Total Hip Disaster

I have let this blog lie dormant for a year now--witness the title of my last entry.

Maybe that's where it should lie, but I feel the urge to update things.

Looking back on 2005, I can say that things went fairly well from a hip point of view. I finally ditched the cane in May, though I did go back to it briefly around the end of July/beginning of August after a gruelling week of walking in New York City. By the 7th day of our trip, I had some scary pain shooting down my thigh and decided that using the cane, which I had conveniently packed in our suitcase, might be the appropriate course of action. I also used it once or twice on a trip to Montreal a few days later. Since then, nada.

I am not in perfect shape by any means. The knee on my opposite leg is giving me hell for what I put it through during the many months of hopping. I really don't want to even consider knee surgery at this point, but it does bother me. My hip seems to be fairing quite well. The range of motion is still significantly less on the operated side, though I can lace up my shoes and put on my socks. My thigh becomes sore quite quickly--perhaps due to the mega-revision stem they had to put in. This hip replacement experience has been significantly less successful than expected, but the bottom line is that I am walking, and with very little to no limp.

I have continued to frequent several hippie sites: Hip Universe, Hippies With Humour and Totally Hip. Each one has its strengths and weaknesses, but my hippie friends are now an important part of my life. I'm sure I'll be on these sites for many years to come.

On the exercise front, I am much less assiduous, though I realize that I must do as much as possible. Today, I took a fairly long walk--over an hour, with a break for coffee near the end--and will go and do some hip exercises once I've finished writing here. Hip exercises are definitely a permanent part of my life.

All in all, it's been a pretty good year--and a complete sea change from how I was feeling two years ago after my THD.

Happy 2006 to all of you who might drop by this blog!

Well, it's almost five months later and much has changed. The beginning of my post-revision life is chronicled in the blog my husband and I kept called "wendysrecovery", but I think it's worthwhile to add a post-scriptum to this blog.

I had the revision surgery on August 9, 2004 and the short description is: it worked.

Note to Netscape users: If you press any of the so-called shortcuts for bold, italics, quotation marks, etc., you will lose everything you have typed. Being quote unquote stupid, I have done this twice.

So here I am again, trying to talk about my upcoming surgery:

So far, I have felt fine and quite calm. This run-in with the blog program has gotten me more hot under the collar than the surgery. Well, I suppose that's something positive in the sense that it has taken my mind off being cut open and violated (albeit for a good cause) and made me think about those nice computer nerds who do things that don't work and frustrate ordinary bloggers like myself. Grrr.

Just like in the song, my bags are packed, I'm ready to go. It's a gorgeous summer day, sunny but not too hot or muggy. We'll all go out for a car ride and a little walk.

Despite my bravado, I am scared. A little knowledge is a dangerous thing and I know just enough about what can happen during surgery to feel scared out of my mind. But then again, despite feelings to the contrary, nothing says that things have to go awry. In fact, I think I have a pretty good chance of coming out of this second surgery much better than I ever was since becoming severely arthritic.

My husband will be keeping a blog chronicling my recovery (see link). His first post should appear tomorrow.

I wish myself the best of luck. I'd appreciate the same from you the reader!

Today I went for my last therapist appointment before my revision, on August 9. For a good part of the session we talked about how this experience is helping me to learn to assert myself and feel less subject to the real or perceived wrath of others.

My hip situation was not the sole focus of this discussion.

However, I spent the last 15 minutes of the session talking about a very real fear: what the doctor will say as I come out of the anesthetic after surgery. My first experience was so shocking that I am already fearful of a repeat performance. As I recall, as I opened my eyes and focussed on the doctor's face, he said to me--with no preamble whatsoever--"we fractured your femur". No "hello", no "how are you feeling", just the blunt news that something bad (not to mention, something I had no idea could happen) had occurred. Welcome to hell.

My therapist very wisely suggested that I speak to him about what I need to hear first upon regaining consciousness, so as to avoid a similar shock. I promised to send the surgeon a fax to this effect today.

Of course, the minute I left my therapist's office, I could no longer find the words to make this request without doing something that scares me even more: implying, through my words, that I was expecting a second round of bad news; implying that that is what I expect of this surgery. That is what is at the root of my inability to ask him to speak to me first in human, rather than medical words.

I don't feel that I can do this. And that is precisely why I am expressing my fear in a safe place: here.

As I sit writing this post, I know that one week from now at this time
I will be lying in my hospital bed, the revision surgery over.

Up until today, I have felt relatively calm and gone about my daily life without too many moments of fear. I just came back from a one-week vacation with my family. We went "home" to visit with old friends and my husband's family. It was a hectic visit and we now feel rather worn out, but at the same time it was wonderful to see everyone. I did all the driving, racking up almost 1,400 kilometres in 8 days. Fortunately, I am very comfortable driving. In fact, the surgery has made driving long distances much easier to do. I find it strange that I no longer have pain driving and have a small but noticeable (at least for me) increase in range of motion since having had the surgery. It was actually "successful" in certain ways but overall, due to the fact that I cannot walk without crutches, it has been a terrible failure.

I used two crutches throughout my vacation time and now that I am home, for the most part I am continuing to rely on this maximum support. Psychologically, I can accept this situation since I know that I am about to go for surgery. It would be much more difficult to accept if I knew it was forever.

I sent out a general e-mail to a number of friends and colleagues, informing them of my upcoming surgery. I have received many messages of good wishes and support in return. It is truly touching to know how many people are cheering me on.

But as I sit here I do feel fear. Not even my surgeon really knows what is going on inside. Although he suspects it is a loose stem, he will only find out for sure once he opens me up. I find this very frightening. On the plus side, I found out recently from a friend who is also facing a much too early revision that my surgeon is known in medical circles as the "king of revisions". I suppose I cannot ask for more.

I have avoided doing too much reading on the actual process of replacing the stem and on the expected outcome. Statistics, as I have learned the hard way, are meaningless. Only the actual result is significant.

The moment I fear the most is waking up from the surgery. The first time around I don't even remember the surgeon greeting me. As I recall, his first words were to inform me that they had fractured my femur. I have to admit that I dread what his first words will be this time. If I remember to do so, I will ask him to at least say hello before telling me how it went.

I think the most important thing I can do this week is try as hard as possible to visualize a good outcome. This is not an easy task but I must at least attempt to do so. I will also continue to allow myself to express my feelings in this forum. I feel that I owe it to myself to both express the fear and encourage myself to hope.

My cat is sleeping peacefully on the windowsill, right behind my computer screen. She is calm yet alert. Admirable.

I'm in waiting mode again. Today marks S-day minus three weeks and counting. I have gone for my pre-admission tests, x-rays, etc. I know that I can continue to take my anti-depressants and calcium, but not my multi-vitamin or my shark cartilage. I will probably be the first case of the day since I am considered a "serious case". It's good to be in the spotlight and scary knowing why this is the case.

All things considered, I'm feeling fairly positive and relaxed. But today I feel a bit down. I've been reading posts from my various hippy sites (these sites warrant their own special post) and people are reporting in on their stellar results at the six-month or two-year or whatever mark. I can't help having that feeling again that I didn't have a hip replacement at all. It feels like someone played a horrible joke on me and that instead of a hip replacement I had a disability augmentation operation! It's a conspiracy (cue in the theme from "the Twilight Zone"!

Today, I went to have my car serviced and started chatting with a woman in the waiting area. Six degrees of separation really do exist: she went to high school with my surgeon and told me all about the fact that she had had a crush on him, that he's a twin from a wealthy family, that he's twice married, etc. etc. My surgeon, made human.

So that's where I am today. My cat is stretched out on the window sill right behind my computer. I see a single ear and an elegant orange paw. Her greatest worry is whether or not she will be fed her favourite food or not. Lucky Miss Bean.

I just came home from a short assignment. As I was driving along I saw a thirtyish couple riding their bikes and a man who looked old enough to have grown children rollerblading. One of the songs from the 60s musical "Hair" was playing on the radio. The sun was shining brightly. This weekend there's a street fair on a major artery not far from my house. The street is closed to traffic and people are wandering around happily, kids are eating ice creams and going on rides. It's a perfect summer day.

I enjoy driving right now because in the car I am as mobile as anyone else. I sing along to the oldies while reminding myself to check the mirrors and drive responsibly! I feel free.

As I drove along, noticing all those people moving freely on their own steam with no hesitation or help from a cane, crutches or a wheelchair, I got a little lump in my throat, though I succeeded in warding off the sudden onset of depression. I will not stay this way because I cannot. My doctor cannot ethically leave me as I am because it will only get worse if left untreated. I look forward to my upcoming surgery as the first step towards recovery.

Well, I've got the date for my revision surgery: August 9. Same hospital, same doctor, different feeling. This surgery is not elective. If something is indeed loose, letting it be will cause further deterioration of the bone. Not something we want to happen. So I'm going under the knife again.

I really, really want to get my life back. I want to the regular, slightly neurotic, slightly high-maintenance, fairly intelligent, often worrying, full of love for my husband, kids and family, hard-working, house hunting (even though we're not planning to move), constantly thinking about my weight, francophile, etc. etc. person that I was before my surgery. True, I'm still all of those things and more (hear husband groan in background) but I just want to be a regular person again.

I want to go to France and walk, walk, walk. I want to do the laundry. I want to vacuum. I want to take my kids to the amusement park without constantly looking for a bench. I want to replace the worry in my husband's eyes with a twinkle of excitement as we get ready to go to Glasgow for the World Science Fiction Convention next August.

I want the prayers and good wishes of every person who visits this blog.

Last week I went out for coffee with my wonderful cousin. She's 33 and the daughter of my first cousin on my mother's side of the family. I thought we were just getting together for a chat, as we try to do every now and then despite our hectic schedules. She went and got the coffee, sat down and said she had wanted to see me to tell me something important: she too has just been diagnosed with osteoarthritis of the hip.

That confirms the extremely strong hereditary component of this awful disease. When I was a child, my mother blamed her arthritis on poor nutrition during her childhood in czarist Russia. I blamed it on "bad architecture" and the shoes attached together with a bar that I wore at night to correct my pidgeon toedness. But here's my beautiful cousin, in great shape, studying to be a yoga teacher, for pity's sake, and she too has the family affliction. Indeed, she is the same age that I was when I received my own diagnosis.

I remember studying basic genetics in high school and learning about Mendel and his plants. It makes me think of my own family: two sisters, both with OA, each have a daughter. One has OA, the other doesn't. The daughter of the unaffected daughter has OA (like her grandmother). My cousin also has a brother who is 29. So far, he has displayed no symptoms of the disease and my gut tells me that he won't. I certainly hope not, and I hope my two boys don't develop it either.

My cousin is understandably distressed. However, I feel that she is being very proactive by continuing with her yoga, doing special exercises prescribed by the physiatrist, wearing orthotics, benefitting from my experience, etc. If I had known what she knows now, perhaps I would have been in better shape today. I do think, however, that my "coup de grace" came when I had two children. Pregnancy is not kind to the body and it's particularly hard on the hips. I was straight with my cousin. I told her to seriously weigh the pros and cons of having children. Like virtually all parents, my children are the joy of my life, but would I have had them if I had known the effect they would have on my body? I don't know.

At the ripe old age of eleven, my elder son has decided to be a medical researcher. I just might encourage him to study the genetic component of OA.

I am once again waiting, but this time I know approximately when the surgery will be done and tentatively what will be done. My surgeon is hoping to only remove the stem of the prosthesis. It should come out quite easily since it did not properly bond with the bone in the first place. Hopefully, the cup will not have to be replaced. I asked about the chances of another fracture: he believes they are low because he will go in through a very long incision--the classic technique.

So what now? Clearly, I feel much better knowing that something can and will be done. However, my job (should I choose to accept it) is to come to terms with my psychological state, to whit, my feeling that disaster is once again in the cards. Actually, I'm not sure that I feel the overwhelming sense of dread I felt the first time around.

But now that I am in a relatively calm state, it is time to peek once again under the bed where the monsters lurk in order to hopefully smoke them out.

Why the title, "Judge, Defendant and Prosecutor"? It comes from a discussion I had with my therapist today. I think it is extremely relevant. I am the defendant, envelopped in fear. The prosecutor is the past, replete with damning evidence that seems to point inexorably toward disaster in the future. The judge is the rational, adult me who has to weigh the arguments.

I just realized, there is one person missing from this equation. Where is defense counsel? Who is defending me? Perhaps I must find a fourth person.

On June 16 I went back to see my surgeon after six weeks off physiotherapy. I was prepared with a list of questions and comments on my non-recovery. I was also ready to figuratively bash in the head of the student who would interview me before the doctor came in.

Nothing went as I had expected.

When I arrived at the hospital, I immediately starting trembling. Waiting for my husband outside the door to the Orthopedic Surgery Department, I couldn't read or relax. Even seeing the words "orthopedic surgery" brought tears of fear to my eyes. When my husband arrived, we went into the OS waiting room. The man who took my hospital card looked at my name and then said that someone had just been talking about me. He went into the back and came out to say that they were wondering when I would arrive. I burst into tears. A few minutes later, I was ushered into the examining room and the "fellow" (junior surgeon) du jour, a young Australian, came in to ask me the usual "student" questions. I was ready to give him a piece of my mind before he even said a word. He started by asking how I was feeling and whether there had been any improvement over the past six weeks. I was shocked, but pleasantly so. He had actually looked at my file before coming in! What a change!

My surgeon came in shortly thereafter. I started crying as soon as I began to talk about my situation. We talked briefly and he asked me how I was doing. As soon as he heard my comments, he said that he would operate again to fix the problem. This time, he said that he took entire responsibility for what had happened to me. Many of those to whom I have told this story, have pooh-poohed his apologies. I, on the other hand, feel incredibly gratified to have heard him say that. He came down off his pedestal to meet me in my space. He treated me humanely and with concern. Yes, I'm sure he's thinking about his reputation and the possibility of a lawsuit, but both my husband and I felt that his words contained true, human concern for someone who is suffering and a genuine desire to make things better.

When he said more surgery, I again began to cry--not out of fear (which is there, nevertheless) but rather because I was afraid I would have to wait until the winter. His response was immediate: surgery will take place in August.

"People mean well and do not see how distancing insistent cheeriness is,how it denies another's reality, denies a sick person the space or right to be sick and in pain."

Marilyn French

I ran across this quote in our local newspaper and found it so insightful and, dare I say, refreshing, that I copied it out and taped it to the wall in my office.

There is nothing that puts me in a worse mood than being told to stick a goofy grin on my face, buck up and THINK POSITIVE. I've come to the conclusion that being a Gemini means there are two warring people within me: one is the New Ager who believes in the strong link between mind and body, pain and emotions, etc. and the other one who is a cynic to the core and considers all this positive thinking to be merely a way for those who fear suffering to politely distance themselves from the sufferer. I know. I did it myself with my mother.

My mother's suffering went beyond her extremely debilitating arthritis. She also had a condition called tinnitis--a ringing in the ear. It would drive her mad. Her face would crumple into a mass of suffering. It was the tinnitus, much more than the arthritis, that truly crushed her spirit. What could I do? I remember thinking she needed to read books of jokes and see funny movies to take her mind off the physical suffering she endured. That was the only solution I could see. Needless to say, it didn't work.

Then there's another spin on positivity: "il faut prendre son mal en patience", you must bear your suffering with patience (read: graciously). Be a real woman and suffer in silence. Men make a fuss when they suffer and they get a response. Women suffer quietly, smile, do the laundry, tend to the kids and try to downplay what's going on 'til they finally can't get out of bed anymore--and even then.

Oh yes, and then there's the "I'm suffering much more than you and I'M POSITIVE, I thank the Lord every day for the blue skies and the pretty flowers." Well, I'm glad that's the way you feel. I ask the Lord every day, "Why me? What great sin did I commit to deserve this crap?

Last night I had trouble getting to sleep. As I am wont to do, I started obsessing over my dreadful situation, constructing conversations in my head with the surgeon, revisiting all the "what ifs", feeling anger, sadness and frustration welling up in me. When I finally fell asleep, this is what I dreamt:

It was before my operation and I was with my surgeon. I was crying and begging him not to do the operation because I knew what awaited me. He didn't listen. It was as if I were a ghost that he couldn't see. I still feel the depth of my anguish as I cried and begged.

This morning, not surprisingly, the feeling remains. I have just come out of a crying/wailing session. The straw that broke the camel's back this morning was going up the stairs to the second floor, carrying a bottle of water and my cane. With my cane in the crook of my arm, I went up a step at a time, putting the bottle of water one or two steps higher. Just as I reached the top, my cane went tumbling down and I had to go all the way back down to recover it. Of course, I couldn't do any of this if I didn't have one railing on either side of the stairs. I had the second railing put in after my surgery. Otherwise I would have been unable to tackle the stairs on one foot with crutches.

All this leads me to the subject of this post: power. Like it or not, most patients who go through a medical crisis or serious illness do not have the specialized knowledge to make a truly informed decision when choosing a medical practitioner to (hopefully) bring them back to health. We trust in our instincts and in the recommendations of others. Then we relinquish our power. When we put ourselves literally in the hands of a surgeon, we have no more power. He (or less frequently, she) takes over the course one's life. The anesthetist puts us into a sort of coma and the surgeon proceeds to place us in a life-threatening though controlled situation in order to restore us to wellness. When the surgeon's efforts fail for whatever reason, the patient's feeling of powerlessness, which was originally associated with trust, now comes to the surface and bonds with anger, hate, fear and depression.

Powerlessness--perceived and real--is one of the greatest enemies I face now. As my body continues to fall apart due to the surgery (now the elbow of my cane arm is hurting, since it has to take so much pressure), my sense of power and control are sorely tested. I have been robbed and violated.

In the course of cleaning out my e-mail box, I came across a message from a close friend who now lives in Florida. Her husband, a professor of sociology, had been the subject of an article dealing with his work on trauma. I re-read the article and a light went on in my head. Then, this morning, my therapist brought up the same subject. The light shone even brighter. Here is the gist of it:

When we think of trauma, it is usually in relation to those who have experienced the traumatic event directly (i.e. being abused as a child, being raped, etc.). But now, researchers and front-line professionals like social workers are beginning to focus in on the trauma resulting from having witnessed someone else going through a traumatic event.

I now realize that growing up as an only child with a severely handicapped mother has impressed upon me a vision of my own life that, at least for the time being, is impossible to shake off. Her physical trials imprinted themselves on me much more deeply than I could have ever imagined.

As I have said before, the emotional and professional aspects of my life have in many ways been a radical departure from my mother's experience: Whereas my mother was criticized and soon abandoned by a cold, distant man who married her essentially because he wanted a maid (he was a Holocaust survivor and in poor health), I have found a wonderful man who has made it abundantly clear to me that he loves me as I am and will stay by side no matter what the future brings. Whereas my mother, though intelligent and thoughtful, never got a university education and worked as a secretary until her health forced her to go on welfare, I have been able to further my education and now work in a challenging, high-pressure profession which I find in turns frightening and exhilarating and which provides me with quite a decent income. Furthermore, despite my increased handicap, I can still carry out my work quite effectively.

But on a physical level, heredity has shown itself to be a colossal steamroller that seems to leave no room for personal choice. When I was growing up, I saw arthritis and how it had ravaged my mother's life as her problem. It had nothing to do with me. Mom used to say that her arthritis (and her sister's) came from the fact that when they were growing up in Russia in the early twentieth century, they had been poor and thus deprived of proper food (especially calcium). This had led to osteoarthritis in later years. Now I know that her theory was untrue. I am sure that if she had been able to explore her family tree, she would have probably found a number of women whose lives had followed the same path.

I did not personally experience her incapacity as a child. I experienced it in embarassment and frustration, for instance when she called for a taxi just to take her up the street--taxi drivers hate short trips! Now I am in the same situation, though thankfully, I can drive. But I can no longer go to places where parking is an issue, since I doubt I could step up into a bus and I can no longer walk distances that I could walk fairly easily before my surgery.

The outcome of a trial is hopefully based on evidence, the profession a person chooses is often based on the "evidence" of their mom's or dad's profession, we choose to buy a mutual fund based on evidence of past performance. Well, I have seen the "evidence" and so far there is nothing that shows that I will ever get better. Reminding myself that surgical techniques have changed amazingly in the past thirty years or that I am simply not inhabiting my mother's body but in fact my own is cold comfort. The overwhelming proof points in one direction and one direction only.

Much as I hate to admit it, I was expecting a bad outcome from the surgery. The writing was on the wall. I feel that the physical hand that I was dealt mandates that I cannot depart from the script that heredity handed me at birth. If I have one issue to overcome, it is the feeling that all this has been pre-ordained.

I cannot say that I had never felt depressed before this disaster occurred. Yes, there were things in my life that really got me down--one of them being the move we made from a city I adored to a city that I am only starting to appreciate after almost four years living here. In fact, about ten months before my total hip disaster, I had begun to see a therapist to work through all the feelings that had come to the surface after our move. A few months before the surgery (I have trouble calling it that, butchery seems more apt) I had begun spacing out my visits to the therapist and was feeling more "aware" of my feelings and able to deal with them as an adult and not a hurt child.

But the black depression that has come over me due to my new, much more severe incapacity poses a psychological challenge that I would not wish on anyone.

I entered into this adventure with trepidation but also armed with dozens of success stories. The reality has often been too much for me to bear. Like a woman who miscarries and is constantly obliged to explain to those around her that no, she lost the baby, she is not a tired though happy new mom, I too find myself having to explain that I am one of the very few whose hip replacement has resulted in disaster.

Every day, I wake up with the physical reminder of how badly things have gone and the question mark of what my future holds. Luckily, I am able to work (I am self-employed) and the rigours of my job , which fortunately is done sitting down, keep me from obsessing non-stop over the damage done to me.

I began seeing my therapist again before I could even get out of the house but also before I had confirmation of how badly things had gone. He came to my house once and though I was happy to see him, I did not recommence regular sessions until I could once again drive to his office. Many's the time I have sat in his waiting room quietly crying.

I consider my therapist part of my "professional team" along with my GP. Of course my husband and children are integral to keeping me from totally going over the deep end. The three of them give me their total love and support and I am also lifted up by having to/wanting to love them back as much as I can. As I write this, I realize that I don't see my surgeon as being part of this team. No one is perfect and even the best of surgeons make mistakes but he made that mistake on me and it's hard to feel that I'm in good hands considering the enormity of the crime he and his henchmen committed on my body and my life. Strangely, though, I suspect he will be the one to correct the disaster if I have to go for further surgery. But as I say this, I also realize that I will probably go for a second opinion, or maybe even a third.

My arsenal also includes anti-depressants, something I had never used in my life before now. Initially, it was psychologically hard to accept that I would be better off taking them. And this feeling was infinitely compounded by the fact that I have been prescribed exactly the same anti-depressants as those my mother took. It seems to support my feeling of being cursed and that there is no way I will ever get better BECAUSE MY MOTHER NEVER GOT BETTER, ONLY WORSE, NO MATTER WHAT TREATMENT SHE RECEIVED.

Which leads me to the other part of this post: blaming the victim. I blame myself, first and foremost, for even hoping that the surgery would make me better. Given my mother's experience, in my deepest soul I do not believe that I can break free from the road that her life has traced for me. I know this sounds melodramatic but the fact remains that physically, my experience has never deviated from that of my mother's, right down to that one little hair on my chinny chin chin. My physical life has so far been a carbon copy of hers. Professionally and personally, I have been successful in leading my own life but physically I have suffered as much, if not more than she did at the same age. So far, I have no proof that anything will be different. I even blame myself for hoping that something good will happen--something different from my mother's slide into disability. Well, yes, it is different. She slid. I have been projected headlong and years earlier into significant disability.

I also blame myself for not searching harder for a surgeon (see my first posts) and not finding out more about MIS. I blame myself for putting my trust in a doctor. But then again, none of the people I truly trust in life could have performed a total hip replacement...

The expression "caveat emptor" comes to mind: buyer beware. But shopping for a hip replacement requires specialized knowledge that I, for one, don't have. I trusted professionals (my former surgeon, Dr. "Parent", the nurse in the operating theatre, the physiotherapists and all of their advice was WRONG.

Depression and blame are horrible feelings.

All told, I was hospitalized for slightly over four weeks after my surgery. I came home just before Christmas. Of course, I was still not allowed any weight-bearing so I hopped around on my crutches and for the most part stayed upstairs, either in my bedroom or my office. Thank goodness for the Internet.

I live in a city that can get quite cold and snowy in the winter. Up until I came home, we had had very little snow, but shortly after my return home, winter hit with a vengeance. Because I couldn't use my operated leg, I couldn't go outside except when a special transportation service came and picked me up to take me to physiotherapy. As the weeks went by and the snow and ice continued to pile up, I really thought I would go out of my mind. I exercised every day and when I was finally allowed to walk on my operated leg, I paced up and down my tiny upstairs hallway, doing five minutes, then ten, then twenty.

Sleeping was practically impossible. For the first 12 weeks, you have to be extremely careful or your new hip can dislocate. The only totally safe way to sleep was on my back, but grinding groin pain kept me from sleeping more than an hour at a time. Fortunately, my husband is a sound sleeper so the TV and I developed an intimate late-night relationship. At week 10, I couldn't take it anymore and called my surgeon to see if I could safely sleep on my unoperated side with a pillow between my legs to keep me safe. Permission was given and I immediately starting sleeping if not like a baby, then at least passably well.

As the weeks went by, I began to wonder about my recovery. I had been in such pitiful shape immediately after the operation that I couldn't even bend my knee 1 week post-op. Basic movement had come back but I felt that no significant improvement was taking place. My physio kept saying that things were going slowly because of the fracture, but with time I would get better. She went so far as to say that it could take up to 18 months! This was a horrible shock since in my conversations with "hippies" on the Internet, people were starting to get back to normal within about three months.

But I soldiered on, doing my exercises faithfully and crying in frustration every few days.

After about eight weeks seeing the outpatient physiotherapist at the convalescent hospital, I switched to a private clinic and a physio who had been highly recommended to me by a wonderful hippy friend I'd made through the Internet. After examining me, he too said all the problems were related to the fracture and that with time and exercise I would get better. He said my muscles were terribly weak and that was why I was unable to walk at all without a cane. After a few weeks, and seeing no appreciable improvement, I made an appointment with the doctor who ran the clinic. Again, the response was the same. Exercise, build your muscles and you'll be fine.

In February, the knee on my operated side began to hurt. My physio said not to worry, it would get better. In fact, it got worse and worse. At the same time, I became more and more depressed since I felt that now my knee was preventing me from recovering. At times, I even went back to crutches because the pain in my knee was so intense.

In April, I saw my GP who measured my legs and told me that the operated leg was 1 1/2 cm shorter. She suggested orthotics. Though expensive, I had them made and found that they helped with the pain in my knee. At this writing, although not perfect, my knee is much better.

When she examined me, my GP was struck by the extent to which my muscles were atrophied and immediately called my surgeon. The upshot was an appointment ASAP. As usual, I was first met by a fellow (student surgeon) who asked me a few basic questions. I have always found the students to be loathsome, unfeeling creatures. This one was no exception. He started by asking me when my surgery was scheduled for! Obviously, he had not read my file at all. Between gritted teeth, I told him that I had already had surgery. Though this exchange took place almost five weeks ago, it still festers in my mind. If, at my next appointment, I am asked the same stupid question I will send the student packing.

When the surgeon came in, he asked me to walk without my cane. I replied that I wasn't sure that I could. I did manage to take three halting steps and that was it. Immediately, he sent me for x-rays.

After examining the x-rays, my surgeon announced the news. He suspected the stem of the prosthesis was loose--again due to the fracture. The recommended course of action was to cease all physiotherapy and wait and see if the bone would finally grow into the prosthesis. This in itself was devastating news, but it was compounded by the fact that neither the physiotherapists I had dealt with nor the doctor at the clinic had detected this problem. All the physiotherapy I had been doing was in fact making me much worse. How could they have not seen this? I suspect that it's because hip replacements are practically always successful. Only the trained eye of the surgeon is able to see when there is a problem. It's also because NO ONE LISTENS TO THE PATIENT. For months I had been saying that I wasn't improving. I felt as if I was healing into a crippled state--as if someone had slashed my face with a razor and then denied me plastic surgery. Yes, you heal, but without proper care your face will just be a mass of scars.


It's been five weeks since I stopped physiotherapy. I am less stiff in the morning, but the pain continues. My ability to walk unaided is no better than it was in February. In fact, I am walking much shorter distances now than I was before my knee began to hurt. It's not my knee that stops me now, but rather pain in the buttock, below the buttock, on the side and sometimes in the groin area.

I will be seeing my surgeon again in ten days, but he has already told my GP that he wants to wait six months before performing further surgery. That will put me back in the winter and a winter recovery is something I don't think I can handle a second time. Not being able to go out was soul-destroying and I think it also helped to mask my lack of progress. When you go out and put yourself to the test, you can really see what's happening. Also, walking on wooden floors is much easier than on concrete--again, the lack of progress is not so evident.

I realize that I've been avoiding actually talking about my operation. Well, I'm about to face the monster head on:

I had my surgery on November 18, 2003 in a large well-regarded hospital in a major North-American city. My surgeon is one of the top orthopedic surgeons in our area, if not in the country.

A few months before the surgery he asked me if I would be interested in minimally invasive surgery (MIS), a relatively new technique. I immediately got on the Internet to see what information was available. Well, to quote someone else who has recently suffered an MIS-related complication, pretty much everything you find on the Net regarding MIS touts it as the best thing since sliced bread: faster recovery, on your feet right away, smaller incision...I was thrilled to bits that my surgeon felt I could be a candidate for this wonderful surgery.

My surgery began around 12:30 p.m. It was supposed to last 3 hours. My husband was sent to wait in the special waiting room reserved for those waiting for a patient in surgery. When they closed the waiting room, I was still not back. They sent him to wait in my room.

The surgery took 5 hours. When I awoke in the operating theatre I remember seeing my surgeon and some other people standing over me. All I can recall is immediately hearing that my femur had been fractured during the operation. Of course, I was shocked, groggy and in pain. "I'm confused," said I. To which a nurse responded, "Do you know what day it is?" Well of course I did!! But a fracture? That wasn't something I'd had any inkling could happen. I was overwhelmed.

They took me back to my room and told me that I was not allowed to move for the next week. And here I was expecting to be in physiotherapy the next day. The first night I was awoken at regular intervals to check my vital signs. I didn't have to worry about urinating as they had inserted a catheter. I was allowed to "eat" ice-chips--the best ice chips I'd ever eaten in my life.

My surgeon visited twice, staying perhaps a total of five minutes. He was always surrounded by his accolytes--young surgeons in training who no doubt hung on every word he said. He did not seem particularly concerned with what had happened to me and in fact admonished me to keep my leg straight.

The day after surgery, I was taken for a CT scan. I thought it had to do with the fracture and nobody told me otherwise. I was in a lot of pain lying flat on the table and I was also terribly frightened of being moved and somehow disturbing my fractured leg. The day I left for the convalescent hospital I was again taken for another scan and this time I asked why. It had nothing to do with my leg. Apparently, they had detected an anomaly on my lung in an x-ray taken before the surgery and wanted to check it out further. Couldn't someone have said something, or was I too stupid to be given the information? The scans didn't seem to reveal anything worrisome but I will have to go back again for another scan next November. I worry a tiny bit, but mostly I feel furious about how I was treated.

During the eight days I spent in the hospital I felt very weak, but I had lots of visitors and felt that this was but a relatively minor setback in my march towards a new and better life.

On the eighth day post-op (hey, this is sounding biblical!), I was transfered to a convalescent hospital where I stayed for just over three weeks. It was a wonderful place where I went from being totally dependent on others for everything except feeding myself to being able to dress myself, take a shower, use crutches, etc. I began physiotherapy the day after my arrival and felt excited about finally getting on the road to recovery. I was still not allowed to put any weight on my operated leg and would remain three-legged (one leg, two crutches) until seven full weeks after my surgery.

I have yet to talk about what actually happened to me during and after surgery, but I feel that I want to go back in time before returning to the ugly present.

I was brought up in a home where disability was the norm.

When I was around four years old, my mother had to stop working due to her arthritis. I remember vaguely when she got a cane. I was not happy having to walk around with a mom on a cane. But I got used to it. Better that way since it was just mom and me, my father having dropped out of the picture shortly after my birth.

Forty-eight years ago, life was not as scary as it is today for children. I always walked to school alone, rode my bike around the neighbourhood, hung out with friends, etc. Fortunately, I didn't need my mother's supervision because she could barely leave the house on her own. I think she always needed someone to help her get down the front steps and she couldn't drive so she was really housebound.

I did most of the housekeeping--vacuuming, dusting, laundry--but my mother could still cook. So, like many professional women of my generation, my home cooking skills are rather basic!

Growing up, I didn't quite realize how different things were for us. We didn't have much money, in fact we were on what was euphemistically called "mother's allowance"--a step above welfare. I recently found out that it doesn't exist anymore. Now, if you're not a welfare bum, you're on disability. Any way you cut it, nowadays people on social assistance are dirt poor. I guess we were lucky. Forty odd years ago, you could still pay your bills, the rent and eat on what the government gave you.

I loved my mother and really appreciated all the moral support and love she gave me. Her disability was secondary. It was the backdrop to my growing up but it was not top of the mind. I was fine. I could go out, run, dance and have fun with my friends. So what if I had to empty her bedpan because she couldn't get to the bathroom?

I was diagnosed with osteoarthritis (OA) about 14 years ago while in my mid-thirties. The first surgeon I saw said that nothing could be done and that I should just take pain killers. The second surgeon acknowledged the situation and saw me for twice, at one-year intervals. He had the bedside manner of a python. The third surgeon I saw (let's call him "Dr. Oldtown"), after hearing about how wonderful he was from someone I met at the pool, told me that he would prefer to wait as long as possible before operating because I was much too young. He did give me hope though and seemed to be a genuinely caring person. I went to see him once a year and we tracked my slow deterioration.

Five years ago, at my annual "check-up", the doctor said he would operate whenever I gave the word. At the time, my youngest child was only three and my husband was worried that surgery would be too much to handle with two young children (my other son was six) so I did nothing. The following year, we moved to another city.

One of the first things I did after settling in to our new home was e-mail my beloved doctor and ask him for a referral now that we had moved. He replied with the name of his mentor. IMPORTANT LESSON THAT I LEARNED THE HARD WAY: Never follow a doctor's recommendation when it comes to finding the right doctor for you. Ask real people, people that he/she has operated on. People who've been there and done that.

While I had searched for several years in my old hometown before settling on a surgeon whom I felt was the right one for me, what with the stress of the move I put all my trust in "Dr. Oldtown". Why look any further when someone I respected--and more importantly--trusted had recommended his own teacher to me? Then, at my children's new school, I met a parent who was also a staff surgeon at the hospital where "Dr. Greatmanhimself" worked. In fact, he was Dr. Parent's boss! Well, Dr. Parent just couldn't stop waxing poetic over Dr. Greatmanhimself. Even the nurse I spoke to in the operating theatre just before I fell asleep said that she would choose Dr. Greatmanhimself if she or any of her family had to undergo surgery.

I had waited 2 1/2 years to be operated on by this doctor. In retrospect, I realize that I could have had my operation a lot earlier had I gone with someone "good" but not "godlike".

But I shall dispense with blaming the victim (myself) and sign off for now.

Six months ago I took the big step I had been anticipating for about ten years: I had a hip replacement. At 48 (just yesterday!) I am relatively young by hip replacement standards and so I looked forward to regaining some of the physical freedom I had gradually lost over the years as osteoarthritis slowly robbed me of a normal range of motion in my right hip.

Like anyone going in for major surgery, I was afraid. I updated my will and made a list of everything my husband should know in case something terrible happened during surgery. Banking information, automatic bill payments--it was all there, just in case.

But while feeling this fear, I also felt an enormous amount of anticipation. At last I would be able to throw away my cane and walk down the street holding hands with both my children! I would be able to go to the amusement park with them in the summer and not be constantly searching for a place to sit down. I would be able to go back to Europe and explore the narrow, steep streets of little villages in France or Italy. I would be able to go for long walks with my husband as we had done when we first met fifteen years ago. The possibilities of a normal life inhabited my thoughts and helped to keep the fear at bay. And why shouldn't I have this normal life? Literally dozens of people had regaled me with their own total hip success stories or the stories of relatives or friends who were dancing up a storm, golfing to their heart's content--even wind surfing!

What happened on Nov. 18, 2003 has thrown my life into a black hole. Instead of gaining freedom, I am massively more disabled than I was before the surgery.

I do not know if I will ever be even as mobile as I was before. My only mobility is now on the Web.