Monday, November 23, 2009

Three Weeks Post LPAO

It is now three weeks post-LPAO. At this point last time I had a giant leap in progress. This time, progress on the left hip is just steady and slow. I think the difference (again) is that Dr. Millis didn't have to go into the joint capsule on this left side. The first three weeks of horrendousness after my RPAO probably had a lot to do with the joint capsule having to heal up and stabilize. So while my first three weeks post-LPAO felt better than my first three weeks post-RPAO, I think the recoveries are pulling even now.


My pain is generally very low. Most of the day I am in little to no pain. I usually wake up with pain around 4 or 5 in the morning, but once I take a Percocet I can make it quite a while until the next one. That ligament (or whatever it is) is still bugging me from time to time, but not nearly as much as it was last week, when it hurt at every step. Now it is just an occasional pinch from time to time.

Sleeping is still not fantastic, but is getting better. I still wake up a few times a night when I have to roll over. I can comfortably sleep on my right (non-op) side for long stretches at a time. The pain gets worse towards the morning when the previous night's bedtime Percocet has worn off. Last night, in a fit of madness, I tried to roll onto my left side. Ouch. I'm not quite ready for that yet.

I am gradually stepping down on the painkillers. This past week I discontinued the Oxycontin altogether and I have been averaging 4 Percocet/day (day being 24-hour period, in this case). I am still taking the Valium as needed.

I haven't stopped Atarax but I think I will this coming week. My hospital rash is long gone and the itchy-red-spots are pretty much gone as well. Just some residual itching here and there.


Movement is generally the same as last week. Now that the ligament pain (or whatever it was) has let up, I am less reluctant to crutch around. I have even left the house for dinner at a restaurant and other adventures. I am good on my crutches (after much practice!) and I am strong from my pre-surgery fitness level, so moving around is not a problem when the ligament is not bothering me. Some chairs are still uncomfortable, but I can find ways to sit to minimize the pain.

Because I seem to be healing so fast, I have been entertaining delusions of perhaps getting off crutches earlier this time. But I think that is probably not going to happen. I have been ahead in the healing game with this PAO because of the joint capsule -- but cut bones are still cut bones and they are going to take as long to heal on the left side as they did on the right. So I'm just going to be in this I-feel-fine-I-just-can't-walk limbo phase for longer this time. Great.


Both my incisions look great: click the links for the pictures. The one that really matters is the right side, since that will be my permanent scar on that side. On the left side they will open the scar back up again to get the screws out in a few months anyway, so who cares what it looks like now.


My mood is good; mostly stressed. I have had to work a lot during this recovery and it is leaving me with less time to read and relax than I had during my recovery this spring. It is also draining. In the evening I feel like I am going to collapse from exhaustion once I log off work. Another reason I am not getting as much reading done this time around. Happily there's the holiday weekend coming up so maybe I can get through a book.

Next week is my 1 month post-op in Boston. How the time flies as I limp along behind it.

Monday, November 16, 2009

Two Weeks Post-LPAO: Movement

One significant difference from my recovery in March is movement. It is very obvious that this surgery was less invasive and less "destructive" than my RPAO in March. At this point in March I was still quite limited in my hip joint movement, much more so than I am now.

I have quite a bit of leeway in how I can move my left hip without pain. I can straighten it and bend it far more than I could at this stage with my right hip. Of course I cannot lean down to put on a sock on my left leg, or even smear Sarna cream on my itchy left calf, but I can make a more acute angle with my left hip than I could with my right two weeks post-RPAO. I can cross my legs at the ankles (right over left, of course). My left hip also still pops and clicks (painlessly), though more quietly than pre-surgery. (My right hip never popped again after my RPAO.)

The fact that Dr. Millis did not cut any muscles during my LPAO is also noticeable. Although it is weak, my left hip flexor does actually work. I can use my left leg muscles to move my leg around a little bit. At this point in March I could not move my leg at all without someone to help me lift it and replace it in a new position.

All of this should mean increased mobility, maybe even an excursion outside the house (!), but unfortunately the pain I have been having while crutching has been quite a deterrent to getting up and crutching around. So mostly I stay seated or supine, unless I really *have* to get up.

I still need help getting into and out of the shower, because there is a lip, but I can shower on my own. I have a shower chair but I use it more for support than for sitting while I'm showering.

I don't use a special toilet seat -- my right leg is strong enough to lift me from most seated positions even when there is not really enough support for me to use my arms to assist.

I am comfortable sitting in a soft armchair, as long as I can slouch a bit or put my legs up on an ottoman. Dining room and kitchen table chairs are less comfortable, mostly because they involve eating (therefore leaning over the table) and that causes overly-acute-hip-angle problems. Same problem with my office chair (and leaning over the computer). I try to solve the angle problem by sitting on the edge of the chair and angling my thigh down towards the floor, with my foot under my chair, but it is not very comfortable.

Sleeping is the one area in which I am actually doing worse than I was at this point in March. I can still only sleep on my back, with pillows under my left knee. It is not terribly comfortable and when my lower back (what I assume to be the sacrotuberal ligament) hurts, it is not comfortable at all. I am desperate to switch positions during the night, and I have tried, but I still can't sleep on my right side. My left hip and that spot on my back ache when I try to do that. In comparison, two weeks after my RPAO in March I could already sleep happily on my non-op side.

Two Weeks Post LPAO -- Pain & Itching

Today is two weeks from the date of my LPAO, and I have been home from the hospital for a full week. It has been a bit different than my first week home after my RPAO, which you can read about here and here.

For one thing, my activity level my first week home after this surgery was much higher, and not by choice. After my RPAO, I spent the majority of my first week at home sedentary, reading or sleeping in a couch or bed, moving only when necessary. This past week, I had to work full time the whole week. I was, of course, working remotely from Connecticut, not going into the office. But still, that meant sitting upright in a chair at a desk most of the day, and moving around a lot more than I had done in March. Having to work couldn't be helped, but I do think I could have used a bit more sedentary reclining last week.

My pain has been generally well-managed, except for sometimes sharp pain in two specific places. In March, what pain I had would migrate, popping up in different places every time. This time, the pain is localized in two places: the back of my hip joint (it feels like deep inside where my left buttock meets the top of my thigh, maybe the cut in the ischium?), and above my tailbone, on left side, just above my left buttock.

The former pain has lessened over the course of the week and by now is pretty much resolved. The latter pain is much more common and more severe than the former. That pain above my left buttock is almost constant when I am crutching (each time I take a "step" with my left leg, I feel pain there) and can ache while I am sitting in chairs or lying down, especially if I have just been crutching. I have no idea what it is, it doesn't seem to be located near the surgery site at all. I've got an email in to Dr. Millis asking about it.

My best guess is that there is something going on with the sacrotuberous ligament. That would make sense since one of the hamstring muscles originates from that ligament. Maybe when I step a certain way and activate that muscle, it pulls on the sore ligament? Now why the ligament is sore in the first place is a totally different question. Unless of course it is because that ligament connects the sacrum to the tuberosity of the ischium -- the ischium, of course, being the potential source of my other pain described above and one of the bones cut during a PAO. Gosh, surgeons must love it when patients play doctor using Wikipedia.

Moving on. Unlike on my right side after my RPAO, there is no numb spot on my left thigh after my LPAO. Probably because they didn't have to move the nerves around on the left side.

My incision on the left side is fine. The dressing itches sometimes but not too often. It is not generally tender, although earlier in the week it did feel a bit bruised if I pressed gently on my hip near the top of the incision. We have not changed the dressing on the left side. I imagine it will come off some time this week.

My incision on the right side (where the screws were taken out) does not bother me at all. Obviously it was a much shallower cut than the left side. Its dressing came off on Saturday, but the steri-strips remain.

In the hospital I did have some swelling in the hip area on the left side, and my left foot and lower leg swelled up like the blueberry girl in Willy Wonka for a while. But all that swelling is gone now.

My current pain medication regimen is:

-- 1 Oxycodone every 5 hours during the day
-- 1 Oxycontin twice daily
-- 1 Valium as needed during the day
-- 1 Oxycodone and 1 Valium kept at bedside if needed for pain during the night

It is more pain medication than some other PAO women have taken at this point in their healing, but as I wrote a few days ago, I am not being a sissy; I just seem to need more pain medication than most. I am not worried; I will step it down when I am ready, just as I did in March after my RPAO. But currently, especially with that frequent upper buttock pain, I need pain relief.

As I explained in March, the Oxy painkillers do not make me feel mentally foggy in the slightest. Only the Valium makes me a bit scatterbrained and sleepy, so I never take it when I am working, or trying to concentrate on something important like Gossip Girl.

My horrible skin rash has subsided. Probably primarily because I am not laying in those hospital sheets anymore. Earlier in the week I was applying the prescription steroid rash cream twice daily, but since the rash seems to have been vanquished, I've essentially stopped with them now.

Alas, when one itch dies, another is born. Again I am plagued with the itchy-red-spots problem I had in March, probably a side-effect of the pain medications. I am taking Atarax (thrice daily) to combat the itch, and I also try not to scratch. I carry around Sarna lotion and put that on every time I have an urge to scratch. Needless to say, I am very moisturized. It seems to be working because I feel like I have a few fewer itchy red spots than I did mid-week.

I still take aspirin, but I never wear my TED stockings. No one told me I had to. I wore them on the car ride home from the hospital but that was it.

Saturday, November 7, 2009

Recovery Day 5 -- Homeward Bound

Among the many uncomfortable things about sleeping post-PAO is the fact that you can only sleep on your back: still and straight like a mummy (with pillows under one leg). Last night I somehow got it into my head that I might be able to sleep on my right side for a while. Surprisingly, it did not work at all. Neither my left hip nor my right appreciated the change. My left (PAO) hip just ached and my right hip's screw-removal incision pulled and pinched. Position change fail.

Dr. Kim came to visit me in the morning. I had actually never met Dr. Kim, so that was a pleasant surprise. He checked my dressings and asked about pain and had me wiggle my toes and all the rest of the typical morning-rounds check up.

At 9:30 Michelle from PT came to get me. I remembered her from March, she is a great PT. She helped me out of bed (an activity which is going more and more smoothly each time I do it) and wheeled me to the PT room. I walked the parallel bars (without help moving the left foot this time) and then got on the crutches to show I could handle them on a flat surface and on stairs -- two prerequisites for my discharge. All of this went very well today. It is such a mystery why sometimes physical things can be so hard and then suddenly so easy.

Obviously I spent two and a half months practicing crutching earlier this year, so that could be the reason for the crutch success. It went well, except that I seemed to be favoring my operated leg a little too much. As I stepped with my left foot, Dr. Millis kept saying "more weight on that foot!" I'm supposed to have 1/6 body weight on the left foot as I step on it, but that is a hard thing to gauge.

Having passed the PT tests, there were just some loose ends to tie up before getting me out the hospital door. There was a humorous moment sizing my TED stockings -- first they gave me size large, regular length stockings. They were loose and too short, like mid-calf gym socks. My mother kept saying I needed LONG stockings because I am tall, and size medium, so they'd be tight enough. A couple of attempts later what I ended up with were tight thigh-high TEDs. They looked sort of trampy, in a way.

The drive home was much better than it had been in March. I was in less pain, perhaps because the surgery had been less invasive so the little bumps and swerves of driving were less disruptive? Or maybe I was just better packed in with pillows and pain pills? Who knows. Another mystery.

By the time we got home to Connecticut three and a half hours later, I was in a lot of pain. While driving, we'd overshot the timing on my oxycodone dosing and so the pain had broken through big-time. I was at 7 or 8 when we got home, just moaning and staring blankly until the pain came back down.

My parents helped me lurch myself up the 13 stairs to my bedroom, and finally I fell into a blessed night of sleep -- in my own bed, without wires, beeping monitors, vital sign checks or rude awakenings by crowds of interns.

Phase One complete. Time for the long Phase Two.

Friday, November 6, 2009

Recovery Day 4 -- Wireless!

Last night was a terrible night because of the rash. Even though I finally got some steroid creams last night, the itching and discomfort was hardly vanquished, and I had to keep calling for Nubain and Benadryl in between my steroid cream applications.

This morning I wanted nothing more than to leap out of bed, have a shower (preferably stripping away several layers of rash-infested skin in the process) and then marinate myself in steroid cream. Last time I had this operation, I absolutely dreaded getting out of bed because it was so painful and logistically difficult. I think the rash is worse this time around, but I know that getting into and out of bed is somehow much less difficult, so it makes sense that I'm much more amenable to getting out of bed.

Nonetheless, I spent most of my morning in bed, working. So much for taking off from work for two weeks after surgery! Dr. LaReau stopped by to check on me, I ate some fruit salad, time passed.

At 10 my catheter came out. With that, I was wireless! No more leads, IVs, drains, nothing. Just me and my rash.

Finally Kimber came for PT, and it was time to get out of bed again. It went better this time; I was more confident with the limits of what I could do, and I also trusted Kimber more. Once up and in my wheelchair, I was taken to the PT room to try walking on the parallel bars. Again, I was pretty confident about it -- after all, this had been a less invasive surgery and I had already done this learning-to-walk-again thing before.

As all you proverb fans probably guessed, it went terribly. At least I felt it did. Just like in March, I couldn't slide my op-side foot forward to save my life. I was so disappointed and confused. This time they didn't cut that muscle! It is supposed to work! Why can't I move my foot?! Kimber helped me slide my op-side foot forward for each "step" but it just felt like cheating. I couldn't do it myself. The whole endeavor hurt my hip and my pride and I felt like a sad failure. I had thought it would be so much easier than in March and it wasn't.

At least when I got back to my room my sheets were changed. But I didn't get to take that long-awaited shower because (of COURSE) I got the only room on the floor with a bathtub instead of a walk-in shower. Perfect. So I had to wait for a new room to open up so I could switch rooms to take a shower. Which meant getting back into bed to stew in my own boiling skin for a few more hours.

I have been on oral pain medication since the epidural came out yesterday, but I still feel like they are not yet covering my pain properly. There are "gaps" where the pain comes through and when I ask if it is time for some more medicine I end up having an hour or more to wait.

Just like in March, I feel like I always have more pain than I "should" have. I know it is probably in my head, but I just get this vibe from people like they think I can't possibly be in pain when I am taking "so much" medication. But I am not exaggerating my pain. When I ask for medication, it is because the pain is at a distracting level, like 5 to 7. Actually, earlier today, when I told one of my nurses my pain had returned and asked if I could have some more medicine she looked at her watch and sort of sighed disapprovingly and said "you are already on a lot of medication..." It sucks to feel simultaneously like a sissy and a junkie.

At around 15:00 two doctors from dermatology came to look at my rash. They didn't take any photos so I guess they were "the deciders." After some chin-stroking they presented exactly no new ideas and no new solutions. So once again dermatology comes up a day late and a diagnosis short. Give me my steroid creams and go away now please.

In the afternoon I got out of bed again for a second session of PT with Kimber. Needless to say, I was not feeling positive about it, but since I had to get out of bed to get my shower anyway, I figured I might as well hit the parallel bars along the way. For some reason, this time it all went much better. Kimber still had to help me move my left foot forward, but at least it felt like I was contributing this time.

And so I earned my reward. Ahh, a shower and a steroid cream body mask. What a spa treatment. After that I was feeling (and looking) much better, so when Dr. Millis stopped by this evening he was happy to see me looking revived. He said everything is going so well that I might even get discharged tomorrow afternoon. The only things left on my to-do list are final x-rays and showing PT I can climb stairs on crutches. And we all know I can do that. Right?

Thursday, November 5, 2009

Recovery Day 3 -- Dermatology Phones it In

This morning my epidural was turned off at 6:00 and I was started on the oral medication cocktail of oxycontin, oxycodone (Percocet) and Valium.

At 7:00 Dr. LaRue came in to check my dressings and I showed him my growing rash. The itching had increased throughout the day yesterday and I could feel that the nubbly, swollen heat rash had begun again, just like last year. ::Sigh::

So far the itching caused by the pain medication has been treated with Nubain and Benadryl, and we've been trying to prevent any rash or further skin irritation with frequent sheet changings and sponge baths, but there is only so much that can be done. I think the rash was inevitable.

As soon as I mentioned the onset of the rash, I was given some over the counter anti-itch cream, but I couldn't get anything stronger until a dermatologist looked at the rash. My experience from last time told me that this would not be happening with anything resembling efficiency.

At 8:00 pain services came again (smartly this time with only one intern in tow) to check on my pain levels with the oral meds. My hips were holding steady between about 1 and 4, depending on movement and time since last dosage.

After all that frantic morning activity I fell asleep until 11:30. I ate a fruit salad for lunch. That is worth mentioning because back in March I had no appetite at all in the hospital and I barely ate anything other than broth until about Friday or Saturday of that week. This time I ate fruit salad the day after the surgery and have eaten a little bit each day since then. Not a lot of food, but a soup here, some fruit there, etc. And that must be good, right?

After lunch, I signed back on to work for a few hours to fight some fires.

Speaking of fighting fires, by early afternoon the monstrous red blotchiness was in full bloom across my back, flanks, buttocks, and down the backs of my legs from my thighs to calves. It had even begun creeping around the front of my left upper thigh and across my stomach. All the while itching violently in hot, angry welts. Although it was clearly the same rash I'd had while recovering in the hospital in March (and therefore my chart already listed all the appropriate steriod creams necessary to soothe it), a dermatology consult was requested.

Meanwhile, Kimber from PT came to help me get out of bed for the first time since my surgery. It went relatively well, despite being herky-jerky and a bit nerve-wracking, and so I spent most of the afternoon sitting in a recliner chair enjoying a break from my hospital bed and waiting for the dermatologist to show up. And waiting. And waiting.

At 18:00 Dr. LaRue stopped by to check on me and took a look at my rash, which was by then much worse than when he'd seen it in the morning. He said he'd personally order up all the dermatology meds that had been used on me in March, and would also make sure dermatology was on its way.

I literally sat in that chair for three hours waiting for dermatology to show up and tell me I had a rash (surprise!), and prescribe me the medications I'd already taken a year ago for the same condition, and that Dr. LaRue had already ordered. Not only was the dermatology consult disrespectfully tardy, but the person dermatology ultimately sent was an intern who just took photos of my rash and threw out a couple of inapplicable but complex-sounding diagnoses that ultimately translated into things like "blocked sweat glands." I suppose blocked sweat glands are what led me to be steweing in a pool of my own sweat for the last few days, right? Eventually the dermatology intern went into a back room to call her attending so she should get coached on what to say to us. Impressive. At least I should finally get some steroid creams out of the ordeal.

Overall, today was physically miserable because of the discomfort and frustration due to the rash, but from a strictly orthopedic perspective it was a great day with good pain control during the switch from epidural medication to oral medication, and a successful adventure out of the bed and into the chair for a few hours. Moreover, with the removal of the epidural, I also got to remove all the leads monitoring heart rate, breath rate, etc., so that means a night free of strangling wires and beeping machines and one more step towards wireless freedom.

Wednesday, November 4, 2009

Recovery Day 2 -- Awakened by Pain and PT

After a calmer-than-usual night of sleep, I was awakened by Dr. LaRue at about 5:30, as he stopped by during his rounds. He took the drain out of my wound. The entire hip/flank area on my left side is hugely swollen and is making me feel enormously fat and distended. I don't recall my corresponding flank being so swollen in March. It almost made me wonder if the drain should stay in a bit longer -- isn't there so much more fluid in there to drain out? But I guess Doctor knows best.

My pain was still at zero this morning, which is even more impressive considering my epidural is set at 8.5 mL/hr this time as opposed to the 12 mL/hr it was at for my right hip in March. So everything is still coming up roses after this second PAO.

With my pain so controlled and my arms so strong, my nurse and I took advantage of the opportunity to give me another sponge bath and change my sheets again. Wow, the hygiene! I will say, though, despite all the prophylactic sheet changing we are doing, my back and flanks are still hot and sticky and pressed into damp sweaty sheets a lot of the time, so I worry that the heat rash may make a reappearance.

Dr. Millis stopped by to remove part of my dressing as well -- the thick ace bandage wrapped around my entire midsection and left thigh. Once he cut that thing off I felt fantastically better. The bandage had been the source of a lot of itching and discomfort so far, and removing it made me far more comfortable. I still had the two bandages over the incisions on either side, but at least the thick itchy girdle covering it all was gone.

After all that activity, I was exhausted, and so I napped from 10 to 12:30, turning away PT's attempts to rouse me into activity in the late morning. I already find PT's in-bed exercises a bit silly, and I am certainly getting tired of the way everyone in the hospital seems to think it is OK to rouse me from my most peaceful slumber for whatever little test (or intern lecture) they have in mind. I thought I read somewhere that adequate sleep (and hydration) were the absolute best medicine?

When I awoke from my healing sleep, I had another headache. (So much for "absolute best medicine, I guess.) I don't usually get headaches, and I don't remember getting any during my hospital stay in March, but this time around I've been having low grade headaches for a lot of the time. Tylenol has only helped about 50% of the time.

I also had another new pain when I woke up from my nap -- my left hip. The hip pain that had been held a zero this entire time had suddenly broken through, and now my left hip ached at about a three or a four -- enough to cause discomfort while lying still, and to cause me to avoid moving the hip if possible.

Nonetheless, I (grudgingly) went through the in-bed exercises with PT when they came back in the afternoon, and I had to postpone my pity party even longer by spending the rest of the day logged on to work (!) taking care of various crises that had popped up in the office since Monday. I was supposed to be able to take time off from work for this surgery, but unfortunately the schedules in my current cases, and the intricacy of my involvement in them, has made my complete absence from work impossible. I can't say that stressing over the projects (and our firm's shoddy remote intranet connection) is helping my healing, but there is not much that can be done about it, so I'm doing what I can, given the circumstances.

Dr. Millis stopped by in the evening to see how I was doing. I told him about today's hip pain and my in-bed PT, he checked my incisions and sensation. He thought all was progressing just fine, but just as a bonus he ordered me to be transfused with a pint of the blood I'd donated autologously pre-surgery.

Tuesday, November 3, 2009

Recovery Day 1 -- So Far So Good

My first night in the hospital after the surgery was also a fitful, fractured one. Just as during my hospital stay in March, all my machines kept thinking I was dying in one way or another -- no heart rate, no pulse oxidation, no breath rhythm -- and so the beeping started and stopped all night and thus, so did my sleeping.

Every time I woke up I felt as if a large chunk of time must have passed since the last awakening... and yet the clock had hardly moved at all. I can honestly estimate that I woke up every half hour last night because of beeping, itching or a nurse taking vital signs.

One thing that did not wake me up was pain. The epidural has been handling my pain really well; I've been at a zero on the pain scale so far. This time I don't need a CPM machine, either, because apparently it is not necessary if the surgery does not go into the joint capsule.

My recovery so far is already going better than it did after my March surgery. Although I am still plagued with itch problems (as a side effect of the pain medication), having the use of both my arms to move my body around using the trapeze pole above the bed makes it possible for me to lift myself off the bed so my back can be cleaned, my sheets can be changed and towels can be laid underneath me. Hopefully all these precautions will help keep me cool and dry so I can avoid the heat rash situation that so plagued me in March.

So by midday today I was pretty content -- zero pain thanks to my epidural, clean sheets thanks to my two working arms and my lovely nurse, and itching suppressed thanks to Nubain. And so, contentedly, I slipped into a nap.

Only to awaken with a start some time later to find seven doctors crowded around the bed in my tiny room, staring at me, clipboards in hand. I fumbled for my glasses as one of them began to make introductions and ask me questions. Putting my glasses on did not help focus my thoughts; instead it only made me see in frightful clarity that I was indeed surrounded by doctors with clipboards staring at me, awaiting my answer to the pending question that, in my panic, I had not heard. I was paralysed and made idiotic by the surprise and my self-consciousness, and so when I did start talking, I answered most of their questions vaguely and certainly unhelpfully. By the time I regained (a scrap of) my composure, it was all I could do not to laugh when I realized six of the seven were obviously rigidly earnest interns trailing a resident on rounds. (Hey, I watch Grey's Anatomy, I know what's up.)

Not to be a diva or anything, but that bed-crowding scenario was NOT OK with me. I have no problem with a teaching hospital, or with a resident coming into my room with interns to use me as a learning example. But I do not want to be woken up from delta wave sleep to find seven people in lab coats clustered tightly around my bed, scribbling on clipboards. Once you get over the initial shock, it is creepy, and then plain rude. So I politely asked my nurse if in the future I could be warned, and if necessary, awakened, before a med school field trip took a tourist stop at my room.

Incidentally, the seven doctors with clipboards were from pain services, and after having a discussion that was ostensibly with me, but really amongst each other, they decided to put me on Narcan for my itchiness. Never mind that I was already taking Nubain and Benadryl, both of which were doing the job well for me.

A bit later, PT came by to do some exercises. This seemed as ridiculous to me this time as it had when they came the day after my surgery in March. What could PT possibly think they were going to get done with me one day after major hip surgery? Apparently not much: move your feet up and down, clench your buttocks together, etc. But I guess it is never to early to start moving again.

Unlike in March, this time I seem to have an appetite during recovery. Today I ate a fruit salad and a bit of soup, which seemed to make everyone happy. Drs. LaRue and Millis came in to check on me separately during the evening; both seemed satisfied with my progress so far. And of course Dr. Millis stopped the Narcan as soon as I told him it wasn't doing anything for me and that the Nubain had been working just fine, because he's logical like that.

Monday, November 2, 2009

Left Hip PAO -- The Surgery Itself

For the most part, today* was much like Surgery Day for my right hip PAO. Same fitful night of sleep, same chilly walk to the hospital, same admitting and pre-surgery procedures.

This time, however, I had a cold. It seems like I never really got back to 100% healthy after that cold I had in late September after my first autologous donation. As you'll recall, I had a mild cold during/after the first autodonation, and an oncoming sinus infection during the second and third.

And then two days ago I began to have a sore throat. By last night I could tell that I definitely had a cold (or maybe even a continuation of that same unconquerable sinus infection? Please, don't let it be that!). I was very nervous that today's surgery would have to be postponed, which would have been a logistical nightmare.

Last night I tried to get a good long night's sleep (perchance to heal myself of the cold overnight?). Of course that was not to be, and I had a horrible, fitful night filled with nightmares about the surgery being cancelled, interrupted only by the frequent need to blow my nose.

This morning, the pre-surgery procedure was pretty much the same as it was with my right hip PAO in March. Mom and I walked over to the hospital. I had my vitals and other checks done at admitting. I mentioned there that I had a mild cold but the admitting staff didn't seem too concerned about it as long as it wasn't a cough/chest problem.

Because I had waited around at admitting for so long, by the time I got up to the surgical floor, my medical team was waiting around for me. I didn't even get a chance to change into my surgical pajamas before Dr. Millis signed my hips, his resident Dr. LaRue introduced himself and talked about the surgical strategy, the nurses came to check various things, and the anesthesiologist gave his explanation of the procedure. I did tell them that I had a mild cold but they, too, said they'd be more concerned if it were a chest/coughing cold with fever than the nasal congestion cold I had.

Then the anesthesiologist injectected me with the loopy-loo sedation medication and I was wheeled in to the OR at 7:50. I do remember joking around a lot in the OR as the team prepped me and placed my epidural. I remember there was music playing in the background and I asked what kind of music they were going to play while they operated on me. He asked what I wanted and I told him definitely no heavy metal, as that might make him go overboard with the saw. I think I eventually settled on Händel's Water Music.

While I was in surgery, my mother got regular updates on my progress. At 9:30 Dr. Millis had started in on the left hip, and by 11:00 he was cutting bone. By 12:30 he was putting the screws in on the left side. At 14:15 Dr. Millis was preparing to take the screws out of my right hip. Finally at 15:30 Drs. Millis and LaRue came out to tell my mother that I was all done and the surgery had gone well. He also gave my mother a baggie with the five screws that had come out of my left hip. Souvenir!

Dr. Millis did mention that my superhuman bone density had surprised him once again -- this time he was prepared for how difficult my bones were to saw through, but he was not prepared for how tightly my bones would adhere to the screws in my right hip during the past seven months of recovery. Apparently they had a heck of a time getting the screws out!

He also explained that this left hip surgery was somewhat less invasive than my right hip PAO had been, since my left hip was in better shape going into the surgery than my right hip had been. This time they did not have to open the joint capsule or detach the head of the quadriceps muscle. Also the femoral head did not need to be shaved and shaped for better alignment this time either. Thus the surgery itself was faster and my recovery will likely be quicker and less painful as well.

While Dr. Millis was giving this auspicious news to my mother, I was in the recovery area, awakening from anaesthesia in what felt like the throes of death. I felt like I had hypothermia, and I was shivering so violently that it would be more appropriately termed convulsing. I was also gasping for breath, literally gulping huge lungfuls of air but still feeling as if I could not breathe, as if I was drowning. I was given oxygen and was covered in hot blankets over every inch of my body like a heated white burqa. I remember pleading with them to stop the shaking; they ended up having to give me a horse's dose of Demerol to calm it.

By the time my mother came into the recovery room to see me, I was breathing normally and my convulsions had been reduced to chattering teeth and an occasional body shudder. I was still covered in blankets as they brought me up to my room. I was given some Nubain for the itching and promptly fell asleep.

*Obviously, I did not write this post on the day of my surgery. I wrote it a few days later, but post-dated it for chronological consistency.