The Real Work Begins

Had a decent sleep, was on my back so the snoring didn't help Lisa any, will try my side tonight.

Home Health/Rehab @ 11, Troy arrives on time. We go through a wide range of exercises, including going up and down stairs, which I can now do. Yea for football on the big screen downstairs!

I worked really hard the month before surgery on toning up core and upper/lower body. Paid off as Troy said I was already doing advanced exercises, but lots of work to be done. And so it goes. Two weeks of in home PT followed by PT at a facility. Pretty comprehensive plan.

A little more than 72 hrs post-op and feeling pretty darn good.


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Discharge Day

Everything points to leaving today. Up around 5 AM, Amanda is kind enough to get my coffee (breakfast doesn't come until 7). Expecting Dr K to show around 630, I've been told he discharges before surgery. Doesn't happen, a little disappointed but I have PT @ 9 anyway. Dr R, my internist, stops by, marvels at how well I am doing...I feel good.

Down for a session with Todd, we both agree I am ready for a cane, ditch the walker. It comes easily, I will be the 2nd Dr K patient discharged with a cane...nice.

Back to the room, Lisa arrives...just a matter of waiting for the discharge, which comes about 1230, via Dr K's PA. Call in Rx for pain meds to Walgreens and we are off!

Good to get home and back with family, almost watched the entire World Series game, but a bit sleepy.


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Tuesday Afternoon

Off to rehab, Todd is the man. We go over the basics of the scootter, and off I go, no problem. Practice a step up and step down. Practice in and out of a faux car...sweet. Mobility is great...because I am a Dr K patient. Apparently a number of docs still using posterior approach, rehab is long and difficult. Wow.

Still need pain meds, tried stretching it out to 7PM, pushed the button @ 630 for my little cup.

Quiet, as I turn off the lights @ 830PM


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The Next Day

Raining outside, cozy inside. The nurses spring for a cup of coffee around 5:30AM, I do need that morning Joe. Dr K comes in to check, says he is pleased how it went...think I am pleased too. He is in the office today, if I need anything call him...nice. Breakfast arrives exactly at 6:45, followed by shift change and the usual routine of questions etc. Occupational therapy shows up and gets me out of bed and on the walker in the room and to the bathroom to "practice". Went really well, surprised how good the hip feels, just a little muscle soreness, NO HIP PAIN.

Rehab woman next, we go for a walk, with the walker down the hall...piece of cake...really. This followed by Social lady organizing Home Health/Rehab coming to the house Thur/Friday.

Out of bed, sitting in a chair, keyboarding this.


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A Room with a View

MO Luck strikes, I have a corner room, two windows looking out, nice. Miss Lisa saunters in, they told her I would be in Recovery two hours...not me. Feeling pretty good, staff got me a Coke had not eaten all day and needed a caffeine boost. Ordered lunch/supper, ham and cheese, chicken noodle soup, a brownie and 2 more Cokes...why not?

An RN and CNA assigned to my room and settle in to the routine. Oral pain meds, temperature, BP and heart rate...the tests happening quite a bit and through the night. IV clindamycin started. Lab draw at 3:15AM, not sure what that was for. Intermittent sleep, the pulsing compression cuffs a little distracting but I like them more than a clot. Indeed.

2nd shift change in the evening. Mboy comes to visit and we watch the World Series, good game and nice distraction.

Quiet in the room.


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Post Op Day 1

My head clears a bit as I get oriented to Recovery. No pain, but I have acquired a few more accessories...a catheter and drain reservoir for a drain coming our of the incision area and automated compression cuffs on both calves (over compression socks). While in Recovery a neighbor who works in the Recov stops by, her husband Bob fell on Sunday and broke his ankle, it has to be pinned on Thursday...think my situation is actually better than his.

Ice chips and looking forward to busting out of Recovery, which happens quickly, on my way to the floor @ 2:45, one hour after my arrival. Room 991.


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Location:NKC Hospital

My New Hip

Yesterday was the day, out with the old and in with the new.

Started with my Hibiclens shower at home to eradicate any lingering bacteria. My reporting time to the hospital was 8:45 and of course we (Miss Lisa and me) arrived on time. A quick stop to sign in, name, DOB, right hip and then take a seat in preop waiting...not very long. Taken back to preop area, #3, where the poking and prodding begins. Labs, iv lines and more name, DOB and right hip (how they could ever get the wrong hip...it would have to be a major screw-up). Miss L brought back to #3 where we have more than an hour to surgery time. The preop area is cold, I ended up having warm blankets, twice and Lisa needed one too. Anesthesia stops by, H&P stuff (history and physical), yes, my name, DOB and right hip.

Time drags on, eventually going almost an hour past schedule. Part of the reason is OR setup, a left hip was before me and they have to set up a right hip for me. My surgeon Dr K arrives, chats briefly, and then marks my Right Hip. Shortly after that a different anesthesia person, the one who will be taking care of me, stops, we begin to chat and...

Fade to black.

The clock in Recovery says 2:10. A bit groggy, I get oriented as a nurse sitting next to me starts to talk. It is over, just like that. I have a new right hip.


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Location:NKC Hospital

H-Day

The last week has flown by, trying to get work in order and then having to make a last minute day trip to Baltimore last Friday. Maybe it is better, not much time to ponder the whole ordeal. Looking forward to feeling better.

I stopped my b.i.d. naproxen last Monday as part of the preop regimen. I discovered two things...my naproxen really did provide me pain relief and Tylenol just isn't the same.

Part of my frustration with all of this was the quick onset of my hip problem, or at least that is how it felt. Part of it, I believe, was my pain being masked by the naproxen...which I had been taking for my knee. Had I not been taking naproxen I think I would have noticed the pain in my hip sooner...not that I would have done anything different. It just got to the point where I had breakthrough pain...emphasized by the withdrawal for preop.


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Doc Shopping

Getting over the denial part, time to find the right doc to do the hip job. Lots of advice available between actual hip patients and the net. Throw in my secret advantage of chatting with a device rep who hangs out in the OR and Miss C the nurse case manager, let the beauty contest begin.

Criteria #1
The surgeon should be fellowship trained in hip replacement. My orthopod is a nice guy and did just fine with my meniscus...but not a hip guy.

Criteria #2
If at all possible an anterior surgical approach is the best. Least disruption and quicker recovery. I talked to a woman who had one each, posterior and anterior, her reaction was, "oh my god, what a difference the anterior approach makes". I don't think any recent fellowship trained doc would do posterior unless there were other factors (like obesity).

Criteria #3
Karma. Okay, I can do without it but it is nice if you are both on the same page and get good vibes.


The field narrowed to 3, then to 2 with the discovery that one of the highly rated docs only does trauma. Doc #2 was scheduling into next year, believe it or not people scheduling hips to get in on insurance for this year. So off to Doc K for our interview...Miss Lisa joins in the fun. K is personable and takes plenty of time to review MRI and options...meets all 3 criteria in my book, so we book the date on the spot...October 28th, 10AM. Almost 6 weeks away, it doesn't seem real.

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But It Doesn't Hurt When I Am Sitting

I suppose denial is part of any difficult situation. After the diagnosis I continue to look for any glimmer of hope that maybe it isn't so bad and possibly I don't need the surgery. I sit in my home office for a good part of my work, my right hip feels just fine, excellent as a matter of fact. And my short walk to the house isn't all that bad. Possibly I can tough it out? Reality can be an unrelenting master. A recent trip to Boston was the proof. I landed at the most remote gate, the walk to the baggage claim was a hike. Only I can't hike, limp maybe. Every right step is painful and it begins to grind on me, literally. Makes me mad to be in the physical state I am as people briskly pass me by...jerks. It just reinforces the fact that my hip will not get better, only worse and the only solution to get back to normal is a new hip.

My pre admission nurse at North Kansas City mentioned her sister just had her right hip replaced, three weeks ago. Everything went well and her sister noticed the difference immediately. 58 years old...driving her car after two weeks post op. Encouraging.


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Is It Really Happening...To Me?

It started in May, I can't recall exactly when.  An occasional "tweak" in my right hip.  Nothing major, hardly noticeable and for us older runners something to be expected.  Aches and pains tend to be part of life north of 50 and beyond.  The pain did not persist, just an occasional hello and then gone.  I was doing a little training for a half marathon in June, The Hospital Hill Half, which I promised son Matthew I would do.  The emphasis is on the "little" of the training part because being a veteran of many halfs it isn't a big deal, especially at the pace I planned to run.

Mission accomplished, we completed the Half on June 1st, Matthew started leaking oil about mile 10 but he gutted it out and got his first half medal.

Mid June I started to have a more persistent ache in my hip.  I had an orthopod visit scheduled for my 6 month OrthoVisc injection (great stuff) in my right knee.  I mentioned the ache to the PA, she did an exam and xray.  She felt it was muscular in nature, IT Band or Piraformis, and prescribed Physical Therapy.

Did that for three weeks, during which I did the annual 4th of July Lenexa 5K run with Dan.  We have done it for many years.  I labored some, especially at the beginning, the hip was just not right.  On my final PT session I resolved to fire my PT guy...but he had already decided I was not responding.  Back to the orthopod.

Time for MRI.

Hindsight is 20/20 and I should have had an MRI a month previously but...

Dr B comes in the room to discuss the results.  No candy coating here...a simple, "You have AVN" (avascular necrosis).  My reaction was, "Bo Jackson, right?"  Answer, yes.  Additionally osteoarthritis and shredded cartilage, take your pick of the offending party.  Bottom line, when I can't stand the pain let him know and I get a new hip.  I think I knew it was coming but was hopeful maybe there was a fix short of yanking out the lame hip...nope.

Stainless steel and ultra high molecular weight polythene hip replacement (Photo credit: Science Museum London)

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