Tuesday, March 25, 2014

Two Weeks!

Today is the two weeks since my surgery, and I can't quite believe how well I'm feeling.   I can stand, and hobble a bit without my walker, and am having lots of fun scooting about on it. Then I wave admonishing finger at myself, mentally. Slow down, Anthea. 

When I look back on my the two week mark on this blog (It's a Rollercoaster!), I remember the frustration. It's a long haul, that's for sure. As before, I ran out of Dilaudid, and went back to Celebrex topped up with Tylenol. The pain is always there in the background, even with painkillers. Without them - too much!

This time around, I had a two week follow-up call from Colleen at the Joint Replacement Clinic. It was very useful in answering a few questions I had.

Off with the bandage!
I mentioned to a nurse in the hospital that I'd only changed my dressing once last time. She said that people often mess around with their dressings too much. So this time I haven't even pulled it up to take a peek. Colleen said I could peel it off, and take a shower without it. 

Some people get staples, but my surgeon used steristrips, which will eventually fall off. The drugs make me sweaty and stinky, so showers feel extra wonderful. The only slight drawback is that if I don't have help, my left leg has to airdry.

Last time I was waiting for my 6 week surgeon visit, hoping that he'd lift my restrictions. That was before my physio explained the reasons for them. Besides the outside incision, the inner joint capsule is also cut. It needs to grow thick scar tissue to keep my new, ceramic femoral head in place. 

My restrictions, if you remember are:
1. don't bend at the hip past 90 degrees
2. don't twist at the hip
3. don't cross the operated hip over the midline of the body

I have to keep these restrictions for three months, so everything heals up tight and strong. During the operation, the surgeon dislocates the hip, so he can get at the acetabulum (hip socket) and femoral head (the top of the thigh bone). With too much range of motion, the new hip is in danger of re-dislocating, again and again. We wouldn't want that!

As with most things, it's easier the second time around. It works for me to keep the alignment between my pelvis and my thigh bone from going past 90 degrees. So if I turn, I turn with my whole body. If I bend forward, I keep my pelvis upright, rather than tipping it forward. I feel like I live in a pelvic tilt. 

I remembered another reason I don't use my reacher much. I don't need it for getting dressed. When I put on my pants, I hold them as low as I can without tipping my pelvis forward, and lift my operated foot up as high as I can without going outside of my restrictions. This allows me to (just barely) hook my foot into the top of my pant leg, then squirm it up to the top of my thigh. Then I put my other leg in, pull my pants up, and... Voila!

Today's quote: 'Slow and steady wins the race.' the Tortoise and the Hare

Friday, March 14, 2014

Walkers and Reachers

Well, I've been home a week. I'm told I'm more chipper this time, and have been spending more time on my feet and less in bed. It might be that things feel a little easier as I know what to expect this time around. 

I love my four wheeled walker! Last time I had the two wheeled version, as the 4 wheeler is deemed too unstable for hip replacement patients. The problem with the 2 wheeler was, as I got more mobile, I kept leaving it behind, and hobbling around. Not so good for the the 'symmetry, symmetry, symmetry' my favourite physio recommends. As before, I can walk a bit now, and in the kitchen I loco-mote leaning on counters to move in small spaces. The walker does get a bit in the way, especially when all four of us are in our tiny kitchen.

The 4 wheeled one moves so smoothly, with a swirly, gliding quality that makes me want to create a dance piece with it as partner. The wheels make a sound like distant thunder that makes the cats nervous, and I have my own comfy seat. It also has handy side zipper pockets, and a huge compartment under the seat that carries books and pens. I love it!

As last time, it's a challenge to walk slowly, though I try. I've heard more than once 'walking consciously is the best physio you can do', so I keep my steps small, my weight evenly on both feet, and press on the walker as little as possible, keeping my shoulders relaxed. I find it ironic that, though my job is healing, I often find myself rushing around the house, for no reason at all.

I told the nurse at the hospital that I hardly used the reacher last time, and she raised her eyebrows. The reacher has a handle on one end, and pinchers at the other, so you can pick things up. I realize now I'm back at it that I use the 'Golfer's Reach' instead. With my left the operated hip, I stand on my right, and reach my left leg behind me. If I were older, or less fit, I'd be using the Reacher more often. For me, it seems a bit finicky.

It's interesting to have this blog, so I can check in on how things went last year and compare. I didn't have the soreness in my upper back this time, but I think that came from spending more time in bed.  

It's seems I got back on the mat with Restorative Yoga a little sooner, which is feeling wonderful. It's easier to know how to move, as I spent three months staying within the same restrictions a year ago. I just have to transpose my body memory to the other leg. 

Today's quote: 'Smile, breathe and go slowly.' ~ Thich Naht Hanh

Monday, March 10, 2014

One Week Later

There! Surgery done on both hips, no third hip hanging around to require me to get this done again.

It was easier this time, knowing what was coming. I was much calmer the night before, and going through the pre-op steps. Maybe too calm. Last time I cried as I was being given my spinal on the operating table, and woke up just as it all finished. I think the tears earned me stronger sedation. This time, I was awake, though drifting. The spinal deadens any sensation from the waist down, and I was shielded from seeing by a blanket tent. There was a plastic covering over me, like a thin air mattress, with a vacuum cleaner hose constantly blowing warm air into it. Though my ears were full of the hum of the air, I could hear a rhythmic banging. In my stoned state, I called out a few times 'Hey! What're you guys doing? What's the banging?".  No one replied, and when I asked them before being wheeled out, they said they couldn't hear me either due to the noise of the machine. Good thing! 

My roomie, Flo
I got into the operating room, out of recovery into my hospital ward much sooner this time. I wasn't lucky enough to have a private room, or a great view, but I did learn a lot from my roommate. Her name was Flo, 91 yrs old with dementia and epilepsy. She doesn't always remember to take her meds, and this year, same as last, her husband found her on the floor having a seizure, in which she broke her hip. So, just like me, second time round of hip surgery. That's where the similarity ends. She doesn't remember where she is from one moment to the next. All she knew for sure is that she wanted to get up and go home. So if she wasn't taking off her gown so she could get dressed, she was removing her IV, or trying to sit up. Her husband and the nurses explained to her over and over, "Flo, you've broken your hip, you have to stay here and heal." To which she'd reply 'Ah!" as if she'd finally understood, only to to go back to trying to escape. I was impressed with the kindness of the nurses, and the fact that they never resorted to tranquilizers, or strapping her down, which I remember happening to my Grandma.

As before, I was complimented often on the speed of my recovery, how soon I was able to sit up in bed, swing my legs off the side and walker myself to the bathroom. With Flo as an example of the more usual hip replacement patient, I understood why. On my third day after surgery, I was practicing stairs, and checking out. On Flo's third day, she was lifted into a wheelchair, to practice sitting up for awhile. Poor Flo. I hope she's gone home by now. She really helped me to count my blessings!

The pain seemed worse this time. There is a screaming entry in my journal from the day after, saying, "It hurts too much!". Though I haven't experienced it, I suspect it's like childbirth. The pain recedes into a distant memory, with other happier details plastered over top of it. Already, I don't remember how badly it hurt that day, less than a week ago. 

On that note, I've been juggling meds, to manage the pain. My first night home from hospital was a bit intense. First, the hospital bed that changes positions at the push of a button really helps with getting into a comfortable position. Second, there are more drugs at the hospital. Every four hours or so, I got 2 tylenols, 1 celebrex (anti-inflammatory) and two dilaudids - and 2 stool softeners. They send you home with a prescription for Dilaudid, and no advice other than '1 - 2 every 4 hours'. The next morning, I decided to supplement a bit with Tylenol, which has helped a lot. 

On the stool softeners, there is some pain I do remember from last time - wicked constipation from the drugs! I thought my healthy, high fibre, home diet would kick it out, but it wasn't enough. So this time I'm taking a couple healthy scoops of natural fibre in water every morning, and everything's moving smooooothly. Sorry if that's TMI, but I thought you'd like to know if you're going into surgery too. 

Same as last time, I have to take an anticoagulant for a month, the same time every day. The change was that this time each does was a little needle in its own packaging, that I had to stab myself in the belly with. I'm not afraid of needles, but I've never had to self-administer. I was not keen! Luckily, when the surgeon came to gave me my walking papers, he said I didn't have to use that method. In fact, I can just take 325mg of Aspirin every day. Phew! Also preferable as those needles were worth about $25 each, ringing in at a few hundred dollars for the 28 days.

Today's Inspiration is from Pema Chodrun ~

There is a story of a woman running away from tigers. She runs and runs and the tigers are getting closer and closer. When she comes to the edge of a cliff, she sees some vines there, so she climbs down and holds on to the vines. Looking down, she sees that there are tigers below her as well. She then notices that a mouse is gnawing away at the vine to which she is clinging. She also sees a beautiful little bunch of strawberries close to her, growing out of a clump of grass. She looks up and she looks down. She looks at the mouse. Then she just takes a strawberry, puts it in her mouth, and enjoys it thoroughly. Tigers above, tigers below. This is actually the predicament that we are always in, in terms of our birth and death. Each moment is just what it is. It might be the only moment of our life; it might be the only strawberry we’ll ever eat. We could get depressed about it, or we could finally appreciate it and delight in the preciousness of every single moment of our life.

Monday, March 3, 2014

My Left Hip!

Well, it's been awhile since I've checked in. My right hip has healed up really well. I still need to do some work on strengthening the external rotators, but other than that it feels better than new. Even the torn hamstring I've been flirting with since I overstretched jumping a hurdle at 13 has vanished. Better living through surgery!

The fly in the ointment is the left hip. It has been getting stiffer and sorer. To the point that, on Thursday morning at the end of yoga, I said to Zack that I'm ready for my next surgery. That we should manifest it to happen soon, so I can get it over with and move forward with two healthy hips. And what happens? Just got a call from the Joint Replacement Clinic, there's been a cancellation, and I'm booked in for Tuesday, March 4th. Needless to say, I'm a bit overwhelmed, but excited!

It's a little easier this time, having gone through and come out the other side. I remember how last time I just went to sleep, woke up, and it was done. How the pain after that was the pain of healing. I do notice in reading through my blog a hint of impatience, a soupcon of frustration. I'm going to try to meditate this time, to help with the acceptance part of my healing.

I've jumped through my hoops - got my lung, heart and hip x-rays, a blood test, talked to the pre-op nurse and pharmacologist. I've collected my sock pull, walker, reacher, high seat, crutches and toilet seat from the Sooke Loan cupboard. I've had the Last Hot Tub, the Last Yoga Practice, the Last Supper and the Last Glass of Red Wine and Square of Dark Chocolate. I have my pink sponges ready to go for the Last Shower. 

My bag is packed, the mattresses in the living room for the Last Family Sleepover. Tomorrow I have to be at the Royal Jubilee Hospital (the 'Jube') at 7:40am. Guess I'll be going into surgery at 9:30 or 10. Wish me luck!