Back in the game

For almost two months now, I've felt "normal." I don't think about which is the "new" hip or the "bad" hip. When I swing onto my bike, I don't think about being careful when I kick into gear. I can power walk again and summer activities have been remarkably "as they used to be."

Actually, the "new" hip feels better than the "old/real" hip. This concerns me because I'm not prepared to go through this anytime soon again. My doc tells me that it's typical to notice this. As the strength of the replaced hip develops and advances, the weakness and deterioration in the other hip becomes more apparent.

Occasionally, I feel some minor pain in the prosthesis. It doesn't happen often but was unsettling at first. My doc says the prosthesis will continue to grow into and absorb bone for as long as a year. Hmmph.  A new kind of growing pains at such an advanced age.

We are planning a family ski trip -- the first in several years. I'm looking forward to it tremendously.

Day thirty five

Almost there! Well, actually, I'm realizing that while I expect to be "released" to normal activities at 6 weeks, it will be an ongoing process. 

In the past two weeks, I've had my most significant setback and the most advances in activity. (Enduring contrast -- go figure.)

Early in my fourth week, I had a really awful day. I was achy. It hurt to walk. I was ready to reclaim my walker and actually alarmed that something might be wrong. My activities in the previous couple days had not been unusually strenuous or different. I had no fever, so I tried to calm down. I remembered nursing staff's advice to listen to my body. I gathered up my laptop and current novel, took more Tylenol, went back to bed and spent most of the day there. Disappointing, but an appropriate move.

Later in the day, I felt better, a little. Not great, but better. I stayed quiet. Took more Tylenol. The next day, I was not miraculously back to my previous "high," but continuing to climb back to that level. I was cautioned that this could happen, but I didn't like it.

In the past week, I've felt that range of motion has slowly but gradually improved. Nice to be able to realize this. I can comfortably reach below my knees -- though not my toes yet (a pedicure is becoming a major priority). While I still need my grabber to gather pants around my right foot and the extended shoe horn to put on my right shoe, I've figured out how to put a sock on by externally rotating my right knee and reaching behind my back (an interesting maneuver). Small accomplishments, but genuine advances.

Mostly, my hip is starting to feel like it belongs to me. My walking stride is longer and smoother. If there weren't snow on the ground and ice on the sidewalks, I'd be starting to power walk again.

So, what's my short term future look like? 

I have my follow-up appointment with my surgeon next week. At this point, he expected to be able to release me from the positional restrictions (I'm really looking forward to sitting down in the bathtub and doing my stretches again, the latter probably the greater challenge). While I might have hoped to be "normal" at this point, I'm realizing I'm probably not ready for cross country skiing (really, there's that much snow left), my usual outdoor bike ride over hills or tennis yet. However, I'm getting pretty clear encouragement that my body is progressing and that we'll get there soon. Plus, I'm not willing to take any significant risks right now. Not so bad.

While I'm not the type that usually needs or welcomes the proverbial pat on the back, the continued encouragement (in some cases, amazement) from staff, family, friends has helped. Just when I'm wishing I could walk faster or snatch something from the floor without thinking about it, someone cheers me with a "look at you!" or "you look terrific!" (Well, then there's my friend that captions all her emails "new hip, old lady.") That network of personal community support makes a huge difference -- don't go into this without circling the wagons.

Day twenty-one

Actually, I'd like to start counting down instead of up: 21 days LEFT until I'm "released" to normal activities again.

At six weeks from surgery, (or, three more weeks) I should be clear of all restrictions. In the past week, I've felt a little stronger, faster and able to do most activities with some finagled adjustments. I can reach the USB port on my computer tower if I lean over sideways and keep my right leg straight. I can kneel down to use the scanner on a low shelf if I am careful finding supports to help me get up again. I can reach the bottom bin of the dishwasher if I swing the weak hip leg back when I lean over. Still can't get my right sock on, shave my lower right leg or do a pedicure (all of which make for an interesting hygiene situation). I can get my skinny jeans on -- but can't get them off! (Extremely interesting.)

I know I shouldn't be complaining. I can walk at almost a normal pace (mine was pretty fast). I no longer totter very much when I accidentally pivot on the weak hip leg. My exercise regimen on the stationary bike is up to 40 minutes and almost 4 miles (still pretty puny, but improving) though I haven't been able to break a sweat yet. The exercises my therapist gave me have become "easy" -- I have to remember how it ached to swing my right leg sideways or do those little squats. My caboose isn't very sore any more -- I don't flinch when I sit down now.

I'm driving again! (Kudos to everyone who so cheerfully took me places!) Actually, there's no problem with leg strength or ability to operate the gas and brake pedals. It was seating position and getting in and out that took some planning. I have an interesting 4" piece of foam carved into a wedge shape to scoot my caboose up to a level position in my car seat (still have to keep my knee below my hip when sitting). Practicing getting in and out of the car was trickier than getting the seat elevation right. To avoid risk of dislocation, I'm not supposed to internally rotate my right hip/knee/foot (pigeon-toed position). Since I had this tall cushion, I had to raise the steering wheel and carefully slide my right leg in straight and first. It works, but took some planning. A lot of the business of recovery is figuring out how to do stuff -- safely.

I've been very fortunate to have flexibility in my work schedule -- as well as extremely understanding co-workers. I was able to arrange projects and due dates so that I had extra time to execute. I don't usually need to be anywhere at a specific time. If I have a day when I'm not feeling so great, I can back off. On a better day, I really try to work ahead.

I have to remember what so many of the nursing staff have reminded me: take it slowly. I'm not good at that. I'm used to pushing myself, meeting deadlines, exceeding goals. It's tough (well, unrealistic, actually) to set "goals" for recovery. I have to listen to my body. It sends different messages every day. Some days are better, some not so much. Sometimes I hear that it's time to stop working and sit down and read something simple. Again, my friends and family have been my support. A ten minute phone call, a little bit of laughter, a cheerful work discussion all help my outlook, attitude and get-up-and-go.

Day fourteen

First time on my stationary bike: 1.25 miles in 15 minutes on a flat course. Pretty pitiful (compared to the usual 11 miles in 60 minutes over hills). Doesn't feel like an auspicious start. 

Here's where recovery (even though I'm probably ahead of the timeline) slows down and gets frustrating. I'm still progressing, but at a slower rate.

Had my post-op appt with my surgeon yesterday. (He's delighted. I'd like to be walking faster.) Got a couple of good releases: sutures and sticky dressing removed, no more scratchy support hose, done with the nighttime knee immobilizer, OK to take a "real" (instead of spot spraying) shower. Still reinforced are the positional restrictions: keep the knee lower than the hip, don't cross knees/legs, keep at least a 90 degree angle at the hip/torso. Should be able to drive sometime next week. But, I still have a swollen, sensitive caboose -- careful sitting down!

So, there's still another month of this.

I can work, but my concentration is still a little fuzzy. Have to be careful taking phone calls and what I promise I'll do. My organization and analysis isn't so sharp. I'm trying to utilize my time on all those computer "housekeeping" projects I haven't had time for lately. 

Household matters are improving slowly. I've tried to relocate frequently used items to upper drawers and shelves where I can reach them. Still can't pick up the turtle's dish or get at the lower dishwasher rack or move stuff out of the dryer. Can't put on or take off my socks (but I haven't dropped my underwear yet!). My daughter was really getting good at putting on my TED hose -- she'd straddle me like she was hitching them up on her own leg. We laughed so hard I almost got injured.

Friends and family continue to line my surroundings with cheerful encouragement. Cards and emails continue to offer care, concern and comic relief. I had to ask for rides to/from my appointment, for lab work next week and to/from Bible study. People are candid when they can't, cheerful when they can. It's been good practice, asking for help.

A wise friend commented this week, listening to my impatience to get moving at a faster rate, that recovery comes on it's own schedule. So, I've had to acknowledge slower days and going to bed earlier and better days when I can get out in front a little.

Day nine

So this is what it's going to be like. Another 2-3 weeks.

I can't complain. I'm motoring around with my little cane. I'm down to 3-4 doses of Tylenol. My intestinal tract has remembered how to operate. I'm lucid enough to do simple work projects and keep lists of what should be done but isn't. Heck, I should be celebrating.

I'm coping OK. My caboose is still a little sore. It's like the muscles in my back side haven't remembered what they're supposed to be connected to. I've got the "typical" bit of swelling and fluid retention that comes after any surgery. My caregivers caution that not enough exercise aggravates this -- as does too much exercise. (That's perfectly clear.)

Now's where things get a little frustrating. I've made all this progress and should continue to be able to walk farther, faster, etc. But my positional "restrictions" continue 'til about a month after surgery. So I can move around better, but I still can't do anything.

My dear friends are prodding me, offering help, visits, outings. I'm not good at asking for this and feel blessed by their persistence and creativity. 

My husband and daughter are making huge efforts to maintain the household. I know it has to be difficult for them. They want to maintain the status quo, but they haven't the time for it. Z hasn't felt well the last couple days and it's been so difficult to watch her labor through her commitments without being able to offer much help. I'm trying to focus on the things I can do -- organizing meals, handling tasks that can be done at counter level -- rather than the things I can't -- loading/unloading the dishwasher, laundry, feeding the turtle. It's the simple stuff that wears you out.

Current mantra: focus on the positive; it makes everyone feel better.

Day six

My recovery, though it seems slow to me, has been predictably on track. (These days, hip replacement is such a reliable procedure.) While my caboose feels sore from so much time perched on it (have to sleep on my backside, too), clearly this is not a significant complaint at this point.

My family has had me on a whirlwind of entertainment this weekend. We lunched and dined out (moving around in the snow -- got cold toes) in the midst of a power outage (what an adventure!). I've been able to ditch the walker for a cane -- still makes me feel like an octogenarian -- so I'm beginning to pick up speed a little, have more freedom to join the family upstairs and motor around on my own. After four days, the pain meds have finally worked their way out of my system, so I'm starting to feel more normal. 

Adhering to my "safety restrictions" is becoming an issue. I'm not supposed to sit with my knees higher than my hips. When we went to restaurants yesterday, Z was my "cushion bearer" -- most chairs are too low and I need to sit up higher. I can't lean forward or reach down -- need to keep a 90 degree angle between my thighs and torso. This is the difficult one to remember. Can't touch my toes. Can't reach for something on the floor. Have to use an extension "grabber" to put on my pants! As I was dressing the other morning, my nightmare was that I'd drop the grabber between removing my jammies pants and putting on my underwear. I was wondering who my first phone call would be....

It seems as though I spend most of my day doing exercises, the icing regimen and personal care activities -- talk about feeling like an old lady! Simple things like hair/face/sponge bath take so long! It's frustrating, but I have most of my life back in my control. That "control" issue has been my challenge in all of this. I need to spend more time contemplating what this means in "getting out of the boat" and in the larger ramifications of my life.

Every time I pick up my phone, someone has left a thoughtful message or encouraging anecdote. Ah, the simple joys of a data package! The support, understanding and encouragement of family and friends has been the key to my outlook and upbeat state of mind through all of this.

Through next week, Home Health sends a nurse to do my blood work and I'll finish with therapy at home. The following week, I'll need to ask for help again -- rides to the office for labs and a followup surgeon's appointment. This is never easy. But, as I look back on my requests for friends to "check in" on me last week -- these visits were some of the happiest moments of my week. 

I can already anticipate some frustration setting in over the next couple days. I've got some work projects in limbo that will need attention. However, I don't quite trust myself to organize or communicate effectively yet. Thinking I'd have all this time on my hands, I've accumulated a list of simple, "housekeeping" projects -- clearing out the family photo files, organizing my address book and figuring out how to import it into my phone, etc. Will see how all this works out.

Day three

Yikes! My body does not handle narcotic pain medication well. After a round of nausea and dizziness again this morning, I went back to plain Tylenol. Actually, my discomfort is pretty minor -- mostly just stiffness while my muscles are figuring out how to work again. Now, this afternoon, I'm feeling pretty normal again. 

My nurse and therapist (who have to be nice, but who I trust) say I'm doing well. It's difficult for me to see progress from day to day. My nightmare is that I'll get up in an sleepy haze and walk off without my walker, doing fine, then realize I've left it behind and panic.

The outpouring of emails, texts, phone calls and encouragement from friends and family has made a huge difference for me. Every time I pick up my phone, someone has something kind to say to me. My sister calls me every day. My son calls me during his lunch hour. My primary advice to anyone facing this is to get your support network geared up. Recovery is so tedious and boring -- contact with the real world and a modicum of comic relief are essential.

So, after a spectacular two days, now I'm having an "OK" day. (Knew it couldn't last.) I'm trying to vary my activities -- new novel, the play my daughter's rehearsing, keeping up with Bible study, New York Times online, following progress of a couple work projects. I think if I keep on some semblance of an agenda, I'll quit staring at the ceiling and lamenting my inactivity. 

I'm also really glad we spent time setting up my temporary living quarters. I feel very self sufficient in my little basement bedroom. We moved in the guest bed, a table and chair. I'm adjacent to my office. We put the mini-fridge on top of the counter so I can get my own drinks and yogurt. And, I'm doing pretty well with stairs, so I think I'll feel like going up/down regularly pretty soon, too.

All in all, I think I'm on schedule and shouldn't be complaining about anything. Hey, for hip replacement, it doesn't get any better than this!

The day after

So, it feels like I'm in a long tunnel, but I can see a smidge of light down there at the end.

I've been ambulating all day and feeling pretty confident. My body tells me I've had surgery. The spinal block is gone now. I can feel the hardware -- more the length of the stem than the hip socket. Weird. But, it all seems very stable and full weight bearing is OK. 

As I anticipated/feared, I've been in someone else's control since I got here. Getting dressed/undressed. Putting on/off a knee immobilizer while I'm in bed. Dealing with footwear (thought I'd brought my loosest shoes, but not loose enough -- poor nurses). Trundling along to/from the bathroom. Nursing staff has been tremendously sensitive -- giving me private moments whenever they can while assuring my safety. I have to admit, my ability to stand up and move around is great -- this was my biggest unknown.

This afternoon at home, home care staff will "walk" me through my daily regimen. I'd arranged for nursing staff to come am's and therapy pm's. Fortunately, then I should be  organized and set up for safety around the house -- and independent activities.

Now the injected pain med is starting to wear off. My thanks go out to the nurse for encouraging me to take more oral pain meds than I'd planned (usually 1/4 dose -- now up to 1/2).

I count myself very fortunate. The experience makes me pray for all those people out there who are so much sicker than I am.

Surgery and a blizzard

The snow took some of the edge off the pre-op routine. Everybody had a story about what the snow plow did (or didn't do), school closings that made the normal morning routine a scramble, snow blowers that didn't start. So the mood was light-hearted and entertaining while staff poked me, strung tubes all over me, told me all about the joys of spinal anesthesia.

So I had just a few waiting alone moments to contemplate the 90 minute procedure and weeks of recovery following. I knew I was wrapped in prayer. At church yesterday, one of the little blue-haired ladies that organize the prayer chain trotted across the hallway to hug me, wish me well and challenge my report that I would be well fed and looked after by my family. Walking into the church office last week, the secretary told me she'd be praying for me Monday morning. In the grocery store, a woman in my prayer chain that I see infrequently, promised to pray for me Monday. Many emails from my Bible sisters completes this circle of love.

Actually, the surgery itself wasn't a tremendous issue for me. It's a lot like having surgery at home -- I was the only patient early in the am so I had everyone's undivided attention. My surgeon and the surgery center have negligible infection rates. Since I haven't been suffering extensively, I didn't think they'd find any surprises in my hip or bones. It's the relative unknown of the first couple days that concerned me.

So after 1 1/2 hours, I found myself waking up in the pleasant little back room set up for 23 hour/overnight visitors. The spinal anesthesia meant my legs were numb -- a little unnerving, but I'd been appraised about this -- they woke up on schedule in about 3 hours. I was pretty awake by then, too -- except I felt like I couldn't open my eyes all the way, like I was squinting. Mid-afternoon, my physical therapist came by to supervise my moving around with a walker -- completely wrecking my image of the strong, YOUNG patient. Plus the afternoon nursing staff was huddled around their station to witness this feat (cheerfully, encouragingly, embarrassingly) my first walk. Not thrilling but it was reassuring to know I could stand and walk down the hall to the bathroom. 


I called my family members to reassure them all was fine. My mother had hip replacement (same side) when she was 67 (see, I AM too young) so they feel like they have a yardstick for my recovery.


Everyone is concerned about my pain level. This hasn't been a concern to me, though. Also, I'd previously taken the pain medication they planned for me and knew I'd have to halve the dose, at least. Actually, I'd rather weather the discomfort than feel snowed on narcotics. My husband has always said I'm a cheap date.


The nighttime staff is in and delivered a sandwich/salad for me. So I'm organizing my bedtime reading and settling in for my first night with my new hip.





 

Days before surgery

I'm probably as ready as I will be or can be for this. Still not happy. What's difficult is that no one can tell me how I'll feel or how much I'll be able to do. Will I have trouble walking down stairs to my temporary basement home Day One? Will I be comfortable being alone or do I need to ask people to stay with me?


So, I've asked for help from my friends. Everyone's cheerfully willing, but this is difficult for me.

Nurses advise me that I'm probably fine "home alone," but the first day or so I should have someone in the house when I need to move around. So I put out a request for friends to stop in to "check up" on me in the late morning and mid afternoon. Everyone's been great. I feel blessed for the care -- but self conscious.

Also, I'm trying not to make my family feel like they can't take care of me. Clearly, they're loving supporters. This is a short term hurdle for me and they have logistical issues. D will have been away the prior week and will assuredly come back to a chaotic schedule. Z starts rehearsal, preparing a major role. With great alternate support available, I'm hoping it will be fun to have my friends share the journey.

Then, there's the "home care" staff, what gramma used to call "visiting nurses." I organized them to come the first few days to do my blood work so I didn't have to get rides, hobble in and out of transportation and trek to the office for this -- and thinking they would fill in the support schedule. Mostly, this idea just makes me feel like a gramma. Also, I'd expected they'd be able to say that someone would come at 8am, etc. -- but they haven't been so clear with their schedule. So, I'm afraid I've got a friend coming to "check" on me between 10 and noon -- sure enough: that'll be when the nurse shows up!

Nursing staff has been cautious (understandably) about suggesting how I'll feel or what I'll be able to do. "All patients recover differently" -- of course. But I'd really like a "most of the time..." what happens. I'm not viewing this as a contest with objectives I need to beat, I'm just trying to make contingency plans. I know I'll be motoring around on my own by the end of the first week and picking up speed the second week. But, it's the unknowns about early days of recovery that bug me the most.

While I'm not "anxious" about the pre-op chaos, I wish I could just skip it and go right to the OR. The surgery center is a calmer, milder place. I know most of the nurses -- they care, they're sympathetic, they successfully tread that fine line between being professional and being friendly. There's that awkward hour before surgery when they stick needles in me, make me take off my clothes, have me talk to anesthesia (like I have an opinion about anything), let the doc come in and do his hoo-hah, etc.

Same deal in the first couple hours post-op. Feel like I'm in a fishbowl. Well, actually, I pretty much am. Check-ups with anesthesia. Attentive nursing staff. Doc's send off. Drugs. I'm hoping I can stay lucid enough to read the interesting books and articles I've packed and try to block out all the rest of it.

I know by the end of the week I'll be motoring around with my walker pretty independently. I just with I could jump to day 4. However, I know there's a plan here for me. The Lord is either making me take a time-out for some (incomprehensible!) reason or putting me in a position to witness (something I'm not typically very good at). Paul's words about being content in whatever situation you're in (most unfortunately) comes to mind here.

Wish I were more excited about the adventure.

one week before surgery

I can't say that I'm nervous. A little overwhelmed, maybe. Still not wanting to be in this situation.

I've been reorganizing my household for post op safety and "rehabilitation." Stairs will be a challenge for a week or two, so I've decided to land in the basement -- near my office, near the only bath tub that I will be able to step into and TIVO. We set up a bed, a large work table, moved the mini fridge up on to the counter where I can get to it without bending over "unsafely."

Then there were the "appliances." (I acquired all this stuff for my octogenarian mother-in-law two years ago then gave it away, with a "Heck, we won't need this stuff for ten years" attitude. What foresight. The prospect of needing this stuff  is demeaning: commode riser, walker, canes, grabbers, long handled shoe horn, sock-donner, dressing stick (whatever that is -- my brother-in-law, the hilarious one, offers to teach me to use it). 


Determined to be organized and prepared, I've borrowed chairs with arms and placed one on each floor of the house. (Would you believe, I had not a single one in my household?!) Post op, I'm not supposed to ever be in a position where my hips/torso are at less than a 90 degree angle -- I'm not supposed to lean over and I need to sit in "tall" chairs (with arms, so I can push myself up). Go through an hour of household activities sometime and try not to bend over! 


This is where those long-handled "grabbers" come in. I'm dreading the first time I have to pull my underwear and pants on. I've gone around the house moving things from bottom drawers, cabinets and shelves up to places where I'll be able to reach them "safely." 


Since my busy family leaves the house before 7 most mornings and doesn't typically return before 6 in the evening, I'm trying to set things up so that I can be as self sufficient as possible. I have enthusiastic and devoted friends offering help -- and I'm blessed for their care -- but I'll feel more "normal" the more things I can do ("safely!") myself.


The next project is organizing a meal plan for my husband and daughter that doesn't depart too much from usual, so we don't feel too disrupted. They're very self sufficient, but healthy eating is important to us and they'll feel better if they can maintain the usual program. With just the three of us, it's pretty simple. I've almost always got quick meals set aside in the freezer. I'm thinking if I just leave them a suggested menu for the first 4-5 days, all they have to do is thaw and make salad.


This reorganization is a stress -- for my family, too. I'm grateful they've been not only tolerant but cheerfully helpful. (Hope I can make that last!)


It's been helpful to have a mentor/consultant. My brother-in-law, Jack, the hilarious one, had a hip replaced last spring. His daughter, Katie, came home to care for him his first week post-op. They've been encouraging (well, they have to be) and have had great first-hand advice. My doc's nursing staff and the surgery center staff have been immensely helpful, too -- but, it's difficult for them to deal with a doc's wife. Every patient recovers differently -- they have to be diplomatic. Jack and Katie give it to me straight -- they've been through it and they know me.




So, I'm still not happy. But it's not cancer, chronic pain.... I'll get through it. Hey in a short six weeks, I'll be nearly normal, maybe.

two weeks before surgery

It’s just not fair. I’ve done nothing to deserve this. I’m 58 years old. Fit. Active. Don’t have a history of participating in loony sports. And I need hip replacement.

The warning signs started last spring. When the Wisconsin winter weather breaks, I usually start a cross training program of bicycling and power walking. I play tennis with an enthusiastic and understanding husband. In the spring, I struggled walking, experimenting with shortening and lengthening my stride to avoid the catches and twinges in my hip. Finally, I had to reduce my walk to a “stroll.” Cutting and pivoting on the tennis court brought a grinding discomfort.

I was reluctant to prod my husband, an orthopaedic surgeon for a more serious consult. Our son suffered an ACL tear late in the summer – we had enough orthopaedic issues to deal with at the time. We both thought I had some sort of impingement that could likely be resolved with an arthroscopic procedure – some day.

But my discomfort progressed, slowly but noticeably. I tried to keep my body and walking mechanics in alignment, but I began to fall into a walking limp, experiencing “catches” and “clicks” in my hip socket. I started being really careful walking up and down stairs in case my increasingly unstable hip didn’t hold on to a tread. My only pain free sleeping position was semi-sitting with a pillow under my knee.

Six weeks ago I would have said I’m still not ready. Who is ever ready to plan major surgery? But, things have deteriorated steadily. I lumber instead of trot up the stairs now. An afternoon of prowling the mall with my teenage daughter leaves me sore and hobbling the next day. Even the stationary bike, now my only exercise outlet, is starting to cause discomfort. So, I’m guessing by the last week in February, I’ll be “ready” for my procedure.

What bugs me about this? OK, it’s a tremendously reliable procedure that brings relief to thousands of old people.(Note me!) I don't want to be "slow" for 6 weeks. I don't want the "restrictions" to "protect" my new hip: can't lean over, can't touch my toes, a challenge to put on sox/shoes/underwear... and there's lots more. OK, this is minor stuff in the scheme of a healthy life. It's not cancer or chronic pain. I'd just choose to be able to "pass" on this.