All the cool kids are getting arthritic joints replaced these days. More than one million total joint replacements are performed in the U.S. annually, according to The American Joint Replacement Registry at the National Center for Biotechnology Information. This number is forecast to quadruple in the next ten years with an estimated four million total joint replacements done annually.
When I was told a year ago that my hip soreness and low range of motion was actually stage four arthritis and I could either live with this or have a total hip replacement, I instantly felt my age. Or older. However, the number of younger people, from 45 and up, are having joint replacement surgery more frequently these days. In an article published online from The Cleveland Clinic, the total number of hip replacements went from 138,000 in 2000 and increased to more than 310,000 in 2010, with a 200 percent increase in the youngest age group of 45 to 54 year olds. I’m right in the mix at 56. Previously, people in this age group were considered too young to get a hip replaced. Technical advances in the construction of the new prosthetic joint are resulting in better built and longer lasting joints. Having a hip joint last 15 to 20 years has allowed younger patients the opportunity to have this life-changing surgery at a much earlier age.
My hip replacement surgery is scheduled for November 10. It’s taken more than a year for me to get to this place. The orthopedic surgeon who diagnosed my stage four arthritis was very professional, to a fault. He looked at my x-rays, tried to make my right hip move like my left hip, sat on the stool next to the exam table and said, “It’s definitely advanced stage four arthritis, bone-on-bone in places, and several spurs. There’s no cure for this and you will need a total hip replacement. And, you will also need to lose 25 to 30 pounds before you can have this surgery. I will set you up with a dietitian for a meal plan and weekly accountability. Any questions?”
I was so stunned by what he had said that I had no idea what was happening. The next thing I knew, I was out of the exam and that was that.
Instantly, I felt ashamed that I let myself get arthritis, that it was all my fault because I was seen as being undisciplined in terms of my physical health. I had to atone for my sins before I would be allowed to have the procedure that would dramatically improve my quality of life and my health because I could be active again. Mind you, plenty of middle aged current and former athletes are also getting hip and knee replacements, not just those of us who would rather be a spectator.
If you have read other posts of mine, you have likely gathered that I have lived in a larger body for my entire life, save the times that I have been on the low part of the dieting roller coaster. I divorced dieting and diet culture after 40 years of dieting up the scale. To be told a) I had to lose a significant amount of weight and b) that I needed a dietitian and weekly weigh-ins for accountability, made me furious.
Doing a little online research, I learned that the 40+ BMI was an industry standard. The risk of contracting infection or having serious post-surgical complications is quite a bit higher than for those with a lower BMI. (Let’s keep in mind that persons with a lower BMI are not strictly healthier because they have a lower height to weight ratio.)
It got me thinking about people who are denied getting joint replacement surgery due to the size of their bodies. People living in larger bodies are keenly aware of their size compared to others and likely that they have completely trashed their metabolism through the restrict and binge cycle that is chronic dieting. It’s not because they haven’t tried. If diets worked, we wouldn’t have to keep doing them, right? The diet industry doesn’t make any money if you don’t keep trying to “do better the next time.” When you have been on every single diet possible, both using sound medical guidelines and full on crazy stuff with no permanent weight loss, being told that you have to lose 25 pounds in order to have the surgery is very defeating.
And I wallowed around in my anger and my feelings of being discriminated against for almost a full year. My psych provider and I spent a lot of time talking about this and we landed on a binge eating disorder diagnosis. I was shocked. I had such sad images of what I thought BED looked like and that wasn’t me. But, being ashamed, feeling guilty, or upset about my eating, eating when full or not hungry, eating in secret (and not just huge amounts of food), and frequent dieting without weight loss, were definitely mine.
Over the past year, my second year without dieting, I allowed myself to eat what I wanted, when I wanted it. I definitely gained weight. But I also regained my connection to my body and its needs. I began to trust myself again with food and without restriction. Foods were no longer good or bad, they were just food. Once I stopped my obsession with eating, restriction, and dieting, I actually lost weight. Not the 25 or 30 pounds I was instructed to lose, but enough that I got to a BMI of 40.
Earlier this summer, I started looking around for another orthopedic surgeon that would take me on. I found one at a large teaching hospital at the University of Iowa. I was completely honest and forthcoming with the surgeon and his team. He was very compassionate and even apologized for my previous terse interaction with the first surgeon I met with. My level of trust skyrocketed.
I am a little more than a month away from my surgery date. There are pre-op appointments, strengthening exercises, and literally getting my house in order between now and then. I’ll be sharing my experience and would love to hear about how you navigated joint replacement surgery. Do’s and don’ts are welcome. Leave me a note in the comments.
Thank you, Laura. So glad your turning to a new job is helping release tension. Chris’s brother Fred just retired…
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Your picturesque writing style captivated me.
Not that anyone asked... 
Laura, so enjoyed your blog and especially to hear that things are going well. Will be in touch.