Good medical news

Yesterday we drove to Mackay for my one-year post-op checkup with the orthopedic surgeon. He said the x-rays looked excellent (pointing out various technical details) and told me that that he didn't need to see me again for checkups, though of course if I developed problems (especially pain) I should get in touch with him or someone else. He also said I had no restrictions on what I can do, though he advises against high-impact activities. He reckons the implants are good for at least 20 years, and probably 30, though nothing's guaranteed... depends on a lot of variables.

Leg improvement

On Saturday evening I stood up from sitting in Eric's recliner chair and something in my left leg went click and it HURT LIKE HELL when I put any weight on it. He helped me into the bedroom to lie down, and we both freaked. Saturday of a 3-day weekend—what a time for something to happen! Fortunately it didn't hurt when I was lying down, so I stayed in bed. Now the weird part—when I got up on Sunday morning, my leg felt—and functioned—better than it had for months. I was walking without lurching! We assume something snapped back into place (instead of out of place, as we'd first thought). It's still doing fine, and I’m finally improving my walking distance and speed. Oh, and as an extra bonus—my bad left knee has been hurting a lot less than before.

Learning to walk again

Although I was able to walk again fairly soon after my second hip operation, four months later I'm still not walking well. I have a very noticeable limp or lurch, which is much worse if I'm not paying close attention to what I'm doing or if I'm a bit tired. So, a few days ago I finally got around to visiting a local physiotherapist to see if he could suggest anything I could do to improve my walking. He didn't tell me much I didn't already know, but he did tell me some specific exercises I should be doing (or doing differently than I'm doing them now) and he pointed out a few things about my walking that I didn't know (because I can't see what I'm doing or feel just what the real problem is). One of his suggestions was to exercise in a swimming pool. I said that was an excellent idea, but the chances of my actually doing it were very low. (Me: "I could say 'okay, I'll do that', but I gotta be honest: I won't. Anything that involves getting dressed, out of the house, down two flights of steps, and driving or walking somewhere... it won't get done. So let's talk about stuff I'm likely to actually do.") I was wearing my "Grumpy Old Woman" t-shirt, just for his benefit. Eric and I had been investigating treadmills, and the physio agreed that using one was an excellent idea, especially after I assured him that I DO ride my exercise bicycle, because it's right there next to my desk. Last week the local Sports Power store (where I had bought the bicycle and some weights and various other odds and ends over the past few years) had not had in stock the treadmill that I was interested in, but some arrived yesterday, so we went in and bought one. The ever-helpful Wayne from Sports Power delivered it later in the afternoon and unpacked, assembled, and tested it. My room is now rather crowded, though fortunately the treadmill will fold up to free up a bit of floor space if needed. Here are some photos.

All's well with the new hip joints

Yesterday I saw the orthopedic surgeon for a 5-week checkup on my right hip. He said I am doing very well and now have no restrictions on what I am allowed to do (except "no jumping, running, or other impact stress on the hips" for the rest of my life). Mainly my task now is to do as much walking and other exercise as possible, to strengthen the leg muscles on the right side, and then to get both legs back to my former level of fitness. He gave me another exercise to do, to help me stop limping when I walk.

Medical progress

Today I walked down and up 15 steps without using either crutch or cane (though holding on to the railing with one hand), and putting only one foot on each step in the normal manner (instead of putting one foot on the step and then putting the other foot on the same step. Thus I leaped several stages of recovery in one bound! Incredible. I'm still limping/lurching a bit as I walk (apparently due to tight muscles on the right leg) but that seems to be improving daily too. I feel about 10 years younger than I did a few months ago.

Medical costs

I saw the full bill from the hospital (charged to my medical fund) for the right hip operation: just under $12,500. That includes the 4-night hospital stay, operating theatre fees, and the implant itself, but doesn't include the surgeon's and anaesthetists' fees (approx another $5,000, most of which is also covered by my medical fund). Presumably the other hip cost about the same except for one extra day in hospital. I suspect this is somewhat less than a comparable operation would cost in the USA.

Medical progress

The staples were removed yesterday from the incision in my leg, using a staple puller much like those I'm familiar with from business offices. The surgeon says I can pretty much do whatever I want instead of sticking to the list of restrictions on activities (designed for the "average patient"). The fact that I walked into his office without using any crutch or cane, 10 days after the operation, probably didn't hurt my case any. Mind you, my "walk" at the moment has a fair amount of stagger and lurch in it, but that should improve rapidly. The only rule is: if it hurts, stop doing it. Sitting at the keyboard for any length of time makes my hip ache (not bad, but noticeable), so I'm using that as an excuse to spend more time in my recliner chair reading novels. I continue to have very little pain (in contrast to the first operation), other than a brief bout on Wednesday night which succumbed to high-strength prescription painkillers and has not returned.

More hip hooray!

On 6 November I had my right hip replaced. The surgeon, hospital, and device used were the same as for the left hip, but the two experiences were otherwise very different. The second seems to have taken place in an alternate universe to the first... one that for the most part I found much more to my liking. The anaesthetist was a different person and he took a different approach, using different drugs. Probably this was his standard approach, but the choice may have been influenced by the complaints I had made about inadequate pain relief following the first operation. I remained in the recovery room for an hour or more and was returned to my room (where Eric was waiting) around 6 pm., having gone in to pre-op around 1:30. I felt okay but very spacey. Over the next 12 hours I experienced some quite entertaining hallucinations, mainly of the parts of the room moving around in several dimensions whenever I tried to focus on some­thing. The effect was most pronounced when I looked at my travel clock to see what time it was; the clock face would strobe forward and back so it was impossible to focus on. Other than that, I felt fine. One thing that had con­cerned me was the possibility of a repeat of the severe pain I’d had on getting my own blood transfused back into me. The surgeon avoided this possibility by doing the transfusion during the operation itself. For the first time in my life (except perhaps as a very small child), I reacted to the anaesthetic drugs by being unable to keep any food down. Most disconcerting! Normally I can eat soon after waking up, with no ill effects. I found it quite odd that I felt perfectly fine otherwise. The next day, after receiving an infusion (through the drip) of some anti-vomiting drug, I was able to eat. I felt little pain during the day or that night (unlike after the previous operation). The physiotherapist had me up and walking in place that afternoon. On Thursday morning, after the surgeon had inspected me, a nurse removed the drains and I went into the shower (using the crutches, not the walker) and demonstrated that I could get around on the crutches just fine. The physiotherapist rewarded my progress by having me practice going up and down a step 10 times. In the evening I went for a walk around the hospital corridors and met another of my surgeon's patients: a man who’d had a knee replacement operation on Monday. He said he was having both hips and both knees replaced, at about three-month intervals: right hip 3 months ago, left knee this week, right knee in January, left hip 3 months after that. He was making a good pace and said that by the next day he thought he wouldn’t need the crutches at all. Saturday the dressing was removed from the incision and we drove home. I had no problem getting into the car, despite the passenger seat being on the wrong side for putting my good leg in first. I was still experiencing a remarkable lack of pain. I almost immedi­ately stopped needing two crutches and was getting around fine on one... and in some cases (in the kitchen or the bathroom) not using a crutch at all.

Hip + related medical stuff

Trip to Mackay today: the surgeon says I'm doing very well. I walked in without using a cane or crutch, so I suppose that helped. We filled out the paperwork for the next operation, so that's all organised for 6 November. This time we'll stockpile only 2 units of blood instead of 3, and the surgeon has agreed that unless I really, really need the blood, I won't get it back (because of the bad reaction I had last time). He thinks I might have had a reaction to one of the additives; the risk of another bad reaction isn't worth it for a routine transfusion. I had gone in prepared to argue that point rather strongly, but I'm very glad that I didn't need to. I also mentioned the muscle cramps I've been having intermittently in the operated leg, and he said (a) that's normal and (b) his recommended treatment is to drink tonic water, the kind with quinine in it (he said many brands remove the quinine, so I need to check the label). I said "I suppose I shouldn't be too generous with the gin" and he laughed. Lastly, I asked about the edema in my left knee and he said (a) that's normal, (b) be patient as it will eventually go away and (c) pressure stockings might help. We had quite a long chat about this and that, because his next appointment had cancelled so he had plenty of time. For example, we talked about how much people differ in their reactions to chemicals. He said he had always disbelieved the idea that food dyes caused behavioural problems in children -- until one of his own children showed unmistakable symptoms that could be correlated precisely with comsuming certain processed foods and soft drinks. His other child shows no symptoms whatsoever from eating or drinking the same items. Afterwards Eric and I stopped at the blood bank to drop off paperwork, and I chatted with the head nurse there about my reaction to the transfusion last time. She showed us the list of additives used in their blood storage packets; Eric will be looking them up on the Internet later. After that, we went to the store in Mackay that sells Apple computers, so Eric could look at the new 24-inch iMac. It has a shiny, very reflective screen, which he doesn't think he'll like.

Hip: staples out, all well

Eric drove me to Mackay yesterday to have the surgeon remove the 17 impressive-large staples from my leg. His camera failed at the critical moment, so I don't have any photos of the instruments used, but they were a set of needle-nosed wire snips (almost identical to the ones Eric uses for electronic work) and tweezers. The surgeon said all is going very well and I can have the other hip done whenever I want. We agreed on November 6th, assuming all is still well at my next checkup on October 4th. I'm using only one crutch now, and getting around the apartment quite well, albeit very slowly. Now I can carry my own cup of tea, or plate of dinner, from the kitchen to the table. I'm trying to walk around as much as possible, as well as doing the set of exercises the physio gave me, to strengthen the leg as much as possible. Unfortunately, the pain in the other leg is hampering these efforts a bit. We discovered that the before-and-after x-rays were on CD as well as film, so here are some images. Before: After:

Hip hooray!

Had the operation on 27 August as scheduled. Arrived at the hospital at 10:30, filled out paperwork, showered, donned one of those fetching hospital gowns (and a reasonable bathrobe), and sat around waiting for quite awhile after unpacking a bit in my assigned room. At around 1:30 pm I was wheeled away, bed and all, to pre-op, where I remained for only a few minutes before being taken in to the operating theatre. I was returned to my room around 5:30 p.m., more than an hour later than expected. The surgeon explained later that the x-rays had shown I needed a size 1 hip socket replacement. However I actually needed a size 0, the smallest one. I assume they had to get one from stocks and sterilise it before finishing the operation. I was fully awake, and Eric says I was showing good spirit on my return, despite a drip, two drains, a catheter, a pressure cuff on each lower leg (squeezing at half-minute intervals), an oxygen tube in my nose, and a heap of monitor gear connected to me. I wasn't exactly comfortable, but neither was there much pain. However, when the nurses started transfusing my own blood back into me around 9 p.m., I suddenly had considerable pain in my hand. Indeed, I let out an involuntary shriek that probably could be heard through the entire hospital. Opinions varied on what the problem was, so everyone spent some time adjusting the drip rate, adjusting the position of my hand, and so on. The only thing that helped was a slow drip rate (55 ml/hour max). Unfortunately, that wasn’t one of the choices: a rate of 150ml/hr was required to get all the blood into me before it warmed up to the point where it had to be discarded. Eventually a shot of morphine reduced the pain to a tolerable level and they managed to get two units of my own blood into me. In the morning I felt fairly good, all things considered. The physiotherapist arrived in the afternoon to get me standing and then walking in place. Apart from an incident on the second night when I had to argue rather vehemently with the nursing staff for adequate pain relief, the staff were friendly, helpful, and at times quite amusing. The food ranged from good to excellent. I had a private room. It’s mainly a day surgery; few patients remain overnight and the place is remarkably quiet. The surgeon visited several times a day (his office was at one end of the corridor, and the operating theatres were at the other end). Almost as soon as I was detached from an amazing amount of postoperative torture devices, and less than 48 hours after the operation, I was doing laps around the hospital hallways on crutches and practicing stair-climbing. I got home today. I'm getting around on the crutches well, and didn't have any trouble getting up the 35 steps from the carpark to the apartment (veeery slowly). I'm allowed to stop using two crutches or even one crutch as soon as I feel confident that I don't need them. BTW, the crutches are a type called "Canadian" and they are very comfortable to use, with a moulded hand grip.

More hip problems

Ten days ago my left leg took a turn for the worse (nerve pinch in hip, apparently) and Hurts Like Hell much of the time, despite various medical treatments and codeine tablets (fortunately available without a prescription here in Australia). I've been spending most of my time lying in bed, although that isn't always an improvement over sitting up. Eric has reorganized my desk so I can lie in a recliner chair, type, and use the big monitor. The distraction of working is good for me, though the codeine makes my brain fuzzy at times. Monday we went to Mackay for the first round of blood collection (in prep for the op). To my surprise and relief, riding in the car was less uncomfortable than sitting in any of my chairs (or lying in bed) at home! So I made it there and back, and the bloodletting went okay (no dizziness or whatever, not that I expected any). I've phoned the surgeon's office and suggested that, given the change in my left leg, I'd like to have that hip done first. I have an appointment with him next Monday (when I go to Mackay for the second blood collection) to discuss this and fill in some more paperwork.

Hip surgery plans

I saw the surgeon today and liked both him and the private hospital. He confirmed that both hips need replacement, and opined that the pain in the left knee is probably caused by problems in the left hip, so most likely replacing that hip would fix the knee as well. I liked the surgeon: he was very straightforward, no nonsense, but pleasant. Not a hint of "talking down" to me, and answered questions with what I considered an appropriate level of technicality (not too much nor too little). And there was no delay getting in to see him at the time of my appointment -- somewhat unusual in my experience with specialists. The hospital is small and does mostly day surgery. Most of the 25 or 30 rooms are private. It does not have any cafeteria or food service other than what the hospital provides, so Eric will have to pack a lunch when he comes to visit. I am having the first operation (on the right hip) on Monday, 27 August (5 weeks from today), and the date for the other one will be decided later. I may be able to have that 2-3 months after the first, depending on how quickly I recover. I am going to be very impatient for the next 5 weeks to pass! One reason that I can't have the first operation sooner is that they want to stockpile 3 units of my own blood to use in transfusions during the operation, and I can only give 1 unit each week. This means Eric will have to drive me to Mackay (2 hours each way) one day a week for the 3 weeks before the operation, to have blood taken. Unfortunately there are no facilities closer to home to handle this type of blood donation. I received a packet of information from the company that produces the replacement hip. This info included a DVD of post-surgery exercises, which I am still going through, and a credit-card-sized card with the patient's and surgeon's names, date of operation, etc, for me to keep in my wallet to show to security people at airports and other checkpoints. Eric and I stayed Sunday night with friends in Mackay. Turns out that K had built the surgeon's swimming pool last year. Small town!