Thursday, April 30, 2009

New exercises today

Had PT right after meeting with the OS (to get staples removed). It is conveniently in the same building. I got to do lots of new stuff today. All the exercises the PT had me do to this point were stretches and muscle contractions.

Today he had me start with some sort of sitting machine that had steps that worked like a stair climber. Did that for ten minutes. Next was leg press with only my operated leg. Started with 60 pounds and moved to 75. Did that for 10+ minutes.

After that he put me on a short rolling chair that he attached some ankle weights to and he had me pull myself around the room for a while. That worked the heck out of my hamstrings!

Then I got to get on the recumbent bike for 10 minutes. It felt great! No pain at all.

Last thing was a contraption to electrically stimulate my quads while having me flex the quads each time it cycled. That felt weird but really kind of neat. I'm sure many of you have had that done. I've had a similar thing done to my back before but that was much more painful. Did that for 15 minutes and I was a bit tired.

What a day. Felt great to do some real work. I'm sure I'm going to hurt tomorrow but it will be worth it.

Got the staples removed

I'm exactly two weeks out from my hip replacements. Saw the OS today to get my staples out and do a status report.

He was very pleased with how the incision has healed and how I am feeling.

He gave me clearance to start elliptical and stationary biking. I just have to use pain as a guidance and don't break any of the angle rules. Oddly enough he doesn't want me swimming for another 3-4 weeks. Don't know why. Maybe something to do with being able to easily get into bad angles?

I can go ahead and switch to a cane. Definitely happy about that.

Still have to sleep on my back or non-op leg with pillow between legs for another 2-3 weeks. I used to always sleep on my operated leg so this is really causing me sleep issues.

I can finally drink again. I need a beer and some buffalo wings or pizza.

Doesn't want me to drive for two more weeks, which is fine. I work from home so just mainly need to go to PT.

Great meeting from my standpoint.

Also, I have a few pictures to share. I was able to get a picture (with my phone) of the x-rays taken by my GP (second image) a couple of months ago when I didn't know what was going on with my hip. Also, for reference I have the one from 1988 (first image), about 8 months after the surgery to repair my hip.

In the latest x-ray on the right you it shows where the extra bone and scaring virtually wore away the cartilage in the socket, especially on the edges. This is where most of my pain was coming from. The bones had no cushion to absorb and lubricate the impact from any activity. It's difficult to believe I ran a marathon in this condition.

Also, the second x-ray shows a faint line near the bottom that the OS drew to determine the leg length discrepancy so he could fix it with the prosthetic. It's nice to be level now :-)

I also put together a small collage of my scar as it's progressed so far. The total scar is 11 inches with 9 of that being the most recent (he cut through the existing scar). Interesting to see the progression as it heals.

Sunday, April 26, 2009

First real test of the new hip

Not much to report on Friday. Another good day. I did go to see my GP about the fever and cold or allergies that seem to be afflicting me right now. Unfortunately nothing conclusive either way. More than likely allergies based on the symptoms and pollen activity in the area. He was concerned about my fever even though it's continued to be low. He gave me a prescription for some antibiotics. Hopefully that will help clear up whatever is going on.

Saturday was the last day for the OxyContin, Celebrex and blood thinner shots. I still have Lortab for pain and have to take aspirin for 6 weeks to replace the blood thinner shots. They are really concerned about blood clots these days. Much different than the past surgeries I've had.

Saturday was also to be a big day. The Komen Race for the Cure for northwest Arkansas was scheduled for today. I was originally signed up for the elite race but the hip replacement canceled that. My wife and our dog Bella, however, were signed up for the first ever Bark for the Cure. This was a chance for people to bring their best friends out to support a great cause.

We had decided
a few weeks before surgery that if I was able to I would come to the event so I could at least watch. I love animals and really enjoy taking Bella out in public. It's good therapy for me and my wife and Bella just loves it. She definitely gets a lot of attention.

We left the house at 7 am. The Bark wal
k started at 8:30, but the elite race started at 7:30 and the regular (big) race started at 8:00. They were expecting 18,000 people this year, so we were worried about parking. The saving grace for us was that the Bark walk started at the PetSmart store instead of the Pinnacle Promenade entrance area where the other races started. We were able to park reasonably close, and come to find out we could have gotten closer but we took some of the first spots we saw just in case there wasn't anything further in.

We walked to the starting line and that's where we were going to setup a chair for me to hang out. The walk was probably 300 yards or so and by far my longest since the surgery. Of course I had both crutches and took it easy, careful to watch my form.

There were so many dogs there already. It is just fascinating to see them all and how they interact. Like I said, Bella gets lots of attention from both people and other dogs. She is a harlequin Great Dane, so she's tall, large and uniquely colored. She's our first Dane and is just a fantastic dog. We love seeing other Danes, too, and luckily there were a few there today.

The walk started a few minutes late but not bad. They announced over 900 dogs registered for the walk! That was amazing, especially for a first time event. It was a lot of fun for me just to watch.

I heard an announcement that the finish line was at a different location.
Uh oh! It wasn't far, probably about the same distance I had already walked. I felt good so I decided to go and try to meet my wife and Bella at the finish. I made it over there and apparently the Bark walk was much shorter than we expected. They had already finished! By the grace of God they found me accidentally. They were about to be on their way to find me at the start line.

It made sense
where the finish line was because it was located at the main vendor fair for the entire Komen event. We decided to walk around for a while. I still felt okay but was tiring. It took an hour or so to make it through all the vendors. The Promenade was vibrant! It is such a beautiful shopping area and really needs to do more large events like this. Just a perfect venue.

A lot of the dogs and owners from the Bark walk were doing the same thing we were. I'm sure the participants from the main even
t were wondering where all these dogs came from :)

Where the Bark walk ended there were treats and water for the pooches. Bella got a drink of water and a couple of treats. We met up with our friends and their dogs Phoebe and Gabe, a Pomeranian and a Golden Retriever. They had doggie ice cream! Bella got to lick clean one of the containers and it was obvious she loved it. She loves real ice cream, so doggie ice cream would be no different.

Our friend went to get Bella
a container for herself. It was just a small cup but it was frozen. Our friend tried to soften it up a bit by squeezing the container. Unfortunately the entire bit of ice cream popped out of the container and onto the ground. Bella quickly grabbed and ate the entire thing in almost one bite. A few minutes later she promptly threw it up :) She probably got a brain freeze from all that cold at once.

The funniest thing we saw all day was a chocolate Lab in a pile of ice. So
meone dumped a whole cooler full of ice onto the walking area for the dogs to cool off with. That puppy, which was probably 4 months old, was adorable to begin with, but he jumped into the pile of ice full on. He had all fours spread out with his belly fully onto the ice all the while trying to eat as many pieces as he could. He was soaking wet by the time it was all over. He didn't want to share the ice with other dogs! Looked a lot like those cute puppy commercials where the food is spilled on the floor and the puppy just lays completely in it. It was great and made everyone laugh.

Before long it was time to go home Bella and I were both worn out. We made the long walk back to the vehicle. I was not in too much pain, just extremely tired.

We made it home and in a short while I had some lunch and then took a nap. I made it through a big step on the road to recovery.

Thursday, April 23, 2009

Still running a fever

Again had a low fever through the night and woke up at 99.5. I've had a headache when I've woke up the past few days as well. I figure I either have a cold or allergies flaming up. Things are starting to bloom around here and it is likely allergies that is bothering me. I have stuffiness in addition to the headaches. Of course I'm scared to take any medicine in addition to all the drugs I'm on from the surgery. I took Lortab shortly after getting up and the fever and headache were gone in a short while.

While I was at PT this morning I received a voice mail from my OS's nurse. She was calling to tell me the lab results from yesterday were in. Luckily my PT is on the second floor of the building where my OS's office is. Good timing on the voice mail, because I just stopped by to see the nurse on the way out after PT. She happily smiled and told me everything was clear. No infections and no sign of pneumonia trying to start up. Whew! I asked her if it was okay to take something for the allergies or cold and she said yes and recommended I see my GP to make sure I take the right thing. Perfect. I'll go see the GP tomorrow and get this figured out.

The rash on my back seems to be getting better. Put some more Benadryl on last night. It seems to be working. There appears to be no more spreading and what does exist has started to dry up and heal. The pink spots around my incision haven't gotten any worse either, so hopfully all this stuff is fine and will just go away.

Not much more to report. It's been a full week since surgery and other than a couple of scares I'm extremely pleased with how everything has turned out. I'm glad it's almost Friday and there are no home baseball games for the Hogs this weekend. The Komen Race for the Cure is the big event. I was signed up to run in the elite race, but of course that was before I knew I'd be getting a new hip. My wife and Bella will be taking place in Bark for the Cure, so I'm going to try to go sit and watch. Should be fine and fun.

First PT Session

Had my first physical therapy session today. Apparently PT for hip replacements varies widely, I supposed based on things such as the surgeon's preferences, patient's age and condition, insurance policies, and other things. Some patients have to do PT before they are released to go home. Some are sent home and have inpatient (in-home) PT for weeks before being allowed to even ride in a car to go to outpatient PT. Certainly confusing but regardless, I was to attend outpatient PT the week following my surgery and go 4-6 weeks and continue on my own at home at PT's discretion.

All went well. Mostly straight forward type exercises and stretches. Only thing that was uncomfortable was swinging the leg out to the side a few inches, well almost a foot, and then back in. The therapist said that would be hard but we would progress a little farther out each week. That was the primary exercise that he wanted me to be extra careful with.

The therapist wants to be on crutches or at least a cane for 4 weeks, even if I'm feeling good walking. Said it's critical to have support there if it's needed, which obviously makes sense. Also said he doesn't expect to see me more than another week or so, as I can do everything at home and he doesn't believe I'll need motivation to actually do the work.

Learned a few more dos and don'ts and he showed me which muscles were affected by the surgery and how. That was nice to see diagrams and hear it explained. He has always worked with many of my OS's patients, so I felt really comfortable with his methods.

Anyway, nothing earth-shattering. If anything, I can do a little more than what I thought already.

Wednesday, April 22, 2009

First scare

Yesterday afternoon my back was itching. As I reached back to scratch it I noticed more bumps than I had previously noticed. A couple of days ago I felt like I had a couple of small pimples. I had my wife look at them and that's what they looked like. Okay, no big deal.

Well, when I scratched yesterday and felt more of them my stomach knotted up a bit. I went to the bath room and pulled up my shirt and looked at my back the best I could. Sure enough, probably 20 or so little dots. They were really small, not inflamed or red in color but they itched like hell. Crap! I'm officially freaking out at this point.

Of course my incision starts itching at this very moment. It's kind of like when you see a spider then a little later you feel invisible spiders crawling around on you. Maybe it's a sympathy itch. Whatever it is I scratched it, careful not to hit the staples. There were no little dots anywhere around my incision so I figured it was still okay.

I checked on it a couple more times and around my incision had developed clusters of pink spots. Double crap! I'm really freaking out at this point, because I figure I've got an infection and my implant is in trouble! Yeah, sometimes I overreact. I calmly called the nurse and left a message. A short while later the doctor's office called and told me I had an appointment for Wednesday (today).

I called my wife to bring home some Benadryl. After reading and asking some questions on it seemed to be a prudent thing to do and shouldn't cause any trouble. I didn't scratch the rest of the day. After some calming messages from the folks on bonesmart and my wife, I was in good shape and not as worried anymore.

Last night I had the best sleep I've had since the surgery. Bella didn't need out during the night and I was able to sleep the entire night in the bed (vs having to move to the couch at some point due to sleeplessness). It felt great!

Quick start to the day. Some coffee. Catch up on news and message boards. At some Kashi Go Lean cereal - great stuff!

Oh yeah, also checked my weight. 154. Sweet! Right where I've been for the past couple of months. I figured I had gained some weight since I haven't been able to be active lately. I can't wait to get healed. I can't stand being sedentary for very long. My appetite is way down from when I was running, though, which is a good thing, because I was eating a LOT.

Worked until my dad came over to take me to the doctor. I can't drive yet.

Didn't have to wait long to see the doctor. I really like it there. People are friendly. My doctor and his nurse are just wonderful. They always answer all my questions even when I know they are super busy.

The surgeon checked out my rash and thought it might be heat rash but he didn't know for sure. Wasn't concerned as it relates to my hip. He wants me to use cortisone cream and see if it gets better.

He checked my incision area to look at the pink spots. He definitely was not concerned. He said it looked like abrasions from either where I scratched it or something the tape caused. Said my incision area looked good and he was happy with it. It has developed a nasty looking bruise though. Man, is it ugly! He was not surprised, though, and I really didn't figure he would be.

He was slightly concerned that I've had a low-grade fever every night. He wasn't really worried since it's been low, but just to be safe he ordered a chest x-ray and lab work. Yes, I had to get stuck with a needle again and pee in a cup again. Oh, well. I had that done immediately upon leaving his office. They will call me as soon as they get the results. Hopefully that will be by tomorrow.

My hip is actually feeling pretty darn good. I only use one crutch around the house for the most part. It's totally sufficient and I can carry things easier that way. I've been working on walking without a limp to train my muscles correctly. The pain meds must really be working or I'm used to pain.

My PT finally starts tomorrow and I'll see the OS again next week to get the staples removed, so he'll be able to check things again soon.

Tuesday, April 21, 2009

Second day back to work

Since I'm not doing official PT until Thursday I did some simple exercises on my own. Just basic flexes. Also walked around a bit on the crutches. I'm feeling it a bit today but not too bad.

Made it through the night in my own bed without having to move to the couch, which was a nice thing. Only got up twice to go the bathroom. Did wake up a few times but was always able to get back to sleep. Didn't take any pain pills through the night. Probably should have because I'm still running a small fever, 99.6. I know this is not very high but it's happening every night. Took two Lortab when I got to see how fast it will break, because I need to have a good understanding of what's happening when I talk to the surgeon or nurse next.

Going to do some more exercises today. Want to walk a bit more and work on form. I have done that much. I've just been walking to get around. Need to make sure I train my leg muscles to walk properly. The surgery lengthened my leg about 3/4 inch to make it equal length with the left leg, so I 'm dealing with that difference. I'm sure it's going to take some getting used to. It certainly feels different. I also have some extra tightness down the back of the leg because of the muscles being stretched. The OS said that would happen and it would feel uncomfortable for at least a few weeks.

It's day two back at work. I'm working on the couch again. It was certainly comfortable enough yesterday. I'll be ready to get back to the desk at some point, but I'm sure that position is going to be uncomfortable for any length of time.

Looking forward to a good day.

Monday, April 20, 2009

Post-op, Day Five

Had another interesting night sleeping. Slept a good couple of hours and then had to pee. Dang! Shortly after I got up Bella got up and ate and of course needed to go out soon. My wife let her out and I was having trouble getting back to sleep. Rather than keep her awake, I decided to move back to the couch again.

I had the longest sleep since the surgery, over 3 hours. Woke up, watched a little TV and slept again for a while. Checked my temp and I was running a slight fever again. Highest I checked was 100.3. Woke up for good, made some coffee and read some things online. I was going to return to work today (I work from home) for the first time since surgery. Mondays are full of conference calls, so I knew I'd be on the phone for a while.

I made it through the calls fine and through the day fine. Took a few breaks to rest and made sure I took all my meds. I really hate giving myself the shots with the blood thinner. Only five days of those left.

Talked my OS's nurse today to get a few questions answered.
1. Don't need to take iron pills but won't hurt. My blood counts will get back to normal.
2. Had a dentist appointment scheduled this week to get a permanent crown installed. Found out I need to cancel that for a while and will need to take antibiotics before I see the dentist next. I didn't realize how dangerous dental work could be if you've had an implant, but the risk of infection is high. Luckly I read the warning labels on my medicine yesterday or I wouldn't have known this.
3. The fever isn't a major concern right now but if it gets above 101 then I need to watch my incision for changes and contact the OS. It's been below 100.5 so far and the incision looks fine and isn't sore. I guess some fever is normal after major surgery because of how hard the body is trying to heal itself, and it's made worse by being active during the day. My fevers have all been at night. Just have to keep an eye on it.
4. Asked about the dizziness I experienced and they weren't concerned.

So good, so far. I'm too much of a worrier and I think all the information available to read online makes it worse.

Made my PT appointment but couldn't get it until Thursday. I was hoping to get in tomorrow . I'll just do some simple things at home in the meantime. I'm ready to be healed :)

It's been a good day and I'm feeling better each day so far.

Sunday, April 19, 2009

Post-op, Day Four

Had a rough night sleeping. I crashed hard for a couple of hours early last night and then woke up several times through the night. I came back to the couch so I wouldn't keep my wife awake. Overall, I got several hours of sleep but not more than hour and a half at a time. Still ran a slight fever but my thermometer was not working, so I don't know how bad it was. It was gone by the morning.

Had a pretty good day. Just rested and read. Spent a lot of time on the message board reading and researching everything I could about hip replacement recovery. I've learned so much from there it's incredible.

Figured out all my drug schedule. I don't like doing all this but it all is there for a reason. Here is the list of things I have to take.

Lortab - (for pain every 6 hours)
Fragmin - (a self-administered shot to the stomach once a day for 7 days and then 81 mg aspirin once a day for 6 weeks for anticoagulant)
Celebrex - (once a day anti-inflammatory - 1 week)
OxyContin - (once every 12 hours - 1 week)

I can definitely feel the effects of the drugs. I'm scared to death of screwing up. I've watched too much CSI over the years, so I think the smallest mistake will kill me. As long as I follow the instructions I'll be fine.

Late afternoon I was finally going to get a real shower. My wife helped me through this. She covered the dressing with Saran Wrap and waterproof medical tape to keep it all dry. We have a large walk-in shower so it was easy with little risk of falling or tripping. She helped wash my legs. After the shower she changed my dressing. I just about passed out from being dizzy. I hadn't eaten anything in a while and I had been on my feet the longest since being at the hospital, so I wasn't too worried. I laid on the bed while she finished with the new dressing. It felt so good to be clean.

Had a great dinner, vegetable beef soup made with brisket that I smoked a few weeks ago. It is OUTSTANDING. The second time we've had it. Something about the smoked brisket flavor and the spices my wife puts in the broth just make it incredibly tasty.

I stayed awake all the way until bedtime. I thought not taking a nap would help me sleep better. On to day 5.

Saturday, April 18, 2009

Post-op, Day Three

I slept extremely well for several hours and woke up when the CNA came in to check vitals and see if I needed anything. I was hungry again and she brought me a snack a little later. Did I say how much I liked the night nurses? They rocked! I ran a bit of a fever again but it never got bad and broke again before morning. I guess it's a bit normal after surgeries, especially if you're active during the day. My body was sore and working hard to try to heal itself. That at least sounds logical and I think I've read something to that effect.

I slept on and off again during the night. I was really sore from walking the previous day. The nurse gave me another small dose of morphine before the shift change, thankfully, and I took another nap before breakfast.

I need to digress a bit. This was the first time I've ever had a catheter. I know some people have to be attached to these things permanently and that is a horrible thing. I would never, ever wish for that. That being said, it was nice to not have to worry about getting up to go pee or use a bed pan. Pretty amazing, actually. I never even had to think about it. Liquids got in the bladder and they went out. In layman's terms, of course. I would love to be able to use something like that in front of the TV on football weekends :-D

Anyway, my catheter drain box and overflow bag filled completely up overnight! I was drinking a ton of fluids, mostly water and some Sprite Zero. The CNA got a kick out of it. I was very well hydrated and the urine was virtually clear as water at one point. I was very cognizant about hydration when I was running a lot, so i was proud of this ;)

Pretty good night overall, a bit restless, but not as bad as the first night. The RN came in to change my dressing and remove the blood drain. The first night there was a lot of blood that drained from the incision area. The second day and night. Almost none. Not even measurable. When she pulled the tube out it was an odd feeling but not bad. This one was installed a couple of inches from the incision. For my previous surgery it was installed right at the incision but with a bigger tube. That one actually hurt. This one didn't. Felt good to get it out.

Breakfast arrived soon. It wasn't as good as the first morning but it was still good. Bacon, eggs, cinnamon roll, a banana and cheerios. The eggs were bland, but the bacon and cinnamon roll were awesome! I sliced some of the banana in my cheerios and put too much milk in so cheerios were flying everywhere, but it was good. I was nice and awake and ready to tackle the day.

Went through the final nursing change of my stay. Two totally new nurses given it was the start of the weekend. Both seemed very nice and friendly and I found them to be that way the entire duration of the day.

The OS came by during his rounds and was pleased with my status and progress with walking the day before. He said I could go home this afternoon after another round with the therapist. Woo hoo! This was what I was waiting to hear.

Since I was being released I also got clearance from the OS to have the IV and catheter removed. I wanted to get up and move around some more under supervision on the crutches, but it was so difficult with all that equipment attached.

I asked the RN if she had talked to the OS yet. She had not, but said she would go find him or read his discharge notes. In a few minutes she returned to remove my equipment! The IV was easy. She just unhooked it and left the needle in just in case I needed something else before I left. Then came the catheter. The moment I was most scared of. The prep-nurse had told me I would have a catheter installed but since my pre-op vitals were good they would install it while I was knocked out. The removal was a different story.

The RN told me about the balloon feature that was holding it in place and how she would relieve the air pressure and do a quick yank and that I would get an uncomfortable feeling for a few seconds. Yeah, right. Just uncomfortable. I was scared to death of what this was going to feel like. She showed me how she was letting the pressure out and then with no noticed just yanked! DAMN! It was extremely uncomfortable and felt like a whole bunch of urine came out.

She took care of emptying the tank and when I looked down not a drop was to be found. It just felt that way. I felt fine in just a few minutes. All things considered it was worth it. Only thing left was I'd have to prove that I could urinate normally on my own before I could be discharged. That would not be a problem, as I would later prove.

I was able to move myself to the bed to get the catheter removed and then back to the chair on my own with the nurse watching. I was feeling great at this point! Genuinely, great! I sat in the chair and read cycling magazines and waited for my wife to arrive.

My wife showed up mid-morning and that put another smile on my face. We just waited around for the therapist to show up. Pretty boring, but we had plenty to read.

The therapist arrived and took me for a walk around the floor. I went probably 3x the distance I had gone the day before with very little pain, but certainly weakness. Before the surgery I had a difficult time believing I would actually feel like this but I did. The pain was mostly, if not all, muscular. My hip seemed to be operating well. The therapist left and all that remained was lunch and being discharged.

We talked to the RN to see if my wife could get my prescriptions, so she could go pick everything up before I was discharged so I wouldn't have to wait in the vehicle. The RN obliged and my wife left.

Lunch arrived (albeit a bit small) and I ate quickly, like normal. It was spaghetti and a salad and a piece of chocolate pie. The spaghetti was okay, but bland. Salad was good and the pie was great. Yum! Now, I just had to wait.

Oh, I got permission to go ahead and dress in clothes and get out of the gown. I got to use some of my new tools to reach down without breaking the 90 degree rule. Took me a few minutes but I succeeded. I felt really proud, like a child riding a bike without training wheels.

Oh again, reverting back to the catheter moment - the nurse had left a bottle that I had to pee in to prove that my bladder was working. By lunch I had filled it up completely and even had to go in the toilet after that. Did I mention I was drinking a lot of water? The nurse was shocked, and of course laughed when I told her I thought things were working okay.

My wife showed up soon having got my prescriptions filled and eaten lunch herself. She brought me some of her leftover lunch, Chick-Fil-A nuggets! I couldn't turn those down. Best fast food chicken to be found! Now, just wait, wait, wait.

A little over an hour later the RN showed up with my discharge papers. Woo hoo! I signed some papers and they wheeled me out to the vehicle. 20 minutes later and I was home.

My wife got me settled in and I was pretty much down for the rest of the day. She is such a fantastic caretaker. Words can't express how good she is to me. Day 4, upcoming.

Friday, April 17, 2009

Post-op, Day Two

Surgery day went extremely well for me and I was as happy as I could be. I can't even explain how excited and relieved I was to have this surgery. I've been in pain, sometimes significant, for 23 years since the accident that originally broke my hip. I believe this is a new beginning for me that will allow me to be active for many years without daily pain.

As I mentioned in my previous post I was given some morphine to start the night off. That was a great relief and let me sleep well for a couple of hours. I was in-and-out of sleep the rest of the night. Partly because I just don't sleep well anyway, partly because the nurses checked on me every couple of hours, and partly because I was in pain. I also ran a slight fever and the Vicodin did help break it.

After the morphine I received Vicodin a couple of times. It wasn't very helpful, at least not very quick acting. I still made it through the night okay and was pretty wide awake by 5am. The CNA brought me some black coffee which really hit the spot. Breakfast wasn't until 7, but that tided me over and I watched TV and surfed the internet on my wife's Dell Mini, which is a great little machine. I used the heck out of it thanks to the hospital's free wifi.

Breakfast arrived right on time and it was fantastic. Cheese omelette with some ham bits sprinkled on top, a biscuit with gravy and a piece of sausage, and some fruit. Some milk, juice and coffee to wash it all down. The food is great here. Not at all like previous hospital stays. Bravo WRMC!

I went through a nursing shift change (7 to 7 is the shift). The current RN told the new RN that the Vicodin wasn't working well for pain and that I would likely need at least one dose of morphine during the day. I heard the conversation. Remember this for later.

The OS came to see me during his rounds. First time I had seen him since the surgery. He was happy with how the surgery went. Said everything fit well and he expected the implant to work great for me. He said that he had a heck of a time dislocating the hip, so he was happy with the fit. In a total hip replacement, when the implant is installed the surgeon puts the new hip ball into the new socket, checks rotation and then dislocates it on purpose to make sure everything is installed correctly. It's quite disturbing to watch. Here is a video of an entire procedure almost identical to mine in case you're interested.
It's very long, but some key points are between minutes 6-10 where the cut and cauterization take place. Around minute 14 is where the first part of the hammering occurs. At minute 19 is where they bore out the socket where the prosthetic socket goes. Around 23 is where they begin hammering in the implant. The hammering goes on for 15 minutes or so and then they fit the hip back into the socket and then dislocate it to make sure it fits and moves correctly. They then put it back in and then stitch it up. It's just very disturbing how seemingly standard power tools are used to cut, shape and fix your bones.

My implant I now have is a Wright branded cobalt material metal-on-metal (metal head and metal socket). This allowed me to have a much larger head, which is harder to dislocate, wears better and longer, has better range of motion and is more suited for very active people. The ball he installed is 44 mm versus something like a 22 mm traditional head. Here is the site that shows what I've got in me. Oddly enough it's called the Big Femoral Head :-)

He also expects me to recover well given my age. Told me I could go home tomorrow depending on how well the therapy went today. Said the only concern he had was I lost more blood than he liked. Again because of my age, he wasn't too concerned, but he was going to prescribe iron pills for me. Said I should be able to return to fairly normal activity in 6 weeks and also can start stationary cycling then. I could begin cycling outside after 3 months, but only in the neighborhood until I got comfortable.

My wife called about 8:30 to check on me and then she took Bella to day care again and then came to see me. I was very happy to see her. I love my wife very much and can't express how well she takes care of me. It made me smile just to see her.

We just chatted for the next couple of hours. The occupational therapist came by to explain my limitations and how I would be able to perform daily activities, such as dressing, picking things up, limitations on movement, etc. He brought a set of tools for me to use, including a grabber to help reach and pick up things, a hook for general use, a long shoe horn, a bath scrubber with a long handle, and a thing to help put on socks. I'm not to bend past 90 degree angle, so I can't dress like normal. I knew all this was coming, so no big deal.

Finally, the physical therapist showed up. His whole purpose was to see how good I could get along with assistance. He brought a walker with him similar to these. This was the first time I had been off the bed since the surgery. The therapist helped me get down and settled correctly on the walker. I had to use one for months when I originally broke my hip, so I knew how to use it already. I was able to walk down the hall and back. It hurt pretty bad and I had a bad limp, but I could tell the pain was muscular and not the hip implant. It felt strong already!

The therapist was happy with my work and suggested we try crutches for the afternoon session, which I was more than happy to do. Walkers are very cumbersome but crutches or a cane are much easier to deal with. The therapist left and I rested. Lunch eventually came, thankfully, because I was hungry.

Shortly after lunch I had some surprise guests, a couple of very good friends. They brought me a bag full of magazines to read, which was very thoughtful. We chatted for a while and it was very pleasant and certainly lifted my mood. Just another example of the quality of friends I have.

Next, I had to visit with the "case manager" assigned to my hospital stay. She is the person to make sure I get everything I need when I'm discharged, things like prescriptions, setup of physical therapy, purchasing crutches or other tools, etc. She was fairly friendly but seemed more intent on telling me what would be best for me rather than listen to my concerns. I felt a bit like a child being scolded a bit but it probably wasn't as bad as I perceived it. Anyway, in the end everything was fine and I was all set for whenever I could go home.

I have neglected to mention that I asked the CNA for pain medication around 9 or 10am and she said she would let the RN know. It's after lunch at this point and I have yet to see pain relief. A little while longer watching TV and reading. Pretty boring but I was worn out by all the activity.
I asked again for some pain relief and the CNA was surprised the RN had not come by yet. She said she would contact her again.

The therapist showed up a little later with the crutches for my second walking session. This went really well. The crutches were definitely a good fit and allowed me to get around better than with the walker. The therapist was surprised how well I was walking and so was I. My research had led me to believe I would be able to walk the day after surgery but I was skeptical. After this session I was grinning ear-to-ear.

I got back to the room and was understandably tired and in pain. I rang the nurses bell and asked for more medicine and told the CNA that I had not had any pain medicine since 5am. She didn't know what was going on but promised to get it resolved. A little while later the RN finally showed up with pain medicine and of course she brought Vicadin instead of morphine. Remember the conversation she had with the previous RN? Yeah, the one where the other RN told her that Vicadin wasn't working well for me. At this point I'm frustrated and hurting so I wasn't going to turn anything down.

I don't know why this nurse didn't give me any meds earlier in the day and then why she wouldn't give me morphine or something else besides Vicadin. She wasn't particularly friendly and had a bit of a strange personality, which was unfortunate because all the other nurses were absolutely fantastic and extremely helpful. Oh well, I wasn't going to let it upset me anymore. In about an hour or so I started feeling some relief and I knew dinner would be coming soon which would help me feel better, also.

Shortly after dinner arrived, I had some new guests. My parents showed back up and shortly after that my brother arrived and brought his wife and two boys, my 5-year old and 16-month old nephews. I was excited to see everyone but I'm not sure my nephews knew what to think. The 5-year old was fascinated by the catheter and the normally outgoing 16-month old suddenly got very shy when the nurses came in to switch shifts. I had a nice visit with everyone for probably an hour or so. They all left to go eat and it was time for me to start winding down.

My parents had been nice enough to pick up Bella from day care and drop her off at our house, so my wife was able to stay with me all day. That was great for me to have her around all day. She stayed with me a little while longer until the night nurse gave me some morphine (yay, finally!). I got sleepy very quick, so my wife left me for the evening.

Day three report coming soon.

Thursday, April 16, 2009

New Hip Installed

I had my old hip removed and new hip installed on the afternoon of the 16th. The preceding posts explain the reason for it, so I won't rehash all of that.

On the 15th I was able to eat normally until midnight. I had to give up NSAIDS (anti-inflammatory) and aspirin for the week prior to keep blood from being too thin, and no alcohol 24 hours prior, although I stopped having any drinks a week prior, also. With a fairly major surgery I felt it prudent.

I continued elliptical work almost daily until the 14th. I figured I needed to stop and let my body rest at least a couple of days. I just hope I don't gain any (or at least much) weight during the recovery period. I'm not necessarily a health nut, more of an exercise nut, so this period of sedentary activity during recovery is going to be rough but it's worth it.

I was anxious all night on the 15th. I had a good dinner and slept pretty well until about 4am and then I couldn't get back to sleep. I got up and read some things online and got a few last minute work things taken care of. Didn't have to be at the hospital until 10am, so I had plenty of time for last minute prep.

My lovely wife took Bella (our Great Dane) to doggie day care. I showered and had to use some special soap called Hibiclens which is an antiseptic. I had to use the whole bottle, which was an effort because there was enough to wash an elephant. I even had to sign a form that stated that I bathed correctly and used the whole bottle. I felt like a kindergartner being told to eat my veggies. Anyway, I did that correctly and then finished packing my bag and was ready to go.

Only about a fifteen minute ride to the hospital. A little dreary and cool and I was finally getting a bit nervous. Not really nervous about the surgery itself, because I've had two previous surgeries on this hip. I just wanted everything to go correctly.

Got to the registration area, signed in and paid my share of the bill that insurance was not covering. My insurance has been great so far. Hopefully there will be no complications with all this, because it is quite an expensive surgery. My share reached my out-of-pocket max of $1,250. Well worth it to have a good leg again.

Only had to wait a few short minutes before the prep nurse came and got me. My wife had to wait in the waiting area until the prep nurse was done. I put my gown on and the process started. The nurse was my age (37) and was the first of many over the next few days to ask why someone so young was having a hip replaced already! She took some more blood and then started my IV. She also gave me some drugs to start getting me relaxed. Then she prepped my hip by shaving most of my leg and then washing and coating it with iodine. She also put TED stockings on my legs and some automatic air wraps to help with circulation for the next few days.

When prepping my hip she noticed a couple of blemishes, either pimples or ingrown hairs, one on my butt cheek and one on my leg a few inches from my previous incision scar. They were almost healed but any kind of nick, cut, abrasion, etc., near the incision can lead to a cancellation of the surgery due to the risk of infection. I knew the blemishes were back there but thought they were far enough away not to cause a problem. She said they were indeed close enough to cause a cancellation but they looked almost healed so there was a good chance the orthopedic surgeon (OS) would be okay with them. So, she circled them with a marker and called the OS to let him know that he needed to look at them. She told me they were more worried about fresher active wounds and these were closed up well, so that made me feel a little better but I was nervous until I saw the OS.

She finished the prep work and was ready to allow my family in to see me until it was time to go. Of course, I had to pee, so she helped me get down the hallway with IV in hand and butt cheeks exposed. You really have to leave modesty at home when you are admitted to a hospital. I've been through it before, so it's not a big deal to me. Besides, I've worked hard to get myself in shape, so I don't mind showing off a little. Ha ha. :-p

My wife, mother and father all came in and were able to chat with me for about an hour. It was nice and helped pass the time. I really have very loving and supportive family and friends. I'm the type of person to feel guilty about receiving any kind of help on anything, but this week I had to leave all that behind. I'm very blessed with people who care about me and it's been more than obvious throughout this entire process.

At 12 noon it was time to go to the next step. The prep nurse started wheeling me over to see the anaesthesia folks. On the way the nurse stopped and got me another warm blanket. That was great! I went into another area and saw four different people related to anesthesia. I had to answer another round of questions and then got my first tiny dose of anesthesia. Starting to feel good at this point. I was set for general anesthesia but they threw a curve ball at me. They asked if I wanted a spinal block which would help a lot with the pain. I had heard the term but wasn't really familiar with it. They explained how I would get a shot in the back and when they found the right nerve my leg muscles would start twitching. Sounded painful but I remember how much pain I had in the previous two hip surgeries, so I was all for it! I gave them the go-ahead and they found the right nerve almost immediately. They were pleased and I was too because it didn't hurt too much. I then met the primary anesthesiologist. Just a few more minutes wait and they wheeled me into the operating room.

I remember being wheeled in and parked and that's it. I've always had a bit more recollection but this one was almost none. I woke up and it was done. Holy crap! I couldn't believe it. I was groggy coming to but felt much better than in the past. I guess everyone did their job great, because I was in much better shape than even when I just had my screws removed. I had to stay in recovery for a bit and then was taken to my room.

My room was on the seniors floor. I was probably the youngest person by 40 years! Needless to say every hospital employee who came in was surprised to see someone so young. I had a great room but was still too out of it to realize.

So, backup in time a bit. My wife was given an ID number for me which would display on a monitor in the waiting area with my status. Apparently, the status never changed to show that I was ever in surgery, so when they went to get her to tell her my surgery was finished she didn't even know I had gone in! She thought I must have been delayed for some reason. She even asked the front desk people to check on it and apparently they were rude and wouldn't help. An unfortunate blemish on an otherwise fantastic few days at Washington Regional. The same lady wasn't real friendly when we checked in either, so it wasn't a surprise. Anyway, after the nurses got my bed setup they allowed my wife and family in.

I was in some pain but not horrible. I was fairly coherent at this point and had some nice conversation. I was freakin' starving because I had not eaten since 8pm the previous night, around 33 hours. With all my running the past 18 months I was on a steady 2,800-3,000 calorie a day diet. My body was going to have to eat something! The RN asked if I felt like I could hold something down, like a light snack and some juice. I told her I was ready for a full meal, and it happened to be just about dinner time, so they brought in a full meal. The nurse told me to take it slow and she left. I promptly began wolfing down everything. Nothing slow about it. Not on purpose, I just felt good and was very hungry. Didn't feel nauseous at all. The meal was turkey and dressing with gravy, a roll, some veggies and a dessert. Pretty darn good meal.

My wife had to go pickup Bella from day care while I was eating, so she did that and my parents and my brother stayed with me. She made it back to the hospital and was happy that I ate something. She also stopped and bought me some reading material. Mostly cycling magazines and books since that's going to be my new hobby (instead of running) when I recover. My parents and brother stayed a short while longer and then left for the evening. My wife went to the cafeteria to get something to eat and she brought it back to the room, so we were able to visit some more.

I was starting to hurt pretty bad so the nurse gave me some morphine (yay!) and my wife left soon after so I could get some rest. I slept GREAT for a couple of hours but woke up at some point and wanted a snack. The CNA and RN checked on me at various times during the night. They were both awesome! The CNA found a nice snack for me, turkey sandwich, Baked Lay's, and applesauce. She even warmed up the sandwich for me. She was my favorite new buddy :)

That wraps up day one, although technically some of this leaked into day two ;)