Melissa Ann Freed - THR (Right Hip) at 39 yo
Date of surgery: February 5, 2013
Surgeon: Dr. Gregory Klein - Hartzband Group for Hips and Knees
Hospital: Hackensack Hospital, Hackensack, NJ
Prior to surgery
When did you first notice symptoms and what were they?
About 5 or 6 years ago when I was still teaching Jazzercise I noticed pain deep in my buttock area and down the back of my leg (sciatica). Over the years the pain began to worsen, then I noticed pain in my groin area as well it was also a very deep pain that sometimes went down my thigh and even into my knee. What started out as a slight pain began to get worse and worse for the next six years.
What was your medical diagnosis (traumatic osteoarthritis, congenital hip problem, avascular necrosis, etc)?
My final medical diagnosis was Osteoarthritis of the Hip. I also had Hip Dysplasia along with Hetorotrophic Ossiphication bone growing into my thigh muscle due to a previous surgery on my hip. I had a Labrum Tear 2 years before my THR and thought that was the problem and I had really hoped that having surgery to fix the tear would be the answer to my prayers. Unfortunately that didn't happen the surgeon who did that surgery not only made things worse by shaving my femur bone down too much and caused greater damage. I also developed Heterotrophic Ossiphication (this is bone growth after surgery where the bone grows in the wrong area, this condition does not happen too often to people especially women it is more common in men and it is very rare, so no worries, I'm just a strange case! I had this Heterotrophic bone growing into my thigh which was extremely painful and took a long time for doctors to see and diagnose.
What forms of treatment did you seek before considering surgery (chiropractic, acupuncture, medications, bodywork, physical therapy, herbs, etc)?
As a Yoga teacher I was lucky to know so many people in the Holistic field. I began seeing a Chiropractor that was a student of mine when the pain was first getting uncomfortable (the sciatic pain). That helped a little bit, but soon enough the pain would return over and over again until I gave up going. I also tried massage therapy. Again, this helped at the time, and gave some immediate relief, but it was not a steady fix the pain would still continue to return. I tried the herb Tumeric for inflammation, and other vitamin blends at the health food store to help my joints, etc. I ended up going to a Pain Management Office when I finally began to get to the point where the pain became intolerable to live with. They tried anti-inflammatory medications, steroid shots in both my back and hip areas, Celebrex, and even heavy duty pain killers. I had no choice. The only way I could function was to take pain meds towards the surgery date. I have a child to care for and a life to live and I didn't want to spend it in bed every day. I also had a yoga business up until the first hip surgery. I closed the studio, then tried to reopen it but then ended up having the major surgery.
So now I'm taking my time and just working on getting better before deciding if my body can take on yoga again. I am very hopeful to be able to practice and teach yoga again. This website, Dancer's hips gave me the courage to go through with my surgery and made me feel like I was not alone. So many other mom's my age (late 30's) would say, "but your so young... " -- they didn't understand it was the dancing, the aerobics, the running, the power yoga, etc. that probably brought me to this condition earlier than expected. This website was a place of comfort for me, a place for knowledge about what to expect before and after surgery, and even what to expect with recovery. So thanks so much for this beautiful and invaluable website. It was really a huge blessing for me to have.
How did you change your work habits, lifestyle to accommodate the hip problem?
Everything changed for me. I ended up losing my yoga teaching jobs with the 3 gyms I was working for, the 2 yoga studios I worked with, and then eventually I lost my beloved yoga business that I had worked so hard to grow. I just couldn't keep teaching; it became way too painful.
I had to use a cane after I had the labrum surgery that left me worse off - and as a 38 year old woman going through a divorce and being single again, having to use a cane it was tough to take. Especially if I went to the mall or shopping, other people looked at me like I had 5 heads because I was so young using a cane. Which I thought was just so ridiculous everyone has problems, mine happened to be physical and in this day and age people should be less judgmental. I had to stop my divorce proceedings because I was scared of losing my health insurance benefits and knew I needed a major surgery. Thus, basically I had to live with my ex-husband and keep things peaceful for my 9 year old son. I tolerated things that were really intolerable, all while trying to feel well and keep my son happy and my home somewhat normal - which was really hard to do when I was in constant pain. So the hip injury took over my entire life: it dictated everything, from staying in an unhappy marriage to having to lose my yoga business and stop doing the job I loved (teaching yoga).
It was a rough 2 years for me. It was as if my life was put literally on hold.
How long an interval was it from the onset of hip problems until surgery?
Six years - but the last four were the most painful.
What factors, physical, emotional, financial, etc. influenced your final decision to have surgery?
For me there were so many reasons to have the surgery and move on with my life: I lost my business; I was in pain often at night so I was tired often; I didn't have much time to be social with friends; most of the friends I had were through fitness, which I gave up while injured; things with my son were ok, but last year I couldn't go on the 3rd grade field trip with my son that involved too much walking - that was hard to take because I was always deeply involved in my son's life. And of course, I stopped doing the thing I loved the most, my yoga practice and exercising. So when I lost felt like I lost my identity.
It was a very dark and trying time for me. As I mentioned, I had to put my divorce on hold for medical insurance reasons. Living with someone you no longer want to be with, and trying to keep things peaceful for your child while you don't feel well, wasn't fun at all. I needed to have this surgery in the worst way. I needed to get better for my son's sake and for my own sanity and also to get my life back and be able to work and land on my own two feet -- literally!
Were there other dancers you spoke with that helped you?
One of the dancers on the list from this website was also a yoga instructor. She was extremely helpful in recommending doctors and sharing her story with me. I was interested in seeing the other Jazzercise Instructor's stories because for a long time I thought all the practicing and teaching I did when I was a Jazzercise Instructor may be what really started the breakdown in my hips. I find it so hard to believe that yoga could of done this to my hips. I know heredity helped play a part in all of this, but I think the aerobics and all the practicing helped bring this on faster.
What influenced your choice of surgeon?
I had a hard time in the beginning finding a surgeon. Because after the first surgery (for the Labral Tear Repair) and the problems I endured, I wanted to make sure I had a really well experienced and well recognized surgeon for my THR. But some of the surgeons I met with would not take my case because of my Heterotrophic Ossiphication and because of my age. The damage I had didn't show up too well on Xray but on MRI it did. Some of the old-fashioned surgeons in my area would look at the Xray and tell me I was fine and to wait.
The doctors at Hospital for Special Surgery were excellent in diagnosing me, thanks to Dr. Brian Kellie after two years of trying to put the pieces of the puzzle together between my back and my hip pain and which it was, and also exactly what was wrong with my hips. He was able to help me solve the mystery and finally have clarity about what I needed to do. Unfortunately he does not do THR - he only does Labral Tear Repair and other surgeries to help repair and save people's hips. He actually recently performed baseball player Alex Rodriguez's latest Labral Tear Surgery. I truly wish when I had my Labral tear years ago I had gone to Dr. Kellie instead of going to the surgeon that caused the ruination of my femur bone. Dr. Kellie recommended a few surgeons at HSS, but because of my insurance, I was only covered 80% with the surgeons I met with there and the tests alone were adding up fast. As a future single mom heading towards a divorce I just couldn't imagine having this kind of debt on my shoulders, so insurance was a concern. My second concern was I wanted to be in a hospital near my son in case, God forbid, there were any complications I wanted to be close to home. So a good friend of mine recommend Dr. Greg Klein, who at one time not only had worked with the Hartzband Center, but he also was a surgeon with NYU Langone Center and his reputation was fabulous.
Dr. Klein had helped my good friend's mom and her father-in-law (who was also a physician) with both their hip replacements. Then it seemed everyone I talked to knew a person who had Dr. Kleinas a surgeon and spoke highly of his work. My pain doctor also had a good relationship with him, so it was a good fit as they were able to work together and come up with a plan to help me.
Dr. Klein also was the only surgeon who was honest with me by telling me that this surgery may not be the answer to my pain, that some of it can be from my back issues (I have a bulging disk at L5 and slight spinal stenosis) and he couldn't promise me total relief. He was refreshingly honest. He also had a plan for the Heterotrophic Ossiphication (HO) problem, to ensure I did not regrow bone back anywhere else: I had to have radiation the day after surgery that would be quick and painless, and if keeps the HO bones from growing, I was all for it. I was scared to have radiation, but it was such a small dose I had no side effects and the benefits out weighed the side effects. I couldn't risk growing HO bone again.
After the surgery Dr. Klein came to see me and with a big smile on his face. He said to me "I think we got something here." It turned out I had a huge flap of cartilage hanging off the bone and my hip bone was disfigured or funny looking. So in the end I was so blessed to find Dr. Klein.
How long were you in the hospital?
I was in the hospital for 2 days and then in the rehabilitation center for a week. I was supposed to be there two weeks, but I missed my son terribly. So I learned how to care for myself as quickly as I could and went home as soon as I could. I came home on Valentine's Day.
What kind of prosthesis did you get (e.g., ceramic ball/ceramic liner? poly liner? highly-crossed linked poly liner? all metal?)
I believe it is a Zimmer Hip with mostly ceramic with some metal. I was told that it was mostly ceramic because of my young age.
Did you have any complications in the hospital?
I am not good with pain, and so pain control was an issue I had because I had been on pain medication for many years before the surgery. I made sure to meet with the hospital's pain management doctor to find out how they would help me and treat my pain while in the hospital. He assured me they would make sure to keep me comfortable after the procedure, and for the most part they did.
The toughest day was when I was taken off the IV drip of pain medication and they put me on oral medication. The pain was a little more then usual, but the good news was it was more surgical pain and the old pain was gone. That made me so happy. I was able to get through the surgical part better then I expected. My surgeon also introduced me to Lyrica, which is used normally to treat patients with Fibromyalgia, but my surgeon puts all of his post surgical patients on Lyrica for the duration of their healing process. I have to say the Lyrica has helped me tremendously with my pain and it helped me to stop taking other types of pain medications, which was a big relief for me.
Anything else to say about your in-patient experience?
I highly recommend to patients like me who don't have too much help at home, to go and stay at a Rehabilitation Facility those first two weeks after surgery. During those two weeks I stayed at a sub-acute Rehab Facility I was able to learn how to care for myself from the Occupational Therapy Classes that were held daily. The Physical Therapy, which was also everyday, was great. Being in a facility I didn't have to worry about having someone drive me back and forth to physical therapy every day. I also had prepared meals and even help getting up to use the bathroom. Because of the hip restrictions, it was hard to do things like put on my pants or even my socks, so being in a facility and having the help I needed and then learning how to do it myself before going home, was so very important and made a big difference for me. I missed my son and my dog terribly, but I really think that staying there made a big difference and gave me such a positive outcome.
I also would say don't wait as long as I did. If you are told you need a hip replacement, don't wait on it, and think about it and keep making excuses and putting it off out of fear. I am so glad I was finally able to put the fear behind me - through the help of my boyfriend and my parents - and just did it. I now have a new lease on life and can move forward, and that has made all the difference.
I hope to write an update saying I went back to teaching Yoga and all is well in my life. I'd love to go back to school and become an Occupational Therapist myself and be able to help others help themselves the way I was helped.
Did you have any complications, especially unexpected difficulties, after you got home?
I did have some of my sciatic pain return and I became very upset. I thought maybe I had my hip out too soon or made a mistake. However my Physical Therapist took a look at me, felt the knots in my back and explained how the muscles are tight from the new hip and that my gait (how I was walking) was still off due to the swelling, etc. from the surgery. He assured me that with time and therapy, all of that would resolve. He then worked his magic with the stretching he did and my pain would begin to lessen. So PT became my best friend: that was the time I could get relief from the stretching he did for me, and also be able to move and build up the muscles in my leg again. It felt good to move - even if it was simple exercises, it was exercise, so to me it felt good and made me feel better.
I always had larger thighs than my mom and sister and I guess it was from the dancing and athletics I did my entire life. After the surgery it was funny because my left thigh was so tiny! I lost all the muscle in it from the surgery, etc. and I could not get over how little my leg was! But I am now building the muscles back up and its starting to look like the other leg again.
What steps did you take toward recovery? (Physical therapy, chiropractic, acupuncture, medications, bodywork, herbs, etc.)
I have been doing physical therapy and will continue for a total of 12 weeks. I am going to begin acupuncture this week to help with the pain I still sometimes have in my back area, and I am happy to say I'm coming off my pain medications and taking Lyrica for now instead. I also take Ibuprofen from time to time depending on my amount of pain. My "aha moment" that having this surgery was the best thing I did. was going to the mall and realizing I had walked for 4 hours and just started to feel sore, and also didn't need a pain pill. I used to never be able to shop, which was something I always loved to do, and now I can do it again pain free! That's when I knew I did the right thing and that my future was looking bright. I will always be so grateful to Dr. Klein, my friends and family who helped me gather the courage to finally do this -- and my son and boyfriend who wanted me to get well so that we could all finally have a happy life together.
How long did it take you to really feel recovered (6 months, one year, two years?)?
Hard to answer since it's only been 3 months. I will answer when I get to those points. At this early point I have good days that are 100% pain free, which is a first in many years for me, and I have days wnen I know I did too much and need to take it easy and put my feet up.
Did you return to dancing professionally?
My extent of professionally dancing was teaching children ballet, then on to teaching adults Jazzercise for 4 years, and then to teaching Yoga for five years. I am very hopeful to get back to Yoga classes and hopefully teaching Yoga again. But for now it is getting back to even just walking and swimming -- and of course, hopefully someday soon, to Yoga which is what I'd really love to do.
About dance class: Do you take dance classes?
No longer. I'm afraid to take Jazzercise after what I've been through. I just don't want to take a chance. But I am interested in maybe going back to a Ballet class at some point, and I would like to try the new exercise series of ballet and yoga combined exercise classes. I've heard they are wonderful and a great way to get back into shape. Right now I am just so overly cautious with everything. I just want to heal and start getting my life back to normal first.
My father owns a martial arts studio, so I've always been blessed with a large facility to practice Ballet, Jazzercise Routines, and Yoga in. I hope to get back and reopen my Yoga business there as soon as I can get strong enough to practice again.
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, et.)
I always had difficult time modifying and toning things down; that was my biggest problem. I had the old dancer's mentality that pain was part of being a dancer; that pain for the most part was good. I remember as a child bleeding through my ballet shoes for the first time (my first pair of point shoes) and thinking it was the best thing ever! It really was not a healthy way to be. And I had to learn the hard way that our body is special and we are not as indestructible as we think and things can happen.
I have learned to have a new-found respect for my body, and have learned the true meaning of taking it easy, resting and modifying. I plan on going slow when I come back to Yoga, as well as exercise. I hope to start swimming, biking, and walking again once I'm given total clearance, hopefully at my 12 week consult with my surgeon. But my plan is to go slow and to honor my body and practice kindness or "Ahimsa", the yogic word for kindess to all beings, starting with myself. I would tell my yoga students this all the time, to listen to their bodies to take breaks, etc. Yet I didn't take my own advice and I would demonstrate and do everything full out, even when I knew I should have been resting and just vocally cueing and having my advanced students demonstrate for me.
My hope is to learn this new method of teaching so that I can also walk around more and help to adjust and make sure my students are practicing yoga safely and help to put them into their poses while telling them the next pose. I used to be a very visual instructor, mostly using visual demonstration and cueing, but now I will find a new and better way of teaching my students.
Do you do other physical exercise (e.g., Yoga, Pilates, biking, swimming, etc.)? If so do you modify what you do in these activities?
I can't wait to get back to Yoga and I also take Pilates. Swimming I plan on definitely doing and taking water aerobics to help get back into shape. I also enjoy walking and hiking. So I hope that when I update this profile I will be able to report that I'm doing all of the above and feeling like a dancer once again!
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?
The surgery has helped me to get on the right track and get my life back. I am hopeful and happy about finally doing something to improve this situation. Before the surgery I was in constant pain; I lost my business, I lost a sense of who I was when I couldn't practice yoga and I had to learn that there was more to me then just yoga and dance and that life has so many avenues to pursue. I am hopeful to get back to teaching yoga again, but I am also prepared to step back if I need to and pursue other avenues.
I am currently getting ready head back to work, but I may not head back to teaching yoga full-time yet. First I may just go back to working as an Administrative Assistant (something I did before having my son 9 years ago), I am also thinking about taking Real Estate Courses and taking the exam and pursuing that field as well. I am just so happy to start moving forward and getting on with my life.