My Hip Surgery -- An Interim Retrospective

It's been almost two weeks since my second hip replacement (the first was two months ago to the other hip). Some readers of this blog will be persons considering hip replacement surgery for themselves or others. Many of my friends have told me that they have hip pain or know someone who's had replacement surgery. The most common question is "how will I know when I am ready".

Much to my surprise, hip replacement surgery is considered to be "elective" surgery (see "Total Hip Replacement" for a professional discussion by MedicineNet.com). I'm sorry, but in my case there was nothing elective about it. Say, for example, a person puts your hips in a vice and tightens down on the vice causing you constant, relentless, excurtiating pain. Would you consider it elective to extricate yourself from that situation or mandatory?

But, before I get my sheets all twisted up in a knot, thankfully the descriptor "elective" relates to timing, not medical necessity. According to WiseGeek, "elective surgery is non-emergency surgery which is planned, allowing the patient and doctor to determine the best time and place for it. There is a wide range of procedures which could be considered elective, ranging from a hip replacement to a rhinoplasty, and elective surgical procedures are offered at most hospitals. The primary advantage of elective surgery is that it has a much more controllable and predictable outcome, since the variant of chance and emergency circumstances is removed."

So, notwithstanding that my surgery was considered "elective", it was covered. Coverage under my insurance was not an issue.

As to timing, I knew I was ready. My hips went downhill faster than Eddie "The Eagle" Edwards, the first competitor to represent Great Britain in Olympic ski jumping. For a time (more than a year) I was hobbling about, in pain, but managing to some extent on Advil. Things worsened toward Fall of 2009 and by October I was walking in pain but only with a cane.

Once diagnosed with advanced osteoarthritis in both hips I had two choices: (a) live with it and dope myself up to manage the pain; or (b) undergo hip replacement surgery. At that point, I was ready -- so ready that had my surgeon said he could operate the day he saw me, I would have jumped on the operating table immediately. So, that's the answer to the question. You'll know you're ready. There won't be any question.

Retrospectively would I have done anything differently? Sure, I should have been 100or more pounds lighter all my adult life, eaten better, taken better care of my health, etc. But, having found myself in the position I was last October, I would not have changed a thing. I am esctatic that I had the surgeries. My right leg is almost back to normal (operated on Nov. 17, two months ago), and my left leg makes daily positive progress returning to normality (operated on Jan. 7, 12 days ago). Oh, yes, I've lost 75 pounds and continue losing weight through better eating and increasing (albeit currently limited) exercise.

Yesterday I resumed outpatient physical therapy at a local treatment facility (SportsCare Institute, Inc. in West Nyack, New York), 11 days after my second surgery. My progress following the second surgery has been even more rapid than after the first surgery. I attribute that to my having a good opposing leg and hip this time around.

I was also genuinely enthused about being able to do 10 minutes on a stationary cycle without any difficulty, and was even able to move the pedals around their orbit easily and quickly. I was literally speeding! It was a thrill, as if all of a sudden I had two rocket-powered legs. What I had was my two legs being able to use an exercycle without pain. I haven't been able to do that in years. I am feeling terrific about that and look forward to getting back on the cycle tomorrow.

I am also able to get around a bit with a cane (still somewhat unsteady) but still use the walker most of the time.

And, while Vicodin remains part of my daily regimen, I am taking less of it and I can see an end to that in a week or two.

On the topic of costs, I am very lucky. Lucky that I was able covered for much of the expense through insurance, and able to pay for the amounts not covered. Many people are not in that position (most people in the world I would guess). Something's got to be done about that. Being the beneficiary of extraordinary healthcare, I can only wish the same for everyone, and work to seeing that become a reality. So, for those of us who question the current healthcare reform initiative, a choice that involves living with chronic pain is not a choice. Live with chronic pain for a day and you'll see what I mean.

My friends are calling me Lee Majors, the "6 million dollar man". If the cost of my surgeries is a measure, I'd say I'm more like the quarter-of-a-million dollar man.

At Home Now

I'm at home now. At HHH I was assigned to a room that I shared with an elderly man who really should have been assigned to his own single room. I couldn't room with him (noise, toilet issues, cleanliness, etc.). One of us had to go, and I was ready. I stayed from Wednesday until Friday, and got myself discharged.

That was 8 days after surgery. I was a lot further along with my recuperation at that point than I was with the first surgery two months ago. The difference was that this time I have a good and improving hip on the other side, rather than a weak, painful and worsening hip. That is helping a lot.

Transferred to Rehab

Transferred to Rehab
Cheers rang out through the halls of Hospital for Special Surgery along with choruses of "he's leaving, finally" as I was wheeled out yesterday and into an awaiting ambulette ending a marathon 6 day stay at HSS following successful second hip surgery.

An "ambulette" is basically a van with a raised roof and a tail loader. It can double as a refrigerator delivery vehicle when inter-hospital transfer traffic is slow. The van is equipped with floor-mounted tie-down points to secure wheelchairs for the trip.

Every health insurance claim manager should be required to commute to work one day a month in a wheelchair teathered to the floor of an ambulette.

I say "teathered" because that's the best that my amiable ambulette driver (let's call her "Amy") was able to achieve even after a tighten-down adjustment following the first (of many) hard turn Amy took screaming out of HSS' driveway onto 69th Street. My wheelchair and I didn't take that turn, at least not at the same time that Amy and her ambulette of fun did. We followed like a yoyo follows a string tug. I'd say was pulling about 3 Gs.

Riding in Amy's ambulette is something like flying in NASA's padded training jet -- the one that simulates weightlessness for astronautsby flying parabolic trajectories, including the nauseau.

My body and wheelchair needed to be wound wrapped like paletized cargo to keep my freshly operated leg from swinging out beyond the "precautionary" limit during lane changes, especially when the van would go one way and my wheelchair the other way.

Enough about the ambulette. HSS was stellar; my docs and staff could not have been more professional, expert and accommodating. And the view east and south along the East River was grand.

The staff at Helen Hayes Hospital (in Haverstraw) greeted me like old friends, "he's back, ugh!"

At HHH I started with a "heart healthy" diet which translates to no taste, fewer calories. At 3:00 a.m. the hungries woke me. I need to make some adjustments.

My Second Hip Surgery Went Well

It's Sunday evening, January 10. Yesterday the Jets beat the Bengals; this afternoon the Pats were embarassed by the Ravens; and I'm watching Green Bay struggle unsucessfully to reprise last week's win over Arizona. You now have a good idea about what I've been able to accomplish this weekend.

My surgery went well Thursday. I am now the happy host of two replacement hip joints. Dr. Buly used size 7 Titanium Stryker pressure-fit stems driven into the centerline of my femors after carefully dislocating them from my hip plates and removing the tops to get access for the spikes.

Atop each spike is the ball portion of the ball joint that is a replacement hip. The balls' contact surfaces are ceramic and the mating cups by Depuy (a Johnson & Johnson company) are fashioned from polyethelene.

My recovery experience from this surgery seems to be a bit less daunting than the first time around. The accomodations and service at the Hospital for Special Surgery are again superb. Pain control continues to be a priority and everyone here appears to have only one priority -- patients' well-being and comfort. HSS has implemented what every service institution should strive to acheive.

I was able to shuffle along the hallway with a walker yesterday and today. I didn't go very far but it was good to get out of bed and move about.

The plan is to discharge me tomorrow morning, hopefully directly to Helen Hayes Hospital in Rockland County where last time I had a week of rehabilitation following my first hip surgery two months ago. That decision is pending approval from my insurer Oxford. I won't know for sure until tomorrow morning.

Hip Surgery No. 2 This Thursday

I'm looking forward to getting this experience behind me, and to walking again and even playing golf, not that I was ever any good at golf but I have worked my handicap down to 20 on my Tiger Woods Electronic Arts iPhone golf simulator and am growing anxious to test my newly honed golf skills on a real course.  Any chance my technique will carry over?

I didn't think so.

Post-op exam of my right hip went very well. That surgery is healing well, and I am able to put full weight on that hip joint. Quite remarkable.

I am hopeful that recovery will be more rapid this time, and optimistic because this time I have a good hip joint to assist with mobility.

Thursday's surgery is scheduled for noon.

Kazatski is not in my future but dancing should be.