A New, New Hip and an Old Routine - Part 2

A Second New Hip & and Old Routine

After I had a new left hip back in 2017, specifically the Birmingham Hip Resurfacing (BHR) process, I wrote a magazine article entitled ‘A New Hip & and Old Routine’ which followed the process of getting back into what was, and still is, a highly demanding training routine. So, some 5 years later here I am again but this time with a new right hip. Again it’s been a BHR operation and at the time of putting pen to paper or keys to text, it’s10 days after the op. The first operation was carried out by one of the inventors of the BHR Mr Ronan Treacy and along with his co-inventor Mr Derek McMinn they have pretty much between them replaced the hips of nearly everyone who was on the Gt Britain and England Karate Teams through the 60s and 70s.

This time, however, I went under the knife of a Mr Richard Grogan who some years ago carried out some arthroscopy work one of of my knees. Mr Grogan is a specialist hip and knee surgeon with an absolutely first class reputation and the operation was carried out at the Yorkshire Clinic in Bingley, N. Yorkshire and before getting into the gory details I have to say the this facility is one of the best run and ‘on the ball’ medical facilities I’ve ever been in - quite superb levels of care. I said to the surgeon the next day after the op that I was trying to figure out how to break an arm so I could get to stay in longer, essentially to keep getting the food; who’d believe it of a hospital… Dinner on the Monday after surgery ( Brussels pate, Lamb Shank , Cheesecake and coffee) This was following a late lunch after surgery of Salmon and Cream Cheese sandwiches, ice cream and coffee As usual, with these things it’s hurry up and wait, so having got to the hospital at 0700 on the Monday and after a pre-op checks and another X-Ray it was ‘wait out’ to go down to surgery, but eventually, around 1100 down I went.

At this point I’ll just go back to track the deterioration of the hip. The op was on the 22nd July and probably for a good 9 months prior I’d been having increasing problems with my right hip. A post op x-ray that I’d seen back in 2017 when I’d had a consultation with Mr Treacy, it was evident that there was no deterioration of the cartilage in the right hip. It looked good and felt good and, during the intervening years, when my left hip was back to a good level of functionality for both kicking with it and for supporting work with the right, I’d been impacting on pads at head height with speed and power and with no compromise to the dynamic twisting that we apply between the two ‘hemispheres’ of the body, which is the way I kick.

Go back those months, however, and I started to feel some pain, again in the groin as I did with the left hip, but also in the side of the glute. It was always an odd thing when I started to have problems with the left hip that the pain was in my groin, whereas you’d naturally think if it was a hip joint problem that you’d be feeling it on the outside where the hip joint is. Of course, when we take the trouble to look at the human skeleton it’s patently clear where the hip joint actually is, hence the groin pain. This also fooled two sports physios who both came up with separate diagnoses for the pain, both of which were wrong.

So I knew that I was on the deteriorating path with the right and as months went by I took out side kicks against the shields, then roundhouse at head height on the focus mitts an the finally front kicks, so for the past 4 months it’s been hands only and, to be fair up to the past few weeks when the impingement of bone on bone really stared to tell I’d been moving and hitting really dynamically and with no loss of mobility. However, the bone-onbone was striking to see when I had my first consultation with Mr Grogan and saw the XRay, as there was no evidence of any cartilage left. Unfortunately, as I’m inclined to do in these situations I’d really left it too long, as it was inevitable where the hip was going, but with the knowledge of how long the recovery process took the last time I procrastinated. However, here I am and it’s interesting to contrast the last procedure with this latest one.

This time around it was the ‘pre-op’ procedures that stood out initially, as I had to attend the hospital for a range of checks including giving blood, as I understood it to do with the issue of having to have a transfusion. Then, having got through these tests, the next week, and just a few days before the op I had to go and give more blood which, if this had been down to Birmingham would have been a nightmare. The Operation (Monday 22nd August) So, on schedule at 0700, I was at the hospital reception and ten minutes later was getting myself squared away in my room. The op was slated for 1000, but this is a guide more than a given and there was a succession of nurses and people in and out of the room to do blood pressure and blood oxygen level tests, another x-ray and a visit from my surgeon Mr Grogan to say hello and scrawl magic marker signs on my left thigh.

Eventually, I get into the hospital gown, dressing gown and mounted up on the bed to be wheeled down to surgery - where it now all starts. With my left hip I had a general anaesthetic, but this time it was going to be a spinal injection together with something to take me out of it. At this point in time I had two anaesthetists assisted by a nurse and I made it quite clear that I wanted no part to play in the upcoming jollities, so whatever option there was as to the strength of what could knock me out it was going to be the strongest. At this time Mr Grogan came in and I received the spinal, which was so accurate I felt a tingle in the bottom of my right foot. Then lying back all three turned me onto my left side, put an oxygen mask on and having already put a cannula in the back of my right hand injected the knockout.

Over the years I had a few painful moments some very but this had to be a the top of that list; it was literally excruciating in my right forearm for the ten seconds (thank god) I was still compos mentis and then……… I come around in the recovery room, numb from the waist down, but unlike with the general anaesthetic, surprisingly, ‘with it’ really quickly, got a drink of water and after 15 minutes am wheeled back to my room. It’s now wait out until the feelings come back to the leg, and the old toe wiggle is the first sign of life. I’d probably gone under at around 1120 and although I didn’t check the time I’d say it was an hour and a half or so for the procedure. This is now late in the afternoon, the feelings coming back and a succession of nurses are coming in doing regular checks. After my left hip operation I’d had to have a catheter to pee through but this time, and following some advice from the physio who’d been in t see me in the morning when I needed to go I wanted this to be standing up, so with the help of a nurse I got my legs out of bed to stand upright for the first time and at that point it was clear to me that this time I’d be up and about and active far sooner.

With help to lift my operated leg out of bed as I still had no muscular control of it I could get to the bathroom with the sticks. Settling down for the night, more feeling was coming back and I could start muscle twitching and squeezing and pulling and pushing the foot backward ad forwards as per the physio guidance booklet; one big issue post-op is blood clots, the probability exacerbated by inactivity in the lower limbs so movement as often as possible. One of the trials of a hip operation for me is for the first few weeks having to sleep on one’s back, which means it’s hour on then an hour off through the night. Breakfast on Tuesday morning could well have been a full English, but common sense prevailed and it was an omelette. I was determined to try and get out today (Tuesday) which meant passing the usual array of tests, but also having an X-Ray approved by the surgeon and a blood test which is sent off the a Manchester facility, which results have to come back positive.

The other key potential barrier is not getting sign-off from the physiotherapist who wants to make sure you can walk with the two sticks and negotiate stairs in an approved manner using a stick. I had a really good conversation with the Physio when he came to see me and like every other person I’d come into contact with he was first class and it was really enlightening in that I’d always associated post-op pain as potentially causing damage to the new hip process, but he said that with the exception of doing something really stupid, it would be almost impossible to do any damage, which for me then put the pain into perspective and didn’t give it this extra ‘voice,’ that is easy to do. He said that after they had glued the wound the surgeon would have manipulated the leg in all directions and to all extremes to make sure it was in place, so if it stood up to that it would stand my recovery work on it.

The x-ray was good, the Physio was happy and I had a nurse who broke all records to get the results back, chasing them in Manchester until they came through, so by the deadline of 1500 hrs which was the latest Peter Lakin could pick me up that day I was down at reception with my overnight bag and a new hip. Back home that afternoon and it really all starts as it’s all about getting into patterns of operation based on what I can and can’t do and. therefore, what Dawn has to do that I normally would, but although I couldn’t get into the office to help with the Combat Group stuff I had a highly detailed security audit report to write over the next few days that had a tight deadline and I soon realised that trying to keep active and not get stuck too long in one position, such as typing a report and checking notes would soon be in conflict Wednesday; Housebound, working with breaks for the prescribed physio exercises Thursday: A Walk outside Friday: Able to walk without sticks in the house Saturday: Hospital visit for a change of wound dressing Sunday: Up and in the garage/studio for upper body weights and leg physio work but advancing exercises and reps Monday: At home writing a tender document for a security contract and regular movement Tuesday: A visit back to the hospital to have the wound checked and an appointment with a Physiotherapist, resulting in an all good from him and a bit more monitoring of the wound which has been bleeding a bit, which is not a big issue, not helped by the blood thinners I’d been on since the op, to help with avoiding DVT; so now to stop taking these. Wednesday: Still working from home and trying to manage the necessity to have to be working on my Mac Book on the settee and remembering to take breaks to keep moving at regular intervals. One of the challenges since the op has been work, as I’ve had a security audit report to write and submit to a deadline as well as other work issues to keep up with, and anyone finding themselves in the same position needs to make sure that they move and get the leg working regularly. Thursday: Training Day. As many of you know, Thursday is one of my two sessions with my training group and the intention was that I was going to go down to the Dojo, do some bag-work - just striking - some movement around the mat and then into the functional fitness studio next door to do some upper body weights.

At times, my Thursday and Sunday sessions can seem more like the reception area of an A & E hospital and this week was no exception, and Mike Clarke, who’s been training with us for about a year, kindly picked me up on his way down from N.Yorkshire, limping as he got out of the car, as the previous Thursday he’d badly tweeked his knee. It would have been more appropriate for us to book an Uber ambulance to be fair. So, with other absentees due to injury. Steve Williams stepped in to take the session and kept it all to hand work, so alongside everyone else working on pads I was able to do my own thing. Friday: My first visit back to Total Fitness and as Friday is ‘shoulders’ day this was the aim, starting with the ‘arm bike’ and then the gym’s heavy (and I mean f’c’k’n’ heavy) battle rope.

As I’ve re-connected with training it shouldn’t come as any surprise but both the muscles and cardio are down, so everything has to be chopped down, but its vital to get these ‘pegs in the ground’ to know where one is. Even at this stage, though, the hip was allowing a range of motion to be able to cope with the torque that even upper body work puts on it and I added some free squats - not too deep into the mix. Saturday (4th September): I’m back in Total for a cardio session on the treadmill, stationery bike and some light leg extension, hamstring curls and calve work, with Sunday an open option at this moment in time.

Monday coming will be three weeks from the op and by comparison with the left leg I’m a good month ahead of where I was at this juncture. That’s a summary of the first two weeks, so, as I write this on Friday 16th September, just short of four weeks after surgery I’m back into a really good routine and this morning with Alex, one of my training partners, we hit Total Fitness for the shoulder workout, this after yesterday’s Dojo work on the pads which killed me, by the way. I’ll do a follow-up four weeks as by then I’ll have increased the range of all exercises, have more range of movement as well as a wider range of drills on my martial arts days. Peter Consterdine  

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