Helen Heineman's Bilateral Hip Story
(As told to NR)
I was eager to speak to Helen because I knew that she had both her hips replaced at once and I was curious about the outcome. We meet for an informal interview and here are some of my notes: - NR
"Fantastic" was the word Helen used over and over again as we spoke about how she felt about her surgery and its aftermath.
Helen Heineman had a successful career as a principal dancer with the Harkness Ballet and did some choreography for the company. Prior to dancing with Harkness she had been a soloist with The National Ballet of Washington and the Netherlands Dans Theater. When Harkness folded, she danced with Les Grands Ballets Canadiens as a principal. Currently she has returned to her early creative calling and has resumed choreographing.
And her THR story goes like this:
In her 30's Helen stopped dancing, finished her undergraduate work and became a lawyer. When her daughter was born, she left the law to be a full-time mom. As her daughter got older Helen found herself back in ballet class and working to get back in shape in order to choreograph. "I might have gotten away with it, if I had kept on practicing law, " she said at this point in the story, implying that the stress she put on her joints by returning to dance was the factor that precipitated her joint deterioration.
The first sign of trouble occurred approximately 3 years ago in a Pilates session. She hurt her right hip and she feels she was "never ok after that." Progressively, the left hip also began to bother her and they both got "tighter and tighter and movement became more painful." She sought holistic treatment, combining physical therapy, acupuncture, chiropractic adjustment and massage. Finally, late in 2002, her chiropractor, Dr. Ellen Bialo, referred her for x-rays which showed degenerative changes in both hips.
She had heard that Dr. Douglas Padgett was "the ABT guy" and she scheduled a consultation with him in October 2002. He did not feel she was a candidate for surgery at that time and recommended she take glucosamine and see what happened.
Helen continued to choreograph, but noticed that if she did a wrong move she was in "agony" which, she noted, greatly alarmed her dancers. As time went on, it became hard to do tasks of daily living, such as getting out of a car or walking any distance. She began to feel "old and worn out." The final straw came when she found she could not climb stairs. She and her husband were taking ballroom lessons at a studio with a long stairway and she had to pull herself up the stairs, using the railing.
For a second opinion she went to see Dr. Phillip Wilson who had operated on Suzanne Farrell. New x-rays were done that showed that the left hip was now ready to be replaced and that the right had also deteriorated an equivalent amount since the film just several months earlier. Dr. Wilson, who by this time had stopped operating, referred her back to Dr. Padgett.
Facing imminent hip replacement surgery, Helen had to decide whether to have one or both hips done. The left had to be done, but the right could wait. She felt nervous about doing both hips at once, but she knew that if she did both, post-operatively she "would be even." Furthermore, she would not have to go through the convalescence a second time. She now believes that for dancers in good health, who are reasonably certain that they will have to have both hips replaced within a relatively short period of time, it makes sense to do them both at the same time.
Surgery took place at the Hospital for Special Surgery on May 11, 2003, just 7 months after her first x-rays! As is the norm there, she had spinal anesthesia. Dr. Padgett did the mini-incision technique (not to be confused with the very new MIS 2-incision hip procedure) and a cement-less insertion. He found that in the month since he had seen her for her pre-op visit, the right hip had indeed failed as well.
Helen remembers that it only seemed a short while later when they stood her up on her new hips. She was groggy and relieved. As she explains, she had a "cognitive shift" when she stood up. Before the surgery she had imaged having nothing to hold her up immediately after surgery. When she took her first step she realized she "had a whole body" and that the metal hips she now had, were stronger than the ones she had had before. She now had "two legs to stand on!"
Overall Helen thought her experience in HSS was wonderful. She took the pre-operative class they offer to patients, which she found very helpful. She had a private room with a river view! Although she chose to have 24 hour private duty nursing and found it comforting, she noted that the hospital staff seemed very skilled and it may have been unnecessary. Her only advice regarding the hospitalization is that you make sure your urinary catheter is removed during the day rather than at night, so as not to lose a night's sleep!
The in-patient hospital stay was six days in total. She was sent home (not to a rehabilitation facility, but it should be noted that she had helpers at home) with wrist crutches and a vicodan prescription. She soon found that she did not need either. The hospital sent a physical therapist to her home 3x a week. When they informed Dr. Padgett of her progress, he said that she could walk without aids in the house, but recommended that she use the wrist crutches on the street (mostly to fend off inattentive pedestrians, etc.). She experienced some fatigue in the weeks after surgery, however, two months later she was on holiday in Europe doing a lot of walking and managing very well. If she had discomfort from overdoing, she took an Advil.
In the months after she returned from Europe, though, Helen continued to have some intermittent discomfort in the hips that was, at first, worrisome to her. Dr. Padgett reassured her that this was normal, and that she wasn't hurting herself by exertion. At least some of the discomfort, he explained, was related to the facts of the surgery itself, including the insertion of the prosthesis into the femur. The remainder was probably inflammation and could be well managed with an occasional Advil.
And how is she today, seven months later? I found her incredibly agile. She sat cross-legged on the couch and spoke enthusiastically about her experience. She does not experience her hips as alien (as I often do); in fact, she says, she rarely thinks about them at all! She finds the on-going physical therapy that she is doing at Westside Dance PT helpful as she continues to get more turn-out, flexibility and strength. In the near future, she is planning to return to ballet class and may possibly add a pool program (her own water therapy). She is actively choreographing and she maintains a busy NYC life-style.
I'm not certain if everyone needing THR can have such a great outcome or be as upbeat, but being with Helen Heineman would inspire anyone to boldly go where she/he is afraid to go!
(Helen credits Kathy Posin and Lisa Owens for giving her good advice in her pre-op time.)
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