Key Change = Improvement

No matter where we have lived or if it is a past or present hound, the bloodhounds have always let me know that things are okay, relax, get through it and let life play out. Stella reminded me that today as I walked into the kitchen after taking a 2.5 hour siesta to see her outside sleeping. She is intune with the new routine, slightly changed from the norm.

When you blog you never know who is reading your blog. You might know some of them from exchanging emails over the years but you just never know what kind of help or information might be a post away of giving you some answers. Such was the case last night after my post yesterday. Medical background, experience in these kind of situations and knows "the medical game", and it is a huge financial game for sure. Other's have gone through what you have or even worse ... they survived and got back to some form of normal. At the same time something you might write helps someone else and that has happened enough to me over the years, their replies have kept me blogging.

Heidi did not want a personalized photo of her on the blog today ... always turning her head at the last instant as the camera shutter went off.

I asked my surgeon and the PT the day of my discharged why didn't they prescribe Tylenol and Ibuprofen instead of giving me Oxycodone as my only pain reliever? 5mg ... didn't kill the pain entirely, just teased me with numbing the edges so to speak. The PT only answered that if I decided to take Tylenol follow the label for dose frequency and never take it with the Oxycodone. I knew that already ... but okay. Why not any anti-inflammatory ??? Or a muscle relaxer to help my leg/hip muscles in trauma to get a little help relaxing? No answer.

Things are moved out in open and to a higher level so I can reach without bending to get them. Lemons for warm lemon water in the morning, starting tomorrow. Gotta flush those toxins inside of me.

So that pain relief combo lingered inside me. When I spent Friday trying not to take anymore Oxycodone by 8pm and not able to get to sleep I decided I'd make my own decision. I got out of bed, took one Tylenol Extra Strength 500mg and 3 Ibuprofen 600mg just like my dentist prescribed last month when my wisdom tooth was extracted along with some bone. I KNOW the bad stuff about both meds if taken too long or taking too much. I'll follow the rules as I always do when taking meds even after a day of yard work, many months ago.

I've heard from various people that I "need to be your own advocate" in today's medical world. I can do that. So that will take place when I call my surgeon's office, who told me to call them anytime, and ask them to send a "script" to the PT office for an in home PT program. I have also learned in my short time in this medical circus that the word "scripts" mean.

So with that decision I had been trying to get to sleep last night for a couple of hours when nothing was working. The exercises I was doing for my leg and my ankle were not making a difference. My leg was not cramping but felt similar. With the swelling it was beginning to feel like one big blob that needed ice. The thing was I was using ice for the previous two hours.

So ... it was time.

I took the Tylenol/Ibuprofen combo and went back to bed. All the while I was trading emails with my reader that knew all things medical. She was giving me a TON of information and it all explained why I got the lack of answers, why I didn't go straight into rehab, why the 3-days was a key factor for the next 30 days of treatment. The puzzle was all coming together and I was getting answers to why, that the doctors and PT either refused to answer or were just ignoring me. I had the feeling the doctors did not like to be questioned at the time.

I've always asked "why" as long as I can remember.

It was not even 30 minutes later where I feel my leg making changes ... no shit. I could feel the pressure of the swelling decreasing. I cold feel that numb feeling of a leg full of blood, start feeling like a normal leg. I tested a few exercises and noticed my range of motion was the best I had seen so far. Within an hour later I thank my friend for all of the information she gave me and was going to try to go to sleep. 9pm I was out cold.

Both hounds slept through the night and did not wake up the times I got up to use the bathroom. I have found out that when mother nature calls I better get my ass out of bed and down the hallway as fast as possible. Why not use the bathroom right around the corner from my chest of drawers ??? By that time Heidi is laying across in front of the entryway in a deep sleep taking that option away.

Stella nudged my hand at 4am like always. Heidi was wide awake, wagging her tail and almost barking but not quite. They were ready to get up, I was not. Off the bed I went, down the hallway and around the corner to the back door to let them out. They realized food wasn't going to be served so when they came back inside all three of us headed back for another couple of hours of shut eye.

I know I am suppose to feel better every day and I am ... but ... that Tylenol/Ibuprofen combo made that even better this morning. I took my meds, made a cup of coffee and did a little walking around the house to get the leg some exercise. My PT friend tells me the exercises I am doing will not hurt the hip so keep doing them and follow the precautions the doctors and PT gave me. I am.

I spent the day watching some football, did a lot of walking, did some stretching. I took a nap at noon and as I write this post I feel good. In fact I am feeling like I will be staying up later tonight but still be in bed by 8pm or no later than 9pm.

The hounds are fine. I am feeling so good today that I thought for a few seconds that calling for a PT was not going to be needed. But I will still call them and set up those appointments, it can't hurt and only help.

I have written out dates from the recovery timeline to give me something to look forward to and to strive for during this rehab.

Just some facts before I leave.

- Being kept 3 days longer was an option but also going home in 1 or 2 days were.
- Even though I wanted to get home, they told me I was doing good enough already to go home.
     - I wanted to get home as soon as possible for the hounds.
     - I didn't want Stella freaking out anymore than she may have.
     - I knew I could do the same exercises in the hospital at home
     - In my mind the hospital had done all the could, the doctors agreed putting their name on the line to release me.

I've looked and looked with a mirror but I still cannot find my incision on my hip to check it's condition. There is a lot less swelling from the bike wreck and surgery than there was the past 4 days.

Today was a good day in the Wild West.

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.

The Hip Is Not All The Issue

I knew when I went to bed at 4:30pm Wednesday I was following orders from my body telling me to. I had a lot of steps vacuuming and doing laundry. The first two days home I was close to 900 steps per day and when the dust settled Wednesday at midnight I had 2,286 for the day. I was glad that my plan was to cut back a little, rest and sleep more. I had pushed myself a little but that is okay in this process. Pushing yourself is getting up and out of bed when you think it might hurt. Mother Nature and the Hounds are a huge motivating factor pushing the limits.

I sleep very good between the periods I get up. Mostly for me and toward the end of the morning, for the  hounds. It is more stiffness than soreness than anything else. I have not had any kind of severe pain since my wreck on Saturday morning.

Stella woke me up at 4am with the nose nudge to my hand. Heidi was 'lights out' and probably didn't hear us the whole time we were up. She did her job I did mine but when she came back inside she had that smile that dogs get ... she thought she was back to normal routine of eating breakfast as soon as she woke up.

You can see by 7am she figured out that was not going to happen. She waited outside on the patio all morning before MJ would show up to feed them. She is very busy but very conscientious. She washes the dog dishes after each meal. She talks to them although her stay is short now that I am home and gives them a treat before she leaves. So it's good to know the hounds are taken care of from this point forward if something were to happen.

Heidi decided to sleep until the food was served .. her new bed does not arrive until September 16th ... Chewy had to go all the way to their warehouse in Indiana to find one.

Stella followed our routine as much as possible but boy has that changed. First she could not walk for two weeks, now I can't take her for a walk for who knows how long. MJ will take her for the walk if I add a few bucks to my discounted rate she is giving me.

Even though I could get up out of bed the first time they asked me to on Monday morning and all the times I have had to get up at all hours of the night here ... there is always a slight hesitation making that first move. Luckily my arms and my left (non surgical) leg are stronger. I can lift my butt up off the bed a little higher to make swing the bad leg to the left or edge of the bed a little easier. I have to keep it straight at all times and rotate slowly not to put any added stress on the hip joint as I turn.

I then sit on the side of the bed and slowly raise my lower leg to the level of my knee ... both legs. I've been doing the "ankle push" as they suggested for PT to not only strengthen the calf and hamstring but also for circulation to prevent blood clots.

When I stand if I can feel my left heel dig into the carpet that lets me know that I have all my weight on my good leg as I position myself within the walker in front of me. Then away we go, one foot in front of another slowly gliding down the hallway.  I keep telling myself how good it will feel five days from now, each time I am walking. I sit in hard straight back chairs slowly and can't wait until I can sit on the couch again ... but I sink back into that so much I would never be able to get back on my feet at this point in time.

I have three different places with gauze covering holes where they either took blood or put my two different IVs. I would like to take them off but I remember how fast and hard they bled with the nurse took them off. I have gauze but I don't have that brown wrap they use but almost bought a few weeks ago with my cut finger. Believe me, although I think and others do to, that I am doing great so far, there is still hesitation at times to make that first step or move ... there is fear at times.

As far as those past insertion points, they have classified me as a bleeder now. I'm not in the mood to be chasing blood all over the bathroom because I wanted to take off the 4 day old gauze pad. So they will stay until I find out what to do. all three bandages came off without blood shooting all over the monitor ... that's good.  LOL

I try not to dwell on much. It is what it is. Life is constantly in motion and this is what we are riding right now, only to get better. I was pissed off Saturday morning in the ER but got rid of that feeling soon after and thought about nothing but a plan to feel better and what I had to do. As much as I want to I am NOT going to rush this healing/rehab process. I am going to do what the doctors tell me and when to do them.

Different friends of mine and even the surgeon know of other bicyclists that have had a "total" hip replacement and are back in Spinning Class or riding on the road competitively. My friend that is a bicyclist and PT tells me I will have no problem getting back on the bike feeling good enough to ride.

But there's a big elephant sitting in the room with me and the hounds.

My Electrocardiogram Saturday showed that I have a heart murmur. From what friends have told me  the past few days, everyone seems to have one or knows someone that does. But ....... In my case ...

My heart murmur is caused by a genetic deficiency and something called Aortic Valve Stenosis. The aorta valve that opens and closes for blood to leave the heart is not working smoothly and is partially blocked. The valve will not open and close all the way. With a family history of heart disease I always thought I'd have by-pass surgery first not this.

From what the doctor told me again on Monday before I left, my physical condition is a big factor in my fast recovery from the hip surgery and also makes the treatment options for the valve much less severe. Of course I will not know the recommendation until I talk to a cardiologist and I can't see one until a General Practitioner recommends one. In the meantime the doctor says I need to see one fairly soon but with my active life and diet that I eat ... things should be fine until then.

Those last few paragraphs should be a sign that this blog is going to get more truthful or giving out more information than I want to give. I wasn't going to say anything about the heart situation but after a few emails and a comment or two here, I agreed with them. The more honest I am with what is going on with my health might help someone else or others that have the same situations.

Al at BayfieldBunch.com said from the first of his health issues he was going to lay it out for all to see in case it helped someone else. I agree now that I am sitting in a similar lobby that he is. That is hard for someone that has lived alone for decades by choice ... I like it. I like the freedom. I like being single. So now instead of "me me me" my life is heading towards spilling my guts with hopes of not only improving my own health but maybe helping someone else that has similar issues.

Or cannot seem to get a straight answer from a doctor.

So stay tuned I guess.

The hounds have slept most of the morning and I can hear the small voice in my head telling me it's time for a siesta ... so that's what I'll do.

Never fear ... it's great living in the Wild West.

Day 3 - Huge Improvements

I slept solid until 10pm last night when I needed to make a bathroom run. That forces me to work on my technique getting out of bed and back into bed. I was back to sleep and it wasn't until 4am when Stella woke me up "like the old days" ... she went straight outside so she really had to go and it wasn't food induced. Although when she walked back inside she gave me the bloodhound smile where she thought she was going to get fed breakfast but I told her not today. I cannot bend over far enough to dish out the dog food nor sit their dishes on the floor.

By 5:55am I been watching the sun come up from the bed instead of the patio ... it was time to get up.  Oh, that large wedge of foam is better than putting two pillows between you legs to sleep. That keeps the hip area stable during the night.

I could feel by the way I got out of bed that I was feeling stronger today, a lot stronger. Mentally I felt normal and had to remind myself about my hip and that I had to use the walker. Even after scooting and sliding to the edge of the bed I always sit for a couple of minutes to make sure things are ok and remind myself of the procedure to standing up with the walker.

The hounds are helping with my rehab because I might be walking a little faster down the hallway, around the corner and to the backdoor to let them outside. I want to open that door soon enough so Heidi doesn't pee in the house. Stella checked me out standing at the counter with the Nikon D3200 and knew once again the chances for a walk were slim today.

Too hard to walk with a walker and holding a Nikon D3200 so I zoomed outside while standing at my counter at the end of the kitchen to take his photo.  A cool 62° breeze was blowing through the house. I am now rolling the walker across the floor as I walk with a normal continuous steps instead of one foot at a time. Yet I am very causious and take my time to turn around or to make a turn just like the PT showed me.

Stella's eating pattern has been disrupted and she no longer eats as soon as she wakes up. The dog sitter has to feed horses first and can get her around 7:30am and then again around 3:30pm. She thinks it's best to feed dogs 8 hours between meals and so do I ... so Stella no longer eats at noon because she is not being fed at 4am.

With the reaching tool they gave me I can pick up anything on the floor. With outlets up high in some places I could plug in the vacuum and it's light enough and smaller than my Dyson that I can pick it up to unwound the electrical wire. .... So with a Swifter I dusted all the tables and bookshelves in these, I vacuumed the whole house and felt motivated enough to do a large load of laundry.

All of this was going to be finished on Saturday when I got back.

I am ALWAYS AWARE to keep my knee facing forward, making turns easy and not reaching for things. I would hate to have that new hip pop out of joint, which I was warned about before coming home. FOLLOW INSTRUCTIONS.

You can see Stella is happy to be back at the blogging desk.

Chewy will start delivering our dog food and dog treats. They will also send Heidi a brand new dog bed, arriving September  16th.

Things are good in the Wild West.