It's been two weeks since I updated this online journal because, well, not a lot has happened. I wanted to leave some distance between the one-month milestone and today - the six-week checkup with my surgeon, Dr. Mokris.These past two weeks have been a little frustrating for me, but it's really nothing I can especially quantify. In general, I think my progress has been good. After parking the crutches as reported in the previous post, I haven't picked them back up again. I'm still experiencing some discomfort, still taking some meds from time to time, still walking with a bit of a limp... but, remember, it's only been 43 days since I got this new hip.
I did have one weird thing happen. I bit into an apple and cut the gumline below my front teeth. So what's the big deal? Well, when I got discharged I was given some paperwork that says for any dental work - even routine cleanings - I should have a pretty big dose of antibiotics before the procedure. The goal is to prevent any type of infection from entering the bloodstream and taking hold at the surgery site. This is a very bad thing that typically requires having the artificial joint removed, the infection treated aggressively, and then another new joint put in. That sounds like a big, big deal - because it is. Sounds like weeks and weeks in bed, probably some of it in a hospital bed.
Of course, I didn't think of any of that until several days after I'd sliced open my gums on the apple. And then I got freaked out. What was that I'd read about dental procedures? I wonder if it applies to oral trauma of any sort? (It does).
The Internet is great - it pays my mortgage - but it's not a great place to go if you're looking for "Don't worry - this will never happen to you" assurances. I found plenty of horror stories of people who'd gotten infections in a similar manner and had to have their prosthetic joints removed and eventually replaced. And it was days (almost a week, in fact) after I'd cut my gums - with no antibiotic. For whatever reason, I was really starting to feel crummy. It's easy to say it was some kind of psychosomatic thing - I was worried about something so I started to manifest it in imagined symptoms - but the truth is I'd been feeling crummy for days after the periodontal injury. It was only when I started trying to figure out why I felt so bad and why the hip pain seemed worse that I made the dental/infection connection.
A call to the surgeon's office resulted in a massive antibiotic onslaught. And I don't tolerate antibiotics so well. So last week - and even this week - have been crummy. First I was convinced I'd ruined my new hip by biting into an apple, then I had to endure miserable medication to try and prevent an infection. I lost a lot of sleep, felt really, really lousy for several days, and had plenty of time to kick myself for how I'd handled the whole thing. Plus, of course, it's been a particularly difficult time at work and even though I put up a brave front, it's still been tough going back to work so soon after surgery and maintaining a full schedule. Well, in the end, I don't think there was an infection, no thanks to me since I'd waited so long. I'm not sure why my post-op pain has seemed to get a little worse in the past two weeks nor why I've felt lousy overall. Maybe it's because I've pushed myself, who knows?
All of that brings me to today - my six-week post-op visit with Dr. Mokris. Some x-rays and a few questions and answers and he smiled and said, "You're doing great." He said it's not unusual to still be experiencing pain at this point and he encouraged me to stay the course.
This has been such an interesting experience. When Dr. Mokris asked me how I thought I was doing, I said, "I don't know. I've never done this before. How should I be doing?" That gets to the crux of why I started this blog - and the #1 (maybe only) complaint I would tender about this process: Nobody really tells you what to expect.
Dr. Mokris and his staff are awesome. Their "customer service" is superb. Same with the hospital where I'd had my surgery, Carolinas Medical Center. The service there was what you'd expect at a fine hotel - everybody was helpful, not at all the old-school hospital experience. And yet, in all of that, I had the general feeling like, "Here's your new hip - see you in six weeks." I guess from a medical standpoint that's a good thing. This procedure has been refined so much that the results are very predictable, the complications are extremely rare, and the outcome is almost always good. But this was still my first foray into all this - I don't have the same perspective of the surgeon, his staff, or the hospital. I wouldn't have minded a little booklet that said "Here's what to expect." I did get some paperwork - things to do and not do, what symptoms warranted a call to the doctor, stuff like that - but beyond that, there just wasn't much follow-up. I had more follow-up after I bought my Honda Civic than I did after I got this hip.
Of course, all's well that ends well - even though I'm still not back to 100%. But I'm a fairly young joint replacement patient (just had to work that in one more time), I've had some experience in the medical establishment, I do my research, and I have someone at home to help me. What about the person who's 74, lives alone, and is too intimidated by doctors to ask questions? I can imagine this experience might scare the tar out of them - for good reason.
As "well" as I've done in the six weeks since my operation, as optimistic as I am, and as much as I try to downplay pain and limitations, I have to reiterate: This operation and its recovery are a big, big deal. Doesn't matter how routine it's become - it's not routine for the person going through it. Information is important - and I don't think I got enough of it leading up to the procedure and immediately afterward. Hettie referred to the "do this and don't do that" paperwork as cave-drawings - and that's about what they looked like... just some line drawings of people crossing or not crossing their legs, photocopies of photocopies. For a state of the art operation using state of the art technology, the information is still pretty basic.
I actually started this post on the day of my six-week visit with Dr. Mokris - and I'm now finishing it the day after. I'll update this blog again - hopefully to report when I'm pain-free and when I've gone sailing and snorkeling and who-knows-what-else. But I want to close today's entry by trying to answer the biggest question of all: Was it worth it? That's certainly what I'd wanted to know in the days and hours before the surgery.
After my six-week checkup yesterday, I made my way to the other side of the Carolinas Medical Center to visit my mother who was waiting to undergo a minor surgical procedure of her own. Six weeks and a day after I'd been in the pre-op suite, I found myself back in exactly that same room. It was ironic, to be sure, and maybe a little therapeutic. As I left my mother and started the hike back to where I'd parked, I paused just inside the pre-op suite and looked at the door marked "Patient Restroom." I think I wrote about visiting that restroom in my blog report about the day of my procedure. I remember going there and walking back to my bed thinking, "These are the final steps I'm taking on the hip I was born with. I don't know when I'll walk again - but by some measure, life will never be the same."
Six weeks and a day later, back in that same place, looking at that restroom door, about to leave the pre-op suite on my feet (as opposed to on a gurney), I recalled those thoughts...the uncertainty of whether I was doing the right thing...the fear I had of the unknown. I paused a little longer, prompting one of the staff to think I couldn't figure out how to open the door. He offered "Just push the button - the door will open." So I did. And in the nanosecond before the door responded, as I left my mother and my wife behind in the pre-op suite, I shook off the doubts and concerns of six weeks ago, stood a little taller, and walked through the door.
Yeah, it still hurts...and yeah, I'm still limping. But I'm able to report, without reservation, I have no regrets. It was the right thing to do. If you need to do something big - take a risk, get a little or a lot outside your comfort zone - to get better, don't let fear hold you back. Let fear motivate you to investigate all the options, to find your own Dr. Mokris, to decide when the time is right for you... but don't let it hold you back. Whether you have a hundred people cheering you on or you're in this thing alone, you're worth it. Go for it. Six weeks later, I'm glad I did. Six weeks from now (when Dr. Mokris says I'll probably be totally pain-free), I think I'll be really glad I did. My mother's surgery appointment forced me to go back to place where the biggest part of this journey began - and it gave me an opportunity to look back at the person I was six weeks ago and tell him, "You did the right thing. You stared down your fears, overcame the pain, and you're walking out of here a better person." It was a moment I'll always remember.
P.S. After writing about that dramatic moment leaving the pre-op suite behind me, striding through the door with confidence (albeit a little gimpy confidence), I'd like to end this entry by telling you I marched across the CMC campus with a new purpose and determination, got in my car, and drove away a new man. Unfortunately, it didn't happen exactly that way. Instead, I got lost -way, way lost - in the vast hallways and stairways of the Carolinas Medical Center campus. I was like a scared rat in a maze, going down one hallway after another, finding myself in fire exits and service elevators and places I had no business being. Of course, true to form, I didn't ask anyone for directions. Not the people in the blood bank, the heart lab, the ventilation shaft, the cafeteria, or the maternity wing. I just kept at it until I found my way to something that looked remotely familiar - and finally found the skyway to my parking place.
That's almost a better metaphor for this whole experience than if I'd walked out of that place like Clint Eastwood at high noon. I mean, it would be great if everything in life went according to plan, in a nice linear fashion, without distraction or detour. But most of the time it just doesn't work that way. Go with the flow, even if you're doing in on a new hip, a new knee, or with a new heart valve. Be patient. Don't let the detours rattle you too much. You'll get there.
PPS. Mom's fine. Here's a picture of Hettie teaching her to snorkel a couple of years ago near Elbow Cay in the Abaco Islands, Bahamas. I hope we can all go back someday. Oh, by the way, the x-ray at the top of this page is mine - from my six-week checkup. I Photoshopped the smiley, but the rest is all me.
