“You have bilateral hip dysplasia.”
“What?” I sat in the doctor’s office, next to the canal near my apartment outside of Copenhagen. She was pointing to my X-ray on her screen and the notes in Danish. To me, my hips just looked like hips, even as she began to explain what that meant.
Isn’t that what dogs get? I thought to myself. I had studied pre-vet at university, and my heart dropped. When dogs get hip dysplasia, there’s nothing you can do. You have to watch as your beloved pet deteriorates until it hurts them to walk and move around. Was that going to happen to me?
I was diagnosed with hip dysplasia at 27. It completely blindsided me. Unlike many other hip dysplasia stories, I had minimal frustrations with pain. Growing up, I had always been active, though my athletic journey really began when I left for college. My casual soccer, hiking, horseback riding, and yoga transformed into an avid dance passion. I started with blues, swing, and tango partner dancing in my early twenties. I would dance 2-3 times a week for 3-4 hours at a time. I’d travel to dance conferences that would last all weekend. I was kicked off into a more intense level of athletics – and found my absolute passion for aerial dance. I gained almost 20 pounds in muscle in about two years, and by the time I was 26, I was teaching part-time at a dance studio in Copenhagen and competing in aerial hoop competitions. While I still had a full-time day job, I was intensely training every moment I got – and I loved it!
Sure, occasionally, I had aches and pains. I had a phase in 2014, where I had moderately severe shoulder and neck pain. MRIs and tests later, they still couldn’t pinpoint what caused it, and eventually, the issue went away. Looking back, of course, in hindsight, you can see little warnings that something wasn’t quite right. The person to really catch it was my physiotherapist and osteopath in Denmark. I was seeing him regularly for general maintenance, as I knew I was asking a lot of my body, and I wanted to make sure it was happy and healthy. After a few months of seeing him, he continued to comment on my hip movement. He thought something wasn’t quite right, and since exercises and manipulation weren’t helping, he thought I should get an X-Ray.
That X-Ray completely changed my life. So back to that doctor’s office in Copenhagen. I had been living abroad for almost 3 years. Mostly I had stayed healthy and had only a few experiences with the health care system. I left the appointment with a referral to a surgeon, which is every aspiring athlete’s worst nightmare. I began my obsessive research about my condition, which led me to PAO surgery. I thought to myself, oh, whatever I have can’t be that bad. I bet I won’t need that. And I waited for my appointment (which was over six weeks away).
The day before my appointment with the surgeon, my husband and I were driving around running errands. I picked up the phone and after exchanging a few words in Danish (mostly asking to switch to English) he said:
“I can’t help you. Your condition is so severe that what I have to offer won’t fix the cause. I’m going to refer you to a PAO specialist.”
The rest of the conversation was a blur as he explained that there were only two hospitals in Denmark who performed hip preservation surgery. One in Copenhagen and one in Aarhus (about four hours away). He warned me that the wait time was extremely long. Based on some research I had done, I asked to be sent to Aarhus.
Then, I looked for a second opinion. I had no idea how long it would take for me to get an appointment in Aarhus – it could be 2+ months. I wanted to know if I could keep training. I wasn’t sure if I was even supposed to keep taking the stairs based on the information I had found online. I was scared. So I went to a private hospital for another opinion. In Denmark, there is a wide-sweeping public health system. It’s great – mostly. It’s wildly different than the American health care system. On the one hand, I never worried about how expensive it would be if I was sick. On the other hand, if you have a rare condition or need to see a specialist, you might have to wait a long time.
“You could have as little as five years until you need a hip replacement.” He said, pointing once again to my X-Ray that meant little to me.
I thought he was full of cr*p. I felt fine, how the heck could my hips be falling apart that badly? I had fidgeted in the waiting room for almost forty-five minutes to hear this guy tell me the impossible. He had explained that my hip was some of the worst he had ever seen and that the angle was 0-5 degrees. He recommended I have surgery as soon as possible.
I had just started a new job, had no private insurance, and felt like I had to face an impossible decision. Would my new work be OK with me taking 8-12 weeks off? Even with the increased job security of a socialized country that might not fly – they weren’t obligated to keep me if I didn’t work out in a three-month trial period. I decided to get a third opinion. That’s when I took a trip to a little town called Vejle, where Kjeld Søballe had a private practice. I had read his articles and was full of hope – maybe he could help me.
Kjeld is one of the most cheerful surgeons I have ever met. He greets every patient with a warm smile and speaks plainly. He cheerfully told me that I did need a PAO surgery and gave me the same timeline as the previous surgeon. He reassured my concerns and answered all of my questions. He had a newer method approaching the PAO, where he didn’t need to cut muscles and tendons. The incision was much smaller, and the correction only required two screws. He said I would be walking without crutches 6-8 weeks after the surgery. I scheduled my appointment and went home.
The next few months were a painful waiting game. Mentally mostly, but after having my issue pointed out, I started to notice the discomfort I was in as well. Ironically, I was carrying my young dog up and down the stairs of our fourth-floor apartment to protect her hips. Despite the intense training schedule, I noticed my hips would burn and fatigue as I reached the top. At night, I noticed the painful ache at the top of my hip that I always thought was nothing. I started trying to find resources on how to pre-hab for my surgery. I didn’t find any clear guides about how I could prepare my body best, so I used hip-replacement guides instead.
We received a check-in from the surgeon’s assistant, asking me basic questions about my health and living situation. When I told her we lived on the fourth floor with no elevator, she hesitated.
“That’s not going to work. You won’t be able to take the stairs for some time.” She said with certainty.
So on top of the anxiety of preparing to take time off of my intense consulting job – we decided to sell our apartment and move to the inner city where we could rent a more modern apartment with an elevator (not an easy find in Copenhagen). We managed to find a place we could move in time. Two days before my surgery.
I drove to Vejle (about a 2.5-hour drive) with my husband and my mom, who had flown from Colorado to help with my recovery and unpacking our new apartment. I was so nervous. I had never had a major surgery except for my tonsils out, which had been a pretty unpleasant experience. I cried the night before the operation in the hotel room. I cried again as they prepped me for surgery the next day. The nurses were so sweet. They pet my hair like I was their daughter and held my hand as I was rolled to the operating room.
I woke up confused but in reasonably good spirits. The nurses told me it went perfectly, and everything looked great. The surgeon came by and said to me that he had made several adjustments before he was happy. It was a severe correction, as my dysplasia had been extreme. The nurses kept sharp attention on my pain levels – which I didn’t seem to have much of at all. The main discomfort I had was nausea from the antibiotics and anesthesia. After one night in the hospital and one night in the hotel, we went home.
Recovery from a PAO is long and tiring, but I didn’t experience much pain. I found that every few days, I was able to do something new. Bend over to pick something up, sit on the toilet without a booster seat, and lift my leg a little higher. I almost didn’t need my mom to help me, she found that most of the time I slept or watched movies and didn’t need much from her. The hardest thing is not being able to get food or water and carry it for yourself. Of course, it was uncomfortable. Sleeping is awkward, and my leg felt like a dead weight, I had to use a towel to haul it to where I wanted. But it was nowhere near as bad as I was expecting. At my six week checkup and X-Ray Kjeld told me I was healing great and that the physio would coach me on how to start slowly transitioning from two crutches to one.
I worked hard on my recovery. I did all the exercises that the physio told me to do and regularly went to physical therapy. I found that strength came back quickly, and I could really feel the difference in my hip! It just felt better, like an irritation had been removed and soothed. I remember thinking, “So THAT’S what a normal hip is supposed to feel like!” I was amazed at how much better it felt when before I wasn’t sure if I needed the surgery. Sure it wasn’t easy, I think that getting back to walking normal distances is the hardest part. I was doing handstands and pull-ups long before I could comfortably walk the whole distance from the metro to work. It took months before I didn’t feel like I was waddling or limping.
My goal between sides was to get back to aerial at least a bit – to recover my strength so I could recover quickly from my right side. My physical therapist and the surgeon warned me that might not be possible. I was humbled when I found they were right. I pulled a muscle in my groin. It was super painful and slowed my recovery – I had a few weeks of painful walking and beyond that whenever I tried to engage my body for inversions (going upside down) it would hurt again. Humbled, I began other activities to fill in the gaps. I managed to hike, do yoga, calisthenics, and even horseback ride between surgeries.
Going in to have my RPAO was hard. I felt great and I knew the recovery I had ahead of me. I wanted to get it done as soon as possible because I was planning to move back to the US and I wanted enough time to recover before moving (little did I know that plan was going to be extremely thwarted). So about six months after my LPAO I went in for the other side.
The experience was very similar to the first side – except the second time I was much more nauseous and ended up throwing up in the hospital and several times after. I also did experience some nerve damage on the upper layer skin of my thigh that is still there three months later (when I put my phone in my pocket and it vibrates I can’t feel it!) but my overall healing went even better than the first time.
Except…I woke up from the hospital at the beginning of the Covid-19 pandemic coming to Denmark. I watched from afar as the world began to shut down. Luckily, I was already social distancing by sleeping at home 11 hours a day. The only issue was my screw-removal surgery was canceled and my checkup appointment for my hip was pushed from six weeks to eight. Oh, and the US Embassy advised that my husband and I leave immediately for the US if we still wanted to move. That meant that my original plan of moving four months after my surgery was ruined – we needed to move while I was still on crutches.
Moving is another story altogether that I won’t go into, but my RPAO was over with, and once again, I felt the improvement in my hip immediately. I’m now back in Colorado and 2.5 months out of my RPAO. I’m navigating recovery without the full support of physical therapists and gyms to keep me motivated, but I’m beginning to walk further and can squat and ride the stationary bike. I still have plenty of healing to do before I can start more intense sports, but I’m so glad that I decided to prioritize my long term health. My hope is that taking these two years now to invest in a happier, healthier body will mean that I’ll be able to stay active my entire life without having pain or an early hip replacement. I’m incredibly grateful to Kjeld and his team for giving me a great place to heal and my physiotherapists, who encouraged me to keep pushing myself.
Private Hospital Mølholm – The hospital where I had my surgery. Many international people travel here to have their PAO surgeries.
Dr. Kjeld Søballe – The surgeon who performed my PAO surgeries. He has his research and methods published on his websites. Including a full video of the surgery with his commentary! (I wouldn’t recommend watching it if you’re squeamish)
Gmb.io – I used this online program as prehab for my surgery and did modified programs once I was cleared for all types of movements for rehab. The way they break down movements into small pieces was a great way to re-explore my body after the mechanics of my hips had been so drastically changed