Progress Report

Officially five weeks post-LPAO now, and there is more good news to report.

I have been to the gym three times since I got the green light to start last Tuesday. Getting on that bike and moving my blood around feels so good after a month of basically being sedentary. I have fewer restrictions on my movement than I did at this point last time, plus I got started going to the gym the day after I got permission from the doctors, so the mood-enhancing effects have already begun.

At the gym I have been riding the stationary bike for 30 minutes on the "random" setting, with a highest resistance of about 6-8 (out of 25 available on the bike). It may not sound like much but after my RPAO I had to start at zero resistance for 10 minutes, and work up from there. Plus, my cardiovascular endurance totally disappeared during my month of the Couch Workout, so 30 minutes at level 6 has me breathing hard enough already! But I'm looking forward to improving on that front as well.

I've also done some upper body work at the gym (although with all the crutching, I don't think I've lost that much strength) -- lat pulldowns, rows, chest presses, etc., but I've been pretty lackadaisical about it so far; must step it up a bit.

Interestingly, I just realized that I -- completely coincidentally, without having gone back to check my post-RPAO entries -- quit my pain meds at exactly the same time post-LPAO *to the day*. Amazing! So yes, I quit my pain meds today, exactly the same way I did at the five-month mark last time: I woke up with very little pain, and figured, hey, why not give it a shot?

One of the reasons I decided to go off the pain meds now was that I wanted to feel pain as the warning sign it is. Now that I am putting more weight on the left leg, and using one crutch at times, I don't want to push things too fast simply because I've numbed the pain and don't know that I am putting too much strain on the joint. But so far, so good. What pain there has been is minimal and tolerable and subsides if I give my hip a rest for a while.

So now I am pharma-free, except for aspirin (allowed to quit next week), fiber, and calcium. I sleep well on both sides. My incisions look great. My only niggling problem is that tight spot on my spine where the epidural was, although I don't feel it nearly as often now. If it is not gone by next week I'll let the team know.

One Month Post-LPAO

Today was my one month post-op appointment with Dr. Millis and the team. I already had a feeling my left hip was healing faster than my right hip had earlier this year, but my appointment today confirmed this.

I got the standard x-rays before seeing the team: supine AP and false profile. When I went over the films with Erin, she pointed out the areas of bridging -- where the bone had begun knitting to fill the cracks. My bones have done a spectacular amount of knitting in the past month! The cut in the illium was barely visible (except the big gap to fill caused by moving the acetabulum), and the other two cuts were bridging nicely. I'll try to get the films so I can post them. Both Dr. Millis and Erin were impressed.

I reported that I am down to two Percocet a day, one in the morning and one before bed; Valium occasionally as needed. That strange pain (that I thought might be a ligament) is completely gone now. I still take one Atarax at nighttime. I am sleeping much better now, able to sleep comfortably on both sides now, as well as on my back. I still have the strange pulling feeling at my epidural site, so Erin told me to let them know if it got worse or continued much longer.

Erin did my range of motion tests and they were good as well. My hip can bend below 90 degrees towards my chest now and rotation was good. My straight leg raise was high and strong, too, which I think is because I was in good shape going into the surgery. I think if the muscles around your hip are strong going in, it can only help in the recovery.

When it came to movement, I admitted that I'd been putting more weight on the leg this past week. Erin had me walk with one crutch and then a few steps without crutches. One crutch felt OK but without crutches I definitely felt that sinking feeling you get when the leg is not ready to take the weight yet. So I am officially allowed to start using one crutch, but always keep the other around in case I need support or my gait becomes uneven "like a penguin," to quote Erin. Great news, huh?

I am allowed to go to the gym now, with far fewer restrictions than I had post-RPAO. I can do the stationary bicycle at zero resistance to start, as usual, but I can increase duration and resistance faster this time. And I can do any upper body and core exercises I want, provided my hip feels fine when I'm doing them. This is great news because the faster I can start getting back into shape the better; I'd rather not lose as much fitness as I did after the right hip surgery.

It is amazing how much different this recovery has gone compared to my recovery in March. Other women have said that one hip is always worse than the other, but you never know which one will be the bad one. Imagine if this one had been worse than the RPAO! But luckily it is going fantastically so far, and I'm feeling really great. But I doubt I would have appreciated the speed and ease of this recovery as much if I hadn't had such a rough go of it in March.

So good news overall, but there's still a lot of healing to do. I am going to try not to get overexcited about this progress, and continue to take it slow and steady so I can keep knitting away as well as I have been. I return to see Dr. Millis and the team in four weeks (Dec. 29), but I'll update here before then, to report on how the new weight-bearing and gym visits are going.

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.

PAIN and its MEDICATION

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

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.

INCISIONS

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.

MOOD

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.

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.

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.

Off The Meds

It has now been five weeks since my surgery.

Today is the first day I have gone without any pain medication at all, and it feels fine so far. I had really been stepping down the dosage slowly prior to that, going by whatever pain level I felt. This morning my hip hardly hurt at all, so I decided to give the day a try without medication.

At this point I can sleep on my right (operated) side for long periods during the night. It feels a bit funny, but it is not painful. I sleep through the night with no problems. I am still clocking about nine or ten hours of sleep every night.

I can move my leg around quite a bit using the muscles near the hip; they are starting to recover nicely. All the exercises I got last week from the physical therapist are going very well; they are almost too easy. Only the hip abduction exercise is still difficult.

I have not been to the gym to do the exercise bike or the weight machines for my upper body -- I'm still trying to work out a membership with the YMCA up here in Connecticut. I really hope to get to the gym soon, as I feel that my sedentary lifestyle is affecting my mood as well as my body.

I am still working on getting my new 1/3 body weight weight-bearing allowance right, but the added weight isn't adding pain in my hip. Even when I've accidentally stepped on it with full weight it has not been painful, just obviously weak.

The numb spot on the side of my thigh is still there. It feels like it might be a little less numb, but it is hard to tell.

My incision has actually regressed and is not looking as good as it was in my last photo. One of the subdermal sutures has poked out at the top of the scar, creating an open wound, so I have to wear a Band-Aid over that part. The rest of the scar looks fine, but it is just redder and more noticeable than it was when I first took the Steri-strips off. I am not sure why. I am allowed to massage the scar with Vitamin E oil now, so maybe that will help.

So basically I am at the point in my recovery where I feel totally healthy, except I am on crutches. It is a very frustrating feeling. Progress was obvious before: less pain, more movement. Now everything just feels stagnant. Before I wasn't frustrated because it was very clear that I was injured and needed to rest and heal. Now it is easy to forget that all I have in those cracks is "fuzzy white stuff" and the bone needs time to heal together into a strong, solid unit again. And so it is easy to fall into the foul mood I have been in for the past three or four days.

I am not bored: I've got plenty to do, especially where work is concerned. But I don't want to do any of it any more. I am tired of this variety of sameness. I move from book to magazine to work task to TV show, I move from bed to armchair to table to couch, but it is all the same. It is all still and slow and seated. And I am really tired of sitting.

Three Weeks Post-Op

It is now three weeks post-op and things have definitely improved. Pain is down (as is pain medication), movement is up, and the incision looks amazing. Next week I go up to Boston for my 1-month-post-op visit and then we'll see how much progress I've made internally as well.

PAIN and its MEDICATION

I have far less pain now than I did a week ago, and I get by on far fewer painkillers per day. This past week I have been taking an Oxycontin twice a day, morning and evening, and filling in with Vicodin three times during the day; yesterday I dropped it down to only two Vicodin during the day. This past week I also stopped taking the Valium all together.

Because of the reduction in medication, I don't have the same skin reactions as I did before, so I have stopped taking the Atarax (although I still use the topical rash cream morning and evening in the relevant areas).

My pain is generally very low. Most of the day I am in little to no pain; towards the afternoon I start to feel an ache and that is when I take the Vicodin. If I am going out to something I usually take a Vicodin beforehand as protection, as Dr. Millis suggested, and then I am able to sit through dinners and events with no problem. I sleep well, not waking up too often, and I don't wake up with too much pain in the mornings.

Overall there has been a huge improvement on the pain front this week. Actually Dr. Millis predicted this would happen. When we spoke a week ago he said that I would probably notice a sudden lifting of pain over the next week or so; a disappearance of the constant aching pain that I'd had since the surgery. And so I did.

MOVEMENT

I have made great strides (sorry) in the movement department as well. With the reduction in pain, and the knowledge that I am not overly numbed with pain medication and am not likely to do anything that will "ruin" the surgery, I feel much less nervous about my right leg in general.

I can bend carefully in more directions and at sharper hip angles without the prior pinching; I can move my right (operated) leg out to the side or in across my other leg a little bit (not talking huge ballet swings here, maybe 20 degrees in each direction?); I can rotate my right foot inwards and outwards when my leg is stretched out before me. I can lift and move my leg more often now (which is still not that often) without using my arms to assist, but I can also tell that many of the muscles around my hip are (not surprisingly) very weak indeed and, once I get the go-ahead, are going to need some rehab work.

One thing I have not noticed with any of my increased movements is popping, grinding, clicking, snapping or any other Rice Krispies sounds or feelings coming from my hip. Perhaps that will come with larger movements, but so far so quiet.

I know that I have put a little more than the allowed weight on the operated leg at times (by accident) in the past week and I haven't had any pain result from those brief occasions. I am still under the hospital-discharge instructions to put no more weight on my operated leg than the weight of the leg itself (i.e. resting my foot on the floor), so that is what I do, but it feels like I am ready to put some more weight on the operated leg.

Honestly, with my pain so low and my movement so improved, sometimes this whole surgery/recovery/crutches thing feels fake. Like I could just throw my crutches aside and walk if I wanted to. I suppose that is a dangerous feeling because it could lead to me acting carelessly with a hip that, while feeling much better, is by no means even close to completely healed.

But it seems my naive pre-surgery superhero feelings have begun to resurface -- the ones that made me think this recovery wouldn't be that bad at all (at least not for *me*) and the ones that are making me think the doctor is going to tell me I can throw away the crutches and walk when I go see him on Tuesday. Thank God my parents never got me a Wonder Woman costume for Halloween as a child; I probably would have jumped off a building expecting to fly.

INCISION

One great reminder that none of this is fake at all is the five-inch scar across my abdomen. All the steri-strips are off and it looks amazing, see for yourself. Dr. Millis must have used skin glue or something because the incision has healed together so smoothly and so quickly. But I can't get too excited about it: he is going to reopen it to get the screws out eventually, and I don't know that it will heal up so nicely the second time around.

MOOD

I am in good spirits most of the time, especially now that the pain and itching have lessened and I've gotten more relaxed about the movement of my hip. I am not bored in the slightest: on the contrary I am relishing the opportunity to read voraciously in various media and keep up with my favorite TV shows and movies. This is the part of me that is hoping that the doctor does *not* tell me to throw away the crutches and walk next week. I'm not done with my pile of books yet!

Nevertheless, the bookworming has slowed down in the last couple of weeks as I'm back to working almost full days now during the week. I feel up to it mentally and so far I think I have been doing as good a job as I would be doing if I were physically in the office. Probably better, since I am comfortable and only have a 13-stair commute.

Two Weeks Post-Surgery: Movement

I am more mobile than last week in the sense that I am more confident on my crutches. Other than that there is not a significant amount of progress. I am in good shape for crutching -- prior to the surgery I did a lot of step-ups onto high platforms, squats, lat pulldowns, rows, triceps dips and other "crutch muscles" exercises, so I actually have not felt much difficulty crutching due to fatigue/weakness of any of the supporting muscles. (That said, I don't do much crutching other than around the house for necessary tasks only.) The real difficulty is with the muscles that were affected by the surgery in my right leg, as I describe below in the bit about the stairs.

I'm concerned sometimes that I accidentally put too much weight on the bad leg, or that I create too sharp an angle at the hip by leaning forward in a chair, for example. I left the hospital with instructions to keep the angle between my torso and thigh between 80 and 30 degrees (with 0 being flat out as when you stand up straight or lie down flat on the floor, and 90 being your knee brought up so your thigh is perpendicular to your body). So my concern is that I might accidentally push the hip a bit too far with weight-bearing or the angle, since I'm protected by the painkillers.

Or I might just fall on my face, like I did yesterday. I was waking up from a nap, and clearly not really fully awake or coordinated. As I got up from the couch and reached for my crutches, I lost my balance and fell forward. I caught myself mostly with other limbs, but I did land moderately hard on the floor with my right (op-side) knee, jarring my operated hip. It hurt right away (even through the painkillers) and of course I instantly panicked that I had done some sort of significant damage to my hip or hindered the recovery in some way. It feels OK today so maybe I am not made of porcelain. But lesson learned: wake up, THEN stand up.

I know I'm being a bit overly cautious, but I just really want to be very careful and treat my hip as properly as possible during this healing time, especially when it is so early and everything is so loosey-goosey in there; I feel like the slightest mistake (like clumsily falling) might cause some small setback or damage that would prevent the joint from healing as strongly and solidly as possible. I'm afraid that pushing oneself too hard and pushing the boundaries of healing too soon could create microscopic weaknesses in the healed joint that over time could cause pain, problems, and potentially more surgery. I want to heal this hip once, well, and for GOOD. (And then do the same thing to the other one.)

My current movement project is going down stairs -- as we know last week's breakthrough was sliding my right (op) foot forward using the hip flexor/upper quad when taking a step forward with my crutches. Going down steps is a slight variation on that, as I put the crutches on the lower step, place my right (op) foot on the lower step, then (with all my weight on the crutches) bring my left (non-op) foot down to the lower step where my crutches and other foot are. So the additional difficulty here is that rather than just sliding my right (op) foot forward, I also have to use muscles around my hip to support the entire weight of my right leg while the right foot is in mid-air over the lower step before I place it into position.

Previously I had either cheated by slithering my foot over the edge of the stair and down onto the lower stair (i.e. never losing contact with the ground) or having someone place my right foot on the lower stair with each step. But by now my hip flexor/upper quad muscles are strong enough for me to place my own foot on the stair below (sans slithering or assistance) for several steps in a row. This morning I made it down almost all of the 13 stairs down from the upstairs, so that was a pretty good achievement.

I still need help getting into and out of the shower (there is a high lip that I need help getting over with crutches, plus there are zero handholds to grab on to for support), but I can shower myself using my shower chair. Although a shower feels fantastic, the entire undressing/getting in/not falling off the shower chair/getting out/drying myself with all weight on left foot/redressing process is sometimes an exhausting ordeal, so the glee can be somewhat tempered.

I have been fine with using a normal toilet since I got home. I think this is due to my pre-surgery leg workouts -- my left leg has been doing quite well at lifting my entire body weight from various seated positions even when there is not really enough support for me to use my arms to assist.

Similarly I never got myself a leg-lifter to position my leg; I just grab it by the knee and move it around with my arms. To make small adjustments to the position of my lower leg I have been using an excellent trick I read in someone else's blog -- slip the non-operated side's foot under the ankle of the operated-side leg and use the good foot to adjust the position of the lower leg on the operated side.

I am perfectly comfortable sitting in an armchair with an ottoman for hours. I can sit in an armchair without an ottoman for a while as well, as long as I can slouch a bit. Dining room and kitchen table chairs are less comfortable, mostly because they involve eating (i.e. leaning over the table) and that causes greater-than-80-degree hip angle problems. I 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 as you can probably imagine, that is not all that comfortable for long periods of time either, so I prefer the armchair route.

The leg-under-the-chair solution is also helpful for getting up from armless chairs or other seating positions where there is not a lot of support nearby for using my arms to help me stand up. With my right leg under the chair and my right knee pointing 45 degrees towards the floor, I can lean forward to use my body weight to help me stand up using just my left leg, without creating an overly acute hip angle from leaning forward.

There has not been much progress in sleeping positions. As last week, I can sleep on my back (with two pillows under my right leg) or on my left side (with two pillows between my knees and one between my ankles) for long periods during the night. I can switch between these positions by myself, although it is not something I can do in a state of half-sleep, so I do still wake up several times per night to make these switches. Last night I must have been dreaming something topsy-turvy because I woke up in the midst of an attempt to turn on to my right (op) side to sleep. I did complete the turn, figuring I might as well try lying on the operated side, but that experiment lasted about one second, as it hurt immediately and not insignificantly.

Although I can't move all that much, my spirits are still high. I'm in a good mood most of the time, and I'm never bored. I have so much to read (books, magazines, newspapers, blogs) and so much to watch (Netflix! Hulu!) that the days pass quickly. I've also started to log back in to work this week, but so far I've just been responding to two weeks of emails and trying to get my inbox back in order.

Transitioning Hospital to Home

Saturday involved more physical therapy, now including walking with crutches, as well as in the parallel bars. All of it is still very very tiny amounts of movement -- 3 stairs here, 12 crutch-steps there. Nothing like what I'm going to have to be prepared to do when I go home. They train you "how" to do the motions but they don't work on strengthening you to handle how much your muscles are going to have to be doing by the time you are moving. It is all well and good to practice 3 stairs, but my house has 13 to get from first to second floor. But I suppose form is most important; I'll have plenty of "on the job" training as soon as I get out of here. I was not sent home with any PT "prescription" or any discussion of types of exercises I should focus on at all.

Today (Sunday) I go home around noon, after having spent seven days in the hospital (including the day of surgery). By now my pain is pretty well managed with oxycontin and oxycodone. My PT is progressive in the sense that I can now walk more steps and even handle some stairs, up and down. But the heat rash itching has not gotten any better despite the creams and powders.

Last night I managed to fall asleep on my left (non-operated) side for about an hour, but had to be rescued like a beached whale when it was time to be rolled over onto my back again. Of course when I woke up I had that same strange "where am I" feeling I always have had in the hospital, and the concern that I'd woken up in a dream (rather than FROM a dream), if you know what I mean. That has happened to me more than once while here at the hospital, like there must be some other alternate reality that I am missing just before I wake, and in that other reality I don't wake up every day in a gown on a gurney scratching my back raw. Also -- and this must be the drugs -- every time I wake up I feel like I'm in a different room. Very similar to my other hospital room, but a different room nonetheless.

The doctors came by early this morning on rounds (as usual) and I was completely out of it and falling asleep in the middle of conversations (as usual). That is so very embarrassing. Patients are never nodding off like junkies in the middle of coversations with Dr. Gregory House, for example. Unless it is important for their differential diagnoses.

I am ready to go home. I don't think this hospital bed has much more to offer me (other than the trapeze, which I will sorely miss).

All the paperwork has been done for my release; Dr. Millis himself wheeled me to the door and wished me well (I'll see him in three weeks for follow up anyway) and was very sweet about everything. Some of the nurses seemed genuinely sad to see me go, and say that they have requested me as a patient for next time (which I have to think is a lie, can you even do that?)

My mother and I got on the road about 1pm and stopped for a coffee/restroom break at McDonald's on the way. It was my first time in public on the crutches and it is just a joke how slowly I move on crutches. People must think I'm kidding -- I look healthy and strong enough, and yet I'm heaving like a cast Clydesdale and I'm moving about 6 inches a minute. I couldn't make eye-contact with anyone at the McDonalds because I have to study the ground for each step and think so hard about my muscles, so I don't know if anyone was staring or not, but this one poor kid did have to hold the door for me for like 5 minutes as I snailed my way through. Bet he regretted that one.

The drive home was about three and a half hours; my leg kept jiggling or bouncing with the car's movements, plus I missed a painkiller while I was asleep during the journey, so needless to say I was in a world of hurt and exhaustion when we pulled in the driveway. It was all I could do to make it up the back steps to the den and pass out on the couch. After a while I had mustered enough strength to make it all the way upstairs to my room to sleep again.