For the past two or three years, I have been facing the inevitable. All three of my older sisters have had hip replacements on their right hips for degenerative arthritis when they were approximately my age. Now it was my turn. But in my case, metal sensitivities made getting a hip replacement a more challenging problem.

For over two years I searched in the US, the UK, and Europe for an orthopedic surgeon who could both relieve the rapidly growing pain in my right hip, as well as accommodate my sensitivities to the metals found in alloys used in hip implants.

Thanks to the stem cell injections I received over those years of discomfort, I was able to buy time and remain active while I searched for further help. If I had known about stem cell therapy ten years ago, I might not have needed surgical intervention. By the time I found help for the arthritis, the femoral head and the socket were bone-on-bone. The femoral head had become deformed from all the friction, and I had painful osteophytes (calcium deposits) that jabbed me like daggers when I bent over to tie my shoes.

Titanium alloy is the metal used in most implants these days. The alloys are added to strengthen the titanium. Although my immune system does not react to pure titanium, I don’t tolerate titanium alloys. Most of the titanium alloys contain nickel, cobalt, or aluminum—all of which can cause me to have an overactive immune response that could eventually lead to autoimmune disease.

In 2007 I had a serious snowboarding accident. The orthopedic surgeon placed a stainless steel plate in my leg to hold the shattered pieces of bone in place. A year later I had a massive autoimmune reaction that had been brewing ever since the metal was placed in my leg. The autoimmune reactions were so severe that they almost took my life.

Stainless steel is an alloy that contains nickel. Over the past two decades stainless steel surgical implants have been gradually phased out because an estimated 15% of the population is hypersensitive to nickel.

When I started feeling chronically sick months after the accident, I sent my blood to Germany for special testing for reactions to various metals found in surgical implants. After the testing was completed, the German company called me up and said that I had a massive immune reaction in the test tube when my blood was mixed with nickel. They also said that I reacted to cobalt and aluminum.

I asked the orthopedic surgeon to remove the plate from my leg. Within two weeks after removal of the plate, all of the elevated antibodies had dropped down to normal. Sadly, the damage to my body remained.

The orthopedists I talked with assured me that the titanium used in hip implants was pure. But the manufacturing companies I spoke with said that they no longer use pure titanium because it is not strong enough for hip implants.

It looked like a total hip replacement was going to be a dead end for me. Not ready to resign myself to a wheelchair, I re-focused my attention on “hip resurfacing.”

Hip resurfacing involves only the femoral head (the ball) and acetabulum (socket) of the femur. The neck of the femur and the top of the femur (the greater trochanter) are spared, which means that less metal is required. Although hip resurfacing is reserved mostly for young athletes from 40-55, I didn’t let that fact deter me.

Night after night I spent watching YouTube videos about hip resurfacing surgery. Tired at the end of long days of seeing patients, I only lasted about 5 minutes per video. I was discouraged to see that hip resurfacing also involved metal—although much less than with a full hip replacement.

One evening I watched a video by an orthopedist named Dr. James Pritchett from Seattle, Washington, considered one of the top surgeons in the US for resurfacing procedures.  After five minutes I thought about turning off the computer and going to bed, but something told me to keep watching.

Toward the end of the video, Dr. Pritchett said that he could work with patients who had sensitivities to metals. I replayed that section to make sure I heard his words correctly.

I immediately emailed Dr. Pritchett to enquire about what he does to accommodate people like me who are aware that they have metal sensitivities.

Dr. Pritchett was an engineer before becoming a surgeon. He said he enjoyed figuring out mechanical problems and had discovered that he could encase the metal parts with a microscopic layer of ceramic to keep the metal from having direct contact with the surrounding tissue. Adding to the good news, Dr. Pritchett said he uses spinal anesthesia instead of general anesthesia. And he does not use any glue to secure the cup in the socket.

I made a pitch to him for taking me on as a patient.  I said that, although not a young athlete, I’m an older former athlete. I continued my little shuck and jive spiel and said that I felt biologically younger than my chronological age.

He said that he was reluctant to take me on because of my age and gender, which, in his mind, meant that I had osteoporosis and would be at risk for fracturing the femoral neck and then would need a second operation—the total hip replacement I was trying to avoid.

Undeterred, I got a bone density test and sent him the results. It showed normal bone density—probably due to all the heavy packs I hauled up high mountains when I was younger. Dr. Pritchett responded immediately, “Ok. You’re in. My medical assistant will get you all set up.”

Such good news! I felt guardedly optimistic.

Surgery was scheduled for right after Thanksgiving. My brother John and his wife Kaye generously offered their home just north of Seattle as a place for me to recover after surgery.

I hastily completed all the pre op blood work, physical exam, interviews, and paperwork. One of my patients, Mike Beste, kindly offered to drive me to the airport in his luxurious and spacious vehicle.

On November 27^th, 2018, I walked into Swedish Orthopedic Institute and surrendered myself for the operation.

Although I was originally scheduled to be the first surgery of the day in the early morning, I ended up the last on the schedule. The nurse explained to me that if patients are expected to have complications, they put them first on the schedule so that there will be time to deal with anything unexpected that arises. Being re-scheduled for the end of the day could have meant that, in spite of my seventy years of age, I appeared to have less potential for complications than the others on the schedule that particular day.

I had the good fortune of being assigned to a wonderful nurse, Bonnie, who happened to be Kaye’s very close friend. In the pre-op area where I was prepped, the mood was festive and jovial, as though we were having a party with lots of jokes and laughter. Being surrounded by friends and family helped dissipate the anxiety.

Just before Bonnie wheeled me into the surgical suite, I remembered to tell the anesthesiologist not to give me Fentanyl—a synthetic cousin of heroin — because it had caused me to have a respiratory arrest in the past during a medical procedure.

Next thing I knew I “woke up” in the recovery room. The Asian nurse attending me said the surgery went well. She called John and Kaye to let them know my status. I heard her say, “Your sister is very talkative and funny, and she asks a lot of questions.” I don’t remember much about that time, still under the influence of the drugs.

Early the next morning, Dr. Pritchett came in to see how I was doing. He said that my joint was “a mess,” and that he had to work very hard at removing thick layers of calcium deposits in the joint and along the femoral neck that had built up after more than two years of chronic inflammation. He said he also worked hard at doing “carpentry” to remodel the shallow socket in order to securely place the metal cup. He said the surgery was a lot of work, took almost twice as long as most hip resurfacing, and that he was tired at the end of the day. Other than that, it sounded like the surgery went well.

Before being discharged that morning, I got a lesson in how to use the walker, how to walk up and down stairs, lower myself onto the toilet, and get into and out of a car, and into and out of bed.

Before the session was over, I got a short visit from a doctor who lived in my building in Denver in 1979 when I was in medical school and he was a resident in internal medicine. I ran into him and his wife at the Albuquerque airport on my way to Seattle. What a pleasant surprise that was!

Dr. Pritchett made a foot-long incision on the lateral side of my hip. He used a posterior approach so that he would have plenty of room to visualize the joint and have enough room to do the necessary surgery.

Using a posterior approach meant that the initial recovery would take longer than an anterior approach, and there would be more restrictions during the recovery phase.

One of my challenges will be not bending over to put on my socks and shoes and not picking up anything off the floor for six weeks in order to avoid dislocating my new hip. I had to get a special gizmo to put on my socks and another gizmo for picking things off the floor. During those six weeks, I’m not allowed to cross my legs or bend forward more than 90 degrees to avoid the risk of dislocation. I have to sleep on my back with a pillow between my legs to make sure that the affected leg does not cross the midline while sleeping.

John and Kaye drove me home the morning after surgery. They have the ideal place for recovery. Their peaceful and quiet home has a large glass window overlooking a lake visited by ducks and otters and other wildlife.

Kaye had been through two hip surgeries already, so she had valuable tips to give me, along with useful equipment to loan me, including a walker. She generously gave up her favorite chair next to the window overlooking the lake so that I would be comfortable.

Days 1-3: I don’t remember much except that I was in a lot of pain. I decided not to be stoical and took the prescribed opioids. They fogged my brain and made me feel slightly depressed and nauseated. But I welcomed the relief from the lancing pain. I didn’t sleep much while lying on my back with a pillow between my legs.

Days 4 & 5: Off the opioids, morale better. Off the walker by 4^thday and onto a cane. I’m moving VERY slowly and deliberately. The constantly rainy, overcast weather helps me not miss being outside. I sit in Kaye’s favorite chair and stare out at the lake.

The recovery seems slow, but I am learning how to be patient. I decided to reframe this time as a Zen retreat in mindfulness meditation. I’m learning how to practice what I preach.

John and Kaye are taking very good care of me. Kaye buys all organic food from a fantastic health food store not far away. She has already switched to a ketogenic diet, which is what I eat—low in carbs, moderate in protein, and high in veggies and plant-based fats. I think Kaye’s cooking is helping me heal very quickly.

Each evening, John makes a crackling fire in the fireplace. We sit together in the living room and watch the Netflix series, Schitt’s Creek,a Canadian TV sitcom with slapstick humor that makes us laugh uproariously.

Days 6 & 7: Tomorrow I go for my post op appointment with Dr. Pritchett. I will thank him for his hard work on my joint and I will tell him how much I appreciate the good care that I received from him and the whole team at the Swedish Orthopedic Institute.

After the appointment, John and Kaye will drive me to Medina on the east side of Lake Washington and drop me off at the home of Michael Braverman and his family. Michael and Suzanne Braverman are the generous people who bought me my first iPhone, and more recently paid for my trip to Antarctica in 2017. I have been treating three generations of the Braverman family for many years. They wanted me to spend at least one day and a night with them so that I could meet in person one of the newest of the grandchildren and their son and daughter-in-law whom I’ve been treating over the phone but have never met in person. They were so gracious and kind to me.

Day #8: I flew home on Alaska Airlines. I paid to have extra legroom on the three-hour flight back to Albuquerque. At the airport, Mike Beste waited for me with a customized wheel chair, ready to drive me home.

When I got home, I was greeted with a homemade dinner. My neighbors had organized a team of people to help me. Each day someone came to my home and asked if there was anything I needed and dropped off a nutritious and delicious homemade meal. Just thinking about it moves me to tears.

My challenge coming home has been to not overdo my level of exertion. I’ll have to have a talk with myself about that.

I have to confess that I began seeing a few patients shortly after I got home. I know that sounds insane, but being of service to others helps me to keep my mind off myself.

Today it’s been 3.5 weeks since the operation. I’m still using a cane but hope to be off of it soon. I have been walking a mile with the cane on the bike path next to the river each morning for the past few days. It feels blissful to get outside and move around.

Many people have given me gifts that I’ll never be able to repay. One of those gifts has been a series of bodywork sessions called Alexander Technique. It is powerfully calming to the nervous system.

I am deeply grateful for all the kindness, care, and concern that I have received around the time of the surgery and during my recovery—the flowers, cards, prayers, errands, grocery shopping, and words of support and encouragement. I am awash in gratitude for my community far and near.

I can’t wait to get back to hiking, biking, swimming, and doing yoga again. I look longingly out my upstairs window at the beautiful mountains above Santa Fe!

I’m wishing all of you peace in your heart, joy, and good health during the holiday season—and beyond!