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??
Great comments on the French hospital – are they all like that ? No searching for parking spaces at expensive prices – the tram sounds amazing as are all the specialisms on one site …at the moment driving to Chemo at DCH weekly and although I have a parking permit for one the 10 dedicated parking spaces – 5 are for private ambulances/patients and there are often lively verbal disputes about usuage !
Didn’t realise that there are so many hip/knee replacements in France – something to do with the weather or diet perhaps ?
Regards – Peter T ,
Dear Peter T thanks for taking the time to reply at this difficult moment. Yes, it’s not just what goes on inside the hospital, it’s also ease of access for patients and visitors. As I said we’re super-lucky to have such wonderful hospitals in our region of Occitania, but driving/parking in general is a bit of a nightmare in a city like Toulouse with a medieval centre and a large agglomeration, with car-parks at the end of the metro lines usually saturated, not to mention ‘technical incidents’ on the metro itself… Thinking of you and sending warmest wishes xxx
Hi L, another wonderful and funny blog. Glad MDM is on the mend. Tell him he has a piece of A320 in his hip! I used to stress test them back in my aerospace days. He’ll be fine, avoid turbulence and bird strike, lol. Much love my French Yorkshire friend ❤️
Chère cousine, thanks as usual for your great comment, which I showed to the MDM and we had a good laugh. Well, we are spiritual children (old children) of Airbus, having lived in the ville rose for so long, but didn’t know every time we boarded an A320 with our usual trepidation (we are fearful travellers) we were actually in safe hands as it had been stress-tested by a good, sober, Punjabi-Yorkshire lass. And don’t mention turbulence, I’m sure you have landed at the UK’s highest airport, Leeds-Bradford, in your time??? Once it was so bumpy with those wuthering winds the inside plastic rim of the window next to us fell out as we touched down. But S will keep bird-strike in mind, our owl is going mad at the moment, he or she is lovestruck with another owl (unspotted as yet) so there’s all-night hooting and frequent flying going on from our roof top to the acacia across the chemin. Whew. Country life, hey? Extra special hugs to you at this difficult moment my dear xxx
PS readers, if you just can’t face the news at the moment, give yourselves a treat with Sheila’s mad, bad, hilarious Vodka Wardrobe series set in Bradford:
https://www.amazon.co.uk/Sheila-Patel/e/B075WWBSQQ
Having already commented here, I’m starting a new thread–I think—still related to the subject at hand–MDM’s new hip experience–but from a different perspective since having searched online for more info on Professor Reina and his team. So interesting–partly because I’ve recently had my own hip replacement experience–which involved trauma, but not to the hip itself (probably another story for another thread).
In a YouTube video, Prof Reina and a colleague, Dr Tonetti, discuss various aspects of hip replacements. What interested me in particular was the apparent differences between the French approach and the Anglo-Saxon one. I knew from living and working in Toulouse for five years that there are many, many cultural differences between the French and us Anglo-Saxons (and there are plenty of differences among various Anglo-Saxon groups too, but that’s for another day), but I never considered the difference in the western medicine field of joint replacement being among those. In the discussion is the mention of the difference in the Anglo-Saxon view of hip replacements done as the result of a trauma or of arthritis–apparently in the French view, this difference is not really seen as a difference at all, as their view is more “global.” I would love to have a conversation with Dr. Reina on the cultural differences in the field of medicine he observed during the year he spent at the Mayo Clinic in the US and the one he spent in England at Oxford–I presume he has long lists.
You’ll remember that on my return to the US from France, I worked as a cross-cultural trainer for both American and “foreign” (often French) clients, each trying to better understand the other from cultural viewpoints. In the field of medicine the overall care protocols may vary considerably due to this factor (one example of this might be the case where the entire family would inhabit the patient’s hospital room because that’s what was done in their home culture). So, I was especially interested to know that these cultural differences carry over into the business of hip surgery.
Must agree with you, Laurette, that Prof Reina would be an excellent choice of surgeon, as well as someone very interesting to talk to. Thank you to MDM for providing the opportunity to learn about what’s going on at “Purpan,” as we always referred to the hospital there for the time I was in Toulouse. It would seem that southwestern France is in very good medical hands.
Wow Nancy thanks for that really interesting follow up. I’d never thought about the mechanics of joint replacements as a subject for cross cultural discussion! But of course that’s your area of expertise. When we worked together in Toulouse it was always fascinating to have your take as a psychologist on the role of cultural diversity as it affects communication in the world of international aviation. Also I seem to remember you worked specifically with a group of doctors while you were over here? I’ve just watched the YouTube link you sent; although very technical as you would expect involving two experts heading a national symposium on orthopaedic surgery (SOFCOT) it was very reassuring to see the pros and cons of different approaches tabled for discussion, and, as you say, from a cultural as well as a technical angle (OK I confess I had to look up ‘acetabulum’, learning that it’s the socket into which the ball fits as part of the hip joint). I say ‘reassuring’ because how many people do we know who have had/will undergo such procedures? In the 2015 blog I cited statistics of 160 000 hip and knee replacements each year in the UK, so this is a subject of burning interest to many. (I have put a hyperlink to the video on my blog page as don’t know how to do that in the comments) And yes, we are very lucky in Occitania to have access to such excellent hospitals – of course as you know I consider myself an honorary ‘toulousaine’, having lived in the city for many years, so I may be somewhat biased – Iam already crossing my fingers for Toulouse to win the Rugby final against La Rochelle this weekend 😉 xx
Oh dearest Lolo…what a life, hey!
Who would have …ever…guessed?
Where are our “galavanting” days?
Can’t forget your Chagall type of flight somewhere in Les Landes in an unprecedented storm and a “flooded” return back to your then flat Rue du Coq d’I….
Survived it all …..( “we shall overcome”song)
A big hug to Sylvain, from the “happy” shoulder.
What a life (or nine of them) indeed chère Mims. Yes, that storm was early June, if I remember, a fickle month…Thanks for the happy shoulder hug I will pass it on, and thanks for the memories, what’s the saying, mieux vaut avoir des souvenirs que des regrets?? Let’s hope we have a lot more 😉 xx
Great as usual chère Laurette! J’ai bien ri!
Félicitations au MdM pour ce rapide retour à la normale! Le progrès est toujours étonnant, effrayant parfois mais pas dans ce cas ci 🙂 Je pense que les “hortenses” de tous les genres possibles vont se multiplier irrémédiablement. Pour le meilleur et probablement pour le pire aussi hélas.
Mille bises à vous deux.
Au plaisir de se revoir!
Merci cher Toto comme d’habitude! Nous avons bien ri aussi aux ‘hortenses’ en multiplication… comme tu dis ‘a double-edged sword’, et toi dans ton métier tu est bien placé pour le savoir (déjà on tremble à l’idée l’AI, et où ca peut nous mener…) au plaisir de se revoir indeed, la chambre d’ami t’attend…ainsi que quelques bulles et lots of ‘catch-up gossip’!xx
What an amazing recovery and how the after care has changed in the 8 years since you had your op. I hope that the MdM soon regains his old swagger and that the lawn becomes fully mowed! ( Although please don’t overdo it!)
Your photo of Eugénie Grandet reminded me that that was one of my set texts for A level French – maybe yours too as I suspect we did the exams from the same examining board. I always found Balzac a bit turgid but it was good to have memories revived.
Bon courage to patient and carer!
Thanks chère amie, yes, astonishing progress in the field of medicine and elsewhere. We are getting back to normal, I no longer have to mow the lawn (well, the weeds) and act as chauffeur. No, I can’t remember doing Eugenie Grandet for A levels, mind you I can’t remember what the set texts were in anything – I even did Latin, did you? Have you re-read Balzac lately? I think you might get on with him better now. Bon courage to you also, and your ‘patient’, hope he is making progress and la vie en rose returning to your 20-year old house in paradise xx
Fabulous read, what amazing service in France and mowing the lawn after 3 weeks!!! Amazing! Great read and we wish MDM well and a swift recovery. Made me laugh so much, see you soon, from me and himself x
Aw thanks Paula, glad you enjoyed it! Yes – see you soon is a great idea! The years are rolling by, I was looking at our photos, remember the lavender hedge behind us on the terrace? All dead and gone now ;-( But – we are replanting. Hope all is going well for you and himself xx
You DO have a vivid imagination. This made me laugh. I know I’d be wandering around, taking pictures, wondering if the place was safe enough for an alien invasion.
LOL! I love how upset you were about MDM and Hortense. And I had no idea what an epiglottis is. I had to look it up!
I’m glad to read MDM is on a quick road to recovery. It sounds like he took it seriously, followed instructions, which I’m sure aided in him getting better.
Hope your arm is back to normal soon!
Take care.
Thank you Denise! Yes, the MDM was a good student, and Hortense kept him on the straight and narrow, heh heh. Thanks for your kind thoughts, do hope all is going well in the US, probably an emotional visit after all this time. You take care as well xx
Thanks so much Nancy! I was laughing too at your comment, even though I knew the incredible story, and the fortunate intervention of the guy who came to fix something and found you in the barn…. I’m assuming all is well now? Did you get that Smartwatch that sends an alert in case of further falls? Sounds as if it belongs to the hi-tech future we have been plunged into. Next model will probably be able to air-lift you via drone 😉 Keep upright and keep smiling! Lxx
All is well now, Laurette, thanks. I did get the Apple watch with the fall detector feature…HOWEVER, I have discovered that that particular feature does not always work as promised, which is why I went to the expense of investing in it in the first place. (Does Apple know that this alleged feature is not always functioning, but continues to use it as bait just to sell more watches?) Anyway, I want the model with the air-lift! Please let me know if it appears first in Toulouse, as it seems that Toulouse is into high tech transport and would be a logical launch site. Hope your arm is getting back to its original state of well being–that’s been a long haul for you. In the meantime, I’m making a concerted effort to remain upright.
Oh that’s disappointing about the watch. Yes, you know the airlift drone is maybe not as far in the future as we imagine when you see that amazing Téléo (which we haven’t yet tried). Who would have thought you could commute to work from one bank to another in la ville rose without touching the ground! Remember the traffic jams on the bridges (actually I think there are still straffic jams on the bridges, and everywhere else as the city keeps growing). Yes, the arm takes a long time, the shoulder didn’t like being wrapped up in velcro for 2 months xx
Great post, Laurette!! I was laughing all the way while entranced with all of the recent Toulouse achievements, including the hyper space-age transport systems in and around Toulouse–the Téléo, especially, but also the tramway at Purpan (I don’t think I was ever actually there to see Purpan in person during my long-ago sojourn in La Ville Rose), but it sounds wonderful.
I found my own solution to those months of pre-op prep one is made to go through preceding major joint replacement surgery–I went through it twice–once for each knee back in 2013 and 2014. Having just had a hip replaced last September, I found a way to circumvent all of that running around in the weeks prior. It’s easy. You just fall and break one of your legs high enough up that the best way to fix it is to replace the hip. You get transported to the hospital by the hospital ambulance (no early rising necessary) and then just lie there and everyone runs around and does everything for you–because you are immobilized and can’t do anything for yourself. Perfect. This continues for the 48 hours you are there. (Because my surgery couldn’t happen until the following day from when I was admitted, and even then it wasn’t until late in the day due to the pre-op crowd having previously been scheduled ahead of me, my discharge was the day after.) So, bottom line–avoid the month+ long hassles of all of those pre-op appointments–the list you provided boggles the mind– and just arrange to have a judicious leg fracture, and all will be well–sans hassles.
Interesting that “Hortense” had MDM on crutches. I only had a walker for the initial week-10 days, then it was off to Physical therapy with my cane. But wow–lawn mowing just 3 weeks post-op is amazing!! Good for MDM–and for you!