Hip Replacement Surgery–Part 2

I can be honest now, now that it’s all over.  I was terrified.  When I first heard I might need hip replacement surgery, I was a bit cavalier.  Ho hum.  Then I was given a reprieve.  My doctor thought that because my pain wasn’t constant that the problem might not be bone on bone but due to inflammation.  That reprieve lasted until December 18, when the Kaiser surgeon called me and said that the arthritis was bad, advanced and that taking cortisone shots would be a very short lived band-aid.  The surgery was back on.  Only this time, I wasn’t at all cavalier.  I was really scared.

Until I had this operation, I’d never been in a hospital.  I haven’t even had my tonsils out.  When I closed my eyes and tried to visualize what might happen, all I could see was a big knife going into my back side deep.  That’s as far as I could get.  I’d shiver and try to distract myself.

I talked to a lot of people.  99% of my friends raved about total hip replacement surgery telling me that they were walking, dancing, doing yoga so much better than before and had no sign of anything irregular in their hip.  I heard them but I think the information didn’t lodge anywhere important or as one of my parents used to tell me “it went in one ear and out the other”.

Hip replacement surgery has come a long way since doctors first starting researching and experimenting with the possibilities in 1962.  I have titanium in my hip.  Initially it was stainless steel.  The ball part of the titanium is stuck into the hip socket tightly and only loosens up as the bone accepts the implant.  In the past, the replacement could come loose after only 10-12 years and cause more pain.  I’m under the impression this replacement could last the rest of my life.

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An X-ray showing a right hip (left of image) has been replaced, with the ball of this ball-and-socket joint replaced by a metal head that is set in the femur and the socket replaced by a white plastic cup (clear in this X-ray). from wikipedia

I had this surgery February 23rd.  I was released to my friends’ home February 24th.  I couldn’t go to my home because of so many steps.  On March 5th, I left my friends’ house and came to my own home.  I thought the 45 stairs going up to my front door would take me 30 minutes to climb.  It took me 5 minutes.  It was easy.  I followed instructions and used a crutch.  California stairs, as opposed to New York stairs, are not high and much longer.  That’s my observation anyway.  I didn’t have to lift either leg very high.  I was so excited.

The next day, a Physical Therapist came to my home and told me I should start using a cane.  He said I was walking well.  I was given exercises to do three times a day.  Today, I can walk around my house without even using the cane.  I go slow and step carefully.  I have to go up and down 10 stairs to go to the bathroom.  Easy peasy!

Today I have two big problems:  The first is trying to respond to all the people who have cared enough to write me an e-mail and ask after my recovery.  I tire easily and it’s hard to keep up with the correspondence.  This is what a friend of mine would call a luxury problem.

The second challenge is balancing out activity-meaning my leg and foot are towards the ground: I’m walking or sitting at the computer, making a meal with rest–meaning my leg is elevated and above my heart.  Each day I feel different but I have learned to follow directions and I err on the side of caution.

I’ve seen three different PTs and each one says that this operation is one of the best inventions of the 20th century.  I now agree.  Two months ago, I was checking on my will and my living will.  I was scared and non-believing of all these other folk who related tremendous success.  And here I am today, feeling in great spirits, pleased as punch with my progress and looking forward to my return to Paris!

I also have a lot of gratitude to the friends who have brought me over prepared food so I wouldn’t have to stand too long to make meals. To those who have driven me to stores or gone to the Library for me.  Especially to my friend Susan who flew out here from Arizona to help me transition from chez Koch to chez Sara.  She was a hard task master but I listened.  I hope I don’t have to have another surgery to remember how precious all these friendships are.  You know who you are.

A bientôt,

Sara

Hip Replacement Surgery–Part 1

Today I have a new hip, a round, probably cream colored ball, that replaces the round top of my femur, which is attached to a stem that fits into my thigh bone and has been placed in the empty socket where my old arthritic hip used to be.  Got that? I am nine days post-surgery and, for the second time in two days, feel a burst of morning energy.  I’ve made a few lists of things I can actually do and started checking them off.  I’ve begun the process of straightening and sorting all my belongings that made it over to chez Koch, my home away from home.

Chez Koch is where two remarkable and generous friends have let me stay for the first ten nights of my recovery.  It is a ranch style house, the only steps being the two very small ones that allowed me in the front door.  Between lots of naps, I’ve slowly been learning how to walk again with the aid of a walker.  My Physical Therapist at the hospital said “you have wonderful posture.  Were you a dancer?”  Meaning that if I stand erect and walk, the surgical leg moves directly behind me slightly stretching the thigh skin, exactly as it is supposed to do.  Then he said “You walk like Frankenstein”  In my cautiousness, I was forgetting to bend my knee of the surgical leg.  This produced a few chuckles from the watching staff.  Dancer and Frankenstein describing me within two minutes of each other! Well, as they say “only in San Francisco”.  It turns out there is a Ballet showing in the City at the moment called “Frankenstein”.

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Kaiser San Leandro Medical Center

For the record, I didn’t like being in the hospital.  It was my first time and, hopefully, my last.  It wasn’t the constant poking and prodding that I’d been warned about, it was the double speak.  I had the orthopedist who performed the surgery.  I had a Joint Care Coordinator, a physical therapist, an occupational therapist, a day time RN and a night time RN and both of them had trainees.  I had a substitute doctor as my surgeon was unavailable when I awoke Friday morning.  Each of these people knocked carefully on the door of my single room at Kaiser San Leandro Hospital.  Each entered with an opinion or feedback.  Almost all the opinions and feedback contradicted each other.  For me, already scared by someone having taken a scalpel to my backside, opening up a fairly large portion of said backside to go in and out of the hip area, not to mention drugged silly with anesthesia so as not feel the above mentioned activity, I just wanted one person to be decisive and tell me exactly what to do.

Not to be.  I had immediate problems.  I couldn’t stand up long enough to get anywhere to take a pee.  My blood pressure would drop to the floor, giving my stomach a good shuffle on the way down so I thought I might vomit.  I’d break out in sweats while shivering.  This all turns out to be normal if one has low blood pressure to begin with and then adds anesthesia to the mix which drops blood pressure even more.  I suppose it’s nice to have that information but what I felt was weak, vulnerable, lonely and wanting someone strong to tell me what to do.

By Friday afternoon, I had a mini-meltdown, no one would agree what should happen to me.  I thought I was in a crazy house and wanted out.  I called my friend Jane and she came and got me.  Kaiser I’m sure was happy to see me go.  I’d like to think I’d been mirroring back their very bad communication efforts and they wanted me GONE but I think that would be a bit arrogant.  I’m sure I was just a difficult patient.

From Friday evening, February 24 thru Saturday, March 4, my world became my bedroom, my slow trips from bedroom to bathroom and then slow trips from bedroom to kitchen.  The most difficult thing physically that I had to accomplish was hauling my surgical leg up onto the bed when getting ready for a rest.  I had to use a bungee cord that I would hook around the insole of my foot and gently pull the leg up, followed by the good leg, until both legs were safely propped on a pillow.

It’s been a kind of nether world.  Not much exists outside of these walls. Friends have been bringing me meals and doing shopping for me, often staying for a bite and a visit.  Everyone wants to know about me so I have perfected the story.  I see the paper each morning and that the same man is still President but it feels so far away as not to really touch me.  I’ve read four mysteries. It’s not a vacation from life, it’s more like a detour.  I’m off the track I know.  I don’t know this one very well so I’ve slowed down to a crawl and trying to pay attention.  The problems of my normal track aren’t the problems of my today.  Today, it’s how to balance out activity and rest so as not to push myself too far.  Today, it’s the fine line between pain meds and laxatives so that a secondary pain doesn’t take over all my attention from my healing hip.  These are huge problems to me.

Part 2 soon….

A bientôt,

Sara

Network, the movie

Until Saturday evening, I had never seen the movie “Network” that won four Oscars in 1976.  Turner Classic Movies is probably my favorite TV channel in the US and, as usual, leading up to Oscar Sunday, TCM is showing 31 Days of Oscar…..in alphabetical order!

I don’t know how I missed this movie.  I was recently out of Graduate School, wanted to stay in the Bay Area where jobs were scarce and was probably working around the clock to make ends meet.  I remember the iconic line “I’m mad as hell and I’m not going to take this anymore”.  I also remember that Peter Finch, who starred in the movie and won the Oscar for Best Actor, died before he could pick up his Oscar.  The belief is that his heart was already weak and some of the long impassioned speeches compromised his heart even more and he died of a heart attack months after the release of the movie.

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What was stunning to me as I watched Saturday evening, was how prescient the movie was.  Although supposed to be a “outrageous satire”(Leonard Maltin) , it predicted the news as entertainment and the hero worship of men who express their anger on TV and therefore relate and identify with the supposed mass majority of the American public. The movie opened forty-one years ago and predicted the rise of Donald Trump: a figure that TV made.

In a review that the great Roger Ebert wrote in 1976, he said “we may doubt that a Howard Beale could get on the air, but we have no doubt the idea would be discussed as the movie suggests. And then Chayefsky and the director, Sidney Lumet, edge the backstage network material over into satire, too–but subtly, so that in the final late-night meeting where the executives decide what to do about Howard Beale, we have entered the madhouse without noticing.”

Ladies and Gentlemen, welcome to the madhouse.

This is indeed a great movie.  I encourage you to read the Ebert review then think about the rise of Donald Trump.

http://www.rogerebert.com/reviews/great-movie-network-1976

Don’t forget to watch the Oscars this coming Sunday 4pm PST and 7pm EST.  There’s always something memorable even if you have to slog through a lot of commercials and boring speeches to get there.

This will be my last post for awhile.  On Thursday morning, I will be having total hip replacement surgery on my right hip.  I’m told that the process has advanced so much that  I could go home the same day.  I asked to spend one night in the hospital.  I have to learn Physical Therapy and be disciplined about doing it three times a day.  My goal and reward is, if everything goes well as is predicted, I have a return flight to Paris on May 2nd.  I miss Paris terribly.  It is something I will hold in front of me as the undisciplined part of me tries to talk me out of doing PT.

A bientôt,

Sara

Making an informed decision

At some point in my thirties, I flew to Princeton from my home in California to visit my mother.  She was still teaching at Rutgers University Medical School.  For the first and last time, she tried to fix me up on a blind date with one of her medical students.  I don’t remember his name but I do remember it was the first time I heard the moniker ‘MDeity’. It was a moment when something fell into place.  “That’s exactly it” I thought.  It’s a fight to get oneself on equal footing and give and ask information.

I was told on December 19th that I needed hip replacement surgery, that the alternatives that had been suggested would only put off the inevitable and not be very helpful.  Since that day, I have received no other information.  Last Friday after a week and a half of trying to reach his assistant, the surgeon himself confirmed February 13th as the date I would have the surgery.

Over the three day weekend, I chatted up many people and the first question they asked me was “Will it be posterior or anterior surgery?” Huh?  Do I have a choice? or is it made for me?  Today is January 17 and I still haven’t met the doctor.  I have been trying to put together a network of support for myself and I have no information and have just found out there are two kinds of surgery.

I am very anxious, I will admit it.  Being able to meet with a doctor, bringing in a list of questions helps me quiet the scary voices.  And for the most part that has been my experience.  I belong to Kaiser Permanente and they have excellent physicians and surgeons and I’ve always felt treated as if I were an intelligent woman.  So what is going on?  I wanted to throw a temper tantrum in my living room as if I were five years old.  Instead, I called a friend and complained.  It did feel better.  Then I spent the next hour and a half on the computer reading about the two different kinds of hip replacement surgery.  I had to sort through the advertisements disguised as informative articles.  During which time, I was informed by e-mail that I had an appointment tomorrow with the orthopedist.  He only does posterior surgery.  If I want the anterior surgery, he has to refer me to someone.

I now know what the bones in the hip look like.  I know the part that will be replaced and I learned about the muscles that get cut and repaired (that’s where most of the pain comes from in the healing process) and the other long, ropey looking parts of me that the orthopedist has to push to the side to get to the hip.

Maybe I should have done this reading sooner.  I want to know exactly what will be happening to me.  I also have to do a lot of work.  My home has 55 stairs up to the front door.  I cannot come home to my house.  So I asked some friends, whose children are long gone, if they would accept me as a house guest/patient.  They have two small stairs to their front door!  I have to have people who will shop for me, cook for me, visit me, cheer me up.  I’ve been busy and, I realized, assuming I’d be meeting with the orthopedist and getting information from him that I know nothing about.

I am convinced it’s my job, and your job, to not let physicians get put into the MDeity role. We all have to do our homework.  But something else is happening also.  Doctors are given X amount of time to be with their patients.  They all have an enormous load.  I think what happened was a lack of time.  I fell through the cracks. And that caused me to feel extremely anxious, under-valued, even invisible so that my normal pre-operation anxiety blew up into fear and anger.

At my age, I probably can look forward to more than a yearly physical.  Shit happens and the older we are, the more shit happens!  We have to stay informed so that we don’t get abused in any way but also to make very good use of the time given us by overworked doctors.  I will arrive at my appointment with my long list of questions, I will act like an intelligent woman who deserves respect and I hope I make an informed decision between the two types of surgery.   Wish me luck.

A bientôt,

Sara

Interesting reading:  http://jaykrusemd.com/hip-surgery/posterior-anterior-total-hip-replacement.php