Getting to the Orthopedic Surgeon

So, I was up to going to the GP. This was not the most pleasant experience, since I knew there was going to be a fair amount of shock and lecturing. Dr. B, a little eastern European woman did keep it down to a dull roar, but also commanded the tests I knew I was going to need. Primarily, a Pap smear, a mammogram, and a colonoscopy. (Just for the record...the colonoscopy is in the future. My priority was the hip). I had to keep saying, and the HIP. The pap smear was a non-event. I liked the doctor and later my daughter used him and he removed two ovarian cysts, so that turned out to be a good thing. The whole mammogram thing could have its own blog, but the short form was: they found something funny and shipped me around to various doctors (me in pain THE ENTIRE TIME) until we were at the point of stereotactic needle biopsy, when, after a half hour of looking they couldn't find anything to stick a needle in. I have to go back. I will at the end of the month. So then that brings us to the orthopedic surgeons, and I saw three of them. The first one was Dr. A. I loved him and he loved me. He said I needed a new hip, all he had to do was look at the x-ray to know that, but he also said that once they fixed my hip, they would fix everything else that was wrong with me. No one would be able to find me because I was out taking a walk. I saw him intertwined with the whole breast thing, so I asked him for some pain meds. He prescribed Meloxicam and Tramadol, which provided more relief than I thought possible. I did have to discontinue the Meloxicam five days prior to the needle biopsy, which fore-shadowed the surgery itself. It's an NSAID, you see, which causes bleeding. The problem with Dr. A was that he was a knee guy, not a hip guy. So, Dr. A sent me off to Dr. P, a hip guy, with a fairly ringing endorsement. When you are choosing a doctor, pay attention to everything. Pay attention to how easy it is to get an appointment and how they treat you when try to make your appointment. Pay attention to the receptionist, because that's where the tone of the office begins and even pay attention to the questionnaires you have to fill out. I felt not good about Dr. P's office from the word go. The young man who made my appointment for me sounded like he was on summer break and someone had gotten him a job there because he couldn't find one anywhere else. He seemed that way when I showed up, too. Now, one would expect that a lot of people in the waiting room of an orthopedic surgeon would be in pain, so that the system would require the least amount of walking from them. This was not the case. The questionnaire was also redundant and circular (and LONG) and by the fifth page, I was muttering, "Haven't I answered this twice before?" I waited a long time in the waiting room. A man came in, a perfectly average seeming man, and besides his wife, he had his patient advocate with him. He didn't seem to be elderly, or suffering from dementia, or anything like that, so I wondered why he needed a patient advocate. And me, being new at this, sat and wondered, am I going to end up with a patient advocate too? IF I do, how come? After the long wait, I got ushered in to an examining room. After another very long wait, Dr. P showed up. I wish I could go into more detail about this, but honestly, it was so awful, I've blocked a lot of what went on. I do know that when he started to discuss elements that could impact the success rate of the surgery, I took a pre-emptive strike and mentioned my weight. (Upfront....I am 5'3" and weighed, at the time of surgery, 256 lbs. I'm not happy about this, but I'm not slitting my throat either). He said that there was very little chance of a good outcome for me at my weight and that furthermore, very little chance of my losing weight unless I had gastric bypass surgery. I was nonplussed by this, to say the least, and honestly, the appointment went downhill from there. He asked me things like what did I want from the surgery. I said I wanted the pain to stop. He said there was no guarantee it would ever stop and he wasn't going to give me narcotics. At that point, I said, rather irked and shocked, "I don't WANT narcotics!" He asked me questions over and over that I had answered, until I finally started saying things like, "As you could see if you looked at the forms I filled out...." He used technical language and then made me feel stupid when I asked what it meant. He ended up by telling me that he was the physician of last resort and that people came to him when everyone else had turned them down. I left shattered, as you can imagine. I had a gigantic, crying fight with my husband and ended up calling my sister-in-law, a nurse, to get another recommendation. She called back within a half hour with the name of Dr. D. (I was supposed to see Dr. D first, but Dr. B's office screwed that up somehow. This is what you get for being a medical babe in the woods). She had heard bad things through the grapevine about Dr. P and good things about Dr. D. So I made an appointment with Dr. D and some time later, set off there. Things were different from the start. He had a nicer office, which isn't that important, but it was staffed with nicer people, which was important. Even the forms were more sensible. (And scarier...there's a lot of grade your pain going on, and questions about how it affects you, including continence. I thought, Continence?) When I finally saw the doctor, he was business-like and professional. And when I said that I knew that my weight would influence the outcome, he gave me the most profoundly sensible answer I had encountered either from a live person or on the internet. He told me that yes, it influences it, insofar as infection is concerned, since the more layers you have to cut through, the greater than chance for infection. This made total, objective sense to me. No trace of you're a hopelessly bad person and don't deserve to feel better, just something completely clear. He then said, do you want me to look? I said sure, and he had me get on the table and asked permission before he flipped up my skirt. I don't carry a ton of weight in my legs, I'm much more of a spare tire girl, so he said, in effect, nah, you're fine, and that was the end of the discussion about my weight. We then discussed time frames. He said it was up to me, as far as he was concerned, it should have been done yesterday. I said I wanted to wait till the end of the summer. (Don't do this! That was idiocy on my part!). I wanted to lose some weight and I wanted to try some physical therapy. I left with a prescription for PT, and for a lift for my shoe. For a while, the lift (because my legs were now unequal due to cartilage loss) and the Meloxicam made life almost normal again, but nothing lasts forever. Moral? (And I knew some of this, and forgot it). First and foremost, the doctor should never make you feel stupid or bad. He works for you. That cashmere pullover? You helped pay. (Well, that and the kick-backs Dr. P was probably getting from his buddy, the gastroenterologist, but that's another story). And if he works for you, he can be fired. You can fire him, and you should fire him, because if no one calls him on his behavior, he'll just keep on. Also, ask for stuff. Don't be a stoic. If they have it and it's not bad for you, they'll help you out. And if you don't like the first doctor, keep looking, because there's a better one out there. And if you know a nurse, by all means, ask a nurse, because really, they know everything.

Let's Try This Again

Two nights ago, while I was wondering if Frankenstorm was going to take my lights, my house, or both, and I couldn't sleep owing to various things related to my hip replacement surgery, I decided to start a blog. I was posting from my Kindle Fire and apparently it didn't take. That's fine. I probably had a nice little buzz anyway, so I'm not sure what I wrote would have made much sense. What I aim to do here is to tell anyone who wants to know, just what it's like to get a new hip. I'm going to go all the way from the first pain through denial, to the decision process, to the replacement itself and the rehab, which is where I am now. In the months leading up to mine, I found snippets here and there but nothing really told me what I wanted to know: what is it like, up close and personal, to get a new hip? So here we go. I'm lucky, relatively speaking. I only had arthritis in my left hip, nowhere else. I don't have crooked fingers, achy knees, any of that. Now, how did this happen? I may go into this in more detail later, but suffice to say, I believe that my arthritis was caused by repeated stress on that particular joint in a particular way. The pain started, oh, maybe 7 years ago, and I can say honestly, that there was seldom a day, once it started, that I didn't have pain. It was a nag at first, nothing big, but I knew it was there and sometimes that first step after I stood was an adventure. I started taking two Advil every morning, prophylactically, and that did a decent job for a while. Everything works for a while, until nothing works at all. So we have pain as a given. With pain, especially if you're me, and you love to wear high heels, comes a bit of insecurity. At 50 I was still rocking 4-inch heels. The heights came down and down and down. In 2009 I went to Germany for ten days with my daughter and it was a 4-cities-in-10-days extravaganza, and my best friend was my extra-large bottle of Advil gelcaps. We took trains and public transportation and went on foot and it was painful. I remember sitting in a cafe in Berlin, looking to see if 6 hours had elapsed and I could take two more. I made it through the trip, which honestly, I didn't think I had in me, but the next year, when the other daughter wanted her own trip to Europe with Mom, I had to beg off. I couldn't have done the stairs, the trains, the general non-handicapped accessibleness of Europe again. Everything adds up. Someone, somewhere, says hip replacement and your first thought is, no, not me! but later on, when you can't get that leg comfortable, you think...yeah, maybe that could be me. In a couple of years. You start looking for parking places closer and closer and closer to the store, and you stop going to places where you cant' park in front. You look at the distance between here and there and it yawns like an expanse on the veldt. The tundra. Like you're climbing, if not Mount Everest, then at least Mount Katahdin. You can't shop because you can't stand for any period of time, and when you do shop, it's somewhere with shopping carts, which are, let's be honest, secretly walkers. That I have anything at all chic or stylish in my life at this point is owing almost entirely to the fact that Target has shopping carts. And you know what the weird thing is? You want to keep it a secret. You don't want anyone to know, except, hello, you're limping and sometimes someone doesn't realize that we're not supposed to mention that the Emperor doesn't have any clothes and asks you why. I always went with a repressive, "I have a bad hip," and since I can be very repressive, that usually stopped all conversation. I didn't want to talk about it, because I didn't know what to say. Was I going to get it replaced? Beats me. I think that there was not a time in the seven years that this pained me, that I didn't hope, at least subconsciously, that the next time I stood up, it was going to be miraculously gone. I had nothing to say. My hip hurts. I take so much Advil that I'm starting to sneak how much I take. In my spare time from being in pain and worrying about that, I worry that I'm killing myself with the Advil. And then you read articles. I read one in the aisle in the grocery store, in "Arthritis Monthly" or whatever it's called, written by a woman who was finally breaking down and getting one done. She was decidedly ambivalent, which honestly sort of puzzled me, because if you know this is happening, then go fix it. And then I read an article in "Vogue" by a woman who had it done, and I thought, hmm. Vogue. So not a lumpy old lady. Now, making this much more complex than it needed to be is the fact that I was a complete avoider of the medical profession. COMPLETE. No screenings, no checkups, no this, no that. (PLEASE do not lecture me). If I got so sick I needed antibiotics, I went to the walk in clinic. I knew, from those, that my blood pressure was high...and the one time I DID go to a doctor for my hip, I got such a lecture about neglecting my health that I forthwith stayed away from doctors for the NEXT five years. Well, it got so bad that I had no life. I finally made an appointment to see a GP, since I had enough sense to know that was the gateway, and it fell on the Monday after Easter. And now I'm going to close, because I would write all day long, but the physical therapist is coming in an hour and I'd like to rest, and if I tell you everything, what, as my mother used to say, will you have to look forward to?

New Hip plus Frankenstorm

Well, since I'm a baby boomer, I suppose it makes sense that I finally need a replacement part. I've read an awful lot of stuff that promised to tell you everything about getting a new hip, but they were lying. So, while I'm recuperating, I'll try to really tell you everything about getting a new hip (from my perspective) and then, how rehab goes. It started, for me, with pain. I don't have arthritis anywhere in my body, but I did, for reasons I may or may not go into, have pain in my left hip. I always knew it was there; I never got used to it. I began starting my day with a prophylactic 2 Advil and for quite a while that worked.