Surgery and the Hips - Part 10

At the recent surgeon appointment, the surgeon said I was clear of all restrictions and that it looked like I had no infection. Just having no infection was a big Christmas gift for just about everyone, considering how it was last year with the infection and antibiotic spacer.

I'm getting back to swimming soon, which will help me in the transition from walker to cane. With home PT, I went from one lap to four, and should be able to get to more with swimming. I also should be going from in-home PT to outpatient, returning to the same place after the left hip's final surgery. Around the beginning of the new year, I'm going from twice a week in-home PT to three times a week outpatient. This should be interesting.

I also had this job interview a week before the appointment, and the only way I could get there was to drive. Since I couldn't find anyone to drive me there due to it being short notice, I had to drive myself against doc's orders to not drive. Fortunately, it wasn't too bad a drive, and I had just a little pain.

Surgery and the Hips - Part 9

I've made some big milestones since my last post back in July with Part 8.

I continued to do swimming and water walking in the local community pool until it closed, then went on to the local rec center which had a hot tub/spa. I kept on going until my next surgery which was November 3, this time on the right hip, right as I predicted back in Part 5.

I started the process for surgery in September, and was cleared for surgery at the presurgical appointment three weeks beforehand. Fortunately, this time, I wasn't in that much pain, but my walking was beginning to go downhill again. The surgeon and I agreed on using the lateral procedure rather than anterior in the interest of avoiding infection.

I finished my internship with Sprint about the first or second week of August. The money was used to pay off the previous bill from the nursing home and a student loan with just a little left to carry over to pay for the next surgery bills. It was a rather educational internship and I met up with three other deaf who also worked within the same campus, but a different building. Two of them were former classmates back at NTID. One person I worked with Sprint knew some sign and was a supervisor, so we talked here and there when we could.

Come the date of surgery, there wasn't a lot of pain, just a lot of improvements. The same nurses and physical therapists from the previous surgery last year were there and it was nice to talk with them at times. For physical therapy, the first few days, I wasn't able to go too far. But with the last day, I was able to make it all the way from my room to the PT room, stopping twice. Right when PT ended, Jamie and our neighbor friend showed up and we all talked a bit before heading back to my room. Then we had checkout and left. Doc's orders were to not drive until cleared, and a few other things related to post-hip surgery including some prescriptions, one being for oxycodone. Strong stuff, but not as strong as the dilaudid I've had before. That was an interesting experience. I had percocet during PT after the spacer surgery and after this surgery.

But it was dealing with Purple's discontinuance of their IP-Relay service (1 / 2 / 3 / 4) that's caused the most problems. This is the most critical time in terms of recovery and communications with doctors, and I'm left without it (Why IP-Relay is Important to Me Personally). I was dealing with the news a day after surgery via my phone and a laptop via wireless in between visits with the doctors, nurses, and PT. This was NOT the thing I wanted to deal with during my recovery period. Fortunately, I was able to change my phone number to the one I use with my Sorenson VP. Shame on you, Poople. Tell the truth to the FCC, please.

With the first home PT appointment, I was only able to do one "lap." Two weeks later, with Jamie watching when she was off work that day, I did seven laps. Later on, I was able to do eight. This means that my swimming and water walking helped out quite a bit. The nurse checked the incision area when she visited, and so far, everything's looked good. The incision area measured was 30 centimeters or 12 inches, using 43 staples. They were removed two weeks after surgery. Jamie wanted to watch the removal since she missed the last three. It wasn't too painful, just had a few areas that were sensitive.

I'm still on the walker, but could be using a cane maybe within the next month. I'm still a little too unsteady to use it. I did manage to do a slow lap with the PT helping out.

I've got an upcoming post-surgery appointment with the surgeon soon. So far, no sign of infection. Jamie and I have been changing the tegaderm coverings of the incision area every 1-2 days. This means that if I go this far without an infection, this will be a big milestone for me and an even bigger Christmas gift for her.

Surgery and the Hips - Part 8

I've had a couple big milestones since my last post.

Swimming and water walking are great therapy. The local recreation center has a more accessible pool that has no steps, while the local public pool has steps. I managed to get down them, however difficult it was. I couldn't do that last year. I'm still a little unsteady in the shallow area, but when I start walking in the deeper area around 4 feet, it gets easier. Physical therapy ended earlier, so I'm doing things on my own.

Then later on, Jamie and I were invited out to a dinner party with some other deaf people. It looked like I just had two steps up into the house. Then I go up the first step, and look inside, only to see several more steps after the first step inside, each going up and down. I almost considered just going back home, but I figured I'd try and see how far I could get, what with all the physical therapy and other things I've done since the last surgery.

I managed to make it up there. Then down both sets of steps to the basement, doing it backwards, with another step to get outside to the porch. Then right back upstairs for dinner. Dinner was good, having also met and talked with various people.

I'll soon be starting the process of the next surgery. All this should help me get through it quickly. But none of us are in any mood to see me go through another joint infection. I'll be talking with the surgeon about doing what I did earlier after the third surgery, which was a month of oral antibiotics.

I've also had an internship with Sprint in Reston as a Technical Support Intern which ends near the end of July. They didn't have any problem with my physical therapy hours and worked around it. Normally, I'd be doing 11am-7 (going 3-7 when I had PT), though I had "class" with someone else, usually going 8am-4. Getting there, I used the Fairfax County Parkway and am usually able to get there less than an hour.

Surgery and the Hips - Part 7

Since outpatient physical therapy started, my walking has been improving. I've transitioned from walker to cane, after around a year and a half of using the walker. Even then, it's still difficult, but it'll improve. I've been taking my quad cane to PT.

When I had in-home therapy, and just two weeks before the late March surgeon visit, I started developing something that felt like when the elbow's "funny bone" is hit, going from the hip area down to my foot. It got to be a bit painful in the foot area if I walked using the cane. Fortunately, the "funny bone" effect went away shortly after I started outpatient therapy. It still comes and goes but it's limited to between the hip and knee and is very minor. The surgeon recommended I see a back doctor, but even with the "funny bone" effect mostly gone, I kept the appointment. At the appointment, the doctor takes one look at me, together with my description of the "funny bone" effect, told me to keep doing what I'm doing.

The same day of that appointment, I kept the walker upstairs and used the cane. I managed to use it all day. Walking was slow, though a bit unsteady. That will improve. Still have a ways to go to straighten out the muscle contractures in the knees, though.

One interesting observation is that sometimes there's a bit of a muscle ache and it'll feel a little like a "phantom pain" like when the spacer was there.

Surgery and the Hips - Part 6

A lot of things have happened since Part 5. Around mid-January, I went from 10% weightbearing to 50% for two weeks, then finally full weightbearing. Fortunately, I'm now in outpatient physical therapy. That last "snowstorm" we had was barely a dusting two days before my appointment.

Then the DC area had FIVE snowstorms. The area school systems had snow days that were 3-5 times more than they were last year. Two of the storms caused my surgeon appointments to be cancelled and postponed. I never went out until the snow and ice melted. I was NOT going to go back to the hospital in pain if I was to fall and dislocate my new hip joint.

And no infection as of the end of January, what with my taking antibiotics for 4 weeks after the November surgery. That plus the infectious diseases doctor said they kept my tissue/blood sample for a bit longer time, about 10 days, to make sure there was no infection.

Now I can do things that I had to put off.

Hospitals and the Deaf Patient - Part 2

In Part 1, I mention in the last paragraph:

"In this day of high tech and the Internet, there's no excuse for anyone to claim it's difficult to contact the deaf person when there's also email, texting, and instant messaging besides the relay. A little low tech like keeping paper and pen around goes a long way as well."

When I had home health care, rather than use the relay to play phone tag with each other, we used texting. It's worked so well that I could easily refer back to the texts as a reminder or the physical therapist could easily change a session date and time. I'd also be in contact with the supervisor/office manager when it came to signing paperwork and evaluations.

Also after the third surgery, I got emails from the doctor's office a few times telling me of a change in medication dosage. This allowed me to better acknowledge I got the email and would act on the dosage change.

I've kept copies of my xrays from the knee surgeries and from the three hip surgeries, which also makes it easier for me to pass on what I have to another doctor. The hip surgeon's office has a patient portal which allows me to watch for upcoming bill payments, make a payment, make an appointment online, med refills, and other things.

On a more lighthearted note, the physical therapist and I used "markers" from torn postcards to show how many laps I did in the walking exercises (Surgery and the Hips - Part 5). Now and then one of us will lose track of how many laps I've done.

Surgery and the Hips - Part 5

Back in mid-November, I had surgery to remove that wrecking ball of an antibiotic spacer and put in new joint hardware. I was only in the hospital for 3 days, and did well in my physical therapy tests, allowing me to go home sooner. This time, I don't quite remember being in the recovery room, only waking up in my hospital room.

Interestingly enough, it was the same room I had back in July, room 403.

I started again with in-home physical therapy the day after I got home. I'm still using the walker, with a restriction of 10% weightbearing on the left leg. I've been able to do things I wasn't able to do when I had the spacer in me. My house has a wall that separates the living room and foyer from the dining room and kitchen, allowing me to walk around it. I couldn't go more than 4 times around with the spacer. Now I've been able to get 6 times around and was able to get up on the exercise bed and do some exercises I wasn't able to do before. Another is that I'm able to sleep better. Of course, there's still some swelling in the leg and I have to keep them elevated, but the swelling's improved. Sleeping on my side I can do, but not for too long.

I was taking some antibiotics for a few weeks after discharge with pain meds. I've had the staples removed as well. Interestingly enough, the first surgery used Dermabond to close the incision, and the second used stitches. With this third surgery, the surgeon didn't reuse the anterior incisions due to the condition of the skin due to the infection, but used the lateral approach.

Still got a ways to go in terms of going from walker to cane. Next surgery could easily be late 2014.

Surgery and the Hips - Part 4

A week after I was in Acute Rehab, I was moved to a nearby nursing home, where I stayed for 6 weeks. I wasn't able to return home due to the house not quite being set up for my needs.

Enduring 6-7 weeks of IV antibiotics via the PICC line wasn't too bad, but it definitely made things easier with the blood draws.

Physical and occupational therapy in the nursing home helped out in getting me back to being able to do things. It got easier to walk and do other necessary things. At one point, my hearing aid's earhook and tubing decided to go bad. This required me to make quick work in ordering replacements from the audiologist and replacing them on my own. That meant I had a week of not being able to use my hearing aid.

Jamie helped out in bringing clean clothes every week including some other things I needed.

The nursing home had daily activities, but I missed a lot of them due to PT and OT. They had these practice stairs which I couldn't use at first, then finally able to use it. But the spacer prevented me from using them effectively due to the weight limitation. After a bit of research and therapist recommendations, I picked up on a stairlift and had it installed the day after I got home.

Apparently the spacer has other ideas in terms of being able to sleep at times...

Surgery and the Hips - Part 3

Surgery on the right hip will definitely be delayed, possibly til possibly mid-2014.

As it turns out, I returned to my doctor's office to have some discharge from the incision checked out a little over a month after the initial left hip replacement surgery. When the doc took out fluid from my joint and I saw what was aspirated, no one had to tell me it was infected. Fortunately, the doctor's office was within the same hospital I had the surgery, so it was a simple matter of being readmitted.

It was pretty funny when the nurses on the floor said "weren't you just here a few weeks ago?" Yep, and I'm back due to the joint being infected. Even the physical therapist doesn't look worse for wear after my telling and showing her previously how I use the walker on the steps.

After some talking with the surgeon and his fellow, it turns out that the joint definitely was infected. Two days later, I have surgery to replace the infected hardware with an antibiotic spacer. They have to give me painkillers in recovery as I'm in quite a bit of pain. I don't quite remember the trip from recovery to my room.

It was difficult enough getting out of the hospital bed. Their giving me a strap with a loop on the other end for my foot helped out in getting me in and out of bed.

I had a blood drain which creates a vacuum when compressed. I couldn't resist.

"Somewhere out there, a vampire's going to be very happy."

A few days later, I'm told I'm going to be moved upstairs to Acute Rehab, and had to agree to 3 hours worth of therapy daily. I have a PICC line put in for the IV antibiotics and blood draws. Using pain meds helps out in controlling the pain while I go through physical and occupational therapy. They've got this monster of a platform walker that's helped me out in getting back to walking.

When going through physical therapy, remember that they also specialize in wedgies...

Hospitals and the Deaf Patient

Before I had my knee surgeries, one of the first things I did was go to the hospital where I was to have the first surgery and visit the Patient Relations office. I talked with them about interpreters and passed on to them my surgery date, my surgeon, and how long I will be there. This was probably my most important contact.

From there, let them know to pass on to other medical people that they will be dealing with a deaf person via the relay. In my case, email was used with the Patient Relations contact as well as the surgical scheduler in the surgeon's office. With the scheduler, when it came to surgery dates, I did it in person since there was some paperwork such as patient instructions and hospital information.

While you're doing all this, visit the financial office of the hospital to pass on your medical insurance information if possible. This may save a little time with checking in.

The next important thing to have is an advocate. What this person does is make your medical decisions when you are unable to do so. Filling out an Advanced Directive is the next best thing to do. While the chances for death or complications are small, it still helps to have both advocate and the directives if something arises.

When I went to the rehab facility after the first knee surgery, there were a few problems (More on the Knees and Surgery - Part 3, Part 4). At first, the people didn't believe there was such a thing as the ADA. They had never heard of captioning. When one of the coordinators talked with Jamie about interpreters with me in the room, one of the first things the coordinator said blew my mind.

"We're here to make money."

Is that something you want to hear when you're recovering from surgery and need some rehab and therapy to regain at least some use of what was operated on? I didn't get an interpreter for a few days. The business office had to compliment Jamie when I went there by myself saying that she was a good advocate.

Sure, they're there to earn money to pay the staff and to take care of their patients, but that kind of comment is pretty cold and uncaring. This is when the advocate is most needed since this person can more easily give the facility more information about these unknown things.

When I had inpatient therapy, which included in-home nursing support and physical therapy, we arranged our appointments ahead of time, and I watched for the person. Then we went from there.

With outpatient physical therapy, it's important for the patient and therapist(s) to find a way to communicate, since not all physical therapy offices will be able to provide interpreters. In my case, I made sure the therapists in the office knew about me. One thing that helped was a paper showing all the exercises I would be doing and watching others do their exercises at times if I was to do what they were doing.

Before I had the hip surgery, I had a contact in the first hospital related to a joint class, which told about what to expect pre- and post-surgery. This person was my contact who arranged for the interpreter for pre-surgical testing and the joint class at the second hospital before the first hip surgery.

Fortunately, I didn't need to do as much footwork as I did before since the contact I mentioned above took care of everything and it was also the 2010 legal case mentioned in Surgery and the Hips - Part 1.

Remember that it is the initial communications between the patient and the health provider(s) in the beginning that can go a long way.

In this day of high tech and the Internet, there's no excuse for anyone to claim it's difficult to contact the deaf person when there's also email, texting, and instant messaging besides the relay. A little low tech like keeping paper and pen around goes a long way as well.

Next - Part 2

Surgery and the Hips - Part 2

Physical therapy started the next day for me, twice a day. I was barely able to make a circuit around the nurses station, going only 1/4 of the way around with the help of a walker. Next day, I made a full circuit before heading into the physical therapy room. Then the day before I was to leave, in two physical therapy sessions, did the equivalent of two circuits. I even scared the physical therapist and may have given her more gray hair showing how I use the walker to go up and down steps, doing it in the fire exit stairwell.

One of the things I had to do post-surgery that day was to sit on the edge of the bed. Just doing that beforehand would have been painful. In this case, it wasn't. But I wasn't able to stand due to my having low blood pressure and the concern I could pass out.

Before heading home, I had to ask questions of the surgeon, his fellow (he learns from the surgeon), the physical therapist, and others. I couldn't resist when one thing that came to mind was on roller coasters. I asked if I could ride them, maybe at least a year after surgeries are done. The answer I got was that I could. Personally, I'd see how the ride was built and go from there, knowing how fast and bumpy they can be. I've got almost no driving limitations except that I not be under influence of the pain medications. The way I am now, probably won't be for a bit.

Most important was the restrictions. Seems I have almost none. Only thing I need to be careful of is that I not have extreme ranges of movement. The fellow said I'd also know if I dislocated the hip and to call 911 to take me to thoe hospital for getting it back in place.  It's also around this time I find that there's not two approaches to hip surgery, but three. Anterior, posterior, and lateral. Seems lateral is approximately between anterior and posterior. Another webpage shows more approaches. I also found out earlier that my incision was closed by stitches under the skin, but the skin is closed via not stitches nor staples, but something called Dermabond.

As usual, I used humor here and there when the time was right.

Other than all that, the second surgery should go just as well as this one. I've got the same people from a home health care agency coming in for nursing support and physical therapy from when I had the knee surgeries.

Surgery and the Hips - Part 1

Finally, I got the call saying that my surgery time was 11:30am and I had to be there by 9:30am. Going through Registration, I find that there's been some changes in the way ASL interpreter requests are handled. According to the Registration person and interpreter, there was a case in 2010 that was settled in 2011.

Hospital fined for failure to accommodate
Inova Health System settles with Justice Department

Definitely an improvement there. I had interpreters the entire time I was there, even at night. One nurse I talked with briefly mentioned what they went through in the training classes related to this. I half expected him to show one of his test papers, after talking with him about how the classes went.

Going through prep, it was painful enough having someone lift my left leg onto the wheelchair footrest and prep bed. One of the people I talked with was the anesthesiologist. He tried learning some sign and got everyone in the room laughing a bit when he got a couple signs wrong, then right. We talked about what he was going to give me and so on. The surgeon came in briefly and we wrote in the area where the incision was to be. Other people came in as well. I also had an epidural, or spinal block, right before heading into the operating room.

Going into the operating room, I wasn't able to make note of the room number like last time. I was awake just long enough to take a quick look around the room before going under. What made things different here was the fact that I was requested to leave my hearing aids on as they were going to talk with me some before the actual surgery started. Only thing is that they said I wouldn't remember it and they were right. I didn't wake up in the recovery room, rather, in the operating room. My arms were out on my sides and there was a sheet blocking my view from the stomach down. All that was taken down just before going to the recovery room where I spent about an hour. Total time going through both was about 4 hours.

Then my bed was wheeled to where I would be for the next few days. Interestingly enough, it was room 404. You may recognize 404 as being a "not found" error on a website.

Next - Part 2

Post-surgery Knees - Part 9

Crap...

Double and triple crap...

Just when I've been improving like I said in Post-surgery Knees - Part 8, something else comes up and it's a nice setback.

Seems I may need hip surgery since my left hip's giving me trouble. I'm figuring it's a fall I had in a parking lot that did it while going to an event in the early summer. I was doing good all through the summer up til a couple months ago. Then my ability to walk started getting worse, even using the cane. I just started using the walker for extra stability and it's paid off in less pain.

I had xrays done, and even a radiology friend doesn't like what he sees. I should know more soon with this doc appointment in a couple weeks.

And I was so looking forward to actually walking with the cane to get my degree...

And if this isn't bad enough, I need one more internship to graduate.

Post-surgery Knees - Part 8

I returned to Clemyjontri park last year. This time, I'd left the wheelchair and cane in the other car. I was already over halfway there when I remembered, and even Jamie knew I was in for a bit of a challenge.

Apparently I did better than I thought. I was able to stop a few times in places before continuing on.

I'm wondering if I can actually do the graduation walk this May 2013?

Can't do it if I use the wheelchair too much. Now to get back to my exercises.

Post-surgery knees - Part 7

I'm continuing to improve here and there, though I need to get out walking more.

I mentioned my being able to walk into the local grocery store. My ability to have longer shopping times have improved.

There's also an area in front of this building next to me that I've walked around to see how many laps I can make. Since the surgery, I can do just one lap easy, compared to barely shortly after the surgery. I just did two laps. Now to try doing more. I'm hoping to get to three or four by summertime.

We had a small flood at our house back in early September, and I was able to pull up part of the carpet with some help before someone came by and said we could stop. The cleanup service came by later that night. We were able to save some more cash by pulling up the tiles which had 4% Chrysotile. This kind of asbestos comes out of the body more easily than the other kind. The health issues that come up years later come from prolonged exposure. Our exposure time was a few hours, and we only broke about an average of one tile per row. Mopping the floor twice with a strong mixture of bleach and water was a bit tough, but it also cleaned up any remnants of mold and other dirt.

All that work is good for me. Still more work downstairs to do.

Post-surgery Knees - Part 6

Been having some improvements here and there. I've been able to go on short walks here and there. That'll improve in time. I also had a couple milestones.

First was my being able to walk into the local grocery store without the wheelchair, just using the cart to help move around. I can do short quick stops there, but not longer shopping times, yet.

Second was my walking to the store from home before dinner at a friend's place. I was never able to walk that far til now. Then while Jamie went into the store, I sat on a bench outside, then we both walked to the friend's place.

Heading to an ASL dinner via the local metro/subway, I managed to walk around a bit more, going to a bookstore to look around some before dinner.

I still can't quite effectively use the elliptical/stepper machine, though I can use a leg press.

I've doing some gardening here and there. I can't quite do it all day, but it'll happen sometime.

How many rows can I mow this summer?

Stairs and the Knees - Part 2

In the first post, Stairs and the knees, I mentioned it was a bit difficult to get down the steps carrying a laundry bag. I just toss the bag down the steps.

Going upstairs, I put the bag up a few steps, go up those steps, and repeat the process til I'm at the top. If I can, and the bag is light enough, I'll just toss it up the steps. Now and then I've done it Santa-style, on the back.

One other interesting thing is that it's getting easier to carry things around. With my volunteer job as computer refurbisher, I had difficulties a lot of the time in carrying the computer from a storage area to my work area. I had someone bring the computers to me at times. Now, it's getting easier to do that, making sure no obstacles are in my path.

Hills and Wind and Water after Knee Surgery

Booktoots posted Natural Way to Increase Resistance While Walking and it got me thinking...

Where I live is a steep hill going downhill going one way from the house. Going the other way is a gentle hill. You wouldn't really notice it if you weren't looking at it. But it's there. Walking to the store and back I can't quite do yet. Towards the store, you're going up the hill. It's a gentle grade, but it's still some good exercise. Going up my driveway is easier than going downhill. Can't quite do that when it's snowed or there's some ice around.

Where I used to live had hills galore of varying steepness. You could stay on the same street and go uphill a little, then downhill, then suddenly downhill, then turn a corner to another street, and go right back uphill. Then go round a corner, downhill a bit, then go around another corner, steep hill, then gentle hill. Back home, one gentle hill up and down. Wow... Good walking.

Personally, water walking does a great job.

When I was still able to use a bike in high school, I had this paper route that took me up a hill, then down. Think how hard it was for me to go up the hill when the wind was blowing hard. Now think how much harder it is when your bike is stuck in third gear...

Post-surgery Knees - Part 5

Whoa... It's been a few months since I last posted. Been a little busy with an online class and some other things.

I'm improving more here and there, though still using a store's electric scooter. One scooter I used ran out of power halfway through my shopping. I managed to walk to the front of the store to get a cart, take it back to the scooter, transfer the items and finish up my shopping. That was a little easier than I thought. One of these days, I'll do a quick bit of grocery shopping without the scooter.

A few weeks ago, the local area had about an inch of dry snow. I had to see if I could do it. After a little bundling up, I spent 30 minutes shoveling a path through the driveway and sidewalk without help. I had to stop once to rest. Then recently, we had a snowstorm which dumped about a few inches of snow. I managed to get half the driveway done, with Jamie taking finishing the rest. I did it again that morning to get the rest of the snowfall, again getting half the driveway done.

There was also this ASL dinner I went to between surgeries. I went back out there and had to stop a couple times to rest a bit. Getting my tray with food up the steps was a little difficult, but I made it, something I wasn't able to do last time I was there.

I'm getting there in terms of my endurance. It'll take time, though. Let's see how much of the lawn I can mow this summer.

Post-surgery Knees - Part 4

It's been a little time since I last posted about my knees. I've had a couple milestones since then. I'm still swimming here and there and doing water walking.

We have an elliptical, so I'm just easing into the thing. It's tougher than it looks since I can only walk or tread on it slowly at the moment. Riding an actual bike will take a bit more time.

I managed to walk from the house to a friend's place, only stopping for a few minutes to rest, then walked right back home. It was a pretty warm day and I was sweaty by then.

I was also at Jamie's dad's place and managed to walk from his house to the lake. Getting there required me to walk downhill on a gravel and rock path. Fortunately, it wasn't too long a path. I wasn't able to go down it before the second surgery.