...I have difficulty seeing over my pelvis.
November 8, 2007 5:08 AM   Subscribe

Virtual hip replacement and others (flash). Ostensibly aimed at school-agers, but I learned a few things. I also winced once or twice.
posted by Wolfdog (18 comments total) 2 users marked this as a favorite
Hip op you don't stop.
posted by nthdegx at 5:29 AM on November 8, 2007

My 10 year old stepdaughter plays with these all the time. She wants to be a surgeon. Or a rock star. She's not sure yet.
posted by Cookiebastard at 5:32 AM on November 8, 2007 [3 favorites]

She's not sure yet.

Why not both?
posted by Alvy Ampersand at 5:47 AM on November 8, 2007 [1 favorite]

I'll finally be getting a couple of these soon. Probably the first of the two at least next year sometime. Although my femurs are slightly bowed outward from the dual osteotomy I had as a child—this complicates things greatly because, as you can see from the link, the new hip and partial femur connect to the old via an extension into the marrow—the femur needs to be straight. So they don't know what they're going to do. I may have to have preparatory surgery. I'm looking forward to being much more mobile, but I'm very much not looking forward to the surgery and recovery.

The difficulty of the recovery can vary greatly. My sister's first hip replacement, when she was 28, was pretty rough—the surgeon, in his zeal to get the tightest possible joining between the femur and replacement, pounded the artificial so hard into her femur that it cracked the femur. Her recovery from that surgery was very difficult and prolonged. Her second surgery, about three years later (and just a couple of years ago) went much more smoothly and her recovery was very rapid.

I strongly suspect that my dad has the oldest existing artificial hip in the US. One of his hips has a partial steel ball—this was done before they started replacing hips. But the second hip was replaced with one of the earliest artificial hips in 1974. I think he was at that time the youngest person to have had a hip replaced at the age of, um, 31. He's still walking on that hip, so it's almost 34 years old. As he was the youngest at the time, and this was done in the first years of hip replacements, he very well may have the oldest one in existence. Most people who get hip replacements are in their 60s, or so. And this was especially true in the early days because they had no idea how long these would actually last. Another interesting thing about his artificial hip is that his predated the time when they were manufactured to order (or, at least, predated when they were exactly sized). His is about an inch too-long, so one of his legs is longer than the other. He's had to wear a lift for as long as I can remember, adding considerable cost to his footwear.

They also replace the other major joints these days. My dad has two artificial shoulders and an artificial knee. My sister hasn't had any other of hers replaced yet. I'm pretty sure that at least one of my shoulders needs to be replaced as I have very limited range of motion in both and they hurt like hell. Shoulders are really the worst joints to be degnerated—although ankles are pretty bad, too. But thing about shoulders is that you are always sort of using that joint and it's not like others where you can ease them by taking the weight off of them. So shoulders hurt all the time, no matter what you're doing. And they can interfere with sleep pretty badly.

These are often titanium, I think. I know that both my dad and sister set off the metal detectors at the airport and they carry a doctor's letter with them. That's a bummer. On the other hand, they can (and sometimes do) use the disabled person line through screening, which is faster and easier.

These surgeries really are brutal—though all orthopedic surgeries are pretty brutal and orthopedic surgeons are like mechanics or carpenters. They use big saws and mallets and it's pretty shocking to watch what they actually do in surgery.

My mom's an RN, she made a life career change when she was about 40 and went through school then. She had no trouble with anything she did and has done in terms of squeamishness...except for orthopedic stuff. Partly it was because her two kids have had these kinds of operations. But she almost passed-out during nursing school when she observed her first orthopedic surgery.
posted by Ethereal Bligh at 5:51 AM on November 8, 2007 [2 favorites]

Ha! I've got to show her that movie, Alvy.
Why is there a watermelon there?
posted by Cookiebastard at 6:02 AM on November 8, 2007

Ethereal Bligh, does your family have some sort of congenital bone condition that requires orthopedic surgery early in life?
posted by tehloki at 6:08 AM on November 8, 2007

So ... is it early onset osteoarthritis, or something else?
posted by Comrade_robot at 6:14 AM on November 8, 2007

These surgeries really are brutal—though all orthopedic surgeries are pretty brutal and orthopedic surgeons are like mechanics or carpenters. They use big saws and mallets and it's pretty shocking to watch what they actually do in surgery.

I had 3 orthopedic surgeries as a kid - 2 of them bilateral osteotomies - and a handful of non-orthopedic surgeries since then, including two that were considered "major" surgery, and involved drilling a short way into the skull. Had you asked me to classify the surgeries, I would've called the orthopedic work major surgery, and everything else minor surgery (and I wouldn't have classified "minor surgical procedures" as surgery at all), but that's apparently not how it's defined.

This is one of the few areas in life where I can honestly claim to be a total bad ass. But yeah, orthopedic surgery scares the crap out of me.
posted by spaceman_spiff at 6:18 AM on November 8, 2007

“So ... is it early onset osteoarthritis, or something else?”

Yeah, we have a congenital condition that results in early onset osteoarthritis in adulthood. Also developmental problems in the bones and joints in childhood.

It's an extraordinarily rare collagenopathy, only found in seven families in the world. Specifically, it's an Arg519-Cys mutation in type II collagen.
posted by Ethereal Bligh at 6:29 AM on November 8, 2007

“2 of them bilateral osteotomies”

Me, too. I had a bilateral osteotomy on my femurs/hips when I was ten-years-old. My hips were growing out of their sockets and my legs were also turning outward. They cut the femurs in half, rotated the top portions back inward, bound each of the femurs together with pins, and put me in a body-cast from my waist to my toe joints for, um, three months, I think. I first learned to get around the house while standing up using crutches, but eventually I would either balance or use the walls and pivot around one foot and then the other. My mom was a nervous wreck. But you know how kids are—I was fearless and wanted to be somewhat mobile.

Was your recovery especially hard? I don't remember that mine was. When the case came off, I had very little strength in my legs, I couldn't even lift a leg straight while sitting.

One of the worst pains I remember experiencing in my life, though, was the day—about two weeks after my surgery—that they decided that I should have some weight placed on my hips. They put me on a table that rotated to vertical. When the weight started to settle on my hips, I remember the most horrible pain. I cried and begged them to not do it. But this was a children's charity hospital where I was in a big boy's ward with twenty other boys and my parents were hours and hours away and only visited me on the weekends. The nurses weren't very sympathetic. I was really, really unhappy in the hospital and missed my parents greatly and felt abandoned. That was the worst part. The physical pains from the surgery and recovery seem almost trivial in comparison to how badly I remember the emotional pain from that time.

My sister had six or so surgeries by the time she was eighteen-years-old. But hers were all in regular hospitals with semi-private rooms and my parents were with her 24-hours a day. I always felt envious, perhaps bitterly so, because of that. On the other hand, she had six surgeries as a child and I only had one.

You've been under the knife many times. Do you have any fears related to that? My sister has a fear of dying while under anesthesia.
posted by Ethereal Bligh at 6:41 AM on November 8, 2007

Oh, rereading my comment and my mention of the pins with which they secured my femur halves together reminds me of a funny story.

I went back into the hospital after three months or so to get the pins taken out and the body cast taken off. I figured they were going to do this as a surgical procedure.

So, one morning my surgeon came by to my hospital room. “Time to take out those pins!”, he said with a grin. He was a big, expansive, cheerful bear of a man. He wheeled my bed out of my room and into the corridor. At the point where I was expecting to turn down the corridor toward OR prep, he instead went in another direction.

“Where are we going?” I asked.

“To the cast room”, he replied.

So he wheeled me into the cast room. He walked over to a cabinet and then turned around with these big pliers in his hand. “Here we go!” he said.

“What?! No way, you're kdding me!”

“It'll be a piece of cake. Won't hurt a bit, I promise”, he said. “It's all scar tissue around the pin, all the way through your leg.”

And, sure enough, as I squeezed my eyes shut I could feel him gripping the pin in my right leg with his big pliers and as he gave it a couple of twists.

It squeaked.

It didn't hurt, but the feeling of pressure on my femur, inside my leg, was really, really weird and unpleasant. And he just twisted and pulled the thing out. And then he did the other.

He was a really nice man, but since then I've had some suspicions that all orthos are just slightly cheerfully sadistic.
posted by Ethereal Bligh at 6:50 AM on November 8, 2007

Just watching the cartoon made me squeamish. Though it was fascinating to see the surgery details anyway.

I wish they had an advanced mode where they didn't lead you by the nose: "pull the scalpel to the right"--and then it moves only the correct way. They should have a free-moving mode, where you can cut anywhere you want, and only your skills as a virtual surgeon can make the procedure a success.

Of course, this would take a lot more software.
posted by eye of newt at 8:17 AM on November 8, 2007

Apparently I have a promising career in orthopedics ahead of me.

Can the Flash cartoon print out a reference letter for me?
posted by bicyclefish at 9:04 AM on November 8, 2007

EB, thanks for sharing your story. Just so I have this straight, you type these huge-ass answers while in constant pain?
posted by maxwelton at 9:34 AM on November 8, 2007

Uh-huh. :)

Seriously, pain is funny. Speaking for myself—but I'm pretty sure other people who have bad chronic pain will agree—it's not really the pain itself that's the worst. You can sort of get used to pain, at least a little.

What's really bad are the secondary effects of pain. Chief among these is fatigue. The constant pain just sucks the life out of me.

And, in general with regard to living with my illness, it's the limitations it places on me which is the most difficult thing for me to live with. For about ten years now, I feel like I'm in a constantly shrinking box. As soon as I get accustomed to not being able to do a bunch of things, then there's more things to add to the list.

Last month I was feeling an unusual amount of muscle pain for some reason. I don't know why—sometimes when some joints act up it causes me to hold or move my body in some especially abnormal way, which causes other aches and pains in muscles and such.

Anyway, because of this, I got it into my head that a nice, hot bath would be just the thing. Now, I can't take baths any more because I can't get down into and then back up from the bathtub. I do have a shower bar, but the combination of my various limited ranges of motion, and some atrophied strength, all make it so that there's really nothing I could use that would make it so I could take baths easily.

Nevertheless, the more I thought about taking a bath, the better the idea sounded. Finally, I just convinced myself that I'd be able to sort of sit down and fall and control it by holding onto the bar, and then I'd later figure out how to get back up when I was down.

The sitting down/falling down part went relatively okay, though it was a bit scary. But it was when I was ready to get out of the bath that I discovered I had overestimated my ability to improvise some way of getting up.

I tried a few things, hurting myself in the process, and then gave up for a while, then tried a few other things. It took me about an hour-and-a-half before I was able to get out of the bathtub.

The whole time there was about half of me that found it comically amusing and I sort of also made fun of myself for being foolish. Another part of me was a little bit scared, worried that I'd fall and seriously hurt myself as I tried to get out of the bath. And yet another part—a part I tried very hard to ignore—was screaming out silently in a sort of terror and frustration that I was trapped in my bathtub.

I mean, it was absurd. Who can't get out of their bathtub? There are times when I face my inability to do something that almost everyone else takes completely for granted and I feel like screaming or weeping. But I usually just put it out of my head as quickly as it comes into my head. I kind of decided a long time ago not to dwell on things like this or to feel sorry for myself. I think generally that's healthy, but to be perfectly honest, I'm not sure that I really have emotionally dealt with these sorts of things very well. I think it probably ends up being expressed as depression, which I constantly fight.

That's all a bit personal, but I'm willing to talk about it if it helps give voice to how other disabled people feel about their experience. I think maybe healthy people overestimate how awful the direct experience of the disease and/or pain is while underestimating the emotional pain and difficulties in living with the disability. I'd happily keep the pain if I were otherwise given a normal life back.
posted by Ethereal Bligh at 9:54 AM on November 8, 2007 [4 favorites]

Was your recovery especially hard? I don't remember that mine was.

Having the cast on wasn't that painful (after the first few days, anyway). Rehab was hard, though. And no walking with the cast on - it went up to my sternum. The second time, I ended up having late-night muscle spasms every night like clockwork for about three weeks. They didn't respond to drugs - and we tried a lot of different things, including morphine and muscle relaxers - so they just removed the cast and put me in a brace. I cannot imagine pain much worse than that, but I was 8 at the time, so perhaps that colored things somewhat. I also remember having my pins removed, and while I wouldn't say it was painless, it wasn't nearly as bad as I expected.

You've been under the knife many times. Do you have any fears related to that? My sister has a fear of dying while under anesthesia.

Yes and no. I had one (cochlear implant surgery, so minor by my standards) this summer that involved being conscious for the intubation, and I remember that it didn't bother much at all, to the point that I was attempting to fingerspell to one of the anesthesiologists while it was going on. There must be some underlying fear, though, because I have a hard time trusting some doctors, and my personality immediately pre-surgery is ... not one that I'm particularly proud of.
Putting a mask over my mouth and nose does freak me out, though. Thank goodness for Versed, heh.

It's all led to some funny stories, though - like the time an allergist was prepping for an allergy test, asked me if needles bothered me, and then glanced at my chart. "Oh. I guess they probably don't." There was also a surgery a few years ago on my ear (yes, my ears are as screwed up as my legs) that left it draining a significant amount of bright red blood onto my shoulder for about a week. I felt pretty okay, if tired, near the end of that, and went out to a coffee shop in town, where I discovered that I have a much greater tolerance for blood pouring out of orifices than the general population.
posted by spaceman_spiff at 11:36 AM on November 8, 2007

Wow. About 75% of the words in this thread are from Ethereal Bligh. I have to hand it to you man, you whimsy a mean tale.
posted by tehloki at 3:48 PM on November 8, 2007

Not one person giving you props for the Douglas Adams quote -- but don't worry, I got yer back!
posted by bpm140 at 8:17 PM on November 8, 2007

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