The Age-related Stigma of Walkers

When I was first finally  diagnosed with  severe bilateral osteoarthritis of the hips and it was vey clear to all that the only solution left by this point was total bi-lateral hip replacement, I went into the Surgeon's office for my first surgery consult. After he looked at the x-rays and discovered how ugly they were, and was stunned that I was even moving upright (though terribly painfully) and only managing the pain with ibuprofen, he told me,
"Martha - if you can get hold of a walker, I'd really recommend it. You'll be a lot better off."

I groaned a bit, and he said, "I know - it feels like old lady equipment."

I told him, "Oh, I'm well-past that stage - I am only 55 and feel like I'm 85, but just knowing what it is and that it can be well-handled and truly repaired is great. it's just - another thing to deal with, you know? After already having added a shower bench, cane, and grippers to my daily life by necessity."

But he was right about the "old lady" thing, too. these extremely helpful assistive devices really add a stigma to your daily life. Much like a wheelchair. People see you coming from a long way off - you are by nature not able to really walk tall, but leaning in somewhat to take the weight off impossibly painful limbs. People perceive weakness, vulnerability,
Now - I'm a strong woman in most ways. Age is just numbers, usually, and it turned out that my issue was not age-related, but congenital hip dysplasia...
  I was really grateful for the tubular two-wheeled walker (which woudl be required post-surgery, anyway)given to me by a friend who was about to give her late mom's walker to Good Will, adn by the loan of a fancy four-wheeled and seated "Cadillac" walker loaned to me for work and getting around in the world outside my apartment (I use a cane between the house and car, but the walker all the time, otherwise - it fits perfectly into the back of my little Rav4).
They have made life so much more possible and drastically less painful.
The device is easy to transport, ad FAR superior to crutches, which are painful and nearly impossible to se for many of us.

There are some physical issues that come from using a cane or walker  -hands, wrists, arms and shoulders, etc. get cranky and painful. Massage helps. In my case, having the great good fortune that it is a temporary condition ( and empathize as much as I can with those for whom it is not) is what keeps me at it... my upper extremities should forgive pretty well and come back to my *real* new normal - shortly after I am released from my need for support devices

But you do get a bit of a pity-factor from people. I know it's human nature... it is the most awkward thing it the word, being faced with someone clearly disabled, and wondering whether you should offer help, or will you e insulting someone, etc.
I had many encounters like that from the other side of the coin before all this went down for me.

--For the record - the thing to do (for most people I think)  if it looks like someone could use a hand is to cheerfully, lightly ask, "Hey - can you use a hand?"
If not they/we will usually say, "No thanks, I've got it." or, ""Sure - thanks! If you can grab that door /pick up that thing I dropped/reach me that can from the top shelf etc - I'd appreciate it!"
You might get a different reaction occasionally, but I thikn I can speak somewhat clearly on teh cubject now from this side of it, and you will usually be appreciated.

-- Also for the record - things NOT to do - 

•    Do not react with Pity. We do not need or want it. I am not a "Poor thing." Yup - this sucks, but have a little sensitivity - just a little. 
•    Don't get all flustered and freak out, tryogn to help then stopping and then getting all tongue tied. Relax, We are exactly like you - just in pain and limited a bit, and with Equipment. 
•   PLEASE do not use the Disabled stall in the bathroom, unless there is no other available to you, or you NEED it physically, or because you have little kids to deal with. It is not for stretching out your legs, or just having a poo, just because it's bigger. And if you DO - please don't camp out in it. Peopel who are in pain probably take longer to get there, so need to go pretty badly, and are probably in physical pain. Waiting can be miserable. (You have heard this from me before - that's because it's a bigger deal than you might think. I know *i* didn't realize what a big deal it was.  Now I do, so I'm sharing it with you. You're welcome! 

Back to the subject at hand. 
This goes  to a bigger issue - how we in america see older people - even ones who just appear to be older because we have issues or conditions "before their time". We don't see them. And if we do, we are uncomfortable about it, and squeamish.
Relax. in fact, try to work against that. Do some volunteer work, so spend some time with older people. If they are in a care facility, they may well be lonely.
Learn their name, their history - just ask them, "Where are you from?" or, "What dod you do for a living before you retired?" In a short time, you will suddenly be talking to a Person - interesting, with a history and loves and fears and hopes, even.
I occasionally sing for a group called Sing for Your Seniors, founded by a friend who is a professional singer in New York. We have a Sacramento chapter, and professional singers get together with a pro pianist, and go and perform and senior facilities. The most important part of this is, BEFORE and particularly AFTERward, we sit down and talk to the people that make up our day's audience.
We don't just pop in, sing a few ditties and pop out. We get to know the people. They show such appreciation, and in minutes, you see PEOPLE. And you might make a few new friends. I am surprised at how many of them were themselves performers of one kind or another, and really feel taken back to happy times. Sometimes you'll touch a heart string, and they will be ready to tell you a story of the person they loved, or their family... We all benefit and share a fine time.


I find myself grateful in the *extreme* that all of this is temporary for me and that really about 7 or 8 months of my Life going missing, or at least diverted to a different track for the time being, is a relatively (extremely!) short time, and so worth it all...

And looking forward to packing up and returning the loaned and purchased Paraphernalia of Disability.  The least I can do is share what I am learning, and not let my lessons go to waste. This also helps me remember to actually learn them, and apply them for the rest of my life.

-M

Rain and Canes, Walkers, Coats and Layers

I live in Northern California in the great Valley, and we have a continuing little dance with drought. It seems that the majority of the time, we have a lots less rain that we should.
So the winter is spent thusly - when it rains, especially if it's a hard and rain, we will say, "I know we really need the rain,but I REALLY wish it would clear up for a while!" and comparative to most other places, we have a very mild winter, and it does indeed clear up soon.
In 46 years living here, iI remember a total of ONE Thanksgiving when it rained or went below 45 degrees - usually higher (yesterday it was in the 60's).
The other thing we say is when it does NOT rain enough - "I know we REALLY need the rain, but I will take all of these beautiful, sunny and mild days, thank you!"

We tend to like sunshine here. I also actually am one who enjoys rain - under normal circumstances.
In my current physical state, I am very VERY grateful for current dry, mild weather.

Last week we had one properly rainy winter's day. And the thing is - when you are dealing with a cane or a walker, wet pavement, leaves in abundance, and wet handrails, represent a possible threat. It is so much easier to do what is our worst enemy - to fall.
In Anterior Hip Replacement, that is your biggest restriction, post-op. "Don't fall."
In Posterior surgery, there are three restrictions for several weeks, as they risk dislocation - Do not cross your surgery leg over your center meridian line, or lift your knee up further than to make a 90 degree angle, and I forget the third one... a very good surgery, still a tad longer to recover and a few no-nos.
Again - for Anterior surgery - "Don't fall."

Th other thing is, wearing thicker clothes, more layers, and coats.

And then you go outside and your hand gets wet and cold using the all- important puddle-wet hand rail, and the stairs are wet as is the sidewalk, and the stretch of lawn on the way to the car is getting mushy, so dealing with the cane is not as stable; , and the gutter is full of wet leaves, so the walker's wheels are getting jammed up with them, and you slide across the driver's seat on the doctor-recommended plastic bag for ease of scooting, and you end up half-choked with the layers of clothing you are wearing.

And so, let me go officially on the record to say that so far ( and the forecast bears it out0, I have really only dealt with wet conditions one day, and any other bits of rain we have had were on weekends.

Falling is not an option.

After Monday, I hope not to have any more need of the "Cadillac" walker with the four wheels and seat. It's been swell, and sturdy, and made my life much, much more manageable.

I thank my friend Delta for the loan of it after her friend Claire left this life, with no more need of it.
After I am released to drive and work, and am sure I can't borrow it I will return it with one little epoxy repair to a weld, and gratitude.

And then I'll walk to my car. I might even dance to it.

Four Days out from Hip Installment #2

It's T-Minus Four days as I write this.. my sister is dusting and vacuuming - items which I can't really thoroughly do on my own, and which have needed doing for a while, as friends have gotten busy with work, school and impending holidays.
It is for two-fold great reasons, aside from the obvious "Let's clean the house" ones.
It will be doubly important to have it clean when I come home from surgery, and she has developed some allergies to many things, dust and cat hair being high among them. And,  here I have a home that has gotten dusty, and cats with the most ridiculous amounts of fur.  ..
It is ch much better now, and more comfortable. I have a hard time making it clear that this is not how I CHOOSE to live. Disability has made it impossible to properly tidy, dust, vacuum, sweep and mop on my own.

SO all should be much better for her after this - I am pleased - I don't want her to feel miserable through this month.

We pick at each other a bit, as sister can tend to do like no other, but we work through it and our hope is that as we get more used to each other's habits and needs it will calm down.

Backing up a bit to catch up that last few days...

Wednesday was my last day of work for the duration. It crept up on my poor boss - Monday she was shocked to hear it - but not in a bad way. It just went very fast. And slow, of course, but here it IS.
I wasn't able to get all the things accomplished that I would have preferred, as I was awaiting information from others, who were very very busy... but that's life.
It will get done either before i get back or after, and nothing will catch on fire.

driving away Wednesday started (Well, continued) a chain of small realizations...
"I *think* this will be the last time I even need my walker at work - the morning routine of
" Arrive at work, park in the disabled spot by the door, call Robin ( the very willing and helpful  receptionist), unlock the back hatch, Robin gets the walker ("buggy") out and brings it to me, puts my purse and bag on it, opens the front door, in I go, Robin calls the elevator for me... "Thank you's and have a great day"s are exchanged"...

this routine should - I think - be done. I may need the cane... I truly hope that by the time January 6 (projected return date) rolls around, I will be truly ambulatory and walking on both of my own feet, unassisted. I dream of it.

Wednesday evening Toni arrived back in town, we took five double-loaders full of both of our laundry to the laundromat, went for a very unusual fast food foray to Jimboy's for very tasty tacos, and got it done. We came home, put laundry away, and made gluten-free  dinner rolls which turned out all right, and eventually made to to our beds.

Thursday, yesterday, was of course Thanksgiving. We ot up, I showed Toni how to use the coffee maker (She doesn't drink it, but I'll need her to make a cup a day for me, most days), made a bot f breakfast, and made the cranberry sauce. We puttered, showered etc. and got off to the Day at our brother Christopher's house in the next town, in plenty of time to visit with our in-from-out-of -town niece, Michele and her lovely family, husband  Matthew and wonderful, sweet baby Avery, who is 17 completely adorable months old. The meal and dinner were splendid, all gluten free ( hooray - at least five of us are GF) and company was great. Later, joined by more extended family, desserts were well-indulged. We finally made it home near midnight. My time of night, but Toni is an earlier night girl.

I had sat in a dining char the whole day, because all the furniture in the world seems to be about a foot to low for getting up from. A ridiculous style, in my estimation - I see no use for it, and it's painful and impossible to rise from for most people. Oy. So I was very sore when we arrive home, festooned with bags of leftovers. We eventually got them wedged into the refrigerator, watched a bit of telly and off to sleep.

Then up today, and at it for cleaning (with a stop for me to cut all of the hair from around the roller in my vacuum cleaner. Between my 3+ foot long curly locks and the cat's five-inch fur, it was pretty well immobilized, This is a common occurrence in my vacuum cleaner.

Now we are preparing to head back to visit the family one more time - it is the first time TOni has met wee Avery, and I haven't see her aside from Skype dates since last Christmas. She and her parents are precious to us, so it's lovely to visit!

We'll come home again, to stop at the grocery store for most of the final pre-op food needed...
try to clear some space in the fridge, get it all organized and ready!

7 days from now....

A couple of Facebook statuses to tell the story...

11/25/13 11:00 PM
A week and a day until the Great Hip Replacement Caper of 2013 enters Phase II (December 3) - and boy do I feel a lot better before this surgery than I did for the first one! What a difference Great Results make - and having some knowledge and experience - and some great doctors, nurses and their medical teams. 
Having my sister here as the home team leader will be so great, and Mariam too, as always - I love and appreciate EVERY person who gave their time and love the first time - but I confess that not having to build a spreadsheet and keep track of who has what shifts to watch after me is so much easier. However, I would LOVE visits through December! Laughter is pretty swell physical therapy. 


11/26/13 7:50 PM

Today, I had a great pre-op consult with my very cool and skilled (and yes - cute!  ) surgeon. He was pretty excited about it too, and that was really neat! Thanks for going with me, Mariam! 

It was great - I was practically giddy when it was done. Green light, my sister Toni arriving tomorrow to hang out with me for the duration... T-Day with the brother and his fam, including the wee grand niece 
Next Tuesday is Go Day, and then it's nothin' but better. As much as I've said it, It begins to actually sink in that I will be *repaired*. So many years of deteriorating hip joints, and a lifetime of walking on deformed hips, without even knowing it...
Talk about your Thanksgiving!!  — feeling giddy and excited.

Truly - today, Dr. Smith was quite excited to talk about the upcoming surgery - really happy to see how excited I was, and he gives all the time you need in the world. He is respectful, and friendly, and it was great to see him pretty smiley this time. The last time, not knowing me, and not know what he might find, he was understandably a little conservative. I understand and appreciate it. 

But this time it's fun, because he sees how much more confident and relaxed I am, and we are both going in better-informed, and feeling a bit, I think, like co-conspirators in a wonderful event! 

I really like my surgeon, and am extremely fortunate that THIS guy is the guy I was able to sort of conjure in to my situation - I couldn't have asked for a better doctor and surgeon for *me*. He also trusts my choice of supplements - most MDs are skeptical... but he was totally respectful, and trusts that I am intelligent and study and learn before just jumping in to anything. I don't just take the latest trendy supplements. 

After the appointment, I made THREE shopping trips - to the drug store, the Gluten-free Grocery store for supplies to bake GF dinner rolls for Thanksgiving(and a coconut cream pie I didn't intend to buy, but what the hell, it's Thanksgiving!!) , and to the Co-op for some foodstuffs and 

I really am quite excited, and though emotions are running high, I am mostly quite happy - I am feeling a good lot of joy, and it feels *GREAT*! I'm feeling it because I know what to expect, and it's GOOD! 

Dr Smith did remind me that often people will feel something and think, "Hey - I didn't feel this last time!!" or such - I promised him i would be cautious, and it I had any questions, not to freak out, but to *ask*. Having a house- call nurse helps that a lot, too. 

It is amazing and marvelous to me that this time next week, I will be tucked into my hospital bed, having had surgery, my first post-op visit from Dr. Smith, sat or stood up already ( this time, milder pain meds, so perhaps this time I will be ready to stand up on the first day- Either is just fine!) , a good visit from Toni (one of my dear sisters) and Mariam (My dear friend who "stage Managed" my first surgery - organized, stayed with me, helped with everything)  - and then perhaps a  pain-med enhanced post or two on Face book - and then in three more days, home again, to begin the whole healing process again - and this time, to an end - not to the next phase. 

Two proper legs, learning to actually walk again, unsupported - I'm been using a walker with occasional short bits painfully supported on a cane since June. Hard to believe - six months since I have actually *WALKED* - and that, terribly unstable and painful. I cannot actually tell you the last time I walked without pain. 

But I WILL tell you the next time I do. 

8 Days out and counting

The countdown continues! Calm is the watchword, and it seems to be holding at the moment!

Today I had a relaxed day.
Met a friend for brunch - lovely. I'm afraid I babbled on a bit - I tend to these days...
Nice to have company, perhaps? Hadn't seen him in a while. It was lovely.

I did some organizing - took 8 bags of random things from when I got rid of my old car and didn't yet have a new one - sheet music, blankets, a space heater, car supplied (Radiator fliuid, oil, jumper cables, maps, the little skull that hung from my rear-view mirror, ev). This is to clear a path in my erstwhile dining room - really not useful for it, but a storage area now - so that my sister Toni can access the sliding glass door to my balcony to smoke when she is here to watch after me post-surgery. She completely agrees that it is the thing to do, happily - I just want ed to get it started so that all that is left when she arrives some time next week is for her to carry the heavier things to their proper places (a closet, garbage, etc. ).
It felt great to get through the bags and sort things - almost all of it is now put away, or poised to be taken downstairs to supply my new (to me) car again.

Toni has a lot of people to visit before my surgery while she is here from Colorado, and is having a little trouble tying down exactly when she'll be here - it's a little nervous for me, but it's OK, too - we need to do laundry and grocery shop, as well as cooking a few things to take to my brother's for Thanksgiving next week, but it's OK to be flexible. It will all get done, and the bit of cleaning that needs doing which I can't yet do (and a few little tidying repairs) she can do while I'm in the hospital for 4 days.
As for the care duties, there is very little she needs to do medically - nothing in the way of bandages or bathroom duties - all of that is well in hand pretty much after the surgery. Mostly it'll be medications to be responsible for me taking at the right times,( pain meds, though I'll be on them for only a few days, make big holes in your short term memory).
Otherwise, she'll just keep me company to see that i don't go falling, and to get things - cook and serve meals, things I can't reach, etc. and possibly, helping me get my legs into bed, though this time it should be manageable with one good leg, And I already have the leg-lifter (A fabric-covered rod with loops at either end to lift the left up until I can do it on my own)  this time.
And probably accompany me on night time trips to the loo, just to be cautious.
I have friends on backup to spell her so she an get out now and then or perhaps go out of town on an overnight visit, and soem others bringing meals now and then sho she doesnt have to cook all of out meals. She's great at it and likes to coo, and is familiar with gluten free cooking, so it will go well.

She is a country /small town type of girl, and hates the city, but we'll take a bit of time to show here exactly where the doctor's office and hospital are ( happily, 10 blocks from my apartment!) as well as the gluten-free grocers, the Natural Foods Co-op, drug stores, etc. are.

Another thought -
There's been a bit of confusion about my post-surgery followup appointment - it was clearly scheduled for December 31 ( I remember a conversation with the assistant about it being New Year's Eve) and I have a paper fro her with it written in - and now my online medical information shows it or December 30.
 Either one would work, but I am concerned - one or the other is mistaken, and I do not want to go in on the wrong day. Not huge, but I'm very glad I checked the system.

A GOOD day!

I think I have (Please oh, PLEASE!) found my zen place here, pre-surgery.
After my Panic and its alleviation, I felt pretty peaceful, and realized, "It's going to happen, on time, and it will be as good - probably better! - than the first one - because:

1. I will have a good leg to stand on - I really didn't for the first go-round.

2. because I will have two well-functioning hips and healthy legs (the knee pain goes away very, very quickly!), I will now be able to continue on in the physical therapy, not having to stop where the "Walking away from the walker and cane" part comes in.

If I haven't already said it thirty or five hundred times, I cannot wait to push aside the walker (both of them!) and WALK. unsupported. I know it may bee a few weeks, and then perhaps a bit of time with the cane maybe, but it will be soon now, and I am SO antsy for it!

3. My lovely new Left Hip, which was doing REALLY well, and has now developed a bit of pain, (likely due to the way I have to compensate for the very badly degenerated right hip), will be able to move FORWARD in its progress again, and so will the right one!

So, this morning I got up rather leisurely, listened to my Saturday morning NPR shows, made a nice breakfast (2 poached eggs, the last chicken apple sausage, a GF Bagel with creme cheese and a lovely strawberry freezer jam) and some strawberry rhubarb yoghurt)

A friend came over for a nice visit to bring me a jar of her new bread and butter DILL chips... and a good gab over a cuppa.

I went to get a great massage from my friend Curt...

and I met my dear friend Sam (my Deborah's husband) for delicious Nepalese/Indian food.
I feel content and happy. I really hope to avoid any more of the Meltdown Blues. They are just unnecessary, and I feel really calm and happy. :)

My hip hurts like a bitch, but I'm choosing the places I go, and trying not to sit in one lace too long.

Tomorrow all my plans are hear at home - sleeping in, relaxing, doing a little tidying as my limited mobility permits, and catching up on Dr. Who! :)

Good night, readers.

Acetabulum

See definition and X-ray results below*

Perhaps one could be excused for being a little freaked out when test results look like the X-ray below - taken this week for my pre-op to the second Hip Replacement.

Medical terminology can be so daunting.
My understanding, which I'll confirm next week at my Surgical pre-op consult, is that the second hip replacement addresses pretty much all of these issues (At least the ones that are associated with the right hip. The others should stop degenerating after the hips and all of their issues are replaced).

I suppose at this point, unless it postpones my surgery, it might actually behoove me to stop looking at the deep details, since the surgery is happening and there is no doubt whatsoever that it will be a vast improvement.

When my surgeon told me after the first surgery that he had unexpectedly found congenital/developmental hip dysplasia during the surgery and had to re-sculpt my acetabulum, as it was not the normal round shape, but oblong, and to ensure its security, he added two screws, he said, "The screws went solid into mahogany, not spinning into balsa wood", I love the imagery - it was poetic, but really clear! Strong base bones - YES! Thank you, whatever cause my deformed hips, for leaving me a strong anchor, at least!

So fingers are crossed and hopes are high that the right hip is as solid and reparable. The two differences I see are that the first set of x-rays said that there was some uncovering of the femoral head - meaning, I believe, that the curve of the socket should cover more of the ball of the femoral head - it said it was more on the left than the right, and the left is purring along pretty well!

The current one has this - which the left did not have, "… likely

superimposed avascular necrosis …"

"Necrosis" is a creepy term - but I am working hard to just let it be. Hoping the anchor bones are nice and solid again… Dr .Smith is great about explaining things to me until I am really solid on it. I appreciate that more than I can say.

"Lateral uncovering" means, I believe, that the edge of the socket(acetabulum) that would usually cover the top of the femoral ball is not where it should be. Makes it hard to move that joint properly. I'm trying to be very careful with it for the next 10 days. Nobody needs any emergencies around here. 

*Acetabulum
The acetabulum /æsɨˈtæbjʊləm/ (cotyloid cavity) is a concave surface of the pelvis. The head of the femur meets with the pelvis at the acetabulum, forming the hip joint.^[1][2]

http://en.wikipedia.org/wiki/Acetabulum

*XR HIP 2 Views RIGHT

FINDINGS:
Left total hip arthroplasty is in place without complication.
Ossific fragments noted adjacent to the left acetabulum,
unchanged. There is severe osteoarthrosis of the right hip with
prominent subchondral cyst formation, sclerosis and likely
superimposed avascular necrosis with collapse incongruency of the
articular surface. The right hip also demonstrates lateral
uncovering. There are degenerative changes of the lower lumbar
spine, sacroiliac joints and pubic symphysis. The bones are
osteopenic. Phleboliths are noted in the pelvis.

This Has Been A Long Day

A long day.. I managed to get up and out in a decent time to get to work by 9:30 - a plus.

Busy work day, shortened by my Pre-Op appointment with my Primary Care Doctor.
The lovely news that I am a nitwit and must NEVER panic at things I know not enough about ... the second urine test - fingers crossed that I was able to be more careful.

home... made a  lambchop and roasted vegetables for dinner...

Wrote another Hip poem (Thank you for the Information, Jt!) ...
Then off to see a production of Macbeth, set post-apocolyptic... excellent production - I was SO tired I was nodding a bit, but it is a very intimate theatre, so I worked hard not to nod off... rude.

Many hugs afterward, saw friends I haven;t seen in some time (One reason I love the theatre :) ) my lovely friend Jeffery chivalrously fetched my card from around the corner for me - I realized I was so painful, because I was a boob and forgot to take my afternoon dose of Tylenol.

I was developing a cold - another thing NOT to have before surgery - so I HAD to stop at Safeway for some Coldcalm.

*sigh*

I'm home... winding down. exhausted, I overdid it... but in only a wee and a half I'll be home for good.

Night folks.

The Great Urine Test Panic of '13 and a few other thoughts

The age-related stigma of walkers

The two-week countdown begins

Labs/x-rays

The Great Urine Test Panic of '13

Two days ago, I read my pre-op test results, didn't entirely understand them, and sent this panicked series of messages to a dear friend:**********************************
Need a little moral support- my urinalysis came back with a high white blood cell count.. High enough and it means delay. I cannot delay this. XRay show serious degeneration on the right. Delay to 2014 will mean badbad things... 2500 more out of pocket i don't have no sister to stay with me, and probably a wheelchair. Urgent call and email in to surgeon.... I'm shaking like hell. Shit shit shit.
-------
Waiting for info...
-------
Surgeon's assistant just replied. He's not too oncerned about the results. They ordered a culture, and he'll look at the results of the culture and let me know if there is anything of concern.

[the culture came back high - anti-biotics were recommended]

I'm taking that as a " surgery is on December 3"

He also sent word that the new left hip x-ray looks fine.

Sorry for the panic spew... I was pretty freaked. I REALLY do try not to do that.... I really do.( and i usually succeed! ) High stakes, i guess! good acting exercise, huh!? :}

***********************************

After this, I contacted my Primary Care physician to get a prescription for an Anti-biotic ASAP, as much as I hate whet they do side-effects-wise - but having an infection is not an option with surgery.

I have a friend who had her elbow replacement delayed by a month and a half after discovering a UTI. I spoke to her during this panic and she said that 1 - hers was discovered two days before surgery -

and 2 - I have 11 days to get this handled with anti-biotics.

The next day, Thursday,  I already had my pre-op appointment with Dr. Norene, my Primary Care Physician. I went in, still pretty worried.

I apologized for my panic, and told him iI *know* better - that i know I am not the expert - but this pushed my biggest nightmare panic button,

He VERY calmly looked at my tests and said, "Yes - WCB is higher... but - did you see this line that says "Squamous cells"? That means skin cells - and that you didn't quite get a "Clean catch" when you gave the sample. It's a contaminated sample, so not valid. After we're done and we get your EKG, go right down to the lab and give another sample and we'll re-do the test. 

Then we'll see if you need the Anti-biotics. "

The EKG was perfect, BTW. 

So I re-did the sample, and took great care to get it right. Very relieved about the anti-biotics. They do a number on my fairly delicate digestive system, and I really didn't want to deal with that right before surgery.

Update: Late in the day today, Friday, my very kind and patient Primary Care Physician took the time himself to send me this note - my response follows: 

Repeat urinalysis
To: Martha O Kight

From: David L Norene, MD

Received: 11/22/2013 7:24 PM PST

Hi Martha:
You did a good job. Your repeat urinalysis is perfectly clear. No WBC or contamination.
Hooray!
David L Norene, MD 11/22/2013 7:23 PM

And my response, because I think it is as important to give positive feedback as negative: 

To: Office of David L Norene, MDFrom:

Martha O Kight 

Sent: 11/22/2013 9:32 PM PST
The day I lucked into you as my Primary Care Physician was a great day. :)
Thank you most sincerely for your response and your calm demeanor - and your great patience with me.
I promise I am not really an hysterical person by nature - and I promise to be careful not to jump
the emotional gun in future. :)
Thanks for sending me the message personally so late in the day on a Friday.
Have a fantastic weekend, Dr. Norene!
Best,
-Martha

A less-good night

One of my intentions with this blog is to show people who might face this kind of surgery that it's *great!*  It's all gonna be OK. and it IS - both of those things!

But  -I think giving you an idea of some of the harder things you face is part of it - and you might see that they could be worse, and they pass.

I've been experiencing insomnia (Not entirely typical for me) on and off since the second surgery, and some before that, because pain would wake me in the night.
Because I have associative knee pain (which, wonderfully, pretty much disappears overnight when the hip is replaced!),  That knee pain has been pretty biting.

At this point, because I am in the middle of two replacements, the "old" leg is realllly not happy. It is, naturally deteriorating  - it HURTS. Not as much as the left one did prior to surgery, but I am noting that the pain spikes are higher - a night or two ago I had a couple of DOOZIES - I'd call them about an 8 - it's been a while for that, and I'm not loving it.
 And the left, because it is working a bit of overtime holding up for the right, and just being freshly (10 weeks) repaired, though INFINITELY better - is having some pain, increasing a bit. I am working on not letting it worry me - it should be pretty normal.
Some, I am certain, is because of the body mechanics of my left foot wanting to center itself under my body to take the burden of both legs. The right doesn't straighten all the way and can barely bear any weight at all any more.
Amazing to think that this poor wretched thing was the dominant leg, less than three months ago.

Another little side effect, without being TOO indelicate, but honest - and i emphasize - *EVERYONE WILL BE DIFFERENT*  - but - has to do with the immediate after-effect of constipation I mentioned in earlier posts?
Hemorrhoids, and an imbalance in the system which also cause erm - indelicate itching. How's that for gilding the lily? There are creams and pastes - and they help a bit - but good LORD I'd have thought ths would be gone by now! It is less frequent, and seems to flare up again after sitting for prolonged periods on certain hardnesses of chairs.
I was a part of my dear friend's memorial celebration yesterday, and we were there and sitting on plastic folding chairs for about three hours, including the pre-and-post program, lunch, etc.

Anyway, this discomfort, combined with pain and my body's URGE to shift position from lying on my back to sleep - I have always been a mobile sleeper - are, tonight, conspiring to keep me rudely awake. a trip to the loo to move about a bit and deal with a bit of anti-tch tactic may eventually help.. but here I am writing to you, Dear Readers.

Tomorrow I have work in the morning, a memorial service (Yes another lost friend - the third of three I could have attended, but chose to opt out of one for sanity's sake - this is becoming excessive... ), pickup of contact lenses at my eye doctor, and pre-op blood work.
Because when I went in for my X-rays and blood work today, my doctor's office had not put in the order for the labs! Ack! My pre-op appointment with my doctor is in 2 days and with the surgeon is in 7, and surgery the following week... I put in an urgent request to have the labs ordered by tomorrow. Fingers crossed. NOTHInG needs to hold up this second hip surgery. I'm MUCH happier and looking forward to it... but the lab's have to happen NOW.

Right.. that should do it for now. Perhaps sleep will come soon enough to give me  oh dear - at this point, it'll be a bit over 2 hours' sleep. Wow. OK then. I'll have a whole month to rest up soon...

Good Days, and a Little Detective Work.

Good Days, and a Little Detective Work.

Today I had an interesting, and ultimately great, day.

Started VERY tired - I'm sleeping more deeply this past week or so - but it's a bit harder to wake up. So in the morning, I'm groggier. Also the right leg is more painful.

Fully to be expected, as  it is still malformed and the joint is just not going to stop deteriorating.

I found this website that shows great examples of exactly my physical issue - congenital/developmental hip dysplasia., with excellent comparative x-ray images and explanations. http://www.chiropractic-help.com/Developmental-Hip-Dysplasia.html

I was thinking that the cause of mine is possibly due to having been born in a high-radiation area - 90 miles equidistant from Hiroshima and Nagasaki, Japan, just 14 years after the bombs were dropped. I was in utero at least 6 months in that location (Possible more - we're having  a bit of a time tracking down when exactly the family moved to Japan, and the base is now closed, making records more difficult to find).
I wasn't remembering anyone in the family having hip problems…

However, in this web site, it mentioned that it is often genetic, and to think of predecessors who limped or walked with a cane, etc…

It's kind of a big "DUH " moment.  My dad died at 44 but he did already have back problems - I don't know if his hips were involved - my mother was really healthy until she got cervical cancer - her bones were very strong (She broke her back and with a year of chiropractic treatment, was totally healed and never had another back problem). But - our grandfather on my dad's side lived into his 90's, and even when I was a little one, I clearly remember him walking with a cane, and talking about having a "Hitch in m' gitalong". He moved fairly slowly, and I believe he would have been about 79 years old.
(Thanks to my sister Pat, the Keeper of the Family History, for helping me figure out the dates so I can better try to understand this whole mystery. SHe seems to think that he had an injury working as a cowboy in younger days, but it could also still be connected to dysplasia, even so. )

So. Back to my day. Work was a bit painful - it's getting to a place where, in the morning when I am in need of coffee and water,  my coworkers, as kind and generous as they are with helping me, are getting very busy, and there might even be a touch of "Helper fatigue" involved. I do not blame them a *bit* - I am deeply grateful for all they have done. But it means more moving around the office on a very painful leg(always with the walker, of course) - painful from the waist to the floor, it is so out of sorts that the whole damned leg is really pretty bad. Probably a consistent 4 out of 10 for pain, spiking at about a 7 or so if I don't move it for a while ( as in the middle of the night, sleeping), or if I sit on too short a chair, or getting in and out of the car. I have discovered a Thing: living room furniture is all built *very* low these days. Painful to sit on and get up from, so I tend to bring in a dining chair when visiting friends or family.

Then the day improved -

I made it through, knowing I had an hour music rehearsal at my house, and then my dear friend's poetry reading (with an open mic piece from me - my second Hip Surgery poem - I'll post those in another entry). I was so tired driving home, I very, very nearly fell asleep in bad traffic - very scary, at least scary enough to jolt me with adrenaline and get me home safely.

Musicians arrived, songs were run through and I made it out of the house at a reasonable time to make the reading… very excited to see my friend Jt read - he's a rockstar at it… and we have a great community of very talented serious poets in this city, many of whom were going to be there for the Open Mic section.

Jt and our dear friends were there, already holding a seat for me, the host, Bill, had put me on the open mic list, I got settled and we were on!  Jt and the other featured poet were great - Jt is really in fire these days and it’s a treat to see! The evening went great - my piece ( recently re-worked) went over very well, and even the couple or three oddball readers were entertaining. Everybody gets a chance to read at the Shine, and they have a great rule - "No bloodletting" - listeners are responsive and vocal, but no need to be mean. Poetry with Legs at the Shine Café is a Safe Space. I think it's a great idea, and it makes for a lively and quality night.

I got home well, in a LOT of pain - it was my first three-stair-trip day in a while… but really very well worth it. Ice did a lot to remedy the issue, I slept well… even a dead car battery thins morning was dealt with swiftly and easily,  and tonight I have a massage from the wondrous Curt.

I cherish the Good Days, and sometimes a *little* over-doing isn't necessarily a bad thing. The trade is worth it.

Twenty-something Things I look forward to:

Twenty-something Things I look forward to:

1. Using a regular bathroom stall

(and not being angry every time I go into the public bathroom and find three empty regular stalls and someone parked in the disabled stall just because it's roomy).

2. Not having pain/frustration-related meltdowns on a regular basis.

(today, it's too many trips to the microwave to heat up my lunch, the lunchroom being occupied by a meeting - and the fact that I am sick of imposing on the generosity of my co-workers. and yes, I am going to eat a disgusting half-frozen enchilada because my hands and hip and knee just can't bear another trip across the building.)

3. Walking, just moving forward on my own feet with no physical support.

4. Walking for pleasure/exercise in my beautiful neighborhood, rain or shine.

5. Just getting in and out of the car. 

No pain, no messing with getting the walker out of the back or putting it back in, with or without help.

6. Carrying - anything -  up or down my stairs. 

Groceries, garbage, luggage, a small friend... anything.

7. Taking a dance class - to improve my dancing, for fitness, to learn, and for fun!

8. Yoga

9. Sex

10. Vacationing somewhere interesting (even the part where I have to present my Hip Replacement card to security at the airport )

11. Vacuuming. 

Really. And I don't like vacuuming, but when you REALLY need to do it, it stinks when you can't do it yourself.

12. The first time I can just take a deep breath, prepare, and - run. I am not a "runner" and dislike running as exercise. But being ABLE to run if I want to - sublime.

13. Standing, walking, dancing, doing anything on a stage 

(Especially if it doesn't involve having to sit down.)

14. Getting ready for anything and into the car in half the amount of time it takes now.

15. Not feeling the need to explain why I am using a walker everywhere I go.

16. Not having to "deal" with the walker in public places - 

where it goes, who will bring it back to me when I need it, etc.

17. Not having to pace myself for endurance.

18. Shopping where I need to 

without having to consider the size of the parking lot or the inside of the store, or how many things I should not buy because I can't get them up the stairs (Too big, too heavy, etc.) And I don't like shopping, even normally.

19. Strolling.

20. The ability to focus fully on something -  

acting, work, driving - without having a big chunk of my head distracted by pain and the ever constant working out of how to get the thing I dropped, how to move this leg with a minimum  of agony, how am I going to get up from this seat that is lower than I thought it was??

21. Climbing my favorite mountain again.

22. The luxury of forgetting - just every once in a while. 

Of not *having* to be SO SO CAREFUL of every single physical movement, all of the time. Mindfulness is the way to live, don't get me wrong! This whole journey is, i am certain, a huge lesson in the value of mindfulness, living in awareness of the moment as much and often as one can.

But - the luxury of being able to drop one's guard, just every great now and again.

Nerves/feelings returning...

One thing that is a common occurrence with Anterior Hip Replacement surgery , which they are very clear to tell you, is that there is a swath of numbness after the surgery, Mine for this first round is not at the incision site, rather to its left, starting about half an inch from the incision and about 3-4 inches wide, and starting about 3" above my knee and extending about 8-9' up toward my hip. It is odd, and sometimes it get a little bit frustrating,
If it is permanent, so be it - that is to me a fair exchange to have my life back.
So, I'll avoid sitting on radiators until and if it comes back.

But - I think it may be coming back. From my friend Christian's terrible nerve injury, I know it takes something like a good half an inch a month for nerves to grow back.
Not sure if that's what is happening, but I am getting few odd pains and sensations in places I haven't felt in three months.  In the last day or two, there will come a rather intense small-ish pain now and again. Nothing dire, but I certainly notice it.
And it is a little exciting to feel *something* along that numb outer-though area swath. I keep massaging it and putting oil on it in hopes of stimulating those little nerves.
It would be nice to have the feeling back!

It's late, I'm nodding off and I keep having to delete nonsense phrases I type as I am falling asleep at my computer.

and so - boa noite!

-Martha

Frankenstein

London's National Theatre has been showing encores of their live broadcast of Frankenstein, Directed by Danny Boyle and starring among other fine actors, Benedict Cumberbatch and Johnny Lee Miller. The two actors traded the roles of Victor Frankenstein and The Creature ever other night.

I watched both versions. As an actor, it has been fascinating and wonderful to watch these two top-quality actors perform the two roles. Miller is very very good. Cumberbatch is a transcendent actor - head and shoulders above most, in his focus, integrity and dedication to creating the roles he plays.

The first 30 minutes of the piece is the Creature being "born", and learning how to use his body  - as he has a full-grown brain, it is very fast to learn, but the body still needs to learn to move, sit up, walk, run, eat, learn what sun and rain and birds are...  and just generally make his way in life, as he is immediately cast out, Frankenstein being terrified of his creation.

The play addresses a lot of issues - abandonment, loneliness, the need for human compassion, how we learn to love, hate, care for and scheme against each other.

And of course there is this poor Creature, ugly due to the great scares and stitches, his odd speech and gait... and this is when it really started to feel personal - universal.
In an interview, Miller said that he studied his 2-year old a lot, and how the child moved and interacted with the world. Cumberbatch studied recovering stroke victims, and peopel who recovering from accidents and war wounds, to see how they moved physically, but also the vulnerability which can be so heart-rending. It shows in his performance - he was not afraid to go to those places, where no human is comfortable to go. And it made me feel at once better-understood, as I learn to walk in a way tht I will never have been able to in my life (my hips having had birth defects no one knew about until my first replacement surgery). But it also reminded me that, even though my friends have been incredibly generous and kind and very very helpful, it has been a long time of asking them for help - with laundry. shopping, getting things up and down the stairs, other household chores which I simply don't have the strength or balance for, or too much pain to be able to do (I need both hands for rails to get down stairs, so I can't take the garbage down... etc).

At the terrible risk of sounding self-pitying, it has become harder and harder to find friends who can help me. They are getting busier now that summer is over (School is back in for students and teachers and the theatre seasons pick up, so more people are in rehearsals).
So = it feels more solitary. Ironically, I had a dozen people who had planned to perhaps come and see Frankenstein with me today and every one had to cancel. I understand on the one hand, but on the other - it felt lonely. I went on my own, and it was lovely. But - a little lonely.
THe pain I am still in does make be feel quite vulnerable, while at the same time working on how much independence I can exercise - some by necessity, some by desire.

And next weekend is the memorial celebration of one of my best friends, Deborah. We made final plans tonight, and I will rehearse one of my songs with the guitar player on Wednesday. Not sure how this fits in to the subject, but it was how my day ended. Vulnerable.

Chronic pain, and our estimations about our own strengths or weaknesses...

This morning on Facebook, my friend Colleen, who has been going through a series of very serious health issues, one after the other, posted this status, and I am including a selection of the subsequent posts - most were kind thoughts about getting better soon, very nice. I am choosing the parts of the thread which I find relevant to my point here. Colleen lives a very busy life in a semi-rural neighborhood in my city. She and her husband are very much in love, she is bright and funny and very kind, They have a little menagerie of wonderful creatures they love very much in their lovely home and nice chunk of property - goats, fancy chickens, ducks, cats, doves - a place that makes them very happy. 

This post is about our ability to endure pain, and even more, our self=perceptions when we ARE handling it like a boss, but we just don't realize it. 
It's not that I think we are heroes or anything, but thinking of ourselves as weak, when in fact, we are actually stunningly strong, does no on any good. 
Acknowledging that we are strong and tough is good for us - because sometimes we are enduring so much more that we ever thought we could, and that is worth noting. 
I had a bit of an epiphany about this when I was first diagnosed with what was so much worse that the wrong call of "soft tissue Damage" in my hips, and they deteriorated to grindstones. 

I hope this might help others dealing with pain issues. Remember to celebrate your Strength, and please don't downgrade your courage to self-depracation. It is important to KNOW how strong we are and that we are capable of getting ourselves better as time rolls forward into whatever course of action is required for our healing!! 



Colleen: 
"i have not posted much on Facebook lately except to hit "like" buttons. Seems i have fractured my left wrist and now i have a calcium deposit there that is causing a boat-load of pain. i managed to weasel my way into my orthopedic surgeon Friday who gave me a cortisone injection which helped a lot initially but now its back to super painful. i don't know what to do.
Will try to get into my Rhemetologist and see what he can do. i love him. If anyone can help me, it's him. If he can't help, i'm hacking my hand off at the wrist. Low threshold of pain. Gots to do what I have to do. All this was typed with one finger and took about half an hour."

-- many kind thoughts of healing here-- 

Colleen: 
"I truly appreciate the sympathy and kind thoughts. I just really needed to complain last night. I'm kinda a big baby when it comes to pain."

Her friend Catherine:
"I don't care if you are a big baby or the toughest chick on the planet  --You do what you need to do, and know that we are out here and want to help if we can. I live close enough that I can be of some help even if I am 4 eyed and 4 wheeled! I hate pain. It makes me grouchy. ((((Colleen))))) hugs."


Martha:
"You know, Colleen - I really thought I was a HUGE pain wimp, too. Always hurting, always creaky and cranky about it, feeling like such a complainer. And then three different doctors looked at the X-rays of my crumbled hips, and reacted almost identically: "You're - still able to walk or even stand up? At *all*??" and then, flipping through my chart, "and, wait... you're only taking ibuprofen for the pain???" . 
And when the diagnosis was a clear "severe Osteoarthritis" and the conclusion was that it was advanced enough that there was really only one solution - two total hip replacements!!! - I realized that my "Pain wimp" thoughts were TOTALLY WRONG. I am a freaking studdette amazon, and I powered through life and performances when most people would have already been in a wheel chair.  (To clarify - I am in NO WAY disparaging people who need a chair - I've been on a walker for six months now, and grateful for the support it affords me! Just saying that I was upright much longer than would have been expected by someone with crumbled hips). SO - my dear lady - I would submit - please don't diminish your strength. You've been going through a series of physical challenges, any two of which would have completely immobilized most of us. 
We do what we have to do to live life in these chronic pain conditions, it's true - but, lady - you are an Amazon. Pain sucks a LOT. ANd I dearly hope you get relief and a big break from it, soon. "