Surgery Notes

St. Vincent's Hospital Now

Wrote most of this three months ago just after my hip joint replacement surgery. Taken me this long to get around to finishing it.

Most of the people I saw were pretty women with a variety of personalities. Connected with some, did not connect with others.

Nurse Jerri thinks I sound like Kevin Costner.

New Operating Room

Remodeled operating room. Last time I was here the surgery center and the operating room were all very industrial looking like something out of Star Wars. This time it was all soft pastels like a modern doctor's office.

St. Vincent's Hospital Ten Years Ago

Remodeled exterior. When we arrived, I walked out of the parking garage and saw this big, shiny, new building (top) and I thought 'this wasn't here before'. Turns out they just put a new facade over the old one (above).

Aisles in new garages are narrower than in the old one which is why I prefer to park in the old garage, even though I have to walk a hundred yards farther to the hospital entrance.

Masimo Root Patient Monitoring and Connectivity Platform

Numerous connections while I am lying in bed after surgery:

• Intravenous line
• Electronic pulse monitor
• I think there was an oxygen level monitor as well, but I don't recall where that one was connected to me. Might be combined with the pulse monitor. The other end was connected to a fancy looking machine that didn't seem to do much (above).
• Warm air hose connected to hospital gown
• inflatable bladders wrapped around my lower legs to reduce the chance of blood clots and / or cramps. The ran on a cycle of about a minute - Inflate on one leg, then deflate, then repeat for the other leg. Funny thing was I noticed when it was inflating on my left leg (the surgery leg), but I had to pay attention to notice it on the right leg.
• How many times did they take my blood pressure? I wouldn't be surprised if they measured it dozen times.
• remote control for the TV. Not connected to me, but it was tied to the bed so I would be able to retrieve it. Not a problem until they started changing beds on me.
• There was nothing on there that I was the least bit interested in watching. Or listening to.
• The controls for the bed were built into the hand rails, so they didn't need to be disconnected or reconnected.

None of these connections were a problem until the gals from Physical and Occupational therapy showed up and wanted me to get out of bed. I suspect a lot of this was just protocol. Problem is I don't know how sick I am. I could be well on the healthy side of the hill, but then again I could be walking on a knife edge where one little glitch could send plunging into the abyss. So I didn't complain other than to commiserate with the njurse who had to struggle with warm air hoses. I don't think I needed any of it, but if I was just a little older and/or feebler, they could have been important. The last thing the administration wants to hear about is a catastrophic outcome to a routine procedure. Or a complaint from a Kevin that his feet are cold.

Oxy

Oxycodone
My pills are the one at top left.

I took (53) Oxycodone tablets, 5 mg each, since my surgery on January 13, 24 days ago. Divide 53 by 22, since I quit taking Oxy 2 days ago, you get 2.4 tablets a day. At first I was only taking 1 or 2 day, probably because I was still full of the anesthetics from surgery, but a week later I was up to 3 and then 4 tablets a day. A week after surgery I dropped down to 2 tablets a day.

The instructions on the bottle say 

TAKE 1 TO 2 TABLETS BY 
MOUTH EVERY 4 TO 6 HOURS
AS NEEDED FOR PAIN

At 2 tablets every 4 hours, my bottle of 40 tablets would only last 3 days.I guess different people have different pain nerves.

Middle of last week I would start feeling cold 6 to 8 hours after I took an Oxy. Found if I took another Oxy the cold went away. Now I am beginning to suspect maybe I should stop the Oxy, so I did, and for two days I couldn't sleep for shit, so I started the Oxy again and two days later, about 9PM, I started feeling cold, colder then I have ever felt, even when I was at winter camp with the Boy Scouts, back in 1963. I spent the night camped out in the recliner in front of the gas fireplace, piled high with blankers. OK, that's it, no more Oxy.

That was two days ago and I am finally starting to feel human.

When I went in for my two week checkup, a week ago, I got a refill script for Oxy. When I was filling in the intake form I selected Walgreens on Cornell as my pharmacy. Well, it's on Cornell, if you forget that Cornell makes two 45 degree bends before it gets to the Walgreens on 10th. So we went to the Walgreens on 10th and Baseline, waited in line at the drive up window for 15 minutes, only to be told we were at the wrong pharmacy.

Huh, here I thought a script was a script. I mean you have to pick up prescriptions for narcotics in person at the doctor's office and then hand carry it to the pharmacy. I'd never seen a script like this, it was printed in color on some fancy paper, it was almost like the title to a car. Great, now we get to drive four miles to the Walgreens on Cornell and dropped off the script. 

It was going to be a 20 minute wait so we went and had dinner at the Copper River restaurant. This place has kind of weird layout. The front door opens on to Cornell Road. It's 35 feet away from the curb, so you aren't stepping into traffic. Meanwhile, it's 100 feet from the parking lot. I suspect this is because of the plague of cuteness infecting city planning. Somebody has got the idea that everyone is going to walk everywhere and no one is going to drive cars anymore so we need big fat sidewalks and no parking for automobiles. I'll give them that it's cute, but it's also very stupid.

After dinner we head back to Walgreens to pick up the script, and miracle of miracles, they have all the paperwork in order so all I have to do is identify myself. Did I have to show my driver's license? Don't remember, probably.

There were some times early on when I would get into a very pleasant dream state. I would like to go there again, but not at the risk of feeling cold as ice.

Peter Pan

Why does British copyright law have a "Peter Pan clause"?
Chris Spargo?

I am mending from my recent hip surgery. I am done with the walker, I don't think I ever really needed it, but my wife, concerned as she is, insists that I use it. Given how much help she is, I try to follow her directions.

Strange things going on in my body. Doc gave me a bottle of (40) 5 mg tablets of Oxycodone, saying take one or two ever four hours. I've been taking one or two a day until yesterday. Yesterday evening I started feeling very cold and the pain in my hip was becoming more pronounced, so I went ahead and took one. Within an hour the coldness and the pain had lessened significantly. So the cold is my new indicator that maybe it's time for another oxy.

I think the reason I wasn't needing very many oxy early on was because the drugs they used during surgery had not completely worn off. I'm still not taking very many oxy, maybe 3 or 4 a day which is just a fraction of my maximum prescribed dose.

Hip Joint Replacement Surgery

My Hand, Festooned With A Needle and an Electronic Doo-Dad

Left the house at 5AM yesterday morning and got home around 7PM with a new hip joint. Dr. Elizabeth Lieberman from the Orthopedic and Fracture Specialists performed the operation at St. Vincent's Hospital in Beaverton. While I was there I was almost entirely under the care of women. I think I only had two guys dealing with me. Let's see how many I remember:

• the receptionist greeted me, collected $455, and started putting data in the computer,
• the nurse who guided me to the surgery preparation room
• Rosh prepared me, which seemed mostly to making sure she had the right person and the right operation, i.e. lots of typing on the computer
• a vampire to stick the needle in my hand so they could pump me full of drugs
• Dr. Li, the anesthesiologist came by and introduced herself,
• her assistant, a man, came by and talked to me,
• I think Rosh wheeled me and my stretcher to the operating room. I can't be sure it was her, but then lying flat on my back I couldn't see who was pushing my stretcher.
• Did Dr. Lieberman's surgery nurse come by before I got to the O. R? Probably, but once I was in the O. R. she got me on the operating table (carefully covered with a sheet) and got me in position so the anesthetists could stick c spinal tap needle in my back.
• And that is all I remember before I woke up in recovery, where another man checked my vital signs and entered more data in the computer. I was still pretty out of it, I don't recall anything else about that, I wasn't there long.
• Then it was off to Short Surgery Care Center / Unit (?) where I spent several hours sleeping and occasionally eating Kellogg graham crackers. That was a high point. I've been working on losing weight for a while and cookies are pretty much verboten. When you have been deprived of cookies for a while, even graham crackers are a treat. I ate at least six.
• Kathleen was my primary nurse in the SSC. Rosh also came by. She got to insert a catheter into my urethra to drain 560cc of urine out of my bladder. I had no sensation down there. Not draining the bladder could cause big problems.
• Around 3 or 4PM Jerri, the Physical Therapist came by and ran me through various exercises for the feeble, like getting out of bed, walking across the hall to the restroom where I was able to urinate by myself (only 250cc this time), walking down the hall with a walker, and climbing the world's shortest staircase (3 steps). She seemed to think I should remember all the rules from last time as it was only three years ago that I got my right hip joint replaced. I vaguely remembered going through the motions, but the rules? Not a clue. The big one is 'if in doubt, knees out'.
• While we were out of my room (number 7), someone came by and stole my stretcher, so they had to activate the movers, a crew of, I dunno, half a dozen lovely young women to pull a bed out of another room and wheel it into mine. I suppose there is some difference between a 'bed' and a 'stretcher' but the only difference I noticed was that the safety rails were chrome steel tubes on the stretcher and plastic panels on the bed,
• Next was the Occupational Therapist. I think the big deal here was getting dressed.
• Now I get one more nurse to go over my rules for when I get home. Fortunately my wife was there to absorb all that so all I had to do was smile and nod.
• Lastly, a cute young woman (a CNN maybe?) got me in the wheelchair and wheeled me to the Phil and Wife Nike Entrance where my wife was waiting with the car. She gave me a little help getting my feet in the car.

Every time I met a new person I had to tell them my name, birthday and why I was there. Then they collected my vital signs (pulse, blood pressure and temperature) and entered it into the computer.

That's all for now.

Walking the Dog

Dog Water?

I have upped my walking to 30 minutes. It's been a year since I got my new artificial hip joint installed and while I could walk comfortably since shortly after the operation, walking for a few minutes would cause the joint to start aching. After a while I was able to walk around the block (ten minutes), but this summer I have started tackling longer distances, like three or four miles. Great achievement, but it left me so wiped out I would need a couple of days to recover. Sad, very sad, as the great and benevolent Donald likes to say. But now I've been doing 30 minute walks every morning and all is well.

I go early in the morning, before breakfast and before I've taken a shower because if I wait till those two chores are done, life takes over and a walk takes the back burner which means it doesn't happen. While I am out, I will usually see about a dozen people, some are working (roofers and landscapers mostly), some are just out walking and about half of these are walking their dogs.

Today I noticed this little puddle adjacent to a paved walking path. Been by here every day for a week and today was the first time I noticed it. It looks like someone deliberately made this hole for drinking water for dogs, but it has a definite brown tinge from the adjacent asphalt paving. Doesn't seem like a good idea, but if it was really bad I suspect dog's wouldn't drink out of it.

Talking to Jack about his dog Ruthy yesterday. It seems like Ruthy likes to eat cherry pits she finds on the ground. Jack's neighbor has a cherry tree that hangs over the fence, and there's a cherry tree at a nearby school where they go for walks. So what's the big deal? Dogs eat all kinds of garbage, that's how they get that wonderful dog breath. Well, seems cherry pits are full of cyanide. If you just swallow them whole it's not a big deal, but if you crunch them up it doesn't take more than a dozen to send you to your maker. The crunch is the key, but dogs like crunchy things, so, yeah, you wanna take precautions.

Wasn't there a tune called Walking the Dog? Yes, yes there was:

Rufus Thomas - Walking The Dog (1964)
Reelblack One

Your Tax Dollars at Work

First Ball and Socket
Replaced in Second Surgery

Just got a statement from UnitedHealthcare. It has my total medical expenses from last year, which means it includes my hip joint replacement surgery.

Merry Christmas

Wes' Last Minute Gift Ideas for Hopeless Nerds - Ft. Watch Wife Work
Watch Wes Work
Don't know if I need any tools, but I enjoy listening to Wes and I like tools so it's double good. 

I'm pretty much fully recovered from the hip surgery I had this summer though I am still learning how to walk. My hip joint deteriorated slowly over a couple of years, so the part of my mind that controls walking was slowly able to adapt to the problem. But then I had the surgery and now everything is suddenly better, but my mind is still adjusting. One thing I noticed is that I don't seem to be able to walk a straight line, I kind of weave a little. Of course now I'm wondering if I ever did walk in a straight line, and now I'm wondering about people in general. Somebody should investigate.

Anyway, since I am now mobile I can pick some tools and start fixing things around the house. But while my hip was deteriorating, I gave a bunch of tools over to Osmany's care. I talked to him about this and he brought (four) five-gallon buckets full of tools over and dropped them off. It's like 200 pounds of stuff. I have not even begun to sort it out.

Beside tools, Wes also mentions some books, which prompts me to wonder how many books I read this year. It seems to me I only read one book this year, A Deepness in the Sky by Vernor Vinge. Checking over this blog, it appears that I read about half a dozen books. I suspect the Vinge story seems like the only one because it  took me about four months. I finally finished it a couple of weeks ago. I mostly read it when I was waiting for someone, but that was okay because it's a complicated story. Each little bit that I read contained enough ideas and concepts to mull over that it would keep me occupied for a while. I did read maybe half a dozen other books this year. On my daughter's recommendation I have started reading Babel by R. F. Kuang. It looks promising.

Anti-Fudge

I've been lying low since last Wednesday's incident and my hip joint has apparently recovered. I was worried there for a couple of days that maybe I had done some real damage, but apparently not. As a bonus I tripped over the Peloton in the dark and fell down. That didn't seem to bother my hip at all, so that's good. My foot is now all kinds of technicolor. It's is a real conversation starter whenever I run into someone when I am not wearing my shoes, which is pretty much all the time now since it still hurts like a sum-bitch to put them on.

Fudge

I feel like I am back to square zero. I started going for walks around the block, ten minutes, last Saturday. Everything seemed to be fine. Wednesday I am just finishing my walk, I'm about 100 yards from my house and my hip starts hurting. When I got back to the house it was hurting like it was before the joint replacement surgery. Two days later and it still hurts like a sum bitch. Fudge. 

Show and Tell Tuesday

Implant Samples
Planks in the table top are six inches wide

IAman brought some samples of mechanical bits used to repair broken bones in people. I found the variety astounding. Of course, I'm used to dealing with ordinary nuts and bolts, not imaginary stuff from a different galaxy.

Tuesday

I walked around the block today, third day in a row. Takes about ten minutes. My daughter says I haven't done it in a couple of years. I don't recall. I do remember talking to my wife around Christmas that my leg was getting worse and I should probably do something about it, and then for the next six months it got progressively worse to the point that walking out to the truck parked out on the street was an expedition. Anyway, the new hip joint seems to be working.

Firemen Carry

My wife recorded these short videos last month when they hauled me off to the ER. For your amusement.


Hauling me away to the ER part 1


Hauling me away to the ER part 2

Aches and Pains

Just some observations on my life in the recuperation lane.

Every since my surgery last Friday little aches and pains have been showing up in various places. This may have been happening since my first surgery just over three weeks ago, but my memory of that time has been lost in an anesthetic haze.

Sometimes half of my hand or foot will fall asleep. My hand or foot will be divided by a line that runs between the third and fourth digits - i.e. the outer most two digits and that side of the appendage will fall asleep and I'll get that tingling sensation you get when an arm or leg falls asleep. Diligent flexing of the affected appendage will generally wake it up and the tingling will go away.

Occasionally I will get a cramp in my legs. Before my first surgery cramps in my calves were  becoming more frequent. Since then they have diminished considerably. Now and again I will get a mild one in the back of my left thigh, the one that didn't cut into.

Last night I got a muscle spasm around my right hip joint. This was almost in the same place as when my hip dislocated itself a week and a half ago. That was a bit concerning. The pain hung around for an hour or so but this morning it's gone.

Yesterday I got a pain in my right shoulder. That was weird, why should I be getting a pain there?

Cramps are more intense versions of muscle spasms. Neither one is under conscious control, but cramps are intense, painful and will get my full attention. Muscle spasms are more like little curiousities - huh, look at that. Cramps can generally be cleared by stretching the affected muscle, though sometimes it takes a lot of work. Muscle spasms generally go away by themselves after a few seconds.

Oxycodone

It's been five days since I've had a shower and my wife tells me I'm getting a little ripe, so we're going to try and get rid of some of the stink this afternoon. I've had very little energy which is not surprising given the second round of surgery, but I also haven't been getting much sleep. Pain is negligible, but sleep is elusive. Two nights I tried going without an oxycodone, but it didn't work. I finally gave up around 3 AM and took one of these prescription opioids. That allowed me to sleep but I wonder what's going on. Am I getting hooked on this stuff? Insidious is what it is.

I suppose I'll need to keep taking it until my hip has healed properly just so I can get enough sleep. Then maybe I'll be able to tolerate going without sleep for a couple of days until I relearn how to sleep without it.

Revisit Hospital

Went in for surgery Friday afternoon to correct the misaligned hip joint. Is misaligned the right word? Seems appropriate. Didn't go to the Operating Room till around 4PM. Last time I was here they sedated me as well as given me a spinal block. I remember a whole lot more about the pre-op and post-op this time. For instance, I remember scooting off of the gurney and onto the operating table, and then sitting there while they started sticking a needle in my back. That was it until I woke up in post-op.

KCI's Prevena Incision Management System

$4,000 - Disposable

Saturday I was pretty much in limbo, just kind of lying there, dozing now and again. Since I only spent one night here the first time I expected the same this time. All was fine until we get to the occupational therapy (last step before discharge) and we notice the incision is bleeding, not gushing, but more than a couple of spots. They apply pressure with a big fat elastic bandage but that doesn't quite do the trick, so they hooked me up with a portable vacuum pump to suck the excess blood away and call it good.

Well, good enough. Here it is two days later and there is no sign of blood in the tubing, but this electronic leech is supposed to stay attached to my hip for a week. I would have been better off spending another night in the hospital.

Emergency Room Visit

Two weeks ago I had surgery to replace my worn out hip joint. Wednesday morning I was supposed to visit the doctor for a routine follow up visit, see if everything is progressing okay. At 4:30 AM Wednesday morning I felt a muscle spasm around my new hip joint and a clunk-a-bunk sound and all of a sudden I couldn't move. Well, I could move my hands and feet but that right leg wasn't going anywhere. What do I do? I could holler for my wife, but she's sleeping, she's had a rough couple of days with her own problems, and I am loathe to disturb her. I can scoot down the bed until my lower legs are hanging over the edge, but that's as far as I can get.

About 5:30 AM I hear rustling noises so I know the boss is awake and I start hollering. Eventually I get her attention and we start figuring out what to go. I call the clinic and talk to the on-call doc and he advises me to call 911 and get an ambulance ride to the hospital, so we put that in motion.

Ambulance and fire truck arrive about 6:30 AM. I always wondered why they always seem to send a fire truck along with an ambulance, now I know. It's for the man power. For the ambulance crew to be able to deal with the patient, first they need to extricate them from wherever they are. In my case you wouldn't think it would be too bad, but they still had to get 240 pound dead weight out of bed and down the stairs. The six of them carried me in some kind of blanket. It was a bit snug going down the stairs, but we all got down without incident.

The ride to the hospital was uneventful though a bit bumpy. I always thought ambulances would have a soft, cushy ride, but they don't. They must have rocks for springs. I felt every bump in the road. It wasn't painful, just annoying. The ride on the stretcher into the Emergency Room wasn't much better. I think the hospital must get the wheels for their gurneys at the scratch and dent sale. Bump, bump, bump, bump all the way down the all. It would all be tolerable except that all the floors in the hospital are glass smooth. You'd think with all the pristine floor they could spend an extra quarter on getting some ROUND wheels.

Once they got me ensconced in the ER they hooked me up with an IV (Intra-Venous line) and gave me a dose of dilaudid, also know as hydromorphone. That gave the whole ER thing a warm, fuzzy glow.

Clay from the clinic came by and introduced himself. He was there to assist Dr. Wang with getting my hip joint back together. That was the last I saw of him. A bit later I'm wondering when they are going to get going and the nurse tells me they're getting ready to take another X-ray to make sure the joint was back together, and I'm like what? When did they do that? While I was knocked out, apparently.

My wife drove me home. We stopped and picked up a couple of cheeseburgers on the way and were home by 2:30 PM.

My surgeon was a bit distraught over this turn of events, but evidently thinks she has identified the problem, so I will be going in for surgery again tomorrow (Friday) afternoon.

Hip joints becoming dislocated is a rare but not unknown event, but usually when these rare events happen, the ball part of the joint goes backwards. In my case it went forwards which makes it double rare. My wife wants to know why. I tell her it's because I'm a Martian and we're just weird.

P. S. I hoped to include a video of me being carried down the stairs, but it hasn't been dropped into my grubby little hands yet, so you'll just have to use your imagination.

Hospital Visit

Meet Adventist Health Portland's Dr. Elizabeth Lieberman
OHSU

Tuesday I had my right hip joint replaced by Dr. Elizabeth Lieberman and the crew at St. Vincents Hospital in Beaverton, Oregon. This is typically an out-patient procedure and I would have been sent home that afternoon. However, something went wrong in between closing the incision and when they took an X-ray in surgical post-op - the joint came apart (dislocated), so they took me back to the operating room and put me under once again. No cutting this time, just Doctor Lieberman getting rowdy and twisting me into a pretzel or some kind of wrestling take-down, and the joint reassembled itself. Because I had proven to be troublesome patient, she decided to keep me confined overnight. She's done over a thousand hip joint replacements and this is the first time she has encountered this problem.

Doctor's initials on my right thigh
Right thigh, not the left

I had no objection, I was fully doped up and having plenty of pleasant dreams. In the middle of the night when it's pretty quiet, I heard this noise. It sounded like the tune Mosquito by Gustavo Bravetti, it wasn't very loud, but it was definitely there. Every now and again I would hear giant dump trucks rumbling by, but that was probably just the service carts the crew was pushing down the hall.

I probably saw upwards of two dozen people in my private room and only three of them were men. One of the men was a vampire who came to suck my blood around 3 AM in the morning, He tells me that he had his hip joints replaced, which I thought was a little odd because he looked like a kid, maybe 35 years old. Turns out he is 45 and had his hip joints replaced when he fell out of a helicopter in Iraq. He was 22, the helicopter was 20 feet off the ground and there was an RPG (Rocket Propelled Grenade) involved.

The ambiance of the of the operating room was noticeably different than any other place I have been. It wasn't any one thing, it was a combination of whole laundry list of small differences. Bunches of machines I had never seen before, the tone of the people speaking and the direct action and lack of waiting. I suppose that's what this is all about. Getting all the ducks in a row may take hours, but once you are there, it's 'once more into the breach' my friends. Kind of like going to war or staging a theater production or making a movie.

Discover the CARESTREAM DRX-Revolution Mobile X-Ray System
Carestream Health

I noticed several new machines. Usually X-ray machines are like permanent installations with their own room. Here they had a portable one that they rolled up to my bedside, slid some kind of imaging tablet underneath me and boom, picture. It took just a couple of seconds. They showed me the image after they got my hip joint back in its socket. There is a small display screen on the back of the machine head. They just swung the it over to where I could see it. I don't recall seeing the one they took immediately after surgery. They may have, but I kind of doubt it, you never want to show the patient ominous images.

Exergen TAT-5000 Temporal Artery Professional Thermometer
This is only one I found that looks like it fits the bill.

The nurses had a thermometer that they used to check my temperature. I never did get to see it. They ran it across my forehead and the down the side of my head behind my ear. It felt like a ball point pen with a a tip the size of a child's marble.

Scanning Technique: Bladder
Clarius Mobile Health

They also had a little ultrasonic machine whose sole purpose was to measure the amount of urine in my bladder. My bladder apparently has a capacity of about 250 cc (1 cup), which kind of explains my frequent trips to the bathroom.

I've been home for a couple of days now and things seem to going okay. My hip is still plenty stiff. I'm taking 5 mg of Oxycodone every five hours and the pain is negligible.

Hip Joint

Iaman had surgery a couple of weeks ago to replace one of his hip joints with an artificial one. The surgery went well and he went home the next day.
    Hip joint surgery is a big deal. It's major surgery. Any time you go in for surgery there is a risk that you are not going to come out of it. Doctors have a pretty good idea of what they are doing, but people are complicated and it's entirely possible that something weird will happen and they won't be able to cope with it. The odds of something bad happening are pretty low, but they are not zero.
    My father had trouble with his artificial hip. He went in the hospital and spent the next six months in there or in rehab before he passed away. He was old.
    My father-in-law went in for surgery to replace one of his hip joints a couple of years ago. He survived the surgery fine, but then he lapsed into a coma for a week or so. They suspect he had a small stroke. He woke up and seems to be mostly there, but he has trouble walking, so he's in rehab. He's about the same age as my father was.
    All this is to show that Iaman's going in for surgery was fraught with terror, kind of like taking your first flight in a plane. Everyone tells you it's safe but there was that news report last week about the plane that fell out of the sky and everyone on board died. What if the same thing happens to your flight? I mean it might.

    Iaman survived and went home and he's flying high until the anesthetic wears off a couple of days later. By now he's started taking morphine so he's feeling no pain. A few days later he steps down to Oxycodone. He lives in a retirement community and he knows several people there who have had the same operation and they tell him things like the recovery was no big deal. They quit the Oxy after a couple of days and were just taking Tylenol. They're big fat liars. That might be the way the remember it, but that's because they were high on Oxy.
    After a few days of Oxy, Iaman tries cutting back. It doesn't work so well. He's supposed to take a pill every six hours. If he skips one, 30 mintues later everyone knows he's skpped his pill. Grimacing, he relents and takes his medicine.
    This surgery has about the same impact on your body as if somebody broke your leg with an ax. It's gonna hurt, and it's gonna hurt bad for a while. That's why the doc gave him a case of narcotics the week before. He's gonna need them.

Leg Bones

An X-ray showing a right hip (left of image) has been replaced, with the ball of this ball-and-socket joint replaced by a metal head that is set in the femur and the socket replaced by a white plastic cup (clear in this X-ray).

I'm in Vail, Arizona, babysitting my 230 pound little brother who is going in for hip joint replacement surgery tomorrow morning. He is a little concerned about how the surgeon is going to fix the length of his leg. The surgeon's plan is to compare kneecaps. Iaman's concern is that the reference leg also needs a joint replacement, so that leg might not be the right length either, and so should not be used as a reference.
    This reminds me of a couple of horror stories I heard. Not to worry, they turned out okay. One was from a woman I know in Iowa. She was in an auto accident in her younger years and both of her legs were severely injured. When they put her back together she was four inches shorter than she had been. Her legs, from what I have seen of them, are not disfigured. There might be a couple of scars, but nothing prominent. Then again, she could have been pulling my leg. I have no corroborating evidence.
    The other story is about a young man in Ohio, He was a few years ahead of me in high school. He got a job as a lineman working for the power company. He fell 80 feet from a power pole. He landed on soft ground, which I suppose saved his life. He sustained severe injuries, mostly to his hip joints. The doctors were able to put him back together, though he too ended up several inches shorter than before.

P.S. Operation was a success.

Arthroplasty Notes

Hip & Knee devices, next to femur model. Titanium, Oxinium and polyethylene.

Iaman reports:

Hi, I'm scheduled for my Hip Arthroplasty (the surgical reconstruction or replacement of a joint) [this November], by surgical scheduler Narcy. I cannot drive for 2 weeks.

Notes from Orthopedic Surgeon Consultation.

• "Yep, your hip was bad a year ago". No range of motion right leg, limited on left.
• I've exhausted my cortisol shot effectiveness limit of 2 shots.
• No bilateral replacements in same operation, have to wait at least 6 weeks.
• Doc has done 10,000 + hip arthroplasties then he stopped counting.
• He does about 6 operations a day 2 days a week, Mondays & Tuesdays.
• He stopped Birmingham Hip Resurfacing (BHR) after doing 500, a smaller device, yet more invasive.....but worse were certain patients, but not all, with gout interacting with the synovial fluid would have enough metal on metal erosion to warrant a revision(go in again & fix, in this case with a conventional device). An unexpected bad outcome, after thousands had been installed.
• Doc has used the Smith & Nephew hip device for years a primary feature is their patented Oxinium ball that has significantly less wear. Oxinium is Zirconium alloy (used to clad nuclear reactors). S&N not part of the Warsaw Cartel.
• Doc really doesn't like ceramic, "just try to clean out the glass when one shatters", from athletic hits,falls, or car crashes.
• Doc uses the standard proven posterior approach, "imagine a line between your jeans front & back top of the pockets." This allows good access to the head of the femur for pounding the device into the femur with a 3 pound hammer. If anything happens, bone breaking etc., there is full access. Versus the touted new minimal anterior approach where a special table and a assistant is needed to contort the body to access the femur head, at an angle. If something goes wrong the posterior approach is needed to fix anything.
• None of the docs provide quality stats, though google says this is a essential part of the vetting process.
• Bones density varies per person from Balsa softness to Ebony like hardness.
• The standard angle between the head and femur is 135 dgrees, though it varies per person by +- 7 degrees, causing knock-knee or bow-legs.
• Doesn't glue device into femur, the glue acts as a barrier to bone adhesion, pressure fit of titanium which bone will attach to within 6 weeks.
• Though he uses computer alignment on knees, doesn't use on the "universal ball joint" of the hip. The placement of the marker screws is more painful that the results warrant.
• High protein diet 2 weeks before operation significantly improves healing.
• No recliner-chairs post-op for 6 weeks, stresses hip joint.
• Post-op antibiotics for all dental work, curiously mouth bacteria have a affinity to metal joints.
• I like this Docs private practice better than the big bone factories. Direct telephone to live person. Staff is personable, not so fatigued. Small quiet reception area versus crowded airport terminal like setting. Zoey, a Bichon , roams the office unobtrusively.
• Learned new word Kinematics, which describes the motion of objects without consideration of the causes of motion.
• Bones are innervated, they have nerves in them.