My New Hip – The Symbol of Baby Boomer Health and Wellness – Post #1
I started my readers off on this journey with me in overcoming arthritis of the hip by posting the saga of my Total Hip Replacement: “Arthritis – How To Deal With It“. The last line of that post was that I was awaiting my scheduled surgery on September 18, 2018. It’s September 26, so it’s now time to walk y’all through the rest of the story…the “real” story. I am still in the middle of “living” it. I’m going to do this in a series of posts. Otherwise, it would be too long a read.
Those of you who have had major…or even minor surgery…know that the entire medical industry has brought their technologies, practices and procedures to incredible new heights. That’s honestly the primary reason I decided to move forward at this point. One quick indication is the depth and diversity of their pre-op information and preparation services delivery. These doctors and hospitals have this process down cold.
You have a vital role in this pre-op prep:
Ask All the Right Questions
One key word of caution to everyone is to get referrals…yes, plural…from your primary physician. And then spare no time or effort in vetting each of the doctors, particularly talking directly with previous patients.
A major word of caution here (which will be another post coming soon the BoomerHealthy.com) is to start now developing a great relationship with a great Primary Care Physician (PCP). Some of the steps for selecting and vetting your orthopedic surgeon that i will go through in the following paragraphs, apply to finding and vetting your Primary Care Physician as well, and then in developing a strong, trusted relationship with that person. At this point in our lives we will need more and more specialists and we’ll need a strong, reputable network of doctors that can come from your PCP.
I just started a relatively new relationship with my PCP, Dr. David Palmquist, MD. I had bounced around and wasn’t really concerned about my PCP because I never went to the doctor. Literally, without bragging and offending the Gods, I have been ridiculously healthy my whole life. But I knew this was going to be a very important and critical year for me with a minimum of 3 important surgeries in my mental check list.
My health insurance representative recommended Dr. Palmquist. Great referral. After talking to 5 other potential PCP candidates, my choice of Dr. Palmquist was very easy. I haven’t been disappointed at all. He’s the consummate professional and considers my opinions and needs before making any decisions or recommendations. By now, he has my total trust. And as you will read later in this post, he has been there from the very beginning through every step in the process on 3 separate procedures. I won’t bother giving you Dr. Palmquist’s contact info because his dance card is full, but you can check out his work and references, as well as his entire practice, at HealthMark, www.healthmark.org.
Dr. Palmquist gave me 3 potential orthopedic surgeon candidates. He told me he had sent both of his parents to the orthopedic surgeon he was recommending, Dr. John S. Woodward, Jr. here in Denver. Dr. Woodward is one of the partners at HealthOne OrthoOne Premier Care. www.OrthoONEdenver.com.
My first question was, “How good is your relationship with your parents?” He thought that was very funny. I thought it was a smart question. My point was…and is…clear. There is no limit to the questions, information and intelligence you should try to build. This your body this surgeon is going to carve into. You want the best, most qualified person you can find.
Do your due diligence.
I’m going to tell you a bit about all of this because, if you aren’t getting at least this level op preparation prior to your procedure, you should start asking for better service.
1. Get your Primary Care Physician to recommend a few surgeons and discuss with your PCP how to prioritize them…how would he or she prioritize them? Have your PCP help you prepare your concerns, your questions, you priorities.
2. Schedule face-to-face visits. Meet the surgeon, his or her primary team and Medical Assistant. Their Medical Assistant is a critical cog in the wheel. This person is responsible for managing all aspects of the scheduling and the information delivery, whether in print or online or verbal…probably all three.
Also in these meetings get your surgeon to give you as much information about your case as possible. Get them to share your x-ray images and any advice, counsel or recommendations they may have for your specific case. What’s unique about your case and what do they recommend to make this the best possible experience and outcome?
When you complete these visits, if you’re like me, you’ll know who your surgeon is. probably won’t be their resume, their experience, their referrals or reputation. For me, it was Dr. Woodward’s personality and style. That confirmed it for me.
3. The Medical Assistant Phase. Here is where the Medical Assistant becomes most important. He or she will take over from this face-to-face meeting clear through your entire post-operation phase. You will learn to know and appreciate this person. Their role is vital. In my case, Dr. Woodward’s MA is Tara Karsten. Her actual title is Surgical Navigator and she certainly lived up to that role. Tara was the first person I talked to. She scheduled my face-to-face and follow up pre-op meetings with Dr. Woodward. She scheduled my meeting with the hospital team. And she guided me in scheduling all of my required incremental meetings with my PCP, the anesthesiologist and physical therapists.
One final quick note here: yes, the MA is primarily the traffic cop in this equation, but knowledge is vital in this role as well. As I went through the process, I learned that Tara has a wealth of knowledge far beyond just the scheduling and dissemination of information. Extremely valuable. You will see Tara’s name referenced several times in the remainder of this post
4. Learn all the details about your procedure:
I won’t get too detailed here, In a total hip replacement (also called total hip arthroplasty), the damaged bone and cartilage is removed and replaced with prosthetic components.
- The damaged femoral head is removed and replaced with a metal stem that is placed into the hollow center of the femur. The femoral stem may be either cemented or “press fit” into the bone. The surgeon then positions new metal, plastic, or ceramic implants to restore the alignment and function of your hip.
- A metal or ceramic ball is placed on the upper part of the stem. This ball replaces the damaged femoral head that was removed.
- The damaged cartilage surface of the socket (acetabulum) is removed and replaced with a metal socket. Screws or cement are sometimes used to hold the socket in place.
- A plastic, ceramic, or metal spacer is inserted between the new ball and the socket to allow for a smooth gliding and “better than natural” performance going forward.
- Dr. Woodward also told me there were “erosions”, pockets in my socket bone due to long overuse. He explained that he would use my own bone matter from my femoral head to make a “paste” to fill these pockets to make the ball and socket system work even better. I, of course, agreed. I already have a jawbone on my right side that was built from “some dead guy’s” bone matter. This was better. At least it was my own bone matter.
5. Meetings, meetings and more meetings: I’m not a “meetings” guy. In fact, in my career I have cut as many meetings out of the calendar as possible. Lots of wasted time and talk. But in this case, these meeting are vital to the coordination among all the various contributors: Dr. Palmquist, Dr. Woodward, the hospital, the surgical center, and the physical therapist. I won’t go into detail here but the critical points in all of this were my education into what exactly was going to happen to me, my knowledge of what each of these contributors brought to the overall success of the process and how each worked together for the best ultimate success, and collection of many data and fluids from me, and finally planning all the next steps in the post-op phase and being sure that I understood the value and contribution of each of those. A well orchestrated team. These people, every single one of them, gave me lots of confidence and comfort in that knowledge.
5. Personal Preparation: The ball was now in my court. I couldn’t ask Tara to schedule all of my meetings and doctor visits. I had to make most of those calls, show up for the meetings and manage whatever those doctors or nurses required. At one point about two weeks prior to my procedure I had a list of 173 to-dos I had to complete by 4:00am on September 18 when my alarm would ring on the day of my procedure. Most of it was preparation for coming home. One of the highest concerns for most of the specialists I talked to was how well I would be taken care of after I left the hospital. So, those preparations took priority one. Grocery shopping, medical supplies in place, planning for someone to drive me home, someone to be there for the first few days, having my office in place and set up so I could work from home as soon as possible. Make sure I have a walker, a cane, hard-backed chair, loose-fitting clothes, clean clothes, clean linens, bathroom prep, kitchen prep, care for the dog…the list went on and on. And yes, I did check off the very last to-do at 4:45am on September 18 as I parked the car at the hospital where my son could find it the next day to drive me home.
6. The Day of the Procedure: As Dr. Woodward said in our last pre-op meeting, “just be happy I’m a morning person.” My procedure was scheduled for 7:00am, to be the first procedure on his docket for the day, which meant I had to check in at 5:00am which meant I had to wake up at 4:00am. Not my usual way to start a day.
Of course, I made my part happen. Double, back-up alarms, two options for driving to the surgical center, my bag was packed, one last check list for arriving back home. The pre-surgery nurse had given me anti-bacterial wipes to use as opposed to showering. Cold and sticky, but who was I to question. I actually arrived 10 minutes early and was in my hospital gown at 5:05am.
My pre-op nurse was Katie and she was great…the perfect balance between professionalism and caring for the frightened old guy. She did a little shaving, telling me she knew exactly how Dr. Woodward likes it. She then “autographed” my hip at the point of incision. She also put on one of those anti-bloodclot stockings, all the way up to my right hip. She explained that these are very necessary to avoid blood clots and that they would put one on the right leg post-surgery. She set the IV needle (painlessly which is how I measure my nurses) and then just let me lie there and try not to freak out.
On that note, I will pause this series of 3 posts. Good theater, huh? Please feel free to comment with your thoughts, opinions or experiences. Your feedback and dialog are what make these posts so valuable. Thanks.Tags: arthritis, hip replacement