CHAPTER SIX
LZM Cowboys Up

As I sit in my "studio", (a name suggested by a friend after telling me to stop calling it my "junkroom") at my laptop, the sun casts the shadow of my home onto the bare wall of the home next door, I catch movement with my right eye and look out of the window. I recognize the movement as some one's adorable golden Cockerspaniel that is loose in the neighborhood.

I thought I was ready to document the history of my hip. I see though that I would rather talk about a cute little dog....and the weather.

It is becoming more difficult to recall the details. I want to write it all down before I forget all the hard work and determination it has taken to be able to walk upright without waddling like a duck out of water. Keep that duck in mind.

The first instrument of support I used to assist me in walking was a walker. The walker was brought to me to help me get onto the bedside potty chair. I soon used it to walk to a chair to sit for a few minutes while a contraption was put on my bed. This contraption was a metal pipe framework that had had hangy downy thingys for each of my hands to hold onto and aid me in pulling myself up and in getting in and out of bed. Then, I was able to go all the way to the real toilet. Well, actually, a plastic riser was put on the seat of the real toilet. I would also have a riser on my toilet at home for a couple (few?) of weeks.

I always had to keep the right surgery leg out in front of me when I sat down, otherwise it hurt hugely. When the hospital physical therapists descended on me the next day, they told me a bunch of other positions I wasn't suppose to get into, for fear of dislocating my new hip (which would have been nice to know BEFORE I started moving around). Just getting in and out of bed was painful and labor intensive in itself. And then you add on their admonitions of, "be sure to stick that out that way", and "don't turn this the other way". You had to be a contortionist. And luckily I was used to being flexible and adventurous in bed!

My biggest fear was doing something to dislocate my new hip. So, whatever I was asked not to do, I didn't do, and whatever I was asked to do, I did, and then some. I did some of the exercises the hospital physical therapists told me to do three times; six times, or ten times, or more, a day. They were very matter of fact and humorless and I wanted to show them a thing or two.

I weaned myself off the drugz quickly because that would mean being connected to one less wire. The pills I was given to replace the morphine took me to a tropical island where I felt secure, contented, warm and sunny for awhile before I fell asleep.

Then I had the drain removed from my incision by a male nurse (not Pall) who had neglected to when asked to do so earlier. Now he was anxious to get off work and was treating me roughly. The dressing had been changed on other occassions by other nurses without so much pain.

"What did I ever do to you? I have only been nice to you."

He made no reply.

Painful as it was, that was one more thing I wasn't connected to, making me much more mobile.

No hospital stay is complete without a mention of the food. I am usually ravenous all the time, so when I found myself without much of an appetite, I thought it was the food. When asked why I hadn't eaten much of the cardboard that had been slathered in brown tinted thin wallpaper paste I said, "I think it is the food, not my appetite." One of my favorite nurses, Windy, would bring me little containers of raspberry sherbet and fix me chicken broth in a styrofoam cup, so I wouldn't starve! When I got home, though and could have whatever I wanted, I realized that it was my appetite. Wish that side affect had lasted longer!

Coming soon........Let me out of this place.

CHAPTER FIVE
Drugz

It was a male nurse, Pall, with long full prematurely grey hair, gathered at the nape of his neck who kept calling me Becky. As he explained things to me I nodded or shook my head because I was still too groggy to speak. His kind round Polynesian face smiled and expressed concern easily. I had the feeling a butterfly was following him around in the room, and having a hard time keeping up with him.

"If you want anything, need anything at all, Becky, just let me know. I am here for you, Becky!" he declared brightly and left the room.

I looked at the clock high on the wall directly in front of me. 10:30 and it is light out so it must be morning. What happened to "starting to wake right about the time I went into recovery"? Why isn't my husband here to me tell how things went? I felt no pain, but I wanted to sob. That feeling is returning to me as I write this. I calculated that it had been three and a half hours since I went in to surgery. The surgery was suppose to take 45 minutes, which would mean it took me over two hours to wake up. Where is my husband? I felt alone and abandoned. I am sure it was all exacerbated by the drugz I had been given. And as I had been informed by Pall, I could get more every six minutes by pushing the button on the end of the cord that was wound around the railing on my bed.

While I was still groggy, Dr. P stopped by with his 'I am trying to smile' expression, and said,

"You did fine, just fine."

If he said anything else I don't remember it. I do remember what he was wearing, though! (I would link back to that description if I knew how)(I would also punctuate properly if I remembered how!)

Then I had to pee because you are encouraged to drink lots of water. And I do, and did, without being encouraged. I told the nurse's aid and she said,

"I'll get you a bedpan."

"I have never been able to use a bedpan, ever. Do you have a bedside potty?"

Dr. P had told me at our first visit that they would have me get out of bed as soon as three hours after surgery. So, I just assumed I could get up. The nurse's aid brought me a potty chair and another nurse's aid (they weren't called nurse's aids, but I forgot what they were called. Their names were written on a board on the wall under the clock in front of me along with the name of the nurse and the names were changed every shift.) to help me get out of bed. It was difficult getting all the tubes and machines I was connected to out of the way. And, oh boy, it hurt and was scary. It continued to be decreasingly painful to get out of bed for several weeks. At first I moved in small incriments to see what movement would hurt least. Then I would forget what worked least painfully by the time I needed to get out of bed the next time. But, I made it. It was only later that I learned that most of the nursing staff had never seen that even attempted so soon after a total hip replacement surgery. I was a star!

The next time Pall came into the room to attend to Karol in the bed next to me, on his way out of the room he asked me,

"Becky, do you need anything, anything at all?"

I shook my head and indicated with my hand that he should come closer to me. He did and I softly said to him,

"My name is Betty not Becky."

"Oh, my gosh, I am so sorry, Betty!", emphasizing the Betty.

"That's okay Pall", I said, emphasizing the Pall.

But, when my husband finally walked into the room, it wasn't okay. I was angry to have been left alone for so long. He explained that when I was brought to my room where he had been told he could wait for me, I had appeared to be awake with my eyes open and even told him,

"It hurts."

He says he said loving things to me; stroked my hair , kissed my nose and forehead", until I started drifting off after about forty five minutes. He told me he was going to go to Walm*rt to get me a CD player because the one we had previously purchased specifically to entertain me during my hospital stay, didn't work properly. He was then going to get something to eat. (HOW DARE HE?) He says he then "kissed your widdo forehead", said he loved me and that he would be back soon. At some point in time I think I dreamt the last sentence, but I do not remember any of the rest.

Especially not starting to wake up right about the time I went into recovery. It just makes me indignant that "they" don't believe me when I tell them about my sensitivity to anasthesia. If the dentist doesn't use less "stuff" when he numbs me I will be numb for four or more hours. Twenty years ago I had my gall bladder and apendix removed (The surgeon did not tell me it was routine to remove my appendix at the same time as my gall bladder). It took me a really long time (four or five hours) to wake up from that.

Starting to sound too much like whining. I'm going to take a break and come back to tell you all about my miraculous recovery.

CHAPTER FOUR
You're Going to Do Fine!

I was unable to take the xrays that had been taken of my hip to my first appointment with the orthopedist, because of a computer problem. I was promised they would be faxed. They weren't. When my husband and I had been led back to a room at the Orthopedic Clinic by Dr. P's nurse, Baron Niece, she said I would have to have another xray, or Dr. P would not see me. I was very distressed. Not the foot I wanted to start out on.

Dr. P presented (I watch both 'Grays' and 'ER') as a white haired Julius Caesar. Instead of a white toga and crown of leaves, every time I saw him, except in the operating room, he was dressed in brown loafers, white socks, chinos, a brown belt and a light blue shirt with long sleeves rolled up and a button down collar. He usually wore a 'I am trying to smile' or a 'I am trying to understand' look on his face.

He shook hands with me and my husband then explained what he had just seen in my xray. I asked him,

"What are my options?"

We will never forget his answer,

"It is like a flat tire. You either fix it, drive on it anyway or park it."

I had learned as much as I could about hip replacement surgery options on the net, and I knew he did the "anterior approach" that I understood to be less invasive. He misunderstood me when, just to show him I knew a thing or two, I said I wanted the less invasive approach, which he took to mean a new experimental one. I think he thought that his subsequent explanation of his successful surgery method had changed my mind and convinced me to have the surgery. Several times during the visit and as he left the room he told me,

" You're going to do fine."

Actually, I was still trying to adjust to the reality of having to have the surgery much sooner than I had expected to. Dr. P's nurse, Baron Niece came in with instructions, paperwork and brochures. We set a date, August 5, 2008 at 7:30am.

As soon as my husband and I walked out of the clinic doors I started to sob. My husband folded me in his arms and rubbed my convulsing back. We got into my car and I continued to let out a bunch of nasty toxins through my tears. Eventually I stopped, and from then on I was resigned and courageous:D Tah! Dah!

When H and the others heard the news of my upcoming surgery at my next PT appointment, their attitude towards me seemed to change. It was as if I had graduated "summa cum laude". Now I think it was more like they were missing me already as I now do them. My last PT would be just before my scheduled trip to Virginia that I already wrote about. It was a sad day for me. PT had become one of my few pleasurable contacts with the outside world.

I returned from Virginia around 11pm July 24th. Twelve days until my total hip replacement. There was so much to do that I didn't have much time to get nervous. I had a pre-op physical with my primary care physician on the 28th. The next day I had a Barium swallow that my ENT ordered to find out if I have a hiatal hernia. (Turns out I have something called a presby esophagus with esophageal dismotility because it is so dry in Nevada.) I was also scheduled that day for a pap, but it dawned on me the day before that it would be impossible for me to get my legs in the stirrups with the severe osteoarthritis in my hip! And I cancelled that.

The following day my husband took me to the hospital to do the paperwork and tests required before surgery. I filled out a gazillion forms and answered as many questions. Then, while my husband went to our dentist to have a crown put in, I had blood taken, gave urine, had a chest x-ray and an electrocardiogram. My husband picked me up and rewarded me with all the crabs legs I could eat. Yum!

Two days later, on August 1st, I went to see the ENT. In between all this I was trying to get the house cleaned and the laundry done, in preparation. Monday, the day before my surgery, I went to see Dr. P. He drew a wide line about five inches long on my right hip with a huge permanant marker. And told me,

"You're going to do fine."

The next morning, at five o'dark thirty, we parked in the practically deserted parking garage at the hospital. The hospital itself felt "other worldly". My surgery was scheduled for 7:30am. A nurse prepared me for surgery while my husband read his book in the corner of the room. Dr. P came by and assured me for the umteenth time that,

"You are going to do fine."

He said the surgery should take about 45 minutes. The anesthesiologist came by. I told her about being sensitive to anesthesia. She assured me that I would be waking up right about the time I went into recovery. So, I kissed my husband and was wheeled into the operating room soon after 7, where Dr P waited with his 'I amtrying to smile' expression. He asked me,

"Where is your blue stripe ?"

I pointed to it and that is the last thing I remembered until I woke up alone, in my room about 10:30am. It makes me want to cry even now, remembering what waking up felt like. Then a male nurse came in calling me by the wrong name.

CHAPTER THREE
Doctor Who ?

The doctor I wanted to adopt was sent off to Afghanistan. So, I made an appointment with Dr. M, who had taken his place. H, my physical therapist, had called Dr. M and explained why she thought I should be evaluated by an orthopedist. The first thing Dr. M said to me was,

"So, you're ready for a new hip?"

My eyes instantly expanded with shock (clever way to say wide eyed, isn't it?) and I defensively replied, "I certainly hope not!"

I thought I was going to see the orthopedist to be evaluated, have a nice friendly conversation about my options. Plus, this was the first time I had seen this "doctor". She seemed abrupt and was dressed in black so I erroneously labeled her as "g*stapo". I think it was my shaky emotional state and her newness......anyway, to get on with it, she set me up with a referral to see an orthopedist.

I went on line and investigated my options for an orthopedist. At my next visit to PT I took a printout of possibilities with me. H had assured me that she would help me choose an orthopedist. She took the list to study and said she would consult with the other therapists and give me their recommendations at my next visit. Before my next visit, the receptionist called to ask if I would mind changing my appointment to an earlier one. I agreed.

From the tiny reception and waiting area with five chairs, two end tables (which barely fit) and no frills, you turn left down the narrow hall passing five treatment rooms on the right. Just before the last room, there is a big opening to the right into the "gym". The "gym" is a big room with machines, high adjustable treatment tables, big adjustable low padded platforms and all kinds of blocks and balls and pulleys and ropes and blocks and ......fun stuff. And, oh yes, the mirrors! Three or four therapists at a time might be treating one to three people at a time. I was in the gym at this earlier than usual appointment, being guided through my exercises and working on the equipment while H was consulting with the other therapists about the best orthopedist for me. I knew they would come to a wise choice because I also knew they all adored my quirky character. I worked hard, encouraged the other people who came there to be treated and tried always to be cheerful. (This advertisement was paid for by lzm)

B, one of the therapists was working with a man who overheard the therapists discussing me and recommended the doctor who had done his second hip replacement. Yes, I said second. Two different doctors and two different approaches. The first was a negative experience. He recommended the second approach and doctor, who was Dr.P. Before he left we got together and talked. He was at PT because he had just had knee replacement surgery.

"Would you mind me asking how old you are.?" I asked.

His surprising answer was ten years younger than I am. And since I intend to remain eternally youthful I am choosing not to divulge that information.

He brought some brochures for me to his next PT appointment.

I saw this as divine intervention and I can't wait to introduce you to Dr. P. But, this is my husband's day off and we are planning a huge excursion to the lieberry and then to the new Black Bear Diner which is connected to the new Nugget Casino. I have just 60 pages left to read in the book I want to finish and return.

CHAPTER TWO
Continuing

I fell in love with my physical therapist. It was not H's twinkling eyes, endearing freckles or amazing red hair that made me fall. It was her hands. Laying on the therapy bed in the small treatment room, H instructed me to turn on my left side, my backside to the tastefully wallpapered mauve and blue wall. She pulled up the red shorts I was provided with, to expose my bare hip, then slipped a small pillow between my knees. As she poured warm oil from a squeeze bottle onto my hip and thigh it felt a little like foreplay. Her fingers found all the aching spots without any direction. She would linger on the areas that cried out for her touch as if they were speaking to each other. My eyes closed and I made some small mewling sounds as my body melted into the surface I lay on.

Too soon she asked, "Did that help?", shocking me back from that new fuzzy warm place I never wanted to leave.

"That was heaven", I answered.

Then she taped me, adhering special flesh colored flexible two inch tape that looked sorta like crepe paper, at a point near my waist to just below my knee, along what (I think) she referred to as my "T-bar", which would stay adhered until my next visit. Then she sent me home.

Twice a week I went to that "house of heaven". Routinely I would change into shorts (my own on subsequent visits). One of the assistants would give me an ultrasound treatment on my hip and thigh or hook the area up to the electric pulse machine and cover it with a cozy heating pad, turn down the lights and leave me. A timer would go off and the assistant would stop rubbing me with the ultra sound "thingy" or come back in and unhook me. H would come in and manipulate me for a bit (my favorite was when she pulled my affected leg) and gradually had me do exercises. Then she would "touch me" and take me to heaven for a short while. Eventually she took to the gym where I did more exercises on the padded platform and used some of the machines, including the stationery bicycle, which was my favorite because of z.

After several (?) months H suggested I talk to my doctor about seeing an orthopedist. And I did.

Gotta do some laundry.

meme for Z

Z (http://razorbladeoflife.blogspot.com/ )at Razor-Blade of Life tagged me for this meme.
#1. Go to your sixth picture folder then pick your sixth picture. (The problem with this is that going there is a post in itself.)
#2. Pray that you remember the details.(Remembering too many details will be the problem here.)
#3. Tag 5 others, leave a comment to let them know they've been tagged. ( I tag those who read this and want to do it!)
TOTAL HIP
REPLACEMENT
SURGERY
Chapter One
Discovery
The bed cradled me in a perfect sleeping position and I tried to will myself back to sleep. Being unsuccessful, I rolled over so I could see the luminous numbers on the alarm clock that has sat on the very same long low six drawer dark oak dresser for 27 years. I quickly calculated that I had slept long enough. With resignation I sat up, swung my legs out from under the cozy bed linens, stepped onto the thickly padded carpet with the ball of my right foot. Confidently my right heel followed. Sharp stinging pain shot up from the padded little shock absorber and I quickly raised my heel back up and sat for a moment wondering what could be the cause of this pain.

This incident happened almost two years ago to the day. I was unable to rest weight on my right heel without pain. I quickly investigated on line and discovered I had something called "plantar faciitis". I followed all the suggested remedies, always wearing athletic shoes with over the counter orthotic inserts and doing the suggested exercises. There was some relief. I cowboyed up. At the doctors I was told that orthotics weren't covered by my medical coverage. Shortly thereafter I began having sharp pains mid thigh on the outside of my right leg that made me stop in my tracks. It became more frequent and more frequent. I diagnosed that the "plantar faciitis" changed my gate, causing this new pain. I was thoroughly convinced that the doctor I had been assigned and I were totally incompatible. So, I went through an act of congress to change. I went to a new doctor (who I wanted to adopt) and he sent me to physical therapy and had my hip xrayed. The xrays revealed:

FINDINGS: AP and frogleg views of the right hip demonstrate severe degenerative changes consisting with joint space loss, subchondral sclerosis, osteophytosis, and subchondral cyst formation. The femoral head is deformed by osteophytes with thickening of the proximal femoral neck, perhaps resulting in a component of femoral acetabular impingement. There is no evidence of fracture or dislocation. Soft tissues are unremarkable.

IMPRESSION: Severe osteoarthritis of the right hip as described above.

I will have to work on this long sad story after I go to the library to pick up some books they are holding for me, before the library closes. Let's just call this z meme Chapter One.