It’s a miracle! Just a week after your Halloween surgery, you are up and walking around without pain. For the first time in three years, you are finally walking normally. The rush you get from taking a walk in the crisp November air fuels your creative energies. You’re busy with your redevelopment efforts, designing a new line of jewelry and making new digital collages. Rehab is progressing; your strength is returning. Thanksgiving is approaching. You’ll be making a feast for your kids and their partners, your other mom and dad, and a few other guests. Your energy levels are high and your attitude is great.
Five weeks after your Halloween surgery, as you stand up from your desk one morning, your operated hip gives out. You sit back down to keep from falling. Your leg becomes unstable and the hip begins to hurt again. Although you’re walking with a limp again, you ignore it for a few weeks hoping that whatever it is will resolve on its own. Finally, when it doesn’t improve, you call the clinic and see your surgeon, who sends you for x-rays, and then for a consult with the hip-joint replacement surgeon at the clinic. Your arthroscopic hip surgery has failed.
The new surgeon is young-ish, nice looking, and like most other surgeons you’ve met, more than a little arrogant. He consults the x-rays and sends you for yet another MRI with contrast dye. Your hip joint has degenerated significantly. To relieve the pain and regain function, he recommends hip-joint arthroplasty, a complete joint replacement with a polyethylene and titanium prosthetic joint. You will be in hospital approximately three to four days, after which you will either go to a rehab center, or home if you have someone to care for you. If you go home, a home health nurse and physical therapist will visit you for several weeks, at which time, you should be able to manage regular physical therapy at the clinic.
You live alone and you really don’t have anyone who can stay with you at your home for two weeks while you recuperate. While you are investigating rehab centers, out of the blue, your middle brother announces that he will come up and stay for two weeks to take care of you. You will not have to go to a rehab center, nor will you have to worry about who will care for your kittens, who are less than a year old. You schedule surgery for mid-March, right after a three-day trip to D.C. to work, and right before your birthday. You are more than just a bit worried about taking pain meds for this surgery, based on previous experience, but your surgeon either doesn’t believe you or figures it’s worth taking the risk. He argues with you about post-surgery pain relief, but you are adamant.
Surgery takes about two hours. The damage to the joint is worse than the MRI and x-rays indicated. You come out of recovery with the remnants of a nerve block and anesthesia; you refuse any additional pain relief. Hooked up to an IV, you are calling the nurse for the bedpan every 20 minutes. Moving is exquisitely painful, but you are determined to get by without narcotics. You raise yourself up with your left arm, in which the IV is inserted and taped on with paper tape, each time more difficult than the last, sapping the little energy you had over and over. For 15 hours, you manage without pain relief. In the morning, your surgeon pops in and with a wry grin, compliments you on how amazingly well you look for someone who has neither slept, nor taken pain medicine all night after major surgery. You give him “the look.”
He takes a seat next to the bed and talks turkey to you. “Rehab will be here soon and they will make you get up whether you want to or not, regardless of how much you hurt. You will have no choice. You must try something.” You agree to try Tramadol, but only if someone stays with you for the first half hour after you take it. While the drug does make you nauseous, it doesn’t kill you. It also does nothing for the pain. Next, he insists that you try half the lowest available dose of oxycodone. The charge nurse agrees to sit with you for another half hour, just in case. A few minutes later, you’re feeling very sleepy, but your vitals are stable. The pill takes the edge off the pain. This is very good news.
A little while later, your brother arrives and sees to it that you get something good to eat. While the ortho floor is fabulous, the care is amazing, and all the rooms are private, the food is pretty bad, even by hospital standards. He goes to the café and buys you things he knows you will eat, salads, fruit, and real coffee. Once you’ve finished your meal, rehab comes to torture you. You are able to stand up with a walker, take yourself to the potty, and get back to your bed. You will do anything to be done with that damned bedpan, which brings back ancient memories from your spinal fusion a hundred years ago. They repeat the torture several times during the day and into evening. Midday, you have a visitor, a woman whom you only know from Facebook. You are mortified that someone you are meeting for the first time sees you in this wretched state, but she isn’t the least fazed by it. She even brings you a beautiful birthday present, a hand-crafted wooden box with one of her remarkable paintings set into the top. You and she are destined to become great friends. She and your brother visit for a while before you take another pill and drift off to sleep.
The rehab routine continues for two more days, by which time you are walking with crutches, although not very well, and ready, according to the hospital, to go home. You try to time your departure with your pain pill schedule to help ease the hour and a half ride home. You’ve been off the IV for several hours, which eliminates the kind of urgency you felt the last time you went through this. You make it home without incident; your brother helps you up the steps and into the house, and soon, you’re in bed, crutches and walker by your side, resting as comfortably as someone with hip-joint replacement surgery can after four days.
While you’re snoozing, your brother goes grocery shopping. He comes home with all kinds of delicacies (and a serious case of grocery envy) in an effort to get you to eat. They have no such huge markets with their seemingly endless arrays of food out in the middle of Amish country, where he lives. Between the pain medicine and the blood thinner, which makes your blood feel like ice-water in your veins, you have very little appetite, even for the wonderful, exotic foods and fresh fruits he serves you. The visiting nurse comes to check up on you, making sure you’re balancing your vitamin K levels, which affect the blood thinner you must take for a month. You are cold inside out and no amount of clothing or blankets makes you warm enough. The physical therapist comes in several days a week to work on strengthening and flexibility, and to make sure you’re getting up and about reasonably well. You are walking with a cane by the end of the second week, which is good, since your brother, who has gone way over and above, has to go home. He’s a natural caregiver and you are tremendously lucky.
You’re on your own for the duration, although you may not drive for another month. It doesn’t matter anyway, since the turbo in your Saab has blown out and you haven’t the money to fix it yet. At the beginning of the third week, six days after your brother has gone home, you take your usual afternoon pain pill, but this time, something is wrong. That familiar feeling creeps up on you; your breathing slows and you feel very sleepy. You think about calling 911, but instead you get up, drink a lot of water, stay on your feet walking around the house, and call a friend to keep you talking and awake. This reaction isn’t nearly so severe as the last time when you went down for the count. You’ll be fine. After an hour or so, you do feel fine, but that’s the last damned pain pill you will ever take if you have anything to say about it.
Fortunately, you have lots of friends who go shopping for you, scoop the cats’ litter boxes, fill your prescriptions and take out the trash. The incision is a 6-inch long zipper on your hip, and though it has been slow to heal, it’s getting better by the day. Super glue covers your zipper, which means you may shower after the first week. As the glue peels away, the stitches dissolve. Once you feel you can walk well enough to go out, a friend takes you grocery shopping. You negotiate the stairs well enough with your cane, but your right leg seems a lot longer than the left; you are listing to one side. When you stand up straight with both heels on the ground, your right knee sticks out, and when you lie down and stretch both legs out, it’s quite obvious that your knees no longer line up.
The surgeon advises against getting a lift for your shoe. Wait six months and see if it settles. The difference in leg length causes a noticeable imbalance and your left leg becomes weak and painful. Within six weeks after surgery, limping badly, you have bursitis in both hips and must discontinue rehab. Since both hips hurt now, your rheumatologist shoots you in the tush with cortisone, which temporarily relieves the bursitis. Your walk is gimpy and you are still using the cane; you know it will come back. Meanwhile, you’re coordinating your annual art fair and preparing to participate on an FDA panel dealing with metal-on-metal prosthetic hip joints at the end of June, after which, you will take off for your brother’s home for the July 4th holiday. The Saab story has been repaired and you don’t give a second thought to driving 8 1/2 hours with your new hip. You are determined to get on with your life and nothing, nothing at all, is going to stop you.
(to be continued)