Hip Replacement in MZT

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Dr. Mario Castellanos Gonzáles, Mazatlán’s foremost joint surgeon, IMHO, with me post-op

In February 2020 I had a full hip replacement (received a prosthetic), here in Mazatlán. The surgery has fortunately been a 100% success and completely pain-free. I can’t sing the praises of my surgeon more highly—Dr. Mario Castellanos González and his team. I have received world-class surgical treatment, hospital care and physical therapy in an exceptionally professional, kind and caring manner. The surgery, prosthetic device and hospital stay cost about US$12,000, 100% of which was paid by our insurance company. I spent one night in the hospital and am now on week five of my recovery. I am still walking with a cane, but very much able to walk without it.

I am over the moon pleased to be out of pain and increasingly mobile! My family and friends up north were scared for me to have surgery here. Yet I completely believe it was better here than it may well have been up north, for various reasons I’ll outline below. I share my story in hopes it might help some of you who seek a similar procedure here in Mazatlán or elsewhere.

Click below to jump to the section you want to read.
Context/Background
Note on Foreign Helpers
Best Joint Surgeon in Mazatlán
The Surgery
Recovery in the Hospital
Heading Home
Physical Therapy
Financials
Friends, Family and the Community at Large
Key Learnings

Context/Background
I have had two hips bone-on-bone for many years. I am tough and very tolerant of pain; birthed my son with no drugs. I am active: hiking the lighthouse several times a week, swimming 35 km/month, walking and taking dance lessons with my son. I tried everything to help my hips get better. I changed my diet, going gluten- and lactose-free; avoiding nightshades and processed foods; and having a homemade vegetable, ginger and turmeric smoothie for breakfast each morning. I took a rotation of supplements like collagen, glucosamine and chondroitin. I have done yoga since my teenage years, spent a couple years in physical rehabilitation, tried acupuncture, homeopathic medicine, ozone treatments, massage and anti-inflammatories.

The pain got so bad in my left hip that there were nights I’d cry in bed, despite the CBD oil. I had trouble sleeping. We’d have to plan our road trips around how long I could sit in the car without severe pain. And, increasingly, my husband had to walk and hike while I stayed back, at the bottom of the hill or the base of the trail. Heck, one evening we walked the malecón to Valentino’s, and I was overwhelmed with such pain we had to get a pulmonía to take us home! Active me, still in my fifties! I neither wanted to live with excruciating pain, nor did I want to become increasingly immobile! I was too young for that!

I asked my friends, locals and foreign, to recommend a traumatólogo or orthopedist. Of course, I’d met with a couple over the years, but this time I was more serious; something had to be done. I met with about five specialists and can’t say I was blown away by any of them.

  • Two local doctors told me quite sternly that I was a “typical American” who wanted a quick fix and couldn’t tolerate pain. These two told me my hip was shot, desgastada, bone-on-bone, no cartilage left and would never get better. They recommended I lose weight (but wouldn’t refer me to a nutritionist; “just close your mouth”), take narcotics for several years and use a cane and then eventually a walker. Their advice was to delay any hip replacement as long as I could, so that the prosthetic wouldn’t wear out before I’d need another one. While I could see their point, I knew I’d already lost a lot of muscle and fitness due to not being able to hike, swim, dance or walk long distances. My quality of life had suffered terribly, and my extremely bad left hip was negatively affecting my knees and right hip—the domino effect. Plus, I hate taking drugs, and years of narcotics plus use of a cane and walker? No, I guess I’ll claim my “typical American” birthright.
  • Three of the doctors recommended hip replacement to me. Surely there must be another way? A prosthetic was so drastic. All three said yes, replacement was the recommended option. One of the three gave me an interim option of Synvisc shots—a synthetic version of the fluid that surrounds the joints. He said it might give me another six months to a year. I researched this, and found that while it’s proven effective with knees, most studies show it doesn’t help with hips. Studies and experience with friends had shown me that hip replacement has gotten amazing, that it can really bring people a new lease on life. While I surely didn’t want it, I did want my life back. I didn’t want to see my health continue to deteriorate due to lack of activity. So, I bit the bullet.
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Note on Foreign Helpers
Like most of you, I imagine, I had heard about a Canadian woman who is voluntarily helping foreigners here in town with their medical needs. I speak Spanish, so language is not really an issue, but navigating a medical system in one’s home is hard enough; in a foreign place it is nearly always a challenge. Her medical training could be helpful. I called a couple of my doctor friends to ask about her. One knew nothing about her, the other said she had called him and made an appointment, and then never showed. I figured meeting her to discuss couldn’t hurt.

Speaking with her by phone, she was absolutely in love with “her” hip replacement surgeon, the one she recommends. He is a retired military doctor who, she assured me, takes time to “align both legs.” She also connected me by phone to one of “her” patients, who told me she’d had several joint replacements at Hospital Marina with this lady’s help, with great success. I made an appointment to meet with her and the surgeon. When we showed up for the appointment, neither she nor the surgeon were there. I texted her, as we had been doing, but she did not respond. After some confusion in the office, a nurse asked me in and spoke to me in English, explaining that the lady does help foreigners voluntarily, that she works with the surgeon she told me about, but that neither of them were available today. He didn’t know why she hadn’t cancelled, and she never contacted me again. So, I don’t have great things to say about her, and am absolutely over the moon happy to say I went with Dr. Castellanos.
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Best Joint Surgeon in Mazatlán
I finally decided it was time. I’d do a replacement of my left hip, the really bad one, and hope to get a few more years out of my right one. I researched, networked and interviewed, and finally decided to ask Dr. Mario Castellanos González in the Polimédica to operate on me. He seemed to be the surgeon with the most experience with hip replacements here in Mazatlán—he’s been replacing joints here in Mazatlán for 30 years! Dr. Castellanos trained at Tacoma General Hospital in the USA in 1990, at the Institute of Orthopedic Surgery in Latina, Italy in 1999, and spent time at Houston Methodist Hospital in 2009 to learn a new post-operative pain management procedure for knee and hip replacement. He was able to operate on me in Sharp Hospital, close to my home, or in his own clinic. Dr. Castellanos has his own surgical team, including a dynamite anesthesiologist, Roberto Sandoval. He was not set up to work with my insurance company, which is based in France, but Sharp Hospital was able to arrange for all billings to go through them and agreed to interact with the insurance. His patients include locals and foreigners, as he is bilingual.

When we met the first time, I voiced my concern that two doctors had cautioned me not to get hip replacement too early. He explained to me that mobility was important to overall health and that technology was improving all the time. He showed me a hip prosthesis that he had removed from a patient after 25 years, and the prosthetic was still in mint condition! He’d had to remove it only because the patient had fallen and broken her pelvis bone. I found the endurance of the prosthetic extremely encouraging and hoped I might have such luck. Dr. Castellanos told me about another patient on whom he has replaced two knees and two hips, and the guy still regularly plays tennis—against doctor’s advice. He also pointed out that a younger person recovers more quickly and more fully and by doing it sooner rather than later, the bones he works with are in better shape. I knew that one of my foreign friends here in town had her hip replaced with Dr. Castellanos and was very happy with him. So, all in all, it felt like the right decision.

Dr. Castellanos has a beautiful modern office on the eighth floor of the Polimédica Building. The receptionist’s name is Maribel, and she is charming but only speaks Spanish. The space includes a well-equipped gymnasium and physical therapy facility. In his free time, he coaches American football. He told me my wound would be closed with staples not sutures, that I’d need a walker and an elevated toilet seat post-op, and that I’d have six weeks of physical therapy beginning two weeks after surgery and full recovery from hip replacement would take about six months.

Dr. Castellanos gave me his cell phone number, and I was able to call or WhatsApp him whenever I had a question. There were times he even answered me late at night, and without fail he answered quickly. What a blessing to have a talented surgeon who is also so accessible and caring about his patients’ welfare! He is amazingly dedicated.
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The Surgery
I had fasted from 10 pm the night before my 9 am surgery—not even a sip of water. The morning of the surgery I of course first had to check into the hospital. That was less than ideal, as I’ll describe in the Financials section below. For some reason they took me to my room on the third floor, rather than directly to the operating room. No big deal. In the room they changed me into a hospital gown, put a cap over my hair, and rolled my bed down to surgery.

Once in the operating room I was dumbfounded. The only other time I’d been in a hospital surgical facility it was MUCH smaller than this—in an oncology ward in Kansas City, MO. This room was huge, had gigantic overhead lights, loads of space, and it seemed like about ten professionals attending. I was lifted from my rolling bed onto the table and rolled onto my side. They cleaned my back and my leg. Tears welled in my eyes. I said a prayer out loud and invited those in the room to pray with me. One lady kindly held my hand and calmly prayed with me. Dr. Sandoval inserted an IV or drip into my lower back; from there down I would have no feeling whatsoever for the remainder of the surgery and post-op recovery. I was awake, but Dr. Sandoval gave me a whole lot of happy medicine; I was very much one with the world! There was no mask over my nose and mouth and no tube down my throat, which I very much liked.

The leg to be operated on was hooked up into a sling. I remember panicking to think that my privates were uncovered, but no, the lady nearby assured me that no one could see anything. I guess I went in and out of sleep during surgery, because I definitely heard the electrical saw. I even happily joked with Dr. Castellanos, “You promised me I wouldn’t hear anything, yet I hear you cutting my bone…” I woke again from the jerks of the hammering (of the prosthetic into my leg), and a third time with the pushing of the screwdriver as the cup was inserted into my hip. It sounds awful, I know, but I was so high that it was actually kind of cool. Each time I stirred Doctor Sandoval leaned over and gently whispered in my ear, asking if I was ok, reassuring me that all was well.

The next time I awoke I was in the surgical recovery room. I was so thirsty. I was initially given ice chips, then small sips of water. I waited there till I could wiggle my toes and feet, then got to go up to my room—again pushed on the bed.

Let me also mention here a bit of the pre-surgery preparation. I spoke with a couple of friends in the USA who have had hip replacements. They both told me it took them almost FIVE WEEKS of preparation before their surgery, as you need to get blood tests, X-rays and an EKG and cardiologist’s guidance. They told me it took that long for each of them to get appointments and receive the test results and reports. Here in Mazatlán, I did it all in a relaxed manner over two normal days!
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Recovery in the Hospital
My surgery started later than the programmed 9 am, due to the check-in issues I’ll describe below. Dr. Castellanos called my husband Greg when it was finished to tell him all went really well—I’m guessing surgery took about 2 ½ hours—but I didn’t get back upstairs to my room till nearly 3:00 pm. My husband Greg and friend Dory were going crazy up in my room by that time. I believe it was either miscommunication between the post-op and floor nurses, or the floor nurses just didn’t want to or have time to come get me.

Once I got to my room, I was REALLY thirsty, REALLY hungry, and I REALLY had to go to the bathroom. We waited almost an hour for a bedside commode. I finally said that I really had to go, so a nurse helped get me up and my husband and son helped walk me to the bathroom. That was a huge mistake. While I could walk fine, I was so drugged that I broke out in a horrible sweat and nausea and had to sit down—my son had to quickly bring a chair into the bathroom. All because the nurses hadn’t thought to get either a bedpan or a commode for a hip replacement patient! The toilet is too low to be used comfortably for a post-op hip replacement patient, but with the help of my family I managed it. Fortunately, food and drink arrived much more quickly and easily than did the commode.

Nursing service improved drastically with the evening and overnight nurses, who were absolutely wonderful. The food I ate was understandably bland but healthy and good. There was plenty of it. A foodservice person came before each meal to take my order. I was blessed with non-stop visitors, flowers and gifts. While I was in the hospital I was kept on a saline solution, an antibiotic to prevent post-op infection, an anti-coagulant to prevent blood clots, an anti-inflammatory and pain medicine. During my very short stay I got up a few times to walk around the room and down the corridor, and I flexed my feet and toes, tightened my leg and butt muscles in bed as often as I could. Greg spent the night with me, laying on the extra bed in the spacious room.

The biggest surprise post-op was that I had absolutely no pain. Never. Zero. Not during the surgery, not after, not during recovery (other than my two self-inflicted setbacks, see below). After suffering with so much pain in my hip for so long, this was a hugely welcome but astounding relief! Dr. Castellanos’ pain management method is amazing! They continued pain management drugs during my one-day hospital stay, but I didn’t take any once returning home, so it’s nice to say there was no pain.

In the morning the nurses changed my gown and my bandage. I was taken in a wheelchair downstairs to get an x-ray of my hip. Dr. Castellanos came in around 9:30 and reviewed with me how I was doing and showed me the x-ray. He was quite proud of how the prosthetic was at a perfect 45-degree angle in my pelvis. He reported that I was in no danger of osteoporosis, as my bones are so hard that he actually sweated while he hammered. The surgeon cautioned me to keep a pillow between my legs to keep them a good distance apart from one another. That scared me, as I had woken up after surgery with a pillow between my legs, but no one had told me what is was for. When the doctor told me, it was because he saw that I had my legs crossed in bed. He said for sure not to cross my legs for at least a year after surgery.

Before surgery Dr. Castellanos had said I’d spend two nights in the hospital, but the morning after my surgery he told me I could go home that day. I expect that was because he saw me walking with my walker already, and he could see that I had two terrific caregivers in Greg and Danny, plus my friends who’d visited. What a great Valentines gift!
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Heading Home
I was sent home with prescriptions for an anti-inflammatory, an anti-coagulant (to prevent blood clots due to limited mobility), a week’s supply of antibiotic (standard post-surgery to prevent infection) and pain relief (which I never needed to use), along with instructions to “walk as much as possible but don’t overdo it.” A bit ambiguous, but my body was pretty clear about what it could and couldn’t do. I was honestly never in any pain, no exaggeration. It amazed me after such a major surgery. I was very weak in the surgical leg, however, and especially in the evening for the first week to ten days I would need my husband or son’s help lifting it into bed or onto the couch.

At home we removed every throw rug in the house, as they are a tripping hazard when you’re on a walker. We stacked pillows on an armed chair to allow me to sit and get up more comfortably. I have the world’s absolutely best partner, who carried my stuff from one room to another for me, cooked and cleaned, and waited on me hand and foot. I honestly don’t know how people without a live-in partner or helper do it. I’d recommend getting help if you live alone. I will admit I was spoiled. You don’t have your hands free if you’re using a walker, so fasten a bag of some kind to the walker to enable you to carry things around. I would also move things from one flat surface to another, sort of like a bucket brigade, in order to get things from one place to another. Cups with lids are really helpful, too. Greg fastened an S-hook on my walker with a rubber band, and I used it to carry my drink with me in a sealed, handled bottle or cup.

I had been told to keep my wound bandaged until I saw the doctor again in two weeks. My wound oozed quite a bit for the first week, so we had to change the bandage, which we covered with a waterproof plastic, every morning. My surgery did not involve a drain, as I am told some do. Neither was it minimally invasive; my perhaps 8-inch wound was closed with 23 staples. By the second week we were down to changing the bandage every two or three days. Once my staples were removed, two weeks post-op, I no longer required any bandage.

I was instructed not to bend my hips further than a 70-degree angle—this makes sitting in many couches and chairs impossible and prevents you from bending over to pick up low-lying objects or anything from the floor. The surgeon said I could shower but be careful not to get the bandage/wound wet. I chose instead to sponge bathe and wash my hair in the sink for two weeks. If you will shower during the first two weeks, most people recommend a shower chair. I was able to sponge bath standing from the get-go, so I suppose the need depends on your mobility.

When I got home, I really had a hard time moving around; I could walk with the walker, but not for any length of time. I got tired very easily and needed to sleep a lot. Which, of course, is good as it aids recovery. Something I did not hear a lot about is the amount of core and upper body strength you require to recover from hip replacement: you need to be able to stand up, roll over, get into and out of chairs or bed without over-reliance on your legs, and you will be using a walker and then a cane for weeks on end. So, wise to start building core and upper body strength before surgery.

I worked on my computer from a lounging position, being careful to get up and around every hour minimum. I had found some basic exercises on YouTube designed for hip replacement patients, to keep the blood flowing and prevent clots. I did these every day, some of the exercises every chance I got, and found they really helped me feel I was doing something during the first two weeks. The exercises start at 11:45 in the video embedded below or via the link just above. I took a couple of walks outside with my walker; the fresh air and being out in nature really cheered me up.

I experienced significant swelling and bruising in the first few weeks post-surgery. Moving around helps with that, and I kept my feet and legs elevated above my heart when resting. I went to the bathroom a LOT, but I also drink a lot. About a week into my recovery I had my first self-inflicted setback—my fault for not thinking before moving. My leg was swollen, so I laid on my bed and put my feet up against the wall. Fine, no problem. Though at first you will need someone to help you lift your surgical leg. Well, when it was time to put my legs down, I forgot to ask for help. I just basically forgot I was wounded. I rotated my hips and legs down onto the bed, and pain shot through me. The sharp pain was short-lived but walking on my surgical leg and moving it around was very sore for the next two days. Oops.
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Physical Therapy
Two weeks post-op I went into the surgeon’s office; he checked out my wound, removed the staples and reviewed my mobility and pain. By then I really did not need the walker, though I did use it. I was told I was doing great and could graduate to a cane. I was also given a prescription for six weeks of physical therapy. Normally, Dr. Castellanos’ patients would go to his facility for therapy. My son’s girlfriend, however, is a physical therapist, and she designed and supervised an exercise plan for me to do in my home, based on the surgeon’s parameters. He instructed me to return to his office after two weeks of physical therapy.

Sofia Soto from ST Physical Therapy (fully bilingual and VERY talented) spoke with my surgeon to ensure her plan was appropriate for me. She gave me exercises to do every day in the privacy of my home, building from 5 repetitions to 15 over the course of a couple weeks, and doing the full set of exercises once followed by a second round. I really liked this set up, as it helped me build strength gradually and never overdo. She came to supervise three times a week. If I had the energy, on the days she didn’t come I could do the exercises twice/day. I used a Pilate’s ring, a resistance band and “core sliders” (small foam pad that you step on and then slide your foot on the floor) to strengthen my hips/thighs/glutes and restore hip mobility, and an inflatable wobble cushion to strengthen my ankle, foot, leg and hip muscles while building flexibility.

During the first week I had to lean against a piece of furniture for stability, as it was challenging to put all my weight on my surgical hip. The exercises I had were so very simple, yet they were amazingly exhausting. Especially at first, I had to rest between exercises, and definitely between rounds. Friends joked to me that the “PT” of “physical therapy” stands for “pain and torture” or “physio-terrorism.” I won’t deny that. The surgeon does the work during surgery; your recovery is all you.

By the end of the second week of PT (one-month post-op) I was able to stand unsupported to do my exercises, and Sofia added new exercises to my program. Now I would also lay on the bed and do pelvic lifts, leg lifts while laying on my side and face down, as well as bicycling using a portable pedal exerciser. When I returned to my surgeon’s office for my one-month checkup, he had several medical students observing our visit, and spent the time bragging to them what an ideal patient I was and how quickly I was progressing. He reviewed my physical therapy plan and advised me to continue and to graduate to doing some of the exercises in the swimming pool.

I guess his encouragement went to my head, as that evening I experienced the second self-inflicted setback of my recovery. We planned to go out to a nice dinner with our son, and I was in a hurry to do my PT and get ready for dinner. I rushed through my full set of exercises, rather than taking the time to listen to my body. And, for the first and only time, rather than doing the full set followed by a second round, I did a second round of each exercise as I went, to save time changing out equipment. I felt the strain in my muscles, but nothing major. Then, as we went out the door for dinner, I held our heavy door with my body for my two men. As I stepped away from the door, I believe I twisted my surgical hip a bit weirdly, and combined with having overdone my exercises, I again felt a very sharp pain shoot through my hip and leg. I could barely walk, even with my cane! That setback cost me three days of progress, during which time I couldn’t do my therapy. Live and learn. It’s a delicate balance between pushing oneself and overdoing it.

As I write this, I am on my third week of PT (five weeks post-op). I can walk around the house without my cane, and often do so inadvertently. I’ll walk somewhere to do something without thinking, and then later I’ll wonder where I left my cane. I do still use the cane when I go outside, as I find that people can be pretty pushy, and the cane helps them realize I am not currently fleet of foot. Plus, it provides added help on uneven surfaces. My new hip is in many respects already stronger and more flexible than my other, natural hip (which is bone-on-bone and also needs replacing). For example, I can lift the leg with the prosthetic hip higher. Due to my setback and some chilly weather I haven’t yet done exercises in the pool, but plan to start soon.
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Financials
You’ve probably heard the horror stories of foreigners feeling like they are held hostage in Mexican hospitals, as they have to pay the bill before they are released. We are in Mexico, and the customs here can be very different than where we come from.

In my case, this was not emergency surgery. I had time to plan and schedule it. I got pre-approval from our insurance company, MSH International. We are enrolled in a group plan available through our membership in AARO (Association of Americans Residing Overseas), but they have plans available to individuals as well. MSH assured me they had an agreement with Sharp Hospital. They approved the quote from Sharp for a total of $250,000MXN, which included payment for the surgical team, the prosthetic and a two-night’s stay in the hospital. I believed all was good. My girlfriends arranged a dinner for me the night before surgery to wish me well.

During that dinner I got a call from the administrator of the hospital, telling me I’d have to pay US$10,000 cash the following morning or I wouldn’t be able to have my surgery. Seriously? The evening before my surgery and now they’re telling me this? I felt very abused, and he was amazingly confrontational. My local girlfriends assured me that if their insurance pre-approves surgery, they do not have to pay cash to the hospital out of their pocket. This was obviously a thing for foreigners. And it felt very ugly. I called my surgeon. I called the hospital’s head of Medical Tourism. Neither could help; money is in the hands of the administrator, I was told. It ruined our nice dinner among friends.

Fortunately, in the morning the administrator showed up in a much more human mood. They wanted a security deposit of 75% of the 250,000-peso estimate. My husband talked to him, and they finally agreed we could put the amount on a credit card, and the charge would be reversed once payment was received from the insurance company. We have a US credit card, so the charge was just over US$9000.

In the end, the hospital bill for one day’s stay was significantly higher than the estimate that the insurance company had agreed to pay, so the insurance company and the hospital negotiated for a couple of weeks. We were blessed in that the insurance company kept their promise to us and paid 100% of everything— MXN$326,835, and we weren’t to be out even one peso. God bless MSH and AARO! They paid the hospital as soon as the final agreement was made, about three weeks after my surgery. I can’t fathom how the bill came out higher than the estimate, as the hospital stay was shorter and there were no complications. Greg says it is partly because of IVA being added to the final bill and not included in the estimate.

At this point, we still have not been reimbursed by Sharp, but I am counting on it. I don’t understand the medical field. It’s only the second time I’ve been interned in a hospital. I don’t like knowing that the hospital was able to make money off my money for at least a month now, nor do I like that the surgeon and his team have to wait three months to be paid their professional fees. But I am thrilled with my good fortune on the cost—or at least I will be once the charge on my credit card is reversed.

My advice to you is to be sure to meet with the administrator of the hospital with plenty of time to spare and clarify how much money you will need to deposit (and how and when) in order to have your treatment. I do not believe this is something unique to Sharp. I’ve heard similar stories from people who use Hospital Marina, Clinica del Mar, El Centro Quirúrgico and other hospitals around town. My surgeon told me that in his clinic he would have wanted payment up-front, and we would then work directly with our insurance company to get reimbursed. My upset was due to the last-minute surprise; better to know going in. You may remember we did a hospital comparison late in 2017; hopefully someone might update that soon.

My in-home physical therapy with Sofia is 350 pesos every time she visits.
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Friends, Family and the Community at Large
Your community of friends and family love you, and they will no doubt be very supportive. I know I was and am completely blessed. And, people say the darnedest things, so be prepared with a smile. I figure people want to be supportive and encouraging, but it can come out insulting or discouraging, especially if you get tired, as you probably will, or discouraged. I had a lot of people tell me,

  • “You’re too young to have hip replacement!”
  • “Hip replacement is so quick and easy nowadays!”
  • “I/my cousin/my best friend was walking, good as new, three weeks after surgery.”
  • “Are you sure you want to do this in Mexico? Wouldn’t you rather come home for the surgery?”
  • “My friend’s body rejected the metal” and other horror stories.

In reality, hip replacement is not the exclusive domain of the elderly. There are loads of young people who need hip replacement due to reasons as diverse as injury, genetics and arthritis. Yes, the surgery is a technological, medical marvel, but it remains major surgery and is definitely not to be taken lightly. The bragging about record-time recovery? This can easily become a danger if you start to second-guess yourself or compare your progress with others. Each of us is unique. Our recovery needs to be at our own pace. The last thing we need to do is beat ourselves up mentally. And, honestly, I heard such amazing stories that I’m pretty sure people’s memories become incredibly rosy and they remember recovery as much faster and easier than it actually is. The racism you might experience, the talk about medical care in what some might call a “third world country” (which Mexico is not), my best advice is to hear the love behind the doubt; that person wants you to be well. Kudos to you if you’re able to educate regarding stereotypes and biases prior to or after major surgery. Personally, I left that battle for a time when I was feeling stronger. If you are a friend or family member, I’d suggest listening, empathizing and asking questions as safer and more supportive options than offering an opinion. Before the person has made their decision, share your horror stories if you feel it will help your friend make a more informed decision. If not, hey, maybe best to keep that story to yourself.

The final point I’d like to make in this section is how people in the community respond to the physically handicapped, in my very limited and fortunately temporary experience. I was astounded how even when I was on a walker or a cane in a medical building, some people would push me out of the way as they rushed to an elevator; people would step right in front of me as they passed me on the sidewalk—thinking I could quickly stop or jump out of their way, I suppose; and some drivers would actually speed up in their cars, trucks or pulmonías as I was trying to cross the street. It was discouraging; I naïvely imagined the general public would be more considerate of those with impaired mobility. And then, fortunately, there are those strangers who are total angels and go above and beyond your wildest dreams to be of assistance.
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Key Learnings
Prior to Surgery

  • Lose weight if you can.
  • Talk with the hospital administration regarding payment and insurance, in addition to your surgeon and the medical staff.
  • Obtain a walker and install an elevated toilet seat.
  • Build your core strength as well as upper body muscles as you will need them as well as your glutes and quads for recovery.

In the Hospital

  • Make sure the nurses bring a bed pan or portable commode into your hospital room before you return from surgery.
  • You will need a walker immediately post-surgery, so bring it with you to the hospital if you have it.
  • Hospitals are very cold. Bring warm socks, slippers and your favorite blanket to keep warm.

At Home

  • If you live alone, I would recommend you have a friend stay with you for a while or hire help. I have friends who’ve done it alone, but it’s hard for me to imagine how.
  • Remove throw rugs as they’re a tripping hazard while you’re on a walker.
  • Clear walking paths in your house so you don’t trip as you go between rooms.
  • Install an elevated toilet seat (from a medical supply store) for use at home. Toilets are too low for recent hip surgery patients. A grab bar is not a bad idea, either.
  • Do basic exercises to keep your blood flowing during the first two weeks of your recovery.
  • Put pillows in an armed chair so you can sit and get up without bending your hips over 70 degrees the first few weeks. And keep one in the car so you have one wherever you go—chairs here tend not to be the most comfortable, and with a metal hip that’s healing, less so.
  • You will graduate to a cane from the walker, so you will need to get one of those as well.

Physical Therapy

  • I loved having equipment at home so I could do exercises anytime I was able. I felt it aided my recovery. Follow your therapist’s advice.

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Summary
It has taken me quite a bit of time to write this all up, so I most sincerely hope that it will be helpful to some of you in some way. I know I got world-class care during surgery, recovery and therapy. I feel I’ve experienced a miracle, a second lease on an active life, and for that I thank God, Dr. Castellanos, my family and my insurance company. I did not have to wait years on end to get my prosthetic, nor lose my overall health or mobility in the process. My healing is not yet complete, but you will be seeing me at the pool soon. After that, see you at the lighthouse!