Monday, May 16, 2016

Get Hip!


You probably know - I complained about it enough - that my right hip went very decidedly bad on me about this time last year.

It'd been coming apart for some time before that; I'd lost about 1/4" to 3/8" off my right leg starting back in about 2011. It was sore, and a little awkward. I went to a couple of orthopods who told me that I'd be getting a new hip...but that if I could hold off longer that I'd be happier with the long-term results.

So I did. And the leg seemed to stop deteriorating; I managed with minimal discomfort and the same shoe lifts I got from the physical therapist in 2011 for about four years.

Then, last winter, the leg really started to go to hell. Painfully, to begin with. It HURT. And I began to really lose bone in the hip joint; by early summer I was an inch shorter on the right side than the left, and was wearing a real no-shit cripple shoe on my right foot just to be able to walk at all. And walking was fiendishly painful. I have a fairly high pain tolerance, and by mid-autumn I was pushing right to the extreme edge of that limit.

I was ready by November to get the damn thing parted out and replaced. But that's when The World's Best Health Care SystemTM kicked in. Because I hadn't worked for my current company a full year (never mind that I'd worked for the sonsofbitches damn near four years in my earlier incarnation...) I wasn't covered by the disability insurance policy. AND I would lose my health coverage, period, if I couldn't work 20 hours a week.

So I put off the surgery until March.

On March 1 I went under the knife.

I don't really know what the surgeon did and, frankly, I don't want to know. The entire notion of being opened up like a beef carcass, my femur cut off at the proximal joint, drilled out, and a metal rod slammed into it is faintly sickening. And the surgeon's assistant, questioned afterwards, described an interior hellscape of floating bone chips and towering arthritic spires that had to be picked out or ground off, respectively. I was a mess inside which seems to have gone a long way to explaining how painful the thing was. I had lost a lot of blood in the OR, and my blood pressure remained low for another day or so.

To kill the pain of this flensing I received a spinal anesthetic. This is not a "block", as I had assumed - similar to the epidural that is common for knee surgery or caesarian section - but a general anesthetic delivered through the spine. And it works, delightfully. I awoke Tuesday afternoon in very little pain. I couldn't feel my legs, but, then, hey...there's always tradeoffs, right..?

That happy condition lasted until about Tuesday evening as the spinal began to wear off. I began to take the pain medication - oxycodone, "hillbilly heroin" - at low doses. Not ideal, but...manageable. The OT and PT people got me up and walking, frailly, but walking. The hip hurt, but...differently. This wasn't the deep, grinding pain of the disintegrating joint but post-op pain of sliced and sewn-together muscles.
Wednesday afternoon I was released, and hobbled on my walker down to the main door of Good Samaritan and my Bride in the Subaru.

Getting into and out of a low vehicle when you've had a hip replacement is ridiculously balletic. First you have to lay the seat back far down so you don't have to bend at the waist. Turn backwards to the door. Stick your new hip-leg out and lower yourself down, leaning back until you're almost supine, your legs sticking out the door like a dead mobster in a videogame. Then you scoot far up the seatback - to clear your feet from the front of the doorframe - and swing them inside. Then you slide forward, and if you want you can put the seatback up a bit.

Then you have to do that all backwards to get out. I did, and tottered up the steps, into the house, and into bed.

And that night, the pain came.

The nighttime hours between Wednesday and Thursday might have possibly been the worst of the entire business. I went from 5mg every three hours to 10 to 15; by midnight I was lying awake, unable to find a comfortable position to lie, begging the clock to move to the next time I could take another painkiller. I've been in pain at various times in my life, but that was about as bad as I've ever hurt.

And by Thursday afternoon the pain was, largely, gone.

Not that it was gone-gone. I still hurt when I get up after sitting a long time; the joint stiffens up and I have to hop and limp a couple of steps to loosen it up. But by the weekend I had gone from the walker to a cane. After a month I dropped the cane and haven't needed it since.

I still have, and will always have, a deep gouge in my right hip.

Now I am ten weeks post-op. I have some lingering soreness. As I said; I can't sit for long without stiffening up. But the overall pain and discomfort level is far, far below what I was living with just three months ago. My legs are nearly the same length; I have a half-inch lift in my right leg and always will - until my left leg goes bad and I have to have THAT hip replaced...

I won't pretend that I'm happy about all this. I shouldn't have to have had this hip replaced at all; I'm not sure what happened, whether it was just bad luck or bad genetics or misuse - I did abuse the hell out of my legs when I was younger - or a combination of all the above. But I shouldn't have to have aftermarket parts in my goddamn hip and I'm sure as hell not pleased that I do.


Given that I don't have a choice, the alternatives could be worse. I am free of the constant nagging-to-screaming-out-loud pain I have lived with for nearly five years. I can walk straight again, and hopefully soon dispense with the last of the "precautions" which prevent me from, for example, tying my right shoelaces.

Call no man happy until he is dead. But...I am a happier man than I was back in February, and, perhaps, that is enough. For now.


Ray said...

Hope you have a safe speedy recovery, You have more then earned it!

Ael said...

Good for you.

And yes, you Yanks really have a messed up medical system.

Forcing some wretch who desperately needs help to hobble along in agony, messing up their body and making things worse until some whimsical bureaucratic deadline arrives is cruel and unusual.

Of course, Canada is much better. We have queues which make *everybody* wait. Cruel but not unusual.

Leon said...

Just make up a good story about that scar for the chicks. Tell them how you fought off a bunch of Hells Angels to protect a woman's virtue. Chicks get totes turned on by cool scars.

So I've been told.

Glad you're recovering.

Big Daddy said...

The pain was worth the gain, we could see a huge difference in your movements and relative lack of pain pre and post op. Also a plague upon the individuals who make policy at your employer. Wouldn't want the company to go bust, but they could benefit from something embarrassing and painful.

mike said...

welcome back. keep up the physical therapy. don't swear at the pretty therapists when your pain level climbs.

Barry said...

I told you so, FDChief - within two months, you'd be glad that you did it.

FDChief said...

I am, in general, pleased and, yes, Barry (and everyone else who advocated for this surgery) you were correct...

One oddity, though; so long as I am up and walking about I have very little discomfort. But sit down for any period of time? When I get up again the damn thing has stiffened up on me. That's not supposed to happen, right? WTF?

I need to talk to the orthopod about that.

Lisa said...

I'm so sorry to hear of the pain and the terrible gash, but I hope you continue to enjoy recovery, and freedom form the pain you had so long endured. I imagine that in Portland you have access to some crack therapists (I hope).

Please keep us informed of your progress, or let's say, the healing trajectory.

I must share this tremendously inspiring and well-written story for anyone dealing with physical problems. It ran in the NYT last week and is by Jacques Leslie (the author of “The Mark: A War Correspondent’s Memoir of Vietnam and Cambodia”)--

Learning to Walk in My 60s

Don Franscisco said...

Glad to hear you are much better - rest up!

FDChief said...

Lisa: I am beholden to you for your kindness, you are ever the soul of grace.

So far nothing has really changed. I need to find out about this odd stiffening after lack of movement; is it something that will pass, is it something that I can DO something about, or is it permanent..?

I thought your article was interesting largely because of his discussion about the limp, and, yes; the ortho and the PT people (who are really tremendous) both emphasized that the most critical part of rehabilitating this surgery was NOT giving in to the tendency to take weight off the leg and limp, that limping would, indeed, become a habit and potentially damage the muscles of my right leg. I have tried, therefore, to walk correctly. I think, as your author notes, that weariness tends to produce more of a limp, and I've had people tell me that I am more noticeably one-sided when I'm tired.

Again; am I "happy"? No. I got a shitty deal, and there's no pretending otherwise. But am I "happier than I was"? Yes. The glass is definitely half-full...

Lisa said...

We all care about your state of wellness, Chief.

I am interested to hear what they say about the stiffening after sitting. I believe we are one mind-body (despite the expert's need to divvy us up), so the messages from the brain part are inextricably a part of the rest.

I think your therapists are correct in that we must exercise control over our thought. The body has it's own mind throughout, and will want to favor injured parts. I believe that is what muscle spasms are, too -- attempts to protect something (as it sees it.)

The injured side will drag when tired; you are exhausting your neurotransmitters, in addition to other things. We must tax the will, but it tires.

Barry said...

FDChief: "One oddity, though; so long as I am up and walking about I have very little discomfort. But sit down for any period of time? When I get up again the damn thing has stiffened up on me. That's not supposed to happen, right? "

One thing which was a problem for several months was like that, if what you're feeling seems to be in the meat, and not in the actual joint. The surgeon said that they cut through four layers of tissue, and stitch each one up separately, but that the layers heal together at the wound. He used the phrase 'one wound, one scar'. It eventually works free, but that took a few months.

I would ask you to pay this forward - tell the next guy you meet who's suffering that they should get the surgery. I got to the point where I was taking two tramadol and two Vicodin, and they would not get me through the night.

Blogger said...

Claim faucet bitcoins over at Easy Bitcoin. Up to 33 satoshis every 10 minutes.