Hip Hip

Hip hip

Hip hip

Hip hip

Hip hip

When you're on a holiday

You can't find the words to say

All the things that come to you

And I wanna feel it too

Island in the Sun - Weezer

Five years ago I learned that my right hip had some issues. All I had was a mild muscle strain that I wasn't giving time to heal. But I because I had a previous stress fracture the doctor wanted an xray to rule out the possibility of another stress fracture.

From a March 2014 MRI:

Severe right side degenerative change within the hip joint with near bone on bone contact. There is also a paralabral cyst with probable labral tear

December 2014 MRI:

Anterior and superior advanced labral tearing and degeneration
Advanced right hip osteoarthritis

But even with those scary-sounding radiology reports, my hip was totally asymptomatic. I ran roads, trails, marathons, ultramarathons and took part in plenty of November Project zaniness

But midway through this January 2018 run with the Hyannis Marathon on the horizon, things went wonky. I took a few weeks off and tried some light jogging in March but it still wasn't good. I did a couple months of physical therapy (range of motion, core stability, gentle strengthening, balance...), Harvard Stadium stairs, and walking up and down the Summit Ave hill. Slowly but surely my hip felt better and better. Not like great for running fast, but good for long, steady efforts. Key training, which was as much to build my confidence as it was to build fitness, included:

• April 15: the TARC Don't Run Boston 50k - I walked a lot, jogged a bit, got lost on the Blue Hill trails more than once, and fortunately finished before dark. If the goal was "time on my feet", then 11 hours 38 minutes of wandering around was a great thing.
• April 22: Harvard Stadium x4 in a bit less than 3 hours

  

With that "exercise" under my belt I felt ready to give it a go at the Massanutten 100 on May 19. It was a rainy and muddy mess that wrecked the skin on my feet. It was also an amazing experience and great comeback from where I had been a few months earlier. I enjoyed it so much that I signed up to go back to Virginia to do another 100 miles at Grindstone in October. Four months of big volume summertime Stadium training with weekly walk/jog sessions at Summit Ave or Larz Anderson park had me ready for Grindstone and that went really well too.

Up and down the very small hill at Larz Anderson

I took a couple weeks off to relax after Grindstone and let the big blisters on my heels heal. I didn't feel injured during or after Grindstone, but in November and December my hip was hurting more and more. Did I need more physical therapy and strengthening on the stairs? Or was it finally time for surgery?

Ultrarunner-extraordinaire Andy Jones-Wilkins has written extensively on iRunFar about having both of his hips resurfaced by Dr. Thomas Gross in South Carolina. When I met Andy at Grindstone he had only positivity and enthusiasm for the surgery.

In a traditional total hip replacement, the head of the thighbone and the damaged socket are both removed and replaced with metal, plastic, or ceramic components.

In hip resurfacing, the femoral head is not removed, but is instead trimmed and capped with a smooth metal covering. The damaged bone and cartilage within the socket is removed and replaced with a metal shell, just as in a traditional total hip replacement.

Considering my age (relatively young for a hip replacement), size (not small), and desire to have a few more decades of active life, a resurfacing seemed the way to go.

But hip resurfacing is a relatively rare procedure, and to the best of my knowledge there are no surgeons in Boston who do it and only a handful in the country who do the surgery frequently. So I got a fresh set of xrays and sent them to Dr. Gross, not sure if I even wanted him to agree that I was a candidate for surgery. But he did, I decided to take the plunge, and the surgery was scheduled for March (and subsequently moved up to February when he had a cancellation). For a while it was not clear if my new health insurance company would pay for the $25,000 procedure, but they agreed to and it was all systems go.

On Sunday, February 24 my dad and I flew to Charlotte, NC and drove to Columbia, SC. I had made a same-day round trip visit to Columbia for a pre-op visit with Dr. Gross a few weeks earlier. After 4 hours of driving and 5 hours in a plane in one day my hip was really unhappy. I remembered to not eat or drink anything after midnight, didn't oversleep, and arrived at the surgery center at 6am as ready as I could be.

The surgery lasted a couple hours and the anesthesia (a combination of IV sedative and spinal block) was great - I didn't feel anything, didn't remember anything, and didn't need a breathing tube.

My new hip

There are a bunch of activity restrictions that I have for the next 6 months to allow my bone to grow into the implant (which is placed without cement) and reduce the risk of a femur fracture. Right now, the prohibition on bending at the waist more than 90 degrees is the big one. As Dr. Gross says "We have seen patient break their wound open, severely strain their weakened muscles or even get a stress fracture with too much activity too early."

The first couple days I was on Oxycontin and Oxycodone. They didn't seem to be doing much to help so I dropped them on post-op day 2. I tried lots of ice but so long as I was just lying in bed it didn't hurt much, ice or no ice.. My quadricep is sore and tight from whatever position they twisted my leg during the procedure. Today is post-op day 4 and my quad is much better. The stitches and wound are still sore - once I get positioned properly in a chair or couch it is fine, and walking (with a crutch for stability) is fine too.

On Wednesday my dad and I flew back to Boston. I had a stomachache that morning and worried about vomiting in the car or having some other accident in the plane. I came very close to throwing up during the drive back to the hotel on Monday afternoon just after the surgery, and didn't want to deal with anything like that again. Please just let me get home unsoiled and intact.

Back home, by wife Melissa has been taking care of the kids, cleaning, cooking, and all that. I've been focusing on lying around, doing very minimal exercises like heel slides, and some light computer programming.

One great thing is that even with the motion restrictions and sore muscles, it has been obvious all week how much better the hip joint feels. The pinching, aching, tingling, and all the other consistent and variable pains that were a constant in my life all seem gone. Of course I haven't been able to really test it through its full range of motion, but within the limits of what I am allowed to do the improvement is wonderful. Keeping fingers crossed!