Tuesday, November 15, 2011

Hip replacement…can wait

“You walk too fast for a cane.”

That’s what Doug told me during my discharge evaluation following my most recent round of PT sessions.

But he confirmed the cane was set at the appropriate length and showed me, with the aid of a mirror, how walking with it takes the pressure off my right hip.

As he breezed through his discharge checklist, Doug noted that my hip scored three points higher for strength ~ woot! Then he lowered the boom: “Flexibility-wise, you’re in a holding pattern, though. Your arthritis is bone-on-bone, so there’s not much to work with.”

Even though I knew that, hearing it was disheartening.

Every PT session starts with a query to rate my pain level, with “10” being the worst pain imaginable, and “1” being pain-free. I’m consistently at five or six.

Lately, as my curiosity about hip replacement surgery has increased, I’ve been quizzing those “in the know” to learn more.

Doug said I would likely do well recovering from hip replacement because a) I’m young (bless him…then again, the hip replacement patients he treats are in the 70+ club), and b) I already exercise.

“When you’re coming in here with a pain rating of five or six every session, you’ve got to consider your quality of life,” Doug said.

My friend, L, had both hips replaced in the early ‘90s and she’s still doing well – effectively defying the 15- to 20-year rule for prosthesis longevity. We had a good conversation about what to expect and one of the things she said resonated:

“People who hesitate and finally have the surgery often wish they’d done it sooner.”

Hmmmm.

So, after Doug’s encouraging words – and that of L – I was starting to think that the time for my hip replacement surgery – or at least a cortisone shot -- was nigh.

“That would be like jumping from step 1 to step 4,” according to Dr. Kabir, my rheumatologist.

She said that cortisone weakens bones, so it should be used sparingly. In addition, each shot is an opportunity to introduce infection.

Instead, we talked about the in-between steps -- including over-the-counter medication and prescription-strength drugs -- that should be explored before a cortisone shot or two. And then we can get serious about hip replacement.

Currently, I take a couple of ibuprofen “as needed” and find it has a residual effect that can last a few days. So, there’s no reason to rush. In the meantime, I’ll be interviewing some of the hip surgeons Dr. Kabir recommends. Sounds like a plan.