Theses: Piper (12) & Martin Luther (95)

In 1517 Martin Luther posted his 95 theses as a protest to the religious practices of the day. I had a similar occasion occur when I felt I was ready to be released from rehab following hip surgery. After 7 days in the hospital and 3 days in rehab, I tried to make as lucid an argument as I could for my release.

I posted these arguments, virtually, in my room. Had these arguments not worked, I was ready to take the next step of contacting the hospital ombudsman. But Dr. Govani, the doctor for the rehab wing, fully agreed with me, particularly on item #3, and I rolled past the frowning nurses on my way out.

Positive

1. I want to go home.

2. There is no medical reason for me to stay.
   
   
3. Medicare is the #1 entitlement cost. Let’s both do our part, today, to bring this cost down.

4. My wife needs to go home.

5. My home has all the necessary equipment for limited mobility.

6. I have had 4 previous orthopedic and 3 general surgeries, so I know the routine.

7. I have Visiting Nurses service.

8. I have done everything asked of me in PT and OT.

9. I have returned to medication levels prior to surgery, i.e., no stool softeners, no pain pills and no supplemental Lovanox.

10. Further stay has increased risks to me, namely:
    a. heart stress: BP went up to 157/77 last night just thinking about going home.
    b. cumulative risks from infections to myself and wife are getting significant
    c. my brain is starting to deteriorate
    d. my general overall mental outlook is declining

11. Dr. Nick Ting actually was ready to release me to home last Friday (11/26/10), but I declined.

12. I have met all my personal, post-surgical goals.

Contraindicated

1. Limited mobility. I have always improved in the past. I have a functional family (wife, son & daughter) for support

2. Swollen legs. This is improving daily now that I am getting out of bed.

3. Shorten stay. The ‘normal’ stay, while undefined, seems to be about 10 days. While I have been here only 4 days, I believe I am ready & capable of going home.

4. Temperature rise and incision bleeding. The temperature rise to 101 is a fluke (just my body getting ready to go home); the bleeding is minor and not unexpected.

I invite you to check out the history of my pre-surgery and post-surgery feelings by checking out our blog at:

http://cc-hip-redo.blogspot.com

Let’s aim for a 12/2/10 release, sometime around 13:00 hours.

Larry L. Piper

12/2/10, 01:30

(The bottom line is that I rolled out of the rehab ward about 15:00 hours on 12/2/10. The doctor said he had a flat tire, so that delayed his arrival about 1 hour. We got home about 20:30 hours with only two brief stops. I slept the last three hours of the trip, all of which was in the dark.)

A Christmas Letter

 We mailed the following letter (sans pictures) in with our Christmas card this year.

A reader of Dear Abby was making fun of the annual Christmas Letter. It went something like this: 'We spent the year traveling for world peace, our #1 son had an audience with the Pope and our #2 son won the Nobel Prize'. So with these caveats in mind, here goes our life in 2010.

We started the year by inviting two cats into our family, Mike and Ike. We had gotten rid of our last cat on 9/10/2001, so we took the events on the following day as an omen, and we had resisted adding anymore cats. The personalities of brothers Mike and Ike fit our family lifestyle, and we both get more from them than they get from us.

Larry took over the Presidency of the local computer club. It was not so much a position of honor or knowledge as it was to give the former president a break from his 14 year 'reign'. These presidential duties did temporarily sidetrack Larry from his main goal: to check into the possibility of a pacemaker. The story is long and convoluted, but essentially in mid-2009 Larry could tell he was NOT coming back from the back fusion surgery. His resting heart beat had dropped to 35, and a visit to the cardiologist confirmed that he was a candidate for a pacemaker. Unfortunately, the cardiologist 'forgot' about the office visit. But a new doctor had come to town. Officially she was an electrophysiologist, and she had a new $5 million operating room at her disposal. An appointment in March confirmed that a pacemaker was needed (bradycardia is the technical term), so on April 27 Larry had both a pacemaker installed and some cardiac ablation done. The two procedures were day surgery, and recovery was complete in two days except he could not raise his left arm for six weeks (to let the internal leads heal).

The big event of the year was our 50th anniversary. The manditory trip or family dinner was never on our radar. Judy concocted this plan to share our celebration with family and friends at the Loons baseball game. The Loons are a three year old, A-level professional baseball team in the Dodger's organization. So about 12 of our family and 18 of our friends were able to join us at a cookout at our house before we all enjoyed the game in prime seats behind home plate. Larry put together a PowerPoint show that contained over 100 photos from our married life.

The most visible accomplishments in 2010 were changes to our house. We did the changes with our checkbook rather than our own sweat, which was both a seismic shift in our philosophy and a boost to the local economy. The key was finding a good, local contractor. Mike first reroofed our 25 year old garage in May. When we saw what a great job he did, we turned him loose on new siding and windows for the house. Then we had a 55 year old spruce removed from the front lawn, and voila!, we had a new home. Checkbooks are a wonderful thing!

Larry had some adjustments made to his pacemaker and a second cardioversion done in late summer. Now his heart was hitting on all cylinders. But the hip pain had returned. The expert opinions said he should return to Cleveland Clinic for the redo operation after 22 years. Larry's original hip surgeon had retired in 2007, but a new surgeon even more capable than the first had taken over. The downside was a four month wait for an open surgical date. But then the gods smiled upon us and a date became available at Thanksgiving. The surgery took twice as long and the hospital stay was about three times as long as expected. The recovery period will be tougher than previous surgeries, but as Judy noted, 'if we had done the surgery at any place other than Cleveland Clinic, Larry might not have walked normally again.'

All in all it has been another good year. We have a lot to be thankful for. Life is good.

Pregnancy, Marathons and Orthopaedic Recoveries

Pregnancies, as we all know, take 9 months to reach fruition. And the process cannot be shortened to 1 month, as the joke goes, by putting 9 men and 1 woman or 9 women and 1 man on the job.

Running your first marathon takes a similar amount of time. I had a couple DNFs at the 26 mile distance before I devoted the necessary 9 months time and effort into training for the distance. I have talked with and coached other runners who have voiced similar feelings in conquering the marathon distance.

So that leads to an orthopedic surgery recovery. This is a subject on which I have abundant experience. The 'party line' on hip replacements is 1 year before you will be back to normal. My 1st hip took a little less than 9 months; the 2nd hip took a little longer. But the back fusion was a totally different matter. The bone paste used in the fusion takes a minimum of 3 to 6 months to 'set', and, like concrete, continues to harden up to 2 years later. During this first 3 to 6 months, one has fairly restrictive movements.

So this is the predicament in which I once again find myself. My left hip redo on Nov 23 will take 3 to 6 months to set because Dr. Muschler had to use bone paste to build up my hip area. During this time I must have absolutely zero weight on the left foot for 6 weeks. At this point we will make another trip to Cleveland Clinic where an X-ray will show the healing progress. I truly believe that Dr. Muschler will extend my non-weight-bearing restrictions another 6 weeks. This can be a depressing outlook. During the previous back surgery in Nov, 2008, I passed the time by writing a book about my life -- to give to my two children. What I will do this recovery period is unknown at this time. All I know for sure is that I have 9 months to do it. Any suggestions?

The photo above is from day 20. Tomorrow I expect the Steri-Strips to be completely removed (Day 22).


Larry

Routine Has Set In

The duties of blogger have fallen to me. Judy is busy taking care of both of us.

I gained strength rapidly after recovering from the 5 hour car ride home. I am into a routine that consumes most of my day. I see a visiting nurse once per week to who checks my general progress. A PT (physical therapy) nurse comes in two times per week and we work on exercises for about an hour. Throw in a 2^nd PT session, meals and a couple naps each day and it is time for bed.

I have been able to sit up for 20 minutes at a stretch for the last 3-4 days, so I can read a little email and type into my daily diary or this blog. My mind is starting to work again, and the reality of 6 to 12 weeks of this recovery routine is beginning to set in.

I will try to write another blog tomorrow; it will be more philosophical than medical.

Larry

We're Home

Eat, Sleep, Rehab

Today was Larry's first big PT and OT day. He did very well.....you know Larry....he's there to do more than necessary and as usual he charmed them all. He seems to be getting stronger now. The therapist put him thru the usual PT moves but now 30 reps each. Of course, he did 31. After seeing him morning and afternoon, she has him pegged. He told a couple of jokes and while waiting for transportation back to the room, one of the lady patients said tell us some more in case I am not here tomorrow when you are.

He is sleeping soundly right now. My head nodded a couple of times while catching up on my emails. We solved a couple of problems today having to do with computer related renewals. We did not anticipate being here this long……optimistic souls that we are. So we have lots of good check marks for the day.

Larry's lack of strength is the main factor in getting out of rehab and loss of flexibility from his back surgery. Since the surgeon did so much rebuilding in the hip, the new bone has to heal solidly. So we may very well be trapped in the house this winter as much as we were with his back surgery. It will be so nice to get home we won't mind. It's hard to remember that you are almost 72; you think you will spring back as you have always done. And he will be back; it just takes longer.

Oh yes, I am doing all this computer work from Larry's room. It took some persistence to get on the Cleveland Clinic wireless here at Lakewood, but it works. It’s so nice to be able to communicate with family and friends easily.

Over and out.

Judy