A High-Tech Hip Implant Keeps a Family Ties Star on His Toes
It's one of those overnight success stories made even more improbable by the fact that four and a half years ago, Valentine was told he might never walk normally again. While bicycling in Manhattan, he had been run over by a truck; his left hip and his pelvis sustained 37 fractures. Doctors told him that the hip tissue would gradually die. They also told him that they did not want to give him a conventional artificial hip replacement because a young person's level of activity often causes the cement with which it is implanted to fracture. He was advised to prepare for the possibility of life as an invalid.
Intent on beating the odds, Valentine asked around and heard about a European artificial hip, the Autophor, which was then being evaluated for use in the U.S. Valentine also tracked down Dr. Steven Stuchin of New York's Hospital for Joint Diseases Orthopaedic Institute, who agreed to take his case.
A year later Valentine was able to walk with a cane; six months after that he was back on his own feet. He spoke with correspondent Suzanne Adelson about his experiences.
It was about 4:30 in the afternoon on Sept. 17, 1981. My agent and I had just signed a contract for me to appear on a soap opera in New York, and I was on my way to sign a lease for a new apartment. I was riding my bike on Eighth Avenue. I had just passed 42nd Street when I was rear-ended by a truck. The impact flipped me up in the air, and when I landed, the truck's front tires ran over my body, across my pelvic area and over my left hip. Then the back tires came along and pushed me for about a block and a half before the truck stopped.
I never lost consciousness. I remember looking up as the driver shifted gears to try, I think, to start moving again. He didn't know I was there. I was screaming. All I could think about was getting somebody to hear me.
A guy who had been standing on the street jumped onto the truck's running board and wrestled with the driver to get him to stop. Then the guy came running back to me and said, "What can I do?" I said, "Tell him to back the truck off me." At this point two back tires were on top of me. I could feel the pain all through my thighs and pelvis. It was excruciating, and I felt very hot. People had begun to gather and were staring at me, and I said to the man, "Please let me hold your hand." I found out later from my lawyers that he was a drug pusher. I guess that's why nobody could find him afterward.
When the police and an ambulance arrived, they pulled me to the side of the street. The ambulance attendants began pinching my legs and asking, "Do you feel anything?" I said I felt pain. They said they had to straighten my legs to get me on the stretcher. I could feel bones shifting and crunching. The only thing that saved me from being killed or paralyzed was the backpack I was wearing. It got jammed up behind me and acted like a cushion and kept everything intact.
Just before 8 p.m. my doctor, David Fleiss, arrived at St. Clare's Hospital, where I'd been taken. He told me that within 24 to 48 hours my bones would set in the position they were in, but my condition was so unstable they couldn't operate. He said he was therefore going to put my hip back into its socket and put me in traction. They had two guys lying across my chest, two others holding my shoulders while another two pulled my leg as the doctor guided the hip back into place. I didn't feel a thing. The anesthesiologist had come by then, and I was completely out.
I was in traction for 51 days. I couldn't stand being inactive. I asked for some weights so that I could at least exercise my arms. I tried to do sit-ups. Finally, one day Dr. Fleiss came in and said, "You don't realize it, but this is a very serious thing that has happened to you. You almost died. You may never walk again without a cane. It doesn't look very promising."
That's all I needed to hear. It was like, "Don't say I can't, because I'm going to." I had a physical therapist come every day. I couldn't move my left foot, not even the toes, but I started tying washers onto a thread and lifting them with my toes. Gradually I progressed to picking up pencils with my toes.
I left the hospital in November. The doctors told me that in time my hip tissue would probably die because the blood vessels feeding the area had been destroyed. They said I'd have to wait and see how much pain and limitation of motion developed before I could get further treatment. So for the next two years I lived with a dying hip.
At first I went to my parents' house in Saratoga Springs, N.Y. I'd go to the YMCA pool every day and work out. I moved from a walker to crutches, then in May 1982 I returned to Manhattan. I went to the Sports Training Institute for physiotherapy and to a psychiatrist for psychotherapy. I wanted to find out why this had happened to me and where I was headed in my life. I never gave up. I never said, "I'm finished." The trucker's insurance company paid me $830 a month, but after I paid all my bills, I had $7 a day left over for food and transportation. With financial help from my folks, I went to acting classes and to auditions, but my gait was very bad. The producers would say, "Gee, Scott, you're a good actor, but you walk with a limp, and what if that hip breaks on the set? We can't get insurance on that."
The pain was very bad. I had gone from taking aspirin to a variety of anti-inflammatory drugs. Then it got so I needed a little codeine, then Darvon. I got so angry. I felt like a laboratory rat, trying all this stuff, yet nothing was working. I couldn't bear to put any pressure on my foot. There were days I'd get up and go out, but I'd wind up just standing there holding on to a tree until I could psych myself up to walk.
The money from the insurance ran out in May 1983. I applied to Medicare and Medicaid, but I first had to prove that I was disabled. I had to get letters from my senator, my congressman, my assemblyman. It went on and on, trying to get enough money to live. That same month, my hip was declared dead. Dr. Fleiss said my options were to have a hip fusion, which would turn my leg from the pelvis to the knee into one bone, or to have an artificial hip implanted. There were two kinds, the conventional one that is cemented in and might have to be replaced after three to 12 years, or the cementless kind that can last a lifetime, if it works. It requires shaping the hip bone to conform to the implant, which is designed to allow the bone to grow into spaces in it. I went everywhere, Boston, Baltimore, Albany, looking for a doctor to do this operation. Then Dr. Fleiss suggested I call Dr. Stuchin. I got an appointment immediately with him and with Dr. Victor Frankel, the hospital's chief surgeon, and went right to the head of the class. They saw I was young and determined and that I definitely needed the hip. They explained that there was the possibility that my bone would not grow into the implant but that without it I would be doomed to a life on crutches. I said go ahead.
Next to the accident itself, that operation was the worst thing that ever happened to me. They had to cut out the diseased part of my hip. The pain afterward was excruciating. If you could get your hand up, it was only to say, "more Demerol, please."
It took me a year and a half to fully recover from the surgery. I was in the hospital for 13 days and went from using a walker to two crutches. The rest of that time I spent strengthening my muscles and working from two crutches to one and then to a cane. Financially, I survived on Social Security disability payments. I had no money for physical therapy, so I worked out a trade: I cleaned lockers in exchange for the use of exercise equipment.
After I learned to use a cane, I started going on auditions again. I'd leave my cane outside the office door. My left leg is still an inch longer than my right, but nobody notices my limp now. It's only apparent at the end of the day, when I'm tired, or if I've been sitting for a long period and my hip gets stiff.
I know there's always a possibility that the replacement won't hold up. But when I saw Dr. Stuchin last February, he said it was doing fine. There were a few times along the way when I banged the wall, but I wouldn't quit. I always felt that at some point in your life, someone's going to toss you the ball and you'd better stay in the game so you can be ready to run with it.