Monthly Archives: April 2013

Post-Op Appointments

I went to see both my PCP and Dr. Tomford yesterday. My wife drove me into Boston and back in the same day. Lotta driving. Traffic was heavy because of the memorial service for the slain MIT officer Sean Collier.

My PCP was interested mostly in the sore throat. She thinks it is thrush, but thought a throat culture at this point was pointless. She gave me a prescription for a lozenge version of nystatin, which she says is as good and some people think is less unpleasant. My antibiotics have run out so now the nystatin will be assisted by my natural microbiota.

A visit to Dr. Tomford’s office always starts with a trip to the x-ray department down the hall. After getting dressed and returning to the reception area, I was led immediately into an exam room. Shortly thereafter Dr. Tomford entered and apologized for not yet getting the rest of the video. But he is working on it. I showed him stills I took from the video I have and asked if it would be OK to put them on this site. He kindly named the tools shown in each still.

We looked at the x-rays (all digital so they are up on his computer screen.) Everything looks good. He watched me walk on two crutches then on one crutch. I am to stay on two crutches until May 2, one month after surgery. Then I can switch to one crutch for two weeks, then no crutches. I can drive after May 2, too. My next post-op appointment will be one year after the surgery because everything is going so well.

I thanked Dr. Tomford for a surgery well done.

Things are Going Well

The sore throat is subsiding. Two doctors and two diagnoses. One is thrush, a fungal infection often seen after antibiotics kill all the good bacterial that keep the fungus in check. The other diagnosis was “Probably viral but we’d better give you an antibiotic because you just had a hip replacement.” OK, but the antibiotic will just worsen the thrush situation, won’t it? I’ll take the full run of antibiotics then keep taking the nystatin for the thrush and hope for the best. I am also taking a second Omeprazole (acid reflux medicine) before bedtime because sometimes acid reflux can cause a sore throat. I am also using a vaporizer to increase the humidity in my bedroom. I am able to sleep on my left side, which helps, too.

I am off the Oxycodone. Four Tylenol Extra Strength a day is working just fine. I can walk without crutches for short distances and without too much of a limp.

I will be meeting with my PCP and my surgeon Wednesday and I will give you another report then.

Audio

I recorded the operation using an old iPhone 3G. I downloaded Audacity, an audio editor, and am learning how to create little mp3 files of the interesting parts of the 2 hour and 45 minute voice memo file. Here is my first snippet. It is the sound of sawing off the top of my femur.

20130402 120254 saw

Enjoy.

A setback

Wednesday night was a bad night for my sleep. I had some swelling and/or mucus in my throat that cut off my breath. The cycle was I would nod off, my mouth would open, and I would be awakened by a snork or a fear of not being able to breath. And repeat.

Thursday was a pretty typical day in spite of that, although I spent more time in bed than I would have otherwise. We had guests on Thursday for dinner, and I had planned my pain meds peak to coincide with that visit. All seemed OK.

Friday was a low energy day. I felt a sore throat coming on. I stayed in bed most of the day. I felt nauseous in the afternoon. I slept better Friday night, woke up with a raging sore throat.

Today, Saturday, I have more energy, but feel I have lost a few days of activity working toward recovery.

The sore throat is probably not bacterial; there are no white spots among the red, and I do not have a fever.

I had my first official shower this morning after 10 days of sponge baths. It felt good.

Pain Meds

I have tried to stay at half the recommended dosage of pain meds so I can keep my digestive system up and running. It has been a success for the most part. My digestive system has allowed me to eat every meal and my bowel movements have been OK. The pain has been tolerable. (Maybe 1 to 5 on a scale of 1 to 10. I hate trying to quantify pain on that scale.)

My usage since I have been home:
PO day 4: 2000 mg Tylenol, 15 mg Oxycodone.
PO day 5: 2500 mg Tylenol, 15 mg Oxycodone.
PO day 6: 1500 mg Tylenol, 20 mg Oxycodone.
PO day 7: 2500 mg Tylenol, 20 mg Oxycodone.
PO day 8: 2500 mg Tylenol, 25 mg Oxycodone.

The max dosage for Tylenol is 4000 mg/day or your liver starts to suffer. The max recommended dosage for Oxycodone is 60 mg/day for post-op surgery pain. The pain got ahead of me on PO day 7, so I have upped the dosage to 3000 mg/day Tylenol and 30 mg/day Oxycodone. I don’t wake myself up at night to take the meds so I haven’t achieved those levels, but I did manage to bring the pain back to tolerable levels. However, no BM for two days in spite of taking a stool softener, Docqlace. I’m upping Docqlace to 300 mg/day to see if that helps.

Fortunately, as the days go by, the need for the pain meds will decrease. But not yet.

Physical Therapy

Lori from Porchlight come by Monday and gave me two sheets of exercise to do. One sheet contains exercises to do while standing at the kitchen counter, the other to do while lying in bed. She wants me to do each set twice a day but not together, which is what I had just done as she was showing me the exercises. I am exhausted when she leaves and have to take a nap. Now I know why Lori doesn’t want me to do them all at once.

Lori came again on Wednesday and took me through all the exercise she had given me before then added a third set I could do while sitting down. I had planned my pain meds to peak during her visit and that was good because it was quite a workout.

She says that next week she is going to have me walking, walking, walking. She will prescribe a trip to Stop n Shop to walk around the store hanging on to a cart. I am supposed to be house-bound to be under Porchlight’s care, but this trip to Stop n Shop will be OK because it will be by prescription.

Post-Op Day 5

Today is Sunday. I get into a routine. Keeping track of the meds I have taken and when is a challenge. I solve it with a spreadsheet app for my iPad called iSpreadsheet by SavySoda. I create a spreadsheet for every day with a row for each med and a column for each time. I can see at a glance when I last took my painkillers so I don’t take them too often or too close together. It’s not an ideal solution. Maybe I should write my own app?

A physical therapist came by from Porchlight to evaluate me. She was either being nice or I have great range of motion in my new hip for just five days from surgery. The plan is to have a PT see me three times a week.

More walking around the house on the crutches. More visitors. Some time on my computer in a chair. Sitting is not very comfortable.

Post-Op Day 4

Today is Saturday and is post-op day 4. I slept well my first night in my little bed. There were a few adjustments made as to what I needed nearby. They all seemed to be upstairs so my wife made many trips.

Amy, from Porchlight Visiting Nurse Association, Lee, came by and admitted me to their care. All my vital signs were taken and a plan of action was laid out. I call if I need anything. Otherwise a nurse will come by twice a week and check my vital signs. Amy wil send out a physical therapist to evaluate me tomorrow.

I walk a bit around the house and sit up a bit. I had many visitors. I also spend time in bed napping.