Tuesday, October 20, 2009

LPAO Pre-Op Appointments

Today my mother and I were back in Boston for a combination post-op / pre-op visit. Seven months post-op for my right hip, two weeks pre-op for my left hip. Overall it was a long day with some confusion and scheduling mishaps, but everything got done and everything is great, at least with my hips.

I had my appointment with admitting, which was much quicker this second time around. I signed my various proxies and consents and I spoke to the anesthesiologist and the admitting nurse. My insurance pre-authorization is "in process," so hopefully I'll get the confirmation in the mail any day now.

I had my third and final blood draw at the hospital blood center, and then I went up to see Dr. Millis. The scheduling mishaps meant that Dr. Millis did not have my pre-op left hip MRI or my post-op right hip X-rays to view prior to me seeing him, but nevertheless he put me through my range of motion tests and discussed both hips with me. My range of motion was great; nothing hurt; my muscle tone and fitness were much improved since my last visit in July.

Finally, on our way back home, we stopped at Waltham so I could have my pre-op MRI and post-op X-rays. The nurses had a lot of trouble injecting the contrast for the MRI because my veins kept rolling away or blowing out, even when they used an infant needle. They had to stick me six times to get 30cc of contrast into me. Clearly it was a wretched experience, especially at the end of a long and draining day. Pun intended.

My biggest concern today was really my general health and the useability of both today's blood draw and my two prior blood draws. At the hospital blood center (unlike at the New York Blood Center), they told me to contact them if I got sick with a cold or flu-like symptoms within 48 hours of my blood draw. This was a concern because, as you may recall, I got sick after both my previous blood draws.

My first blood draw was September 25 and I believe I wrote that I'd woken up that morning with a raspy throat and immediately fell into a (relatively mild) cold after the blood draw. My second blood draw was October 5; I woke up that morning with pressure in my left sinus and was diagnosed the next day with a sinus infection. Obviously in both cases I was already sick when I gave the blood.

Today I asked the blood center nurse about both cases and she felt fine about the first draw but wanted to run the second draw scenario by my doctor. Dr. Millis was fine with it but said we'd use the October 5th pint last, if necessary.

The problem is that today was my third blood draw, and I am still not 100%. In fact, I finished a 10-day course of antibiotics for my sinus infection three days ago (on Saturday 17th), and unfortunately woke up yesterday with the realization that my sinus infection was back. It had not been vanquished by the 10 days of antibiotics. I have to admit I didn't take super-good care of myself during the course of the antibiotics; for example, my sleep schedule was messed up by a trip to Los Angeles.

So today I have a sinus infection and I had to give my third blood draw. This on-site (in Boston) pint gets separated out for its plasma so maybe that mitigates things? I don't know. It is worth noting that (without knowing about the sinus re-infection) the admitting nurse checked my general health, including lymph nodes, looking in my nose and throat, breath sounds, etc. and declared me healthy. If I was really really sick, she'd have been able to tell, right?

I told Dr. Millis about my sinus infection and asked him if I could get back on antibiotics and take them until just before my surgery and he said yes. So that is the plan. I am going to try my very hardest to take the best care of myself possible these next two weeks (which I already should have been doing, but anyway) and hope that this second course of antibiotics can kill this thing. Obviously if it doesn't, there goes my surgery date.

Monday, October 5, 2009


Today was my second autodonation prior to my LPAO. This time my blood pressure was 120/80 and my hemoglobin (iron) level was 13.8. At my first autodonation (September 25) my blood pressure was 104/80 and my hemoglobin was 15.9. (Normal hemoglobin for women is 12-15 gm/dL of blood.) I'm taking iron supplements, of course, and trying to be as healthy and rested and hydrated as possible so my body can make more blood, but it can only work so fast. Luckily I have two full weeks until my next autodonation.

It is harder to stay healthy this time around, though. Maybe it is the season, but I have been a bit sick recently. The day of my first autodonation I felt fine, but my throat had been a little rough when I'd first woken up and I knew that I was on the verge of getting sick. And I did get a mild cold after the autodonation.

I hope the blood will be OK. When I woke up with a raspy throat the morning of the autodonation, I did some research; it seems the reason you can't give blood when you are sick is because you need that blood yourself to fight off the sickness -- not because your blood will be tainted with sickness. All I care about is that the blood I get post-surgery is not going to hurt me.

This morning I could tell that I was again on the verge of something -- this time it felt like I might have the stirrings of something in my left sinus (under the cheekbone). But again I felt fine going into the autodonation: no fatigue, aches or other signs of sickness. So we'll see. I will definitely ask Dr. Millis about this during my pre-op later this month.

It is hard to believe that I have less than a month left until my second surgery. I'm almost seven months post my RPAO and I've recovered so well -- I'm playing tennis twice a week, seeing my trainer twice a week, and I even did Pilates for the first time last week. I feel strong and relatively fit again (cardiovascular endurance is still not what it was). My left hip doesn't hurt at all, ever, and my already-PAO'd right hip is pain-free most* of the time. It is possible I've been pushing it a little too hard, though.

In a way, it is depressing that I have come this far and recovered so well, only to bring it all back to zero and have to start recovery all over again. But on the other hand, it is helpful that I now know the process of recovery, and the timing, and I know that if all goes as well as it did after my RPAO, I should be at this level of strength and recovery again by May. But then again, if I've learned anything from this process it is that recovery is impossible to predict, so really, anything could happen.

I am glad that I am having the second surgery in the winter. It is supposed to be a record-breaking cold and snowy winter this year, and now I have an excuse to sit inside by the fire for most of the winter. My parents' house in Connecticut, nestled in the snowy woods, is a great place to spend a winter.

I'm not there yet, though. I still have a month left. A month to tie up loose ends in NYC and at work, stay (get?) healthy and strong, and enjoy all the walking and tennis and Pilates that I'm lucky enough to be able to do in this brief interlude.


*My right hip does hurt sometimes, and it is very confusing. I can't predict it or make sense of it at all. The pain is usually in the front, (which is where the labral pain was before), but the pain is not on impact like it was with the labrum. Instead it hurts when I lift my leg to step a certain way, or in a deep squat. I think it must be the muscles (especially the hip flexor) getting fatigued and sore. But what is taking it so long!? I have been working on my strength for months; all my other muscles are back in business. Why would the hip flexor keep hurting on and off for so long?

The other strange thing is that it doesn't seem to be correlated to my activity (as least as far as I can tell). Some days I step on the tennis court and am sore after 5 minutes of play. And some days (like tonight) I can play an hour and a half and not feel sore until the end. Why is that? Some days I walk to work and it is pain-free; some days I start to walk and it is sore as soon as I get out the door. Another question for Dr. Millis.

One reason might be that I am constantly pushing the envelope with my hip -- if I were not walking to work every day and playing tennis twice a week, it might feel totally pain free all the time. We'll see what Dr. Millis says later this month. Whatever it is, it can't matter that much, since I'm about to slow way down on the activity level for a couple of months.