First Follow-Up Visit

January 27 had assumed the significance that last day of school had when I was a kid: restored to freedom.  So I wasn't happy when I awakened to 18" of snow and no bus service.

Still, I prepared for work as usual, even leaving at the same time to make my early appointment on East 77th Street.  Fortunately, the 86th Street transverse road under Central Park had been plowed and traffic was light at 7:30 a.m.  I trekked crosstown, snapping photos along the way.  The snow already had been cleared from the sidewalks in front of the apartment buildings on Fifth Avenue and the snow blown entrance to the Metropolitan Museum of Art was bathed in early morning light.

A lone technician manned the phones at the radiology clinic.  He couldn't believe that I had walked to my appointment just six weeks after hip surgery.  We chatted easily until enough staff had arrived to begin the day.  Another technician x-rayed my hip and I arrived at my 9 a.m. appointment with plenty of time to spare.

The resident who had enlisted me for an orthopedic study picked up several forms from me.  He answered a couple of questions that I couldn't wait to ask ("Can I go swimming now? Can I ride my bike?  Can I get rid of the elevated commode?") but assured me Dr. Ranawat would be in soon.

At 9:45 a.m. the receptionist finally heard from Dr. Ranawat, who was stuck somewhere on Long Island.  All appointments were cancelled for the day.  Tough luck GHI patients! He abandoned 3 of us.

I hadn't realized how much getting the all clear from my physician meant to me.  I really wanted an interaction with the guy that fixed me.   Speaking to the resident, or hearing from a woman who left a message on my answering machine this afternoon just doesn't do it.  "Your x-rays looked great.  You can abandon all your hip precautions and go back to work," announced Julie in a chirpy voice, not realizing that I had passed that threshold of recovery 3 weeks earlier.  More than anything, I wanted to walk pain-free without a limp in front of my physician and hear him tell me that my recovery has been as remarkable as I think it has.  That's something they should teach in medical school if they don't.

But as my first after-work swim at the Columbia pool in nearly 2 months proved, my recovery is just beginning in some respects.  My kick seemed a little . . . mechanical, and it felt like I was doing the breaststroke in concrete.  I swam just 30 laps instead of my usual 70.  On the plus side, my Speedo nearly covers the scar and being able to sleep on both sides of my body without a pillow between my legs was pure heaven!

Maybe my stamina and exercise routine will have returned to normal at my 3 month follow-up visit.  Let's hope Dr. Ranawat shows up this time.

Back To Work

This is what I tell people when they ask:  "The surgery was a success, I'm recovering very well, but only time will tell if replacing my hip solved the problem."  I still walk with a slight limp and some discomfort but Anna, my physical therapist, assures me this will go away.  I'm not convinced--knee pain suggests to me that I will need to have that replaced, too, before I'm completely back to normal.

An overweight, much younger colleague at the Health Department, who has had both her hips replaced, observed "the surgery must be less invasive than when I had it."  She couldn't believe that I was able to get around without any assistance at all.  I held my tongue.

The only bad thing about returning to work today was carrying my hip cushion on the subway.  I had planned to stand during the subway ride from 86th Street to Chambers Street because of self consciousness, but as soon as an end seat became available, I put the cushion down and sat on it.  I even got a seat going home.  Too bad if people thought I had a delicate ass!

Anna told me I should massage the scar on my hip as soon as the bandages fall off so that the tissue doesn't stick to the prosthesis.  That sounds a little strange, but the exercises she has been recommending are helping me build strength.  Over the weekend I tentatively began climbing stairs normally.  Today, I completely abandoned the method I have been using since leaving the hospital.

Anna also eliminated the tingle machine after tonight's therapy visit.  "We use it mostly for people who are in pain," she explained.  I didn't miss it at all.

3 Weeks after Surgery

Is going back to work on Monday such a good idea or am I just reluctant to give up my relative freedom (if being trapped inside during the winter constitutes freedom)?  In any case, after doing a morning of errands and chores, I'm utterly exhausted.  On the plus side, however, I descended the stairs normally for the first time with 15 pounds of laundry on my back no less.  I'm still not strong enough to climb them.

18 Days after Surgery

Anna, my new physical therapist, shows me how to do several exercises in addition to the heel slides that I have been doing since the 1st day after surgery and the bridging that I learned from Chitra, incorrectly as it turns out.  Knee fall out, ball squeeze while sitting and hip hiking seem like nothing in comparison to my usual exercise routine, but I know that I will take them just as seriously.  Listening to BT's "These Hopeful Machines" on my i-Pod with the lights out improves the ice and tingle machine experience, too.  I decide on weekly visits, at least in part because to date, Anna is the only professional who has indicated that my recovery is going as well as I think it is.

17 Days after Surgery

Pain-free when I get up in the morning, I decide to stop taking percoset.  I'm pretty sure that if I didn't have a supply of more than 80 pills, I wouldn't be able to do this.  I also decide to return to work next Monday, a week from today, and pray for my bowels to cooperate now that I'm free of narcotic-induced constipation.

15 Days after Surgery--New Year's Day

I awake feeling better than I have in 2 weeks but a walk up to 96th Street in the early afternoon reminds me that my recovery still has a long way to go.  I begin limping almost immediately and also experience knee pain that seems unrelated to the surgery.

Dr. Ranawat's nurse told me I will have to observe my THP for 6 weeks, which means that I'll have to continue using the abduction pillow, elevated commode and hip cushion until the end of January, when I see Dr. Ranawat for my first follow-up visit.  She also told me I'll be able to ride my bike at that time, which gives me something to look forward to: sleeping on my surgical side and restoration of my normal routine, which includes biking to Fairway every weekend to grocery shop.

13 Days after Surgery

I have an 11:15 appointment to have my sutures removed at Dr. Ranawat's office at the Hospital for Special Surgery.  This will be my first post-surgical encounter with public transportation, and I'm a little apprehensive.

Typically the 86th crosstown bus moves so slowly that even though I miss it at Columbus Avenue, I'm able to limp to Central Park West and catch it there.  It's nearly empty, so I put down my hip cushion and sit.  It's 10:15 by the time I get to York Avenue. After a 20-minute wait with no M31 in sight, I decide to walk downtown to 70th Street. This requires some careful navigation to avoid some corners where ice has formed or the slush is deep.  This is the longest distance I've walked to date.   I make the appointment with 5 minutes to spare but am kept waiting nearly an hour until a room becomes available.  It occurs to me that I may be a 2nd tier patient and I spend some of the time musing about health care rationing.  As if it didn't already exist!

The young, efficient nurse instructs me to put on a pair of what appear to be the lowest quality cotton gym shorts.  She works quickly and scolds me gently for walking as far as I have, especially without a cane in this weather, but also adds that walking is the best possible therapy.  "If you overdid it today, you'll definitely feel it tomorrow" she warns.

I mention the New York Times article about the recall of titanium prosthetics that appeared the day before my surgery.  "Dr. Ranawat's father is an orthopedic god," she tells me.  "He predicted exactly that outcome--the release of metals into the blood stream--in a paper that he published years ago."

She also agrees to give me a refill for my percoset supply, which is dwindling.  I've been taking no more than 4 pills a day, supplementing the dosage with in-between consumption of acetaminophen, as the Duane Reade pharmacist advised.  She suggests taking tramadol instead.  Fortunately, I still have a supply prescribed by Dr. Goldstein months ago. I stopped taking them when they didn't do much to relieve my pain.

I assure the nurse that I will take the bus home but it takes enormous effort to wait more than half an hour for the M31 to pick me up.  I do some light grocery shopping and return to my apartment a little after 2 p.m., utterly exhausted.