In the end it went off without a hitch. After five years of increasing pain that went from nagging to inhibiting to excruciating, I had a new hip.
First a recap. Last month I wrote about the onset of the pain in my right hip and its slow worsening. I’d first noticed it in 2019 after running the Anchorage Mayor’s Marathon. It was the ninth time I’d completed that one, and as usual there were a lot of aches and pains afterwards. It was just that the hip hurt more than usual. I chalked it up to weeks of training and paid it little mind.
Over the following years though, I began to pay it a lot of mind. On a trip to India on the cusp of the pandemic I walked endless miles and felt minor but nagging pain in the hip on many nights. That summer on two hikes it got much worse. On the second, descending the back side of Crow Pass from Girdwood, I finally went down in pain and couldn’t get back up for half an hour until some ibuprofen took hold. On the excruciatingly long and painful trek out along Eagle River, I decided that hiking was out. I didn’t want to do it anymore. This wasn’t normal for me.
The next three years were a melange of gradually worsening pain and repeated insurance struggles. Hiking was done, but mountain biking kept me active and it didn’t hurt. An initial diagnosis of sciatica owing to spine issues solved a separate problem, but didn’t address the intensifying arthritis in the joint. Fights with my insurance company caused my waiting too long for an MRI, as well as a long delay on the needed surgery itself. Physical therapy commenced, NSAIDs were prescribed, osteopathic manipulations began, and my wife noticed that I was limping more and more.
During a January 2024 trip to Peru that involved a lot of walking, pain woke me almost nightly and I texted my wife suggesting it might be time. Still, I came home at the end of the month and briefly entertained replacing our deck that summer, a long-delayed project. By late February however, that idea was cast aside. It was time.
I finally got two things I needed in March. A referral from my doctor to Alaska Fracture and Orthopedic Clinic in Anchorage, and word from my insurer that the procedure would at last be approved. That’s more or less where I left off last month, except for a few subsequent details.
In March last year my wife and I flew to Anchorage for the day for a consultation. There an x-ray was taken, and the P.A. watched me walk. The x-ray showed what I’d pretty much known to be the case. My hip was shot. It was actually a bit surprising I was still moving about as well as I was, but I’ve been active all of my life and had the strength and the pain tolerance to just keep pushing through. After watching me walk, he also diagnosed me with something I had not known about: my right leg was shorter than my left, and by that time it was a complicating factor. Measurements were taken, paperwork was filled out, and a plan was put in place.
The visit was instructive. We were both impressed with Alaska Fracture and Orthopedic Clinic, where we were shown the type of joint that would be used in my hip. I was told how it would be done and what to expect. I was also told they would restore my right leg to an equal length with my left, which they did. An explanation of the recovery process was given.
After a surprisingly brief visit, a replacement was scheduled with Dr. Douglas Prevost, who came highly recommended by several friends who had seen him. I wanted to do it after the snow melted so I’d be able to safely walk outdoors as soon as possible. Since we had a three week trip to Ireland set for May, we planned the replacement for June 10. A summer of outdoor activity was out the window. It didn’t matter though. If I didn’t get it done, a summer of outdoor activity would still have been out the window.
Again, blessed with a high pain tolerance, something you need if you’re going to spend decades riding — and frequently crashing — a mountain bike, I continued to ride. I maintained short walks as well. April went unexpectedly well, but the pain had always been intermittent, so this wasn’t surprising. I’ve been attending the Fairbanks Cycle Club’s Tuesday night mountain bikes since the 90s and planned to make the one ride scheduled between our return from Ireland and the surgery.
That wouldn’t happen. The visit to Ireland in May was when the hip finally and fully gave out. Pain would be the dominant theme of the trip. In Seattle, following the first of three flights, I nearly turned around owing to how badly I hurt. Next, a night of extreme pain in Dublin led to the cancelation of a planned 130 mile bike ride. I’d overestimated my abilities.
Walks were repeatedly and and increasingly punctuated by needed rests on benches. By our return to Dublin for the final days, I could barely keep going. By Boston’s sprawling Logan Airport on the trip home I couldn’t keep up with my family. When we got home to Fairbanks, I was finished. There would be no single and final mountain bike ride in that brief window. All that was left was a ten day wait. The surgery couldn’t come quickly enough.
On June 9th we flew to Anchorage and I enjoyed a final dinner out. Early the next day I checked in at Creekside Surgery Center. The operation would take place that morning. I’d be discharged by late afternoon. I had been told by the P.A. in March that we could go home that night, but my wife, being a far better planner than I am, had us scheduled to return to Fairbanks two days later. This was a wise decision.
After a lengthy wait in pre-op, the anesthesia was administered, and my inert body was rolled into the operating room.
Later that afternoon, consciousness slowly returned. The surgeon had come and gone with his post-surgery check. According to my wife I was talking to him. According to me, no memory of this exists. What she did say is that he assured us I would be able to return to mountain biking and running.
What I do recall is getting out of bed that afternoon. As many have heard, they waste no time getting patients up and moving after a hip replacement. I was guided out of bed and onto a walker and slowly headed for the bathroom. I came back dizzy, nauseous, and still unable to fully support myself on the walker however, and was helped back into the bed. I’d had a bit of an adverse reaction to the anesthesia (not uncommon for me), and had to wait for that to wear off.
Soon enough however, we were out the door with more pills than I’ve ever imagined taking in my life. Opioids, NSAIDs, antibiotics, muscle relaxants, and much more. The pharmaceutical diet would go on for weeks, one drug after another slowly being dropped.
The day after the surgery I felt up for meeting a friend for lunch. At that point I needed assistance getting in and out of the car and to the table, but I was moving. The next day we drove to the airport and my wife had a wheelchair brought for me. I was rolled through security, onward to the gate, and aboard our plane where my wife, again always the better planner, had booked first class seats. Much easier to get in and out of than coach.
I was rolled off the plane in Fairbanks and went home, where the recovery began. The hardest part in my case wasn’t the pain or lack of mobility. It was having to adjust to sleeping on my back, never a comfortable position for me. But you can’t put pressure on the joint. Sitting around was also difficult, although the heavy smoke in late June was a balm since I wouldn’t have been out anyway. And the lack of exercise had me quickly gaining weight. Extra pounds I’m still trying to shed.
The pain was strictly limited to the muscles that had been stretched and moved so the surgeon could access my hip. The joint itself never hurt. Even more surprising for me, and this contrary to what my biggest pre-surgery concern had been, I felt nothing in the part of my bone that had been sawn off and the artificial joint attached. I never did.
Improvement didn’t take long. The surgery had been on a Monday, and my initially limited movement around the house was aided by a walker, which I needed even to rise from bed or my chair. Then a funny thing happened. Six days after surgery, needing to go to the bathroom, I instinctively stood up and walked in and was all the way there before I realized I had done it unaided. And without noticeable difficulty.
The next morning, a Monday, I walked into my first physical therapy session, held out my walker, and told the therapist, “I don’t think I need this anymore.” She agreed. She taught me to use a cane and we commenced with the movement exercises. About half an hour in she asked me, “Are you sure you just had this hip replaced a week ago?” Decades of mountain biking was paying off.
I went home with the cane, hung it on a chair, and started walking about the house. On Wednesday I went in to my second physical therapy session, handed my therapist the cane, and told her, “I don’t think I need this anymore.” She agreed.
From the first Sunday after the surgery onward, what amazed me was that I could see significant improvement daily. By the following Friday, I was in the kitchen cooking. Because I wanted to be. On Sunday, thirteen days after having my hip replaced, I went for a brief walk outside. It was less than a quarter mile and I got tired, but I made it. And I was glad I hadn’t had the surgery in winter, when this wouldn’tt have been an option.
I kept at the PT exercises religiously and continued taking short walks. After less than three weeks I was driving. On the third Sunday after the surgery, twenty days out, I decided to try a one mile walk. I went three. A week later I was walking six miles. The day after that I rode my bike to my PT appointment, an eleven mile round trip. I had absolutely no difficulties. And from there it just kept getting better.
In a telehealth session a month out, I was told the bad news: running marathons would be possible, but they would reduce the life expectancy of the hip, which is about twenty years. Figuring my life expectancy is about twenty years as well, I decided to bite the bullet on that one. Anyway, I’ve run seventeen of them and most people have run none. I have some bragging rights. And to be honest, I don’t miss the training at all. Just the events themselves.
Mountain biking was going to have to wait until fall while the joint continued to set, but road riding was a go (I’d already begun that one). My physical therapist told me I was progressing far ahead of schedule. Again, decades of mountain biking was paying off. The muscles that needed to recover had a strong foundation.
I flew to Anchorage in September for in in-person followup and that was it. I was cut loose. The next week I joined my Tuesday night mountain bike ride pals for a late season go on the Ester Dome Single Track. I had no problems and no pain afterwards. I’m now back to my normal cycling routine, and when I run, I’m going three to six miles. The only time I even think about the hip anymore is when someone asks me how it’s doing. And I used to think about it almost daily because it hurt so much.
For those contemplating a hip replacement, my advice is, do it. Like everyone I’ve known who has had the surgery, it’s been a game changer. Daily pain is gone. Movement is as free as it had been for most of my life. I’m hiking and running again, and biking without pain. It had been a long time.
My advice? Don’t feel stressed about any of it. Find a good surgeon, one your friends recommend and who has good online reviews. Build those muscles beforehand with exercise (really, you should be doing this anyway). If you fly to Anchorage or Outside, book a couple of extra nights in a hotel and get that first class ticket home. Do your physical therapy. Get out of your chair afterward and move as much as you can. It comes back quickly.
Was it the best medical decision of my life? Yes. One of two I hold on an equal par, actually, but yes. Yes it was.
