Keeping it Real

Just six hours or so after the shower milestone, I'm in a bit of a slump. The fever is back and I'm pretty sore. I tried to stretch out the time between pain meds - plus I've worked it pretty hard today - trying to impress the Physical Therapist with my Olympic-class crutch work, doing all the exercises I had been doing before, plus the ones she showed me today. Well, what a shock that I've had a bit of a setback.

These are the times to remember the up-ticks in your progress. Maybe even keep a diary so when you're down you can remember when you were up. It's really silly of me to have been thinking I was a few gimpy steps away from being back to normal this soon (just two days) after surgery. The hospital discharge papers said "out of work four to six weeks." Maybe it was six to eight weeks - I'm too sore and fevery to go look! Anyway, I was thinking I'd make it in for to six days. So I've gotten a bite of the reality sandwich - I'm not going to let it get me down. I've been through a post-illness recovery before, many years ago, and I should expect the ups and downs. Lesson learned.

If you're heading toward a hip replacement or a surgery of any kind, I think it is important to be realistic. I kind of let today's high-points go to my head for a few hours. The pain and the fever have reminded me otherwise. That's OK. In some respects, I can control a few things along this journey, but in others I'm just along for the ride. As we used to say when I was in the TV business and the ratings would come out, "Don't get too high on the highs - and don't get too low on the lows." Keep your head on straight, keep smiling. There are a lot of snake-oil salesmen out there peddling postive attitude stuff, but keeping the right mindset is important. Let's see if I can practice what I preach through the rest of his evening, through more pain and fever!

Ain't Nothing Like the Real Thing, Baby!

"Ain't nothing like the real thing, baby...." That was a song from the 60s - and if you are considering a hip replacement, you should be old enough to know that. Most of you, anyway. One thing I have learned, though, is that arthritis and other joint-attacking diseases don't discriminate by age. People in their 20s need joint replacements. Those affected by rheumatoid arthritis often need multiple joint replacements. People suffering traumatic injuries - car crashes, hard falls, stuff like that - can damage a joint beyond salvaging, too. Those things can happen at any age. That's something important I've learned through all of this.

Anyway, the title of this entry refers to the fact that I got a shower today - less than 24 hours after being discharged from the hospital and just over 53 hours after the hip replacement procedure - and it was wonderful. Many precautions were required, including getting secure footing in the shower, placing waterproof bandages over the incision area, lots of range-of-motion exercises, and in general approaching the entire process as a series of carefully-orchestrated steps. I wouldn't recommend approaching something like a shower this soon lightly. Seriously, think hard about it, have a step-by-step plan to avoid disaster, and don't try it alone. The best advice is the old tried and true sponge-bath, but sometimes you just gotta push yourself. This was like taking a dip in the beautiful blue-green Caribbean on a steamy hot afternoon. Well, maybe not - but you get it: I'm happy I was able to do it. Whether it's a shower, being discharged from the hospital, or just being able to sit up in bed, milestones are important in recovery. Don't worry about trying to immitate my timeline - just do what you can do, when you can do it, and recognize the significance of every accomplishment, no matter how small it appear to others.

48 Hours Later: I think I'm on Track

It's now been a little over 48 hours since the procedure to replace my left hip. I've been home for less than 24 hours. I'm glad to be here, but last night I wondered whether I'd made the right decision to come home as soon as I did. I had a bit of a fever - which, for me was a lot of a fever, since my baseline temperature tends to run a little low. It was up about 3 degrees last night - 100.4 for me... more like 101.6 for you 98.6ers out there. My concern was infection, so we followed the discharge instructions and called the surgeon's answering service. A physician's assistant called back a few minutes later and Hettie spoke to him. He said post-op inflammation and fever is normal and advised her to give me some Tylenol - and call back if that didn't help. Again, I was concerned about a post-operative infection. Those can get bad in a hurry, so I asked for the phone and spoke to the PA myself. I asked him how I could differentiate the normal post-op fever from a post-op infection and he said the likelihood of an infection showing itself this early was "just about nil." He told me infections with this type of surgery tend to show up five to seven days after the procedure. That was great information. The lesson, again, it to advocate strongly for yourself: ask the next question, request the next bit of information... don't worry that you might be annoying the doctor, nurse, or PA - this is your health, your life on the line. I'm glad Hettie called and I'm glad I wanted to get on the phone.

The fever dropped a bit overnight. It's still not gone, but I feel better knowing it's not likely to be an infection. The home health care nurse is coming in a few hours - so I can get her opinion, as well.

Quick updates on pain and movement: Until this morning, getting in and out of bed was very, very uncomfortable. OK, it was actually one of the most painful things I've ever experienced. At one point, the night after the surgery, I'd gotten up to use the bathroom and just stood beside the bed, one hand on a walker, for what seemed like an hour, trying to muster the courage to get back in bed. I tried a few times and - in pilot-speak - aborted the approach. It hurt that much. The overnight nurse came into the room at one point and I heard her gasp when she saw the empty bed. Then she saw me standing beside it. I explained to her why I was standing and she went and got a shot of pain meds which she put in via my I.V. line. That helped. Eventually, maybe ten minutes later, I made my way back into bed.

Anyway, that's been the worst pain so far - getting in and out of bed. I have really pushed it since the operation - standing, walking, going home from the hospital. If you're more patient that I and don't mind staying in bed for a full two days after your operation, I think you can avoid that kind of pain. The static pain - pain from not moving - is pretty manageable via the meds.

Now, more than 48 hours after my hip replacement, getting in and out of bed is far, far less painful. If the in-and-out-of-bed pain Wednesday and yesterday was a 10, now it's a five or six.

Range of motion is also lots better. I'm on crutches - nice Physical Therapists came by to show me how to use the crutches and to evaluate if I were ready to go home yesterday morning (I had to convince then, as well as Dr. Mokris, that I could go home). They showed me some exercises to extend my range of motion - and I've been doing them ever since. I can now move my operative leg several more inches in every permitted direction. I still wouldn't want to walk without the crutches (I did so a few steps the night of my operation), but things are getting better.

Returning to the point of making this blog - giving a real-time account to someone considering this operation - I believe I'm on track, maybe even a little ahead of the game in my post-procedure recovery. I don't want to sugar-coat it - this sucker hurt a lot. But it was a pretty big deal. And, as of this moment, nothing has happened to make me regret my decision to proceed. I'm glad I did it. The pain has been rough in spots, movement is certainly limited, but all in all, it's very, very do-able.

More soon, as I continue to get stronger and be more able to spend time at the computer.