11 days Post Op for Total Hip Replacement

Well, here I sit with my new hip.  My body is still trying to figure out how to operate with the new parts, and asking when I can swim again!   I cannot lie, the first week post op was rough.  Why? Maybe because I had a drug reaction to the narcotics and broke out in a vicious rash on my back. YUK!  The nurses said I can continue the drug and take antihistamine, or change to tramadol (which I had left over from before the surgery) or get a different pain killer. I decided to take the antihistamine for  day. Decided that was not working, and took a day of the Tramadol, then said the hell with it, I will take Tylenol as directed.  Basically I stopped taking prescribed meds on day 6.

The other episode that took place was a bit of swelling in my shin that was blue. Then the swelling went down, but it stayed blue. That worried me, but the nurses reassured me that it was not a blood clot.  Basically the first 48 hours I spent icing and getting up to go to the bathroom, and a few ROM exercises. I did not have an appetite, but I was not worried about that. I mean, who wants to eat after having a bunch of drugs pumped into your body for two days?  I think aside from the drug rash and the DVT (deep vein thrombosis) scare, there are overwhelming feelings of doubt such as,  will I get better, if so when, what have I done to myself, it hurts to move, when will I be able to sleep through the night, and when am I going to have a BM??

Thanks to the help from my neighbor, who supplied me with some Senna, I was able to have a BM three days after being released from hospital. The first time I really felt like eating anything solid was three days after being home from the hospital, and one of our friends brought over a wonderful meal of salad and quiche, which really hit the spot. After that I started to feel like a normal person again.

There are plenty of forums on the web these days for people to communicate their hip issues pre and post surgery. I'd scour them to find info to see if I was on the right track or to learn more about what to expect during the recovery process, and what I was experiencing. The take away form all the reading is, take it slow, do what the PT says, listen to your body, and utilize all healing techniques available. Seeing as though I am a doctor of Chiropractic (retired) I always look to forms of natural and eastern medicine. At 10 days post op, I had an acupuncture appointment. That was wonderful!

Walking - that is something they tell you to do religiously or as much as you can. I would go out into the rain, cold, or snow and wobble down the driveway and back with the walker. The time it took to do that was almost 10 minutes. Then I progressed to the cane on day 5 and I'd time myself for 10 minutes. I was happy to note that I negative split the time it took to go down the driveway, plus the length of our property line on the road and back to the porch.  Everyday I'd add a little more distance to the walk.  I was actually vacuuming on Sunday, and a friend came over, and said, "I don't think you should be vacuuming."

The PT came to the house two times the first week. The first day she came, she wanted me to do a straight leg raise while lying down on the bed. I could NOT lift that leg on my own. She helped the leg, and I'd have to hold it and push down. It was very difficult to do.  Later, I researched post op exercises, and read that the straight leg raise was something that was done 4 wks. post op. So the next time I saw her, I told her I wanted to hold off on that exercise. She agreed. The other exercises were easy. Standing ones are done with the assistance of the kitchen counter: Marching in place, heel to butt kicks, hip abduction (standing and laying down), hip extension, leg extensions, and even baby squats. I did some research on-line to see if there were other exercises, and I added the pelvic hip lift (bridge). She told me to do the exercises 3xs/day 10-20 reps.  Now that it's the second week of rehab, I was able to do the straight leg lifts.  She wanted me to start getting up from a chair without kicking my leg out, and to think about walking more normal, and less antalgic.   Today she also wanted to see if I was ready to walk without the cane. Hummm...I know that I was not ready for that, as my pelvic would drop if I put all my weight on the operated hip and lift the other knee like a march. That is called the Trendelenberg test. If you can do that test without the hips tilting, then one is ready to ditch the cane. I am not quite that far along, and I can't imagine anyone who has had a posterior incision would be ready to do that less than 2 weeks after surgery. Maybe I will be cane free by Friday, which is 2 weeks to the day.  I have read that patients with an anterior incision take a week less to recover due to the fact they don't cut through as many muscles.

Getting my muscles to relax at night is a challenge, and I thought something was wrong with the implant because the pain has been keeping me up at night.  One night I was sleeping on my side with the BIG pillow they provide you, and as I rolled onto my back, my glut contracted so hard, that it took TWO hours for it to relax. Needless to say, I got out of bed and did some work on the computer to pass the rest of the morning away.  One of the areas that was also very very sore to touch immediately after the surgery was my IT band lateral to the knee.  I knew that I'd have to work on that to get it to relax. I'd massage it, ice it, heat it, and even did ultrasound on it. It's better now.  The other muscle that cramps is the adductor muscle. Basically, since the Dr. had to pound that stem into my leg, (which I felt during surgery) my lower ankle and knee are bruised.  The bruising is subsiding, and my range of motion is improving.  Everything is in small increments, and healing cannot be rushed, like a fine wine!!

This Friday is closing in on the two week time table of post op, and I am looking forward to the freedom of driving. I will have a chiropractic appointment this week, so he can adjust my pelvis using the Thompson technique that does not require rotating the body and turning the leg inward.  The scar looks great. It's closed, and I will start to put Vitamin E oil on it daily.

All and all, positive things are happening everyday. It's good to know that these major surgeries are available to people of all ages.  I cannot imagine a life of limping around and not enjoying the activities that I love to do.  Time to get up and go for a walk!

The HIPPY Tale

                             Here we are at the Crouse hospital in Syracuse, N.Y. at 6:30am.

As we departed for Crouse at 5:15am, we both were thinking the same thing, and that was, it felt like we were getting ready for a triathlon. Getting up before daylight, packing a bag, and sporting water bottles. Everything felt the same, except we did not require a wetsuit or a bike. We did bring running shoes for PT, but that was not required either.   It was rather fun making the parallel between a total hip replacement (THR) and an ultra distance triathlon.  A triathlon race requires a good attitude, positive thoughts, and the right equipment. A major surgery such as a THR requires a good attitude, positive thoughts, and the right equipment (provided by the doctor of course). 

We were truly in good spirits upon our arrival to Crouse.  The valet park our car,  and he told us that his wife had her hip replaced, and is the best thing she did. 

 Our first transition area (T1) starts on the 5th. floor where I get to wear the didey of a gown and potentially moon anyone that happens to be behind me.  A young lady named, Christine came into the room to stick me where the IV would go. 

She seemed to be in a hurry, as she inserted the needle between my elbow and wrist on the flexor side of my arm. After she left the room, I started to have a sharp stinging sensation in the area.  That did not seem right to me.  I waited 5-10 minutes but the hot stinging sensation was still there. She thought it might be the tape. That is not going to work for me, so I asked the other nurse, and she looked at it. She agreed that Christine needed to re-do the IV portal.  She removed the first one, and put the other needle on the dorsal side of my wrist. Thank goodness, because when the other needle came out, my forearm flexor tendon was raised and hard as a rock!  Five days later I am still sporting a nice 2" bruise on my arm.  You may not think we are off to a good start, but Russ and I consider this a mild race mishap, kind of like forgetting your socks, and having to borrow a pair from your spouse (did indeed happen to me) . Haha.  Luckily it was easy to forget it all happened because they gave me a cocktail of drugs to get things started.   Time really seems irrelevant since we are really at the disposal of the doctors and nurses so that they are sticking to their schedule.  About 90 minutes before surgery time, Dr. Clarke, and his assistant came in to mark up my leg. He immediately informed me that, "The tattoo is toast." I replied that it was okay, I can always get another one on the other side!!!

As the meds started to kick in, my mom called, and by then I was laughing and giggling. Russ thought it was quite funny.  The entire process seemed a little surreal to me.  I have never had major surgery, yet, I was feeling elated that after the surgery and after recovery, I will be able to resume a normal active lifestyle without pain or limitations!

T2 will be the "holding" room where pre-op patients are taken downstairs. Here we are making a speeding transition into T2.

The holding room looked like an Embassy suites where you can see what was going on in the middle of the room, and all the patients were in private room with glass doors facing each other. This Embassy suites provided you with a very warm blanket too! In the room was a beautiful black and white photograph of a waterfall. We were told that one of their doctors did the photo. Russ and I were pretty cheery while waiting for the different nurses to  talk to me and sign my life away. One of the nurses said, "Gee, you guys are in a really good mood, most patients are really nervous." 

So there I am with the warm blanket, and the stylish hat.  It's just about time for the event to begin, and Russ has to wait on the other side of the operating room. He can watch the progress of the surgery on a screen. I am given a number, and he can see where they are during each step of the process. He was told that it will take about 50-60 minutes for the procedure from start to finish.

One thing that Russ told me was, "If you are awake (which I was) when you go into the operating room, DO NOT look on the table where all the tools and equipment are."  So there I am with my eyes closed, and the ER nurse comes over to me to introduce herself to me. I told her why I had my eyes closed, and she said to look at the table next to me. Then the anesthesiologist came over to give me the epidural in my back. I was a bit nervous about that, only because I met a Para-Olympic athlete that is in a wheelchair after a routine surgery due to the epidural not being done correctly.  They had me slide over to the smaller table and sit over the side and lean forward while being supported by another nurse. As the epidural is injected I can feel a warm sensation going down my right leg. Like warm water flowing down to the foot.  After that I was on my back and they opened my legs like I was going to get a pap smear, so I figured they were putting the catheter in me. I am not sure because they placed the oxygen over me, and I dose off.  I do remember laying completely on my left side, in order to expose the right hip for a posterior incision. There is much discussion about this and that and what the doctor prefers, then lights out!

T3 is the Recovery room.  It took about 2.5 hours for the epidural to wear off.  As it was starting to wear off, I could feel this wave of tingles come and go in my left calf first.  That sensation was from the calf pump machine that they hook your up to in order to prevent blood clots. I pretty much wore those the entire time I was in the hospital. Foot pumps is another way to keep the blood flowing and I did those all the time in bed. I was very happy when I could wiggle my toes again.  The nurse said that Russ could come into the room while we waited to be transported to T4. Since surgery is more complicated and involves a lot more people than a triathlon, there are more transitions to go through as you can imagine. The recovery room nurse was fantastic, just as all the nurses are at Crouse. We really felt like we were in special hands. 

Now starts the tough part. 1. Staying ahead of the pain, and not chase the pain. 2. Wanting to move mentally, but the body is not cooperating, 3. Wondering when I will be able to go home. 

The final transition area is T4, which is on the 6th. floor where I will stay for a few nights. Dr. Clarke did 8 joint replacement that day, so 8 of his patients were on the 6th. floor. There are 40 beds on that floor. Friday night was rough. I won't bore you with all the places I was feeling pain and stiff. From my hips down my body literally felt like it was in a straight jacket.  My back was tight, and the bed was not comfortable. It was not fun. Around dinner time I told nurse Kaleigh that I HAD to get out of the bed and stand up. She seemed a little surprised. I stood up and my right side felt foreign. Throughout the dinner hour I was pretty nauseated and threw up twice. Every few hours a nurse would come in and give me some pain meds, but they seemed to wear off too quickly, and I was uncomfortable most of the night. My roommate who had her lower spine fused was not a happy camper either.  At some point I was able to sleep a few hours, and a sweet, young, soft spoken nurse, named Jessica came in to put fresh ice on my hip (which I did not even notice she did) and give me more pain meds. Around 1am I decided I needed to get up again, so I rang the nurses station. Jessica came in and we went for a walk. I shuffled with the walker out of the room and down the hall about 10 ft, and  felt nauseous, so she quickly brought me a chair, and I felt defeated that I did not walk back to my room. Oh well. Maybe tomorrow will be better. 

Saturday the P.T. person arrived to get me up and out of bed. This time I was able to walk about 15 ft. Later that morning I had a light breakfast of yogurt, orange sections and coffee. One of Dr. Clarke's surgical nurses came in to see how I was doing. He was not in the surgery room. What really made my day was when Russ arrived, and we spent the afternoon together. We watched TV in bed, and walked the halls. We walked A LOT!  I teased the nurses that we were doing a half marathon, plus I would teach them yoga. I would stretch my torso left to right and side to side to try and limber up.  We even sat in the hallway for a bit for a different change of position and scenery.  I asked Russ to get me a Starbucks coffee from across the street, which he kindly did, and I ordered lunch. Lunch was a turkey sandwich, but as soon as I looked at the sandwich I could not stomach eating it. Russ enjoyed it.  It was about time for Russ to head back home to take care of Yigo, but before he left, my roommate was having issues. She had not had a BM 5 days after her surgery and the nurses were very upset. They informed her that she was at risk for a colon obstruction.  Since the suppository on Friday did not work, the nurses were determined to get things moving for her. So, there Russ and I are sitting in the bed, enjoying an old western, while my roommate is eating Kentucky Fried Chicken. No Joke!  When the nurses came in, she had to stop eating, and her family members had to leave the room. The nurses told the patient that she needed an enema. OMG!  Two nurses, one male and one female, proceeded with the procedure. One nurse had never done one before, so this was a learning experience for her. Thankfully the patient went to the bathroom in the bathroom and not a bed pan. After all was said and done, she happily resumed eating her Kentucky Fried Chicken!!!

We are very fortunate to have one of our neighbors, Gary take care of Yigo, which Russ was spending the day with me. It was getting to that time, so Russ and I bid our farewells, in hopes that I would be released from hospital the next day, Sunday.  I took a selfie in the hospital bed, and here is a pretty picture of the incision site. 

Saturday night was a better night's rest.  I did my best to get up on my own to go to the bathroom. Transferring in and out of the bed is the toughest. I was looking forward to showing the PT on Sunday that I can walk up the 3 steps in the PT room.  Hospital beds usually have an apparatus overhead that you can grab to pull yourself up, and I did that a lot to take the pressure off the bum!

Sunday morning I ordered the usual breakfast of yogurt and coffee. I tried a piece of rye toast, but that did not task very good.   The P.T. arrived (different guy than Sat) and I showed him I could accomplish the 3 steps up and down twice, plus walking a block around the nurses station. He said that I was good to go, and saw no reason why I should not be released. I was told that either Dr. Clarke or a P.A. would come in to check on me, and if they release me, then I be discharged. The P.A. arrived around 10:40am, and asked me a few standard questions, like is your calf swollen or painful, etc. Her name was Sophia and she saw no reason why I cannot be released. I spoke to my parents, and my dad asked me if I had had a BM. I had not.  Sometimes they won't release you from the hospital until you go, but I was able to go home.  When I finally did have a BM on Tuesday, it was after taking some fiber pills along with a natural herb called, Senna that helps the digestive system get moving more efficiently. 

I was thrilled to be going home!  I notified Russ, and he was excited too.  The paperwork was very easy, and even Kaleigh mentioned, "This is the easiest discharge I've done."  Kaleigh is a student nurse, and she is a hard worker. She was fantastic! Always there for me and asking me what I needed. One time, I had strained my inner thigh muscle (adductor) trying to get back in bed, and it brought me to tears. I was nervous that I did something wrong. She came in to give me Tylenol, plus a little lecture on what I needed to do and not do as part of the recovery process.  She had a nice balance of being stern and kind in delivering the message that I needed to be patient, and not push it, and to know that my body will heal in time.  Then she said, "That is my lecture for you today." It was great, and it really sunk in!  Whomever she marries will be one lucky person!

Ready to get going, Russ brought all my belongings down to the car, and the transport person brought a wheelchair to my room.  Here we are leaving room 6001, in hopes of a speedy recovery at home!

                                                   Nurse Kaleigh, my saviour!

Going Home!

I will write a little more about the recovery experience.  It will be a long road, so more to come. My motto during this process will be, be happy, be positive, and be grateful!

Pre THR (Hip Arthroplasty)

I really believed that I'd die with all my original body parts. Seeing as though God did not have that plan in mind for me, I am looking forward to having new parts. Those parts will be comprised of 4 different prosthetic pieces, a stem, a liner, a socket, and a ball, oh my!   I am nervous and excited all at the same time.  My husband even commented on my elated attitude over dinner this evening.

This winter has been brutally cold not only for upstate NY but for the entire U.S. Thankfully today we had the most wonderful and warming sunshine with blue skies, I could not resist taking Yigo (our dog) for a nice walk along the canal. I think I walked about 800km in 45 min. Wow - that is blazing a trail! HaHa!  

I look forward to the day when I can stroll and x-country ski along this beautiful trail without pain!!

The surgeon putting in my new hip is Dr. Michael Clarke. I hear only good things about him, and he was very nice and compassionate when we first met.  We first met, one year ago (March 2013) when he told me I have dysplasia, and am a candidate for a Total Hip Replacement. WHAT??!!  Not what I had in mind before I turn 50.  I mean really, how does one go from racing a half Ironman (70.3) in August of 2012, to needing a new hip two years later?   As a runner, I think I did pretty good in not going completely insane. Luckily I have experienced modifying my routine in the past from other minor injuries. The fact that I love to do other forms of aerobic activity besides running does help, however I miss running with a passion! 

So - tomorrow is the big day for Dr. Clarke to perform his routine hip arthroplasty surgery. I am one of the 600 routine joint replacements a year that Crouse hospital performs.  

Our day will start at 4:45am by showering with the antibacterial wash before we are to report to the hospital at 6:30am in Syracuse, NY.  The surgery is scheduled for 10:00am. Apparently the procedure takes only 90 minutes or less. I anticipate everything going smoothly, and hopefully only staying one night in the hospital. 

I have recieved many well wishes from friends and family, and it feels good that there are loved ones out there thinking of me. I am not crazy about doctors, or hospitals for that matter, but when it comes to major procedures, I guess I have no choice. :-)  I will use acupuncture as part of the healing process, and continue with chiropractic care and massage. 

The most important piece of information that I want to hear from the doctor is when I can resume swimming!!!!   Wish me luck!