The Trip to the Hip
A story about my experience with total hip replacement surgery.
A story about my experience with total hip replacement surgery.
The night passes so slowly. I didn’t sleep much and woke every two hours or so to look at the clock and see that time had become a snail. When I finally detected the pale blue light of dawn sneaking through the partially drawn curtains, I breathed a sigh of relief. I grabbed the trapeze above my head and pulled myself up. Mother nature was calling so I began maneuvering myself and my IV stand toward the edge of the bed. I was getting better at manipulating my leg although it still hurt like an explicative.
I pulled the walker in front of me and stood up as I had been taught, the injured leg slightly advanced of the good one. I reached over to the clutter table and grabbed my toothbrush and toothpaste. Might as well as long as I was up. This trip was easier than the night before as I was learning how to move and to trust my legs.
As I was coming out of the bathroom, Dr. Namazian walked in on his morning rounds. “Ah good to see you’re up! You’re going home today?” he asked like he wasn’t sure.
“Yes. I have to wait for my sister to finish up work here.” I replied attempting to grasp the back of my gown closed. ( Like the doctor hasn’t already seen me naked inside and out!) He looked down at my feet and noticed I was standing slanted putting more of my weight on the good leg.
“You know you can put your full weight on you leg.” He looked up at me like I was insulting his work. “Oh sure,” I thought. “Easy for your to say. You haven’t been sliced and diced.” I smiled and shifted my weight. Slightly.
The discharge nurse, Alyce (pronounce A-leese), came in all bubbly, carrying her clipboard with paperwork to fill out. She asked questions regarding they type of care I would be given at home. Would there be someone home to help me? What kind of shower was there to use? She took down my sister’s phone number and address and asked if this would be where Physical Therapy Home Care would be going. I was planning to stay with my sister for the next two weeks until I felt strong enough to be able to deal with the commotion in my own home.
Then she grilled me about the medication they would be sending me home with, Warfarin, a blood thinner, to help prevent potential blood clots that could possibly dislodge and end up in my lungs or brain causing death. And with that thought, I wiggled my feet under my sheets to keep that blood flowing. She informed me that someone from the Anticoagulation Clinic would be in to tell me all about this wonderful medication I was to be taking.
Not too much later a nurse from the Anticoag clinic arrived wheeling in a TV set and a VCR (I didn’t know they still had those) She asked me if I had started on the Warfarin and I said that they had given me one the night before. She asked me to watch the video so I would understand what this medication was supposed to do and what it could do if I wasn’t careful with my dosing and timing. Here, read them for yourself:
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Notify your doctor right away if you experience any of these warfarin side effects:
Other less serious warfarin side effects that you should tell your doctor about include:
Although rare, warfarin can also cause skin tissue death (necrosis) and gangrene requiring amputation. This complication most often happens three to eight days after you start taking warfarin. If you notice any sores, changes in skin color or temperature, or severe pain on your skin, notify your doctor immediately.
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She gave me the instructions on how to take them. I was to take one tablet every day at 5 PM and get a weekly blood test to make sure I wasn’t in danger of getting any of the aforementioned items. This is the same drug my dad takes every day to help prevent another heart attack, so how bad could it be?
Next up was physical therapy.
A different physical therapist (Gregory Peck believe it or not) took me for my morning stroll and talked me through some exercises to do while lying in bed. Then an occupational therapist came in and showed me how to dress myself using my grabber.And so I was ready! I was sitting up in a chair wearing the sweat pants and sweat shirt I had arrived in and waiting for someone from my family to show up.
Dad got there first and informed me that my handicapped throne was in his trunk along with the walker that had once belonged to my grandmother (God rest her little 4’ 11” Jewish yenta soul!). Karen showed up soon after and began to hunt for a wheelchair to ride my handicapped butt to the car.
With a wheelchair finally located, I walkered my way over to her. I had to hold my injured leg up as it was too painful an angle to rest it on the foot rest. They loaded my bags on my lap along with a set of crutches, and Dad carried the walker and my grabber. So off we went down the hall and out the door into the sunshine and wind. Poor Karen is a tiny little thing, my height but probably a good 20 pounds lighter. She is currently suffering from something called “frozen shoulder syndrome” which has caused her to have limited and painful movement of her arm. so she struggled a bit to push my carcass and chair up a hill and into the parking lot.
She wheeled me up behind her fancy-shmancy BMW and I began to think about what it was going to take for me to get into that car. I couldn’t get the walker between her car and the car parked next to hers, so I stood up from the chair and used the cars’ sides as substitutes. Karen opened the car door for me. I took a deep breath. Remember that toilet seat incident pre-handicapped seat? Well this was even lower. The movement wouldn’t just require lowering myself into the car, but then pivoting my body around to get my legs into the car. Thank goodness for leather seats as is made it easier to pivot my bottom while getting my legs into the car. My dad had placed my aides in the trunk of Karen’s car and gave me a kiss good-by. I thanked him for all he had done and knew I would see him soon, as he visits my sister often. Karen got into the car and we were off.
Ok, this has nothing to do with my hip. But it is relevant to other ideas that cripple ignorant people. I wish they would get off their arrogant uninformed prejudicial high horses and read the book they think they are espousing.
5 AM
“Here to check your vitals.”
I throw my right arm over the side of the bed without opening my eyes. Fall back to sleep.
7:30 AM
Flood of light suddenly fills the room and a booming voice says, “Good morning! How are we doing today?”
I blink like a coal miner coming out of a cave a noon. It’s Dr. Namazian, making his morning rounds. “Better today, I think….” I’m still half asleep.
“Good! How’d you like to go home tomorrow?” he asks as he approaches the side of my bed.
“That would be great,” I answered
“Hey! Why do you still have that catheter in. That has to come out! You just got a new hip and that can cause problems if it stays in there.” he was genuinely shocked to see that. So he walks to the other side of my bed lifts my blankets and proceeds to pull the darn thing out of me. No real warning like a nurse would say, “Now just relax. This won’t hurt.” I thought he might call in a nurse to take care of that, thinking that a doctor wouldn’t want to mess with a foley cath. but he had no problem pulling that thing out of me and taking care of the contents of the bag himself. I thought that was pretty impressive actually.
Then he walked to the other side of the bed, “Ok let’s take a look at this thing.” And without much warning he picked up the pad that was under me and literally flipped me on my side. I winced in pain, but it was a much faster move and much more comfortable move than the nurses had tried. You could tell he definitely wasn’t afraid of hurting his work. He then peeled of the bandage that covered the wound, commented on how nice it looked and then recovered it. “Have you been up walking?” he asked as he helped me roll back over.
“Well I tried yesterday, but nearly passed out twice.” I said looking for some sympathy.
“Oh well. You aren’t the first to feel that way and you won’t be the last.” Obviously no sympathy there. He walked to the end of the bed and asked me to move my feet then he pulled on my surgical leg as if to make sure it was the same length as the good leg and covered my feet back up. “Get up and walk today. It’s important for your recovery.” He smiled, turned off the light and walked out of the room. His entire approach that morning, although it seemed abrupt, was good natured and friendly and showed he had confidence in his work. This made me feel that way too.
Breakfast came and I ate remembering how food helped me feel better last night. I ate the muffin and some fruit and drank some juice. I then filled out the menu request form for the following day. I watched some TV and waited for Physical Therapy to return. I was ready today. I was going to walk no matter what!
2AM
Still so restless and now the pain in my gullet was competing with the dulled down pain of my hip. I twisted my body as much as possible trying to find a comfortable way to move the air collecting in my belly. I stretched my hand over my head. I arched my back. I moved the bed to sit up higher. I moved the bed to lay flatter. Nothing worked. Then it hit me. This pain wasn’t air; it was hunger. I hadn’t eaten anything since 7:30 PM the night before surgery. I had been too sick to my stomach to brave hospital food, but now my body was rebelling. I buzzed for the nurse. “What can I get you?” she asked.
“You know when you asked me about having some broth or something…. I think I’m hungry now and that’s why my stomach is bothering me.”
“Do you want me make you some broth?”
“Please. I think it will help.”
When she returned a few minutes later she brought a cup of hot chicken broth, a couple of packages of wheat crackers and some string cheese, and set them on the moveable table tray in front of me. I flipped on the TV and watched some late night show while I consumed my feast. The soup was like a salve going down my throat. It was like my stomach was waiting for it with the open arms of a woman greeting her man home, after a long trip at sea. I alternated between the crackers and the string cheese trying to eat as slowly as I could because it felt so good, so soothing. I think the Tylenol also had something to do with the sudden feeling of comfort. My eyes began to feel heavy and I caught my head bobbing more than once. Finally, I fell asleep, deep asleep, with a cracker in my hand.
Tuesday was over.
Once back in bed I thanked the nurses for their patience and apologized for the ordeal. They brushed off the apology and asked me if there was anything else I needed. “Something for this pain, would be nice,” I hinted with a smile, even though there were tears beginning to well up in my eyes. “Oh and can we see about getting a raised seat for the bathroom?” I suggested thinking optimistically about the future.
“I’ll see what I can do.” She headed for the door, “Do you want me to shut this?”
“Yes, please. Thanks.” The door closed and all was silent and dark. I was exhausted, but sleepless, and aching with pain and began to wonder why I did this. I felt sorry for myself and I missed my family (no one had visited or called today) so I cried because no one could see me.
The nurse came in and turned on the softer of the two lights. She checked my blood pressure again and added another IV bag to the stand. “You’re pressure is still a little low for me to give you something through the IV. I can give you some Tylenol with codeine?” I nodded my head, and used my hands to try to press the self-pity and sadness out of my eyes. She returned with the laser gun and scanned my bracelet. The computer on the other side of the room beeped with the acceptance of my number. Then the nurse logged in the medication, amount and the time when I received it. “I can only give you one right now.” That was better than none, I thought as I swallowed the tablet praying that it would at least wound the dragon enough to force it back into its lair. Just for a little while…….
9 PM
Evening came and the dragon that lived in my hip was clawing with such gusto so that I couldn’t lie still for more than a minute or two. My torso was aching from the pressure of gas caught in the upper regions of my body and refusing to move towards the exit. I felt full and nauseous. And then a sudden horrible urge hit me. “Oh my god! I think I have to poop!” Here I was attached to the IV machine, and a catheter hanging out my ‘hoo hoo.” and I thought, there is no way in HELL, I’ll take a dump in the bedpan! I didn’t care how much it was going to hurt or how hard it would be to get me to the bathroom, the idea of lying in my excrement was motivation enough to leap tall buildings in a single bound if necessary.
I pressed the nurse button. I could hear the little attention bell dinging in the distance and I thought, how do I tell them I need to go potty without sounding like a child or an uneducated dolt? “Yes, can I help you?” came the voice over the speaker. “Er…. yeah….um…. I have to …. um go to the bathroom.” the words rushed out of my mouth, because by this time I thought it was nearing an emergency. “OK, I’ll be right there.”
She came in holding a bedpan. “Uh, I’m sorry I really want to do this in the bathroom.” I pleaded.
“Are you sure?” she asked eyeing the equipment attached to me and remembering that I was still without pain meds. “This is something the therapist are supposed to do.” she added like she was taking a risk at a lawsuit if something went wrong.
“I don’t care!” I said without hesitation. She left and returned with her assistant. They moved the IV stand closer to the bathroom door and unhooked the collection bag from the side of my bed and laid it next to me. I began to scooch myself down the bed while turning my body until my sore leg was just at the edge of the bed. “You’ll need to hold my leg.” I explained, “while I get my other leg off the bed. Try to keep it the same distance apart.” I warned remembering my earlier experience. The nurse managed to hold onto my leg until the last minute when she let it slip from too high a point to the floor. “OWWwwwww!” I cried, as tears of pain welled in my eyes.
“Sorry.” she said with remorse.
“That’s OK.” I said through breathy puffs of air trying to work through the pain so I could stand up. I genuinely meant that too, because I knew she was trying her best to help me do something that I probably shouldn’t have been doing.
I grabbed onto the walker that was left in the room and the nurses helped me stand up and gingerly walk to the bathroom. I looked at the toilet seat and found it interesting and frightening that my toilet was just an ordinary hospital type potty. You’d think that in an orthopedic ward a toilet would be equipped with a special seat to raise the height to an acceptable level. So with a deep breath and my back to the toilet seat, both nurses helped steady me as I bent my legs to start what seemed like a long descent into a bottomless cavern. My leg was screaming with pain as I tried to control the speed at which I was moving. About one hour later (OK, a gross exaggeration, but that’s what it felt like) my backside landed on the seat. (mental note to self: ask Dad to get a raised seat for home) The nurses guided my various tubing out and shut the door so I could have some privacy.
It was gas.
My nurse came in to reattach the IV. “Do you have to pee, yet?” My answer was no. I had no urge at all which seemed odd to me because they had been pumping bag after bag of fluid into my arm. I pushed on my bladder to see if it felt full. It did. But I still had not even an inkling of needing to relieve myself. She looked at me and scolded me like she was my mother, “You don’t want me to have to put that catheter back in now do you?” I smiled and then sighed. I thought why is every little thing so complicated?
The nurse poked her head around the privacy curtain that hid the bed from view if the door was open. “Anything yet?” I shook my head. “Wanna try?” I relented and let her bring a bedpan, which turned out to be a shallow pink (OK mauve) triangular shaped bowl. I thought how the heck does this work without getting very messy? Answer: It doesn’t. She lifted the blankets and my lovely dressing gown and slipped the pan under my tush.
I looked at her with curiosity, “What if I miss?”
“I’ll clean you up.” she smiled. It must be weird to be used to wiping adults’ butts.
The pan was awkward and I felt my butt cheeks touch the bottom of it. How on earth am I supposed to pee without getting it one me, I thought. I tried to relax. I looked at the ceiling and thought about waterfalls, and faucets and getting a catheter put back in, when low and behold a trickle of liquid made it down and around my butt and into the pan. It wasn’t much, but maybe enough to hold off the catheter. I pushed the “help” button on the bedside controller, the one that also works the TV and the lights. The feeling of sitting in my urine was disturbing and I wondered why the nurse wasn’t coming to fetch the nasty thing out from under me. (OK, I know urine is sterile and clean, but still).
The nurse returned, “All done?” she said reaching for the pan with a towel in the other hand ready to catch the pee that would drip from my cheeks. I stayed arched as she wiped me clean (one must swallow all pride and sense of privacy when in a hospital). She looked at the volume of my efforts. “Is that all?” she scowled like I was deliberately withholding my urine. “Well I don’t think this will be enough. You have to pee.” She took the pan into the bathroom and dumped its minimal contents into the toilet. Apparently the powers that be also agreed I should have done better, because she returned not too long after with the promised catheter. “Sorry,” she apologize while lifting up my gown and searching my privates for the place to insert the tube. (Remember that thing about giving up your dignity?) “Take a deep breath.” and as I did she shoved that tube up me until it felt like it was going to be in my stomach. “Maybe tomorrow.” she smiled and left.
Blood pressure still too low for meds.
Dinner once again stayed on the cart.
Part 1 — Pressure Problems
This could really be just a continuation of the day before because in a hospital one never gets a full night of uninterrupted sleep. One day just melds into the next, in hour after hour of repetitive actions. Vitals, blood, check IV, food, repeat every few hours until discharge…….
I was still woozy and nauseous so breakfast stayed on the cart. I was uncomfortable because I was still in a slight sitting up position, and my back was beginning to cramp. How to move? Above my head was a triangular trapeze contraption, so I reached up as far as I could with my right arm, barely managing to wrap the tips of my fingers around the bar. Then I pulled my body slightly up so that my left hand could reach and tried to adjust the angle of my hips a bit so as to get off the spot that had fallen asleep. It was a move I would do many times in the four days I remained in the hospital. Thank goodness for upper body strength. See, all that time in the gym had some purpose.
6AM
I flipped on the TV, mostly to drown out the noise coming from the nursing station right outside my door. Those people were having WAY too much fun, in my opinion. The nurse came in with my medication, pills that I already take at home but must continue taking here. I had brought my own vials as had been suggested, but they provided me with Kaiser copies. How nice of them to allow me to save my own supply (other than the birth control pills. I had to use my own. Hidden meaning? I wonder.) Each pill was in a separate bar coded blister pack. The nurse would scan a bar code on my bracelet and then scan each pill as she popped them into a tiny cup. This was then recorded on one of the computers that is located in every room. Accountability and drug management, and probably a way of insuring the right person got the right medication. I swallowed them all at once with a drink of water, which by the way, was the most horrible tasting water I’ve ever had. (mental note: ask Dad to bring bottled water) So when not swallowing pills, I would drink only the water that melted from the cup of ice chips. For some reason, that tasted normal.
“On a scale of 1 - 10 how is your pain level? One being no pain and ten, unbearable,” queried the nurse.
I stopped a moment to take stock of my pain. “I guess about a five or six”
“OK, I’ll see what we can do.” She left and returned with my friend the “Vitals Machine” and took my blood pressure. It was low, I’m guessing very low. 80/54. “I can’t give you any pain medication until we get your blood pressure up, otherwise you’ll bottom out and we don’t want that to happen.”
Bottom out ? I pictured it like leaping off a cliff and “bottoming out” on the canyon floor hundreds of feet below. Nope definitely did want that to happen. BUT I did want to do something about the pain that was beginning to crawl out of the anesthesia cave and light the surrounding countryside on fire with it’s dragon’s breath. The nurse left to consult about what to do with the blood pressure issue.
She returned with another IV bag of fluid in her hand “The doctor said we can’t give you any pain medication until we get your blood pressure up.” She proceeded to hang the bag on the IV stand and connect the tubing. She adjusted the flow and said, “Well give you some extra fluids and see if that does the trick. An hour and a half.”
“Wait,” I said as she turned to leave,”Can you take this foam thing out from between my legs? I’m really uncomfortable,” She pulled back the blankets and unvelcroed my left leg. Then she moved to the other side of the bed to do the right. She had to lift my leg to get the strap off. I winced, tears coming to my eyes. The slightest movement sideways would send a sharp twinge up my leg into my hip. “Sorry,” she apologized genuinely sympathetic. “Well get you something for the pain as soon as we get that pressure up. All this liquid should help.” She smiled
Funny how you can feel the cold liquid from the IV enter your vein and travel down your arm. I looked at the bag. Drip…….drip……drip……drip. It was ticking away at a faster pace in order to get the fluid in me as quickly a possible. I turned the TV back on and tried to ignore the pain. I kept the room dark because I was still dizzy and I found it more peaceful feeling somehow.
The nurse returned shortly to inform me that the doctor wanted the catheter out. “This wont hurt” she said tugging on the tube up my urethra. She was right, it didn’t hurt at all, just a little disconcerting. “You have to pee within the next 6 hours or we have to put it back in,” she said, almost like an admonishing mother saying “Eat all your vegetables or you’ll have to go to your room!”
Pee? Wait a minute. That entails getting out of bed and walking to the little bathroom, which is about 5 or 6 good steps from the end of my bed. And then there’s the sitting down part to consider… and …. The thought of the pain all that would cause made me ask, “Uh, will I be walking to the bathroom?” my face twisted in an anticipatory wince.
“Well, no. You can use a bed pan.” she suggested matter-of-factly.
Bed pan? Hell NO! I thought to myself. I smiled outwardly and cringed inside my head.
“Physical therapy will be here later this morning to help you get up and start walking.” she mentioned on her way out the door. Oh goody! I thought. That oughta be loads of fun.
«blink,blink» dim lights, ceiling…………..«blink,blink» nurse next to bed typing………………….«blink,blink»someone’s talking to me, I think……………….«blink,blink»”How are you doing?” fine…………………«blink,blink»how long was I in surgery? “Two and a half hours”
I’m so groggy and still feeling dreamlike, dizzy. I can’t keep my eyes open. Two people in surgical attire (minus the masks) come and begin to push my bed. I’m assuming to get me to my room. Florescent lights buzz by overhead in a smeared stream of light. The aide at the end of the bed smiles at me (I think). He looks like a maniacal Jim Carey and he’s pushing that damn bed at what feels like light speed. Taking turns like an idiot teenage driver trying to emulate the Fast and the Furious. Bump! Into the elevator. 4th floor. Doors open and Evil Knievel is at it again. We get into the room and at this point I’m so dizzy and nauseated that I know I’m going to vomit. They help me into the bed and then hand me a pink plastic box over which I retch and retch, but thankfully, being that you aren’t to eat or drink before surgery, nothing came up, except the feeling of bile not quite making it to my mouth. “Are you all right?” Jim Carey inquired? I probably would have been I thought, handing him back the empty box, if you hadn’t taken gurney driving lessons at the Ontario Motor Speedway. I lay back and rest. I close my eyes because the room is spinning. I think I fell alseep again.
My dad was there by my bedside putting my little bags on a table behind the bed. He inquired with the customary question, “How are you feeling?” Sometimes I think, isn’t it obvious…. like crap. But I didn’t say that, I smiled instead, because talking was way too complicated a movement at this point. He moved around the bed, careful to step over the foley catheter that was conveniently collecting my urine and around the IV tower that had several bags of clear liquid dripping their contents into my vein. The nurse entered with a machine which she placed at the foot of the bed. She strapped a velcro booty around each foot and turned it on. The booties filled with air alternatingly, right, pshhhhhh, silence, left, pshhhhhhh in a neat little rythmn, pumping against the soles of my feet. It’s to keep the blood moving in your legs and help prevent blood clots (which can break off and get into your lungs or brain and KILL you) she smiled.
Dad sat with me and watched some TV. I was lousy company, for sure. I was still sick to my stomach, and refused my dinner tray when it arrived. Just the thought….. I couldn’t move my legs because they had been velcroed to a large piece of V-shaped foam to prevent me from moving the operated-on leg past the mid-line of my body, a BIG no-no with hip replacement. My upper body was raised to a slight upright position and at that moment, I felt, as Pink Floyd might have said “comfortably numb.”
others who have had hip replacement surgery:
