Hip Traveling (and Status at 21 Weeks)

I think I mentioned previously that I was due for some travel in early December. Here's a report.

Yes, Virginia, your artificial hip will trigger metal detectors. My itinerary was simple (Allentown to San Francisco via Chicago), so I only had to clear security once while leaving and returning (this is not the place for TSA stories and ranting about how we are surrendering our rights and succumbing to our collective fears, though that is a tempting topic...). Overall my experience with security was ok, but I'd guess that any one person could end up being treated far better or far worse than I was.

I traveled without any card from my doctor or copies of X-rays. There's no way you could expect security personnel to accept those cards and not do a search. I left plenty of time, and in each case the search took maybe 5-10 extra minutes (but see below). My single Birmingham prosthesis set off the normal walk-through detector. At Allentown I was directed to a screening area, where I was offered a private screening, which I declined. I had to wait for maybe five minutes while they finished working with and then helping an elderly lady put herself back together. The search was no big deal to me but the screener does get fairly familiar so if this bothers you a lot, request the private screening. At San Francisco, a brusque agent shunted me to a weird little roped-off spot that looked like a penalty box where I waited for almost ten minutes; they were very busy and the agent made a pathetically feeble attempt to get the attention of a male screener. I'm glad I wasn't on a tight connection.

A few lessons and things you might consider. (1) Yes, leave time if you can, but realize that if you have tight connections that involve leaving security and changing terminals (say, an international arrival followed by a domestic connection), you could be hosed by the extra time required. (2) TSA says they will respect your privacy, but lots of luck if you think that you can somehow explain that to a busy and impatient agent, and somehow have the whole process be discreet: you are going to set off the detector, the agent's first response will be to ask you to step back through, and they will not be expecting you to disobey and instead try explaining something to them. So just deal with this all happening in a public setting. If it really matters to you, don't travel with someone if you're trying to hide your hip from them! (3) One thing I realized that might be a big hassle one day are circumstances where you have to move through security multiple times (cancelled flights, etc.). If nothing else, popping out of the secured gate area will be that much bigger of a hassle. (4) On a related note, be prepared to set off metal detectors at all other places that employ them, not just airports. (5) In the case of international travel, especially to developing countries, I would definitely bring some sort of doctor's card plus a small image of a hip x-ray. When I think of traversing security on domestic flights I've taken in China, some visual evidence of your implant could really help if there is a language barrier. (6) Given my experience with just two screenings, one thing to keep in mind at a busy screening area is that if you are traveling alone, try to keep an eye on your belongings as they travel through the x-ray. You'll be unable to pick them up until you're done with your manual screening, so valuables, laptops, etc., plus your shoes, will be elsewhere for a while.

It's now some 21 weeks since surgery, and all is still well. The new hip feels good, with a few clunks now and then, and my unrepaired hip continues to lobby for its turn. I had a slightly odd experience when I laid down to retrieve something that had rolled under my bed, and while on my stomach, I somehow felt like I pulled something near the repaired joint. It kind of freaked me out (I wasn't twisting or anything odd) and it ended up feeling like a set back in terms of stiffness. But nothing dramatic happened and after two weeks I'm back to feeling fine.

For any reader who has cycling interests, here's some performance-related information. Understandably, this was my lowest-mileage year in a decade: I managed 2712 combined miles between the road and the trainer, with many more miles being on the trainer than normal. Still, given that I had the hip replaced in August, and that starting in late May I was pretty much crippled, 2700 miles feels pretty good. Of those 2712 miles, I managed 942 miles in the ~5 months after surgery, 211 of them on the road, after recovery but before cold weather. In the two months before surgery I managed only 282 miles that were pretty lame; in the five months of the year before that, I was able to do 1488 miles before my trip to Hong Kong and the rapid decline in my hip. My first (tiny) trainer ride took place 16 days after the operation, and my first road ride (of 15 miles) took place 51 days after the operation. I could have ridden outside sooner than that, but I didn't want to take the risk of falling onto the repaired joint, or encountering some environmental or traffic condition out of my control that would demand excessive torque or twisting. It was hard not to ride, but a femoral neck fracture is not worth it!

I have a follow-up visit with my surgeon next August 19th. I've already posted tons of too-much information, and I think it's time for some radio silence. I'll report any major changes or incidents. And, as is seeming likely, given the decline in my other hip, if I opt for surgery in June or July I'll report on the run-up to that.

I hope all the details and reports I've posted have proven helpful to others facing the decisions associated with hip surgery. So far I am really glad I went ahead with the procedure. I really can't remember what the pain on my left side was like (it is just gone), though what I'm feeling in my other hip does help me remember how much of a difference the surgery made. Good luck to you if you're in a similar boat!

14 Weeks: Report

No news is good news: things are still going well. What triggered this posting was my ~3 month followup with my surgeon. I'm walking basically normally (my doctor sees a slight limp but that might be just the way I walk, or my other hip acting up). I stopped therapy in early October as I found I needed the time to get fully back to work, plus I felt that I could do the exercises at home just as well (I spent about $80 to buy some of the key PT bits like ankle weights, "standing foam", and such). The weather has turned cold after a long and strange warm spell, so I'm off the road bike and on the trainer, back up to 17 to 18 mph an hour, getting close to where I used to be.

I feel the occasional twinge or tightness around the new joint, and I still get some soreness around my quadriceps, but that is fading. At times the joint will shudder a little, probably something to do with lubrication. And if I put the joint in tension, say by stretching out my leg, and then dragging back my heel, there's just a wee creepy feeling, almost like a suction (which it probably is, if you think about it). The doctor feels that is normal, and may diminish. Finally, I still feel a little weakness or lack of fine control if I relax my bent leg: it feels a little floppy. So, I'll keep up some of the PT exercises.

I'm sure anyone that has read this far is desperately wondering: what about the u-trou test? Passed! I can comfortably drag on boxers or socks while standing, with no risk or feeling I might go down in a heap. Such a milestone.

At this point, the one lingering outcome of all this year's hip fuss is that the 15 or so weeks of little or no exercise before and after the operation did bring up my weight by about 8 pounds from where I'd usually be at this season. With cold dark weather coming and just the trainer to ride, I'm a-feared that Thanksgiving could be scary unless I seriously start to put a sock in it. Of course, this could be due to middle-aged metabolism, not middle-aged hip.

My next scheduled doctor's appointment is next August (!). I've been cleared to do anything, with no restrictions. I'll probably not post much more to this blog, unless something particularly good or bad happens. Fact is, my right hip is clicking, twinging, and moaning, and my doctor says it really does look bad. So who knows, before August, I could be posting Middle-Aged Hip Returns: The Sequel of Symmetry.

Oh... the only other thing that's looming is my first air travel since surgery. Security will be fun. Maybe I'll post about that experience...

Eight Weeks

It's eight weeks to the day since my surgery. That seems like a good reporting point that might interest people.

This past weekend I put in two rides of 17 miles each, and managed the second one in about 15 mph. That's getting better, and now it's just a matter of restoring fitness, losing some pounds, and just plain riding the bike. I experienced no soreness in or around the repaired hip. I did feel more twinges in the other hip than I would have wished for: it looks like some planned obsolescence is striking, and the odds seem good that I'll be treating the other hip sometime before too long.

I'm still slightly tentative with my left leg (avoiding even little hops, and guarding it from large twists) but that may be in my mind as much as a physical limitation. I am walking as normally as I ever have, and any limping is due to my untreated right hip. The muscle trauma in my quadriceps continues to fade but is still detectable, just a bit. Mostly I can pass my Underwear Test: standing on each leg and pulling on pants is now fairly easy, although I have to concentrate some when balancing on my left leg. For clothing as grabby and stretchy as cycling shorts, I'm still being a little careful.

All in all, I'm feeling remarkably well and recovered, not just from the surgery, but from the hip trouble itself. I'm still skeptical about some of those reports about walking easily and unaided only two weeks post-op, but at eight weeks, I'm feeling energetic, strong, and confident.

Eight weeks is also a good time to throttle down this blog. I'll continue to report monthly, or if something special comes up. But for now, I'm going to focus on NOT thinking about the middle-aged hip!

Day 51: Back on the Bike

It's been unseasonably warm and pleasant here in eastern PA and I've been watching the weather with a growing itch to get on the bike. I figured I'd wait until I was fully eight weeks past surgery, which would occur after this coming weekend. But today, I just couldn't take it anymore: I couldn't get a slot for physical therapy, so I headed home to exercise and ride the trainer in the basement, and then I just decided to go for it and take a road ride.

First of course, I had to find all my riding stuff (gloves? what gloves?), replace a battery in the cyclocomputer, etc etc -- I'm always clumsy and inefficient at the start of the riding year, and this is what this ride was like. Plus, as I mentioned in another post, I've been less attentive to natural things like the weather and sunset, so I got off to kind of a late evening start...

I managed a very comfortable 15 miles in 65 minutes. I know that's  s  l  o  w,  but I didn't want to push things, and it's been 14 weeks of little exercise since that last crappy, sore-hip, rain-drenched ride that marked the end of my riding. Plus, I'm 8-10 pounds over normal summer weight and frankly I'm out of aerobic shape.

But at last! Back on the bike! It felt great: no pain (on my left side), no problems with balance or stiffness. I still have a little bit of a knot in my left quadriceps, but wow, it's just feels amazing to feel so much better, so soon.

The Hip Gets the All-Clear

Yesterday on the 11th of September, five weeks and a day after surgery, my surgeon give my hip the all-clear: I can jog, hop, and ride without restrictions. That's great news, although I think I'll hold off on the hopping. My doctor did prescribe more therapy, as I'm still a little stiff and especially if I've been sitting for a while, I walk with a rocking gait at first (technical name: trendelenburg gait). He thinks this is due to some residual weakness in the hip region, possibly because my abductors were weak even before surgery tweaked the region.

I'll be taking aspirin only through the coming weekend, then I'm done with that.

With the no-restrictions news in mind, I pushed a little harder on the trainer yesterday: I comfortably did 10 miles at 16 mph, pushing a harder gear. Not exactly fast, but progress.

Before and After

I'm trundling along, using a cane for longer distances and otherwise nuttin'. I still feel some tweaks high around the hip that keep me from walking normally at times, especially after sitting still for a while (I feel best right after the stretching in therapy, despite the exercise). I'm not quite ready to stand on my left leg and risk the mortification of tumbling to the floor in a tangled pile of legs and half-engaged u-trou.

BUT... the purpose of this post is to show you the before and after X-rays. That's what you've been looking for, right? One image was taken a month before surgery, and the other 10 days after.

Day 28 - Four Weeks In

I was feeling like I was perched on a plateau, but I have been gaining some flexibility and strength. On Friday (two days ago), the elevator at work was gummed up somewhere, so I hiked up to my 4th floor office using the stairs, walking fairly normally. Yesterday we did a half-mile walk around the neighborhood, and I managed it without crutches, walking in style (in my opinion) and "a lot better" (in my wife's opinion). Anyway, for sure I wasn't waddling. I also got in 25 minutes on the trainer and today made it 30 minutes at over 15 mph. Aside from lacking some strength overall and definitely in my left leg and hip area, the main thing I notice now is some ligering tightness, and stiffening up if I sit still for a long time.

It's only been a month since surgery, so I'm feeling pretty good and optimistic at this point. Given statistics about femoral-neck fractures tending to happen in the first two months, I'm glad I'm halfway to that vague milestone. I also feel like I need to reign myself in and not overdo it until I'm further along.