Lessons from a Hip Replacement

Ellen, Age 73

Three years ago, at age 70, I began to experience pain in my upper right leg after playing tennis. I diagnosed myself with a groin pull and made an appointment with a physical therapist. After about five minutes, she said, “Ellen, I hope this isn’t a shock to you, but I don’t think you have a groin pull. I think you have osteoarthritis.” Wow. Really? I’d fast-walked a bunch of marathons, I was a slow but avid tennis player, worked full-time, was healthy as a horse. My medicine cabinet consisted of an emergency asthma inhaler and a bunch of vitamins.

Now fast forward. I had a total hip replacement on May 31, 2012, eight months after that first pain. I am an unusual case in that most people say they waited too long. My fear, as I was making my decision about having or not having surgery, was that I was waiting too short. Now, and ever since the surgery, I have no regrets. None.

At first (pre-surgery), I tried everything to reduce the ever-increasing “groin pain.” I went to physical therapy which helped for a few months. I had a cortisone shot that brought joyous relief for exactly two-and-a-half weeks. I then started on the course that I maintained right up until surgery, and for much of that time, I was pain free.

I continued to work. I went to pool therapy twice a week and loved it (in my experience there is nothing better for pain relief than spending an hour in a very warm “therapy pool”). I took six Tylenol-arthritis pills every day plus an NSAID. On the downside, I stopped playing tennis and going to yoga classes. My life became pretty sedentary, but my plan was to put off surgery for a year or two, for so many reasons.

I wanted to enjoy the upcoming summer; we had a lot of plans. I knew that hip replacements don’t last forever, and the longer you wait, the less the chance of it wearing out. Maybe there’d be advancements in technique or product if I waited. But really, I did not want to face my own vulnerability, my frailty, my imperfection. I was fine thinking of myself as old, an old lady, an old granny, but old and strong, old and athletic, even old and beautiful, old and healthy as a horse. The idea of a joint replacement was, for me, incompatible with that.

Three things changed my mind about waiting. One, I started to read about the effects on the liver, of the meds I was taking. Two, I went for my annual physical and my primary care doc said he’d like to see my hip X-ray. He called me the next day and used terms like “bone on bone” and “necrosis.” Although originally fine with my plan to wait a year, he now advised surgery sooner than later, with some urgency. (Interestingly, my orthopedic surgeon kept saying the timing was completely up to me.) Three, although I had been avoiding physical activity to control the pain, I loved nothing better than hiking. So my husband and I planned a short hike, under an hour. I experienced a little pain, but it was worth it. Then we drove to an annual Greek festival in our neighborhood. We sat down with our huge souvlakis and I couldn’t get up. The pain (despite all the painkillers) was over-the-top. I scheduled an appointment with the surgeon the next day.

The rest was straightforward. My surgeon was miraculously able to fit me in, the following week. It was great for me that I had little time to prepare. I immediately shifted to preparation mode. I cancelled all my summer plans through the middle of August. I bought two long, loose summer dresses at Walmart, knowing that for a while I wouldn’t be able to bend over to put on shorts or pants. (The funny thing is that I have come to love these dresses. They cost $16 each; far less expensive than anything else in my closet. I bought them as throwaways, but they’ve become keepers. In fact, I recently had them both shortened at $25 a clip.)

One of my sons, my sister-in-law, and a dear neighbor offered to assist my husband, Doug, and me with any post-op care I might need, and it was a relief to have that lined up in advance. I figured I’d be in the hospital for the standard three or four days and then go to a rehab facility for a few days before coming home. That was the plan.

The day of my surgery, I felt great and wondered for a few seconds if I was jumping the gun. Luckily Doug was there to remind me about all those Tylenols. What I remember next is waking up after the deed was done and being wheeled through the halls of this large teaching hospital. I felt fine, almost giddy. I had told the nurses I’d like a private room, but they said there were only two on the orthopedic unit, and they were both taken. Bummer.

So we arrived at the door of my assigned room. I looked in and saw an empty space for my bed, and noted that the patient in the other bed was… a man. Gulp. What quickly went through my head was, “Well, I know it’s a new world. Men can marry men and women can marry women, women can be frontline soldiers and CEO’s, men can be stay-at-home dads. I think that’s all great, but really… this is carrying gender liberation too far.” At that point, the orderlies who were wheeling me around burst into laughter. So did I. They said, “Well it looks like there’s been a mistake. Sorry, we can’t put you in this room.” Thank god.

Soon after a nurse came over and said, “We have a private room ready for you now.” I have no idea how all that happened, but I spent the next three days in a lovely room with a beautiful view. Doug was there all day, every day. I got gorgeous flowers from family and friends, and they were deeply appreciated. The first flowers to arrive were from my Dad, who was 97 at the time, with a perfect brain. Amazing, really, that he knew to send them, when and where, no help.

A few things stand out about my hospital stay. One, my surgery was on a Thursday. I stayed in bed that whole day, as I recall. On Friday I needed a blood transfusion and then the weekend arrived. The upshot was that I had almost no physical therapy while I was in the hospital, since weekends — at least in this hospital — are not fully staffed. Lesson: Plan your surgery for early in the week to get the best help.

Two, there was a tremendous range of nursing care. My favorites were Jerome and Fred, who were kind, competent, and good humored. My least favorite was a nurse whose name I don’t remember, who told Doug not to come until noon the next day because he’d just be in the way in the morning. Happily he paid no attention and arrived at 9 a.m.. When I told Jerome that story, he reported the nurse to his boss. Apparently, that’s the opposite of hospital policy. Family members are welcome and they have a positive influence on patients and staff. Lesson: Not all nurses are created equal. Don’t let the bad ones get you down, and express your unbridled appreciation to the great ones.

Three, I never saw my surgeon the whole time I was in the hospital. Oh well.

Four, because I kind of lost a day when I had the transfusion and I hardly had any physical therapy because it was now the weekend, I expected to be discharged on Monday. I was still planning on a few days of in-patient rehab in what I heard was a nice local facility. At 5 a.m. on Sunday morning, a pleasant young intern came to my bedside with a clipboard and said, “You’re discharged to home. You can leave any time today. Everything looks really good.” Lesson: Go with the flow.

Five, the discharge day is a bit of a blur, but Doug came over soon thereafter, and since I was not going to rehab, we ordered a hospital bed to be delivered to our home (I didn’t think I’d be able to walk up the 15 steps to our bedroom). Doug and I drove home with a walker and a few other assistive devices like a sock-aid, a raised toilet seat, and a reacher/grabber. I already had a borrowed cane. My son drove three and a half hours from his home to meet us at ours. I walked into the house, and immediately, with the help of my cane, walked up the 15 steps with relative ease. We canceled the hospital bed.

It was fabulous to have help from family and friends those first few days. I was using the walker, couldn’t bend, loved being cooked for and pampered. And Doug turned out to be hubby-nurse of the century, rivaled I told him only by Gabby Giffords’ astronaut. Lesson: Family and friends, I love you.

Today I am myself again, and have been for some time. I play tennis, hike, and with the exception of beeping through the old-fashioned airport security scanners, might not even remember that I have a bionic hip.

I want to close with the two the biggest takeaways for me. First, I am so glad I did not wait any longer than I did to have this surgery. It did not change me for the worse. It improved me. It improved my quality of life. It brought me back to myself. I will not wait in the future if I need help and help is available.

And second, the summer of my surgery, I slowed down. I erased my calendar in order to heal, and I found joy in doing nothing. I spent a lot of time at home, cooking simple meals, wearing shorts and a tee shirt (and my two Walmart dresses), and reading for pleasure, not information — that was the summer of the Fifty Shades of Grey trilogy, and I read them all. I recently received an email from a friend who wished me a “summer with the right balance of fun and laziness.” Thank you, hip replacement, for forcing me to live this wisdom.