Today is the 21st day since my first surgery (SDH). We've been home a week now and are settling into a routine.
[Warning: lots of boring details follow that probably only other PAO patients-to-be would find interesting.]
I haven't had any pain medication since the morning of Oct 4th (PAO+6), two days before we left the hospital. The narcotics messed up my bowels so I'm trying to stay away from drugs. My hip feels tight and tender, and hurts if I move it certain ways, but the pain is now more at the level of significant discomfort rather than outright pain (as when, say, one is sent out of recovery without an epidural bag).
Speaking of bowels, mine are working fine now, for which I am very grateful. That ileus was no fun.
My incisions are healing well. The glue is starting to peel so it looks funny. My last drain hole has closed up so today we removed the gauze and Tegaderm for good. The skin on my thigh is red and bumpy, likely due to irritation from being shaved.
Because I had two surgeries close together, and probably because I had so much IV fluid pumped into me (somehow gained 20 lbs in the hospital, not by eating!) I had more
edema than normal. Both thighs and my midsection were pretty swollen but that has subsided noticeably. My non-operated left leg is pretty well back to normal, and my operated right leg is getting closer to normal. What is amazing to me is how much my leg muscles have shrunk in just three weeks--they're puny.
Dr Mayo specified several restrictions for how I can move my leg:
- No straight-leg lifting. This is because he had to cut across some muscles, and until they heal only the stitches through the muscle sheath are holding the muscles together.
- No abduction (moving the leg from inside to outside, as when making snow angels). This is because for the SDH surgery he cut a slice of bone from the greater trochanter where a bunch of muscles attach (instead of detaching the muscles themselves), and then screwed the bone back into the femur. This chunk of bone needs time to re-fuse with the femur, and using the muscles that attach to it could hinder fusion by pulling on the bone fragment.
- Maximum 60˚ hip flexion on the knee CPM machine. This is for the same reason as the "no abduction" rule. Evidently the hip CPM machine puts an upward force on the trochanter, which can result in the trochanter fragment not re-fusing with the femur. Dr Mayo prescribed a knee CPM machine instead and told me to limit it to 60˚ of flexion at the hip. I still need to figure out what 60˚ at the hip translates to at the knee, since the knee CPM machine is calibrated for knee angles; one way is to get a goniometer to measure the angle.
These limitations mean that I can't lift my leg into the car, into the tub, out of the CPM machine, etc. I need either someone to lift it for me, or to somehow lift it manually.
The most disruptive effect of this is that when I need to go to the bathroom at night, Krista has to get up in order to get my leg out of the CPM machine (see picture at left). Because of all the IV fluid I'm still shedding, I sometimes have to get up three times during the night; it's like having a newborn again.
I'm training the boys to help move my leg in situations like this in order to free up Krista. They're doing a good job, super eager to help however they can.
Once my leg is out of the CPM machine, I'm able to crutch around the (single story) house by myself, and I can seat myself at the couch, kitchen table, or commode. I can sit for an hour or two with some discomfort. I'm able to get in and out of our minivan with someone lifting my operated leg. I sit in the middle row because there's more leg room.
I still have to wear the TED hose (compression socks) which, along with the anti-coagulant Fragmin shots, are intended to minimize the chance of blood clots. After two weeks of daily Fragmin injections are done I'll be able to stop wearing the TED hose. Krista gives me the shot every morning after breakfast.
My herbalist sister has been loving on me with vitamins and supplements to aid healing (E7 protein powder, oatstraw tea, plus a bunch of other things--so many that it's hard to keep up!). I need to work through her list and get a routine going.
I've managed to find a comfortable enough position to work a few hours. I'm definitely not ready to be back at the keyboard full-time, but it's good to know I can work some to stave off poverty.
We've made a few small trips, to an apple farm with the kids, and to Walmart. I crutched around at the apple farm and then found a seat while everyone else walked around. At Walmart I used an electric cart; it worked fine but was somewhat uncomfortable, especially going over bumps. But it's good to be out!
We got a commode that perches over the toilet. It's very helpful for me because it effectively raises the seat about a foot, saving me from having to bend my hip too much, and it has handles on the sides so I can raise and lower myself in a controlled fashion. We only have one bathroom, so we just leave it set up and everyone uses it. The kids think it's fun to be perched a little higher.
We're renting a shower chair, which is necessary for me to be able to shower. Our bathroom has a tub shower, so the chair we got is taller and wider than our tub, allowing me to sit on the chair with my legs outside the tub and then rotate into the tub. I'm very glad to take showers again; during the two weeks I was in the hospital I had only one shower.
We're also renting an electric hospital bed from
Apria which can raise or lower the head and feet separately. It has a trapeze which helps me to get myself in and out of bed. The mattress sleeps hot and sweaty without a mattress pad, but is reasonably comfortable with one.
So that's life at week three.
