Hip Replacement Surgery
Mar. 31st, 2021 02:19 am![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
stdesjardinsI made it nearly 54 years through life on my starter set of hips, but as I'm sure you know those things have only a fifty-year warranty so the time came to upgrade to an implant that will make every airport security screening just a wee bit more inconvenient. This has been coming for a while. I've had canes which I've used occasionally for a while now, but it wasn't until about September 2019 that I had enough trouble often enough that I began using them routinely. It wasn't that I always needed them after a long walk, but I would begin limping often enough that it just made sense to bring one with me whenever I left the apartment, just in case. Then around September 2020, after a summer in which I maintained my mental health during isolation by going for long walks outside almost daily, I began needing the cane almost every time I took a long walk, and I also started having trouble sitting down (that is, not passively sitting, but the physical action of transitioning from a standing to a sitting position). It was clear that getting my left hip to bend 90 degrees was no longer easy, and something was seriously enough wrong that I made an appointment with my rheumatologist, who said it was time to get a hip replacement.
So I got a recommendation from my primary care doctor and took the first available appointment with the surgeon she recommended, which was February 4. That was far off, but at the time it seemed like I was in no hurry. Except that, well, my hip kept getting worse, and by the time February rolled around I was in extreme daily discomfort. Winters are always hard on me, and this winter in particular really did a number on me.
I think it's not a coincidence that I experienced a sharp September decline in both 2019 and 2020, by the way. I tend to do better in warm weather and worse in cold weather, so I suspect that any deterioration in the summer months was masked by a temporary improvement due to warm weather, so once the weather turned cool again I was hit with a few months of deterioration all at once.
So February finally rolled around, and the X-rays showed a really terrible joint with bone scraping on bone, so I got the first available surgery date, which was March 16. Ankylosing spondylitis made the surgery more problematic in a couple of ways. Ordinarily they'd do a spinal block for this kind of surgery, but that isn't safe with a fused spine, so the alternative is general anesthesia, which is also not safe with a fused neck but it's unsafe in a more manageable way. Except it turned out that the anesthesiologist at the hospital had been doing research on using ultrasound to position spinal block, which meant I ended up getting the less traumatic anesthesia and the anesthesiologist got a really exciting guinea pig, so, win/win there. The other issue with the AS is that the surgeon was worried about the bone growing back after the surgery and messing up the joint again, so I had a radiation treatment before the operation to prevent that. The odds of my getting cancer are a bit higher as a result, between one chance in a hundred and one in a thousand over the next ten years, but it seems worth the risk.
The night of the operation, I was able to walk about forty feet down the hallway (with the help of a walker) before I needed to turn around. That's good enough that I was able to go home the next day. I had already prepped my apartment with an elevated toilet seat, which has been very helpful, and a shower seat, which turned out to be basically unnecessary, and I had stocked up with a bunch of low-prep groceries, which turned out to be less helpful than I expected, because tasks like "bring soup from a pot on the stove to a bowl on the table" are way more difficult when you need both hands to use a walker. I found it was easier to get takeout from the tapas restaurant across the street than to make myself soup, which was not what I expected at all.
The operation was on Tuesday, and by that Friday I was able to walk about a third of a mile in the courtyard before my hip started complaining. I planned to gradually increase how far I walked each day, except that on Saturday I was struggling with the walker more than seemed reasonable and my inspection revealed that one of the wheels was sticking. I had my first physical therapy appointment on Tuesday the 23rd, a week after my operation, so I decided to take it easy until then.
Also, I had practically zero appetite after coming home, but shortly after midnight on Friday it was like a switch flipped and I could eat again and had more energy. I still have a smaller appetite than usual, but I feel pretty good and have a decent energy level.
At the PT appointment, I asked about ditching the walker. It was clear that there was a safety issue with just using a cane, I was really unsteady, plus it turned out that my cane was too short: I hadn't noticed at home when I tried the cane because I was in my bare feet, but with shoes on the canes which was the perfect length before the operation was now about half an inch too short, which, you can compensate for a cane that's a bit too long much more easily than for one that's not long enough. So that was a thing, she said I definitely needed to keep using the walker when I was outside but I could use a cane at home.
Fortunately, I got steady on my feet very, very quickly once I began using the cane, and within a couple of days I was able to resume my courtyard walks with just a cane. I thought that the limiting factor would be (like my first attempt) when the joint started complaining, but instead I was able to do four laps (each about a tenth of a mile) before I got tired enough to need to sit on a bench, and then I was able to do another four laps, without any noticeable increase in pain. So I quickly got to the point where I'm walking for a mile or more each day, and I still get tired more easily than I did pre-operation, but one the whole I'm doing fantastically. I'm starting to walk without the cane at home. Not always, but to go from one room to another I don't really need it.
Pain management has been a bit weird. My pain level hasn't been very high, mostly around a 2 or 3 with occasional spikes up to maybe a 4, but I still need to take oxycodone multiple times a day or I feel like garbage. I've settled into taking two pills in the evening, one maybe around 9pm and the other before I go to bed, and then another in the morning when I get up, and one more in between. Taking less than that seems to result in my feeling worse and being less active, so I am going to rely less on my subjective sense of whether the pain is too much and more on "does taking this pill make me feel better/more active". And I'll experiment with very gradually tapering off; I think I can probably get by with three oxycodone a day at this point, for instance, but if I try reducing the dose and I feel bad I'll just go back to four. I figure there is no hurry to get to zero as long as I'm trending in that direction.
And this morning I finally got an appointment to get the vaccine, so that will be a big relief. It will probably also be the last time I use the walker. I may not need it, but if I have to stand in line for any period of time I will, and bringing the walker greatly reduces the chance that they'll make me stand in line for any period of time.
So I got a recommendation from my primary care doctor and took the first available appointment with the surgeon she recommended, which was February 4. That was far off, but at the time it seemed like I was in no hurry. Except that, well, my hip kept getting worse, and by the time February rolled around I was in extreme daily discomfort. Winters are always hard on me, and this winter in particular really did a number on me.
I think it's not a coincidence that I experienced a sharp September decline in both 2019 and 2020, by the way. I tend to do better in warm weather and worse in cold weather, so I suspect that any deterioration in the summer months was masked by a temporary improvement due to warm weather, so once the weather turned cool again I was hit with a few months of deterioration all at once.
So February finally rolled around, and the X-rays showed a really terrible joint with bone scraping on bone, so I got the first available surgery date, which was March 16. Ankylosing spondylitis made the surgery more problematic in a couple of ways. Ordinarily they'd do a spinal block for this kind of surgery, but that isn't safe with a fused spine, so the alternative is general anesthesia, which is also not safe with a fused neck but it's unsafe in a more manageable way. Except it turned out that the anesthesiologist at the hospital had been doing research on using ultrasound to position spinal block, which meant I ended up getting the less traumatic anesthesia and the anesthesiologist got a really exciting guinea pig, so, win/win there. The other issue with the AS is that the surgeon was worried about the bone growing back after the surgery and messing up the joint again, so I had a radiation treatment before the operation to prevent that. The odds of my getting cancer are a bit higher as a result, between one chance in a hundred and one in a thousand over the next ten years, but it seems worth the risk.
The night of the operation, I was able to walk about forty feet down the hallway (with the help of a walker) before I needed to turn around. That's good enough that I was able to go home the next day. I had already prepped my apartment with an elevated toilet seat, which has been very helpful, and a shower seat, which turned out to be basically unnecessary, and I had stocked up with a bunch of low-prep groceries, which turned out to be less helpful than I expected, because tasks like "bring soup from a pot on the stove to a bowl on the table" are way more difficult when you need both hands to use a walker. I found it was easier to get takeout from the tapas restaurant across the street than to make myself soup, which was not what I expected at all.
The operation was on Tuesday, and by that Friday I was able to walk about a third of a mile in the courtyard before my hip started complaining. I planned to gradually increase how far I walked each day, except that on Saturday I was struggling with the walker more than seemed reasonable and my inspection revealed that one of the wheels was sticking. I had my first physical therapy appointment on Tuesday the 23rd, a week after my operation, so I decided to take it easy until then.
Also, I had practically zero appetite after coming home, but shortly after midnight on Friday it was like a switch flipped and I could eat again and had more energy. I still have a smaller appetite than usual, but I feel pretty good and have a decent energy level.
At the PT appointment, I asked about ditching the walker. It was clear that there was a safety issue with just using a cane, I was really unsteady, plus it turned out that my cane was too short: I hadn't noticed at home when I tried the cane because I was in my bare feet, but with shoes on the canes which was the perfect length before the operation was now about half an inch too short, which, you can compensate for a cane that's a bit too long much more easily than for one that's not long enough. So that was a thing, she said I definitely needed to keep using the walker when I was outside but I could use a cane at home.
Fortunately, I got steady on my feet very, very quickly once I began using the cane, and within a couple of days I was able to resume my courtyard walks with just a cane. I thought that the limiting factor would be (like my first attempt) when the joint started complaining, but instead I was able to do four laps (each about a tenth of a mile) before I got tired enough to need to sit on a bench, and then I was able to do another four laps, without any noticeable increase in pain. So I quickly got to the point where I'm walking for a mile or more each day, and I still get tired more easily than I did pre-operation, but one the whole I'm doing fantastically. I'm starting to walk without the cane at home. Not always, but to go from one room to another I don't really need it.
Pain management has been a bit weird. My pain level hasn't been very high, mostly around a 2 or 3 with occasional spikes up to maybe a 4, but I still need to take oxycodone multiple times a day or I feel like garbage. I've settled into taking two pills in the evening, one maybe around 9pm and the other before I go to bed, and then another in the morning when I get up, and one more in between. Taking less than that seems to result in my feeling worse and being less active, so I am going to rely less on my subjective sense of whether the pain is too much and more on "does taking this pill make me feel better/more active". And I'll experiment with very gradually tapering off; I think I can probably get by with three oxycodone a day at this point, for instance, but if I try reducing the dose and I feel bad I'll just go back to four. I figure there is no hurry to get to zero as long as I'm trending in that direction.
And this morning I finally got an appointment to get the vaccine, so that will be a big relief. It will probably also be the last time I use the walker. I may not need it, but if I have to stand in line for any period of time I will, and bringing the walker greatly reduces the chance that they'll make me stand in line for any period of time.
no subject
Date: 2021-03-31 02:58 pm (UTC)no subject
Date: 2021-03-31 03:27 pm (UTC)no subject
Date: 2021-03-31 10:41 pm (UTC)Yay, science! I'm so glad the procedure went well and the recovery is going well. Taking that walker for your vaccine appointment sounds good.
Thanks for all the details. I was hesitant to ask much on Twitter. If I'd been working downtown, I'd have liked to help with dinners etc. I'm glad the tapas place at least helped some.
no subject
Date: 2021-04-01 02:52 am (UTC)no subject
Date: 2021-04-01 01:53 pm (UTC)