Isabella Harrison, trim and neatly turned out in lavender pants with a matching top, leans over her walker to push it methodically in front of her. Occasionally, she stops to straighten her back. "I've started to hunch over from using this," concedes the 96-year-old, a few months after undergoing hip replacement surgery. Harrison lives independently in her own home in a beautifully landscaped gated community in Virginia Beach.
For her January hip operation, the retired general surgeon made the trek to Newport News in order to take advantage of a minimally invasive joint replacement technique. Orthopedic surgeon and sports medicine specialist Anthony Carter introduced what he calls "the jiffy hip" to Virginia in 2006 and estimates he has done close to 1,000 of the procedures; he practices with the Hampton Roads Orthopedic and Sports Medicine group and is the chief of surgery at Mary Immaculate Hospital. All six doctors in the practice have since adopted the technique.
Carter's group uses an anterior, muscle-sparing approach which results in a much more rapid recovery times for patients. "For someone in their 90s, it makes a huge difference. It helps people who want to get back to work. It helps all the patients," he says.Carter learned the procedure from a surgeon in Santa Monica, Calif., who in turn learned it from a French surgeon in the mid-'90s. Why doesn't everyone use it? "It's a new technique. It's a learning curve. Some don't want to invest the time in it," says Carter.
Harrison and Carter, both surgeons and both pioneers in their own right, have something of a mutual admiration society going. "She has a scholarship endowed in her name at Johns Hopkins," says Carter. "She was an innovator for her time. Now she's getting the benefit of some new techniques."
Harrison, born on a dairy farm in New York State in 1914, was one of the first female graduates of Johns Hopkins Medical School in Baltimore, and became one of the country's first female surgeons. She describes her mother, a homemaker, as "advanced for her time" in supporting her career. "My father was shocked by it but he went along with my mother," she says. "I think it's the best profession, but then it's the only one I've ever had."
She doesn't recall her first operation, but as a general surgeon Harrison performed hundreds and hundreds of hernia operations, so she reckons that's probably what it was. She also performed appendectomies and bowel surgeries, and also fixed broken bones if they didn't require the services of an orthopedic specialist.
In her era - she was a medical resident in World War II - the ready availability of antibiotics revolutionized the practice of medicine. "It broadened the scope of surgeries tremendously," she says. She spent much of her career working for the Veterans Administration, where she became a director of the residency program. She particularly enjoyed the VA's emphasis on training and was happy not to have to concern herself with the financial aspects of a medical practice. She never encountered gender-based problems from other doctors, though patients there could be more difficult. "But they were really stuck," she says.
Before her surgery, she felt stuck, too. For several years debilitating pain from degenerative arthritis in her right hip kept Harrison largely wheelchair-bound. Apart from macular degeneration that now prevents her from reading and from her lifetime hobby of bird-watching - she identifies most of the common species at the bird feeder outside her living room window by their song, most recently she noted a rare visit from a Rose-breasted Grosbeak - she has maintained generally good health.
She retired from medical practice in her 70s, when she moved to Virginia Beach to be near her nieces. It was through a cousin's research that she learned about Carter's "jiffy hip."
"I'd never seen the operation or even heard of it before," Harrison says. "It's a similar prosthesis but the procedure is much simpler. There's no cutting all those muscles. I was able to stand almost immediately."
Her primary care doctor advised her against surgery, afraid that the rehab would be too hard at her age. However, she didn't have any reservations. "She was miserable with the pain. She wanted to have something done. She learned about it, she was excited," says Carter. After the 45-minute operation, conducted under spinal anesthesia, Harrison was out of bed the next day. She continues with physical therapy a few times a week, where she's learning to walk with a cane. Currently, she's misplaced the cane, though. "I think they're ready to throw me out," she says, while demonstrating her mobility by swinging her right leg back and forth, then side to side with apparent ease.
The surgery relieves the pain of arthritis and improves function. "Most are back to most of their activities after two to three weeks," says Carter, noting that traditional recovery time is up to three months, or at least double the time after his "jiffy" procedure. "With the standard operation there are still lots of dos and don'ts. Patients have to hold off on high impact activities."
For Harrison the greatest benefit of the surgery has been an end to her arthritic pain. "It doesn't feel quite the same as the 'normal' side," she acknowledges. "I can't do much, but it doesn't hurt when you're resting or quiet. The pain has gone."
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Anthony Carter practices with Hampton Roads Orthopedic and Sports Medicine, 730 Thimble Shoals Blvd., Newport News. For information on the group, call 873-1554 or go to hrosm.com