Past encounters with medical procedures gives me some idea of what to expect from the overall surgical experience that I'm facing. I really hate that sensation when you first come partially awake after the effects of general anesthesia. A female voice is calling your name in this somewhat insistent, annoying fashion. It sounds like she's talking from the other end of a 100 foot tunnel. Then eventually you wake up enough to realize that it's over and then you can take stock of whatever they've done to you. This time what will be done to me seems a lot more significant than taking out my tonsils or inserting implants to fix the ravaging effects of breast feeding three children.
Mostly I'm worried that I'll wake up with the epidural still in effect and not being able to feel my legs and then panic. I'm hoping that I remember enough to know that it's nothing to worry about. But I worry that I'll worry. If that makes any sense.
On Wednesday I went to the hospital for my pre-op appointment. The first phase consisted of a chirpy guy named Andrew going over my financial history. Poor Andrew was trying very hard to be bright and upbeat, but he was really just freaking me out because he was talking really fast and I was trying mightily to keep my breathing under control so I didn't hyperventilate. At the end he informed me that my estimated out-of-pocket was going to be $948. I told him that I wasn't paying anything until I got an itemized bill because that figure came from the bundled payment for the DRG that had been assigned to my procedure. He blinked and said "I'll just put here that the patient is requesting to be billed". I smiled. Point for me.
The second phase involved me going upstairs to the surgical ward to do the medical half of the preparation. A lovely nurse came out and greeted me and took me back. This is the type of nurse that I hope I get on my surgery day. Late 50s to early 60s so she'd seen it all and nothing would rattle her. If she was aware that I was nervous, she chose to comfort me with her brisk, efficient and professional manner. She cooed over my blood pressure (104/56 -- which is actually HIGH for me, I told you I was nervous) and a pulse rate of 60. Then we went over medical history, previous surgeries, any health conditions. All this did serve to assure me that I really am pretty much the ideal surgical patient. I'm unlikely to go into cardiac arrest on the table or need a blood transfusion. Both of which, I'm sure, would mean that my out-of-pocket would end up being a lot higher than $948.
It struck me how every part of the medical establishment is designed to make the patient the "thing" and in control of the people who will be taking care of you. Not that they don't try extremely hard to treat you like a person. They really do. But it's unavoidable that at some point, I'll be an unconscious "patient" that needs to be operated on. How a surgeon can view a patient otherwise is beyond me. I mean, he's going to cut up my pelvis. If he spends too much time thinking about me as a person, I'm sure that process becomes a lot harder. At least it would for me. If I was a surgeon, I wouldn't even want to meet my patients. Maybe I'd have made a better ME than a surgeon. At least when you're an ME, your patients don't come back and complain about your bedside manner.
Ok, so there's the waking up part, which is going to suck. I hate being "in recovery" and away from my family with nobody for company except the nurse at the other end of the 100-foot tunnel. But at some point they are going to transfer me to a room and then I can be back with the people I love. Weird that I won't be leaving the hospital. That's a first for me. Every other surgical procedure I've had done was as an out-patient. So at some point they cut me loose and let me go home. This time, my home away from home will be a hospital bed on the 6th floor. I wonder if there will be other PAO patients up there or if I'll have to share the hallways with 70 year old hip replacement patients.
I've read a lot of blogs and posts on discussion groups and adjectives like "tough", "grueling", "hard" are what people use to describe the first two weeks. So I imagine, given that I'll improve every day that the adjectives to describe the first two days would be things like "major suck ass" or "I can't remember because I've blocked it out". When discussing my surgical options with Dr. Peters, I said that I was aware that the recovery from a PAO was going to be a bit more difficult than a hip replacement. His surgical fellow chimed in with "oh, recovery from a hip replacement is a cake walk compared to a PAO..... a cake walk". Well, that's encouraging. Maybe they were playing good doctor bad doctor, I'm not really sure.
So the PAO recovery will be long and I'll have quite a challenge ahead of me. The difficulty is that I'm still not sure what that challenge will entail. And I won't until I get there. I hate that. I want to know everything there is to know now. It's not the pain that scares me, really. I can deal with pain. At least I have in the past. I've given birth to 4 children with no medication at all. But that pain was different, really. It was pain with a purpose. I could define it as "what's necessary to get the baby out" and look at the end result rather than focus on what was going on at the time. I had a goal in mind. And what adorable, gorgeous, perfect little babies they all were. It's hard to get as gooey about a hip, right? I can't dress it up in cute clothes and nobody is going to throw me a "hip shower" and buy me presents. So what should my definition of this pain be? Maybe its "what I have to go through to not be in constant pain any more". Or "what I have to go through to get back to doing yoga the way I used to".
Whatever comes, I can handle it. I know this. But that is small comfort in the wee hours of the night when I wake up from a deep sleep with images of what is to come. Just 5 more nights to get through. Then it will be about coming back. And I will be back. Of this I am certain.
Thursday, May 31, 2012
Wednesday, May 30, 2012
And you ask yourself "how did I get here?"
Since I started this blog to be informative to other people thinking about and researching PAO, I wanted to write about how I got here. In an earlier post, I described how my pain initially started as a sharp ache after long periods of walking in December. At the time, I figured I'd strained something and it would just get better on its own.
In March, my mother and husband finally persuaded me to see somebody so I did some research and found an interesting orthopedic specialist who was also an ultra-marathon runner. I figured that anybody who did something that like in his spare time had to be pretty zen. I was half expecting him to tell me that I was just getting old and I should take Advil and quit my complaining. He did an exam and took a single x-ray. The exam consisted of him moving my leg around and asking "does this hurt?" "how about this?". Most of it didn't hurt, but when it did hurt, it hurt a LOT. It was a sharp, catching pain right inside the hip socket followed by a dull burning ache in the same spot.
So when he put the x-ray up on the light board, he said "hm, I'm not surprised that your right hip is bothering you. You've got a really shallow socket on that side". That was the first hint that this was structural and not something minor. He told me he wanted me to have an MRI to see the condition of the cartilage. At first I argued with him about the unnecessary cost and time. I wanted to make sure that the MRI would actually mean something and wasn't just going to lead to more tests and no results. He assured me that it would tell him a great deal and that he could make treatment decisions from it about whether it was cartilage or something that could be fixed with therapy. So off I went to be shoved into a metal tube.
The MRI wasn't too bad and the CD of images I got was pretty interesting. It's always an odd feeling to see your insides. To realize that there is all this stuff underneath the fleshy exterior that we think of as "self". After waiting another week, I got to see him and review the results. My husband and I had already done some research and I was suspecting that I had a cartilage tear by comparing my images with those I found on the internet (how did we ever live without the internet??). And the doctor agreed. I had a tear in the labral cartilage that covers the femur head. And nothing I could do was going to fix that and it wouldn't heal on its own. So I knew I was facing surgery, but hoped I could get in and out and on my way pretty quickly. This orthopedic doctor didn't specialize in hips (who knew that even the specialists specialize?) so he referred me to another doctor who did a lot of this sort of arthroscopic surgery.
Another $35 co-pay later, and I'm sitting in an exam room wearing a pair of disposable shorts and silently chastising myself for not shaving my legs the night before. This doctor wanted to do another series of x-rays and again I found myself questioning the additional expense. But he assured me that he needed to see the hip "structurally" in a way that doesn't show up on the MRI. So down the hall I went to get more x-rays, including one of my leg in a "frog" position with my foot on a block and the knee rotated outward, which hurt like hell.
Back to the exam room and he comes in and spends about 5 minutes taking measurements of my hip on the x-ray. This was done with a pretty cool computer program that allowed him to click and drag little arrows all over the screen. Then he turns and delivers what was, to me, pretty devastating news. He tells me that he thinks the cartilage is torn because I have hip dysplasia. The way my hip is structured is unstable, so eventually the cartilage just gave way. He could go in fix it, he says, but it wouldn't address the underlying structural problem. Now I'm realizing that I'm out of the frying pan and into the fire. What I thought back in December as some sort of ligament strain is now just getting worse and worse every time some new doctor takes a look at images of my hip.
He wants to send me to yet another specializing specialist who does "surgery to address hip dysplasia". More waiting, more wondering. And I've just been told that my hip is malformed. At this point all I can think of is that I need a hip replacement. At 44. Short of a cancer diagnosis, this is about the worst thing I can imagine. The scheduling desk then tries to give me an appointment that is 3 weeks away and I lose it. It's amazing what a woman in tears can accomplish. Normally I don't give way to sobbing in public but I'd had all I could take. So they found me an appointment 2 weeks out and explained the doctor wasn't even in the state the following week so that was the best they could do.
During this waiting period, I get back on Google and start researching hip dysplasia. I have to do searches on "adult hip dysplasia" or I get a bunch of results about German Shepherds. And I read, and read, and read. I do searches on "non surgical treatment of hip dysplasia". I do searches on hip replacement and I finally discover a procedure called PAO. It sounds pretty gruesome to be frank. But, it saves my hip and that is of the utmost important to me. I read about the movement limitations of a hip replacement and I learn that they only last about 10-12 years. At the end of my reading, I'm determined to make my case for a PAO despite being over the age of 40.
As it turned out, I didn't have to argue at all. After another exam and more measurements of my hip, the third doctor tells me that yes I have hip dysplasia. The clinical criteria for this condition is a center edge angle measurement. You get this by drawing a straight line up from the center of the femur head and then another line that goes from the same spot to the outside of the hip. Anything less than 25 is considered dysplasic. My left hip is 20 (and so far has not given me a single problem). My right hip is 10. Less than half what it should be. So that's that. Nothing I can do at this point but put up with the pain or get it fixed. In some ways, it's nice that it's that simple. There's no watchful waiting here. The doc tells me that if I don't get it fixed, then I will develop arthritis and need a total hip replacement in "2 years at most".
He tells me that the last time he did a PAO on a person over 40 was over a year ago. So I'm unusual. I asked him why me and he said that my cartilage is still in really good condition (discounting the tear, which he can fix) and I don't yet have arthritis. I'm a normal weight and always have been. And I don't have any other underlying medical conditions. And for that I'm grateful. The thought of having metal parts in my body was pretty appalling to me. However, the doctor did tell me that I'll need a hip replacement eventually. Which could mean anything. As long as it's not today, I'm good. I'll cross that bridge when and if I come to it. In the meantime, I'll get to see x-rays of my hip with three metal screws in it. My 15 year old son will be very impressed with THAT.
In March, my mother and husband finally persuaded me to see somebody so I did some research and found an interesting orthopedic specialist who was also an ultra-marathon runner. I figured that anybody who did something that like in his spare time had to be pretty zen. I was half expecting him to tell me that I was just getting old and I should take Advil and quit my complaining. He did an exam and took a single x-ray. The exam consisted of him moving my leg around and asking "does this hurt?" "how about this?". Most of it didn't hurt, but when it did hurt, it hurt a LOT. It was a sharp, catching pain right inside the hip socket followed by a dull burning ache in the same spot.
So when he put the x-ray up on the light board, he said "hm, I'm not surprised that your right hip is bothering you. You've got a really shallow socket on that side". That was the first hint that this was structural and not something minor. He told me he wanted me to have an MRI to see the condition of the cartilage. At first I argued with him about the unnecessary cost and time. I wanted to make sure that the MRI would actually mean something and wasn't just going to lead to more tests and no results. He assured me that it would tell him a great deal and that he could make treatment decisions from it about whether it was cartilage or something that could be fixed with therapy. So off I went to be shoved into a metal tube.
The MRI wasn't too bad and the CD of images I got was pretty interesting. It's always an odd feeling to see your insides. To realize that there is all this stuff underneath the fleshy exterior that we think of as "self". After waiting another week, I got to see him and review the results. My husband and I had already done some research and I was suspecting that I had a cartilage tear by comparing my images with those I found on the internet (how did we ever live without the internet??). And the doctor agreed. I had a tear in the labral cartilage that covers the femur head. And nothing I could do was going to fix that and it wouldn't heal on its own. So I knew I was facing surgery, but hoped I could get in and out and on my way pretty quickly. This orthopedic doctor didn't specialize in hips (who knew that even the specialists specialize?) so he referred me to another doctor who did a lot of this sort of arthroscopic surgery.
Another $35 co-pay later, and I'm sitting in an exam room wearing a pair of disposable shorts and silently chastising myself for not shaving my legs the night before. This doctor wanted to do another series of x-rays and again I found myself questioning the additional expense. But he assured me that he needed to see the hip "structurally" in a way that doesn't show up on the MRI. So down the hall I went to get more x-rays, including one of my leg in a "frog" position with my foot on a block and the knee rotated outward, which hurt like hell.
Back to the exam room and he comes in and spends about 5 minutes taking measurements of my hip on the x-ray. This was done with a pretty cool computer program that allowed him to click and drag little arrows all over the screen. Then he turns and delivers what was, to me, pretty devastating news. He tells me that he thinks the cartilage is torn because I have hip dysplasia. The way my hip is structured is unstable, so eventually the cartilage just gave way. He could go in fix it, he says, but it wouldn't address the underlying structural problem. Now I'm realizing that I'm out of the frying pan and into the fire. What I thought back in December as some sort of ligament strain is now just getting worse and worse every time some new doctor takes a look at images of my hip.
He wants to send me to yet another specializing specialist who does "surgery to address hip dysplasia". More waiting, more wondering. And I've just been told that my hip is malformed. At this point all I can think of is that I need a hip replacement. At 44. Short of a cancer diagnosis, this is about the worst thing I can imagine. The scheduling desk then tries to give me an appointment that is 3 weeks away and I lose it. It's amazing what a woman in tears can accomplish. Normally I don't give way to sobbing in public but I'd had all I could take. So they found me an appointment 2 weeks out and explained the doctor wasn't even in the state the following week so that was the best they could do.
During this waiting period, I get back on Google and start researching hip dysplasia. I have to do searches on "adult hip dysplasia" or I get a bunch of results about German Shepherds. And I read, and read, and read. I do searches on "non surgical treatment of hip dysplasia". I do searches on hip replacement and I finally discover a procedure called PAO. It sounds pretty gruesome to be frank. But, it saves my hip and that is of the utmost important to me. I read about the movement limitations of a hip replacement and I learn that they only last about 10-12 years. At the end of my reading, I'm determined to make my case for a PAO despite being over the age of 40.
As it turned out, I didn't have to argue at all. After another exam and more measurements of my hip, the third doctor tells me that yes I have hip dysplasia. The clinical criteria for this condition is a center edge angle measurement. You get this by drawing a straight line up from the center of the femur head and then another line that goes from the same spot to the outside of the hip. Anything less than 25 is considered dysplasic. My left hip is 20 (and so far has not given me a single problem). My right hip is 10. Less than half what it should be. So that's that. Nothing I can do at this point but put up with the pain or get it fixed. In some ways, it's nice that it's that simple. There's no watchful waiting here. The doc tells me that if I don't get it fixed, then I will develop arthritis and need a total hip replacement in "2 years at most".
He tells me that the last time he did a PAO on a person over 40 was over a year ago. So I'm unusual. I asked him why me and he said that my cartilage is still in really good condition (discounting the tear, which he can fix) and I don't yet have arthritis. I'm a normal weight and always have been. And I don't have any other underlying medical conditions. And for that I'm grateful. The thought of having metal parts in my body was pretty appalling to me. However, the doctor did tell me that I'll need a hip replacement eventually. Which could mean anything. As long as it's not today, I'm good. I'll cross that bridge when and if I come to it. In the meantime, I'll get to see x-rays of my hip with three metal screws in it. My 15 year old son will be very impressed with THAT.
Tuesday, May 29, 2012
Down the rabbit hole
I do health systems research for a living. For the last 8 years, I've gained a lot of knowledge about health care delivery. The system is broken, we know this. But it's the only system we've got. Now, as I prepare to start my journey through a complicated gauntlet of information, questions, standards, and billing, I reflect on what I know about how care is managed and delivered.
In my family, I've always seen myself as the last line of defense in health care. When my father had to have open-heart surgery, I prided myself on the fact that nobody got to him during the four days I was there without going through me. I questioned every person who showed up in his room, confirmed every procedure, and validated everything they did to him. Now I'm going to have to turn that duty over to my husband. I won't be competent enough to do it. At least for a while. How long, I don't know. Certainly in the few hours after my surgery, he'll have to stand watch over me and make sure that I don't become the latest casualty in a health care system that injures 1,000,000 people a year and kills another 90,000. I'm not trying to freak you out. But those are the facts and when you're in my line of work, you can't just ignore the facts.
So, ask questions and check everything. Follow the doctor's directions to the letter. Another hot topic in health care quality research is hospital readmissions. I don't want to be in the hospital in the first place. I certainly don't want to end up BACK in the hospital. Yet about 10% of patients do (higher for Medicare patients, who are older than I am). Keeping myself from getting an infection in the surgical site will be the best way to make sure I get out and stay out. I can do that. Oh, and not falling down the stairs.
Finally, I know that after all this is over, I get to deal with the medical bills. Medical facilities have a variety of numbers that they put on bills, many of which are meaningless. First there is the "charge" for the stay. That's meaningless. That's just a number that the CFO of the hospital has decided will be assigned to this particular DRG (diagnosis related group). I'd have to start another blog to explain medical billing in any detail, I kid you not. Based on the charge, and my insurance, there will be an "allowable charge" (a lower number) that my insurance company and the hospital have worked out ahead of time will be the amount that they will actually get charged (as opposed to the "charges" which nobody gets charged unless they are uninsured. The irony) Then there will be co-insurance and a bunch of other complicated crap that I'll have to wade through. I'm already theoretically $500 into this journey ($250 deductible toward the MRI that I paid, plus my co-insurance which they have billed me at $322 but which I have not yet paid).
My plan is to ask the hospital for an itemized bill, preferably before I even leave. Then I'll go over that in great detail and question every single line item. It's entirely common for hospital patients to be billed for stuff that was never done or to be billed more days than they actually stayed. This is because hospital set rates for all the "stuff" that you'll need for whatever they are going to do for (to) you and it gets billed automatically. If you deviate from the expected course, there isn't necessarily going to be somebody who will catch that. You'd think the insurance companies would, but they don't. It typically falls to patients.
Being down the rabbit hole is an interesting place to be for somebody who does what I do. Knowing as much I as I do from my vantage point up here in the data, I'm curious as to what the view from down there will be like.
In my family, I've always seen myself as the last line of defense in health care. When my father had to have open-heart surgery, I prided myself on the fact that nobody got to him during the four days I was there without going through me. I questioned every person who showed up in his room, confirmed every procedure, and validated everything they did to him. Now I'm going to have to turn that duty over to my husband. I won't be competent enough to do it. At least for a while. How long, I don't know. Certainly in the few hours after my surgery, he'll have to stand watch over me and make sure that I don't become the latest casualty in a health care system that injures 1,000,000 people a year and kills another 90,000. I'm not trying to freak you out. But those are the facts and when you're in my line of work, you can't just ignore the facts.
So, ask questions and check everything. Follow the doctor's directions to the letter. Another hot topic in health care quality research is hospital readmissions. I don't want to be in the hospital in the first place. I certainly don't want to end up BACK in the hospital. Yet about 10% of patients do (higher for Medicare patients, who are older than I am). Keeping myself from getting an infection in the surgical site will be the best way to make sure I get out and stay out. I can do that. Oh, and not falling down the stairs.
Finally, I know that after all this is over, I get to deal with the medical bills. Medical facilities have a variety of numbers that they put on bills, many of which are meaningless. First there is the "charge" for the stay. That's meaningless. That's just a number that the CFO of the hospital has decided will be assigned to this particular DRG (diagnosis related group). I'd have to start another blog to explain medical billing in any detail, I kid you not. Based on the charge, and my insurance, there will be an "allowable charge" (a lower number) that my insurance company and the hospital have worked out ahead of time will be the amount that they will actually get charged (as opposed to the "charges" which nobody gets charged unless they are uninsured. The irony) Then there will be co-insurance and a bunch of other complicated crap that I'll have to wade through. I'm already theoretically $500 into this journey ($250 deductible toward the MRI that I paid, plus my co-insurance which they have billed me at $322 but which I have not yet paid).
My plan is to ask the hospital for an itemized bill, preferably before I even leave. Then I'll go over that in great detail and question every single line item. It's entirely common for hospital patients to be billed for stuff that was never done or to be billed more days than they actually stayed. This is because hospital set rates for all the "stuff" that you'll need for whatever they are going to do for (to) you and it gets billed automatically. If you deviate from the expected course, there isn't necessarily going to be somebody who will catch that. You'd think the insurance companies would, but they don't. It typically falls to patients.
Being down the rabbit hole is an interesting place to be for somebody who does what I do. Knowing as much I as I do from my vantage point up here in the data, I'm curious as to what the view from down there will be like.
Monday, May 28, 2012
The unbearable whiteness of cleaning
I think my house is the cleanest it's been in its life. And I'm talking about the type of cleaning that you do when you move -- dusting the top of the 'fridge, cleaning the baseboards, vacuuming behind the dryer. Of all the things I'm worried about, being unable to move and having to watch my house get dirty ranks right up there with falling down the stairs.
I've always been a clean freak. Even as a teenager, I was fond of taking a toothbrush to the grout in my bathroom. This is going to be a challenge.
So this Memorial Day weekend, I've spent time cleaning everything I can think of. My goal is to get my house SO CLEAN that is actually stays clean for the next 8 weeks. Probably not going to happen, but that's the idea.
I'm also happy to report that the kids really stepped up as well. And I'm not talking about the kind of stepping up that they do when I read them the collective riot act and threaten to withhold TV, video games, computer, food and water until they actually start acting like functioning members of this household. This was the type of stepping up that comes from the fear that Mom might actually die in surgery (no, I'm totally serious. Cheyenne has asked me three times who is going to buy her clothes if I bleed to death in the operating room). Said 12-year old cleaned the microwave without even being asked!! And she also picked up her room. The fact that I discovered later that she'd taken everything off the floor and stuffed it in the closet and closed the doors doesn't diminish the fact that she really tried. Morgan vacuumed nearly every square foot of the house and also picked up his 3-year old sister's room. His reaction when he found it completely trashed again 6 hours later was priceless. Welcome to my world.
I've also made a list of "mindless tasks I can do while seated and floating on pain medication". These include cleaning out my closet of clothes I haven't worn since the Bush administration and cleaning out my pantry of things that are on the verge of becoming sentient. I figure my mother can help with these tasks and it will satisfy my need to continue to be a vital part of this household even though I won't be able to push a vacuum or operate a car.
This time next week I'll be enjoying my last evening before my surgery. Meanwhile, I'm going to find more things that are dirty.
I've always been a clean freak. Even as a teenager, I was fond of taking a toothbrush to the grout in my bathroom. This is going to be a challenge.
So this Memorial Day weekend, I've spent time cleaning everything I can think of. My goal is to get my house SO CLEAN that is actually stays clean for the next 8 weeks. Probably not going to happen, but that's the idea.
I'm also happy to report that the kids really stepped up as well. And I'm not talking about the kind of stepping up that they do when I read them the collective riot act and threaten to withhold TV, video games, computer, food and water until they actually start acting like functioning members of this household. This was the type of stepping up that comes from the fear that Mom might actually die in surgery (no, I'm totally serious. Cheyenne has asked me three times who is going to buy her clothes if I bleed to death in the operating room). Said 12-year old cleaned the microwave without even being asked!! And she also picked up her room. The fact that I discovered later that she'd taken everything off the floor and stuffed it in the closet and closed the doors doesn't diminish the fact that she really tried. Morgan vacuumed nearly every square foot of the house and also picked up his 3-year old sister's room. His reaction when he found it completely trashed again 6 hours later was priceless. Welcome to my world.
I've also made a list of "mindless tasks I can do while seated and floating on pain medication". These include cleaning out my closet of clothes I haven't worn since the Bush administration and cleaning out my pantry of things that are on the verge of becoming sentient. I figure my mother can help with these tasks and it will satisfy my need to continue to be a vital part of this household even though I won't be able to push a vacuum or operate a car.
This time next week I'll be enjoying my last evening before my surgery. Meanwhile, I'm going to find more things that are dirty.
Friday, May 25, 2012
You can never be too prepared
I cope with stress by gathering information. That's how I keep from giving over completely to anxiety. If I just know enough stuff, then I can prepare for anything. So I read. Back in 1995 when I was pregnant with my first child, I checked books out of the medical school library. These days, it's far easier to learn a great deal about PAO.
I know where they'll make the incision. I know that the surgery typically takes about 3 hours. I know I'll get an epidural (how ironic that after giving birth 4 times, I'll finally get an epidural!) I know I'll be in the hospital for 3 days. But knowing all of this data doesn't really tell me what will happen TO ME. So I wait, and I read and I prepare.
Today I called Dr. Peter's nurse to get the results of my blood work. My hemoglobin is 15 and my hematocrit is 43. Everything else they tested is "in normal range". Those two numbers were the ones I was worried about so I can check worrying about them off my list now. I also asked about medication and what I should bring to the hospital. My concern now is whether anybody is actually going to pay attention to the list of stuff I'm already taking and make sure that it won't interact badly with the stuff they are going to give me. I'm already weaning myself off the Xanax because I won't take that while I'm taking narcotic pain medication. How ironic it would be to survive a major surgery only to succumb to the same lethal cocktail that carried off Heath Ledger.
My plan now is to read up on living with a walker or how to manage on crutches or whatever other search terms I can think of. I'm terribly aware that my mobility, and therefore my productivity, are going to be excruciatingly limited. I think that might actually be the hardest part of this whole thing. I expect the first few days to be pretty difficult as I learn to manage the pain and recover from the effects of the actual surgery. But once I'm out of the hospital, it will be all about trying not to make myself crazy by holding myself to the same standards as I did when I had the use of both my legs.
I was thinking today that even the simple act of watering the flowers in my garden is going to be a challenge. Jarrah will not take kindly to me not being able to pick her up. I'll miss going to yoga class. But I have to think it'll be worth it. Right now, I can do very little. I hope that on the other side of doing less, I can eventually find a place where I can do what I used to.
I know where they'll make the incision. I know that the surgery typically takes about 3 hours. I know I'll get an epidural (how ironic that after giving birth 4 times, I'll finally get an epidural!) I know I'll be in the hospital for 3 days. But knowing all of this data doesn't really tell me what will happen TO ME. So I wait, and I read and I prepare.
Today I called Dr. Peter's nurse to get the results of my blood work. My hemoglobin is 15 and my hematocrit is 43. Everything else they tested is "in normal range". Those two numbers were the ones I was worried about so I can check worrying about them off my list now. I also asked about medication and what I should bring to the hospital. My concern now is whether anybody is actually going to pay attention to the list of stuff I'm already taking and make sure that it won't interact badly with the stuff they are going to give me. I'm already weaning myself off the Xanax because I won't take that while I'm taking narcotic pain medication. How ironic it would be to survive a major surgery only to succumb to the same lethal cocktail that carried off Heath Ledger.
My plan now is to read up on living with a walker or how to manage on crutches or whatever other search terms I can think of. I'm terribly aware that my mobility, and therefore my productivity, are going to be excruciatingly limited. I think that might actually be the hardest part of this whole thing. I expect the first few days to be pretty difficult as I learn to manage the pain and recover from the effects of the actual surgery. But once I'm out of the hospital, it will be all about trying not to make myself crazy by holding myself to the same standards as I did when I had the use of both my legs.
I was thinking today that even the simple act of watering the flowers in my garden is going to be a challenge. Jarrah will not take kindly to me not being able to pick her up. I'll miss going to yoga class. But I have to think it'll be worth it. Right now, I can do very little. I hope that on the other side of doing less, I can eventually find a place where I can do what I used to.
Finding out
It's a strange thing when a doctor tells you there's something wrong with you. Something really wrong. Not just that you need glasses or a cavity filled. But something truly WRONG with you that can't be fixed by anything simple. When I first heard the term "hip dysplasia" I felt like I'd been slapped. Here I was, not quite 44 years old, being told that I was broken.
My story actually begins on the streets of Manhattan. Although unaware of how my life had changed, I was aware that my hip hurt after two full days of chasing my speed-walking sister around the city. Christmas came and went, but the pain remained. Bothering me in yoga, going away for a while, making its presence known again while walking through the mall. I kept waiting for it to get better. But it didn't.
So now I'm aware that my right hip is actually malformed. It meets clinical criteria for being dysplasic (the left one doesn't, thank goodness). And I have to deal with that. I have to make my peace with the fact that something went wrong while I was forming in the primordial ooze of amniotic fluid that nurtured me. Something that now has caused my labral cartilage to tear and my hip to hurt. And without a fix, it will keep hurting. And it will only get worse.
The final decision that I needed surgery came on May 23rd. A day that had lived in my head for two weeks as I waited to see "the hip dysplasia guy". Meanwhile, I researched. I read up on hips and mechanical function and what can go wrong with them and what can be done to fix them. I learned the term periacetabular osteotomy and read blogs written by people who have had them. After meeting with Dr. Peters and getting his very calm, very measured opinion, I'm now writing one of my own.
I'm writing this because I found reading the experiences of other people to be very helpful as I did my research. I'm also writing it because, I found out, I'm "a one percenter". That is, I'm one of the 1% of people over 40 who actually get to have this done. So this blog will be for those select people who find out that they will get a PAO, even though many people their age won't.
My thoughts wander to where this blog will eventually lead. I wonder what I will write on June 6th or if I will be able to write then at all. So maybe I should wonder what I will write a bit later, say, June 10th. I wonder what my experience will be like. I hope that I can eventually say "yes, it was hard, but I did it and now I've been free from pain for a year". I really hope so.
My story actually begins on the streets of Manhattan. Although unaware of how my life had changed, I was aware that my hip hurt after two full days of chasing my speed-walking sister around the city. Christmas came and went, but the pain remained. Bothering me in yoga, going away for a while, making its presence known again while walking through the mall. I kept waiting for it to get better. But it didn't.
So now I'm aware that my right hip is actually malformed. It meets clinical criteria for being dysplasic (the left one doesn't, thank goodness). And I have to deal with that. I have to make my peace with the fact that something went wrong while I was forming in the primordial ooze of amniotic fluid that nurtured me. Something that now has caused my labral cartilage to tear and my hip to hurt. And without a fix, it will keep hurting. And it will only get worse.
The final decision that I needed surgery came on May 23rd. A day that had lived in my head for two weeks as I waited to see "the hip dysplasia guy". Meanwhile, I researched. I read up on hips and mechanical function and what can go wrong with them and what can be done to fix them. I learned the term periacetabular osteotomy and read blogs written by people who have had them. After meeting with Dr. Peters and getting his very calm, very measured opinion, I'm now writing one of my own.
I'm writing this because I found reading the experiences of other people to be very helpful as I did my research. I'm also writing it because, I found out, I'm "a one percenter". That is, I'm one of the 1% of people over 40 who actually get to have this done. So this blog will be for those select people who find out that they will get a PAO, even though many people their age won't.
My thoughts wander to where this blog will eventually lead. I wonder what I will write on June 6th or if I will be able to write then at all. So maybe I should wonder what I will write a bit later, say, June 10th. I wonder what my experience will be like. I hope that I can eventually say "yes, it was hard, but I did it and now I've been free from pain for a year". I really hope so.
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