What I Wish My Surgeon Knew: I Am More Than a Hip

I have suffered with pain in my legs since childhood, despite maintaining an active lifestyle. The first surgeon I consulted with diagnosed me with femoroacetabular impingement and a labral tear. I underwent surgery, but the pain persisted. So I underwent two more arthroscopies, yet the pain still remained. The next five surgeons I consulted with suggested I give it time, do more physical therapy exercises, continue receiving injections in my hips, and stop my favorite physical activities. But I sensed there was more going on in my legs than impingement and labral tears. My legs looked different from other people's legs, and my joints felt like they were maltracking, slipping out of place. I experienced pain when standing or sitting for too long, while exercising, and even while sleeping, though I had worked tirelessly in physical therapy and rested and iced regularly. I did not want to give up my cherished activities of running, tennis, and hiking, too. After 4 years and six surgical opinions, a surgeon diagnosed me with a rare condition, aptly named "miserable malalignment syndrome." As I had thought, my leg bones were, in fact, abnormally rotated. The surgeon who made the diagnosis proposed bilateral femoral and tibial osteotomies and subsequent surgery to remove the hardware. Although the arduous process called for up to eight surgical procedures—which was a shock to hear—it felt right to me, because it would let me return to the activities that meant so much to me. Now that I am nearing the end of this surgical journey, I would like to share how you, my seventh surgeon, aligned my legs and my life for the better: You saw me as a whole person and not just a body part. I was apprehensive that you would dismiss me. After years searching for a diagnosis, consulting with numerous surgeons who seemed to focus more on my imaging studies than on me, and even undergoing three arthroscopic hip procedures, I feared that another doctor would do the same. Yet you walked into the room and validated my concerns at once. Instead of looking at the images of my one hip joint, you looked at CT scan images of each of my legs and then looked at how the two of them worked together during gait. You asked how I was functioning in day-to-day life. You gave me a holistic look over and listened to me before diagnosing me. After years of surgeons telling me that my legs were "within normal limits," that all I needed to do was go for another round of physical therapy, and that I was still healing from the first surgery that took place 4 years prior—I finally had a diagnosis that I knew to be correct all along. From our very first interaction, you treated me as more than a hip, more than a leg, more than an image. You treated me as a person. You considered my life goals as you developed a treatment plan. During each of our appointments, you always remembered and acknowledged what my goals were for these surgical procedures and for my life. Not all of my surgeons explored those issues with me, and they didn't always weigh in on my passion for sports, and for running in particular. When they didn't have an intervention to offer, they recommended I quit my favorite recreational activities rather than continuing the search for the cause. My encounters with you have been so different. Each decision that we make together is oriented toward supporting my active lifestyle, my desire to run again, and my career goals as an occupational therapist. You called me the day before surgery to review the surgical plan and recovery, and let me ask questions. On Sunday evening, the day before my first operation with you, I received a phone call from a familiar number. I thought to myself, "Great, the surgery is likely canceled, especially calling on a Sunday." My heart raced as I answered the call and thought about all the preparation I had done. Instead, you greeted me and said, "I am looking forward to the surgery tomorrow. I wanted to call and go over the surgery details with you and give you an opportunity to ask any questions that may have come up since the preoperative appointment." This conveyed how much you cared about me, and it meant the world. You asked how you could make this experience better for me. After several operations on my right leg, it was time to start the project on my left leg. During my preoperative appointment for my left femoral osteotomy, you asked how we could improve this process and what we could do differently on this part of the journey. I felt that we could up the pace a bit, with less time in between procedures, since we already knew how my right leg responded to these operations. The way you asked for my feedback made me feel valued as a partner in my care. You asked how I was feeling emotionally. At another preoperative appointment, you asked how I was feeling. Instinctively, I listed all of my physical symptoms even though we had already covered them. After listening to me patiently, you queried again, "How are you feeling emotionally?" No surgeon had asked me that before, and it caught me off guard. But your timing was perfect. I had been anxious about this surgery in particular: another femoral osteotomy. I knew what to expect, which is good—but also bad. It's a big operation, and a big recovery. You validated my apprehension and assured me that I had done it once before, so I could do it again. I left the appointment feeling confident and ready to go. The day after the operation, you came to check on me at the hospital. After looking at my leg, you asked again how I was feeling both physically and emotionally. You understood that the leg is only a part—and perhaps not the biggest part—of what happens to a person after surgery. What I Wish My Surgeon Knew I wish my surgeon knew how much each of our interactions improved my recovery, my physical and mental health, my career as an occupational therapist, and my ability to enjoy my favorite activities. Because he listened, cared, made a diagnosis, and developed a treatment plan in partnership with me, I will be able to work and enjoy my most fulfilling outdoor activities. This would not have been possible without his attentiveness and concern for my overall well-being. I wish my surgeon knew that our interactions may have only been moments in time for him, but for me, these interactions have aligned my legs and my entire life for the better.