Friday, April 15, 2011

My New Bike Passion

It has been over a year since my last update.  I can't say the hip is 100%, then again at almost 63 I am at best about 80-90% of my former self physically. Even that is a probably an exaggeration.. Anyway the new,(well new 18 months ago) hip has allowed me to take up mountain biking. A much more dangerous endeavor where I average one or two crashes per ride and if I land wrong on the new, well almost new, hip I am in deep shit. 

I think it is cool  at my advanced age I have a new passion. Something I can look forward to each weekend. I still ride the road bike  50-60 milers  just to make sure the new, well almost new, hip isn't defective. I mean I'll never find out sitting on the couch if it really works.

Monday, March 29, 2010

A New Biking Season Has Arrived

It has been a while since I updated the blog. Christmas Day to be exact.  The colder than normal winter here in the North East of the US has limited my usual weekly winter riding to weakly riding which to me is once or twice a month.

While starting around March 1st I have been riding every week, about 50 miles per ride, and the hip feels good, a recent article in the NY Times http://www.nytimes.com/2010/03/10/business/10device.html?pagewanted=1&adxnnlx=1268399568-qQBrp%20OxeslB7lfopbasKg has caused me some grief.  If you scroll further down the blog you will clearly see  that the artificial all metal device in question is the hip residing in my body. While the failure rate is pretty low, 3-4%, my average 4 hour ride is an extra approximately 20,000 revolutions of the hip at an 80 cadence (per minute) above and beyond my normal activities.

While I am clearly not a hypochondriac, even though I have been accused of being one dozens of times from multiple people over many years,  my hip does seem to ache. By some strange coincidence the ache or pain started a day or two after the  I read the article. What are the chances of that?

However I feel good about my 52 mile ride yesterday. Real good.

Friday, December 25, 2009

Three and A Half Months

They say that with a total hip replacement that it will take the patient a full year before there will be 100 percent recovery. What that means at a year the hip will be what it will be. Pretty much forever. Hopefully that is perfection.  For if there are problems, well  that's all folks.

Fortunately for me I would say at this point I am probably 90 percent. If the hip didn't improve any further I would be satisfied. While it is not perfect basically the only areas for improvement  the  (repaired) leg needs to get stronger and maybe some more range of motion. I  can ride 60 miles and can even jog a bit.


However the scar is pretty (oxymoron) ugly. Being a typical male it doesn't stop me from showing it off. 

Wednesday, December 2, 2009

12 Weeks Post Surgery

I haven't posted in a while as at this point in the recovery the changes are more gradual. While I am not fully recovered my life, physically at least, has returned to normal. The hip is no longer holding me back. While the new hip is not 100% I'm getting dam close to it.

1. The leg difference has been reduced to a 1/4 inch or less, so my limp, while still there, is hardly noticable anymore. At this rate it should be fully gone in another month or so. It is not unusual to have a limp for up to a year.

2. My bike riding has progressed to where I am riding noticeably better than  before the replacement. However I have a small ways to go before regaining the full strength  I was about a hear ago. My weakness is going up steeper hills as I haven't developed the ability to sustain power long enough needed to make to the top with most of the other riders in my group. A 50 to 60 mile ride is not a big deal anymore.

3. I now have better flexibility than before the surgery doing such things as reaching down to tie my shoes. There is still a small amount of stiffness when I am in one position for a while ,like lying down or sitting, and then getting up. But what once was pain and discomfort for a few minutes is now only a minor discomfort for a few steps. I also expect that to be gone in a month.

4. I generally feel normal physically, actually better overall than before the surgery as at that point the degeneration of the hip was taking it's toll.

I feel blessed to be able to have such a great recovery.

Monday, November 9, 2009

Weeks Eight and Nine-A Great Day

Mike, 52, was dribbling down the basketball court  late on a week day night when he tripped over someones foot. Instinctively to break his fall put his hands out. Upon landing he instantly felt a pain in his right arm. Since it was near the end of the game he immediately left the court to go home. He figured although painful it wasn't anything serious and would sleep on it. Over the course of the night the arm started to swell and the pain kept him up. An early morning trip to the emergency room was in order. After examining  the arm and taking an X-ray the doctor had some news.  His arm was broken, however it broke in place and didn't need to be re-set. A simple cast to "baby sit" his arm for 6-8 weeks while it healed was all that was needed.  Mike would look forward to playing again.

Meanwhile in an operating suite in another part of the hospital a surgeon was about to make an 8" incision into my upper thigh with a scalpel, which could pass for an Xacto Blade. As soon as he cut through the skin blood started oozing out which was instantly cleaned up by the assistants with gauze and surgical sponges. He made his way cutting deeper and deeper like an explorer finding his way through a jungle. As the surgeon continued he made sure not to cut any major arteries or nerves. It was necessary to cut through muscles and detach tendons from the thigh bone along the way. Finally  he reached the "Holy Grail", the hip capsule.  As he cut through the capsule senovial fluid was released from it's hopeless chore of trying to lubricate a joint that was bone on bone. Once the capsule was opened and the joint exposed he was ready for the main event.

With the assistants holding my body in place the surgeon placed one hand on my thigh and one behind the knee twisting my leg to dislocate the joint. Now the femur or thigh bone was ready. Without missing a beat the nurse handed him a saw. He quickly started to cut across the bone 3" from the end removing the ball  about the size of a hand ball. Next he was handed a drill and started drilling 4" down into the thigh bone to create a shaft so he could place a stem with a shiny metallic ball at the end that would be the main part of my new hip.  A quick hammering of a cup into my pelvis and the joint was ready to be put back together. Working backwards he sewed up the hip capsule, re-attached the muscles and tendons and eventually worked his way to the opening closing it with 22 distinct snaps of the staple gun.

As I work up about 30 minutes later I realized my body was not happy  being violated.. The morphine drip was no help, my leg swelled up to almost twice it's normal size and within a few days my temperature reached over 102 degrees. Luckily my body became reasonable to the idea and started to return to normal.  Within a week I was home.

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Mike had been real busy at work and waited a few days past the eight week mark to have his cast removed on a Saturday. It was eight very long weeks for him without  basketball, his love. After waiting in the office way past the appointment  the physicians assistant finally started to cut with a circular buzz saw along the length of the cast. The PA asked Mike to support the cast from the bottom as he cut through it.  It opened  like an elongated clam shell exposing a pale thin arm. As the PA was finished in his excitement Mike dropped the cast. In a few weeks he could finally play basketball again.

His only thought was this was a great day.

At that very instant as the cast smashed against the floor, I was finishing my bike ride heading to the parking lot where I started  with the group about four hours earlier. For the first time in over two months after 6 or 7 shorter solo rides I felt I could handle the steady pace of the group. As I looked down at my computer while zooming past the entrance to the lot I  noticed I had gone over 50 miles. I immediately raised my arms in triumph like I just won a stage of a major bike race. I was back.

I was a great day.

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At this point you realize there is no Mike (well maybe somewhere), no broken bone and certainly no cast falling to the floor. There is however someone who is amazed and appreciative at what science, a good surgeon, and well planned physical therapy can achieve.  50 years ago I would be confined to a wheel chair the rest of my life. Today even after a major surgical violation to my body  I have recovered faster than the garden variety broken bone the neighbor's kid always seems to get.
 

Wednesday, October 28, 2009

Week Seven Post Surgery

Progress  continues at a steady pace luckily there haven't been any pot holes. I go to outside physical therapy twice a week and think I am one of the few that asks to increase the weights.My limp has lessened to where it is only slightly noticeable..  There is still  soreness moving from one position to another like sitting for a spell and getting up to walk.  However this is much less then even a week ago. Sleeping is much better as I can sleep on either side for a few hours before the soreness wakes me up. For the first time I can bend enough at  my waist to tie my left shoe, probably one of the most convenient advances.

My cycling continues to improve  reaching 40 miles over the past weekend while increasing  climbing by about 75% over the last ride. All while going 3 tenths of a mile faster. Riding up any kind of hill at my old pace is difficult as a combination of being out of aerobic shape and not being able to push hard on the pedals is holding me back. However I can now climb out of the saddle for the first time for any length of time. I should now be able to keep up with the B- group as long as it isn't one of those silly rides where we go round and round in circles looking for anything resembling a hill. Stats from the last ride.http://connect.garmin.com/activity/17091884

I will be seeing the surgeon next week for my 8 week check up.

Tuesday, October 20, 2009

Sixth Week Post Surgery-Jesus Sighting

As many of my friends and family know and from what I have posted on the blog, cycling is an important part of my life. From the obvious, a good way to stay in shape to the less obvious, a great way to escape from life's problems.  As I usually ride with my group at the local bike club because I can't keep up  I have been riding solo. During a solo two hour ride the mind enters places that in normal circumstances wouldn't be visited. It is an excellent opportunity, like running, to get to know oneself.  The chemicals produced in the brain,endolphins,(every time I see that word I can't help but think of those rather large but cute fish jumping out of the water at Sea World) during a long intense aerobic workout cause thoughts to become dream like and somewhat spiritual. Very nice and addicting in nature.

As I have been increasing my mileage every week,because of the surgery and the inability to put a lot of pressure on the pedals I have been avoiding what I consider real hills. On Saturday I decided to take a loop out to Syosset to try Stillwell Hill, a good choice because while fairly long isn't especially steep except in a short section or two. Approaching the bottom I didn't know what to expect. I started pedaling up and to my surprise was easier than I expected. The first part is fairly flat and about a 1/3rd of the way up there is a steep section. I made it through the section with an euphoric feeling filling my body. It was wonderful.

At about the half way mark to my shock and utter surprise an image of Jesus appeared. He (sorry girls Jesus is a man) was real and in person. Now I am Jewish and not at all religious so seeing Jesus came as a total shock. Now I know what everyone is thinking. But I swear to.......let me put it another way. I saw him and with total belief knew it was him. If I am lying, the next time I am in an open field or at the top of a hill let lightning strike my shiny new metallic hip with a vengeance. We nodded to each other, he told me I am doing great and quickly disappeared. I finished the hill with a new found determination and continued back to my house completing 38 miles. My best and most interesting ride so far. Stats for the ride. http://connect.garmin.com/activity/16458570

I consider myself to be doing fairly well for six weeks post surgery. I can go up and down a flight of stairs without holding on. I have been walking without any aid for over two weeks and I just completed my 5th session of physical therapy. The scar is healing nicely without very little itching or peeling. The pain is gone except when I sit for a long time or sleep in an awkward position. I can sleep on the surgical side now for about an hour. The only physical outward sign to anyone who didn't know is a slight limp, mostly due to the surgical leg being about 1/2" longer. However as the therapist suggested may happen over time the legs are now slightly more even.  Looking forward I am feeling good about my progress.

P.S. I just want to add that while I am successfully re-gaining my cycling ability I miss riding with the members of the club. There is something nice about sharing riding and conversation with other people. As luck would have it,  Jesus Hernandez a member of my club caught up with me on one of the hills in Syosset. While it was a brief meeting and conversation it was great to see him.

Tuesday, October 13, 2009

Five Weeks Post Surgery

Hard to believe it is five weeks already. As the first week or so went very slowly each new week seems to appear before I know it. . While I don't feel it on a daily basis when I reflect on the past week I can see the improvement.

It is about 10 days now walking without any aid. While I still have a limp (which I understand may be there for about six months and not unusual) it seems to be lessened by the day. I still have to be careful with bending over as there is still the possibility of dislocating the hip until the hip capsule fully heals, typically in about 8 weeks.   I had my 2nd session of physical therapy last night (more about the therapist measuring leg length later) and there is improvement in range of motion. On most of the machines and exercises they are increasing the weights as the legs are getting stronger. I wish I started a week or two earlier. I can stand on the surgical leg carrying all of my weight which is necessary to do some of the exercises.My fourth ride post surgery was 25 miles which is an increase of five miles at about the same average speed. Click on the link to see the stats.http://connect.garmin.com/activity/15810119. Sleeping is still somewhat of a challenge however if I get the pillows just right between my legs I can sleep on my side. My favored side to sleep is the surgical side and look forward to that in about a week.When I am just sitting around or relaxing the pain is totally gone. Finally

Now to the leg length measurement. When I went to the therapist last week I asked her to measure the discrepancy between my leg lengths. One of the main challenges for the surgeon during hip replacement surgery is to get the leg lengths as close to the same as possible.  When I walk I can clearly feel the surgical leg is longer or hitting the floor before the other. While lying down I  had my family try to see the difference in the lengths and the surgical leg appears to be about half an inch longer. This is border line unacceptable as the goal is to have a goal of no more than 1/4" and if true orthotics would be necessary.

I found the results of the "professional" measurements very interesting. She first individually measured the length of each leg while I was lying on a table. This was done two ways. First a point is determined on the pelvis and the tape was stretched to a point on the ankle bone. Secondly she started from the belly button and measured again to a point on the anke bone. She did this for both legs. Both legs were approximately the same length. She then while still lying down on a table making sure I was square  and pararallel to the long sides of the table  determined that the surgical leg was extended (didn't say longer) about half an inch past the other leg. So while both legs are about the same length  the surgical leg visually appeared to be extended or longer. My pelvis and  or back might not be perfectly straight and a possible cause. During surgery they re-attach the tendons to the bone, repair and re-attach the muscles. It is impossible for the surgeon to get the exact same tension on the parts as pre surgery. So the joint will slightly shift as the parts adjust over time and return to their proper tension.This should probably take another month or so and hopefully will cause both legs to reach the ground at the same time.

Monday, October 5, 2009

Four Weeks Post Surgery

 I finally arrived at four weeks. When I was in the hospital in severe pain one month seemed like an eternity.Overall I am satisfied with my recovery.

 I went on my third  bike ride yesterday, exactly three weeks and six days from the slicing, dicing and stapling. For the first time I felt I belonged on the bike. I was riding the bike, not the other way around. While I am still below where I would normally be speed wise, 15.4 mph for 20 (very flat) miles reflected a vast improvement from one week ago of 13 miles at 13.8 mph.  I could accelerate, although modestly. http://connect.garmin.com/activity/15334829 Next week I am planning  an also flat 25 miles. After that  the challenge of the hills begin.

The front lawn was looking very sad and sorry from not having it's favorite hair dresser, my son, take care of it.Lately he has been giving himself a headache at some school in Baltimore with an "s" after it's first name.It has been more than five weeks so a trim would not work. A full styling was in order. So out came the lawn mower with me behind as it was converted into an expensive, mechanical and noisy walker. Without those tennis balls on the bottom of course.  Did I add heavy as all of the turns necessary to maneuver the mover over the postage size lawn made me feel I was wrestling Hulk Hogan.  Between the riding and the wrestling I was exhausted and sore.

I had been walking with only the assistance of a cane for just under a week. A few days ago I tossed the cane and started walking on my own. Mostly shorter distances, like around the house, shopping in a store if I got a good spot.. I forgot about yesterdays excesses and was abruptly reminded first thing this morning. So out came the cane from the dumpster which will be used for the next day or so.

The vast majority of the pain is gone. Certainly nothing that can't be controlled with a few Advil. Sleeping is another matter however.  I am typically a poor sleeper. Trying to sleep on my back is improbable at best. While  allowed to sleep on my side, my preferred choice, the surgical side is out for at least a couple of weeks for obvious reasons. The "good" side while not where I would normally first turn seems to pull the muscles, or the internal stitches or something in there, (inside the gruesome cavity)  and after a while causes pain. I have tried all different combinations of pillows by tossing and turning them into place. So while I can fall asleep for an hour or so the pain wakes me up. It is improving daily and hopefully within a week won't have the pain.

Tomorrow I will see my primary doctor for a post surgical check and will start out patient physical therapy. I should be ready to kick some ass after that.

Tuesday, September 29, 2009

Three Weeks Post Surgery

I finally got on the road bike for the first time since the surgery. It was last Saturday exactly 19 days post surgery. As far as I can tell this is a World Record for riding a bike so soon after total hip replacement. I welcome anyone to scour the internet or ask  their doctor to find anyone who has done this earlier. As I mentioned a few posts ago the surgeon gave me the OK to do anything I wanted with the new hip.. So if I was into  robbing a bank I could do it without any crutches or a cane if I felt up to it.

I pumped up the tires, filled the water bottle, put on my Saturday best cycling clothes and climbed aboard the bike for a nice easy 10 mile very flat out and back loop I often ride from the house. The link to the stats from the ride >>> http://connect.garmin.com/activity/14422882 . One item of note was a clicking sound as I peddled I had never heard before and wasn't sure it was something mechanical with the bike or the new hip. The rest of the day I spent recovering  from the effort.


I continue walking with the assistance of one cane and still can't seem to get rid of an aching pain I have in the leg which I mostly feel at night. Very annoying. I am told from someone who had their hip replaced about six months ago this is common and by the fourth week it should go away. I am still mostly sleeping on my back which is OK until about 4 or 5 in the morning when I can't take it any more, trying to then sleep on my slide without much success. I will be going to work tomorrow for the first time so my scam is over.

Today I took my second bike ride, exactly three weeks after surgery. I added three extra miles on a similar route as the first ride. This time I wanted to put out a greater effort as I felt comfortable I wasn't going to break the new hip or any of the muscles or tendons surrounding it. I ride this route quite frequently and usually average around 18 mph for  the ride with an average heart rate of 150 beats a minute. I  really pushed myself today and wound up with  a fairly slow 13.8 mph  average at the same 150 heart rate. So I was working as hard as I usually do with much slower results. It is like I am getting on a bike for the first time. When I got home I was so exhausted I passed out for two hours. The stats for the 2nd ride  >>> http://connect.garmin.com/activity/14629968. This time there was no clicking sound so I won't have to take my bike to the shop or hip to the surgeon for repairs.

Anyway that is it for week three.

Thursday, September 24, 2009

Day 17 Post Surgery Day 10 At Home

Pretty much an uneventful day today. I am walking only with the assistance of one crutch.

Since I went off the Lovinox yesterday I can now take more traditional NSAID medications for the minor pain which still remains. I took two Advil in the morning which took about half the pain away. What was left I could deal with. As the Advil wore off I took a Mobic which is similar to Advil but lasts about 15 hours.

My exercise consisted of  running around (in the car) doing a lot of errands. So it was in and out of the car probably 6 or 7 times. I  also did the 7 exercises the therapist gave me with a little more intensity and repetitions.

Like a newborn baby I counted and documented my progress on a daily basis. As the baby gets older the days turn into weeks. So as I will soon arrive at three weeks I will be posting weekly for the most part. If anybody has any questions or would like some additional information between posts please email me at;
gerry_w@hotmail.com

Wednesday, September 23, 2009

Day 16 Post Surgery Day 9 At Home

Finally got to see the surgeon today to get the stitches out and a consult. They took some X-Rays of the hip and the doctor measured the difference between the legs. He claims the difference is only 1/4". First I want to say the surgeon who I know for about 12 years or so and has done prior preservation of my body is a cowboy. By that I mean if he thinks the patient is doing well he will let the patient basically do whatever the patient, me, feels I can do within some kind of reason which I haven't figured out yet.

So Gerry you are progressing very well, the X-Rays look great and you can do whatever you want. You mean I can throw the crutches away? Sure. How about driving? No problem. Go to work? Why not. Now the question I was sure he would say wait.... No not that....... Can I ride my bike? Yes with the only caveat I have enough range of motion to rotate the pedals. Which I think I do.

Well fortunately the patient is only a dude ranch cowboy.  I still have a light to moderate amount of pain which I guess is my body telling me I still should hold back a little. I did the therapist's list of 7 leg exercises, Sets of 30 each and I am pretty sore from that. In addition April  and I spent about 30 minutes walking around Whole Foods, which crutches appropriate for the dude ranch cowboy which wiped me out. Both fiscally and physically. (they don't call it Whole Paycheck for nothing) I did however get in the car with Allison for a nice drive to Starbucks for a treat. Yahoo!!!

Day 15 Post Surgery Day 8 At Home

Another uneventful day which I guess is good.

I got some good exercise in today. I did all 7 of the different leg exercises the physical therapist gave me for the first time. Except for leg lifts they all involve holding on to a ledge and moving the legs  in different directions to build up the muscles. The hardest and  most painful were knee bends. My walk involved trying to chase the ice cream truck as it  creeped through the neighborhood with its little jingle. There I was in my pajama pants, in broad daylight with two crutches, going about 2 mph wandering around the neighborhood. I never did get my ice cream but did manage to walk about 1/3rd of a mile.

After more than two weeks post surgery what amazes me most is how tired, exhausted really, I am after the most simple of any physical activity. Even after my shower tonight I was drained.

Tomorrow, the stitches come out and I get to talk to the surgeon.

Tuesday, September 22, 2009

Day 14 Post Surgery Day 7 At Home

Finally reached the two week mark post surgery. One week at home. Nice and symmetrical. I was a  little lazy today except for a nice walk, with crutches around the block, of a little over half a mile. .57 of a mile for those keeping track. Since it was around the block I got a little nervous at the half way point.If I turned back or kept on going it was the same distance. Of course when I got home I needed a nap. Not that I have needed an excuse to take a nap lately. My hemoglobin registered 9 when I left the nursing facility which is a bit on the low side. I called my primary doctor and he said it would take 2 or 3 weeks to get to a more reasonable level.

I am looking forward to seeing the surgeon on Wednesday to get the stitches out and find out when I can move on to doing more activities. Like, driving, going to work, walking with  a cane, bike riding and..... never mind.

Monday, September 21, 2009

Day 13 Post Surgery Day 6 At Home

Time is starting to fly. I will have two weeks after tomorrow. Once you get past the pain and discomfort of the first week this whole process gets better. I hope I look back at where I am now in a few weeks and can say the same.

I left slug mode today. Finally. Not a lot of physical activity just the right amount..I walked, with crutches about 1/4 mile going up the block and back at a slightly faster pace than a few days ago and wasn't as drained as the last time. I estimate there was about 50% of my weight on both legs.  A  few leg exercises.were in store managing  15 leg lifts. Three or four days ago I couldn't lift my leg  an inch off the bed.. I also did a few leg extensions sitting at the edge of the bed. So nothing major here. I am in a little less pain than yesterday so maybe the extra work helped. Tomorrow there will be more.I seem to get  the pain later on in the evening. A Percocet and a half should do the trick. Last night it was two.

I also noticed the surgical leg is longer than the other. By lying on the bed, both legs evenly outstretched, April and Allison estimated the difference is slightly over half an inch.  Maybe 3/4 of an inch which is I'm not thrilled about. Not much I can do about it at this point.

It was great  having Allison take care of me. Her smile is special and comforting. I saw a maturity in her I hadn't experienced before. However I missed April very much. I knew approximately when she was coming home and every time I heard a car drive up the street I was like a kid hoping it was her each time. When she finally arrived I  wasn't disappointed.  All is well again.

Sunday, September 20, 2009

Day 12 Post Surgery Day 5 At Home

Pretty much another lazy day in slug mode at home. The pain which I still have is an allover ache in the repaired leg from the knee to the hip. Unfortunately it is about the same as yesterday. Maybe the slug mode is not a good strategy. I will try to become more active tomorrow and see if that helps.

I haven't mentioned that I have been on Lovenox which is an anti clotting agent from the moment I entered the recovery room 12 days ago. Blood clots can sometimes form in the leg and travel throughout the body landing in places you don't want. It is an expensive well engineered needle delivery system which is administered in the stomach area twice a day. At the hospital the nurses gave the shot. At home it is self administered. Something I do not look forward too.  There is always the possibility of getting an injury that could cause bleeding that would be hard to control. You also can't take any blood thinning pain relievers like Aspirin or Advil. With the light to moderate pain I have I would much rather take Advil than the Percocet. At least in the daytime.

I mentioned a few days ago that "The Wife", April has been taking great care of me both in the Hospital and at home. It is a comfort to know that she is always there for me. April long ago planned a well  deserved getaway with a few of her friends for the weekend.. In her place, "The Girl" my 17 year old daughter,  Allison has stepped in. She has brought me food and any anything else I needed, set the table and cleaned the dishes. When I am in pain or a little depressed seeing her smile makes me instantly feel better. She hasn't left the house in the two days April has been gone. Amazing in itself for a teenager to stay home Friday and Saturday night.

I can't find the words to describe how lucky I am.

Saturday, September 19, 2009

Day 11 Post Surgery Day 4 At Home

Nothing much happened today. Basically day two in slug mode. No walks, no specific exercises. When the physical therapist evaluated me on Wednesday he said I was progressing well and was almost a week ahead of schedule as far as I was getting around and the repaired hip in general.

Each day I get a little bit better so I decided not to push it due to the pain, which is slightly better than yesterday. I took a half a Percocet in the early evening and it took the edge off. The swelling is almost all down to what it should be considering there was major surgery on that leg. I took a few steps using just one crutch just to see where I was progressing and I can do a couple of leg lifts with the repaired leg. My thinking is my getting around and about is providing somewhat of a workout and I want the bone to grow into the implant and all of the muscles and tendons that were re-attached to heal before I push it. After the two week check up I will ask the surgeon what I  can do. 

Friday, September 18, 2009

Day 10 Post Surgery, Day 3 At Home

Today I turned into a slug all day, pretty much just lying around napping. My main exercise was getting up to go to the bathroom which at my age happens quite often. Maybe that is Nature's way of forcing people to move around a bit. Anyway I had a general aching feeling in my upper leg last night and this morning which forced me to take a Percocet both times. A little more pain than I expected.

I figured it as due to all of the activity yesterday. At around 10am I had a physical therapist come over from the home health service, which most insurance covers, to evaluate my house for safety and me for progress. Of course when he wanted to see the upstairs he made sure I  dragged myself up. He showed me how to safely get in and out of the bath tub. Which he did so well  I snuck a shower when April  went out later. He then went through some basic exercises which I had to perform in front of him because he must of been afraid I couldn't understand his stick figure diagrams. The terrorist. I was pretty tired when he left and figured I could get a 45 minute in before the nurse, from the same home service arrived.

True to form  the nurse showed up about 20 minutes early and before I was fully up was showing me how to jab a needle in my stomach area to avoid blood clots. She said I no longer needed to  have the wound covered. (A picture of which is displayed right after the cover came off). We went through some other stuff and she left. Finally nap time.Later on in the late afternoon I took a nice 4 block walk, on crutches with April. I was walking better than the first day home probably putting about 40-50 percent weight on the "fixed leg. I am generally moving about much better and have more control over the repaired leg.

 One of my main problems, besides more pain than I expected (I don't want to give the impression I am in a lot of pain just a general ache from the knee to my butt), was trying to sleep only on  my back. I don't know about anyone else but I always sleep on my side. The repaired side is most comfortable with the other my 2nd choice in tossing and turning. Because of the surgery I have to sleep on my back with a pillow between my legs to prevent dislocation.


So seeing how being a slug didn't help, tomorrow I will try to be a little more active, doing my stick figure exercises and maybe another walk.

Wednesday, September 16, 2009

Day Eight Post Surgery- Day One At Home

I finally made it home on day eight post surgery. I couldn't blog from the nursing home/rehab because the Fred Flintstone computer was just too slow. It took me 90 minutes to type something that shouldn't take more than about 20 minutes. My surgical calf blew up like a balloon Popeye style just sitting there.

I spent three much needed days at the facility as I wasn't ready to go home from the hospital. I was there an extra day as it was.Since I arrived on a Sat I got just a basic evaluation but didn't receive any rehab either Sat or Sunday. But the rest was good as the leg felt a little better each day and I got a chance to get up and about on the crutches and walker.

Except for Saturday I stopped  taking the Percocet once I got to the facility. it relieved the moderate pain but didn't want to  continue getting clogged up. It was 5 days since the choo choo train came in to the station. Yesterday I got a good evaluation to see if I was ready to go home. They taught me how to use crutches, get  in an out of chairs, walk on an uneven pavement and refreshed what I shouldn't do to dislocate the hip. I got in about 30 minutes of rehab.  I was taught how to shoot myself up in the stomach with Lovenox which is a blood thinner. Blood clots can form until the device is healed internally.

Each day I got a little better. I can see for the first couple of weeks this is one day at a time Walking short distances with the crutches or is a great excuse for nap time. Much of the walking I got was with walker going from the bed to the bathroom and back. Most of the people prefer the walker, I prefer crutches for longer distances.

It is great to be in the comforts of home. Wonderful. I still have some challenges. My new hip leg is very swollen  below the knee when I  stand or sit in a chair. The only thing that keeps it from blowing up is lying down. While some swelling is normal, my Popeye calf is due, I believe, to a pre existing condition. The left leg has always a little thicker than the right due to constantly getting pounded by baseballs and softballs when I used to catch 15-20 years ago.. Tight socks will make an indentation in the bad leg and not the good one. I hope because of the  surgery it hasn't gotten worse. I also have a very low grade fever between 99.5-99.9. While this is typical in the few days after surgery it should be gone by now. I will call the doctor tomorrow morning.

 I still have moderate pain although not as bad as the fist few days.It is still difficult to move around, like getting up from the bed or down to a couch. I am pretty confident it will continue to get better. Once erect (on crutches), it is reasonably easy to get about. I did my first decent walk outside today going down the block and back. I almost  didn;t make it back as I walked a bit too far. I wound up walking 285 yards at 1.1 mph. Took my Garmin GPS from the bike.

I just want to say "the wife" has been great throughout this. Without April cheering me up  every day at the hospital and nursing facility it would have been almost impossible.I could look forward to seeing her and enjoying the goodies she brought always making sure I always had everything I needed. She always looked great.. At home it has been more, much more of the same. April and Allison went shopping buying the ingredients to make a Yarlsburger and asparagus dinner. Yummy.

After reading this through I can see it was more interesting when written on the pain meds.

Saturday, September 12, 2009

Day Five- Tale of Two Facilities

The morning started with the promise of leaving the hospital where I had the hip replaced..Temperature check, site wound healing check, blood pressure  check, surgeon gave some encouraging words double check. I was ready to go. Because of the previously mentioned mostly minor complications I stayed an extra day.. Not happy but the thought it will cost the insurance company another $3,000-4000 made my hip pain a bit less..

 Before leaving there was one more chore. A date with the physical terrorist. Much to my delight there is a different terrorist on the weekend. Someone who evidently has a clue as how to rehab someone who just had hip surgery or any surgery I would guess. I tried walking on crutches which the first terrorist wouldn't allow, and walked, fairly quickly and steadily about 50 feet before feeling dizzy on the crutches. Again I clogged the main artery of the hospital's 2nd floor with  the chair the therapist  (I really don't think this woman is a terrorist) quickly threw under me before I hit the floor.. After about 5 minutes I returned to the cutches and ambled back to the room on to a chair where she put me through some leg and  body exercises. I didn't know a therapist could do that.

One of my conclusions is it is important to have a therapist that cares for.the patient, not someone who is glad I walked only a few feet so she could move on to not helping the next patient.more quickly, I feel some of the medical issues were caused by not successfully getting around and not having the legs manulipulated, blood and fluids moving around. There is a lot of  not so nice stuff that happens during surgery. By walking and exercising the legs ,fever is reduced, the swelling goes down along with the temperature the wound drains easier. The surgeons, nurses, aides and every one else were  nice and work very hard for their patients. The first therapist was a true terrorist. It must have been her friendly and perky behavior that failed my personal security sensing devices. The second a true therapist and helper.

So it is off to the next facilithy which is a nursing home partially used to permantly park older people after driving around and around  many neighborhoods  looking for a spot. And for people like myself who need therapy after surgery, a stroke or what not. I parked in  the short term parking area.

My first impression is I will get good care. The nurses, aides and especially the therapists gave the feeling of wanting me to have a successful and short stay. It is too early to know for sure but I am avery optimistic.

Tomorrow hopefully real rehab will start. As for computing there is no wifi. What is why fly?? However an older desktop computer was found on the third  floor and when dusted off  works enough.    I   am  thinking faster than the words appear on the screen and is making me a little nervous. The mouse is barely working and I suspect it must have been used for medical research at one time. The password is "res" which is short for resident. If the password were resident I would have been very nervous.

* Not that I have to mention it but the computer has no spell check

Friday, September 11, 2009

Day Four

With the possibility (probability the way it was presented) of having the surgeon open me up and start digging  and probing around in there and not have it happen it couldn't be a bad day. Needless to say it was a worrisome sleepiness night for both me, my family and friends who are following this.

The pain is slightly reduced and I have a little more movement. Neither of which is significant. I had trouble walking again with the aid of a walker and stopped after about 10 feet and turned around. I was getting dizzy again but it is possible, probable actually I just couldn't handle the pain. A wimp I guess. The leg is  still swollen and I have a low grade fever.

Tomorrow I am leaving the hospital and will be staying in a nursing home for rehab. I figure I will be there from about 4 days  to a week. I want to be somewhat independent before I go home.

I don't know if they have wifi there and it is possible I will be away from the computer until I get home. My original thought was to post daily for about the first 10 days to 2 weeks and post weekly after.

Thursday, September 10, 2009

Day Three Started Off Pretty Well

The switch to  Percocet was a good move. Not only did it do a better job of relieving the pain it also didn't make me dizzy. I need Percocet around  the clock as it starts to wear off in 3 1/2-4 hours the increasing pain tells me to take another dose.

My low blood pressure was also contributing to the dizziness so the doctor gave permission to  not take BP  medicine in the morning. I never know when the physical  terrorist is coming and Murphy is always ready to invoke his law.She came just as the medication was wearing off. The pain was pretty good (how can pain be anything good) at that point so I shooed her away suggesting (OK telling) her to come back in 45 minutes. She is in the hospital anyway so not a big deal.

So the big moment arrived and I was ready for her. With trouble I  got up and sloooooly started walking (if you can call l it that) with the aid of a walker. I managed to go about 20 feet in the hallway where I became dizzy and they rushed a chair for me to sit down. So here I was clogging the main artery on the 2nd floor before I could get up and walk back to my room. When back I  was dizzy again and they sat me down in a chair for a while because they want me upright. While  I  was disappointed I didn't do all that well for day three I was satisfied I  made some progress. The effort made me pass out for almost 3 hours and for anybody that has ever stayed overnight in a hospital is a big accomplishment.

About an hour ago they took my temperature which was 102 degrees which set off a flurry of activity  including 4 blood cultures, (not your grandfather's blood test) a urine sample and a technician lugged  an X-Ray machine to my room because I can't get off the bed without major multiple person effort. The entry site of the surgery was somewhat red and very warm, OK hot, although I don't have any specific pain there. My friggin leg is killing me though from the surgery,

They feel there is an infection somewhere in the wound and I go back to surgery tomorrow morning so they can prod  and poke around in there taking some samples of the tissue for testing. They didn't have to tell me this as when they came into the room with "no food or drink after 12 midnight" I knew what that meant.

***Update***
Fortunately there wasn't any additional surgical intervention. The house (not that House) doctor over reacted to my condition last might. You might say he was a bit of an alarmist as he got everyone in an uproar. Even though he is an internist he isn't familiar with what may typically happen after hip replacement surgery. While I am having fever longer than usual the surgeon thought the wound looked good and everything was progressing, although a little slowly.  It was a restless night.

Wednesday, September 9, 2009

Day Two

Day two was not a very good day. The PCA drip doesn't seem be relieving the majority of the pain although it helps me  to sleep and keeps me in a happy stupor . I was looking forward to the physical therapist getting me up and about. As the drip wasn't working that well I kept on pushing the  button in anticipation of the pain associated with moving  for the first time.In the meantime I have been doing a great slug imitation. As it turned out I became very dizzy and almost passed out, partially because of the morpheme drip and  also due to low blood pressure. After discussing the situation with the doctor he has me trying Percocet, So as far as getting moving and about it was a wasted day.

Tuesday, September 8, 2009

First Day Of Surgery

My replacement was scheduled for 7am but I didn't get into the operating room  until about 7:45. They gave me a spinal to to  numb the lower half of my body and through my veins gave me a cocktail that included the same medicine that killed Michael Jackson. They said that they were talking to me a bit during the surgery but I have no memory. Thank god.

The surgery lasted just under 2 hours and the doctor said things went really well although I was in no shape to talk to him. The entry was from the side (not anterior-lateral) and the incision was about 6".

I want to  keep this short as I am in more pain than I expected, or at least hoping for and have some minor (hopefully) complications. First the wound bled out and left a 2 foot stain on the sheets. They changed the sheets (very painful) and dressed the wound. Thank god for the PCA morphine pump. That was about 4 hours ago and the new bandage is completely dry  as are the sheets. Very good. My main concern is have a fever that has been going up the past 3 or 4 hours to 102.4. However I am sweating pretty good now which is a great sign.

Tomorrow they will get me out of the bed to start some physical therapy which I am looking forward to. Right now the catheter is my best friend.

Monday, September 7, 2009

Less Than 12 Hours Until Surgery

Tomorrow morning at 7am I will be under the knife. While I have been looking forward to the surgery now that the time has come the nerves have become unsettled. I doubt I will sleep well.

The past  4 or 5 weeks I have been fortunate to be able to go to the gym about once a week to work on my entire body.Bike riding once or twice a week has kept my legs in shape although my mileage and speed have been steadily decreasing.  Where my rides were typically 60 miles I struggled through 40 this past Saturday.

In searching the internet one common theme from others who have had the surgery is they wish they had it sooner. So I decided once I knew the hip was trashed to schedule the procedure immediately. As the 7 or 8 weeks  wore on it seemed as though it has been a race to get the surgery before the hip deteriorated to where I couldn't arrive at the hospital in good shape. I think I won.

If the wifi works in the hospital I hope to give an update every day on my progress and daily for the first few weeks when I get home. I have gained valuable information from others on the internet and want to share the same.

Feel free to ask questions or make comments.

Monday, August 17, 2009

Surgery Is Scheduled For Tuesday Sept 8th


The hip replacement is scheduled for Sept 8th 7 am, the first work day after the Labor Day weekend. Three weeks from tomorrow. I hope surgery is a little like car manufacturing where it is better to buy a car assembled on Monday after the weekend then Friday at the end of the week.

The surgeon will be using a device made by DePuy. The Corail model. Ain't she a beauty? It is a metal on metal implant. I believe the stem is made of titanium and the ball and cup liner are made of cobalt chromium which is extremely hard and should outlast me. If they dig up my coffin 500 years from now all they will find will be a funny looking metal thingy bouncing around in a large box. The stem and outer cup later (the darker grey textured cap) is covered with hydroxyapatite (HA) which encourages bone growth. They don't glue these in anymore but instead once positioned the bone grows into the device to secure it.

The surgeon will be making an Anterolateral incision ( between the side and front of the hip) of about 5 inches. Surgery should be about two hours.

* There are quite a few manufacturers of artificial hips and many different approaches to surgery. I don't want to imply that the above is any better or worse than what another doctor may use.

Thursday, August 13, 2009

Introduction

I am a male 61 years of age and live on Long Island, New York. I am 6' 210 lbs. My main source of activity is cycling with my local bike club. For a little background I am a "B" rider who averages between 15-16 miles per hour on 50-60 mile rides. The roads of the North Shore of Long Island where we mostly ride are comprised of a lot of short but steep hills along with good stretches of flat roads.

For the past nine months to a year I have been developing a pain which I thought was some kind of groin pull or injury to my upper quad. Over time it got progressively worse, especially after riding where the next day I am pretty sore. When it also started to hurt along my backside and side I decided to go to an orthopedic doctor. At that point I figured it was some kind of hip inflammation and was hoping a cortisone shot would fix it. Much to my surprise when the surgeon saw the X-ray he immediately knew my hip was in the end stage of arthritis. The articular cartilage, which is similar to the shiny ends of a chicken bone was completely gone. Bone is rubbing on bone.

He told me I would at some point relatively soon need a total hip replacement. He said I could continue to ride as I wouldn't do any further damage. When I did not want to handle the discomfort any more I should have the surgery. This started me off on an extensive internet search for information which is typical of my compulsive nature.

The point of this blog is to document my hip replacement journey so anyone else in the future in a similar situation can have an idea what to expect. As everyone's experience is different, this will be my story.