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The Three R’s of Hip Dysplasia Part 2: Resurfacing [Patient's Story]
October 3, 2017
This is the second of a four-part personal account detailing the inspiring story of Nicole Mullins, exercise professional, advocate, and enthusiast, who met her greatest challenge within her own body.
Written by by Nicole Mullins, PhD, ACSM EP-C, NSCA CSCS
Let's do this.
My search to find a skilled surgeon, who not only understood the complexities of my case, but also showed respect for what I know, have experienced, and want to do in the future, was very long and very frustrating. Now, however, I am thankful that it was, because it ultimately led me to South Carolina, for what I believe was the best possible care. I was finally in the hands of Team Gross and Team Providence for my hip resurfacing procedures.
Renowned hip surgeon Dr. Thomas Gross performed resurfacing surgery on my right hip on Monday, and on my left hip on Wednesday. I can honestly say that I had an amazing week at Providence and, aside from some unavoidable post-surgical pain, I actually enjoyed much of it. I love watching people who work hard, care, and help others. This time I got to watch very closely, as a great many people were doing these things for me!
My sister, Michele, and I arrived at Providence Health Northeast bright and early. Check-in was quick and smooth, and I my pre-op session was very fun (yes, I have stopped taking the narcotics!). My nurse, Gloria, had me chuckling the whole time with THE thickest Southern accent that I have ever heard. She prepped me thoroughly, as Dr. Gross’s protocol involves diligent precautions against infection, nausea, blood loss, and other complications. Once I was ready for the OR, my sister kept me company until ‘go time.’ Then, after I was given Versed, I provided the entertainment, imitating Gloria’s Southern drawl.
Dr. Gross said that all went "perfectly" on Monday, which I learned via Michele. Apparently, I did speak with Dr. Gross, though I do not remember.
I was very relieved to hear that Ms. Webb remembered to take some intraoperative photos for me. This was a personal request, as I felt a very strong need to see the internal causes of my pain. The images were validating. Due to the lifelong hip dysplasia, the cartilage wear on my femoral and acetabular surfaces was extensive, and far greater than indicated on X-rays.
Once out of recovery, I was alert the rest of Monday.
Everything about the day went quite well, with the biggest challenge being the pain and tedium of getting in and out of bed with lots of gear. I am grateful for the gear that was controlling swelling and monitoring my vital signs, it just presented some bonus challenges to moving.
The nurse and nurse tech assigned to me after surgery were excellent. Actually, EVERYONE at Providence was excellent. I had wonderfully kind, attentive, respectful care from so many people… Gloria, Elese, Regina, Julie, Virginia, Tamara, Kelly, GeJuana, Cynthia, Jason, Mahesh, Olivia, Donald, the dietary staff… EVERYONE! I am sorry to those I am leaving out. I truly am grateful to everyone.
I felt pretty good the next day, and I was quite active. I was in some pain, but my nurses helped me manage it well. Dr. Gross, came by to check on me in the morning and offered to answer any questions. I asked if I could step outside to see some sunshine. He said, “No,” nicely, but firmly, and reminded me of the importance of minimizing infection risk. This outdoorsy girl couldn’t help but ask.
My occupational therapist (OT), GeJuana, came to my room at 10:30 to teach me my “hip precautions.” For 6 weeks, I would have to avoid: bending my hips past 90 degrees, internally or externally rotating my hips, crossing the midline of my body with either limb, and performing straight leg raises. GeJuana taught me how to get undressed, take a shower, and get re-dressed, without violating my precautions, by using some nifty tools. It was slow and required concentration, but I was grateful to be able to shower and dress with minimal help, thanks to great instruction, cool tools, and wonderful waterproof bandages.
Movement as Medicine
On Tuesday, I got to work both one-on-one with a physical therapist (PT) and to attend group physical therapy.
As an educator and an exercise physiologist, I can say that this is excellent practice. The repetition of information enhances the retention of important material, and the short, frequent bouts of exercise help promote blood flow and control inflammation.
Shortly after getting dressed, I worked under the direction of Cynthia, a very compassionate and skilled PT. I walked some short distances, with a walker, in the hallway outside my room. Since I had no limitations on my walking, other than not going alone, I did as much as I could. Exercise is medicine!
Moving my lower body in any way, of course, did hurt, as one would expect the day after major surgery. Scooting out of bed was one of the most difficult tasks, because it is hard to move without lifting the legs, and it is hard to drag the legs without them tending to rotate.
Upper body strength helped me A LOT, as did my care providers, when needed. I appreciated that they allowed me to move to the extent that I could independently, and then stepped in when I gave the nod.
After PT, I ate lunch and then went to hip class at 1:10, which included five patients who had received new hips from Dr. Gross on Monday (impressive!). I was the only one that week destined for bilateral resurfacing. It is my understanding that “bilaterals” are the small minority, but it was clear that the team had lots of experience working with those destined for double duty.
All five of us with new hardware repeated our hip exercises, learned how enter and exit a car, and practiced going up and down stairs with crutches.
I, however, also received some additional instructions, to help me prepare to handle these tasks with two new hips.
When I got back to the room, Michele arrived and stayed until I went to get standing X-rays and to walk some more. At about 6:00 pm, I Skyped with my parents for a half hour, then ate another good dinner. I think I turned the light out a little after 10:00 pm. Overall, it was a busy and positive day.
The next morning, a very attentive, kind, skilled, night nurse, Regina, helped me wash my left hip with antiseptic skin cleanser and dress in a fresh surgical gown. Michele walked over from the Courtyard and accompanied me to the surgical floor. Pre-op this time was a bit less smooth, due to my apparently very “valvey” veins. My nurses were professional and caring as they diligently worked to secure an IV; the misses seemed to hurt them more than me. Once prepped, as on Monday, Michele kept me company until OR time.
The next thing I knew I was in recovery, but this time, I was in quite a bit of pain upon waking.
My left hip hurt A LOT. The nurses responded quickly to my whimpering with something that successfully took the edge off. I got out of recovery later in the afternoon than I had on Monday, but the surgery had again gone well.
Michele spent some time with me, and then headed back to the hotel when we were both ready for dinner. I generally eat quite healthfully, but I definitely hate to cook, so there is no doubt that I ate more elaborate meals at Providence than I normally eat at home. I took total advantage of having a wide range of healing nutrients on my menu, and ate every morsel of my mashed potatoes, baked chicken, green beans, dinner roll, and banana pudding. Yum!
I didn’t do much else at the end of this second surgery day, but rest and recoup, which is a good thing, because the next day turned out to be the toughest, by far.
Dr. Nicole Mullins is a professor of exercise science, in the Department of Kinesiology & Sport Science (KSS), at Youngstown State University. She earned her Ph.D. and M.A. in exercise physiology from Kent State University, and her B.S. in exercise science from the University of New Hampshire, where she competed in gymnastics. She is certified by the American College of Sports Medicine (ACSM), as a Certified Exercise Physiologist (EP-C), and by the National Strength and Conditioning Association (NSCA), as a Certified Strength and Conditioning Specialist (CSCS). She is a lifetime competitive athlete and physical activity enthusiast, with a mission of educating as many people as possible on the essentiality of regular physical activity and sound nutrition for making the most out of life.