It's been three weeks as of yesterday.  This recovery thing is boring and tedious.

So, yes, I'm back to work.  I saw the surgeon on the 23rd, and told him I wanted to go back to work the next day.  I also told him that we're moving, and that I'm quitting the week of the 15th.  He didn't understand why I would bother at first, until I flipped it by pointing out I was still loyal to my docs.  He doesn't want me lifting patients, and doesn't think I'd even be able to handle eight hours, much less ten, yet.  He said the worst of it would be the fatigue, and he's right. 

I was able to do three hours Thursday, then took myself out to lunch, crawled home and slept for four hours.  Friday I did four hours, and felt like I could barely make it to my car at the end of it.  Today, I made it four hours, feeling tolerably rough after that when I was done.  Was able to go get some lunch (because I still do not want to prepare food that has more than three ingredients).  I didn't have to sleep this afternoon, but I was able to do....nothing.

But sit here and stew about it.

Sure, pain, but when haven't I had pain for the past two years solid.  From something or another.  Ridiculous upside-down boob implants.  Wires tied to my ribs poking up until the scar tissue formed.  Walkin around on a broken fibula because denial is fun.  Whatever.  Fatigue is a lot of it, far more than it has been a factor with the other surgeries...deep to the core of your body, and sleep is kind of beside the point.  I'm mentally very awake.  But I can't do much of anything.  It's nice to be able to read non-school books again, but I have things to DO.  I do remember some fatigue after the pectus surgery, but it was just so exciting at the time to have my left lung open....I wasn't so bloody over it and bored of my own medical problems.

I've also had three weeks of tinnitus, which is I think related to the oxys.  Maybe withdrawal?  I don't know.  Sometimes I am getting nauseated still, the day after I have any narcotic.  So I'm not excited to take any at all.

The only things I really know about withdrawal are from taking care of my patients from the ICU, who typically weren't in a state of erudition to be able to explain particularly well.  (And you know.  Typically I had to tie them down.)  And Trainspotting.  When I think of withdrawal from opiates, I picture Ewan McGregor crawling out of a toilet.  I feel like I'm crumpled enough to fit somewhere small like that, but what I'm going through is just not that cinematic. 

I finally broke down about an hour ago, and took one so that I could get downstairs easier. 

I'm only writing my complaints because someday I will look back on this and know from whence I came.  (Yes, I used the word 'whence'.)  It's gonna be better, and I do know that I'm improving every day.  It's just too dang slow.

Yeah, I know, I am a terrible patient and I just don't have time for this.

I think the hip is recovering well.  I guess.  I mean, this is supposed to take six to eight weeks and I'm going on three and it's not done yet.  Which is annoying. 

They gave me #60 of oxy 5s on discharge.  In the last year, surgeons have heard that there's an opioid crisis and so they've taken the opposite approach to what they used to do.  For my pectus, I had gallons of drugs.  On one hand, 300mg of oxycodone should (and is) enough to kill me handily.  But the script is to take 5 - 10mg every 4 hours.  Do the math there.  At max dose, it's not even enough drug through the end of the week.

I called one week later and spoke with the ortho nurse (who had been very kind and professional), and explained that at the rate I was taking it, I'd be out by the following Thursday or Friday.  I said he could either send me a script for more, or let me start taking ibuprofen in between (ibuprofen, for you non-clinical people, creates a higher risk for bleeding, and is often a no-no postoperatively).  We decided another #30 and to keep on the aspirin. 

I ran out Thursday.  I think 60 tablets over ten days freshly post total hip isn't bad.  (Especially spending one night in the hospital, not two). 

It is Sunday.  No script has arrived in the mail.  Maybe it will arrive by my post-op appointment Wednesday.  The voicemail I left for the RN Thursday night mentioned that narcs can be e-prescribed now.  (No callback Friday.)

I'm so glad we're fixing the opioid crisis, patient by patient.

Glad I fought for the Zofran, because since off the oxys (and some times before), I have been nauseated most of the time.  Anyone who's been through both will tell you that the nausea is the worst.  Pain you can have some strategies to work through, distract yourself, yell or cry through...not so much nausea.  Underneath it, you might be perfectly happy and yet, you must be this useless lump sitting somewhere in your house.  Not getting anything accomplished.

I've lost about 8lbs since the OR, which is of course mostly fluid.  But I am only eating about two-ish meals most days.  And an apple with peanut butter is a meal right now.  The swelling in my leg is better, but it's still significant.  It feels enormous.  I wish I could have just one dose of 40mg of Lasix, and that would probably make me feel better, too. 

So I'm a little discombobulated, but I'm hangin in there.

Am working with a physical therapist at home.  She's okay.  She's not a nurse, which is fine when she isn't trying to be one.  Am dutifully doing exercises. 

And I'm supposed to go back to work Thursday.  It won't be a 10 hour day.  I hadn't thought much about that until this past week, but it can't be. 

*grumblegrumble*  I have things to do. 

What's a year without another major surgery?

Yeah, that's my left hip.  Better images to come once I can get to them.

After the roller-skating episode, I was on a scooter for several weeks.  Then when I got off of it and started walking, I started to have this problem with intense pain in my left hip and having it give out on me.  I'd just be walking and all of the sudden, I couldn't support my own weight.  I did the requisite several months of ignoring it, and telling myself I'm fine and it's just week.

Then I saw my PCP, who sent me to one orthopod, who sent me to an injection.  The injection was FANTASTIC.  She was alarmed when i literally hopped up off the table and starting hopping around in circles, suddenly able to move.

Which was diagnostic for the fact that it was truly a joint problem, not a muscle weakness problem.  Had the MRI, the barrage of Xrays.  They diagnosed femoro-acetabular impingement (FAI) (CAM type, if you are a person who cares about these things).  Which sounded like not a real thing to me at the time.  People insist it's a real thing, and medical literature insists it's a real thing.  It's basically that my acetabulam (the socket) is cupping too much over the head of the femur, restricting movement.  That's sounds like rational physics.  What I am having difficulty squaring with is why I could abduct my left leg last year, and couldn't now.

The surgeon also said I had very significant arthritis for my age.  Cool.  And that the cartilage was barely there.  This makes sense to me.  My cartilage...which is of course, the root problem of the pectus. 

They gave me two choices, one minimally invasive, an approach to try (keyword was try) to correct the FAI, and hope the cartilage grew back.  "Try" didn't sound very good to me, and "hoping" my cartilage would behave in a way I wanted it to also sounded like a bad idea.  They said I'm very young for a total hip replacement.  I said I'm very young to not be able to do exercise for the next twenty years, even if I do have to have a second replacement in my sixties.  And buying that twenty years of mobility in my hips is important for every other aspect of my health.

So a total hip replacement it was.  Monday.  I came home Tuesday.  I have a physical therapist coming out to the house three times a week.  I have a walker.  I have ordered a purple and green feathered boa for it. 

So I have a metal plate on my left humerus, left fibula, lowest left ribs, a new left metal joint, and two metal bars in my chest. 

And no, the surgeon didn't want to go through the paperwork of giving me my hip bone back.  He actually said to me, "You don't want that."  I blinked.  "Yes.  I do."  Surgeons.  Honestly.  It would be good for all of them to interact more with people who are conscious.  I didn't get my bone.

I think he was good though.  He's the head of the infection control committee, and I was fussy about infection prevention, and I believed him that he was particular.  In all other ways, the surgeon was a good guy.  The incision is healing well, looks clean and good.  I had 500cc of blood loss, which seemed like a lot to me, but I don't know what's typical for an ortho surgery like this.  I still feel the effects of that; my heart rate has been running high all week, and I can feel that my pressure it lower than normal.  Just a faint light-headedness.  I keep drinking a lot of water, but honestly, I think it's just giving me an edematous left leg, not really pumping my pressure up.

Post-op, my recovery was pretty difficult.  They didn't want to give me a scopalamine patch (my first choice) or Zofran (second choice) because of my QT interval immediately post-op was a little long.  Therefore, I got hypotensive, tachycardic, diaphoretic, and was vomiting for several hours.  I told my night shift nurse to please call the resident and get me a scope patch and I offered to have her put the resident on the phone with me, so I can suggest some places where he could put that QT interval.

I got phenegran and a fluid bolus.

Mostly, I stopped vomiting because I stopped taking IV morphine.  (Which I only had because I was throwing up the PO oxy.)

The nursing care in the hospital was really great, from pre-op to discharge.  I had good people.  I had a lot of PAs this time, and I thought I got good care from them.  I asked one of them who is soon to be sitting for his boards why PA and not NP, and he said he thought the NP was less flexible.  Which is puzzling to me.  Then he admitted he didn't know about it before he started PA school.  Curious.  I think we as nurses do not do a good public relations job for ourselves.  NPs are far more flexible, career-wise, than a PA.  More independent of scope, and better-rounded.  He would have made a good NP. 

I'm doin okay at home.  I walked a half mile, around the track once with Bex yesterday (with a walker).  I'm doin all right.  There's a lot goin on in my world, so I'll post some more in the next few weeks.

Got more metal in my body now, so had to share photos.

Apparently, I still have readers.  I haven't looked at the blog in weeks, and I have some visitors.  Welcome.  Or welcome back. 

Here we are again.