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    6月14日

    I, Robot

    NewHip2My friends tease me that I’m now bionic and in a very real sense, it’s true. I am part man and part machine.

    This blog post is mostly about answering the questions I keep getting asked, but a little about making sure I don’t forget some of the more interesting aspects of this experience.

    What Happened?

    NewHip Thirteen days ago, I had my right hip replaced. A medical team led by James Bruckner, MD cut a hole in my right leg, detached a few muscles, popped out my leg from my hip, sawed off the top of my femur, jammed a spike into it and attached a metal ball to the end, dug out a hole in my hip bone and popped in a cup that matched the size of that ball, inserted ball A into cup B, tied my muscles back on and sewed me up. All this took about two hours. I happened to be asleep at the time.

    That was June 1. Over the next three days I learned to walk again and, one by one, the various tubes were disconnected from my body. By June 4, I could do all the exercises necessary to manage on my own, and I was kicked out of the hospital. My sister Heather drove me home and stayed with me for another week. Thanks, no doubt, to her superior nursing skills, I was mostly self-sufficient by the time I drove her to the airport (!) and she flew back to Edmonton.

    Why?

    I’ve had arthritis all my adult life. Every few years I would investigate the state of the medical art and each time I decided to put off any procedure. Until recently, new hips were small metal balls inside plastic cups. They work fine but the life expectancy of the device was only 10 to 15 years, meaning someone my age would likely need a second operation. The re-do is much harder for the surgeons and on the patients than the first procedure. Technology marches on and the new. larger, metal-on-metal joints are expected to last 50 years. That’s probably enough for me.

    Finding the right doctor is tough. I left Group Health because I wasn’t impressed with their orthopedic surgeons but who knows, they might have been great. I tried to find the best doctor in Seattle. That’s impossible for a layman, of course, but I could find out who had the best reputation and then hope for a correlation between that and actual skill. Dr. Bruckner’s name kept coming up. He’s actually “out of plan” for my Premera insurance but the Microsoft coverage is so good the experience cost me next to nothing anyway. My top advice for anyone wanting surgery is to first get hired by a company with great insurance.

    Before Surgery

    I had to attend a class before my operation where all my questions were supposed to be answered. This turned out to be a complete waste of time. No, it was worse because nearly everything I learned was wrong or at least misleading. Well-intentioned nurses and physical therapists and occupational therapists did their best to explain what was going to happen. In an effort, presumably, to not oversell, everything was presented as a worst-case scenario. This had the distinct effect of freaking me out. I wasn’t going to be able to drive for six weeks. In reality, I was cleared for driving after eight days. Complicated procedures were explained about how to get into and out of the shower. By the time I was allowed to shower, I was mobile enough to just walk in.

    The worst example is a medieval torture device called a “wedge” designed to keep my leg positioned properly while I sleep. Again, the message was the wedge would be my nighttime companion for six weeks. I did use it for two nights. On the third, I mentioned to the nurse that I was ready to go to sleep so she might as well tie me to that hated chunk of Styrofoam. She looked at me like I was crazy. Did I really want that thing? Uh, did I have a choice? Apparently I did. I wish I had known. That alone would have cheered my up tremendously when I most needed it.

    Recovery in the Hospital

    The morning after my surgery I was asked to stand on my own and, with the aid of a walker, try to propel myself 50 feet. I had been warned that this would be the hardest 50 feet of my life. Another lie. Before I sat down, I had walked 100 meters and could have gone further. I should point out that my epidural anesthesia had not worn off by this point, so I was very lucky. Still, this unexpected ability to walk at all made me absolutely giddy. Look at me! Like Frankenstein’s monster, I can walk!

    The second night, the epidural did wear off, and it was an incredibly difficult few hours as I twisted in pain. Unnecessary pain, it turns out. There was a call button right next to my head. All I had to do was push it and a nice nurse would supply lovely narcotics. In my delusional state, it took about an hour to figure that out. Drug-induced sleep came eventually and it’s been clear sailing since.

    Recovery at Home

    Nurses and physical therapists drop by every few days to test my vitals, determine my blood coagulation properties, and teach me new exercises. I had been told I would need a walker for two weeks and could then graduate to crutches and finally a cane. When the PT guy showed up on Friday (four days after surgery) I tried to impress him by marching sharply to the door to let him in. Sharply for a guy with a walker, I mean.

    After a bit of chitchat, he asked me if I still needed the walker. Once again, it hadn’t occurred to me that I might have a choice. He had me walk down my hallway unassisted, with just his hand out so I could grab it if I felt unsteady. Once again, a huge rush of endorphins made me impossibly giddy. I could walk on my own.

    Don’t Get Carried Away, Jim!

    I have to be careful, here. Yes, I can walk but as my doctor says, you can’t rush human biology. It’s going to take several more weeks to actually heal. Months to heal completely. I can’t sit very long. I tire easily. I have to control my pain medication carefully. But it’s so fun to walk.

    Psychological Effects

    Despite all my reading and the bogus classes, I was completely unprepared for the emotional side effects. Each new task I could perform made me feel like I’d just won the Stanley Cup. Each setback after I pushed myself too hard was a major letdown.

    Most importantly, my new ability to move my leg in ways not possible since my youth has been psychological whiplash. I limp. That’s who I am. My bad hip meant I had restricted movement of my leg. I don’t walk like a normal person. That wouldn’t be me.

    The most important part of my physical therapy is learning to walk without swinging my leg around like I have done for decades. I can do this only by concentrating since my gimpy gait is so deeply ingrained. Every time I take a straight step, the kind you take every day, it feels wonderful but weirdly wrong. It feels like someone else. It feels impossible. It feels miraculous. I choke up when I do exercises where I just lift my right knee straight up. I could do this when I was a kid. And now I can do it as an adult. Who knows what else I’ll be able to do.

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    Susan发表:
    Thanks for the detailed description of your experience. I'm thrilled that you will be going through an amazing discovery process of what you will be able to do after a lifetime of limitations.

    I had shoulder surgery almost 2 years ago . Nowhere near your experience - except that I, too, thought everybody had overblown how painful it would be. I even stopped taking the "hard" meds - until the local anesthetic wore off, about 2 days after the surgery. OMG! So that's what they were talking about! I took enough meds to knock me out for 36 hours. But I felt better. ;-)
    6 月 24 日

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