With a good amount of trepidation we headed north towards Madison, Wisconsin, on this occasion for my second bout of hip surgery. My decision to go ahead with further surgery was prompted by the rapid decline of my right hip – hiking was resulting in more and more pain and now sleep was becoming uncomfortable!

Almost 2 years ago I underwent arthroscopic work for a torn labrum, with an unexpected microfracture to try and fix the lack of cartilage. All those years of squash, Ironman triathlons, mountaineering, on top of other more stupid things whilst growing up had taken a big toll. This first attempt at repairing an abused hip never felt like it was going to work, with lingering groin pains and limited flexibility all the way through recovery, and on into a period where I should have been almost back to new.

Having an extremely active, adventurous lifestyle is always going to cause complications when recovery is involved, leading me to believe that I, yes me, was probably the biggest factor in why things had gone so belly-up! Within 8 months of surgery I’d raced a 100 kilometer mountain bike race in Utah, shortly followed by the toughest 100 mile mountain bike race in the US, the Butte 100. The straw that broke the camels back was our 110 mile hike around Mt Blanc in September 2015, less than a year after surgery, something which I never recovered from.

I wasn’t about to make the same mistake again!

Not sure how I found Dr Rogerson, one of only a handful of Orthopedic surgeons who perform the Birmingham Hip Resurfacing procedure, but from day one I was confident that this guy and his Orthoteam could get me back climbing the worlds biggest peaks and mountain biking once more. Fortunately there is no desire to ever sign up for Ironman no. 6, eliminating the need to run again! In hindsight I should have at least researched other surgeons, something that as the surgery date got closer scared me – had I made the correct choice, is there someone better out there, will he be like Dr Philippon (first hip surgeon) and operate on me after over 12 hours of other procedures. The most I had done in research was to email the one and only Scott Tinley, one of the original Ironman founders, whom I had read a report on how he had recovered, and since swore by, the exact same procedure under the exact same surgeon. He replied to my email telling me how things were still good some 9 years later and that I was making the right decision – if this was good enough for Scott Tinley then it was good enough me!

A couple of months prior to surgery new X-Rays were sent to Wisconsin to verify that my hip bone was big enough to take the metal on metal ball and socket resurfacing. This came back positive, and as long as my local Dr verified that I was healthy enough for surgery then this was going ahead. My biggest fear was that once my hip area is opened up the surgeon discovers something that prevents him from carrying out the resurfacing, instead having to put in a full hip replacement – although replacing hips has come on leaps and bounds I still think that I would destroy it, giving me no backup plan. This relatively new BHR procedure was pioneered in Birmingham, England, and has a reputation for allowing the patient to lead an active lifestyle with zero limitations, apparently including Ironman triathlons. Only time will tell but I’m extremely optimistic! …and if I do wear it out then there’s always the full replacement option!

Surgery
We arrived in Madison a couple of days prior to surgery, welcomed by a bike friendly university city, complete with the most impressive Capitol building I’d seen. The downtown area was located on an isthmus between Mendota and Monona lakes, the latter being the venue for the Ironman Wisconsin swim – the lake shores were full of people out running, swimming and biking, giving the city a great fit vibe. Our first couple of nights were spent in Madison Hostel, a convenient Hosteling International facility in the heart of downtown, after which I switched to Stoughton Hospital where the surgery was to take place, and Andrea moved into a dorm room at the hostel. The entire next week we were in a HipHab facility, part of an assisted living community, complete with pools, gym, and everything necessary to begin the process of getting me mobile again.

Finally getting to meet Dr Rogerson, one of the BHR gurus the day before surgery gave Andrea and I the necessary warm and fuzzies for success. The guy and his staff made us feel like everything was going to be a breeze! Further X-Rays showed how messed up my hip really was, partially due to wear and tear, with significant blame going to my parents for providing bad genes – thanks mum and dad for ensuring that I’ll be returning at some point to have the left side repaired too. Hopefully you both at least provided me with good bone density so as these manmade implants take hold!

This was my third time under a surgeons knife in the past 4 years so apprehension was not really a big deal, at least not for the surgery itself. Pain from having an eight inch incision and hip dislocation did however cause me some concern, especially with my reluctance to pop narco pain pills like candy. I like my highs to come from hauling ass down a mountain bike trail or standing on a countries highest point. Those highs would have to wait for the lows I was about to go through – various nurses, anesthetists, and assistants were now relentlessly asking me to verify which was my surgery hip, then taking blood, attaching me to an intravenous drip, cleaning the area, and consenting to this, that and the other! With the formalities done they must have wheeled the bed all of ten feet towards the operating room before I was out cold, unaware if it was sleep or something more sinister they had secretly hooked up to the IV. On each of the other surgeries I’d been through I was in the operating room getting into position before the sleep drugs were added to the mix sending me into la-la land, whereas this time I recall nothing other than Dr Rogerson hovering over me post surgery muttering something about a successful mission!

Most of Thursday afternoon was a haze, spent dozing and trying to make out what was going on around me. Andrea gave me the good news that everything had gone to plan even though my hip was more of a mess than was initially thought. My femur and pelvis were still intact, alleviating fears that I would be coming out of surgery with a full hip replacement. I now have that option for a later date!

From what I understood the first 24-48 hours after surgery would be the miserable ones, usually followed by a rapid improvement. Successful rehab involved movement, movement tended to equal misery, and misery would be exasperated if I didn’t get moving – a vicious circle that would allow me very little sleep at night, nausea, and even a good barf after sitting on the beds edge for too long. I was already longing to get the hell out of hospital, bought on by being prodded with needles, four hourly vital stats being taken, and visits from pharmacists, occupational therapists, and other trying to provide me over the top attention and care! Why do I need my blood pressure taken at 3am when I’ve probably spent the past 4 hours battling discomfort and only just nodded off? Why do you insist that I know how to use the crap grabbing device or the sock putter-on-er during your 7am visit? Come back later when I’ve slept! The only people I cared to see during my two nights in hospital were my wife and the food delivery people.

It wasn’t long before I’d completed the necessary 200’ crutch walk and emptied my bladder, both necessities in being allowed out of hospital. I was still feeling a little nauseas, and admittedly I had to pop a couple of narco pain killers, but when Andrea came to drag me screaming from Hospital I was happy as a pig in shit! Even the thought of maneuvering myself into our SUV and the 20 mile drive into Madison couldn’t dampen my excitement.

Recovery
Andrea did an awesome job moving me and all our stuff, two fat bikes included, into the small one bedroom apartment. We had already been through a guided tour of our room and the facility but my first observation was still ‘how the heck are we both going to sleep in that tiny full size bed?’ Andrea was going to suffer for sure! I did move from the bedroom to the futon after the first night due to the space I needed to get comfortable, allowing both of us to at least get a few hours sleep. Discomfort aside, it still felt great to be self sufficient again, even though this meant Andrea would now be my carer for at least the next couple of days – I was down to a single crutch within 3 days so it became far easier to carry hot drinks, ice packs, and help out with cooking.

The HipHab recovery protocol only expected me to stay in town from Saturday until Tuesday, at which time I could just continue with the recommended stretches from home. My question then would be… what if we don’t have a home? We find that there aren’t many occasions when having our own home beats not having a home, this being one of them! If we haven’t got anywhere else to go then why don’t we stay put, which is exactly what we did. I also felt very much more at ease having skilled physiotherapists on hand that had treated hundreds of patients just like me. Twice a day I would see a physio to go through walking exercises, pool sessions, and stretching routines, all of which dramatically improved my flexibility and strength – I only wish that protocol allowed me to stay longer in the 95°F therapy pool. It really was remarkable how quickly the pain subsided, how much further my stretches could be pushed, and how much faster I could walk to the cities bars and coffee shops.

By the time we were due to depart a week after arriving in the rehab facility I was feeling substantially better, my oversize ass cheek had begun to shrink in size, and I had real confidence that I’d be walking crutch free a week or so later with no swelling and no reason to be waking every time I rolled over in bed. At this point I’d have my life back. In the meantime we had a thirteen hour drive to make it through and I still have some critical post-op timeframes to adhere to:

• 3 weeks – ditch the stocking, finish Xarelto blood thinners (start Aspirin for 4 weeks), ride a stationary bike, drive
• 4 weeks – finish Iron tablets, fly
• 3-5 weeks – hit the pool after dressing has completely come off
• 5 weeks – follow up appointment with new X-Rays
• 6 weeks – ability to bend past 90° at the hip, rotate the leg inwards, cross legs, ride a regular bike with flat pedals
• 8 weeks – ride a regular bike with clip-in pedals
• 3 months – begin more advanced stretches
• 6 months – NO LIMITATIONS

My biggest regret in having this surgery is that I didn’t dive straight in with this two years ago – more research and seeing other experts may have shown that my hip needed a far bigger repair than a torn labrum. The past 2 years has never been pain free, always leaving me with lingering doubts that something bigger was going on. Then there would be moments such as Andrea and I standing on top of Mt Washington and I’d wonder if this surgery was even necessary – the return hike would always tell me that it was!

Dr Rogerson, his Orthoteam and the team from the HipHab facility in Wisconsin provided me with the best possible service and support, ensuring that I never regretted this decision, however miserable the first 24 hours were. I’m almost looking forward to having the left side done there in the future!

August 17th – August 27th 2016