In 2015 I got a new bionic hip and wrote a blog called ‘The Hippy Hippy Shakes’ (I know, I know…) My main worry at the time was that an inferno would break out and I would wake up hipless in the operating theatre and there would be a lot of firemen running around and a bunch of surgeons lying on the floor in singed gowns and an abandoned drill and a size four stem and ceramic head on the table just to my left. (I have an active imagination.)
Last month it was time for the Maître de Maison to get his new spare part – and time for a totally different experience: “The Hippy Hippy Shakes Season 2: Journey into The Future”.
While I spent eight days in hospital followed by three weeks in a rehab centre, it was all over for the MDM in a matter of hours. Patient and carer (me) departed our four-house hamlet in the Tarn at 6 a.m., checked into the hospital in Toulouse at 7 a.m., and were back in the hamlet with the nightingale and the owl the following afternoon. Post-surgical physiotherapy began at our wonderful AB Kinés centre where we have season tickets (I am still being treated for shoulder complications after last August’s broken arm).
Huge strides have been made in the field of medicine: the MDM’s experience had a definite futuristic, sci-fi feel to it, in keeping with the growing reputation of Occitania’s capital city over the last fifty years. It’s here that Concorde was developed, followed by Airbus and Ariane. La ville rose, Cité des violettes, now has a third label – Cité de l’Espace. Toulouse is also home to one of the country’s top university hospitals (CHU – Centre Hospitalier et Universitaire), a centre of excellence with different hubs covering health care, teaching, research and innovation, and which is systematically ranked from 1st to 4th place among the other 30 similar institutions. Linking three of these hubs is another futuristic invention, the Téléo, an urban arial ropeway inaugurated in 2022, now used by 6000 passengers a day. Its ten-minute glide above the city allows travellers to cover 3 kilometres in 10 minutes, avoiding the traffic jams while enjoying the views across to the Pyrenees.
Although his hospitalisation was much shorter than mine, the MDM’s journey into orthopaedic space was considerably longer, involving a tailor-made, hi-tech tool. Rewind to April and the first consultation with surgeon Nicolas Reina, who joined the hospital in 2018 as the youngest Professor of Orthopaedics in France. Kudos! Professor Reina had previously spent a year in the UK as Clinical Fellow at the Nuffield Orthopaedic Centre in Oxford, as well as in the US at the famous Mayo Clinic. More kudos! The appointment was at the CHU Purpan, a huge campus with 7 different hospitals and a tramway running through the middle.
Pierre-Paul Riquet, the hospital which houses the traumatology and orthopaedic surgery department, has six floors, endless corridors, banks of lifts, cafes and shops, a vast rooftop terrace, and a lot of people milling about talking into smartphones. As you walk through the doors you half expect to hear a disembodied voice saying ‘Welcome to Galactica!’ During the MDM’s hospitalisation, I resorted to taking photos of the route to his room after walking in never-ending circles the first time I left him and tried to get back.
That first day, the waiting room was packed with people all hoping for new hips and a new lease of life. After consultation with the Professor and his team, a date was fixed for last week in May, and things began to accelerate. We were handed over to the administrative and nursing staff and a date was set for a preliminary day of education (école des patients) starting at 7h 45 a.m. during which Professor Reina would give a presentation followed by a Q and A session, meetings with physiotherapists, nurses, anaesthetists and other medical personnel would take place, and the six patients in attendance would be able to enjoy a nice lunch together, chatting with a nurse.
A computer link was set up for the patient to log on to at home 35 days before the op, a vital (and somewhat mysterious) part of the process.
Back in the hamlet, the MDM activated the link and got launched on his daily ritual. Each morning he disappeared into the study to engage in cryptic communings with his laptop.
‘Who are you talking to?’ I asked at the end of the first week.
‘Oh it’s nothing, just Hortense.’
‘Hortense?’
A vision of a 19th-century heroine in a crinoline flashed across my mind. Wasn’t there a Hortense somewhere in Balzac who came to an unhappy end?
‘Yes, she wants me to measure my biceps.’
‘Pardon?’
‘And my calves. Can I borrow your tape measure?
Another day I spotted him carrying a large mirror. Peering into the study I saw him holding it in front of his face, mouth wide open.
‘Hortense wants to know if I can see my epiglottis,’ he said, catching me lurking in the doorway.
OK so we had definitely entered a fourth dimension. My suspicions were on high alert. This was no lady in a crinoline at the other end of the computer. This was a sci-fi Barbarella-like minx with designs on the MDM’s epiglottis and shapely calves.
I marched into the study determined to have it out with the sexy blonde in the fishnet tights.
‘Right. Show me this Hortense.’
With a long-suffering look, the MDM turned the laptop in my direction.
On the screen, a picture of a happy couple hiking through the mountains on Olympian hips. Not a fishnet in sight. Hortense was “Orthense”, a computer programme! Two differently-spelled words with same pronunciation.
The idea of having an operation is not something most of us look forward to with whoops of joy. In some cases it can be frighteningly impersonal, the lone patient struggling to understand what’s going on in an arcane medical world becoming more specialised by the day. I remember my own pre-op anxieties in 2015, having consulted Dr Google (doesn’t everybody?):
‘I was now a bit of an expert. Acetabular cups, femoral stems, greater trochanter, lesser trochanter-the vocabulary was down pat, I just needed to figure out how to put it into sentences.’
Was there a way to involve the patient more fully in the hospitalisation experience, to lessen their anxiety and sense of abandonment in an unfamiliar world? Professor Reina and his colleagues believed so. In a 2021 article in La Dépêche he talks about solutions to fill this gap in patient care, establishing a better quality of communication between busy doctors and their patients. Digikare, a local tech startup was brought in to help, and “Orthense” was born. Starting 35 days before surgery, patients begin working with this digital companion to evaluate and manage their pain and to keep track of the different administrative documents required and the numerous appointments necessary at different stages in the process – X-rays, blood tests, nasal swabs, ECGs, consultations with the anaesthetist etc. The support programme continues for a year after the operation. As more and more data is fed into it, surgeons will also be able to predict the kind of patients who may be at risk and so avoid complications.
It’s just over three weeks since the op. From Day 1, the MDM set out with his crutches and has been walking determinedly up that hill…. Now, with his wonderful new hip, he’s abandoned the crutches and even had a go at mowing the grass. Yippee!
He’s also getting help from his digital sidekick Hortense/Orthense, who will be holding his virtual hand and not letting go until… 1st June 2024!
A resounding ‘merci et bravo!’ from the patient and his carer to:
- Professor Reina and his brilliant team of medical and administrative personnel at CHU Toulouse Purpan for their professionalism and empathy.
- The staff and volunteers of Le Laurier Rose, offering on-campus accommodation and a sympathetic ear to those stressed-out mortals accompanying patients.
- Dr Marie-Madeleine Polomeni-Lucas, anaesthetist and specialist in hypnosis and pain relief at the Hôpital des enfants, CHU Purpan, for her precious friendship and psychological support throughout.
- And, of course, Chère Hortense 😉
PS All comments welcome in English et en français !
PPS Here’s a link to a video sent by Nancy Babcock. You can read her interesting comment in full below, but I didn’t know how to insert a hyperlink to the video in the comments -remember I’m a non-tecchie??