The Hip Saga Continues

Better mood. Happier post. . . 

Sorry it's been so long, but now I finally have something to write about.

July 24th I had total hip replacement surgery.  The night before, I showered twice, using antibacterial soap, per the doctor's orders and then anxiously sat around, not eating or drinking and definitely not sleeping, until it was time to head to the hospital   I arrived at Penn Presbyterian Hospital at 7 am and was registered for surgery.  I got changed, taking yet another sponge bath, and then waited for the surgical team to be ready for me.  

Once inside, I met with my surgeon, it was brief, but long enough to feel like I was more than a bag of bones needing repair.  The anesthesiologist let me know that he'd be using a spinal block and then knocking me out with sedatives rather than using general anesthesia, which he let me know was his preferred method for this type of surgery.  I was pleased to hear that because it was what I was hoping they'd use; general anesthesia scares me given my complicated pulmonological situation.  The spinal block was such a weird sensation, gradually losing all feeling in my lower half was really strange.  I actually remember waking up in the middle of the surgery, very drugged, but feeling no pain or pressure or anything like that.  The anesthesiologist soothed me back under and the next thing I knew I was in recovery.  

So, using a lateral approach, they replaced the top portion of my femur and a piece of my pelvic bone with a ceramic, artificial hip.  The way they do it is actually crazy - take a look at this video if you're interested.  The only part that kinda gives me goose bumps is right around 1:22 and continues to 1:45, where they widen the hole they've drilled with what is essentially a hammer and a wedge.  Orthopedists seem  to be the closest thing to carpenters that exist in the surgical world, what with their saws, power sanders, power drills,  pliers, screwdrivers, mallets, pins, plates, and screws, it seems that they could build a house just as easily as they could replace a hip..  The surgery took a remarkably short amount of time, just a few hours, and then it was off to recovery and my hospital room.

I felt better as soon as I woke up.  Well...that was probably because of the high dose of morphine that I was taking, but more than that there was just something indefinably different about the way the whole thing felt.  It was really amazing.

The first few days were a mixture of total drugged delirium and hellish pain.  They spilled a bedpan once, trying to take it out from under me, and I screamed louder than I've ever screamed in my life, that kind of all out, unguarded, primal scream that you couldn't fake if you wanted to, as they held my on my side so that they could change the sheets.  I begged them to just leave the damn sheets on the bed and go away.  I don't remember much else from those four days, but I remember that pain like it was yesterday.  It was a totally different kind of pain than the hip pain I've been experiencing for the last year and a half though, it was surgical pain, sharp and profound, not the pressure and dull ache of the AVN.  That was gone completely and it was immediately clear that I'd made the right decision when I pushed for the surgery.

My time in the hospital and the dopiness and pain that came with it was over quickly.  They bandaged me up, got me up, walking (a few feet with a walker) and off to rehab.  Because I made the decision of which rehab to stay in while under the effects of lots of morphine and, apparently, no guidance from my family, I decided to stay on the skilled nursing floor at Penn Presbyterian, rather than going to a SNF that would have been a more convenient place for visitors (they still came though).  But boy-oh-boy was it a nice place to stay.  My room was big enough for two, but there was no second bed; I had it all to myself and that was glorious - no sharing a bathroom, no listening to someone else's TV or snoring or visitors, no forced small talk or having to listen to someone I don't know go on about their irritable bowel disease or other gross encounters.

Rehab was hard.  I had one hour of physical therapy, focusing on strengthening my legs and butt, and one hour of occupational therapy, focusing on daily living tasks (strengthening my upper body, dressing myself, doing my laundry, the dishes, making coffee and tea, getting in and out of the bathtub, going up and down stairs, etc.), every afternoon, six days a week.  I'd be beat by the time I got back to my room, but the progress was easy to recognize and happened quickly.  By day ten after surgery, I could walk downstairs to the vending machines using my walker and all around the unit using my cane.  By day fourteen, when I went home, I was using the cane all the time.

My sweet brother came downtown, picked me up, and brought me home on August 7th.  I had home PT and visiting nursing come out to the house for about ten days after I came home, but I was advancing very quickly and my ortho doc took off all of my hip precautions during the first follow-up visit, so I couldn't have the at-home stuff anymore.

So in the last couple of weeks I've stopped using my cane and I've actually gotten back to being able to do a lot of the things that I haven't been able to do for so long.  I've been making dinners, I've done some laundry, cleaned out the fridge, cleaned up the kitchen, swept the floor, taken the kid to and from school, gone shopping, and other stuff, stuff that I've wanted to be able to do so badly, but have been limited from almost entirely.  BF is pretty happy about it, too.  It's a weird thing to get used to doing again, though, this "normal life" thing.  I'm pretty used to being a total couch potato and that's not something you bounce back from quickly.  So it's taking some time for me to ease back into normal life.

I've also run into another problem, namely my other hip.  I was sleeping on my back of the first month, but as soon as I could, I started sleeping back on my right side.  Soon, however, I had to start switching sides back-and-forth between my left and right sides and my back throughout the night.  My back is just uncomfortable, my left side has the incision, which is still sore when you put pressure on it, and my right side has advancing AVN, which has become much more pronounced since the surgery.  I don't know exactly what I'm doing that's aggravating it so badly, but it's been getting worse and worse as time goes on.

I have another follow-up appointment with Dr. Lee, the orthopedist, next Wednesday, when we're going to discuss what the next step is moving forward.  At the last appointment h said he wanted to see how I continued to progress and that he thought we might do core decompression on the right side, but he'll have to look at some new x-rays to see how far the AVN has progressed.  It might be too bad to try the core decompression on.  I want the right hip replaced completely, I don't want to mess around with this decompression thing.  The fact is that the core decompression is an iffy procedure to begin with; it requires another spinal block and sedation and another hospital stay, but it also isn't a sure thing - there's a sizable risk that my bone won't react well to it and I'll have to have a total hip replacement anyway and there's a good amount of time where I'd be on crutches, still in pain, waiting to see whether it works or not.  And even if it does work, there's a good chance that in the next few years I would still need a new hip.  Also, from what I read, this sounds like a crappy option with a long recovery and uncertain results.  Not what I'm looking for. So who's problem would that solve again?  I'm going to be pushing that we just go right ahead and replace it now (or close to now).  I'm doing some volunteer work for the Obama/Biden campaign right now, so I'm hoping that we'll be able to schedule the surgery for just after the election, then I could work right up until Election Day and still be home in time for Thanksgiving and be walking before Christmas and New Year's.

So that's the story about the hip.  The rest of my life is getting better.  Some growing pains; I'm not really sure how to function now that I'm functioning better and the right hip pain is still limiting me, but things on the whole are good.

So that's it for me for now. I write these things like letters and I've never known how to end a letter gracefully, so bye!