Hello everyone,
It's been about a year and a half since my left artificial hip underwent "refresh" surgery. Everything's been perfect...up until three weeks ago.
On February 20th, while kneeling on the carpet fixing something, I had a dislocation. "Oh boy," I thought. "Here we go again." From prior experience I knew there was a chance that I could pop the hip back together by moving in such a way that a steady pressure was applied on the joint. I tried it; it worked! There was a distinct thunk when it came apart and again when it popped back together.
What the heck did I do? This was very disturbing. Near as I can tell, in that kneeling position, I had my knees very close together, which means there was outward pressure on the joint. I think most of my weight was on my left leg, so it suddenly came apart.
I have VA medical care and the VA has this internal email system, which is very cool. I can contact the various clinics and the doctors directly. This incident deserved notification. I dispatched a note to the Orthopedic Clinic at the VA's West Los Angeles Medical Center. I wrote:
"I had a 'refresh' of a 1994 total left hip replacement in August, 2015, at VA West LA. Today, I had a dislocation of that hip. Fortunately I was able to move in a certain way and it popped back into place. All I was doing was kneeling on the floor, working on something. This is the first time that's happened since surgery. Now I'm worried. Any advice? Is this anything significant? Do you want me to come in for X-rays? Should I just be more careful and carry on? Thank you."
I was told to book an appointment for X-rays. On that day, I arrived early. The Ortho Clinic people were still at lunch. I went to the Imaging Center down the hall. Turns out they already had the X-ray order. I grabbed a seat and waited. There was no reading material; I made a mental note to cart magazines I've read to the VA. The TV on the wall was silent. Why didn't they have captioning on?
Soon, a fellow in a lab coat called my name and we went to an exam room. I pulled off my pants, put metal things on a tray then lay down on my back. He shot two pictures from different angles then sent me on my way.
I reported in at the Ortho Clinic. Again, no reading material. And again, a silenced TV without captioning. I should start asking for the remote to fix that. A young doctor called me in and took me to his exam room. The X-ray pictures were on his computer monitor. We introduced ourselves then he pointed to the screen.
"It looks perfect," he said. "Just like it did the day we put it in." That's a relief! I had no idea if situations like mine sometimes result in damage to the implants. I figured it might be in good shape simply because there was no subsequent pain or hitch in movement or instability.
I explained what happened and what I did to pop the hip back together. "Very few people can do that," he said. I told him I learned to do that just by accident; that I'd had several dislocations with my old hip that I did not realize were dislocations. That's how I resolved the matter. It wasn't until I'd suffered two catastrophic dislocations that required ambulance rides to the hospital that I realized my old hip had a problem.
He put me on my back, had me extend and lift my leg, then put his hand on my foot and moved it into several positions. "Any pain or discomfort?" Nothing, I said. He told me to avoid sharp abdominal angles and to keep two fists distance between my knees. Sharp angles? I have a lot of lower back pain these days. The Pain Management Clinic has me doing daily exercises. Two of those have me on my back then pulling one leg by the knee into my chest while raising my head. The other is the same but with both knees to the chest. I demonstrated for him.
"That's pretty extreme," he said. "I wouldn't recommend that you continue doing that." As a result, my daily stretching exercises got shorter.
He said I'd probably have no further problems so long as I observed the rules of position. I told him I definitely did not want to go through hip surgery again. Then he let me go.
In subsequent days, I increased my awareness of leg position. I noticed that it's nearly impossible to keep a leg away from the body centerline; sometimes it's just going to happen. I'll try to keep such moments very brief and with minimal weight on that leg.
My primary care physician summoned me to the VA Sepulveda Outpatient Clinic in LA's San Fernando Valley on March 14th for my annual checkup. They had me go visit the lab the prior week to provide blood and urine samples. I took a couple magazines with me. When I walked into Building 200, I went to a waiting area that has seats and tables. That's where the magazines are found.
I dropped a copy of National Geographic on one table. At the next table, I picked up a magazine, put the second mag I had under it and dropped them on the table. I wasn't sure how it would be received. It was "Modern Drunkard," to which I have a subscription. I seldom drink; it's just outrageously funny reading. I guessed it would get to the trash can within hours. Or maybe some veteran would confiscate it...for personal use.
The checkup went well; I told my doctor about the dislocation. His resident assistant read off the lab numbers. I'm right where I should be weight-wise for my age (71) or most any other. Six feet, 190. They like that I hit the gym or lap pool five days a week. The doctor told me to pay attention to what the Orthopedic Clinic doctor said; I told him I would.
In the days that followed, I began wondering how to prepare for another dislocation. I live alone in a two-story house. My nightmare is that I'm upstairs and a dislocation happens that I cannot pop back together. Odds are, my phone will be nearby. I could call 911 easily enough. Then what? The EMTs and fire guys arrive to find the door locked and me very unable to go down the stairs without screaming in agony and quite possibly hurting myself.
Do they bash in the door? Then they load me in the ambulance. Nobody else is home. The door is damaged. Anybody can walk in. I've got a lot of stuff in there that I totally do not want the local thieves taking. Somehow, I was thinking, the emergency people need to have keyed access. But where would I put a key? Definitely not in one of those fake rocks. Not above the door. Probably not in a magnetic key case attached to the underside of my van, which is always outside. Leave it with the neighbors? But what if they aren't home when an emergency happens?
Then I thought, OK, I could put it on my fence. There's a few feet of six-foot-high wooden fence near my front door. It's brown. Like any fence of that sort, a couple 2x4 rails reinforce it near the top and bottom, and those beams are on the inside of the fence. I could hang the key on a small nail under the top beam. Nobody is ever in my back yard and the neighbors would never notice it. I'm certain the bad guys wouldn't think to look there.
To prevent a new, shiny metal key from being seen, I could spray paint it and the nail the color of the fence. If the day comes when I need emergency help, I can tell the the 911 dispatcher exactly where to find that key. Done deal. Today, I had a duplicate key made and picked up an aerosol can of flat brown paint approximately the color of the fence.
Problem solved. I think. But that's going to happen in the next day or two. Today, it was toenail-clipping time.
There were two sets of circumstances in which my hip came apart and I could maneuver to pop it back in. One was toenail clipping. Before surgery, I lived in an apartment building that had staircases. I'd go out back, to the alley, clippers in hand, sit on a step then clip away...until anyone approached, that is, then I'd hide the clippers and pretend to just be enjoying the view of the fence across the alley.
I'm right handed. It was when I clipped my left foot that the angle got dangerous and the hip popped out. I moved out of that place last June. No outside stairs here. I figured the empty bathtub was the best place. I unlocked the front door in case that hip came out again and I had to call 911, then went up to the bathroom, cell phone in hand.
I laid down in it, on my back, and clipped my right foot. Then I took a deep breath, hoped for the best, angled my foot in a bit then clip-clip-clip-clip-clip! Relieved, I exited the tub, returned to the front door, locked it, then went about my day...with shorter toenails.
The adventure continues -- hopefully without any further problems.
United States
It never occurred to me that it would be a dislocation danger. Hmmm... I guess it's good you can correct this yourself. But I do wonder why it keeps happening. Did you ask during your appointment?
