June 03, 2007
Are you a candidate for total hip replacement?
Making the decision to have hip surgery is a tough one. Some people are so incapacitated by their arthritic hips that the choice is easy to make. Others are not quite so disabled by their pain.
Maybe your pain fluctuates. Perhaps you can delay or defer a total hip replacement by exercising, taking pain medications, or going to physical therapy. But chances are if you have found this page, those conservative options may not have worked out for you.
In my book, GETTING HIP: Recovery from a Total Hip Replacement, I discuss various treatments that may be effective in preventing total hip surgery, including some alternative medicine choices. I also talk about how critical it is to choose a good surgeon (up to 50% of the success of total hip replacements depends on surgical expertise), different types of implants that are available, hip resurfacing instead of total joint replacement, and how to get a second opinion if you're unhappy with the first doctor that you see. If you're already booked for joint replacement, you’ll want to know how to prepare for the operation, physically, socially and psychologically. You will also need tips on how to minimize your pain postoperatively, and how to pace yourself after surgery. Everyone has a different experience after a total hip replacement (THR). Some people have rapid recoveries whereas others take much longer. Your recovery may be entirely different from that of another person, so it's important not to compare your experience with theirs. I interviewed ten people around the world for GETTING HIP so that readers could hear about a wide variety of recoveries from the short and sweet to the more lengthy and complicated; your own recuperation may fall somewhere in between mine and the people that I spoke to.
Many doctors use traditional metal and plastic implants whereas others are experimenting with new prostheses, such as the ceramic-on-ceramic or metal-on-metal. I interviewed people with conventional implants and those with ceramic or metal implants: people who ranged in age from 43 to 73 at the time of their surgery. You may decide that the time is right for you to have your hip replaced and then have to endure the frustration of waiting for an appointment with an orthopedic surgeon, and receiving a surgical date, or being told by your family doctor that you're too young for the operation. Waiting lists are a problem for people who rely on public health care systems in Canada, the UK and Australia. Many Americans depend on HMOs, which are notorious for creating delays in all kinds of procedures, including joint replacements.
Or maybe you've already had a total hip replacement. In that case, certain lifestyle changes can go a long way towards making your prosthesis last longer. GETTING HIP devotes a full chapter to taking care of a new prosthesis so that it will last as long as possible, and a final chapter on the future of hip replacements. Many exciting advances are being made in the field of stem cells and cartilage regeneration.
HEAR ME ON THE RADIO Recently, I was on The Good Life Show with Jesse Dylan, discussing hip replacements and my own experience. The show is broadcast all over North America on Sirius Satellite Radio, has esteemed guests such as Deepak Chopra and Andrew Weil and has over four million listeners; you can hear the interview here and see a small picture of me on the way to the gym: http://www.tglshow.com/integrated.php [Can't find me? I'm the 12th person from the bottom of the page.]
BUY GETTING HIP If you'd like to save money and get an autographed copy of GETTING HIP, buy the book from me directly by clicking on the CONTACT ME button at the end of my link section. GETTING HIP is currently available for $11.50 US or $14.25 Canadian, not including shipping and handling(which is $3.50 within Canada and $5.00/US to the States). That's 25% less than what the book sells for on Amazon!
Just send me an e-mail to confirm pricing and I'll mail you the book. I accept PayPal, checks and money orders. If you don't want to wait for the book to be shipped, GET THE E-BOOK for $5.00/US by writing to sigridmac at sign rogers.com or by clicking on the button that says "CONTACT ME" at the bottom of my link section, on the right. E-books are delivered immediately, can be read on your screen, or can be printed out, so that you can read them in the comfort of your big chair. Do it through me or via PayPal -- it's easy.
WHY DO YOU NEED GETTING HIP?
Hip replacement surgery was not what I expected. I'd had other surgeries in my lifetime and each one required a passive convalescence. Orthopedic surgery is different; we need to be active partners. It's also critical to find out what the hip precautions are before surgery because there are certain positions that post-op patients cannot adopt for at least 4 --8 weeks. Knowing these precautions beforehand allows you to hip-proof your house, move objects up to waist level, and buy certain items like reachers and long handled shoehorns well before the operation. You also want to plan in advance because you'll be out of commission for a period of time. How will you do your shopping? Who will do your errands? What will you use for transportation during the period of time when you can't drive?
GETTING HIP addresses all of these issues and more. It talks about how to reduce your chances of becoming anemic or developing swelling in your legs following the surgery, as well as proper pain management.
TESTIMONIALS -- WHAT PEOPLE HAVE TO SAY ABOUT GETTING HIP
Linda May Bowser, webmaster of the Totally Hip Online Support Group, calls GETTING HIP "totally captivating!"
"GETTING HIP is written in such a manner that it captures your attention from page one and just won't let you go. In fact, when Sigrid sent me a personal autographed copy, my mom picked it up while my Dad and I were repairing some dining room chairs. She started reading it, and then took it home with her to finish... before I could even get a good look at it. Well, today, I made sure to get my copy back so I could read it as well. "
Ottawa Seniors declares GETTING HIP to be a "must read." Ottawa Seniors Newsletter December 2004 “Hip Replacement? If any of you or your loved ones has just or is about to go through a hip replacement, then there is a book by local author Sigrid Macdonald that is a must read. Find out the mistakes that can be made and the best tips and tricks to ensure any unnecessary suffering or problems are avoided. You can read more about Sigrid's experience and how to get the book by going to the Articles/News section of the website or by searching for "Sigrid" in our Services Directory."
Swamy Swarma, Professional Book Reviewer, Recommends GETTING HIP
"Getting Hip is the first person account of Sigrid Macdonald, who went through a Total Hip Replacement Surgery and felt the need to share her experiences before, during and after surgery. At places poignant, at places serious and at some places humorous, the book gives a detailed account of what is involved in a Total Hip Replacement Surgery, including the decision to go in for the surgery, type of implant to be selected (given a choice) and what to expect in terms of pain, restrictions on movement and post-surgery life style etc.
"The author has referred to several books on the subject and has added her own wisdom to the subject...If you are considering a hip replacement or if you need to support a friend or relative who is contemplating such a surgery and are looking for a layperson's perspective of what is involved in a major surgical operation like Total Hip Replacement, this book is certainly recommended."
Total Hip Replacement Patient, Peter Nixon, calls GETTING HIP "the best book out there."
"I read this book 9 months after having simultaneous bilateral total hip replacements. In my opinion, it is the best book out there that documents what those in need of a total hip replacement are experiencing, from the onset of the symptoms of hip pain, to the procedure itself, and through the recovery process. I wish I had known about this book prior to my surgery, and during my recovery.
"Most helpful to me was the point that was made that there is no 'gold standard' for recovery, and that, while all patients will experience much of the same in terms of the recovery process, we will all require different amounts of time to recover."
EXCERPT I have posted the introduction and first chapter of GETTING HIP below, so you'll have a sense of what the book is about. Please drop me a note before you leave. I love hearing from other total hippers and wish you the best of success with your surgery. Thanks for visiting and stay hip!
Sigrid Macdonald
Ottawa, Ontario
INTRODUCTION
Every year, almost 400,000 North Americans undergo joint replacement surgery. Arthritic hips, knees, shoulders and occasionally, ankles are replaced with metal and plastic implants. Total hip replacements (THRs) constitute approximately half of these surgeries, allowing people who would otherwise be completely disabled by pain to resume full and active lives.
We are in the miraculous era of the Internet, the DVD, the CD player, the Cell Phone and the Palm Pilot. It is easy to take these technological advances for granted and to forget that they were all developed and made accessible within the last twenty years. Likewise, the first successful total hip replacement was not performed until the early 1960s. Fifty years ago, those who were afflicted by severe arthritis would have suffered relentless pain with no hope of effective treatment. In many instances, they would have spent the rest of their days in a wheelchair. Dr. Seth Leopold, of the Orthopedics and Sports Medicine Department at the University of Washington, considers the total hip replacement to be the most important operation developed in the 20th century, in terms of the amount of human suffering that it has relieved.
In April of 2003, I was one of 17,500 Canadians who required a total hip replacement. Many people have swift recoveries from hip surgery. The books that I read indicated that most people were able to dispense with their crutches about six to eight weeks after the operation, and that three months postoperatively, they felt relatively normal. This was not my experience nor was such a textbook recovery shared by all of the people that I interviewed.
I had a significant degree of pain and swelling in my leg that lingered for months after my THR. Although I was only 50 years old, which is young in the world of hip replacements, I needed to use a walker for more than ten weeks. I spent an additional eight weeks on a cane. Instead of feeling well three months after the surgery, my hip did not feel anywhere near normal until five or six months postoperatively. At first, I thought there was something wrong with me. I felt inadequate and worried that something had gone wrong with my operation because it took so long to regain my muscular strength, and the ability to walk again comfortably. Then I created this web site about my experience and began talking to other people who had had the surgery. I discovered that I was not alone. Not everyone had a speedy and painless recovery, although most people experienced considerably less pain than I did and regained mobility much faster; but several of those individuals required multiple joint replacements later on.
Some of my suffering was needless. I made many mistakes, which I would like to share with prospective hip patients, so that they can benefit from my errors. Unlike other surgeries, people cannot sit back, relax and let time heal the wound following hip surgery. They need to be active participants in their own rehabilitation. Information is power. If you are considering a hip replacement, the more you learn about the operation beforehand, the better off you will be.
This book is geared towards people who are wondering if they need a total hip replacement and to those who are waiting for hip surgery. It is also written for individuals who have already had their hips replaced, especially if they are under the age of 65. There is a strong likelihood that they will have to have additional hip surgery down the road since the average lifespan of an artificial joint is only 10 to 15 years.
GETTING HIP may serve as a useful tool for friends and relatives of people who are undergoing joint replacements. I offer a great deal of information about how I decided to have the surgery, what is involved in the preoperative exam, and the mechanics and history of the operation itself. In addition, I provide a detailed description of my own rehabilitation, from the time of the surgery to six months postoperatively, as well as advice on how to take care of a new artificial hip and a final chapter on the future of hip replacements.
Each patient is unique. An arthritic hip may be the only health issue facing some individuals whereas others, like me, may have additional medical problems. One person might have an extensive social support network, a large family or a supportive spouse, whereas another person might live alone and have very little assistance. One patient may recover quickly and effortlessly with minimal pain and another may experience a delayed recovery with quite a bit of discomfort. 55-year-old Ranny Welton of Mexico, Missouri drove himself to work one week after his hip replacement. He used a walker in the hospital, went home with a cane, and was walking without any assistive devices two weeks later! But 73-year-old Suzanne Carlos of Ottawa, Ontario spent months on a cane following her surgery. Age is not always the determining factor in recovery, either. After my surgery, the orthopedic nurses told me that sometimes patients in their eighties or nineties resume walking right away, yet someone in their forties or fifties may take much longer.
My own recovery did not occur until somewhere around the fifth or sixth month after surgery. The timetable for other people's recoveries varies. I have included interviews with ten people who have had hip surgery. Nine of these individuals had total hip replacements. One had a procedure called hip resurfacing, which results in fewer restrictions than total hip surgery, since the hip is reshaped rather than replaced. Most of the interviewees reside in the United States but two are living in Canada. One is in the United Kingdom and another is in Denmark. They range in age from 43 years old to 70 years young at the time of their THR, and most are quite satisfied with the results of their surgery.
Some people may think that the title of my book, GETTING HIP, is too facetious or lighthearted for such a serious subject. I have deliberately chosen an upbeat title because I believe that humor is an important component of the recovery process. There is nothing funny about hip replacements but I did have some amusing experiences during my rehabilitation. I have tried to laugh about these occasions and to share my comical moments, as well as my difficulties and frustrations.
I hope that this book will be read by members of the medical profession and by the staff that treat total hip patients, such as nurses, physiotherapists, occupational therapists, visiting home nurses, counselors, and home care workers. Often, in their day-to-day jobs, medical personnel are only able to spend brief amounts of time with their patients. They cannot grasp the extent to which a patient's life has been affected by the deterioration of an arthritic joint, and the difficulty that is involved in going through total hip surgery.
GETTING HIP is also directed at health care policy makers. The accident that caused my hip injury took place in New Jersey, which makes this an American story. But my surgery took place in Ontario so this is also a Canadian story. We have universal health care in Canada. When it works properly, our Medicare system is fantastic because everyone is insured. Health coverage is a right in this country, not a privilege. However our health care system is overburdened and under funded. Consequently, there are long waiting list to get in to see a specialist and even longer lists for surgery. I had to wait 18 months for my operation. This was in addition to the 18 months that it took to decide that I was going to have the joint replaced. That translated into three completely lost years for me.
The baby boomers are turning 50. As the population ages, the incidence of arthritis and the subsequent need for total hip replacements will increase. The Canadian Orthopaedic Association and the Canadian Arthritis Society have joined forces to warn the public of a "crisis in joint replacement surgery." Both organizations claim that there is not enough manpower to perform the surgeries and that people are waiting far too long. We need more orthopedic surgeons in Canada and we must learn to treat our nurses and physiotherapists with more respect and remuneration, so that these crucial medical people do not continue to emigrate south of the border. Surgeons need better access to operating rooms. We need more hospital beds so that orthopedists have a place to put their patients once they have scheduled operations. New advances in joint surgery are exciting, but they will be of limited usefulness if the Canadian national health care system cannot make this routine operation available to people in a timely fashion.
Waiting lists may not be an issue for Americans but insurance coverage is often a problem. 43 million Americans lack health insurance, according to CNN's medical authority, Dr. Sanjay Gupta. The uninsured tend to receive catastrophic care in the emergency room. They are less likely to receive preventative treatment. Medicaid, Medicare and Health Maintenance Organizations cover millions of other Americans. HMOs are notorious for creating delays in the approval of medical procedures, including hip replacement surgeries. Chris Warner is the owner of Panther Enterprises, a physician recruiting service in Long Beach, California. He says, “The morass of government programs and private insurance plans is bewildering, extremely convoluted, complex and very expensive: some say at a cost of two hundred billion dollars a year. Physician's offices are rampant with cascades of forms, paper, regulations, codes, manuals, phone calls, hair wringing and teeth gnashing as a direct result of this third party oversight, due to spending constraints by individuals and employers. As a result the basic fabric of our health care system is in grave jeopardy." Thus, Americans, Canadians and Britons, who also have a public health care system, all experience some type of frustration with access to joint replacement surgery.
Lastly, this book may be of interest to the dedicated people who campaign against drunk driving. I needed hip surgery before I turned 50 because I fractured and dislocated the joint at the age of 28 when I was hit and badly injured by a drunk driver. My hip became arthritic, eventually wore out and needed to be replaced. For many years, I was a member of Mothers against Drunk Driving and Remove Intoxicated Drivers. I appeared on three television shows about drunk driving including 20/20, 60 Minutes in Australia, and a Manhattan cable TV show entitled “Alcohol Abuse.” According to Mothers against Drunk Driving, in 2002, 17,419 people were killed in the U.S. in crashes involving alcohol, representing 41 percent of the 42,815 people killed in all traffic accidents. Fortunately, lobbying efforts have paid off and alcohol-related fatalities have decreased significantly since my accident in 1981. Injuries have also declined but still number about 500,000 each year in the United States alone. Even one serious injury can alter a person’s life forever.
Finally, I hope that I can convey my sense of awe for the science of joint replacement and my gratitude that I was born at a time when such impressive technology could relieve my suffering.
Maybe your pain fluctuates. Perhaps you can delay or defer a total hip replacement by exercising, taking pain medications, or going to physical therapy. But chances are if you have found this page, those conservative options may not have worked out for you.
In my book, GETTING HIP: Recovery from a Total Hip Replacement, I discuss various treatments that may be effective in preventing total hip surgery, including some alternative medicine choices. I also talk about how critical it is to choose a good surgeon (up to 50% of the success of total hip replacements depends on surgical expertise), different types of implants that are available, hip resurfacing instead of total joint replacement, and how to get a second opinion if you're unhappy with the first doctor that you see. If you're already booked for joint replacement, you’ll want to know how to prepare for the operation, physically, socially and psychologically. You will also need tips on how to minimize your pain postoperatively, and how to pace yourself after surgery. Everyone has a different experience after a total hip replacement (THR). Some people have rapid recoveries whereas others take much longer. Your recovery may be entirely different from that of another person, so it's important not to compare your experience with theirs. I interviewed ten people around the world for GETTING HIP so that readers could hear about a wide variety of recoveries from the short and sweet to the more lengthy and complicated; your own recuperation may fall somewhere in between mine and the people that I spoke to.
Many doctors use traditional metal and plastic implants whereas others are experimenting with new prostheses, such as the ceramic-on-ceramic or metal-on-metal. I interviewed people with conventional implants and those with ceramic or metal implants: people who ranged in age from 43 to 73 at the time of their surgery. You may decide that the time is right for you to have your hip replaced and then have to endure the frustration of waiting for an appointment with an orthopedic surgeon, and receiving a surgical date, or being told by your family doctor that you're too young for the operation. Waiting lists are a problem for people who rely on public health care systems in Canada, the UK and Australia. Many Americans depend on HMOs, which are notorious for creating delays in all kinds of procedures, including joint replacements.
Or maybe you've already had a total hip replacement. In that case, certain lifestyle changes can go a long way towards making your prosthesis last longer. GETTING HIP devotes a full chapter to taking care of a new prosthesis so that it will last as long as possible, and a final chapter on the future of hip replacements. Many exciting advances are being made in the field of stem cells and cartilage regeneration.
HEAR ME ON THE RADIO Recently, I was on The Good Life Show with Jesse Dylan, discussing hip replacements and my own experience. The show is broadcast all over North America on Sirius Satellite Radio, has esteemed guests such as Deepak Chopra and Andrew Weil and has over four million listeners; you can hear the interview here and see a small picture of me on the way to the gym: http://www.tglshow.com/integrated.php [Can't find me? I'm the 12th person from the bottom of the page.]
BUY GETTING HIP If you'd like to save money and get an autographed copy of GETTING HIP, buy the book from me directly by clicking on the CONTACT ME button at the end of my link section. GETTING HIP is currently available for $11.50 US or $14.25 Canadian, not including shipping and handling(which is $3.50 within Canada and $5.00/US to the States). That's 25% less than what the book sells for on Amazon!
Just send me an e-mail to confirm pricing and I'll mail you the book. I accept PayPal, checks and money orders. If you don't want to wait for the book to be shipped, GET THE E-BOOK for $5.00/US by writing to sigridmac at sign rogers.com or by clicking on the button that says "CONTACT ME" at the bottom of my link section, on the right. E-books are delivered immediately, can be read on your screen, or can be printed out, so that you can read them in the comfort of your big chair. Do it through me or via PayPal -- it's easy.
WHY DO YOU NEED GETTING HIP?
Hip replacement surgery was not what I expected. I'd had other surgeries in my lifetime and each one required a passive convalescence. Orthopedic surgery is different; we need to be active partners. It's also critical to find out what the hip precautions are before surgery because there are certain positions that post-op patients cannot adopt for at least 4 --8 weeks. Knowing these precautions beforehand allows you to hip-proof your house, move objects up to waist level, and buy certain items like reachers and long handled shoehorns well before the operation. You also want to plan in advance because you'll be out of commission for a period of time. How will you do your shopping? Who will do your errands? What will you use for transportation during the period of time when you can't drive?
GETTING HIP addresses all of these issues and more. It talks about how to reduce your chances of becoming anemic or developing swelling in your legs following the surgery, as well as proper pain management.
TESTIMONIALS -- WHAT PEOPLE HAVE TO SAY ABOUT GETTING HIP
Linda May Bowser, webmaster of the Totally Hip Online Support Group, calls GETTING HIP "totally captivating!"
"GETTING HIP is written in such a manner that it captures your attention from page one and just won't let you go. In fact, when Sigrid sent me a personal autographed copy, my mom picked it up while my Dad and I were repairing some dining room chairs. She started reading it, and then took it home with her to finish... before I could even get a good look at it. Well, today, I made sure to get my copy back so I could read it as well. "
Ottawa Seniors declares GETTING HIP to be a "must read." Ottawa Seniors Newsletter December 2004 “Hip Replacement? If any of you or your loved ones has just or is about to go through a hip replacement, then there is a book by local author Sigrid Macdonald that is a must read. Find out the mistakes that can be made and the best tips and tricks to ensure any unnecessary suffering or problems are avoided. You can read more about Sigrid's experience and how to get the book by going to the Articles/News section of the website or by searching for "Sigrid" in our Services Directory."
Swamy Swarma, Professional Book Reviewer, Recommends GETTING HIP
"Getting Hip is the first person account of Sigrid Macdonald, who went through a Total Hip Replacement Surgery and felt the need to share her experiences before, during and after surgery. At places poignant, at places serious and at some places humorous, the book gives a detailed account of what is involved in a Total Hip Replacement Surgery, including the decision to go in for the surgery, type of implant to be selected (given a choice) and what to expect in terms of pain, restrictions on movement and post-surgery life style etc.
"The author has referred to several books on the subject and has added her own wisdom to the subject...If you are considering a hip replacement or if you need to support a friend or relative who is contemplating such a surgery and are looking for a layperson's perspective of what is involved in a major surgical operation like Total Hip Replacement, this book is certainly recommended."
Total Hip Replacement Patient, Peter Nixon, calls GETTING HIP "the best book out there."
"I read this book 9 months after having simultaneous bilateral total hip replacements. In my opinion, it is the best book out there that documents what those in need of a total hip replacement are experiencing, from the onset of the symptoms of hip pain, to the procedure itself, and through the recovery process. I wish I had known about this book prior to my surgery, and during my recovery.
"Most helpful to me was the point that was made that there is no 'gold standard' for recovery, and that, while all patients will experience much of the same in terms of the recovery process, we will all require different amounts of time to recover."
EXCERPT I have posted the introduction and first chapter of GETTING HIP below, so you'll have a sense of what the book is about. Please drop me a note before you leave. I love hearing from other total hippers and wish you the best of success with your surgery. Thanks for visiting and stay hip!
Sigrid Macdonald
Ottawa, Ontario
INTRODUCTION
Every year, almost 400,000 North Americans undergo joint replacement surgery. Arthritic hips, knees, shoulders and occasionally, ankles are replaced with metal and plastic implants. Total hip replacements (THRs) constitute approximately half of these surgeries, allowing people who would otherwise be completely disabled by pain to resume full and active lives.
We are in the miraculous era of the Internet, the DVD, the CD player, the Cell Phone and the Palm Pilot. It is easy to take these technological advances for granted and to forget that they were all developed and made accessible within the last twenty years. Likewise, the first successful total hip replacement was not performed until the early 1960s. Fifty years ago, those who were afflicted by severe arthritis would have suffered relentless pain with no hope of effective treatment. In many instances, they would have spent the rest of their days in a wheelchair. Dr. Seth Leopold, of the Orthopedics and Sports Medicine Department at the University of Washington, considers the total hip replacement to be the most important operation developed in the 20th century, in terms of the amount of human suffering that it has relieved.
In April of 2003, I was one of 17,500 Canadians who required a total hip replacement. Many people have swift recoveries from hip surgery. The books that I read indicated that most people were able to dispense with their crutches about six to eight weeks after the operation, and that three months postoperatively, they felt relatively normal. This was not my experience nor was such a textbook recovery shared by all of the people that I interviewed.
I had a significant degree of pain and swelling in my leg that lingered for months after my THR. Although I was only 50 years old, which is young in the world of hip replacements, I needed to use a walker for more than ten weeks. I spent an additional eight weeks on a cane. Instead of feeling well three months after the surgery, my hip did not feel anywhere near normal until five or six months postoperatively. At first, I thought there was something wrong with me. I felt inadequate and worried that something had gone wrong with my operation because it took so long to regain my muscular strength, and the ability to walk again comfortably. Then I created this web site about my experience and began talking to other people who had had the surgery. I discovered that I was not alone. Not everyone had a speedy and painless recovery, although most people experienced considerably less pain than I did and regained mobility much faster; but several of those individuals required multiple joint replacements later on.
Some of my suffering was needless. I made many mistakes, which I would like to share with prospective hip patients, so that they can benefit from my errors. Unlike other surgeries, people cannot sit back, relax and let time heal the wound following hip surgery. They need to be active participants in their own rehabilitation. Information is power. If you are considering a hip replacement, the more you learn about the operation beforehand, the better off you will be.
This book is geared towards people who are wondering if they need a total hip replacement and to those who are waiting for hip surgery. It is also written for individuals who have already had their hips replaced, especially if they are under the age of 65. There is a strong likelihood that they will have to have additional hip surgery down the road since the average lifespan of an artificial joint is only 10 to 15 years.
GETTING HIP may serve as a useful tool for friends and relatives of people who are undergoing joint replacements. I offer a great deal of information about how I decided to have the surgery, what is involved in the preoperative exam, and the mechanics and history of the operation itself. In addition, I provide a detailed description of my own rehabilitation, from the time of the surgery to six months postoperatively, as well as advice on how to take care of a new artificial hip and a final chapter on the future of hip replacements.
Each patient is unique. An arthritic hip may be the only health issue facing some individuals whereas others, like me, may have additional medical problems. One person might have an extensive social support network, a large family or a supportive spouse, whereas another person might live alone and have very little assistance. One patient may recover quickly and effortlessly with minimal pain and another may experience a delayed recovery with quite a bit of discomfort. 55-year-old Ranny Welton of Mexico, Missouri drove himself to work one week after his hip replacement. He used a walker in the hospital, went home with a cane, and was walking without any assistive devices two weeks later! But 73-year-old Suzanne Carlos of Ottawa, Ontario spent months on a cane following her surgery. Age is not always the determining factor in recovery, either. After my surgery, the orthopedic nurses told me that sometimes patients in their eighties or nineties resume walking right away, yet someone in their forties or fifties may take much longer.
My own recovery did not occur until somewhere around the fifth or sixth month after surgery. The timetable for other people's recoveries varies. I have included interviews with ten people who have had hip surgery. Nine of these individuals had total hip replacements. One had a procedure called hip resurfacing, which results in fewer restrictions than total hip surgery, since the hip is reshaped rather than replaced. Most of the interviewees reside in the United States but two are living in Canada. One is in the United Kingdom and another is in Denmark. They range in age from 43 years old to 70 years young at the time of their THR, and most are quite satisfied with the results of their surgery.
Some people may think that the title of my book, GETTING HIP, is too facetious or lighthearted for such a serious subject. I have deliberately chosen an upbeat title because I believe that humor is an important component of the recovery process. There is nothing funny about hip replacements but I did have some amusing experiences during my rehabilitation. I have tried to laugh about these occasions and to share my comical moments, as well as my difficulties and frustrations.
I hope that this book will be read by members of the medical profession and by the staff that treat total hip patients, such as nurses, physiotherapists, occupational therapists, visiting home nurses, counselors, and home care workers. Often, in their day-to-day jobs, medical personnel are only able to spend brief amounts of time with their patients. They cannot grasp the extent to which a patient's life has been affected by the deterioration of an arthritic joint, and the difficulty that is involved in going through total hip surgery.
GETTING HIP is also directed at health care policy makers. The accident that caused my hip injury took place in New Jersey, which makes this an American story. But my surgery took place in Ontario so this is also a Canadian story. We have universal health care in Canada. When it works properly, our Medicare system is fantastic because everyone is insured. Health coverage is a right in this country, not a privilege. However our health care system is overburdened and under funded. Consequently, there are long waiting list to get in to see a specialist and even longer lists for surgery. I had to wait 18 months for my operation. This was in addition to the 18 months that it took to decide that I was going to have the joint replaced. That translated into three completely lost years for me.
The baby boomers are turning 50. As the population ages, the incidence of arthritis and the subsequent need for total hip replacements will increase. The Canadian Orthopaedic Association and the Canadian Arthritis Society have joined forces to warn the public of a "crisis in joint replacement surgery." Both organizations claim that there is not enough manpower to perform the surgeries and that people are waiting far too long. We need more orthopedic surgeons in Canada and we must learn to treat our nurses and physiotherapists with more respect and remuneration, so that these crucial medical people do not continue to emigrate south of the border. Surgeons need better access to operating rooms. We need more hospital beds so that orthopedists have a place to put their patients once they have scheduled operations. New advances in joint surgery are exciting, but they will be of limited usefulness if the Canadian national health care system cannot make this routine operation available to people in a timely fashion.
Waiting lists may not be an issue for Americans but insurance coverage is often a problem. 43 million Americans lack health insurance, according to CNN's medical authority, Dr. Sanjay Gupta. The uninsured tend to receive catastrophic care in the emergency room. They are less likely to receive preventative treatment. Medicaid, Medicare and Health Maintenance Organizations cover millions of other Americans. HMOs are notorious for creating delays in the approval of medical procedures, including hip replacement surgeries. Chris Warner is the owner of Panther Enterprises, a physician recruiting service in Long Beach, California. He says, “The morass of government programs and private insurance plans is bewildering, extremely convoluted, complex and very expensive: some say at a cost of two hundred billion dollars a year. Physician's offices are rampant with cascades of forms, paper, regulations, codes, manuals, phone calls, hair wringing and teeth gnashing as a direct result of this third party oversight, due to spending constraints by individuals and employers. As a result the basic fabric of our health care system is in grave jeopardy." Thus, Americans, Canadians and Britons, who also have a public health care system, all experience some type of frustration with access to joint replacement surgery.
Lastly, this book may be of interest to the dedicated people who campaign against drunk driving. I needed hip surgery before I turned 50 because I fractured and dislocated the joint at the age of 28 when I was hit and badly injured by a drunk driver. My hip became arthritic, eventually wore out and needed to be replaced. For many years, I was a member of Mothers against Drunk Driving and Remove Intoxicated Drivers. I appeared on three television shows about drunk driving including 20/20, 60 Minutes in Australia, and a Manhattan cable TV show entitled “Alcohol Abuse.” According to Mothers against Drunk Driving, in 2002, 17,419 people were killed in the U.S. in crashes involving alcohol, representing 41 percent of the 42,815 people killed in all traffic accidents. Fortunately, lobbying efforts have paid off and alcohol-related fatalities have decreased significantly since my accident in 1981. Injuries have also declined but still number about 500,000 each year in the United States alone. Even one serious injury can alter a person’s life forever.
Finally, I hope that I can convey my sense of awe for the science of joint replacement and my gratitude that I was born at a time when such impressive technology could relieve my suffering.
# posted by Sigrid Macdonald : 6:07 PM
