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08/01/2013
Sharing Genes but Not a Room
CHAPTER 36 - Hip Surgery and Shared Genes
I mentioned in my last column that I might discuss my upcoming hip replacement surgery, which was performed on July 2 by Dr. Paul Lombardi in the Morristown Medical Center here in New Jersey. If you have not already had hip replacement surgery, based on the number of my friends and associates who have had the surgery, chances are good you will need the operation later in your life. Because of the somewhat uncommon nature of my surgery, I thought it would be of interest to discuss my experience.
Prior to my surgery, I had planned to use the surgeon who had performed my wife's knee replacement some years ago. However, someone called my attention to an article in the New York Times on anterior hip surgery, as opposed to the side or posterior approaches used by most surgeons. The article described faster recuperation times experienced by those having the anterior approach, in which the surgeon goes in from the front. In the anterior approach, the muscles are pushed aside, not cut. The article also stressed that one should not demand anterior surgery from their surgeon unless he or she is quite experienced in the procedure. When I found that Dr. Lombardi, in the same group as my wife's surgeon, was routinely using the anterior approach, Lombardi it was, especially since he was highly recommended by a beautician in the shop where my wife gets her hair done. (You might question the reliability of such a recommendation, but the shop's clientele is highly skewed to older women and joint replacements! I did, incidentally, get additional opinions from actual medical sources.)
Before my surgery, I attended a class given by the hospital for hip replacement patients and found it quite interesting. There was one other Lombardi patient in the class. The therapist and nurse who led the class discussed the surgery and the precautions needed to be taken following the surgery. Several times, they would be discussing a specific precaution and tell us Lombardi patients to ignore what they were saying. For example, the other patients were told they should not sit with their knees higher than their hips (the 90-degree rule). They were also told not to bend down to pick something up or tie a shoelace. We were also told that the chances were that there would be a stay in a rehab facility following surgery. I was shocked when told by Lombardi that I might go directly home the day after surgery - no rehab!
On the day of my surgery, I was wheeled into the operating room and remarked to the anesthesiologist that in class we were told that we would be knocked out before getting the spinal injection. He replied, "No, I'm going to need your cooperation." I wasn't happy to hear that but did as told, sitting on the edge of the operating table dangling my feet and hugging a pillow while he got his needle. The next thing I knew, a nurse in the recovery room was telling me, "You have a new hip!" How great is modern day anesthesia?!
In addition, what a joy to be wheeled from the recovery room into a private room, just one of a bunch of private rooms on that floor of Morristown Medical Center. In the experience of myself and my wife, our major complaints in our numerous hospital stays have concerned roommates who watch their TVs at all hours of the day and night. In my last stay at Columbia Presbyterian Hospital in New York, I was fortunate to have as a roommate a professional rapper who insisted on practicing aloud new raps at midnight and other ungodly hours! And, wonder of wonders, in Morristown I was allowed to have the door closed at night, blocking out the perpetual noise found in hospitals during all hours of the day or night! Because my surgery was delayed from morning to afternoon, I did not make it home the next day but did come home after two nights in the hospital. I was on my own at home, my wife being in a rehab facility for her own medical problems. Within two weeks, I was driving and back to walking at the mall.
All in all, it was a most pleasing surgical/post-op experience. Except for one thing. Longtime readers of these columns will know that over the years I have shamelessly taken any opportunity to bring up the fact that some years ago I had a hole-in-one, a gorgeous shot witnessed by our editor of StocksandNews, Brian Trumbore. Well, that hole-in-one has come back to bite me following my surgery. I've also noted that, a couple years after my ace, I came to the same hole and found the tee had been moved back. Wanting to select the proper club to reproduce my great achievement, I started to pace off the distance to the new tee location. However, in the interim, the course had banned metal spikes and I had duly replaced mine with some plastic equivalents. The effect, when stepping on a railroad tie wet with dew bordering the cart path was like Teflon on Teflon, and I broke my leg down near the ankle! As a result, I have a plate in my leg in that location. A common side effect of hip replacement surgery is swelling of the operative leg, which I found aggravates the plate and, while the hip is fine, I've been hobbling due to the hole-in-one many years ago!
Hence, my advice to fellow golfers - you may not want to card a hole-in-one; you may regret it years later! Speaking of years later, I had thought I had written my last about our 17-year brood of cicadas, which died off about a month ago. However, for the past few weeks, I've noticed a lot of twigs on our driveway with dead leaves on them and, looking up at many trees in our area, can see large patches of dead leaves at the ends of branches. I speculated that these were the result of the female cicadas drilling into the branches to lay their eggs. Sure enough, an article appeared in our New Jersey newspaper, The Star-Ledger, citing these dead patches as actually being signs of life, the lives of the cicadas now being born and falling to the ground to burrow there for the next 17 years before emerging to sing their loud songs searching for mates.
OK, one last parting thought about cicadas and us humans. After reading a short 2-page article by Carl Zimmer titled "Genes Are Us. And Them.", in the July 2013 issue of National Geographic magazine, I wondered how closely we are related to the cicada. Most of the two pages in the article is devoted to a neat graphic depicting our DNA and the percentages of our genes that we share with other animal species and even plants. For example, who would have thought that we humans share about a quarter of our genes with the genes in a grain of rice! We often hear that we share 90 percent of our genes with our close relative, the chimpanzee. This doesn't seem surprising, given our striking resemblance to the ape family but, obviously, we're a lot different from a grain of rice.
The genes we have in common with rice and other plants are certainly an indication that we share an evolutionary history that points to a common ancestor dating back to the dawn of life here on Earth. From the article, I think I can make a fair approximation to my question as to how closely we're related to the cicada. We share 44 and 47 percent of our genes with the honeybee and the fruit fly, respectively, so it would seem to me to be likely that we share somewhere in the neighborhood of 40 to 50 percent of our genes with the cicada, it being another insect. You might be surprised to find that the mouse, gene-wise, is almost as close a relation to us as the chimp. We share 88 percent of our genes with that little critter.
Zimmer is careful to point out in the article that, over the course of time, the same genes in different species can evolve to perform different functions. I assume, for example, that the same gene may be involved in the production of different proteins in different species. In the graphic of our DNA, the last point on the graph is for us humans, with 100 percent of our genes being, of course, human. But what kind of "human"? Another article in the same issue of National Geographic discusses in detail the work of one of my new scientific heroes, Svante Pӓӓbo, and his group at the Max Planck Institute for Evolutionary Anthropology in Leipzig. Pӓӓbo and his colleagues are best known for their deciphering of the DNA of the Neanderthal human and finding that those of us of European extraction likely have several percent of Neanderthal genes in our DNA. I've discussed this work and more recent work on another human, the Denisovan, found more recently in a cave in Siberia. Purportedly, the cave was once inhabited by a hermit named Denis. It seems as though there was hanky panky going on between us modern humans and both the Neanderthals and Denisovans. I remain amazed that Pӓӓbo and his group managed to coax nearly complete decoding of such ancient DNA from fossils tens of thousands of years old.
Erratum: I'm blaming it on preoccupation with my then upcoming hip replacement surgery and my wife's being in a rehab facility for a back problem. In my previous column, I said, "I .... found in Wikipedia that our own Milky Way contains a hundred million stars and may contain 400 million". I misquoted Wikipedia - the two "millions" should have been "billions". At any rate, I now have a new hip and my wife is back home from rehab. Hopefully, I'll now be able to tell the difference between a million and a billion!
Next column should be posted on or about September 1.
Allen F. Bortrum
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