House of Pain.

datePosted on 10:36, May 25th, 2018 by Pablo

I am on the mend, sort of.

Or better said, I am out of surgery and convalescing after having my left hip replaced. It was an interesting experience. They decided to give me a spinal with a light sedative, so I got to hear the sounds and feel the tugs. After the first tugs (slicing and dicing as they opened me up), I heard a circular saw. That is used to cut off the top of the femur and old hip ball. Then I heard a grinder. That is used to “sand” down the pits and sharp projections caused by degenerative arthritis on the hip socket. I then heard hammering on metal. That is the sound of the fitted metal plate being hammered into the hip socket (think of the spikes that are used to hold down railroad ties. Here the spikes are hammered into the hip socket through holes in the fitted metal plate). The hammering was also the new titanium hip ball being hammered into the new top of the femur (also attached by a spike). Then more tugging as they sewed me up. They cut and separate the abductor muscle to get to the hip. Took about 1.5 hours.

The first night was agonising once the spinal wore off (took about 4 hours). They prefer not to give painkillers until all lower body sensation is restored, so one has to suffer until the painkillers kick in after normal sensation resumes (which works downwards from the point of injection to the toes). For me, that included suffering through a pain fever (where one is hot to touch to the point of discolouration and blistering amid profuse sweating). I would say the pain was 8.5-9 on a scale of 10, all through my pelvic girdle. The next day they got me up and we started “exercising, ” (i.e. walking with a walker and crutches) and the worst pain was (and is) in the femur that was operated on (pain at about 7.5-8 level). I now have incision pain (a hot tearing sensation) as a constant more than anything else, on a scale of 5 or so out of 10.

I assume the various pains will begin to wear off soon but boy, I could use some opiates at this point (they try to avoid using them and I have a reaction to morphine anyway). Instead, I rely on the mobile pharmacy of non-opiates that was provided to me upon my release.

I was released after 3 nights in hospital and transferred to my in-laws as a halfway point while the family support crew worked. Lets just say that the 100 meter walk on crutches to the car and entering/exiting said vehicle was excruciating. It managed to combine deep bone, pelvic girdle and incision pain into one big ball of wretchedness. Beyond that, I am incredibly fragile and vulnerable to falls, which is a problem because along with infections dislocating the new hip is considered to be a terminal game changer for the worse.

I will go home tomorrow and continue to use the crutches and cane until I can walk by myself. I cannot bend forward, twist my hips, cross my legs or have my knees higher than my hips for six weeks. I need special chairs for the shower and loo. I cannot drive for that time (a problem in a one driver household located a half hour from the nearest main town). But I am told that it is all worth it once the pain goes away and will be able to exercise and perhaps even jog again.

That is my motivation because I have promised the little guy that I will soon be able to kick the ball and chase him around the paddock. Let’s hope so.

PS: Other than a couple of glitches, my experience with the public health system (so far) was 9 out of 10. In terms of institutional processes and staff care I received excellent treatment. I did go private for a couple of tests but everything else was done publicly and the total time from when I was put on the waiting list (as an acute case) to surgery was 3 months. Happy to see my tax dollars put to good use.

16 Responses to “House of Pain.”

  1. Sanctuary on May 25th, 2018 at 10:44

    Your ears must be burning , I have in my diary a note to send you an email this weekend asking after your health!
    Glad the operation is over :)

  2. Sanctuary on May 25th, 2018 at 10:48

    Modern medicine is amazing though. I often think that in 1000 years, long after WW1 and WW2 are forgotten, the 20th century will be remembered as the age of medicine. In 1900, you could still die of an infected finger 100 years later and everything has changed.

  3. Pablo on May 25th, 2018 at 11:02

    Thanks Sanctuary.

    One of the things that my fellow patients and I spoke about in the orthopaedics ward was the fact that we were lucky to have been born in the 20th century. One lady had silicon finger knuckle implants to replace the originals destroyed by rheumatoid arthritis!

  4. James Green on May 25th, 2018 at 12:15

    Not to spoil the advances of the past century, but I think the medical advances of this century will be even greater. I think of the 19th century as the century of chemistry, the 20th as of physics, and the 21st as of biology.

    I hope you recover soon.

  5. Tiger Mountain on May 25th, 2018 at 14:26

    good on you for sharing your experience–us politics followers are human too!

    you might try cannabis in some form, not sure why NZ medicos are so opiate shy, they should try having a bloody hip operation and see how they go…

  6. Pablo on May 25th, 2018 at 14:44

    Ha Ha. I need cannabis just to deal with politics! As for the practitioners, I believe that they emphasise the removal of the long term original arthritic pain and deemphasise the short term post-op surgical pains so as to not discourage people from seeking treatment. Better knowledge of the latter would not have stopped me because I had no quality of life left when it came to mobility, and a little forewarning might have helped me mentally prepare for these first few post-op days. Anyway, I remain hopeful and optimistic.

  7. George Broad on May 25th, 2018 at 14:56

    I am so pleased your op is over and successful.As we age our bodies deteriorate but it’s great when our brains still cope, at least the critical parts. I wince for the pain you suffered but by having a spinal injection at least you missed the risks and after effects of general anaesthesia. I hallucinated for a week and had other after effects for several weeks after my open heart surgery. I hope that gives you some consolation.

  8. Pablo on May 25th, 2018 at 15:04

    Thanks George.

    I would have preferred to have slept through it but in retrospect it was an interesting experience listening to the tool sounds and banter (although I got the feeling that the anaesthetist warned the other staff that I was pretty awake from the chest up). I was asking questions during the procedure, so had a sense of engagement with the medical team that I otherwise would not have.

  9. Erewhon on May 25th, 2018 at 21:18

    I am kind of astounded you had such a good experience with a medical system that has been systematically wrecked since the 1980s by year after year of neoliberal wrecking balls.

    But hey, a good result is a good result. The pain sounds awful but hopefully it is short term pain for long term gain… cold comfort when you’re getting into the car, though…

  10. Pablo on May 26th, 2018 at 06:49

    Yes, my expectations were not particularly high but were happily proven wrong, and then some. It was interesting that virtually all of the professional medical staff involved–nurses, surgeon, anaesthetists–were fairly recent immigrants, whereas most of the administrative and support staff were NZ born. I can only hope that demographics do not factor into quality of service provision (i.e., some regions with certain ethnic profiles do not get differential treatment even if disease rates are higher in them), and that there is no rural/urban dichotomy in provision even if patients need to head to urban centres for treatment such as mine.

    I also assume issues of unionisation, collective bargaining differential pay rates, etc. play a big role in how DHBs deliver services, but in this case it was pretty much first class. Or maybe, even after 20 years in NZ, I still retain my impressions of the US public health system and so my threshold of consent/expectation was set very low and what I received by the way of treatment is fairly standard, at least when it comes to orthopaedic elective surgery.

  11. Phil Armstrong on May 26th, 2018 at 18:56

    Hullo Paul, I have been a avid follower of your radio commentaries with Mitch for some time, and look forward to them. My wife had and hip replacement and her first husband also, and as with you, the aftermath was painful and uncomfortable, but both got much better with time.
    So look after yourself and have a speedy and full recovery.
    God Bless,. Phil

  12. Pablo on May 27th, 2018 at 09:22

    Thanks Phil.

    I am heartened by your wife’s experience. Lets hope that I follow the same course.

    Mitch is a good guy, a bit conservative but old school in terms of his approach to news radio. He also does his research so is far more than a talking head. He has been good to me by giving us time to talk rather than the usual sound bite approach. It is also fun to listen to the feedback from the IVs we do. He sure gets some strange creatures listening to him!

  13. Barbara Matthews on May 27th, 2018 at 12:59

    I was lucky (!) enough to have a hip replacement four months ago. Had to wait a very long time for the op, but very successful. Wish you all the very best for your recovery. (Guess all the hip and knee people are coming out of the woodwork, sorry about adding to it.)
    Barbara Matthews.

  14. Pablo on May 27th, 2018 at 17:52

    Cheers Barbara.

    Normal transmission will resume shortly.

  15. Kumara Republic on May 27th, 2018 at 18:34

    All the best. And all the more thankful we have a universal health system despite the myriad of issues.

  16. Pablo on May 27th, 2018 at 19:56

    Thanks KR. I agree completely.

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