First Bike Ride

After going to the gym again on Saturday and riding the stationary for bike for 20 minutes I felt ready to give the real road bike a try today. Kirsten and I went out for a warm, breezy 11 mile ride. After a little fiddling with a new bike seat, we settled down into a slow but steady ride. I could feel a little bit of pressure in the hip, right in the socket, but it is not painful. At this point in recuperation it is more painful to lift my leg at the knee than it is to put weight on it. I thought that might be a problem on the bike, but it's not. Gentle peddling pressure is no problem, pushing harder starts to cause a little pain, but it's a gentle ache of a pain, not a sharp one. And I can start to see that it won't be long before I can throw my leg over the seat to get on the bike instead of stepping over the crossbar as I have been doing for the last few years. Cool! Not quite yet, but soon.

I was surprised that it was my heart and lungs that were the limiting factor in getting up the hills rather than than my leg and hip strength. My legs felt great. I couldn't do Ride the Rockies again any time soon, but the legs and hip felt great. Kirsten has been riding a bit while I've been recuperating and I wasn't quite able to keep up with her. I think that is terrific. Hopefully if we both ride and train together at this point we can continue to do so from now on.

I don't want to get too gushy about medical technology. Grandpa always said that God sends the cure and the doctor sends the bill. But, it is less than 6 weeks since a total hip resurfacing and I'm out on a fun 11 mile ride! Wow. And, as a friend of mine says, I mean that forward and backward.

Sweet Spot

My lovely and impossibly busy sister says she enjoys taking time to check in on my ramblings every day. Perhaps, contrary to previously stated intentions, I ought to go ahead and make more frequent entries than just once a week. You are sweet, Cami! Flattery will get you anywhere.

I went to the gym today for the first time post surgery with my buddy of 30 years, Brian. I could brag that we were there from 10:30 to 1:30, and we were, but it was much more a function of two old retired buds catching up on any and everything than of the effort we put in. None-the-less, I did turn the crank on a spinning bike for 20 minutes or so and then did a resistance circuit with Brian. He asked me if the bike hurt. I thought about it and said yes and described the general, dull ache. Then he asked how it feels when I am not on the bike. Oh. Hmm. Yes, there is a general dull ache. Good point! Cool!

In fact, the hardest effort of the day was putting on a sock and gym shoe. Bending over far enough to put on a sock and tie a shoe is still getting to where the hip pain starts to get sharp. There was nothing like that on the bike. And after 20 minutes on the bike I could walk with less limp than just before, particularly if I was conscious of trying to do so. I realized, in trying, that to some extent my limp is a habit reaction from before the surgery to hip pain . But limping no longer helps, in fact it makes things a little worse.

Shucks. There is a big sweet spot between somewhat painfully putting on a shoe and using it with exertion almost pain free, one that I can fine tune a steady recuperation into. No excuses!

5 Weeks

Not much new. I feel about the same as last week. There is still pain and limited motion but a little better all the time. I'll try to check in weekly with any objective updates.

New Parts

I asked on Wednesday about getting copies of the X-Ray just for fun. Rob, the PA pictured, said their X-ray copier died 6 months ago but that we could snap a pic. I made him pose as a consequence while I snapped a pic with my phone.

Checked Up, Checked Out

Went into the surgeons office with Kirsten on Wednesday morning for the followup visit. We met with the nurse and then the PA; we knew the surgeon would be out. It seems, as I expected, that all has gone as well as it can. The TED's (surgical hose) use was lifted, the 90 degree movement precaution was lifted, I'm off the narcotic meds and can now use ibuprofen or acetaminophen and/or naproxen in the approved combinations. I'm still taking an aspirin a day for blood thinning. All the news was good news.

It's been just a month and it is nice to have the restrictions removed. There is still background pain and pain when I get to the 90 degree point or too bent. The background pain is enough, it seems, to make me a little more tired than I would be otherwise. I'm still stiff and move slowly when I first get up from sitting or sleeping. I tried the toilet without the riser and that seems a little soon. But yesterday when I got up in the morning and walked to the kitchen to start the copy I thought for the first time that I feel better in many ways than before the surgery. The furthest I have walked is 3 miles and that was over rough ground in Capitol Reef. I was a little stiff but it wasn't too far.

Time to start getting stronger again. I specifically asked about the gym, a bike, weight bearing and the answer was to let pain be the guide at this point. The only continued restriction is to stay out of tubs and pools and such for another couple of weeks. So, meeting Edsall at the gym tomorrow.

Riding the Plateau

Kirsten and I are still in Torrey, probably until this coming Tuesday. Hip recovery has slowed down and evened out. I'm still taking some meds, about 1/3 the originally prescribed dose of Lortab. Going for a mile walk without that amount would be more painful than fun. Initially I thought the doc might have prescribed too much, but now I think it might turn out to be about right. I keep myself on the edge of being uncomfortable and that has me slowly and steadily cutting back.

I am still just walking a little over a mile a day, most days. Getting around is a little easier but that has resulted in me tweaking the hip a bit too much a time or two getting off a low couch or just getting up or down in general. The over-tweaked pain lasts a day or so. I walk down steps now one step/one foot at a time but still generally two step going up with the good leg going first. Raising my left knee more than about 30 degrees is still the most painful movement. The pain of walking is getting back to the same point as before the surgery. Most of the pain is the familiar hip pain I had before, but some of that is just starting to go away and there are some new sensations, mostly of tightness. There is a sense that my leg isn't quite in the same place as before and that my left foot is, for the time being at least, a little pigeon toed. It feels better when I walk to try and turn that foot out a bit. K says I land a lot more on my heel now than before, when I used to step flat footed on the left. Progress!

My body is starting to feel the lack of all around exercise. I see the surgeon's office next week and I hope to get some go ahead to hit the gym a little for some upper body resistance work. I'll get a better idea then of when the 90 degree restriction will be lifted and a bike, or a push up or sit up starts to be possible.

Dark Leafy Greens Never Hurt No One

Day 19

Last Tuesday another new nurse named Sue came in to run the blood test via a finger prick. Basically she is measuring for the speed of coagulation and shooting for a measurement between 2 and 3 on a scale of about 5. The result determines the amount of blood thinner to take. I had been right at 2.0 which was making them happy but Thursday's measurement came in at 1.5. A little too low, no big deal, the meds would just need to be adjusted. As Sue picked up to leave she reminded us of the precautions to take along with that of eating no dark leafy greens and the like (with vitamin K). Eh? We asked her about the diet restrictions and as she described it in more detail like that of no cranberries and vitamin supplements, Kirsten and I both had kind of a déjà vu reaction that maybe once we had heard this before. In fact, I had enjoyed a couple of great spinach salads over the weekend. Turns out the vitamin K thickens your blood! But, like I said, your veggies never hurt no one. By this weekend, citing how much more active I seem to be than the usual patient (I am? oh good.) they had me drop the Coumadin and go to one regular aspirin a day. They also cut me free of the home health care. To boot I have dropped the crutches and have used a cane only for outside walks. Today I plan to walk without the cane as well. I'm sleeping ever better, according to Kirsten and, while still taking Lortab we are continually cutting it back. Without it I still get too uncomfortable to be very interested in walking. We're back in Torrey for 8 or 9 days so it is nice we don't need to go into the local clinic for a blood test. Finally, on the medical front, my blood pressure was slowly creeping back up, presumably from no bike riding and we went back to a half my formerly prescribed dose of Lisinopril. The BP obligingly dropped right back down. Still got the lovely surgical hose. Yesterday I drove for the first time, hose and all, just the mile into Torrey for a general store run. No problem including the new relative ease of getting in and out of the car.

The bills have started coming in. No drama, but I'm finally glad to have been paying those insurance premiums. The hospital, not including the surgeon or anesthesiologist was around $35k but the amazing thing is that the prosthesis alone was about $25k of that. Zowie.

Ramp up and down

Thanks for comments. I've hit a little bit of the recovery doldrums. Travel yesterday left me with a bit of a flat tire and I begged off on the Chicago concert last night. Kirsten went with 3 others for a girls' night out. Maybe I'm not the only curmudgeon.

One mile is the most I have walked at one time so far. The PT urges me to be walking more often instead of further. Given the relative comfort of doing that and my desire to get off the meds I think I will do that for another week or so. I walked .4 miles early this afternoon and will try to round it to a mile tonight. I've been completely off the oxycontin since Friday and have pared back the lortabs to 2 at bedtime then one every 5 hours or so. But even on that I took a long nap today that didn't feel very natural. Yet there is still a constant background pain. It's there but not too bad. K and I are going to try less Lortab during the day and see how that mixes with stepping up the mileage. I'm trying not to count days until no orthopedic stockings and the 90 degree restriction is lifted (20? 30?). The 90 degree is particularly tricky at my desk when I am already sitting quite upright with my feet on the floor and want to reach forward on the desk to get something. So far my hip is still in the socket. Separately, I think I'm getting close to being able to sleep on the incision side.

There is a minor mystery. Right after surgery the surgeon referred proudly to a 3 inch incision. The one on my hip looks like 8 to 10 inches. Makes me wonder if he mixed me up with someone else. The follow up visit with the surgeon is in two weeks. There will be X-rays which I hope to get copies of, just for a souvenir, and we'll discuss what incision was 3 inches. In the meanwhile I guess I'll have to give up on my bikini swimsuits.

The Stretch

Day 13. On Friday we went to a Diana Krall concert at Red Butte Garden with Doug and Dona et al. Doug took advantage of the Americans with Disabilities Act, to a minor extent, when we drove up to the gate and went in with two friends through the VIP/handicap entrance. The concert was sold out and the main gate line was a thousand people long waiting for the 6 o'clock gate opening. We went right through. Amazingly by 6:10 the main lawn was already full, but the wheel chair access is a cement strip all the way around the top of the lawn where there was plenty of room for my higher chair and for all of us. I sat, very comfortably, in a standard portable canvas sling chair. The opening act was a pleasant surprise, K and went for a walk between acts, then Diana crooned to us until about 10. Doug slickly parked the car nearby in the VIP lot so the walk out was short. Very smooth.

Saturday we got up to meet with some friends, pick up some books, get Sock-eye Salmon at the mini mart, back home to pack up and headed down to Torrey. By the time we got here, I was getting a bit tired. I'm tired, but care-giving is a maybe more of a strain than recovering. My nurse is coming out of a long Sunday afternoon nap as I write.

D and D came down to Torrey today. While they were driving down K and I went out, with my new Garmin 305 gps watch, for a desert stoll. K keeps singing, "If you're a nerd and you know it, check your watch . . ." We figured it might be about a half mile out to the neighbor house. I set out with two crutches then asked K to carry one on the way back. Even though the road is uneven dirt the walk was pretty easy. Sure enough, 1.02 miles round trip. Good thing I had the watch.

I'm weaning off the meds. In the morning my back hurts as much as anything, a pain I am familiar with and that I hope goes away as my new functioning hip kicks in. The 90 degree bending limit keeps me, in the meanwhile, from stretching out my leg and back the way I would like. But I don't need meds for that. So I quit the oxy as of Friday and going to half strength on the Lortabs. I imagine I'm off the Lortabs in a week. I can't take Ibuprofen or any other anti inflammatory while on blood thinner, so I will have to see how Tylenol does. Tylenol isn't usually much help, but the pain is diminishing fast enough.

I think I am in the middle phase where I am not yet better than I was before surgery but am getting better every day, slow but sure. There may not be much to report for awhile. Joe asked about the mental aspect. I feel happy and satisfied with how it is going, but with my usual impatience to get it done and be able to get back to normal workouts, no crutches, no toilet risers, no handicap parking, less dependent, able to sleep on my side, yada, yada. The stretch.