Wide Awake At 3am

I wake up in the middle of a dark bedroom with two sleeping hounds. It's so quiet that I hear nothing. I don't hear them snoring, breathing or running in their sleep. I hear nothing outside in the distance like I do sometimes. I'm not too hot nor cold like I was just a morning or two ago. The window is wide open and it's 66°.

It's 2:14am and something has woke me up.

I feel literally nothing in my hip, on the side of my hip ... it feels normal, zero feelings of any kind. Yet when I woke up I was just on the verge of rolling over on my ride side to sleep, the surgical side. Rarely do I sleep on that side and I can confirm I haven't for at least the past 26 nights. Was I dreaming or was I really about to roll to my right side?

I lie there for a second waiting for some sort of feeling or twinge of pain from that unadvised move ... there isn't any. I wonder how long my surgical side has been moving? From the hip all the way down to my foot ... what has been moving while I slept and in what angles? Did the hip, knee, foot or leg move outside the safety zone? Is there even a safety zone?

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By 6:30am I had my answer from a friend that is a PT and works with a lot of patients from the same surgeon that I had. ---

"Dr. ********** is right. You need to listen to your body! Sometimes that comes through trial and error because everyone is different. If you’re walking a lot then the next day you can’t move because you hurt so bad, it’s too much. Cut back. If you’re walking a lot and don’t feel bad at all, then you’re fine! It really just depends how YOU feel! You won’t hurt the hip... only if you fell on it or really twisted it or something."
 
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I don't know that there is ... the doctor never verbally issued one. So in a way the 'confusion' I spoke of a few days or weeks ago is there lingering in the background. It's also one of the things that come with writing about my health issue or rehab. I expect it and knew from the start when I decided to write about what I was going through ... there would be a lot of comments and different ideas from readers and Facebook followers.

It's hard to sort out at times because most people have a different idea or an opinion. That comes with blogging on any subject and it's also prevalent in my Facebook updates to friends, a few family that use Facebook but don't follow the blog.

I have no problem with the different opinions. I like reading them. I listen to what people say because some of them are more experienced with this "medical train" than I am. Others have had the same surgery or know of someone that has. Some readers have even taken care of someone that has had the same surgery. So there is a lot of information out there just from the feedback I get in blog comments, emails, Facebook comments, texts and information I find online from my own research.

At 2:15am, all of this is going through my mind as I lie in a dark room with an open window on the south wall in front of me that looks like a large movie screen as it captures the light from the sky. It looks bigger in the dark than it does in the daytime.

Since I woke Heidi up at 8pm on Thursday night to go outside for her last pee of the night, she is sound to sleep at 2:14am. I feel that's a good trade and keeps me from chasing her down a hallway at 1:30am hoping to get to the backdoor before her, to let her outside so she can pee. Getting old is a pain in the ass, even if you are a basset hound.

I hear Stella now running in her sleep. Her paws are moving against the wall she sleeps next to. Is she with Sadie chasing deer again in the field back in Indiana? That has to be it because she has not ran like that for years and out here in the Wild West she has only trotted during her walks but has never ran full speed anywhere.

By the sound of her paws rubbing the wall .... she is in a full sprint gallop after something.

I decide to take my own trip to the bathroom and the first thing I feel when I stand up has nothing to do with my new hip or a leg and foot that is back to normal size. It's my left shoulder. I must have slept on it wrong or it is still reminding me I threw too many baseballs when I was a kid decades ago. At one time I was playing on three different baseball teams and a few times pitched too many innings in a week. Yes, I still feel the damage done to a left handed pitching arm 50 years later.

Where's that Ibuprofen?

I feel good coming back down the hallway with the walker that now glides over the tile floor since I added those two Wilson tennis balls to the rear legs of the walker. That adjustment also makes the walker glide over the carpet when I am in the bedroom or computer room. Remember, I use the walker from the time I go to bed until I carry the first of two cups of coffee to my computer room.

This morning that happened at 3:54am !!!!

Yes, I had been laying in bed awake all of that time trying to get back to sleep. My watch told my my pulse rate was 52bpm so there was nothing there that kept me awake. It was 66° outside, no wind and cloudy skies ... but my mind was working, sorting through all the latest comments I had read the previous 24 hours. I don't dwell on them but it's amazing the number of things I should or should do during this rehab.

It confuses me at times, just like it is at 2:45am.

I also think of my friend that just returned home after 77 days in 3 different hospitals after having major back surgery. He can stand up straight he said, for the first time in years. He is learning to walk again with is wife holding him up one step at a time. Last month he had to learn how to breath again on his own. His situation and recovery makes mine look like a day at the beach in sunny southern California.

I suggested to him last night to add the tennis balls to his walker for a smoother 'ride'. He replied my walker was the exact one he had been using in rehab. He is another old friend at 68 years old with major surgery to rehab. My list of friends doing that grows by one.

I start thinking about my situation again as I lay there. I can barely see the silhouette of the chest of drawers. I see the tiny green light of the wired in smoke/carbon detector. I feel how good my hip feels, it feels normal, like nothing ever happened. Do I dare move my right leg sideways to the point of a twinge so see how far it goes?

No, don't think so.

Honestly I don't know what is too much or not enough. The doctor didn't set firm guidelines with numbers of reps, or minutes for walks, or dates of the month ... all numbers that I like because I am and have always been a 'numbers guy' ... remember I have the addiction to spreadsheets even in my time of retirement.

I think back to that room 14 days after surgery where I had my followup appointment. My surgeon told me things look great and even said fantastic as he watched me walk across the room. Had he seen the x-rays they had taken before I was called into his exam room? Greg was right with his comment yesterday ... face time with him was about 10 minutes, it seemed rushed and he ended our consultation within a minute after reading a text on his phone.

But at 2:45am while thinking back to that appointment and double checking to see if I missed something he said, I only remember him telling me to walk as much as possible AS LONG AS I did NOT walk to the point of fatigue.

Although my neighbor told me I didn't know the meaning of that word 'fatigue' and I didn't know what my body was saying no matter if I rode a bike or not for many years ... I do know that if my leg muscle or hip would 'fatigue' I would collapse immediately, just as I did that Saturday when 3 people held me as I tried to stand up on the side of the road. I collapsed immediately then and I would now if I walked to the point of fatigue.

So ... I do remember "that limit" he set for me.

He also told me to rest so I could heal. He reminded me that he had sewn a lot of muscle with the new implant as well as muscle torn in my bike wreck and that I needed to rest. But ... he didn't tell me how long to rest. Sitting in a chair count the same if I am laying in bed? Probably not, but at least I am not moving ... so that has to mean some sort of rest.

He didn't give me the numbers my brain needed to know what is good or bad, what is good rest or not enough. He didn't give me a number of steps I need so I still don't know what is too much walking or not enough. "Don't push yourself, I know how you bicyclists think" ... "Listen to  your body and it will tell you how much is too much or not enough"

I understood his instructions ... but I'd like some numbers. 6,000 steps in a day too much? An hour nap not enough? The 'urge' to walk and keep walking ... is that listening to my body?

I don't know the answers to any of those questions really.  Ha Ha

So that is why some blog readers or Facebook followers say be careful after they have read what I have done that day or that week. That is why some friends on Facebook say 'back off' and do only what the doctor tells you.  LOL

I thought I was and think I am following those doctor's orders.

So .... around 3:30am as I am reading Ed Fry's blog that is linked on my sidebar ... I realize that I am not going to get back to sleep. I might as well get up, make some coffee and blog. Really, I have a big urge to write.

Yes ... at 3:45am as the coffee is dripping into the pot, the hound have gone outside then headed back down the dark hallway to go back to sleep in the dark bedroom ... I FELT LIKE BLOGGING !!!!

Just like the times last December when I had moved this blog to a Wordpress blog I had, I felt like writing at all times of the night so there were a few days I was blogging at 4am and was wide awake.

I am not sure what was worse though ... freezing weather outside in December or a cane handle sitting on my desk reminding me my new hip is only 26 days old as of right now and it needs to heal.

or ....

Sitting in a chair reading a book or laying in the prone position in bed with my eyes wide open wondering what in the hell happened that beautiful Saturday morning on September 7th?

Don't take what I said about blog and Facebook comments wrong. I want those comments from all different ideas and beliefs. I have gained a lot of information from comments on the blog and Facebook as well as private emails and texts. The good stuff out numbers the questionable stuff. It more of the "TONE" of how it's said that upset me the other day NOT what she said. She wasn't the first nor the last person to say the same thing about seeing a cardiologist.

It was the 'tone'.

So I guess I will classify this post as rambling, no photos.

I will add that once Stella saw I was blogging she walked from the bedroom to her corner on the right side of my desk and has been sleeping every since with the room light on ... at least she didn't let out a bloodhound howl wanting her breakfast served at 3:56am ... that will probably come later this morning. She LOVES food, I've never seen anything like it with my other hounds.

After all of this ... I only know one thing ... what the doctor told me "listen to your body" and that will tell me what I'm doing today.

It's still dark outside but with the windows open and no cold air blowing anywhere, it's a great morning here in the Wild West ... I need a 2nd cup of coffee.

I'll blog later tonight with some photos of the day.

Confusion Runs Amok

Sorry, no photos today.

This confusion on my Physical Therapy started with myself as soon as a few hours after surgery. I was told by my surgeon pre-op that they would have me up and out of bed walking a few steps with support within HOURS AFTER my operation. I came back to reality around 9:30am Sunday feeling better than I thought I would. A few hours passed and I asked one of the nurses either taking blood, my vitals or lab work ... when are we going to start the PT ??

The first time I got was 6pm Sunday night because someone was coming in that needed to be here. The nursing staff changed shifts at 6:30pm and starting officially at 7:00pm for the next 12 hours. I repeated that same question a couple of times up until midnight then said screw it when I wasn't getting an answer.

So unlike I was suppose to ... I didn't walk one step, did not get out of bed, did nothing but lay in bed adjusting the back and legs to get the most comfortable.

Monday morning I was told I was being moved up to the orthopedics where I would start a little PT and they would evaluate what I could do and not do, then recommend to the doctor whether I go home or stay with them a minimum of 3 more nights because insurance companies did not like less than 3 nights. Once again ... times not met with no explanation. I am beginning to think this GREAT DEPT I heard about was beginning to really disappoint me and confuse me.

Finally around 9am a PT comes in, introduces himself and told me to get up and out of bed then sit in the chair nearby. I did that with no support except the walker and felt no pain of any kind. When I asked him about the lack of walking 24 hours earlier like the surgeon told me I would have he explained no one is here on Sundays to do any PT work. Hmmmmm.

We head out to the hallway after I showed him I could use the walker, get into the bathroom, pee, turn around and walk out ... walking out to the hallway with him every step of the way. He kept telling me I was doing great and I had no problem walking slowly to the end of the hallway with the walker and the PT next to me ready to catch me if I collapsed.

Then I didn't hear anything from anyone as I waited for the surgeon and hospital doctor to come in and evaluate me for departure that afternoon. I talked to a couple of case workers and a different nurse ... all surprised I was not already taking any kind of medication before I was admitted. Isn't that what all people 67 years old do? Why not me? What ... you don't have a walker at home you can use?? "Why would I need a walker before now?"

Let's just say my confidence level in this operation was in a nose dive and I was planning my escape from this building no later than 4pm.

It was time for lunch so I ordered a few things still waiting for the surgeon and doctor to show up. Now at this time I am guessing that I will need to get up out of this chair, walk to the hallway ... do something for them to approve my discharge. ... No, they only based it on the PT's recommendations. Yet even with everything signed I wasn't going anywhere unless I had a walker.

The Case Worker told me even though she had ordered the walker and the service was in town, 5-10 minutes away ... the walker might not show up until tomorrow !!!! Really? This was going to be easy. I called the Case Worker back in and "sweet talked her" to the point she gave me the phone number of the hospital supply service. Once she left I called that number, giving them my date of birth ... and promptly told them I had being discharged at 1pm and needed my walker today.  They had 50 minutes to get this done.

Just like clock work ... at 10 minutes till 1pm ... that happy smiling Case Worker was walking in my room with my new $121 walker saying "look here" .... well no shit. Get off your ass and call someone to make it happen. I was having flashbacks to my working days where more and more people were turning into slackers with no concerns for deadlines ... I knew once again I was not mentally stable to work in todays workforce .... since retired I have turned myself into  a professional slacker.

Doc comes in ... What about my PT schedule. "The PT has given you two exercises to do and explained what those are for. Your PT is to learn how to walk again and then walk."  That is a no shit answer from the surgeon. When I asked the admitting doctor the same question he told me "The PT will cover all of that with you at the time of discharge."

Nothing was said and by 3:45pm I was picked up by the neighbor and was heading home.

- Three friends living in Sacramento, Chicago and Atlanta are confused ... "your PT??"
- I am confused and a little scared ... "only two exercises to do ... but for how long"
- Neighbor and his sister in-law confused ... "I've never heard of anyone having a hip replacement and not in a PT program immediately after their surgery."
- My friend, fellow bicyclist and is a PT, in fact works with patients from this hospital in a different town ... asked me last night how I was doing then replies .... "You're doing well. I'm still surprised they don't have you in PT though ... that confuses me a little"

Lights go off in my head once I heard a PT say that. One that is familiar with the hospital and surgeon.

When I told her the PT told me their PT program was only for Knee Replacements .... she replied.

"That's false. I treat hip replacements every day. But maybe because you're so active they felt you didn't need it. I'm not sure what their thought process was."

THEY told me to do the Ankle Push but not how often. I decided to lift my lower leg to the same level as my knee because it makes my right leg feel much better. I do that sitting on the edge of the bed or sitting in a chair. I know from cycling that simple exercise will strengthen my thighs and the tendons wrapped around my hip. It's like pulling the pedal UP on a bicycle while pedaling.

So I am a little concerned. It's Thursday night when she tells me this. I lay in bed since I have been sleeping since 6:45pm and start doing a few more exercise that make my right leg feel better. It is my RIGHT hip that was replaced.

I do a heel slide until it hurts because it makes my right knee feel better. I do the Abduction, sliding the right leg outward, back and forth slowly ... it's the same move I have to do getting out or in bed. That makes my hip feel better.

But WTF ??? Why didn't THEY tell me to do those two exercises ????

Another I found today that is legit after searching on the internet. Standing with the walker to support me ... I left my lower right leg, bending it back toward the leg and that looses my knee and quads up ... makes them feel much better.

I called the surgeon's office and told them I was having some memory lapses and wanted to go over again the exact exercises I was to be doing but also for how long. I wanted to ask him again when do I start this PT program. I have a follow-up appointment with the surgeon in two weeks. They told me the doctor could not answer those questions over the phone and I would have to set up an appoint to come and talk to him about those questions.

I calmly declined and told her I'd see him in two weeks, disconnected from the call I asked Stella who was staring at me a few feet way ... "Stella WTF is going on?" She wags her tail and slides out a new long piece of drool ... maybe in anticipation of a walk ... isn't that PT ??  LOL

I can only come up with this idea on why I don't follow the protocol of other fellow Total Hip Replacement rehabbers. I am in a lot better shape than most 67 year old men or women. I always thought I was younger than my age said I was, activity, diet, etc of those younger in most cases.

Maybe I really am in that good of shape and that moves me away from a PT way that my friends, neighbor and PT friend thinks I should be doing. Although my neighbor told his sister in-law I was doing all of this alone and he personally thought I was doing an amazing job. My PT friend thinks I am doing great based on the exercises I tell her I am doing and all the other stuff. My dog feeder that shows up twice per day told me this morning she is amazed how good I am walking with the walker only 5 days after surgery.

So maybe the confusion of all of us is not needed. Honestly I have no idea anymore.

My neighbor told me he parked the Mini back in my garage to keep it out of the sunshine and away from the eyes of car thieves. No, that is not a problem in this area and my neighborhood is loaded with new Tacoma and Tundra 4x4 OR's. He said I haven't known you long but I know well enough to keep the keys to the Mini so there is no chance I decide to take it out for a joy ride.

"If you are doing that ankle exercise, it might be for blood circulation but that is the accelerator foot also" ... as he laughed walking out the door. The car is nice to look at though. I'm glad it's back inside.

You are welcome to comment or email me with your thoughts or experiences on hip replacement physical therapy ... The wagon is pretty large for all of us confused people so jump on if you want.

Stella and Heidi really get excited when MaryJane walks in to feed them.

Up at 6am officially and it was the best I felt. It's only 12:40pm now and seems like 6pm. I'm a little tired, a little sore and am going to go lay down for a while.

Another beautiful day in the Wild West.