My Aching Hip: Deciding to Go Under the Knife

Five years ago, I complained to my primary doctor of a lingering pain in my left hip, causing me to use a cane on our daily walks. After having x-rays taken, he referred me to a surgeon, who told me osteoarthritis had caused cartilage deterioration in my hip. She offered cortisone shots to ease the pain, explaining the shots had to be repeated over time. They were not a permanent fix.

Not fond of needles, I told her I’d prefer surgery. After showing me the x-rays revealed the cartilage had not deteriorated to bone-on-bone contact, she explained Kaiser Permanente’s policy, which was driven by the Affordable Care Act: avoid surgery when other means of pain management are available. She prescribed Ibuprofen, taken daily.

The pain medicine worked well for a while. I told myself, nobody dies of a little pain in the hip. I’d just continue taking those pills. No need to go under the knife for a cure.

Fast forward five years, to when the pills stopped working. The pain and stiffness in my leg had grown to the point where I could no longer put on my socks unassisted. The last time I needed help doing that was from my mother sometime in 1948.

After a visit to my new primary doctor, and more x-rays, I returned to see the same surgeon, who told me the new x-rays qualified me for surgery. She told me someone named Carlos would call me to schedule the operation. She said the current waiting list ran two to three months.

Ever the optimist, I emailed my surgeon a week later to ask when I might expect a call from Carlos. Her nurse wrote back he would call six to eight weeks before the scheduled date. My primary doctor gave me a prescription for Meloxicam, a stronger painkiller. It worked well enough to give me the patience to await Carlos’s call.

To my surprise he called within a week, offering me a November 6 surgery date at Kaiser’s Zion hospital in San Diego, 25 miles from the Chateau. With my pain under control, I told him I would prefer to await an opening at Palomar Medical Center in Escondido, just 11 miles away.  A few years ago, I published a column about the place. I dubbed it, The Palomar Hilton Medical Center, with its rooms with a view and a dream team of nurses. You can read it here: https://www.osidenews.com/2015/07/26/the-palomar-hilton-medical-center/

A week after Carlos’s call I regretted turning down his offer. Awakening that morning, I got out of bed to head for the bathroom. The pain in my hip returned with a vengeance. I managed to make it down the hall only by clutching at the walls and hopping on my right leg. After retreating to bed, and Karen’s insistence, I emailed both my primary doctor and my surgeon, pleading with them to save me from having to spend months flat on my back, awaiting another call from Carlos.

The pain returned to a manageable level after I spent most of the day in bed. Within two days Carlos called again, this time with an offer of surgery at Palomar Medical Center on October 30. I gladly accepted.

Now, as I await my appointment to go under the knife, I’ve had the time to second-guess my decision. What is the operation’s history? How risky is it? Can I trust my surgeon? What will it cost?

What’s the history of hip replacement surgery?

The earliest recorded case of attempts to perform hip replacement procedures dates back to 1891, when Themistocles Gluck tried to use ivory implants to replace the femoral head. In 1940, an American surgeon, Dr. Austin Moore, performed the first metallic hip replacement at Columbia Hospital in South Carolina.

What are the risks?

According to the Mayo Clinic, the two most common risks are blood clots and infection. My surgeon told me the mortality rate for those undergoing the surgery was less than half of 1 percent. The Arthritis Foundation cites a 2011 research report setting it at .029. Looks like my odds of survival are pretty good.

Can I trust my surgeon?

One of my favorite authors, Malcolm Gladwell, wrote a book titled “The Outliers,” in which he explains the 10,000-Hour Rule: the key to success in any field is practicing a specific task for 20 hours a week for 10 years. I, of course, looked up my surgeon’s bio, discovering Amy Steinhoff, MD, has been in practice for more than 12 years, exceeding Gladwell’s standard, and has five-star reviews from her patients.  

How much will it cost?

According to a January 22, 2015 report by California Healthline Daily, the cost of a hip replacement in San Diego County ranged from $24,000 to $47,000. But as a member of Kaiser Permanante Senior Advantage (HMO) we’ll pay nothing for room and board, surgery, anesthesia, x-rays, laboratory, tests and drugs.

Those are the reasons I’m now confident of my decision to undergo surgery at the Palomar Medical Center on Halloween Eve. To see how I’m preparing for that surgery, watch for my next blog entry: My Aching Hip: Preparing to Go Under the Knife, which will appear here:  http://theriehlworld2.blogspot.com/