Hip Replacement, Recovery and the yoga of healing

This page will be the very opposite of cool, so if that’s the sort of yoga you’re

 

English: Hip replacement using cementless implants. 16 days post-surgery. (Photo credit: Wikipedia)

 

seeking, I’m going to save you some time and encourage you to surf on. No hard feelings.

Hip replacements involve walkers and drains and quite often severe limitations, and having had one just prior to my 43rd birthday, I can tell you they feel the subterranean opposite of cool.

But like so many other things in life, the  truth is that while the process is tedious, the problem solved painful and deeply limiting, and the daily recovery mundane and filled with potential frustration, the result and even the path leading to it are cooler than cool, the stratospheric pinnacle of awesomeness.

During the process – the bits leading up to the surgery (a right total hip replacement), the pain and shame and self-blame (I know, what a crock, right?), the fear of all the what-ifs leading into a surgery (a paramedic knows far too much about what might go wrong and how ugly it might be), the recovery (avec le walker, complete with yellow tennis balls), the limitation and then the daunting task of regaining new optimal functioning, I wanted to write, I considered writing, I wrote in my head and in my journal, but I didn’t cross the threshold of public sharing, my blog. Part acceding to shame monsters and part simple self-protection during a time of deep vulnerability, I kept this part to myself – mostly. I did publish a reflection on imperfection and what it means for teachers, probably more revelatory than I’d like, but there all the same. And a few bits and pieces.

Now I’d like to share what I learned about disability, surgery, recovery, hips and yoga in the process.  The overarching message my soul was sending me had to do with challenges and their meaning, ability and self-concept and how stories can heal or hurt depending on how stuck inside us they get.

Here are some facts: I was born with a mild birth defect of my hip joints that made them susceptible to injury, even after the best treatment available in the late 60’s and early 70’s in the US. As a result, in combination with a desperate need for self-mastery born of other unhappy events, I sustained two (yes, I learn slowly) stress fractures of the femoral shaft and neck setting me up for degenerative joint disease. Docs at the time of the first injury told me to stop running (it was my religion at the time) and that I would need a hip replacement by the time I was 30. Figuring I might as well as smoke it while I got it, I kept running and weight lifting like the competitive madwoman I can be, hence the second injury.

Over the past 5 years the pain in my hip from lack of cartilage and bones grinding one another down had led to a pronounced limp, postural imbalance and worst of all, inability to hike or walk very far. Miserable in this one respect, I kept hopping out of ambulances (gingerly, impact was a bitch), practicing and teaching  yoga and avoiding the hip replacement. Maybe I could heal myself. Maybe I could make it one more year. Maybe I couldn’t get pregnant after a hip replacement (turns out, easier because less inflammation in the body). Maybe… I was scared. Scared to go forward, scared to stay put, couldn’t go back. Back to what?

Turns out, I had no idea what it felt like to have a properly working joint. When we moved temoprarily to Silicon Valley for Dear Hubs’ career, my plan was to write and teach. My plan was side-tracked when I was put in contact with a surgeon who was not only wise and kind, but performs the procedure in a way that obviates hip precautions. That’s right: no limitation post recovery. Think about that.

It didn’t take me long to think about it. Having worked hip dislocations enough as a paramedic that I could do it in my sleep, I knew all too well what awaited me in terms not only of limitation, but of consequence regardless of how careful I might be. Some of my patients’ hips dislocated when they stepped from a sidewalk to the grass. A procedure that avoided this? Sign me up!

That didn’t take away the fear prior to surgery: I’d also transported people whose joint appliances had gone wrong somehow – there are myriad ways, as it turns out. I knew of hip sockets gone empty and bodies confined to bed for lack of skeletal support when the implant had to be removed. I had witnessed the surgery when intubating in the OR and knew they would saw off the top of my leg bone, bore it to make way for a 7 inch metal spike and screw a cup into my pelvis. None of that sounded fun.

The anterior approach that Dr. Kliman in Palto Alto used left me feeling like I’d been kicked in the upper quad for about 9 months, but also means they don’t sever a single muscle or disrupt the joint capsule. Translation? Essentially the same risk of dislocation that I had before. I could do yoga, ski, dance, hike, cross my legs and anything else I wanted with abandon. Once I’d recovered.

Even in the weeks leading up to the replacement I was exercising about 2 hours a day, when you include dog walks, yoga and gym visits. Because the quadriceps muscles are stretched quite to their limits for joint access, the post surgery window requires nearly total rest so that the muscles can recover and regain their functional shape. Clearly you don’t want to be abed the entire time – the body would seize up. But my limit was around the block with a walker for nearly a month. Then two, three… up to five blocks. For a full three months, no yoga asana, no weights, no craziness, no abandon. Two miles were my max limit. And even swimming was verboten until the scar had fully healed. I was a basket case. And not a well-woven one.

When the three month mark hit, I was ecstatic… then deflated. Turns out, my hip had been so non-conformist from the very beginning that having an anatomically “correct” appliance in there was a wholly different experience. It was wonderful – riding bikes made sense for the very first time in my life! – and my muscles had to re-learn everything. Add to that a degradation in my sense of balance, an inability to lead up stairs with my right leg and feeling like I was learning to live again. I was re-weaving my basket.

As I write this, my surgery was 1 year, 1 week and 3 days ago. I’ve had my first year surveillance X-ray and all is hunky dory. I can lead up stairs with my right leg, my balance is restored, I can walk – I revel in walking and hiking – miles without pain.

I do not run, jog, do plyometrics (jumping exercises), carry a heavy pack or do anything that could wear my appliance out more quickly than regular living. I can do Sun Salutations with ease again (that just happened a couple of months ago) and understand so much more the yoga of pain, of limitation and of modification. I will never tell another yogi that what feels aligned in their own body is not aligned because it’s not symmetrical to my eye. I will never push a student’s limb into the place that looks right to me. I listen deeply to what my students tell me feels right in their bodies and invite them to explore alternatives, or sometimes to simply go deeper into where they are.

It turns out my limitation was a great gift, but one I had to struggle with mightily until I wore myself out enough to listen to what it was teaching. I still listen and am still learning from the experience. I enjoy more rest now than ever before in my life. I care less about deadlines, consequences and what other people think. I care more about the integrity of movement, work, meaning and expression and know that these win out every time.

I’ll write more about modifications, asana, practices and meditations that helped me and arose from this experience. They all come down to this: be still, even with pain. Pain really doesn’t entail suffering; we can make suffering without pain and skip suffering with pain. In the stillness, listen. Listen into sensation, past judgement (your own), past fear and trust what comes to you. Even when it seems simple. Too simple. Just follow the inner teacher.

Related articles

• Yoga for Hip Pain (everydayhealth.com)
• Yoga at Home: Yoga can “Restore” You at Any Age! (athomeyoga.typepad.com)
• Hip Replacement Surgery Checklist (everydayhealth.com)
• Total Hip Replacement (fitnesspedia.wordpress.com)
• A Red Letter Day for Writers Who are Also Hip Replacement Survivors! (theauthorlink.wordpress.com)
• Hip Replacement Surgery: Planning for Recovery (everydayhealth.com)
• Making friends with yoga – again. (smellsgoodfeelsgood.wordpress.com)
• Hip Pain and Sex: Staying Intimate (everydayhealth.com)
• Well: Relief Tips for Joints Besieged by Osteoarthritis (well.blogs.nytimes.com)