Hips For You - Guide to Total Hip Replacement

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Clusty

Jo

Bi-lateral  THRs   Dr. Swank  Nov. 2010

I am a 52-year-old (now former) female backpacker who was injured in a backpacking fall 3 years ago (my family doctor, who is my age, jokingly calls this 'old people trying to do sports').

After the fall, I experienced back pain (caused by 2 ruptured discs, which I now successfully control with physical therapy exercises) and progressive hip pain over the next 2 years. Two different orthopedists in Cincinnati said that while I showed some 'mild arthritis' of the hips, I was not a candidate for surgery.

In September 2010, unable to walk up a flight of stairs (I had to crawl), I took myself to Cleveland Clinic where more extensive testing (the first MRI anyone had bothered to do, plus an X-ray that used more extensive measurement techniques) showed 1 millimeter of hip socket clearance and severe IT band tearing (apparently 5-6 millimeters clearance is considered normal).

Cleveland Clinic said I needed either resurfacing or replacement. I chose not to stay in Cleveland for the surgery so they provided me with the names of 2 physicians in Cincinnati that they recommended. The first name on the list was Michael Swank.

Dr. Swank seemed extremely intelligent and thorough and took great care to answer any and all of my questions on a level that seemed tailored to my understanding of anatomy and medicine. He recommended replacement versus resurfacing because I have a nickel allergy (based on how cheap jewelry makes me itch) and resurfacing is done using all metal.

In November 2010, I had the first of two ceramic on ceramic hip replacements--left hip first, via the anterior approach. I spent one night in Jewish Hospital but worried that I should have stayed another--I really didn't know what to expect when I left, but the visiting nurse came out later that day and helped allayed my fears.

The first 2-3 days I felt pretty down (pain medications only seem to make me feel loopy and don't really take the pain away). I felt much better once I got off the heavier narcotics and started taking more tylenol-based meds. I was off all walking aids within 2 weeks and limped a bit for about 1 more week. The incision itself was glued, not stitched (there are stitches inside) so you can shower right away--yay!

Dr. Swank generally requires 6 months before the second hip, but my recovery was so rapid I was able to talk him into 4 1/2 months. In March I had the same procedure on my right hip, but it was remarkably different. Instead of feeling like I'd been in an accident, I felt GREAT. To the point I wanted to leave the same day(!), which of course, they did not allow. Apparently, in the months between my surgeries, Dr. Swank began adding several rounds of steroids post-operatively for those patients whose medical conditions would allow it.

The result was no post-surgical 'hangover', and very little need for narcotics. I was up using the real bathroom the very first night (no bedside throne needed!). My biggest challenge over the next 2 weeks was not overdoing it! I was off all walking aids within 10 days and even drove at 2 weeks, and it was my right hip! The limp lasted maybe another week. But by 6 weeks I was hiking around the local parks.

Both replacements were done using the anterior approach which I highly recommend. The physical limitations are much less (you can bend forward with no restrictions--which makes daily living much easier), there's no incision on your backside so sitting or sleeping was easy, there's also much less risk of damaging the sciatic nerve.

I highly recommend Dr. Swank for this procedure--he's worth coming into town for. He does only hip and knee replacements and the head nurse at Jewish Hospital told me he's nationally known for his innovative techniques. Even my family doc, who was listed as one of 'Cincinnati's Best Doctors' told me during my pre-op physical that Swank is who he'd use if he needed the surgery.

I should also mention that Dr. Swank's staff is excellent--his medical assistant and his nurse practitioner are very bright and pleasant, even his scheduler is sharp. And the visiting nurses they chose for the coumadin therapy follow-up did a great job. They talked very highly of Dr. Swank's successes--how amazingly few patients needed any blood transfusions and almost no post-op infections.

I've since learned Dr. Swank is now a professor at The University of Cincinnati Medical School--not surprising. I would want to be taught by the best. I'm just grateful I found him and have my life back.

Jo

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