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Dee Kaltenbach: Jazzercise Instructor
 
Dancer Questionnaire
Your Name: Dee Kaltenbach
Date of surgery: November 28, 2005
Surgeon: Dr. Horwood
Hospital: Fairview General Hospital, Cleveland, OH
 
Give us some biographical background.
I am not a professional dancer, but I was a competitive baton twirler (which included dance and gymnastics)in my earlier years and have been doing Jazzercise for 25 years. I have been a Jazzercise instructor for 18 years (which incorporates dance moves), teaching nine classes in five days. Having had a total hip replacement has made me change my life, that is why I am answering your questionnaire.
 
Prior to surgery
When did you first notice symptoms and what were they?
I first noticed problems with my leg in October of 2004. I had shooting pains that went from the hip to the groin down to the knee. It was hard to figure out what was actually hurting the most.
 
What was your medical diagnosis (traumatic osteoarthritis, congenital hip problem, avascular necrosis, etc)?
Osteoarthritis was the diagnosis.
 
What forms of treatment did you seek before considering surgery (chiropractic, acupuncture, medications, bodywork, physical therapy, herbs, etc)?
I finally ended up in the emergency room the week before Christmas in 2004. I could hardly walk, couldn't walk up the steps, ended up having three hot flashes, which the emergency room nurse said can be brought on from pain. I went to an orthopaedic a week later. Xrays were taken in the emergency room telling me I had no cartilage in my right hip. I was put on an anti-inflammatory drug. I tried to rest more often between workouts and physical activities.
 
How did you change your work habits, lifestyle to accommodate the hip problem?
I have always been athletic. But, I have been involved with Jazzercise for 25 years, that's half of my life. I have taught for eighteen of those 25 years. I was teaching nine classes in five days for many of those years. Jazzercise was my business, so I kept teaching all my classes up until the weekend before my surgery. Moves where I would have to turn out from the hip, like plies or lunges, were very painful. I found I to fake a turn out from the hip, it was slightly more than a neutral position. Very frustrating. Some days I would have to drop the impact on some of the higher impact routines. I was told to do as much as could for as long as I could. When I went in for surgery, I was in wonderful physical condition. My upper torso strength got me in and out of bed almost effortlessly....I said "almost" because I still struggled some.
 
How long an interval was it from the onset of hip problems until surgery?
I lasted for a year before I had to admit I needed the surgery.
 
What factors, physical, emotional, financial, etc. influenced your final decision to have surgery?
Well, like I said Jazzercise was my business. I was told once I had the surgery my career as an instructor would be over. (I don't think that is true, the more I hear and read.) My husband was very unhappy with the job he had been at for some 15 years. I told him once I got the surgery and I couldn't teach anymore, I would have to find a new career. We decided to move a month after my surgery to North Carolina. We are waiting to open an ice cream parlor down here. I am still considering teaching a couple classes a week just to keep in shape and just the fact I miss Jazzercise and teaching. I will probably also try to get a part time office job.
 
Were there other dancers you spoke with that helped you?
No.
 
Surgery
What influenced your choice of surgeon?
His reputation in the Cleveland area.
 
How long were you in the hospital?
Four days, I was deemed "the miracle patient" because my recovery was so fast.
 
What kind of prosthesis did you get (e.g., ceramic ball/ceramic liner? poly liner? highly-crossed linked poly liner? all metal?)?
I was to have metal on metal, titanium. But once the surgeon got in there, he found my pelvis was too small to place the metal cup in, so I ended up with a plastic (or some kind of synthetic material) cup instead. Everything else is titanium.
 
Did you have any complications in the hospital?
No.
 
Anything else to say about your in-patient experience?
I was told to start on crutches once I was able to walk the halls. I understand Dr. Horwood recommended crutches over a walker. He said it would give me more mobility. It was not a problem.
 
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Post-op
Did you have any complications, especially unexpected difficulties, after you got home?
No, I found working with the PT made me a little stronger everyday.
 
What steps did you take toward recovery? (Physical therapy, chiropractic, acupuncture, medications, bodywork, herbs, etc.)
I did my exercises the PT told me to do, I made myself motor myself with my crutches around the house just for the exercise. I took Vicodin only at night because it made me very drowsy, I think I took this for a week. I had Lovenox shots (blood thinner) in my stomach muscle for 10 days.
 
How long did it take you to really feel recovered (6 months, one year, two years?)?
 
I was told before I moved out of state by Dr. Horwood, that I didn't need any physical therapy afterward, I could accomplish what I needed to by walking or biking on my own. I went back to a Jazzercise class as a student about mid January 2006. I started out very low impact and standing on the floor work. I now dance through a class a little more than low impact, still cannot turn out the hip in an attitude position completely and comfortably. The inside thigh (adductor) is sore after class. I figure all my muscles have gotten lazy. So, I'm starting my fourth month after surgery and I feel some what recovered. I sure don't have the hip pain I had. I don't have to think of how I turn with my hip as much. I enjoy being able to get back into the body movement. I focus more on each body part now. I think each month I will only get stronger. I hope to return to teaching again maybe after the summer.
 
Anything or any practitioners that you would highly recommend?
Before the hip surgery, do as much as you can for as long as you can. If you start sitting around to baby the pain your joint will freeze up.
 
Moving again
Did you return to dancing professionally?
No.
 
About dance class: Do you take dance classes?
3 Jazzercise classes a week.
 
All post-THR patients are advised to limit impact on the joint and to avoid overcrossing the legs. Given that, do you actually modify your dance class? E.g., are there parts of the class that you skip (petite allegro, grand allegro?)?
I was lowering the impact for the first month or so. I chasse and skip lightly and march right now. I need to strengthen my inside thigh to help with the hip turn out.
 
Do you use fifth position?
I concentrate on making the turn out in a plie a little more each time.
 
Other
How has the surgery impacted you professionally, physically, emotionally, spiritually, and financially? Is your life different now? Did you have any outcome, good or bad, that was different from what you expected? Any other thoughts to share?
As I said, I will hopefully return to teaching some classes, not as many. I try not to worry about my other hip.
 
February 28, 2006
 
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