Doctor Eclectic

Doctor Eclectic
Doctor Eclectic

Thursday, October 10, 2013

Hip, Hip, Hooray!

similar to my right hip
Two weeks ago Wednesday I entered Saddleback Memorial Hospital at 1:00 PM for 3:00 PM surgery to replace my right hip.  Am I glad I had it done?  A definite yes!  Was it the “Sunday in the Park with George” experience, friends had suggested?  Not so much… It has, however given me some perspective on the procedure, elective surgery in general, and how the ACA may dramatically change our healthcare delivery system, some elements for the better.

I was definitely lacking in coping well with the three major adaptations involved in the procedure: loss of driving privilege and consequent dependency; change in sleep patterns, and change in routine.  My personal view is that the medical staff could have better prepared me for these before the procedures, which might have made for less stressful scheduling and smoother conditioning for my, euphemistically termed “Coach”.

Cobalt, Ceramic and Titanium
My recovery was complicated by a “bout with gout” that gave me serious pain in my right ankle, both knees, and my right big toe.  I have medication that is quite effective for my out and when I started taking that I rapidly got back to comfort in doing my exercises.  My goal for today is to use my walker, not for support as I walk, but for security, as I gain strength and balance to eventually move to a cane, and soon after, to normal, if cautious walking.

The first I learned about sleeping was at a class orientation where half of us were scheduled for hips and half for knees.  We hip people were shown tools to assist in dressing, eating and reaching, and our “wedge”;  a three-foot long by one-foot wide Styrofoam piece with Velcro straps that would be our new bed companion, for about four weeks.  Our old bed companion would soon find better accommodations, since sleeping exclusively on my back brings out the snoring in me.  The second night was the worst since Mary, now on the fourth level couldn't hear my cries for assistance.  She solved the problem the next night by adding a night light to help me orient myself, and by retrieving the Bosn’s pipe I used to call our children in for supper when they were young.

Last night for all intents and purposes I slept through the night, with no need to get up.  And I have adapted well to the changes in my routine.  Much of what I do is virtual, from home, on the computer with a few exceptions.  On the day of surgery one of those exceptions came in the form of a call from my agent for a CarMax commercial in LA.  The 11:30 audition didn’t fit with the 1:00 PM procedure and my agent seemed ok with that.  The next day, however, I got a callback for a Hyatt commercial.  I let them know I could make the shoot, but not the callback and asked for a reschedule.  Didn’t happen…

That experience made me realize how much the driving thing would affect my routine.  I usually try to go to my consulting job (about 50 miles away) once a week, although there is no contract or requirement to do so.  The commercial thing is another matter and to have Mary drive me for three hours for a 5-minute audition is unfair to her.  The driving she does with me as a passenger is predicted to be a month, although I’m hopeful for acceleration.  It has been mostly for social, with a couple exceptions: my driver’s license yesterday, a haircut on Tuesday, and some shopping, masquerading as Physical Therapy.

The vagueness of predicting of how long I will be a dependent passenger is understandable since the starting point of the patient varies significantly, as does the procedure, appliance, and recuperation from doctor to doctor, but I would think that planning the timing of an elective procedure should take into account the availability of the caregiver for an anticipated length of time.

Which brings me to one of my observations: I had no idea of the number of knees replaced in a year in the U.S. (about 600,000, with an almost equal number of knees).  I had been told that the procedure is bankrupting Medicare as people live longer and have desire, and perhaps productive need to have the procedure.  Cost containment has directed post-surgical home visits and disallows one I think would be cost effective: i.e., a pre-surgical visit my a Physical Therapist to the site of recovery, where one’s routine and environment could prepare the patient for recovery.  Even if this had to be paid for by the patient, it would be money well spent.

Perhaps this could be a Silver or Gold upgrade under the ACA.

My experience prompted me to look into what exists in books to prepare.  Most are very technical and I ordered two to read on my iPad.  I might write a book if I find a good illustrator.  The working title is, “Grandpa got a new hip, and boy, are we glad!”  But that will wait as my monthly Writer’s Club meeting on Friday complicates tickets we have to see Bernadette Peters.

There is a film opening soon called, The Fifth Estate, which reminded me that the Fourth Estate was very important to me in college.  Read my next Post to see what is the Fifth Estate and why we should shake the dust off from our notions of how important are the influential processes of our government.

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