Morphine

Recovery from this surgery has been the worst by far.

The last few days since I left the hospital have been really tough.  They gave me a slow-release morphine pill when I was in the hospital to help with the pain.  I was never quite sure how much it was doing, but I felt pretty good on Wednesday when I left.  On the way home, I felt good enough to eat at my favorite restaurant (Firebirds Grill) while we waited for CVS to fill my prescription order.

When I got home, I took some of the new pain drugs we just got, which should be the same ones I was taking at the hospital, and I went to bed for 4 hours.  When I got up, I thought I was dying.  My mouth was so aggressively dry that it almost unendurable.  I know what you're thinking: "His mouth was a little dry?  That doesn't sound so bad."  Have you ever heard of the cinnamon challenge.  It feels roughly like that.

So I drank some water and calmed down, and then I transferred to the wheelchair so I could go pee.  That went okay, but by the time I was ready to transfer back into bed, I felt so weak and light-headed, I didn't think I could continue sitting up, and I definitely didn't trust myself to do the transfer into bed.  We ended up using a slide board to do the transfer so I didn't have to support my weight.  I haven't used that since rehab over a year ago.

When I got in bed, I felt completely terrible.  Weak and light-headed and just awful.  I wasn't sure what my blood pressure was, but I felt it might be dangerously low.  I couldn't find my pulse which has never been a problem.  Eventually, I decided to call the paramedics to come measure my blood pressure.

While I was waiting for the paramedics, I decided to use my fancy adjustable bed to elevate my feet, and my mom had the idea to use my fancy air-pumped leg squeezers to try to squeeze blood up toward my heard.  I think that worked, and by the time the medics arrived, I was feeling a lot better.  When they measured my BP, it was in a pretty good range, but I would love to know what it had been.

The paramedics said that both the dry-mouth and the weird feeling could be caused by the morphine, so I decided to stop it cold-turkey.  The pain would be better than the side-effects.  So I stopped all pain meds on Wednesday night.

The problem with slow-release pain meds is that they don't leave your system just because you stopped taking them. It is now Friday evening, and I think I'm still feeling some of the after effects of the morphine.  I think I have a morphine hangover.  I haven't been out of bed in two whole days, and the dry-mouth, while improving, is still a problem.  The lightheaded feeling is better, but still present, and the pain has slowly been returning.  Turns out the morphine was doing a lot about the pain.  In general, I feel horrible, but I don't regret stopping the morphine... yet.

I'm so glad my mom has been here.  I don't think I could do this without her.  She has allowed me to stay in bed by bringing me everything I need when I need it.  Without her, I would have had to transfer out of bed every 4 hours at least to pee.  I don't think I could have done it.

In the next hour or so, I'm going to attempt to get out of bed and into the wheelchair.  I have no idea how it's going to go, but I'm looking forward to trying it.  I think the pain is going to be a problem, but I also think I'm going to have to either suck it up or go back on the morphine.  It would have to be incredibly bad for that to happen.  I don't ever want to take morphine again.

Surgery Report

HO Surgery number 3 is in the books, and I got to keep the leg.  As I lay here in my hospital bed the day after surgery, I feel like I should post an update.

I was able to talk to Dr. Dahners before the surgery, and explain my concerns about what I wanted to remove.  We agreed that he would try to get all the pieces.

The last 2 HO surgeries have caused relatively little pain for me, but I think I have been steadily regaining a small amount of sensation in my right hip.  It's what has allowed me to feel pain from the HO, and after this surgery, I was in agony.  A day after surgery, I'm still very reluctant to try to move this hip at all.  I doubt it will damage anything, but it hurts really really bad.

I talked to Dr. Dahners this morning, and he told me he thinks he was able to remove all of the bone we talked about.  I had been wondering since the first surgery what sort of tools he uses to cut bone, so I asked him.  Hammer and chisel is the answer.  That would explain the pain.  I wish I could get another CT scan to confirm the results, but he says he tested the range on the OR table and it was in the 125-130 degree range.  That's all I could ask for.

I lost a lot of blood in the operation.  When he removed the piece attached to the femur, it cut a lot of blood vessels.  I ended up losing 900cc of blood which is about a quart.  So twice what you would give to the Red Cross.  They wanted to avoid giving me a transfusion because it increases the risk of complications, so I've been very tired today.  My blood pressure has been coming up slowly over the last day.  Right after surgery, it was at about 84/43.  It's now up to around 89/47, but that's still really low.  So I get light-headed whenever I exert myself at all, but the pain has been keeping me from exerting myself.

I know they are going to send me a physical therapist tomorrow morning to evaluate my strength and mobility.  I'm expecting to go home tomorrow, but it will be interesting to see how that happens.

If this post seems a little loopy, it's because I have been taking the narcotics this time.  The past two surgeries, I was able to avoid the good stuff, but this time, I'm taking whatever they offer me.  So far it has been Oxycodone and a slow release morphine pill.  The morphine particularly helps, but it makes me a little loopy.  Tired mostly.

Mom and I are getting pretty good at this surgery thing.  We have gotten really good at packing for these short hospital stays, and really good at remembering what to ask for and when.  If you ever need to go in for a surgery that will result in a night or 2 in the hospital, I can help you out.  For instance, bring ear plugs.  It can make all the difference in letting you sleep at night.  Also, bring your own pillow.  Hospital pillows are made of plastic for easy cleanup, but that makes them as uncomfortable and sweaty as they could possibly be.

I'll probably be going home tomorrow, but it will be interesting to see how active I'll be when I get there.  I'm taking some of these drugs home with me, and I may end up sleeping the rest of the week.  I guess it just all depends on how quickly the pain subsides.

CT Scan

I got my hands on the CT scan on Friday, and it's pretty fascinating.  If you come over, you should ask to see it.  Anyway, here is the picture that is most relevant to what we're doing with this surgery today.  It is from the side.

CT scan

So the part circled in red is in front of my pelvic bone, and the part circled in green is attached to the front of my femur.  When I bend my hip, those pieces of bone approach each other and crush all the muscle that is between them.

Dr. Dahners believes the part in green is what is causing the bulk of my problems, but it's deep inside and near a big artery so it will be dangrous to go after.  I think he's willing to try it, but if he messes up, I could end up losing the leg.  I hope that doesn't happen, but I think it's worth the risk

Adventure Time

I have surgery this coming Monday to remove some bone in my right hip that Dr. Dahners thinks may be impacting my range of motion.

In recent days, I have been thinking that range of motion is not my only problem in that hip.  I also have a lot of pain, and it's possible that the pain is not caused by the same bone that is causing the range of motion issues.  Unfortunately, I don't know what is actually going on in there because when I met with Dr. Dahners a week ago, I failed to ask to see the CT scan myself.  Before they cut on me for the 3rd time, I'd like to ask an intelligent question or two about what they are going to cut and what they will leave.  But I can't do that unless I can see the CT scan.

I can get a copy of the CT scan at the hospital.  I just have to get there.  I don't know many people who can help me during a work day.  Tobi was at orientation for a college course she is starting, Gus was helping a neighbor with something all day yesterday so I found myself with an entire day to kill and only one thing I really wanted to do.

I have car I can drive.  There isn't a step in the process I haven't done before.  The more I thought about it, the more excited I got.  Eventually I realized that if I didn't try it, I would regret it.  And so I decided it was time to have an adventure.

First I had to plan.  What are the steps in the plan, and what can go wrong?

1.) Transfer into the car in my parking garage.  First I have to get to the car.  As long as my neighbor is at work, I should be able to get to the driver's door.  I've done a ton of car transfers.  They aren't the easiest, but I think I'm getting pretty good at them by now.  I have to get the wheelchair parts in.  I've proven a couple times that I can do it.  It's really hard, and one of the pieces could roll away where I can't reach it.  If that happens, I'll have to call somebody to come fetch it.  I don't really think that will happen, but I have the number of the Palmisanos across the hall.  They're elderly, but they could probably come wrangle a wheel if I screw up badly enough.  I will also need to check the fuel level.  As long as it's more than a quarter of a tank, I should be fine, but I'm not going to want to take it to a gas station.  That would require an extra pair of car transfers, and I'm not even sure I have the skills to pump gas yet.  That would be a deal breaker.

2.) Drive to the hospital.  It's about a half-hour on the road.  It's the middle of the day so there shouldn't be much traffic.  After trying them out, I'm not really worried about the hand controls.  They are pretty easy to use and pretty intuitive.  I'm slightly concerned that I still have Cullen's license plate on the car, but I can put my new tag in my backpack in case there is a problem.  But there shouldn't be a problem.

3.) Park at the hospital.  There is a handicapped parking lot right in front of the hospital, but I don't think most of the parking spaces have access reserved on the sides of the car.  That makes it fairly useless for me so I'll probably have to park in the parking garage.  The handicapped parking spaces in the garage should be level so transferring out of the car should be about as easy as it gets.  And there are always a ton of people around so if I get in trouble, I can probably flag down a pedestrian.

4.) Roll into the hospital.  I've been in the hospital many times so the only obstacle I'm worried about is the bridge from the garage to the hospital.  It is sloped, and while getting down it is easy, it might be too steep to get back up.  But again, there are always a ton of people around, and people who are generally sympathetic to people in wheelchairs, so I bet somebody will offer help before I get desperate enough to ask.

5.) Return home.  The return trip should just be the reverse of what I've already done.

6.) Park at home.  Depending on what time I get home, my neighbor could be home from work with his car occupying the parking space that I need to use to disembark.  But if that happens, there are some handicapped spaces near the building that I can use.  That shouldn't be a problem.

Once I broke it down into steps, it seemed even more doable.  I knew I would get physically tired from the car transfers, but there should only be 4 of them and I had all day to do them.  When I got home, I could sleep for the rest of the day.

By the time I had formulated my plan and packed up the pills and supplies I might need for a long outing, it was 11:00.  Still plenty of time.  The weather was excellent, and I was excited to get started.  It was the most exciting thing I'd done in a long time.

When I got to the parking garage, I was relieved to see that my neighbor's car was gone so I could access the door.

I put the keys and my phone in the map pocket on the door as I usually do when getting into a car, and I tossed my backpack in.  The transfer into the driver's seat went fine.  Once I got in, I started the car to check the fuel level.  It was less than 1/8th of a tank.  Not nearly enough to make the trip.  But I had spent too much time mentally preparing for an adventure, and I'm a problem solver.  I wasn't ready for the adventure to end before it started.

So I came up with a plan.  I would ask Mr. Palmisano, my elderly neighbor, to ride with me to the gas station across the street and pump my gas.  I'm not even sure the Palmisanos are home, and this request seems like something best explained in person, so I decided to just roll back upstairs and knock on the door.

So I transferred back to the wheelchair.  Midway through the transfer, I realized something wasn't right.  I had lost momentum halfway between the car seat and the chair seat, and found myself stopped directly in between.  I tried again to muscle myself at least partway onto the wheelchair seat which is how a lot of my sloppier transfers end, but for some reason I couldn't get any closer.  I looked down to see if I could figure out what was hanging me up, and... shit.  My left knee was hopelessly jammed in between the front legs of the wheelchair.  I tried to go backwards into the car, but the hand holds I had chosen meant I couldn't push that direction.  I couldn't go forward, and I couldn't go back. It took me a long moment to accept it, but I was going down.

Since my injury over a year ago, I have never fallen out of the wheelchair.  That's good because I don't have the skills or the strength to transfer off the floor.  I haven't even tried it since rehab.  I had always assumed that my first fall would be in my apartment, but that would not be the case.

I was still dangling, mid-transfer, between the car and the chair, but I knew I couldn't stay there for long.  My strength was going to give out any second, and I thought I should probably try to lower myself as gently as possible before weakness dictated an uglier landing.  My biggest concern was the awkward position of my left leg.  I was going to end up sitting on it while it was tangled up in the wheelchair.  I was hoping the position wouldn't be so awkward that I would injure it when my weight came down, but there wasn't really anything I could do about it so I just tried to make sure it happened slowly.

When I got to the ground, it seemed like my left leg wasn't too awkward underneath me, but I was still sitting on my bare ankle which was directly on some very abrasive concrete.  My right foot was still in the car which was probably more awkward than the left leg.  Fortunately I had saved enough strength that I was able to wiggle myself out of the chair and get my right foot free of the car.

If you're looking for something unpleasant to do, try rolling around on the ground in a parking lot.  At least the concrete was dry and relatively clean.  It would have been really unpleasant in a McDonald's lot.  Imagine if there was broken glass or a spilled milk shake.

After all my struggling, I found myself seated on the ground next to my car.  This scenario was not something I had planned for.  I was not supposed to screw up a simple car transfer.

The parking garage was empty.  Fortunately the map pocket where I put my phone was within reach, so I could call for help, but who to call?  I needed was somebody who could physically lift me up and put me in the wheelchair.  The Palmisanos were never going to manage it.  Pretty much everyone I know was at work, and even if I could find somebody to come get me, it would probably take them at least 15 minutes to arrive, and that's if they could drop what they were doing.  Mosquitoes swarm in my building's parking deck, and I wondered if I would have any blood left by the time someone got to me.

Then I had an epiphany.  I recently made friends with the maintenance guy that works in the complex.  He's friendly and strong, and he has a golf cart so he can get here quickly.  So I called Katie at the front office and explained the situation, and she radioed Brett, and he arrived in seconds.

So my adventure did not end the way I had hoped, but if you know how it's going to turn out, it's not really an adventure, is it?  I don't regret it at all.  What did I get out of it, you ask?

• Excitement!  It felt really good to be really excited about something.  And when things didn't go right, that was exciting too.
• Pride.  I'm pretty proud of myself for figuring out a solution to my problem.
• Knowledge.  I learned that I'm not quite ready to drive on my own.  I learned a good way to really screw up a car transfer, and I doubt I'll make that same mistake again.
• Confidence.  It seems counter-intuitive, but I tried something, it went very wrong, and I survived.  Maybe I should try more stuff.
• Interesting stuff to write about.  Usually I have to force myself to write a blog entry.  I wrote this one at 5:30 AM when I really should be sleeping.

What I did not get out of the experience is the CT scan that I wanted from the hospital.  Anybody want to take me on Friday?  Update: I have located a ride to the hospital on Friday.  Thanks, Brittany!

More Surgery

It is once again time to throw some text at my blog and see what sticks.  Here we go.

I went to see Dr. Dahners last week.  I got a new CT scan of my hips, and he thinks he can see some bone in my right hip that it should help to remove.  Therefore, we have scheduled more surgery for August 26th.  My mom will once again be visiting to help me in the first week of recovery.  I hope it helps with my range of motion, but I really hope it helps with the pain.  My right hip hurts a lot lately.  I'm encouraged that the area he suggested cutting on is close to where most of the pain is, so I'll keep my fingers crossed.

I've been seeing an Occupational Therapist on a weekly basis for my thumb/wrist.  I think it's a little better, but still a concern.  I'm also dealing with pain in my back where they put the metal rods near my spine.  Since I've been moving my back around more and arching my back when sleeping on my front, I can feel the rods poking me more.  It does not feel good.  Just another thing to try to figure out.

My van is back in operation.  It was down for several weeks, and it's fortunate that it died at a time when I had enough flexibility to get into a car.  It's also fortunate that Cullen had a car I could use in the meantime.  We have started calling that car The Raspberry, and I'm currently working on buying it from Cullen.  Oh, and look what I did with it today.

I just did a few laps around the parking lot, and I still need to figure some things out to make it safe in traffic.  I also need a lot of practice with car transfers and getting the chair in and out of the car, but overall, things went really well.  I hope to own this car by the end of the week and be menacing the highways of North Carolina within the next month.  Maybe sooner.