That really doesn't adequately describe how I feel right now. Remember being in middle school and people would try to stick post-it's on each other's backs saying 'kick me'? Right now, I'm the 'kick me' kid. Anyone who knows me will tell you that I'm the person who is always happy. Lets things just roll off her back. Can't be fazed easily. The higher the pressure, the better I handle the situation. I think I'm like that in personality because I had many tough obstacles to overcome as a child. But right now, it feels as though nothing can go right.
Last week I flew home for my father's funeral. This was physically challenging being only 2 weeks out of surgery combined with the vascular complication that I'm dealing with. Emotionally, it was a nightmare for the obvious reasons as well as some lesser known ones. Without delving into some very personal family matters, it will suffice to say that I have not been close with my extended family for many years of my own volition so it was a big family reunion wrapped up around my father's funeral all while in a lot of leg and hip pain. As my biological mother also passed away when I was a child, standing at a grave site where I have now buried both of my parents at the age of 26 is just...well, surreal I guess. I'm still in shock.
I need to write a letter this week to United Airlines. In the world of air travel that has become less and less about the customer and more and more about the bottom line, they went above and beyond to accommodate me on my flights from upgrading me to seats with more leg room to checking my luggage through to my destination without the typical baggage charges and at most stops having a wheelchair waiting for me at the gate. (Although after what I paid for a last minute flight, a little accommodation was in order...) One customer in first class on a flight even asked the flight attendent to find "that tall redhead on crutches". He was offering to trade seats with me so that I would be more comfortable and on a second flight another gentleman did trade seats with me. There really are some kind people out there. Just a heads up, the only carrier that still offers bereavement fares is Delta and it is a meager 10%.
My leg started warming up about 3-4 days after starting on the high dose aspirin. It's definitely still swollen and purple but warmth is a good thing. The blood is flowing! Except that now that the blood is flowing, I have some sensation back which means that it hurts. Understatement. The pain is ridiculous. Just for comparison, by day 4 post op, I was taking 800mg ibuprofen for pain and then 5mg Valium in the evening for muscle tension/spasms. Now at it's worst 10mg Valium, 10mg oxycodone, 800mg ibuprofen and ice packs on my hip and calf aren't making me comfortable. Don't get me wrong, I'm glad the blood is flowing again...a cold leg is not a good thing. But there are definitely times right now that I would rather have my leg ice cold with little sensation than warm and feeling like someone has chopped it up with a chain saw. Of course this is a wonderful predicament to find myself in heading back into 4 day work weeks this weekend. The pain isn't off the charts 24/7. It is constant and it is always much more intense than it ever was after initial surgery. But it varies between 'okay I'm going to suck it up and push through this because I have to' and 'OMG I can't move and I'm trying not to scream right now'. And you just don't know what you'll get when. I've left two separate messages to try to schedule with the vascular surgeon as instructed since I'm back in the Springs this week but they have not returned my calls. Talk about frustrating. And you can't just schedule like a normal patient. All new patients must schedule through the nurse. I'm not sure what I have to do at this point to get the appointment. I don't think they'll really do anything but it would at least be nice to know how long of a ride I'm in for with this pain roller coaster.
I started physical therapy today which was less than pleasant. I had no desire to go since my leg has been hurting so much. After being asked about 10 times by the therapist if I was sure that DVT had been ruled out, I asked a few questions of my own, none of which led to answers I liked:
1) My hip is snapping/crackling/popping around with small movements like it did before the surgery. Is this normal?
The PT didn't like the sound of that and was going to talk to my surgeon about that. Because of my collagen problem we aren't even ready to start moving my hip around in passive range of motion yet.
2) The surgeon say I could lose the brace and crutches at week 4 which is next week. How will we go about that?
My PT spoke extensively with my surgeon about my case today since I'm 'not normal' and said that at the 4 week mark it will take an additional 1-2 weeks to get me off of the crutches. I will need to stay in the hip brace an additional 3-4 weeks from the 4 week mark until we achieve enough stability in the hip joint that the brace isn't needed to help ensure that the joint can keep itself stable.
3) The surgeon said that I would be able to start doing simple stroking and footwork on my skates around the 3 month mark and jumping probably around month 4 with being at the full level of play I was at before surgery around the 6 month mark. So I get to start skating again in early August right?
The PT looked at me like I was nuts and then said it would be September or October before I would be able to even touch a pair of skates for footwork alone.
Needless to say that made for a pretty rough afternoon. Nothing, and I mean nothing, seems to be able to go right with this hip surgery. First the damage being much more extensive than originally thought, then the vascular complication, the insane amounts of pain in my leg from the complication and now you're telling me I not only don't get to toss my crutches and brace next week (which I've only been counting down the days til) but instead of early August it's going to be September or October before I can start skating again?!
Someone please come take my skates so that I don't have to hop past them every time I go in and out of my garage? Wait--first can I be pulled across the ice on my good foot just to feel the cold air in my face and maybe do a few power pulls? That might be reassuring. Then please take them away so I don't have to see them until I can have them back. My heart is in my skates and right now it's in a million pieces for a lot of reasons.
Saturday, May 24, 2014
Sunday, May 18, 2014
Doctors' Wives, Lawyers' Wives and Nurses
That's who Kristin says post op complications always happen to (or in the modern world of course, the husbands too). But before I go any further with this, Kristin gets a huge, Texas-sized, shout out wrapped up in a thank you because there is no way I would have survived the past week emotionally or physically without her. She has been a friend, a mom, a grizzly bear, a drill sergeant and a sneaker of not-so-secret updates to her husband who is a surgeon making sure things never were too out of control all of for which there are no words to describe how immensely grateful and lucky I am to have had her and to continue to have her nearby.
At my initial post op check up, I asked my surgeon if some mild swelling in my left ankle and foot as well as some slight darkening in color were normal. He said yes but never looked at them. I took him at his word and went home. I continued to feel better as the week progressed and was on track to head back to work on Friday evening, still on crutches and in my lovely brace of course. The pain was continuing to subside and I was only taking ibuprofen for pain control and Valium at night as needed. I was honestly just feeling pretty stir crazy and was looking forward to getting back into my groove. As the week progressed, however, I noticed that my leg started to turn darker in color. It was so gradual, however, that it didn't really strike me until I was getting ready for work on Friday evening that there may be a problem. I was dressing and noticed that the discoloration was from the hip down, and was dusky to ruddy purple from the knee down. There was some marked swelling and it was hard to bend my toes. Additionally, my leg felt cold to the touch. As a nurse, I know what signs and symptoms to look for after surgery in patients as a common complication is a DVT or deep vein thrombosis (a blood clot), however, I was missing several key markers for it. I figured it was just swelling from the hip and went on to work. The next evening, however, it was much worse, and the capillary refill (how fast the blood refills an area of skin when you push down firmly on it making it blanch) was slower than it should be. I took a picture of it and sent it to my mom. She freaked out a little. Kristin had returned from being out of town that evening and as I headed out the door I asked her if she wouldn't mind running it by her husband Brook, who is a surgeon, just to make sure it wasn't a big deal.
Apparently your leg isn't supposed to look like mine did, as he called her as soon as he received the text. After being berated for not calling about it sooner, I very begrudgingly paged the PA the next day who, of course, sent me immediately to the ER to be evaluated for a DVT.
Sunday: I expected the usual DVT workup: EKG to rule out pulmonary embolism, ultrasound of the veins in the leg to look for DVT and blood thinners if indeed I did have a DVT. What I didn't expect was that after determining that I did not have a DVT and the PA was ready to discharge me, the ER physician came in, took one look at my leg and combined with the fact that they couldn't find any pulses in the foot or ankle by touch but rather had to use a machine called a Doppler, ordered a test called an ankle brachial index which tests for blockage in your arteries in your arms and legs. (I might mention that the test on my left leg made me nearly lose it the pressure of the BP cuff on my leg was so incredibly excruciating) Mine came back significantly decreased on my left leg. This of course set off a series of tests to then determine what was blocked, all with relatively potentially scary outcomes. First they did a CT scan looking for blockages mainly in the pelvis. When that was negative, they then did an ultrasound of the arteries in my leg looking for an arterial occlusion. Let me clarify for a moment here. DVT's are a fairly common complication after a surgery that keeps a patient bedridden in the sense that some 600,000+ a year are diagnosed. And those are the ones we know of. These are blood clots that form in a vein, which takes blood from an extremity back to the heart and lungs to pick up fresh oxygen. Arteries carry blood that just came from the heart and lungs and is delivering it to the extremity. What makes an arterial occlusion so much scarier than a DVT is that a blocked artery means that wherever the circulation is being cutoff at isn't receiving oxygen. That means that every minute all of the tissue beneath that occlusion goes without oxygen, it slowly dies. Arterial occlusions in the extremities have up to a 25% loss of limb rate. Scary! Very fortunately, that test also came back negative. Finally, they redid the ABI test using a computer that gives a much more accurate reading than the bedside one they did in the ER. It came back slightly lower in both legs than they would have expected but still passable and okay. After 9 hours, they had no answers as to why my leg was swelling, turning dark purple and freezing cold, and loosing pulses. As if that wasn't frustrating enough, at no point did we so much as see a vascular surgeon nor did anyone from my orthopaedic surgeon's large group ever come in. I know the ER did call vascular surgery in on my case because Kristin specifically told them to and she herself called the answering service for my surgeon multiple times and wanted him paged to the ER. I wouldn't have minded if whoever was on call for the ortho practice came in, but to be put through nearly every vascular test in the book and not so much as be seen by neither an orthopaedic surgeon from your surgeon's group nor a vascular surgeon I think is wrong. Clinical observation is an important part of medicine. Otherwise, we could turn medicine entirely over to computers and robots. The way I see it is if we went off tests alone, I wouldn't have had my gallbladder out 4 years ago. I had problems with it for 5 years before they finally took it out, despite the tests being normal. The first words out of my surgeon's mouth were, "I didn't need a pathology report to tell me that should have come out years ago." You have to put the tests together with the hands on assessment.
Monday morning: I had an already scheduled appointment with my ortho surgeon. I'm going to put a disclaimer in here and say that maybe someone made the group decaf coffee or something that morning. It was quite a strange appointment. Kristin had wanted to go with me to ensure that they were on top of things after the previous day's events, however, she had a previous commitment. So I left the house under strict instructions not to leave the doctor's office until they could thoroughly explain what was going on. They had already been copied on the ER visit because the PA took me back and made some offhand comment about me having quite the day yesterday. Another woman came in the room and said she was the NP and that we had met before. I said we hadn't met before but it was nice to meet her. She said she had assisted in my surgery. Okay hello, um I think it's a little obvious then that I wouldn't have met you since I was under general anesthesia at the time...so she looks at my leg and basically ho hums it off that it doesn't look very bad (unfortunately it wasn't looking nearly as bad for whatever reason that morning) and starts talking down to me about how 'we as medical professionals sometimes know too much about things and overly read into things and can panic ourselves'. Okay stop. Last time I checked I wanted to wait until my appointment that morning to have my leg looked at. I was being told by my coworkers, friends and, oh yeah, friend's husband who has been a surgeon for 20 years that it needed to be looked at. And so I called your answering service. Explained what it looked like to your PA. Who then berated me for not getting it looked at sooner and said I should have gone to the ER Friday night. So no I didn't push the panic button. When I start to get a little snippy with her, she finally goes out and gets my doctor. Wait. I just spent 9 hours in the ER last night and I wasn't going to get any face time with my doctor? He comes in, looks at my leg and says that they see this complication in about 2% of cases, what they call 'slowed venous return', explaining that there's swelling in the hip from the surgery putting pressure on the veins so they aren't able to return the blood to the heart as quickly as normal. He said that swelling in the hip peaks at 7-10 days (I was at 11 days post op). He said to wear a compression stocking which should help with the swelling and discoloration. He then said we needed to get physical therapy going ASAP. I had to remind him that he said we weren't starting PT until I was 4 weeks post op. I then also had to ask if he was going to have my stitches removed. He sent in the PA to do that. The PA then tried to schedule me for a 1 month follow up in July. And I had to ask about if PT would contact me in two weeks and if I could literally just start walking in two weeks or if I had to graduate down from the crutches. Truly a bizarre visit.
Wednesday morning: Brook was coming in to town and we were planning on him having a look at my leg as he has had experience in vascular surgery. But he did need to know some basic instructions that, come to think of it, were never issued from the orthopaedic office such as how many hours a day to wear the compression stocking, how long to expect to wear the stocking, at what point would they expect a resolution to the issue, at what point or what symptoms would warrant a call to vascular, etc. You would have thought they would have made those clear. After several phone calls back and forth, they basically said they didn't want to issue any instructions, they wanted vascular to made those determinations. Woah, wait. You never said you wanted me to follow up with vascular. If you wanted that, you should have said that at 8:20am on Monday morning when I was in your office. Now it's Wednesday, I have to get on a flight this weekend and go home for the following week, and there's no way they'll get me in by Friday. Not to mention now I don't really feel comfortable not being seen by vascular for two weeks if you want them to see me. So they then say that since the tests came back fine in the ER and vascular has no appointments this week, I'll be fine until I get back in town. Oh and by the way, you're at an increased risk for DVT's since you're flying. Thank God that girl was on the phone with me when she said that...my leg is turning purple,
I'm a nurse and you're going to tell me I'm at an increased risk for DVT because I'm flying. Guess what? The only reason I'm flying is because it's less of a DVT risk than the eight hour drive.
Wednesday afternoon: Dr. Brook Redd to the rescue. Seriously. There is nothing like cutting through a mile sized ball of insane medical red tape than using a blowtorch. This is how healthcare in America should be. Parking it on a couch for five minutes, seeing what's what and making some professional judgement calls. And that's all there was to it. The tests were all normal so it was simply a matter of first making sure that clinically the tests weren't missing something based on the way my leg looked, and secondly how to manage it. That's the not so awesome part as it tends to involve a very sexy thigh-high compression sock
pretty much from the minute I hit the floor in the morning, parking myself whenever possible and super elevating it (like that's happening), and mainlining high dose aspirin--no one trip me, the bruises are already starting to pop up. It's going to take a while, 4-6 weeks at least he said. But, trying to stay positive here, after Sunday there are a lot of really bad things it could have been that it's not. And for that I'm very thankful. And I'm just as thankful to be able to know that I'm okay to go home this weekend. And I'm thankful to be able to get around all the...well you fill in the blank...I've been dealing with since Sunday. Super. Hero. Doctor Guy.
Saturday: AGONY. Okay I've pretty much been in agony since about 9:30pm last night. We went to a movie and while Kristin will be the first in line to tell you it's impossible to get me to park it I obviously did sit for the movie. Sitting is not the most comfortable position just yet. I was in a lot of pain by the time they dropped me off at home last night. Somehow, my Valium ended up downstairs instead of up--in case you're contemplating any kind of surgery involving crutches, either buy a ranch or temporarily move into one--and literally by the time I was in bed, settled with an ice pack on my hip and had realized it wasn't on my nightstand, I was in too much pain to move, let alone go all the way back downstairs to try and find it. I had a hair appointment Saturday morning so that I wouldn't have to mess with my hair on Sunday and Monday--I have strong leg muscles but there's no way I'm standing on one leg to straighten my hair for an hour. I suppose at this point it may be necessary in explanation to mention that on Sunday, after we got home from the ER, my mom called me and told me that my father passed away, which is why I am flying home. Obviously, one would not normally undertake that kind of trip two weeks post hip surgery with this complication as well. I took my aspirin and 800 mg ibuprofen (I'll take my chances with gastritis at this point) and headed out. Had the car washed and toughed it out through the hair appointment. I offered to come help Kristin with unpacking boxes as they just moved but thank goodness she didn't need any help because I literally sat in the garage for 10 minutes trying to find the willpower to get myself out of the car. I knew I was in trouble. I somehow managed to get parked on the couch with three pillows each under my leg and foot and ice packs on my hip and calf but they didn't get me far. As I had to work later that evening, Valium was off the table. I finally caved and took some Oxycodone when the spasms started. I tried to nap a little so that I wouldn't be too exhausted for work but the pain was still very significant. In nursing we have patients rate their pain on a 0-10 scale 0 being no pain and 10 being the worst pain of their lives. I was trying to convince myself I was comfortable enough to nap around a 5-6. Needless to say the meds were doing more for my brain trying to tell me I was okay than the actual pain. I'm just hoping the pressurized plane isn't a recipe for misery tomorrow. I vaguely remember texting Kristin asking about it and I think Brook called me. But between trying to not sound like I was crying--when you're hurting that much you're like a leaky faucet--and being a little med goofy it's all kind of fuzzy.
Perhaps it goes without saying that this whole week has quite possibly been the most convoluted week of my life. I don't think Hollywood could even have come up with this one if they tried. The Serenity Prayer may very well become my mantra for the next few days...if nothing else to keep myself from playing a game of real world kitchen style operation on my leg ha ha!
At my initial post op check up, I asked my surgeon if some mild swelling in my left ankle and foot as well as some slight darkening in color were normal. He said yes but never looked at them. I took him at his word and went home. I continued to feel better as the week progressed and was on track to head back to work on Friday evening, still on crutches and in my lovely brace of course. The pain was continuing to subside and I was only taking ibuprofen for pain control and Valium at night as needed. I was honestly just feeling pretty stir crazy and was looking forward to getting back into my groove. As the week progressed, however, I noticed that my leg started to turn darker in color. It was so gradual, however, that it didn't really strike me until I was getting ready for work on Friday evening that there may be a problem. I was dressing and noticed that the discoloration was from the hip down, and was dusky to ruddy purple from the knee down. There was some marked swelling and it was hard to bend my toes. Additionally, my leg felt cold to the touch. As a nurse, I know what signs and symptoms to look for after surgery in patients as a common complication is a DVT or deep vein thrombosis (a blood clot), however, I was missing several key markers for it. I figured it was just swelling from the hip and went on to work. The next evening, however, it was much worse, and the capillary refill (how fast the blood refills an area of skin when you push down firmly on it making it blanch) was slower than it should be. I took a picture of it and sent it to my mom. She freaked out a little. Kristin had returned from being out of town that evening and as I headed out the door I asked her if she wouldn't mind running it by her husband Brook, who is a surgeon, just to make sure it wasn't a big deal.
Sunday: I expected the usual DVT workup: EKG to rule out pulmonary embolism, ultrasound of the veins in the leg to look for DVT and blood thinners if indeed I did have a DVT. What I didn't expect was that after determining that I did not have a DVT and the PA was ready to discharge me, the ER physician came in, took one look at my leg and combined with the fact that they couldn't find any pulses in the foot or ankle by touch but rather had to use a machine called a Doppler, ordered a test called an ankle brachial index which tests for blockage in your arteries in your arms and legs. (I might mention that the test on my left leg made me nearly lose it the pressure of the BP cuff on my leg was so incredibly excruciating) Mine came back significantly decreased on my left leg. This of course set off a series of tests to then determine what was blocked, all with relatively potentially scary outcomes. First they did a CT scan looking for blockages mainly in the pelvis. When that was negative, they then did an ultrasound of the arteries in my leg looking for an arterial occlusion. Let me clarify for a moment here. DVT's are a fairly common complication after a surgery that keeps a patient bedridden in the sense that some 600,000+ a year are diagnosed. And those are the ones we know of. These are blood clots that form in a vein, which takes blood from an extremity back to the heart and lungs to pick up fresh oxygen. Arteries carry blood that just came from the heart and lungs and is delivering it to the extremity. What makes an arterial occlusion so much scarier than a DVT is that a blocked artery means that wherever the circulation is being cutoff at isn't receiving oxygen. That means that every minute all of the tissue beneath that occlusion goes without oxygen, it slowly dies. Arterial occlusions in the extremities have up to a 25% loss of limb rate. Scary! Very fortunately, that test also came back negative. Finally, they redid the ABI test using a computer that gives a much more accurate reading than the bedside one they did in the ER. It came back slightly lower in both legs than they would have expected but still passable and okay. After 9 hours, they had no answers as to why my leg was swelling, turning dark purple and freezing cold, and loosing pulses. As if that wasn't frustrating enough, at no point did we so much as see a vascular surgeon nor did anyone from my orthopaedic surgeon's large group ever come in. I know the ER did call vascular surgery in on my case because Kristin specifically told them to and she herself called the answering service for my surgeon multiple times and wanted him paged to the ER. I wouldn't have minded if whoever was on call for the ortho practice came in, but to be put through nearly every vascular test in the book and not so much as be seen by neither an orthopaedic surgeon from your surgeon's group nor a vascular surgeon I think is wrong. Clinical observation is an important part of medicine. Otherwise, we could turn medicine entirely over to computers and robots. The way I see it is if we went off tests alone, I wouldn't have had my gallbladder out 4 years ago. I had problems with it for 5 years before they finally took it out, despite the tests being normal. The first words out of my surgeon's mouth were, "I didn't need a pathology report to tell me that should have come out years ago." You have to put the tests together with the hands on assessment.
Monday morning: I had an already scheduled appointment with my ortho surgeon. I'm going to put a disclaimer in here and say that maybe someone made the group decaf coffee or something that morning. It was quite a strange appointment. Kristin had wanted to go with me to ensure that they were on top of things after the previous day's events, however, she had a previous commitment. So I left the house under strict instructions not to leave the doctor's office until they could thoroughly explain what was going on. They had already been copied on the ER visit because the PA took me back and made some offhand comment about me having quite the day yesterday. Another woman came in the room and said she was the NP and that we had met before. I said we hadn't met before but it was nice to meet her. She said she had assisted in my surgery. Okay hello, um I think it's a little obvious then that I wouldn't have met you since I was under general anesthesia at the time...so she looks at my leg and basically ho hums it off that it doesn't look very bad (unfortunately it wasn't looking nearly as bad for whatever reason that morning) and starts talking down to me about how 'we as medical professionals sometimes know too much about things and overly read into things and can panic ourselves'. Okay stop. Last time I checked I wanted to wait until my appointment that morning to have my leg looked at. I was being told by my coworkers, friends and, oh yeah, friend's husband who has been a surgeon for 20 years that it needed to be looked at. And so I called your answering service. Explained what it looked like to your PA. Who then berated me for not getting it looked at sooner and said I should have gone to the ER Friday night. So no I didn't push the panic button. When I start to get a little snippy with her, she finally goes out and gets my doctor. Wait. I just spent 9 hours in the ER last night and I wasn't going to get any face time with my doctor? He comes in, looks at my leg and says that they see this complication in about 2% of cases, what they call 'slowed venous return', explaining that there's swelling in the hip from the surgery putting pressure on the veins so they aren't able to return the blood to the heart as quickly as normal. He said that swelling in the hip peaks at 7-10 days (I was at 11 days post op). He said to wear a compression stocking which should help with the swelling and discoloration. He then said we needed to get physical therapy going ASAP. I had to remind him that he said we weren't starting PT until I was 4 weeks post op. I then also had to ask if he was going to have my stitches removed. He sent in the PA to do that. The PA then tried to schedule me for a 1 month follow up in July. And I had to ask about if PT would contact me in two weeks and if I could literally just start walking in two weeks or if I had to graduate down from the crutches. Truly a bizarre visit.
Wednesday morning: Brook was coming in to town and we were planning on him having a look at my leg as he has had experience in vascular surgery. But he did need to know some basic instructions that, come to think of it, were never issued from the orthopaedic office such as how many hours a day to wear the compression stocking, how long to expect to wear the stocking, at what point would they expect a resolution to the issue, at what point or what symptoms would warrant a call to vascular, etc. You would have thought they would have made those clear. After several phone calls back and forth, they basically said they didn't want to issue any instructions, they wanted vascular to made those determinations. Woah, wait. You never said you wanted me to follow up with vascular. If you wanted that, you should have said that at 8:20am on Monday morning when I was in your office. Now it's Wednesday, I have to get on a flight this weekend and go home for the following week, and there's no way they'll get me in by Friday. Not to mention now I don't really feel comfortable not being seen by vascular for two weeks if you want them to see me. So they then say that since the tests came back fine in the ER and vascular has no appointments this week, I'll be fine until I get back in town. Oh and by the way, you're at an increased risk for DVT's since you're flying. Thank God that girl was on the phone with me when she said that...my leg is turning purple,
Wednesday afternoon: Dr. Brook Redd to the rescue. Seriously. There is nothing like cutting through a mile sized ball of insane medical red tape than using a blowtorch. This is how healthcare in America should be. Parking it on a couch for five minutes, seeing what's what and making some professional judgement calls. And that's all there was to it. The tests were all normal so it was simply a matter of first making sure that clinically the tests weren't missing something based on the way my leg looked, and secondly how to manage it. That's the not so awesome part as it tends to involve a very sexy thigh-high compression sock
Saturday: AGONY. Okay I've pretty much been in agony since about 9:30pm last night. We went to a movie and while Kristin will be the first in line to tell you it's impossible to get me to park it I obviously did sit for the movie. Sitting is not the most comfortable position just yet. I was in a lot of pain by the time they dropped me off at home last night. Somehow, my Valium ended up downstairs instead of up--in case you're contemplating any kind of surgery involving crutches, either buy a ranch or temporarily move into one--and literally by the time I was in bed, settled with an ice pack on my hip and had realized it wasn't on my nightstand, I was in too much pain to move, let alone go all the way back downstairs to try and find it. I had a hair appointment Saturday morning so that I wouldn't have to mess with my hair on Sunday and Monday--I have strong leg muscles but there's no way I'm standing on one leg to straighten my hair for an hour. I suppose at this point it may be necessary in explanation to mention that on Sunday, after we got home from the ER, my mom called me and told me that my father passed away, which is why I am flying home. Obviously, one would not normally undertake that kind of trip two weeks post hip surgery with this complication as well. I took my aspirin and 800 mg ibuprofen (I'll take my chances with gastritis at this point) and headed out. Had the car washed and toughed it out through the hair appointment. I offered to come help Kristin with unpacking boxes as they just moved but thank goodness she didn't need any help because I literally sat in the garage for 10 minutes trying to find the willpower to get myself out of the car. I knew I was in trouble. I somehow managed to get parked on the couch with three pillows each under my leg and foot and ice packs on my hip and calf but they didn't get me far. As I had to work later that evening, Valium was off the table. I finally caved and took some Oxycodone when the spasms started. I tried to nap a little so that I wouldn't be too exhausted for work but the pain was still very significant. In nursing we have patients rate their pain on a 0-10 scale 0 being no pain and 10 being the worst pain of their lives. I was trying to convince myself I was comfortable enough to nap around a 5-6. Needless to say the meds were doing more for my brain trying to tell me I was okay than the actual pain. I'm just hoping the pressurized plane isn't a recipe for misery tomorrow. I vaguely remember texting Kristin asking about it and I think Brook called me. But between trying to not sound like I was crying--when you're hurting that much you're like a leaky faucet--and being a little med goofy it's all kind of fuzzy.
Perhaps it goes without saying that this whole week has quite possibly been the most convoluted week of my life. I don't think Hollywood could even have come up with this one if they tried. The Serenity Prayer may very well become my mantra for the next few days...if nothing else to keep myself from playing a game of real world kitchen style operation on my leg ha ha!
Tuesday, May 6, 2014
Ice, Ice, Baby
Five days out of surgery and it seems as though it's been five weeks. I'm not sure why I was so incredibly anxious to have my hip repaired because the aftermath is significantly overrated. Take this morning for example: it took two hours for me to shower, start a load of laundry, unload the dishwasher and fix a bowl of cereal. That's insane! The amount of energy it takes to get from point A to point B usually leaves me about ready for a nap by the time I'm finished. I seem to live and die by ice packs so thank goodness for the homemade ones we've made. We found a recipe online, however, it seems to be a bit backwards and the correct ratio seems to be three parts water to one part rubbing alcohol double bagged in ziplock freezer bags.
I had a check up with Dr. Huang yesterday who said everything was looking good. He was greatly surprised that the MRI gave no indication that I had any damage other than a torn labrum. This lead him to believe that he would be performing a simple labrum repair with the slight reshaping of the head of the femur as it was not perfectly round (this is very common in labrum tears). When he was performing the surgery, however, he found that I had extensive cartilage damage and due to that damage, I had also developed a bone spur which he removed. The cartilage damage was why he had to perform the microfracture. He used a newer technique that a well known surgeon in California and he have been using for about eight months and have been seeing excellent results from. I was cleared to head back to work this weekend if I so choose but aside from that I have to pretty much stay parked on the couch for the next three and a half weeks. The brace has to stay on unless I'm laying down, I'm not allowed to sit up or bend past a 90 degree angle and there is absolutely no internal rotation allowed with my leg (which is much easier said than done as zero degrees of rotation is my extreme point of external rotation).
I am proud of the fact that I made it until bedtime last night without any oxycodone (I win our bet Jen) but I still need the Valium for the muscle spasms occasionally. I don't start physcial therapy until week four when I'm allowed to start walking again because of the collagen disorder but a normal patient would have started it immediately, which I would think would be pretty miserable! But then again I also feel like the brace is the only thing that keeps my leg from just flopping around at the hip so maybe normal people don't have that sensation either.
Well it seems to be nap time again so until my next post, feel free to send some energy my way!
I had a check up with Dr. Huang yesterday who said everything was looking good. He was greatly surprised that the MRI gave no indication that I had any damage other than a torn labrum. This lead him to believe that he would be performing a simple labrum repair with the slight reshaping of the head of the femur as it was not perfectly round (this is very common in labrum tears). When he was performing the surgery, however, he found that I had extensive cartilage damage and due to that damage, I had also developed a bone spur which he removed. The cartilage damage was why he had to perform the microfracture. He used a newer technique that a well known surgeon in California and he have been using for about eight months and have been seeing excellent results from. I was cleared to head back to work this weekend if I so choose but aside from that I have to pretty much stay parked on the couch for the next three and a half weeks. The brace has to stay on unless I'm laying down, I'm not allowed to sit up or bend past a 90 degree angle and there is absolutely no internal rotation allowed with my leg (which is much easier said than done as zero degrees of rotation is my extreme point of external rotation).
I am proud of the fact that I made it until bedtime last night without any oxycodone (I win our bet Jen) but I still need the Valium for the muscle spasms occasionally. I don't start physcial therapy until week four when I'm allowed to start walking again because of the collagen disorder but a normal patient would have started it immediately, which I would think would be pretty miserable! But then again I also feel like the brace is the only thing that keeps my leg from just flopping around at the hip so maybe normal people don't have that sensation either.
Well it seems to be nap time again so until my next post, feel free to send some energy my way!
Friday, May 2, 2014
Day 1 Post Op
Well it's day one after surgery. There is a lot more pain than I had anticipated but most of it can be attributed to the fact that the damage to my hip was much more severe than anticipated.
My skating friend Alyssa's mom Kristin took me to the hospital yesterday morning and stayed with me until they kicked her out of the pre op room. I may not have admitted I was a bit nervous going in but I was. The surgical staff were absolutely incredbile. My nurse Jane had to be the best RN in the building. She quickly had me set up in a bed, IV line started, fluids and antibiotics running and oxygen on. I didn't find out until I was in pre op that they would be doing a nerve block in my hip. Dr. Huang, my surgeon came in and chatted with Kristin and I for a bit and answered my questions. Anesthesiology came in shorly after him. They gave me some Versed so that I wouldn't really be awake for the nerve block and the next thing I knew, Jane was telling me I was in post op and it was all over. They did a great job with pain control and just gave IV Torodol and then oxycodone by mouth--the only two drugs I can actually handle. As soon as I said I felt slighly sick to my stomach, they loaded me up with Zofran, Phenergan and a Scopalamine patch. Dr. Huang was very thoughtful and had left orders for every drug they had so there was no waiting around for the nurses to call and get orders from him.
Dianne and Jerry my 'adopted grandparets' (very good family friends) spoke with Dr. Huang after the surgery and were very impressed with how he took the time to explain everything he did, how I would be feeling and answered all of their questions. They then were able to come back and be with me while Jane gave them my discharge instructions. Without question, this was the easiest surgical experience I've ever had. I had no problems maintaining good oxygenation like I have in the past, never threw up and was so coherent I gave Di and Jerry directions to my house. I even was able to get upstairs to my room easily and they picked up my medications. I'm so grateful they were there for me!
I'm equally thankful for Kristin and Alyssa without whom I would not have made it through the last 24 hours. They've heated up food, brought up drinks, made ice packs and made sure I'm comfortable and drinking plenty of fluids. I've decided that having your gallbladdder or appendix out is MUCH easier than this surgery...just getting up to go to the ladies's room is a 20 minute undertaking!
Dr. Huang had said that there was no indication on the MRI that I would need the more extensive microfracture repair done, so we had planned on the simple labrum reattachmet and shave down of the head of my femur bone since it's not completely round (which is fairly common in labrum tears). Unfortunately, when he started working on my hip, he found the damage to be more severe than the MRI indicated. He did have to do the micofracture as well as remove a bone spur that he found. This means that instead of the 2 weeks on crutches, I'll be on them for 4-6 weeks. It also means that the pain will be more intense than if he had only done the simple reattachment.
So for now it's lots of pain meds, muscle spasm meds and ice packs. And full week of taking it very, very easy. I have a follow up appointment on Monday and my hope is that I'll be over the worst of it by then. I have a little shower stool and a rolling walker with seat in it so that I can roll around the house and work instead of hopping aroud which should be very helpful. That's about all for now; I'll keep you posted. And for my Kansas friends, I should be coming for a visit in 2-3 weeks.
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