Standing for the first time (August 23rd)

This was the first time standing after the second hip.  It wasn't nearly as painful as the first one.  There was way less pain in the groin area and moving the leg side to side was so much more painful last time.  When you straighten the leg the first time, the stiffness in the hammy is probably the most notable.   There is really no pain deep down in the joint.  You would think that after all that carving, grinding, and hammering on bone, that there would be some bone pain, but there really isn't.  Also on this event, the catheter removal was much easier and less painful, the gut issues were way better, everything seemed easier. 

Shark Bite No. 2 (August 24th)

I know this is a little gross and sadistic, but I have to show off my wound again.  It's something to be proud of, I guess.

Here is the wound on the right side.  It's about the same as the left was.  I think there is a little more bruising with this one.  Swelling is not too bad though.  It looks worse than it feels.  If I had a straight on butt shot it might look as if a great white chomped on my arse and then quickly spit me out, just enough chomping to scar the cheeks but not enough to actually split me in two.  Lovely, huh?

Day of Surgery No. 2 (August 23rd Right Hip Resurfacing)

Much of the 2 days prior to surgery were spent wandering around Seattle's waterfront stewing about the upcoming surgery.  I knew I had already done it before, but that didn't help all that much.  I had a lot of anxiety the day prior.  Surgery was scheduled for Tuesday morning at 0730, but I was required to be there at 0540.  I don't think I slept much at all the night before.  You know you're anxious when you get up before the alarm clocks go off at 0500.

Once we got into the pre-op area, I took the requisite oxycontin and celebrex and knew there was no going back.  Without anything in my stomach the narcotic made me pretty loopy and that's a good thing.  The IV went in much better this time, maybe because I was not dehydrated.  We met with the surgeon and discussed some of the interesting aspects of HR.  I always like that about my surgeon, he likes to talk about the technical stuff, when he has time.  I then met with the anesthesiologist.  I mentioned that I was numb for longer than expected last time and so he looked at the dosing from before and I suspect made some minor changes.  I was wheeled into the OR and laid on the surgical side while the spinal numbing started.  Gravity got the juice into the surgery area and then I turned over.  Then I think the Versed was put in and I don't remember much after that.

I woke up in the middle when they were hammering in the acetabular cup.  I think there was about 4 solid hits where I recall scooching forward a bit on the operating table with each blow.  I asked the anesthesiologist what was going on and he replied, "that happens sometimes when they start hammering", then I fell asleep again, he probably turned up the juice a little.  I then woke up near the end and tried to lift my head and look over the surgical sheets and someone quickly pushed my head back down and asked that I lay still while finishing up with the sutures.  They probably didn't want me breathing on the wound.  Anyway I stayed awake into the recovery area and actually felt pretty refreshed, like I had a decent 4 hour nap.

In the recovery area, I had the shakes but not as bad as before.  They gave me some Demerol and that settled it down.  Once again, ice chips and warm blankets never felt so good.  I was wheeled into my room much quicker this time and felt more aware and refreshed then last time.  Here it is, for the next 26 hours or so.

Getting Ready for No.2

It's been awhile since I posted here.  Been busy enjoying my summer.  However, I'm on the brink of heading in for the right hip.  We're leaving tomorrow morning to go back to Seattle to see Dr. Pritchett, bright and early at 0540 on Tuesday morn.  We'll spend 2 nights in Seattle on the front end having fun, celebrating our 19th wedding anniversary (bronze).  Fitting since we'll be putting some bronze to work on the oarlocks of a livery boat at the Center for Wooden Boats on Lake Union.  Bronze makes a good bearing, wonder if anyone has ever made a hip prosthesis out of bronze.  I'm hoping to get out of the hospital in 32 hours or less.  A hip buddy of mine just got out of Swedish in 32 hours.  A little competition is good for the soul, but might not be so good for a brand new hip. 

I finished up a new cane for lighter travel. It's totally pimped out.  I found a cool pool cue from Goodwill and thought it would make a good cane.  A few years ago, a friend gave me an LED flashy gearshift knob so that I could "pimp out" my truck, like he planned to do.  I don't usually go for the bling bling, especially on my vehicles.  So the knob sat in the closet for a few years waiting to be used for something cool.  Surprisingly the knob fit nicely on the top of the cue, just had to lightly screw it on.  It threaded on to the nylon end and made a really solid connection. I then measured and cut off the bottom.  The diameter at the bottom was a hair under 7/8".  A couple wraps of electrician's tape and the pharmacy cane tip fit perfectly.  Here's a couple photos.  

Who knew Hip Resurfacing could be so fun!  Bling Bling, BTW - I'm not a Coors fan, I prefer Pacifc NW ale.

I'm no where near as anxious about this surgery.  Although I'm not looking forward to the several weeks of being gimpy, or not being able to roll over in bed for a week or so.  I am looking forward to being able to ride a bike in a month or so, that's going to be pretty awesome. My right leg has been pretty uncomfortable lately, not as bad as the left was, but its obvisou the hip needs to get fixed.  The range of motion is bad and if I overdo it, like step too high, I'll have a painful limp for a day or so.  Today I was happy that my leg hurt, reinforcing why I'm doing this.

Well I've got my medical stuff packed, except for the urinal.  I'll get a freshy at the hospital.  I've got my tunes (Dropkick Murphies, Flogging Molly, Pogues, and Tesla).  Everyone needs a little 80's hair band rock once in awhile, sweet.  Got a full bottle of oxycodone which I'm hoping I won't need.  Maybe I can sell it down in Whiteaker to help pay off the new $500 copay my insurance provider initiated mid plan year because hip resurfacing (HR) is "of questionable medical value".  huh? 

The insurance co-pay increase happened right after the FDA requested more data on HR.  The FDA requested more data on HR because HR, at least metal on metal, has been around since the '70s  before there were rigorous testing protocols, in the US.  Somehow insurance heard that as "questionable medical value" yet data from various national orthopedic registries suggests that hip resurfacing is as successful as total hip replacement.  Oh well, I guess you can't blame insurance for trying to save a little money.  I feel sorry for the poor sap that lives his life not able or willing to pay that extra $500 to get his hip fixed.  What's $500 going to do for a $50,000 procedure, anyway?  It's just a deterrent.

Enough about that.  I'll post after I get back from Seattle.

7 weeks Post op

It's been 7 weeks since I had surgery on the left hip and it feels really good.  Pretty much no pain at all in the hip.  None in the leg like I had previous to surgery.  Problem now is that the right hip is hurting because I'm pushing the range of motion on the left and it works the right over.  I get pain under my knee cap and down the side of the leg.  Weird how I just got used to it in both legs and hobbled around not really knowing I was in pain.  Sucks.

Oh well, I plan to get the right done some time in the next few months before my insurance costs go up next year.  My PT is very happy with my progress and so I am I.  However, I still can't tie my shoe very well.  Some day.

x-ray

Here is my x-ray from my 2 week post op visit to my surgeon.  I made it extra large for detail.  The dense implant (metal) on the right is quite obvious.  In addition, you can see that the right hip (on the left) has a lot of degeneration (lumpy femoral head, tight spacing at acetabular rim, huge osteophyte on femoral neck).  This is why most surgeon's who saw my pre-op x-rays thought I would be in more pain on the right.  The right looked worse than the left. 

I tried to show the abduction angle measurement that I made myself which is identified by the yellow lines.  The surgeon will do that on his own also.  The target angle for all hip resurfacings is generally 40 degrees. That's the angle identifed as alpha on this image.  It represents the outward tilt of the acetabular cup and is measured between a straight line across the pelvis and a straight line along the face of the acetabular cup.  You can see the small indentations on the implant which designates the edge of the cup.  The cup wall is about 3 mm thick and is bevelled at the face, so the "ledge" is soft and not abrupt.  However, it still shows up on the image.  Keep in mind that the both pieces of the implant are essentially touching and the x-ray makes it look like one piece.  See the Birmingham ad in another post here to get a better understanding of how the 2 components go together.       

The software that my surgeon's radiologist uses is OmniVue and the images the radiologist gave me had a free viewer version of OmniVue.  It's not very robust, but it's free so I shouldn't expect much.  I pulled the image up using the free viewer then drew on the lines for measuring.  The software measures the angle, but it uses the edges of the image as the reference, not the line through the pelvis.  The number "31.8" can be seen on the image.  That's the angle provided by the software.  I was not square on the x-ray table, mostly because at 2 weeks post-op I was still a little tender and getting straight on the x-ray table was not a priority.  I could not export the image, so I used Faststone Capture to do a screen capture at high resolution and generated a tiff, brought it up in Paint.net and fuzzed out the personal info and personal area.  BTW - The radiologist did not throw a lead codpiece on me, I suspect because of my age.

I then measured the angle between the lines, on the screen, using a protractor.  The angle is about 38 degrees.

There is much talk about abduction angle of the acetabular cup in the hip resurfacing community.  The reason is because the steeper angles (near 55 degrees or more) may cause increased wear on the components and metallosis (high metals ions in the fluid around the joint).  There is a general belief within the community that you are more likely to have metallosis and problems with steeper angles.  The well-known Belgian surgeon (De Smet) supports the argument that steeper angles cause more wear and higher metals concentrations, in his study comparing the BHR to the Conserve. 

 http://www.surfacehippy.info/pdf/bhvsrconserv.pdf

On the other hand, Pritchett does not suggest that steeper angles are directly responsible for metallosis.  Pritchett suggests that there are other factors that are in play and provides details in his paper on metallosis. He also suggests that metallosis occurs in about 4% of resurfacings. 
  
http://www.pritchettorthopedics.com/articles/pritchett_metallosis_of_the_hip.pdf

Also, there is talk that a larger component will have less wear, due to the increased surface area which spreads out the weight and thus the wear.  This is why some surgeons suggest that smaller framed people are not good candidates for resurfacing.  However, most of the top surgeons will do resurfacing on smaller framed people.

In summary, I'm happy with my angle and I'm not too concerned about excessive wear or metallosis.   

             

3 Weeks Post-Op

Tomorrow will be 3 weeks since surgery and I am doing about as well as should be expected.  Sitting in a hard chair is still a little tiresome for the left flank.  Probably due to residual swelling.  I'm walking with a cane, but not using it much, or at least trying to not put much weight on it.  When I walk without it I have a swagger, which I think is more fear than much else.  My PT thinks its more of a subconscious disconnection due to capping the surfaces with something that isn't bone.  There really isn't any pain with rest.  I do get some discomfort if I walk too long, or put too much energy into my exercises.  

I went to my kid's soccer practice tonight where they practiced with the North Eugene High Team and it was great for me since I didn't have to coach.  Also the kids are beginning to connect with the high schoolers where they will be next fall, so it was good all around.  I wanted so badly to get out there and play, but stood on the side with my cane and did my simple dance steps to work the new hip.  With time I might be out there again, but I might not and that's just the way it goes.  Even if I do no. 2 this fall, I will have a solid 1.5 years from now before playing an impact sport like soccer.  With the 1.5 years since I've played, that will be 3 years without playing.  A lot changes in 3 years and I've lost any drive to play soccer with people who are super aggressive and rough. It's sad because a lot of those people are 50 years old, 10 years older than me and they still don't understand what's important in life. 

Cane

I went to my first PT session today.  I walked with one crutch for a bit in front of the PT and he recommended sticking with the crutch for a bit.  He then rubbed my butt for awhile (the suture zone).  I was expecting some serious bending and stretching.  In time, I guess.

I finished my weekend project, making my own cane.  I think I spent too much time standing at the workbench this weekend and not enough time doing my PT exercises.  Back got sore.

The cane has a steel top that is shaped like the top of a human femur.  I used a hollow blacksmithy 2" ball for the head, welded on some thin-walled tubing for the neck and then added a piece of elliptical tubing from a crappy kid's donor bike for the main femur, then I had to go free-form on the top and add various 3/8" wire and 1/8" strap to make the greater trochanter and the lesser tochanter on the inside. I made kerf cuts in the bike tubing to bring it's diameter down consistantly as you move down the shaft.  I did a lot of welding and grinding, then some sanding and then some wire brushing.  The finish on the steel is simply olive oil burned in at high temp, like seasoning a cast iron pan.

I found a piece of hardwood in the shop for the "stick" of the cane. Rounded it down with a plane and sanded it.  It smelled like black locust but appeared more reddish, maybe osage orange.  It took danish oil well and just has a really nice smooth finish to it.  I completed it with a homemade steel ferrule, like the top.  Then I put one of the rubber crutch tips on the bottome  That doesn't go well with it, though, it's too medical-looking.  I'll try to find a thinner black rubber stopper.

It's a little heavy, but it reminds me of walking with my old-school Chounard laminated wood ice axe, or with my handy mini mattock that I used a bunch for soil sampling several years ago.  Plus, the kids reminded me, it can be used as a weapon.  Lovely.  Also, the piriformis (small top knot on the greater trochanter) adds a little massage to the hand if you want to mix it up a little. 

It looks pretty cool, but it's not exactly anatomically correct and hopefully Mr. PT won't tell me I can't use it. 

2 week post-op appointment

Sorry, no photos.  I saw my surgeon on Friday March 4th to get my sutures out, have an x-ray, and to talk to the doc.  The sutures were a little stubborn and had to be wiggled a little before pulling them out.  I was picturing grilled chicken on a skewer, with the sutures being the skewer, but no meat getting stuck to the suture.  It felt good, but a little painful here and there.  It was the most glamorous part of the surgeon's assistant's job.  When she wasn't setting up appointments and answering thousands of questions from prospective patients, doing insurance pre-authorizations, transferring lab results to the hospital, and all that other lovely office stuff, she was busy looking at people's butts and removing their sutures. 

I got an x-ray, which the surgeon will put a protractor on and measure the angle of the acetabular cup with relationship to the pelvis (I think).  The goal is 40 degrees.  There appears to be some debate in the hip resurfacing community about the steep angles (ie 50 and 55 degrees) causing higher wear and thus elevated metals ions (Cr, and Co) in the blood.  Then there's a lot of debate simply around elevated Cr and Co in the blood.  I could go on, but I won't.

Then I chatted with the surgeon.  I had about 25 questions for him which I wrote down while riding the train to Seattle.  It was a good visit and I sort of thought maybe I should become an orthopaedic surgeon.  He mentioned some of his research on different types of bearing materials for resurfacing.  Give me another 15 years and maybe I'd be there.  Doubtful, oh well, I think that ship has sailed.

I took the train up to Seattle and back in the same day.  When I got back into to Eugene at about 8:45 pm, my wife and a friend were waiting at the station.  Right next door to the station is the Jackaloupe Lounge, a well known Eugene establishment.  It was nice to have a beer before heading home and going to bed.  It was a great feeling to be nearly 2 weeks post op.  The wound has healed well, not much pain, and my surgeon indicated that I was right on schedule with recovery.  I was so stoked that I figured I could drink a whole pitcher of HUB IPA.  Not such a good idea when you're not in shape.

The next day I began a metal and wood working project.  I decided I was getting close to using a cane and wanted to do away with the crutches, so I built a cane.  I'm close to being finished with it and when done, I'll post a photo.

Also, today, I went back to work.  Walked around the office with one crutch and sounded like a peg leg pirate coming the corner.  It was a pretty easy when you're sitting at a desk most of the day.  

Swelling no. 2

Sorry that these photos aren't quite as exciting as the suture photo.  When you sit around the house all day, you get a little bored.  This is a photo of my feet at day 8 post-op.  It's not horribly obvious, but the left side of my left foot has now received some swelling.  I guess it takes a few days for stuff to sink down to the foot.

A general update - I'm down to about 6 x 500 mg of acetaminophen per day.  Yesterday I had a major charlie horse in my lower quad for about a day which reduced my motivation on the exercises.  I should have massaged the quad and really iced it up, maybe even stayed a little heavier on the meds.  At about day 6 post-op I was able to sleep on my side with pillows between my legs.  I'm up to about 8 hours of sleep a night broken into 2 hour to 3 hour segments.   Very nice.

A couple days ago, I made the mistake of falling asleep while laying on my stomach.  My wife had just changed the dressing.  I generally sleep on my stomach and since it had been over a week since I laid in that position, I fell asleep.  It was very comfortable.  The problem came when I woke 3 hours later and could not roll over on my own.  I was like a turtle, but the opposite.  For those of you planning to do a bi-lateral surgery, you might think twice about it.

A tool of the trade

No, not a bone saw, or scalpel,...a raised toilet seat!  This is the best invention ever.  I never thought I would ever need one of these and even when the pre-op nurse discussed prepping the house, I sort of ignored it.  I was thinking I could get away with sitting at the regular level.  Doctor's orders - "Do not bend more than 90 degrees at the hip!"  They scare they hell out you, as if you might dislocate the new hip and botch the whole deal in one minor mistake.   I wasn't going to push it, best not to go acute, stay obtuse. 

The toilet is light and can be used as a walker to get around in the bathroom.  You can put it in the tub and take a cat bath and the toilet gets cleaned at the same time.  See what I mean, a sweet invention.   

Birmingham Hip Resurfacing

http://www.rediscoveryourgo.com/Product.aspx?Product=BirminghamHip

I just found this while checking in with my fellow Hippies (Surfacehippy.info).  This is what is in my hip.  These guys have been making this implant for 10 years or more and they have the lion's share of the market.  The parent company (Smith&Nephew) have been around since 1856 and they are the largest ortho prosthesis maker in the world.  The designers of the BHR (Treacy and McMinn) are in Birmingham, England, thus the name Birmingham.  Some of the other metal-on-metal prostheses are the Wright Medical Conserve Plus, ASR Resurfacing, Cormet by Biomet, Duron by Zimmer, and there are probably a few others out there, that I don't know of.    

Appetite

OK so it's not at as appetizing as Guy Fieri's tangerine flank steak stir fry, which I'm watching right now.  This is my lunch today.  It's a double-wrapped black and pinto bean burrito, with Colby cheese, and a little habanero hot sauce.   Seth - this might be better than the BB bean and cheeser.  The beans are one of the few preemptive moves I did before surgery.  I knew I would want to have easy-to-make, but good, food in the fridge. 

BTW - the kitchen, which we have dreamed of making bigger for 15 years, is the perfect size.  I can pretty-much spin around on my good leg and grab what I need while supporting myself with the other hand. 

That's my chair!

Geez, I get up for one second and the dog steals my chair.  "I'm the pilot of that recliner, you're the co-pilot, dog".  Yesterday I tried to finish Metroid Prime Corruption on the Wii.  Spent all day playing it.  The stupid boss at the end took 30 minutes for each try and I tried 5 times, even looked up a walkthrough, and still didn't finish.  I gave up and today I'm playing Ratchet and Clank, a little more my speed. 

An update on the leg - My quad feels like it was in a charlie horse competition with the Dropkick Murphies, and that part of my leg wasn't even really messed with.  Actually, it probably was in a weird indirect way, though.  Everything in my body is pretty much back to normal other than the hip and leg.   That's really good. The pain is more like the pain you get in your muscles after a whole day of soccer.  Not a horrible pain.  

99.9% better

So the quality of this photo is not so good, but as you can see, I'm 99.9% healed.  Sort of, not really.  However, who needs more than an easy chair, a warm fire, a cool grabber, plaid pants, pub hat, and a brewski? 

BTW - Please do recall that I stopped the hard stuff about 48 hours prior to this photo. Acetaminophen does wonders for me.

Swollen

This is about 3.5 days post-op and I'm walking around the house pretty well with crutches.  First day home was bad because of the cramps and nausea.  The second day home was mostly about getting the plumbing working, and today I've been blogging, and doing some exercises and resting.  I feel sooooo much better, all around.  The swelling as you can see here is a little wild, but not horrible.  It's expected.  Last night I put a pillow between my legs and gingerly rolled over onto my stomach to get much needed rest (I don't usually sleep on my back).  In the middle of the night I woke up and realized that I could not roll back over with out a lot of pain. Sandy had to help.  But in short, I slept 3 sessions of 2 hours each, the best sleep I had gotten in several days.

Leaving Swedish

Getting ready for the ride home.  6 hours in traffic and rain and snow.  I prepared the car as much as I could beforehand, but there was no way it was going to be as comfy as a hospital bed.  In this photo, I was still pretty unaware of the havoc that the anti-biotics and narcotics had done.  About half way to home, the nausea and abdominal cramps set in and lasted for about 24 hours.  My last dose of narcotics was the day I left the hospital.  I'll take the pain over the nausea.  I could have got some anti-nausea meds, but I was ready to be done with meds.  All I needed at this point was acetaminophen anyway, so why take the heavy stuff. 

Sutures

Sorry there wasn't much forewarning about this post.  It's not only graphic, it has nudity.  Here are the sutures, 2 days after surgery.  Looks a little painful but it's not that bad, really.  Notice the surgeon's initial, JNP, to the left of the wound.  When I was in pre-op, I tried to take the pen from the surgeon and annotate my hips.  This was because my friend Geoff suggested it.  Smiley face on the left one, "NOT THIS HIP" on the right, "leave this area alone" near the middle, (forgetting that I'd get a catheter).  The surgeon knew I was hopped up on goofballs and smiled at me and kindly reminded me that he uses the pen and I point to the hip that will get worked on.  He put's his initials on it and then I guess folks in the OR all come around and say, "yup, that's the hip the patient pointed to".  Double-checking is a good thing.

At the pre-admissions conference, the nurse asked me what I was coming to Swedish for and replied, "well you should know, didn't the surgeon tell you when he sent all the lab work over?", she kindly replied, "we KNOW what we are doing to you, you just need to tell us, so that everything lines up.", "oh, I see".  Again, Double-checking is a good thing.

BTW - the cut is long so that the surgeon can have some room to work.  When you do resurfacing you need some room to dislocate, get the tools in there to grind the femur top, grind the cup area in the acetabulum, and be able to sight the angles and make sure it all lines up right.  None of the muscles below get cut, they just get moved over a little.

Walking on Oxycontin

"Hey guys, where's my room again?",

Here I am cruising the halls of the new Swedish Orthopedic Institute in Seattle.   I had just been doped up with some Oxycodone and maybe Oxycontin, too.  Can't remember.  This was about 36 hours after surgery and I'm surprised I didn't get in trouble for cruising on my own.  Sandy was nearby to help break my fall if I stumbled onto my new $40K hip.  Yikes.  In short, it felt great to not have a catheter in or be on the IV and be able to "walk" around a little, I think this may have been the morning we left Swedish.

Flowers from Sandy

I received a nice bouquet of flowers from Sandy.  This was after she watched me reel in pain from the first PT session.  It was about 12 hours after the tied the last suture.  Miss Ratchet came in and removed the wedge between my legs and let the operated leg drop over a little to the side, frogleg style and I wasn't ready for that.  It felt like someone stitched my appendix to my left leg meniscus.  "Feel the stretch"  It was a strange sensation, it was sort of painful but even more deep.  I think the hip capsule was getting stretched a little more than it needed to.  I reeled around in the bed for awhile and then stared shaking again, like I was coming out of anesthesia.  The poor PT (her name was actually Hillary and she was very nice) didn't get very far.  She got some warm blankets and that made me stop shaking and then I started crying like a baby.  I think it was a mix of pain and drugs, but mostly pent up emotion about the whole event.  I just needed a catalyst.  I'd say a little hip capsule stretching and uncontrollable shaking worked.

So, the whole time, Sandy was feeling a little woozy and had to sit down, thinking she might pass out from watching me reel around like that.  Hillary said she'd come back later.  She did and then Sandy promptly went for a walk and stopped to get me some flowers.  The second session was no where near as bad.     

Binder

Here is my binder or 3-ring notebook with all the pertinent info I gathered over the year.  I think I was missing a couple papers about the difference between the Wright Conserve and the Birmingham implants, but I had a lot of details about FAI and one of my favorites, which is a summary of a 20-year study on hip resurfacing co-authored by my surgeon, James Pritchett.  Much of the other info that I did not have in the binder, was gained through participation in the Hip Talk Forum and general info on Surface Hippy.  As the surgery approached, my interest in clinical and technical info about hip resurfacing was balanced with more of the softer side about hip resurfacing.  The stories that were presented on the forum, as well as the support and encouragement from everyone was extremely helpful. 

This photo shows the binder with one or two signatures from staff at the hospital.  My friend Geoff suggested that I get the geeky notebook signed by all the staff that helped me, akin to a getting your cast signed.  I even got a signature from the room cleaner.  She was Laotian and I think she told me about the communist government and oppression at home in the 80s and why she came here, but I wasn't quite sure because I didn't really understand her.  Needless to say, I ended up with a signature from pretty much everyone, even the nice nurse that yanked the catheter out of my hoozit.  "Is this gonna hurt", I asked.  She replied, "take a deep breath".  You know its not gonna be so good when they tell you take a deep breath.  "Now exhale".

Right after recovery

I think my legs may have still been partially asleep here.  This is a couple hours after I got out of recovery and had some dinner.  Hospital meatloaf, mashed potatoes, gravy, and canned green beans never tasted so good.  This is the desert, a chocolate shake.  Happily I was on anti-nausea meds, and happily no one forewarned me that the narcotics pretty-much stop the main plumbing.  I think I made some phone calls to people that night, not sure why I was so talkative.  

Like I said, I was super anxious before surgery and blogging was not the first thing on my mind, so we simply did not record some of the pre-op stuff.  I'll summarize it here:

When we got into the pre-op area, they gave me a prophylactic dose of Celebrex (for the joints), Oxycontin (for the pain in recovery), and some other things.  I'm surprised they didn't give me any benzo's (i.e Vallium, Xanax).  However, being a light-weight with heavy narcotics, I needed nothing more than the oxy to make me sing sea shanties as they rolled me into the OR.  I had the choice of general or regional anesthesia with some heavy sedatives.  I chose the regional (spinal) which is supposed provide an easier ride out of anesthesia than general.  Surprised I did that,  but I had total confidence in Don (my anesthesiologist), probably aided by the narcotics.

All the stress and anxiety and there I was rolling into the OR and the whole time I had an overwhelming sense of calm and confidence.  Everyone was chatty and so was I.  They were happily preparing instruments and pouring solutions into stainless steels bowls.  The bench was not much different than mine, tools all marked and organizing nicely.  Don and a nurse asked me to scooch over on the operating table, which was flat and thin and was more of a workbench than bed.  I received the spinal and my feet began to tingle and fall asleep.  Pritchett (my surgeon) was there setting things up.  He got me on my side and clamped my pelvis into a, well, a clamp, a really big clamp.  Don used a cold stethoscope to check on where my feeling was.  I couldn't feel much below my navel, but I could tell that the surgeon and assistant were setting up my hip for surgery, probably looking down the length of leg, sizing up the angles.  Don then gave me some benzo's in an IV, and then I think some form of another sedative.  That was about all I remember.  I was awfully chatty and it's possible the surgeon gave the Don the wink, "this guy is asking too many questions".  Pritchett assured me later on that I wasn't bugging him.

When I came to or remembered coming to, I had an awful set of the shakes.  My recovery nurse, named Beth, reminded me that I had asked her her name three times prior to me actually remembering her name.  I kept asking for ice chips, who knew ice chips would taste so good.  Warm blankets never felt so good, even though I didn't feel cold.  Beth and I had a little discussion/argument on my BP.  She had a bit of a tough outer shell but she was really sweet after you break through the shell.  I kept putting my head up and looking around and she kept telling me to lay down and rest.  I ate three cups of ice chips, probably because I was so dehydrated.  She was a little concerned about the slow recovery of feeling in my legs.   After she got the go-ahead from anesthesia to release me, I gave her a hug for being so troublesome. 

Then Irving came to wheel me back to my room.  He was a little more chatty.  On the way out of the recovery room, I noticed the dude recovering next to me wasn't very talkative and wasn't lookin' too good, but he was awake.  As we passed by, I was thinking "must've had the general".  When we got to my room, Irving said there was a beautiful woman waiting in my room.  Sandy suggested to me and Irving, that I should have replied, "don't tell my wife".  Geez, even when I'm not all hopped up on goofballs, I'm not that witty.

Can't wait to get this over with!

On the ferry, looking into the sun.  It felt nice, but damn was I anxious.  I'm usually pretty good at calming myself, but I guess when you haven't been under the knife since childhood, and you know it's a major joint surgery, it's sort of expected.  The other aspect adding to anxiety, is that I was questioning whether or not I should be doing this now.  I could limp along and get more used to the easy chair, drink more beer, gained a few more pounds, watch the hypertension creep up,....  That wasn't going to cut it, though.  I missed the days of being able to climb in the trees with the kids and set up ziplines, or chainsawing in the wood lot and being able to do it for more than hour without having several days of pain to follow, I missed being able to tie my shoe without pain.  I had already forgotten about soccer and running, and sort of forgot about bicycling, just because things had deteriorated enough.  Those became distant to me even though it had only been a year since doing them.  I simply wanted to be able to sit in a picnic table again.

On the other hand, I spent a year researching this topic, looked at all the options, participated in the Hip Talk Forum, created my own 3-ring binder on the topic that my coworkers harassed me about, and with all the questioning I was doing, I would always end up telling myself, "I wouldn't be here if it wasn't the right decision". 

Ferry ride to Seattle

Here is my beautiful wife next to me on the ferry ride from Bremerton to Seattle.  I don't know if I could have done this without her.  The ferry ride was quite nice.  Reminded me of my youth when visiting my grandparents in Seattle.  There was a point waiting in line for the ferry when I was super anxious and got myself all keyed.  I looked over at a gangway at the dock that was part of the State Park system and there was a sign designating the park name and so forth, which was a Washington State Park, which, reminded me of my youth, because the grandparents would take us to Discovery Park in Seattle a lot.  Long story short, I had a very calm feeling come over me and no matter how much I tried to get anxious, I couldn't.  Maybe my body gave up and just said, "rollover dude!"

Good luck kiss from a Dane

A Great Dane, that is.  I said I was going to Swedish, didn't I?   Actually I don't think many Scandinavians work at Swedish.

This is Sandy's friend's dog.  She has 2 great danes.  This is Jagger, and I think he is the biggest dog I have ever met.  This was in Bremerton where we spent the night before admission to the hospital.  Sandy's friend Sam, had 2 Great Danes and they had a very calming effect on me.  We went out to dinner at a brewpub in Silverdale next to Bremerton with Sam and her boyfriend, Phil.  It was great to get out and have some distraction from the anxiety.  However, on the next hip, I'll try not to drink the high test IPAs prior to surgery.  Sadly, since I had an afternoon surgery, I easily persuaded myself to drink more than less that night.  I knew if I got up at 6:30 am, I could guzzle a gallon of water and be good to go for the day.  Hey, they said I could eat and drink up to 8 hours prior to surgery.  I was acting like it was just another day in the field working with the drillers.  Mentally, that may have been good, but physically, it wore me down ahead of being quartered.  Not good.

Beer and a Great Dane

Night before surgery.  I think I told Sam and others that I like the smell of dog feet.  That sounds weird, but there really is supposed to be a normal, non-fetish reason for liking the smell of dog feet.  Obviously that would be a dog foot that did not recently step in something.   It's a bit like, liking the smell of fresh cut grass, maybe because it reminds us of our childhood or something.  Anyway, I was relaxed (damn double IPAs) and so was Jagger (the dog).  They also say that petting a dog will lower your BP.  I know that one has a really/normal scientific following and you won't be considered weird for rubbing your dog's tummy.

Galloping Gurdy

Well, not quite, but this is the trip across the Tacoma Narrows on our way to Bremerton.  Not much significance here, just that the kids recently studied harmonic resonance.  The old bridge video of Galloping Gurdy was quite popular amongst the 8th graders earlier this year.

Knitting

This was Sandy's favorite past time during the trip, other than cracking jokes with the staff, helping me go to the bathroom, filling my water cup, emptying the pee jug, all that fun stuff you do for your spouse when they need your assistance, oh and texting and facebooking to keep folks current.   

Driving north

Driving north on I-5.  The weather was decent for the drive up to Seattle.  It was good to be the driver, kept my head out of it.  Our goal for the day was to get to Bremerton and stay overnight with an old friend of Sandy's.

The night before embarking on my new hip journey

OK, so I have never blogged before.  This will be my attempt to keep you all posted on my first hip resurfacing and the progress.   In summary, I have femoracetubular hip impingement (FAI), which has caused full blown osteoarthritis in both hips.  Chronic hip trauma as a youth or genetics, you tell me?  I knew I had limited range of motion several years ago, but it wasn't until a year ago when I really began the search that got me here.  I visited several ortho surgeons and found out that arthroscopic surgery would not be very successful for my condition and a total hip replacement was not appropriate for my lifestyle and age.  I chose resurfacing and elected to have surgery a little earlier than many folks in this position, mostly because I want to be active again and be able to have fun with my teenage boys before they leave home in a few years.  

Here is the night before we embark to Seattle.  I'm anxious and have not been heeding warnings to take it down on the beer prior to surgery.  Stress kills!  I spent most of the weekend prior to surgery working on a beefy wood and steel ship's ladder for the kid's room and every time I drilled into steel or wood, I'd remind myself of the surgery. Fun times.