Saturday, August 23, 2014

Diary of a Mad Hip Replacement

by W. Hock Hochheim

     Many of my friends (and many more strangers) are searching the web and/or inquiring about getting hip replacements. I'll tell you this little quick medical summary so that you might be aware of some future concerns or problems for yourself, your families, and significant buddies/others.

     Some readers don't know me, but after five years of several doctors, chiropractors, therapists, misdiagnoses, and off-target treatments, back in July, 2012, I had my right hip replaced. Unique in this operation was that the old hip ball and spurs had to be chiseled out with a hammer and chisel causing some complications and a guarantee of extra "uncomfortably " (think pain) for awhile. Dr. Peters of Dallas, who was excellent, has been replacing the hips of all kinds of people, including sports stars, for decades now, and he told me in post-op that he has had to chisel out a hip only a few times. I could tell he was a little invigorated by the 15-minute chiseling experience. That was how hard my hip was locked in. Chiseled or not, all should be fine by the end of September.

     The biggest misdirection from off the hip that I and many patients experience is a switch over of attention to the back. Back problems? Insiders know that if you have a back problem (my two lower discs are deteriorating), many doctors start looking at your back as the real problem in your hip and legs. Very common. "Referred pain" from your bad back. After a process of elimination, the truth hopefully bleeds out.

     Probably the most irritating little group I've dealt with is what I will affectionately call here "hippy-alternative" types. These are the over-believers who think they or their guru are bonded into the real healing powers of the galaxy. One guy in Europe in 2010 insisted that he could fix all my problems by working on the high center of my back between my shoulder blades. At that point, I was having surgeries on my upper thigh muscles, which really needed doing. I said no, but in a hallway he snatched me from behind in a bear hug and bent me back in search of the ultimate "pop." It didn't happen.

      "Ve vill verk on this later."

     "THAT will be a ... no!"

     I have a new rule now - if you can't read an x-ray or authorize one to be made, you can't work on me. When the veteran hip doctor tells you that you are in "Bone-on-Bone, Stage 4," and there is no stage 5, a tulip bath, a massage, and a yoga session ain't gonna help you out. But it does seem that everywhere you go, there are these tribes of "non-x-ray-readers" who insist you should avoid a board-certified, med-school grad or doctor and meet them instead down at the old incense studio for a life-changing event.

     Any-who, they chiseled out the old and rammed in the new through a 13-inch-cleaved slit on the outside of my hip. It does feel as though I was hit right there in the hip by a car doing about 25 miles per hour. Took about 90 minutes in the "theater" to finish the replacement. I got to see this busy theater just before my eyes went narcotic night-night.

     Woke up, and the road to rehabilitation began. The docs now worry about blood clots and a host of many common problems like infections and those pesky "unsafe moves" - which threaten to fire the cobalt/titanium orb out of my hip socket like a canon ball.

     People luv 'em some yoga, don't they? But I don't. In the last three years, yoga has almost KILLED me or made me wish I was dead. Let's get a little more mainstream in treatment. A normal hospital physical therapist almost KILLED me with certain leg stretches to the rear. And a chiropractor almost KILLED me by pulverizing the length of my right thigh weekly with some kind of rubber grommet machine that looked like a belt sander. Let me tell you I crawled out of some of those places. None of them knew I needed a new hip, as none were x-ray readers. Nor did I at the time. (The chiropractor did read x-rays but only concerning the spinal cord.) Looking back now, we can see why those types of moves and treatments should not or could not be done to a guy with a Stage 4 hip.

     How did I get this condition? First off, my left hip is just fine. Perfect. "Like a 25-year-old." So the loss of the right one is probably not genetic but rather from abuse, they say. A few guesses? Thousands of power kicks since the 1970s? I always did equal time with the left but probably not while sparring, huh? Another is a propensity to land on my right side when taken down because I had better "landing tricks" with that side. This is a known football player problem as they subliminally try to land to some cushion and some advantage whenever possible. So takedowns since the 1970s are a good guess, also.

     Anyway, feel free to email me if you have any problems or questions about hips. I have made all the mistakes, so maybe I can tell them to you. It has been a long, strange road.

The Summer of my Discontent. Diary of a Mad Hip Replacement Continues....

     Thanks for all the calls, emails, cards etc. Quite a number, so I figured I would make this health post as a centralized update. Plus, it may help some folks considering this operation and about to deal with one coming up.

     I know a lot of older people get this done. But it is a big operation, and it really does suck. It is a major surgery. Resuscitator. Catheter. Our neighbor, a surgeon, says it is a very bloody mess of an operation. Simple. But bloody. Imagine sawing off the leg bone, too. Someone told me the operation is like being hit in the hip by a car doing about 25 mph. Yup. I can see that now. Or rather I can feel that. It's all muscle pain as they cut six inches of muscles and skinned/lifted muscle off the bone. Then they stretch the muscle afar, too, like REALLY far to disconnect the leg from the pelvis and do their sawing.

     I am into the third week of rehab and can walk, albeit a bit painfully, without even a cane. But I like having that cane in my hand right now, because once in a while, I totter. Plus, at the end of the long day, I need the cane more. You just get tired.

     On the subject of the cane and the "fighting cane." As has been said before by many, if you really need a cane? You REALLY NEED a cane. You can't be picking it up and fighting with it. The day before the operation, I did 45 minutes on the treadmill and another 45 of exercises, so I am a unique patient compared to many of these older people who get new hips. I am cruising along with my rehab exercises and even doing a lightweight, hand-weight routine, also.

     The biggest problem for me so far is the mandatory anti-blood-clot/blood thinner meds. They give many people flu symptoms, and I must be very susceptible to them. I take them and get chills, achy all over, etc. Like the flu. Then they wear off, and I have a few decent hours. This medicine is essentially poison given at a lower dose that debilitates your blood. They will be over in one week.

     I've lost nine pounds since July 27. Some of that is muscle, but some is fat, too. I'm down to 227 pounds, and I would love to hit 220 or 222 and stay there. As Buffalo Nickels calls it - "the operation diet."

     I told you that they had to hammer and chisel my hip out, which is an oddity. My hip was so locked in and growing worse. Now I can easily stand straight up again instead of being bent over. Jane said the very afternoon of the operation when they made me get up out of bed for the first time (fearing blood clots, you have to take a few steps), I stood up straighter than she has seen me stand in ten years. That first afternoon.

     Martial artist Bill Wallace has two new knees and two new hips. I remember years ago when martial artist Larry Hartsell had his replacements. Back then, it was like scary, brain surgery. Of course, it wasn't really, but we were all worried for Larry. Now we all seem to know several people with new hips. Seventy-year-old people playing tennis and skiing. I am very optimistic.

     I am under some writing and film work deadlines and have to FORCE myself to sit and work. But I am a bit lethargic and want to stare at the TV - and there is really nothing on television. I know I will quickly forget the discomfort I am having this "summer of my discontent." I would suggest to anyone needing this operation that they have it. It is a big deal in a way, but then it is not really.

     You all pace yourselves with your workouts. Pacing is hard to define in present tense, but in past tense you know exactly where you screwed up.

Diary of a Mad Hip Replacement Continues

     Yesterday, I hit my four-week mark, and the doctor "released" me. Released means no more drugs and home health care needed. Of course, they would continue pain medications for anyone at this point, but I am only on Tylenol right now anyway. The drugs were really bothering me. This also means a bit more of a workout, and I did a bit more by tiptoeing through the gym and doing the sit-down, upper-body machines after our morning walk, or as I have been calling it, my "morning limp."

     But starting today, I have split the walk up in three sections:  1) with cane, 2) no cane, and now 3) SLOW jog. There are light poles on the walk, and I use them as markers to rotate through. It hurts to walk without a cane and slow jog, but Barnhart has hurt me way more than this in training. And in stick fighting, your thighs can take a whooping. Leg pain not new. So my personal goal is to multiply these into more slow-running segments. I will not rush this. The hip bone structure must heal.

     Yup, this picture to the upper right is actually me ... so-called "jogging" today. HA! Small poodles walk faster. Cane in right hand. But that is four weeks and a day after the operation.

     All the pain is still muscle pain. Within the next four to six weeks, the hole they created to insert the replacement will continue closing up. And within nine months to a year, it will reach its peak. Unlike Bill Wallace, it is not my plan to replicate all the abuse that brought me to this point in the first place. There are certain moves like the "reaching-back-high-over-my-shoulder" moves that I cannot do for a year.

     But it is obvious that I have not walked properly in years. Walk? I have not even stood up properly in years. I see now how I have favored that right leg if just standing still. And it is depressing to discover a flight of stairs and say - "ahhh - damn! Can I do that?"

     Get this, on July 26 I weighed 237 pounds. Which is way too much. On August 24, I weighed 222 pounds. If I could somehow maintain that, it would be great. Some muscle gone but some fat, too.

     This is a tough guy group, so have a look at my scar one week after the operation. This way, if you need one of these operations, be you a regular or be you someone searching the net on hip replacement information, looky here. The scar is 5 to 6 inches, but I know people who've had them as long as 15 inches. I think, though, these modern days they are able to limit the scar length. In this photo, the scar has been sealed by that great clear plastic bandage - Tegaderm. This seals it from germs and prevents bad scarring. The gauze under it is a hole that ugly bodily juices drained out of. Small bottles of stinky dark red yuck while I was in the hospital. The hose and bottle were removed my third day. The gauze was placed there and sealed, in case I leaked any more fluids. Tegaderm - don't leave home without it!

     I sometimes wonder how many times since the 1970s I have been thrown down on my right hip by partners? How many times have I blasted round and back kicks into heavy bags? Did crazy exercises? Makes ya wonder....

     At the very bottom of the picture to the left, on the top of the other leg, you can see the top of the support hose/socks one MUST wear 24/7 to prevent blood clots. The doctor also released me from them today, too. But he wants me to wear them while flying for awhile. I have to take an aspirin and wear these socks for the next few flights, but get this - he and all his doctor buddies take one aspirin before every flight as routine anyway. A habit I will start and maintain.

Three years later....

     If I were a normal "walk-around" person, my hip would be just fine. But since I do what I do, as in martial teaching and training, I sometimes hurt the hip area and can feel discomfort in it for days. Three times now I have had to take the five-day steroid packs to calm things down.

But it has been a great thing and an improvement for me. Good luck to you.