Wednesday, July 29, 2009

Three Weeks

Has it been three weeks? Has it ONLY been three weeks?

Time seems to be moving slowly; I'm focused on my 8-week "bye bye crutches" appointment and I’m not even halfway there.

As I write this, it is 105 degrees in Portland; we’ve had record high temperatures the past few days. I still have trouble regulating my body temperature, and coupled with the heat this has been difficult. We don’t have air conditioning because our house is up on a hill and surrounded by trees; it never gets hot enough for us to need air conditioning (until now). We do have a basement which is cool, but I'm at the point in my recovery where I want to get out of the house and be more active. I can’t really do much outside without dissolving into a sweaty tired mess.

Today my parents took me out to lunch at a nice air conditioned restaurant. Then we went to the grocery store (also cool) and pharmacy (not bad). I did a lot of walking in the stores and felt pretty strong on the crutches. I didn’t realize how tired I was until I got home and took a two-hour nap!

So here is my three week update:

~Scar looks good and I’ve started massaging Vitamin E oil into it. I’ve heard that Bio Oil works well but also heard that any oil is fine, and since the scar already looks so good I see no reason to buy the Bio Oil because I have some Vitamin E.
~I try to sleep in my regular bed but still bail out in the middle of the night to the hospital bed. The mattress on the hospital bed is horrible, but I can change the settings and get more comfortable. Plus I hate waking Perry up with all my tossing and turning. I did spend one night early on sleeping in the recliner but did not repeat it because the hospital bed is better. I can usually sleep on my non-op side with a pillow between my legs but sometimes that just hurts. It’s hard to move the pillow and my leg around to find the sweet spot but when I do, it's great.
~My pain level is usually a 1 and I’m not taking any pain killers. The pain I do get feels muscular and not like it’s inside the joint or in my bones. It’s hard to tell for sure, but I don’t think I feel anything where the bones were cut. I feel sharp pain if I move my leg too abruptly. I am trying not to actively lift the leg as I was told not to, but occasionally I do by accident. I’m able to do it, but I feel sore in my hip flexors and my inner thigh when this happens. I’m trying to be more aware so as not to do it accidentally.
~I’m trying to do things around the house like laundry, cleaning, etc. I carry things around the house in a tote bag around my neck, in my teeth, in a backpack, tucked into my waistband … whatever is handy. It takes a while to bring all the clean laundry in to the bedroom and put it away – several trips with the tote bag – but I feel productive. My house is a mess – we have a long-haired cat shedding everywhere and the vacuum cleaner is just not going to happen with crutches – but I have learned to live with it. Laundry, of course, is not optional.
~Thanks to the CPM machine, my range of motion seems excellent. I can bend over to pick things up from the floor, reach forward and touch my toes, tie my shoes, paint my toenails, bring my leg in to my chest (not all the way by any means, but darn close), sit on the floor, and pull my operated leg up over my head with my hands a la Biellmann. OK, OK, I can’t do the last thing, I was just seeing if anyone was still reading.
~I have gently tried external rotation (e.g., sitting cross legged). My external rotation (turnout) has always been limited and it’s exttremely limited now because of post-surgical stiffness. This surgery did not correct my anteversion (my femurs are rotated inward) since that would be an additional surgery (femoral osteotomy) and my surgeon did not want to do it. (I didn't really either, although the thought of better turnout almost made it worth it.) I don’t know how much my external rotation will improve once I am able to stretch and work on it. I hope to have external rotation that is no worse (and if the stars align, better) than before. Otherwise returning to ice dancing, with its requirement for turnout in order to do even the easiest turns, may be challenging or impossible. This was my biggest outcome fear going in, and it’s too early yet to know how this will turn out (pun intended) in the long run, because I’m not allowed to do any real stretching or rotating yet.
~I’ve lost 12 pounds. I’ve been eating very healthily and I’m definitely not starving myself or dieting. Everyone says my formerly muscular legs are looking wimpy. So we can safely assume that’s 12 pounds of muscle gone to hell.
~Sneezing and coughing aren’t as excruciating as they were earlier in my recovery, but I still feel them in the joint/incision.
~My hands still hurt when crutching but I’m getting used to it and it rarely bothers me.
~I can still see the bruise from my first Fragmin injection, given to me in the hospital by Nurse Ratched. I can still see the bump where the IV needle was inserted. I can just barely still see the bruise from my autologous blood donation! Needles and I just don't get along.
~I am going to have a glass of wine before bedtime. I haven’t had an adult beverage since before my surgery. I have a feeling I will sleep quite well tonight.

Tuesday, July 28, 2009


It's really not all that gory, but I know some people are squeamish and if that's you, please do not read on. For those of you still with me, here's a pic of my incision on the eve of three weeks post-PAO. The skin is dry and yucky, but the scar itself -- lookin' good.

Here's the guided tour:

~This photo was taken facing me, so it's right side up. The top of the scar, upper left in the pic, is at the top of the iliac crest.
~The entire thing is about 6 inches long.
~The dot at bottom left is one of two small holes left by the drains.
~The skin around the scar is lumpy and swollen. The entire hip is swollen but not as much as I expected; I can wear normal-sized clothes (although I haven't worn anything tight or form fitting yet).
~The purple cross-hatch marks are magic marker. It's slowly wearing off, but I don't really want to scrub it. Touching the scar is still a little bit icky.
~Overall I have been impressed with it from the first time I saw it in the hospital. There were no steri-strips, staples, or stitches. (All stitches are internal, with super glue holding it together on the outside.) I was truly expecting something horrifying and it's really not.
~Clearly I need to work on my tan.

Stay tuned for my 3 week update tomorrow.

Monday, July 27, 2009

Farewell to Fragmin

Today was my last Fragmin (anti-coagulant) injection. To say that I am happy about this is a gross understatement. The injections weren't really all that bad, and didn't really hurt (just a bit of a sting), but I just never quite got used to giving myself a shot in the abdomen each morning. I dreaded it each day.

And a cheery adios to my elastic TED stockings as well. I actually ditched them yesterday since my legs are not swollen and we are experiencing a heat wave here. Plus they were pretty stretched out and I don't think they were compressing anything.

I've been looking forward to these milestones. Next milestone? I can stop taking iron supplements (they do yucky things to my digestion) in just over a week. After that? I get to drive and go to the pool in 3 weeks and 2 days! At that point I will also go back to the office part-time.

Sunday, July 26, 2009

Sweat Hog

, I am old enough to remember "Welcome Back Kotter," which means I could be menopausal. However, I don't think that's the explanation for my hot flashes.

We are having a heat wave in Portland, with temperatures expected to peak in three digits tomorrow. But our house is cool, and I've been spending the majority of my time indoors.

It's been a bitch trying to regulate my body temperature. I think this is a residual effect of all the heavy-duty drugs introduced into my formerly drug-free body over the past several weeks -- epidural, general anesthesia, oxycodone, oxycontin -- as my body tries to detoxify. But it seems to be taking forever!

My last Oxy was 5 days ago, and I did experience two days of withdrawal-type symptoms (nausea, headache, irritability, inability to sleep, sweating). The only remaining symptom now is the hot/sweat/cold cycle I'm in. It's far worse at night, when I wake up drenched, throw open the windows, throw off my clothes, and then become freezing cold. I load up on blankets, and the cycle repeats. All night long. In between I'm able to sleep, but every morning I wake up soggy and, well, smelly. And unhappy.

It could be worse. My hip pain is really minimal, for which I'm grateful. I'm just taking occasional Tylenol for pain. My last Fragmin injection is tomorrow (YEAH!) I get to ditch the lovely TED compression stockings tomorrow (YEAH!) Overall I feel fantastic. I just wish I could stay cool, or warm, or somewhere in between, and remain there.

I got on the scale this morning to find I'd lost just over 10 pounds since my PAO, which is not something I expected. I had gained 10 lbs. from date of diagnosis and was able to lose 5 of that before surgery, so now I'm 5 pounds below my weight before all this started. Perhaps it's all water weight, although I've been careful to stay hydrated during this sweatfest. I actually look a lot thinner, especially my legs and rear, and I think I may be losing muscle mass, which is not something I want, but would explain the severe weight loss. I can't wait for physical therapy (starting in September) so that I can sweat legitimately and start building those muscles back up.

Saturday, July 25, 2009

Hip Arthroscopy Warning

I felt the need to write about this because hip arthroscopy is a fairly new surgery which can produce wonderful results for some people. Because of fast and positive outcomes on high-profile sports heroes, the surgery has been in the news recently. Many orthopedic surgeons may be hot to try it, or see it as a "cure all" for hip pain.

Hip arthroscopy in the news:
Hip Doctor to the Stars
Alex Rodriguez Article
Why so Many Hip Scopes All of a Sudden?

But consider this warning: If you have hip dysplasia, please read on before considering hip arthroscopy. I am not a doctor (ah, the road not taken!), but have already read about too many failed hip arthroscopies performed on people with hip dysplasia. As a hip dysplasia patient myself, I feel obligated to pass on what I've learned.

So many orthopedic surgeons, even those who specialize in hips, don't fully understand hip dysplasia. It is frequently misdiagnosed or overlooked. Arthroscopy may seem like a quick fix for a torn labrum or cyst causing hip pain. However, for those with dysplasia, arthroscopy can further de-stabilize the hip joint, causing increased pain, rapid deterioration in the joint and the need for further surgery.

For those with normal hips, a torn labrum may be caused by sudden trauma (such as a fall) or repetitive injury from sports. For those with dysplasia, a torn labrum is almost always caused or exacerbated by the dysplasia itself. If the tear is fixed but the underlying cause is not, the likelihood of a new tear is great. If the torn labrum is debrided or trimmed away the dysplastic hip, already unstable due to poor mechanics, is further de-stabilized. The likelihood of a repeat tear is extremely high. Once the dysplastic joint is de-stabilized by arthroscopic surgery, arthritis and other problems can set in quickly. Often the post-arthroscopy joint can not be saved by conservative methods such as periacetabular osteotomy (PAO), and a hip replacement is the only remaining option.

If you have been diagnosed with a labral tear and have dysplasia, I urge you to seek the opinion of a doctor who is a dysplasia expert before considering any surgery. If you don't know whether you have dysplasia, ask your doctor to check your x-rays. In particular, if there is no other reason for you to have a labral tear, or if you have other hip symptoms which you may have ignored until now, or if you are in the risk group for dysplasia (first-born female and/or breach birth), DO NOT consider arthroscopy until you know the facts.

For more information on hip dysplasia please check the references listed on this blog, in particular the
Hipwomen Yahoo Group
Hipwomen can help you make sense of your diagnosis and refer you to a physician who specializes in hip dysplasia in your area. Learn all you can about your body - knowledge is power!

Friday, July 24, 2009

2 weeks post-op

I am a couple of days late with this post as my two week post-op day was Wednesday and it is now Friday. I don't have scar pictures (the post-op photo I took with my phone is pretty blurry), although it looks good. I'll have to get Perry to take a photo tonight because this just wouldn't be a PAO blog without scar photos!

Last night I took a bath. Shhh, don't tell Dr. Mayo, because I don't think I'm supposed to. Some hip chicks are allowed to do hydrotherapy when they are still in the hospital for crying out loud, so I didn't think a bath would kill me. I was careful not to get the scar wet. I am a Pisces. We fish like to be immersed in water. I can't swim until week 6 per doctor's orders, so this is the best I can do. It felt really good to sit in warm water.

Here's my progress at the two-week mark (as of this past Wednesday):
~I am off all prescription/narcotic drugs. Had a bit of withdrawal for a couple of days (headache, nausea, sweating, inability to sleep) as I probably came off them too rapidly; I don't recommend that. Next time I'll taper more gradually. I'm just taking occasional Tylenol for pain. I think I've had just one dose of Tylenol.
~CPM is at 90 degrees, meaning I can get rid of it
~I can sleep on my non-operated side for about an hour and can flip on to my stomach (but can't sleep that way)
~I can shower (sitting down) by myself
~I can shave my legs
~I can get dressed by myself without any helpful devices. Hardest part is to put on socks and shoes, but I can do it.
~I can get in and out of the car without assistance (passenger side - can't drive for 4 more weeks)
~I have been working from home up to 4 hours per day (but not on a very regular schedule; usually about an hour per day).
~As mentioned, incision looks very good. It looks too good, in fact. Who would believe I had major surgery with this wimpy scar? It lacks the necessary gore factor.
~I did laundry while sitting on a stool last night.

Problems I'm still having:
~Sleeping through the night now that I'm off narcotics; usually I get 4 hours of sleep and then another 2-3 during the day. Despite this, I'm not really tired.
~My hands are killing me from crutching. I could crutch for miles if it weren't for that. I have padding for the handles and I have padded bike gloves, but still.
~Regulating my body temperature. I thought this was related to taking the opiates, but it's still an issue. One minute I'm sweating and the next I'm freezing.

Monday, July 20, 2009

Things your doctor may not tell you, part 2

The dietitian came in with a computer on a rolling stand to take my food order for the day. Usually they do it the day before for the next day, but since I'd been in surgery most of the prior day they did it early in the morning. I was able to specify exactly what I wanted to eat at all three meals. I found out that you need to be very specific. If you don't order salt and pepper, you don't get salt and pepper! There were plenty of vegetarian entrees. I was hungry and ate everything they served me for the rest of the day.

Occupational Therapy came in right after breakfast and talked to me about safety at home, how to move my own leg, and how to set the CPM machine.

Physical therapy came in a bit later. I told the therapist about my epidural problem, because she had a walker with her and wanted me to get out of bed. I said that I would try, but I didn't know if I could bear weight on my numb left leg. First she got me to sit up on the edge of the bed, which was more difficult than you can imagine. If my leg had not been numb, I could use it to maneuver myself around. Without it, I could only rely on my arms and her assistance to get my right leg out of the CPM, scoot to the edge of the bed, and turn myself sideways to sit on it. After all of that exertion I ended up sitting upright and was pretty proud of myself. Until ... I started getting very dizzy! My head felt full of cotton and my ears were ringing. I was pretty sure I was going to pass out and so PT made me lay back down immediately. This is extremely common for people who have lost a lot of blood. She said once I had my transfusion I should be able to sit up without passing out!

The rest of the day I spent reading a bit, napping a bit, talking with Perry, eating, and having my vitals checked every couple of hours. My surgeon and anesthesiologist came to visit and answered some questions. Most importantly my surgeon said that the operation had gone very well.

In the evening I used my earplugs and got a pretty good night's sleep. The noise of the CPM, the nurses station outside my door, and the foot booties inflating and deflating were all easy to tune out since I was exhausted. For two months before surgery I'd practiced sleeping on my back since that was not natural for me. I was able to sleep on my back without problems in the hospital and once home, so I recommend practicing beforehand.

Friday was very much like Thursday. My numb leg felt a bit stronger. PT got me up on the side of the bed again, and again I got dizzy, so we went no further. The day passed uneventfully.

Around 4 PM the nurses told me it was time for my transfusion. They were aware I had donated my own blood. I checked the label on the blood bag myself and everything was OK. I looked forward to feeling stronger after the transfusion.

The bag of blood was hooked up to my regular IV. I will say that the transfusion was painful. I have heard from one other hip chick that her transfusion was painful. Others have not mentioned it. I do not think it is painful for most people, but when it comes to giving blood or getting it back, I obviously have difficulties. The nurse said that blood is actually caustic and it could be burning my skin or veins as it entered my hand through the IV. My hand and the IV site were stinging throughout the transfusion. The nurses offered to re-do the IV but I didn't think that was the problem, and figured that messing with the IV would also hurt. I put an ice pack on my hand and watched several episodes of "What Not to Wear" to distract me. Each unit took a few hours so I knew the pain would be short-lived. It wasn't horrible, but it was pain.

I was also sensitive to the saline solution used to flush the IV. So, obviously I am sensitive to things which others may not be. Many of the nurses pushed the saline solution in really fast, which hurt more. I told them to push it very slowly, which hurt less. I am surprised that they aren't always gentle, but then I realize that I may be one of very few people who are sensitive to the saline and experience pain. At least now I know to tell them to do it carefully for less pain.

This was a very big day because they took out the epidural. A couple of hours before, they started me on oral medications (Oxycodone). Then they took out the epidural (which did not hurt, by the way, other than taking off the tape which was just annoying and still itches!). After the numbness wore off (a couple of hours), I was able to sit up on the side of the bed without dizziness and use a walker to go sit in a chair in my room. A small step for womankind, but a huge step for me.

I ate lunch sitting up in a chair while my bed was changed. I can't tell you how good it felt to move around and get out of bed, finally, even though every step I took was painful. I could not move my operated leg forward at all since it was so weak, so I had to use my toes to creep it forward, without putting any weight on it of course. Then I could move the walker forward a bit.

They took out the catheter so I could use the regular toilet (although I used a bedside commode at first so I didn't have as far to go). The catheter removal did not hurt. I got up several times with the walker and each time it got easier. I still needed help getting my leg in and out of the CPM machine.

They started me on Fragmin injections to prevent blood clots. I will have to inject myself when I get home, so I asked the nurse on duty, nurse D, to show me how to do it. She said don't worry, it goes into the fatty part of your abdomen so it doesn't hurt. Then I pulled up my shirt and it became clear that I don't have any fat on my abdomen. Well, she said, it may hurt for you. Great.

This is the only RN that I had a strong dislike for. She was mean and nasty, in my opinion. For this injection, she pinched the skin on my stomach, took the Fragmin injector, and slammed the needle into my body with quite a bit of force, which hurt. She then pushed the plunger as hard as she could, which stung. I still have a bruise from where she injected me over a week later. Throughout my stay, she was abrupt with me and would not answer any of my questions.

The next day another nurse injected me and since then I've injected myself many times. Not a single bruise has occurred, and the injections have not hurt. The kind nurse who showed me how to do it the RIGHT way the next day said to pinch the skin and shake it so the nerves are occupied and feel less pain. Then put the tip of the needle against my skin and push it in very slowly; she said there is no reason to hold the needle up high and jam it in to the skin, other than to cause pain. She also told me to push the plunger slowly so it wouldn't hurt.

Nurse D, When I have my LPAO I will specifically ask that you not be assigned to me. I strongly suggest you find another job, since obviously nursing is not your cup of tea. I won't put up with your kind of shit in the future.

In addition to nurse D who is an RN, there were two CNAs that I don't want around me either. One was just plain stupid. As in, when she talked, I wanted to correct her grammar and tell her I didn't care to listen to her babble on and on about her bad family situation. That in itself would have been tolerable, but when I asked her to help me get my leg out of the CPM machine she pulled on it HARD, which hurt. I told her she couldn't pull my leg straight out like that and she said, well, she had NEVER DONE THIS BEFORE. I couldn't believe they had assigned someone to me who was not familiar with how to move a PAO patient. That's not supposed to happen at Tacoma General. I really had to go to the bathroom so I didn't have time for her to get someone who had done it before. I instructed her exactly what I needed done to get me out of bed. She was clumsy and didn't apologize for hurting me.

Later on she grabbed my right wrist (the one with the IV) to take my pulse, and pressed down hard on the IV needle itself, and I said OUCH, she looked at me blankly. I said look, don't you see the IV there? Can't you use the other wrist to take my pulse? She looked at me blankly and said, "it shouldn't hurt for me to push on your IV." Right, well, it does honey, so get away from me. You are a moron and I won't put up with your kind of shit in the future.

Finally, there was the CNA who tried to move me the first day. I never got her name and she only came in one other time when I rang the call button. She was young and inexperienced and had an annoyed look on her face every time I saw her. I don't want her around me either in the future. I can just tell that she'll do something to me that is stupid and painful because from the expression on her face I can tell she just didn't care. I won't put up with her kind of shit in the future either.

This operation cost something like $100,000, which I narrowly avoided paying myself. My out-of-pocket costs are still going to be several thousand dollars for co-pays, etc. For that amount of money I expect the best quality of care. I may sound harsh, but I won't put up with anyone who doesn't live up to that standard.

They removed my IV line today and also the drains from the incision. Neither of these things hurt. Then they changed the dressing on the wound for the first time. I saw the scar and it looked good! Pretty big, but neat and not swollen. The stitches are under the skin, and the outside is super glued shut. There is purple permanent marker with hatch marks along the scar line, which looks worse than the scar itself. I took a picture with my phone before the dressing went back on. It is pretty fuzzy; I'll post it later alongside the two-week scar photo for comparison.

I'm now on oxycontin and oxytocin for pain managment, and I'm able to handle it pretty well. It can make me tired and last night a little nauseous, and I have a headache sometimes. But today I've been visiting with my parents who are here, and my aunt and uncle visited from Seattle. I'm coherent.

I think they are going to let me go home tomorrow, but I need to learn how to use crutches first. PT did not show up at all today. I found out later that someone called in sick and the backup person didn't get the message. I was concerned that I didn't get to try crutches because I really really really want to go home tomorrow and if that's the only thing holding me up, I will be upset if I have to stay an extra night.

They moved me in to another room since they needed mine for someone who might have seizures and my room had a monitoring camera. No problem; the new room was just exactly the same but on the other side of the building. I now had a view of a church steeple instead of a smokestack. Had it not been cloudy there was supposed to be a view of Mt. Rainier, but I never saw it.

I got to take a real shower after breakfast, sitting down of course, and it felt great.

PT did come in and show me how to use crutches. I had to climb two stairs, up and down, and crutch down the hallway and back, before they'd let me graduate from crutch school. Success!

Then it was a matter of getting my prescriptions filled (I had no money but my mother paid) and getting all of the paperwork signed. I was in a hurry to be discharged because if we hit rush hour traffic the 2.5 hour trip could expand to 4 or more hours. They got everything done quickly and I was discharged by 1:00 PM. They wheeled me down to the car and I got in without problems. The two and a half hour trip was easy, and when I got home my home hospital bed and CPM were waiting for me. There's no place like home.

Final Advice
My best advice for anyone undergoing PAO or any surgery --- get in the very best physical shape you can beforehand. Although you may have limitations on your activity before surgery, do as much as you can to strengthen your arms (for using crutches), your non-operated leg (to help support all of your weight) and your operated leg (the stronger it is to start, the easier it will be to rehabilitate). Eat well and be in the best possible health you can be. A strong, healthy body can better tolerate the massive stress of this surgery. Be a fighter, come out a winner.

Sunday, July 19, 2009

Things your doctor may not tell you,part 1

Here are my memories of pre- and post- op PAO surgery. I hope these details will be helpful to others undergoing PAO. Note that your experience is likely to be very different from mine. The more blogs you read, the more you will realize that each person is different and recovery rates/pain levels will vary. The point is not to compare yourself to anyone else. However, reading about other people's experiences can help prepare you for some of the things you will encounter during your surgery and recovery.

This was pre-op day. I signed a lot of papers, provided my Advance Directive, answered the same medical questions multiple times, and MADE SURE the hospital knew I'd donated my own blood. I mentioned it at every opportunity and made sure everyone wrote it in my chart! After the difficulty I had donating blood, I was adamant that I'd be getting it back. Hip Chick Tip: Make sure the hospital knows if you have made an autologous blood donation, and check the bags of blood to make sure they are yours before you are transfused. You can insist they show you the bags of blood, or have a friend or family member on hand if you are too weak or incapacitated.

I met with an anesthesiologist (not mine, it turned out), who answered questions, and my surgeon and his PA, who explained all of the risks to me and also answered last-minute questions. They did a mini-physical exam on me and they wanted to take blood, but I got so distressed about this that they told me they could take it out of the IV line on surgery day so they'd only have to poke me once.

We checked into the hotel. Hip chick tip: If you are going out of town for surgery, ask your hospital if they have negotiated special rates with local hotels for you or your family. I ate a light dinner and tried to go to sleep early, since my alarm was set for 4 AM. I am not a morning person, but I was required to get to the hospital by 5:30 for my 8 AM surgery. The night before and morning of surgery I was required to shower and scrub myself with special antiseptic scrubbing pads. You won't get another real shower for a long time, so take advantage of this! I felt very clean as I got into bed, and I slept on and off throughout the night.

The hospital provided free/valet parking, although they weren't running the valet at 5:20 when we showed up. I couldn't eat or drink anything from midnight on, but I can tell you I wasn't hungry. I didn't take my cane with me since I am perfectly capable of walking a short distance without it and I knew I wouldn't need it coming out. I didn't realize I'd have to walk from the check in area to the pre-op area through a maze of corridors and elevators, following the check-in lady and 5 other pre-op patients and their families, all of whom were more mobile than I was. They were walking way too fast for me and had we gotten any further behind we would have been lost in the maze forever. But, as luck would have it, we finally arrived at the pre-op area.

I was pretty shaky by then; not woozy or tired, but the kind of shaky you get when you have stage fright. They call this a "fight or flight" response, and if I could have, I would have run away. Instead, I went into the little curtained room reserved for me and changed into my lovely oversized tie-in-the-back hospital gown sans underwear. I had to run out to pee a couple of times and, being new to this whole scene, I wasn't ready to moon everyone yet. Hip Chick anti-mooning Tip: The gowns tie in the back. Hold the ties/opening to the side of your body with your hand and it's easier to keep the gown closed. (Note - after you've had your surgery you will no longer give a shit who sees your private parts.)

I lay on my bed in pre-op and the pre-op nurses worked their magic - asking me medical questions I'd answered before, listening to me tell them I'd donated my own blood, giving me three hospital bracelets (one showing my allergy to Amoxicillin, the other an ID bracelet, and the third containing numbered tags that would later be used to label things given to me or taken from me,such as blood samples). I was very nervous about the IV insertion, based on my very very bad vein history. I had Perry there holding my hand, and he distracted me by asking me a question about our bathroom remodel. It was a good ploy, because there was nothing I cared less about at that point than where the light fixture should be hung. Thanks to this distraction, they were able to numb my hand and find a vein with very little pain. I listened to my Ipod to pass the time and distract me further. They allowed my husband to stay with me until they wheeled me to the operating room. Hip Chick Tip: Music is great therapy. Some surgeons will allow you to listen to your Ipod during surgery. No, you won't be awake enough to hear it or remember, but some researchers say that it might still be soothing to your unconscious mind. I had Perry take it at the last minute, but it was great to calm me down beforehand. I'd even made a special "relaxation playlist" for this purpose.

I asked my pre-op nurse who the anesthesiologist was, wondering if it would be the nice person I had spoken to the day before. She looked in the computer and paused before saying that "Dr. S is very thorough but a bit ... abrasive. He doesn't have a very good bedside manner; he'll never smile, but he is an excellent anesthesiologist and will take good care of you." Great, I thought, this is my first surgery. Why can't I get somebody nice?

Dr. S. showed up and I heard him talking to the nurse outside my curtained room as he reviewed my chart. "She's 46?" he asked the nurse in surprise. They don't see many PAO patients my age; most are teens or in their 20s, so I am highly unusual. Dr. S came in to introduce himself and was wearing a jacket and lanyard which indicated he might be a fan of a certain university football team. I greeted him with, "You must be a Cougars fan!" and we were instantly friends. He smiled, and I found that he had a very dry sense of humor. I told him that I was anxious and not really into pain and he said he'd take care of that soon. I finally relaxed ... I was in good hands. Hip Chick Tip: Doctors are people too. Don't be scared of your doctor. Ask questions until you get answers you understand. Try to engage your doctor if his/her bedside manner isn't the greatest. Sometimes it works, sometimes it doesn't, but it's worth a try.

Finally, the time came for me to be wheeled into the OR. I kissed Perry good-bye and down the hallway I went, feet first, with Dr. S by my side. Technicians were still setting up equipment in the room, and I was introduced. They transferred me to the operating table. I was given something to make me relax somewhere along the way; I'm not sure when they did it but I didn't feel too nervous at that point. Dr. S had me curl into a fetal position on my side so he could place the epidural. There was some problem with the equipment and he was upset about it; he spoke rather sharply to the nurse and technician. Eventually it was fixed. I don't remember the epidural insertion being painful, but I was worried about equipment problems this early in the game! Not long after, Dr. S said, "We're going to put you to sleep now." That is the last thing I remember until I woke up in recovery.

My operation lasted 6 hours. I woke up in recovery and felt ... fine. No nausea. No pain. Nobody was there when I first opened my eyes, and I remember wondering, hey, did they really do the surgery? Is it over? I feel way too good to be coming out of surgery! But indeed, that was the case. The recovery room was large and bright, with about 6 people in beds just like mine. I was next to a huge window. There on the roof of the building next door was -- a construction worker. Looking right at me, it seemed. A nurse saw that my eyes were open and came to check on me. My first words were, "is that a construction worker?" and "is my surgery over?" Yes and yes.

My mouth was dry but otherwise I felt very relaxed with no pain or nausea. They fed me ice chips and gave me sips of water. I kept wondering when they were going to take me to my room. There was a clock on the wall, and I kept dozing off and then waking up to see that time had crawled by -- 10 minutes here, 15 minutes there -- until two hours had passed. During this time I discovered that my left leg (the non-operated leg) was more numb than my right leg. Yay. This happens sometimes since epidurals can be unpredictable. It meant that I would not be able to get up and walk as quickly because my good leg would not move or bear weight well. Sometimes the epidural does not numb the operated leg at all, and other pain mitigation methods have to be started immediately. In my case, my operated leg was only numb from just below the waist to about 6 inches below the incision, which was enough to keep me out of pain. My non-operated leg was numb from the waist to just below the knee!

They finally took me out of recovery. Perry met me as they were wheeling me in to my room. I had a private room with a nice view of Puget Sound (I couldn't see it from my bed without sitting all the way up and turning around, but my guests could see it). Coming out of surgery I was hooked up to an epidural, a foley (urinary) catheter, a suction drain, an IV, and a machine hooked up to booties on my feet that inflated and deflated every 20 seconds to keep the blood flowing in my legs to prevent clots. I also wore lovely TED compression stockings which, while unfashionable, were not uncomfortable and reached to my knees. I was pretty sweaty and probably didn't smell great, and my naturally curly hair was a big rat's nest. Thankfully no pictures exist of this event.

The rest of the day consisted of getting used to my new surroundings. I was always assigned to a nurse (RN) and assistant (CNA or LPN). Thankfully they wrote their names on a white board at the beginning of their shifts because I am not good with names. Some of them only took care of me once, and others I saw multiple times during my stay. Most were kind, caring and competent. Some, I'm sorry to say, were not. Three in particular were so bad that when I go back to get my left PAO, I will specifically ask that they not be assigned to me. Not sure if that is possible, but I am going to ask so their supervisors know that I won't tolerate any bullshit. More on that later.

I was thirsty and my lips were chapped. My stuff was still in the car so they provided me lip balm (do take your own, theirs was yucky but better than nothing). I drank a bunch of water and juice. At 6 PM they brought me dinner and it was ... Meat! Slices of some sort of meat. I am a vegetarian and had told them that at check-in. I asked for something else but should have asked what my options were but was a bit out of it so I just asked for something "vegetarian." They brought me pasta soaked in spicy red marinara sauce and a salad and dinner roll. I wasn't nauseous, but I didn't want the first thing to hit my stomach post surgery to be spicy, and it didn't look appetizing. Had I known better, I would have asked for plain pasta. I picked at the salad and ate the dinner roll, but that was all I ate. I figured I would make up for it tomorrow.

The nurse explained that they would take my vitals - temperature, blood pressure, oxygen level, and pain level - every hour. They showed me my call button. They gave me an ice pack for my hip. All was well.

I was getting tired. Perry brought my stuff in from the car, including my beloved pillow from home. He was also exhausted and I told him to go get dinner and sleep at the hotel. He needed a good night's sleep and I was feeling fine - no itching, no pain, no nausea - so I saw no reason for him to stay.

Right after he left, three nurses came in to my room. They told me they had to move me to a different bed because the bed I was in didn't have a trapeze and wasn't suitable for the CPM machine I would need. Then they started talking among themselves about the best way to move me. Right in front of me, as if I couldn't hear, they admitted to each other they had no idea how they should do that. One came up with the idea to put the beds side by side and pick me up in my sheets and swing me from one to the other. Visions of them dropping me between the two beds flashed through my head. "Wait a minute," I said, and they all looked at me as if they were surprised that I could talk. "If you don't know the correct way to move me, I am not going to let you move me. Please go get someone who knows how to move me." One of them looked at me with a disgusted look on her face. More about her later. The other two I never saw again during my stay. They finally went to get a supervisor, who, when they described how they intended to move me, told them that there was no way that would work. She went out of the room and got a board, which they rolled me onto, and they moved me that way. They weren't very gentle and yes, it hurt my hip.

OK, can you imagine what would have happened if I had been out of it on drugs, or hadn't spoken up? I wish that Perry had not left because had he been there he would have raised a huge ruckus. As it was, he didn't know about this until the next day because I wanted him to get some sleep and didn't want him to worry. This was my first night in the hospital and I realized then and there that not everyone gave a damn about me or had my best interests at heart. To some, I was just another body. For the most part, as I said, the nurses were kind, caring and competent. But BE FOREWARNED. Nobody takes your safety and health more seriously than you do. Always be ready to speak up, and if you can't speak up, have an advocate with you who will do so on your behalf. Don't just let people do things to you without explanation. Whenever they gave me medications, I asked what they were and what they were for. Whenever they changed my machinery, I asked specifically what they were doing. Whenever they forgot to do something (and even the best nurses will, whether it is forgetting to wash their hands before examining you or forgetting to put your squeezing booties back on before leaving the room), I reminded them. You won't get a lot of sleep in the hospital because it's noisy and they wake you up frequently for vitals. So you might as well be vigilant about your own care.

This wasn't the best way to start out. It was probably the worst thing that happened while I was in the hospital because I was scared they weren't going to listen to me and I would be injured in a fall. No, they didn't drop me, but they could have. Lesson learned.

They got the CPM machine hooked up to the bed (it seemed that just one person on the staff knew how to do this, and the whole time they were doing it, it seemed like they were about to push it in to me. I shielded my incision with my hand and moved as far away as I could, because the thing is heavy and has a metal bar on the side which, if it slipped, would have done a lot of damage.) Finally it was in place and my leg was in it. They started me at 30 degrees which felt fine. Some time during the night they increased it to 40.

I had a lot of energy and was coherent in my speech, which was shocking. Since I'd never had general anesthesia or strong pain drugs, I figured they'd knock me out and make me dopey. That never happened, and when I spoke to my parents on the phone that night they couldn't believe that I sounded like a real person. Night fell; I fell in and out of sleep, and as promised, was woken up every hour for vitals.

Saturday, July 18, 2009


Here are some lists which may be helpful to those facing PAO:

Stuff I took to the hospital and needed:
~A notebook and pen. I wrote everything down - questions, instructions, how I was feeling - because my memory wasn't 100%. It's fun to re-read some of my entries now.
~A lightweight bathrobe that reached just above my knees. I wore this when I was working with physical therapy in the hallways so I didn't feel exposed and when I had visitors.
~Cell phone - I made a lot of calls for things like making sure the hospital bed would be delivered on time and to keep in contact with Perry and my parents when they weren't in the hospital. Since I didn't have a watch it was good to have the cell phone so I knew what time it was.
~Book - I was told I'd be too out of it to read, but I wasn't. I didn't have the attention span to read for long periods of time, but I was glad I had the book for times when I was bored.
~Box of chocolate for the nurses and others at the hospital - mixed reviews on this because everyone was on a diet. A few nurses really liked chocolate and I was glad I had something to offer them. I ended up eating most of it but there's nothing wrong with that!
~My favorite body lotion (which the physical therapist loved too). When they took tape off I had dry, irritated skin and this helped.
~My favorite lip balm - my lips were very dry after surgery and throughout my hospital stay.
~Ear plugs - hospitals are noisy. CPM machines are noisy. Ear plugs are a must if you want to get any sleep at all.
~Basic toiletries - toothbrush, toothpaste, deoderant, hair brush, etc. The hospital had all of these things but they were inferior quality and it was just nicer to use my own. Don't take things like makeup or hair styling products because you won't have the energy to care what you look like. Just take stuff to keep you clean and comfortable.
~Baby wipes - I used these when I couldn't shower. It didn't work very well but was better than nothing, and good to wipe my hands and face now and then.
~Laptop - goes against the advice to take no valuables. I could have lived without it because I didn't do any blogging, but I did check my personal e-mail once per day. I should have taken my Blackberry instead since it's a lot smaller and less expensive if stolen.
~Ipod - goes against the advice to take no valuables, but I took my nano and not the expensive Ipod given to me by a friend, and figured nobody would steal it. It was very worth having; listening to music kept me calm and entertained.
~Chargers for all of my electonics
~Health insurance/prescription card - you will need to get your prescriptions filled before leaving the hospital. Someone will need to pay the co-pay so make sure whoever is helping you come home has money or give them your credit card in advance.
~Advance Directive
~List of my medications/allergies
~My own pillow - I have a pillow I love and it made me more comfortable.
~Clothes to wear home - loose, comfy sweats or pajama bottoms and a t-shirt. Sturdy shoes.
~Comfort items for the ride home - If you are riding a long way in a car or airplane, a small pillow or rolled up towel will help pad where the seatbelt goes right across your incision. Since I was being driven home in my own car, I had a couple other pillows for padding as well. I also had a plastic bag placed on the car seat which made it easier to swivel into and out of the car.

Stuff I took to the hospital and didn't need:
~Prunes for constipation - didn't eat these until I got home but I probably should have.
~Peanut butter in case I was desperate for something to eat and there was nothing vegetarian on the menu. Didn't touch it as the hospital had plenty of vegetarian items.
~Several pairs of underwear - didn't wear them at all as even the boy shorts were uncomfortable. It wasn't a big deal to go al fresco.
~Several comfy nightshirts - on the day I was going to start wearing my own clothes they discharged me, so I never wore them! I wore hospital gowns for 5 days and that was fine. If you want your own clothes though, do bring them.
~Drivers license - I thought they would ask me for ID at some point in the check in process, but they didn't. Damn, I should have sent someone else to have the surgery in my place!

Stuff I left home:
~Credit cards

Things do get stolen at the hospital, although with a PAO you will rarely be far from your room; sometimes though you may be sleeping and out of it. I don't like to be paranoid but better safe than sorry.

Stuff they will give you in the hospital to take home:
~Crutches (the physical therapist will adjust them for you too)
~Non-slip socks (I bought these in advance but the hospital sent me home with a pair)
~TEDS (anti-clot elastic stockings you have to wear for some length of time; for me it's two weeks)

Stuff you may want to buy/install before you get home. (I don't think insurance pays for most of this, but you should check with yours to be sure. Mine paid for the commode because it was delivered with my home hospital bed. I think all of this qualifies as deductible medical expense on your taxes, so save your receipts and consult your tax adviser.) Even though I didn't need some of this, you might:
~Commode (I didn't need it)
~Raised toilet seat (I didn't need it)
~Grab bars in shower and near toilet (I didn't install them but if you are handy it's not a bad idea)
~Shower chair (invaluable to sit down while showering)
~Hand-held shower head (makes it much easier to shower; if you can, get one with a pause switch - I didn't and wish I had)
~Grabber (this would have been handy in the hospital too)
~Sock putter onner
~Other hip kit items (long shoe horn, long handled scrub brush, dressing aid)
~Comfy chair (recliners are great)
~Home hospital bed with trapeze (I have one because my surgeon prescribed a CPM machine; otherwise it would have been nice to have but I would not have spent the money for it. Depending on your mobility and whether your insurance will pay for it, it might be something you consider renting).
~Walker (easier to get around with than crutches at first for some).
~Non-slip socks (they gave me some to take home in the hospital but I'm not sure if this is always the case).

Daily Routine

I picked a great time to have surgery. It had been really hot here in Portland with beautiful sunny days. Our house is in a forest and very well insulated, so it stays cool. I love sitting in the living room watching the hummingbirds and squirrels. I can wear shorts and tank tops around the house and don't have to worry about trying to stay warm. Best of all, I don't have to put socks on (something which I don't think I can do on my right side by myself yet).

I have been waking up at 5:30 AM to have breakfast with Perry and sit in a chair for a couple of hours. Our new recliner is being delivered today and I can't wait for that as the chair I'm sitting in is a bit uncomfortable. I usually check e-mail and read the news in the morning. I am a bit obsessed with checking other hip chicks' blogs to see what they are up to, especially those that are a few weeks ahead of me in the recovery process. We all heal differently, but it's good to know what to look forward to.

I've been leaving comments on other hip chicks' blogs with more regularity because I can empathize about both pre- and post-surgical issues. I am trying not to make a career of reading and commenting on blogs, but it's hard not to be obsessive about it since it's what I am living every day.

I have noticed that most peoples' blog entries tend to taper off or stop just about the time they are allowed to ditch the crutches and start walking. This makes sense because at that point people pretty much go back to their normal lives. I would like to hear more about the physical therapy experiences people have at that point, but I'm sure I'll have the experience myself soon enough.

The only "complication" I've had is that my hands are sore. I'm using padded bike gloves, but they aren't helping much. The crutches are a bit more cushy than the walker so I'm using those more, but it's easier to carry things with the walker. I put a bike basket on the front -- the same kind of bike basket that used to go on my pink Schwinn when I was 10 years old -- only this one doesn't have plastic flowers on it. My Mom's friend had it hanging in her garage and donated it to the cause, and it has been invaluable.

I am allowed to walk as far as I'm comfortable with the crutches as long as I don't put any weight on my right leg, which means most of my weight will be on my hands. The doctor made it clear that it's a good thing to walk and exercise but I haven't ventured out very far yet. I think my hip could go miles without a problem but my hands might not make it that far. Since we live on a steep hill, I think I'll try going to a flat neighborhood to see if I can crutch a block. Someone can follow me in the car in case I poop out.

(Speaking of, yes I did, on Wednesday. My sister Linda won the betting pool.)

Most days, after sitting in a chair for a couple of hours I go take my meds and inject myself with Fragmin, the worst part of my day. Then I usually get tired and take a nap. When I wake up I work for a few hours each day on my laptop. I don't want work to think they can survive without me for too long! Usually I read a book in the CPM machine in the afternoon. When Perry gets home he helps me take a shower. A shower chair is invaluable and Perry installed a hand-held shower head as well. I strongly advise everyone to have those things to make your life easier.

I got a bedside commode because my surgeon told me to, but I've never used it. I don't have a raised toilet seat either. I know those things can be helpful but I haven't found the need. I would advise people to buy the raised toilet seat and have it available. Try the toilet without it. If you find you don't need it, return it.

The only other assistive devices I have are a grabber (invaluable - things fall on the floor all the time and I can also use it to help get my pants on my "bad" leg). I have a sock putter onner but haven't tried it yet as it has been too hot for socks. Usually people buy a "hip kit" which has a long shoe horn, a sponge on a stick for washing, a grabber, and a dressing assistant device. I didn't think I needed all of that and the grabber was on sale, so it was cheaper to buy just what I needed. However, usually it's cheaper to buy everything as a kit and some people may want the other items. I can reach my lower legs to wash them and can put my shoes on without a shoe horn so I didn't need all of the items.

I try to do my isometric exercises about 5 times a day, 20 reps each time. Those consist of the following exercises done lying on my back:
~Glute squeezes
~Pointing and flexing my feet
~Hamstring exercises in which I pull my heels down and toward my butt
~Quad exercises in which I tighten my quads and push them down into the bed

I try to get up 5 or 6 times per day just to stroll around. I'd do this more often if my hands hurt less.

I spend 20 or more hours per day in the CPM machine and I'm up to 75 degrees. I need to get to 90 degrees before I can stop using it.

My IV site is still sore and tender. Obviously anything having to do with putting a needle in one of my veins is a problem. Not intolerable, but something I've learned about myself.

Wednesday, July 15, 2009

On the flip side

I am supposed to spend 30 minutes twice per day on my stomach to counteract the effect of laying on my back for so long. Yesterday I flipped over with just a bit of trouble; it felt great to be off my back. I thought it would be impossible to flip back over, but it wasn't hard. I have repeated the flip today and almost fell asleep on my stomach, it felt so relaxing.

I got up early today and sat at the table to eat breakfast with Perry like a real human being. I then sat on the couch and spent 4 hours reading my e-mail from work. Several people told me to knock it off and quit working, so finally I did.

Healing-wise, everything is going really well. The only thing I dread each day is my Fragmin injection. Fragmin is a blood thinner I must inject daily for 2 weeks to prevent blood clots. It barely hurts, but I dread it each day because it's hard to push a needle into your own stomach. I'm really not afraid of needles, despite all of my negative posts on giving blood. It's just not the most pleasant part of my day.

Speaking of blood, in the hospital the professional vampires came to take blood from me daily. They were truly vampire-like because they always woke me up at 3 or 4 in the morning when it was still dark outside to take blood. That said, they were truly wonderful and able to get blood out of me with no pain. Sara, the phlebotomist with the mostest, told me on the first day that the reason I've suffered in the past was because there is a tendon right below my very tiny crooked rubbery rolling vein (this is true in both arms). Unless someone is careful, when my vein rolls they will probably poke me in the tendon. A needle in the tendon hurts like hell. She said with the large needle they use for autologous blood donations, it is likely that the needle was stuck in my tendon for the entire 45 minutes I was trying to donate. She said anyone would have been shaking and screaming in pain. I no longer feel like such a big weanie.

I'm still working on my long post regarding the details of my hospital stay. It may take a few days because there are many details to share. Meanwhile, let the healing continue.

Reminiscing ...

Here's me one day after surgery. I wasn't going to post this but why not; it's instructive. You can see the CPM machine in the foreground, moving my leg up and down. The orange "trapeze" over my head was invaluable in moving around, especially when both of my legs were numb. I won't go into detail on the icky stuff but it's all there (drains, IV, epidural, ice packs, etc.)

This was my own room but as you can see, it's not spacious. The door to the bathroom is in the background, not that I got to use that until the final days. The view out the window, which I'm gazing toward, was of a smokestack on an older part of the hospital, but if I turned around and stretched I could see trees and Puget Sound. Guests had a great view in that direction. I saw a couple of beautiful sunsets out the window, perhaps made more spectacular by the oxycodone and other drugs.

In any case, this is what a person looks like one day post PAO. Basically just glad the hard part is over and wondering when I can have a shower!

Tuesday, July 14, 2009

I put my pants on today, and other exciting news

It has breen almost a week since I (or Perry) posted. So much has happened that I don't really know where to begin. I've been meaning to post but kept putting it off because I was in the middle of a very good book ("Memoirs of a Geisha") and just couldn't put it down. When I did put it down it was usually because I fell asleep, or someone was taking my vitals, or a physicial therapist was torturing me. So I apologize for no news, but in this case it's good news.

I'll go back and discuss my experience day by day in a second, longer post after this one. For those of you without hip problems (my friends and family), reading this longer post may not be necessary since it's really just a lot of boring and gory details. For those of you awaiting PAO, I hope the details of my experience will help you prepare for your own surgery and recovery.

So here's all the good news in a nutshell for those of you who won't be reading post #2:

1. My surgeon said everything went really well. He is not a demonstrative person but he had a big smile on his face and I am certain that I will have the best possible result based on his positive attitude about the outcome. Of course, much of my success is now up to me ... and how hard I work at rehabiliation. But I know that Dr. Mayo did all he could for me surgically. He not only did the PAO, he shaved the top of my femur (the ball of the hip) which had a knob that was catching when my hip flexed. Now it's round and should work better. (Yes, that's probably why my hip hurt every time I tried to do a mohawk or a choctaw!)
2. I am in a lot less pain than I expected.
3. I had great pain management in the hospital, and most of the procedures I'd been dreading were not nearly as bad as I'd imagined.
4. The nursing staff at Tacoma General was mostly kind, caring and competent, with a few exceptions who were not. Overall the standard of care from the nursing staff was better than most hospitals, for which I am grateful.
5. I got to come home on the 5th day after surgery (yesterday), which is probably the earliest they would have let me come home in any case. I was very ready to leave!
6. The drive home was 2.5 hours and pretty uneventful.
7. It is great to be home. I have my hospital bed set up in my office and from the windows I can see beautiful green tree tops outside. It's very quiet here (not so much in the hospital of course) and I'm getting lots of rest.
8. Although my mom and sister checked in on me today, I'm home alone and able to get from bed to couch to bathroom using my walker just fine. I'm able to get my operated leg in and out of the continuous motion machine and on and off the bed myself (something I had trouble with in the hospital). My bed at home is much lower than the hospital bed and thus easier to get into and out of.
9. I am SO EXCITED that I was able to put my pajama pants on BY MYSELF this morning without any assistive devices. As expected, I was al fresco all week in the hospital and the first day home; this morning I wanted pants. My non-op leg is very mobile and strong so I was able to maneuver the pants onto the bad leg using the good one. You have no idea how exciting this is until you've had hip surgery.
10. I still haven't pooped. My family has started a betting pool called, "when will Terri poop." Estimates range from tomorrow at 7 AM to Friday at 8PM. I'm eating prunes and hoping it's sooner rather than later!
11. Spinal Tap fans --- the control on the CPM machine goes to ELEVEN. Of course, that means it's LOUDER.
12. My scar looks great. I could post a picture but will save that for later since I'm not sure where the camera is.

Thanks to all of my friends who've been such great support for so long. I am very grateful to have you all in my life. Terri

Wednesday, July 8, 2009


This is Terri's husband, Perry, blogging on her behalf.

After arriving at the hospital at 5:30AM, Terri went into surgery at 7:50AM and her surgery was completed by 1:50PM. The doctor met with me at about 2 and informed me that everything went very well. The outlook for the future is excellent! I'm waiting for her to finish up her post op recovery and get into her room to see her.

I want to thank you all for your support and well wishes and I'm sure Terri will be back blogging within the next week.

Tuesday, July 7, 2009


I am not sure why I am so attached to this old hip. I mean come on; it's no good. It was never any good! It's a piece of crap that was built wrong from day one. And yet I am sitting staring wistfully at my leg as if ... as if ... I should be mourning the impending loss of my dysplasticity.

I keep telling myself that the PAO is going to fix what's wrong with me, give me significantly improved function, and drop my pain level. After 46 years I should be ready to say good riddance to my miserable old uncovered hip without shedding a single tear.

True, I'll have a scar, blah blah blah, but that seems a small price to pay. I'll have to go through nasty surgery and recovery, yadda yadda yadda, but I've already come to terms with that. The future's all good, but I can't help but think I somehow need to formally say good-bye to the old hip. After all, this hip hiked all over Oregon, rode horses in Colorado and accompanied me on trips to Japan, England, France, Mexico and Canada. This hip and I got into all kinds of trouble in ballet class together. This hip was able to get me through my gold dances despite the fact that it was totally, absolutely, 100% unsuited for the job. This hip even jogged now and then under heavy protest.

It's not really going anywhere, it will just be re-fashioned into a new, improved structure. I should be celebrating this change and looking forward to all of the adventures my new non-dysplastic hip will share with me. I'm planning to hike Machu Picchu some day. I want to tango with Perry in Buenos Aires. I'm looking forward to walking the 3 mile loop on the scenic road just above where I live. And, I am hoping my new-and-improved hip might allow me to test the Cha Cha Congelado or even (gasp) the Rhumba some day. OK, stop laughing y'all -- by the time I fully recover, I'll be able to take them masters!

The pre-op appointments went well today, and I was able to convince them to save my one good vein for tomorrow's IV, so no blood letting occurred. The x-rays looked about the same as the first set last year, so my arthritis isn't any worse. Dr. Mayo was very honest in saying that I will still have hip pain post PAO, and that I may some day still need a hip replacement, but maybe not. I should get at least 10 years out of the reconstruction, maybe more. This surgery also won't give me any better turnout than I had before (and it may actually be worse), and that is disappointing. I'll still struggle with Mohawks and Choctaws on the ice, and I'll probably still get that grinding feeling every time I do them. But I WILL be able to walk more than a block without pain, and hike, and ride a bike, and walk the aisles of the grocery store like a normal person.

So it's time to say adios, adieu and buh-bye to old righty without regrets. Here's to new possibilities. See you all on the other side.

Monday, July 6, 2009

The really truly absolutely last skate

I just spent 3 hours on the ice. Some of that was just going around and around in circles talking. Tim came out to skate with me one last time. I don't think we've skated together since January or so, but it was just like old times. Somehow we actually skated well, considering. Several really nice spins, side by side twizzles in unison, Starlight, Viennese, Samba, Blues (formerly our nemesis dance - it was fine), parts of Midnight Blues and Tango Romantica, and most of the RAVENSBURGER (not at speed but probably recognizable). We did the circular footwork from our free dance. We did various bits of choreography from our free dance. All pretty good really.

We did start to try our spread eagle lift, but just as it was going up I heard a hip crack and we aborted. I thought it was mine, but it was actually his hip that cracked. We decided to forget about lifts for the day.

We didn't work super hard and took several breaks. It was really great to be out there with Tim again.

Sunday, July 5, 2009

The hip bone's connected to the ...

It seems the hip bone is connected to every other bone in my body and when I walk, most of them hurt. My back hurts, my shoulders sometimes hurt, my shins hurt, my thighs hurt, my tailbone hurts, my feet hurt. All because I am walking "funny," which is not the same as "comical." I use a cane, I limp, I compensate, and when I don't use the cane I waddle. All of this causes stress on many of my body parts.

Of course, the hip is not a bone at all, it is a joint where the femur meets the pelvis. There are more specific names for the various parts of the joint, but in basic terms that is a good description.

In just a couple of days my hip bone's going to be disconnected and reconnected. With all these pains, it seems like good timing. I've decided that tomorrow I am going for one last skate, even if it's just a couple of laps. It's going to be the last "thing" I do before surgery and I think that it's the right thing to do. Then I'll put the skates in a box and ship them off to Harlick for refurbishing. Meanwhile, I'll ship myself up to Tacoma General for similar extensive repairs. It sounds like a good plan.

Saturday, July 4, 2009

Independence Day

Moi and my mom/fellow type O+ blood donor staking out a place to sit at the parade in Gearhart

Today I'm celebrating exactly 6 years since I moved back to Portland from Colorado after my divorce. I always consider it my own personal independence day, in addition to our nation's birthday. I am at the beach with my family (mom, dad and Perry) as a last mini vacation before surgery. It's sunny and warm (unusual for the Oregon coast). We watched the Gearhart parade and then spent time on the beach, watching people drive and get stuck in the sand. Hilarious.

Off to fireworks viewing at friends' house in Seaside tonight. A happy, healthy and safe holiday to all.

Thursday, July 2, 2009

I'm OK with "OK"

I hate countdowns, and yet there’s no other way to describe this last week. Every morning brings me one day closer to the inevitable. I’m lucky that the weather is beautiful and I am home from work this week, making it hard to wallow in self pity. I’m trying to get out of the house as much as I can since I may be stuck inside during the most beautiful part of the summer. Right now I’m at a coffee house blocks from where I live, just because I didn’t want to drink coffee and type this at home. Plus there are no chocolate croissants at home, and I just had to have one this morning.

So far I’ve been sleeping at night and I’m able to eat. When I’m anxious about something I have trouble with both of these functions. I’ve had intestinal issues but I’m not sure if those are caused by nerves or the abundance of iron I’ve been taking as prescribed. I haven’t had any memorable pre-surgery nightmares yet. In fact, I’ve been sleeping better and more than usual, which is strange. Perhaps my body is preparing itself.

People have been a bit too cheery around me at times, which I’ve found mildly annoying, but I realize that’s all par for the course. Everyone keeps telling me that I’ll “be OK.” Science can make almost anything OK nowadays. We’ve come to expect that modern medicine has a quick fix for everything. Feeling out of sorts? Pop an anti-depressant. Aches and pains? A bionic joint will fix you right up. Even previously fatal diseases such as cancer and HIV can now be treated with varying degrees of success. People are accustomed to seeing their ailing friends back in action quickly after medical interventions.

In the scheme of health care, I know that my malady and its correction are pretty minor things because hip dysplasia is life changing, but not life threatening. I will live through this. But it’s a longer recovery than most orthopedic procedures. It’s a rare enough condition that my spell checker doesn’t even recognize it. The surgery to correct it is so rare that my primary care provider, and many orthopedic surgeons, have never heard of it.

So most people don’t have any idea what this surgery entails. They envision me bouncing back quickly and feeling no pain; back to my old activities with no reminders of my problem. In reality, I know that the recovery period for this surgery is approximately two years, and I need two surgeries. Even if I do the second one as quickly as possible (six months after the first), my total recovery time will then be two and a half years. A time during which I will experience pain, frustration, and limitations on my activities. As soon as I’m somewhat recovered from the first PAO, I’ll undergo the second, and my crutches, walker and cane will reappear on the scene. My co-workers will again have to pick up the slack for me while I’m out of the office, and they may not be as happy to shoulder the burden a second time. Even after a full recovery, I’ll still be limited from certain activities for the rest of my life, and it’s likely I’ll still have some (manageable) hip pain. It doesn’t sound much like bouncing back, and it isn’t the wonderful recovery people are expecting. It’s hard for casual friends and acquaintances to be supportive for that long.

Upon reflection, I’ve realized that “you’ll be OK” is exactly what I might say to someone facing surgery too. It marries concern with optimism and, I suppose, depending on how you define “OK,” it is likely true. This surgery and the recovery afterward will contain awful parts and good parts and I’ll probably experience both discouragement and progress in a single day. In the end, however, I know it will all be OK.