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Thursday, June 16, 2011

June 2011- I decide to have the other hip resurfaced



At about 2.5 years later (2009) and probably because of the increase mobility of the new hip, the right side started to give me similar arthritic symptoms as the left. Joint space decreased, I started to feel my gait compensate, my back muscles got tighter, knee discomfort, tight/weak psoas, gluetal amnesia, significant pelvic rotation, etc. However, only on this side, most of the symptoms were on the lateral/posterior side. That is were the bone spurs were forming. On palpation, you could feel them. I decided to act, instead of waiting, cause I didn’t want to risk my otherwise healthy spine and lower extremities, not to mention my psyche, emotions and attitude. And thank god we have options that we can help ourselves out of a pain spiral of immobility. We have a choice.


Katrina’s right hip resurfacing
Pre-op 5/31/11

Surgery day (kind of graphic for those who may be sqweamish)

My mom and friend Kathy came with me to the hospital. I had a lumbar plexus nerve block that was inserted in the pre-op area. This flexible thread of a needle will stay in my back for about 3 days to keep the post op pain to a minimum. A little stick and it was in, didn’t feel much obvious effect. After adding a bit of "relaxing medicine" I was brought into the OR and then was administered a full nerve block that numbs the whole lower body, from the chest down. This was administered by a trainee (UCSF is a teaching hospital) under the instruction of the anthestiologist. He was having a bit of trouble so it was a bit painful. After 2 or 3 tries and a few “don’t moves” they were in. In a moment or 2 the medicine took effect and the numbing was full and quick. I believe that is the same medicine as an epidural for baby deliveries. I was turned onto my side and was prepped for the surgery. It was weird to feel your lower body numb and have no control of it. I was very cold, shaking deep throughout  my body. There was a lot of clanking around of operating table parts, tools, what have you. Dr. Vail’s eyes had a look of “sorry for all the noise”. They drape your upper body and put you into a heated tent so you are more comfortable. The anethstiologist asked if I felt anything? I said like what? They said, “Did you feel the bladder catheter?” I said no. The lady who put in the catheter smiled thru her mask and her eyes said, “Good I am glad”.  I felt the pressure of Dr.Vail's hands on my hip. That’s the last thing I was aware of. Next I was in post op feeling thirsty.

No discomfort from post-op. I was wheeled into my room. Yea! It was a private room. With a killer view of a mountain of waving Euclucptus trees and sky. (UCSF ortho ward has killer views from all the rooms). Was hooked up to the morphine drip and checked by nurses on a regular schedule.  At 7pm my husband Sean came into the room to visit I was asleep. He said I was kind of out of it. I was on a PCA (patient controlled anthestic) i.e. a morphine drip that helps keep the pain low and I had the nerve block in for a day or so more.


Day One- all the nurses at UCSF were great. The resident ortho Dr. Yamamoto who works under Dr Vail had a great bedside manner, was gentle, listened well, explained the muscular anatomy that was effected in the surgery…because I asked I wanted to understand the process. Physical therapy and occupational therapy came by today to get me to feel what its like sitting up, swinging my legs over the bed a standing up. My blood pressue went way down (91/50) and I felt lightheaded and nauseous.   I was shown how to use the tools to put on/take off socks and clothes, my “grabber”-best device for picking things up out of reach, how to sit on the toilet and what it feels to walk on the new hip! That was enough for the day. I still had the numbness in the leg, and it was a bit worrisome, cause I wanted to move it, but couldn’t. I was told that I would be weaned off of it slowly, as so not to have pain. Because I had the numbness, and no control of my new hip, I wanted to get that nerve block out.  I was still on the drip. My friend Blanche came and visited me in the afternoon, that was nice.

Day 2- Dr Vail came by early in the am and felt I was doing great. I am feeling minimum discomfort still. Nerve block was finished and I had tingling, then full sensation back in my leg. It was still very weak in psoas area and tender posterior /lateral side glutes. I started doing basic PT/Pilates therapy for strengthening…isometrics & Heel slides, quad/glute contractions ankle pumps and circles…all good. I noticed that since the hip joint has been so stiff, tight and dysfunctional that I really feel “loose” in the beginning and the muscles have been stretched during the process, so there is the sensation of instability. You can feel deep in the joint and surrounding muscles a sense of tugging and stretching and dull ache. BUT nothing like the OA.This is quite a remarkable awareness the day after surgery.

Started to gain appetite back (darn) but made sure that I ate, steamed veggies, chicken, yogurts, fruit. Things that were nutritious and fibrous. The pain meds make you constipated, and I was given stool softeners daily, which continue while on painkillers. My friend Rhonda came to visit. The morphine drip ended today. The pain now is managed on Percocet. Dr. Yamamoto changed the dressing and I got a peek at the 8 inch scar. NICE!  Clean, dry, no redness. He said Dr. Vail’s work always looks like this (my 1st surgery looked perfect too). I told him that Vail should have been a “seamstress”…I must have been pretty out of it.