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”.

san-leandro2_tcm28-831256-300x212.jpg
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.

220px-Networkmovie.jpg

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

Happy New Year—-from Oakland, Ca.

In France, one has the entire month of January to send out New Year’s greetings.  Sending cards for the new year is popular, sending Christmas cards is not.

8.jpg

So I’m wishing every one of you a wonderful 2017.  What I wish for us all is an ability to navigate our world, our politics (or their politics as the case may be) and to be the best citizen of this world that we can possibly muster without bringing in more anger, more hatred and bitterness than already exists.  It’s not a new concept but imagine if we did one good, kind deed a day and it spread like “The hundredth Monkey Phenomenon”.  Well, I’d like to imagine it!!!

https://en.wikipedia.org/wiki/Hundredth_monkey_effect

Yesterday, I got on a United flight to San Francisco to return to my California home for 4 months.  I was taken by surprise in mid-December when I was told that I needed hip replacement surgery.  Actually, I was given a choice.  It seems that doctors today cannot actually say “you must have…..” without fear of litigation.  One of my choices was surgery.  I went to all my friends who have had hip or knee replacement surgery and asked them one question: “In retrospect, if you had had the surgery done when you were first told that you might need it, would you have done it?”  Without exception, they all said yes.  When I was talking to the orthopedist and he was telling me the pros and cons of cortisone shots, I asked him straight out “is there any reason to delay it?”

The answer, not so surprisingly, was “No”

So I’m scheduled for surgery in mid-February.  The curious fact about me is that I have never been in a hospital since I was born.  My father used to joke “Sara, you were born in Garfield Hospital in Washington, D.C and they immediately tore it down”.  Yes, of course, I’ve been in many doctor’s offices and had two one-hour procedures (that I can remember) but to have a serious surgery and spend the night, that has been my sister’s realm.  And to say I’m a bit anxious would be an understatement.

IMG_5290.JPG
View from my bedroom window

Now, the window I get to look out of is my westward-looking windows here in Oakland.  I can see the San Francisco Bay, the Bay Bridge that spans from Oakland to downtown San Francisco (4 miles) and the Golden Gate bridge.  Many evenings, there is a sunset that cannot be rivaled.

California has been suffering a terrible drought for going on six years.  There has been rain, quite a bit of rain, in the last couple of weeks.  As my Uber drove me up my street from the San Francisco airport, the landscape looked strange.  It hit me that everything was Green.  Really Green!  And because it rained on and off yesterday evening, the green was sparkling like itty bitty diamonds jumping around on leaves, on new grass. Now sixteen hours later, it is pouring cats and dogs, as we like to say in English, or I’d go outside and inspect the gardens and see all the changes.

My cat, Bijou, stayed in Paris.  She is living with a friend who has a larger apartment than I did and also has children who love cats.  When I said good bye to her on Thursday evening, everyone had a bit of a hesitant smile.  Bijou was moving around carefully, looking around each corner before she let herself into a room.  W and E looked excited but not sure how to react to her.  I taught them to clap their hands very loudly when Bijou jumps up on a counter or somewhere she shouldn’t be. As if by direction, she immediately jumped up on a kitchen counter.  I clapped very loudly, she jumped down and scampered back to the laundry room which is her temporary quarters.  Then I left and felt my heart thudding with sadness.  It didn’t seem right to make her fly two long plane flights just because I have to have surgery.

IMG_0425.jpg
Bijou (photo by Fatiha Antar)

Banya, on the other hand, who grew up in Oakland and moved to Paris with me is in kitty heaven.  She was an indoor/outdoor cat, became an indoor cat in Paris and never seemed to adjust.  Now she is home after a long plane ride.  She must have known she was coming home because she stayed calm and hasn’t stopped purring.

 

IMG_0413.JPG

I wish I had a smart closing line like Garrison Keeler and could say “and that’s the news from Oakland where all …..”  If anyone can dream up a really punchy line for me to close with, there is a small Thank You coming your way.  Until then,

A bientôt,

Sara