Posts Tagged ‘hip replacement’

Irish Prime Minister Kenny Attends Mass In Sandy-Afflicted Section Of NYC

That’s me in the front of the mob shooting Enda Kenny the Prime Minister of Ireland in Sandy Hook, Brooklyn.

KA Kiyosh LNY 1

Looking forward to being able to do this again. Chinese New Year 2014, Sunset Park, Brooklyn

crutches & Kiyosh

One of the few advantages of crutches: giving your son a boost uphill.

As pictures began appearing on facebook showing me in crutches, my friends naturally wondered what the hell happened to me.  I’ve responded with comments that I’m getting a total hip replacement. With little time to elaborate, I feel I’ve left people who know me in the dark, with just the general sense that something terrible happened to poor Konrad. So I’m writing this blog for anyone interested in knowing more, and for myself.

In addition to being the father of a three-year-old boy, I have a physically demanding career that I chose and love, and a spiritual-physical practice that has kept me in exceptional shape. As an independent filmmaker and videojournalist for the daily Catholic news program Currents, I use the camera as an extension of my body. As the first significant issue my body has ever had, the emergence of this serious disability has rippled through my parenting, my creative and professional expression, and my physical practice.

The Problem

Around 2010 or earlier [update: yes, earlier…check out this post] I started noticing a weird pinching in my left hip when I made certain pivoting motions. This would happen after I’d done all-day group zazen sits connected with my aikido dojo, Brooklyn Aikikai. KA Kiyosh aikido 1I’ve been training there since 2005, and it’s been a good practice for keeping my body and mind tuned. Then very gradually up until now I’d feel pain and stiffness in my left hip — after sitting down, standing, walking or any other particular weight-bearing mode for an extended period. The progress of this “hip issue” picked up in fall/winter of 2012. It was particularly noticeable in aikido class. From the time I was stretching to doing techniques and ukemi (taking falls) my left hip was undeniably suffering from a progressively diminishing range of motion and ability to take weight.

Then there was a wake-up call in summer of 2013. The day after moving and installing air conditioners in our apartment, I found I couldn’t walk normally — I had to limp slowly down the street. Though that state soon wore off, it heightened the urgency of figuring out what this problem was. I was unused to consulting doctors though or using the health insurance I fortunately had, and didn’t even have a primary care physician. So there was some further delay while I figured out how to do that and whom to see. My internet research suggested that I was developing osteoarthritis, but there was no established medical “cure” for that except hip replacement. At age 45 I wasn’t ready to accept that.

I was given some hope that my situation was less serious than I feared when the primary physician I saw for a referral said she didn’t think I had osteoarthritis because I was young and had it only in one hip. She thought maybe it was bursitis. That dissipated my sense of urgency somewhat, and it was some months before I felt the further progression of my hip problem badly enough to take the next step and see an orthopedist.

On March 8, 2014 I saw Dr. Raymond Walsh in Bay Ridge. By then the seriousness of my situation was undeniable. I couldn’t comfortably put my whole weight on my left leg and its range of motion was at the point where tying my shoe or putting my sock on was almost impossible. Dr. Walsh took an x-ray and immediately told me I had osteoarthritis.??????? He showed me that I had osteophytes (bone spurs) around the hip socket, and that due to the reduced space in the joint the bones would rub together with certain movements. He said I’d likely need a hip replacement, but to know for sure I needed to get an MRI to determine if the damage extended to inside the acetabulum, or hip socket, and see a specialist in “surgery on the young hip,” someone who specialized in ways to address the deterioration of the hip short of hip replacement.

That diagnosis, which for a year or more I’d suspected but hoped against, came the day before Ash Wednesday. That day I received ashes for the first time, on camera, as I was shooting a Currents report in DUMBO. Reflecting on my mortality as never before, this day gave me a space to spiritually process this life event.KA ashes

My pain, stiffness and limp progressed rapidly as I continued to work, take my son to school and walk around as best I could. I was starting to experience some aspects of the psychosocial and logistical isolation of the disabled. As I encountered people I knew, they’d say “what happened to you?” and how much of my story they heard depended on their patience. Once one of the fastest walkers I knew, I was now plainly limping and unable to keep up with people for a “walking and talking” conversation unless they felt like walking abnormally slow. Sometimes they did, sometimes they didn’t.

On March 12 I had the MRI Arthrogram of my left hip done at NYU Langone. That was an experience in itself for someone who’d rarely seen a doctor. Before the MRI I was put on a table for an x-ray, which a woman doctor then used as a guide to inject the necessary dye into the joint space. That was probably the most intense medical procedure I’d had up to that point. She said I’d feel “pressure” as the needle reached its mark, but what I felt was more than that.

On March 25 at the end of the workday I tried to walk to the subway and after a block and a half it was too painful to continue. I called a car service to get me home, and next day I was rested and still took my son to school. His stroller had become more and more like a walker for me at that point. But once I dropped him off at daycare I no longer had that. I was able to walk about half a block at a time before resting, just casually standing in one spot on a city sidewalk. I got a cane in the chain drugstore and went to work.

Two days later I had my second visit with Dr. Walsh. Because of some miscommunication at NYU Langone, they didn’t have my MRI results sent yet, but we managed to get a written report faxed over. The report reinforced his inclination to believe I would need a total hip replacement, but before making that conclusion he told me to see Dr. Srino Bharam, the best local person for fixing “young hips,” who would tell me honestly if he thought he could help me.

Dr. Walsh also said I should be on crutches rather than a cane. He gave me some and showed me how to use them. I was now, incidentally, unable to do my usual tasks involved with solo shooting: carrying equipment. The last shoot I’d done had been limited when I realized I couldn’t move while carrying the camera. My bosses at Currents were very supportive and accommodating, as I continued contributing to the show, editing together pieces archival footage, skype interviews, and even “stand-ups” shot in the office.

The Turning Point

On Wednesday, April 2, Dr. Srino Bharam looked at me, my x-tray and MRI and told me I was not a candidate for hip debridement, or arthroscopic repair of the joint. He believed I’d have to go with hip resurfacing or total hip replacement, but not right away. He suggested I get a steroid injection to get rid of the inflammation and see a physical therapist to see if I could get off the crutches at least while I figured out my solution, because he believed using crutches would weaken my hip-related muscles.

I was left alone in the exam room for a moment, and that was when I hung my head down and absorbed the news, that a hip replacement was virtually inevitable for me. I went straight from Dr. Bharam’s office to Hospital for Special Surgery for my steroid injection.

Though I wasn’t looking forward to having another needle inserted into my joint space, I knew it was best to do the injection right away since each trip to Manhattan was now a big undertaking. This doctor used ultrasound to guide the needle, and he calmly told me the stages of its progress. That worked much better for me than the way the MRI injection was done.

Konrad Kiyosh museumWithin days, the steroid made all the inflammation in my hip disappear, like magic. The pain went away and the range of motion returned to the point where I could put on my shoes and socks again without much effort. I went to see the physical therapist, and he told me he still couldn’t get me off crutches. The best thing for me would be to get the hip replacement as soon as possible. He’d seen people wait and try alternatives for months and years, then wish they’d done the operation right away.

I had done a lot of researching and thinking about alternatives to hip replacement. The other possibility Dr. Bharam mentioned, hip resurfacing, I felt was too chancy even if I could find a surgeon who would do it on my hip. There were a few experimental methods to regrow cartilage; one of these was being tried by an aikido teacher I knew. But it was costly, not covered by insurance, and took a year or more to know if it was working. Another aikido teacher I knew with hip arthritis was able to walk without pain after months of treatments with Qi Gong Master, FaXiang Hou. After looking into the cost and pondering this route, I decided that with no prior knowledge of Qi Gong, I couldn’t live with the uncertainty and fear that I would be making my hip worse over time. Though I had substantial cartilage left in my hip, it had worn through at one or more points, so bone bruising had started.

Karl Kiyosh tractor 1Konrad Kiyosh woods 1My partner and I had previously scheduled a trip with our son to see my dad in Bay St. Louis, Mississippi. Though we considered canceling the trip, we decided to go ahead. It was a much-needed, restorative time for all of us.

On the trip I also got to see what it was like to be handicapped in the airport. We were skipped to the front of the TSA line and I was taken everywhere in wheelchairs. But I couldn’t help noticing that two of the people assigned to wheel me around had serious musculoskeletal issues themselves. The man who took me from the return flight was limping as badly as I was before my steroid shot.

KA Kiyosh airportTwo days after we got back to NYC, on April 24, I saw Dr. Brian Nestor, an orthopedic surgeon who’d been recommended by Boris the physical therapist. I found his recommendation weighty because he had sent his own close family member to Dr. Nestor for a double knee replacement, which another surgeon had not wanted to do in one session. After seeing him I felt more educated and reassured about the long-term outcomes of total hip replacement with the particular approach he used. He showed me a sample of the implant, which I found quite elegant and beautiful.

When I saw his assistant afterward she told me they’d had a cancellation and so had an available slot on May 19. May 19! Just over three weeks away! The next ones started at the beginning of June. But it seemed that May 19 slot was there just for me. With the 6-week recovery time it revived the possibility of taking a trip crucial to a documentary I’d been working on for several years. But it was a big decision to make so quickly. After wrestling with the decision over the weekend I took the May 19th appointment.

KA Michelle hospital KA hospital dischargeAs someone who generally does not make decisions quickly, has been almost completely unknown to doctors and scared of needles, I’m surprised at myself that in the space of less than two months I went from someone with a hip problem to someone getting a hip replacement at age 45. The surgery itself, a week ago today, was a whole other chapter I’m still living out as I go through rehabilitation. I may post about that as well, particularly if anyone reads and comments on this blog.

Though I’m still as amazed as my friends that this has happened to me, “that sucks” is not my attitude. Total hip replacement surgery is one of very few restorative surgeries that have such a high level of success going back 50 years. I’m lucky to have had this particular issue instead of others with less certain remedies, and to have have recently started working full-time for a good, caring employer that offers robust health insurance. And my partner, son and extended family overwhelm me with both the support and motivation to rehabilitate to my full potential.


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