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Hip replacements the second one was much different than the first One Patient’s Experience

Date: May 19, 2014 Category: Uncategorized

It was somewhere in 2002 in Memphis Tennessee that I was facing the decision to keep struggling with the pain of the cartilage having worn away on my right hip and is a hip replacement the right decision for me. I was an avid workout person and played sports at Penfield High School and Geneseo State University back in the 70’s. It got to the point that I could no longer take my sons to sporting events that involved steps. The pain during work outs started to impact what things I could do. And the final straw was how difficult it was every day just to put a sock on my right foot. The question of quality of life was front and center.

This was a time in early 2000 that Hip Replacement evolution had developed a less invasive procedure. As I study the different choices I identified only one doctor in the Memphis area that was promoting this new practice. With some careful planning and juggling insurance to have the proper coverage I had my first Hip Replacement July 1st 2004. Two small incisions – one in the front and one in the back of my hip area instead of a long incision down my entire right leg.

This was a miracle to me at the time. 3 days in the hospital, I would be fed Intravenous methadone treatments. The staff would get me up three times a day to walk and start physical therapy. Then 7 days of home care support. My sons had to stay with me to help me get in and out of bed for the first 4 days at home. But all in all I was back in society driving, working being a Dad and working out in the gym in three weeks.

I had a bad feeling when my right hip was replaced that the left was just a matter of time. In fact the deterioration of my left hip became obvious in 2012. So now what? I had moved back to Upstate NY and had to study the present state of the Hip Replacement technology. My family and friends could see the obvious limp all the time. All knowing I was going to have to move forward with a second hip replacement. One of my neighbors works in Niagara Falls and was looking at a local newspaper and there was an article about a person who had a Hip Replacement by Dr. Violante and how he was so happy with the outcome of the new hip procedure Dr. Violante was performing.

I contact Dr. Violante’s office and set and appoint to meet with him. When I visited Excelsior Orthopedics facility they did an x-ray and I met with Dr. Violante. The interesting point of the x-ray was my “other hip replacement” was obviously shown on the x-ray. When I met with Dr. Violante he reviewed the x-rays – discussed my prior prosthesis with interest and explained that the Hip Replacement technology had major improvements. He told me what I already knew that my cartilage was no longer in my left hip and that there was a way to have a single incision on the anterior area around my hip which was less invasive. Dr. Violante was very personable and charismatic – but more important he is an educator when it comes to the present Hip Replacement his dedication to the practice.

After I left Dr. Violante’s office I did additional research on the procedure and on Dr. Violante and decided that I would move forward with this newest approach. I scheduled with Dr. Violante office for April 24th.  My anticipation was very much my recovery would be similar even with the new procedure. As last time I still continued my exercise routine up until the day before the procedure. My pain was such that I could only use a stationary bike for 30-40 minutes daily with other activities associated with strengthening my legs. I also attended the pre-hip/knee replacement class a week prior.

When I arrived a ECMC at 6:00 a.m. to have my left hip replaced the staff was fantastic.  Again, having “been there done that”, may have helped me just let the process take its course more calmly. About 1 ½ hours before the operation Dr. Violante stopped by to see how I was doing and to initial my left hip.  He told me we are going to try and discharge you the next day!  Soon after that the anesthesiologists took over and the next thing I know I am in the recovery room.  Strangely, I was in little or no pain.  I attributed this to the anesthesia that was obviously still warring off. 

In a short time my bed was moved to the floor in ECMC that was for recovering from my surgical type. They told me I had to eat something soon so they could start me on my pain killers.  My mind immediately went to my last hip replacement and I expected to have morphine drip again and was ready to get them to hook me up in preparation for the pain I expected.  Each step of the way the staff would ask me what is my pain from 0-10.  I was not in any pain.  So I would tell them 2-3 so they would give me pain killers – again expecting it was going to be here soon and really bad.  They gave me a few pills for pain.

As is procedure the physical therapy team came in and got me up to walk with a walker.  Like everyone they asked me what my pain was 0-10.  Now I was getting to the point that I had to say I am really not feeling any pain.  As the day went on I was given a few minor “exercises” to do while I was laying there. Now the evening night time is coming my way and I was getting ready for pain.  But more interestingly I was certain I would need someone to help me out of the bed when to use the bathroom in the evening/night. The night nurse was great and I told her that I would ring my bell when I needed to go. She acted strangely by the request.  I was still in the 2004 mindset and things were much different in 2014.

As the night went on I discovered I in fact could get myself out of bed!  This wasn’t right!  I still was in little or no pain – this wasn’t right!

In the morning when a hospital is full of the morning sounds of the first round of doctors follow up I waited anxiously to see what would happen to me next. Dr. Violante and his team arrive and I could not say enough positive to Dr. Violante based on what my expectation was and what actually was happening.  The team again stated we think you will be discharged TODAY!  The physical therapist arrived soon after and they got me up and wanted to see me walk with the walker.  My mind was in 2004, so I took really small steps.  The team encouraged me to open my gate – or distance I would step. We walked the hall ways and it seemed to them that I was doing great.  They told me to walk every half an hour.

In the next 2 hours I was a man on a mission walking up and down the hallways as instructed. The discharge resource that was fantastic had gotten word that I was to be discharged.  My plan was to go to the in-house physical therapy because I live alone and felt as if (based on 2004) would need help.  But this new procedure has “no restrictions” – meaning I could get myself in and out of bed with no help. The discharge planner came in my room and told me that she believed insurance would not cover the costs of me going to in-house therapy and that she was going to set plans to discharge me to home!  She took care of getting me the prescriptions I needed and by 3:30 the next day I was home!

The following day a home physical therapist came to visit. This person was fantastic; he gave me instructions and helped me immediately get additional exercise and a program was set up.  I was given a pill in the morning and the afternoon that was for pain.  Like everyone else the therapist asked my how my pain was.  Though it seemed implausible it was near 0.  I had 3 additional visits the following week from the in-house therapist – each time we would increase numbers of reps and he added multiple new items for me to do. We also walked with a walker about a ¼ of a mile.

On May 5th I returned to Excelsior Orthopedics to meet with Dr. Violante and get my staples out, have an x-ray etc. I walked in with a cane.  When I went into Dr. Violante’s office and met with him there were a few issues with fluid buildup in the area of the incision, but other than that I had no pain. Dr. Violante says to me, “well let us see how you can walk”. I was pretty much thinking he was crazy (my mind was in 2004).  I walked out of the exam room and down the hallway with nothing to support me!! I was not given any more pain medication and given permission to drive my car 12 days after the operation!!

The next day the home physical therapist came to close out my paper work and he says to me – lets go for a walk!  He says I will have the walker with me – but let us see how you do. I walked ¼ of a mile without any help on day 13.

My experience is mine and mine alone.  Everyone based on their present circumstances will have a different outcome. But the reason I wanted to author this document was because of all the FEAR I experienced in getting ready for this major surgery and the FEAR I see in others who are in the same pain I was in prior to the surgery, but may wait and suffer when the medical community has advanced so far with Hip Replacement.  I also was fortunate to find a surgeon who has trained himself a better way to help us who suffer.  When you look up the many methods available and doctors who perform Hip Replacement many have not changed their practices and retrained themselves with the latest technology. 

In closing there was an even more important thing that needed to happen. The support from family and friends must be in place for a person who lives alone and has this procedure.  If I did not live alone I would have still needed all the positive outreach, but living alone increased the need for such support and I really need all that was there for me.

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