Archive for the ‘hospital’ Category

Hip hip boo hoo

February 15, 2019

Last week I had my follow up appointment after knee replacement surgery. I have to say that I found the knee replacement surgery a doddle and had full mobility after just a week or so, and the pain has been negligible, compared to my hip, but you will find out why that is shortly.

Here’s the X-ray of the said knee replacement, with a side view on the left and front view on the right and yes, I know the X-ray is reversed!

The knee is fully healed and I have full range of motion and what is more…no pain!

My hip replacement however, has not been all that I expected, for a start I have had continual pain, so much so that the past few months I have been unable to sleep and you know what that means? …yes, grumpy Bernice. We knew after the post op checkup X-ray and subsequent MRI that there was a probable crack in the trochanter which I was expecting it to have healed by now. There was also a suggestion at the time (and the reason I had the MRI) that something more sinister could be going on rather than a break.

There was apparently lots of discussion between radiologists and my surgeon as to what was going on but I was pretty confident that the surgeon was right and it was just a break.. did I really say that? “just” a break?

However, my surgeon was adamant that it was stress fracture, the talk of worse things he played down considerably so that I would not worry or panic. He now tells us that he discussed it with his wife, who just so happens to be a cancer specialist, and he was sure he was correct and that there was no need to put me through the trauma of a biopsy, which we discussed at the time of the first MRI when we considered having it done whilst I was under anaesthetic for the knee replacement. But the week before the knee surgery we discussed the biopsy possibilities again and I was more than comfortable with his recommendation that we don’t proceed with it. And at this stage the pain was not so bad and in fact had started to dissipate however, over the last two months the pain has increased, a lot.

Last week during the knee checkup I explained to the specialist that my hip was becoming excruciatingly painful, especially at night, and I was not a happy chappy. He quickly sent me back to the X-ray dept next door for another X-ray, this time of the hip.

And what do you know? It’s definitely fractured, with the offending piece having completely broken off at some stage! No wonder it’s been damn painful. The following pictures are of my X-ray on the lightbox so there is some shadowing and reflection.

the offending trochanter which is the knobbly piece at the top of the femur

The trochanter circled in red, the break is indicated by the yellow arrow. Not only has it completely broken off, it has moved a bit. Ouch!

So another MRI was booked and I had that on Tuesday as well as a follow up appointment with the specialist.

This latest MRI confirmed the specialists view, what has happened is that the stress fracture developed over time to become a full on fracture. I was relieved that a) it was nothing more serious and b) that I had a very reasonable excuse for being in such pain and I wasn’t just being pathetic!

We talked at length about what to do about it, coming to the conclusion that doing nothing for the trochanteric break was the only real option. It is now healing nicely albeit slower than I would like, and further surgery is definitely not in the scheme of things. The thought of them having to do further surgery to rebreak it, then reattach with screws, plates and wires is a daunting prospect particularly as everything I’ve read and studied all come to the same conclusion; the outcomes after 12 months are almost identical wether nothing is done or surgery is performed. So with good pain management the priority, we now have a plan in place and hopefully it will continue to heal and I just have to be patient (not one of my best qualities) and definitely no skydiving or other dangerous activities, even though I’ve been walking around on a fracture for months.

Apparently fractures occur in a very small number of replacements but they are the most common complication after total hip replacement surgery and of those small number of fractures about 5% are trocanteric fractures. So it’s just my shit luck to be part of the very, very small percentage to have this occur! I always knew I was a bit “special” 😉.

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It was all going so well

December 2, 2018

My surgery and subsequent recovery had been going so well, I’m well ahead of expectations of range of motion and activity and all was great. The physio came out to see me on Monday, she was also impressed at where I was up to but she did say that she thought I should pop back to the hospital to get the dressing changed as it appeared the wound was oozing somewhat.

Instead I rang my surgeon and talked to his receptionist about what to do. She suggested I come in and let Hugh have a look but also to start the antibiotics I was given for a just-in-case situation like this. By late that afternoon I was at his office getting it looked at. It turns out that the wound itself was fine, but I had reacted to the glue on the dressing and it had formed blisters all around the wound. Ouch.

So he cleaned it up and put on a different dressing. This was Tuesday afternoon. Thursday the dressing was again soaked but also bit of an ugly shade of green.. so I again rang Nicki who suggested I send Hugh a photo of what it looked like. So I did. I mean how many surgeons give you their cell phone number?? He rang almost immediately and said remove the dressing clean it with the special wash I had been given and send him another picture.

Which we duly did. He rang back again, saying he thought the wound looked fine, it was just this allergic reaction, so sit in the sun with it exposed for a while, and then put on the Manuka Wound Gel he had told me about, redress and come and see him in the morning. Which we did on Friday for a dressing dressing change and some ointment for the blistery, itchy, hot, annoying rash that circumnavigates the long thin scar of the surgery.

I go back to him on Tuesday for another check up, I hope to goodness that the rash and blisters have cleared up by then otherwise I may be very annoyed!

There will be no pictures in this blog entry, I do not need to share the ugly side of my wound, it’s bad enough having it out in the sunshine for people to see.

Apart from that and a very swollen ankle and foot, all is well and I am well on the road to recovery..

Roy also has a post op checkup on Tuesday, let’s hope that it is also a good result.

All done and dusted

November 23, 2018

Yay, I’m going home. I did try and convince my surgeon to keep me in and do the other knee on Monday but apparently he’s a bit busy! This experience of knee replacement surgery has so far been a relatively painless one, hence I have no hesitation in having the other knee done. I have to say that I was prepared for the worst, everyone had told me that hips were a doddle compared to knees, that the pain would be terrible and the physio daunting. Hugh, my surgeon, was at pains to tell me how hard it was going to be and how it wasn’t going to be pleasant etc. I can remember Mum telling me that she would rather have ten hips done rather than one knee, I wish I could tell her than the opposite is true for me. Perhaps I was really prepared for it to be relay really bad, but my expectations haven’t been met.

I have been totally surprised at the lack of pain, it has been well managed by staff and I don’t think I’m on any different painkillers to last time either. I have been really well cared for by all of the friendly nursing as well as ancillary staff at Southern Cross Hospital.

Today was time to remove the dressing….look away now if you are squeamish!!!…yeah right, I am the worst one for not wanting to know or see what is going on.

this is what the dressing post op looks like. It is called a Pico dressing which has a little sucky motor attached to it to ensure everything is airtight.

According to the blurb

PICO represents a unique way of treating patients who would benefit from the application of Negative Pressure Wound Therapy (NPWT). PICO has been shown to provide positive patient outcomes when applied to open wounds, closed surgical incisions and skin grafts.  

The PICO system is canister-free which means the pump is small enough to fit in the palm of your hand. This makes the system very discreet and portable for the patient to wear.

The PICO pump generates an effective negative pressure of -80mmHg and provides therapy for up to 7 days.

The PICO pump is connected to a conformable, innovatively designed dressing which:

  1. Is easily applied and removed, minimising skin trauma and delivers the negative pressure across the wound bed or closed incision
  2. Is designed to reduce the risk of pressure points and supports patient comfort.
  3. Manages the fluid away from the wound or closed incision through a unique combination of absorbency and evaporation.

Very clever stuff they have these days.

once the dressing was removed, this is all there is to see,

Still got that lovely pink stuff on my skin.

And redressed ready to go home.

Now I am just waiting for the final discharge notes and prescriptions to be delivered and then we will be off home. One knee done, one to go.

Knees up

November 20, 2018

The worst bit about going into hospital for surgery is the waiting time before you actually get taken into theatre. I had to check in at Southern Cross North Harbour Hospital at 11am and by 11.30 I was ready and waiting for the inevitable, I was wheeled down to the theatre at 1.35pm, left outside the door of the theatre once the anaesthetist had put in the needles ready for what comes next. As I was left by myself waiting (5 minutes seemed like an hour) wondering wether I should do a runner, actually that would be more of a limp, or just breathe in, breathe in, breathe in…….and out and calm myself down.

They were soon back to have me walk into theatre, this time I was very good and didn’t look around at all to see all the gory bits and pieces, I hopped onto the theatre bed which they have at the side so I could face the wall and not see anything behind me, the epidural was put in seamlessly and painlessly then the sedative injected. Next I knew I was in the recovery room. But what a weird sensation of having no feeling of anything below my waist. I tried desperately to move my feet and toes but I don’t think messages were getting through.

I was back in my room by 4pm where Roy was waiting for me.

my attempt at a selfie post op!!

After an hour or two, a light snack was brought in for me to try, jelly, ice cream and little sandwiches….I thought I was at a kids party! I haven’t had jelly on its own for years, and it was delicious. See, I qualified that Keith by saying jelly on its own, I know you made that lovely layered dessert for Debs birthday that included a jelly and fruit layer!!

The epidural eventually wore off over the evening but I had also apparently been given a femoral block. What does that do? well, you feel no pain at all and I can tell you it was bliss. For the first time in I don’t know how many months I actually slept for 5 hours straight, unlike my usual pattern of no sleep until the early hours of the morning and then for a maximum of 2 hours at a time.

I was put on the bending knee machine which you can gradually increase the incline of the bend. I eventually got it up to a 90 degree bend without too much trouble.

I don’t think it will get that far today now that the effects of the block are wearing off but I have to say that any pain i do have is being well managed unlike when I had my hip done and things were excruciatingly painful, until I realised I could ask for pain meds!! I have walked around the bed with crutches today, which is apparently pretty good, and I will have another couple of goes later this afternoon and evening.

So far this hospital experience has been very different from when I had my hip done, same surgeon and anaesthetist just different hospital and protocols. I have been made very comfortable and haven’t felt so terrible afterwards which means I have a better appetite, which of course makes you feel better too.

Well, that’s it, just over 24 hours since surgery was completed, and I think I’ve written this in some sort of sane manner! I’m sure someone will let me know if I haven’t .

Now comes the hard recovery work.