Jane’s Story

In April, 2002, I had a total hip replacement with Dr. Swanson. It was a solution to 30 years of pain and progressive disability that began when I was 19 years old.

As a child and young adult I was extremely active and athletic, beginning ballet at age 3, skiing at 12, and hiking, bicycling, yoga and running at various ages in my teens. I had no limitations and participated in all these vigorously and with good form.

At 19, I noticed an ache down the outside of my leg, starting at the hip level. It was only present after I jogged or skied and lasted for a few hours. It always cleared up after a night’s sleep. I ran daily as exercise from age 19 to 30 and then stopped. I could run comfortably, but when I warmed down afterwards, the side leg muscles would ache and I would limp. Rest and abstaining from running would make the aching go away but I was developing a slight limp that was with me all the time, even when the hip wasn’t hurting.

I was in Chiropractic school at age 30 and had a series of hip x-rays taken. The head of the radiology department consulted with me and told me I would have to have a hip replacement some day, but to not start too soon, because “they don’t last more than 10 years.” The x-ray showed that my hip sockets were somewhat shallow and my left leg had a different shape than the other side. The femur was thinner and did not have a normal angle and there was calcification along the rim of the socket. The radiologist asked me if I had had surgery as a child, because he said it appeared as though some bone had been grafted along the outer edge of the rim to make the socket deeper and more ideal. I had never had surgery.

The radiologist’s advice to me was to “stop walking.” I asked him what he meant and he said, “get a ride everywhere and do not run for exercise anymore, because you will need a hip replacement someday.” I asked him if there was anything I could do to slow down or prevent the degeneration and he said “no.”

I left very upset and did not want to face the situation and did no research to learn more about it. I felt since I was too young for surgery anyway, I would be doomed to just wait for some undetermined and unknown set of circumstances until I would somehow know it was the right time for a hip replacement. I had always been oriented toward natural means of healing and preventive nutrition and fitness, and couldn’t believe I would have to have such a serious surgery someday.

As I went through my 30’s the aching after exercise began to be a chronic ache which was only gone after a good night’s sleep and began soon after I began to move around in the morning. It then progressed to shooting nerve pain down my leg and into my foot. The nerve pain was so sharp that it sometimes made me jump. My toes started moving on their own when I would lie down and I noticed the muscles in my left thigh getting smaller. By about age 44 my leg had started to shrink so that my pants were much looser on that side and the pant leg was about 1” longer on the thinner leg. I couldn’t walk in heels at all without severe hip and low back pain.

By age 47 I had stopped having a restful night’s sleep. I was unable to lie down comfortably in any position and woke up puffy and exhausted and in as much pain as that in which I went to sleep. I had not walked comfortably for about 10 years, I had not hiked or skied for that long as well. The next November I bought a pair of crutches and used a wheelchair in the malls when I did Christmas shopping. In December we went to the family condo for a ski vacation. At this point I decided to research surgery and have it done before the next year was out. I had met two people that year who had had hip replacements done and they were very happy with their results, but the gruesome 12” scar was scary to me.

I began to research hip replacements on the internet and came across a website of people who had the procedure done. In the course of about 6 weeks on the internet I educated myself about the techniques and materials used and found there to be quite a lot of variations. I set up two consultations with prominent Los Angeles doctors. The consultations with these two doctors were similar, both suggesting metal and plastic surfaces for the femur and acetabulum, respectively.

I had done enough research at this point to have concluded for myself that this combination would almost certainly insure that I would have to have a revision done at some point. I wanted a harder material than plastic against the metal femur head, but did not want metal-on-metal. In talking with two women on the hip website, both more than 5 years younger than I, I discovered that there was such a thing as ceramic-on-ceramic, a perfect solution for me. This material left no metal ions or plastic debris in the body and can wear indefinitely.

To top it off, the women I met had 3-4’ incisions. They had had their surgeries a year earlier and were back to full, normal lives.

I consulted with Dr. Swanson who had done hundreds of ceramic mini-incision hip replacements. My hip dysplasia was very advanced. The femur head was all but gone, badly misshapen and with no cartilage on the surface. It was only about 40% in the “socket” which was more like a ski slope than a cup. The surgeon had to completely recreate a new socket.

In addition, Dr. Swanson had to lengthen my leg 2 1/2 cm. This was a tricky situation. Over the years the femur had slid up in the socket till it was bone on bone, and has caused a functional shortening of the leg. Because I functioned with it that way for so long, the muscles and ligaments had also tightened and were functioning shorter as well, although they weren’t functioning much. They were extremely weak. I couldn’t lift my leg up to the front or the side. I was lifting it in and out of the car with my hand.

The danger in a dysplasia case like mine is in that if you lengthen the leg, will you have enough nerve length in the sciatic nerve so as to not stretch the nerve? If the surgeon lengthens the leg beyond the actual length of the nerve, it can get stretched and possibly be damaged beyond recovery. This can result in foot drop and possible chronic unchanging nerve pain. Dr. Swanson monitored the nerve during the procedure to make sure it was not stretched. We discussed this beforehand in a very direct manner and I told him I would prefer to end up with a leg that was short rather than a stretched nerve.

As it turned out, I had enough slack in my sciatic nerve to accomplish the full lengthening so that my legs are now perfectly even! My leg is so perfect in it’s symmetry with the other leg and functions so smoothly, one would never know it was an artificial joint!

When I stood on my legs for the first time the morning after surgery, I looked down at two knees and feet pointing straight ahead, exactly the same! (My left leg had been rotated out about 45% and I had not been able to point it straight ahead for many years.) The pain in the joint was gone!

I liked the way Dr. Swanson handled every aspect of my treatment. From the very beginning, I received a response to my email inquiry the same day. My consultation was lengthy, and at the end of his work day, yet he conducted it without rushing and answered my questions thoroughly. He looked at me and listened with interest, and was direct and informative. Although he was humble, he was confident. His competence proved out in the results of my surgery.

As far as pain after surgery, I discontinued all medication the second morning. I have never needed any medication for pain. I took an anti-inflammatory for 6 weeks because the soft tissues were swollen from the changes they made after the leg was returned to its normal length and position.

The incision closed very rapidly and has given me no trouble. The scar is fading. I am continuing to work at getting the muscles flexible and strong after so many years of inactivity and limping. The nerve pain down my leg faded and finally subsided.

In November I took up boogie-boarding and in December I went cross-country skiing. I can walk as long as I want without any pain or discomfort of any kind. I am looking forward to hiking this summer.

I took a new job when I returned to work. My hours are long and I have a lengthy commute each day. I have no pain and move around actively and tirelessly every day. I am much healthier now than I was for 5 or so years before surgery and life is good!

I am very pleased I found Dr. Swanson. He did a first-rate job in restoring my normal anatomy as well as handling every aspect of my care. I am lucky and grateful that after 30 years of pain and inability, I am able to be pain-free and can look forward to an increasingly active life. I thank Dr. Swanson for spending his life becoming competent and applying his skill in a consistent and ethical manner. I have referred several people to him who have had successful outcomes, and would send anyone to him in the future.

Jane Sibley

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