It is now May 2019, two years after I first thought, “There’s something wrong with my hips.” Two hip replacements later, I am free from the pain and disability I struggled with for years. What follows is a summary of my hip adventures; my Hip Tips in PDF form that you are welcome to print, use and share; and the link to the videos, x-rays, and photos taken along the way. If you are interested in seeing where I was at a particular stage in my journey, my Hip Adventures theme is organized in date order and most entries are labelled by the week or month post-surgery when I wrote that particular post. To access the entries, click on Hip Adventures at the end of this post. My intention has been to record and share my journey as a support and inspiration to others facing or experiencing hip replacement.
Here are my Hip Tips for my fellow hipsters out there. If you are going to have hip replacement surgery, or know someone who is, please feel free to print and use this document:
To view the video log of my journey and see X-rays and photos, click the link below, which will take you to Google Photos. The first video is a brief summary of my whole journey done for the BoneSmart forum. The videos of what I could do after my recovery are at the end, after the x-rays and photos. They include cross country skiing, Tai Chi, Yoga and Belly Dance.
Rhonda’s Hip Videos
To see descriptions of the videos: On your computer click on the “i” in the upper, right corner of a video or photo; on your phone click the “…” in the upper, right corner of a video or photo, then click “Info”. This will tell you what you are looking at and when it was created.
Summary of My Hip Adventures
How do I summarize a life changing journey? I’m going to do my best to give you a condensed version of what it is like to go from dysplastic to bionic.
History
This journey, unbeknownst to me, began when I was born. Hip dysplasia is a congenital birth defect that affects about 1% of the population. It is most common in first born daughters, which would be me. I count myself lucky that I led an athletic, adventurous life for 51 years before this condition literally took me down. Many people with dysplasia have problems from birth and endure multiple hip surgeries over the course of their lives. I truly got lucky.
I first began having problems when I was running track as a teenager. I attributed it to chiropractic issues and switched to cross country skiing and other non-impact sports. Turns out that was a good thing, probably saved my hips from going sooner. I didn’t have problems again until I was 41. At that time, I started having groin pain while hiking, especially when going downhill and taking long strides. I attributed that to a horseback riding injury which involved a groin pull in 2007.
I tried several therapeutic methods for healing my “groin injury”, including chiropractic, physical therapy, massage, and yoga. At first it helped, but gradually over time, I had a harder and harder time walking long distances and hiking over uneven terrain. My muscles would be unusually sore after workouts and didn’t seem to recover normally, especially my legs and glutes. I had been a belly dancer and spent a decade performing with a troupe. Belly dancing became increasingly painful and eventually I had to give it up. Then, dancing at all became impossible. By the time, I was 50 (2016), walking was an increasing challenge. Bending down and lifting things (hip hinging) led to back spasms. I was increasingly disabled, while taking increasing doses of ibuprofen for pain.
I had always been strong and pushed myself to the limits physically (and in many other ways). The pain and disability forced me to slow down, to be gentler and kinder to myself. This wasn’t an easy thing for me. I realized how much of my sense of worth was attached to my physical abilities and looks. I had to quit the gym (I’d been a gym rat and even co-owned a gym at one point). It hurt too much to do my workouts. I switched to walking and doing yoga, Tai Chi, and a machine called a Health Rider, which was easier on my body than the ellipticals and treadmills I’d been using at the gym. I opened my own studio where I taught yoga, Tai Chi and belly dance from 2013-2017.
In the fall of 2016, I was getting worse, but I was still convinced I had a soft tissue injury that needed to be rehabbed and strengthened. I decided to try more aggressive therapies including Pilates, skipping and jumping to challenge my legs, and active release therapy. My return to being more aggressive was the last straw for my hips.
In May 2017, I was walking with my partner across a creek and a stone turned under my foot. In my attempt to keep my balance, I felt a sharp pain shoot through my right hip. I knew in that moment something was wrong inside my hip. It was the first time that thought had occurred to me. Scott talked to me that night as I nursed the pain with wine and ibuprofen, “You’ve been trying to rehab this for a long time, and it is only getting worse. You need to see a doctor.”
Diagnosis
I called the Reno Orthopedic Clinic (https://renoortho.com/) when we returned from our trip and made an appointment to see Dr. Shukla for July 6th. When I went in for the appointment, the techs took x-rays of my hip before I saw him. I had prepared a list of my symptoms and what I had already tried in the way of therapies. When he came into the room, he had the list and told me to follow him out to the computer so he could show me the x-rays because, “They tell the whole story.”
I will never forget standing in front of the big screen, looking at my hips. Dr. Shukla said, “Let’s start with your left hip.” I informed him I wasn’t having problems with my left hip. That’s when he told me I had bilateral hip dysplasia. He explained that it was a congenital condition and it meant that my hip sockets were shallow (like saucers instead of cups) and the head of my femur was deformed with rough edges that had worn away the cartilage in my hips. He pointed out the white areas of arthritis, the places where my left hip was already bone-on-bone, and the bone spurs that indicated distress. Then he turned to my right hip. It was just a mass of white and I couldn’t even make out the hip joint. That’s when I understood why he’d started with my left hip… Even I could see there was nothing left of the cartilage and it was almost totally bone-on-bone. I wondered how I was walking at all, so did he.
He took me back into the consulting room after introducing me to his assistant, Davis. I asked him what my options were. He said I could try an injection and more physical therapy, but it really required replacement. He told me that most people with dysplasia have their hips replaced and about 10% of all the replacements he does are in people with dysplasia. I recall taking a deep breath, and saying, “I don’t see that there is anything left to work with in my right hip, so what would be the point of putting off a replacement? I already can’t walk far and it’s keeping me up at night.” He informed me he was scheduled for a month, but we could start the process right now. With my head spinning, I found myself suddenly arranging to have my right hip replaced.
I recall having two thoughts at this point: 1) Thank God there is a fixable reason for all of this; 2) I’m going to have to have two hip replacements. After I got over the shock, it took me awhile (and a few major crying jags) to digest it all. The hardest part was knowing that I would need to have BOTH my hips replaced.
Preparing for Surgery
One of the things that helped me prepare was getting on some of the online forums, and looking up the medical and orthopedic sites, which explained my condition (you don’t know how many dog hips I looked at!). I found the International Hip Dysplasia Institute, BoneSmart, and PeerWell to be particularly helpful sites, as well as individual blogs giving more detailed descriptions of people’s hip replacement experiences and suggestions. That’s what inspired me to start my own blog. My clinic also had an excellent joint replacement class which was very informative.
By the time my surgery came around, I felt as prepared as I could be. My walking was so bad by then, I could hardly get around at all. One of my regrets on this end, is that I waited so long to see a doctor.
Right Hip Replacement
On September 20, 2017, I had my right hip replaced. It took about 90 minutes. Unfortunately, my femur was more distressed than they had anticipated (had a bunch of bone spurs growing on it indicating stress, probably because I waited too long…), so my surgeon was concerned that it might have micro-fractured when he placed the stem of the implant into the hollow part of the femur. To support my femur, he had to install a cerclage cable. It looks a lot like a zip tie you would use to tie up your electronic cables, only it is made of twisted metal. It went around my femur to support it.
When Dr. Shukla came to talk with me after the surgery, he told me about the cable and that it might bother me. If it did, he said he would remove it once the bone mended and grew around the implant. He was pleased with the outcome of the surgery and was able to correct my leg length discrepancy (my right leg was always about ¼ to ½ inch shorter than my left). I had problems tolerating the oxycodone they gave me for pain and had a rough night in the hospital, but by the next morning, I was better and able to go home.
The first 72 hours were the roughest! I had anesthesia and pain med brain, my bowels weren’t working right (this is normal, and I give tips about how to manage this problem in my Hip Tips), and I hurt. The majority of my pain was along the side of the hip and when I sat down. My recovery was longer than I’d expected. I struggled to use my leg and physical therapy was difficult and painful. Friends who had their hips replaced had told me I’d be walking easily within a week to 10 days. It took me two weeks to get from the walker to a cane and I was having a lot of problems with bearing weight on the surgical leg. Stairs were very problematic. My flexibility came back before my strength. This gave me hope and I did yoga and PT at home, hoping my walk would soon return. It actually took 3 months.
Fortunately, during this time, I rediscovered swimming! I always tell all my fellow hip people, “Get thee to a pool!” It is truly a miracle! In the water, all the weight is off the joint and you can move again. It was the best place to get my normal walk back. I relished my time in the water, lamenting that life on land was still such a struggle for me. I remember thinking it must be because of the dysplasia that it was taking so long.
At the 3-month mark, I was finally walking without a limp. But stairs were still the bane of my existence and many of my favorite one-legged yoga poses were not possible. I was frustrated. And then my other hip went… Dr. Shukla had told me that the surgery would either cause my left hip to go very quickly, or it would slow it down. It turns out the first thing Dr. Shukla tells me is always what happens.
Left Hip Replacement
I had my left hip replaced on May 16, 2018. What I learned from my first hip replacement definitely helped with my second round. I did not wait as long, so I wasn’t as disabled and that made a big difference in the surgery and recovery. Because I had not distressed my femur, Dr. Shukla didn’t have to cable it. My muscles were also a lot stronger on my left side. I immediately felt better than the first time and was walking without aids in 4 days! It seemed like a miracle and I was so grateful. This is the recovery I’d expected the first time, only better. My biggest dread going into the second surgery was having to go through another difficult recovery. I was also very happy that the hard one had been the first and not the second—imagine how disappointed I would have been! Davis reminded me that no two hips are ever alike.
I had 6 weeks of physical therapy with my first hip, but only 3 weeks for my second. Even my PT said that my first replacement recovery was one of the more difficult she’d witnessed and my second was one of the best she’d ever seen. By the end of physical therapy, I was pretty strong and walking around the block easily without aids. I could do a lot more than I had been able to with my right leg. I knew, without a doubt, the cerclage cable was causing my pain and continuing disabilities on my right side. It would have to come out.
This only became clearer as my recovery progressed and soon my left leg was much stronger than my right. Every time I flexed my muscles over the cable, it made a snapping noise and it hurt. The muscles themselves were atrophying and my massage therapist was expressing concern about the difference in my muscle tone. I still couldn’t balance on the leg or step up onto it easily. It quickly fatigued when I tried to walk more than a mile. It was difficult and painful to go up and down hills, over uneven terrain, and up stairs. While hiking, I used hiking poles because I didn’t trust my leg under me. I knew that my right leg was now holding my left leg back from a full recovery. So, at my 6-week follow up, I explained what was happening and Dr. Shukla and Davis said that I could have the cable removed.
I opted to do the surgery on October 31st after a summer of recovering from my second hip replacement and doing some camping and short hikes. I continued to have problems related to the cable all summer. In hindsight, I should have had the cable removed sooner, perhaps six weeks after my second hip replacement. It would have saved me some of the pain and challenges I endured in the later summer and fall.
Surgery to Remove Cerclage Cable from Right Femur
The surgery to remove the cable lasted only 20 minutes. They put me under, but only lightly. I was ready to go home an hour and a half after the surgery! It was nothing compared to a hip replacement. I asked Dr. Shukla if I could have the cable and they gave it to me in the recovery room. I will never forget touching it the first time. It was literally like a piece of barbed wire! It had a large, square, rough-edged end where the cable is tightened around the femur (there are photos of it in the Video link). Then the end of the cable is cut, leaving a sharp, frayed edge which had been gouging into my muscles! I was so shocked. How could something this awful be used in the human body? It looked like something I would have fixed fence with on our ranch when I was a kid!
Davis told me my muscles had fretted over the end, fraying it and loosening the cable. They had to open my incision longer to find the cable and remove it, so my scar is about an inch and a half longer than it was. He did a beautiful job stitching it up though and it healed very quickly.
When I went in for my follow up appointment after the surgery, I spoke with them about the cable. My intention was to advocate for changing to a kinder and gentler system. In my online research, I had found one and I brought pictures with me. I will never forget Davis telling me they had already changed their system. They had found something even smaller and less invasive than I had! He drew a picture for me on a piece of paper.
He told me the difficulty they face is that implant manufacturers have yet to send these newer cables with the implants, and the operating rooms in the hospitals are reticent to carry them. They had had some success in getting ORs to carry a few, but sometimes other surgeons used them all! He asked if he could use my blog and the list of what changed for me after the cable came out, to advocate for the better system. I said, “Absolutely!” I would love it if my blog could help prevent suffering for others.
This is one of the things I love about my surgical team. They are always looking at ways to improve what they do and their patients’ experience and healing process. They listen and they care. I will be forever grateful to them and my excellent physical therapists, Lori Beck and Jessie, at the Reno Orthopedic Clinic (https://renoortho.com/) for giving me back my ability to walk and do all the things I love again without pain. It seems like a miracle to me after so many years of struggle.
Recovery
I did another 3 weeks of physical therapy to balance out my muscles and strengthen my weakened left side. At 6 weeks, I resumed my regular massages with my skilled therapist, Stephanie Wilson (https://www.facebook.com/massagebystephaniewilson). I did this after every surgery and it really helped with breaking down scar tissue, improving circulation, removing toxins, and relieving tension and pain in the muscles. I would encourage everyone to work with a massage therapist as soon as your surgeon okays it. Thank you, Stephanie for your magic, healing hands that have helped me through this whole adventure and beyond!
Within 4 months, I was able to walk 3 miles regularly, swim 1000 meters 3-4 times per week, cross country ski 3 miles (including back country skiing which involves breaking trail through fresh snow), dance, lift and carry 25-50 pounds, go up several flights of stairs, and do most of my yoga and Tai Chi. One-legged yoga poses were the last thing to come back and that took about a year from my last replacement (May 2019). It was such a thrill when I could finally do the Dancer Pose again! I can now do everything I really want to do. I feel strong and balanced, my flexibility is back and better than it was in my hip flexors and surrounding muscles, and I am at last pain free! I recover from exercise normally again. I sleep well. My energy has returned, along with my enthusiasm for life. At some point, I realized all the pain and disability had led to a depression. Now the clouds have lifted, and a new, sunny day begins with my new bionic buns!
How I’ve Changed
I’m not the same person I was two years ago when my hips really started to go on me. I’ve become softer, gentler, easier on myself and others. I understand what people in their 80’s and 90’s feel like. I’ve been there. I know how lack of mobility can change your life and shrink your world, how pain brings on fatigue, depression and difficulty sleeping. I have more empathy and patience.
Here is an excerpt from my blog, written about a year ago, on March 20, 2018—6 months after my first hip replacement and 2 months before my second:
Lately, I’ve reflected on the bigger picture surrounding the events of this year. I know that I am in the midst of a major transformation of my life, not just my butt… I am entering a new phase, hopefully with more compassion, patience, tolerance and wisdom. I am realigning the deeper parts of myself, creating a firm foundation within and without. I guess what I’m trying to say is I know it isn’t just about my hips, but about my whole being, my whole life. I will never be the same after this year. And that is not a bad thing.
I can already feel the softening, the slowing down, taking hold of me. I don’t want it to let go as I heal physically. I won’t let it go. For me, life has always been a race to get things done, to reach goals, to make plans for the future, to run away from the pain of the past or the anxiety of the present. This experience has literally sat me down, forced me to get and stay quiet. I’m finding that I love the peace of stillness and silence. There is no place to go out there, nothing to do, just be here and now in this moment. Though I have understood this intellectually and pursued it in meditation for the last 27 years, it’s only now that I am experiencing it more and more. And I want more! More of less. These old hips have been a godsend.
As this journey has unfolded, I’ve realized I am not my body. That might sound funny, but it was quite a revelation to me! I am reminded of the words of one of my yoga teachers, “Remember you are not in your body; your body is in you. Your energy field extends a few feet beyond your body and connects your Spirit and the Universal Spirit. Your body is just the vehicle you ride around in on Earth until it gives out and your Spirit returns to its Source.” My hip adventures helped me to fully realize the truth of what she’d said.
These days I don’t carry the old attachments to my body—how it looks and what it can do—as indicators of my worth. I am more into being and less into doing. I still spend a lot of time caring for my body, but it’s different now. I actually CARE for it instead of trying to beat it into submission. I’m sad about all the years I pushed myself so hard and caused needless injuries in the process.
Now I eat healthy and do gentle exercises like swimming, walking, yoga and Tai Chi. I’m careful not to fall, and work on balance exercises every day. In the mornings, I do a Tai Chi/meditation/prayer practice which helps center and prepare me for the day. During this practice, I ask my body what it needs that day and I’m finding I can hear it ever more clearly. I think I’ve finally befriended my body. It’s sad to think it took nearly 53 years, but it’s better than never!
I’m also much more aware of the wonderful people in my life: my family, friends, neighbors and Scott—my beloved partner. I am so grateful to all of them for their help and support. When you are not able to function normally, you feel vulnerable and frightened. I am so grateful to all of them for their care, which helped me feel safe and loved. I’m especially thankful to Scott for his sunny, steadfast support through it all. When I would slip into despair, he always encouraged me to have patience, it would get better.
Another change I’ve noticed is the blossoming of my spiritual life. As my physical attachments have lessened, I’ve become more interested in my interior life. I take more time for reading and contemplation. My sense of Self is expanding. The boundaries which have always kept me separate, are falling away. Increasingly, I sense myself as part of everything and everything as part of me. There is more love, peace, kindness, and happiness, even when hard things are happening. I know that all things pass, but that which I am, endures. In some moments, I feel pure bliss and a deep sense of well being.
I’ve come to see my Hip Adventures as a gift. Along the way, I am learning who I really am—part of everything and everyone. No longer separate and alone, an outsider looking in. I’m not sure why it was this experience which brought me Home, but I am grateful. Now I am also grateful to have strong legs and hips to walk on and to serve with, as I embark on a new journey.