Tuesday, May 13, 2014

NEW HIP: THE FIRST YEAR

The cause of my deteriorated left hip is likely unknown.  I thought it might have stemmed from a slip on wet mud on a hike to Reed Lakes four years before.  I jumped a small creek, the right foot stuck on the ground behind, while the left foot slid forward causing me to do the complete splits.  I heard a pop, and my left hamstring and hip were instantly sore.  It took a year and a half for the hamstring to heal, but soon afterward it became more difficult to exit my car as I put my left foot out and transferred weight onto it.  

Over the next three years, the pain increased gradually. In 2012 I moved from Alaska to Ridgway, Colorado, looking forward to a summer of hiking, climbing, and cycling.  The pain increased quickly; I had been having a difficult time sleeping for a while, but by summer, sleep was only intermittent, and the pain was constant.  Hiking was a huge pain, particularly going downhill.  Rock climbing was my passion, but I had to lift my left leg with my hand to make a move upward.   

When I'm in Salt Lake City I always stay with my brother, Tony, , and Dr. Michael Bourne, is Tony's long-time friend and an orthopedic surgeon at the Salt Lake Orthopedic Clinic.  He had been performing the 'anterior approach' to total hip replacement longer than anyone and had trained others.   By fall, I made an appointment to have it fixed.  Dr. Bourne met with me, X-rayed the hip, recommended a Total Hip Replacement, and scheduled the surgery for November 28, 2012.

Every operation creates a bit of apprehension.  It all went well.  I awoke tired, groggy, and sore, full of anesthesia and pain killers.  The next day the nurse and therapist took me on a short walk to get my muscles up and going.  Not much pain, but I was weak and very nervous, not knowing how much I should do.  Tony and Shelly visited and cheered me up.  My niece Annie's husband Jason Hohl stopped by.  I loved it!  My brain was a fog.  A very understanding male nurse pulled out my catheter; that was an experience of a lifetime!


The healing begins

Tony and Shelly had borrowed an orthopedic chair, like a large adjustable lawn chair where I read and watched TV.  By day 4 my constipation pain was far worse than any pain in the new hip, so I stopped taking the pain medication.  In speaking with other friends, the pain pills are the worst.  Each day I would set a goal to walk, using my arm crutches for balance and to keep me from falling on the hip.  Dr. Bourne's only restriction was that I shouldn't fall.  A stroll round the block was my first goal.  It felt good, and in retrospect, I would walk even farther or at least more times each day to get the muscles and tendons back in shape quickly.  A physical therapist came to the house and helped me into a daily regimen of exercises which I did religiously.  Then a nurse appeared and changed my dressing.

The therapist noticed that I might have a blood clot, so Dr. Bourne ordered a sonogram of the leg which found a small clot in my left calf.  The Coumadin blood thinner he prescribed was the worst part of the entire surgery and recovery.  It was nearly impossible to keep it on a level course, and it continued to spike to a dangerous high; so I had to stop for a couple of days and start again.

After two weeks recovery at Tony and Shelly's place in Salt Lake, I had my check-up with Dr. Bourne   The X-ray showed that the surgery was perfect; my hips were absolutely level, and I was mobile and healing.  Dr. Bourne and Tony Miller, his P.A., asked me to walk across the office without a limp.  It was a proud moment.  Then he released me to drive the 385 miles back to Ridgway.  I stopped every hour, stretched the leg and walked around the truck.  My movements were tentative but not painful, more of a certain stiffness.

Once home, Nori and I took daily walks, mostly on the Uncompaghre river trail, flat, paved, but with ice, so I was extremely careful and held Nori's arm when we encountered the slick spots.  Each day we walked farther, starting at about a mile and working up to five.  Physical therapy started in mid-January, and my therapist LeeAnn was excellent, massaging my sore, tight, and rock-hard IT band.  She gave me stretchy rubber bands that I tied onto the bedpost and worked the muscles in my thighs, hips and back.  Every day I worked a full regimen of stretches and muscle building exercises.

January 27, 2013, two months after surgery I felt ready to go cross-country skiing.  Although I worried a bit about falling, I have good balance and my muscles felt strong.  Going with friends up Ouray CR-31 we climbed up above the old mining village of Ironton, had lunch in the mountains, then skied back down to the car.  Now the sky was the limit for XC skiing, although I held off downhill skiing that winter.  The worry about a fall on a hard ski slope wasn't worth the pleasure of skiing.  Hiking up the hill on my skinny skis felt great, so Nori and I spent a considerable time in the mountains.

Ironton ski tour

February, 5, 2013, Jim Donini invited me to join him and his wife Angela for ice climbing in the Ouray Ice Park.  It seemed early to kick my new hip into the hard ice, but I thought it might be nice to get out climbing.  I was ginger going up the ice, swinging my ice tools solidly, but delicately placing my crampon on the ice and stepping up.  It all worked beautifully, and the top-rope belay made me feel safe.  I was now back climbing!
First day back on the ice, Ouray Ice Park

Two days later my good friend Kitty Calhoun, a world-reknown mountain guide, invited me to go "mixed climbing", meaning climbing rock walls covered with ice with ice tools.  I would belay her, and then she would safely belay me up.  The climbing was difficult, but my hip felt great. The moves consisted of stepping up on just the tips of the crampons poised on tiny edges.  I worried about any fall on the rock, but Kitty had me on a tight rope.  My confidence increased.  As winter wore on, I climbed often with Kitty, mostly hard mixed climbs up Camp Bird road.
On the overhanging rock with Kitty Calhoun

March 31 was my 70th birthday; I wanted to celebrate it with my friends at Indian Creek, Utah, near the Needles district of Canyonlands National Park.  My children Thor & wife Sarah, and Daphne came, friends came from as far as Salt Lake, Portland, and Bozeman.  George Lowe even flew three friends from Denver.  The hip was getting strong, and I was leading long difficult cracks in the Wingate Sandstone.
On the "Second Meat Wall" with Mary Ann Dornfeld

Over the summer and fall I climbed often in Indian Creek.  My friends Jay Smith and Mary Ann Dornfeld and I climbed South Six-Shooter after Jay's back surgery.  The surgeries gave us back our climbing lives.
Leading "South Six-Shooter"
That left hip in action!  Starting up the cracks on South Six-Shooter
A panorama of Jay, Mary Ann, and me on South Six Shooter

By spring I had continued my walks which were now turning into long hikes as the mountain trails opened up.  As the roads dried out, Nori and I started cycling, riding all the county dirt road around Ridgway, up to Ouray, Pleasant Valley, Montrose.  It soon became our passion.  I rode a single-speed mountain bike with no rear suspension and with the new metal hip, I felt the bumps more than previously, although there was no pain.  One day Nori and I went to Grand Junction where she bought a beautiful carbon-framed road bike and surprised me with a full-suspension mountain bike.  Now the bumps in the road were cushioned to a very tolerable degree.

Nori hadn't ridden a road bike before, but on our first trip to Moab on the new road bikes, we ended up on a 44 mile trip up 2,500 feet to Deadhorse Point.  She flew down the 22 mile hill at a top speed of 38 MPH!  By now I didn't even notice that I'd had hip surgery.  The next day we cooled down with a 32 mile round trip down the Potash road along the colorado river.
Nori and I looking out over Dead Horse Point

Mid-summer my brothers and their wives invited us to climb Mount Elbert, the highest mountain in Colorado.  Brother Jim and his wife Teri have a home in Salida, and Tony and Shelly drove from Salt Lake to meet us.  It was the first time in almost 40 years that we had done an adventure together.  I wrote a short account of the hike on my bloodspot.
http://ralphsclimbingblog.blogspot.com/2013/10/rocky-mountain-high-family-story.html

Suffice to say, that the hip was performing marvelously on long hikes with a 4,000' elevation gain and descent.  I had bought a pair of ultra-light Black Diamond hiking poles to lessen the shock on the hip when I hiked downhill, but by mid summer I wasn't feeling any shock or pain on the muscles.
The family atop Mount Elbert

By fall the ice was forming in the San Juan mountains, and I began ice climbing in earnest.  Among the beautiful climbs was "Stairway to Heaven" with Mary Ann Dornfeld and Sandy Heise.  It is roughly a thousand feet high above the town of Silverton, CO.  The wind was blowing hard and a party ahead of us rained ice chunks down, but we had a great day, lowering off just as the sun was setting.
Stairway to Heaven

With Sandy Heise on the climb

Although I held off downhill skiing for the first year, this past winter Nori and I bought ski passes to Telluride.  I hadn't skied at a resort in quite a while and was apprehensive about a fall, doing the splits, or in general injuring the new hip.  Several of my friends who've had hip replacements are avid downhill skiers, and the new hip felt perfect, so off we went.  We skied the whole season without incident or without coddling the new hip.  Steep runs, tight turns, everything was just like before.  After a while I forgot that inside me was a metal post and ball.

The hip was now better than ever; I hardly ever even noticed that I'd had an operation.  In February, 2014, my long-time climbing partner, Jim Donini, and I climbed a fairly difficult rock and ice climb in Ouray called "Birdbrain Boulevard", and since we were both 70, "Rock and Ice" magazine got word of it and wrote this fun article:
http://www.rockandice.com/lates-news/70-year-old-legends-tick-bird-brain-boulevard-iv-wi-5
"Birdbrain Boulevard" is the thin crack on the right side of the photo.
"The Ribbon" is the ice runnel in the center

At the start of the crux pitch, "Birdbrain Boulevard"

This spring the desert called me to Indian Creek and the desert towers and cracks starting in February and March.   In mid April my friend Roger Schimmel and I took a trip to the desert and climbed two sandstone towers, Psycho Tower in SW colorado, and Lighthouse Tower on the Colorado River east of Moab.

Lighthouse Tower
 
Leading the first 5.10 pitch
Following Roger on the second pitch
Roger and I on the summit of Psycho Tower, Gypsum Valley, Colorado

Over Mother's Day weekend, I visited my brother Tony and his family in Moab, Utah.  Among the many things we did was ride our mountain bikes on the "Slickrock Trail", a test piece for mountain bikers.  Although the physical effort was monumental, I worried more about falling off the bike onto my new hip, so I took it easy and ran the bike up the steepest rock steps.  All in all it worked out well.  I'm not sure if single-track mountain biking is in my future, but it was a fine day with Tony.  And, neither of us fell!
On the Slickrock trail

The hip has been amazing, and I've been able to do everything I've wanted to do, and some things I'd not imagined I could do.  The future looks very bright; next week Nori and I are heading for Italy to bicycle through Tuscany for two weeks.

2 comments:

Madalyn Oconnell said...

For others, an injury can be a hindrance from living their life to the fullest. But with your experience, you proved that you can overcome everything if you just work on it. Anyhow, one year is a huge achievement. Which is not surprising, because you’ve been taken good care of by Nori and your surgeon. But still, go for an annual checkup with your orthopedic, to make sure that your hip is healing properly. Take care!

Madalyn Oconnell @ Steadman Hawkins Clinic

Asa Firestone said...

Inspiring! I am 33 and just had the anterior approach done for a total hip replacement. I had avascular necrosis from a former snowboarding injury. Bird Brain and Indian Creek are some major goals of mine (also getting back up El Cap) so you provided some major inspiration for me! Good work and if you are ever in Boulder, stop by the A-Lodge and say hello, I am the owner there and would love to learn more about your experiences personally.

Best,
Asa