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;

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.

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.