Those of you who have been following my work for a while know that I have had prosthetic hips for almost twenty years now. I dislocated the left hip about a month ago (you can read the account here) and had to endure a six-hour trip to the emergency room. Indirectly, the hip incident resulted in the prospect of a new joint replacement ordeal, and the old concerns and fears are cropping up once again.
“Bone on bone.” I had heard that phrase twice before in my life, and both times it led to a joint replacement.
How did the dislocation of one prosthetic joint lead to the potential replacement of another joint, you ask? Well, it happened purely by accident. Because I had dislocated my hip recently, I thought it would be a good idea to see my joint replacement surgeon for a check up. I arrived an hour ahead of my appointment in order to have both of my hips x-rayed beforehand so that my surgeon could have the films on-hand for my exam. I was extremely anxious while I waited to see the man who replaced one of my hips because I was unsure what damage, if any, the recent dislocation had done. There was a chance that I was going to have to get the entire hip ripped out and replaced for a second time, which was what I was told would have to happen if ever the prosthetic slipped out of place.
The waiting room was empty when I arrived, and by the time I was called in, the lobby was completely full. I had forgotten that my surgeon was one of the best in the world. The wait was worth it, though.
After a short time, I proceeded into the exam room, all the while silently praying that my hip was solid enough to stay put. As I sat waiting for the doctor, someone suddenly disturbed me to grab the skeleton model that was stored in the same room in which I was waiting. As it was wheeled out the door, it reminded me that I wanted to ask the doctor about my shoulders when we were done with the hip. After years of taking steroids in the form of daily oral Prednisone, my shoulder joints were slowly and surely disintegrating. The process is called Avascular Necrosis, and although it is not fully understood, the process can destroy the joints of R.A. patients. I knew I was going to have to get them replaced eventually, but since there was not much discomfort I figured it would be a while yet.
The doctor came in a few minutes after the nurse removed the hobo skeleton from my room, and to my surprise, he remembered me. This was a man who had performed a hip replacement on me almost thirteen years prior, and had not seen or heard from me in over ten years. A man who must have performed countless joint replacements in the time since our last meeting made the effort to at least act like he recalled me personally. This is probably why he is the best joint replacement man in the country, but I digress. We said our greetings, and I told him why I was visiting him that day. I explained that the left hip (the one he didn’t replace) had dislocated and I was just checking with him to make sure that it was a fluke – not due to a flaw in the implant. He nodded and pulled the x-rays up on the computer screen. After a minute or so, he said that everything looked good. The doctor even told me that the plastic cups that form the top of the hip implants were in better condition than he would have thought after almost fifteen years of use. “Good news!” I thought. “How about the dislocation, though, was it just a one-time event?” I asked him. The doc told me that as long as the hip does not dislocate again, it is nothing to worry about, and to take it easy until the muscles fully repair themselves from the dislocation. This was fantastic news, and even better than I expected. I was about to say my goodbyes when I remembered to ask him about the shoulders. He told me he was indeed the one who replaced shoulders, and said he needed to see x-rays first. I told him that I think there were old x-rays of my arms from 2008 in the computer. He found those old x-rays and pulled them up. He studied them for about three seconds, and then dropped the hammer.
“See here?” He pointed to the spot on the x-ray where my arm bone met my shoulder bone. “See how there is no space in between? That’s bone on bone.”
“Bone on bone.” I had heard that phrase twice before in my life, and both times it led to a joint replacement. The instant I heard the doctor say it, I knew what it meant. I couldn’t believe that my shoulders both had to go. Not to mention the fact that the x-rays were from three years ago, which means things have only gotten worse. Even though I knew the answer, I asked the question anyway. “So, I need replacements?”
“Yes, these shoulders needed to be replaced in 2008.” The doctor looked at me with a crooked smile on his face. He was like that though – a friendly, funny, warm guy with a great bedside manner. “Ugh” I thought “another two joint replacements? How much of me is going to be left when I finally kick the bucket?” At this rate, they would be burying the Terminator in fifty years instead of me. I half paid attention as the doctor explained the procedure and snapped back to attention when he said, “so let’s get it scheduled.”
So, it looks like I will be going in for my second round of bionic replacements in about three months. Minus two bone shoulders and plus two plastic and titanium shoulders. I used to be the sixty thousand dollar man, but after this set of replacements I figure I can call myself the hundred-k man, at least. I’m moving up the world, baby! Of course, all the concerns about operation complications and possible pitfalls sprang to mind, as well as the concern about who would help to take care of me for the first few weeks. But the truth is, I will figure all that stuff out as I always do. The positives are going to outweigh the negatives on this one, so it’s a no-brainer. I just wish it wasn’t such a long road to recovery, but then again, nurse sponge baths aren’t so bad.
Keep an eye out for the Shoulder Replacement article special on CreakyJoints.org where Daniel will be covering his replacement experience from pre-op to post-op!