I’ll Take a Hip Replacement Please!
(and Other Decisionsâ€)
By Susan Flansburg, ORA Orthopedics Hip Replacement PatientIn Part 2, Susan visits her orthopedic surgeon to determine the best course of treatment for her debilitating pain: Cortisone shots or surgery? Hospital or outpatient surgery center?
It was clear my hip joint was shot. A radiologist had classified my X-ray as being clearly evident of osteoarthritis, so I was off to see the orthopedic surgeon.
As noted in my first blog, I chose Dr. Joseph Martin at ORA Orthopedics. Full disclosure: heâ€™s a friend, and I trust him implicitly. That said, I would never entrust my body to someone who didnâ€™t have great credentials, even if that person were my sister. (No chance of any surgery from her!)
Dr. Martin had me lie down on the exam table to measure how far he could bend my leg toward my chest and from side-to-side. Then he watched me walk.
â€œIs this a good day or a bad day?â€ he asked. It was as if he had read my mind: some days I could walk almost normally â€“ and would convince myself I was fine â€“ while other days I could only hobble painfully.
â€œItâ€™s a good day,â€ I chirped. I still held out hope for a different resolution. My optimism faded quickly as he began to review his findings.
â€œYouâ€™re definitely a candidate for treatment,â€ as he pointed at the X-ray. â€œYour hip is bone-on-bone, which is causing inflammation you experience as pain. You can see where youâ€™ve got a bone spur here.â€
(Bone spurs form as your body tries to repair conditions such as osteoarthritis. It adds bone to the area, forming â€œosteophytes,â€ or bone spurs.)
Dr. Martin said one available treatment option is cortisone injections. My husband nodded vigorously. Thatâ€™s what he would have chosen.
But I asked what the long-term result would be. He said cortisone shots might delay surgery for a year, all told, if they worked.
If. They. Worked.
I asked what kind of hip surgery he would plan to perform, and he said it would be a minimally invasive anterolateral hip replacement, composed of a ceramic ball, plastic glide, and titanium fittings.
A well-informed friend had recently described his own hip replacement, encouraging me to make sure my doctor used the same procedure and materials. I was satisfied after my own research that they were the right choice for me.
I said, to my husbandâ€™s obvious surprise, â€œPut me on your surgery calendar.â€
An X-ray tech did a quick set of new films. (She said they would be used to determine correct dimensions for my new hip.) Then Kathy, Dr. Martinâ€™s nurse, scheduled me for surgery at the hospital.
I went home feeling calmer than I felt in weeks. I had a surgeon I trusted to replace my worn out and painful hip. I could think of something else and not obsess about my hip; at least the surgery was on the calendar. The question was where to have it done?
When Nurse Kathy called that evening to schedule my pre-surgery lab tests, I asked her if I would be a candidate for outpatient surgery. She looked at my record and said yes. I could go to either a hospital or surgery center.
It was up to me.
“Sleepless. My hip hurts while I work, walk, stand, sit and sleep (or trying to).” (Susanâ€™s journal)
ORA Crow Valley Surgery Center or a Hospital?
I considered the options.
Interestingly at the time, influenza was peaking in the Quad Cities. The newspaper was reporting more people were filling hospital rooms and hallways. I likely wouldnâ€™t encounter flu or any other contagion as rampantly at the Crow Valley Surgery Center.
For another, Iâ€™m not a fan of â€œbig boxâ€ places, whether they are stores or hospitals. Crow Valley would be quiet and small, dedicated to only a handful of patients on any given day.
Nurse Kathy gave me another consideration when I asked where SHE would go. She said she would choose the surgery center, because it would provide more personal attention. I would have the same nurse all day long, from intake to surgery to recovery and my room.
Of all the friends I asked to weigh in, only one said she worried about the risk of a complication occurring during the procedure. She said she would choose a hospital with its robust staff and equipment inventory.
I chose the surgery center and never looked back.
â€œBoot camp at Crow Valley Surgery Centerâ€
I made the above decisions in early January, and had an entire month to wait. Iâ€™ve never seen time go more slowly.
Not that I wanted the surgery. I was scared to death. But I did want it to be over.
Since nothing I could do would make time pass faster, I did the next best thing. I read everything I could about hip replacement. I began Prehab sessions. And I visited Crow Valley Surgery Center, for Josh Crewâ€™s â€œBoot camp.â€
Nurse Josh called from the surgery center to schedule my personal â€œboot camp.â€
The Crow Valley Surgery Center is really nice. The waiting room was attractive, clean, and quiet. Josh ushered us into a small conference nook where we listened and asked questions for an hour. He described the procedure, and what I needed to do to prepare.
He answered every question with great patience and good will. â€œWhat if I get leg cramps during surgery?â€ I asked. â€œIâ€™ll let your nurse know you are susceptible to them, and sheâ€™ll take good care of you.â€ He actually wrote that down!
Other matters included:
- Getting labs done at Genesis (blood work, EKG). Josh would schedule.
- Seeing my primary care physician for surgery approval. Josh would schedule.
- Purchasing a bottle of the skin cleanser Hibiclens to clean the surgical leg twice, once the night before and once the morning of surgery. Up to me.
Josh also gave me a tour. It was staffed with cheerful people, looked brand new, and had a wall of windows in the overnight rooms. I could see deer grazing the fields outside. I went home feeling calmer and more assured.