Birmingham Hip Resurfacing

[Troweltalk]

Hello all, I'm a 52 yr old male who is 10 days post surgery for the installation of a Birmingham Hip Resurfacing (BHR) procedure.

broken link removed: https://www.birminghamhipresurfacing.com/

So far my recovery sounds very similar to those on the forum who have had a THR, I am walking with crutches and able to navigagte stairs relatively easily. No hip pain any more, but still uncomfortable from the surgical wound. I'm a large frame (250lbs) and have a football player build, including large glutes, so the surgeon said he needed to use a larger than normal incision (14" and 42 staples to close), which sort of freaked me out at first as I was expecting a max of 8", but it hasn't been an issue so far.

Was wondering if anyone else had a BHR and would like to make contact, especially of they are going through recovery now.

Thanks!

 

[JudyS]

Mudpro
I wanted to welcome you to bonesmart. You have found a great place. I am 51 and had a THR on June 6th. Can't help on the resurfacing end of things, but wanted to welcome you.
Judy

 

[Troweltalk]

Mudpro
I wanted to welcome you to bonesmart. You have found a great place. I am 51 and had a THR on June 6th. Can't help on the resurfacing end of things, but wanted to welcome you.
Judy

Thank you Judy. Doing research and networking with others who are (or have) gone through a similar procedure is I think a good use of this down time during recovery.

Bill

 

[JudyS]

Absolutely . Good to know what others have gone through and what is considered normal!!
I just had a knee scope/microfracture/scar tissue removal and was concerned as my knee was red and warm. People here told me it was all normal which was great especially as it is a weekend.

I was sold on resurfacing. I brought it up with my doc who did not recommend it for me due to bone density issues. He was absolutely correct as my femur fractured in surgery. My range of motion is awesome with my new hip too. Makes me really worry about the other one now.

Judy

 

[Josephine]

You sound like you are doing extremely well, Mudpro. Keep us posted on your progress.

 

[mrpunch1966]

Mudpro,

Sounds like you are making good progress and it is nice to know someone is has gone through what I am experiencing now. I had a hip resurfacing (left) on Wednesday 14th Jan. I am quite young at 42 to have osteo arthritus (funny shaped hips, life of sport - playing through injuries etc. I have been amazed at how well things have gone so far. The biggest problem I have had is with the side effects of the drugs. Morphine and Codiene seemed to give more problems with side effects than the pain they were intended to reduce. As a so called fast track patient I was discharged from hospital only two days after surgery. The physios had me walking the day after surgery and I was allowed home after completing their "stair test". The hospital sent me home with instructions and a shopping bag full of drugs. I found keeping up with the instructions of adminstering four different types of medication difficult and the side effects meant that I really struggled to sleep. An outreach nurse has been visiting on a daily basis - she has been brilliant - answering any questions and changing my dressing. My sleeping seems to be improving - have several relaxation CD's next to my bed which help me to nod off.

Bye for now mrpunch1966

 

[clwhit]

Welcome aboard! Wishing you a speedy and successful recovery.

~Carol

 

[Troweltalk]

Punch,

I'm nearing my 6 week mark and have been very pleased to see noticeable improvement every few days.

What kind of "side effects" are you haivng from your medication?

They sent me home with Oxicodone (pain), Vitamin C (promote healing) and Sentaot (stool softener), and of course Cumadin (blood thiner). I was already on Liptor (cholesterol) so they OK's that as well. the only side effects I experienced were a. constepation; and b. blurry vision. Prune juice took care of the constepation, and the blurry vision seemed to clear up as I diminished taking the oxicodone.

I weaned off the oxicodone, but my advice is take it as directed until you feel you don't need it anymore, that was every 4 hours at first for me. The pain is a distraction and a hinderance for both your PT and your sleep, and you NEED plenty of both!

I've found that reading every personal account I can find, there are no two that are identical. My recovery has been slower in some ways and faster than others from accounts I have read online. As Jo and many others often say on this forum, "let your body guide you" is really good advice. Do as much as you can as often as you can without causing you increased pain that is lasting.

I recently discovered the website for the McMinn Center (inventor of the BHR), which has some very useful rehab info:

https://www.mcminncentre.co.uk/

My problem was I had a doctor who had done many resurfacings, but was not in my immediate area, and I couldnt find a physical therapist with any experience at all with resurfacing. So up until this point, they've been treating me as if I had THR. The McMinn rehab protocols may differ from what you've been told, but that makes for good conversation with your therapist and/or doctor.

Good luck, you're about to get your life back!

 

[Josephine]

Ahem! McCinn didn't actually invent the BHR - that was done way back in the seventies by a team of surgeons at the Birmingham Orthopaedic Hospital (now no more). But that site isn't too shabby. Nice one! Thanks for the link.

Also, all patients are got up the day after surgery, whatever type of operation they've had. When I was a young nurse, we used to keep people in bed until they had their stitches out! And the number of patients who got thrombosis or took ages to rehab was apalling. But even McKee (1960) used to get his patients out of bed the next day and caused a lot of incredulity because of it.

McKee was the first inventor of the hip replacement and I used to be his scrub nurse.

Mr Punch - do share you problems if you wish. We're good at helping out with all sorts of things like that.

 

[mrpunch1966]

Punch,

I'm nearing my 6 week mark and have been very pleased to see noticeable improvement every few days.

What kind of "side effects" are you haivng from your medication?

They sent me home with Oxicodone (pain), Vitamin C (promote healing) and Sentaot (stool softener), and of course Cumadin (blood thiner). I was already on Liptor (cholesterol) so they OK's that as well. the only side effects I experienced were a. constepation; and b. blurry vision. Prune juice took care of the constepation, and the blurry vision seemed to clear up as I diminished taking the oxicodone.

I weaned off the oxicodone, but my advice is take it as directed until you feel you don't need it anymore, that was every 4 hours at first for me. The pain is a distraction and a hinderance for both your PT and your sleep, and you NEED plenty of both!

I've found that reading every personal account I can find, there are no two that are identical. My recovery has been slower in some ways and faster than others from accounts I have read online. As Jo and many others often say on this forum, "let your body guide you" is really good advice. Do as much as you can as often as you can without causing you increased pain that is lasting.

I recently discovered the website for the McMinn Center (inventor of the BHR), which has some very useful rehab info:

https://www.mcminncentre.co.uk/

My problem was I had a doctor who had done many resurfacings, but was not in my immediate area, and I couldnt find a physical therapist with any experience at all with resurfacing. So up until this point, they've been treating me as if I had THR. The McMinn rehab protocols may differ from what you've been told, but that makes for good conversation with your therapist and/or doctor.

Good luck, you're about to get your life back!

Thanks for your reply,

It's great to see you are improving every day - six weeks is still only a short period of time.

I was given morphine initially in hospital - in syrup form. The hospital gave me Paracetamol (pain relief), Aspirin (blood thinner), diclofenac (pain & anti inflammatory), codeine (pain & anti inflammatory), lacruose (constipation), senna (constipation). The side effects were terrible nightmares, palpitations, anxiety, itching, nausea. These seem to have settled since I stopped taking the codiene. I too had constipation - this problem has now been sorted. I also struggled to pass water after the catheta was removed in hospital - but after being threatened to have the catheta put back in I managed to go. (Concentrated on waterfalls etc lol). I agree with you guys about listening to your body and when I have done too much my body lets me know. I am taking advice of drinking as much water as possible and feel better now i'm sleeping more. Some of the things you normally take for granted are frustrating - putting on socks, showering etc. I am hopelluy going to get a shower board and a device for highering the toilet which will make a big difference.

Thanks for your help and advice - I think this forum is excellent and all patients should be made aware of it. There is nothing better than hearing it "from the horses mouth"

Cheers Andy

 

[mrpunch1966]

Ahem! McCinn didn't actually invent the BHR - that was done way back in the seventies by a team of surgeons at the Birmingham Orthopaedic Hospital (now no more). But that site isn't too shabby. Nice one! Thanks for the link.

Also, all patients are got up the day after surgery, whatever type of operation they've had. When I was a young nurse, we used to keep people in bed until they had their stitches out! And the number of patients who got thrombosis or took ages to rehab was apalling. But even McKee (1960) used to get his patients out of bed the next day and caused a lot of incredulity because of it.

McKee was the first inventor of the hip replacement and I used to be his scrub nurse.

Mr Punch - do share you problems if you wish. We're good at helping out with all sorts of things like that.

Josephine,

Thankyou for your kind offer of support. I am making good progress and hopefully not going to have too many problems but would like to share thoughts and ideas.

Cheers Andy

 

[Josephine]

Of course! Anything you want to dicuss, feel free.

 

[mrpunch1966]

Josephine,

After my early euphoria believing I would heal very quickly I am now finding things a little difficult. As a person not being comfortable sleeping on my back I have struggled to get a good nights sleep. I found that lifting my knees helped initially but am now experiencing a lot of pain at the back of my knee and thigh when lying down. The pain I was experiencing before the operation is still there - groin, hamstring and lower back. My left thigh feels like I have a constant dead leg and there is numbness largely around my scar area. I have listened to all the advice from my surgeon and outreach nurse - am doing my exercises and gradually increasing my distance walking twice a day. After sitting for short periods of time my hip stiffens up which eases off after a while.
I keep telling myself that the symptoms and pain I am experiencing are those normally associated with post op trauma. A little voice at the back of my head keeps telling me that the operation just hasnt worked and if anything I am now worse. I have spoken to my surgeon this morning and am going for an xray on Thursday to check things out and hopefully allay my fears.

Thanks for listening - Andy

 

[Josephine]

Well, I know exactly what you mean about not being able to sleep on your back - I find that a problem too as do many other of our members.

BUT - and remember this - you are still only 12 days post op. That is like - well, almost yesterday! Everyone has that peak of time when things seem so much worse and you wonder if you did the right thing after all. Our expectations were that once the op was done we would be up and running round the garden like two year olds!

Wrong!

After my early euphoria believing I would heal very quickly I am now finding things a little difficult.

Major surgery takes some major healing and that throws up all sorts of aches and pains and discomforts. It doesn't mean that things are going wrong and neither does it mean you'll be like this forever! Give your body a chance to heal.

As a person not being comfortable sleeping on my back I have struggled to get a good nights sleep. I found that lifting my knees helped initially but am now experiencing a lot of pain at the back of my knee and thigh when lying down.

Use LOTS of pillows in your bed. Be slightly sitting up and have a stack of pillows (or folded up blankets with a pillow on top) so your legs are supported in a nice comfy position. I am lucky enough to have an adjustable bed and it makes a deal of difference when I can elevate both ends of the bed into this position.

Make sure you take a dose of pain killers an hour or so before you go to bed and take another if you wake half way through the night - a lot of what you are describing is post-op pain and it needs to be dealt with.

The pain I was experiencing before the operation is still there - groin, hamstring and lower back. My left thigh feels like I have a constant dead leg and there is numbness largely around my scar area.

All of this is normal but what is your regimen for pain management? Are you not taking your pain meds because you think you should be okay by now? You MUST make sure you are medicating yourself properly all the time.

I have listened to all the advice from my surgeon and outreach nurse - am doing my exercises and gradually increasing my distance walking twice a day. After sitting for short periods of time my hip stiffens up which eases off after a while.

This too is perfectly normal. Everyone suffers from this to one degree or another.

I keep telling myself that the symptoms and pain I am experiencing are those normally associated with post op trauma. A little voice at the back of my head keeps telling me that the operation just hasnt worked and if anything I am now worse. I have spoken to my surgeon this morning and am going for an xray on Thursday to check things out and hopefully allay my fears.

All you are suffering from is unattained unrealistic expectations! Don't listen to that little voice - called 'I Told You So' - he is a liar coming out of your fear and frustration after months maybe even years of pain and limited life. That time whilst you struggled to make this decision, experienced acute fear and anxiety about whether it would be a success or not. Now you are going through quite normal healing period and your 'little voice' is poking at you saying "See? See? I told you this wouldn't work! I told you! But would you listen? Oh no - you had to know better though I told you and told you!"!!! He's a liar and a thief because he wants to rob you of getting your life back. But it's too late - you made your decision and you are going to get your life back! But it will take some time yet so just be patient a little longer, ok?

 

[Troweltalk]

Boy, Jo. You are SO right on the nose!

Along about day 12 or so, I was still optomistic, but some doubt about what I had gotten myself in for were creeping into the back of my head. I was also having a lot of trouble trying to get a good night sleep. Not to repeat Jo's good advice, but this is what I did:

Took pain meds as needed, especially an hour before going to bed, and again as needed throughout the night. I eventually weaned off haivng to take a second dose in the middle of the night, later I weaned off the heavy duty stuff, but I still take one 50mg Ultram about an hour before lights out, just to help me relax without the aches and pains we notice most as we lay there in the dark with no other distractions.

Pillows, lots and lots of pillows. Some firm, some soft, some double wide, some single. I'd stick those suckers under my legs, between my legs, under my ankles, and anywhere else that got my legs into a comfortable position. I still (at 7 weeks) use them, and you will readjust them throughout the night as the pressure on your legs get to you. You will slowly be able to sleep on your good side with a pillow between your leg and that will be a much appreciated change to just laying on your back, even if its just for a half our or so at first. I still can't sleep on my operated side yet.

If your x-ray looks good, if you are able to do your therapy without "really" hurting, if you are getting just a little more mobile every day -- wel that means you are on the same road as the rest of us. Its a MUCH slower process than we may have projected it to be. I sometimes wonder if all the so-called "success stories" about folks jogging at 6 weeks, or jumping rope at 2 weeks, actually do more harm than good about creating unrealistic expectations.

I had a great day yesterday, abandoned the cane and able to get around with just a slight limp. So I decided I'd throw a couple of steaks on the backyard BBQ and feel "normal" again. Well I ran out of propane in the BBQ and had to change the tank. As I rushed around to swap out the tanks I lifted a new heavy bottle and twisted my body, and stepped off a 1" variation in the concrete floor -- my new hip gave me a reminder that I am FAR from healed yet, and I twisted my ankle on my good leg... REALITY CHECK!

Take it one day at a time, as you look backwards, you will see your progress was slow but steady!

 

[mindjoy]

You can also check https://surfacehippy.info/, they have a Patient Forum similar to this one.

Regards,

John
(BHR on right hip 12/11/2008 dr. Brooks in Cleveland, OH)

 

[mrpunch1966]

Josephine & Mudpro

Thankyou so much for your support and advice I really appreciate it. Patience has never been my greatest trait and I know that I have to let my body heal itself. Initially I saw quite dramatic progress and naively thought this was going to be the daily norm. After seeing my surgeon last Thursday my confidence has been given a boost. He is really pleased with my progress and feels that I am well ahead of schedule. I am quickly realising that although I have got to push myself I have also got to be realistic. I agree that some of the people who are running/ice climbing etc with a few short weeks need to be careful with their rehab to ensure they are not being reckless. Using more pillows at night is definately helping with sleeping and after stopping taking my medication completely I am now taking paracetamol before bedtime and as and when required. My surgeon recommended to keep taking the aspirin and paracetamol but looking to phasing out the diclofenac when appropriate.

Thanks again for all your help

Stay in touch Andy