Surgery T+2 - They Shoot Horses Don’t They?

There’s a particularly gritty Sidney Pollack film that has since passed into obscurity named They Shoot Horses Don’t They?  The backdrop of the film is one of the gruelling marathon dance contests of the depression era where desperate contestants win a few dollars by staying on their feet longer than the competition — literally for days. They lead character, played by Jane Fonda,, points out that when horses get into the dilapidated state the dance contestants are in, they are humanely put out of their misery.

Couple this with the frequent comment of friends and family that they wish me the sheer patience to get through this and you’ve got a good mental snap shot of where I am. I’m doing well, I’m just tired of this. For example, every 8 seconds I have a foot compression system for circulation that alternately sqeezes the right and left balls of my feet. It has been doing this nonstop for 36 hours. I feel like I’m on the death march to Bataan or something.

My IV site is also disintegrating and I have no more sites so we’re trying to keep it as intact as possible, which means that I am trying to keep my left elbow as straight as possible, which means I am typing and eating one-handed. I have no idea what this means for physical therapy because I can’t use my walker with just my right arm.

As I am wont to say, “ARGGHHH!”

Just get me up, get the friggin tubes out of me and get me out of here.

Hopefully we are on the way of accomplishing a good deal of that.

On the brighter side, I’ve decided that my PT guy is a physical teddy bear, not a physical terrorist. And friends, clients and family have sent some gorgeous flowers. And my care has been excellent By this time next week I’ll probably be wishing for all this staff to be at my beck and call.

Thanks for checking in and letting me rant.

Hip Surgery T+1 Day

Well, wherat can I say. The surgery went great and I have absolutely no pain. Although that might change today for two reasons. First, Dr. Tucker put pain medicine directly into the surgery site, which wears off after about a day.  The second is they’ll start physical therapy today. But they believe strongly in pain management, which is a great attitude to have.

The one issue I had, not suprisingly was getting the IV started. Dr. Pirinelli is an angel disguised as an anesthesiologist and he was as upset as I was that we had problems. He blew out two veins in the right arm before he struck blood on the left arm.

At this point I’m really not having too many issues. My blood pressure is very low 90/45 and my hemoglobin is as well, so they’re returning my blood to me, which ought to help solve the issues. I also got some food in my system this morning as well which should help all the way around.

While I’m have very minimal discomfort around the incision, I can already tell the joint pain I was having has improved for the better. Of course, the drugs have a bit to do with that, but it is different and it is better. Dr. Tucker said there were no surprises. There was a little bit of cartilege left, but it was very unhealthy, so we made the right decision.

They’ve got me on antibiotics through today and I got my first blood thinner shot in the tummy. The shot was nothing and I don’t think I’ll have any problems doing them myself when I get home. I’m wearing those TED socks to help prevent blood cots and all day yesterday through this morning they had these gadgets on my feet that would pump up, then deflate. All this is to keep everything moving.

They strapped me into this strange wedge-shaped pillow and my right leg is also painted green. I’ve got some pictures on my phone and I’ll build a page for my medically minded voyeuristic friends once I get home and can download them.

I’ve got a great team of people taking care of me and am very pleased about that.

I will tell you that I had fear and trepidation in my heart going into this. If there is anyone reading this that is contemplating the surgery, based on my experience, please don’t hesitate.

Overall, I think it was a rousing success and I don’t think I could have asked for a better outcome. I know that part of the outcome were the wonderful thoughts and prayers people have sent my way and I am truly grateful. I’ll check in tomorrow with news after the PT.

Cheers.

Last Post Before Surgery

The surgery is day after tomorrow and I’ve started counting hours instead of days. This will be the last post until after surgery, although if Presby Dallas’ Wi-Fi works as promised, I hope to update the blog soon afterward.

I’ve got a busy day planned for tomorrow — all the things I won’t be able to do for a while: breakfast at the deli, movie at the mall, jazz and lobster at Nate’s, with a break in the middle so hubby can watch the NASCAR race and we can catch up laundry and other house stuff.

I have really short hair and, as of yesterday, I have really, really, really short hair. Since I’ll be using a walker after surgery, I need something that is just wash and wear. I also had my acrylic nails removed since I’m not supposed to wear polish in surgery and I won’t be able to get back to get them done for a while. I feel like surgery has already begun with all this cutting going on.

I’ve spent the day getting the guest room ready for my brother who is coming in the Sunday after my surgery, and also doing some initial packing for the hospital. I’ve labeled my walker and reacher and crutches. Packed all my electronics and some clothes like my robe and slippers.

I’ve decided to give up the fear. I’m really focused on the getting well. Jack was out of town last night and I spent much of the evening reading blogs of people who have gone through this. (I didn’t know Martha Stewart had hip replacement surgery.) I also played with the virtual hip replacement surgery at http://www.edheads.org/activities/hip/index.htm – which I recommend to anyone contemplating or undergoing this surgery. I’m very encouraged that my imagination has blown the whole surgery fear out of proportion.

For some reason both yesterday and today my hip has really been giving me trouble. May be the weather. We’ve been having rain for the first time after weeks of 100+ degree Dallas summer. However, I really think it’s the fact that my hip has figured out its days are numbered and is throwing a fit. At any rate, it’s slowing me down and keeping me from getting some things done that I feel like I need to — like grocery shopping.  I have to pick up some prescriptions and something quick for dinner when Jack gets home this evening, but I’m not going to be able to spend the time or energy to stock anything up.

So this is it. The quiet before the storm. I really appreciate all the support and good words. I especially appreciate those sending prayers my way. I strongly believe in the power of prayer, so thank you.

The laptop’s packed. I’ll write more after surgery.

Third Time’s a Charm

After two aborted tries to donate the second unit of blood, I was down to my last shot this morning because a week from today I have surgery. I’ve changed/upped my supplements in the hope that things would work out. I started them about noon last Friday and today, Monday, after only three days, my hematocrit popped up from 10.8 to 12.0. Success!

Then I panicked because, if you’ve been following this blog, I have problems giving blood. But things went well. I had a milder reaction than last time although I still feel really lightheaded and weak. I’m going to take it easy the rest of the day (in part because my hip has also been giving me fits), then it’s a downhill slide to the surgery.

I take today as a good omen that everything will go well

I’m also going to continue to take my extra supplements up until the surgery to make sure my blood levels are where they need to be. Last time I gave blood, my hematocrit dropped from 12.5 to 10.5 and basically stayed there for a couple of weeks until I upped the supplements.

That’s all for now. Thanks for checking in.

All Dressed Up and No Place to Go — Again

Went to donate blood yesterday. Hemoglobin is still 10.8 and it needs to be at least 11.0. I tried to get them to check it again, but they wouldn’t. They did say that if I came in first thing on Monday, they would try again. So I immediately drove to the North Dallas mecca for all natural healing, herbs, vitamins, foods, etc. I didn’t want to take any additional iron or folic acid because I don’t want to go toxic. The lady there suggested some additional things that might help, so I’m going to take maximum dosages over the weekend and try, try agin. I can only think that the Methotrexate is interferring with RBC and/or hemoglobin production. Dr. Cheatum said that I could take up to 10 folic acid tablets/day around the time I take the Methotrexate (I currently take 6 the day before, the day of and the day after, as well as two on the other days). So, I’m going to up the folic acid intake a bit as well. That’s all I know to do. I’m taking all the B vitamins, including lots of B12, so we’ll see.

 

I just basically lost it this morning. I am so frigging tired of dealing with this. It seems like every day my life revolves around either getting ready for the surgery or dealing with the disease. I know it’s not going to get better any time soon, but I’m really frustrated with the whole situation.

On Thursday I went in for my pre-op physical, so I had all the test I just had done in June, then again in July for Dr. Cheatum. I’m getting so radiated I really am going to glow in the dark. My doctor apologized, but all the blood work, EKG and chest X-Ray info has to be within 30 days, so what are you going to do? Unfortunately, since my hemoglobin was so low on Friday, I know it’s going to show up drastically low on my pre-op tests. (It was 12.5 in June when I had my checkup.) I’m hopeful that won’t interfere with surgery. I really do not want to reschedule.

 

I took the fifth dose of Methotrexate last night — same routine, around 6:00 pm. This seems to work. I still feel like someone let all the air out of my balloon about an hour later and get a headache if I sit up or stand up for more than a few minutes. Other than that, no major side effects.

We’re down to the final countdown to surgery now. I’ll check back in after I try to give blood again on Monday. Thanks for checking in.

The Demise of the Dancin’ Pole and Other Non-Events

Not much significant has happened, but there are a few things worth mentioning for those of you who have been keeping up.

First of all, you’ll remember my determination NOT to have a grab bar in my bathroom and, instead, ordered a floor-to-ceiling pole. Time for Plan B. The wonderful website where I’ve been ordering my medical goodies goofed and what I got was an extension for the pole, not the pole itself. Unfortunately, the pole would cost about $250 and that’s just more than I want to spend on a temporary situation. So, yes, I’m going with the grab bar and contractor/husband Jack will be installing it so at least I don’t have to have other contractors in my house.

I took my fourth dose of MTX this past Friday. So far so good. No side effects. I took it early (6:00 pm) again on an empty stomach and did fine. Slept like a baby again for the first time since the last dose. I overdid myself this weekend, though, with shopping, cooking, laundry, etc. I was in a lot of pain by Sunday and actually wound up staying home in bed on Monday as well.

My brother is going to come into town and stay with me the week after the surgery (Sun-Thurs). Jack has some out of town trips that week and it will be good to have someone around. He has his own back/health issues, though and I told him it was going to be like the infirm taking care of the invalid. I’m sure we’ll get by, though.

I’ve got some other friends “on call” if I need anything, which means a lot.

This Thurs and Fri have some exciting events. I get my pre-op physical on Thursday and will (hopefully) donate my last unit of blood on Friday. Both have prospects of being traumatic events, but I’m optimistic everything will go well with both.

We’ve cancelled the trip to Las Vegas August 12-14. We just ran out of time. Jack has to be in Phoenix the 15-16 and I may try to go to a family gathering out of town on the same days. Then all of a sudden, it’s Sunday before surgery on Monday. This will give us, especially Jack, some breathing room to get everything done before my hospital visit.

I’ll update this weekend after the checkup and blood donation. Thanks for checking in.

Quick Update

Well, I was supposed to give my second unit of blood yesterday. I got all pscyhed up for it, had a good breakfast, even loaded up my IPod shuffle thinking some music might help me relax. We got through all the paperwork, then started on the physical screening. Everything went fine until she did the hemaglobin check. Normal is somewhere north of 12.0. Mine was 12.2 last time, it was 10.6 this time. I guess I hadn’t recovered since the last time I gave blood. They let you autodonate if the value is 11.0 or above, but I didn’t make the cut. So now I’m scheduled to try again on Friday, August 8. My pre-op physical is on August 7, and I don’t want to take a chance of showing up anemic for that, so I have to wait. I just wish I could have gotten it done and over with yesterday. If I can’t donate on 8/8, I’m basically screwed because I’m then within the time limit before surgery. Keep your fingers crossed.

I did find out from my friends who have had hip replacement surgery that they generally give your blood back to you, even if you don’t need it in surgery. My friend Joan said she was feeling very low after her surgery until they returned her blood back and that made her feel better almost immediately. At least they just don’t throw it out.

That’s all I know. I’m now on a quest to pump up the old red blood cells. I’m already on iron and folic acid, and I take a B vitamin supplement so my B12 levels are okay. Not sure what else to do.

Thanks for checking in.

3rd Dose and Other Stuff

Last night was the third dose of Methotrexate. I took it on an empty stomach about 6:00, ate dinner about 8:00,  and took the rest of my nighttime  meds and supplements around 9:30. I never did get the creepy crawlies, but did get a raging heading about 1/2 hour after I took the MTX. It didn’t hurt when I was lying down, which is why I must not have noticed it before. I also got the first good night’s sleep I’ve had in weeks and woke up less groggy this morning than previous Saturdays. So taking it early is probably a good thing. I’ve only got two more doses before surgery, but that ought to give me a good enough sample to get this process nailed.

On the insurance / $$$ front, I think the entire surgery will cost me about $5,500 out of pocket, which is less than I thought. Making deals with my surgeon and anesthesiologist helped a lot. That doesn’t take into account the loss of revenue since I won’t be working full tilt in August and probably September, but I’m working on that too. (Thank you, clients.) That’s the downside of working for yourself — no sick pay.

The home health care nurse came by on Thursday morning and she is delightful. The insurance has approved four visits. She said the first visit will be either the day I am discharged or the next morning if I don’t get discharged until late in the afternoon. I also found out from my Blue Cross nurse (more about her later) that they’ve approved 10 home visits by the physical therapist while I’m off. Sounds like I’m going to be busy!

Blue Cross not only has a 24-hour nurse hotline, but it has a program where they have nurses call people who are scheduled for surgery to make sure they don’t have any questions, have the patient information they need and provide them with resources. My nurse is Maria and I now have her direct line in case I have any questions or issues.

I do need to check to see if my policy covers home aid. I think I’d like someone to come in the mornings to help me in and out of the shower and get me up for the day — at least for the first week or so. Jack is more than willing and capable of doing this, but I don’t want him to have to make the decision of choosing between taking care of me or running his company.

Jack decided I needed a grab bar in my bathroom next to the toilet and I have rebelled. Sorry, but grab bars are for old ladies and I’m not there [yet]. So instead I’ve ordered this pole that extends from the floor to the ceiling. It can also be moved to the bedside or whereever I might need some extra help getting up or down. I’ve always wanted my own stripper pole and now I’ve got one!

The next blood donation is Monday at 9:30 am. I’ve got my mind made up that I’m not going to have issues with it, but honestly, I get physically nauseated when I think of it. I’m trying visualization techniques where everything goes okay and even when I envision things going smoothly, I literally get sick to my stomach.  We’ll see. One way or the other, that part will all be over Monday and for me that’s a major hurdle to put behind me.

The following week I have my pre-admit checkup/clearance with my internist. The week after that we have our sojourn out to Las Vegas for Jack’s birthday. Then it’s time for the surgery. It’ll be here before I know it.

I’ve gotten a lot of good thoughts and support and I appreciate each and every one of you. Thanks for checking in.

Ouch - First Blood

Just when I think I won’t have anything to update for a while, new stuff happens.

I “deposited” my first unit of blood yesterday morning. I have a very strong vasovagal reflex when getting poked with a needle. In addition to the light-headed, fainting issues, my veins basically clamp down. The last time I had surgery, they blew out three veins before getting the IV started. Anyway, I made it through the poke and blood draining fine and thought I was home free. The instant they removed the needle (which has always, in the past, been a relief), I crashed. My blood pressure plummetted and it took another hour for them to get me revived to the point that I could drive home. I was basically down the rest of the day. I get to do this again next Monday. What fun. And by the way, for those of you who think about donating your own blood before surgery — note they charge you for it. My charge was $270, which I had to pay then file with the insurance — for each draw, or a total of $540. Between the reaction and the cost, it’s almost enough to take a chance on NOT needing the transfusion during the surgery. The bad news is that I thought they could use the blood for someone else if I didn’t need it, but apparently it’s disposed of. They don’t do all the screening/testing that they would normally do, so they can’t give it to anyone else. Learn something new everyday.

The home health-care nurse is coming tomorrow morning to get me “checked in” to their system. The insurance has approved her coming for four visits after surgery. She’ll check my vitals and make sure everything is healing the way it should. All this is making me nervous. I’ve never had anything done serious enough to need someone to come to my house before. I haven’t heard from the home therapy people yet, but I’m sure they’ll show up soon enough.

I dropped my application for disabled parking sticker by my surgeon’s office today. While I was there, they discussed the payment requirement. My surgeon is out of network and base price is $6K. The insurance will pay $1200, and he’s reduced his price down to $1100 for my portion — which is basically what he’d get if he were in network. I’m lucky in that I’ve got a great surgeon with his own practice. If he were in a joint practice, he wouldn’t have that kind of flexibility. Now, I have to have the same conversation with my anesthesiologist who is also not in network to see if I can make a deal with him.

That’s all that’s new for now. I’m learning that this health care business is a part-time to full-time job keeping up with stuff. Thanks for checking in.

Methotrexate - Round Two

I took the second dose of methotrexate last night. I took it around 9:30 and was sound asleep soon after 10. I was wide awake with the creepy crawlies again about 11:15. Four hours and two really bad science fiction movies later, I fell back asleep at around 3:00. So now I’ve got a week to figure out a strategy before my next dose. Right now, my inclination is to take it around 6:00, so by 10:00, I’ll be ready to go to bed and to sleep.

Lack of sleep is one of the major problems that arthritis sufferers have because of the pain. It’s not nice that our medicine contributes to the problem.

I spoke with Dr. Cheatum’s office about having to go off the medication before my surgery and, to my surprise, they immediately said the recommendation is two weeks before to two weeks after. After Dr. Tucker warned me that Dr. Cheatum’s stance was that you didn’t have to discontinue the medicine, I was pleasantly surprised. Based on my schedule, I’ve actually got a compromise of 10 days before and 10 days after.

I’ve finally found some blogs of people who are/have taken MTX, and boy are they depressing. Right now I don’t have any side effects besides being tired. I’ve decided NOT to follow the blogs. Either I’ll get the side effects or I won’t. Everyone reacts differently and I’ll just make myself crazy worrying about what might happen. Dr. Cheatum has me on folic acid which helps mitigate the side effects, and not everyone who posted on the subject was and I think that is a major difference.

The one nugget of information that I found, however, is that the injectible MTX causes less side effects than the tablets. I suspect that would be the next step if I can’t tolerate the the tablets.

I continue on my nest-building quest in anticipation of surgery and recovery. This weekend I’m going to build soups and other goodies to put in the freezer. I’ve already built Mexican Soup (grilled chicken, black beans, sweet potatoes, spicy tomatoes, cumin, cilantro) and White Bean with Fennel. Today I’m going to create Italian soup (kind of like minestrone but with sweet Italian sausage). Shopping and cooking are very hard for me since I’m on my feet, so I do it in spurts when I can — with lots of rest in between.

On a final note, it’s been over a week since I’ve had a drink and, for someone who enjoys her glass of wine at the end of the day, I’m amazed that I haven’t missed it. I’ve been drinking those wonderful flavored sparkling waters from Wal-Mart — no calories, no sodium, just refreshing flavor. I go through about a quart an evening which has also got to be good for me.

That’s all I know. I expect the foreseeable future to be fairly quiet. No more doc appts in the near term. I’ll update the blog as I take the MTX doses and if anything else develops.

Thanks to all who have offered their love and support as I work through this.