I am a 40-year-old American endurance athlete, about to become a statistic.
A long and winding path over the last four years has led to a total lack of cartilage in my right hip. I’m one of the many people leaving their own country to seek medical treatment in a foreign land.
As we age, outdoors athletes face the same challenges as everyone. Tackling health issues keeps us in the game. But skyrocketing premiums and health insurance exchanges can force even healthy individuals to the global healthcare market.
For five years, I’ve raced in pain. As time progressed, the pain increased from a whisper to a scream so bad we had to abandon the 2016 Patagonian Expedition Race. I investigated many options and spoke with myriad medical professionals. It finally became apparent that surgery was my only option.
Jason Magness is an athlete, adventurer, and a founding member of YogaSlackers. He traveled halfway around the world for a medical procedure this past spring that would keep him healthy and active. This is his account.
‘Birmingham’ Hip Resurfacing
May 3, 2016: 48 hours ago, my wife Chelsey and I boarded a plane in Seattle. 28 hours later we were in the intense early-morning heat of Chennai, India, home of the Asian Joint Reconstruction Institute.
There, for the price of 500,000 rupees ($7,800), I can get a somewhat complicated procedure known as a Birmingham Hip Resurfacing. My hope is to avoid a total hip replacement (which has more post-op limitations) and to continue competing in my various sports at a high, professional level.
There were many reasons for this decision, which I will touch on, but price was a big one. In the USA, this same surgery typically costs five times what it does in Chennai – about $40,000.
Hip Replacement In Foreign Land
Upon arrival, a clean-cut Indian was holding a sign: “Mr. Jason Magness”. Leaving the airport, our drive was typical Indian fare: No order to the traffic; a cacophony of honks that left me imagining aimless, squawking bats. Our driver tried not to get too close to the other honks, hoping his own incessant beeps would keep a small buffer of space around our speeding car.
The hospital “suite” was clean but sparse, white marble everywhere. It reminded me a little bit of a quarantine ward from an 80s zombie movie, or a surreal David Lynch world. After a few hours’ sleep in my hospital bed (yep, I got to stay in a hospital bed even before surgery) I was wide awake. Chai tea waited on the table in the suite’s “living room”.
Noise and heat filtered in from the open window as AC blasted inside the room. The sounds of India are difficult to describe to anyone who has never been. It is exactly the sound you’d expect when you put nearly four times the population of America into an area 1/3 the size.
‘You Don’t Look Like A Patient’
To me, it was all comforting, reminding my wife and I of our crazy honeymoon trip here in 2012 when we raced a tiny auto-rickshaw from one end of the sub-continent to the other. A time when my hip pain was only starting to whisper to me, and doctors and physiotherapist were still diagnosing it as a groin strain.
A few hours later, the visits started. I was given an admissions wristband. Almost everyone’s initial reaction to meeting me was, “You don’t look like a patient.”
Despite their English, the British-Indian accent created enough of a language barrier that trying to explain to them I was a seasoned expedition athlete was difficult.
The next two days were full of “investigations.” Blood tests, an EKG of my heart, X-rays of my pelvis, a meeting with the anesthesiologist, and eventually a meeting with the man who would cut me open.
Chelsey and I even worked out a deal with the nurses: unlimited Chai refills for yoga lessons.
Traveling For Hip Replacement: 73,650 Rupees
May 20, 2016: Nearly two weeks after my surgery, I became the proud owner of a little card that I have to carry through the airport security alerting TSA of my metal implant. I also inherited a pretty 10-inch scar on my butt that I can show them (which I actually had to do once) if they become suspicious.
The actual surgery went by in an anesthetic haze. I woke up feeling more thirsty than I can ever recall — and that includes memories of a desperate 140-km desert crossing in the Abu Dhabi Adventure Race.
My biggest initial challenge was learning to pee while sitting up in bed. I still had a couple tubes and needles attached, including a nerve blocker for the pain, so I was pretty immobile and would not be taken back to my room until I’d passed a liter of fluid. It was an annoying skill to master, but I am encouraged knowing that it will certainly come in handy during my next long ocean paddle.
Hip Replacement: Recovery And PT
Physical therapy started the day after, and within a week I was frightening my nurses with my level of activity. Handstands came on day two, modified yoga on day three, and by the end of the week, I’d walked a mile without my cane. The nurses started coming to my room in groups, just to see what we might be up to.
By the end of the hospital stay, there were at least three of them coming in every time just to give me a pill. There was certainly no lack of attention.
A few days post-op we moved to a nearby hotel where I spent my days walking laps around the building, training my upper body in the mini fitness center, binge watching Sci-fi series on Netflix, and eating amazing Indian fare.
My limited mobility made it difficult to explore much of the chaos outside, but Chelsey spent some time each day wandering amongst the temples, tenements, traffic, and tea stands that litter Chennai.
By that point, I hadn’t spent a single dime on anything other than the plane ticket. In the end, I had to go to the hospital staff and settle up my bill. They gave me an itemized list of everything, along with its associated cost. Most notable was the line item:
Surgeon fee – 73,650 Rupees.
A quick conversion was all it took to realize that Dr. Bose’s fee had only been $1,100! This was less than the roundtrip airfare I paid to get there. I honestly tried to give him a “tip,” but the hospital administrator was just utterly confused and so I finally just dropped it.
Hip Surgery Under $10,000
October 26, 2016: Nearly six months have passed, and the surgery is a distant memory for the most part. I know that I am still recovering and working hard to re-train muscle firing patterns to be healthier than the ones I built while compensating for my damaged joint.
I have more range of motion, stability, and strength than I can remember. Best of all, I am pain-free for the first time in nearly five years.
Athletically, I feel full of potential, too; stepping up my training in the past two months. This includes a 300-km (186-mile) road cycle, 25-km (15.5-mile) mountain run with 6,000-plus feet of elevation, a 5-km (3-mile) open water swim, an 8-hour orienteering course, and a return to teaching advanced partner acrobatics.
The total bill was $7,320. Adding in the hotel and the flights, we’d spent less than $10,000 for a two-week trip to India, including all food, lodging, a new hip, and unlimited Chai.