Get Hip!

Well...

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 System^TM 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.

But.

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.

Shoeless Ruminations

This post germinated from a couple of seeds.

First, my own body. Because although my surgeon got me a lot of leg length back he didn't get me everything. I'm still about 3/8 to 1/2 inch shorter on the right side than the left. Meaning? That walking barefoot for any distance is fairly hard on me and, in practice, means that I can't go barefoot other than for short distances indoors.

And, second, an article in the World's Worst Newspaper advocating going barefoot as much as possible. I've tried to find it on the paper's website but it seems to have disappeared.

But the gist of it was a local mom (or dad) advocating for kids' playing barefoot as much as possible in the form of an anecdote about her/his kids shucking shoes-and-socks and the shocked reaction of the other parents at the playground.

Note that this is entirely expected here, where a substantial proportion of us embrace every "natural" and "paleo" and "organic" and "local" and whatever-isn't-whitebread-and-mainstream thing you can imagine. Raw milk, antiflouridation, tattoos, kids going naked until puberty, hipster this and hipster that...the people they make fun of on Portlandia? Yeah, that's kind of us. A lot of us, anyway.

Portland, BTW, is very much a Skinnerbox for that particular subset of barefoot enthusiasts, the barefoot runner. Despite our nasty cold, wet winters and our urban setting we have a fairly large number of people out pounding the pavement (or the trail) sans shoes and, often, railing against the shoes as the worst thing to happen to feet since the ingrown toenail.

So I wasn't surprised that Oregon's Newspaper would print something like this. What surprised me was my instinctive reaction to it; that the author made a case that was only effective prima facie, and that there were a lot of potential problems she didn't address.

So do I think that walking around barefoot is a bad idea? Hell, no. I'd love to be able to walk barefoot again. Like running (and playing soccer, and squash, and about a gajillion other things) I am now unable to do that, but I like to kick my shoes off as much as anyone.

At the same time, as a medic, and as someone who has seen something of the lesser-paved parts of the world, and has studied a little history, I also have a certain ambivalence to the notion of the average Portlander (or the average person in an industrial-Western-culture-type society) wandering around barefoot.

For one thing, we're not born to it. Aboriginal cultures that live their lives barefoot typically have a thick layer of callus on their soles that act as form of sandal; most of us don't have that nor do we have the years of ambling about skyclad from the ankle down to develop it.

For another, our industrial landscape is not friendly to bare feet. Pavement is unforgiving and the sort of litter we produce includes some really nasty dangers; metal, glass, plastic, and half a dozen other sorts of objects that will rip the hell out of even the toughest sole.

Another is the sort of historical amnesia you tend to see when antivaccination quacks turn up. Sorry, barefooters, but that's the comparison that comes to mind; you guys just seem very blithe about some very nasty diseases that love to attack your bare feet. It's been so long since most of us had to live barefoot that we tend to forget the hookworm, strongyloidiasis, and cutaneous larva migrans that were fairly common hazards for people before the widespread adoption of shoes.

And people DID widely adopt shoes, long before the coercive power of advertising made having this or that possession the key to coolness and riches and power and getting laid a lot. The Fort Rock people made themselves sandals damn near 10,000 years ago.

Even without the hammering feet take on pavement or the risk of picking up a nasty parasite the universal hazard of stones, thorns, even things like the sharp edges of dry leaves are damn hard on the foot. You could see why as soon as they can people would try and come up with some sort of gimmick to protect their feet.

So I guess that while I'm not completely hating the notion of floating about bare-toed I'm not sure that the idea is right up there with not getting involved in a land war in Asia as a no-brainer.

So, anyway, I'm curious; anybody else got any thoughts on this barefoot thing? Any particular insight or ideas on this? In your opinion is the Oregonian writer spot-on on the wonder of leaping about shoeless, completely off-balance, or is this more a case of being largely where I am; not utterly agin it but with a lot of reservations..?

Just random musing for a Monday...

Love Means Never Having To Say "Wha...the hell? Gah! Get OFF me!!!"

One thing that often gets pushed aside during post-op recovery is marital...ummm..."personal time".

That, in turn, leads to inappropriate behavior as demonstrated at bedtime last night.

The Bride (already halfway towards unconsciousness): "Mmmm...can you nudge me tomorrow morning? I don't want to sleep through my alarm."

Me: "Nudge? Hell, I can do better than that. I can remove my garments and lie on top of you writhing with lascivious abandon."

Bride: (opening one eye): "Gah. Okay. I don't promise anything like 'enthusiasm', you understand." (Mojo is whatever you'd call the complete and utter polar opposite of "morning person"...)

Me: "I'm okay with that. 'Acquiescence' will do just fine."

Bride (snorts sleepily): "Mmmmhmm."

Me: "In fact, I can pretty much work with anything right up to 'violent resistance'".

Bride: "You need to go to sleep, Romeo."

Vous pouvez me demander ce que vous voulez, sauf le temps

Every year at this time I get to read through a round of e-mails and/or Facebook posts about the change from Standard to Daylight time.

DST is, admittedly, a sort an oddity. My understanding is that it was one of those wartime expedients first cooked up in 1918 and repeated in the Forties to reduce the use of things like coal and electricity. The mystery to me is how it generated a constituency to be continued after 1945.

I admit to liking the long sunny evenings under DST while not minding the dark mornings. But there seems to be enough bitching and moaning every year on this weekend that I can't imagine that mere preference was enough. And it seems that the U.S. largely went off DST in the late Forties and returned in the mid-Sixties...why? The Wiki entry on "Daylight saving time" says that:

"(i)n the mid-1980s, Clorox (parent of Kingsford Charcoal) and 7-Eleven provided the primary funding for the Daylight Saving Time Coalition behind the 1987 extension to US DST, and both Idaho senators voted for it based on the premise that during DST fast-food restaurants sell more French fries, which are made from Idaho potatoes."

Clorox? French fries? WTF? Clorox and Idaho solons managed to push DST through the national legislature? Seriously?

My thought would be that if everybody who wants DST to be a thing wanted more people to want DST to be a thing they'd push to make it happen they'd push for it to happen Friday afternoon at 4pm instead of in the pre-dawn of a Sunday morning. Push beer-thirty up one hour? Where do I sign up for that..?

From The Past Is Never Really Past...a short history of Trump Steaks^TM. Best quote from the link?

"Martha Stewart, however, had perhaps the most unique response to Trump Steaks. In an interview with Joan Rivers, the lifestyle mogul and former Apprentice contestant replied “Too bad!” when Rivers said that the steaks weren’t actually from a slaughtered Donald Trump."

Sorry, but there's not enough Trump Vodka to wash that down...

Speaking of nasty water-like things, here's an interesting version of DST; again from the Wiki entry:

"Roman water clocks had different scales for different months of the year: at Rome's latitude the third hour from sunrise, hora tertia, started by modern standards at 09:02 solar time and lasted 44 minutes at the winter solstice, but at the summer solstice it started at 06:58 and lasted 75 minutes."

There are other applications I'd be okay with time working that way, too. Hmmm...

The hip seems to be rehabbing decently. I've been trying to get up and walk on it per the orthopod's direction, and it moves fairly well with relatively minimal discomfort. It's still a little unsteady but I've ditched the walker for a cane. If I work it too hard as I did yesterday it's achy enough that falling asleep is difficult without 5mg of hillbilly heroin.

The photos that I've included with this post are from the day out that Mojo, Missy and I enjoyed yesterday. A couple of rounds at Trackers Portland indoor archery range let our Inner Mongol out for a stroll, followed by a trip south to Aurora, where the Colony museum and the local handspinners were having a field day that included everything crafy, from dropspinning and weaving through adorable furry bunnies. We all enjoyed the hell out of it, especially crafty little Miss who acquired her own backloom and has been weaving away on her doorknob ever since...

Right now I'm killing time waiting for friends to come over for the Timbers match this afternoon. Mojo and Missy are out at Crystal Springs feeding the ducks, and The Boy and his pal Michael are playing some sort of hack-n-slash videogame.

Just another Daylight Sunday.

Parted out

So I'm back at home after two days at the hospital getting rid of the old worn-out hips parts and getting a shiny new metal one. True to form, the post-op pain pretty much held off until last night when I'd walked through the door and then hammered me flat; my right leg swelled up from the iliac crest to the top of the knee and I had a very, very bad night last night.

Things are better today, but not all that much. And I STILL haven't managed to get a used-food blockade runner past the Hillbilly Heroin Barrier; today has been the first stage of Operation Big Dump which has involved prune juice and several bowls of raisin bran. No luck so far, but we'll see...

(TMI Update 3/4: OBD is a go..!)

The reason for the tissue blow-up was, apparently, that when the ortho team opened me up what they found was a complete and utter mess; floating bone chips, arthritic spurs, all sorts of nasty junk. They had to clean all that up and in the process tore up a lot of soft tissue. Hence the pain and the suffering.

But I'm recovering, slowly, and having a worse time with the boredom than with the pain, at least at the moment. I'll be back in a bit with a longer update, but I just wanted to get this out so's you'd know that I wasn't food for worms, brave Percy.