Tuesday, June 11, 2013

This is Hip

I'm now about six weeks into recovery from hip replacement surgery on April 25. Here's the new hardware:
The device is made up of some exotic metals and other materials. Its press-fit in place, no screws or glue. The surfaces of the metal that are in contact with bone have a texture to them that closely resembles the texture of bone. Over time, the bone will grow into the metal helping to secure it in place. The ball is ceramic and it sits in a chrome-cobalt alloy socket that is lined with a super-durable polymer. Ceramic is smoother than metal so it causes less wear on the polymer lining resulting in a hip that will last me a long, long time (fingers crossed). The stem that goes into the femur is surrounded by a polyethyl etheyl ketone liner that allows the implant to be just a bit flexible and behave more like bone. At least that's what Dr Hip tells me. There are lots of different ways to do a hip replacement these days and this combination of materials seems to be the best choice for a (relatively) young hip patient, like myself. Dr Hip used the more traditional lateral-anterior approach meaning I have a vertical 8-inch scar on the side of my right hip. There are alternate "minimally invasive" approaches that result in smaller incisions and quicker recovery, but they have their own issues. The surgery took about 3 hours, a little longer than normal because, as Dr Hip told Carol afterward, I am built like a tank.

Amazingly, I was in the hospital for a total of 30 hours. We arrived at 6:30 am on Thursday and by 1:00 pm on Friday I was home in my own bed. The afternoon of the surgery, my surgeon and a physical therapist came to see how I was doing.

Doctor: "Do you think you can get out of bed?"
Me: "Um, well, yeah, I think so."
Doctor: "OK, do it."

Within hours after the surgery I was on my feet and shuffling a few steps across the room with a walker. On Friday morning a physical therapist took me for a longer walk around the floor and showed me how to safely go up and down stairs until I was healed. The surgeon came back around noon and said everything looked good, I had passed the physical ability tests indicating I could get around safely with some help (Carol took a couple weeks off of work to help take care of me). As long as the post-surgical pain was manageable with pills rather than stronger IV meds (which it was), I was free to go.

YES!! I've spent more than my share of time in hospitals in recent years, so the quicker I'm out of there, the better. The arthritis pain was now gone since those parts were replaced. There was plenty of post-surgical pain due to well, just look at the X-ray! I was on a steady diet of Norco for the first couple of weeks and have slowly tapered it down to just an occasional dose when I over-do it.

The first couple of weeks I had in-home physical therapy and in-home nursing care twice a week. I was on blood thinning medication after the surgery to minimize the risk of blood clots and blood samples I am doing physical therapy twice a week and exercises every day to heal and strengthen the muscles that were cut during surgery and have been neglected due to the arthritis pain that made it difficult to walk, stand, sit, etc. I managed to tweak my knee doing my hip exercises, so that set me back a bit. I can now walk short distances without a cane. The hardest thing is sitting for extended periods, so long car rides are out for the time being. My exercises are intended to both strengthen the muscles, but restore range of motion that became so limited due to the arthritis.

I have a second follow-up with Dr Hip tomorrow and I'll have a better idea of what's coming next. Probably more physical therapy. If things continue to go well, I expect to be back at work by the last week in June or first week of July.

A couple days ago we got copies of the billing from the insurance company (Blue Cross). The price for the implant and supplies was $90,000(!!), of which Blue Cross paid $15,000. Two days in a semi-private room was billed at $80,000(!!), of which they paid $8,000. The surgery itself was about $3,800 (which seems cheap by comparison), of which they paid $3,000 and anesthesia was $2,250, of which they paid $1,250.  So, all tolled, the bill was about $180,000 of which Blue Cross paid about $28,000. I don't really understand how they come up with these crazy numbers, I'm just glad we have good coverage.

Thanks to Carol once again for taking care of me through some rough days. And thanks to the capable hands of Dr Hip for putting me back together again.

I continue to be a lucky man!

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