I have been silent for great gaps of time over the past two years, and PTSD (Post-Trump Stress Disorder) is responsible for a lot of that, but after that, there has been the pain. It took up my whole head some days and it didn’t really seem like something one ought to be blogging about and bringing other people down.
So, against all logic and conventional symptomatology — turned almost entirely on its head in this case — what turned out to be happening is, both of my hip joints are completely destroyed, like you read about, and have to be replaced.
No one has a very good explanation. At least two people from divergent walks of the health care spectrum have invoked “genes,” which I believe is a graceful way of saying “We have no fucking idea.” The best anyone can do is to note that this is a thing, that people from time to time have both hips go to hell from some putatively auto-immune malfunction that selectively burns out only that joint. The rheumatologist X-rayed everything; I probably glow gently in the dark. I’ve been tested two and three times for all the autoimmune markers, lupus, ankylosing spondylitis, you name it. Zilch (whew). I have the bone mass and general joint integrity of someone easily twenty years younger. Just this.
I am still trying to figure out where I fucked up.
(I know where other people fucked up. When I went to my longtime chiropractic colleague, Dr. Bill, with the dislocation I incurred in 2011 — it was slight and just felt like a little strain to me — he completely failed to recognize it, and got his ass on his shoulders when I figured it out after ten months and had the Engineer yank it back into place. When the pain got worse again after an interval of a few years, eventually migrating to the other leg as well, he simple kept shoving my legs in directions they didn’t want to go, until one day I hobbled into his office and he asked with a creepy little smirk “Have you tried sitting in a bath with Epsom Salt?” I dropped some f-bombs, and we haven’t spoken since.
Go figure. Twenty-seven years I depended on the bastard’s diagnostic acumen and uncanny ability to refer patients to the specialist they might need if something was out of his league; I saw it over and over, but it wasn’t there for me. Yes, the pain manifested in a way almost opposite to most hip arthritis, but ferfrigsake, this guy’s wheelhouse is identifying skeletal origins of pain; it’s all he does, all day, every day. I have no idea why he hung me out to dry, but screw him.)
One under-appreciated perk of my profession is that you get to see the work of surgeons progress in real time. I’ve worked on pre- and post-op knees, shoulders, hips, spines; I’ve seen the disasters and the gold-medal jobs. So I am booked for February 5th with a surgeon who did hips on two of my clients in the past two years; unlike the surgeries you’ve probably seen, he goes in from the front, hauls the muscles aside without cutting them whatever, using retractors he designed himself for the purpose, places the new joint — a cute piece of engineering designed to let the bone grow into its surface layer, sort of like a Chia Pet — both by eyeballing and with a fluoroscope, and sends you home in a day or two. I am advised I will be able to do one flight of stairs a day right away.
Despite this and other predictions of far less impairment than you usually expect, I have been inundated with dire admonitions: buy a new chair, don’t stand up, don’t sit down, don’t get out of bed, lie flat all the time, don’t put on socks and shoes, don’t put on pants, don’t wipe your own ass, GODDAMMIT PEOPLE just let me talk to the surgical team about precautions? It’s worse than when women announce they are pregnant and immediately get regaled with everyone’s childbirth horror stories. I am considering an embargo on any and all helpful advice, enforced with a whack from my Alpine poles, which I have to use now to get anywhere.
This is because there is apparently no cartilage left. The surgeon — a fairly laid back type, with the confidence of several years and several thousand surgeries worth of experience doing this one method — eyeballed my X-rays, recoiled slightly but visibly like a cat that has just sniffed a glass of whisky, and said “These are very bad.” When I asked about the state of the labral cartilage that holds the joint snug, he said “You don’t have one.” This explains why I keep feeling as if I’m going to be dumped on the floor if I put my foot wrong.
At least I can work, because the job description pretty much involves leaning my weight on the supine client. And I can lift, if I can pole my way to the weight station, which has to look hilarious as I clamber onto a bench and then blow up a couple of forty-pounders handed to me by the Engineer, who has been a saint. I did have to give up squats. The surgeon says those will come back. He operates out of a sports medicine clinic, and he’s used to insane people like me.
Everyone says I’m going to be fine, my stomach is upset, my heart rate is up and I had a terrifying bout of classic anxiety palpitations (fortunately the day after getting a clear EKG), I spend all day and night thinking of things that could go wrong, and I still have Post Trump Stress Disorder.
Maybe I can live tweet the whole thing.