health care, hip resurfacing, orthopedic surgery, surgery, Uncategorized

Humbled by Mortality

Today…I bought a cane.  A cane!  I am 46 years old. I am only 46!  I have inherited some bad genes.  Genes for coronary artery disease (CAD), genes for diabetes (which I have dodged so far), and genes for osteoarthritis (OA).  About one year ago I stopped taking the statins, those wretched, wretched drugs that are supposed to be wonder drugs that will bring naughty lipid profiles up to toe the line.  I predict Hupy & Abraham 1-800-BAD-DRUG commercials in the near future, featuring statins. I had started aching–my legs, arms, even the spinal erector muscles ached.  An endocrinologist in Monroe, WI named Dr. Bekx tweaked my regimen with CoEnzyme Q10, Niaspan, the water-soluble Crestor that had been touted as “the best of the best of the best” in that class of drugs.  Dr. Bekx is a brilliant man, and even among physicians he stands out.  Tweak as he may, the myalgias (muscle aches) persisted to the point I could not stand taking even the tiniest dose.  I began to list them as an intolerance.

pill bottles

Mr. Polypharmacy!

By July I thought the statins should be long gone from my system and the pain should therefore also be gone…but it wasn’t.  My primary doc set a referral to a rheumatologist, Dr. Wilson.  A reputation of being difficult to work with preceded her, but I found her to be delightfully candid with a fast, dry wit.  Upon exam, she brought each of my legs up to my chest and I nearly came off the table in pain!  After reviewing the family history and getting an anterior-posterior x-ray of my hip joints, she told me I had osteoarthritis in both hips.  Mine was so bad that I had bone on bone, grinding, in each hip.  Worse, I had bone spurs that had been laid down as part of the body’s response after it received a chemical signal that something was bad in each hip.

OA hip

Arthritic hip; both of mine are bone-on-bone

Next was a referral to the orthopedic surgeon, Dr. Wolff.  From Madison, WI, he has a stellar reputation and a great surgical history.  Better, he was well-liked.  I cared little about that part because I would rather have a sound, gifted surgeon than one who simply made me feel good about some gaffe that occurred intraoperatively.  Surgery was originally scheduled for early December, but I just couldn’t wrap my mind around the notion of a total hip replacement on each side–not at age 46!  Sure, just lop off the proximal end of each femur and shove some hardware down in the center of the remaining leg bone!  No way, not for me, not at 46.

total hip hardware

The more common “total hip” replacement

A salty mare of a charge nurse that we love and work with in the emergency department suggested I look into the program at Sauk Memorial Hospital.  So I did, and I realized they offered hip resurfacing–new titanium alloy surfaces covering the head of the femur and the corresponding cup that is attached to the hip bone in the acetabulum.  Touted as the ideal surgery option for a male in his 40s or 50s with OA who plans to return to a vigorous lifestyle of running and skiing, this sounded like my perfect solution.  I would not likely run marathons again, but I do plan to ski with my sons.  By choosing this option, I get to keep my bones but I just get new surfaces so my bones are no longer grinding together–the titanium parts are!  Now that sounded like a capital idea!  When I met and spoke with Dr. Arnold Rosenthal, I liked him immediately.  He confided that he had the hip resurfacing done years ago himself and has loved the outcome.  Suddenly the man had street cred with me…like a mom-to-be taking suggestions from her doc who had already had a baby herself.

hip resurfacing hardware

This is hip resurfacing hardware; generally titanium alloy

Having never been cut on and placed under a general anesthetic, I am scared witless about this surgery.  I have decided to have both hips resurfaced and the closest the surgeon will do them is 6 weeks apart.  So, six weeks it is.  I will be on FMLA from work for 12 weeks.  Since osteoarthritis is a degenerative process, my hips will never be better than they are today–they will only get worse.  I cannot continue to gobble up the tramadol, naproxen, acetaminophen, and motrin as I have been for months or my kidneys will begin to fail.  My physician even added hydrocodone recently to help manage the pain all the other times that I am not at work.  Ibuprofen causes my ANA or anti-nuclear antibodies to spike and then I begin to feel pretty cruddy, so I reserve that stuff for breakthrough pain while at work. I cannot imagine a day where I don’t have to take something to manage pain, but that is the ideal I strive for by committing to these two surgeries.  Living with chronic pain is pure hell.

chronic hip pain

Living with chronic pain

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