THR My Story (long)

[dw152]

Looks like my story is pretty familiar around here, but here goes.

Once my life settled down in my late 20s, I made a commitment to be healthy and to exercise. I was done with graduate school, my two kids were old enough to give us some breathing room, I had a steady job, and we had just bought a house and settled down. One thing led to another, and I found that I liked being an amateur athlete. In my 30s and 40s, I did it all -- mountain bike racing, road bike racing, centuries, triathlons, marathons and ultramarathons and trail races and 5ks and 10ks and half marathons. My favorite activity was long bike rides, and long trail runs in the woods.

Because of life circumstances, I slowed down a bit in my 50s. Covid came when I was in my late 50s. My life changed again, and I found that I had a lot more time to exercise, so I started playing tennis. I lived close to a club, so I was over there 5, 6, 7, 8 times a week, often playing much younger players. I was doing it all - singles tennis, hard hard cardio tennis, hard sessions with a coach, and some easy social tennis. I had plenty of energy. Even now that I'm in my early 60s, I had plenty of energy. I felt great! I had also lost about 30 pounds, and my cholesterol and blood pressure went way, way down.

Along the way, things happened. Nine years ago, I was getting in my car. It had snowed, and there was ice on the ground. As I opened the door, I planted my left foot on a slippery part of ice. My left leg shot out sideways and I slid down, with all my weight pushing my leg outward at a terrible angle. It hurt *bad*. I thought I had dislocated my hip. My groin was in terrible pain. After a 10 or 15 minutes, I could drive home, but I couldn't run for a month. I concluded that I must have torn my adductor and my flexor. I eventually got better and seemed to make a full recovery.

About five years ago, I noticed that I was having trouble swinging my leg over my bike. I figured I was getting old (true) and out of shape (probably true). I had to really tilt my bike over on its side, and I was coming close to falling over as I tried to mount my bike. A little bit after that was covid and when I started playing tennis. Tennis was fine at first, but my left groin started hurting. I also noticed that my left knee would splay out when I bent over. It was getting hard to do certain things, like tie my shoes.

About a year and a half ago, I had a routine physical, and I mentioned the groin pain to my doctor. She gave me a referral to a physical therapist, but I didn't go. Through all the running and activities I had done before, I was pretty good at diagnosing my problems (so I thought), and I wanted to fix my problem myself. I figured my body was adapting to the new sport of tennis, and that I had to do a better job of stretching, and maybe some targeted exercises.

But over the next year and a half, the pain kept getting worse. I was doing yoga, and some poses I just couldn't do, especially if it involved my left leg. I figured that old injury from when I slipped on the ice was flaring up -- maybe I had detached a groin muscle or something? So I kept working on stretching and strengthening, targeting my upper left leg.

The pain kept getting worse. After an hour or two of tennis, I was in a lot of pain. I was limping around, and wasn't chasing balls any more. The turning point came when our tennis coach recorded us playing, and I saw how bad I was limping.

So I went back to the doctor. I still thought this was related to when I slipped on the ice, and I just wanted a referral to a physical therapist. Just give me some exercises, and I'm dedicated and will do them. But my doctor is smarter than me, and she ordered an x-ray. Funny thing was - the night before my doctor's appointment, I just happened to look up hip arthritis. Could that be my problem? No - of course not. Not me.

So three days after the x-ray, I got the results. When I read the results, I was shocked - advanced osteoarthritis of the L hip, with other damage noted, including a previously broken pelvis. My doctor called me right away and tried to be reassuring, knowing that being active is important to me.

As I said, I was crushed by this news.

Arthritis? Really? I did some research, and I learned that it doesn't just happen to older people. There are plenty of stories of people much younger than me that have had this problem.

I saw an orthopedic doctor about a week later. I had stopped playing tennis at that point, and I was feeling much better. I told her that, but she looked at my x-ray, and then back at me with a skeptical, raised eyebrow. She quickly started talking about hip replacement surgery, but I told her that I wanted to try PT first. She gave me a skeptical "I guess it won't hurt" reply. She also gave me the worst news possible - that if I got a hip replacement, no more running. That's soul crushing news to me. She did say that I would be able to play doubles tennis. That got my attention, and since she sounded authoritative, I asked her if she played. She said "no, that's just what we tell people." Hmm. Even when I play doubles, I play pretty hard. I'm not just standing there hitting the ball if it happens to come to me. Now I'm confused.

Anyway, a few days later, I saw the physical therapist. He looked at my x-ray and was also very pessimistic. He gave me a list of exercise, most of which I was already doing. He measured my range of motion in my left leg, and (not surprising) it was getting pretty limited. However, he did tell me which surgeons in my HMO do different techniques, and since he knew I was active, he recommended two other doctors.

After that, I spent two months trying PT, reducing my activities, and switching to more cycling, no tennis, and much less running. Cycling has always been my best sport, so I started some long-neglected maintenance on my numerous bikes. But I've found that riding has been a bit of a problem. I really struggle to get my left biking shoe buckled, and I still struggle getting on and off the bike because I can't lift my leg. Also, my left leg is not tracking properly. I get much less power, and I'm afraid I will cause knee problems because my knee splays out as I pedal. Some of my rides have been pretty painful, and some are just uncomfortable. If I do an easy ride on my indoor trainer, sometimes that makes my hip feel good. Sometimes running has felt great, even when I run with some of the younger guys, but sometimes it hurts for days afterwards. Walking is hit or miss. My wife and I were in New York city last month, and we walked all over. After about 45 minutes, I had to take a break because I was in pain. By the end of the day, we walked about 5 miles, and when I got to the hotel I was exhausted from the pain.

I followed the PT's advice, and two months later made an appointment with another orthopedic doctor. At first, she was negative on surgery, but I think she was trying to manage expectations. I told her that I'm sort of in this middle ground -- my pain isn't too bad and I can probably live with it if I just sit on my butt all day. But I've also cut out some of my favorite activities, and even safe activities like biking are giving me trouble. Each time I ride, I'm worried that I'm going to be in pain, or that I'll fall over trying to mount my bike. I also mentioned to the doctor that my wife thinks I should get a replacement now while I'm young and healthy and get it over with. The doctor replied that she didn't think I should wait five years. If that's the case, then I may as well get it over with, so now we're proceeding with surgery.

This doctor was a bit ambiguous with the approach she will use. She said that she does the posterior or the anterior approach, depending on some things. I think she will try to do anterior, unless the arthritis is too severe. Not sure why that matters. She also told me that I'll get a spinal, which scares the absolute heck out of me. I don't like needles and get very anxious, but she dismissed my concern. I get it - there are numerous advantages to a regional anesthetic, but that is a big phobia I have. I guess I will have to put my big boy pants on for that.

Since the visit, I have about 5,000 more questions, so I will send her an email. I won't see her again until right before the surgery. One thing that bothers me about this whole thing is that making a decision like this is based on a 20 minute visit with the doctor. I know this is routine to them, but it's a big deal to us.

As I said, when I got the news, I was crushed. I'm a runner dammit! I was actually president of our small local running club. I play tennis non-stop! I'm still getting invitations to play, even though I haven't been to the club in over two months. You're taking away my identity! I was really really crushed for about a month.

Fortunately, I am a problem solver, and I tend to be pretty optimistic about life, so I've developed some longer-term strategies. I'll get back on my beloved bikes. I haven't swam in a decade, but I'll rejoin a swim team. I'll play doubles tennis and pickleball. I'll try Orange Theory and maybe pilates. I will probably sneak in some running and singles tennis. I'm 62 now, so even if some running wears out the prosthetic, so be it.

Every day I do question my decision to get the replacement surgery. Do I really need it? I think objectively the answer is that I do. I'm also scared - I know what they do, and it does freak me out.

At this point, I'm waiting to see the dentist so I can a clearance for the surgery. After that, we will schedule a date.

Once I get the surgery, I'm not too worried about the recovery. 30 years ago I had major shoulder surgery, and I was dedicated with PT and made a full recovery. I've had two knee surgeries (meniscus), and two foot surgeries. I know what it's like to be down, and then slowly make progress day by day. I like that part of the process. My wife is conveniently retiring in a month and I know she will take good care of me, so I am fortunate there. I work a desk job, and the doctor says I'll be out of work for six weeks, and I'll spend that time diligently doing my exercises, and bugging the doctor about when can I get on my bike, and when can I get in the pool?

Thanks for reading this far.

 

[Layla]

Your story is all too familiar. Most not as athletic as you, but equally as disheartened by the diagnosis, even if they suspected the possibility. I think you will be surprised at how quickly you bounce back. I encourage you to read lots of threads here as you will find many returned to the sports they love from tennis, to skating, to skiing, to running. Don't view it as an end to the activity you so enjoy, but a beginning to hopefully get back to all that you love and are missing, without the pain!

I will leave some pre-op reading for you and. encourage you to come back with questions or concerns and we'll do our best to advise. We welcome you here and thank you for joining us!
Best Wishes as you make decisions and move forward!

HIP PRE-OP ARTICLES

If you are at the stage where you have joint pain but don't know for sure if you are ready to have surgery, these links may help:

​

Score Chart: How bad is my arthritic hip?​

Choosing a surgeon and a prosthesis​

BMI Calculator - What to do if your surgeon says you're too heavy for joint replacement surgery​

Longevity of implants and revisions: How long will my new joint last?​

If you are at the stage where you are planning to have surgery but are looking for information so you can be better prepared for what is to come, take a look at these links:

​

Recovery Aids: A comprehensive list for hospital and home​

Recliner Chairs: Things you need to know if buying one for your recovery​

Pre-Op Interviews: What's involved?​

And if you want to picture what your life might be like with a replaced hip, take a look at stories of amazing hip recoveries
@dw152

 

[Jaycey]

@dw152 I was younger than you when I got the dreaded diagnosis. Nope, you don't have to be old to have arthritis.

She also told me that I'll get a spinal, which scares the absolute heck out of me.

Yes, in my earlier days on this board I was more concerned about the spinal than about the actual surgery. I HATE needles! But honestly, it is a none event. And a spinal is so much easier to recover from

I work a desk job, and the doctor says I'll be out of work for six weeks

Please set your expectation realistically. The suggested time off work is 10-12 weeks and then a phased approach. You may not need this time. But it's best to set the exception in advance to avoid frustration later.

 

[dw152]

I work a desk job, and the doctor says I'll be out of work for six weeks

Please set your expectation realistically. The suggested time off work is 10-12 weeks and then a phased approach. You may not need this time. But it's best to set the exception in advance to avoid frustration later.

Thanks. One thing about being older and wiser (I hope) is that I prioritize my health. I will take as much time as I need. After one of my foot surgeries, I rushed back to work the next day. That was a mistake, and I learned from my mistake.

 

[Going4fun]

Just heads up: the ban against running is surgeon specific. Lots of surgeons these days (and yes this seems to be a change in the past ten years) are fine with running. My two surgeons (both at nationally known practices) both approved of running. Indeed before my first surgery I was like you in that I ran within maybe a week of the operation. Couldn't run very long and it hurt awfully bad, but I ran.

Same with singles tennis--that is surgeon specific--not some blanket overall recommendation. What my first surgeon said was that he didn't want me running if I was taking it up for the first time. But as long as I've done the exercise before (and my body has developed the supporting muscles and muscle memory and all) he was fine with running. I have no restrictions. Same with second hip.

Just so you know.

 

[LaKarune]

Hi @dw152! I am 19 days into my THR and when I read your story I related to a lot of it. I did a lot (a lot a lot!) of research into different surgical approaches when I finally faced the fact that I needed this surgery, and one of the things I learned is that there is no longer one Anterior or Posterior approach; there are many, and they take different routes to get to your joint. Based on my particular movement basis and goals, I chose a surgeon who uses a "mini-posterior" approach with a dual mobility prosthesis. (My preop thread is here if you want to strap in for a rollercoaster ride of emotions, lol.) Posterior does not mean cutting muscles anymore, and the surgeon I ended up choosing prefers the "mini posterior" in part because the approach he takes usually allows less permanent numbness in the leg near the incision, which can be a side effect of more popular anterior approaches. He likes it for other reasons as well, and I learned from speaking with several surgeons and hearing from members on this board that every surgeon will approach the surgery their own way, that no one approach is measurably better than another now that no one is cutting muscles, and the most important thing is to use a surgeon with a great track record, thousands of successful surgeries under their belt, and who you are comfortable with. If you're iffy about the first surgeon you talked to, definitely meet a few more.

I want to circle back to that x-ray: did you find out from that x-ray that you had actually broken your pelvis in that fall 9 years ago? My god, finding out both that you need a hip replacement and you had broken your pelvis in the same appointment must have come as quite a shock.

My recovery seems to be going pretty well so far, and the fact that I prehabbed with a brilliant PT and came into the surgery relatively strong certainly helps. This was enabled in part by a Celebrex RX, which brought down my inflammation enough for me to work on maintaining whatever strength and stability I could. If that path is in the cards for you, I highly recommend you take it. I also pretty much lived on heating pads pre-surgery to help manage the pain (I had a labral tear and severe OA secondary to until-then undiagnosed developmental dysplasia in the hip).

I've found this board to be the best resource out there both for info about the surgery and for support from people who totally get what you're going through, so I'm glad you found it. Taking care of your nervous system is almost just as important as taking care of your hip, and this community can really help with that. Keep us posted on how you're doing and of course throw your questions out there.

 

[dw152]

Just heads up: the ban against running is surgeon specific. Lots of surgeons these days (and yes this seems to be a change in the past ten years) are fine with running. My two surgeons (both at nationally known practices) both approved of running. Indeed before my first surgery I was like you in that I ran within maybe a week of the operation. Couldn't run very long and it hurt awfully bad, but I ran.

Same with singles tennis--that is surgeon specific--not some blanket overall recommendation. What my first surgeon said was that he didn't want me running if I was taking it up for the first time. But as long as I've done the exercise before (and my body has developed the supporting muscles and muscle memory and all) he was fine with running. I have no restrictions. Same with second hip.

Thanks, and agreed. I sort of hinted at this issue in my story, but it was already so long, I didn't want to go too far into it.

From what I can tell, the advice not to run, or not to play singles tennis, is a little old school. I will heal well enough to be able to run again, and there is nothing biomechanically that would prevent me from running. The issue is wearing out the hardware.

And from what I can tell, there aren't a lot of controlled studies that support these restrictions. I have looked at some of the research, and the most relevant study I saw indicated that there was no difference in the wear rate of the latest plastic cup liner in people who ran and those who did not. So the doctors play it safe and caution against running and high impact activities.

I don't like to ignore the doctors because I trust them, but I also realize why they say things. No running, and only doubles tennis, is just standard advice that's been around since they were residents 20 years ago. It's also conservative. When my doctor told me doubles tennis was fine, she doesn't see the level that I play at - there is plenty of running involved. As I said, I don't just stand there and wait for the ball to come to me. So that sort of made me realize that the decision is as much mine as it is hers. I did not bother to ask the second doctor I saw (who will do the surgery) if I can run or not - I'll make that decision.

I'm also a bit older, and I don't intend to go back to my high-mileage days. At my peak, I ran two marathons and a 50 miler over a month, plus I was biking and swimming in between. My goals are much more modest now - two or three easy runs a week with friends, and nothing more than five miles.

Hi @dw152! I am 19 days into my THR and when I read your story I related to a lot of it. I did a lot (a lot a lot!) of research into different surgical approaches when I finally faced the fact that I needed this surgery, and one of the things I learned is that there is no longer one Anterior or Posterior approach; there are many, and they take different routes to get to your joint. Based on my particular movement basis and goals, I chose a surgeon who uses a "mini-posterior" approach with a dual mobility prosthesis. (My prep thread is here if you want to strap in for a rollercoaster ride of emotions, lol.) Posterior does not mean cutting muscles anymore, and the surgeon I ended up choosing prefers the "mini posterior" in part because the approach he takes usually allows less permanent numbness in the leg near the incision, which can be a side effect of more popular anterior approaches. He likes it for other reasons as well, and I learned from speaking with several surgeons and hearing from members on this board that every surgeon will approach the surgery their own way, that no one approach is measurably better than another now that no one is cutting muscles, and the most important thing is to use a surgeon with a great track record, thousands of successful surgeries under their belt, and who you are comfortable with. If you're iffy about the first surgeon you talked to, definitely meet a few more.

Thanks, and good luck with your continued recovery! I hope it goes well for you. I will check out your thread.

I'm sure each doctor will do things slightly different. I don't have a lot of options for shopping around for doctors since I am in Kaiser. Plus, I don't want to overthink it too much. I did find out that the doctor I'm going with was one of the highest rated doctors in my area in an annual local survey that carries a bit of weight (I think). The physical therapist also recommended her, and those kind of insider recommendations are usually solid. I didn't get a bad feeling from the first doctor - she was just a little cold and factual. Nothing wrong with that, but that was my initial visit, and my head was swimming at that point.

I also think there is a lot of hype around certain techniques. If you get on google or YouTube, you'll see the great success stories of people, and doctors accompanying them describing their minimally invasive approach. I think this procedure is a huge market in the medical industry, which has forced a lot of progress, but I also detect some sales going on.

I want to circle back to that x-ray: did you find out from that x-ray that you had actually broken your pelvis in that fall 9 years ago? My god, finding out both that you need a hip replacement and you had broken your pelvis in the same appointment must have come as quite a shock.

I asked the doctor about that. She said the break likely occurred from me actually falling and my pelvis hitting the ground, but I can't remember when I've done that. I mean, I've fallen on my butt a few times in my life, but I never had a level of pain that I would associate with a break. When I slipped on the ice nine years ago, I didn't go all the way down, but it was pretty traumatic. I'm pretty sure that fall damaged my hip cartilage and led me to my current situation. But yeah, it was a heck of a shock. I don't think I've abused my body, but I certainly have used it a lot.

My recovery seems to be going pretty well so far, and the fact that I prehabbed with a brilliant PT and came into the surgery relatively strong certainly helps. This was enabled in part by a Celebrex RX, which brought down my inflammation enough for me to work on maintaining whatever strength and stability I could. If that path is in the cards for you, I highly recommend you take it. I also pretty much lived on heating pads pre-surgery to help manage the pain (I had a labral tear and severe OA secondary to until-then undiagnosed developmental dysplasia in the hip).

I've found this board to be the best resource out there both for info about the surgery and for support from people who totally get what you're going through, so I'm glad you found it. Taking care of your nervous system is almost just as important as taking care of your hip, and this community can really help with that. Keep us posted on how you're doing and of course throw your questions out there.

Good advice. I'm remaining active, although I've cut back. I was exercising about nine hours a week, but now I'd down to about half that, mostly biking. When the outdoor pools open up I'll see if I can still do a flip turn and resume lap swimming. I run once or twice a week if my hip isn't feeling too bad that day and have started walking through my neighborhood, mapping out routes I can do during rehab. I'm also doing exercise bands, working the adductors, abductors, flexors, hamstrings, and core.

 

[dw152]

@LaKarune I've been reading your pre-op journey. A couple of things you said really resonated with me:

Ironically, my pain was so much worse in November than it is now. I’ve been prehabbing (new word for me) with PT for about a month, made possible largely by Celebrex and a really great physical therapist, and I have so much less pain and more stability now. I’m finding myself slipping into some magical thinking, like maybe my body is figuring this whole cartilage thing out on its own.

In February, I was in so much pain I could hardly walk. I was playing a lot of tennis that month (and many previous months), most of it pretty hard. Once a week would be easy social play, but the rest of the time were hard drills or singles against young guys. My last day of playing tennis was 28 February, and once I stopped, within a few days my hip started feeling better. I had developed a flaw in my technique where I would over-rotate and pivot on my lead (left) foot on the follow through, which means that my foot would be planted and my entire body would pivot around my leg and hip joint.

In the 2.5 months since I stopped playing tennis, some days it doesn't feel too bad, and I convince myself that I can tough it out and maybe I was a baby for going to the doctor in the first place. But then I try to tie my shoes or, even worse, try to buckle my bike shoes, and I'm cursing up a storm trying to reach the outside of my shoe. Getting on and off my bike is very hard because I can't pivot on my hip and swing my leg over the seat and top tube. And when I bike, I can tell that I'm only getting about 50-75 percent power out of my left leg, and it's tracking at an odd angle. I can't ignore those facts. And truthfully, I was in a lot of pain back in February, but kept denying it. Now, I think that if I ignore this, I'll gradually return to that level of pain even with reduced activity.

I go through phases of sobbing / crying about the fact that they have to cut off the head of my femur. I love my bones and I would like to keep them all.

I said almost this exact thing. I've had my bones for my entire life and I sort of like them. I feel a little cruel allowing someone to saw off a bone, bore out my pelvis, and insert a rod down my leg. It's also permanent, so there is no turning back. Objectively, I understand it, and it's impressive that this technique has been developed, but my logical side has trouble convincing my emotional side.

 

[Eman85]

While you're recovering you should write a book. I have ADD so reading all of that is too much for me. Skimming I did see you want to run and play tennis. post-op you can do anything you want to, it's your hip and your life. You pays your money and you takes your chances.

 

[Caison113]

Hello @dw152 and welcome to BoneSmart. I read your entire post and nodded several times. You are a little older than me, and except for some of the specific sports, my story tracks pretty exactly to yours (feel free to poke around in my post history for specifics). You also sound very analytical (like me) who wants to know as much as they can about everything so they feel like they are making the right choice. The funny part about that approach is that this decision is as much emotional as it is rational.

I made all the same bargains and ”deals” with myself about how I could modify and push through. Imagine doing this 10 years younger though. It’s even harder to convince yourself when everyone around you keeps telling you how ”young” you are. Even my father, who had both hips done, didn’t do that until late 60s/early 70s. It was frustrating and not a little humiliating honestly to have to tell friends I was getting my hip replaced.

All I can say is that, absent a complication, this surgery will be one of the “easiest” and best ones you can do. Being fit going into the surgery is a big plus, so another reason not to wait until you’ve atrophied down to nothing to get the surgery. Make sure you get a couple of opinions and then go with the surgeon you like the best. The approach is really for them to worry over. Each approach has its own complications that can occur, but long-term, there is really no difference according to the research.

A few more points: (1) “going back to work” means different things to different people. I also work from home at a desk, and I was getting back to work 5-6 days after the surgery. I was keeping a light schedule but I could do emails and shorter conference calls easily enough. My deal was once I was off narcotics, I would start to work again. (2) The ”no running” advice is meant to be the best guidance to help the joint last as long as possible. It doesn’t mean you will be having a revision in 5 years necessarily, but as you can imagine, the pounding on the pavement is more likely to cause issues than swimming or yoga. (3) I played tennis after my first surgery (also doubles) but I was only doing it a few times a month in a league. Again, frequency/intensity matter overall. (4) I’m back to kickboxing, biking and hiking now with no problems — in fact they are all much better. I’m not pretending I’m 22, but I wouldn’t have done that even if my hips were fine.

Last, to circle back, you are doing all the right things for the body and limitations you have. What you really need to work on is your brain telling you that you can fix this. Unfortunately, there is no fixing hip arthritis at this point at time. Life is truly so much better for me now that I have these stupid hips fixed. My quality of life is immeasurably better as is my range of motion. Now I can simply do things that I had to make excuses over and I don’t miss my original parts one bit. They got me as far as they could but it was diminishing returns once I hit the point where the pain was really interfering with my life.

Best of luck going forward.

 

[djklaugh]

@dw152 As said several time already everyone is different with their experience with joint replacement. And recommendations from surgeons also are different. I was 64yo when I had my BTHR (bilateral = both hips replaced in the same surgical session) and when discharged from my surgeon's active case load he said my only permanent restriction was "no bungy cord jumping". Now I am not athletic nor was I at the time of my surgery but he said if I wanted to take up practically any activity that was fine with him. Oh and yes I too have Kaiser and all my surgeries have been done by Kaiser surgeons with very successful out comes!.

When I first saw the surgeon I was experiencing a lot of pain and lack of ROM in my right hip and the left one felt OK to me. But surgeon came in to the exam room and said "Ms M, I've reviewed your x-rays and medical records and all I can offer is hip replacement and I'd recommend you do both at once". Well, knock me over with a feather! He showed me the x-rays and right hip was fused to pelvis and left was bone-on-bone.

As for your surgeon being "cold and factual" .... my experience has been (also worked for Kaiser for 24+ years and in other medical settings too) some surgeons did not find their medical school classes in "Bedside manner" and "Relating to your patients" of much interest. They usually are excellent surgeons but don't do warmth very well. I had to work to convince my hip surgeon that I was more medically knowledgeable than many of his other patients and my questions were for my own information and I was not questioning his skill or expertise! But once we got past that he was willing to answer all my questions and was more approachable.

Adding my *hopefully" helpful suggestions for success in joint replacement:
1- load up on patience! For how ever long your hip has been getting bad, the muscles, tendons, and ligaments around the hip (and in other areas of your body) have been functioning in maladaptive ways and it is going to take time to heal and recondition every thing. Also Kaiser being Kaiser it can take quite a while to get from first visit with surgeon to actual trip to the OR. Took me 6 months and that was back in 2011.
2- get new shoes! Both your usual walking around shoes and also any and all shoes you wear when running or playing tennis or doing other activities. The old wear patterns can interfere with regaining a normal gait and slow your recovery.
3-plan on being bored and frustrate with your perceived "slow" progress. Usually it really is not slow ... it's just normal. Seems to be par for the course for practically everyone I've ever heard of ..... myself included.
4-different movements may require longer rehab than others. Right after my surgery I could walk (slowly), climb stairs (slowly), and get into and out of a car OK. But it took about 4 months of PT to get left foot onto right knee and nearly 9 months to get right foot onto left knee.

Best of everything to you!

 

[dw152]

Hello @dw152 and welcome to BoneSmart. I read your entire post and nodded several times. You are a little older than me, and except for some of the specific sports, my story tracks pretty exactly to yours (feel free to poke around in my post history for specifics). You also sound very analytical (like me) who wants to know as much as they can about everything so they feel like they are making the right choice. The funny part about that approach is that this decision is as much emotional as it is rational.

Indeed it is.

When my doctor first told me I would be getting a spinal, I voiced a slight surprise and my fear of needles. She explained all of the benefits, and I told her to stop using logic because it was interfering with my emotion. I hope she saw the humor in that.

I made all the same bargains and ”deals” with myself about how I could modify and push through. Imagine doing this 10 years younger though. It’s even harder to convince yourself when everyone around you keeps telling you how ”young” you are. Even my father, who had both hips done, didn’t do that until late 60s/early 70s. It was frustrating and not a little humiliating honestly to have to tell friends I was getting my hip replaced.

I have to admit that I am also a bit embarrassed to admit that I need this.

A few more points: (1) “going back to work” means different things to different people. I also work from home at a desk, and I was getting back to work 5-6 days after the surgery. I was keeping a light schedule but I could do emails and shorter conference calls easily enough. My deal was once I was off narcotics, I would start to work again.

I primarily work from home also. But I want to focus on recovery as much as possible, so I'm going to be strict about taking time off so that I can take of myself.

Life is truly so much better for me now that I have these stupid hips fixed. My quality of life is immeasurably better as is my range of motion. Now I can simply do things that I had to make excuses over and I don’t miss my original parts one bit. They got me as far as they could but it was diminishing returns once I hit the point where the pain was really interfering with my life.

Thanks for your words of encouragement.

@dw152

As for your surgeon being "cold and factual" .... my experience has been (also worked for Kaiser for 24+ years and in other medical settings too) some surgeons did not find their medical school classes in "Bedside manner" and "Relating to your patients" of much interest. They usually are excellent surgeons but don't do warmth very well. I had to work to convince my hip surgeon that I was more medically knowledgeable than many of his other patients and my questions were for my own information and I was not questioning his skill or expertise! But once we got past that he was willing to answer all my questions and was more approachable.

Cold and factual doesn't bother me at all to be honest. Doctors need to deal with facts. But a little understanding of what these things mean to us would help. I hate it when a doctor says "running is dumb, so you should save it for running to catch a bus." That may be the truth, but a little cushioning would help us.

But again - cold and factual is fine. It's not easy becoming an orthopedic surgeon and I have a lot of respect for them. I did not mean that as a criticism.

When I talk to them, I try to strike a balance between being informed, but not trying to micromanage them or try to be smarter than them. Most of the Kaiser doctors I've had have been wonderful in this respect and have truly listened to me.

Adding my *hopefully" helpful suggestions for success in joint replacement:
...

Wonderful advice. Thanks so much!

 

[dw152]

Some events from this week:

I don't have a surgery date yet. I did my blood tests this week. Everything was fine except my vitamin D is a little low. I asked the scheduling nurse if I should just get some vitamin supplements, but she said that they notified my primary care doctor and I should wait until she tells me what to do. The only remaining thing I need is to get a dental clearance, which I should get next week.

To get a baseline, I did a cycling power test this week. With all the tennis I've been playing the last several years, I haven't been cycling too much, so I'm not in the greatest cycling shape, but no big deal. When I was doing the test, I noticed my left leg wasn't generating as much power as the right. The test keeps increasing the power level (resistance), until I could not keep up. When that happened, I could still pedal with my right leg, but my left leg felt like a wet noodle. But I now have a baseline power number that I can use during my recovery.

The rest of the week wasn't too bad. I did manage to go for a short run and a short walk. Not too much pain. Just the usual limited range of motion.

Today I went for a six mile hike. The old version of me would have run this, but my hip hurt just thinking of that. Hiking uphill, my left leg again just wasn't generating much power, so my right leg is doing most of the work. On flatter and downhill sections, I have that constant, nagging tugging in my groin. I know that affects my gait, and could lead to secondary issues. Over the last half mile, my left groin and thigh started barking and I struggled a bit to finish. I thought maybe I could substitute hiking for running until I get the surgery, but now I'm not sure.

My attitude shifted this week. I've gone from resigning myself to the surgery because it was inevitable, to now slightly looking forward to it so I can just go for a walk in the woods without pain. Well, I'm not looking forward to the actual surgery, but now I'm looking at it as a step towards being rid of this pain.

 

[RoosterRick]

Welcome to the forum @dw152. Like @Caison113, it seems you and also I have a few things in common. I have been where you are currently with the emotional process of accepting that your hip is not salvageable with conservative treatment. No amount of PT, diet & supplements, training more, training less, not training at all, acupuncture or voodoo is going to fix this. And then there is the discomfort/pain. The sharp pinch you feel in your groin when you tie your shoe, or lift you leg over the top tube on the bike, or walking/running uphill and downhill. Likely caused by impingement and bone spurs in the worn out hip...it won't get better either. But the THR offers you a high probability of getting your active life back, without the pain. As I'm sure you know, being in the best physical condition possible going into the surgery will pay dividends in recovery. Embrace your pre-surgery training and know you are actively helping your post-surgery recovery. Good luck on your journey!

 

[Mojo333]

I'm another end-stage OA victim back to an active life with BTHR.
I was a bit older than you, but a young 53 and was floored when I heard my hips were bone on bone.

. I've gone from resigning myself to the surgery because it was inevitable, to now slightly looking forward to it so I can just go for a walk in the woods without pain

I also, fairly quickly after my diagnosis, began to look forward to getting my hips fixed so I could back to my passions in life.

I have a slightly different take on pre-surgery "training "
As you noted, your body is having to compensate and this actually causes other issues which I did not need to deal with while recovering from surgery. (Tendonitis, groin strains, etc)

Any loss of muscle tone, can be regained after surgery.

I just pushed through work, and then babied my hips and tried to stay out of pain (which became impossible) and concentrated on building up my upper body strength which was Super Helpful during early days of recovery.

I was a prolific icer during recovery but heat was one of the best soothers pre-op days.

Sitting out in the sun and getting some good old natual Vitamin D, while noshing on a bit of yogurt (Calcium helps with Vitamin D absorption) and working with some arm weights sounds like a good pre-op plan to me.
Boooring , I get it... but All Temporary.

Hope you get a date soon.

 

[dw152]

It's been a week since my last post, so here's an update.

I still don't have a date for surgery. The last thing I needed was a dental clearance, which I hoped would be routine. I saw the dentist this week. During the visit things were sounding great, but then they told me I needed some work done. It was a surprise for sure and sank my spirits. Best case is that this will result in a month delay to schedule the surgery, but worst case it could mean a much longer delay and complicate things.

I was already not looking forward to hip surgery, but I really really don't like going to the dentists. I mean, I really really really don't like going to the dentist. I'm not sure what my biggest fear in life is, but dentists are close to the top. I had some bad dental experiences when I was younger and those still linger in my mind. I also don't like sharp things, and I really don't like sharp things in my mouth. I'm really really not looking forward to the next few weeks while I get this resolved. When I used to be on long training runs or rides, I would remind myself of PCP - patience, courage, and perspective. I think I need to revive that inner chant to help me through this.

I'm continuing to stay active as best I can. The weather in my area has been nice, so I got out on the trails on my bike one evening this week. My left leg still doesn't track properly and I'm not getting full power out of it, but I can feel my biking fitness coming back and, as long as it doesn't mess up my hip, I'm going to continue biking. I'm doing hip exercises with exercise bands regularly, and my hip is probably stronger than it's ever been in my life. I managed a short run which surprisingly wasn't painful, but I walked through my neighborhood today and my hip was pretty uncomfortable. When I do my walks, I am mapping out routes of varying distances that I can use during my recovery. So far I have a 1 mile route, two 2 mile routes, and my route today was just short of 3 miles. The outdoor pool will open up next weekend. I haven't swam laps in ten years, but I'll jump back in and see if I can remember how to do a flip turn. I'm hoping all of these things will lead to a successful recovery.

I have some time off scheduled over the next two weeks, and I plan to do some hiking during that time. Growing up in southern CA, I did lots of hiking in the mountains and deserts when I was young. When I moved back east, I started running and biking, but never hiked much. I'm expecting that will be one of my main activities after hip surgery.

 

[LeftKath]

Ughh. I don't like dentists either. We had mean one when I was a little kid. The one I've been seeing for the last 20 years is great but I still get nervous before appointments. Hopefully you can get that dental work tidied up soon. I'm headed for my second hip replacement tomorrow. I'd been a pretty active person (not as athletic as you though) too prior to this bone on bone arthritis. It came on gradually and quietly ate away at many things I enjoyed doing.

Scheduling issues in our community led to a 9 month wait for my right hip replacement and a 6 month wait for tomorrow's. Because I knew that I was facing a long waits I got hip injections both times. They took the edge off the pain somewhat for a few months. The injections and some meloxicam prescribed by my PCP allowed me to keep my fitness level up through walking, stationary biking, weights and yoga. I also used heat, a foam roller and one of those massage guns on the muscles that are angry at having to compensate for the bad hip.

Take Care

 

[nasruddin]

Your story (post 1) sounds similar to mine. I was never a runner but did everything else. In the past 2 1/2 yrs all of it got to be increasingly difficult for hip (some things I've had to stop, other things reduced).

You might want to look at Klapper & Huey's book "Heal Your Hips" for some aquatic exercises (the land ones are probably things you already know, but you can look thru them for ideas). I never paid much attention to aquarobics or the like (or did much swimming - too inconvenient). The 1st time I tried a sequence of their water program I was knocked out. There's some real exercise in there. I was also surprised I could still swim - kicking motions are still ok even with underpowered bad leg (I can't cycle at all - that should 've been a giveaway a couple years ago, but it wasn't that important to me then, at that time hiking and power yoga were it). Your milage, or lane-age, may vary.

BTW I don't think the book's exercises can actually heal your hip if you're already far enough along to be ready for surgery. I am hoping they help me go into surgery with some core/hip/thigh muscle and maybe help with recovery afterwards.