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A 76-Year-Old Woman Considering Total Hip Replacement

John J. Callaghan, MD
JAMA. 1996;276(6):486-491. doi:10.1001/jama.1996.03540060062037.
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Dr DALEY:  Mrs W is a 76-year-old woman who is considering total hip replacement. She is married and lives in suburban Boston, where she sees a primary care physician in private practice. She has 2 children and 3 grandchildren. She is insured by Medicare, and she and her husband have supplemental Medigap insurance.Mrs W has been in generally good health. Her primary care physician follows her for hypercholesterolemia and situational anxiety. She has been taking pravastatin sodium, 1 tablet (20 mg) each evening for several years. Her total cholesterol is 5.69 to 5.95 mmol/L (220-230 mg/dL) with medication (7.76 mmol/L [300 mg/dL] without medication). She is calm in the face of other people's illnesses but has lived with fear of developing cancer all her life. Her primary care physician has treated her anxiety with regular checkups and reassurance along with alprazolam, which she uses occasionally (less than once a


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