Caitlin Kelly

I was standing in baggage claim at the Vancouver airport in July 2010 when my orthopaedic surgeon called with bad news. I had, he told me, arrived at an unwanted destination: AVN.

That stands for “avascular necrosis,” also known as “osteonecrosis” – fancy talk for dead bone. It happens as a result of poor blood supply to the bone, and often is associated with long-term corticosteroid use, alcoholism and lupus. But none of those apply to me. Exactly why AVN struck my left hip, which was already in pretty bad shape, is something of a mystery.

I started feeling pain in that hip in March 2007 and noticed it was newly difficult to sling my leg over my bicycle seat. When it really started to hurt – sometimes I could barely lift my left leg into the car after my regular four-mile walk – I saw a doctor, who diagnosed me with hip osteoarthritis, or OA.

Despite the pain, I kept up with most of my active hobbies – skiing, softball, cycling, hiking, ice skating, tennis, dance. Until I couldn’t.

In January 2010, my hip, for no reason I could determine, suddenly plunged me into months of excruciating pain. X-rays and MRIs revealed the OA was severely degenerative. Coupled with the AVN, this means every step I take hurts, making me, on my worst days, waddle like a drunken sailor.

It also, the doctor insisted more than a year ago, means hip replacement.

I’m only 54. Although I know some patients choose to have the procedure done in their 40s or even younger, it’s a major operation many of us try to postpone as long as possible. One good friend, at 69, was swallowing 12 painkillers a day before he finally gave in.

I was in shock at the idea of surgery. Even after years of progressively worse left hip OA, I move as often and as fast and for as long as my body lets me.

Major surgery?

The doctor said it, as he says everything, with imperial authority, waiting, it seemed, for me to immediately and obediently schedule the operation. Instead, I told him I’d get back to him in a year or so, after I finished writing and promoting my second nonfiction book, Malled: My Unintentional Career in Retail.

The truth is more complicated. The whole idea of another surgery bothers me. Since 2000, I’ve had arthroscopies on each knee and a shoulder repair. I’m just really sick of doctors, medication, X-rays, MRIs, surgery and the long, tedious months of rehab necessary after every operation.

And as a self-employed writer in a recession, not being able to work at full steam – and writing a book while doped up on major painkillers was challenging enough – is a real concern.

My doctor warned me to avoid torquing my hip. A sudden twisting movement could further damage my fragile hip joint, even shatter it, requiring immediate surgery. So, no horseback riding. No softball. No running. Bicycling was allowed, but only 20 minutes at a time, not my usual 30 to 60 minutes. I took powerful steroids for six weeks to reduce the inflammation, but was often crying in pain and sleeping with a pillow between my knees. I still resisted surgery.

“Are you prepared to try anything?” the surgeon asked me in August 2010, when I refused to have the operation right away. The only remaining option to relieve my constant pain – at least for a while – was a demanding challenge: three months on crutches (the short ones that grip the forearms, called “Lofstrands”), to give my weary hip a break.

Even on my “sticks,” as I lovingly called them, I refused to slow down. I still did my pool aerobics class twice a week, crutching warily across slippery tile floors. I flew from New York to keynote a conference in Las Vegas, where I talked to retail execs about my insights into life as a sales associate – gained from my research for Malled – and swung self-consciously down the marbled halls of the Bellagio, past gamblers and newlyweds and tourists.

While on crutches, I also did several months of physical therapy, which hugely improved my mobility, strength and flexibility – much to my dubious surgeon’s surprise. At the end, I asked my PT how soon I could return to my jazz dance classes, which I had to stop when the excruciating pain came on.

“You’re kidding, right?” Helen asked. Of course not!

The music is healing, whether African, folk or pop. I easily place my palms flat on the floor when we stretch, my flexibility intact. “Nice port de bras!” a fellow dancer tells me – nice arm work. I smile, comforted to know that I’ve still got it, at least from the waist up. My damaged hip is not all of me, just one broken part.        

Jazz class roots me, not just to the floor and to my fellow students and my understanding young teachers, but to my younger, stronger, healthier self. I’ve been a dancer since I was 12. Seeing my reflection in the mirror, my arms and feet still strong, graceful and quick, as rhythmic as any of my uninjured classmates, offers a powerful vindication. The doctor sees me as just one more middle-aged female patient, a surgery-in-waiting. Strangers stare and wonder why a healthy and young-looking woman is limping so heavily.

If I gave up and let OA define me, I could easily succumb to depression or anger.

I still attend museum exhibits, although wandering for a few hours on stone floors exhausts me. I still go into Manhattan to see shows or visit friends or shop, even though the subway never seems to have a functioning elevator or escalator. I carry over-the-counter anti-inflammatories with me, but on a pain scale of 1-to-10, I need to hit about 6 or 7 before I’ll take one; my normal 24/7 pain level is usually a 2 or 3, which is nothing in my world.

But now I have to make a deliberate decision to have the surgery that – I hope – will rid me of this pain for good. I am constantly ambivalent about inserting an artificial hip into a youngish body so soon.

But I want my life back!

I’m planning the hip replacement for this winter so I can be strong, healthy and ready to run the bases with my softball team by next summer. What else is there to do in those long, cold months? Might as well get it over with then.

In the meantime, I need to remain feisty, independent and, yes, a little disobedient. It’s who I am. So I take my mountain bike out, not for the safe 20 minutes I’m allowed, but for 60 to 90 minutes, cruising a flat gravel path beside the Hudson River or a bike trail near my home. I recently saw two brown bunnies and a turtle, making whatever aches I suffer later well worth it.

Reveling in the smell of sun-warmed pine needles, the shrieking of hawks circling overhead and the late afternoon sunlight glowing through a rabbit’s ears remind me that the rest of my body, and my life, is just fine.

Award-winning journalist Caitlin Kelly is a regular contributor to the New York Times and author of the books Malled: My Unintentional Career in Retail (Portfolio/Penguin, 2011) and Blown Away: American Women and Guns (Pocket Books, 2004). She lives in Tarrytown, N.Y.