Sunday, February 28, 2010

Home Alone

Last night, for a period of several hours, i was at home alone. This ostensibly unremarkable occurrence was in fact so rare that i cannot remember the last time it happened. Of course, i have been alone at night on road trips, and i have been at home alone during the day (as i was recently after my surgery). But i honestly can't remember the last time that i was alone during the evening hours in my own house. (Note: I am callously discounting the presence of our chihuahua in my definition of alone)

This situation required an unlikely alignment of the planets. First, my younger son had a sleep-over for a friend's birthday party. My older son was at his girlfriend's parents' house (not unusual), and my wife was out with friends. I suspect that such situations will occur more frequently, especially when my younger son gets to high school.

Lest this sound pathetic, i must aver that i am quite good at being alone. I had complete control over the television, so I watched Inglorious Basterds on-demand, without having to filter out any of the extraneous background conversations that are typical of a house with teenagers and proto-teens. I did not have to share the computer, and i could turn the sound up and listen to fragments of songs on last.fm without piano or cello or violin or Iron Chef America in the mix. i could even read a book in my living room. It probably would have been more enjoyable were i able to open a bottle of wine (doesn't mix with my blood-thinners), and if i could move from place to place without my cane, but i'll take what i can get.

In my current job, i work almost entirely with people in their 20s, and i am often struck by the radical differences in our lives, of which they of course have no knowledge. Probably 80% of the interesting things in my life, both good and bad, occurred after 30. Many of my coworkers, i would guess, spend evenings alone on occasion and they probably either take it for granted or desperately try to avoid it. I suppose "wisdom" is the label we give to the difference between our expectations at 25 and our reality at 50. I wonder if there is the same dichotomy between 50 and 75.

Monday, February 15, 2010

My First Week as a Cyborg

Today is one week since my hip replacement surgery. At this point i can walk fairly well with a walker and my pain is minimal. I actually managed to get up (and down) my driveway this afternoon with my physical therapist. That was encouraging because going up and down inclines prior to my surgery was very painful. My leg is still pretty swollen and the area around my incision is so stiff that it feels kind of like i have a 2x4 taped to my thigh.

The surgery last Monday went fairly well, although it started later than it was supposed to. Surgery is sort of a 5-phase process. There's pre-op where they get you into an embarrassing gown and nifty socks, set you up with an IV, take your vitals, shave appropriate areas etc. Pre-op has this monitor with all of the on-going surgeries, like flight departures at the airport except it doesn't update to show you delays.

After pre-op is another staging area, where multiple people come around and ask about your medical history, and they mark the area for surgery so that there's general agreement about what's being done. This is also where you consult with the anesthesiologist. In my case, she recommended a spinal, which basically means that your lower half is completely turned off, so they give you an extra sedative to keep you in a medium sleep.

Next they take you to the actual operating room. Here they administer the initial anesthetic (spinals feel really strange), transfer you to the operating table, and knock you out. If you're lucky (as i was) that's the last thing you'll remember. I don't really remember much about the operating room. It was larger than i expected, almost like a classroom. My x-rays were on one wall. There were several people there when i was rolled in, but not the surgeon.

After the surgery, there's a post-op area (although that's not what they call it). I'm not really sure how long i was there. I woke up there, and was still pleasantly morphined. I can remember being in the room, with other patients and a few nurses, but i'm vague on what they actually did in this room.

Finally, they take you to a regular hospital room. I was catheterized and had a blood drain connected to my incision, but i didn't feel too terrible. I think it was around 2 in the afternoon at this point, but i'm only sure that there was still daylight. I was happy to find that i had no post-operative nausea, but i kept expecting it, even after i ate dinner.

I made it through the first night, and at 10am on Tuesday the physical therapist arrived to help me stand and walk for the first time with a walker. It was fairly hard, but i still had some morphine in my system so that helped. I managed a full lap around the hospital floor, which is apparently unusual. I did another lap later in the day with an occupational therapist, and finally made another excursion in the afternoon.

I was originally expected to go home on Wednesday, but because i had shown good progress they arranged for me to go home Tuesday night. The first couple of days at home were a bit tough (on me and my family). All of the biomechanical processes of standing, sitting, lying down, etc. are pretty tough. It hard to get from place to place with a walker, and you can't really carry anything with you.

So far, i've been really lucky. I never had any post-op nausea, and i haven't had any bad reactions to the Vicodin i take for pain, or the blood thinners i have to inject myself with every day. I've had a decent appetite, and i haven't had any problem with infections or fevers. My physical progress is encouraging and i get a bit more mobile every day. I'm hoping that this week will show as much progress.

Friday, February 05, 2010

Pre-Op

I'm trying to get away from the litany of woe that this blog has become, but i can't think of a way to put a cheerful spin on my impending surgery. I am about 2 days away from the event now. I look forward to an end to the irritating pain that has accompanied my every move for the last year, but it's difficult to accept that i will never run another marathon, never spend another Sunday afternoon running down some trail, never fight another sparring match, never play another pick-up game at some random basketball court.

I'm trying to focus more on what i can do. I'm thinking that i will try swimming. There's a good master's program in the community in which i live, and i've started to identify events that i can train for in the future (the Alcatraz swim is intriguing). I probably won't be able to spar in the style that i've become accustomed to, but i think this might be an opportunity to work on boxing. I hope to be able to revive my interest in backpacking, since at least the long walks will get me into the same territory where i would previously have run.

The remainder of this month is probably going to suck. I'll be in the hospital for a few days, followed by physical therapy and daily nurse visits for a while. I have to take blood thinners for 3 weeks after surgery. I've never had a general anesthetic and i don't really know what the aftermath will be like. I cling to the idea that in a month i will be essentially normal, except that i will have entered a new phase of life in which certain activities are no longer an option.

Probably the worst part of these weeks leading up to the surgery has been the sense of isolation. I've always had relatively few people in my life that i could have meaningful conversations with about things that are important to me. There are not that many people who have both an intellectual side and also understand the compulsion to run long distances, or the desire to fight, or even the general notion of taking on physical challenges. There are even fewer people with those qualities who have had to accept giving up all or some of it. Strangely, my current workplace is the first where there are several people who run or do other endurance events. When i hear people talking about doing a half-marathon or running a trail, i get this indescribable sense of being outside of their world, looking in. I imagine that it's like being a ghost.

The nurse at my orthopedic surgeon's office said that i might be the healthiest person for whom they've ever done a hip replacement. I take some comfort in this. A doctor acquaintance once told me "we know how to fix joints, but we don't know how to fix hearts". He meant that people should be more concerned about the damage done by lack of exercise than potential wear and tear to joints (though the inability to fix broken hearts applies in the more poetic sense as well). So, while i'm bummed about the limitations imposed by having an artificial hip, i'm also well aware that far worse things can happen.