Author Topic: Twice the Fun!  (Read 2264 times)

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Twice the Fun!
« on: June 05, 2012, 06:50:28 PM »
My better halfís been after me for awhile now to recount my recent experience in becoming a bilateral BHR uberman. Since I did my best to share all the fun I had on the first surgery, seemed I had a responsibility to do so with the second. Second time around, should have known what I was in for, or so I thought. I was also under the impression that I should have an idea on how things should go based, an idea based solidly on personal experience. Put me up there with other notables who suffered from a tad too much hubris - Midas, Liberace, Joe Dirt. Anyway, given my outstanding level of fitness/vitality (Iíve been told I can easily pass for a man in his late 40Ďs) and my recent familiarity with the process, this recovery should be a piece of cake. Despite what Iíd been told I was just certain I had it all figured out, like how on day number X, my level of stiffness/pain/swelling would be at level Y. Looking back on that pre-admission visit and my chat with the PA Iím reminded of that scene from MP & The Holy Grail with Tim the Enchanter: ďI warrrned yewh but no...Ē With that, hereís a summary of my latest excellent adventure, organized around some of what I considered to be more important points. Again, I apologize in advance for the erratic use of tense, lack of subject/verb agreement, wholesale lifting of Shakespearian plot lines and the occasional exaggeration. Here goes...

Food and Irregularity. 1st time out I had what I consider major league constipation, most likely due to the anesthesia and pain meds following surgery. This time around I thought that Iíd be able to get a handle on it, so to speak, by modifying my diet a few days beforehand - increasing my fiber intake, cutting down on the meat, cheese and ale, thinking happy thoughts about the healthy bacteria in my gizzard, etc. Certainly that would be enough to do the trick, right? Not hardly! It was almost a week before I could... er, make any movement in that dept. Even now, 8 days post op, Iím still not regular but I remain hopeful that this will improve as I decrease the use of the pain relievers to zero over the next few days. Until then Iíll rely on whatever laxative my DW has added to our ďlittleĒ home pharmacy (looks like Iíve opened my own Walgreens annex in our kitchen cupboard) to do the trick. That and more fiber. Which reminds me, its time for me to have another piece of wood...

Pain Meds. Admittedly, Iím not a fan of pain. You could even say that, despite having played hockey for most of my life, served in the military for 24+ years, and having lived with chronic osteoarthritis pain for over eight years, I have a low threshold for it. Seems I should have taken better notes last go round on this topic, too. Anyway, I recall that 10 days after the first surgery I was totally off pain relievers and thatís about all I had loaded in my memory banks going in to round two. As a result, this time I failed to ramp down and off as smoothly. In fact, today, day 12, Iím still in need of one 5mg dose of oxycodone every 4 - 5 hours, especially at night. Iíd tried increasing the duration between dosages to 6 - 8 hours 3 days after surgery. Ended up on a pain roller coaster, going from pain free to aching then cycling through it all over again. What worked before was decreasing the dosage (2 pills, 1 pill, half a pill) while holding the duration between from 4 to 6 then 8 and then ten hours. Now all I can do is implement the dosage reduction and hope the tapering coincides with the depletion of the prescription and diminishment of pain below the mild discomfort level.  [Note: Night time discomfort still pretty high, enough to wake me up 2 - 3 times a night, though itís muscle pain/stiffness down around the knee not pain in the joint]. Fortunately this affords me the opportunity to keep up on the latest infomercials]. Which brings me to...

Beer. Fellow Alemeisters will understand why this topic is included. Others may elect to skip to the more conventional topics below. First surgery I celebrated my release from the TEDís and declaration of no clots with a trip to a local burger pub to indulge in suds and cholesterol laden delicacies (back on the probiotic/whole food/zero fun regime shortly after though). This was at the two week mark and coincided with the end of my use of pain killers and muscle relaxers a day before. This time around, TEDís came off, no clots found but pain meds were still a part of my nighttime routine. Hence, and to my chagrin, hoisting the elixir of the gods was forbidden. Oh the humanity! Took me almost three weeks to discontinue the use of the pain killers and though my interest in doing so was more out of a fear of their prolonged use, I must admit that I was at least in part motivated by thirst. Others more learned than I would no doubt agree (see Wikipedia entries for Ben Franklin, Ralph Kramden, Jeff Spicoli, Doug and Bob Mckenzie, et. al.).

Physical Therapy. For whatever reason, perhaps my robust physique (see above), medical plan and/or my docís professional opinion, Iím once again doing a self directed course of physical therapy, consisting of going for short walks (1 block to 1.5 miles) on my crutches and range of motion exercises for the operated leg three times a day. I know there are others out there who receive daily visits from nurses or physical therapists who put them through their paces while others go off to a local med/PT center to get their fair share of abuse. Despite being on my own here Iím making what I believe to be decent progress. Why just yesterday I was able to do multiple sets of power cleans with the couch... Seriously though, I am quite proud of how good my quad and glute flexes have gotten and my heel slides/ankle rotations are, in my DWís opinion, quite compelling. Bottom line, canít honestly say if Iím doing better, worse or the same as last time on this metric, and this may be one of the advantages of having professional assistance with the post op exercises - built in measurement/record keeping. Might also help to have someone hit you with a cattle prod if you fail to hit the mark (ďGet that knee higher, mister!Ē). Not sure if insurance covers such a motivational program but for those who follow it may bear looking into.

Swelling and Bruising. This is one area that I can say thereís a difference on the second surgery. First time my leg was extremely swollen from hip to ankle. This was accompanied by severe and extensive bruising. Basically the back of my leg was purple from butt to calf. Even had some strange bruising in my nether region which even now strikes me as odd. Second time the bruising and swelling have been confined to my upper leg, both much less severe than the first. Elevating the leg and regular use of ice packs may have made the difference on this point. There was some slight amount of unexplained bruising again in the dangly bits that Iíd like to attribute to the procedure but as a former fan of Agents Mulder and Skully, I know the truth is far more sinister (cue creepy sci-fi music).

Mobility. Another area of improvement, second time around. As the first surgery was three months ago I still have all the move around skills I developed - one foot side shuffle, moon walk, double crutch hand stand, single crutch vault to double salchow, etc. In truth Iím also painfully aware of the need to carefully go up and down the stairs. No need to repeat the two or three little tumbles I had the first time and the weeks of angst/worry that followed as I contemplated whether or not I would wind up with a THR revision. Thankfully that did not come to pass.
Sense of Humor. No joke, this is a key area for good health and recovery. Even the hardcore science type skeptics out there would agree with me on that point. First surgery I was the life of the surgical ward, or at least I thought I was. In fact I swear I saw ďJohnny VegasĒ written on top of the chart hung outside my door. No doubt this was in part due to the bags of clear fluid that were routinely added to my IV, perhaps in an attempt to shut me up. Quell mystery! Seems to have backfired though as my DW recalls my first words to her following surgery were something to the effect of ďI feel GREAT!Ē. The second time, well, not so much. Instead I felt like that toddler in the E-trade commercial (ďNobody knows...Ē). Didnít really get my rapier whit/sense of bonhomie back until just a few days ago (3+ weeks after the fact), which coincided with the diminishment of pain/discontinuance of pain meds/resumption of Operation Oktoberfest (might be a grad school project out there on this for someone - let me know if you need a test subject). In any case, like the sage once said: ďA flute without holes, is not a flute. A donut without a hole, is a DanishĒ. So gentle reader, if youíre still reading this and take nothing else away, seriously, do whatever you can to keep your sense of humor. Your nurses will thank you, your kids will be embarrassed and, most of all, your recovery will benefit. So there you go. Oh, and World Peace! With that...

Good hunting!

Bilat BHR Dr. Brooks, Cleveland Clinic
Jan/May 2012

Dan L

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  • LBHR Dr Brooks, 10/2011; RBHR 2/2012
Re: Twice the Fun!
« Reply #1 on: June 05, 2012, 07:20:05 PM »

Thanks for the update and levity, sounds like you are really coming around, glad to hear it.   These experiences are no small shubbery from the knights that say "neee", and twice in a few months is far from "total consciousness" if you get my drift Mr Spackler, and regaining the humor mojo is indeed a great sign.

I had very similar progression the second time; bruising less, (except where it's really not needed) hoover dam colonic work stoppage regardless of much better pre op diet (made zero difference), and meds a bit more than first time (although more zanaflex and less narcotics).  The zanaflex really helped with the mid night pain/stiffness, along with 8 hour otc tylenol, after I was done with the narcs.

The recovery from there has been really positive.  I mowed the lawn on one crutch (dont tell Phil...) near the 6 week mark and have not looked back.  Still get muscle soreness when doing alot of work, but the motion in the joints when rambling around downtown at lunch, and doing all the spring yardwork or walking the dogs, is smoother that silk, really, really cool.  (I recently found dress shoes for work with no heel-- what a difference).

It is funny how much I looked forward to getting out for a beer and good meal, both times, drove my wife crazy, although less so the last time.

PS you get some kind of award for associating the brothers McKenzie and Jeff Spicoli in one sentence, yeoman's work my friend (and probably mostly gibberish for our overseaes hippys not blessed with late night reruns of SCTV and Fast Times). 

Great to hear from you,

LBHR Dr Brooks, 10/2011; RBHR 2/2012


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Re: Twice the Fun!
« Reply #2 on: June 05, 2012, 07:45:39 PM »
Great Report Dozer!  Glad your sense of humor has returned and the ales are finally flowing.
Keep the healing vibes and look forward to your next report. 
Successful LBHR 1/19/12 Dr. Cynthia Kelly
Fear causes Hesitation and Hesitation causes your worst Fears to come true


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Re: Twice the Fun!
« Reply #3 on: June 09, 2012, 08:50:30 PM »
Did enjoy reading :)
Bilateral BHR Dr McMinn 6Dec2011


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Re: Twice the Fun!
« Reply #4 on: June 09, 2012, 11:32:11 PM »
Hilarious, Dozer
Hernan, LHR 8/24/2010, RHR 11/29/2010 - Cormet, Dr. Snyder


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