This Has Always Been Something of a Stretch For Me

So I've been post surgery for a little over a month now. I'm faithfully going to my physical therapy treatments and have found how badly I've been out of shape. I'm certainly not the ideal specimen of a 52 year old male but I don't think I've been neglecting my physical health these last few years. Still, I've come to find out I've been quite physically below par. My therapist is stretching and twisting and pushing me into shapes heretofore unimaginable to me. He's Brazilian but perhaps I misheard. He is more likely Bavarian given his obvious predilection for pretzels.

I'd like to blame all this pain and difficulty recuperating to my feeble and untrained adaptation to 20 or so years of hip problems. Certainly that's only part of the reason I am now in this sorry state. My therapist is pushing me into positions I wasn't able to get into before any of my surgeries! It boils down to just one painful word: S t r e t c h i n g.

Wait a minute. I'm no slacker. I've been going to a gym between 2 to 3 times a week with the occasional vacation break for years now. I think I'm relatively physically fit. I've mostly avoided the beer belly (but not the beer). My diet is relatively healthy, filled with vegetables and lots of water, a bit high in the protein and a bit low in the fruit departments.

After my first surgery I was very good about stretching, especially the IT band. This is a strap of connective tissue, a ligament that stretches from the hip to the knee, running down the side of the upper leg. I've been very good about stretching the right side IT band (good side) and also the left side as well (bad side) ever since I was allowed to do so post surgery number one. I would 3-4 times a week, lay on my back, flop my leg over to the opposite side with the leg about 90 degrees to the long axis of my body. My hip and midsection would twist and the IT band would stretch. I looked like an old statue of a Hindu god fallen over. Same facial expressions too, no doubt. I would do this to both sides, in fact I was able to stretch more on the left leg (bad side) than the healthy right side (good side).

Now post surgery number two, this band is giving me pain and problems. I had thought that my stretching this way well ahead of surgery would protect this part of me from being affected by the surgery, or at least bounce back quickly. WRONG. Granted, that's the only stretch I really did on a regular basis. Naturally, that was apparently the one that would help me the least post surgically.

I did do my homework, too. I scheduled the surgery months before and checked online, asked my orthopedic surgeon, went to preoperative orientations and asked questions. I'd always ask what I could do physically to prepare for the surgery and make my recuperation easier/faster. It boiled down to a series of strengthening exercises, all of which I was already doing at my gym for years.

Moral of the story? Go to a physical therapist before the surgery as far in advance as possible and get him/her to tell you what to do to prepare for the surgery. Not just exercises but stretches.

Does It Hurt?

I thought that taking a week or so off of blogging about my hip surgery would help me focus on something, anything else. It seems that this blogging has caused me to focus on my surgery and recovery almost constantly. My last blog was all about pain, constant and unrelenting pain. Well I still have that pain, constant and unrelenting pain. I think it might even be better but I really don't know anymore. On that pain scale of 1 to 10, 10 being excruciating, I used to be floating around 3 or so. This past week I think I've been at the same level but because it's constant I'm not sure anymore. It's been over 3 weeks now since the surgery and I still think I'm at level 3 but I could actually be tolerating more pain. I may be so inured of it all that it's become normal and therefore tolerable. That's one of the definitions of level 3 pain, tolerable.

As I see it, my pain tolerance is going one of two ways. I am either getting used to the pain and so it's not registering as high as it really is or I could be so burned out that any little discomfort is painful. I may not even be in pain at all, just a bit sore and I'm registering it as pain level 3. Nah, no way, it hurts too much.

There's Something Crooked About This Whole Thing

I've had several visits with the physical therapist already. The first visit involved an assessment of my condition. The therapist took measurements of every conceivable leg position possible that didn't violate any of my orthopedist's restrictions. As she took the measurements on the right, surgerized side, she took corresponding measurements on the "normal" side. The results were startling for me. She could tell I was both interested then surprised so she was kind enough to talk me through the process, explaining the what and why of the numbers. In a nutshell, I've been compensating for the right hip for so long that I'm almost the hunch back of Notre Dame, without the cool digs, french flair for food, and the view of Paris.

I'm basically twisted, physically. I've been walking incorrectly, standing crooked, and bending asymmetrically. I want to fix it all right now but, guess what, my freaking hip hurts. So I move like a spaz so it doesn't hurt even more than usual which is all the time, with or without medications. I have been compensating for this hip for 17 plus years. How do you right that wrong?

Will it take another 17 years to fix it? By then I'll be bent over and crippled with years and then being crooked like I am now will be the least of my worries.

My second appointment included my walking with and without my cane. All the while, the therapist was commenting on how I moved, correcting this and suggesting that. As he was giving me hints on how to hold my hips, I flashed on that TV reality show, Make Me A Supermodel. There's no way I can do that attitude, show off the designer clothes, own the runway and still keep my balance. Well maybe the attitude, after all lots of the models feign a pained indifference to the whole thing. I've got that pained look down pat.

Now I'm doing a series of exercises to get my muscle strength back and stretch the ligaments and tendons. Apparently, without my being aware, they've been contracting and shrinking like slug in salt water all this time. Yes, it hurts. Yes, the therapists ask if it does but offer no solutions or relief from the pain. Yes, I still do it. Yes, I'm paying for this. Yes, I know it makes no sense. But No, I won't quit now, not if there is a chance that I can walk among the normal, normally. That may be a neat trick since I'm not sure I was doing that even before all the surgeries.

Chronic Pain

Last night I realized that since my operation, I haven't had my usual nightly sleep through. Pre-surgery, I mostly slept right through the night, some nights heeding nature's call but falling right back to sleep once safely back under the covers. Even in the past year, starting mid autumn with my hip pain escalating enough to make me consider and then agree to last week's hip surgery, I was never bothered with chronic pain. Once I stopped using my hip, it stopped hurting me. Lying down, taking a load off as it were, relieved my pain enough that I fell right to sleep. Now, the pain is unrelenting.

Now don't go on thinking that I'm writhing in pain, my face does have a pained look on it but that is pretty much normal for me. On the Graphic Rating Scale of pain measurement, using the scale 1 to 10, with one being pain free and 10 being tear inducingly excruciating, I'm at a 3 or 4. During the day, I can ignore/compartmentalize the pain by keeping busy such as blogging. (That way you get some of pain, too). But at night, the story is quite different. Since I am only allowed to sleep on my back and my right leg can only bend partway, not move to the left but only a little to the right, I just can't get comfortable. Now, there may be a position which would be comfortable but these restrictions don't allow me seek them out. Within this small envelope of allowed movement, there is no position into which I can maneuver that would alleviate the pain. So I hopelessly spend all night just slightly twisting and bending trying to get into that magic position, like a hatching pupae.

I had hoped that the Vicodin would help with the comfortable/pain portion of the sleep equation but in the last 4 nights, taking two just before bedtime gives me about 5 minutes of pain free bliss. Taking anymore to get a full night's rest just doesn't add up.

So, each night I'll take the Vicodin, afraid that without it I won't even get that 5 minutes of pain vacation. I swallow the pills, hoping that this night will be different, the Vicodin will last for hours and I'll awake refreshed and alert. Instead, I lie there each night, like a living mummy, struggling this way and that, trying to wriggle out of my linen wrappings, over and over, only to fail each time. I lie there and wonder if the surgery was worth it.

On a hip and a prayer

While in the hospital for my surgery, I was, for the first time in forever, bombarded with religion. Pretty predictable since I went to St. Mary's Hospital for the surgery. I had forgotten just how secular my life truly had become. I believe that the majority of my fellow urban dwellers are also mostly secular. I and my 4 siblings grew up Southern Baptist, even though my mother, and therefore my father, were United Methodists. This is because, being the pragmatic Wesleyans they were, they sent us to the the Southern Baptist Church not just for the scarier hell fire and brimstone, but we could make the short walk there unattended. As an added bonus, we could be shut away during the summer break at their Vacation Bible School. None of which we could do if we were to go the their church. Naturally, you take to Southern Baptism either a duck to water, swimmingly or alternatively like a lead weight, plunk into the water and quickly sink to the bottom. The water allusion is no accident. I recall sitting after Sunday services with my brother and sisters watching them take off the floor boards of the sanctuary. We'd snicker then ohh and ahh while the pastor, in his special white robes, dip the similarly dressed parishioners fully into the holy blue water, baptizing sometimes the same set of folks week after week after week.

I was one of the lead weights. I'd undoubtedly sink and drown if I were baptized. The whole spectacle was a real turnoff. The last thing I wanted was to take another cold and watery dip after taking my weekly bath just days before. I wouldn't so easily be fooled. Not me.

So given my history, my secularity is not so surprising. You then can understand the strange land I entered called St Mary's Hospital last week for my hip surgery. It was subtle at first. Each elevator had a small crucifix on the back wall. At first I thought is was a logo or design. Then I noticed in my wanderings through these hallowed halls, going for pre-surgery radiology and lab tests, a habit robed nun here and there, not too obvious. The pre-surgery room has very large and noticeable crosses on the walls. I thought, now is the last time to use them if you must. After recovery, on my 7th floor aerie, each of the nurses' stations had a even bigger crucifix. Maybe the post surgery morphine made them appear life size. Some of the staff were addressed as sister instead of nurse. In my room the television options included "chapel" between the welcome station and CNN. There was a couple of priestly visits to my bedside during recovery, each friendly and solicitous, carefully asking after my religious affiliation and making sure that I knew that having none was just fine and dandy. Still, if I needed anything, to talk, pray, etc, don't hesitate. A note on my room bulletin board mentions Sister Mary Timothy is the one to contact should you find anything inadequate during my stay. And lastly, every morning at 8 AM, there was a PA system that rang throughout the rooms and hallways, with the daily inspirational talk with a Brother or Father. Then a chirpy invitation to mass down in the hospital chapel where communion could be had. If you were to ill/indisposed to attend, feel free to turn on the chapel station and you can watch the Holy Eucharist live and uncensored.

Now I am certainly no enemy of religion. If anything, just before my surgery, I felt quite compelled to become desecularized, get baptized, make a sizable donation, maybe for an eponymous pew, very quickly. But I resisted. No doubt much solace and comfort can be gotten from a individuals religious beliefs. And many a patient and their family and friends felt especially blessed to have the best god fearing surgeons in a place where their hands and minds can't help but be guided by the wisdom of the the greater power made manifest within the very walls of the hospital.

I didn't consciously choose this hospital for religious reasons, it just happens to be the hospital in which both my primary care physician and the orthopaedic surgeon were affiliated. I wasn't going to not go there because of it's religious affiliations either. I just felt pretty neutral about the whole thing going into the surgery. Now, on the other hand, even if I didn't sub consciously pray for a good outcome, maybe having had the surgery done there brought in just enough mojo for the prayers given by my partner, family and friends did make a difference.

And to that, I say, Thank God.

The D.L. on the Lag.

I'm back. Like a bad penny that keeps returning. Not worth anything but still legal tender in this land of the 99 cent deal. Anyway, I awoke this morning with the sound of twittering and chirping birds. I had managed to break the 20 winks barrier. That is, I slept for just a bit more than the required 40 winks for a good night's rest.

That is so much better that my sleep at the hospital. At the hospital, my internal biological clock was squelched by the hospital time schedule, also called Greenwich Mean Nurse Time. Days flowed into Night with no division. There were no boundaries between the hours or minutes. Time was divided by patient chores that ignored the rising or setting of the sun. Time was divided by a succession of vital sign checks, various medicine dispensing, blood-letting donations, checking for BM's or urine output. One after the other, switched around depending on each individual department staffing situations.

When I got home, my recovery wasn't just about healing the huge swath of the surgeon's sword, it is also getting over Hospital Lag. No one ever talks about it. You hear often about Jet Lag, the more glamorous cousin. And why not? Who wants to hear about Hospital Lag when you can hear about Jet Lag, an excuse to launch into the trip to Bali to pray for the peace of the world, Cartona to talk about that impromptu olive tasting, or the sheep shearing experience just outside Alice's Station in the outback. Who wants to hear about someone's duel with death at the operating table? I'm sure I'd rather hear about letting Nicole Sheridan cut in line at the salad bar at that chic little spa just across the water from downtown Nice, just like you. But there it is. Hospital Lag.
I thought when I got home to recuperate, I'd have tons of things I could and would do. The lag would be banished by the continuous and frenetic activity I had planned, none too rigorous to impede the healing process, of course. I have so much reading I planned to do. I haven't read a word. I hoped to get my computer organized. I haven't figured out how to access those files yet. I was going to watch all these great movies on the telly. I haven't seen any listing worth sitting thru. I got a "going to the hospital gift" from some of my office staff. It's 2 sets of flashcards for learning slang. Yes, slang. I straight got game to cold kill it, by the way. (For those of you who are "nerds, uncool, or simply suburban" like I was not so long ago, the "D.L." in the title refers to the down low, which means the confidential secret). Okay, so I go to that stuff. I also got to one other thing. I had planned to write about my experiences with hip replacement surgery and recovery. Unfortunately to you, I did get to that.
Did I banish the Hospital Lag. No. After only 3 days and 2 nights at the hospital you wouldn't think my internal clock went dead but it did, it is, and it's still there. I still can't tell what day it is off the top of my head. I often get mixed up when I actually gave my self injection of the anti-coagulant.

Hospital Lag. I wonder when I'll catch up.

It's lonely out here in Hipsville

I was just surfing through the world wide web of the known google universe to see what other blogs are floating out there (see link). There are precious few blogs, considering how many people must be getting hip surgery. Lots of techinical stuff that I went thru but technical and therefore cold. The truth is, the real meaty literary stuff is before the surgery. That's when you're wrestling with momentous decisions like: Whether or not to do it. What types are there, who to go to, what does it involve, what's the success rate, what was that about a parts recall? There are thousands of questions. It can all be confusing, challenging and all consuming.

Recovery is just, well, recovery. Kind of painfully boring, literally. After all, the big decisions are all made. All that remains, questions are what to see on the telly. Questions that now occupy one's time are, should I blog now or later? Let's see, Valium, ibuprofen, Tylenol, Aleve, hmmm, which color pill today. Should I nap now or later this afternoon. That sort of thing. Not particularly exciting. Not quite up to earth shattering, blog worthy, audience captivating, can't put down the book sort of stuff, eh?

There are other blogs I found, Sigrid's for one. She's selling a book. Not really interested in paying to read how someone else is dealing with this. I don't fault her for trying to make a dime from the suffering she may have had to live through. But I plan to get payback via family and friends. That's a different kind of currency, one that won't shrink while the euro swells, if you now what I mean.

Another blog site popped up, http://www.francine-hipreplacement.blogspot.com/, a quick read but not lots of musings and humor, the diversions I really need right now to get me through this. Another one : http://hipsurgerycoach.wordpress.com/2008/05/29/my-story/, took seconds to read, need to sign up and I am sooooo tired of signing up for stuff. Anyway she's done. And finally, a self described club: http://hipsterclub.com/blog.html which appears to have only a couple of members concentrated in the Los Angeles area. They may have more but, damn, I am not websmart and may be wrong. By the way, did you notice, ALL WOMEN! What's up with that? I am not a misogynist at all by the way, it just seems noteworthy. I absolutely do not intend to cast a shadow on what these people have done or are doing, Brava to them and their friends, families, and to the lives they have led, overcoming the whole hip surgery nightmare. I just don't feel connected with them at all. I don't want to be lonely in the blog sphere, but I am.

Maybe it's because hip surgery is more a phenomena of us old farts, not the younger, with it, Internet savvy world of today.

Or maybe the smart ones who are undergoing this experience are smart enough to stay on medication the whole frigging time and are just happily spaced out.

Where did I put that bottle, anyway?