Howdy from Seattle!

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workbill

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Hi Everyone!
My name is Bill, and I'm going in for a right side THR tomorrow!
I found this board a few days ago, and now I"m more nervous than ever...
There's a TON of great information, but also a ton of heart-wrenching stories and hideous complications.

I'm going in for an Anterior Approach, which sure sounds like the way to go nowdays. There's only one surgeon that has much experience up here, and he has a good reputation from what little I can find. We're going with a Metal on Metal implant, which I really like the sound of. The big femoral head and big cup with no polyethelene liner is supposed to be very durable and practically impossible to dislocate.

The one thing I'm most concerned about is the Spinal Anesethia. I've never had that, and honestly, don't have total faith in it. I saw another recent thread where the fellow claimed that it didn't work, and they had to switch over to a general anesethia. Holy Cow, HOW do you know it didn't work besides feeling that scalpel open you up???

Anyways, I look forward to being a contributing member of this little community, and I'll post up feedback as my case progresses!
Bill
 
Welcome, Bill! Can't wait to to hear from you when you're "on the other side!"
Chin up!!!! You will do just fine!!!! :)
 
Oh Bill - calm yourself! You know if it works because your legs first get pins and needles and then go numb. After that it's just a question of minutes before you are numb from above the waist down. I'd never had a spinal either and all my years of nursing had always said that if anyone wanted to give me a spinal they'd have to catch me first! But when it came to it, it was a breeze. The doc was straight in, no messing and almost as soon as he was saying "That's it - all done" and was clearing away his stuff, I could feel the pins and needles in my feet. He'd also said that he didn't fluff around checking sensory levels as he knew from experience that as soon as that started, he'd know we were home and dry. And we were.

In the most unlikely event that doesn't happen, they wait a few minutes and if it still doesn't 'take' then they proceed to a general anaesthetic. And that would be before they've even put the tourniquet on, much less got as far as picking up a scalpel!

And as for the 'heart-wrenching' stories, please read A word of caution about forums which defines how you should put all these into the context of the percentages of people who have problems. Please read it now.

As for the dislocation factor, no THR is impossible to dislocate but the larger heads do seem to have much lower stats than others which is probably what you meant.

And finally - welcome to BoneSmart. Hope we can ease your surgical journey some and answer any questions you might have.
 
Hi Bill--I'm probably the guy you referred to who had the spinal that didn't work. I am also and anterior, MOM, large ball--52-54 mm, BTHR. I can tell you what I know and suggest to you that the spinal was no big deal.
Before I went into the OR, in the pre-op room, I spoke with the anesthesia fellow (as in doctor) who told me about the procedure. Then the anesthesiologist came in to speak with me. He said we have two ways to go here. The first is with a lesser approach of a spinal and some meds to basically relax me. The second approach, and I don't recall it fully, was a spinal, an epidural, and meds. I think that was the explanation. He advised that I would be given a local for the spinal. The advantage of the lesser approach was that I would come out of the surgery quicker and more alert. The disadvantage was that I might hear a few things. I told the anesthesiologist that I didn't mind hearing hammering and sawing, that that stuff just didn't bother me, and that I would prefer to have less anesthesia rather than more. (Lest you think I have a v. high pain threshold, I can tell you that I was and still am absolutely squeamish about the Foley catheter I had).
After discussion, the anesthesiologist agreed to go with the lesser approach.
After surgery, the anesthesiologist came in to tell me that the spinal didn't really take, so they had to give me a GA. He said I had an entire conversation with him about it before going under, none of which I remember.
What I do remember is basically nothing. As I was wheeled into the OR, I had an IV put in and some sedative applied to relax me, I think. I remember feeling something cold in my vein and my anesthesiologist asking me if I felt a burning sensation. I was wheeled into OR and spoke briefly with my OS and met the surgical team. I don't remember much after that. I don't remember the local being applied, the spinal being applied or the Foley.
After surgery, I had a chance to read my folder as they were switching out a defective wheel chair to bring me to PT. My surgery record was unremarkable. My anesthesiologist's record said something like what follows, as best I can recall : 620-wheeled into OR; 622-patient assists in moving to Op table; 624-spinal applied; 628-catheter inserted; 630-patient attempts to adjust himself to more comfortable position; 634-patient still moving; 638-patient restrained; 640-General applied!
I spoke with my OS afterward and he simply said the spinal didn't fully take so they just put me under--no big deal. I did ask him to confirm that they weren't actually operating on me at the time and he laughed and said of course not. I do know that procedure was scheduled for about 2 hours, that my right hip replacement was completed at 8:30 and my left was completed at 9:30. I'm not sure what all they were doing from 6:40 until 8:30, but I am confident in my doctor's statement that it was no big deal.
If I had to do it again, I would go with a spinal. Because of GA, I was in post -op recovery for about 2-1/2 hours. GA made me nauseous for at least a day afterward and groggy as well. Anti-nausea medicine's work fine, but I would have preferred less medication and a quicker recovery.
I'm not sure this will help you much but I thought that I ought to be straightforward. I had a great deal of anxiety before surgery and I infer that you are having some too. What I do know is that the time will come and it will pass and that, by far, the toughest part for me was the pre-op anxiety.
These surgery types really are specialists and are very good at what they do. Best of luck in your surgery.
Tom
 
Welcome to BoneSmart, Bill. So glad you found us.

Try not to worry about your surgery and just remember that on any forum like this, you can get a disproportionate number of posts regarding problems. Many people who have no problems or ones that get resolved go quickly on to living their lives and you just don't hear from them. That's as it should be.

But....we ARE fortunate that a large number of our our BoneSmart family members DO stay around the forum to help people like you with any concerns they might have. So post away with any questions both before and after your surgery. Or just pop in to say hello. We'll be here for you!!!
 
Tom, thank you so much for providing your personal experience. It is an excellent post that will be helpful to anyone awaiting surgery who has not been through this before.
 
Wow, thanks for the great replies already!
Yeah Tom, that was your story that really struck a nerve with me. I know what you mean about not remembering much, I've had that "Versed" and Fentanyl combo for a colonoscopy and an Inguinal Hernia repair, and the amnesia effect is just amazing. I like it, except the doctors always come in and give an outbrief and post-op instructions while I'm still under the influence! :)

I seem to tolerate anaesthia very well, so I'm not inclined to go for the "lesser" system. I can't even watch any of the operations on YouTube because I can't get past watching them beat the implant in with a mallet... I of course want a nice, tight fit, but the mechanics of all that carpentry freak me out.

I loved Josephine's comment about how the only way she'd get a spinal was if they caught her first, but I'm also glad she said it was cool in retrospect. I'm 6'3, 265 lbs, so if I start to object, it'll take everyone in the room to "restrain" me!

I went back and read the link J- posted about being cautious with forums. Of course the smooth-sailing, story book ending people don't post much. I kind of knew that, but it was great to be reminded that this forum is a resource for people with questions and issues, so naturally there are more problems being discussed than really represents the population.

I plan to report back how great the spinal was, how painless the Physical Therapy is, and how my Argentine Tango has never been better now that I've got a shiny new bionic hip!
 
Not sure if I can figure out how to post a "Pre-op" picture, but I'll post a "Post-op" too (if it works.)

[Bonesmart.org] Howdy from Seattle!
 
Cool photo, Bill! Do you really tango? Is that you in the photo????
 
Thanks Jamie!
Yeah, that's me. The gal is the hot-shot instructor up here, named Michelle. She said that I'm her favorite guy to social dance with! I've been studying and dancing for over 10 years, and in fact that's what finally drove me to the THR. Once you can't pursue your passions, it's time to quit the Naprosyn, Tylenol, massages, other "conservative" fixes and just go for it.
 
Bill, you are SO right!!! Life is all about living it, isn't it! You and the hot-shot make a great looking couple on the dance floor. Hip surgery today.....tomorrow - Dancing with the Stars!!! You have the RIGHT attitude!
 
Hi Bill, I had RTHR 2 months ago, and I also had a spinal. It was great - absolutely no problems at all with it. I do remember hearing loud noises and voices but it didn't bother me, and I remember pushing a mask off my face because it was bugging me. And when it was over, I was just all of a sudden wide awake. Good luck to you, and we'll be waiting to hear from you from the "other side"!
Karen
 
Hi Bill -welcome to the board! Josephine's thread about "a word of caution" is definitely right on. I also felt anxiety after reading about complications. I had my RTHR on 3/17/09 and am at the 3 week mark of recovery. I'm doing just fine and getting stronger each day. I too am a former dancer. I studied dance all my life and in college and also teach pilates. Very nice picture! Hope you are back to your ballroom dancing after you are all recovered!

The first week of recovery was tough for me -going from being so active and independent, to having others wait on me. However, it DEFINITELY has gotten better with each week.

I have found this board to be extremely informative and has also helped with my recovery.

Good luck tomorrow, you will do great!! Looking forward to your future posts :)
~Melissa
 
Hi Bill, I had RTHR last August and am still around even with a great result. I did have GA but only because I insisted. Must admit that the nausea afterwards was not pleasant. But after the first 3 or so days, all uphill. I also have MOM, biomet. He did say that if I was younger (still in the child bearing phase) that he would have gone ceramic. I am not worried about the ions at this point (age 56).

Laurie
 
Oh, and have a great, successful surgery day. Just think, by this time tomorrow it will be all over and you will be on the up side.
Laurie
 
Hi Bill
All the best for tomorrow, you look youngish and in good shape so am sure all will go well :)

I am 46 years of age, had a left THR last September and it all went incredibly well - I didn't even need any pain meds once I got out of hospital. I should have taken the plunge 5 years earlier. I too was very anxious beforehand, as it was my first surgery and hospital stay. I could recite all the possible risks and complications and the various probabilities of each. I had a general anaesthetic and my implant is ceramic with a plastic liner and the larger head.

Look forward to seeing you on your return!

Monica
 
Hey Monica! I L-O-V-E the idea of not even needing pain meds once out of the hospital! I also like Laurie's idea of "by this time tomorrow, I'll be on the mend and getting better all the time.

Thanks again, and I'll let you know what the state of the art is like up here in the Pacific Northwest!
 
Bill
Not sure if you are asleep, but just checked in. I had my right hip replacement last jUne. It is the best surgery ever. I love my new hip , it works much better than the other one!!! I can do everything and had no complications with the spinal .
judy
almost forgot the most important thing, Good Luck tomorrow, you'll do fine.
 
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