Recovering from total immobility inspired me to prioritize my health and embrace life after a hip replacement
It happened gradually, but on this day, I could no longer ignore my declining health. I had planned to take a walk to the park at the end of my street, but had to turn around only a few feet from my house. I hobbled through the door, tears of pain and frustration filling my eyes. I was no longer an active midlife woman who ran, hiked, biked, and skied. I wasn’t even 50 and couldn’t walk around the block. Fortunately, my recovery story has a happy ending.
Read on to learn about my diagnosis, the decision to have an anterior hip replacement, and my recovery after hip surgery. You can also skip ahead to my week-by-week recovery after surgery.
Journey to a Diagnosis
Before my eventual diagnosis of hip dysplasia, I thought the problem was my back. Back pain and stiffness came and went but had always been manageable.
But my mobility had gotten progressively worse over the previous year. Friends had come to visit that winter for a ski holiday. I’ve skied my whole life, but on that trip, I was very nervous, worrying that I could hurt myself if I fell. After that trip, skiing was out. I had also stopped running and given up workouts at the gym. When spring arrived, I tried hiking but even that was difficult on the uneven terrain of the Colorado foothills.
Now I couldn’t walk around the block.
I had tried everything I knew to figure out what was wrong: consultations with my primary care physician, a spine doctor and a chiropractor. And I had done a lot of therapy: physical therapy, active stretching therapy, massage therapy and dry needling (dry needling isn’t bad as it sounds and was actually helpful in managing the pain).
To add to the challenge, I was no longer sleeping well because I could not lie on my left side. I assumed this was due to my back spasms. As crazy as it seems now, it never occurred to me I had a hip problem. And I can’t entirely blame the doctors and therapists, because I just kept complaining about my back. Apparently I am very convincing — my back was a red herring.
I’ve always loved golden retrievers: they have such a lovely temperament – it is a shame however about the hip dysplasia they are prone to developing. It turns out I have more in common with golden retrievers than blonde hair and a love of snacks.
After my failed walk in the park, I returned to see my doctor again. She did a physical exam and looked at the x-ray she had ordered. It turned out I had bone on bone arthritis in my left hip, and the cause appeared to be hip dysplasia.
The inside of the hip socket is lined with smooth cartilage so that the ball of the joint moves easily. With hip dysplasia, the socket is not adequately curved so the ball at the top of the femur bone can’t move as easily. This causes the cartilage to wear away, and eventually the surfaces of the ball and socket grind against each other. You can imagine why that might hurt.
She referred me to an orthopedic surgeon to confirm the diagnosis and learn about my options. Surgeon? Surgery? I really believe in food as medicine so hoped that with physical therapy and enough leafy greens, my cartilage might decide to return.
Was a Hip Replacement My Only Option?
I met with a surgeon who confirmed that I had hip dysplasia, I was likely born with it. It’s most common in girls and first-born children. I am both. Apparently they weren’t screening for it in Toronto in 1967. Today it is a part of routine screening in newborns, and can be corrected treatment.
It made me feel better to know it wasn’t really my fault; it wasn’t because I hadn’t stretched after skiing or kept up with yoga. Being born with hip dysplasia, degeneration of the hip joint was pretty much inevitable, he said. Soon after, I learned that my cousin, also a first-born girl, had it as well and was undergoing surgery.
Physical therapy would be important, the doctor said, but hip replacement surgery was the only way to solve the problem. But sure, I should keep eating leafy greens.
Important questions, including about my scar after surgery
The doctor said it was up to me when I wanted surgery. Basically the right time was when I couldn’t live with it anymore. That was six months ago, I thought to myself. But there was another thing on my mind, the scar after a hip replacement surgery. How big would it be? Would I still want to wear a bathing suit? I wasn’t even 50: it sounds trivial and vain, but the idea of a huge scar was adding to my stress.
When I asked about the scar and he said 6-8 inches down the back of your thigh. I left the appointment feeling glum. I couldn’t exercise, I needed surgery, I’d have a scar, and I just wasn’t loving that doctor. I left thinking: there are so many things we don’t appreciate until they are gone: cartilage is one of them. Mine wasn’t coming back.
Younger patients who need hip replacements are encouraged to delay as long as possible, because artificial joints don’t last forever. The current shelf life seems to be about the same as a roof, 20 years. So if I got mine at 50, I’d likely need a second surgery around 70. And subsequent procedures are a more complex surgery.
Two days before a Europe trip, my doctor treated my joint with steroids
To complicate matters, we had a family trip to Europe just over a month away. I did have one option which could provide short-term relief, a steroid injection.
So two days before leaving for Europe, I lay perfectly still while a doctor inserted a long needle into my unhappy joint, bathing it in powerful steroids. It was a lifesaver. It gave me almost total pain relief and I was able to walk comfortably in Europe; I even played a game of “competitive croquet” at a castle in Scotland.
I was so grateful to be able to enjoy Europe with my family (it was my younger son’s first visit), and to forget about my hip troubles for a while.
Serendipity & Finding the Right Hip Surgeon
I returned from Europe and had to face reality. The benefits of the steroid injection would last a few months, four to six at best. I needed to decide what happened after that. I hated the idea of returning to pain, sleeplessness and not being active with my family. And I was worried that my troubled hip was making my back worse.
As I did some more research I read about a procedure called Total Hip Replacement Anterior Approach. It is a newer, more complex surgery and there weren’t as many doctors doing it yet. The surgeon accesses the hip from the front and upper thigh, rather than through the back. The advantages are a smaller incision and a faster recovery because the surgeon can avoid cutting through muscles.
I met with Dr. Craig Loucks, an orthopedic surgeon in Denver who performed the anterior approach to hip replacement. I immediately felt at ease. Like me, he is Canadian, and from a town a few hours from Toronto, where I am from. Second, not to brag, because he wasn’t exactly bragging, just stating some really impressive facts: He was one of the first doctors to do the anterior approach in the U.S., and now travelled all over the world teaching the procedure.
Anterior Hip Replacement: Reassuring News
We exchanged some pleasant chit chat about Canada (possibly a shared love of butter tarts) and he examined me. He told me I needed a new hip and was an ideal candidate. He went over the risks and answered my questions. I asked about the scar: It would be small and slim and on the front of hip, in my bikini line area – hardly noticeable he assured me.
He left me with one final instruction: I was not to worry. I would have the hip of an 18-year-old and be able to do almost everything I did before. It sounded too good to be true. I left the appointment with a sense of relief and hope, for the first time in two years. We knew what was wrong, he knew how to fix it. To feel complete confidence in your doctor is a wonderful feeling.
The surgery was scheduled for three weeks later, and it seemed like my hip knew what was what and called it a day. Sleep was a challenge, I was constantly popping ibuprofen and walked as little as possible.
Preparing for surgery felt like a part-time job. There were several pre-op tests required including an electrocardiogram to make sure my heart was strong enough for surgery. I booked a trip for my mother, who would come to Denver from Toronto to help out with my boys, while I recovered.
Meals were prepped and stacked in the fridge, and a couple of days before surgery, I had a phone call with a close girlfriend to discuss my fears. What if I didn’t survive it? My kids were still young at 16 and 13, they needed me. It may sound melodramatic, but it was my first surgery since having my tonsils out as a six-year-old and a hip replacement is a major surgery.
Hip Replacement at 50 - Surgery Day
I was very nervous on the day of the surgery, but it was comforting having my mom there. My boys were very sweet as they hugged me goodbye. I think my younger son thought my new hip might be bionic.
My husband Sean kept things lighthearted on the drive to the surgery center; my surgery would be done at an outpatient center, because the anterior procedure meant I would not need a general anesthetic. Instead I would be heavily sedated and given an epidural. The sun shone on old snow on the mountain peaks to the west and I thought about how amazing it would be to be able to ski again.
After getting checked in, Dr. Loucks came to see me in the pre-op area and answered any final questions I had. I felt reassured all over again. More than that, it was also turning into a small crush. Who’s not going to crush on the kind, handsome Canadian doctor who is about to give you the hip of an 18-year-old?
The nurse began preparing me for surgery which included shaving the left side of my pubic area. I should have followed my girlfriend’s advice to have it all waxed off ahead of time, but I didn’t get around to it. Zero points for appropriate pre-surgery grooming.
Next came the anesthesiologist who explained I would get an epidural once I was in the operating room. I remembered the advice of my friend Carrie, who had a hip replacement a few months earlier. “Make sure they give you the valium before they wheel you into the operating room,” she had advised. “It’s like wood shop class in there.”
I mentioned that to the anesthesiologist and he told me not to worry. He would administer some “happy juice” now through my IV, and I wouldn’t have a care in the world by the time I reached the O.R.
I can’t actually say if an orthopedic O.R. is like Gepetto’s workshop. I don’t remember being wheeled in, or sitting up as I was given an epidural. And I definitely don’t remember Dr. Loucks sawing the top of my femur off and giving me a new hip. File that under things to be grateful for.
Thankfully, I can’t say if the O.R. was like Gepetto’s workshop
When I woke up, I was back in the recovery area. I began feeling a lot of pain and the monitor beeped loudly, displaying my climbing heart rate. The nurse administered pain medication through the IV – the relief was almost instant and my heart quickly returned to normal.
Dr. Loucks appeared soon after and told me everything went really well. My incision was covered with a bandage and the nurse had placed a sort of compression girdle around my hips. He said it was important to wear the compression girdle because it would keep the swelling down. I had a matching pair of compression tights for my legs, to prevent blood clots. I looked ridiculous but didn’t care. I thanked him profusely for my new hip; I was so relieved it was over.
Sean joined me in the recovery room as the fog of medication began to wear off. I needed to use the bathroom and the nurse gave me the ok to walk to the one down the hall, with Sean’s help. The moment I stood up, my bladder emptied on to the floor. I was horrified. The nurse laughed. Happens all the time with an epidural, she said.
Hip Replacement Recovery, Week by Week
I was home by dinner that evening and able to get to the bathroom on my own that night, using a walker. The following day, I walked to the end of my driveway to greet my dear friend Carrie, who was dropping something off for me. No cane or walker, all on my own. It was like a miracle.
There was significant achy pain to deal with in that first week. It felt like a horse had kicked my leg, as Dr. Loucks had told me it would. I also found having to wear the girdle and compression tights was inconvenient. I didn’t sleep on the surgery side at first. I rested as much as possible that first week and was grateful my mom was with me to bring lunch and tea etc., and to help with my boys after school. Everyone pitched in to get dinner on the table and I did very little.
I was definitely better in week 2, despite some ongoing achiness. I was also very tired of being in bed, so began moving around my house a lot more. That included making meals and driving, which was fine, although I tried to limit it. I had cabin fever so my husband took my mom and I for a drive into the mountains later that week. We walked along a short nature trail and I breathed in the fresh air. I felt great! My mom at the end of the week as I felt I could manage life at that point. My husband was around but at work during the weekdays.
My recovery seemed to stall in week 3 of my recovery, and I wondered if I was healing properly. The achiness continued, and I wondered if perhaps I was overdoing it. I called my surgeon’s office and they said they weren’t concerned and would see me in week 7 as scheduled. I started the recommended physical therapy to recover the strength I had lost and to regain my balance, which was quite off kilter. I was told that was normal.
PT was keeping me busy, along with managing meals etc. I had to be mindful not to do too much. The achiness was slightly improved. Even though I was very active around the house I was still moving very gingerly, nervous about doing something to my 18-year-old hip.
Life felt very much “back to normal” this week, although I was still recovering. I went to a get together with girlfriends, got my hair highlighted (which always cheers me up) and went to a fundraiser for my boys’ ultimate frisbee team. I was sleeping really well also. I could see that I was recovering and felt encouraged.
Six weeks into my hip replacement recovery I got on a plane! I went on a trip with my son, his friends and their moms to tour colleges in California. College campus touring equals a lot of walking, so I was a little nervous but knew I could rest as needed, with other adults there to pitch in. We had a fantastic time and I walked several miles most days. There was only one day where I felt I overdid it because we also had a long walk to dinner and then home again. I have such happy memories of that trip and huge gratitude that my smooth recovery enabled me to go.
It was finally time for my follow-up appointment with the cute hip surgeon, and the reveal of my scar which was still covered with bandages at that point. Sadly, Dr. Loucks wasn’t there, but the doctor who had assisted with my surgery was. He took the bandages off and said he was pleased with how it had healed. I was scared to look — but when I finally did I was amazed how small and thin my surgery scar was. It was about five inches long, and maybe 1/8 inch wide. it was quite red, but I was reassured that was normal and it would continue to fade as it healed, and blend in with my skin. (It did!)
I was given the go ahead to do more extensive exercise at the gym, beyond walking, in addition to physical therapy. I left that appointment with a huge sense of relief and let myself feel that while my recovery would continue for months, the surgery was truly behind me.
Life After a Hip Replacement
It took about six months to recover to my new normal which I define as I was now moved around entirely forgetting about surgery and my hip. I felt amazing. I was able to do everything I did before, other than running. A little over a year later I was on a dream trip to India. Within two years, I was in the best shape of my life. I wrote about how my hip replacement inspired me to prioritize my health in a new way: Fit At Fifty.
I am writing this six years later, and I can see the bigger picture so clearly. I believe that all I went through with my hip and health, was the start of positive changes for me at midlife. I learned I could not take my health for granted and had to prioritize myself in new ways. I’ve written about that in Emotional Upheaval at Midlife.
And as far as that hip replacement scar I was so worried about: when I see it, I feel grateful. It reminds me of everything I now do that I once took for granted: being healthy enough to go skiing with my girlfriends or hiking with my family. Being able to travel to the other side of the world, or walk my dog around the park – these are gifts not to be squandered, and I am determined to take the best possible care of myself. I am grateful every day for my health and what my body can do.
Before surgery, I was stressed about all the things I couldn’t do for my family because of my lack of mobility. In my life after my hip replacement, I appreciate what I can do every day — for my family and for myself. I don’t take my cartilage, or anything else for granted.