Two Weeks Post Op

Hello world, it has been a long time.  I had my surgery on May 24 and haven’t blogged since.  Let me update you in the most minute detail since no one else wants to hear about it anymore 🙂

I had the worst week leading up to my surgery.  I had a menstrual migraine, the worst in months.  The day of my surgery was the heaviest day of my menses and I had a migraine that did not respond to my usual “hit it hard” regimen of 5 mg zolmitriptan plus two Lortabs (10/500).  By the time I got to the hospital, I was almost incapacitated.  Of course, I hadn’t been allowed any fluids after midnight and I am super-sensitive to dehydration.  My surgery was scheduled for 10:30 AM.  Thank goodness they were on time.  I was taken back to a bed, told to strip down to nothing under my hospital gown.  This was when the fun began.  If you are sensitive to details of women’s stuff, I suggest you not read on!

I was escorted to my bed by a wonderful elderly male volunteer.  He was such a sweet fellow and I fell in love with him right away.  He was kind and sensitive.  When he instructed me to change, he waited patiently outside the curtain until I was done.  He then came back in and asked a few more questions and got me settled.  I then asked for a female nurse.  He didn’t bat an eyelid and he very tactfully disappeared when one came.  For those of you who don’t remember, I was having hip surgery.  Hip surgery comes with a no knickers policy.  So with my face as red as a beet, I explain to the nurse what my problem is.  No worries she says (or, since I am in the US, it was probably, no problem).  I was given some of those lovely mesh undies that they give women after having their babies, and a hospital pad.  I was told that surgeons see this all the time.  It didn’t ease my embarrassment.  I was also told I didn’t have to change into these until just before I was to be taken to the OR.

The anesthesiologist comes to see me.  Since I had already taken drugs in the morning, I wanted to tell him what I’d had and how I was currently feeling.  The nurses had kindly turned off the overhead lights for me and I had my forearm over my eyes.  I told him what I had taken and also told him that the minute I moved, I was going to puke all over the bed.  He thanked me and immediately put an order in for three different antimetics – IV Zofran, IV Reglan and a scopolamine patch.  He also ordered fentanyl to be given before I went in to surgery to help ease my pain before the surgery.  Of course, before I could have the fentanyl, I had to get to the bathroom to take care of the wretched business at the other end.  By the time I got back to the bed, I must have been as green as a red-eyed tree frog.  I had asked what anesthetics I was going to get but the anesthesiologist, who didn’t know I am a pharmacologist, was rather vague.  He did tell me I’d get some midazolam (Versed) before I headed to the OR and that I would likely not remember anything about the ride to the OR.  He was absolutely spot on.

The next memory I have is waking and becoming aware of my surroundings.  I was shivering something fierce and this caused my muscles to contract which hurt the hell out of the surgical site.  They had me bundled in about 100 blankets from the warmer trying to ease the shivering.  I think I had 6 doses of fentanyl during that time.  When the anesthesiologist came by to see me he said “usually patients look worse after surgery but you look 100 times better!”  I thanked him for the pain medicine. I was finally awake and un-shivery enough to be returned to the secondary recovery area.

I was already in the continuous passive motion machine (the CPM) when I woke up.  Back in secondary recovery, I made a really rapid recovery.  The only issue was the darned scopolomine.  It is an anticholinergic.  My mouth was so dry I couldn’t talk.  At the time, I had forgotten about the patch so I didn’t realize that was the problem.  I had to see the physical therapists to be fitted with the hip brace before I was allowed to leave the bed.  By this time I was dying to pee and terrified of the potential mess that was under my butt.  I even asked the nurse to take a peak at the sheets since the PTs were two young boys (yes, they must have both been in their 20s!).  For some reason, they just didn’t get the message that I needed to get to the restroom pronto!  Finally the nurse came over and in a loud voice said “DO YOU WANT TO USE THE RESTROOM BEFORE YOU DO ANY THING ELSE?”  I loved that nurse.  She even took me to the bathroom.  I don’t think I can articulate how damned hard it is to take care of female business when you have just had hip surgery and you are in a hip brace, and there are two 20 year old boys waiting to get me on my crutches to practice climbing up and down stairs!  They had the door open before I had even flushed.  All I wanted to do was flush the evidence down the toilet but the nurse insisted that she’d take care of it and for me to just wash my hands.  Well, she didn’t seem to notice the two young boys waiting at the door and appeared in no hurry to flush.   Ugh, second lot of major embarrassment and it wasn’t even lunch time.  Actually, it might have been.  I think I was in surgery for 2 hours.

So here is bit that I am not sure how I feel about it.  My MRI-A was read by a resident, a radiologist who is supposed to be the best in my city, and by the orthopedic surgeon, who is also considered one of the best in the region.  The radiologists diagnosed labral tear.  Along with my symptoms, the surgeon diagnosed labral tear and CAM impingement (bony growth on femoral head).  He wasn’t sure that he wanted to remove the CAM impingement though and was going to play that one by ear.  It turned out that I had a perfectly intact labrum!  It was “deeply bruised” according to the surgeon.  They had to drain a lot of fluid containing all sorts of inflammatory mediators, cut away the synovial tissue that was grossly inflamed, and he did a psoas release (partially cut the tendon going to one of the hip flexor muscles).  So, the surgery was no where near as traumatic as if I’d required anchors to repair the labrum.  But what I am not sure about is whether the surgery was really necessary at all!  My OS seemed to think so.  In fact, he told me that had the labrum not looked to have been torn, I wouldn’t have had surgery and he felt the inflammation was so severe that it wouldn’t have gone away with conservative therapy.  I just don’t know.  I wonder if I should have gone for a cortisone injection into the hip first.  It was decided against because the local anesthetic that was injected with the contrast medium for the MRA completely abolished my pain for two whole days.  There was no doubt that the pain was coming from inside the hip.

I was finally sent back to the hotel after learning to crutch up and down steps and after sitting on an exercise bike for 20 minutes.  I was given a hip brace, night time brace and a CPM to take home with me.  I had to have a follow up PT appointment the next morning so we had to stay a second night in a hotel.  All in all, the experience wasn’t so bad.  I wish I hadn’t had the migraine. I am really interested in medical stuff and wanted to ask all sorts of questions.  But I was too sick to do so.  Well, my wrists are tired from all of this typing.  The story will continue the next time I find time to blog.