More than 300,000 total hip replacement surgeries are performed annually in the United States.
Awhile back, I helped develop a hiking plan for a friend who had hip replacement surgery and wanted to return to hiking gradually as part of her physical therapy. It didn’t occur to me that I would need the same type of plan one day.
I have had the opportunity to hike many of the beautiful trails near Taos over the last 30 years. I began to write about hiking for the Taos News in 2011 and wrote the “Taos Hiking Guide” in 2015.
Up until about two years ago, I was hiking 14 miles round trip to places like Las Trampas Lakes near the Truchas Peaks, sometimes backpacking with no problem and little pain. Then that winter, I started to experience a lot of discomfort in my right hip and leg; occasionally my leg would just collapse and refuse to work.
I had seen Dr. Keith Christian, DOM, of Taos Chiropractic Health Center over time whenever I had a little twinge of pain in my knee or hip and for awhile, he was able to straighten out my body and reduce the pain.
But there came a time when no amount of adjusting reduced the pain or improved function. We both realized that something new was going on and Christian suggested that there was some significant deterioration in my hips.
When I got an X-ray at Holy Cross Hospital last summer, it showed that I had worn out all the cartilage in my right hip and had only a bit remaining in my left hip. I made an appointment with Dr. Sean Marvil at Taos Orthopaedic Institute to talk about options for treatment.
It turns out there aren’t many options: steroid shots can help with pain for a period of months and stem cell therapy is an emerging approach that has promise for the future, but the proposed solution from Marvil was hip replacement surgery, technically known as total hip arthroplasty, at least for my right hip.
The number of hip replacement surgeries in the U.S. is projected to grow over time. The average age for hip replacement is 67 years old, according to the American Joint Replacement Registry. In addition to improving the quality of life for patients, one study in Sweden showed that hip replacement surgery also may add years to a person’s life.
According to the two surgeons I consulted, the reason I needed the procedure is osteoarthritis: a condition that damages the cartilage covering the end of the bones where they come together in the hip socket. This condition arises from a combination of wear and tear and genetics.
Although hip surgery is generally classified as elective surgery, doctors may recommend it if the condition is causing a lot of pain and interfering with the ability to do basic tasks like getting dressed and walking.
Although I had two other friends who have had hip replacement surgery and I was beginning to wonder if my pain was the result of arthritis l, I was still surprised and a little angry at the diagnosis. I had somehow assumed that being active and fit would protect me from needing this kind of surgery. And I am younger than the average age for the surgery by a number of years.
After I had a chance to reflect on the situation a bit, I was relieved that at least there was something that could be done about the pain and dysfunction and that I could again be hiking longer distances. I made the decision to have the surgery and planned for it sometime in the spring of 2020.
Then life intervened. With the coming of the COVID-19 virus, elective surgeries were delayed. My mom who had been diagnosed with ovarian cancer at Christmas passed away in April and during that time all my priorities changed.
Finally in early June, I was able to see a surgeon in Colorado. Due to the requirements of my insurance plan, I had to have the procedure done in Colorado from a preapproved list of doctors in order to have it covered. This was a difficult decision, as I would have been happy to work with Marvil at Taos Orthopaedic Institute.
After reading reviews of all the approved physicians, I chose Dr. Joseph Assini at OrthoOne at Swedish Medical Center in Denver, due to his favorable reviews by past patients.
When asked about the benefits of hip replacement surgery, Assini said, “It is always great to see the amazing pain relief patients get after a total hip replacement. While the path for each patient is variable in terms of time and discomfort, patients will end up happy and generally back to most activities six to 12 weeks from surgery. Being able to help patients get back their quality of life is very rewarding.”
Before the surgery in June, I had a variety of exams and tests, including a screening for the COVID virus. All the test results looked good.
Early on the morning of June 24, my sister Brenda Staab picked me up and we went across town to the Rocky Mountain Surgery Center. I had spoken to the anesthesiologist the night before, who advised I have no food for eight hours and no liquids four hours before.
When I arrived, I checked in and was taken back to the preoperative area where an IV was started and I was given some painkillers. Assini stopped by and marked the right hip where the incision would be.
The anesthesiologist discussed the options with me. The two primary options were general anesthetic or a spinal block with additional medication that made sure the patient was asleep for the operation. We agreed on the spinal block as it is less impactful to the body and less likely to cause nausea and other side effects. He explained that he would put some cold gel on my back before giving me the injection. The cold gel was the last thing I remember until waking up a short time later.
What was amazing to me was that the actual hip replacement took under an hour. After demonstrating I could walk with crutches and perform certain other bodily functions to ensure that the spinal block had worn off, I was able to go home later the same day as the procedure.
I came back home to Taos the Sunday after my surgery to settle into the recovery process.
Recovery and physical therapy
Right after the surgery, I had nausea and a fair amount of pain. I was surprised by the extent of the swelling and bruising I experienced, not only in my hip, but also all the way down my leg to my foot, although Assini and staff reassured me that what I was experiencing was in the normal range.
For the first two weeks after surgery, I had to wear compression stockings which were hot and uncomfortable, but reduced the risk of a blood clot, one of the major risks of surgery. I’ve been taking two aspirin per day as a blood thinner to prevent clots and will need to continue to do so for a total of six weeks.
The pain medication that was prescribed to me was oxycodone – a narcotic drug with many side effects. It carries with it the risk of addiction. For the first few days, I took it every four to six hours and found it made me lightheaded and added to my nausea. Since then, I have been taking only one per day to help me sleep at night and am ready to begin to end that use as well.
In order to get back into shape for hiking and gardening, I have had the pleasure of working with Amryn Ayres of Physical Therapy and Rehab, a program of Holy Cross Hospital. Ayres received her doctorate in physical therapy just over two years ago and has worked at Physical Therapy and Rehab since the beginning of April.
She said, “The goal for physical therapy is to get people back to what they love. Surgery in general has widespread effects on the body in regard to motion, strength and overall function. As physical therapists, we are trained to identify specific impairments and guide you back to feeling better and living your life.”
I first saw Ayres five days after surgery. She assessed my mobility and put together a series of exercises for me to do at home. She’s also looked at my incision and helped determine it was ready to have the stitches removed.
I have been going to physical therapy one to two times a week since returning home and can feel that my hip and leg are becoming stronger.
After hip replacement on the right side, the patient is not able to drive for several weeks. I found Michelle Chandler, who in addition to being a musician and executive director of the Taos Youth Music School, offers various services to individuals and couples, including ministerial counseling and practical support. Chandler took me to physical therapy and also grocery shopping. Without her assistance, I would not have been able to navigate the first few weeks after surgery.
Also, 10,000 Wags Pet Resort was helpful. They picked up my dog twice a week and took him to play group so he got some exercise when I couldn’t walk him.
Although I am not done recovering, I can feel that I’m stronger every day and have been returning to some of my regular activities slowly. I was cleared to drive at about four weeks after surgery and am slowly returning to short hikes with my dog, while continuing my physical therapy appointments and exercises at home.
At five weeks after surgery, I have much better mobility in my hip and the remaining muscle pain from the surgery is gradually decreasing.
Not surprisingly, another thing I observed is having medical insurance is important. The total bill covered by insurance was more than $73,000, with my portion totaling around $3,000.
I may need to have my left hip replaced at some point. But for now, I am going to focus on healing and becoming stronger, so that by the time fall is here, I will be once again hiking high in the mountains around Taos watching the leaves turn to gold.