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Sink or Swim
David Carrithers is ready to go. Standing where the water meets the sand of Lake Washington beach, the 58-year-old looks out to Mercer Island and the Cascade Mountains beyond. The afternoon sky is clear and the lake is quiet. "It is transcendent," David says of open water swimming. "There is no other way to describe it."
Diving into the water, he does a few butterfly kicks before settling into a freestyle crawl and pointing himself toward a buoy a half mile out. David is an athlete. While growing up in Iowa during the late 1960s, he was an all-American swimmer with a scholarship to Iowa State University.
"The osteoarthritis began about five years ago," David says. An avid handball player, he remembers the first time he felt the excruciating hip pain on the handball court. "Playing handball became less fun and I became less competitive. After a lifetime of playing at least three or four times a week, I had to give up the game entirely."
Osteoarthritis, the most common form of arthritis, causes pain, swelling and reduced motion in the joints. It can occur in any joint, but usually affects the hands, knees, hips or spine. Osteoarthritis pain limits motion, reduces physical capability, and can restrict social activities and compromise work capacity. The disease led to so much wear and tear on David's hip joint that he was feeling daily, bone-on-bone pain. Dr. Justin Klimisch, an orthopedic surgeon at The Bone & Joint Center of Seattle at Northwest Hospital, says osteoarthritis is a common reason for a total hip replacement.
"It's painful to stand or sit for a long period of time. People have problems getting up or down stairs, even putting their shoes and socks on," he says. "Typically, what I see in very active patients like David is a 'grin and bear it' mentality. They work through the pain, but eventually it catches up with them."
Throughout his competitive swimming career and during the majority of his adulthood, David dealt with the day-to-day aches, pains and injuries common to competitive athletes and active adults.
"Sports-related pain was the sort of pain you had to endure," David explains. "In a way, it gave me a higher tolerance, which is why I waited so long to address the problem."
Now, he admits he ignored the hip pain for too long. Osteoarthritis didn't just affect David's athletic life. He is also a professor of finance at Seattle University, and the daily pain and lack of mobility began to affect his work life, too.
"The concentration, the focus I needed to be present in my classroom was gone," David says. "The pain was a distraction and it diminished my teaching."
Walking the tiered levels of the lecture hall for hours while he taught became increasingly difficult and he was forced to spend more time supported by the podium. On occasion, the pain was so severe, he actually cried out during class.
David initially sought treatment for osteoarthritis at The Seattle Arthritis Clinic at Northwest Hospital. The Seattle Arthritis Clinic offers a variety of effective medical treatments for degenerative bone disease, but Dr. Klimisch says osteoarthritis can often reach a point where medical treatments no longer work. At that point, joint replacement is necessary to improve quality of life and eliminate pain. In December 2010, David had a total hip replacement. He says he was confident the procedure would go well.
"Dr. Klimisch walked me through the process from beginning to end and described all the different options that were available to me," David says.
Patient education is an important part of Dr. Klimisch's care philosophy. In fact, he is so committed to making sure patients know what to expect, he can easily spend 45 minutes explaining how to prepare for surgery, surgical options, the advanced equipment he uses, managing pain after surgery and the rehabilitation process. His approach is exhaustive, but he believes patients like David benefit from the knowledge.
"Every step of the process is important," Dr. Klimisch says. "It's not only about the state-of-the-art technology we use. It's also about the relationships we create and the patient experience we provide."
As a fellowship-trained specialist, Dr. Klimisch is able to use some of the newest technologies in the field. Before surgery, for example, he uses special "templating" software that helps him identify the implant that best fits each patient's unique anatomy.
"We can find an almost perfect fit for a new hip," Dr. Klimisch says. "That means the implant will be less likely to loosen over time and more likely to restore normal leg length and mechanics. It allows the hip to feel as close to normal as possible."
During surgery, Dr. Klimisch uses the templating software to ensure greater accuracy in the incisions and placement of the new hip implant while minimizing tissue damage. Because of these techniques, many patients are recovering faster and with excellent outcomes. Two days after his surgery, David was resting comfortably at home and already thinking about when he would be in the water again. Dr. Klimisch gave him six weeks for his surgical site to heal properly. But just because the surgery was over, didn't mean the work was done. David began an individualized rehabilitation plan through Northwest Hospital's physical therapy department.
"In the past, I haven't been very good about committing to physical therapy," he says. "But at Northwest Hospital, it was easy, fun and personable."
Dr. Klimisch says physical therapy is critical to a patient's overall recovery.
"Today, the care we provide is completely integrated and designed to cause as little disruption to a patient's life as possible," he says. "My relationship with physical therapists is crucial because I can ensure patients like David are recovering properly and I can intervene early on if there is a need."
Six short weeks after his surgery, David zipped himself into his wetsuit again. Today, more than five months since the surgery, David is diving into Lake Washington for a training swim. His energy is palpable. This summer marks the third consecutive year he will compete in the YMCA Masters Championships with a group of college swimming friends. David laughs at the group's name.
"We just decided to call ourselves ‘OTHG' – the Over the Hill Gang. We've been swimming together for 40 years."
With a new hip and no more pain, it looks like David could be swimming for another 40 years to come. And maybe he'll take up handball again, too.
For more information about Dr. Klimisch or joint replacement at Northwest Hospital, visit www.theboneandjointcenterofseattle.com.