I had the surgery on Tuesday the 28th. Went fine. I woke up with the same dull pain as four years ago, but the doctor hadn't used the blue wedge pillow this time. Doesn't matter to me one way or the other, but I had discarded it by Day 2 last time. I don't know his reasoning - whether he simply doesn't use it any more, or whether he thought I didn't need it. The blue wedge is to put between your legs to keep the hipbones swinging outward - away from each other.
There are three concerns to the success of the hip joint itself. 1) That the foot points right straight forward, so that your leg will end up in the correct alignment when the muscles and tendons heal. 2) That the leg doesn't cross the centerline - toward the other leg - because this could pull the hip out of the socket, until those tendons heal. 3) That you don't bend at the hip to create more than a 90 degree angle, because this will also, and very quickly, pull the hip out of the socket. The nurses tend to shortcut this last one by saying never to have the knee higher than the hip. That isn't always going to do it, of course.
Weight on the new joint is hoped for. It will heal faster. They were recommending full weight by the time I left the hospital. Crutches are mostly to make sure you don't fall over. And to allow for the fact that it takes some time before you can really control the leg normally.
Anyhow, the blue wedge pillow prevents number 2.
Everything was fine that day. Pain, of course. I had a 'pump'. If you're not familiar with that, they have a machine with a button that you control yourself to deliver a dose of pain medication essentially whenever you want. If you push it too often, it just doesn't deliver, but for most people I guess this just wipes out their pain. I thought they had morphine, but it seems that what they actually use in Dilaudid, which I know nothing about.
Except I now know that it does nothing for me.
How do you know whether pain is being relieved, y'know? I have pain, push button, still have pain. Maybe it would be worse if I didn't have it? I actually have quite a high pain tolerance (except when it comes to my veins, when I become a bawling baby), so I wasn't terribly concerned about it.
Along comes Day 1. I knew what was coming; they were going to want me to get up. I *knew* I wasn't ready. They, based on experience with hundreds of patients, *knew* differently. The physical therapist tried to get me up and, of course, I got light headed. I told her this had happened last time and they ended up giving me two units of blood. She wasn't interested. I told her that my blood pressure dropped off to nothing. She took my blood pressure and it was fine. Yeah, well, I'm lying down, dunce! She was going to give up, which delighted me, but one of the nurses volunteered to help her. She told me that it didn't matter if I fainted - she would catch me. I knew she couldn't, and was worried that the hip would dislocate. They hauled at me until I was in a chair, with my head positively swimming. She got lucky - I *didn't* faint. I wasn't able to adjust in the chair though, and they hadn't left any controls within my reach. (I now know that I should have plainly, flatly, stated that I refused to get up.)
It was horrible. After the effects of the next day, the hospital appologized to me. Apparently that nurse was a floater and unused to the special needs of that unit.
After an hour and a half of sitting there crying, I had my roommate call them, and they didn't come, and fifteen minutes later the same thing. The next time I informed them I was getting back into bed now with or without help. Someone came immediately. That incident was the only one I had with the hospital at all. Otherwise the care was excellent.
Along come Day 2. This is more serious because on Day 2 they remove the catheter, which means get to the john or use a bedpan. Can't use bedpan. Sorry. And it was on Day 2 that I fainted 4 years ago.
I'd been using the Dilaudid pump some, mostly because it made me sleepy and I was delighted to sleep. And again, how do you know how much pain you'd be in if you did *not* take the pain reliever? So, knowing that they would be coming soon, I started really pumping it.
You guessed it. I fainted for them.
Unfortunately, they didn't give me blood right away. First they went through a couple more bags of saline solution while they thought about it. Finally, they decided to give me two units the following day, before releasing me.
Well, you know how that goes. They didn't start until 12:30. I asked how long it takes and she said 2 to 3 hours per unit. If I'm average, that means five hours. I can still be on the wheelchair van to the rehab facility by 6:00, right? Not a chance. When the first one finished at 3:00 they 'let it rest' for an hour. The second finished at 6:10.
This meant gettting to rehab on Saturday.
Now, I don't know how common it is to go to rehab. Around here it's pretty much expected. Last time, I went in on Sunday. They wanted me to go home on Friday, but I said make it Saturday when my husband will be home. I learned two things: Getting there on Sunday *sucks* because they won't let you even go to the john until you've been evaluated by PT, who of course is not there: and that 5 or 6 days should be plenty of recovery time before going home.
So I had originally figured that I'd be at the nursing home rehab on Friday and go home on Wednesday. The hospital screw-up meant that I wouldn't be ready until Thursday. Worst, however, was not being able to get out of bed all weekend. I lucked out however. The Saturday PT woman waited for me and gave me a quick eval so that I wasn't stuck in bed. (Not that I actually would have been anyway. Just like last time, I'd have simply gotten up and gone to the john. The big problem with that is getting back in bed. Gravity will take the hurt leg down with little problem. Getting it up again is something else. But I think I'd have just had to deal with some disapproval for a couple days.)
Anyhow, to shorten this lengthy story: The rehab facility physical therapy and occupational therapy were great. They assessed and addressed my needs efficiently. The nurses and aides were also very good. They came when asked unless there was very good reason not to, and in general were kind and sympathetic, not only to me but to my going-senile roommate. The nurse-practitioner was an ass. He came in on Tuesday. When asked when I expected to go home, I said I was looking at Thursday. He was incredulous. Oh, no! It would be two or three weeks before I went home! I decided to ignore him. I *did* end up having to wait for him to sign off on Friday morning. He simply got overwhelmed into it.
Then there's the food.
The food is the real reason I insisted on coming home when I did. It would be nice to still be in a bed that goes up and down, to be 6 feet from the john, everything I needed right there in reach, and plenty of help. But my diet was scaring me. Once in a while there would be sausage with breakfast, but it tasted terrible, and more likely it was just pancakes and/or cold cereal. Pancakes = sugar and white flour. (Well, I'm not about to eat them without the syrup!) The cold cereal was usually fine, and the nutritionist did (eventually) see to it that I got whole milk for it. I made up for shortfall because I had my own granola with me, and usually had that also.
Lunch and dinner both had alternates, and you could always add (instant) mashed potatoes. Sometimes picking between all the options still didn't get me any healthy food. There were three meals during the week that had mashed potatoes, vegetables, salad, and meat. Then there were the 'hamburger' - dry and horrible, with a seasoning which was supposed to make up for it, the 'pizza', the 'turkey salad' - ugh! Poor long suffering nutritionist said that it was the meat-and-potatoes meals that he got complaints on. People just don't eat anything but junk anymore!
Anyhow, my diet was over half flour-and-sugar, and my bowels were telling me about it. How do they seriously expect people to move that glue through their systems? I should have asked Family to bring me raw vegetables, but I kept forgetting.
Family issues didn't come down as expected either. Would you believe that both Son and Daughter got jobs starting on Thursday? Incredible. And they have both been pretty well useless to me because of that. Hubby? Well, he went and picked me up, but he has a policy (a fear): Don't ever help Wife out with anything lest she become accustomed to it.
So all in all: I'm okay. I can take care of myself, for the most part. They have to take care of themselves.