STEAMBOAT SPRINGS Eighty-nine-year-old Vanda Nohinek has plans to raft down Cataract Canyon with her 15-year-old grandson next year. With two new hips and a new knee, one might question Nohineks sanity. But fear not she says.

I feel 20 years younger than I am, said Nohinek from her Steamboat Springs townhome. Im as good or better than I was before the replacements.

Medical procedures replacing full hip and knee joints have gotten so sophisticated that even after Nohineks first hip surgery in 2014, she was back on the slopes skiing and out on the road riding bicycles. Then fall 2015 hit, and Nohinek said her right knee went out. Once again, she consulted with Dr. Alex Meininger of the Steamboat Orthopaedic and Spine Institute.

The whole office is just tremendous friendly and uplifting, she said about the group of local surgeons who recently opened a new clinic space and outpatient surgery center, where they anticipate up to 90% of their surgeries will be performed.

Meininger explained that 20 years ago his mentors told surgical residents that knee replacement patients wouldnt likely be skiing or playing tennis again.

Nowadays, I virtually guarantee theyll get back to those things patients enjoy, Meininger said.

Arthritis and joint pain are not a reason to make sacrifices in your life, he added. If you have goals and desires you need to fulfill, then joint replacement is something you should consider.

Meininger cited a number of advancements including artificial joints designed to feel more natural and the sophisticated instruments used to install them more accurately.

Today, we have available new techniques, such as customized instruments and cutting guides based on MRI or CT images, computerized navigation and robotics that allow surgeons to place the joints more perfectly, Meininger explained. I use computerized navigation to identify the axis of the joint and reproduce it precisely within 1% to 2% of the natural knee joint.

After her knee replacement, Nohinek was back on her bicycle, riding through Europe and logging 26-mile marathon rides in Routt County.

So by the time she broke her right hip last fall, the spunky senior seemed almost nonchalant about yet another surgery.

Wasnt worried at all. What good would it do? she laughed.

Nohinek described how quickly patients are up on their feet, usually the same day they come out of surgery.

Physical therapy starts right away, she said.

Nobody knows that better than Marcia Pomietlasz, another active Steamboat resident who was amazed by her two knee replacements in 2013 and 2015, both done by Dr. Meininger.

I was so excited to have the procedure done, said the 72-year-old avid tennis player who suffered from bone-on-bone arthritis in her knee joint. The new knee works right away.

Both women stressed that a positive attitude and consistent rehab, both with the physical therapist and at home, are essential to a full recovery.

Pomietlasz remembers when her own mother had knee surgery back in the 1980s.

It was a whole different ballgame then. She was in the hospital for four days, she said.

Nowadays, its becoming more frequent to go home the following day and in some patients even the same day.

Pomietlasz even noticed the difference between her two knee operations in 2013 and in 2015. She said by 2015, she didnt have to wear a brace after the surgery thanks to new advances in techniques and medications.

Previous anesthetic techniques caused lasting side effects like weakness in the quadriceps muscle, so patients needed a brace so their muscles didnt give way on them, Meininger said.

Meininger said surgeons are now using shorter-acting medications and targeting specific areas or nerves with anesthesia that need it, which leads to less pain and a faster recovery.

Today, Pomietlasz is skiing and playing tennis with ease.

Even my daughter said, you are skiing so much better now that you have new knees, Pomietlasz said. I was favoring one leg over the other. So yes, this is a whole new skiing experience for me.

Both Pomietlasz and Nohinek encourage older people to put away their fears and seek out answers.

How badly do you want your life back? Pomeitlasz asked. Thats what joint replacement can do. It gives you your life back. The technology is so incredible, and it has to have improved in the five years since I had my last surgery.

Meininger said he is also lucky to practice in an active, mountain community with motivated patients.

Results and outcomes are improved when the patient participates in the process, he said. Our patients have higher expectations for themselves, which means more success.

About two years ago, two private orthopedic practices merged to create the Steamboat Orthopaedic and Spine Institute, which is expected to compete with the reputable Vail-based Steadman Clinic. Michael Sisk, Andreas Sauerbrey, Alexander Meininger, Patrick Johnston and Clint Devin are owners of the new medical facility. Additional doctors in the practice include Bryan Bomberg, Adam Wilson, Alejandro Miranda and Lex Tracy.

In North Routt County, Clark residents Jeanne and Dennis Lodwick are shooing their dog away from a visitor. The duo move around briskly, cracking jokes at each other like an old couple in a comedy TV sitcom.

Jeanne got a new hip just three months ago and is back playing pickleball and paddleboarding. Meiningers partner, Dr. Andreas Sauerbrey, operated on Jeannes hip and also put in Dennis new titanium knee two years ago.

But it was another technological advance that changed the Lodwicks lives dramatically.

It was the most amazing medical miracle Ive ever seen in my life, said 74-year-old Jeanne.

She is talking about her husbands neurostimulator, a sort of pacemaker for the brain.

About 15 years ago, doctors diagnosed Dennis with Parkinsons Disease, a brain disorder that leads to shaking, stiffness, difficulty walking and bad balance and coordination. By 2016, the Lodwicks quality of life had plummeted.

I couldnt hold a glass of wine. I literally had to sit on my hands to keep from shaking, Dennis said.

The two couldnt go out in public, because his intense shaking could lead to accidents. The couple even stopped their yearly driving vacations. Then about four years ago, neurologist Dr. Mihaela Alexander gave a talk about advancements in treatment for Parkinsons patients at the Bud Werner Memorial Library in Steamboat.

After hearing about the procedure called deep brain stimulation, the couple made Dennis an appointment with the Denver-based neurologist.

He endured a battery of mental and physical tests before he got the go-ahead to proceed with the innovative procedure.

As the couple scrolled through cellphone photos of all their surgeries, from old bones taken out of Dennis knee, to an X-ray of Jeannes new metal joint, Dennis tried to paint a picture of how the neurosurgeon proceeded.

They basically bolt a robot to your head that helps guide the surgeon, he said.

Dennis hair covers the two large scars where the surgeon implanted the stimulators on each side of his head with probes aimed at a specific site on the brain. Two weeks after they put in the stimulators, they put batteries on each side of his chest and ran wires to the stimulators in his head. Then after two more weeks of healing, the neurosurgeon dialed in the amount of electrical stimulation theyd send to Dennis brain probes.

It was unbelievable, truly a medical miracle, said Jeanne remembering the first time the neurosurgeon turned on the neurostimulators in Dennis brain. He went from shaking all over to nothing. I told the doctor, thats a really good trick. Lets do it again.

We bought five years of quality life so far. I wouldnt have been able to take care of him without it, Jeanne added.

Dennis brought out his small hand-held programming unit to show us how many volts were going to each side of his brain. The part of the brain that controlled the left side of his body showed 2.7 volts, while 3.8 volts was used to control the right side of his body.

My wife keeps joking shell turn it off if I upset her, Dennis joked.

Although Dr. Alexander was unavailable to expound on Dennis treatment, Dr. Drew Kern, a movement disorders neurologist at UCHealth and the University of Colorado, urged people with movement disorders like Parkinsons, epilepsy, dystonia and essential tremor to seek out a full array of medical help.

Deep brain stimulation is one of many advanced treatments available for patients with movement disorders, Kern said. At UCHealth, we have a team approach alongside our patients to determine the best therapeutic approach neurologists, neurosurgeons, physical medicine, rehabilitation physicians, therapists.

He said patient-centered decisions allow people to live as active a lifestyle as possible.

As for the Lodwicks, Vanda Nohinek and Marcia Pomietlasz, they couldnt agree more and they said it all starts with research.

Always get a second opinion, said Jeanne. Any surgery is an important and difficult surgery. Give it a lot of thought, pick your doctor carefully.

And have a positive attitude and expect the best results, Dennis.

Pomietlasz cant imagine that any active senior would think twice about joint replacement.

If youre happy not doing the things you did before, maybe its not for you, she said.

Theres nothing to be scared of, added Nohinek, who moves nothing like an 89-year-old matriarch. Go see your doctor, and if youre a candidate for joint replacement, just go for it.

Frances Hohl is a contributing writer for Steamboat Pilot & Today.

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The Longevity Project Part 1: Medical advancements are keeping people active well past retirement - Steamboat Pilot and Today