Finally during a trip to Budapest this June I found that after walking around for an hour my hip started bothering me and I was limping slightly.

After that things went fairly quickly: X-rays taken on my return showed left hip dysplasia (the head of the femur was not well centred in the hip socket) and related erosion of the cartilage and parts of the femur head.

I had already heard about Dr Koen De Smet at Gent - just 85km from where I live - from an ex-colleague, who told me that he was the best in Belgium. I didn't know about surfacehippy in those days, so I emailed my running friends for tips and recommendations and Dr De Smet's name came up again. I was very impressed by his web site, and in particular by the detailed data published on outcomes, including negative ones such as infections, femur neck fractures, revisions etc. (the percentages are extremely low): I always find such transparency very reassuring. I was also very encouraged by the remarkably active lives people are able to lead after resurfacing - I started to dream about running again. So I reckoned the sooner I got my hip fixed the better.

My local doctor was a bit surprised that I didn't want to go to the nearby regional hospital at Leuven, but I had had mixed reports from outcomes there and had already decided that it was worth going the extra few miles to get a top expert. I got an appointment to see Dr De Smet in late August and took my X-rays along. He told me that I was a good candidate for left hip resurfacing and that my other hip was OK for the moment. He also told me that my back pain was probably caused by my body shifting weight from the bad hip to the good one: he pointed out that the thigh muscles on my right leg are  noticeably thicker than those on the left side. The X-rays also showed torsion in the lumbar spine due to a slight lateral tilt of the pelvis. I was extremely pleased to hear that he expected my back pain to clear up once the hip had been fixed and that it should be OK for me to run again despite some signs of wear on certain of my lumbar discs.

I was scheduled me for an LBHR C+ resurfacing on October 3rd. I didn't look in any detail at the different types of hip protheses: I trusted  Dr De Smet to make the best choice on my behalf.

Because my hip gave me very little discomfort when cycling I was able to keep fit cycling about 75 km a week and swimming occasionally right up till the the last moment.

October 2nd Pre-ops at the AMC, October 3rd Surgery at Jan Palfijn AZ hospital

From midday on the day before surgery I had blood tests, X-rays and ECG checks at De Smet's friendly AMC Clinic and then checked in at the hospital a few kilometers away later in the afternoon.

By this time I had discovered surfacehippy and I was well forewarned about the truly awful food at the hospital. The main item was spongy, tasteless bread and fruit and vegetables were virtually absent. It was only later that I realised that you I could have ordered kiwis, etc. via a form (in Dutch) provided with the meal tray.

However the standard of nursing and hygiene was excellent and that's the essential thing. I shared a room with 2 other patients, which didn't prove to be a problem.

Surgery came up pretty quickly the next day at 10am (nil by mouth from midnight the night before) - I don't remember much about the preliminaries except that my back felt pretty stiff (it's early days to be sure, but the early morning back pain seems to be a thing of the past :-).

When I woke up on Friday afternoon I wasn't in much pain - I only used the morphine pump on two or three occasions and probably could have done without it. On Saturday morning they removed the drip feeds, but I didn't need to take any pain killers. I didn't sleep well for a few nights, but that's not a big deal when you don't have to go to work or look after young kids the next day.

My main post-op problems were temporary plumbing problems: I wasn't able to pee for ca. 36 hours after the op, so they had to use a catheter on 3 occasions to empty my bladder, which was fairly quick but not much fun. Four or five days later I also had serious constipation problems - this is apparently fairly typical post surgery. Kiwis eaten first thing helped somewhat, supplied with a smile by the people at the Villa Cento Passi Rehab centre at Gent.

Getting about on crutches was surprisingly easy the day after the op, but getting in and out of bed was a problem during the first few days even with the help of the plastic bin liner that I saw recommended on surfacehippy (you put it under your bottom and swivel on it). Putting a sock on my operated foot is still a bit tricky, but I made myself a gadget one day to fix that problem. Getting in and out of cars requires a lot of care - it can hurt a bit even when you make sure to swing your legs together - again the bin liner is a useful aid (when you remember it).

Rehab at the Villa Cento Passi

On Sunday two days after the op we were picked up by Hugo and taken over to the Rehab centre in the same building as De Smet's AMC Hip Clinic. I was booked in for a 5-day stay in a double room, accompanied by my wife Monique.

The rehab centre was great in all respects: nice, friendly staff, a cosy warm atmosphere in a nicely decorated building, great food, and excellent nursing care, physiotherapy and hydrotherapy.

After two or three days of physio, hydrotherapy and rest I was pretty mobile and starting taking the occasional short walk outside the Villa.

On my last day, one week after the op, I took a slow walk for about forty minutes around the well-lit streets of Gent with my 2 crutches from 6.30am - I was wide awake & my wife was still sleeping. All in all I was surprised and elated to find how autonomous & comfortable I already was after a week. I hardly needed my crutch, altho in theory I should have been using one all the time (on Friday my physio said I could switch to one crutch since I was making such good progress).

8-days post op: Home & Walking: At first overconfident, later somewhat subdued

Friday afternoon we drove home to Hoeilaart, near Brussels. Early Saturday morning I took a short walk down the road from home and then brought up breakfast in bed for Monique as usual.

In the afternoon I met my running friends and joined a group of associated walkers. I ended up walking, with my walking stick, for about an hour. I had no discomfort while walking and felt fine afterwards.

It seems that it was a mistake to walk for so long, so early after the op: I felt sore the next day and I'm still a bit sore when walking a week later. I have no discomfort with the flexion and abduction exercises, but I get a twinge high up in the centre of my buttock when walking and it remains a bit sore after walking. I suspect I've irritated a muscle somewhere - hopefully it'll settle down in the next few days. I'm now taking things a bit more progressively. In the meantime I'm still making progress with general flexibility and strength: going up and down stairs is now pretty easy and quick. But I'm a bit disappointed with the set back caused by my overconfidence last week.

Despite that it's been fantastic to be so mobile after a couple of weeks and I'm looking forward to the next few weeks with enthusiasm, albeit tempered this time with a salutary dose of prudence.

Ian Hamilton
(61 yrs, LBHR C+ De Smet, 0ct 3rd 2008)

Update February 2, 2009

I'm posting a follow up to the account of the my speedy, more or less painless, recovery in the two months after hip resurfacing in Gent, Belgium (70 miles from where I live).

I got the green light from Dr Koen De Smet to start jogging already from 3 months (Jan 3rd). Since I had stopped running about four years previously, I started cautiously: running a bit and walking a bit on the 45-75 minute runs that my running friends do every Saturday. It feels great to be running and chatting again with friends and I haven't had any appreciable discomfort either during running or the next day except for a little muscular tenderness on occasions. I've been cycling to the venues and back most weeks, which provides a good warm up for the muscles before running.

This is the only running I'm doing for the moment, but it feels pretty good and last weekend I found myself running for longer stretches with fewer breaks.

I'm not attempting at this stage to run hard or go for long distances - I'm just happy to be able to run with friends again  in the great forest trails that we have  around the outskirts of Brussels area. It was close to freezing last Saturday - I cycled the 5 miles from home to the meeting place (in shorts since I had underestimated the cold), ran for 45 minutes, and then, as the sun was going down, was happy  to accept a lift with my bike to the après where we quenched our thirst with Belgian beer and replaced the depleted calories with barbecued sausages.

That's the excellent news. The not so good news is that in December the persistent stiff back problems, which I thought had been miraculously cured with the new hip, started reappearing. That prompted me to start Pilates classes in January, which seem to be doing me a lot of good, both with the back problem and by improving the range of movement (ROM), stability and strength of the operated leg.

One thing that has taken a bit of time is the sensitivity of the ca. 10 inch scar: it took about two or three months before I was comfortable lying in bed on the operated leg for more than a couple of minutes. That minor discomfort is gradually easing, but I still prefer to lie on the other leg (the fact that the incision is long and runs along the thigh bone and I'm pretty skinny doesn't help).

Before the operation I always used to go up the stairs on the run, two steps at a time. About a month ago I tried that without really thinking about it, but it didn't work - I couldn't get the ROM required quickly enough to manage it. But then a couple of weeks ago it just worked, without planning it I just found myself going up the stairs on the run again - nice to get that back.

All the best and thanks for the advice, info and encouragement that is so abundant on this site.

Update February 25, 2009

This is the write up of a run through the woods that I organised for a group of friends last Saturday.
It was the first one I've done since my Oct 3rd De Smet resurfacing and the first one done on foot for four years (before I had to do it on my bike which was a bit limiting).
Nice to get back to laying hash trails in the woods :-)

HASH No 1478

21 Feb 2009: Hoeilaart, Belgium

Hare: Ian, helped by Peter Briggs

If anyone wants to make an advert about a hip job, they should have been here. After sprinkling the flour with Peter in the morning, Ian was a positive gazelle as he shepherded the pack round a testing trail in the afternoon (can gazelles shepherd – ED).

And it was a large pack, which increased in size (good word – Ed) when one veteran hasher did his usual trick and emerged out of the bushes half way round after arriving late). It was great to welcome back Alma and David Hosie, accompanied by their incredibly fleet of foot grand daughter. Looking for superlatives, this was the widest age spread this year, ranging from pre-teenagers to ridiculously sprightly septuagenarians.

The terrain was familiar to many, but the hares managed to wrong foot the front runners most of the time. Three incidents stand out.

The first was the sight of Mic Mac streaming off into the forest when the trail passed Groenendal station after about four checks. He was never seen again (not even at the après). He may wish to offer an alternative write up. Mind you, he had earlier offered to explain the term "obfuscation" to someone.

Secondly, Ian's clever use of the Sentier de Panorama (Hope I have the right name. I was suffering from vertigo at the time) which saw short-sighted front runners missing the turn off and continuing down into the valley on a well trodden Hash path, while  the rest of us were negotiating a lovely wooded track 40 metres higher up for the first time.

Finally, the sight of another veteran (OK, Peter Blackie) who having got lost early on (Is this because there is not enough shouting – Ed. YES, says Scribe), eventually found the pack after some 30 minutes and, on the basis that short-cutting is for wimps, did the parts of the trail he had missed earlier. He arrived just 20 minutes after the rest of us for Monique's delicious food (Many thanks, Monique), as always.

TURNOUT: 32 and welcome to Catherine, Peter and Ron on their first Brussels Hash.

WEATHER: Dry, coolish and grey sky. Sunday, for the record, was wet and drizzly.

Ian Hamilton (61 yrs),  LBHR C+, Koen De Smet, Oct 3rd 2008