Attitude Adjustment, Island-Style

Last Saturday, just over seven weeks post-op, we hopped a flight to Freeport, Grand Bahama, then drove to the western-most tip of the island for six days at Old Bahama Bay. What follows is a quick recap of that trip in the context of my continuing recovery from a left hip replacement and some lingering discomfort related thereto.

Two important things before I forget: First, I am happy to report they now offer extra icing free at the Cinnabon inside Charlotte airport - a fact that in and of itself makes air travel much more pleasant. Second, I can unequivocally report titanium joint replacements set off airport metal detectors - a fact that only makes air travel more pleasant if you enjoy the full body pat-down by large men who look as if they can break you in two without much effort at all. I certainly prefer extra icing to the pat-down experience, but maybe that's just me.

Some context on this year's vacation plan: I like going to very remote out-islands in the Bahamas, renting a small house and boat for a week, snorkeling, discovering beaches where there are no footprints, and staring up from a limestone rock at the Milky Way splayed fully across the night sky. These are places about as far from Nassau or Freeport as you can imagine - where grocery stores aren't much larger than my one-car garage, the produce market is a stack of melons outside someone's home, and the nights are so dark the heavens shine brighter than any planetarium show. The stars alone are worth the trip. There aren't really tourists in these places and there usually aren't doctors, metal detectors, or wireless networks. We go for the colorful people, the even more colorful fish and coral formations, and the sense that everything about our routine lives is far away and - for a week, at least - largely irrelevant.

This year, mostly because of my recent surgery, we opted for a much more tame approach to vacation. We chose a small resort with a laid-back attitude, a helpful staff, phone service, and cable TV. And we bought travel insurance that included on-site medical treatment and air ambulance service, just in case I did something stupid and messed up my new hip. I missed my true out-island experience, but I know this was the right choice for 2008.

So how'd the new hip fare? Well, I'm happy to report it didn't rust. It did hurt, but it most certainly didn't rust.

Two activities pushed my new hip to its less-than-two-months-post-op limit: Climbing the dive ladder back into the small boat we took on a snorkel adventure and pushing the 14-foot Hobie Cat sailboat up onto the beach after an afternoon sail. I mean, those two things really, really hurt, they were really, really difficult, and afterward I was really, really sore. But I could do 'em - and that's pretty remarkable. No question, upon reflection, that having our own boat for the week would have been too much; just climbing the dive ladder twice was plenty. Trying to get leverage when all you're standing on is water is extremely difficult with two good legs; it's almost impossible with one good one and one weak one. And digging into the sand to push a little sailboat is hard under any circumstances. In this case, it was really a teeth-gritting experience.

As a result, I had a pretty good limp for most of our time on Grand Bahama. But true to my commitment beforehand, I wasn't stingy with the pain meds. I took 'em when I needed 'em - and I needed 'em a lot. At night, especially, I was pretty uncomfortable. Sleep just wouldn't have happened if I hadn't been able to beat back the pain with a couple rounds of hydrocodone. A few times I found myself thinking, "Aw, c'mon, it's time to get off the pain meds." But, honestly, I would have spent most of my time stuck in our hotel room if I hadn't been able to dial back the pain.

I did notice this positive development on the rehab highway: The pain wasn't idiopathic - fancy medical term meaning "we don't really know what causes it." I could definitely tell what was causing my pain: Pushing, shoving, bending, yanking, dragging, climbing, digging in soft sand, climbing the steps to our hotel room - stuff like that. I wasn't hurting just sitting around - and that's a significant sign of progress from just a couple of weeks ago when it hurt just sitting around. I really gave my new hip a workout this week - and (mostly) it rose to the occasion. Of course, it's not really the hip itself that hurts - since it's titanium and has no nerve connections. The pain is mostly in the top of my thigh, where they cut off the old hip ball, and the socket, where they dug out some bone and stuck in a new metal socket. But, honestly, just a little under eight weeks after surgery, I think it's pretty remarkable I was able to do what I did.

I would like to have gone on more snorkel trips - and I would like to have done more sailing in the Hobie - but I could tell I was pushing the limit and (against my nature!), I listened.

Another important observation for someone who might be considering this procedure or who may recently have had it: The water was wonderfully therapeutic. If you live on or near the water or if you have a pool or hot tub, get in the water as soon as your doctor says you can. And keep getting in the water. I don't do swimming pools, but I spent as much time as possible in the ocean - and it was the best therapy I've had so far. I'd trade pain medicine for ocean therapy anytime. Shoot, I'd trade food and shelter for ocean therapy!

Other miscellaneous observations:

1. Don't cut it close at the airport. Setting off the metal detectors and going through the whole pat-down thing takes extra time. Plan accordingly. 2. Consider the travel insurance option I mentioned. Two or three times on Grand Bahama I had "uh-oh" moments where I wondered if I'd done something bad to my new hip. Accidents happen and when they do, you want to get the help you need without having to take out a second mortgage. I felt good knowing if I did hurt something, I could afford to get where I needed to go for treatment. 3. Go for it. We considered not taking a vacation this year, given the recent surgery. I am so happy we went. My attitude about everything is so much better today than it was just a week ago. No matter how I've painted the whole hip-replacement experience, it's a pretty big deal with its share of pain and life disruption. We save and do without a lot of things to take a vacation - and I'm so glad we took this one. As a couple, we've both been through a lot leading up to my surgery and in the weeks since then. We needed a break. 4. As "limited" in scale and scope as our 2008 vacation was in light of my hip surgery, it would have been much, much more limited if I hadn't had the surgery. Everything hurt with a terrible bone-on-bone, sickening pain before this surgery. I'm on the other side of that pit now, climbing out, and I'm so glad to be here.

Another miscellaneous vacation story: We saw a shark while we were snorkeling. Well, I saw it - heading toward Hettie, in fact. It wasn't exactly in attack-mode, but there it was, about three or four feet beneath the surface, looking about as intimidating as anything I've ever seen in my life. It was a big shark, too, maybe five or six feet, and I could tell in an instant it didn't care about my new hip or anything else. There we were, splashing around on the surface looking a lot like lunch - and there it was, looking for lunch, about 15 feet away from us. That's all I needed to know. I had my underwater camera with me but never for a moment thought about taking a picture. Instead, I splashed, spit out my snorkel and tried to say "Shark!" to Hettie, and we got the heck out of there. I'm very happy to report the shark did the same thing. Last I saw, it turned away from Hettie, briefly looked in my direction, and then veered off into the open water. The very thing I feared the most - the thing I've wondered and worried about in twenty years of snorkeling - happened. A shark showed up. A big shark. We weren't in a group of people, either. It was just the two of us. And after the encounter, there were still two of us. I'll call that a victory any day.

I always come back from vacation, look at the 200 or so pictures I've taken, deem none of them anywhere near capable of capturing the wonder of the experience I've just had, then wish I could just go back and do it all over again, this time trying to do a better job documenting what I've just been through. So when we got home last night and I transferred two cameras worth of photos to the computer, that same thought process started in me again. The pictures just aren't that great, in my opinion; I should have done a better job. The experience was unique and no one I know has done exactly that, but it all happened so fast, and now suddenly it's over. Did it really even happen? Will I do a good job trying to share what it was like with anyone who asks?

It's kind of that way with the journey I began several months ago when I went to my doctor and said I just couldn't take the pain in my left leg, or back, or hip, or whatever it was any longer. I needed to do something about it or I'd just end up sitting around watch life go by. When we found out where the pain was coming from and what we needed to do about it, I decided to document the process to the best of my ability - so when someone contemplating a similar journey might ask about it, I could point them to my record of the experience. That's why I've done this blog. And like my vacation photos, I don't feel as if I've done a very good job of recording the experience. Unlike the vacation, however, I don't want to go back and do it again. Once is plenty - and this imperfect record will just have to stand on its own.

I'll add more to the record when I have something new to report... when the pain goes away entirely or I hit another significant milestone. Now eight-weeks post-op and one vacation under my belt, just over a week before Hettie returns to her teaching job, I'm still glad I had the operation, still generally pleased with my progress, still a little disappointed with the level of discomfort I'm still experiencing. Like the momentary shark encounter, though, there really was no way to be fully prepared for the experience - no perfect way of handling it. I do the best I can with the challenges life throws my way, as I'm sure you do, and most of the time things work out.