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.

No comments:

Post a Comment