calm but not

So it's a waiting game. Couldn't get answers to my questions without making another appointment - Nov 3...

and the questions:  which entry spot - lateral or posterial..

I have spoken to several physiotherapists - ones that have worked with patients post surgery - and they both said that the rehab is easier with the lateral entry... the muscles that have to be moved or cut for the posterial entry make the rehab that much more difficult...so.. which place does this surgeon cut.. that's question # 1..

both those physios also say that all of their patients (in the last several years) have had the post surgery protocol that calls for some weight bearing within the first couple of days... not 6 weeks later. Neither of them could understand why someone would still do the operation in a way that required that.

So those are my two questions.

If I don't get the anwers that favour the entry point and rehab I want - I am starting all over again- this time with the names of two surgeons that have favourable rehab details.

Of course it will require an appointment with my GP - then a referral.. then an appoitment down the road with the new surgeons - then finally a date. If that's the route I must take - I will probably have to wait another 4 to 6 months at least.

The first appointment with the surgeon won't be for several months - then to get his or her list.. another several months. Looks like the spring for me. 

Not happy.. not amused..

but perhaps the news will be good with the surgeon on Nov 3...

Love the system.. almost as much as I love the pain I am in - all day - every day...

Remind me not to answer any questions over the phone or by email when someone asks me for simple answers to simple questions. I will make them make an appointment and come to my office to get those answers - maybe a couple of months down the road.

And I really hope it's an orthopaedic surgeon that asks me some questions. 

The Mind Plays Tricks

I have had a comment on the blog... from someone named Tony.. thanks Tony...

and what he said - along with several other people - is stop worrying and just go for it. That is what I will try to do, but as the title of this blog says... The mind plays tricks. I have WAY too much time to think. And I am doing this 'thinking' all the time. Sometimes going with the worst scenario possible - something going wrong with the operation. Sometimes wondering about down the road - what will I be able to do. Sometimes I worry about all the time not working - as a self employed person.. no work.. no pay... there are no sick days.. there are no vacation days.. nothing that pays during that time.

At this point, I am trying to relax and let the time go by - the time required to wait for the next step.. the pre-op appointment where they take the blood.. talk to you.. generally you are a step closer and yet still so far from the day.

These days, a lot of doctors on not giving an actual surgery date until 6 weeks before the operation. So the phone will ring and then you know sort of when the operation is. 

Of course the mind is wondering when that phone call will come... and tries to add the 6 weeks and see when the operation will be... so here we are in Oct.. no call yet.. so the operation would be.. at the earliest at this point... early december... so every week that goes by.. you play the game and see where you might be at this point.. when does the december opportunity leave... when do you figure it will be january...

and so planning things.. like clients that can't get you for 5 weeks.. or any plans at all really... when do you get to plan them? or finalize them... well not until the phone call...

is 6 weeks enough... for most.. but of course where my head is... it's not enough time to get things the way they need to be... so again the mind starts working on the 'unfairness' of the system.. 

the very fact that that is the way it has to work... the hospitals and the system are so stressed, that 1. we are booking 6 months in advance for things.. and 2. even surgery days can't be booked with any certainty until 6 weeks out... and apparently.. even those get changed a lot...

ahhhhh..

and so the mind keeps on churning in circles...

Tony... sure wish I could stop the worrying and carry on!...

as to the type of replacement.. just try and get a surgeon to actually answer that question for you.. that would mean you could actually talk with them!... only way is to make an appointment.. down the road about 3 weeks.. to go to their office for 3 minutes to get an answer they could give in an email or over the phone... a whole day off work (the nature of my work) to get the 2 minute answer... and 3 or 4 weeks down the road...

ahhhhh...

And the Information Just Keeps Coming!

So here it is. It seems it's all about how the surgeon goes in to replace your hip. There is an entry referred to as Lateral - more or less the side of the hip area and there is an entry referred to as Posterior - more or less further back I guess!  Surgeon, I assume, have their favourite way of doing things - just as we might have our favourite ways of doing things as long as the final result is the same or close to it. In this case, there seems to be nobody saying the final result is any difference in the long term. The long term is really just not the short term! The short term is maybe 6 months. So the differences are in those first 6 months, and more specifically it seems the biggest differences are in the first 6 weeks or so. With the lateral entry, the patient will be putting very light weight on the hip (walking) with a few days of the operation; gradually increasing the amount of weight according to both time and healing results. With the posterior entry, there are 6 weeks of NO weight bearing at all. So... here is the dilema; finding a surgeon you like and trust, and finding out that the posterior entry is being used and that means 6 weeks on crutches - no cheating - no weight bearing. Do you go find another surgeon who does the other entry? Will you trust or like them as much? Is 6 weeks too much to ask for 15 years of using your new hip - properly installed and looked after by a good surgeon? But maybe there is just as good a surgeon that will have you walking in a week; and even getting rid of your cane by 4 weeks!

All sounds easy until you realize these are questions that surgeons either don't want to answer, or don't have time to answer, or don't even get posed to them by their receptionists whom you had to leave the questions with.

So I have the calls out to three surgeons:

what is your post operative weight bearing protocol for 1. resurfacing and 2. full hip replacement.

As we speak, one has returned my email. His protocol is 6 weeks no weight bearing for either of the operations - must be the posterior approach. He never specified that it was the posterior approach that requires the 6 weeks, but that assumption is based on a few articles I read, and the fact that he is, for sure, using the posterior approach.

Is the 6 weeks non weight bearing that big a deal?

well.. I live alone and i have stairs.. In addition I am self employed and getting back to work helps pay bills - one way I can be back in 2 weeks, maybe 3 at the outside... with a cane - the other way.. it's 6 weeks before I can even begin to put weight on that side.. then perhaps a couple more until I could do my job properly with a cane.

Ok.. so what about a surgeon who is good, and has the protocol that gets me back on my feet quickly? I think there might be one - still waiting for a response - but he is in Ottawa; and that brings with it a whole other bunch or logistic problems both before and after the operation.

It could be he has the same post operative protocol; only his answer will tell me that.

The third surgeon, in Toronto, can only do the full hip replacement - another decision yet to be fully decided upon - and I think has the quick recovery protocol - although no response yet from him either.

The system grinds along, with me, the impatient patient, barely holding on mentally. Shouldn't be this much of a struggle in my mind, but this is without any exception, the scariest thing I have ever gone through - and I haven't even gone through anything yet!

So go my days - deciding.. changing my mind - getting more information - getting more questions - asking more questions - and not getting all the answers as quickly as I would like. But even when I get all the answers - will I be able to make a clean decision? 

I will keep you informed!

The Physical Edge

So hip surgery is pretty major in that they cut a lot of stuff... stretch and move a lot of stuff.. in order to get the new hip parts in the right place (didn't that sound technical?). I have been told, and it makes sense, to get your body ready for the trauma it is about to undergo - because no matter how benign it might sound - any time under the knife is a trauma for your body. Get your body ready? What does that - or should that- mean?

Your body needs to fight off any infections and it needs to respond to therapy, and it needs to heal from the inside out and all that means feeding yourself right - perhaps for the first time in a long time. It also means - in my case - lose some weight so the whole healing process will be easier on me and my new hip.

If either of those sounds easy, or would be easy for you, then go away! They are both giving me a difficult time. More about that later.

What other 'get your body ready' things are there?  I will need to use crutches and a walker, so upper body strength and stamina will be important. I will also be needing to rehab my leg because of not using it for 5 or 6 weeks, so the stronger those muscles are now, the easier they will be to get back into shape later (or so the story goes). So I have to get into the gym and work on some things, but the pain in my leg and hip makes that one of my not so favorite things to do right now - right now when I need it the most. Swimming, although generally good for me, is even starting to hurt so my last arena of pain free activity is slowing drifting away (was that a water pun?).

Next time - which operation do I want? And you thought a hip replacement was a hip replacement. Hah!

Choosing a Surgeon

"I know a guy" - "my Aunt had hers done - he was great - go to him" - "There is this guy in Montreal... no the other guy in London is better... this guy at St. Mikes...".

What a problem. Of course it makes sense to go to someone that has some success with one of your friends or family, but that doesn't mean you can. Every Orthopod in the city (T0ronto) seems to be booking their surgeries for at least 3 - 4 months in advance and many well into 7 or 8 months in advance.

Too bad I didn't book before I was ready!  Huh?

I suppose if i had to get a new engine in my car, I could go to a number of places and get good results. Even if I didn't get the best results, I could, given a large bank account, go to someone else and have them take a try at it. I don't think it works that way for a hip. Best to choose a good one right away.

Have you ever been to an Orthopaedic surgeon? I am about to make a gross generalization about them - so if this offends you, or someone you care about, feel free to stop reading because it's how I feel based on experience.

They really have lousy 'bedside' manners. They don't really want to give you the time to explain the operation, the options, what to do before the operation - really not a lot of anything except.. and here I will quote - " Yup.. you need a new hip.. talk to my receptionist and we will book you in for the appointments and the surgery. Nice to meet you."

As I started to sweat over the prospect of surgery, rehabilitation, being off work, paying my bills, enduring the pain, more rehabilitation..... I realized I was the only one in the room. The great saviour had gone on to another patient.

Do I sound bitter? Well the good news a couple of surgeons have broken the mold and have spoken to me - one at length. So that means it's possible to be a good surgeon and be able to talk to people.. it's just that most can't. Should we forgive them because they have good hands and do a good job? Not sure. That part sure is important, but so is the mind set of the patient and anything they can do to put my mind in the right place - they should at least try.

Best stop here for now.. getting nasty inside my head and I want only positive thoughts from now until well after the surgery. That could be a long time of positive thinking!.. There's my true challenge in all this.

How it all began

I need to start with how this all began. I need a new hip. I have managed through abuse, heredity, overuse, pure bad luck... to destroy my right hip. They (who is 'they'?) wanted me to wait a little longer - until I was older to get my new hip. Since they only last 20 years - if that - then the idea is that I am going to have to have another one since I am only 55 years old.  If I waited until later in life, I might only need one.

The problem is the reduced quality of life I now have. I love activity - especially tennis and waterskiing in the summer, and tennis in the winter. Since I have now gone over 1 1/2 years without playing tennis, and two summers without skiing, I am ready to go under the knife. OK.. maybe not ready, but resigned. There is another issue. It's been waking me up at night. That's when the doctors all agreed - it's time. 

Nervous doesn't come close to describing how I feel.

From Here to Surgery

So I am sure there are lots of people who have surgery every day, and I am sure they get through it. But I am nervous. I decided that writing a blog about my upcoming surgery might be cathartic for me and somewhat interesting for you. If you know of anyone going through some surgery in the next while, they might be interested in my thoughts as the surgery nears.