Three Years Post-Op

Today I had my checkup with my surgeon.  I'm three years down the track and he's happy with my progress.  I don't have to go back for another two years now.

It's a great result.

It's a little weird though that something that has been so important in my life is now just a checkup every few years.  Physically it is the best possible outcome.  The journey though has taken me through some really tough times and at some level, fundamentally changed the way that I look at the world.

The main goal that I had going in was that I wanted the chronic, persistent pain to be gone.  As I read back over the blog posts, I'm sure there was more that I could say - for fear of failing.  So long as I got through and life was better than it was before - that would be a successful outcome.

And it is - and so much more.

The whole process has been a catalyst for major change in my life.

It's that turning point where I realised that there were people in my life who were only there because I could help them.  When it was my turn, they didn't like it and it caused all manner of grief.

I realised that I didn't have to live with pain.   Physical or otherwise.  While it's part of the human condition to have inner struggles, I don't think I accept my 'lot' in life as much as I used to.  I can do more - it's now my choice, I'm not as limited by these physical constraints that provided an excuse, a protection from the world.   I've struggled with depression - I've seen a few shrinks - sought out alternate therapies - found a new way.  There have been a few people in this journey who I will be forever grateful to.  They don't even know how important their role has been in sending me off in a new direction.  One day I might tell them - but for now - it's still my adventure.

All I can say is that the whole process was definitely worthwhile.  I've gotten my life back.  It's not the life I probably had planned - it could even be better.

RPA: A bilateral hip replacement on TV!

Last week there was an episode of RPA of a bilateral total hip replacement.  The episode is still available on line, if you would like to see for yourself.  I don't normally watch medical programs as I don't do to well with the cutting and opening part which is before anything actually happens.  I tried to watch the BMHR procedure that McMinn has on youtube but failed to get past the first couple of minutes.  I have it on good authority that it is an interesting series of clips (I have a friend who is not squeamish and quite interested in these types of things).

When I got home last week on Wednesday, with my takeaway from work and just about to collapse on the couch, I got a message telling me about it.  We'd only just been talking about these types of programs that morning, so I took it as 'meant to watch' tv.  In the interests of research, I watched the whole episode to see the bits about the hip surgery.  There was a fair amount of unrelated surgical procedures that I had to get through to watch it too!  I persisted though and it was actually quite interesting.

I'm not sure that I would have wanted to know that much information pre-op.  After the fact it was at it's limit.  The cut of the femur was fine, I've come to peace with that part of the op!  The hammering in of the acetabular cup using a mallet not unlike the one I have used to put together Ikea furniture, not so much.

The lady having the surgery was probably about 20 - 25 years older than me, so it was a bit of surprise that the surgeon had elected to do a bilateral procedure.   The surgeon did say that one of the key reasons that he elected to do it this way was her attitude.  Yes, she was healthy enough but attitude was the surgeon's key indicator for success.

The program made it look like a piece of cake.  I had a very positive attitude going in and I didn't look anywhere near that good in the first week post-op.  It goes to show that everyone reacts differently to surgery and some bodies just handle it better.  To be fair, a positive attitude can't make up for the extra two units of blood they gave me before I started to be a bit happier.  She didn't have any drug induced hallucinations either which I'm sure made part of the difference!  Everyone is different as are their outcomes.  You just need to work out what the best possible outcomes are for you and work towards them.

The message really is that you have to have the right attitude going in.  You need to try to get up the day after surgery and start rehab.  You need to work at it to heal.  If you can prepare pre-op to be stronger and more healthy, all the more the better.  Give yourself the best possible chance to wake up looking as well as well as this lady was.

I think over the longer term, I have caught up and my walking is better but its probably not a good comparison given that I can't be sure how far post-op she was in the final scenes of the program.

If anyone does watch it from the link above, feel free to add the extra info in the comments and I'll update the post!  I just can't bring myself to watch it a second time.

You might want to close your eyes for the mallet.  It isn't fun.

What else happened on Game Day?

After I posted my Game Day post, I was called into one of the offices to have a final meeting with the nurse who was organising the last few details that needed to be covered before I went in for surgery.

This was mostly administrative.  All of my details were checked and I was given a red hospital band for each wrist that had all of my personal details on them.  It was red to indicate that I had allergies (alcowipes and fabric bandaids).  Apparently I had one for each wrist for easy access to my details while I am in the operating theatre.

I was then given a bag to put my clothes in and was told that I needed to have a shower with special soap and get into a hospital gown, booties and a cap and moved into a waiting room bed.  My husband was allowed in this room with me and we had a few minutes to chat before they wanted to wheel my bed to the theatre waiting room.

In the theatre waiting room, I was introduced to the anaesthesiologist and her assistant.  The next level of prep was to put me underneath a 'huggie blanket' that pumped hot air around me to raise my body temperature.  With the longer surgeries one of the things that they need to keep a close eye on is body temperature dropping.  Apparently by starting warmer, the risk drops.

As I lay waiting, slowly getting more toasty warm, people would come past and put different things on the end of my bed.  There were leg gutters and the foot pump machine and another blanket.   I didn't know what the gutters and the foot pumps were about until some time later.  It all seemed a little bit surreal.

The surgeon came in to have a quick chat too.  We talked about which side I wanted him to do first, the one that was causing me the most pain and went through the reason that we needed to make this decision before going in.  After the first one is completed, the surgeon and anaesthesiologist make the decision to continue making sure that I am doing well under the anaesthetic and any additional risks or concerns are assessed at this time before they cut the second side and get started.  He marked both legs with a marker pen indicating that I had chosen the right one to be done first and said he'd see me soon.

The anaesthesiologist came back and put a arterial line in and told me that we wouldn't be too much longer.  Not long seemed like a very long time for me.  I didn't have any of my personal belongings so I couldn't read, my husband hadn't been allowed in this area, so I had no one to talk to.  I was too wired to sleep so that was out.   I wasn't nervous, just ready to go in and get things going.   I resorted to eavesdropping on the nurses conversations to keep myself occupied.  Not the most ethical activity but my brain was buzzing and there wasn't much more in this sterile environment that I could do to pass the time.

After cooking for what seemed like forever, it was time to be taken into theatre. I was wheeled in and shifted over to the theatre table.  Everyone seemed happy and cheery and I took that as a good sign.  The operating table was covered with an air mattress type thing making it strangely squishy.  The thing that surprised me was how small the table seemed.  I still haven't figured out how the whole process went as far as how I was positioned for the surgeon to work on me and whether I actually lay on one operated side as the other was completed.  It's another of those questions that I really wanted to ask the surgeon but think it's probably a little silly to want to know these kind of things and keep my mouth shut.

I sat on the side of the operating table as the theatre assistant stood in front of me explaining that soon I would be given something that would make me feel a little drunk and not too worry, he would make sure that I didn't fall off the bed.  The fluid was injected via the drip on my left arm and I started to feel a bit more than a little drunk.  The feeling was quite pleasant and they spoke to me, keeping me in the loop about what was going on.  The spinal was next and I recall leaning forward with the theatre assistant making sure I didn't fall forward in my drunken state.  I don't remember it actually being put in.

The next thing I remember is waking up in ICU.

Best Wishes to Tony for his total hip today!

Just a quick message to send best wishes to Tony who has had a total hip today.  He should be safely tucked in after a successful surgery earlier today and getting ready to start rehab to get his life back starting tomorrow.

Six Week Surgical Review

I went to visit the surgeon on Monday for my six week post-op review. I was a little nervous the night before and while driving back into the hospital. Realistically, I know I've done well and my progress has been steady, so there was no real reason to be nervous. I'm not quite sure what started up the butterflies but they were quickly squashed.

On the way in, we were a little early and managed to get a 15 minute parking spot just in front of the coffee shop so the day was starting off well.

When we arrived in the surgeon's office, we were sent upstairs for new x-rays. Q-Scan uses the new digital machines so I have a nice little CD with the three views showing the perfect placement of my two BMHRs. I had to download a view for the Mac (it came with a windows viewer - the one I downloaded is free and pretty cool. It's a DICOM viewer called Osirix) and now when I have a few minutes I will be able to upload some clearer images. It still amazes me that they are in there. The joints don't feel anything but natural. I guess after so many years of crunching and ROM limitations my idea of normal is a joint with smooth, fluid movement. I know that my limiting factors at the moment as far as mobility goes are to do with muscle strength and tightness not the actual joints themselves.

We headed back to the surgeon's office and saw him pretty quickly. He's pretty happy with my progress and gave me the all clear to lift the hip restrictions. We had a quick chat about my progress, the improvement of the left side foot drop (all better now) and other bits and pieces. The Four Corners piece was raised, which I commented that I hadn't seen though I had heard that it was quite biased and that kind of led into a general conversation about acetabular cup placement (mine is perfect, having an awesome experienced surgeon is crucial), the number of resurfacings he has done (700+) and the success he has had with the BHR (The BMHR is still new though the data is much like the BHR's early data and is promising).

I asked about metal testing and pregnancy for when we get to that point in a couple of years. I was asked if I would supply test results when we go down that path and I said I would happily volunteer results for data for a study on the MOM devices.

[Side Note: I really believe that they are the best option for a lot of people, not just people like me. Some articles still suggest the MOM devices are not suitable for women of child bearing age as there is some evidence that the metal-ions pass through the blood barrier, however, there is no evidence that it will cause any problems. This may get a lot of negative comments and I challenge the naysayers to find hard data before name calling. I am open to an open dialogue of the issue, however, comments with rude remarks will not be accepted. I trust my surgeon and the data that he has researched as an expert in this field. The research I have done supports my belief in him. The decision to have the procedure was not one made without great consideration of a lot of factors. I will eventually write more on the topic of making this decision, so at some point the label 'Decision' will have more posts. Just like this part of our lives, we will do due diligence to any big decisions that we make. Anyway, back to the topic at hand.]

I enjoyed the appointment. I think I'm an interesting topic to talk about! Actually it's the shiny new hips that are interesting as well as the progress that's been made and will be made and all things relating to the new parts that the surgeon knows that I don't. The summary of the appointment is that all is good and I am due for review again in September.

In the meantime, HIP RESTRICTIONS ARE LIFTED! Not that I can really exceed 90 degree hip flexion, but that isn't the point. The point is that the risk of dislocation has reduced and I have passed that first hurdle. (There are other things that I don't have to be as concerned about either - though the seat height is probably the one that functionally is the most difficult to deal with.) It's nice to be able to be able to stretch a bit more, to reach down to at least try and touch my toes - still a few inches off and my hamstrings are squealing! They need a lot of stretching out just like pretty much everything else. I can't reach as far as I could pre-op yet, though it has been almost seven weeks since I've done that stretch so I guess it isn't too surprising that it isn't the easiest thing to do.

So the plan for the coming week is as much stretching as possible and keep on top of the exercises. I have a little bit of work to do tomorrow so I'm going to have to figure that into my day as well to make sure everything gets done. I feel like I should be doing more by now but I am still tiring easily. It's getting better as each day passes though there is still a little way to go yet.

With that in mind, I really need some sleep. It's way past the bed time I have gotten used to. Even though I've always loved sleep, I need even more these days. I guess that's an indicator that my body is still investing a lot of energy into the healing process.

Til next time!