On May 12, a Harvard-trained surgeon sliced my right thigh open and replaced my worn-out hip joint with a shiny new titanium-and-ceramic prosthetic. Or so I was told.
I don’t remember any of it. I don’t remember blacking out. Or riding a gurney. Or anything else until I woke up a couple of hours later in “recovery,” where my wife and a new team of nurses were waiting.
I’d been unconscious. Out of it. A cadaver with a pulse.
More than a million Americans receive artificial hip, knee or shoulder joints every year. This month I became one of them.
Twelve years ago, X-rays showed that my right femur head and hip socket were “bone-on-bone.” Many of my friends had already had joints replaced. One friend has done all six of the major ones.
Joint surgery is now routine, friends told me. “For the surgeons,” I said. I put it off for a long time. I knew someone whose incision became infected and required repair. A college friend died of a blood clot after her second hip surgery. Eventually, though, chronic pain forced me to go under the knife, as they say.
Now I’m back at home, a bruised and swollen couch potato. The pad of my $250 “ice machine” is Velcro-ed snugly around my right thigh to reduce swelling. Within arm’s reach are my black plastic cane, aluminum walker, the stirrup-on-a-stick that I use to hoist my right leg (my “petard”), a shoe horn with a two-foot handle, and a plastic spirometer to measure the height of my breath. It’s all swag from the surgical center.
Then there are the pills, in their green plastic seven-day organizer: Oxycodone (5-mg, cuttable in half) for moderate to severe pain (>6 on the scale) and gabapentin for “nerve pain.” Tylenol and Aleve for routine pain. Eliquis to prevent death-dealing clots. And stool softener to offset a side-effect of the Oxycodon.
A longer ‘healthspan’
My goal is to restart and prolong the “go-go” segment of my retirement journey. It’s well known that “retirement” is divided into three stages. The first is the go-go stage, when, ideally, you’re still healthy and active. Depending on your circumstances, that’s when you’re playing pickleball, spoiling grandchildren, or taking Viking River Cruises.
The second stage of retirement is “slow-go.” It will find you at home or in a continuing-care condo, but still performing all your ADLs (activities of daily living) on your own. During this purgatory, you’re napping or binging sports and texting friends and family on your smartphone.
The final stage of retirement—this sounds like Dickens’ “A Christmas Carol”—is known as the “no-go” stage. You navigate your house with assistance, either from a “caregiver” or a device (cane, walker, stairlift). You might have moved to an assisted living facility, a nursing home, or a hospice. You may recognize your children but not your neighbors.
For the fortunate (i.e., those with good genes, post-secondary schooling and enough savings), the go-go stage might last 15 or 20 years. For others, there might be no go-go stage.
Scientists used to talk about extending the human lifespan. Today, gerontologists are more likely to talk about extending the human healthspan (go-go) and “compressing morbidity” (slow-go and no-go) into a smaller period.
A few weeks ago, at the annual meeting of the Pension Research Council at the University of Pennsylvania, Olivia Mitchell and Steve Utkus presented a paper called “Extending Healthspans in an Aging World.” Today’s “geroscientists,” the paper shows, find that 70 can be the new 60, 80 the new 70, and etc.—but mostly for those born to the right parents and living the healthiest lifestyles.
Had I chosen not to have my hip replaced, I would have effectively abandoned all hope of returning to the go-go segment of my retirement. I would have had to accept an already-begun slow-go era. Instead, I gambled (with about $13,000 in coverage so far from Medicare and a Medigap plan) that the rest of me will remain healthy enough so that hip replacement will restart my go-go-years, and not have been, in retrospect, a waste of everyone’s time and money.
Ahead of the pain
The catch, with joint replacement as with other procedures like heart bypass surgery, is that you have to pass through no-go and slow-go periods before you can resume your go-go years.
My surgically-induced no-go period was extremely short. I did not spend a week or even a day in a hospital bed. Six hours after the procedure, I was sent home with instructions to “walk, just walk” and to take 5 milligrams of Oxycodon every four hours for moderate to severe pain. Thus began my slow-go period of self-supervised recovery.
I don’t know how long it will take for the go-go period to resume. Perhaps as little as three weeks. Perhaps much longer. Friends have told me that they were prescribed and received house calls from physical therapists after their joint surgeries. (At this moment in time, I’m serving almost as my own doctor. I hope I don’t have a fool for a patient.)
Recovery-time can depend on how well you follow your physical therapy regime and manage your pain medication. You have to achieve a balance between the two, since your willingness to walk depends in part on whether you’ve “stayed ahead of your pain” with Oxycodon and other medications.
My wife and I know several people who have lost children to Oxycontin overdoses. I chose not to take any Oxycodon for eight days post-surgery. In retrospect, that wasn’t a great idea. Then I erred in the other direction. (Equally bad idea.) Two weeks post-surgery, after trial and error, I’m sensing progress. Today, I walked without a cane.
Eyes on the prize, they say. The prize will be the recovery of more and more of what I’ve experienced less and less over the past decade: physical exercise without pain.
Oh, what a joy, a mighty joy, that would be.
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