Category Archives: Hip Adventures

Summary of My Hip Adventures, Hip Tips, Videos

It is now March 2019, about 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.

I will continue to add updates to this theme, so be sure to look for entries after this summary, which I will always float up to the top of the theme for those of you who just want the highlights.

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. To see descriptions, 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. 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

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 as of this writing (March 2019), I’m still working on those. But the way I see it, that is more of a want-to-be-able-to-do than a have-to. 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 is returning, 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 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 wellbeing.

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.

16 months right hip, 8 months left hip, 3 months cerclage cable removal

It feels like a new dawn in my world–coinciding with the beginning of a new year. At last, I feel like I’m over the hump of my hip adventures! Slowly, my strength, balance and energy are returning and I am feeling more like myself again. I didn’t realize how much energy this all took and how tired I was. 

I’m happy to say that Scott and I went cross country skiing on Monday! It was the first time in 2 years, another milestone of something I used to do and can now do again. I loved gliding over the snow, watching the sun sparkle like diamonds on a white blanket, winding through the trees with the skis “swoosh swooshing” beneath me. I felt strong and balanced–though my balance is now a little out to the side from where it was before. I also notice this in one-legged yoga poses. I used to hug in close to the mid-line of my body, keeping the weight off the outside of my hips, where unbeknownst to me, I had no functional hip joint. Now that I have hips, I have to remind myself to lean outwards over the joints. I have a new balance point. True on more than just the physical levels of my life.

Now seems to be a time of finding my new balance points from the yoga mat into my daily life. I’ve continued my morning Tai Chi, yoga and meditation practices. They center me into a deeper and quieter place from which to enter my day. I always ask to be of service to the larger good. Then the day unfolds and I am literally led to where I need to be and with whom. Some time in the afternoon, I break for a swim, yoga, or a walk to re-center again. 

Finding balance seems to be about coming into center, then engaging in a more outward way with the world and those around me, and then returning back to center. Over and over. Gone are the days of my youth, when I raced at full-tilt through a day, multi-tasking with an OCD ferocity. Looking back, that was exhausting. “Confusing activity with accomplishment” as Zig Ziglar used to say.

I’m also aware of how much time I spend in the future, the next moment, and not in the present moment. It occurs to me that this is how I’ve been missing my life. My hip adventures have helped to slow me down and be more present in the only moment I have–NOW.

As odd as it may sound, I am grateful for this whole experience. It has taught me so much and truly changed my life. My resolve now is not to forget what I’ve learned–to move forward with ease, strength and balance, all the while being present in each moment with an open heart.

It feels like it is time to write in this blog as things come up that I want to share along the way. For sure, I’ll do an update in May and November–my one year mark for my left hip and my annual checkup. Thanks for being along for the ride!

Post Rehab-7 weeks after cerclage cable was removed

I graduated from physical therapy this week! Hard to believe. It was a bigger deal than I thought it would be–walking out of the ROC for the last time. I won’t be back until my annual checkup next November. This long journey is coming to an end. It began on July 6, 2017 with my diagnosis of  severe osteoarthritis due to congential hip dysplasia.  A year and a half later, I have two new hips and a new lease on a life of mobility! 

I did my usual overdoing after surgery and when I started PT. Then, I had to dial it back into my Goldilocks Zone. I always get way too exuberant after a surgery, so excited by what I can do that I haven’t been able to for some time. At least, after 3 surgeries in 13 months, I figure it out sooner and STOP! 

But, it has been different this time. The setbacks are mild compared to what I’ve dealt with for the last few years. Before when I overdid it, I paid for weeks, even months. Since the cable came out, I had a few days of soreness and a stiff back for a week or so. Nothing like what it was. I finally feel like I’ve crested the ridge of this hip adventure and am on my way back to a more normal life. Instead of feeling like I’m in my 80’s, I feel like I’m in my 40’s! The miracles of modern medicine are truly amazing and I’m grateful to have been the beneficiary of a number of them, including these two hip replacements. I’d be in a wheelchair if it weren’t for these bionic buns of mine!

I want to express again my thanks to my surgeons, Dr. Shukla and his assistant, Davis. They have done an amazing job of reconstructing me and giving me my life back. I also want to thank Lori and Jessie, my physical therapist and her assistant, who helped me to regain strength and balance. Over this last month, they’ve given me challenging exercises to help me rebalance and strengthen my weakened right side. I had my last session with them this Monday and gave them both a big hug. It seemed surreal to walk out the door of the clinic and think, “I won’t be back for a year.” 

Another very ironic event happened the night before my last PT session. On Sunday we had dinner with friends and I was showing them my cable. It had become quite the conversation piece in the last seven weeks and I’ve shown it to everyone. “Look what they took out of my leg!” The response is always, “Wow! No wonder you were in pain!”

Before we left on Sunday, I was distracted saying goodbye to people and walked away from the table, leaving the cable! I didn’t remember until the next day (the day of my official graduation from the ROC). Scott went back to the restaurant to see if anyone had turned it in, but they hadn’t. My cerclage cable was gone! At first, I panicked. Then it hit me, “It’s time to let it go.” Oftentimes, when I reached in my purse to get that nasty thing, it bit me. It was always very ill mannered. I was trying to figure out what I was going to do with it, because everyone had seen it. And then the Universe whisked it away, into the trash, where it belongs. I’m good with that.

So, a new life chapter begins now, or at least, that is how it feels to me. I’m excited to see what it will bring. Already, so many of the things I wanted to be able to do again I can. For example, last week Scott and I ran a wine toss booth at a Christmas Party we attend annually. It requires two hours of standing and bending over to scoop up the rings (people get to take  home the wine they toss a ring over, but most of the rings end up on the floor). Then we danced for another hour and a half to some great tunes the DJ was playing! For a few years now, I suffer after this party. I’m happy to say that I got up the next day and was just a little sore! It was a miracle!

As soon as we get some more snow, I want to try cross country skiing, which I haven’t really done for 2 seasons now. I love gliding across the snow in the pines and I can’t wait to try it again and see how it feels!

Oh yeah! I also was able to walk more than a mile on the beach over Thanksgiving without being in pain during or after! I think it’s been 3 years since I’ve been able to manage sand without pain.

I decided it was time to do another video now that shows what I can do at 7 weeks after the cable was removed, compared to what I could do before. It is the last video at this link: Rhonda’s Hip Adventure Videos. I will continue to update this blog and my videos as my healing progresses. I hope this will be an inspiration and give hope to those of you who may be putting off needed hip surgery!

This whole experience, helped me realize it is the simplest things in life that mean the most and I didn’t know how important they were until I couldn’t do them anymore. My hip adventures have been an amazing teacher about what is really important. My hope is that I will not forget the lessons as I heal. I intend to keep my life simple: do the right thing in this moment, be grateful that I am enough just as I am, and know there is enough of everything I really need right now, right here. And, of course, I am eternally grateful for my beloved Scott, my family and friends, and dear Theo the cat, for your support and love.

Wishing you all a Happy Christmas and a Blessed New Year!

And a Happy Full Moon Solstice today–an auspicious day for setting new intentions! This is the day the light begins to return to our darkened, winter world and we think of the spring to come and the new year ahead.

Scott

Yesterday, my beloved Scott and I celebrated our 6th Anniversary of being together. Six beautiful years with this amazing man! We’ve been through a lot in that time: Scott’s retirement, his mother’s death, my father’s death, the death of two of our dear pets–Sam and Peanut, and two years of hip pain and surgeries for me. Never once has he wavered in his steadfast, positive happiness and generous love. He is truly my sunshine and the love of my life!

As my hips got worse, he encouraged me to go see a surgeon instead of continuing to hurt myself trying to rehab what wasn’t fixable, took care of me when I was totally incapacitated after the first surgery, cheered me on when I was discouraged, cautioned me to take it easier when I was pushing too hard, and worried about me more than I knew as I struggled with continuing pain and disability.

Sometimes we don’t know how our suffering impacts our partners and all those who love us. They go along for this ride too. Here’s part of the card Scott gave me for our 6th:

We are so grateful that at last this ordeal is over, and for the modern medical miracles and awesome surgical team that made it possible for me to walk and dance again. 

I am grateful to you, dear Scott, for all the help, support and encouragement along the way. I know it hasn’t been easy for you and I can never express how much it means to me that you shined your sunny light on me no matter what. Here’s to the next chapter of our lives! I know we can face anything with each other.

Our 6th Anniversay
at Johnny’s Little Italy

Post-op Appointment

Yesterday, I had my post-op with Dr. Shukla and Davis. I got to say goodbye to my “saddle bag” bandage and see the incision. It looks good (I’ll put photos and the xrays at the end, so if you don’t want to see them, don’t scroll down :-).

Yesterday was a celebration, a graduation, into a whole new chapter of my life. I finally have solid, strong, even hips under me for the first time and the cable that has held me back is gone! If I’m careful about what I do, these hips should last me for life. I hugged both Dr. Shukla and Davis and told them how very grateful I am to them for giving me my life and my body back. I couldn’t keep myself from tearing up, didn’t want to. For me, this is a miracle and I’m excited to see what I’ll be able to do as I strengthen my right leg and restore balance to a body which has never been balanced on a solid foundation. I can already do so much more than I could two weeks ago. It was fun to be able to show them! (I promise I’ll make a new video after my physical therapy so you can see too.)

I also talked with them about the cable. I saw Davis first and gave him a printout of my last entry on all the changes I’d seen within a few days of its removal. I pulled out the brochure for the Kinamed SuperCable, which I’d given him after my second hip replacement, when I knew it was the cable that had been my problem with the first replacement.

Then he made my day with a wonderful piece of news: “We found something even better–flatter, smaller and smoother.” He drew a picture for me of the small, flat clasp that holds the new cerclage cable together. He explained that the challenge he and Dr. Shukla face is convincing operating rooms and implant manufacturers to provide these superior cabling systems. He asked if he could use the information on the changes I had seen when it was removed and refer to my blog when they are advocating for the newer system. Absolutely! Then, I would feel like my suffering has not been in vain and that this blog could be of value in preventing suffering for others. These cerclage cables are used in many orthopedic surgeries, not just in hip replacements.

I asked how often they have to remove them. He explained that most people are not bothered by the older cables, except for people who are more slender, fit and body aware. “But, yours was the second one we’ve removed in 4 months.” He also told me my cable had loosened and that’s why it gave me more problems over time.

Then I saw Dr. Shukla and we also talked about the cable. I told him I was so happy to hear that they are using a new system and trying to make it more available. I said, “It’s an insult to your beautiful work to put this cable in on top of it.” He nodded, smiled and blushed. He too requested permission to use my blog as a case study to advocate for change and possibly create a link for other Reno Orthopedic Clinic patients. 

We wrapped it up with hugs and good wishes for a Happy Thanksgiving. I have so much to be thankful for!

I went home and immediately felt a rush of relief. I realized I’d been bracing myself for the conversation about the cable. I wanted to express my concerns and implore them to change systems. But, more importantly, I wanted them to know how much I appreciated their skillful work which restored my body and gave me my life back. 

How great it was to hear that they had already changed! This is how good medicine and strong doctor-patient relationships should be. We work together towards better and better outcomes. Every time I have a surgery, they have some new innovation which has made my life easier. For example, the DVT icing/compression unit I received for my second replacement and the Prevena bandage system used on this incision. I feel so fortunate to have doctors who listen and make changes based on what they hear from their patients.

Feeling heard is truly a salve for heart and soul. I cried and laughed and danced with joy and relief for the rest of the afternoon. I’m BACK! (Well, mostly, still have some rehab to do… I’ll keep you posted on that as I go along.)

Ok, here’s show and tell:

The end result of my 3 surgeries
Perfect, stable, even hips!
New scar on right hip after cerclage cable removal
It’s a little longer, but very fine stitching.
Davis did beautiful work, didn’t he?
A wider-angle view of right hip scar
Left hip scar
Now at 6 months post-op
Wider-angle view of left hip scar

I thought you might like to see photos of my amazing surgical team…

Dr. Shukla
Davis J.P. Ayers II, MSPA, PA-C

God Bless the two of you! Thanks for saving my butt! See you in a year!

Changes I’m Noticing After Removal of the Cerclage Cable

Before I forget, as my body returns to normal, I want to make sure I note some of the changes I’m observing now that I have my right leg back under me:

  • When I wake up in the mornings, I no longer have the achy, arthritic stiffness I’ve grown accustomed to. I thought I’d have to live with that for the rest of my life. Since my right hip replacement, I’ve felt like I was 80+ when I got out of bed in the morning. I did 30 minutes of Qigong and Tai Chi to be able to move and dissipate the pain. Now I don’t have pain anymore. (I even removed the ever-present bottle of ibuprofen from my night stand!) The really odd thing is that pain affected most of my body: legs, glutes, back, shoulders, neck. Now it is suddenly gone and I feel my old self again! Could it be possible that my whole body was reacting to that cable? Maybe it was just a lot of muscular contraction and holding of tension? I don’t know, but it’s a very welcome relief!
  • The soreness from the surgery is already mostly gone. I actually have less pain now than I before the surgery! It’s Day 5 and I can hardly tell it ever happened.
  • I can do lunges and squats, and hinge from my hips. The pain which caused me to favor the right side and shift my weight to the left, is gone. As a result, I am much more balanced and stable when doing these movements. As of Day 5, I can squat all the way down to the floor, sit on my heels, and come back up. I would have screamed doing this before the surgery, or collapsed on the floor.
  • Because of the increased balanced stability in my legs, when I bend down to pick something up, the familiar twinge going up the right side of my back (QL) is gone. I no longer fear throwing my back into spasm every time I reach for the floor. I didn’t realize the contortions I was going through trying to avoid engaging the right leg and hitting the cable. As a result, my back is looser and I feel much more confident using it. I can effortlessly touch my palms on the floor again.
  • This morning, I reached over the right arm of my recliner for something on the floor. I didn’t even think about it. I could never do this without a lot of pain before, so I avoided it. This motion requires me to shift my weight onto the outside edge of my right thigh and it always caused so much pain once my flesh hit the sharp edge of the cable that I stopped. I’d get out of the chair and bend over my left leg instead.
  • I can lift my leg to put on and pull off pants without needing additional support. I trust my balance and can control the right leg.
  • It is much easier to get up from a sitting position.
  • I can tighten my glutes and not feel an aching pain in my right hip and outer thigh.
  • I vacuumed yesterday and caught myself extending the right leg and pushing from there. I’ve been doing left-leg-leading vacuuming for probably 2 years!
  • I’ve stopped continuously massaging the outside of my right thigh.
  • I am no longer constantly aware of having a foreign object in my leg. Now both my implants feel like an integral part of my body and I cannot even tell they are there. It was like this on my left side by about 6-weeks. But the right has always bothered me until now.
  • From my first walk on Day 4: My full, even stride is back! I can walk uphill and step up stairs and onto rocks without pain and with confidence. I was able to lift my leg over a fence, which I couldn’t do before. Uneven ground is no longer a scary negotiation. Hey, maybe I won’t need to always use hiking poles on a trail! My back isn’t stiff and my legs don’t ache when I get home. 
  • From my second walk on Day 5: I expected to be sore, because I did a lot yesterday! I was having too much fun exploring what I could do! I figured I’d pay for it today, which is what usually happens, but instead I am only a little sore. I was able to come back home and do some yoga without feeling wobbly on my legs and having a tight back and achy legs.
  • I can do belly dance moves which have been impossible since the replacement, these moves require me to shift all my weight onto the right leg and engage the gluteus medius. For example, I can now do hip drops, figure 8’s and the 3/4 shimmy. I can also push the right hip out to the right side, as if I were bumping a car door closed, and not get bit by the cable. I might actually dance again! This is one of the great joys of my life and I realize I haven’t even put the music on to tempt me, because I simply couldn’t do it without a lot of pain and awkwardness.
  • I can do the high kick in Tai Chi 24-short form and control, extend and straighten the leg. In Snake Creeps Through Grass, I can step onto the right leg (which is extended out in a lunge) and pull the rest of my body and my left leg up to join it. Before I had to sort of hop my left leg up, using it more than my weakened right leg.
  • From the yoga mat: Poses that engage the right leg no longer hurt, e.g. Warrior I and II. I still can’t do Warrior III or Dancer, which require full extension over the right leg, while extending the left leg back. But, I am finally able to begin tentatively shifting weight onto the right leg and extending the left leg back while leaning forward. I was totally unable to do this before. While lying on my left side, I can lift, circle and hold the right leg with control and without pain which I have not been able to do, particularly holding the leg up and forward while scissoring my left leg up to meet it. I can do a supine twist to the left without the catch in my right side and back. All poses which open the right side are easier and my range of motion is back. It honestly felt like my whole right side froze up every time I asked the muscles to stretch over and rake that cable. And I can certainly see why! It was like pulling them over a piece of barbed wire. I’d say that most of my practice (and daily life) has been affected by the cable and my body struggling to work around it and avoid pain. 

Last night I realized I’ve been depressed. I feel like my life has been on pause and now I’m back! Scott told me last night that he can tell I’m happy again. I feel so sad for him–he’s had to live with my pain, disability and depression all this time. I’m sure he felt like he’d lost his partner, and he did.

Scott and I were trying to pinpoint when the depression started. He thought it was two years ago. That’s when I started aggressively working with physical therapists and body workers in a vain attempt to heal my hip pain. This, of course, only aggravated my condition and increased my pain and disability. Then, I was diagnosed with dysplasia in July, 2017. My right hip was replaced in September, 2017 and the cable was installed to support my femur. It took me 3 months to walk without a limp and walking was never easy or pleasurable again. Then my left hip went and it was replaced in May, 2018. No cable was required. I could walk without aids in 4 days and had no limp within 2 weeks. It was then that I knew my problems on the right were caused by the cable and it had to go. Turns out, it was true!

But it wasn’t just the leg that was affected. Now it seems my whole body was affected with all the aches and pains I suddenly had. And I was depressed. Life had lost its luster. I no longer had the strong body I’d always counted on. Now I feel like my old self again on all levels. I’m 40 instead of 80!

There is no way to express how wonderful it feels to be able to do all the things I love to do with my body without pain. I am indebted to the miracles of modern medicine which have allowed me to walk again, and to my awesome surgeon, Dr. Shukla and his equally awesome assistant, Davis. They are truly masters of minimally invasive hip replacement and surgery. I can hardly tell they were in my leg to the bone 5 days ago. I will be forever grateful to them for my ability to walk, dance, do yoga and Tai Chi, and live my life again. The only thing that could have been better would have been a kinder, less invasive cerclage cable system. Hopefully, that can be corrected in the future, so others don’t have to go through what I have for these last 13 months.

Goodbye to my Farty Friend

This morning, while doing Qigong, the Prevena started to squawk. I turned it off and on a couple of times, hoping it would reset itself. When that didn’t work, I got online and looked up the alarm code. It indicated that my pump was full, but when I looked in the window, I didn’t see anything and had never noticed any drainage in the unit itself. So, I was puzzled. The instructions said to call my doctor if this happened.

Of course, the Reno Orthopaedic Clinic is not open on Sundays. I called and got the answering service. They took down all my information and my issue and said the on-call nurse would call me right back. And she did. She asked if I could see if the pump was full and I told her it didn’t look like it. She said the pump often stops around day 5-7 and the alarm can simply be part of it shutting down. She asked if I had any swelling , heat or pain and I told her I hadn’t since the surgery. She instructed me to cut the tubing flush with the bandage and put a piece of tape over the end, and then throw the unit in the trash. So, I did. Seems a shame to waste a medical device like that, but I guess they make them that way…

Once I cut the tube, the bandage puffed up. Davis had told me it would do that. Here’s what it looks like now:

Alas, I have lost my farty little friend! I am no longer tethered to the Prevena pack. All I have left is a poofy saddle bag on my right thigh! I’ll take it. No more worries in the grocery line.

Third day after cable removal

My leg is having a party, celebrating being free at last! It is truly amazing how fast this recovery is going. I feel my whole body breathing a deep sigh of relief.  It’s like I’ve been all crunched up on my right side, drawing the leg protectively into my body and not using it fully because of the pain. I can already do things pain-free that I haven’t been able to do all year. For example, I can do belly dance hip drops and figure 8 moves that have been impossible. I can lean forward on the leg, though not very far yet. I’m starting to get my forward and side lunges back, and was able to do 24-short form Tai Chi this morning and sit cross-legged for meditation!

I had a couple of tired days on Thursday and Friday, which is pretty normal and often more about getting over the anesthesia and all its various effects. Today I feel great! I have had virtually no pain since Wednesday, so I stopped all the pain meds. So far so good. I’m not even using Tylenol. In fact, the leg is less painful now than it was before the surgery!

Physically, my body has already moved on. It’s over. Emotionally, however, I go from anger to sadness to relief to gratitude to joy and sometimes back again. I’m angry that this brutal piece of hardware was placed in my body and it hurt so much that it really set back my recovery. I’m sad about all the pain and disability I suffered for the last 13 months. Every time I’m able to do something which has alluded me all this time, I cry all over again. When I touch the cable, which I keep on the kitchen table, I tear up. When I notice how much better I feel as I move, that I’m not off balance and favoring the leg, I feel relieved. I don’t feel like I’m 80-years-old anymore. And then there are those ever-increasing moments of gratitude and joy. It is finally over and I am whole again. There were times in this process when I wondered if that would ever happen.

I do want to say in support of my most amazing surgical team, Dr. Shukla and Davis, it wasn’t your fault. You did the right thing by putting a cerclage cable around that femur. I was the one who stubbornly kept walking on a totally destroyed hip until I stressed my femur. It already had bone spurs when you started. The wise and prudent thing was to support the femur until it could knit around the implant and repair any micro-fractures that might have occurred during the replacement. On this end of it, I have two solid replacements that are holding perfectly and I have equal leg length for the first time in my life. I also noticed, looking at my wet footprints at the pool the other day, I am no longer duck-footed! I have real hips for the first time in my life and I can walk again. For me, this is a medical miracle! I will be forever grateful to the two of you for the magic you’ve worked in my body. Without you, I would be in a wheelchair.

What I do want to say is that this piece of hardware does not belong in the human body. I realize that this is the cerclage system that comes with my Smith & Nephew implants. Why they are still using this cerclage system is beyond me. But there is a better one that uses a polymer system and a connector that lies flat against the bone and doesn’t have sharp ends, both for the safety of the patient and the surgeon. Here is a link (which may be helpful for my fellow hip people, or any of you who have to have orthopedic surgery):   http://www.kinamed.com/products/orthopedic-products/supercable. I think I could have tolerated this cable better and might not even have had to have it removed. I found this site when I was Googling problems with cerclage cables.

I do plan to discuss this with Dr. Shukla and Davis at my follow-up appointment. But, I also want to share it here, especially for my fellow hipsters. From my perspective, Dr. Shukla and Davis are gifted in their ability to perform minimally invasive replacement surgery, which causes very little disruption to the muscle tissue. I had the benefit of experiencing this on my left side–I was able to walk unaided in 4 days! It took 3 months to walk as well on my right side, because of this cable. It seems a shame to ruin the amazing work they do with a piece of hardware like this! My hope in talking with them, and in sharing this here, is that others might be spared the pain I have gone through.

On a lighter note… Me and my new friend, the Prevena pump are figuring out how to better live with one another. Scott discovered that it could be disconnected from the bandage for showering, which I did yesterday and it felt wonderful! I also found two pairs of pants I can put the tubing in and still get around. I located my old western belt, which the pump case belt loop fits over, thankfully. So, I am mobile and can drive! In fact, right now, I’m going to the store to go grocery shopping for dinner.

Good to go with my little Prevena buddy

I must say that this unit is pretty amazing. There is absolutely no swelling, bruising or pain in or around the incision. But, it does have one little quirk… It farts. That is the sound it makes about every other hour when it suctions. So, pray for me that it doesn’t do that in line at the grocery store!

Cable Removal Surgery

Today was my third surgery in 13 months to remove the cerclage cable placed around my right femur after my hip replacement on that side. It has done its job of holding my femur together while the bone knitted and formed around the stem of the implant. But, it has caused me a lot of pain and disability for these 13 months and it became very clear it had to go. 

Here’s the email I sent out this afternoon (I was actually able to comfortably sit in my chair at my computer and do it all by myself!):

Hello All!


I am so happy to report a quick, successful, pain free surgery and I was home by 9:30! We couldn’t believe how fast it all went, and easy, compared to hip replacements.


I went in at 7:00 and was out by 7:20. By 8:00 I was conscious and by 8:15 clear. They had me dressed and out the door by 9:00. Unbelievable!
I’m taking it easy at home, but feel well enough and can actually sit to write this email, so thought I’d do it myself. This also works well for Scott :-). 
You cannot believe what a nasty thing I’ve had around my femur for the last 13 months! No wonder I was having so much trouble and pain. It is large, with square rough edges. The end where they cut it after cinching it tight post-hip replacement (imagine a metal zip tie) is very sharp and frayed. If you aren’t careful while handling it, it can cut your finger. And that was rubbing on my soft tissue all this time! I started to cry when I touched it and felt how sharp and rough and bulky it is. I attached photos so you can see it. Scott, thought to add the quarter to show the size. I took one close-up of that sharp, frayed end. I’m so glad I decided to have this surgery to get that nasty thing out of there!

Scott put down a quarter to show the size.
It looks like something I’d have fixed fence with on the ranch!
This was the connector my leg muscles were snapping over.
There isn’t a smooth edge on the whole beastly thing!
Close-up of the connector and the sharp, frayed end where they cut off the excess cable.
This was sticking into the muscles of my outer thigh and I’m sure was causing most of my pain! It is so sharp that you can cut yourself just touching it if you aren’t careful.


I don’t have pain, though I am taking 1/2 a Tramadol every 4 hours to make sure I don’t get any when the blocks wear off… The really cool thing is that my muscles seem to be unaffected. I can walk, touch the floor, sit, bend my knees, reach my toes in a chair–all the things which are impossible for awhile after a replacement. I attached a photo of me doing tree even, on the surgical leg!

Photo was taken at noon, 5 hours after surgery and I’m standing on the surgical leg!


I came home with a new bandage (there’s a pic of that too). It comes with a battery/suction device that draws fluid out of the wound, so there is less chance of infection and improved healing. the surgeon explained that when he goes into the same incision a second time, there is greater risk and that this bandage system seems to ameliorate that significantly. The bummer is that I have to have this attached to me for the next two weeks! That means no pants and it’s getting too cold outdoors to be without them. I’m also not sure how I’m going to shower… May have to get creative with that! But, if it keeps me from getting an infection, I’m all for it in spite of the inconvenience. 

The Prevena bandage and wound suction system. Very cool!
Its main purpose is to remove fluids and prevent infection.
Attached to a battery pack in the black case.
This will be my little friend for the next two weeks…
I include this for my fellow hipsters in case you want to ask your surgeon about it. 
Here’s the link:
https://www.acelity.com/products/prevena-incision-management-system


My sense is when that bandage comes off, I’ll be doing awesome. I’m already noticing that the snap is gone when I flex my muscles. It is now fluid and easy like the other side. I also discovered that I’m already standing more on that leg than I have been. I usually favor it and list to port when standing. I have had to consciously remind myself to stand on both legs, but already that is changing! Isn’t it amazing what our bodies can do?


Thanks to all of you for reaching out and keeping me in your prayers and thoughts. I always feel swaddled in all your love when I go in for a surgery. I dearly hope this is my last.


Much Love and Gratitude,
Rhonda

Soaking in Nature Before the Cable Removal Surgery

We decided to take a trip to the Redwood Forest and the Trinity River to soak in nature and all its good energy before my cable removal surgery. It was such a needed sojourn! 

Here are some of my favorite photos:

Soaking in the energy of this giant redwood
Scott peers through the remains of a burned, fallen redwood 
Our little cabin on the Trinity River
The Trinity flowing by in front of our cabin
Walking down the country lane behind the cabin
Trinity River with Trinity Alps in the background
Painted sheep and their guard dog made this old shepherdess smile
and wonder… who paints their sheep and why?

I came back renewed, yet still having difficulty psyching myself up for my third surgery in thirteen months. But, hiking through the hills of the redwoods, I had so much pain that I knew there was no option. It was the first time I’d done hills since my hip replacements, and even with hiking poles, it still hurt. I really don’t want to live the rest of my life with this kind of pain and disability. I want to be able to hike moderately in beautiful places and not fight this anymore. So, it has to go.

One more day. Tomorrow I spend half the day in pre-op appointments and then, at 7:00 a.m. on Wednesday, the cable will come out. Happy Halloween! Pray for me. 

I’ll let you know how it goes on the other side, when my head clears.