Tuesday, June 14, 2016

Total Right Hip Replacement - Anterior Approach

I know it has been a year since my last blog, Simon relapsed, had a stem cell transplant, and as of today is heading for day 300. Then when I knew he was over the worst days of the Stem Cell Transplant (thanks to his beautiful, wonderful amazing sister Sam) I decided to take a look at my hip problem - this is my journey.
Thought I would share my experience with my recent TRH replacement. When I found out I had to have a TRH replacement, I knew nothing about this, so thought I would share my experience with my followers, or anyone who is interested.
Having had pain in my right groin, for around eight years, which then progressed to below my knee, followed by pain in my hip, I eventually went to a wonderful sports medicine doctor (Corry Cunningham) around the middle of 2014/15. After numerous cortisone injections it was off for an MRI!!
Horror of horrors I was told that my right hip was virtually shot! Did not believe this would happen to me. I am a ‘fitness freak’ been going to Yoga for around six to seven years, train twice a week as well as walking over my 10,000 steps per day. So as one does I thought, if I ignored this fact, it would go away. Guess what it did not!
Due to a family illness I put off doing anything about the hip for over 12 months and finally thought (after my Yoga teacher said her husband was having a hip replacement) may be it was time for me. To find a Doctor, was my next step.
So off to good ole Google went I –researched and research, and as I had promised Doctor Cunningham, that I would speak to him before I did anything, I went back to him. He recommended and gave me referral to two Doctors.
Once I made up my mind on possible hip replacement surgeons, (as I do, I wanted everything done yesterday), so due to my fabulous team of doctors I had referrals to three Doctors! In no time I had appointments to see all three. However once I spoke to Dr James Rohrsheim’s practise manager I was hooked. 
She did not talk about money or pensions; she immediately got me an appointment, (actually the Doctor squeezed me in early as he was going to his country practise the next week), and I did not want to wait!
I think I arrived with duplicate copies of a list of around 18 questions, one for the Doctor and one for me. I had decided on an Anterior approach, which is a cut in the front of the leg (as opposed to the side or through the back) Well James (as he said I was to call him) was amazing, so easy to talk to and quick point out my arthritic hip! He then went on to point out that he did not operate for the sake of operating; only doing so when one could not live with the pain anymore and the pain was impacting on your life style.
Having gone backwards over the previous 18 months in both my personal training and Yoga along with constant pain when walking, getting into bed and general exercising (along with not being able to sleep during the night due to pain) the decision was made and I was booked in for
March 29, 2016.
I needed one more visit to Dr Rohrsheim to be reassured, that I would be able to do such things as: more than touch my toes straight legged, sit cross legged, and get back to the gym and Yoga, as well as drive my sports car and walk up and down my multi-level house! He was assured me I would do it all in a matter of no time without pain! The only drawback he mentioned was an ugly scar – 'Ooh bother,' I commented, telling him I still wore a bikini!! Yes at my age. He also showed me what the implant would look like, showing me the ball insert and socket - an innovation of an Australian company: 
The following is how it all went for anyone who is thinking of having a THR operation:

Surgery day:        (terrified), awoke to no pain, no morphine pump or catheter. Good so far. Up the same day, and guess what, the first thing I did, on getting out of bed was to easily bend down and touched my toes. Upon looking for the ‘ugly scar’ to my amazement and joy, I had this 4in cut in the crease of the top of my leg – glued not stitched which one can now hardly see!!! What a clever surgeon I have!

Day one:      Up to go to go to Physio with frame –  rehab is physical and mental equally, – one has to see yourself doing the exercise and pushing on – no matter what!! This was done twice daily. Take all the drugs they offer you for the first few days!!
I could raise my right leg in a sitting position, and reach out and touch my toes, get up and down from a chair sitting position without using my hands to push up. March backwards and forwards in a sitting position. Also did squats holding on to a rail and up and down on tip toe!
Day two:     Two crutches, then one crutch, exercise more intense and walking distance longer.
Day three:  One crutch, stronger exercises and more of them.
Day four:    (five and six) No crutch with very vigorous exercise, 20 repeats of each one and really long walks. I easily climbed up and down stairs, something very essential for me, due to my multi-level home.

Day seven:  I chose not to go to rehab, so home I was going, but hair dresser first. Easily walked with no crutch and got in and out of a four wheel drive – sitting down on the car seat, back first, then manually lifting my right leg into the car first.

For the first two weeks home I had family members with me. However I could easily climb the stairs, get into my 84cm (33in) high bed, dress and shower myself (no chair), along with putting on my shoes and tying shoe laces. The only thing I had to hire was a pair of crutches (only used one for the next three weeks as my surgeon made me promise, to ‘slow me down’ he said!)
NOTE: My family members did mention (after the fact) that I did throw a few ‘hissy fits’ in the two weeks in which they had close contact with me, however I totally deny this, blaming any ‘mouth malfunctions’ on anaesthetic brain!!
I started walking on the street by myself around day nine – only a short walk and then a little more every day thereafter. I am not saying it was easy, but mind set got me there. In no time at all I was walking my 10,000 steps per day.
Knocked off all strong drugs on around day 12, choosing a drug I knew well, Mersyndol (night and day time strength). Remember the Opium based pain killers play havoc on you intestinal system, so the sooner you knock them off the better.
Week three:         Did not go to rehab, but chose to do it myself with the help of my fabulous physio David at C2K gym Castle Hill. Visited David regularly, doing his prescribed exercers. Also started driving in my little sports car, firstly lifting leg in, then one day miraculously it just lifted on its own without me thinking about it!
Week four: After follow up visit to my surgeon, the ‘magic’ James Rohrsheim, I had a permission to go back to the gym/Yoga letter in my hand, so I headed back to the gym, Yoga and training with great glee!
First training lesson immediately I immediately did wall squats along with working on TRX to get my arm muscles back on track along with waking up my core!
I also had my house totally recarpeted in week five, (a mammoth job, furniture had to be moved and everything boxed up.I had everything back in order in a couple of days. (Not saying I was not tired probably would be in trouble if James knew I was on my leg one day, non-stop for 13 hours)!
I guess around week six-seven I started sleeping right through the night, and could sleep on my good side (as opposed to back). I found sitting for extended periods uncomfortable due to the numbness/tightness from my knee up to the scar. Did have several large hematomas – however due to physio, massage, exercise and Hirudoid cream these are now gone, however, numbness (which seems to move, is still with me, along with very tight muscles in the upper leg, especially down outside and above the knee). Feeling is coming back however, a little each day.

The pictures below were taken by my PT Danni Demorgan (C2K personal trainer) at the end of week nine!!

Extended relaxing pose

 Camel Pose

Shoulder Stand

Left Leg  straight up, Right Leg back touching ground

Right Leg straight up, Left Leg back touching ground

I can do the last three pictures now better than before I had the surgery!!!
Every week in Yoga, I get better and better – despite the fact that another hip surgeon said, after a hip operation one could never do Yoga again!! Each week gets better and better, as of week 11 I can plank (straight arms, side planks), down dog, most of the stretches, sleep on my right side, walk easily 4K – up and down hill – easily static bike 5K, along with so many other things at the gym. From the end of week three, I lived on my own, and walked my puppy every day as well as totally looking after myself. I do not say that were some days that were hard, but ‘the will is stronger than the body’ and although I am not totally there, I am 95% there.
My advice (which is worth what one pays for it, never the less) is:
The longer one puts off hip/knee surgery the longer it will take to get your fitness back and in many cases, due to pain, people tend to be less active, due to pain and then put on weight, which impacts more on mobility. Choose a caring, progressive surgeon, such as Dr James Rohrsheim, follow his directions, and make the conscious decision that you will be fitter, happier and more mobile than you have been for a long time. ‘Feel the fear and do it anyway.’ So on that note, here is my scar today - thanks to my beautiful friend Catherine Heighton, who sent ment Mederma Advanced Scar cream from the US, prior to surgery. Thank you my friend.

Scar week 10