Monday, March 26, 2012

What?! No pain killers?!

You get your wisdom teeth out and are prescribed Viacodin.  You have your femur sawed off and you are offered - nothing!?  Everyone, jokingly, keeps telling me to go for the morphine or, as Little Man suggests, medical marijuana. But no one's offered me any.  Hey - that's not fair!  Where's all the fun stuff?! Actually I have been prescribed something called Tramadex.  It's good for 24 hours.  I take it every morning and it is amazingly sweet relief.  No pain after that all day.

Interestly enough, throughout this entire process, the pain has NOT been unbearable.  You would think, given what we know about the surgery that it would be extremely painful.  I know I certainly envisioned it that way.

There are two main approaches to doing the procedure: anterior and posterior.  

As far as I can ascertain the posterior approach is the easier one for the surgeon.  Although I am no expert, this also seems to be the preferred method for hip replacements, especially in the US (70%).  During the procedure, the tendons behind the hip joint are detached in order to access and dislocate the joint and then are reattached later in the operation, after the implant has been input.  As a result, the recovery for the patient is far more difficult as it takes the muscles and tendons longer to re-acclimate and heal.

The anterior entry is more complicated for the surgeon.  It also requires a special, state-of-the-art operating table. However the recovery for the patient is far easier, because the muscles are not detached but rather pulled aside to allow the doctor access to the hip joint, which he then dislocates in order to input the implant.  The abductor muscles, in particular, are forcibly moved during the procedure but they are not cut or detached.  The anterior approach is less invasive and involves less pain to the patient.  There is also a smaller risk of dislocation of the joint, so that the patient can resume normal activities quicker. 

Dr. Palmtree decided I was a candidate for the anterior approach because I am a young, flexible female, in relatively good shape.  I love that man!

And I am continually surprised by how quickly I feel ready to move.  Although my muscles (especially the abductors and gluts) tire quickly, I have been walking more than a kilometer a day from Week 2.  This week, I want to try to move up to 2 kilometers a day.  I am a little nervous about doing too much, but it feels good and natural to walk. 

I made the final switch from the walker to the cane on Saturday.  Last week, the PT lady reluctantly agreed that I could start to move to the cane but insisted that I do it gradually since she claimed that it shouldn't be attempted before the 3rd or 4th week.  I think she is just not use to dealing with patients under 80 or those who've had an anterior approach!  Whatever the reason, I seem to be moving ahead faster than she's prepared for.

The exercises, on the other hand, are definitely more difficult than the walking.  The more I do, the more I am convinced that any groin pain I do feel is related to the exercises and not the walking.   And even that is subsiding.  I try to do the exercises twice a day.  I do the ones that Ms. PT gave me, but I also try to do some elementary ballet barre exercises.

But as I've said from the beginning, the pain is really minimal.  Not much different from the kind of intense work-out soreness that I am used to from years spent in toning classes at the gym.  So nothing stronger than ibuprofen for me!  Quite unbelievable really. 


(Personal pic.  Yup, that's me!)

Saturday, March 24, 2012

mindless knitting

By now, you all know that I am anemic.  I think that this is the reason why I have no focus for any activity at all other than my knitting. No oxygen to the brain.  Most days I can't even concentrate on a half hour sitcom on tv and you know how little brain power that requires!  So the hypnotic clicking of knitting needles is about the only activty that appeals.


I have just finished the back of the neck which, astonishingly, means that I am halfway finished my project.  The sweater (something I've never even tackled before) is knitted in one single piece, starting from the bottom back, up the back and neck and then continuing down the front.  When finished knitting, you simply fold in half and sew the sides and sleeves closed.  An engineering marvel.


Because it's a V-neck, the instructions say to finish the left front first, leaving the right side untouched on the needles.  And only then to complete the right front.  The two sides coming together after the V closes.  When I went to the knit-shop to buy the yarn, I consulted with the owner, who told me not to pay any attention to the "American" instructions & just do both sides simultaneously, using 2 balls of yarn.


So now I am at a crossroads.  This is not a metaphor.  Rather I mean it quite literally.  Shall I continue with the instructions from the website, the American approach, or listen to the Israeli method as per the knit-shop lady?  I can't move on until I decide. Unfortunately that will require more oxygen to the brain.  ;-)




(Personal pic.  Ignore the yellow markers)

Friday, March 23, 2012

Shanti

After the surgery, I promised myself that I would take things easy.  Mentally as well as physically. That I would expend my energies on getting well, on recovery and not on getting upset and worked up about petty or negative stuff.  That I would let things go...


Here's how I know I've become more mellow:
  • Skunk Hair
    L did my hair using root-touch-up sent by Mom & Shvester (Thanks Guys).  Halfway through the application, she  said "You know, I think this is BLACK".  Now I have skunk hair and I don't care.
  • Sneakers on my bed
    Daily, the Bear puts my dirty, street-pounding sneakers (!) on the duvet when he is putting them on me. Did I say Dirty? Not only haven't I freaked out,  I haven't even mentioned it to him. (Sweetie, if you are reading this.....)
  • The Kilimanjaro stack of dishes in sink
    I just avoid going in the kitchen.  Period.
  • 25 Travelport calls a day
    Yes, 25. At least. (OK - so half of them are from my replacement calling to tell me how much she hates my job).  Rolls off my back.  :-)

Hmmm.  Here's how I know I've got a ways to go:
  • Wednesday's semi-hysterical groin-pain post
    Re-reading my last post, it seemed to me that I was a wee bit overboard.  Probably I should call the doctor to discuss my concerns but I should also relax and give my body a chance to repair itself.  (Plus everyone I've talked to since are convinced it's just a pulled muscle.)
  • Unclenching my butt
    I'm constantly finding that when I'm sitting in the recliner, I'm clenching my butt muscles.  I need to consciously relax the muscles in my bottom.  Constantly. What is that about?!
Obviously I can't sit on the floor and do yoga yet.  But I'm going to go and find my shanti now.  Ommmmm.

Wednesday, March 21, 2012

Uncertainty


(photo credit:  Amazon River/ Internationalrivers.org)


Yesterday I walked too far.  Well everything is relative, so perhaps "too far" is subjective.  I walked a kilometer and a half.  I think that's pretty far for Day 16 after major surgery. I really hadn't meant to walk that far, but I calculated the distance of our route incorrectly and it was a beautiful day.  Before I knew it, Little Man, L and I were trudging up a steep hill in the boiling sun.  By the time we got back home, there was a dull pang in my groin, so I took the additional painkiller and took a nap. 

I could still feel the ache when I woke up this morning and again I tried to ignore it.  Surely I just over-did yesterday's walk and pulled some long-unused muscle.  However the pain and more than that, that niggly feeling persisted. 

For years before the arthritis diagnosis, I had a terrible pain in my groin. That was one of my primary symptoms.  That was really the biggest deterrent to walking. Most of the doctors and physical therapists I saw attributed it to lower back issues.  I know that my
L5-S1 vertebrae are too close together and it's possible that they are pinching a nerve down there causing the pain in my groin. 

I know I have written about this previously, but when I was debating about whether or not to go ahead with the THR, one of my biggest fears was that I'd go through the entire process only to find that it was something else entirely which caused the pain and prevented me from walking. 

Before the surgery, I figured my fear was irrational but now I am afraid that my worst nightmare is coming true.  Did I go through all of this for nothing?  Is the pain in my groin from another source?  Will it continue?  Will it prevent me from recovering completely?  Is it just a sore, pulled muscle that I haven't used in years?  Is it a pinched nerve?  Is it all in my head?  Am I expecting too much from my body too soon? 

Probably the smart thing to do would be to call the surgeon and ask him whether or not it's possible to do too much?  But while I was in the hospital, he told me to walk as much as possible so I can imagine what his response will be.  The PT lady, on the other hand, seems to take more stock in the exercises and less so in the walking.  I tend to side with the doctor, even though in my experience, doctors are usually more concerned with the process than with the recovery.  Looking on the internet is also not terribly helpful.  More than anything there seem to be a lot of odious, old people complaining.  I don't want to be party to their negative energy.  In short, I am confused and feeling a measure of uncertainty.

I know that this process is a long journey which, like a river, meanders back and forth with regressions as well as forward flowing motion.  You can move a long way along the river without progressing at all.

In actuality, the current pain is not nearly as bad as it was before the operation; it's just a little twinge in comparison.  But I can't help but be nervous.  To be on the safe side, I didn't walk much today.  Just to the local cafe and back.  For now, I'm just trying to be patient (not my forte) and rest those muscles as much as possible.

Hopefully my next blog entry will be more positive.  Who knows what lies around the next bend in the river?

Sunday, March 18, 2012

Accomplishments

Before I started this process, I had several obvious goals in mind.  Although I doubted that I'd be able to do that split ever again and would probably have to give up my dream ski vacation,  I had wanted to be able to go back to spinning, yoga & Pilate's.  I wanted to be able to sit on the floor and play with my niece and any future grandkids.  I wanted to be able to walk unhindered anywhere at all without having to wonder if I'd be able to make it back.  My most irrational fear was that after all the pain and suffering of the surgery and recovery, I still wouldn't be able to do those things.  (Part of me is actually still nervous about this...)

Right now those goals all seem very far away still.  Since coming home from the hospital, I have been slowly making progress in walking and with the exercises that the physical therapist gave me.  But I've had to modify my goals, at least for now.

Most of the exercises I can manage without any problems, except for the abductors.  The abductors are the muscles that allow you to open/lift your leg sideways.  That movement I can barely do at all.  As a result I can't haul myself up onto the bed alone.  Someone needs to lift my bad leg and move it to the left as I maneuver the rest of my body up onto the bed.  I do try to baby-sidestep my way around the perimeter of the bed each morning to make the bed. I don't know if this is just due to sore muscles or if it has something to do with the incision site.  Whatever the reason, it is terribly frustrating.

With regards to the walking, I try to walk a little further every day than the previous day.  My first goal was to get to the Makolet cafe and have a coffee!  I managed to achieve that goal on Day 11 after the surgery.   That was encouraging and meant I always have a place to sit and have a cup of reinforcement before moving on.

My next goal was getting to Daughter M's.  On Saturday, I walked as far as her street but hesitated going down the hill to her apartment as I was a tiny bit apprehensive about getting back up again. 

By today, Day 14, I had hoped to get to Kupat Holim because this is the day that the staples were due to come out. No need for that after all, because last week, the nurse agreed that she would come to the apartment around noon to take out the staples and instructed me to take the painkillers about 30 minutes before her arrival.  So this morning I didn't take any painkillers before going out for our morning walk.  We decided to walk over to the clinic anyway and remind the nurse that today was the day.  M and I started out early to give ourselves enough time and we went the long way round.  Afterwards looking on the map, I realized that it was 50% more than yesterday's walk.  Without painkillers.  Big mistake.

Later, after the much-needed painkillers, removal of all 34 staples and a very long nap, I realize how much of a relief it is without the stitches.  The wound looks rather unsavoury but not as raw as I thought it would. But more importantly, I feel so much freer and I seem to be able to move my leg sideways with more ease.  Perhaps it's just my imagination but I'm getting ready to put another check on my list of accomplishments.

The door is open and a world of possibilities awaits.


Saturday, March 17, 2012

Friday, March 16, 2012

The Land of Counterpane

When I was sick and lay a-bed
I had two pillows at my head
And all my toys about me lay
To keep me happy all the day


I never intended to let a full 13 days pass by before posting my next entry.  No, not at all. I envisioned typing away furiously while lying in my hospital bed, in the ambulance on the way home and in between walking around the apartment and running up and down the stairs upon my return home.

But a curious thing happened.  I am somewhat unwell.

That's never really happened before.  I had perfect attendance at work for more than a decade.  I never think of myself as being sickly or even being compromised in any way. If I am not unconscious with a fever, which is hardly ever, I'm working or running errands or taking care of one thing or another or all of the above and sometimes even when I am unconscious with a fever.  That's just the way I am.  Always have been.  Please don't misunderstand, I have been known to spend  my Fridays doing absolutely nothing, but mainly it's because the rest of the time, I'm running around like a lunatic.  It's not just me.  My whole family is like this.  I inherited it.  In fact, the rest of my family make me look like the Dalai Lama!

So after spending 7 luxurious days in Assuta hotel, uh, hospital, I was ready to come home and get started on the business of getting well.  Assuta was lovely, not your average crumbling Israel public hospital with Gestapo nurses.  No, this was an entirely different experience.  And we took V's dad's brilliant suggestion of getting a private room, making the week a real pleasure. The staff were fabulous.  And it was wonderful having M sleep there with me every night. Everyone should have a personal servant for a week: 

"Oh daaahling, I've dropped my (insert here anything superfluous at all) toothbrush/kindle/ iphone charger/ knitting needle/ self-image.  Would you be a dear?!"

Do this 15 times a day. Smile sweetly.  M has been a trooper.  Better than a trooper.  He's been amazing.  Running to Kupat Holim, arranging the insurance forms for refunds etc, making food, walking me.   He must be more exhausted than me!  I should buy him a ticket to Thailand when this is all over so that he can just vegetate on the beach over there.

While in the hospital, they got me up the day after the surgery to walk.  It was painful but not unbearable.  It felt (still feels) like the way you feel the morning after you've done a really really intense workout at the gym and its painful to move your muscles. Times a thousand.  But not a bad pain.  Not an unfamiliar pain.  And on the Friday after the surgery, Daughter M & SIL Y took me out to the park for a walk.  It was so nice that we did it again with some friends on Saturday too.  So I have been moving around from Day 1 - which is a good thing.

However, Prof Palmtree decided to keep me in the hospital for an extra 2 days because my blood pressure and hemoglobin plummeted (plus my railroad track wound was oozing but that's a story for another blog post).  I lost a lot of blood during the surgery, I was tired but not walking or exercising was not an option.  And most of the time, when I was just sitting, I felt fine.  Finally they brought me home in an ambulance (whose ingenious robotic chair schlepped me up 4 flights) on Sunday afternoon.  It felt good to be home again.

By Monday afternoon, I had navigated the stairs and by Tuesday morning I had conquered all four flights and was down on the street walking.  People are always amazed that I managed to get up and down all four flights.  But honestly?  It's harder for people who don't do it every day.  I do.  Even when my hip was bad and I was hobbling along, I could run up and down the stairs.  So it really didn't feel like a huge accomplishment to do that.

But Tuesday after both a.m. & p.m. walks,  when I got to the top floor, I thought I was going to vomit or faint. Or both.  BP dropped again.  That is a scary feeling. Apparently I think I am stronger, well-er, than I really am.  Dr. Muchacha (I say that with love, she has called me Gringo) gave M some iron pills and told me to drink gallons of coffee and eat bucketfuls of salt.  Very medical advice, I know.

As a result, Wednesday I didn't go out.  I was afraid.  My dear friend  came to babysit in the morning, as M went to work and the PT lady arrived.  She gave me the same exercises that they gave me in the hospital and said she'd come back next week.  I walked around the apartment but mainly I just sat in the recliner.  I haven't been watching any daytime TV.  Even reading has not been my primary activity.  Frankly, I'd be happy just staring out the window.  The thing I find most enjoyable is knitting.  The repetitive, meditative motion is surprisingly soothing.  I've never really knitted anything  before and when I am back to my old self, I am not sure I would be able to find the patience for it.  But for right now, it is keeping me sane.  I just don't have the gumption for much else.

Yesterday, I was determined to get moving again.  After doing my morning exercises, M and I went down for a walk.  We got as far as the Makolet and had a coffee.  I felt somewhat flushed while we were there.  But we sat for a while and walked home v-e-r-y slowly and even more slowly up the stairs.  I felt fine.  Relief.  Then I sat down in my recliner and promptly fell asleep for 3 hours.  I literally could not get up.  I spent the rest of the day knitting.

It's funny, before the surgery, I imagined that it would be difficult moving afterwards, but physically, muscularly, I am actually capable of walking.  Instead I've become an anemic Victorian heroine in one of the Bronte sister's novels. Huh?!  How did that happen?  I suppose I just need to get used to the idea that I am still quite weak and readjust my pace accordingly.  Hopefully, I'll be feeling up to writing more often and keeping you posted on my progress.  But for now:

I am the giant great and still
Who sits upon the pillow-hill
And sees before him dale and plain
The pleasant land of counterpane.

- Robert Louis Stevenson


p.s. apologies for the font schizophrenia, I'm still trying to figure this whole blog thing out.  :-)

Sunday, March 4, 2012

Countdown

It's nearly 1am on the day of my surgery. The operation is at 11am & we're due at the hospital at 8:30am. Did I mention I'm not a morning person? But of course, you already know that.

What's worse is that I need to get up extra early and hit the showers with the lovely pink antiseptic scrub. I did the first regime tonight, including shampooing my hair with it because the instructions just weren't that clear. My hair felt a little straw-like afterwards but I guess it doesn't really matter where I'm headed. The instructions were very clear, however, that another scrubbing should be done the morning of the op. I am not doing my hair again.

In any event, everything here at home is now ready. The double-length shower hose that M installed so that I can shower in the stall which we have used as a storage closet for the past 27 years. The high-rise toilet seat that M gave me for Valentine's Day. Yes, romantic! The walker and cane are poised waiting for my return from the hospital. We put the mattress from the spare bedroom upstairs under our regular mattress so that the bed is double its normal height. I almost have trouble climbing up onto the bed now, I feel like the princess and the pea.

Tonight I spoke to V's dad. He had the same thing done (THR, same dr., same hospital) exactly one year ago. When I called him tonight, I interrupted him on his ski trip. Yes, you read that right. SKIING! I told him he was my role model. Can I imagine myself skiing one year from now?! Well considering that I've never skied in all my 51 years, it may not be wise to start now. But you get the picture. I do have a list of things I'd like to be doing a year from now which I'll save for another blog post. Anyway, we discussed the important things: shoes (he recommends crocs!), sleeping positions (back), and that it's perfectly natural to feel a little trepidation the night before.

I don't feel a lot of trepidation, just a tad. Mainly I have been more upset about them cutting off part of my perfectly healthy femur. I know, I know. It's a means to an end and it's for a greater good. That bone is just too damn big for its own good. One thing that made me feel better about it was reading a website earlier today about hip replacement recovery which asked: "are you mentally prepared for the loss of a piece of yourself?" Well put. Reading that made it clear that I am not crazy for being upset about this. In a way, reading that did prepare me for it. The loss acknowledged, a tear shed and now we can move on.

My bag is packed. I'm fasting now until after the surgery. And it's getting late so I really ought to shut off the light and go to sleep.
See you on the other side!

Saturday, March 3, 2012

Follow the Yellow Brick Road

I don’t have a good name for a blog.  That, in fact, has always been the biggest obstacle in starting one.  (Well that, and the fact that the only correct response to that daunting blank page and blinking cursor staring at you is to stare back and snap shut the laptop.)  I read a lot of blogs and also their comments and I am constantly amazed by the “noms de plume” I find there.  Because although I may encompass some of these qualities,  I wouldn’t ever define myself, or title my blog, as Urban Wife, Sweetopia, Lavenderlover, Karen in Kansas (ok  but the alliteration is good & you know what I mean) or even Busy Working Momma.

There are some that do give pause though, Notes from A Broad (that is meant to be a play on words, right?),  The Vegetarian Accountant (hmmm,  fits the bill but neither is really topic I’d choose to blog about.  Not long ago, I did try to write about the inevitability of my accounting job being outsourced and bored myself to sleep, so I couldn’t possibly subject you, Dear Reader!), Fab at Fifty!, but sadly, these clever ones are already taken.

I am a book-keeper, a baker, a knitpurl-er, a lover of arts, a reader and some-time writer, possibly-hopefully-occasionally elegant but not really privileged, a mother and a shviger (!) a daughter and a wife,  but I am not and never will be one-dimensional.  I am the sum of my parts and couldn’t possibly name my blog so narrowly as to miss out of all those other aspects of life. While it’s true that every blog-advice column I’ve read instructs one to have a focus, I think that this could be somewhat limiting.  Wouldn’t you agree?

Yet now, I find myself at a crossroads, about to undergo a total-hip-replacement which will possibly change my self-perception and hopefully my life.  I have always felt strong, healthy and active.  But lately swimming has replaced going to the gym, spinning and yoga.  And never being a few minutes walk from my motorbike has replaced traipsing across Tel Aviv on foot.  I’m far from physically-handicapped and I don’t usually let my ailment impede my life, but almost everyone who knows me has noticed my limping or has seen me, at one time or another, struggling.   So have I finally found my focus?

It seems like the occasion has, at last, presented itself to me.  So I will blog about this:  the adventure that stands before me.  I will keep you posted on my preparation, surgery, recovery (although I can’t promise that all those other things in my life won’t crop up here and there) and take this as a jumping off point and write about what I’m going through and how I’m doing.   And no, I’m NOT calling this blog The Hippy Hippy Shake!

Rather the image that comes to mind is Dorothy, standing in Munchkinland about to being her great adventure in Oz, not knowing where it will lead her but with tremendous optimism and tingly anticipation.  Three small footsteps at the very starting point of the Yellow Brick Road, right where that band of yellow swirl meets the red.  Three notes, ba, ba, ba, Follow the Yellow Brick Road? Three more footsteps, ba, ba ba, Follow the Yellow Brick Road!  And off we go.

Join me on my journey and wish me luck!