Ian Christoph LBHR 12/09/09 Dr. Su

September 29th, 2009

The last few weeks have been a bit of an odyssey, so I thought I should take a moment or two to chronicle my thoughts.  Even though the odyssey has only started, it feels good to get my thoughts down while they remain fresh.

For the last several months I have been limping.  I noticed an ache in my left groin and have felt stiffer than usual.  Trouble lifting my left leg over the top tube on my bike, and tighter playing tennis. Not easy to cross my legs.  Haven’t felt like running for months. Thought it was a pulled groin muscle, and like all pulls, it would get better with time.  It didn’t stop me from climbing 17 miles up the back of Half Dome or playing 5 hours of soccer.  But the aching continued. And the limp worsened.

On September 1st I saw an orthopedic surgeon who diagnosed me with osteoarthritis of the left hip.  Bone on bone. Rats.  So “what does this mean?” I asked.  Well, ok to play doubles tennis for now, bike riding is good. Swimming is better.  Running is out, as is singles tennis, which would accelerate the problem and would hurt too much. But the problem is progressive and the pain will gradually worsen. I won’t want to walk up hills, and in the next 2 - 5 years the pain will get to the point where I cannot tolerate it and I will need a total hip replacement (THR).  But the THR is no panacea. And the activities remain limited. The main problem is that the device only lasts 10-15 years before it needs to be replaced. The harder you use it, and the younger you are the sooner it wears out.  And replacing it is a big deal.  This is a life altering diagnosis.  You start feeling like your world is shrinking.  No running. Less (or no) tennis.  No hiking. Or Frisbee, or coaching soccer. And the aching which I had blown off as a pulled muscle starts to become a more insidious pain that wears on me.  The first thing I want to do when I get home from work is to lie down.

Early October

I could give up the tennis, and the bike riding and even the morning walks up Twin Peaks with Lucy. Forgo trips to London or Australia I had hoped to go on. But I could not escape the pain – I just wanted to pull my leg off my body.

So I sat down and I cried and cried and cried. In pain and frustration.  In fear of what my life was becoming. Giving up so many things I love, until I would have a surgery that brought a different set of limitations.  I hadn't cried from pain for 40 years. The last time I recall crying due to pain is when I fell off a swinging tree vine in the back yard when I was 10 years old and twisted my ankle. I cried when my father died. And when a girlfriend of seven years left me. But I have not had any tears from pain for 40 years. Until now.  My leg was gradually worsening from osteoarthritis. For 9 months slowly, but inexorably worsening. By October the pain was virtually around the clock. Sometimes worse than others. Physical therapy would help for 1-2 days, but the pain was never gone.  Deep, constant, horrible, aching, grinding pain.  Pain that never lets you forget it's presence.   I was in the pain's dark grasp. With nowhere to go.  Little relief from Motrin. And I had told myself that I didn't want to slide down the slippery road of narcotic use. Well, life is tough and that is that. 

Or is it?

So asking around, I went and saw another orthopedic surgeon. And he told me I could have hip resurfacing done.  The first surgeon had mentioned that I “was not a candidate for resurfacing”.  I didn’t even know what he was talking about at the time. But the second orthopedist explained.  With resurfacing, instead of cutting off the head of the femur and placing a metal shaft into the shaft of the bone, as with a THR, you shaving the head of the femur and replace the articular surface with a metal cap.  Same thing with the pelvis. The socket is now metal. A technically much more demanding procedure than a THR.  But with several huge advantages.  First of all, with little bone removed and the geometry little changed the bone stresses are similar. Which means less bone atrophy and distortion compared to a THR.  Less issues with leg length discrepancy.  No dislocation risk. Preserved geometry. And for a young man, lower revision rates.  And if you need a revision in the future, much easier.  Which means there is no need to wait as long as possible - no need to put your life on hold while you wait for your painful hip to deteriorate. Your can return to whatever you want to do - tennis, squash, hiking, running, Iron Man if you are up to it with no pain. 

But wait then.  Why did my 1st orthopedist only mention resurfacing to tell me I was not a candidate? And the second one tells me I am a candidate. What is the reality here? As much as I hate to research my own afflictions, a whole world opened up to me through the Internet.  A couple amazing sites surfacehippyinfo.com and Yahoo chat group surfacehippy were incredibly helpful as resources for the afflicted.

Oct 5

Last night was horrible. I was awoken three times by sharp, profound left groin pain.  Nothing seemed to ease it. Flipping around in bed.  More Aleve.

Oct 7th

Physical therapy is great.  Helps me walk.  But awoke again last night with pain.  Just not as severe this time.

November 19th

Horrible, horrible grinding pain again.  Aching in the morning, but not distracting.  But this evening, just unremitting.  Looking forward to having my surgery on December 8th.  Looking forward to walking without a limp and without pain.  Looking forward to playing tennis.

December 9th, 2009

I had the Resurfacing done yesterday, and for the first time in a long time - the hip pain is gone. Just like that. Gone. Surprisingly little incisional pain. But the horrid pain is gone. I hope forever. And I am lying on the bed at the Hospital for Special Surgery in NYC and smiling. Thank you everyone for all your notes and thoughts. Yours,

Ian

Update February 15, 2010

Here is a picture 2 months post-op.  After climbing up Twin Peaks in San Francisco.