouse around as I was trying to answer emails :p :p

What I did learn as a patient is how critical it is to research your illness and the procedure and also to be assertive in asking for things. I had discussed anaesthesia with my OS in the original consult and based on everything I had read, I did NOT want general. Imagine my surprise when the anesthesiologist who I had never met trotted in and told me that he would be using general. If I wasn't sure of the real benefit to an epidural/spinal and been afraid to assert myself, I would have wound up with general and a much more complicated recovery.

And speaking of medical issues, there is a great search engine I had read about called medstory.com -- It was recently acquired by Microsoft (which is how I learned of it) and it is good because it delivers real medical information instead of the commercial half baked websites that come up when one uses the more general search engines.

[Jazzmatazz49]

Thank you for such an informative post. I'm fascinated with the improvements made in such surgeries in just the past few years. Oh, and I'm glad you're all better!

[syzygy]

Welcome back, and good wishes for a continued easy (and quick) recuperation.

[jtoepfert100]

I'm so happy to hear everything went well. You are fortunate that the food at Cedars was so good. The food when I was in the hospital was exactly how you described it was at the rehab facility. It is shocking to me that hospital food is so unhealthy.

How long will you be out of work? Are you back at home now?

[TKay]

Wow, that's fantastic that you could have the less-invasive procedure. Is that possible for all hip-replacement candidates? Or did you qualify for it because of a specific physiological condition? I'm curious because my 43-year-old friend has needed hip replacement for some time, but is putting it off as long as possible. I wonder if this approach might be an option for her.

In any case, I am very happy to hear you are doing so well. It sounds like everything went beautifully. Here's to continued speed and success in your recovery. And welcome back.

[blazedog]

Wow, that's fantastic that you could have the less-invasive procedure. Is that possible for all hip-replacement candidates? Or did you qualify for it because of a specific physiological condition? I'm curious because my 43-year-old friend has needed hip replacement for some time, but is putting it off as long as possible. I wonder if this approach might be an option for her.

In any case, I am very happy to hear you are doing so well. It sounds like everything went beautifully. Here's to continued speed and success in your recovery. And welcome back.

The approach (anterior) can be done on almost anyone with a few exceptions. Theoretically I am not an ideal candidate because of my ahem -- fleshy thighs:D but the OS told me that this approach was actually better for me because there was less "flesh" in the front than other parts of my ample tush.:D

This isn't necessarily "less invasive/minimally invasive" which has become a catch-all term. Almost all hip replacements are now done with smaller incisions than in the past. What differentiated my surgery was that the incision is in the front of my thigh rather than on the side. Using this approach (incision) no muscles are cut as the incision goes between muscles. In the more standard posterior (side/rear) approach, the gluteus muscles are cut which is why there are many more precautions since there is a much higher risk of hip dislocation since the muscles aren't there to help keep the pelvis/hip in place.

Most surgeons are not using the anterior approach since it requires retraining and the specialized table. Here is an url that briefly explains it and also provides a physican locator. I was quite lucky in that the OS was also affiliated with Cedars and is a "preferred provider" in my plan.

http://www.newhipnews.com/

There is also a technique which was approved by the FDA about six months ago called hip resurfacing. There are theoretical benefits to this type of surgery for young patients like your friend since the femur (thigh bone) is left more intact. Also theoretically those who have had hip resurfacing can engage in high impact sports like singles tennis. Theoretically, a hip implant has a life span of x years so when one needs a new hip implant (revision), theoretically it is easier since there is more bone to work with.

Like any procedure, there are also theoretical disadvantages. It is not generally recommended for post menopausal women (like me). Also, the newer implants are supposed to have a much longer life than the older ones -- mine is ceramic on ceramic (not Limoges:D ) as opposed to the older types which had poly linings. Therefore there might be less chance that I "outlive" my new hip since the older transplants lasted for a shorter period of time.

Your friend is VERY foolish to put off having surgery. I put it off and should have had it done sooner. However, the truism about hip/knee replacement is that one has it when NOT having it is worse than any fear of having the surgery. Living with the painful hip was MUCH worse than anything I have experienced in the past two weeks since surgery.

If you want to PM me, I would be happy to exchange emails with you friend and give him/her a push -- I only wish I had encountered someone on the "other side". There are also some excellent mail lists on yahoo -- Since your friend is so young, does he/she have avascular necrosis?

P.S. I see that you are located in Southern California -- My OS is in Los Angeles and perhaps your friend lives within a reasonable distance of LA. I would at least suggest her seeing my OS for a consult. I can't recommend him highly enough as the pre/post care medical protocol he uses is really top notch when I compare it to others I am corresponding with who used different surgeons -- i.e Fragmen versus Coumadin etc.

[lbd]

Oh ouch!

Don't they have cadavers for that kind of practicing?? I know they all have to start somewhere, but please don't let someone do stitches until they have perfected it somewhere else please! :)

Or at least practice on a less sensitive area!

Glad to hear the surgery went well Blazedog. A family friend recently had a traditional hip replacement and her recovery seemed much more arduous than yours sounds. Thanks for all the excellent information.

[Canice]

Welcome back, Blazedog, and I'm glad everything went so very well! I am soooo grateful for modern medicine and dentistry.

That's really lousy, Stacy! I've never been "worked on" by a student, but I did have half a dozen of them observe a procedure being done on me. Cervical biopsy. :rolleyes: I tried to be mature about it, but you sure don't want to recognize one of them the next day as your cashier at Trader Joe's!

[swquilts]

Glad to hear you are doing well, Blaze!! A friend of ours has to have one....I'm going to show him the picture of your "torture table"!! Last I heard he was having his done your way.

Keep up the walking as nothing is better rehab for a hip patient! Take care....

[bobmark226]

I've never been "worked on" by a student, but I did have half a dozen of them observe a procedure being done on me. Cervical biopsy. :rolleyes: I tried to be mature about it, but you sure don't want to recognize one of them the next day as your cashier at Trader Joe's!


ROFL, Canice, a story worth telling!

Bob

[TKay]

This isn't necessarily "less invasive/minimally invasive" which has become a catch-all term.


http://www.newhipnews.com/

There is also a technique which was approved by the FDA about six months ago called hip resurfacing.

Like any procedure, there are also theoretical disadvantages. It is not generally recommended for post menopausal women (like me). Also, the newer implants are supposed to have a much longer life than the older ones -- mine is ceramic on ceramic (not Limoges:D ) as opposed to the older types which had poly linings. Therefore there might be less chance that I "outlive" my new hip since the older transplants lasted for a shorter period of time.

Your friend is VERY foolish to put off having surgery. I put it off and should have had it done sooner. However, the truism about hip/knee replacement is that one has it when NOT having it is worse than any fear of having the surgery. Living with the painful hip was MUCH worse than anything I have experienced in the past two weeks since surgery.

If you want to PM me, I would be happy to exchange emails with you friend and give him/her a push -- I only wish I had encountered someone on the "other side". There are also some excellent mail lists on yahoo -- Since your friend is so young, does he/she have avascular necrosis?

P.S. I see that you are located in Southern California -- My OS is in Los Angeles and perhaps your friend lives within a reasonable distance of LA. I would at least suggest her seeing my OS for a consult. I can't recommend him highly enough as the pre/post care medical protocol he uses is really top notch when I compare it to others I am corresponding with who used different surgeons -- i.e Fragmen versus Coumadin etc.

Thank you, thank you, Blazedog, for all this information. I will pass it on to my friend. I don't know the specifics of her condition. We haven't talked about it at length. I just know that she had a hip problem at birth (like I said, not sure what exactly). She's known for a long time that hip replacement is in her future. But now, the pain is getting to be too much and she's limping and having other problems. It's my understanding that she's put it off because of the life of the implants and not wanting the revision while she's still young enough to get around. I know that she has Kaiser as her insurance plan, and not be too critical or speak out of turn, but I wonder if that isn't why she's not talking about the other options that you're mentioning. I will definitly inform her about your experience. Maybe there are other possibilities she simply hasn't been educated about.

Oh, and I did consider that my "less invasive" comment was inaccurate. But thanks for the correction anyway.

I'm glad you're doing so well. My friend lives in Long Beach, so I will let her know how highly you recommend your OS. I'll PM you if I need the details. And thanks again.

[blazedog]

Thank you, thank you, Blazedog, for all this information. I will pass it on to my friend. I don't know the specifics of her condition. We haven't talked about it at length. I just know that she had a hip problem at birth (like I said, not sure what exactly). She's known for a long time that hip replacement is in her future. But now, the pain is getting to be too much and she's limping and having other problems. It's my understanding that she's put it off because of the life of the implants and not wanting the revision while she's still young enough to get around. I know that she has Kaiser as her insurance plan, and not be too critical or speak out of turn, but I wonder if that isn't why she's not talking about the other options that you're mentioning. I will definitly inform her about your experience. Maybe there are other possibilities she simply hasn't been educated about.

Oh, and I did consider that my "less invasive" comment was inaccurate. But thanks for the correction anyway.

I'm glad you're doing so well. My friend lives in Long Beach, so I will let her know how highly you recommend your OS. I'll PM you if I need the details. And thanks again.

Less invasive is not incorrect -- it's just that it is applied to lots of hip replacement surgeries.

Kaiser is good insurance in general but it does limit one to the doctors who practice at Kaiser and I don't know if any do either hip resurfacing or the anterior approach since they are less common. I also don't know how one can go out of network at Kaiser.

If your friend has had the condition since birth, it might be a form of hip displasia -- but I really am just speculating as I didn't delve too deeply into congenital hip conditions.

As to the limping and pain -- Without realizing it, one's life becomes so circumscribed and ruled by the pain as the increase in pain level is so insidious. I just reached the point where so many daily activities that I had taken for granted had become too painful -- from a long walk to even window shopping. Even sedentary activities like going to a restaurant become less enjoyable since there is always the underlying pain.

[mcgeiger]

I can't say for the med students, but for us....
(BTW don't read this if you don't want to know, I am very forthright and matter of fact in the following...)


We get cadavers from the humane society (I think) that are unadoptable (read many pitbulls, shepards, etc.) or roadkill (we used to get them from the racetrack but that was deemed bad...) for anatomy our first year. ETA: these animals are not euthanized FOR us, they are euthanized whether or not we need/want animals, and instead of being creamated, they are sent to the school. We volunteer our own animals for physical exam practice, eye exams, orthopedic exams etc. For small animal we have one lab in our junior year using pigs to practice surgeries, they are generally so sick (they were on their way to slaughter) that we use ventilators to keep them alive and they are euthanized without waking up. We used to use dogs, but that was also deemed cruel. We practice sutures on plastic models, electric boards (think Operation the game), and water pressure models. We use cadaver parts for specific labs (tooth extraction, eye dissection, etc). Other than that we have to use patients...good and bad for everything and most medical (vet or human) try to balance costs (human cadavers are $$$$$$$), teaching, and ethics the best they can...

[buffygirl]

Blazedog,

Thanks for posting about this. I'm so glad that your procedure went well. I had a femoral osteotomy to repair my left hip (dysplasia) about 5 years ago. The surgery and recovery was brutal! I didn't walk without a cane or walker for 9 months after the surgery!

The doctors recommended the procedure for me because of my age at the time, 35. They were afraid that I would go thru several replacements in my life time. I'm second guessing that now though. I haven't walked quite right since the surgery and I have knee pain now that I didn't have before. My hip is still really sore. I've found that if I go to my chiro regularly, then I'm in much better shape.

Again, thanks for sharing. I know eventually my hip will have to be re-done.

Kim

[swquilts]

Kim, my DH's surgeon has performed replacements on folks as young as 26! My DH's first was at 35, but was due to necrosis of the bone.

Most replacements last 15-20 years.....

[cookinator]

Hi Blazedog!

I missed this thread but I wanted to wish you a speedy recovery! That is one 'high-tech' table! It is amazing how surgical procedures have changed, I am glad you were able to have your surgery in this new way.
I'm confused..are you at home now? How are you managing?

Now, when you are all healed, lets get together and strap on our rollerskates and ride the bike path in Venice..I'll bring the sunscreen. Just be sure to wear your bikini;) . Maybe we can invite Gail:eek: .

I'm glad you are back!

[blazedog]

Hi Blazedog!

I missed this thread but I wanted to wish you a speedy recovery! That is one 'high-tech' table! It is amazing how surgical procedures have changed, I am glad you were able to have your surgery in this new way.
I'm confused..are you at home now? How are you managing?

Now, when you are all healed, lets get together and strap on our rollerskates and ride the bike path in Venice..I'll bring the sunscreen. Just be sure to wear your bikini;) . Maybe we can invite Gail:eek: .

I'm glad you are back!

I am home now and able to function quite well although I am not cleared for driving -- Although I tell my friends that my driving on Oxy/Percocet still makes me safer than most of the Los Angeles drivers.:D

I have someone to come in a few times a week to help straighten as doing a laundry and taking out the garbage would be difficult to carry.

I am not sure whether I am more tired than usual as I always did enjoy a good afternoon nap and this is the perfect time to indulge myself.:D

[honeygirl1971]

I am not sure whether I am more tired than usual as I always did enjoy a good afternoon nap and this is the perfect time to indulge myself.:D


I agree! :) Even though your surgery allows for much faster recuperation than traditional hip replacement, it's still a major intervention which will require plenty of rest and relaxation! Take good care of yourself! :)