Naomi Rabinowitz: My Left Hip
"Run That Body Down"
Lyrics from the record: Paul Simon (1972)
I have been dancing seriously since my teenage years. At age 16 I went to Juilliard with the hopes of becoming a star. Realizing that I was not the best dancer in the school drove me to pursue other avenues of success. But I never stopped loving to dance and relentlessly pursued excellence in the ballet studio even while attending medical school. Finally in the late 1980's I discovered the world of ballroom dancing and found my outlet. I have a real type A personality, so I was not content to dance socially but rather entered into ballroom competition. Again I found myself back in the studio perfecting my skills for hours a day. I also started serious cross-training with weight training and aerobics to improve my athleticism. I am happy to say that I did well on the competitive circuit and finished among the top five amateurs nationally for some years before turning professional.
Click here to see more dance photos.
Throughout my competing years I had hip pain, and I sought regular chiropractic and acupuncture treatment. I continued to rehearse in spite of the pain, until one day in the dance studio 5 years ago I could not walk. I was seen by an orthopedist who said I had traumatic osteoarthritis from dancing and that I would need a hip replacement "in 6 months or six years." At 47 years of age, a total hip replacement was unimaginable to me, and frankly, I didn't take him seriously. He prescribed an anti-inflammatory drug (Voltaren), which, combined with physical therapy, relieved a lot of the pain and allowed full range of motion. I stayed on that medication for the next 5 years but my symptoms got progressively worse with less and less mobility. I explored the possibility of hip arthroscopy two years ago with Dr. Douglas Padgett who told me that the x-ray showed I needed the replacement. He said that I walked as well as I did because I was thin, and that I should call him in the future when I decided to do the surgery.
Over time the movement limitations in my hips caused me to compensate elsewhere in my body, and I developed neck and low back pain. I had to stop dancing and body building. I continued acupuncture, started osteopathic treatment and began study with a brilliant yoga therapist, Roxlyn Moret. Roxlyn helped me to move in a gentler way and to develop a yoga routine of truncated postures to accommodate my physical restrictions. My frustration with my increasing disability, however, led me to seek a surgical alternative.
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Surgical diary: Dr. R's Total Hip Replacement
The surgery took place on June 19th at the Hospital for Special Surgery, a hospital of impressive utilitarian efficiency but totally lacking in spiritual comfort. HSS does 3000 joint replacements a year of which 2000 are hips. The youngest patient last year was 11 years of age. The oldest was 96 years old.
One week prior to the surgery all candidates have to attend a 1-½ hour class about every aspect of the hospital stay. We were given a detailed instruction book and video about the tasks of daily living during the weeks after surgery. We donated blood to be used in surgery , were x-rayed and examined by the internist.
Dr. Douglas Padgett is my orthopedic surgeon and is widely recognized for his interest in the joint problems of dancers.
Prior to going into the operating room, he came to see me and autographed my left hip right where he planned to make his incision!
After making a 5-inch posterolateral incision, Dr. Padgett performed a minimally invasive total hip replacement procedure. The ball and the neck of the femur were removed and replaced with an artificial "ball-in-socket" joint. Those with strong stomachs can watch a similar video taped procedure on the Internet .
Of the many options for replacement material we settled on highly crossed-linked polyethylene on a metal ball; the stem was tight fitted and un-cemented into the femur.
Click here for details of surgical options:
We used epidural anesthesia with sedation to reduce post-op pain and decrease bleeding in surgery. I was transfused one unit of blood (that I had donated the previous week). After surgery the epidural catheter was left in place and a pump delivered pain medication through it. I was never in pain after the surgery. I was, however quite sick from the post-op meds, to which I responded with very low blood pressure and nausea. It took a full day for the staff to identify why I was so sick. As soon as the pump was stopped I really improved. Since the third day I have never needed more than Tylenol to manage the post-op discomfort. As soon as I felt better I was able to stand using a walker with my full weight on my operated leg. After that my recovery accelerated. I started to have acupuncture in my room that day. The next day I did laps around the ward on the walker and the fifth day I went home with a cane.
At home I was instructed to take iron and aspirin as an anticoagulant for six weeks. I am currently on hip restrictions, which means I can't stress the healing hip by bending the leg past 90 degrees, crossing my legs or rotating the operated leg inward. I sit in an elevated chair everywhere.
The first week I was visited by a physical therapist assigned from the Visiting Nurse Service. She was very helpful in teaching me to walk outside with the cane. The visiting nurse removed the staples on day #12. Thereafter Chris Bratton, my physical therapist (formerly of Westside Dance Physical Therapy), took over my rehabilitation. I was fortunate to have had Chris in the operating room. Observing the surgery informed rehabilitation choices we would make later in my recovery.
I have been most fortunate to have almost daily body work from the Turning Point staff including acupuncture, Tui Na, foot reflexology and Reiki (they are all so talented!) Roxlyn Moret, my yoga therapist for the past year, is continuing to do Bonnie Bainridge Cohen bodywork (see practitioner list for details).
I am walking as much as tolerated everyday out of doors. Today I walked 40 blocks, stopping along the way for a decaffeinated café con leche on Amsterdam Avenue. Weight bearing is supposed to help the bone regrow around the metal shaft in my femur.
This is the saga so far. It is definitely a day at a time process, but also a wonderful learning experience.
Note: This was written within the first 6 weeks after surgery. (07/03)
Click here to read my follow up report at one year post-surgery. (07/04)
Click here to read my follow up report at two years post-surgery. (07/05)
Click here to read my follow up report at three years post-surgery. (06/06)
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