Friday, February 6, 2015

2/5 & 2/6 There and Back Again

The Surgery Report

Wednesday I get a call from Dr. Xenos' scheduler saying I am the last on the docket at 7:30, but that he expects to be ready for me early, probably around 6:00, so please arrive at the hospital around 3:00. 

The anesthesiologist called Wednesday night at 7:00 to tell me I could have breakfast prior to 8:00 and clear liquids until noon. Whew.

After that, a call from the medical supply company lady who is confirming that she's bringing the Game Ready system to the house in the morning at 9:00. 

While I'm waiting on her, Bob takes the form for the handicap placard that Dr. Xenos signed to the DMV. He has both my license and all my signatures on the forms, as well as his own license showing the same address (and name). And the guy says, "Well, she's not here, so I can't give these to you. But I can mail them to the address." He seriously shows Bob the placards going into an envelope and dropping in the outgoing mail close enough that Bob could have reached out and grabbed them. Bureaucracy. But since I have no plans to travel anywhere until next Wednesday to the post-op appointment, it'll get here today and it'll be fine. (The DMV office is literally .4 miles from our house.)

Meanwhile, the Game Ready arrives and we go through all the paperwork and how the machine works. It's really pretty awesome. You can set the temperature of the water running through the compress that straps on and doesn't move, no matter which way you turn. And it cycles on for 30 minutes and off for 30 minutes to maximize both pain management and healing (blood flowing back during the off cycle).

After she left, having not heard back from the company that had taken a sample on Tuesday of the bathroom floor for testing prior to ripping it up, I called to check on the hold up.  The guy says, "Oh, we'll be there this afternoon."

Uh, well, we won't. More irritating, I'm talking to the guy who came to my house on Tuesday and I told him I had surgery on Thursday

So I reschedule him for Friday afternoon.

Then at noon, the hospital scheduler calls and says we can come even earlier, they'll be ready for us by 2:30 at the latest.

We get there and they go over all the cool stuff for notifying the family of updates. You're assigned a number and all around the very large waiting room (like with multiple fireplaces and a dozen big flat screens big) are other flat screen with lists of progress. "22782 is going back for surgery." "24356 is now in the recovery room"  "21432 is doing well, surgery nearly complete." Anyone wanting to know the progress of someone just needs that number and they can call the hospital and get the info, as well as the later room number and phone. (Anyone without the patient's number doesn't get told squat.) And they will text this info to Bob's phone as it becomes available. 

I get my bracelets: the info one, the red one for drug allergies, and the yellow one for fall risk. 

The intake nurse is ready for me about two minutes later and sweeps me back to change. Dr. Xenos stops in about 30 seconds after I get the back of my gown tied to check in. He said, "Are you nervous?"


"Oh, well I am!" he says with a chuckle and a twinkle in his eye.

He's heading in for the surgery before mine, a bi-lateral knee replacement, which takes longer, but then he'll be ready for me. 

During that wait, I go through all the questions, the IV line, and the anesthesiologist visit. He will be doing a very long sounding name of a block that would affect the area for 12-18 hours, thereby reducing immediate pain as well as general anesthesia. I tell him I usually suffer from terrible nausea and he says he will administer Zofran to try and counteract the worst of it when I'm waking up. 

waiting to be wheeled back.

They send Bob back to the waiting room and wheel me down to the operating room wide awake. There is no one else around. I am literally the last surgery of the day. 

The room is really big and I meet my nurses and the anesthesiologist assures me he, and they, will be monitoring me the whole time and taking the best care of me, that's the only reason they are here. Then he puts an oxygen mask on and says it's just pure oxygen at first. I hear him say he's going to inject something into my IV that will burn. I vaguely remember feeling the burn and then nothing else.

While I'm out, I'll get flipped around into traction so the hip can be dislocated from the socket enough that they can inject lots of fluid to get space to insert the scope and tools. 

(clearly, not my hip)

The next memory I have is in recovery, being frustrated that I can't read the clock (no contacts or glasses). And I'm terribly nauseous.

The memory after that is being in my dark hospital room and Sammi saying she and Jason are heading out. 

After that, in the dark, sure I am about to throw up, and being given other meds. 

Everything else is blank. I am told I was talking quite a lot in recovery and my room, but I don't remember a word of it. Apparently I kept repeating that I wished I could sleep like that all the time and that I really liked the photograph framed in my hospital room of the mountains. I had the presence of mind to ask Bob to get my sleep mask out of my backpack and plug in my phone, even though I don't remember doing either.

Memory kicks back in at 2:30 when I wake up, thanks to the IV, in desperate need to pee. I push the call button and Kevin, my nurse, shows up to help get me out of system that tethers me to the bed in sleeved wraps around my calves that massage them to keep clots from forming, the Game Ready sling that engulfs my upper thigh and waist, gently help me move my surgery leg over to the edge of the bed, and get it strapped up into the Bledsoe brace before helping me into the walker to get to the bathroom. I don't put any weight on my left left, and hop along with the walker and my right leg. Then we have to hop back, remove the brace, and pivot the leg back up gently, re-swathe my upper left side in the Game Ready brace, and reconnect to the leg massaging system. It's quite the process. Kevin gives me more drugs and takes off the gauze covering my thigh. He puts two regular bandaids on the two tiny incisions and then gets the game ready back on. And fall back into a deep sleep telling myself I must remember to check on whether I can buy this leg massage unit. And then I think that the sound of the pump on the IV pole sounds like a slow helicopter rotors. The next time I woke up, Billy Joel's "Goodnight Saigon" was playing in my head.

in the light of day: yellow fall risk socks, green leg massagers from heaven, and black Game ready brace, 
with the system visible on the floor in the background

I'm dead to the world until 6:00, when I wake up again, having to pee (and hearing, "yes we will all go down together...) . My morning nurse comes in to help and looks a bit worried that the game ready has been directly on my skin for four hours. Once the big bandage came off, it left all that area exposed to really cold water circulating across it for two of those four hours. She helped me to the edge of the bed but said that Kevin had mentioned that I wasn't putting any weight on my surgery leg. If I wanted to do that again, I didn't need to put the brace on. Okay, great. I gotta pee! When she helped me back into the Game Ready, she had a towel to put between it and my skin. Normally, it works fine on top of your PJs, but with those hospital gowns, not so much. I have a few spots that look like light freezer burn on my thigh at the moment. 

At this point, I'm not nauseous and really hungry. I ask for my backpack and brush my hair, which feels lovely, and about that time, here comes Dr. Xenos on his rounds to check on me. He reports that my surgery was "textbook easy." Pincer and cam were both shaved into submission and he placed 3 anchors to repair the torn cartilage (see below). I was 56 minutes in traction, total surgery time of 90 minutes, 6:30 -8:00. I was in the recovery room almost as long and in my room by 9:30 that night.  This is all good to know, since no one stayed overnight and I'm working on my very limited memory. 

Around 6:30, Kevin comes back in and gets me a warm wash cloth for my face. I ask about breakfast, which you order from your TV screen, but it doesn't start until 7:00. But he says he can bring me coffee and graham crackers. Perfect. I peruse the menu and at 7:00 on the dot, still wary about nausea, order some Cream of Wheat, one sausage (because of the protein choices, it seemed like the least possible one they could mess up -- no way any hospital bacon is ever crispy), a small orange juice, and creamer (because the coffee station on the floor only has chemical crap). It's a 45 minute wait time.

but I'm pretty much pain free!

Bob comes in, and shortly after, Charlie, Dr. X's P.A. comes by and checks on everything. They're very pleased with my lack of pain and my renewed appetite, and he says as soon as I can get cleared by the Physical Therapy team, I can get out of there. While he's talking, the food arrives. 

me, before tasting the food.

So I eat about half of the really, really bland Cream of Wheat and half of the terribly salty and rather soggy sausage before deciding this is just going to make me nauseous again. I stick with the liquids and the graham crackers.

Bob fills me in on his side of the story. Sam and Jason came after class and brought him dinner and they hung out in the waiting room, getting updates on Bob's phone and on the flat screens. Sam had gone to the vending machine when Dr. Xenos came out to tell them how it went, and told Sam it would cost her that Baby Ruth. :)

Then they waited on me to get out of recovery and up to the room (just as long as the surgery), and I wasn't exactly aware of them when they did see me. Reportedly I was scary looking, pale, and sick. So Bob was very gratified to get there this morning and find me pretty much back to normal, i.e. hungry and impatient.

And we wait for the PT folks. 

And wait.

It's 8:00. Then 9:00. Then 10:00. I read, play on my phone, take photos to use for my Hip blog, get another round of meds and get out of bed a couple more times with the walker (no brace) to use the bathroom.

Look, there's the mountain photograph on the wall that I was must have been going on about in my drug induced state. And my coffee and water, which I am sipping on incessantly because I am really thirsty. And my glasses, that I am not wearing on my face (because I can't read with them and I see great up close without anything.)

Bob tells me that he has scans Dr. Xenos left with them after surgery. I don't get to see them until I get home because he'd left them there, but since we're still waiting on PT, check these out. These are photos from the scope camera as he worked on stitching together all the tears. They look like foreign moons:

Finally  PT shows up. And she is not happy that nurses have been letting me use the walker and no weight bearing to move around. She says the brace isn't about weight bearing, it's about range of motion, and without it, I could bend in ways that would not be helpful for healing. I'm quite certain I haven't bent in any direction that is detrimental, but I keep my mouth shut. 

We start talking about my Mobilegs, which she's seen but never tried. She's impressed. We talk about what I'll need at home, and I already have everything. She's impressed. 

So I get out of bed, get on the brace, and pull out the crutches. I've been practicing with no weight bearing, how to hold my leg and not use it. Since Dr. Xenos' protocol differed, we go through what 50% weight bearing means. I can stand with both feet, weight evenly distributed. When I walk, I need to be standing evenly, put the crutches ahead of me, then put the surgery foot forward, using my arms to support at least half of my weight while I move my good foot forward to meet the surgery one. 

Sound confusing? 

It is. 

I'm still trying to put almost no weight on my surgery leg to protect it, which she says will not be good in the long run. My right side will overcompensate and create muscle imbalances. 

So I'm staring down at my feet as we practice in the hallway. I don't have my glasses on, so I can't really see clearly. The last round of meds had something that's made me deathly thirsty, but of course I don't have my water to sip while I'm here in the hall with my crutches and my lips are sticking to my teeth and my tongue feels like it's swelling. And then I get really light headed. Might have something to do with barely eating anything in the past 24 hours, looking down the whole time, and moving more in those five minutes than I had since 4:00 the previous afternoon, before my hip had been dislocated, invaded, and stitched and shaved.

So there I was in the hospital hallway, swooning. 

One of the therapists grabs a chair for me to sit in, another grabs and oxygen tank throws the nose canula on me and turns it up full blast on 100 oxygen, and Bob runs to get me ice water and hard candy for the blood sugar. One of the therapists tells me, "we can't let you go home when you're getting this light headed."

Well, crap. 

After a while on the oxygen, sitting, and sipping, my head clears and we're able to finish the PT session with me proving I can walk on the crutches correctly as well as navigate the stairs both up and down. And not faint.

They confer and, since it's now 11:00 agree to sign off on my discharge as long as I'll agree to eat something substantial for lunch in my room before I go. Deal. Two bowls of macaroni and cheese after another 45 minute wait later, and I'm getting my IV out, signing off, and packing up. 

On the ride home I am suddenly very aware that 1) that fantastic 12-18 hour nerve block has completely run its course and is gone, 2) they packed up the Game Ready at 10:00 when PT started because we were supposed to leave right afterward and it's now been nearly three hours without any icing, 3) all that walking on crutches didn't help the pain level 4) I'm riding in Bob's Jeep, not known for its smooth suspension and 5) Highlands Ranch has some of the bumpiest roads imaginable. 

But we made it and I got up the stairs with very little trouble, into bed, back into the Game Ready, and on pain meds. It's a beautiful day, the windows are open, and it's over. Even Bruiser gets in on the relaxation.

Or, relaxation for an hour.

Then the guy shows up from the company who tested the bathrooms floors, left giant fans that rendered it virtually un-enterable for four days


 . . .  and returned today to pull up the floor.

I don't think we fully appreciated what that entailed.

As I tried to relax in my room this afternoon . . .

and this went on for HOURS. Apparently the vinyl was cemented onto the subfloor.

And now? We still have the giant droning fans . .  and this floor:

And another guy is coming tomorrow to survey and decide what happens next. 

Why do I imagine it will have to involve power tools?

Guess I'd better not drink too much tonight so I don't have to pee until morning and enjoy the sleep while I can get it.


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