Planning surgery

On June 25th, I will have a total replacement of my right hip. Many patients have noticed my limping. It’s time. They say you know when it is time to get the surgery by the pain. The pain dictates. I say this to my patients when we are planning their joint replacements. But, now I am on the other side of that equation: I’m the patient.

When the orthopedic surgeon told me (over 3 years ago) that I needed to have my hip replaced, frankly, I cursed him. Let’s call that denial. I refused to accept it. I’m stubborn (imagine that). I had all the same ordinary and common reactions: I am too young, it’s just a strain, I just need PT. Maybe it’s menopause. I need to lose weight and get in shape. All the things patients have told me; it is part of the process of submitting to the surgeon’s blade. In January, I went and had new x-rays. We also had to fight to get an MRI approved by my insurance company. The insurance company wanted me to do 6 weeks of physical therapy as if that would matter when the radiologist classified my hip as “severe, advanced, end-stage osteoarthritis”.

And in this circumstance, the knife (or the sawsall) is the only thing that will fix it.

One must get to a level of acceptance. And the pain holds you ransom until you do. I take ibuprofen and it helps. I wasn’t doing any of my regular exercise because of the pain. I was a walker. But, over time, walking for exercise – the speed required to make walking aerobic – became impossible. So, I returned to swimming, the sport of my youth. I discovered that when I am in the pool, I have no pain. And muscle memory helped. I cannot swim the breast stroke because my hip simply will not move that way any more but breast was never my stroke. Each time I swim, I have improved my strength. I can swim longer and from a cardiovascular perspective, I have made real progress. I can swim for a continuous hour. But, I still can’t walk through Home Depot.

I cannot get a sock or shoe on that foot without severe pain. When I externally rotate the leg, I strike a large bone spur that has formed. And the pain lingers for a long time. If I am honest, changes in this hip started eight years ago. I went to the Country Living Fair in Atlanta and walking across the uneven terrain caused pain. I started getting a biting pain in my groin (sometimes) just moving my right leg from the gas pedal to the brake. It happened inconsistently so I though it was muscular, one of the adductor muscles.

It was the beginning of osteoarthritis: a non-inflammatory arthritis that slowly destroys a joint. Just from wear and tear. I likely have to add my altered mechanics. I had a clubbed foot at birth that was corrected and I have congentially shallow hip sockets, which prompted the growth of the bone spurs. These CAM and PINCER formations are part of the femoral-acetabular syndrome, which is an early predictor for the osteoarthritis.

And it all eventually leads to needing a joint replacement.

I don’t want surgery. I’ve only had one other surgery in my life: tonsils at the age of 4 which I remember as lots of lime sherbert and stuffed animals. I am not afraid of the surgery or the anesthesia. I have two fears. The first is just letting go of control and being totally at the mercy of someone else. Trust. Trusting the doctors and the nurses, who will have my unconscious body on the operating table, to do their very best work. It requires faith to submit yourself to the care of another person – completely.

The second fear is about my business. If I am not working, we are not generating as much revenue. I still have to pay staff and rent and all the costs of being a small business owner. So, this too requires faith: faith that my patients trust me, my nurse practitioner, Abigail Eley, APRN and our staff to continue to provide their care while I am out recovering. If we can keep the schedules full, then overhead and operating costs get covered while I am recuperating. The plan is for me to return to work on July 8th. I’ll have someone driving me to work and I may confine my work to a single exam room, shuttling the patients into me instead of me changing from room to room. And this is with the expectation that all things go well and without complications. All we can do is plan well and pray.

I am very thankful to my staff for helping me plan this surgery. I am also very thankful to my patients who have entrusted me with their care.

May 2019
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