Hip Replacements, Leukemia, and Learning to Advocate with Nicole Grose Ph.D

Nobody sat us down and said, "Hey, one day your hips might just stop working." And yet here we are.

In this episode, Jan and Patti are joined by the brilliant Nicole Grose, a retired professor, Gen X middle child, leukemia survivor, and now the proud owner of two brand-new hips. Nicole brings her background in anatomy and physiology (and a whole lot of hard-won personal experience) to a conversation that is equal parts eye-opening and deeply real.

We talk about what it actually looks like to navigate joint replacement surgery, from the frustrating search for the right surgeon, to recovering mid-COVID, to the very specific math of being told your new hip will last 40 years when you have leukemia.

This one's for every woman who's ever been waved off by a medical professional, told to push through the pain, or simply never given the full picture of what her body might need someday.

About Nicole Grose Ph.D:

Nicole obtained a Ph.D. in Quantitative Biology, studying the relationship between the nervous and immune systems. She is a recently retired professor who spent nearly 2 decades teaching college-level anatomy, physiology and animal physiology from 2003 to 2021.Her academic expertise and personal experience brings a unique perspective to conversations regarding joint replacement and long-term health. Living with chronic leukemia, Nicole understands firsthand the challenges and realities of navigating complex medical decisions, procedures and subsequent recovery. A GenX middle child of five and longtime educator at heart, Nicole now enjoys splitting her time between Dallas and Michigan's Upper Peninsula.

Nicole is developing an academic success/tutoring business with the goal of assisting STEAM students in developing the skillset to succeed academically as well as in the workplace.

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*Information shared on this podcast is not medical advice. If you have a concern about your physical or mental health, please seek support from a proessional.

Transcript

Jan: Welcome to things my mother forgot to mention, 

Patti: the podcast where we say everything our mothers didn't. 

Jan: I'm Jan, a trauma therapist and author, turned rogue storyteller here to talk openly about the body aging and all the. Wait, what moments of womanhood 

Patti: and I'm Patty, an online business and tech nerd whose purpose is to elevate the voices of women in our world and who doesn't believe in taboo topics.

Things my mother forgot to mention is the podcast for every woman who's ever said, wait, why didn't anyone mention this to me? 

Jan: Join Jan and Patty. Two, outspoken, curious, outrageous women as they dive headfirst into a messy, magical, and often WTF realities of aging health, and quite simply being a woman 

Patti: from rogue chin hairs and vaginal thinning 

Jan: to mental health perimenopause.

In scalp cancer. Yes. Really 

Patti: nothing is off limits. It's funny, it's raw, it's real talk. Your mother definitely skipped. 

Jan: Let's get into it. 

Nicole: Hello, Jan. 

Jan: Hey there, Patty. Good to see you. Happy Friday. 

Patti: Happy Friday. Well, it'll come out on a Thursday, but we're recording this on a Friday and that's very exciting.

And it's end of day, almost Friday. So I'm gonna go from Bingo and have dinner in a little while. So. 

Jan: Nice, nice. 

Patti: I'm very excited. Uh, how are you doing? 

Jan: I'm doing pretty good. I got a little bit of a cold or something, but um, other than that, you know, it's a spring thing. It happens when you're in Boston. Yeah.

The weather is so extreme. It gets really like, it's now it's 70 degrees. This morning it was 30. You know, it's crazy. 

Patti: Yeah. Yeah, we get that day to day. So like it was what, in the eighties and tomorrow's gonna be 60 something and you know, whatever, Texas. Um, but we're not here to talk about the weather. We are here to talk more about joint replacements and this time we have a guest with us who is going to talk about, uh, the joint replacements she's had, and her name is Nicole Gross.

Nicole obtained a PhD in quantitative biology studying the relationship between the nervous and immune systems. She is a recently retired professor who spent nearly two decades teaching college level anatomy, physiology, and animal physiology from 2003 to 2021. Her academic expertise and personal experience brings a unique perspective to conversations regarding joint replacement and long-term health.

Living with chronic leukemia, Nicole understands the. Firsthand, the challenges and realities of navigating complex medical decisions, procedures, and subsequent recovery. A Gen X middle child of five and a longtime educator at heart, Nicole now enjoys splitting her time between Dallas and Michigan's upper peninsula.

Thank you so much for being here, Nicole. 

Jan: Yeah, 

Patti: it sounds so interesting. 

Nicole: Hi. Nice to meet both of you. 

Patti: Yeah, it is so nice to meet you. So, tell us a little bit about, did you ever learn anything when you were growing up about joint replacements? Did your, your parents ever, ever 

Jan: say anything? 

Patti: Yeah. Or, or have their joints replaced?

Nicole: So my mother. Had multiple knee surgeries. 

Patti: Hmm. 

Nicole: I don't know if they were actual joint replacements and I, I doubt that they were, because this would've been in the seventies. 

Patti: Hmm. Right. 

Nicole: And so I doubt that they were, so, we, we didn't have conversations about that. Um, my mother was obese at the time, and so, you know, you just blame the obesity on that.

Right. Which, you know, I now know is, is not true. Um, but that, you know. As a kid I didn't, but you know Sure. You didn't really talk about it because you didn't wanna call someone obese back then. Right? Right. Um, but uh, other than that, no. Lots of broken bones in brothers, uh mm-hmm. You know, brothers who broke bones, but no actual joint replacements.

I think I'm the first one in my family to have, have a joint replacement, 

Patti: Mary. And so you've had your hips replaced. 

Nicole: Yes. Yeah. Both. 

Patti: Yeah. Okay. So tell us a little bit about that. How did you, which one did you start with and kind of, when was that and what did that look like for you? 

Nicole: So I started with the, you know, I have to hold up my hands, right?

You know, right. Left. So I had, had my, uh, my left hip replaced first. And at the, it was right, it, I started having issues right at the time when I was diagnosed with leukemia. 

Jan: I was 

Nicole: gonna ask 

Jan: you 

Patti: when that happened. 

Jan: Yeah. When were 

Nicole: you diagnosed? So, right around, go ahead. 

Jan: When were you di when were you diagnosed with leukemia?

That was one of the questions I wanted to ask. 

Nicole: 2017. 

Jan: Wow. 

Nicole: And right at the tail end of 2017 and in 2019. I got approval from my oncologist. Yeah, you can, you can have surgery. You know, my, my numbers had all stable, stabilized, and so I started looking for surgeons in 2019 and then had, uh, surgery in 2020 right after they reopened the surgical centers.

Mm. From, from COVID, COVID. 

Jan: Right. 

Nicole: But they, you know, interesting thing. Same surgeon for both hips, but it, you know, we just more looked at it like, yeah, you've got severe arthritis, your femur may be necrosing. 

Patti: Mm-hmm. 

Nicole: Uh, we need to get this done. To the second hip where it's like, you know, you're, you have dysplasia, which is where the femur doesn't fit properly into the socket of the hip bone.

Patti: Mm. 

Nicole: And so basically it, it, it just would come out of, you know, it could very easily pop out of the socket. I'm not saying it did, but it just wasn't shallow enough. So it, the. The joint got became compromised and arthritis developed. And so it's that point where he really looked at it and was like, oh yeah, you are never not going to have hip replacements.

That was, you were always going to have them. 

Patti: That was gonna be my question. So with dysplasia, it's always there and it's just, or does that develop dysplasia over time or 

Nicole: how No, it's genetic. That's how your hip is formed. 

Patti: Oh wow. So you would've always, it didn't matter what had happened, you would've had to have that, have that replacement.

Exactly. 

Jan: And your mother didn't have that. You don't know if your mother had it or not. 

Nicole: Well, so funny thing, my mom is scheduled for her first hip display, uh, hip, hip replacement on April 13th. 

Jan: Okay. Wow. And 

Nicole: so I think, you know, probably that knee surgery or you know, what, what she had when I was fairly young, it probably was her hips and it probably her hips should have been addressed at that time.

Jan: Right. 

Nicole: But you know, I don't know that they were doing hip replacements in the seventies, so, or knee replacements even. 

Patti: Right, right. Or maybe necessarily, yeah. Understanding what they're looking for deeply to see what's causing what and, and kind of how that all comes together. 

Nicole: Right? Yeah. 

Patti: Yeah. So were you experiencing a lot of pain leading up to your, your hip replacements, or how did you get to the point where you were like, okay, this needs to happen?

Nicole: I could no longer, let's put this quality of life was so poor. Mm-hmm. I couldn't work out. I, you know, I'm a teacher. I'm standing. It would just be agonizing pain. Um, I couldn't walk more than a half mile. You know, every step was painful. Right. Even sitting was painful and it was very weak, and I, you know, you just start overcompensating more and more because of the weakness, which just makes the arthritis worse and worse and worse.

Patti: Yeah. Yeah. 

Nicole: So it, you know, at some point you can be in a, in a wheelchair or you can use a walker or you can, you know, have your hips replaced. 

Patti: Right, 

Jan: right. 

Patti: Yeah. So what was the process like as you started to look for a surgeon for your hip replacements or 

Nicole: your, A little bit frightening. 

Patti: Yeah. So 

Jan: why and why was that?

Nicole: Well, I, I met some surgeons that I, I realized there was no way in hell they were going to touch me. You know? 

Patti: Yeah, 

Jan: yeah. So, 

Patti: yeah. Why 

Nicole: So I, I had a severely sprained ankle a couple years before. And I didn't know anybody who'd have hip, hip replacements. And I had, you know, I'm trying to find a surgeon. Well, that's not true.

I had a very good friend who, who had had them. Um, but his surgeon was no longer in the area. I. And he said, you know, hey, just ask your orthopedic that, that helped you with your ankle. Ask him, because he'll know somebody and he'll point you in the right direction. So I did, and he pointed me towards, and you know, I don't even remember this ortho's name.

Um, but he, this is at the time when, you know, really they were starting anterior and anterior lateral, so coming in from the side of the hip or the top of the hip as opposed to the back of the thigh. 

Jan: Right? I know 

Nicole: there's, and so 

Jan: position 

Nicole: this, this ortho did posterior, and so when I talked to him, he said, you know, Nicole, I'll do your surgery.

But I'm gonna tell you, I want you to get other opinions. He said, I do posterior approach and you are short. I'm five one. 

Patti: Hmm. 

Nicole: And so he said, the scar on you will be the entire length of your leg, and I really don't wanna do that to you. Hmm. Wow. And he said, you know, and he, he's, he was older, I would guess he was in his seventies.

Patti: Okay. 

Nicole: And he explained the process. He explained, you know, the results. He said, I'm gonna give you. Two names and, and you should go see, you know, check with these, both of these. One is, you know, right next door we're in practice together. And I said, oh, okay, great. Thanks for honesty. And then when I was checking out, the nurse that had been in the room with me came up to me and said, Nicole, you can't go to that surgeon.

He won't touch you because your body mass index. Is too high. Only does very athletic people. I was like, oh, okay. Wow. And she said, you can make an appointment and he's just gonna flat out tell you no. She said, you know, and you know, every surgeon is worried about their success rate and you have success, you know, better success on somebody who has, you know, who has a very lean, muscular body than you do with somebody who doesn't.

Patti: Right, 

Nicole: right. And I was like, okay. And she said this other name, she said. I, I don't want you to go there because he's awful. Well, that's. Thankfully she said that, and then I kinda looked things up and I was like, oh yeah, no, this is not good. And she said, I'm sorry to tell you that you might just check with your primary care physician and ask her, you know, if she has someone she would send you to.

And so, you know, I was almost in tears. I'm like, I, I don't know what to do. I'm, I'm out of my league. I don't. You know, I don't know how to find a, a surgeon for me that I'm not gonna be scared to death. Right? And so I went back and, you know, we had a meeting, an anatomy group meeting, and somebody asked, oh, did you find a surgeon?

Are you gonna have your hip done? I'm like, well, no know. And this person said, oh, I, I, he, he was a, a retired medical surgical. He said, I did a rotation with this guy. You should go see him. I think he pioneered the anterior approach. And I was like, oh, well this sounds great, you know? And so I make an appointment and I see this person and it's important to note that my.

Healthcare is all through Baylor Scott and White. It's all through Blue Cross Blue Shield. That's what you know, we had, and that's Baylor Scott and White. This surgeon was with Presbyterian, but it shouldn't matter. So I go and I see this and he says, okay. He says, um, but Nicole, I, all your physicians are with, um, Baylor Scott and White.

And I'm like, yes. And he said, well, I can do your surgery. But you're gonna need to see our internist here at Presbyterian. And I'm thinking, uh, no. I, I like my oncologist. I like my general practitioner, you know? No, you know, and I'm looking at him and then I realize that he's a very tall man. Older, but he, he had tremors.

And so I'm thinking about my surgery and I'm thinking about a person who can't stand upright without kind of wavering. And I'm thinking, you know, when they cut my sciatic nerve, is there my femoral nerve? Is there, how, is he still doing surgery or is he the front man to have somebody else do the surgery?

Like 

Jan: right, 

Nicole: I don't want him. Right, but who is it gonna actually be? And, and so, you know, I left that and I may have cried on the way home from that one. Oh 

Patti: my goodness. This is a horror story kind 

Nicole: of. And I, and I was just like, how is one supposed to find a surgeon? Yeah. And so. I did, I went to my primary care physician and I told her, I said, I don't know what to do.

I don't know how to do this. I know a lot of people in the medical community, but I, I don't know what to do. And she just said, oh no, you're gonna go see this surgeon. She said, I trust him with any of my family members. You are going to like him. She said, let's make an appointment. 

Patti: Mm. 

Nicole: And I did. And it, he is fantastic.

Just fantastic. 

Jan: How long did it take to make the appointment, Nicole? Did it take a while to get into him? 

Nicole: Uh, I think, I think it was a standard three months. 

Jan: Yeah. It's usually three months. Mm-hmm. 

Nicole: You know, that's just, that's kind of the standard for, that's the standard for any specialist, whether it's an oncologist.

Jan: Yeah. 

Nicole: You know, cardiologists, you can usually get in pretty quick, but any other specialist, it's about three months. 

Patti: Yeah. Yeah. And then how long after that did it take to schedule your surgery and get all of that happening? 

Nicole: I, I took one of the earliest appointment and that was March. And so I think I probably saw him, well, I saw him in October and I think I planned it for spring break.

Patti: Mm. Yeah, 

Nicole: because as an educator I felt like that could be a clean break. And normally what they would do is then put another professor in all my classes for the remainder of the semester, because you know, I would be out for six to eight weeks after that. 

Patti: Right. 

Nicole: If not, you know, longer. 

Patti: Hmm. 

Nicole: And so I think he may have had something earlier, but I pushed it to spring break.

Patti: Right. 

Nicole: But it, it really is about, about three months out once you see them for surgery. 

Patti: Yeah. Yeah. And so what was the actual surgery like for you then? Was it a, did you have a good experience or were there any complications with it? 

Nicole: So I was terrified I would die. Um, 

Patti: sure. 

Nicole: Of which the nursing and the nursing staff is like, no, we do this all the time.

But it was a weird experience because the night before is when all surgical centers got shut down. Every single surgical center got shut down. And so I got a call in the morning, your surgery's canceled. We'll get back to you. 

Patti: I 

Nicole: was like, right, because you're talking This 

Patti: was March, 2020? 

Nicole: Yes. 

Jan: That's when, 

Nicole: yeah.

So March, 2020 and ah, three days before the surgeon called and said, are you ready for surgery? Are you okay with it being COVID, blah, blah, blah. And I'm like. Yes. I mean, I don't have a choice. I have to get this done, you know, and who knows when things are gonna be back to normal. And he said, okay, but your primary care, she hasn't signed off on you yet.

Can you email her and find out why? He said there's, there's something. That she didn't like from your cardiologist. And I'm like, well, that's weird because I, being a cancer patient, you get echocardiograms and EKGs all the time. They're all nor always normal. 

Jan: Right. 

Nicole: And so, you know, in. I got into my cardiologist.

The, the very next day I just called and explained and, and he said, oh yeah, she just wants me to actually put eyes on you and say it's okay. And he said, I have no problem with surgery. And then I go back and, uh, surgical centers were shut down. We're just done and she said in an in, in another appointment.

I'm glad you didn't have surgery when you originally scheduled because you wouldn't have had any support staff. To come to your house, like home healthcare. 

Patti: Right. 

Nicole: And I don't think anyone PT had fully processed that, that, that not only were surgical centers gonna be shut down, but in home healthcare 

Jan: Right.

Nicole: Was gonna be shut down too. 

Jan: And after that you, you can move, you go to a physical therapist and you go to a physical therapist and those would be all shut down too. So yeah. You'd be all on your own. You would 

Nicole: Correct. 

Jan: Be that'd be. Correct. And that that's exactly 

Nicole: what she said. You would've been on your own.

Patti: Right. 

Nicole: And so they moved my surgery to May and then, and that was right after things had opened up and I didn't realize the personalized care I got at the surgical center until the second hip was done in this February. 

Patti: Oh, 

Nicole: wow. 'cause I was one of two patients in an entire surgical center. You know? 

Patti: Yeah. 

Nicole: I had fantastic care.

Patti: Yeah. Was this the first time you'd had any kind of surgery or had you had surgery when you had cancer previously? Leukemia. 

Nicole: No, because leukemia, they, I mean, I had a bone marrow biopsy and then here's your chemo pill. 

Patti: Right. Okay. 

Nicole: You know, so this was the first major surgery, surgery I've ever had. 

Patti: Right.

Nicole: And so I was, you know, terrified. Yeah, 

Patti: yeah, sure. 

Nicole: But I had, you know, I had one-on-one care from multiple nurses. 

Patti: Yeah. Yeah. So then what was the recovery like then? So at that point, because, so then you ended up doing it in May of 2020. 

Nicole: It was in May of 2020. 

Patti: And so 

Nicole: was, 

Patti: were they doing in-home healthcare or what 

Nicole: was it like having it done in that period?

Because that was still pretty, a short, a short window when things were really shut down in a lot of ways. Still, my husband and I would put on a mask before they came in and they wore masks. And so the nurse came in and the PT person came in and they came in twice a week and, um. 

Jan: That's what it was, 

Nicole: you know.

Jan: Did, did this doctor do, um, was it, uh, anterior, posterior? How, what, what was the incision that they did? 

Nicole: It? It was anterior. 

Jan: Anterior, 

Nicole: yeah. Mm-hmm. Not even lateral, but straight anterior. 

Jan: Mm-hmm. 

Nicole: And so 

Jan: why don't you explain what that is? Some people don't know. 

Nicole: So on, in an anterior approach, it's. Very much, this sounds odd, but very much less invasive than posterior and posterior.

They have to actually cut muscles, 

Jan: I know. 

Nicole: To get to the joint. And then, um, is that what you had? 

Jan: Yes, I had, I had one that was posterior and the other one was anter. Mm. And it's, you're right. 'cause the, the posterior cuts muscles and it takes a lot longer to rehab that. 

Nicole: Yeah. So in the anterior, they're just spreading muscles to literally pop the femur out 

Jan: Yep.

Nicole: And put the implant in. And my recovery, I had no pain. 

Jan: That's 

Nicole: great. I had no pain. No pain when I woke up, no pain until I started intensive outpatient. You know, physical therapy, I didn't have any pain. And the pain that I had then was more like muscle soreness. 

Jan: Yeah. 

Nicole: You know, like I had a really good workout.

Jan: Yeah. 

Patti: So 

Jan: great. 

Patti: Yeah. That's 

Jan: awesome. 

Patti: I, and did you have a similar experience then with your, um, your other hip that just. Had you just had recently, or, 'cause you said you didn't get as much one-on-one care when you were at the surgery center. How has the, um, recovery been? Because now we're talking, it's been, you know, almost six years later.

So how have, how has the, have things changed or have you experienced anything different because we're not actively in COVID anymore? What is that, what was that like for you? 

Nicole: So I still got very, I ha I'm having a, a very different. Pain wise and progression wise, a very different recovery. 

Jan: Hmm. 

Nicole: And my surgeon was very honest with me.

He said, Nicole, 50% of people have the same experience. 50% have a, have a worse experience. He said, it's, you know, you, your first tip, you had a, it was great. The second one, you may have more pain, you may be slower to heal, blah blah, blah. But also from a leukemia standpoint. My numbers were better, but I have different side effects because I'm on a totally different chemotherapy medication.

Mm. And so that has caused some healing issues. And the re recovery, I'm much, I am, um, grade one, almost a grade two anemia, uh, have that going into surgery. 

Patti: Mm. 

Nicole: And so that's, he said, we may have to give you a transfusion. We may not. They did not. But because I had, I mean, it's still a bloody surgery. I was probably right on the cusp of whether to give it or not.

And they, they elected to pump fluids, but that meant that I had some pretty significant pain. You know, right after surgery. 

Mm-hmm. 

Jan: Right. 

Nicole: And they were prepared for that with a variety of medical tools, which I'm grateful for. And as soon as I could start taking those, I, you know, my pain level, I, you leave the surgery center and Jan, I'm not sure how it was for your posterior approach, but anterior, you leave the surgery surgical center roughly five hours after surgery.

Jan: Yeah. That, that's how my second one was. I went in the morning and I was out by, you know, six o'clock at night. So 

Patti: that seems so crazy to me that you can have an, an entire joint replaced and they're like, all right, have a great day. Well see you wave. 

Jan: Goodbye. It's crazy. It's 

Patti: push you in the wheelchair and 

Jan: just 

Patti: roll on by.

Yeah, 

Jan: that's, and, and knees are that way too. Yeah. 

Patti: Wow. Well, I guess nowadays you have a baby and they just send you on your way too, so, you know, they don't, however quick they can get you out. It's true, it's true. Although my sister-in-law just had a hysterectomy and she, they kept her overnight, so I was surprised.

I was like, oh, that's the, they like, they found a reason to keep somebody. That's good, I guess. Um, yeah, so very interesting. And so how did you, did you have your physical therapists? Have they been assigned to you or did you go and seek. Them out. 'cause I know a lot of times, at least like when my mom was going through her various joint replacements and things, there would just be like the hospital releasing her.

The surgeon would say, here's the home health people who will reach out to you, and then you just kind of use whoever they have. Is that what you did or did you search for your own? Or what was that like for you? 

Nicole: My surgeon has a very particular post-op plan. 

Patti: Hmm. 

Nicole: And the reason I know it's very particular is the two home healthcare people have have mentioned it.

Hmm. And so when the first surgery I left at midnight, we get home and he apparently has a contract with them that they have to see his patients within 24 hours. 

Jan: Yep. Mm-hmm. 

Nicole: So they had, until they basically had, you know, a, a very short window in which to see me or he would cancel their contract. 

Patti: Oh, wow.

Nicole: And so they, at seven o'clock at night, the day after surgery on the first one, they were, they were there. They're like, sorry to come so late. But I'm like, you know, I'm all doped up on medication. I'm like, what do I care? You know? And then the second, uh, you know, and that was during COVID too, so they're kinda like, ah.

Uh, the second one they had, you know, the next morning I got calls, we're gonna come see you. 

Patti: Yeah. 

Nicole: And again, his office chose the home healthcare people. 

Patti: Yeah. And have you been good about continuing your PT and doing all of that and like the longer term recovery of everything? 

Nicole: So he gave me a choice. I could have outpatient PT or just rehab it on my own.

And I am never one to turn down a personal trainer. So, and that's what I see. That's how I see a physical therapist. And so I, yeah, I started, uh, outpatient physical therapy after three weeks. And um, my physical therapist is amazing. Absolutely amazing because I still have gait issues from when I had a sprained ankle.

Patti: Mm, yeah. 

Nicole: That and, and the first hip replacement that was, you know, they really weren't addressed. And so my, my recovery is, it's gonna take a little bit longer pt. But, you know, I, I'm getting stronger and, um, there's no, um, there's weakness, but it's, it's, uh, weakness on both sides. So I'm, you know, doing PT on both legs really.

One, a little more intensive than the other. Yeah. 

Jan: And Nicole, how does your, um, when you got leukemia, you said it was diagnosed when you had your hip replaced, had, does that have any, um, direct impact on why your hips, you, you have arthritis, or how does that, how does that factor in? 

Nicole: So they're finding out that, you know, I was never not gonna have hip replacements, you know, or I was always gonna get osteoarthritis in the hip, but it occurs quicker.

Jan: Oh, 

Nicole: really? So you really, the, the leukemia itself comes from bone mar comes from your bone marrow. That's where all your um, you know, white blood cells, red blood cells are made. And this is, and so leukemia is really a blood disease, not a bone disease. 

Jan: Right, exactly. 

Nicole: And, and so the leukemia itself causes, um, problems within bone, but also the medication you take for it.

Um, can be very harsh and it can, it can exacerbate, you know, it's, it's, what it does is it keeps you in a constant state of inflammation, so your entire body is in a constant state of inflammation, 

Jan: and that's the worst. 

Nicole: And so. Yeah. So your, yeah. And your immune system's trying to kind of control that.

Always. You get after a while, you know, you get to a steady, you know, a steady state for it or, and, but it, it exacerbates healing, um, increases arthritis, um, you know, it even causes dental problems. 

Patti: Mm-hmm. 

Nicole: Dear. So that just made, um, my, me needing a hip replacement. 

Patti: Mm-hmm. Early. 

Jan: Mm-hmm. 

Patti: Right, right. Because you, you got them your first hip replacement.

How old were you when you got your first hip replacement? If you don't mind saying, 'cause I know you've said the year, so that'll tell us your age. 

Nicole: I do. I, I do not mind because it's, um, I got a, my first hip, hip replacement at 53. 

Patti: Yeah. Very 

Nicole: young. Young. And my second replacement of 58. 

Patti: Yeah. 

Nicole: And so the average for females is 65 to 80.

Patti: Right. 

Nicole: And so they were, you know, they're all like, wow, you're just real early for this. And I remember my surgeon saying to me and me thinking, you know, very early, the first tip that I have leukemia, you know, I have a almost normal lifespan, but not quite, I'm 53. And he says, okay, Nicole, this implant. Gonna, it's guaranteed to last 30 years.

Patti: Right. 

Nicole: And I'm doing the, you know, the math in my head and he goes, 

Patti: yeah, 

Nicole: but I feel confident telling you it will last for 40 years. And I remember looking at him and going, oh, well I'll be dead by then. Oh gosh. And he looked at me and we both kinda laughed. He goes, well, yeah, you know, I mean, I was like, oh, and, and then I think I apologized.

I said, oh, I'm sorry. And he goes, no, it's the truth. You know? It's the truth. Yeah. 

Patti: Yeah. Yeah, because that was something that I was wondering too, knowing that it was earlier, because I know that joints have a, a lifespan and so what, yeah. So that makes sense though, is that it wasn't as much of a concern given some of your other stuff.

Yeah. 

Jan: You know what I just realized? Yeah. Nicole, is that my second hip replacement was not, it was not, um, anterior. Or posterior. It was lateral, it was on the side. I actually looked 

Nicole: lateral. 

Jan: Lateral because it doesn't cut through any muscles. You just spread the muscles and go in. And, um, I tell you, the posterior, I'm really not a big fan of that.

I, you know, not that I have any more hips to replace, but. For anyone that's listening here, you know, you said you went to that surgeon that was older and he, you know, and I think that's, yeah. The older orthopedic surgeons, that's what they learned and they never changed to what's really going on and working today, so anyway.

Nicole: That that anterior approach, you know, is still very well. They used to do what, probably on your second, what you had is a lateral, more anterior lateral. 

Jan: Yes. 

Nicole: And, and that was kind of, that was kind of newer. And so my surgeon doing that anterior approach, even in 2020, that was pretty new surgical technique.

Jan: Yep. Yep. 

Nicole: So, yeah. 

Jan: Well, they get better I think as they go along, you know, technology. 

Nicole: Yeah. 

Jan: What can you say? But, um, wow. And so now you're, um, you're feeling you don't have arthritis in any other joints or how are you doing with your arthritis? Especially with leukemia, 

Nicole: I do have joint stiffness. It also causes a hardening of tendons.

Jan: Mm-hmm. 

Nicole: And so what I do to combat that is. You know, I do a lot of yoga. Not, not right now, since I just had my other hip done, but I do yoga and Pilates, um, kind of for overall and strength training with, you know, lightweights or body weight. And all of that is good for bone density. Yes. Especially Pilates cannot recommend that enough for people, but that they all keep me.

The more you can move, the more that your muscles and tendons stay healthy and stretchy. Right. And then for things like my hands, I. I do. I, it sounds so funny, but I put together Legos, I crochet, you know, I try, anything that I can do with my hands to keep my fingers mm-hmm. 

Jan: Moving, 

Nicole: you know, just like, almost like occupational therapy.

Jan: Right. You know, my, my PT said motion is lotion. 

Nicole: Yeah. 

Jan: Yeah. I love that. I love that phrase. I'm like, yeah, and some days when you get outta bed, you don't really feel like you wanna move too much, but you gotta move. And I think that's great, you know? 

Patti: Yeah. 

Jan: And, and so are, is there any advice that you would give to.

You know, people listening to this about, um, if they're getting replacement parts, uh, hips, knees. I know, I know knees are more difficult. Shoulders. I don't know anyone who's ever had a shoulder, but I know those are very difficult. Oh, 

Patti: my aunt did. Yeah, they're rough. Really 

Jan: rough. They're really rough. 

Nicole: Yeah.

Jan: So any advice that you would give 

Nicole: people? Yeah, the hip is hips are the easiest ones. 

Jan: Yeah. 

Nicole: When I was thinking about this, my, my biggest advice is you don't have to go with that first surgeon. Yeah. If there are any things, any inkling that, hey, I'm not sure, walk away. You know, there, there are a lot of orthopedic surgeons in most major cities.

If you're in a rural setting, that's gonna be harder. 

Patti: Yes. 

Nicole: But you know, find a surgeon that is, that is kind, that is honest. He should have a bedside manner if he doesn't have a bedside manner when you meet him. No, that's a hard note for me. And if you're. And if you're not meeting with him before your surgery, you're just, you're meeting with his staff or his nurse practitioner.

Highly respect nurse practitioners. But you need to meet your surgeon, 

Patti: right? 

Nicole: And if you have a good relationship with your primary care or general practitioner, ask them. They're not gonna refer you. To someone bad because you're gonna come back to them and say, Hey, Dr. So and so was horrible. You know, they're, they, they build relationships and.

They're not gonna just send you to their friend 'cause it's their friend. 

Patti: Yeah. 

Nicole: You know, they very much have, I mean, there are, obviously, there are some that will, but, uh, you know, your general practitioner's probably not gonna send you to somebody bad because she doesn't want you to come back to, to him or her and say, what, what did you do?

Patti: Right. 

Nicole: Yeah. And then the other advice, well, two more pieces of advice when you do your outpatient therapy. You really want a doctor of physical therapy, you want that level of education in your physical therapist, especially for joint replacement because it's not, you're not, it's going to be rare that you're just rehabbing that joint.

If it's your shoulder, you're going to have some back and neck issues that are gonna come into play. If it's your knee, it very well could be your hips causing the knee issues as much as an ankle. You know, everything in your body is connected. Yes. So make sure that you've got a physical therapist with that level of education.

Now, if you're doing well and they pass you off to somebody who doesn't have a doctorate, that's fine, as long as they're in control of your care, like the exercises you are going to do and and so forth. And the last bit of advice I have is do your PT at home. Do it at home. Do it at the, at the office. But have them give you a home plan too.

Yeah, 

Jan: yeah. Good idea. 

Patti: Yeah. Yeah. I think what's interesting too, that I, um, heard you say earlier is that. You had an untreated ankle sprain at some point that likely contributed to, to some of the discomfort or issues you were having. And I think that's an important thing, even though it's not specifically related to joint replacements, that I think sometimes.

Um, sprains can get overlooked as not a big deal, but actually they can be harder and longer to heal than a break. And if you aren't careful with that, it can, you overcompensate and it can throw up everything. So I think that making sure. You're paying attention to everything that's happening in your body before and after replacements and just everything and just making sure you're being careful and aware of that.

'cause I had a sprain that it took a year to heal because I went to the hospital and they just wrote it off and they were like, you're fine. You can, you can walk outta here with nothing. I'm like, I'm literally leaning on an umbrella because I can't put weight on my ankle, but they just waved me off, so I think it's important.

Nice. Oh, that's awful. Yeah, it was 

Jan: terrible. Don't go there. 

Patti: Well, I didn't have insurance and it was, 

Nicole: you know, I, I went to, uh, care Now after my ankle sprain, they put me in a boot and I'm like, how, how long do I wear this? About six to eight weeks. And I'm like, well, what about a handicap sticker? Because I, I know that parking where I worked, I had to walk a quarter mile, you know, and teaching.

And he is like, oh, we don't do that. You need to go see an orthopedic. And in the back of my head, I'm like, why wouldn't I go see an orthopedic to begin with? Right? Like, why did I go to care now? Like, 

Jan: right, right. 

Nicole: You know, I'm just like, yeah. And, and so he put me in a boot, but when I asked about physical therapy, he is like, oh, you don't really need it.

Patti: Yeah. Yeah. 

Nicole: It's like, okay. 

Patti: Yeah, yeah. 

Nicole: But you do, you're right. You do. 

Patti: Yeah. So I think just paying attention to all that stuff and I love, yeah, everything that you said. I mean, it was so, uh, helpful to the reminder to do your pt, do your homework. Um, yeah, this was so great. 

Jan: Your shopping shop around for a doctor I had.

Yes. I totally am down with that one. Because I have certainly done that and found some really bad doctors that really have no bedside manner and other some that are really good and well known. And really, that's a great piece of advice, Nicole. 

Patti: Yeah, absolutely. Well, thank you so much for chatting with us and yeah, sharing all of your experience and everything.

It was so lovely. I really appreciate it. 

Jan: Yeah. Thank you. I, I appreciate it. And hopefully, uh, the rest of your joints, do you have osteopenia or osteoporosis? 

Nicole: I don't. I have very good bone density and very good bones. And the other thing I'll mention, well, one, very nice to meet both of you. This was so, so much fun to do.

This is such a good chat. Um. But uh, when you have leukemia and you have the head of your femur, you know, kind of hacked off. 

Jan: Yep. 

Nicole: Your leukemia numbers get really good. They go really low because in your femurs, you know you have bone marrow, and if you get rid of bone marrow that has leukemia, hey, your leukemia numbers dropped you.

I mean, you know, I, I really, my numbers the first tip, they were just real slow to come down and my oncologist was so excited. He is like, Nicole, you, your numbers look fantastic. And I said, yeah, I just had my femur taken off. He's like, oh, that's right. 

Jan: That's right. 

Nicole: And so, you know, we'll see where my numbers are next.

You know, next month when I have my blood work from my oncologist, we'll see if, you know, they got even better. 

Jan: Maybe even better. Right, exactly. 

Patti: Well, happy healing. Keep healing well, and I hope this one gets better. And that's the end of your replacements. 

Nicole: Thanks. Me too. 

Jan: I don't want any more replacements, right?

Patti: I don't want any, but we'll see how my future goes. So, 

Nicole: fingers crossed, I don't, yeah, nobody should have to go through it, but if you do and your quality of life is bad, then do it. 

Patti: Yeah. Absolutely. Absolutely. Well, thank you 

Nicole: so much. 

Patti: Thanks, Nicole. 

Jan: Thanks for listening to the podcast. If you like what you've heard, please share it with friends, subscribe and leave a review.

Patti: And remember, information shared on this podcast is not medical advice. If you have a concern about your physical or mental health. Please seek support from a professional. 

Jan: If you have a story you'd like to share about things your mother forgot to mention, you can apply to be a guest. 

Patti: We'd also love to hear a quick 92nd thing you've learned in your life.

Jan: You can find links to both of those over at our website at 

Patti: things my mother forgot to mention.com or in the show notes. 

Jan: Thank you.