We hadn’t expected to return to the States until our daughter Ruby’s wedding in October, but that was before Dorothy’s hips gave out. Our strategy for medical management was to pay local retail for normal maintenance, but come back for the big ticket items. So, big ticket item.

We’ve known for a while that Dorothy was eventually headed for hip replacements, but we didn’t factor in how quickly they’d deteriorate once we adopted a largely walking lifestyle. When we started in Oaxaca we were putting in 6-7 miles/day. By the time we left Chetumal, we were down to five minutes of walking followed by 30 minutes of sitting before we could make the return trek.

We found a well-regarded surgeon in Chicago, and Dorothy flew back from Mexico City for a few days at the end of March for scans and consultation. When he came back with the scans, he said, “I’m sorry to ask, but which hip did you want to do first?” They were both in pretty awful shape, but the right had literally zero cartilage left, pure bone-on-bone, while the left still had about 20% of the cartilage remaining. Question answered.

While we were waiting to be scheduled, we were informed that Dr. Surgeon didn’t take Medicare of any kind, and that his fee, which would be fully out of pocket, was $9,000. Hard no. We pivoted to another surgeon in the same practice who did take Medicare. He was happy to use Dr. Surgeon’s scans, but he needed a video chat with Dorothy before he’d schedule her.

Unfortunately, the attempts to connect for this conversation happened when we were in Cuba, enjoying our host country’s robust telecommunications infrastructure. We could never quite get the phones and interwebs working at the right time, so we decided to punt and just connect when we got back to Mexico.

We contacted the office our first day in Chetumal, but were shocked to learn that the first opening the doctor had for a call was three weeks out, at the end of May. Fine. The consult was a formality, as we expected, and they were able to take advantage of a cancellation to get Dorothy in at the end of June. We’d been told the normal cadence was 2-3 months after consult, so we felt pretty lucky.

We’d have to eat our last month of Airbnb in Chetumal, as well as our airfare from Chetumal to Guanajuato. But that was obviously a small price to pay to solve a serious problem. With the first hip replaced, we’d go on about our business and then get the second hip done after Ruby’s wedding.

The day of our return trip to Chicago was June 13th. Dorothy had lab work scheduled for the 15th and surgery scheduled for the 29th. We were packed and ready for our car to pick us up at noon and take us to the Chetumal airport.

And That’s When Things Got Weird

At 11:15, the surgeon’s office emails Dorothy that they’ve finally run everything through the insurance, and the hospital they use is out of network. Our two options are a) treat it as an out of network service and pick up a 40% copay (of an unarticulated amount) or b) reschedule for a month later at a facility that’s in-network.

We’d switched to this doctor specifically over insurance coverage, so this was a particularly bitter blow. We’re minutes away from going to the airport to fly to Chicago. The prospect of waiting another month, and housing ourselves at US costs, is horrible. But the alternative, keeping our existing appointment, requires picking up 40% of we don’t know what.

When we get to the airport we call the hospital, and find out that it’s 40% of… wait for it… $48,000. Or just a whisker under $20,000. *checking the trust fund balance* Nope, not going to fly.

So we’re back and forth by phone and email with the surgeon’s office while we wait for our plane. As of takeoff it looks like we’re just going to have to cool our heels in the US. Which is doubly annoying, because we cancelled our Chetumal apartment so late in our stay we only got about a week refunded. We’ve payed for three unused weeks in Chetumal and now we have to pick up an extra month of US housing. Ouch!

When we land in Mexico City to transfer, we pick up a message that they’ve had a cancellation at the in-network facility, and they can do Hip #1 on June 22nd, a week earlier than previously scheduled, rather than a month later. That still requires some scrambling, but it’s the better problem to have. Dorothy had been heartsick at the prospect of having to wait another month for relief.

Like A Surgeon…

Modern surgery exists at the oxymoronic Venn intersection of delicacy and brutality. Like a sumo ninja. Or a lead zeppelin. Dorothy, a TSA-unfriendly amalgam of aftermarket parts (she prefers to self-identify as a cherried lowrider), has long since embraced the inherent contradictions of the medical-industrial complex, having had both knees replaced almost a decade ago.

Hip replacements are, by repute, easier to recover from than the knees. Not to mention whatever process and material improvements have accrued in the intervening years. There were definitely robots involved for the hip replacement, which wasn’t a thing when the knees were done.

As soon as Dorothy had more or less come down off the anesthesia high they had her take a lap around the recovery room, on her actual legs. She was then poured loosely into a car and sent back home.

Home Is Where The Hips Are

Home, itself, being an interesting concept for we, the homeless. For the first week of our Chicago junket my sister Nef graciously let us use her guest room, but that’s entirely different than offering up your home for 4-6 weeks of post-surgical rehab and recovery. That doesn’t work for anyone.

Unfortunately, non-guest room housing proved elusive. We’d spent the previous seven months exclusively in Airbnbs in Mexico and Cuba, and they’ve been fine. Affordable, great locations, with accommodations ranging from OK to Pretty Good. Meanwhile, all we’ve heard from our stateside friends is how broken and unusable Airbnb is. Which is true. In the US.

The best we could find for a month in Chicago was $2,000, and those were all bedrooms in houses, with access to shared bathrooms and kitchens. Not an ideal rehab setup. Anything that looked like a standalone unit with a real kitchen was well over $3,000. Out of our range.

We finally found a suite hotel the fuck and gone for $2,400 for the month, and that felt like a triumph. We’re the King and Queen of redefining victory. But then, at the last minute, something miraculous happened: a good thing! A good thing happened!

My niece, Amber, discovered that an acquaintance of hers was keeping an eye on a largely unoccupied apartment right in the Hyde Park neighborhood that she and Nef live in. The owner had mostly moved to Michigan, but hadn’t yet cleared out her Chicago apartment and sold it. So we got to housesit for free in exchange for paying the cleaners for the month we would be there. Given the housing and airfare costs we’d had to eat, this was a wonder of wonders: free lodging walking distance from both a Trader Joe’s and a Whole Foods.

About three weeks into our stay we finally met our benefactor, who was so nice that she agreed to let us use the apartment again when we come back in October for Hip #2. I’d never appreciated the benefits of having a fairy godmother before this.

Like Betty Ford, But For Hips.

So now it’s all about recovery.

When Dorothy went in for the hip replacement, Hip #2 was actually in more pain than Hip #1. In adjusting for #1’s thoughtless lack of cartilage, #2 had developed compensatory sciatica. The nerve blocker that had been used during surgery, combined with the post-surgery Gabapentin, fixed the sciatica. Even when the slurry of surgery-related drugs wore off, Dorothy was already in less pain than she was when she went in.

Besides the drugs, the only other component of the rehab was physical therapy. She had someone come in three days a week for the first two weeks, and then two weeks of outpatient PT. She was walking with a walker the day after surgery, and transitioned to a cane in week two. By week three the cane was a comfort object, and she was largely motoring about on her own.

She’s so lucky she did knees before hips. The hips, as promised, are truly much less an ordeal than the knees. I can imagine doing the hips, breezing through it, and then figuring you’d just ace the knees. Only to slam full speed into the brick wall of knee rehab. Doing knees first, though, definitely sets you up for hip success. After you’ve done the knees, the hips are a doddle. Says the man who’s done neither.

Even the PT is easier. The protocol for hip rehab is “Stop if it hurts.” The protocol for the knees was “Harder. You’re not crying enough.”

Dorothy’s followup with the surgeon was at the three week mark, and she was deemed a successful host to her new TSA trigger. She was also cleared to fly at the six week mark, so we’ve made our plans, and will be back on the road on August 2nd. A month in Guanajuato, a month in Rosarito Beach, Ruby’s wedding, and then back to Chicago for Hip #2 at the end of October.

After that, we’ll be headed to Morocco sometime around the first week of December. Christmas in Marrakech y’all!