Transcription:
New Hip, Still Running

Caitlin Whyte: Tom Thorison was very apprehensive of having his hip replaced, but his pain and limp were impacting how active he wanted to be. After a lot of research, Tom chose to have his hip replaced at Upland Hills Health with Dr. Anthony Vallare and Melissa Messer using the Mako robotic arm assisted technology. Since his hip replacement, Tom has completed two 5K races with his 12 year old granddaughter. Today, both Tom and his providers join us to talk about this amazing life changing technology.

This is the Inspire Health Podcast from Upland Hills Health. I'm Caitlin Whyte. Well, Tom, let's start out with you. Tell us about the pain you were experiencing before surgery and why you sought out help at Upland Hills Health?

Tom Thorison: Well, the pain I had continued to increase as time went by and being stubborn, I decided to try to run through pain, work through pain. I kept working and after three different doctor's appointments, all three doctors telling me I needed a total hip replacement, I was still being stubborn and I was told I have a very high tolerance for pain, which can kind of get me in trouble, but I kept, I just kept going. And I would say probably six years before I decided I needed to do something. And it was, it sounds comical, but out on a run, I virtually had someone pull over alongside me and ask me if I needed a ride home.

That's how bad my limp looked. Family many times would comment to me and I got tired of hearing it. And my wife told me too, it's like, you really should look into this a little more seriously. And I have over the years researched what's there, and just nothing ever caught my eye and I'll be honest, I'm not a real fan of going to the hospital. In fact, my blood pressure goes up when I go in the hospital. I guess they call that the white coat syndrome. I did better staying away from the hospitals, but when I finally got to the point of doing serious researching and not wanting to go very far away.

I researched the Dodgeville hospital again and found what Dr. Pelar was doing with a robotic MACO technology and that really got me interested. Things went from there, getting a physical with my primary care doctor and being referred up to the hospital and that's kind of how I got going on it.

Caitlin Whyte: Well, tell us about that so-called white coat apprehension. What makes you nervous to head to the doctor and I'm sure considering surgery was just another level of nerves?

Tom Thorison: That was probably one of my biggest obstacles in my life, actually thinking about going in hospital and having the bone in my leg cut off and replaced with a piece of metal. I just had a hard time wrapping my head around that, and it just is something that I was afraid to do and, but the more I read, the more I understood about it. And with the new technology, it sounded like to me that the more precise that a joint is put. It helps with its longevity, less problems, and that's the end result I ended up with is to me, a perfectly placed hip replacement. And I'm actually feeling the positive results of that, and I do not regret at all going through it. I'm glad I did, but I'm also glad I waited.

Caitlin Whyte: Well, we love to hear that. I'll turn to you now, Dr. Vallare. Just how common is a story like Tom's?

Anthony Villare, DO: It's all too common and actually that sort of pattern, You know, you mentioned that, Gee, I waited too long. Why did I do this? Everybody does that. Nobody likes surgery. I think I would probably be concerned if a patient really was eager to have surgery done. Now some people, they're just eager to have the pain go away. So, and they realize surgery's the only way for that to happen. But yeah, your story, I don't you see anybody who comes in here with just a little bit of arthritis who is just ha having a history where their daily activities, their quality of life is just being carved away from them to such a degree that they're just like, What are my other options?

I usually go over every option with them. Including surgery. It could be cortisone injections, it could be therapy, it could be anything. And then I go, Well, if that fails, it's surgery. Cause I get it. I don't like to have, I mean, I'm a surgeon. I don't like to have surgery on me done either. I've had surgery too, and I have that same anxiety that he does. Probably to a different level because I know what all goes on behind the scenes and stuff, you know? I also appreciate a patient's apprehension and trepidation with that whole idea. Just what he said, going in there and we're gonna open you up.

We're gonna tinker around, we're gonna remove this and put that in. And, And, I mean, it's scary, but that's what we're here to do. Like, we're here to explain to you in layman's terms, in a simple not a simple way, but in a way that people can understand. Because we do this all the time, but a patient doesn't do this all the time and so they don't, to them this is all new and it's coming at them like a freight train. So you gotta have them understand in whatever language is good for them, what's involved with the hip replacement. And the game changer for me was using the robot here at Upland Hills. Like he said it, the precision with which we can place the components. You can't compare it to the old way of doing it before we had robotic navigation.

And his story as far as the outcome, I can say like, that's pretty much the outcome we see with a lot of patients. A majority of our patients, they come in with this pain, they'd like to try to avoid surgery, but they know it's almost inevitable if they wanna get back to a active lifestyle. And then afterwards they're just like, Why did I wait so long? This is fantastic.

Caitlin Whyte: Well, Doctor, how does a patient know when hip pain has turned into needing a hip replacement? Where is that kind of boundary?

Anthony Villare, DO: That's a boundary that I think the patient crosses. The usual story I will kind of tell to even a patient who comes in. I probably told it to him when he came in the first time, is that, I'll tell you the options. And the patient is the one who picks what they would like in terms of a treatment. But usually a patient, and I think the best patient is the one who they know they have arthritis. Maybe they got an x-ray with their family doctor already but they know they have arthritis. They've been fighting with it, dealing with it, trying to combat it, therapy, limbing up exercises, etcetera.

But they come into the office almost expecting that surgery is gonna be an option. And the best patient to have is the one who approaches it not from a position of feeling defeated by the arthritis, but rather angry at the arthritis determined to get back to that pre arthritic level of activity. And they are so ticked off at this arthritis because you know what, but for this arthritic hip or this knee, I would be running around with the grandkids or my kids or I'd be doing, I'd be running races and exercising more, and I would just be more active and you'd be pain free.

And they're just angry that the arthritis has driven them into a chair as their lifestyle. And they want to get it back, so they're just looking at me as the person to help get 'em back to that lifestyle. You don't have to convince someone of a joint replacement because they already kind of realize they've talked with neighbors and friends and stuff and there's the internet and everything, so they already kind of know this is the best avenue to go. I just, I'm there to explain the details of how all this works how this all plays out, and in the end you'll have a pain free joint.

Tom Thorison: That's kind of where I was at is Dr. Villare said very, very frustrated that arthritis wear and tear was sidelining me from doing all that I knew I wanted to do. And thus having the replacement, it's opened that door back up more. And even though I continued to be somewhat active with the joint and the bad condition it was in, I now can do pain free and a lot smoother. So it has really helped me and I think what add adds to the recovery in something like this. And I went into it trying to be as, even though you're limited in as good a shape as I could be in. As far as like the muscles around the joints and everything else, and I think that helped with my recovery. In fact, five days after I had the surgery, I was able to get on the elliptical and start working out about five days, five days a week.

And within seven weeks I was walking on the treadmill and within two and a half months I went for a four and a quarter mile run walk outside. And things were just coming, things were coming along smooth, and I knew I didn't want to abuse the new hip either, and I don't now. I want it to last so I could run faster now. I could run farther now if I wanted to, but I choose not to because I'd rather be older and slower and out there, rather than sidelined again.

Anthony Villare, DO: Yeah, and we would always recommend, you know, wearing a well cushioned shoe with a good insult or a crushed rubber track. You wanna decrease the impact on that hip when you're running, but at the same time, this is what, and you pick and choose your battles when you do these activities, but our goal is to have a patient return to what he is. To what he's doing things without even thinking about the hip. I can kind of do this stuff, you know, it's not keeping me down.

Tom Thorison: And I've had people in the past tell me that once I go to a hip surgery, a replacement runnings out the door, you could never do it again. That's maybe one of the reasons I held off until I talked to Dr. Vllare and I was really on his page just like, why can't I, if I'm careful? And I try to run smooth and be smart about it, and I do wear the best shoes for my feet that I possibly can for cushioning. And I watch my run surfaces where I'm at, run on the level as much as possible. And person has to be smart about it too.

Anthony Villare, DO: Right. You got 30 more years to live if more Tom. So you gotta make that hip last.

Tom Thorison: I appreciate that.

Caitlin Whyte: Well, what an incredible conversation to be a part of. Let's focus on that recovery now, and I'll turn to Melissa. What is the key to a successful hip replacement recovery like this one?

Melissa Messer, Physician Assistant: Well, honestly, I think taking approach just like Tom did, being an active participant in your healthcare is, I think key. So asking the questions, doing the research, reading the information that's given to you. I think if you take a backseat, you might feel lost or maybe not have the dedication. So I think first and foremost is just making sure that you feel comfortable with the decision and taking all the information that's possible.

The next would be, Positive attitude. The surgery is almost the easiest part, us putting the pieces in is almost easy. The next is the patient's job to get strong, get fit afterwards. So it does take dedication, waking up and doing those exercises. And so having a good support system, talking to friends if maybe they've had a hip replacement, getting neighbors, children, you know, spouses involved, can help.

Having that support system, I think, keeps people positive and keeps them focused on getting recovered sooner. So it's one of those things, if you put the dedication in in your first four to six weeks, it's gonna pay off for a lifetime. So we always try to encourage patients to try to find the positive, and if you can really put the time in now, you're gonna be happy with yourself later.

Caitlin Whyte: Of course. And can you tell us, Melissa, more about this Mako robotic arm assisted technology and why it was the best method for Tom's surgery in particular?

Melissa Messer, Physician Assistant: Absolutely. So really it's kind of the cutting edge technology. So as they had mentioned earlier, precision can give you a better outcome. So what I like about the Maco assisted system is that we get a CAT scan of the hip. We can start planning the surgery before we even have taken them to the operating room before we've even put in a scalpel to the skin. So we have the capability of seeing the the hip joint in a 3D model on a computer.

We can start to measure. We can start to figure out what sizes we need, what angles. Then once we're in the operating room, we can take that information along with the live information that we're getting, what we're actually seeing in there, and we can start to tweak it and adjust it. So it's just an amazing piece of technology that kind of marries like what a human can do and what technology can do. And together, what that gives is shorter time in the operating room, less pain, quicker recovery, and who doesn't want that?

Caitlin Whyte: Well, Tom, now that you are recovered, you've been telling us about being an avid runner. Tell us about how your life has changed since the surgery?

Tom Thorison: I now can stand a lot more straighter and it's added to my walk pace, run pace, and being straighter. What it's added to me is I don't get the comments like, what's wrong with you? When are you gonna get that taken care of? I can be around people, and not limp and I appreciate that. And since then I've been running with my 12 year old grand. We finished a five mile run in Madison this past year, and we plan on doing it again this next year. She's out for cross country. She runs a lot faster than I do, but it's nice to be able to be out there and enjoy it together.

It really has changed where in the past I would go out for a run wondering how far I could go, and if getting back to my house was gonna be feasible, considering some of the pain I got into? Now, as I even did this morning, I went out for a three mile run and I can actually enjoy it, actually enjoy the run more, and it's not very fast. I'm only running 12, 12 and a half minute miles. That doesn't sound real fast to some people, but to me right now, I tell people I'm not setting any land speed records, but I'm still out there and I'm enjoying it. And I feel I can get the benefits of more exercise as far as I add in a quite a bit of biking.

The ellipticals been my friend a lot because it helps me exercise in a very smooth uniform way with both legs. It lines me up for the low impact, that's been my best friend during a lot of the recovery. And I only run outside maybe two, possibly three times in a week, and usually only two to three miles. I try to be conservative. That has actually helped me on another level. And going through this in my timing, they find, found out that I had two heart conditions, and having my hip replaced has enabled me to exercise at a level that has helped me with a heart condition. I ended up they found I had a bicuspid heart valve, which was hereditary.

Nothing I could do about it. And also an aortic aneurysm and the running has helped me improve in those areas. In fact, one area improved, they said wouldn't was the stenosis or the calcification in my aortic valve was at a moderate level, one more level up and they'd need to do a surgery as soon as possible. And in my last test, it had gone the other direction to mild. And I can't help but think that having my hip replace. Allowed me to exercise in a more uniform way, and I've been able to focus on that a little bit more. Of course, nutrition and everything else plays into it.

I have always felt that we have our own responsibility to put into our bodies what it needs to heal and to be strong. And that fit right in with going with this surgery. I really took it serious and I wanted to make it work and. I am so thankful to Dr. Villare and Melissa Messer for what they did for me. It's been a big game changer for me.

Caitlin Whyte: Well, thank you all so much for sharing your time and these stories with us. We absolutely love hearing them. Check out our website at uplandhillshealth.org/hips for more information on our doctors and treatment options. This has been the Inspire Health Podcast from Upland Hills Health. I'm Caitlyn Whyte.