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!)

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