My Bum Hip(s)

At my advanced age, I know something about pain. 

In my 30s, I endured a debilitating divorce that exposed a lifelong accumulation of selfish habits. I have suffered the loss of my parents, dear friends and an older sibling. I’ve passed too many spiky kidney stones to count and broke both Achilles tendons a decade apart, each while taking the same lame-ass basketball jump shot without proper warmup.

My body is an imperfect vessel. Never what you’d call a limber man, I’m about as flexible as an ironing board. A clown on stilts. Touch my toes? If I can reach past my kneecaps, I’m playing with house money. Back spasms have kept me in bed for days at a time.

Each year, I accumulate new aches and pains, new rocks to add to my psychic backpack. But the ache I begin to experience in my left leg in 2023 is different. It starts with a sting of pain here and a twinge of discomfort there and steadily worsens. 

So this newest discomfort, I figure, is perhaps sciatica pain, another signal that all is not right with my body. The way that I walk and carry myself is flawed. A new stretching regimen brings little relief.

Worse, I’m headed to Europe that summer, where I’ll be tramping across a small southern Italian village with uneven cobblestone streets featuring tortuous inclines. The day before my flight, I schedule an eleventh-hour cortisone shot for pain management and hope for the best.

I manage to survive my European adventure, yet continue to lug around the leg pain like a new bad habit. I eventually see an orthopedic specialist. X-rays reveal the culprit.

My left hip is shot. The cartilage between the hip-bone and socket has worn away, prompting an agonizing grind of bone on bone, like a car engine running without oil.

But with another summer in Italy looming in 2024 I delay my surgery until mid-August after I return home. Meanwhile, doctors offer some sage advice: Don’t research the surgery on the Internet. You’ll just scare yourself.

Wait, what?

What comes next is not one but two total hip replacement operations, in the interim unleashing a level of chronic pain that is often so intense it reduces me to tears. 

But I am hobbling ahead of myself.

As we Baby Boomers age, our bodies are breaking down. Especially such critical moving parts as our knee and hip joints. 

Each year, one million total hip and knee replacement procedures are performed in the U.S. With our lengthening life spans, researchers estimate that a growing demand for improved mobility and quality of life will make joint replacements the most common elective surgical procedures in the coming decades.

Total knee replacement surgery is the dicier of the two prospects. With so many moving parts the pain, recovery time and need for physical therapy is more substantial. 

Hips are a simpler challenge. 

The hip joint operates like a rudimentary ball and socket. A spherical bit of bone extending from the upper thigh joins with a circular socket in the torso like a mortar and pestle. All movements are cushioned by a layer of soft absorptive cartilage that allows us to run, jump and twist our bodies without pain.

Lose that cartilage and the mere effort required to walk, run or throw your leg up to mount a bicycle can bring agony. But more than any other elective procedure, medical science has figured out how to perform full hip replacements largely without complications.

In many cases, the procedure can be done without an overnight hospital stay and patients are encouraged to get on their feet the very day of surgery.

Still, the actual operation is a mix of modern medicine and Middle Ages barbarity. To avoid infecting the wound, doctors wear space-age suits. But their two main tools are a hacksaw and a hammer. 

After making an ghastly eight-inch incision in the thigh, surgeons saw off the rounded femoral head or ball, then use a mallet to pound the elongated base of a new ball-joint implant into the femur bone. I imagine a makeshift medical tent on some Civil War battlefield, a pile of discarded limbs mounting outside. Then comes a new manmade socket to receive the ball — both devices made of stainless steel or titanium.

Thank God that during all this hacking and pounding my brain will be sledgehammered into a deeply clueless chemically-induced slumber.

I awake from the first hip replacement surgery a Bionic Man, with nifty new body parts that will require notification at airport security checkpoints.

The recovery regimen for hip replacement patients is simple: Do your exercises, use a walker for the first few weeks before graduating to a cane and lastly, with your doctor’s blessing, rejoin life.

Yet when I return to my doctor for a checkup ten days later, I have a troubling complaint: The surgically replaced hip is doing just fine, but I’m now experiencing pain in the other hip. Since he had just done a pelvic X-ray a few weeks before, my doctor says I don’t need a new right hip just yet.

It must be something else.

The next weeks remain a blur of frustration and pain. If I don’t need a new right hip, then what? Did I overcompensate with my movements and strain a muscle in my right hip? Maybe one leg is longer than the other, causing a painful imbalance. I begin a regimen of physical therapy, religiously performing my stretches at home. I start swimming laps in my condominium pool, then hit the jacuzzi.

Nothing works.

To manage the pain, I live on Tylenol extra-strength and stay home to read books and doom-scroll the Internet. I stop taking those therapeutic daily walks with my wife and even make excuses not to leave the house, making her wonder what retirement is going to look like with such a debilitated husband.

I even start using the electric carts at my local Costco, the ones with the little flags in the back that I had always arrogantly called gimp mobiles. I immediately feel a stab of wounded pride.

“People are looking at me,” I tell my wife.

“Dude, trust me,” she says. “Nobody is looking at you.”

And she’s right of course, even though I prompt a few fellow shoppers to jump aside as I careen down crowded sales aisles like a retirement home escapee.

The pain worsens, even more than what I felt with my left hip. It makes my bones ache with sniper-like stabs of agony and a dull ache that resonates down my leg and keeps me awake most nights, lying in the fetal position, clutching my pillow for emotional support.

The worst pain comes when I take a trip to China in November, even though I’d had a second cortisone shot to allow me to walk the streets without discomfort.

It fails.

In January, my doctor approves an MRI that I hope will give me answers. The results surprise even him.

“We’re seeing your right hip deteriorate before our eyes,” he says.

The images even show bruises to the hip bones after so much grinding together.

Wait, bone bruising? I didn’t know that bones could even bruise, that it was even a thing.

I hit bottom two days before my second surgery last month. I lay in bed, speechless, crippled by pain, tears in my eyes. If there had been a strong drug at hand, I would have gladly taken it, despite my fear of falling down the rabbit’s hole of drug dependency.

Finally, after nearly three hours under the knife (and hammer and hacksaw), I awake in the recovery room with no recollection of the trauma my body has just endured. Within a few hours, a physical therapist has me inching around my hospital room with a safety belt tied around my waist.

So far my recovery is going well. The serpentine scar on my right leg is healing and each day I’m able to negotiate a few more walker-assisted steps.

I have learned something from my ordeal. An estimated 52 million Americans — one-fifth of the adult population — suffer from chronic pain, defined a pain lasting more than three months that substantially restricts their ability to work or engage in daily activities.

Many of these unseen victims, still searching for answers, risk dangerous opiate addiction as they grasp for just a few hours of life without misery.

I no longer call those Costco electric carts gimp mobiles. Whenever I run across people using walkers or canes, I take the time to inquire how they are doing and solicit stories of their day-to-day struggles to merely negotiate the world.

These people are no longer invisible to me. They’re my tribe.

It won’t be long before I graduate to a cane and my wife and I are planning a celebration ceremony. Then, hopefully soon, I will once again move through this crazy world without mechanical support.

I’m looking forward to a fuller, more-mobile life. But I won’t forget where I’ve come from, what I’ve endured to be in a place where I can once again put one foot in front of the other without unbearable physical grief.

Bring on the summer, baby. Bring on life.