Mar 31, 2012

Blissful Ignorance?

When I started planning for the possibility of a hip replacement, I did what all geeks do in situations of ignorance; I went to the internet for advice. What I found was a lot of stories about hip replacements gone badly, unhappy patients, people who had gone from misery to more misery, and lots of legal sites trolling for patient-clients. That was a year ago. So, I decided to live with the pain and hope for the best. I made it through the summer, surviving a slightly lower MSF class load but ending the summer feeling my years and miles.

After I got back from my Lake Superior Circle with my brother, I was struggling. In a 1/2 mile walk, I was literally dragging my left leg for the last couple of blocks. After a day of work, I could hardly get out of the car and seriously considered spending the night in the garage rather than deal with the pain of trying to get my lame leg out of the car. Even with fairly consistent dieting and a year of physical therapy, I'd gained 30 pounds the previous year because it's tough to seriously burn calories without a working lower half. Last year, I added a lot of upper body cardio exercise to my routine and cut out even more of the casual part of my diet to get rid of about 25 pounds of lard, but I hit a plateau and the next 30 pounds stuck to me like it belonged there.

By early October, I'd come up with a surgery plan and started looking for a doc to perform it. I wanted a "resurfacing," in spite of the fact that is is a "new" procedure in the US, most US docs won't do it for over-60 patients, and, worst of all, the procedure wasn't invented here (it's Australian, like an awful lot of sports-oriented surgical procedures). Of the six guys who do resurfacing in Minnesota, five wouldn't talk to me at all because of my age; including the surgeon who had trained the other five surgeons. I made an appointment with the one guy who considered me a possible resurfacing candidate, but after reviewing my hip deterioration (too much bone loss) and making a judgement of my physical condition he said he wouldn't consider a resurfacing for me. In the end, I scheduled surgery for mid-December and started looking at how a total hip replacement would affect my life.

While I was considering the new plan, I looked into the company that made the prosthesis my doctor favored, the various surgical options, and anything else I thought was related. I know two guys who had hip replacements and their recovery has been less-than-inspiring. One has serious non-hip-related bone conditions that probably explains his progress and lack of same. The other is a classic American "patient": disinterested in the procedure's details, half-hearted about his doctor's physical therapy and medication, diet, and personal habits recommendations, and downright squeamish about the surgery. That seemed to be a characteristic of a lot of people who were complaining about their surgery's results. I kept looking and found two other people who had had hip replacements and were doing magnificently less than 6 months out from being cut. Both of those guys were conversant in the details of their surgery, were monster physical therapy junkies, and almost overwhelmed me with their insight of all aspects of being cut in a clinical environment and being in control of the recovery afterwards. They both set a standard of patient participation that I hoped to emulate.

Using their model, I went hunting in the weeks between being scheduled for surgery and the actual surgery date. I loaded up on background materials. One of the more education things I found was this Edheads hip replacement "video game" (link at left), which puts the player in the surgeon's seat. As a reference, neither of the poorly recovering patients could stomach playing surgeon (my favorite part of the video is the "pop" sound effect the animation uses when the leg dislocates from the pelvis socket) and both of the high-functioning ex-patients thought this site was the coolest thing on the web, although both criticized the procedure's technique as "out-dated."

Last month an old friend complained that "doctors are always treating symptoms with drugs etc. but never going after the root cause." I have to disagree, doctors have been going after the root cause, at least, since I was a kid. We've had the food pyramid, the diet plate, anti-smoking warnings, anti-lardass warnings, years of "get fit" encouragement, and everything short of boarding up fast food franchises and covering them with poison ivy, but Americans are uninterested in the symptoms. We want easy solutions. Blaming our health problems on unnatural food is like blaming our tanked economy on poor people; it requires a surreal perspective on reality and a massive math incapacity. Blaming the medical industry for focusing on repair procedures is as rational as blaming auto mechanics for buying tools and fixing busted cars instead of giving driving maintenance lessons. We're fat because we eat too much garbage and we exercise too little. We have crap-loads of problems recovering from surgical solutions to our poor health because we're lazy, ignorant, and squeamish (wimps, in plain language). I'd like to think that motorcyclists are an exception to this rule, but there is some serious pork on those Hogs and too many of us use our motorcycles like overpriced wheelchairs.

At four months out, I still have a ways to go to consider myself "recovered." I'm still old, overweight, and weaker than I should be. The older I get, the harder it seems to be to recover from anything. If I work everyday for a month to improve my physical conditioning, but take a couple of days off to relax on a weekend, I've lost ground. From here out, I suspect that will only get worse. However, this picture of John Turner (at 69), from 50 Athletes over 50 Teach Us to Live a Strong, Healthy Life, has been stuck in my head for more than a decade and it's evidence that if you have a little luck, work at it hard, and don't give in to gravity, you can go down fighting. We're all going down, eventually, the trick is to do it with style.

Back in the late 90's, I watched Dick Mann celebrate his 60th birthday by slaughtering the over-500cc competition on the vintage motocross track at Steamboat Springs. I'll never been Dick Mann, but I could do a lot better job of being Thomas Day.

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