The journey to recover from total immobility inspired me to prioritize my health
It happened gradually. But one day I started a walk toward a park down the street and had to turn around. I hobbled home tears of pain and frustration filling my eyes. I was no longer an active woman who ran, hiked, biked and skied. I couldn’t walk around the block.
For a long time I thought the problem was my back. Back strain came and went, but had always been manageable. Things had gotten progressively worse over the previous year or so.
Friends had come to visit that winter for a ski holiday. I’ve skied my whole life, but on that trip I felt very nervous, as though I could really hurt myself if I fell. Skiing was out after that. I had also stopped running and going to the gym. When spring arrived I tried hiking but even that was difficult on the uneven terrain of the Colorado foothills.
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 very helpful).
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’s a shame about the hip dysplasia they are prone to developing. It turns out that golden retrievers and I have more in common 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 highly treatable.
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... about the 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 not as successful. It’s a more complex surgery and there’s more that can go wrong.
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 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, 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, 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.
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 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. Ok, 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 operatin groom,” 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, 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, and thanked him profusely for my new hip. I was so relieved it was over.
Sean joined me in the recovery room and 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. As soon as I stood, my bladder emptied on to the floor. I was horrified. The nurse laughed. Happens all the time with an epidural, she said.
Recovery & My Hip Replacement Scar
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 definitely some achy pain to deal with for several weeks after. It felt like a horse had kicked my leg, as Dr. Loucks had told me it would. At first the recovery seemed slow and I wondered if I was healing properly. I did the recommended physical therapy to recover the strength I had lost and to regain my balance which was strangely off, after surgery. I was told this was normal.
At the follow-up appointment, it was time for the reveal. They took the bandages off and 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 it would continue to fade as it healed and blend in with my skin.
By six weeks out, I felt great and was given the go ahead to do more walking and start other light exercise, in addition to physical therapy.
After Surgery, Better Than Ever
I was able to go on a college touring trip with my son, a few weeks after that. It took about six months to recover to my new normal. I felt amazing. 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 I got healthy after my hip replacement in: Fit At Fifty.
Now, several years later, I see that all I went through with my hip was the start of positive changes for me at midlife. I’ve written about that in this story: 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. Now I appreciate and prioritize all the things I can do for myself, for my own health and happiness. I don’t take my cartilage or anything else for granted. Pass the leafy greens.