What to Do? Do I Get the New Hip, or Not? Advice Needed…
By: Nikki Tate
Tags: Middle Age, Climbing, Surgery, Health, Arthritis

Where’s my cane? I am NOT old enough to need a cane!! [Photo by The Lensemen on Unsplash]

The weird pain in my hip ramped up in 2008 after I’d spent several 12-hour days crawling around under and behind some ancient cedars in front of our house. My father and I had been building a dog run and cutting through the thick tangle of prickly branches, crouching, bending and squatting for hours as we hammered and pounded stakes, wired posts to tree trunks, threaded wire mesh in and through and around awkward corners to make sure everything was secure against escaping canines.

We’d built a ramp and a closing doggie door into the front hallway, all in a rush to meet the deadline of a departing plane I needed to be on. That’s why the date stamp that marks the beginning of the end of my hip is so clear in my mind. When I settled into my seat on the plane I was in agony. My hips complained for the duration of the entire 10-day trip to Europe, where I traveled with my publisher to attend an international publishing conference. We had added a few days to the end of the business trip to visit Florence and see a bit of Tuscany, but the pain did not abate even when I was roaming around places like the ancient hill town of Siena, marveling at how it is possible that Italian pigeons mooching for crumbs in the town square seem so much exotic than those pooping on statues back at home.

My pigeon photos have gone missing… the perils of cloud storage and no filing system. [Nikki Tate]

I thought perhaps I had injured something during all the crawling around in the dirt. But, in both hips? It seemed unlikely. The pain was deep, unrelenting and ominous. I couldn’t sleep. Couldn’t sit without pain. Couldn’t walk my usual, enthusiastic, ground-covering stride. By day 6, I had convinced myself I had bone cancer. I was 45.

It seemed a shame that I was going to die so young — I was barely getting started with my writing career. My daughter had still to be fully launched into adulthood. I had not yet lived long enough to see her future husband.

Photo by Einar Storsul on Unsplash

Weird symptoms and sleep deprivation make for a dark blend in a novelist’s mind.

As soon as I could get an appointment I went to see my doctor. That was the beginning of a series of x-rays, trips to physiotherapists, more x-rays and the bizarre and impossible (to my mind) conclusion that arthritis had come calling. There was no way I was old enough!

“Have you ever injured your left hip?” the doctor asked, noting that it was a lot worse than the right one.

“Well, there was that time I fell off a bridge… with a horse. Like, when I was 21.”

And, yes, at the time the doctor had said — well, he said various things. First, “You are lucky to be alive.” Then, “you could have broken your neck. Or your back. Or both legs. Or your skull.” And then, finally, “… chances are you will develop arthritis in that hip at some point.”

Considering the alternatives, I thought a bit of achiness ‘at some point’ wasn’t really that bad. I hobbled around on crutches for a couple of months while all the bone bruises healed up (I had no idea bones could bruise), and then put the whole incident out of my mind (it’s a good story, the bridge and the horse… I’ll tell it in another blog post).

Fast forward to 2019 — just the other day — when, after years of suffering from increasingly awful pain, I finally went in to see a surgeon. It was busy in the hip and knee clinic and sitting on hard chairs waiting my turn is the worst thing for the hip. It locks up. It whines and complains. As usual, I ignored it.

When my name was called I hobbled over to the surgeon who said, “Where’s your cane? You shouldn’t be walking without a cane.” I wanted to pop her in the nose. I am NOT of cane-bearing age.

“This is you.” She waved her hand at an x-ray. “That hip of yours is shot. No cartilage. That’s bone on bone.” She pointed to the round knob at the top of my leg bone where it sat grinding into the socket in my pelvis. “And, my — look at those bone spurs.”

Not my hip x-ray. I was too stunned to think of snapping a photo. WikiCommons to the rescue… [Hellerhoff [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0)]

Extra bits of bone stabbed into the black background of the x-ray. They looked nasty. When my hip locks and refuses to move I imagine those hooks are snagging on something inside my leg rendering me immobile until I find a curb or a step and stand on my good leg, shaking my bad one over thin air until things jiggle loose.

The surgeon shook her head. “This is bad news. Because you are too young for a hip replacement.”

What now? You’ve just said the hip is shot. I’m fit and would love to be more active except, you know, the whole moving thing…

“How bad is it? What do you do for a living?”

She asked a lot of questions, one after the other. I barely answered before she threw the next one at me.

“I’m a writer. I can’t sit for long before it locks up. Then I can’t stand up. It hurts to walk. Hurts to lie down. No — I can’t sleep- I can’t remember the last time I slept soundly through the night.”

“What do you take for pain?”

“I can’t take anything Aspirin-related. I’m allergic.” And, I won’t take opioids — that just seems like a bad idea. I don’t drink enough red wine to be helpful — either from its purported anti-inflammatory properties or its ability to render me unconscious. And, ever since that terrible Tylenol poisoning incident in Paris, I only give in and take one of those when I’m desperate.

All through my description of my ongoing on misery, she kept shaking her head. “I hear you. But if we replace the hip now —you’ll wear it out. And the second round doesn’t usually go so well.” Her eyes widened when she stated this in a look clearly meant to convey she was imparting a dire warning. What the hell did that mean? ….doesn’t usually go so well… Was she asking me to make a decision now about a surgery that I might need 15–20 years from now? When I’m actually old? Will it matter then if my second fake hip is a bit wonky?

Then she began the list of all the things that could go wrong. Infection in the bone (very bad news — hip needs to come back out and I’ve got nothing. Except, a wheelchair). It isn’t a good fit and I wind up not walking any better than I do now (ok… a limp, but would the pain stop?).

“What do you do for sport? Ski? You’d have to stop skiing — new hips don’t break nicely when you fall.”

Apparently, the new implant is too strong. If I were to fall, the new hip part wouldn’t break. Instead, the surrounding bone shatters. In my mind I heard it going, exploding into shards inside my thigh. Yeah, that would be bad. It would be like that moment when I heard both bones in my arm pop out of place when I had a fall (climbing, that time — not another riding incident) and double-dislocated my elbow. The noise was the first indication something nasty had just happened. The wave of mind-melting pain that followed three seconds later confirmed it. The only good thing about that incident was that I didn’t think about my hip for a few days.

The doctor was staring hard at me now, perhaps recognizing I was drifting away into the bleak land of memory and imagination. “I had to give up skiing when I had mine done,” she said. She gestured to one hip, then the other — her own pair of new installations.

“I don’t ski. I’m a climber.”

Climbing is my thing… that’s why I moved back to the mountains. [Photo: Fabio Lacentra]

“You’d have to stop. The risk of dislocation is too high. I know about climbers — how you contort yourselves into weird, twisty positions. And if it pops out once, chances are it will pop out again.”

“I’m not giving up climbing.”

Heading up a climb at Red Rocks in Nevada. [Photo: Fabio Lacentra]

She took a deep breath. “You climbers…”

Which is the point at which tears welled up and my throat closed and all rational thought abandoned me. Give up climbing? I had come to the office thinking I would be told the normal risks of surgery, get put on the list, and then be sent home again to wait my turn. Yes, there would be physio and it would take some time to recover and get back up to speed, but I know people who are climbers and who have new hips and who are my age-ish.

My world here in the mountains only exists because I came here to climb. I am engaged to a climber. I met him while climbing… well, trying to climb. [That’s a topic for another blog post]. The point is, climbing is not something I am going to give up.

“You’ll have to make some difficult decisions,” she said.

“What are my options here?” I asked, thinking maybe there was some angle to this conversation we had missed.

“Cannabis?”

“What?”

“No — not what you think. It’s not the young people who are telling me this stuff works. It’s my old cowboys. They swear by the stuff. You don’t smoke it. It’s an oil you put under your tongue.”

Her lips were moving and words were coming out. I had come in for a new hip and she was offering me marijuana? Wow.

The end result of all this? The surgeon is sending a letter to my family doctor saying I am a candidate for a full hip replacement. All I have to do is let my doctor know what I want to do and then I can be scheduled, knowing that the new hip might pop out, cause the rest of my leg to shatter, become infected so the new hip has to be removed and I have to move into a wheelchair, or that the new equipment will wear out and leave me with a not-great-chance of a successful repeat. I’ll have to assess just what sort of climber I’ll be with the new hip… if I’ll continue to climb at all.

So, that’s where I sit, uncomfortably at my desk, mulling over my options and typing this post (it helps, when I’m sorting options, to put it all down in black and white). I suspect if you’ve read this far you might know someone who has been in my position, wondering whether the pain is bad enough, whether the risks are worth the potential benefits. Maybe you have been there yourself. Maybe you are there now. I’m gathering information and soliciting advice. Do tell… what would you do in my situation? And, if you know someone who has gone down the cannabis road, should I be visiting one of these new shops that have opened in town since Canada legalized marijuana and related products?

I’m in research and info-gathering mode now. Check back for updates…