Monday, February 28, 2011

Birmingham Hip Resurfacing

I just found this while checking in with my fellow Hippies (  This is what is in my hip.  These guys have been making this implant for 10 years or more and they have the lion's share of the market.  The parent company (Smith&Nephew) have been around since 1856 and they are the largest ortho prosthesis maker in the world.  The designers of the BHR (Treacy and McMinn) are in Birmingham, England, thus the name Birmingham.  Some of the other metal-on-metal prostheses are the Wright Medical Conserve Plus, ASR Resurfacing, Cormet by Biomet, Duron by Zimmer, and there are probably a few others out there, that I don't know of.    


OK so it's not at as appetizing as Guy Fieri's tangerine flank steak stir fry, which I'm watching right now.  This is my lunch today.  It's a double-wrapped black and pinto bean burrito, with Colby cheese, and a little habanero hot sauce.   Seth - this might be better than the BB bean and cheeser.  The beans are one of the few preemptive moves I did before surgery.  I knew I would want to have easy-to-make, but good, food in the fridge. 

BTW - the kitchen, which we have dreamed of making bigger for 15 years, is the perfect size.  I can pretty-much spin around on my good leg and grab what I need while supporting myself with the other hand. 

That's my chair!

Geez, I get up for one second and the dog steals my chair.  "I'm the pilot of that recliner, you're the co-pilot, dog".  Yesterday I tried to finish Metroid Prime Corruption on the Wii.  Spent all day playing it.  The stupid boss at the end took 30 minutes for each try and I tried 5 times, even looked up a walkthrough, and still didn't finish.  I gave up and today I'm playing Ratchet and Clank, a little more my speed. 

An update on the leg - My quad feels like it was in a charlie horse competition with the Dropkick Murphies, and that part of my leg wasn't even really messed with.  Actually, it probably was in a weird indirect way, though.  Everything in my body is pretty much back to normal other than the hip and leg.   That's really good. The pain is more like the pain you get in your muscles after a whole day of soccer.  Not a horrible pain.  

Saturday, February 26, 2011

99.9% better

So the quality of this photo is not so good, but as you can see, I'm 99.9% healed.  Sort of, not really.  However, who needs more than an easy chair, a warm fire, a cool grabber, plaid pants, pub hat, and a brewski? 

BTW - Please do recall that I stopped the hard stuff about 48 hours prior to this photo. Acetaminophen does wonders for me.


This is about 3.5 days post-op and I'm walking around the house pretty well with crutches.  First day home was bad because of the cramps and nausea.  The second day home was mostly about getting the plumbing working, and today I've been blogging, and doing some exercises and resting.  I feel sooooo much better, all around.  The swelling as you can see here is a little wild, but not horrible.  It's expected.  Last night I put a pillow between my legs and gingerly rolled over onto my stomach to get much needed rest (I don't usually sleep on my back).  In the middle of the night I woke up and realized that I could not roll back over with out a lot of pain. Sandy had to help.  But in short, I slept 3 sessions of 2 hours each, the best sleep I had gotten in several days.

Thursday, February 24, 2011

Leaving Swedish

Getting ready for the ride home.  6 hours in traffic and rain and snow.  I prepared the car as much as I could beforehand, but there was no way it was going to be as comfy as a hospital bed.  In this photo, I was still pretty unaware of the havoc that the anti-biotics and narcotics had done.  About half way to home, the nausea and abdominal cramps set in and lasted for about 24 hours.  My last dose of narcotics was the day I left the hospital.  I'll take the pain over the nausea.  I could have got some anti-nausea meds, but I was ready to be done with meds.  All I needed at this point was acetaminophen anyway, so why take the heavy stuff. 


Sorry there wasn't much forewarning about this post.  It's not only graphic, it has nudity.  Here are the sutures, 2 days after surgery.  Looks a little painful but it's not that bad, really.  Notice the surgeon's initial, JNP, to the left of the wound.  When I was in pre-op, I tried to take the pen from the surgeon and annotate my hips.  This was because my friend Geoff suggested it.  Smiley face on the left one, "NOT THIS HIP" on the right, "leave this area alone" near the middle, (forgetting that I'd get a catheter).  The surgeon knew I was hopped up on goofballs and smiled at me and kindly reminded me that he uses the pen and I point to the hip that will get worked on.  He put's his initials on it and then I guess folks in the OR all come around and say, "yup, that's the hip the patient pointed to".  Double-checking is a good thing.

At the pre-admissions conference, the nurse asked me what I was coming to Swedish for and replied, "well you should know, didn't the surgeon tell you when he sent all the lab work over?", she kindly replied, "we KNOW what we are doing to you, you just need to tell us, so that everything lines up.", "oh, I see".  Again, Double-checking is a good thing.

BTW - the cut is long so that the surgeon can have some room to work.  When you do resurfacing you need some room to dislocate, get the tools in there to grind the femur top, grind the cup area in the acetabulum, and be able to sight the angles and make sure it all lines up right.  None of the muscles below get cut, they just get moved over a little.

Walking on Oxycontin

"Hey guys, where's my room again?",

Here I am cruising the halls of the new Swedish Orthopedic Institute in Seattle.   I had just been doped up with some Oxycodone and maybe Oxycontin, too.  Can't remember.  This was about 36 hours after surgery and I'm surprised I didn't get in trouble for cruising on my own.  Sandy was nearby to help break my fall if I stumbled onto my new $40K hip.  Yikes.  In short, it felt great to not have a catheter in or be on the IV and be able to "walk" around a little, I think this may have been the morning we left Swedish.

Wednesday, February 23, 2011

Flowers from Sandy

I received a nice bouquet of flowers from Sandy.  This was after she watched me reel in pain from the first PT session.  It was about 12 hours after the tied the last suture.  Miss Ratchet came in and removed the wedge between my legs and let the operated leg drop over a little to the side, frogleg style and I wasn't ready for that.  It felt like someone stitched my appendix to my left leg meniscus.  "Feel the stretch"  It was a strange sensation, it was sort of painful but even more deep.  I think the hip capsule was getting stretched a little more than it needed to.  I reeled around in the bed for awhile and then stared shaking again, like I was coming out of anesthesia.  The poor PT (her name was actually Hillary and she was very nice) didn't get very far.  She got some warm blankets and that made me stop shaking and then I started crying like a baby.  I think it was a mix of pain and drugs, but mostly pent up emotion about the whole event.  I just needed a catalyst.  I'd say a little hip capsule stretching and uncontrollable shaking worked.

So, the whole time, Sandy was feeling a little woozy and had to sit down, thinking she might pass out from watching me reel around like that.  Hillary said she'd come back later.  She did and then Sandy promptly went for a walk and stopped to get me some flowers.  The second session was no where near as bad.     

Tuesday, February 22, 2011


Here is my binder or 3-ring notebook with all the pertinent info I gathered over the year.  I think I was missing a couple papers about the difference between the Wright Conserve and the Birmingham implants, but I had a lot of details about FAI and one of my favorites, which is a summary of a 20-year study on hip resurfacing co-authored by my surgeon, James Pritchett.  Much of the other info that I did not have in the binder, was gained through participation in the Hip Talk Forum and general info on Surface Hippy.  As the surgery approached, my interest in clinical and technical info about hip resurfacing was balanced with more of the softer side about hip resurfacing.  The stories that were presented on the forum, as well as the support and encouragement from everyone was extremely helpful. 

This photo shows the binder with one or two signatures from staff at the hospital.  My friend Geoff suggested that I get the geeky notebook signed by all the staff that helped me, akin to a getting your cast signed.  I even got a signature from the room cleaner.  She was Laotian and I think she told me about the communist government and oppression at home in the 80s and why she came here, but I wasn't quite sure because I didn't really understand her.  Needless to say, I ended up with a signature from pretty much everyone, even the nice nurse that yanked the catheter out of my hoozit.  "Is this gonna hurt", I asked.  She replied, "take a deep breath".  You know its not gonna be so good when they tell you take a deep breath.  "Now exhale".

Right after recovery

I think my legs may have still been partially asleep here.  This is a couple hours after I got out of recovery and had some dinner.  Hospital meatloaf, mashed potatoes, gravy, and canned green beans never tasted so good.  This is the desert, a chocolate shake.  Happily I was on anti-nausea meds, and happily no one forewarned me that the narcotics pretty-much stop the main plumbing.  I think I made some phone calls to people that night, not sure why I was so talkative.  

Like I said, I was super anxious before surgery and blogging was not the first thing on my mind, so we simply did not record some of the pre-op stuff.  I'll summarize it here:

When we got into the pre-op area, they gave me a prophylactic dose of Celebrex (for the joints), Oxycontin (for the pain in recovery), and some other things.  I'm surprised they didn't give me any benzo's (i.e Vallium, Xanax).  However, being a light-weight with heavy narcotics, I needed nothing more than the oxy to make me sing sea shanties as they rolled me into the OR.  I had the choice of general or regional anesthesia with some heavy sedatives.  I chose the regional (spinal) which is supposed provide an easier ride out of anesthesia than general.  Surprised I did that,  but I had total confidence in Don (my anesthesiologist), probably aided by the narcotics.

All the stress and anxiety and there I was rolling into the OR and the whole time I had an overwhelming sense of calm and confidence.  Everyone was chatty and so was I.  They were happily preparing instruments and pouring solutions into stainless steels bowls.  The bench was not much different than mine, tools all marked and organizing nicely.  Don and a nurse asked me to scooch over on the operating table, which was flat and thin and was more of a workbench than bed.  I received the spinal and my feet began to tingle and fall asleep.  Pritchett (my surgeon) was there setting things up.  He got me on my side and clamped my pelvis into a, well, a clamp, a really big clamp.  Don used a cold stethoscope to check on where my feeling was.  I couldn't feel much below my navel, but I could tell that the surgeon and assistant were setting up my hip for surgery, probably looking down the length of leg, sizing up the angles.  Don then gave me some benzo's in an IV, and then I think some form of another sedative.  That was about all I remember.  I was awfully chatty and it's possible the surgeon gave the Don the wink, "this guy is asking too many questions".  Pritchett assured me later on that I wasn't bugging him.

When I came to or remembered coming to, I had an awful set of the shakes.  My recovery nurse, named Beth, reminded me that I had asked her her name three times prior to me actually remembering her name.  I kept asking for ice chips, who knew ice chips would taste so good.  Warm blankets never felt so good, even though I didn't feel cold.  Beth and I had a little discussion/argument on my BP.  She had a bit of a tough outer shell but she was really sweet after you break through the shell.  I kept putting my head up and looking around and she kept telling me to lay down and rest.  I ate three cups of ice chips, probably because I was so dehydrated.  She was a little concerned about the slow recovery of feeling in my legs.   After she got the go-ahead from anesthesia to release me, I gave her a hug for being so troublesome. 

Then Irving came to wheel me back to my room.  He was a little more chatty.  On the way out of the recovery room, I noticed the dude recovering next to me wasn't very talkative and wasn't lookin' too good, but he was awake.  As we passed by, I was thinking "must've had the general".  When we got to my room, Irving said there was a beautiful woman waiting in my room.  Sandy suggested to me and Irving, that I should have replied, "don't tell my wife".  Geez, even when I'm not all hopped up on goofballs, I'm not that witty.

Can't wait to get this over with!

On the ferry, looking into the sun.  It felt nice, but damn was I anxious.  I'm usually pretty good at calming myself, but I guess when you haven't been under the knife since childhood, and you know it's a major joint surgery, it's sort of expected.  The other aspect adding to anxiety, is that I was questioning whether or not I should be doing this now.  I could limp along and get more used to the easy chair, drink more beer, gained a few more pounds, watch the hypertension creep up,....  That wasn't going to cut it, though.  I missed the days of being able to climb in the trees with the kids and set up ziplines, or chainsawing in the wood lot and being able to do it for more than hour without having several days of pain to follow, I missed being able to tie my shoe without pain.  I had already forgotten about soccer and running, and sort of forgot about bicycling, just because things had deteriorated enough.  Those became distant to me even though it had only been a year since doing them.  I simply wanted to be able to sit in a picnic table again.

On the other hand, I spent a year researching this topic, looked at all the options, participated in the Hip Talk Forum, created my own 3-ring binder on the topic that my coworkers harassed me about, and with all the questioning I was doing, I would always end up telling myself, "I wouldn't be here if it wasn't the right decision". 

Ferry ride to Seattle

Here is my beautiful wife next to me on the ferry ride from Bremerton to Seattle.  I don't know if I could have done this without her.  The ferry ride was quite nice.  Reminded me of my youth when visiting my grandparents in Seattle.  There was a point waiting in line for the ferry when I was super anxious and got myself all keyed.  I looked over at a gangway at the dock that was part of the State Park system and there was a sign designating the park name and so forth, which was a Washington State Park, which, reminded me of my youth, because the grandparents would take us to Discovery Park in Seattle a lot.  Long story short, I had a very calm feeling come over me and no matter how much I tried to get anxious, I couldn't.  Maybe my body gave up and just said, "rollover dude!"

Good luck kiss from a Dane

A Great Dane, that is.  I said I was going to Swedish, didn't I?   Actually I don't think many Scandinavians work at Swedish.

This is Sandy's friend's dog.  She has 2 great danes.  This is Jagger, and I think he is the biggest dog I have ever met.  This was in Bremerton where we spent the night before admission to the hospital.  Sandy's friend Sam, had 2 Great Danes and they had a very calming effect on me.  We went out to dinner at a brewpub in Silverdale next to Bremerton with Sam and her boyfriend, Phil.  It was great to get out and have some distraction from the anxiety.  However, on the next hip, I'll try not to drink the high test IPAs prior to surgery.  Sadly, since I had an afternoon surgery, I easily persuaded myself to drink more than less that night.  I knew if I got up at 6:30 am, I could guzzle a gallon of water and be good to go for the day.  Hey, they said I could eat and drink up to 8 hours prior to surgery.  I was acting like it was just another day in the field working with the drillers.  Mentally, that may have been good, but physically, it wore me down ahead of being quartered.  Not good.

Monday, February 21, 2011

Beer and a Great Dane

Night before surgery.  I think I told Sam and others that I like the smell of dog feet.  That sounds weird, but there really is supposed to be a normal, non-fetish reason for liking the smell of dog feet.  Obviously that would be a dog foot that did not recently step in something.   It's a bit like, liking the smell of fresh cut grass, maybe because it reminds us of our childhood or something.  Anyway, I was relaxed (damn double IPAs) and so was Jagger (the dog).  They also say that petting a dog will lower your BP.  I know that one has a really/normal scientific following and you won't be considered weird for rubbing your dog's tummy.

Galloping Gurdy

Well, not quite, but this is the trip across the Tacoma Narrows on our way to Bremerton.  Not much significance here, just that the kids recently studied harmonic resonance.  The old bridge video of Galloping Gurdy was quite popular amongst the 8th graders earlier this year.


This was Sandy's favorite past time during the trip, other than cracking jokes with the staff, helping me go to the bathroom, filling my water cup, emptying the pee jug, all that fun stuff you do for your spouse when they need your assistance, oh and texting and facebooking to keep folks current.   

Driving north

Driving north on I-5.  The weather was decent for the drive up to Seattle.  It was good to be the driver, kept my head out of it.  Our goal for the day was to get to Bremerton and stay overnight with an old friend of Sandy's.

Sunday, February 20, 2011

The night before embarking on my new hip journey

OK, so I have never blogged before.  This will be my attempt to keep you all posted on my first hip resurfacing and the progress.   In summary, I have femoracetubular hip impingement (FAI), which has caused full blown osteoarthritis in both hips.  Chronic hip trauma as a youth or genetics, you tell me?  I knew I had limited range of motion several years ago, but it wasn't until a year ago when I really began the search that got me here.  I visited several ortho surgeons and found out that arthroscopic surgery would not be very successful for my condition and a total hip replacement was not appropriate for my lifestyle and age.  I chose resurfacing and elected to have surgery a little earlier than many folks in this position, mostly because I want to be active again and be able to have fun with my teenage boys before they leave home in a few years.  

Here is the night before we embark to Seattle.  I'm anxious and have not been heeding warnings to take it down on the beer prior to surgery.  Stress kills!  I spent most of the weekend prior to surgery working on a beefy wood and steel ship's ladder for the kid's room and every time I drilled into steel or wood, I'd remind myself of the surgery. Fun times.