Physically I have no indication that I have artificial hips; sleep soundly, walk for miles, bicycle for an hour, Karate classes, non-impact Jujitsu, dancing, just generally feeling great. I can even get up off the ground without a problem.
The future is bright, getting younger every year.
Healing seems a bit farther along compared to last year's right hip replacement. Didn't have the swelling and bruising issues this time.
Physically I have regressed over the last 2 weeks because I have been going to work and not having the energy to exercise at the gym. Walking in 15 minute sessions during the work day seems to work when I make the time. Weight bearing is not quite 100% on the left leg probably because I weigh too much. As the pounds come off the leg feels better.
Seventeen months after getting my right hip replace the left hip was replaced. Surgery went well and the recovery seems easier the second time around. I believe both recoveries are clinically similar but my mind is much more at ease with the whole "cutting off my leg and installing Terminator parts" thing.
The Tri-Lock® bone preservation stem that is in the right leg was again used for the left leg. See my blog on Co-Cr-Mo for details on the metallurgy.
The right is was an all metal Pinnacle® with Ultamet® metal-on-metal solution (no longer available.) The left hip is the Pinnacle® with AltrX a moderately cross-linked polyethylene bearing against a ceramic lined acetabular cup (picture shows Tri-Lock with AltrX.)
No glue, screws or wires used in either hip. The right hip incision was closed with staples that left a cool Frankenstein scar. The left hip incision has no visible sutures and was closed with Steri-Stipes; nothing needed to be removed post-surgery.
The fact that I have had an artificial hip installed is primarily an intellectual exercise now. By that I mean that my body doesn't seem to notice any more.
Really looking forward to getting on the mat again. For weeks I had been planning on starting the first Saturday after the 6 month mark. But I learned from Kyoshi Ron Joslin at the 4th of July Auburn Fairgrounds that the dojo would be closed for the annual K.I.A.I. Grand National. I start this weekend; new hip, new dojo facilities.
On the six month anniversary I execised for 3 1/2 hours, until I started limping from the OA in the left/organic hip. Right hip not an issue at all :)
To early to go back to the dojo, 6 month hiatus recommended, and the daily walks aren't getting it done any more. Then during my checkup with the surgeon last week he reminded my that his best recommendation is no martial arts at all. Got me thinking, after the other hip is removed it will be well a over a year that I am functionally off the mat; I can't wait that long to get active and fit again.
Sharon suggested something that honestly had not crossed my mind, join a gym. Boeing, the light went on. Working out at the gym is exactly what I should do. I was a regular for years when I lived in the Bay Area; I really enjoyed pushing myself and continually improving body and discipline.
I joined Anytime Fitness here in Auburn. Three days at the gym and I am feeling good about myself.
They include access to the Anytime Health website with membership. So cool. The software tester in me likes the fitness tracking tools. The athletic trainer in me likes the simple instructional videos on the machines and exercises you may include in your training. The martial artist in me likes the tool for designing and managing a set of workout routines you build for yourself (even an option to have today's planned routine sent to you via email daily.)
The article on the site Anatomy Of A (Proper) Workout triggered my memories of how to make progress. Check it out.
Back to working my regular full time job in Benicia. 90 mile commute each way, five days a week. The first week was tiring but the end of the second week back to the normal work related fatigue. I realize that the 2-3 hour Friday commute home is exhausting because I have to pay close attention to the road the whole time, no day dreaming or down time.
I have not use the cane for over a month. For longer periods I forget that I have had the surgery. But the handicap parking is great and I use it whenever I can (need to open car door all the way to get in and out, not enough space in the standard parking space.)
Continue with the walks. Sharon and I have started doing weekend hikes again.
Haven't been to physical therapy since early March. Do the stretches on my own and a lot of walking (30 -60 minutes per day).
Full weight barring on the right leg without reservations. Not feeling tentative about anything any more. I'm sure I'll be able to continue Karate and Jujitsu without a problem come July. Looking forward to doing a lot of dance classes at band camp this summer as well.
The adhesions created by the incision are essentially gone. Bruising is gone and the bundle in my inguinal crease is gone. Just a nice clean scar with a cool indentation.
Putting on my right sock is my biggest obstacle. This weekend I was able to do it without assistance.
PS-Looking forward to replacing the left hip in the fall.
[Click the pictures to view.]
Forest Hill Divide Loop Trail Overlook is a nice hike sutable for out of town guests that are not trekkers. Some steep grades to get you breathing but not too challenging for people who walk regularly. The hike from Foresthill Road out to the Overlook and back is less than an hour.
The Overlook is a nice picnic spot with a grand view. Today there were wild flowers everywhere.
The following is from the American River Canyon Hikes guide by Ferris, Lynch and Toner (outstanding book) pages 16-17 (PDF).
At 1 mile, a side trail to the right leads to an overlook with a magnificent panoramic view of the Middle Fork American River from Poverty Bar to the east, to Brown's Bar to the west. This side trail adds 0.8 miles and 200 ft. of elevation change. ...it meanders in and out of shaded foothill woodlands ecosystem and sunny chaparral dominated by manzanita, buck bush and chemise.The trail is on the right heading toward Foresthill. Google maps has a picture of the "road" off Foresthill Rd. but this unpaved road with gate is not recorded on the map.
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I have been forgetting to take the cane when I go out sometimes. For brief periods I forget that I have had the surgery.
Continuing the exercises I have been doing. Add exercise bike and weight training at PT.
Continue with the walks. My normal hilly route took 30 minutes now it is shy of 25. I walked around the baseball diamond on Tuesday for a 45 minute workout, about the limit.
I still ice the wound after physical therapy, but it is no longer needed at other times.
The therapist used ultra sound and massage a few more times to the wound to reduce the swelling/hardness. The hardness is almost completely gone.
I am occasionally working on breaking down the adhesions created by the incision; gently massage the scar with Dit Dar Jau (make your own). Bruising is almost gone and the bundle in my inguinal crease is going away.
Sitting at the computer remains my biggest obstacle, 30 minutes is too long. :(
Another reviewer here had problems with an office visit. Not my experience, 3 visits and no waiting. Dr. Bergeson patiently answered all my questions and was always cordial, pleasant and professional.
I sought out Dr. Bergeson because my PT was impressed with the surgical results she had seen in his patients.
Staples were removed last week. "No precautions" continues to be the directive.
Started ascending and descending stairs unaided.
Started serious physical therapy yesterday. First the therapist measured the range of motion of the right hip. We need to work on flexibility :)
Continue the exercises I have been doing. Add abduction and adduction exercises against resistance.
Continue with the walks. Suggest walking before doing the exercises to warm the muscles up.
Ice the wound after exercising.
The therapist applied ultra sound and massage to the wound to reduce the spelling/hardness. The next morning the hardness was significantly reduced.
Start breaking down the adhesions created by the incision. Gently massage the scar with lotion or oil in the weeks following any surgical procedure. Adhesions can be minimized by keeping the blood and lymph fluid flowing in the area and by gently breaking them up as they are beginning to form. The objective is to stretch the scar fibers, possibly stimulating the local response to softening the fibers.
Fred and John loaned me a really cool rolling walker, a Nova Cruiser DX model 4202 blue.
The shuffle style is OK when you are putting a lot of weight on the device and moving slowly but by day 3 it was to cumbersome for me. The Cruiser rolls along with fingertip control so it doesn't slow you down when you start booking.
The front wheels piviot 360° while the in-line rear wheels have individual hand brakes.
The brakes work like bicycle brakes, squeeze gently to apply, squeeze hard to lock. In addtion you can push down on the handle and set the parking brake so she wont roll away.
When I first started walking this week I felt like an old lady shuffling around the hospital. Now with the rolling walker I feel like I am an athlete recovering from a good sports injury.
Here are a some specifics that we did, hope others will find it helpful.
I can push and put and lift my body quite easily. The bed is farely high so I don't have far to go from sitting on the edge of the bed to standing, not an issue lowering myself onto the bed. In the hospital it was work to stand up.In order to keep my friends and family updated on my progress I will be blogging the experience here under the keyword/label "hip".
And this required me to buy a keyboard for the PlayStation 3. I am using the new keyboard to write this entry. So much more user friendly (doable) then using the game controller to select letters.
Need to find out the capabilities of the PS3 browser. I stumbled onto the copy text feature but haven't figured out the past text feature :(
If you want to watch an actual surgery I think this video by Dr. Stefan Kreuzer, MD might be for you (I don't want to watch this kind of thing myself
Muscle-sparing hip replacement surgery designed to diminish post-operative pain and shorten recuperation time. The OSI Pro FX surgical table - an addition to the health system's surgical suite that makes possible the minimally invasive, muscle-sparing hip replacement surgery.
The Pro Fx Hip and Knee Arthoplasty Table table is the only surgical table designed exclusively for hip and knee arthoplasty. This table was designed not only for anterior hip replacement surgery but also for spine and other orthopedic surgeries as well as cardiovascular surgeries.
With a unique capability to position the leg, the table allows the surgeon to replace the hip through a single incision that is placed at the anterior – or front – of the hip. There are numerous benefits to the anterior hip surgery.
Anterior hip replacement surgery spares both nerve and muscle tissue. Patients who have the anterior hip replacement surgery suffer less pain, stay in the hospital less time and can return to normal activity much sooner.
None of the restrictions typically imposed following traditional surgery apply when the anterior approach is used. With this procedure, patients are able to begin walking immediately after surgery. They overwhelmingly experience less pain and are able to forgo narcotics following surgery.
Today's surgeons are improving hip and knee replacement recovery times with a new device called the Hana table. Looking more like a piece of exercise machinery, the Hana table allows doctors to manipulate the patent's legs to avoid extensive muscle tissue damage while better exposing the joint.
The majority of the recovery from the traditional hip replacement is not the bone, but the muscle rejoining the bone”. Ciotola said. Most operating tables, when a patient comes in for a hip replacement surgery, they're lying on their back or more commonly on their side.
That is not the best position for the patient or the doctor, he said. The Hana table, manufactured by OSI Products, features adjustable arms that grip the feet and can be positioned where doctors need them.
Many patients are walking about in just 48 hours after this surgery, he said, and within 10 days are completely free to do whatever they want. In traditional hip replacements, patients can not bend over or cross their legs in a chair for up to two to three months following surgery.
"The Hana Table will improve our treatment of hip and knee surgery patients primarily and the Jackson Spinal Table will enhance our capability for spinal surgery," said Dr. Bergeson (my surgeon).
The Hana Table will allow orthopedic surgeons to perform the newer anterior hip replacement procedure which is less invasive than the traditional method. Anterior hip replacement surgery is performed through an incision at the front of the hip, avoiding muscles and tendons to cut through.
A gravity sintering fabrication technique has been developed for producing Co-Cr-Mo alloy dental implants having a porous coating on the root portion. This process allows for control of pore structure enabling ingrowth of either bone or fibrous tissue.
Co--Cr--Mo-based alloy which is superior in compatibility with a living body, corrosion resistance, and wear resistance, and a low magnetic susceptibility which does not exert harmful effects on magnetic resonance image (MRI) for medical examination diagnosis. Their biocompatibility is closely linked to the high resistance towards corrosion thanks to the spontaneous formation of a passive oxide film with elevated chemical and mechanical stability.Histologic and microradiographic sections revealed extensive mineralized bone growth deep into the pores of all implant types and often extending to the core of the one-, two- and three-layered porous-coated implants. Both mature haversian bone and less mature woven bone were found within the porous structure. Extensive but incomplete bone infiltration was found in the totally porous implants, with the remainder of the porosity filled with macrophage-laden connective tissue.
At our initial interview Dr. Bergeson said he was planning on using the DePuy ASR total hip.
On the DePuy Orthopaedics, Inc. (Johnson & Johnson company) website they list the DePuy ASR™ XL System, I confirmed that this is the specific hip replacement Dr. Bergeson was referring to.
Tri-Lock® Bone Preservation Hip Stem is what Dr. Bergeson is going to put in my femur.
Warnings and Precautions
The following conditions, singularly or concurrently, tend to impose severe loading on the affected hip joint, thereby placing the patient at higher risk for failure of the hemi-hip replacement: Obesity or excessive patient weight, manual labor, active sports participation, high levels of patient activity, likelihood of falls, alcohol or drug addictions and other disabilities, as applicable.
The following conditions singularly or concurrently, tend to adversely affect the fixation of hemi-hip replacement implants: Marked osteoporosis or poor bone stock, metabolic disorders or systemic pharmacological treatments leading to progressive deterioration of solid bone support for the implant (e.g., diabetes mellitus, steroid therapies, immunosuppressive therapies), history of general or local infections, severe deformities leading to impaired fixation or improper positioning of the implant, tumors of the supporting bone structures, allergic reactions to implant materials (e.g., bone cement, metal), tissue reactions to implant corrosion or implant wear debris, disabilities of other joints (e.g., knees and ankles).
This implant should not be used with other manufacturers’ components. Use of components other than those recommended could lead to loosening, wear, fracture during assembly or use, and premature failure.
Adverse Events
Change in position of the prosthetic components, often related to the factors listed in WARNINGS AND PRECAUTIONS. Early or late loosening of the prosthetic components, often related to factors listed in WARNINGS AND PRECAUTIONS. Early or late infection. Peripheral neuropathies. Subclinical nerve damage may also occur as a result of surgical trauma. Tissue reactions, osteolysis, and/or implant loosening caused by metallic corrosion, allergic reactions, or metal wear debris or loose cement particles.
I want to do some complex creative project that require additional quilting skills. To the end of having a full set of tools I will be doing small project each focusing on developing my skills.
Started by checking out a bunch of books from the library and looking through them. I've already blogged about Michael James, that is the kind of stuff I want to do artistically. The book that grabbed me for learning technique is Teach Yourself Visually Quilting (2008) by Sonja Hakala. I have learn stuff and remembered other things, nice to see that my quilt teachers passed along a lot of solid tips (include in this book).
In order to learn to sew triangles with sharp points I will be doing the Pinwheel Star Quilt Project on page 128. This finished quilt picture is from the book. Below are the fabrics that I picked for my project.
Picked out the fabric today. This quilt will be machine quilted and bound.
My surgeon does not use the CPM for either hip or knee replacement patients (in general). Recent studies do not find significant impact of using the device six weeks after surgery.
However, as I am a trained therapist myself I have identified a couple of external devices that could be advantageous to my particular surgical recovery.
Racing Wheel with foot pedals for the PS3. This along with the appropriate software can be used to measure pre-op and post-op automotive braking abilities.
The Tony Hawk Skateboard for the PS3. A new device and supporting software should develop balance and fine motor muscle control of the hips.
