All right, hello everyone, welcome. Today we're going to talk about my total hip replacement. It was my birthday just a couple days ago, and that also marks the three year anniversary of the day that I got a total hip replacement on my left hip. Now, the reason I want to talk about this is generally I don't like sharing personal information or personal information like this, because I'm not looking for sympathy or anything like that, but it is so closely related to what I do professionally, where my expertise is. I do think that it's worth sharing and talking about in terms of insights and perspective that I've gained from it.

So, what happened? I had a very rare condition called pigmented villo nodular synovitis, it's also known as a giant cell tumor, but essentially I had a tumor in my hip joint, non -cancerous, non -metastatic, but a large mass. I'd had mild hip pain for many years, that was really nothing that bothered me or prevented me from doing very much. I had x -rays and ultrasounds and the severity really never got above a two or three out of ten pain level -wise at the worst and primarily it was just chalked up to tight so as maybe some labral injuries. I played football in college and there's always and obviously all the training and weightlifting that goes along with something like that and it was always very easily sort of explained away by just you know sort of injury accumulation and training and quite honestly was never really severe enough to do anything more about it. So it accelerated, the pain accelerated really quickly over the course of a Christmas time that would have been in the Christmas of 2020 and then it got to the point over the course of really like a month from being like kind of the usual and then a month later really having a hard time walking, got an MRI that showed the tumor, along with really, really extensive joint damage to the cartilage, to the bone, to the labrum, and was not just your normal like, oh wear and tear, had some old football injuries and needed an arthritic hip replaced when I was 33 years old. It was the tumor creating pressure and inflammation inside the joint and really accelerating dramatically the breakdown of the tissue in there.

So, you know, it's during this time that really I had pretty bad and pretty significant struggles with my mental health. Really kind of feeling, given what I do, feeling like a like a fraud or, you know, an imposter, imposter syndrome, feeling like, you know, how could this happen to me given the resources that I have access to and the knowledge that I carry around with me and the and the the colleagues and people I work with having so much expertise, right? So it was tough in that sense of feeling sort of like a failure is also really difficult not being able to move. And this is really one of the things that I enjoy so much about the work that I do in general now and at that time was, you know, helping people move better, move again, move with less pain is such a rewarding process and not being able to move for an extended period of time like I was was a was a, you know, a painful and uncomfortable but still a reminder of how important this work that I do is because when you can't move very little else is can can be right.

So that's what I had. Got a total hip replacement. I think I was the second youngest person that the surgeon had ever done a hip replacement on or a joint replacement on. Surgery went great. I was very strong going into the surgery. I took rehab very seriously afterwards. And now, I mean starting at like maybe six to nine months after the surgery, I was really back to doing full activity, anything I wanted to, except for running. Running is still the thing that I can't really do, that I used to be able to do. You know, sprinting and going for jogs. And that's a limitation that I'm just gonna have to accept, and that I do accept at this point. I mean, I wasn't a huge runner before. I was a competitive runner in high school, but wasn't really, you know, running was for years and years, hadn't been my primary form of exercise, although I did really enjoy it. Now, That's not something I'm unable to do or, or I haven't figured out how to do it at this point. I mean, I think if I ever figure it out in a way that help, that doesn't aggregate my hip, it's going to be pretty, pretty limited in any case. Um, and that's fine, but I was able to get back to, and I'm still now able to do really, really any other physical activity that doesn't involve running. And so I can bike, row, lift weights, do yoga, hike, walk, um, ski most importantly for me in the winter cross country ski and downhill ski. I can still ski double black diamonds, um, with, with not, not, not like getting through any sort of pain either. Just, I feel totally fine. I feel strong. So, um, that was a really big, you know, kind of, um, it's a big piece of, I think kind of a testament to how well hip replacements can work at hip replacements are the most successful joint replacement.

But for someone like me, who's as active as I am being able to get back to almost all of the activities I did before was super important. Um, and obviously I'm super grateful for it. So that's what happened. That's what I had. And that's what happened. Um, and what it taught me was that, you know, you can be the example and still kind of walk the talk, even in situations that aren't ideal, right? I, I think before I had thought, you know, like walking the talk or, you know, if you talk to talk, you better walk the walk, right? So in terms of, you know, how I practice medicine with, you know, a very preventive mindset, you know, the, the walking the talk part would be never get it, never get any surgery, never get any joint replacement. Why would you need it? We have, you know, we have PRP and MFAT. We don't need any of that surgical stuff and that's I think a very narrow mindset to have. Surgery is not a failure and it can be essential. I mean this is this is very obvious. I mean surgery is an absolute miracle when you need it. I think like many things surgery can be misused and overused and that's where the medicine that I do really has a lot of its or most of its value but even in even in situations that were not ideal you know I didn't or have not or tried not to let the fact that I needed this surgery slow me down right I mean taking rehab really seriously and continuing to move in spite of these things has been for me a good lesson and just sort of continuing to be the example that you know continuing to live in the way that you know the guidance that I would tell my own patients is what I tried to guide myself.

And then the other thing I've thought a lot about both in my own context and also for my patients and the people that I see on a regular basis is you know a lot of people are told that you know I went to my doctor and they just said I'm getting old and that explains what I'm having and that explains you know why I can't do my favorite hobby anymore. And I think that's kind of a kind of a crass way to describe what I think is a more nuanced truth which is getting old is a real thing. You know when you're 55 you don't heal like you did when you were 15 or 25 but getting old is not a reason to stop moving right. Getting old is a reason to adapt and I think there's a big difference there right so if you really like playing a sport tennis for example getting old and maybe not being able to play as much tennis as you used to does not mean that you should stop playing tennis. And I think a lot of people are told oh I have wrist tendonitis, I have knee arthritis, I have back pain. My doctor told me I should stop playing tennis because I'm getting old. And I think the adaptation and modification is the much more nuanced truth. Whereas like if you're used to playing four times a week play twice a week right. Twice a week is so much more than zero. And yeah you we can't do everything that we used to do forever right. You can't play tackle football when you're 75. Not a good idea right. But it's that difference between stopping everything quote unquote because you're old versus hey like listen to your body adapt like we're always changing. Every one of us is changing every day right. Every every molecule in our body completely turns over and is recycled over a seven -year period, roughly speaking. So we're always different. We're always adapting to the stressors in our life, and so being able to just take that mindset over longer periods of time and say what you were doing in your 20s and 30s, whether it's running or playing a competitive hobby or skiing a certain way or a certain level of difficulty doesn't mean that you're going to be able to do that when you're in your 60s or 70s, but that also doesn't mean you should stop it completely. And so that's been a big thing that I've done personally in light of my hip issue is just find things that scratch that itch for me.

So how this translates to better patient care, I think. is, you know, obviously being sick doesn't make you an expert in that sickness. So, you know, just because I have this thing doesn't mean I'm an expert in it. But I happen to be an expert in musculoskeletal disease and got a pretty severe musculoskeletal disease. And I do think it provides me a little more insight into the patient experience and a little bit more room for compassion. Because the truth is that joint replacement is the right choice for a lot of people. And that regenerative injections can be a great method of decreasing your pain between now and when maybe that joint replacement happens. And in some people, yes, it is a very good way to avoid the need for one completely. But I'm very candid and honest with patients about joint replacements, right, are not the end of the world. They're not a failure. If that is the best option to keep you moving, that is what you should do. Now, again, I think there's on an individual basis, there's caveats and nuances because a lot of people are told to have a joint replacement well before they're actually ready for it. In my case, my disability was so significant and my MRI was so bad to kind of go back to the beginning. I had the worst MRI that I have ever seen on any of my patients. None of my colleagues had seen this condition in a hip before. So while joint replacements can maybe be over -recommended, they're obviously the right choice for many people. And so I think my experience in this as far as translating to better patient care results in just really in honesty and in candor and in a little bit more kind of room for compassion, knowing what kind of people are facing. And what they're going through and being able to speak from experience when I say things like take rehab seriously. Which is the same thing as saying to everyone stay strong. Take your strength training seriously because even if you're not facing a surgery or right after a surgery like that is the thing That will make you feel the best. 

If you know our social media account, you know that I don't like to get into personal stuff But I felt that this was that this little episode and especially you know Just you know, it was a three -year anniversary though So I thought it'd be a good time to reflect on it And it's just it's so relevant to my day -to -day experience with patients I think that the few patients that I've told about it kind of personally when I share When I share sort of with them in a personal way, I think it's I think it's It's too relevant to ignore so thank you for allowing me to share I hope that this provides you some insight into maybe a situation you're facing or at least insight into how I operate as your provider and as your doctor. So thanks everyone. We'll see you on the next episode. Take care.