Hips

[rup]

Limped out of the 100-mile a few weeks ago, but deferred on Ktaadn due to pains in hips. I was diagnosed with arthritis in hips 3 years ago, but has never bothered me. Orthopod / x-rays indicate it's now time for a replace. Having problems arising from chair unless done just the right way.

Anyone have any experience / advice? Do both at once, or just 1? Hardware? Recalls (Striker last year), Anterior, poterior, or lateral entry, etc.

 

[psmart]

My partner had both done in her late 40's. One hospital stay, with the two hips done 2 days apart, on her feet (briefly) the day after each surgery. Titanium with a replaceable polyethylene liner. 4" lateral incision. Ten years later, still very pleased with the results. Surgery was done by Dr Thomas King at Portsmouth Regional Hospital.

 

[Stan]

Quick advice based on my wife's experience after a replacement 15 years ago.

They do double knee replacements routinely but I'm not sure they do that with hips because of the rehab process that follows. Get a good orthopedic surgeon with lots of experience and high reviews ... no, make that an outstanding surgeon ... they will select the joint based upon your specific needs etc. and they will also determine a procedure which good surgeons will discuss if you are interested in that detail. I don't believe those are generally patient decisions though someone proactive with their condition will likely be part of the decision process.

My wife dislocated her hip after 15 years, most likely because she had torn some muscle that could no longer provide the full strength and support needed. After four dislocations in 8 months she had "revision" surgery on an otherwise tight hip joint ... so I guess, all other things being equal on the specific joint, one that comes with ... shall we say ... "replacement parts" might be a good consideration for future options as a revision is less problematic than another replacement.

I believe the more muscular you are the quicker your recovery so as a hiker you already have an advantage but keep in shape beforehand.

Best wishes.

 

[rup]

Thanks. I'm seeing another orthopod tmrw at NYU Hospital for Joint Diseases. He / they have great record. Probably do only L as it is troublesome, and R is not presenting problems right now, so can use it to balance lack of horsepower on the L. May be less prone to dislocation as well. Also favor the anterior approach as there is no / very little muscle cutting involved - just pull / push them aside. The thought of having to contend with a healing butt muscle in addition to the hip is not the greatest thought.

Unfortunately Ktaadn to finish NE 4000' has to wait till next year.

 

[rup]

Finally scheduled for asurgery on 11/10. I found today that the hospital wants to be paid ahead of time. What's that all about?

 

[rup]

Today is the opr. Can't wait to get beyond it and finally tackle that last NE 4000 footer.

 

[Kevin Judy and Emma]

Small world. Had my right hip replaced about 8am this morning at Portsmouth Regional in NH. So far, so good. Just took my second turn down to nurses station and back, felt like Washington in rotten snow/monorail. Suffered through it for a few years until I could barely walk and little sleep, very short hikes dwindling to almost none because of the pain. The pain right now isn't much worse than what I was already going through, though I'm pretty well drugged right now. Hope you are doing equally as well or better. Hoping it's all a bad memory in a month or so for both of us. Good luck!

 

[rup]

Kevin - your history sounds like mine.

Successful op, but stayed in hospital an extra night as my BP to 50/30 during initial PT routine - common for such ops. Hip still hurts, but it's surgical pain, and should pass in 2-3 weeks with PT. Nurses say to keep ahead of pain with meds - ie, don't wait for it to hurt. Should all pass in 2-3 weeks as the PT continues.

 

[Stan]

When my wife had her hip replaced, she was in so much pain that she almost regretted the surgery. It didn't take her long to wonder why she didn't do it sooner.

I reminded her why ... it was the interim tequila therapy. It had worked and to this day I conclude all strenuous and not so strenuous activities with a tequila tailgate. Been working nicely for me.

Happy healing to both of you and may you be trail worthy soon, no matter your medication plan.

 

[rup]

10 days out, and I'm walking around the block.

 

[Jazzbo]

Time for an update from Kevin and Rup on hip surgery. I'm currently contemplating similar option for my left hip and could appreciate some comments. I've dialed back on my hiking objectives quite a bit and still had painful hike last Saturday. I function ok with normal activities like driving and household repairs and sitting at a desk, but it sucks doing only small hikes and even those can turn into a painful ordeal.

 

[Kevin Judy and Emma]

Kevin's Comeback 2016

After surgery on November 10th there were weeks of PT and I had to use a cane for several more weeks. I walked as much as I could stand and did my PT at home religiously along with the 2 visits to PT where they stretched me and introduced me to new exercises almost each trip. Each new exercise would be like a step backward, "Oh, I thought I was doing so good until I tried doing this." The answer, of course was, "You ARE doing good, and by next week this one will be a cinch."

Around Christmas Eve I was itching to get out and actually hike something, walks in the park were no longer doing it for me. With longtime VFTT friends MJ & Sabrina and their dogs we hiked to the extreme summit of South Pawtuckaway. Man, it felt good to be in the woods again! A week later we took a longer hike at Ward & Boston Hill in Essex County, MA. I was feeling quite good, and 4 miles was doable, especially since we had a perfect carpet of frozen snow that we could walk on, perfect for micro-spikes, and it took all the rocks & roots out of the equation for me.

On 1/5, 8 weeks to the day after surgery, I decided, (perhaps foolishly) that I was ready for a "mountain". Again with Sabrina and her dogs we set out to hike Gunstock & Belknap from the base of the carriage road. Though I had done this several times before, memory fades and I had forgotten how steep this hike on Gunstock Mtn Trail was, climbing 1400' in 1.1 mile. I survived, and I made it over to Belknap, and then Piper as well. Only 4.5 miles, but 1700 +/- elevation. I was sore for a few days afterwards, but I was using muscles I had not used in quite some time, not to mention the surgical pain.

On 1/14 I was ready for some more, so Judy and I took a friend's dogs with us on a very icy trip to Morgan & Percival. I was pretty happy with surviving this, there was definitely some sketchy ice on the trails we had to be very careful while traversing.

3 days later we were invited to join another longtime VFTTr with his dog Gryffin and another longtime hiking friend on a hike to Mount Jackson, my first post-surgery 4K hike. I was not sure I was ready, and probably would not have pushed myself that far that fast, but I did fine, though I opted out of visiting Webster that day.

Since then we visited Welch/Dickey 1/27 and Mount Liberty 1/30. I feel like I am back to the form I was in almost 10 years ago. It was that long that I dealt with the pain. Since the surgery my twice operated on right knee is a lot less cranky, as well as my lower back, both of whom had become quite angry at always having to do the work my hip should have been doing. I exhausted all my options before giving in to the surgery, but needless to say, I am ecstatic I did! I am not saying it was an easy road, there were a lot of bumps and it took dedication to get better as quickly as I have, but it most certainly has all been worth it!

KDT

 

[Jazzbo]

Hi Kevin .... Thanks for your excellent comments. I'm very happy to hear how well you're doing both for your hard work and happy results and what it might mean for my own situation. I can understand what you mean by other joints picking up the load. I've been feeling pain in my knees since this started. Could make a great case for doing it sooner rather than later in order to conserve other joints.

Ray

 

[Kevin Judy and Emma]

Every single person told me, "Just do it, you'll wonder why you waited so long." I didn't listen, I was adamant about trying every option before giving in. I'll freely admit, part of it was I was afraid as well, there would be things I could no longer do, I was not ready to give up some things, like ice hockey, which so far, I have not returned to, but I HAVE been doing a lot of skating to build strength. When the decision was finally made to go through with the replacement surgery, the fear was replaced with determination that I would do everything in my control to being better. That was the only thing I could control, everything else was up to someone else, and that took a good deal of faith, but fortunately I was not let down.

I received excellent pre-surgery instruction from Dr Gomburg and his crew, the surgeon did an excellent job, I got excellent care and help post surgery from Michelle and the other girls at Access Sports, and I was fortunate enough that my insurance covered it all. In retrospect, I am glad in unfolded as it did, and I did not rush into it. That said, I am equally as glad that it has made me feel better than i have felt in many years! Find a surgeon you're comfortable with. Find a hospital with a good reputation.

If there is any question, the answer is "Just do it."

KDT

 

[rup]

Kevin - glad to hear of your progress. Must be great to be back in mts. Here’s my follow-up.

Surgery on 11/10 was 'posterior'. I had 6 visits of at-home PT, and after my 6-week visit with surgeon Jan 4, started external PT 2x/wk. I've continued the stretching since the at-home sessions. I didn't set a do-or-die mileage target, but never had an issue with walking 1-2 miles – perhaps an occasional mild hip ache next day. But all that has passed. I had my 3 month follow-up with surgeon last week, and was oked to return to the gym and lift weights.

To me, the key was to stretch every day (2-3x / day). I eventually got my L heel up to my R knee, so flexibility returned, although more slowly than I thought. The surgeon has removed all restrictions - except caution for extreme bending from waist coupled with extreme twist at hip - so some exaggerated yoga stretches are out (for now?). I was surprised to hear that some threat of dislocation persists - I thought the risk would ease as soft tissue repaired, and muscle re-developed. We'll see.

So pretty much no problem now. Look fwd to the mts, and eventually to Ktaadn for my last NE4k. How long did it take you to get your endurance back?? Btw, for a recovery compare, how old are you? I’m 67.

ps - My wife says the worst part of the experience was the first 3-5 days home after the hospital. I moved cautiously and slowly, and was somewhat immobile in bed with that foam 'Y' shaped foam pillow between the legs. I was up every 2 hours at night to pee (she was in charge of emptying the p-bottle), as the anesthesia worked out of system. They never told us about that at the pre-op coach class.

 

[Kevin Judy and Emma]

Yes, the risk of dislocation is real and keeps me from returning to hockey, though I know people who have had the surgery and are playing again. It would take a lot, but don't want to risk it. The X-rays show the bone has grown into the porous surface of the metal and has locked the implant in place. Endurance is something I am still working on. Distance and elevation are very real obstacles at first. I am not that aggressive of a hiker, meaning I am not out there every weekend, maybe twice a month. However, we walk on a daily basis, usually at least 2 miles over rolling terrain. It's all good. Even short walks were killing me before the surgery, and everything else was thrown out of whack compensating for the hip. I feel now that despite having 2 knee surgeries on my right knee, it feels better than ever because it no longer has to carry the load for the hip. I am 57, so 10 years younger. Absolutely the first few days/week were the worst. The oxycontin constipated me and after a few days it poisoned me so bad I had the wife call 911. After a nightmare ride in an ambulance to the hospital and a $9500 enema I felt a whole lot better and got progressively better from there. The first few weeks are not much fun, something I don't think they fully prepare you for or make you fully aware of. Thank goodness I had someone here who would take care of me, and loved me A LOT! It's all a bad memory now and it was all worth it. I feel great!

KDT

 

[rup]

With ok from surgeon, started weight lifting last week, and was surprised that the upper body was was weaker than lower - probably due to walking and stretching. One thing bothers me, however: I have a 'click' (not audible, but can feel it with leg motion) coming from L hip. It has not gone away. The surgeon and PTs say its the 'IT sheath' rubbing over scar tissue - something like plucking a guitar string - and not the hip joint itself. Trust they are correct.

and Kevin, you must have great stability to head to the mts in snow. My wife gets excited if I don't use the cane, even though I do not need it at this point.

 

[Kevin Judy and Emma]

Great to hear you are feeling and getting stronger, Rup. I haven't been hiking much the last few weeks. I've been trying to avoid icy trails, don't need a slip-fall at this point in the game, though it could happen on mud or wet leaves. My leg feels stronger than it has in 10 years and I can once again hike pain free. The knee and back pain is almost negligible, so I am feeling very thankful and blessed for that. I've been down with the flu the past 10 days. We hiked the small hill behind our camp we have named "Emma" Hill. It's about 400' in 3/10ths of a mile and there is no trail, so short but significant, and I had no pain, but thought I was going to hack up a lung when we got up, damn flu! The "click" you mention I think will go away. I had it for a few weeks. In fact, I had a lot of clicking and popping going on for several weeks as muscles and tendons which had atrophied moved back into their natural positions. Positions they hand't been in in years, mind you, but now that things are realigned I feel great. The snow was really no obstacle, in fact I was glad to have it. It takes all the rocks and roots out of the equation! Now ice, that's a different story. I'm heading to Mount Washington Observatory in a couple of weeks for a week-long stint and I am sure I will be dealing with ice there! Will be posting here...

 

[CaptCaper]

Great to hear fellow joint replacement hikers on their feet again. My hips seem mine fine. My shoulder isn't too good thou. But I did have total knee replacements. Not both at one time. One 2 yrs after the other. Amazing how it gives us our lives back. I inherited this from my mothers side. Same conditions as she had.
It takes so long to heal and build up one's body and mind to get back into shape after years of being out of wack. But I've been hiking again with no pain for many miles each hike.. I have fallen but never harmed the new knees. How can one hike these mountains without fallen at some point..? I figure I'll worry about the damage if and when it happens as I don't want to be stuck hiking small rolling paved hills my whole life. What's left to it anyway.

 

[Jazzbo]

I confess I am somewhat self conscious announcing in public forom, but hopefully sharing my experience will help others so thougt I would reactivate this thread with my own THP on my left hip on Sept 27 at Newton Wellesley Hospital . Surgery went very well thanks to great great surgical team and great recovry team. I'm in very good hands. Going home this afternoon. I wonder if Rup made it to Baxter this year?