New Hip in Japan

Since my return to Japan on Nov 15th, it was clear that my life was going to be different, and improved.

- My daughter was more active and mobile, pushing me to push myself to keep up with her.

- I was relatively pain free (hip-wise) in my daily activities, and felt more motivated to get out and do something.

- The crutches were quickly becoming an afterthought. In fact, I gave them up at home after a week altogether, used a cane for about two weeks and since Xmas have been cane-less.

- I wasn't struggling to stand up from couch, chair, or even the floor.

- I was gaining muscle mass (and unfortunately flab), because of increased swimming and stationary biking (and unfortunately appetite).

The biggest early drawback was trying to limit myself from doing something too much too soon.

- My daughter is right on the borderline of what your are supposed to lift (20lbs).

- I found myself at times nearly running to catch trains (I should wait until April for that).

- Carrying a backpack with laptop was harder on my back than my hip.

Unfortunately, I became quite ill for 8 days from 28 November through 6 December. I had some sort of GI virus (not a flu virus) that literally kept me in bed or on the toilet for 6 straight days. The Japanese GI specialist I saw felt that my recent operation may have left my immune system a bit weaker. I ended up taking antibiotics, and some 'good bacteria' powder (biofirm) like the stuff they put in yogurt to help your gut recolonize the beneficial E. coli. I've come to realize that antibiotics (whose frequent use I oppose) may be a reality in my future because of my implant. I have to get antibiotics whenever I get dental work done or other invasive medical work.

The upshot of my stomach 'cold', as the doctor put it, was that it set my recovery back a week or more - as I couldn't do my stretching exercises, swim or bike. And I think I regressed a bit in flexibility. Worse, I had just located an American PT specialist on base, and the illness postponed my PT plans into the holidays - when I wasn't able to sign up. At this writing I still haven't set up a PT session and will have to get a new prescription to do so. My job and lab responsibilities have also increased, giving me less available free time, other than for exercises.

At present, I feel I'm close to being where I should be - my leg strength improves daily - but I'm still frustrated by my flexibility. Worse, I'm starting to feel stiffness and some soreness after sitting for long periods in a variety of chairs - finding that I limp more than I thought I did previously. I'm unsure if this is a result of poor posture, bad furniture, or just the recovery of feeling in my operated hip. It makes me want to sit less, but it also makes me question my progress and lack of initiative on signing up for PT.

So, I still have no regrets for having my hip replaced - the pain relief alone is amazing. I'm only disappointed a bit in my perceived lack of progress in rehab. Yet, I still had a mobile holiday that I could only have dreamed of a year ago.

Ganbaremasu!

Midwestern Crawl

More Progress
I had a quick check up at Dr. Su's office on 1 November - nearly 2 weeks postop. The Xray was good, I was told to walk with one crutch while indoors. I used one crutch for the first time right there in the examination room. I was surprised how easy it was. The doc also cleared me to fly out to Detroit for 7 days minimum, and even indicated I could fly back to Japan after that.
I did my last PT at the Joint Mobility Center the next morning before I left for Detroit, and really surprised my therapist with my progress. She didn't see me the day prior, and didn't think I was able to walk on one crutch. My session was a bit rushed, because of the flight time in the afternoon - but everything went well. I got a big smile and a Tshirt from the staff.

Escape from NY
I flew out of Laguardia airport, and had wheel chair service get me to the plane. This was a good idea, as I got through security more quickly and didn't have to stand for long periods in line. I wasn't able to walk through the detector at all with out a crutch, so they frisked me. The TCA guard that did the frisking was very nice, and not pushy at all. I don't think the scanner picked up my implant - but it wasn't a big deal. The worst part was after they delivered me to the gate - no help after that - mostly because I was there an hour in advance. The flight was delayed an hour, and when they let handicaps and 1st class people in - I couldn't get to the front of the line. The gate attendant told me I should have shoved people out of the way. This wasn't really easy with two crutches under one arm and pulling my wheelie carryon with the other.

This was a NWA flight on a 757. They helped me get to my seat, but there wasn't any real space in front of it. When I explained I was supposed to get a bulkhead seat - they claimed this was it. It was a row behind first class and seemed to have a bit more legroom. The worst part of boarding the plane was it took 45 minutes to complete it! This was made worse by the attendants making people stow their carryons in places other than above their seats. In Japan, a plane this size gets boarded in 15 minutes or so. Maybe NYers are slow, but I have a feeling it was the attendents' fault. Unbelievable.

At Detroit airport, the wheelchair service was great, but they had one guy take two of us at the same time. We had to use several elevators, and a train (12 minutes or so) to get to baggage claim. I was surprised that there were no tag checkers of bags in Detroit - but I got my bags. My mother, uncle and aunt were there to meet me - so it was easy after that. Perhaps the strangest thing at that point was traveling in a passenger car not driven by a cabbie.

Slow Life with Benefits
I stayed with my sister in Temperance, Michigan since then with a couple of trips to my home town in NW Ohio, and my brother's place in Cleveland. Both drives were 1-2 hours, but I had no problems. The embolism socks were used, but I feel they aren't necessary. My sister got hold of a stationary bike from a friend, so I was able to use that as part of my PT. It was a normal crank size, and I had no pain at all! Again, a marked point of progress. I've been doing 10-15 minutes biking each day and all my PT stretches using the bench on my sister's wooden deck. This was pretty good, and the weather usually was unseasonably warm. Over the course of the last 10 days, my bridging and all leg lifts have become extraordinarily easy. I even found I could lift my operated leg while lying on my back - and can now raise it 30° up to 11 times in sequence. I could barely lift it at all in NY. I also found that I was rolling over on both sides in the bed with little or no pain, and even slept on my operated side without realizing it. The most stunning change was standing up and walking without the crutch. This began maybe 4 days ago, and I don't do it on purpose. I usually catch myself and get the crutch right away. There isn't any pain at all, so I'm very pleased. I'll be a good boy and use the crutch for the whole 6 weeks post op, like the doctor says.

My right hip seems to be improving visually as well. The bruising is gone, and the incision is fairly clean. I measured it the other day and it seems to be about 8 inches long. This doesn't bother me a bit, though others might not like it. I can feel some of the stitching - they feel like 1 pound test monofilament fishing line. Although they are supposed to disintegrate and dissolve - it seems they are still there. I caught one knotted end on my pants and it yanked out. Ouch! It also itches at times - but it could be worse I suppose.

The only thing I really wish I could change is the diet here. It's too meaty and all available drinks (except water) are sweetened. I bet I've gained a couple pounds here. I also found myself being more sedentary than I liked, except for a long trip to the shopping mall where I walked quite a bit. I thought perhaps this was related to the vicodan - making me drowsy or lazy. However, this isn't likely; I stopped taking it so frequently, down to 3-4 times a day instead of 8.

Back into the Fray
I'd hoped to do a little traveling before returning to NYC, and even toyed with the idea of visiting my friend in upstate New York. But I became a bit apathetic, and also realized I could only go via a one stop flight. This, and the concern I would be imposing on others made me realize I should just stay at my sisters and return to NYC the day before I wanted to return to Japan.

Before I left NYC, I made tentative arrangements to come back to see the Doc one day before flying back to Japan. To accommodate the MD's schedule we scheduled an appointment for 13 November. My week of lethargy in Michigan pretty much made it clear to me that I needed to get back home to my family. Making the flight arrangements back to Japan was a piece of cake, and after waiting for my sister's schedule to gel - I was able to get the the first flight out of Detroit to NYC tomorrow morning. I have to say I'm a bit pensive. I'm eager to get out of here, but not real thrilled to go through another day in NYC.

Hopefully, there will be no complications in my checkup, and I'll be on my way on Wednesday. :-)

It's the little things...

All this fanfare about Apple's new Leopard OS (10.5) has not moved me one iota. I suppose with all the time on my hands I could wrestle with installation on my ancient G4 PB, but I'd rather spend my time writing about other stuff.

Signs of Progress
My last couple of day have been interesting, as I find myself doing things (or trying to do them) that I haven't been able to. I sat up in bed two days ago, without realizing it was the first time without help. I stand on my two feet without a crutch or pushing up with my arms. I turn over on one side in bed, sometimes stopped by pain. I bend over to scratch my lower legs. I've even caught myself trying to take steps without crutches. Although I'm unconsciously pushing my limits, I sort of know I'm not there yet. I've found myself trying things first, then later asking my mother for help if I've failed. But putting on shoes is completely beyond me at this point.

On my own two feet
My reliance upon my mother for things hasn't bothered me much, and she's been good about letting me give things a go first before helping out. We took a nice walk out to the East river yesterday, and I was surprised at my endurance. I took a short video for my daughter, and was pleasantly surprised that I look pretty good.

Unfortunately, I won't have the luxury of her further presence here in NYC. I'm on my own! My grandfather passed away this morning, and mom had to fly back to Ohio to take care of my grandmother and other matters. He was very old, bed-ridden, and not very lucid. But he's in a nursing home and the impression was that he was stable. So my mother felt it would be OK to be here with me, despite complaints from my grandmother that her own needs were ignored. Now I know my mom is dealing with unwarranted guilt issues.

So, I'll continue here in NYC and hope I'm can progress to the point where I can be cleared to leave and attend a funeral. I'm not so close to my grandparents, so the death isn't affecting me as much. I need to focus on my recovery at this point, and if they need me I'll see if I can fly out.

I decided to show myself I can survive, so I somehow got my socks on (woohoo!) and slipped into my open back sandals to get some fresh air. I lumbered about 3 blocks to a deli, got some fruit salad and broccoli chicken, and returned to the Belaire. Folks were very nice about opening doors for me, and I didn't have any major problems. This was a big confidence builder.

OK, leftovers tonight, and PT tomorrow. One step at a time.

Post Op Shop II

Since my last post, things have progressed quite a bit. I remained in the hospital room until yesterday (24 October) noon. This was one day longer than I expected, but mostly due to tiredness.

Crutchety Old Man
On 23 October, the PT person got me out of bed and on crutches for the first time. Crutch use isn't as difficult as you might think, but it takes lots of arm strength - more than I expected. Crutch use mimics the walker - move both crutches forward, then bad leg, and good leg. Though tough at first, I was able to go all the way down the hall to the PT room (~20 meters). Once there, I rested a bit and was then tempted with a short set of stairs (5 steps). I decided to give it a go and was able to go up and down with effort. Up with the good leg, down with the bad leg - that's the mantra for doing stairs. You use only one crutch, and one rail - lots of arm strength again. After stairs, I crutched back down the hall to my room.

Holy Crap
I was able to repeat the crutch feat later in the afternoon - around 2:40pm. But before that I had an ordeal the likes I had never expected when I had to have my first bowel movement. Often after surgery, you are dehydrated and the cocktail of drugs they give you leaves you constipated. When mother nature paid a visit to me, I had to wait 15 minutes before a nurse could help me to the commode. Then when I got there, the urge to go was great - but so was the pain. I had to make a lot of effort, then was scolded by the floor nurse in the middle of it. They were worried I would pass out. Well, after assuring them I would just 'let it happen', I was able to finish. The pain was excruciating, and I was exhausted. And it was embarrassing to have a nurse tech clean me up after. Aaagh! Perhaps this was worse than catheter removal.

Night to Forget
I had hoped to be discharged on the evening of the 23rd, but the constipation episode wore me out. I felt I could use the extra rest and attention. Unfortunately, the nursing staff was not particularly cooperative or quiet that night. I couldn't get pain pills when I wanted, and they bothered me when I was trying to sleep or nap on several locations. Perhaps this was a sign that they wanted me gone. :-) But more likely that they had a very busy night shift.

Discharge
There was no doubt in my mind I needed to leave when I woke up on the 24th. I was tired of asking nurses to do everything (and impatient), and weary of my surroundings (except the great river view). My mother had already checked into the Belaire (hospital's hotel) and it sounded nice. Perhaps the thing that propelled me most was what I saw in the mirror when I got to the bathroom. After 5 days I desperately needed a shave, and my skin was very red around my beard where my eczema (dermatitis) often flares up.

The PT people came around again to confirm my first outpatient appointment, and even arranged for a sales person to come by with a 'reacher' - a device that helps you grab or pick up objects beyond your range of movement. I had one more PT session at 11am to practice crutches and stairs, then signed the paperwork for discharge. I had to agree to only take the prescribed medications (vicodan and enteric aspirin), and a number of other physician mandated restrictions. Then at noon, I said goodbye to my urine bottle and room, while a nice, tall blonde Russian girl wheeled me to the Belaire.

Reality Bites
Once in our 6 floor 1 bedroom apartment, it became clear that home life was not going to be a piece of cake. This realization came crashing down on me soon after I had entered the room. Although this hotel is run by HSS for families of patients needing extended care, it seems to lack things required by disabled or recovering patients like myself. No elevated toilet seat or chairs, low sofas, and a too soft bed. I can't really complain, as this will get paid for by someone else eventually. But you would think they'd pay more attention to needs of the disabled.

I also found that things are quite different when you aren't flat on your back in a hospital bed. You have to walk to the bathroom, stand while washing, move several meters to bed, chair, couch, etc. on crutches. If you change clothes (or pull up your pants), you have to use the reacher (or get some help). Fortunately, my mother helped me with many things, including going out to get meals, cleaning clothes, pushing chairs, picking up dropped items, reaching hard to reach places, lifting my operated leg, etc. Hell, I can't even get to the phones from the couch or bed in a few seconds.

Wow. If I was alone somewhere, I'd never make it after release from the hospital. Now I understand why hospitals in Japan keep you in a rehab facility for nearly a month for full hip replacement.