My Hip Replacement #17

There’s just not a lot to say about this anymore, but a final update or two are probably still out there in the future when I meet with my plastic surgeon again next week and my hip team again in late July. Let’s go from the low points to the high points…

My incision is still healing. It is healing. It is just healing slowly. I’ll see the plastic surgeon again next week and get an official answer on this, but to me it looks better than it did a week ago, two weeks ago, and, of course, when it was downright nasty.

On the other hand, here we are eight weeks out from surgery, and I have no trouble from the replacement itself outside of the incision (though technically I guess the hip itself in “inside the incision”). Let’s be realistic, I’m fifty-six and ache a bit from time to time. That’s probably not going to change no matter how much stretching and exercise I do (though that does help a lot), but my hip really isn’t part of the equation anymore. Thank goodness.

The highlight of the week has to be my twenty mile bike ride yesterday. Twenty miles isn’t a particularly long distance, at least not for me or the friends I tend to ride with here or on the mainland. But it’s the longest I’ve done since getting back on the bike two weeks ago. I could have gone further but the sun was going down and…well…it was time to go home and eat. Besides I really don’t want to overdo it. I haven’t added any hills yet, but probably will see how it goes later this week. At the rate I’m going, and with the breaks I must take due to travel, I expect that by mid-August I should be back in the shape I’d need for a nice long ride to Haleiwa. I’d also be willing to do a wee bit less but haul camping gear. In fact I’d love to go camping in August…who’s up for Malaekahana?

And finally, at least for now, I’ll be flying soon and am perversely looking forward to finding out if I set off the sensors at the airport. Will they want to check my scar? It’ll be an adventure.

That’s it for now!

My Hip Replacment #16

I was so not going to write a post on my hip today but I’ve just received great news. Today I was told that I’d progressed to the point that, as long as I keep doing the exercises on my own, I don’t have have to come back for the last eight scheduled PT sessions.

In truth I’ll miss the them. It’s great to have your own trainer, but now that I’m back at work they do eat into my day. I was scheduled to go into early July with them, but today was it.

Now comes the hard part, motivating myself to continue doing them on daily basis.

And with this post, I hopefully won’t have much more to say about my hip till July when I go back to my plastic surgeon to check my wound. Other than having to deal with that my life is pretty much back to normal. Now we can set about going from normal to super!

Have a great day…I am!

Back to the bike…

Whew…my life has almost, but not quite, returned to normal. I’ll have a few further hip updates, but hopefully I won’t have much more to say about it.

This is the third day I’ve ridden my bike and I’ve had only one small problem. Okay, two. As I mentioned in my last hip update I was doing my laundry on Tuesday and hoping to take a ride once I was done and before the sun went down.

I did. It was great.

I did my favorite ‘easy ride.’ That is, down to Ala Moana Beach Park from Makiki where I live. Then I follow the shore as I head west through the park, through Kakaako Waterfront Park, and on to Chinatown. Then I head back through downtown along Hotel St, through the capitol district, and on home. It’s about 10 miles all in all and takes about an hour as it’s a city ride and I obey traffic stops and such, not to mention all the stops to see the sites. Like this one at the shore:

I didn’t have any trouble during the ride with my hip. In fact I only noticed that I needed to take care with my other leg as I felt a bit of a twinge in my right knee. This is nothing new and generally isn’t a problem as I ride more and more often.

The next day, Wednesday, I rode my first commute to work and…first problem! I ride on Brooks B-17 saddles which I find wonderful for all around riding. I use them for commuting, long rides, and touring. they are on all my bikes. They aren’t ‘cushy’ by any means, but do support me very well when I need support.

After six weeks off the bike, and and big plush saddles when I did my stationary riding, I could definitely tell that my own saddle was not quite up to par. Yeah, that’ll take a few days of riding before I’m completely comfortable again. Don’t get me wrong, it’s really not bad…just noticeable.

The other problem I had was a front tire flat. When I left work yesterday I discovered that my front tire was completely flat. The only thing I can figure is that I left the presta valva open when I pumped up the tire on Tuesday. Luckily I had everything I need to swap tubes and get home. I haven’t looked into it more, but things were fine this morning on my third day of riding.

The best thing I’ve noticed so far? Even before surgery I could ride my bike, right up till the week before surgery when it became just too painful to get on and off the bike. I could still ride, but I simply couldn’t mount or dismount.

Today? I can get on and off with no trouble at all. Swinging my leg up causes no pain at all in my hip. That’s a biggie for me. A real biggie.

I know this sounds manini, after all I’m only riding to and from work for the most part so far, but darn it, to me it’s huge! Yes!

Aloha

My Hip Replacement #15

It’s now been six weeks since my hip replacement and that meant another check with the doctor, this time with x-rays and changes to my daily regimen. Good changes in fact.

Yesterday I had a regular PT appointment in the morning and my therapist said he was recommending I be allowed back on my bicycle. He also intimated that I wasn’t going to need all nine of my remaining appointments as my progress has been excellent. I’m not sure how many I’ll need, but I am headed back tomorrow and suspect I’ll find out.

Since last week my incision continues to heal and looks much better than it did in past weeks. I saw the my plastic surgeon today (there’s a statement I never thought I’d make) and he is very happy with the way things are going. So much so that I don’t need to see him for about three weeks. It would have been two but I’ll be on the mainland and it’s not urgent, unless there are bad changes.

Then it was off to the x-ray department where I had some shots taken of my hip for review. It was pretty unremarkable.

And then my it was back to my surgeon’s office. I saw his assistant again who is a great guy. He checked my wound as well and was happy with the progress as well and happy with the plastic surgeon’s work.

He then showed me the x-rays and said that he could see no gaps that would suggest the device had loosened anywhere: this would lead to trouble. In fact he pulled out earlier x-rays and pointed out where it appears that the bone has done some healing and filled in some spaces between bone and device. Yes!

Then he confirmed that I was allowed back on my bicycle subject to common sense. In short, if it hurts, don’t do it. I’ve been on the stationary bike and doing well so pedaling on flats isn’t going to be the problem: long distances and major hills will come in time.

I’m also allowed to stop using compression hose on a daily basis, though I’m encouraged to use them for any airline flights, and I do have several coming up soon, as well any long drives I might be on. I don’t have those planned. He also said I could get new ones that just went to my knees instead of the one’s I’ve been using the climb my thighs. I’ll look around for some colorful ones.

All in all it appears that everything is currently doing really well. Yes, I still have more healing to do and won’t be able to swim for a while, but hey, I wasn’t doing much of that recently anyway. My bones need to heal a bit more too before I put them to big tests like rides across Iowa (I do wish I could do RAGBRAI this year but no).

And now? It’s time to do some laundry, put some air in my tires, and take my first bike ride in a bit over six weeks. Yes!!!

My Hip Replacement #14

Actually the title of this post, and future ones, should probably be “My Open Wound #XX.” As you might gather, I still have an open wound.

Our story so far involves a bit of infection, treatment for that, and a lot of wet-to-dry dressings. My incision up to this point sort of looked like this —O-o—. The ‘o’s represent areas that hadn’t closed. There was on larger area and one smaller one below it. When I got home yesterday I had only one open area, unfortunately it wasn’t that one of the two had gone away, instead they had joined.

—( )—

Bah! That’s all I could say. Bah!

Okay, I did in fact say a bit more than that, I called my surgeon’s office and said I’d noticed some changes in the wound that concerned me. They scheduled me this morning and took a look and the fun began.

First of all they said nothing about my would looked really bad. It is showing signs of healing, even if it had opened up a bit more. It is shallower they said which is good. I agree there. They also took a sample and are sending it out for culture to see if I still have any infections going on, though it ‘looks clean’ according to everyone who peeked in.

After debriding the wound a bit more they decided that instead of more wet-to-dry dressings (which according to my research are not state of the art these days) they were going to prescribe Collagenase Santyl, a “sterile enzymatic debriding ointment.” Basically this is an enzyme, or so I’m told, that will eat up any necrotic tissue.

Basically it seems the two area joined because there wasn’t much holding them together as far as live flesh goes. As the bit between the two areas wasn’t getting much blood it really wasn’t live healthy tissue or even live fat. So apart it came and voila, a bigger wound, though in fact the wee bit of healing was really only concealing an opening between them underneath.

Some other things were discussed including a negative-pressure dressing, taking me back to surgery and cleaning things up and putting me back together, or sending me to a plastic surgeon for a look.

They decided that having a plastic surgeon take a look was the best option.

So off to another office I went. I didn’t have long to wait, apparently he had an opening and in I went. A genial younger fellow (as in younger than me, not a teenager), he took a look at my wound and said it looked pretty good. He showed me the difference between good tissue and necrotic tissue and fat and said he felt he should ‘neaten things up a bit.’ That meant he went in with surgical scissors and such and snipped and trimmed things up.

He did this in his office with an assistant and blood splatters were kept to a minimum. Actually I’m pretty sure there weren’t any. As the nerves along the incision were cut and haven’t healed, I really didn’t feel anything, though I could hear the snip, snip, snip of his scissors.

Then he said that the Santyl was a pretty good idea for no more than a week and said I should come back then for him to take another look. He also suggested that if I wanted, after things healed up, he could have me back and make the scar much smaller. I thanked him but frankly, I don’t really care. Let’s just say that any bathing suit I would care to wear will conceal this scar.

So where does this leave me?

It’s going to be a while, perhaps a month, before this closes up completely but things look good. This does of course keep me from swimming. I did ask about exercise and the plastic surgeon said to have at it. It’s unlikely to do any damage as long as keep things clean and dressed.

I don’t know if there’s anything growing down there that shouldn’t be at this point. The culture will take a bit of time, last time it was over twenty-four hours, but not much more than that. No one is saying it looks infected though.

I have to go back in a week to have the wound checked by all concerned (well not me really, I am concerned but so far my medical expertise is pretty limited). That will be my six week mark and will include x-rays of the hip itself.

All in all things are good. I’m not happy about the way the wound is healing but there’s not really much I can do besides keep on keeping on. Frustrating? You bet. Dangerous? Not so much as long as I’m diligent about caring for it. Yeah, it’s humbug. Not only that, it’s expensive. My Co-pay on the ointment was $75. Ouch. I should have put a whole lot more pretax money away for this year but who knew?