Four tattoos and ectopic bone

Monday I had a CT scheduled for the radiation oncologist to use for targeting the radiation treatment he'll administer on surgery day. (This single dose of radiation is to suppress additional ectopic bone from forming after this next surgery.)

But the lingering dermatitis on my skin has been threatening the April 26 surgery date. It finally started to go away, so I stopped using the steroid cream, but the dermatitis returned so I'm back to using the steroid cream twice a day. The big question around here the last month or so has been, will it clear up enough for surgery?

Monday before my CT appointment Dr. Mayo carved out a few minutes from his schedule to take a look at my skin. I definitely did not want to absorb the extra x-rays for a CT if we weren't going ahead with surgery on the 26th. But thankfully it has cleared up enough for him to cut. He thought surgery was scheduled for the following Wednesday two days later, but was relieved that he'd have another week to think about how to get at all the ectopic bone. He's hoping to get it all through the PAO incision, but that may not be possible, so he might have to make yet another incision. I'm glad that in a situation like this that's not cut-and-dry he has three decades of experience to draw from.

So I went ahead and did pre-op with Dr Mayo's new nurse Renee and then had the targeting CT done.

The targeting CT gives the radiation oncologist the information he needs in order to plan how to administer the radiation. The tech marked the outside of both hips with crosshairs, plus another in the center near my waistline, and another near my belly button. Then she gave me four tattoos in the center of each crosshair--just a dot made by needle prick. She next taped BBs on each crosshair so the reference points would show up on the CT. Once that was done it took another five minutes or so to get the CT.

So everything's in place. The insurance company pre-approved the surgery. I won't need to bank any blood this time, nor do they have me taking iron. I also won't need to shower with that nasty hex-something-or-ever stuff the night before and morning of. I'll be on a CPM machine at the hospital, will leave on crutches, wearing TED hose and two more weeks of Fragmin to minimize the possibility of clotting and stroke, but when I return home I'll sleep in my own bed instead of a rented hospital bed, and won't need a CPM machine at home. I don't know yet whether I'll need a commode or shower chair again. I'll be on a no-straight-leg-lifting restriction for four weeks, and then I can resume PT.

I'm skipping the epidural, as wonderful as it was last time, in favor of PCA in hope that I'll be able to get back on my feet sooner, which will help the swelling to subside quicker and keep my bowels moving, unlike last time. I'm guessing it'll hurt more than the perfect epidural I had before.

Krista will stay with me for the three or four days I'll be in the hospital. We'll try to update the blog as things progress.

Thanks for your prayers!

[update: added photo]

Dermatitis gone, next steps toward surgery

Dr. Mayo sent me to a dermatologist to check on my dermatitis just in case. He prescribed the same treatment as Dr. Mayo--topical steroid cream a couple of times a day. I continued to do that and the dermatitis has finally cleared up.

Last week I had a follow-up appointment with Dr. Mayo. He's satisfied that my skin has cleared up enough to take the next step toward getting the ectopic bone out. He checked my range of motion: it's still around 50˚ flexion, 5-10˚ internal rotation. He doesn't see a point in continuing to see a physical therapist at this point until he cleans that ectopic bone out.

The next step is another CT scan to map out the ectopic bone, a month from now. I'll also have a consultation with the radiation therapy folks regarding the single, low-dose of radiation they'll give me at my next surgery. Then I meet with Dr. Mayo to see what the CT shows. Thankfully, all those appointments are scheduled for the same day.

Then a month or so after that--likely sometime in April--Dr. Mayo will go back in and remove the ectopic bone and most of the screws. I have nine screws in my right hip, and seven suture anchors. The anchors stay, but I think he can remove as many as five screws through the PAO incision; two will be replaced as he'll need them to secure a chunk of bone that he needs to remove and replace again. If he needs to reopen the SDH incision to get all the ectopic bone then he'll remove the two screws in my trochanter. So best case I end up with two screws remaining.

Keri located some more x-rays (intra-op from the PAO), but we have yet to find the digital photos for the SDH. Evidently the machine that handles those doesn't talk to Multicare's network, so a radiology person has to upload them manually. She's doing her best to track them down. I'm very curious to see them.

My hip feels pretty good, considering. The joint doesn't hurt, just the tight muscles, and of course my range of motion continues to be limited. I still can't drive comfortably. But some things that hurt before surgery don't hurt now, and my hip no longer aches when I lie in bed at night. It really is amazing to think that the body can sustain such trauma and heal so well. Of course it helps that the trauma was intentional and therapeutic.

I can't say enough good about Dr. Mayo. I'm very grateful to have such a capable, conscientious hip virtuoso working on my hip.