Tuesday, January 4, 2011

Keep Up The Good Work

With those words Dr. Muschler concluded our 30 minute, 6 week checkup.

He was completely satisfied with the 5 X-rays that showed my hip was both healing correctly and that the surgery had left my hip-pelvis area in perfect alignment. The ability of orthopedic surgeons to read X-rays is uncanny; they see things like a psychic reading a palm or crystal ball. If anything, they are too good at interpreting X-rays; I will give you an example. Trudy, the X-ray technician apologized for the painful contortions I had to endure in order to get the exact angle that Dr. Muschler wanted to see. I replied, "... no problem. I know that X-rays are the reason I drove 300 miles for this checkup." Then I added, doctors are so hung up on measuring my progress by reading my X-rays that I could walk into the examining room with 3 heads and the doctor would hardly notice."

If I were to list the highlights of the day, they could be viewed as all negative: getting up at 5:30 am in order to make the 5 hour drive, the struggle and pain of negotiating the stairs to get out of our back porch, the long wait and sitting on a hard wheelchair in both X-ray and to see Dr. Muschler, a few obnoxious people with their cell phones, being very tired at the end of a 14.5 hour day and finally taking a fall at the last rest stop on the way home. But most of these things are either routine with most doctor visits or could have occurred had I been closer to home.

So, as the proverbial question goes, what did the doctor say? (I love this comment because most people don't remember much of what is said nor do they ask the proper questions.) But, to give an answer, what I can do is continue for another 6 weeks with the restrictions of weight bearing on the left foot, do all my PT exercises plus the addition of some back stretching, no further restrictions on sitting time, and no restrictions on sleeping on either side or my stomach. The biggie was his approval of my request to start water therapy. What I cannot do is drive the car (although I got a temporay handicap sticker), restricted abduction movements of the surgery leg, and restricted straight-leg lifts of the surgery leg. Also, he doesn't want me to use weights on any of my dozen existing PT exercises (something I have been fudging on). 

Items that were of no concern to Dr. Muscher were just those items that hospital and visiting nurses dwell most upon: swelling in the surgical area, swelling in the legs and ankles, vital signs, bowel movements, even pain levels. 

So the 'choke collar' has been loosened a notch. Judy and I were extremely happy as we left the Cleveland Clinic at 15:30 hours, just in time to beat most of the afternoon traffic jams. I signed a paper that should have a digital copy of the X-rays sent to me in a few days. Once I get these X-arys, I will include them in a future blog.

 The best story of the day was when Dr. Muschler finished his detailed analysis of my X-rays, with emphasis on how happy he was with the healing process and the perfect alignment of all the parts. I then commented that I would assume that some surgeries did not result in such good results. His answer was a classic: "Not with my patients."

I should have more to report tomorrow because my first day of the second 6 week recovery period was a big day.


Sunday, January 2, 2011


Robert Fulghum's, the All I Really Need To Know I Learned in Kindergarten guy, 3rd book was titled Uh-Oh. He gave the term a variety of possible meanings. His underlying message, however, was that Uh-Oh was more than a momentary reaction to a small problem, but more an attitude on the universe.

With that background perspective, I had two such Uh-Oh moments in my hip recovery odyssey. The first occurred on or before Dec 23. Judy noticed I had a large, swollen area around my scar. Neither of us had noticed it before, but agreed it was more prominent when viewed or photographed from the front/back rather than the side (which is the normal view). Neither of the two visiting nurses had noticed anything different in their visits a couple days earlier, but again they were seeing me more from the side.

I immediately jumped to the conclusion that a dislocation had occurred. Dislocations are the #1 warning from orthopaedic personnel, although I personnally place it behind infections and pneumonia when considering surgery risks. I have seen it up close and personal in my right shoulder three times. I could not sit as comfortably as previously, but I was not in any great pain. I cut way back on the PT and used ice to minimize the swelling.

Of course the big question was what to do. The calendar almost guaranteed that few medical personnel were available, either in Midland or Cleveland. My conclusion was that venturing forth from my house was a bigger risk than doing nothing with whatever had occurred to my hip. (That is the reason that nursing homes and hospitals DO NOT evacuate on hurricane warnings because any evacuation process inevitably kills one or more patients.) I also discovered that my three levels of phone contacts at the Cleveland Clinice were: (1) gone on vacation, (2) not a working number and (3) a wrong number.

So by Monday, Dec 27, I went with my first line of defense: the visiting nurses. Although they were not scheduled to visit me that week, my case worker Ashley was available. I was into the mindset that an X-ray would be needed to give a definitive answer to the dislocation question. I had previously determined that my local doctor was working, but that his X-ray technicial was off for the week. That meant I was facing a long wait at either the local emergency room or its alternative Urgent Care. Also, I would be exposed to the travel/fall risks and the interaction with a bunch of 'sick people.'

When Ashley arrived at 10 am, I immediately 'mooned' her. Her reaction was less than medical. She proclaimed my hip as 'funky', but did agree an X-ray was in order. Her phone call to my doctor got me an appointment at 15:30 (no X-ray could be scheduled without a doctor's visit first). I had by then, after numerous false starts, reached a live body at Cleveland Clinic. Their recommendations were: (1) drive the 5 hours to visit the Cleveland Clinic emergency room and (2) X-rays could NOT be electronically transmitted.

The doctor visit was a positive experience on many levels. I was able to negotiate the steps in my house to get to our car. I was happy to breath fresh air and see something besides the inside of my living room. The actual doctor visit was a totally positive experience. He did feel the hip was NOT dislocated. I had a fluid pocket that goes by various names. He suggested some things to do and not do, all of which made sense to me. (My doctor had recently had a hip operation of his own, so he had first hand experience with the procedure.) We had a pleasant exchange on other issues, something that had not occurred in recent office visits. Of course what Cleveland Clinic thinks of my hip and the long term consequences will have to wait until Jan 3.

The second Uh-Oh also occurred about the same time as the hip swelling issue. The bottom line is that I broke the LCD screen in my #1 laptop computer. The details are convoluted, but it was basically the result of my inability to sit up and use the laptop in a normal position.

This Acer laptop had all my recent medical musings written in the form of a diary. I was in good shape for backups, but the thought of all the other programs (over a hundred) that might or might not be restorable was too much to fathom. I did manage to use the laptop with an auxilliary screen, but that mode of operation soon degenerated into a non-functional computer. The local repair guy said replacing Acer LCD screens is not financially viable. He also suggested that, based upon some of the crash messages, the hard drive might have gone south.

But I was successful in both removing the hard drive and reading data from it. I expanded my computer skills another notch in accomplishing these two events. I still face the prospect of buying a new laptop, but as they say, that is only money. More daunting is the prospect of installing the laptop hard drive into a fresh computer, and thereby eliminating the pain of recovery. Bill Gates says I cannot do it; that move implies I am trying to 'steal' one of his precious operating systems.

One of Fulghum's interpretations of an Uh-Oh moment is that a few years from now it won't make any difference. Stay tuned for that outcome.