The Last 10%

Six months have passed since my hip surgery.  My recovery was quick and uncomplicated and I rarely think about the metal components in my right hip, except when I set off metal detectors.  (Last week I passed cleanly through the Columbus, GA Metro Airport metal detector.  It must be broken.)  My surgeon has asked me to speak with patients considering the same surgery.  I’m a poster child.  I am doing everything I did before the surgery, without pain.  I am all the way back.

Almost.  Now and then something reminds me that I’m not quite as strong as I was last December 18.  Peter Vanderwarker kicked my ass biking up Heartbreak Hill this morning, and then kicked my ass again biking up Beacon Street by Boston College.  Peter’s a strong biker, but a year ago I would not have been forced to watch his backside like I did today.  My lungs burned and my legs had no pop, the bitter fruit of my recent lack of plyometric exercise.  This morning’s set of split squat jumps was ugly, but a start.  I won’t recover the last 10% writing blog posts and I need to have it back.  At my age, if your workouts don’t push you forward you are falling behind.  There’s no more maintaining the status quo.

Not Ready to Tap Dance

Last week I graduated from crutches to cane to walking unaided, all in 24 hours.  There is no pain and only slight discomfort, some muscular stiffness around the incision.  What I don’t feel is my femur rubbing against the acetabulum, for the first time in months.  I’m ready to go, and none too soon: my first class is 40 hours from now.

It all went as I planned.  How often can a person say that?

Surgery + 17

I am–

  • walking inside with one crutch most of the time
  • pain-free unless I do something I’m not supposed to do, which I’ve not done for many days.  The muscles around the incision are weak and stiff, but don’t truly hurt.  I remain amazed by the lack of pain despite the invasive nature of the surgery.
  • doing rudimentary physical therapy, designed to fire glutes, hamstrings, abductors, adductors, and groin muscles.  I’m weeks away from picking up my old biking/elliptical/swimming regimen
  • a bit stir-crazy.  Judy and I went to CostCo today and I realized it was my longest and farthest trip from home since I entered the hospital on 12/19.  CostCo is much bigger on crutches than it is on foot.
  • happily anticipating the start of classes on 1/15.  It would be rough if classes started tomorrow but in eleven days I should be ready to go.  On a crutch or cane, maybe, but ready to go.

Me and My Body

Taking stock nine days post-op:

  • I had 3.5 hours interrupted sleep last night, from 4:00 AM to 7:30 AM, the longest sleep in ages.  I felt so much better than yesterday when I was out of bed at 4:30 AM after five hours of catnaps.
  • The lack of pain is surprising.  The surgeon sliced through muscle to dislocate my hip, clean out the socket, install the new surfaces, relocate the head of the femur into the acetabulam, and sew me up.  That should hurt.  The surgical wound is uncomfortable, not painful, and I only feel the hip when I do something I’m not supposed to do, like roll to my side without a pillow between my knees.  That unleashes a bolt of pain with a simple message:  Stop What You Are Doing RIGHT NOW.  Mostly there is a dull ache and stiffness, caused in part by swelling–my right leg belongs to some old, feeble, fluid-retaining fat guy.
  • No, its not the narcotics.  My post-surgical PCA (patient controlled analgesia) involved a self-administered dilaudid drip with an eight-minute minimum interval.  Sounds great in theory but it induced vomiting and profound nausea that made the thought of food repellant.  I stopped using it about 24 hours after the surgery.  The worst pain occurred while they decided what I should take next.  Oxycodone appeared a few hours later.  It stopped the pain along with the functioning of my digestive system.  I took that for little more than a day.  For the past seven days I’ve relied on Tylenol.
  • The medical world uses a subjective 10-point comparative scale to monitor pain where 0 = no pain and 10 = unbearable pain.  I first encountered this scale when I came across the Pain Journal, kept by my late sister during her treatment for ovarian cancer, containing dates, numbers (generally between 4 and 7), and brief notes.  The subjectivity of it struck me then and struck me this week: what relationship is there between descriptions of the pain from different people?  On the wall across from my hospital bed was a chart showing the number scale with icons bearing happy smiles for 0-1 (no pain), downturned mouths for 2-3 (mild pain), and so on to the howling agony representing unbearbale pain.  How does your “mild discomfort” compare to mine? How do culture, experience, mores, and other factors color one’s perception of pain?  While in hospital the highest I rated my pain was 5 and then only once, to convince them to move faster on replacing the dilaudid.  I didn’t feel my pain was at a 5 but I could see a 5 on the horizon if I didn’t get narcotics soon.  I was between 3 & 4 for about the first 48 hours after surgery, then between 2 & 3 until I left the hospital 24 hours after that.  This week I’ve rated the pain between 1-2.  At this week’s worst I could imagine pain much more severe than what I felt.  My first night’s roommate was hospitalized for surgery connected to the loss of his thumb early this year in an industrial accident.  I’ll spare readers the details of the accident but I knew that pain had to be far beyond anything I was feeling.  Maybe imagination heavily influences one’s pain ratings.  Until you are experiencing the worst thing you’ve ever imagined in your life, how can your pain approach 10?

Randall Absence FAQs

Where u been?

  • This is a professional blog.  Please use standard English.

Sorry.  Where have you been?

  • Last Friday, about 12 hours after submitting final semester grades,  I had hip resurfacing surgery at Brigham & Women’s Hospital in Boston.

Why have surgery over the holidays?

  • Because I did not want to miss any (1) classes or (2) summer break.   Winter break provides enough time to rehab so I can start next semester without a hiccup.

Why did you need hip surgery?

  • Who knows.  Not because of a specific accident, illness, or trauma.  For about six years I have had symptoms of arthrosis, the deterioration of cartilage, in my right hip.  The cartilage wore out and my pelvis bore directly on my femur, bone on bone.  Whatever the cause I lived with it without concession–except that I stopped running, which I miss.  This summer I exacerbated the discomfort by climbing up and down a stepladder about 10,000 times while installing cedar siding shingles on my workshop.    I saw an orthopedic surgeon, took Piroxicam to relieve the pain, and scheduled the surgery for winter break.

Is this the surgery my grandma had last summer?

  • Similar, but likely not the same unless Grandma is under the age of 60 and a jock.  Grandma probably had Total Hip Replacement.  Both surgeries involve prosthetic implants but my surgery removes less bone and is, obviously, way cooler.

Does it hurt?

  • Surprisingly little for seven days post-op.  I only feel the hip when I do one of the many things I’ve been instructed not to do, like roll from my back to my side without a pillow between my knees.  The incision doesn’t even hurt very much.  The area aches, the leg is stiff from fluid retention, and my hip and thigh muscles are on strike because they’ve been mistreated.  That’s about it.

Can you walk?

  • With crutches.  I can put all of my weight on the surgical (also known as the “involved”) leg, but I can’t do much else with it.  I walk circles around the first floor of my house, sit in one of the few chairs that do not violate the Global Precautions Against Surgical Hip Dislocation, and climb the stairs to lie on the bed and do physical therapy. That’s why I said below that my ass is glued to my chair.  Each day the leg is a bit stronger with greater range of motion.

Who is your orthopedic surgeon?

  • John Ready at Brigham and Women’s Hospital.

What’s next?

  • Rehab, football, course prep, rehab.  Pretty dull.  Talking to myself–I mean blogging–helps pass the time.