By: Eliza Mimski
Five years ago, before I had hip replacement surgery at age 66, my hip had gotten so funky that I could only walk with crutches. Sometimes it was so bad that I had to climb two flights of stairs to my apartment on my hands and knees. I lived in my bed, and on my couch. When the X-ray technician looked at the films of my hip, he said it was amazing that I could even walk on crutches. Yet with all this, and with knowing that the most successful surgery performed in the United States was hip replacement surgery which completely eliminated the pain and/or mobility problems, I put off the procedure for as long as I could.
I am writing the story of my hip replacement surgery because I want people to know what it was like for someone as frightened as I was. No one I spoke to who’d had the surgery would talk about anything other than the end result, shying away from the details. “I feel better than ever,” they’d say. Or, “I don’t know why I waited so long.” Or, “The minute I woke up from surgery I was out of pain. Now, I walk everywhere and I have my life back.” All of this was great, but at the time I felt I needed more than just hearing about the payoff.
One thing you should know about me: I am no wimp when it comes to medicine. I’ve had plenty of procedures, all the way from forceps being inserted into my spaghetti-thin ureter tube to remove marble-sized kidney stones to going through childbirth without taking as much as an aspirin. I’m tough, emotionally and physically. I’ve been told that I have a high pain tolerance. Yet when it came to considering hip surgery, I was so freaked out that I put it off, yes, for ten years.
Most of the hip replacement candidates that I spoke to were in so much discomfort that they just wanted it to end. They were results driven. They kept their eyes on the prize. They didn’t focus on the long recovery period. So I was different in this way. I had mobility issues that made it difficult to get around, but I had never experienced the agony most others did.
My ten-year process, or the story of a decade:
So, from my first visit to a surgeon until the time I actually walked into the operating room, ten years had elapsed. During this time, the problem had to have gotten pretty bad for me to make me willing to do something about it. I’d had surgery before, but not where surgeons used power tools in the operating room. I mean, they were going to saw my bone in half. One of my biggest fears had to do with anticipating how much pain I would be in once I woke up in the recovery room. I was also afraid that I wouldn’t be able to walk up the two flights of stairs to my apartment once I got home, and that I’d have to call an ambulance and have the paramedics carry me up on a stretcher. And I was afraid of those first two weeks after the surgery while the swelling would be going down and I’d be on a diet of Vicodan. I don’t do well with drugs. I get every negative side effect and then some. And I was afraid of losing my independence. Afraid of the long recovery period, being told that I probably wouldn’t drive for as much as six weeks. And then there was the fear of the unknown, for you never really know what something’s going to be like until you go through the experience.
When the situation deteriorated, it deteriorated quickly. During several months, my mobility had become so limited that I didn’t feel like I had much choice. Either I’d have the surgery or I would end up living the life of an invalid on the couch. At this point, my mobility had decreased to the point where I was forced to use crutches to help me down the stairs and into my car. I could drive okay, but getting in and out of the driver’s seat was so hard. Half the time my hip wouldn’t pop into place and I couldn’t stand up or bend down. Many times I’d be out shopping, hobbling on my crutches, and when I returned to my car I’d spend ten minutes trying to get my hip to catch so I could carefully lower myself into the seat. People would be honking their horns, impatiently waiting for my parking spot. I’d shrug, wondering what I’d do if my hip would never pop. And yes, there I’d be when I finally got home, snaking up the stairs (because the stairs had become my enemy), dragging my groceries along with me as I took on one carpeted step at a time. I’d do this hoping none of my neighbors would see me. Sometimes my neighbors would be entering or exiting the building, and although they’d be very compassionate, I felt embarrassed, and not just because they had seen me in such a vulnerable state. More than that, the whole situation impressed upon me how hard it was getting for me to take care of myself – look how long I’d let this thing go on.
Preparation for the surgery, or panic and control:
When at last I made the appointment with the surgeon, he talked about different procedures. I opted to have what’s called the anterior approach, where instead of cutting through the muscle in your buttocks, the surgeon goes in through the front. They don’t have to cut through any muscle, but temporarily move the muscle aside. It sounded so easy. Apparently, for this procedure, there’s a quicker healing time, lessening the recover by a few weeks. Also, I had heard that sometimes when the surgeon cuts through the buttocks muscle, it can leave lingering pain. And oh yeah, with the anterior approach there is less risk of dislocating your hip. Candidates for the anterior approach cannot be extremely muscular nor on the heavy side. I’m a small woman of about 120 pounds and although I’m pretty fit, I wouldn’t call myself muscular by any means.
That first appointment was the only time I saw my surgeon, except for the day of the surgery itself.Before the surgery, candidates are required to attend an informational class where a nurse explains things like how hard it might be to put on your socks right away, and showing the class a contraption that you could buy for that task that would help you. We were informed that a visiting nurse would come out to our home off and on for the first week to check on us, and that a physical therapist would come out three or four times to teach us a series of exercises we needed to do religiously in order to walk properly. Also, we were told that we’d be taking an anti-inflammatory drug, and meds for pain.
The hardest moments, or into the abyss:
The hardest, loneliest moments occurred a few days before the surgery took place until the orderly walked me into the operating room and I got up on the table. I had been in a somber mood during those few approaching days because it finally registered with me – really hit home – that the surgery that I had put off for ten years, well, it was going to happen. I was actually going to go through with it. In a way, I felt trapped by my decision. I couldn’t back out, but going forward was terrifying. I spent a lot of time alone in order to mentally prepare myself. Just sitting and being quiet, as if to say goodbye to the part of myself that was soon to enter an experience requiring a lot from me in the way of convalescing. I had been instructed to take a shower the night before the surgery and wash myself all over with antiseptic soap. This preparation, the antiseptic smell, brought out even more loneliness in me. As supportive as my family and partner and friends might be, only I could go through the surgery.
On the day of the procedure, when checking in at the hospital, these feelings of loneliness were intensified even more. Time was moving in closer. I felt more and more alone. I remember saying goodbye to my partner and walking down the hallway toward the operating room in a state of quiet desperation. I entered the sterile room and saw a group of doctors standing about in what looked like camouflage suits. They were wearing full head helmets. (Later, I learned that their gear was for the purpose of germ control). The scene looked like a cross between a war zone and sci fi movie. Thank goodness the nurse was kind to me. I don’t even remember what she’d said, but the tone of her voice was comforting and lessened my fear. Nurses are angels.
Getting out of surgery, or now it’s over:
I needn’t have worried about waking up in pain in the recovery room. I felt no pain whatsoever. I had enough pain meds to sink a ship. “I can do this!” my groggy brain telegraphed to me. I had gotten over a big hurdle. During my first night in the hospital I dozed on and off, pain-free, and I was pain-free for the better part of the next day. However, when the pain meds began to wear off, I experienced the worst pain of my lifetime. My leg felt like it was on fire, as if someone had poured gasoline on it and lit a match to it. I was to find out that the skin nerves that had been severed were not happy and they were letting me know it. I rang the nurse’s station and soon her fingers were clicking over her keyboard as she ordered pain medication for me. It took ten minutes to arrive and the whole time I just kept breathing and telling myself that it was going to be okay. Once I swallowed the pain medication I knew it would take a good twenty minutes before the relief would kick in. A clock was visible from my bed and my eyes were glued to it the entire time. Twenty minutes. You can do anything for twenty minutes, I told myself.
(By the way, the skin nerves in my leg never regenerated. To this day, I have no feeling from the top of my knee to the top of my thigh. When I run my fingernails over the area, my leg feels numb, kind of like your mouth feels when you go to the dentist and get a shot. Of course I can feel the muscle beneath the skin, but the skin itself has no feeling. When I spoke to the surgeon about this, he said that a small percentage of patients experience this. I wish he had mentioned this to me beforehand, but when I complained about it to a friend, she said he probably didn’t say anything because he didn’t want to scare me. Knowing that there might be numbness might have kept me from having the surgery, and he must have felt that this possible outcome would be worth the risk).
Leaving the hospital, or learning to cope:
I had the surgery on a Monday afternoon and went home Wednesday morning. That seemed really fast but that’s how they did it back then. Before I left the hospital, I had to prove to the nurses that with the aid of crutches I could climb up and down a few stairs in preparation for the stairs awaiting me at home. I assumed this was for insurance purposes. The hospital probably didn’t want to get sued if I went flying down my apartment stairs. The nurses wheeled me to a concrete stairway. They helped me up, and all by myself I was able to hobble up one stair, two stairs, three stairs, gritting my teeth and moaning as I slowly lowered my weight. It was like climbing Mount Everest on a burning stump. By the time I made it back to the wheelchair I was completely worn out. I guess I passed the test because the next day with a bag full of medications they sent me home.
I left the hospital on crutches. Prior to the operation, I had borrowed a walker from a friend in order to have it ready to use once I got home. When I climbed the two flights of stairs to my apartment, I again experienced that leg-on-fire feeling, but to a lesser extent. Once I made it into my apartment, I consoled myself with the thought that I could remain there for as long as I wanted. I made it to my bed, convinced that I would stay there forever.
After a day or two of Vicodan, I couldn’t take the medication anymore. It made me so nauseous I had to stop. I substituted ice packs instead, and they worked so well that I wondered why they sent me home with Vicodan to begin with. Of course pushing the walker into the kitchen to get a fresh ice pack was troublesome, but at least the horrible side effect was gone.
After a surgery like this, just about everything one does is considered physical therapy, from taking on those stairs to getting in and out of bed to using the walker to go to the kitchen and back, to going to the bathroom (at first I had a portable toilet stationed by my bed), to the actual physical therapy exercises that the visiting physical therapist had me do – mostly hip extensions. I swung my leg to the side, and then forward and back, and then made circles. At first it was so painful that I cried while doing them, but they soon got easier.
After a few weeks I was able to go outside. The stairs and getting in and out of the car were still the biggest challenge. I used a walker for weeks but eventually could walk on my own. First to the corner. Then around the block. One day I went to an art show. Another time I walked up the hill to the store. Gradually, things got easier and easier.
Do I have advice – you know – for the procrastinator?
I don’t know that I have any advice, per se. Everyone has to go through their own process. I believe it’s natural to be scared – terrified – of having a big procedure like this. As the saying goes, we wouldn’t be human if we didn’t feel fear sometimes. I guess the thing that helped me the most was my ability to reassure myself that everything was going to be okay, acknowledge that I was frightened, and tell myself that I would be there for myself. Kind of like a parent talking to a child. The big me talking to the little me. That voice of support and reassurance helped to nurture me and make me strong enough to go through the process, one step at a time. So, maybe that’s my advice. Just take one step toward the surgery at a time, seeing the whole event as a series of actions to get through, creating momentum so that when the day of the surgery arrives, you have done all the necessary psychological work to give you the confidence. Yes, you can do it, and it will be okay.
My life now, or how I became an athlete:
Before the surgery, I wouldn’t have considered taking a walk with a friend, much less a jaunt to the mailbox on the corner. I’d been fine at restaurants and movies, but shied away from anything that required me to be more physical. My world was small, and getting smaller. After the surgery, and I’m talking three to six months afterward, I began walking several blocks to the store on my own. I also began walking my son’s dog, and we now walk up and down the San Francisco hills where I live for up to an hour and a half each day. I’m not allowed to run as the pounding motion can cause harm to my hip, but I walk as fast as I can, and I’ve discovered muscles in my legs that I never before knew existed. Not once through all my seventy-one years had I ever considered myself athletic. But now, for the first time in my life, I think I am. I’m fit and muscular and toned. Yep, that’s how good things have gotten for me.
My surgeon told me that after the period of one year, the hip would belong to me. It would become a permanent part of me, of my body, of myself. I wouldn’t need to worry about dislocating it and repeating the surgery. At the one year mark, my recovery would be officially over.
It’s been five years now and here I am. Looking back at that time in my life, I remember that I didn’t like going through the whole process. I hated it, in fact. Having hip replacement surgery was a major physical and psychological challenge. Without a doubt, it was the biggest medical procedure I’ve ever endured. I did it for my own personal greater good. By taking a series of small steps I gathered the momentum to push myself from one task to the next. I arrived at the big scary day, got through it and with patience and support during my recovery I learned to walk again.