The Next Adventure – Chapter II

July 19, 2019

As I assess my mental and emotional state for the first few days following the THR surgery I believe the following gif sums it up nicely.

Almost immediately following the surgery, and continuing for the next 36 hours I was feeling like Wile Coyote just sailing along in my wingsuit, and then “bam”, the wall just hit me.  Oh wait, I guess I was the one who hit the wall.  This is the conundrum that exists with the application of the medications that are used for operations like THR.  The drugs and medicines are great, in that they significantly reduce and manage the pain involved with the surgery and the initial recuperation.  The problem for me is that I lose sight of why I’m “feeling so good”, and ascribe it to my “natural” ability to overcome my ailments. 

This is where Ann’s support always proves to be invaluable, and it was no different for the THR surgery.  She always helps me realize that the recovery process is just that – a “process”.  It is going to take some time and there are multiple factors at play in managing this.  One of the keys to avoiding the “Coyote syndrome”, getting on an emotional and physical high and then crashing, is to be prepared for the unavoidable fact that not every day is going to be easy, or smooth sailing.

I know people who fall into either the “all drugs are bad” camp, or the “drugs are the full solution” camp.  (When referring to “drugs”, I am only referring to legitimate, doctor prescribed medications).  I fall somewhere in the middle of this spectrum.  We all have different levels of pain tolerance.  I know that for me, once I cross the pain threshold, that is when my mental and emotional stability is at risk.  What I shoot for, is to figure out what the minimum level of pain medication I need to assist with the pain management.

 In reality, this initial recovery process – the first two weeks – is a dynamic balancing act for a process for me that has the following primary components.  I have named this process “The Recovery Cube”.  When I get The Recovery Cube balance correct, then my recovery is going to be successful.

  1. Rest – After talking with the doctor, his PA and other friends/colleagues who had THR, I decided early on that I needed at least 10 full days away from work.  For me, this means not even looking at my work emails for this time period.  I know that removing this stress from my life during early recuperation and recovery is a huge factor in my positive mental and emotional state.
  2. ICE – I know that I am prone to swelling from these surgeries, and so I have incorporated a comprehensive icing, compression, elevation schedule into my recovery routine.  I am icing between 18 and 20 hours per day in the first few days and then slowly tapering that off as I move thru recovery.
  3. Drugs/medications – This is the area that took the most focus and tweaking to get dialed in, and fortunately, with Ann’s assistance, we got this dialed in pretty quick.  Without being really specific, I will just say that the I have used the prescribed pain meds, but at a rate that is far less than the maximum prescribed amount, (both dosage and times per day).  We have quickly figured out the key times when I need to take them.  As the pain from the swelling lessens, I will curtail the pain meds appropriately.
  4. Activity – I was “warned” by my doctor and other medical professionals that their main concern in my case, was that I would “feel too good” and would try to do too much, too early.  They were right, and that contributed to the “crash”.  Again, with a major assist from Ann, I did quickly recognize that and have tweaked this area.  In my case, I like using the walker and I am using it heavily to assist with my mobility.  Even though I can walk unassisted, doesn’t mean I should walk unassisted – yet!

What’s up next?

The post op meeting with the surgeon and the first PT session.  This will be the transition from recovery/recuperation to the rehabilitation stage!

July 16, 2019 – Another “textbook” surgery is now behind me and I’m hip deep in the recovery phase right now, (put intended).

My THR was performed on July 11, 2019 by Dr. Keith Holley and his team at Allied Orthopedics.  Of course, the staff and facilities at Treasure Valley Hospital were also fantastic.  This was my 3rd surgery at TVH and I have been totally impressed with their professionalism, the care they give and the overall experience that they provide.  Having to go under the knife and get body parts repaired/replaced is never fun, but the teams at TVH and Allied Orthopedics go out of their way to remove the stress and set the patient up for success.

We were on the “early” schedule for surgery, which meant a 5:30 AM arrival time.  By 7:30 AM, the final prep work was underway and I don’t really remember anything from that point on.  Apparently, I requested this photo with the hardware in place.

THR (right)
My new THR hardware.

Kind of glad I did that. I think it is pretty cool.  By 10AM I was awake and officially in recovery.  We were prepared for me to spend the night if required, but we also knew that it was realistic that I would be able to return home later that day.  In order to make that happen, they had 3 goals that had to be met:

  1. Be able to walk on my own.
  2. Pass the assessment test of the PT on staff, (included going up and down stairs).
  3. Be able to go pee.  (Some say this may be TMI, but hey, I didn’t set the goal).

The third one proved to be the last one that I was able to meet.  The spinal block can kind of raise havoc with some of those bodily functions, but fortunately it was fairly short lived and by mid to late afternoon, after a few trips to the restroom, all was back to normal.  After dinner, we started the checkout process, which only took a few minutes, and we were on our way.

My post-surgery recovery is progressing in a positive manner, but that does not mean that it is without incident.  As with my other surgeries that I have had over the years, the biggest problem is the swelling.

Swelling and minor bruising post surgery, 4-5 days.

We all react differently to surgeries and trauma, and in my case, my body has seemed to react fairly consistently to these types of events.  (I don’t usually bruise much, but I do tend to have a decent amount of swelling).  This THR as led to some mild to moderate pain, that I think is very tightly coordinated with the swelling/trauma of the operation. 

I’m a firm believer in the use of Ice, Compression & Elevate (ICE).  This was not always the case, and I credit Ann with taking the lead in this area and bringing me along.  Through the years, we have also gravitated to some specific aids in assisting with the ICE process.

Our “GO-TO” solution was a cooler concept that was named the “Ice Man”.  At one point, between surgeries, we loaned this out to someone and now we have forgotten who we loaned it too.  The solution was to buy this “Cold Rush” unit.  I used this on all three of my ACL’s, with great results.  And although we had mixed reviews/opinions as to the effectiveness of these units for hip surgeries, after 5 days I am a convert! 

Ice cold water is circulated thru the pad. (There are different options for pad design, based on the body part to be iced).
The “Cold Rush” ice machine that we purchased for the THR.
The ice machine in action. For the ice pad used, the ice in the cooler has been lasting up to 4 hours.

We also found a couple of these ice pack systems online and we have been using them to augment the icing process.  The one shown below is great, because when combined with the case provided, it gives you a set of convenient straps to assist with compression and mobility.

Ice pack with velcro waist and thigh straps. Works / fits nicely on the hip. I usually get about 1 hour of icing with this.

Final thoughts for today’s blog entry:

We are all unique, and when it comes to surgeries and recoveries our experiences and the recovery journey is going to be different for all of us.  It has been beneficial for me to talk to others who have had already had these types of surgeries, but what I have found out after several different types of surgeries is that my body responds fairly consistently from each one.  The main caveat that I add to that is that over time, I have noticed significant improvements in the techniques, tools and facilities that are available to the medical teams to perform these operations.

For me, the problems with swelling and managing the pain associated with that always seems to be the key to a successful recovery.  When in recovery, ICE is my friend.

What’s next:

In my next entry, I will address the mental and emotional components, as well as some perspectives on drug use (prescribed), in the recovery cycle.

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