An upstanding man

One of the major complications from hip replacement surgery is the risk for dislocations with certain movements.

The risk is greater in revisions than it is for initial total hip replacements. A usual statistic quoted is 10%, but some other studies have shown a risk up to 25%.

One of the main discharge instructions after the surgery sounds easy enough: Do not bend at the waist greater then 90 degrees for the next 6 weeks.

It's just that you forget how much of what you do on a day to day basis depends on doing just that.

For the time being, a "reacher (a tool purchased at a medical supply store)" has become another close friend.

I'm getting pretty good with it. My wife laughed today when I let her know I was able to pick up a single Q-tip from a bottom drawer in a cabinet and that it only took me about 8 minutes to put on my underwear this morning.

Progress!

My friend Jack

I've had a fair amount of "down" time.

I'm post-op day #9 from a left total hip arthroplasty revision.

My current home rehab routine takes about 12-14 minutes to perform and I've been doing it at least 2-3 times a day.

That still leaves a considerable amount of free time remaining over the course of the day.

We borrowed season #1 of the series "24" from our local library a few days ago.

I've been watching a few segments each day and it's helped to compress the day.

The main character is Jack Bauer.

He's become a friend of mine!

To tell the truth

"The medication that I just gave you will help you relax but it's truth serum so be careful what you say," noted the anesthesiologist with a grin. "I'll be back in a few minutes when it takes effect."

My wife was with me in the pre-op room.

The medication was most certainly starting to take effect.

“I want you to know that I have never been unfaithful to you."

"Thanks for letting me know, “ my wife replied, “I was was really worried about that!" 

After the surgery and back up in my room I remembered the conversation. I laughed when rehashing the details with my wife.

"Is that all you remember?" she asked.

"Yes, was there more?"

"Before you went off to sleep you also told me that you didn't think our marriage could last if your mother moved in with us and that you sometimes pretend not to hear Dwight (our toy poodle) ringing the bell (yes...he’s trained to ring a bell on the back door with his nose whenever he wants to go outside)."

We both laughed.

I'm glad it wasn't any worse than that!

The last lecture re-visited

Randy Pausch recorded these most excellent thoughts about life on earth, in 2007, just before his death:

"We cannot change the cards we are dealt, just how we play the hand."

"You have to decide whether you are Tigger or an Eeyore. You have to be clear where you stand on the Tigger/Eeyore debate."

Witnessing a resilient and positive person, who may be in the midst of a life threatening health condition, is truly a life inspiring event. It changes you and it's a blessing!

Epidural baby

Epidural anesthesia has been used frequently in labor and delivery since at least the 1970's. Over the last number of years it has been increasingly offered to many undergoing a variety of other operations as well.

I had a total hip replacement under general anesthesia in 1997 and had severe post operative pain.

I had a total hip replacement revision  last week with epidural anesthesia (that was kept in place for 48 hours post operatively) and had virtually no pain during the post operative period.

The only draw back was the need to have a urinary catheter inserted-also a first for me. This was discontinued just prior to stopping the epidural.

But in terms of a decision tree it relatively simple: Severe pain is not good. No pain is good.

There are also many reports that the elderly, in particular, do much better from a cognitive standpoint with an epidural versus general anesthesia.

If it's an option, take the epidural!

Back at it

It's been about 15 months since my last post. I had written an entry about 3-5 days a week for almost three years when I decided it was time for a break. Some things are the same and some are different.

My wife and I remain happily married and marrying her 22 years ago was truly the best decision of my life. I continue to see primary care patients in their homes and it is truly a privilege and a blessing to do just that. Both children are now in college and doing great. My son just finished his sophomore year and wants to pursue graduate school to become a doctor of physical therapy. My daughter just finished her 1st year and wants to attend graduate school in the future to be a veterinarian. Both are getting observation hours this summer.

We have a new dog, a 9 month toy poodle, named Dwight. He's a hoot.

I have some spare time on my hands as I recover from having had a hip revision 6 days ago. I had a total hip replacement done 18 years ago at age 37 due to developmental dysplasia of the hip and X-rays done almost a year ago noted to significant wear and the need to have an elective repair before irreversible damage to the joint had occurred. The plastic liner was changed to a newer generation more wear resistant liner and the metal head was changed to a more wear resistant ceramic head. The joint capsule also needed to be re-constructed.

It's good to be back!