Thursday, February 08, 2007

Home Again, I Can Groan, Scratch, and Talk to Myself

Wounded animals crawl away to find a comfortable place to die. When confronted with a deteriorating hip-joint (a condition that would have no doubt meant a slow and painful death in hunter-gatherer days, and a fractious and drunken premature senescence in the days of unscientific medicine), I too crawled into something of a protective shell.

Chores that I used to approach with something approaching joy, or at least enthusiasm -- walking to the mailbox, fetching the morning paper, mowing the lawn, walking the dogs -- became something to be avoided, or, worse, left undone completely. This avoidance-of-enjoyable-things has a terrible psychological effect; one can easily see other, even more vital tasks, like bathing or eating, dropping off the list. The inevitable outcome of this process is death. I'm terribly grateful that I live when I do, where I do, under the economic circumstances I enjoy, and with the people who love me and help me and protect me. In another time and another place, this bad hip could easily have killed me, slowly and painfully.

Monday I entered the hospital in a state of terrible emotional turmoil. I was terrified, frankly, by the thought of what was going to be done to my body. (It was a grave mistake, of course, visiting that Edheads site and watching the process of the surgery. I should, in retrospect, have never looked it up at all; it only added to my terror -- those stupid Flash cartoons haunted my dreams, they did -- without giving me any useful information.)

The operation was, as many of you who've experienced it assured me, quite unremarkable. I was completely unaware of anything being done to me -- all my Jacob's Ladder nightmares had been unnecessary. They put you out, zip, zam, zowie, you're awake again. Only now you're in quite a lot of pain.

I never want to go through those first 24 hours again. The hospital pre-op support staff make a great buzz over a device they give you to "control your pain": Essentially, you are given a handheld device that allows you to administer yourself a minuscule dose of morphine every six minutes. I can understand how the idea of this device gives comfort to someone about to undergo major surgery, but now with the experience on the rearview mirror, I call it a fraud. The device gives you no immediate feedback whether the dose was administered or not; you click the button, and something goes buzz. Nothing else happens. It gives you no timer, no visual confirmation that you've waited the proper six minutes. In a state of narcotic alteration, time is extremely subjective, and unless one watches a clock for six minutes -- a ridiculous task to ask of a narcotized person -- one has no idea when a dose has actually been successfully given. If you fall asleep and can't push the button (family members are prohibited from pushing it for you), you're SOL. When you wake up again, predictably in agony, as the morphine has worn off, you have to accurately self-administer three times -- over 18 minutes, during which you can't fall asleep again or pay the same penalty -- to get yourself back to painlessness. I lay for hours, drifting in and out of sleep, grinding my teeth at the knowledge that I was caught in a trap of user-hostile design. (Designers of medical devices, call me. You'll find my consultancy fees amazingly low for your industry.)

During this time, I came to heartily detest another device, this one attached to my feet. It is supposed to massage your feet to prevent blood-clots -- an entirely laudable task, I suppose, but in practice an inflating bladder squeezes one foot and then the other, each time emitting a thunderous popping noise. After a few hours, this became profoundly irritating; it's like being poked at with a stick every time you begin to find health-restoring sleep.

Narcotics being what they are, another problem went quickly from mild irritation to deep agony: I lost the ability to control my urinating muscles. I didn't become incontinent; quite the opposite. I lost the ability to pull the trigger, if you follow. I strained and strained, concentrating as hard as I could, bathroom taps going full autosuggestive blast, and produced -- nothing. I first pointed this out to the nurse on duty at about 4PM on the day of surgery; by midnight I was in exquisite agony. I had the temerity to ask this officious nurse -- a person I will not remember in my will -- for a urinary catheter; you'd have thought I'd asked for a tracheotomy kit to play with. I was informed that a catheter was quite out of the question -- imagine that! A patient trying to direct his own medical care! Who does he think he is, Ben Casey? When finally the dam broke somewhere deep in the lobster shift, I filled one and a half 1000-cc. urinal bottles. The relief was indescribably delicious. Sexual doesn't even come close.

About 24 hours into the stay, my physical capabilities began to improve drastically. During the morning physical-therapy session, if the PT nurse asked for 10 reps of thigh-lifts, I gave her 20. Asked to walk 150 feet, I did 300.

You see, two bits of information had made themselves known to me. First, I'd cottoned on to the hospital's criteria for the release of patients from the Total Joint Center: Once you can do so many reps of the exercises and have walked so many feet (and you aren't running a death-fever from some flesh-eating streptococcal infection and haven't ripped your own sutures out), you are free to go.

The second piece of intelligence became abundantly clear when the first tray of food was set in front of me. It consisted of a dreadfully watery "soup" with some disintegrating gray vegetable matter sloshing about in it; some deeply nauseating tuna-and-diet-mayo lolling about on a bed of wilted lettuce, and a chunk of bread with the consistency of a well chewed piece of Juicy Fruit but with none of the flavorful appeal, accompanied with approximately three molecules of generic margarine. No salt. One package of three-year-old ground pepper. I'll freely grant that my appetite was pretty well shot by the dope, but even if I'd just come in out of the snow after chopping a cord of wood and raising a new barn for the Clodfelters, this grub would have had me throwing my plastic spork across the room and looking up the Suicide Hotline.

Clearly, they were trying to starve me out. So with each painful leg-lift, each abduction/adduction stretch, each heel-slide, I whispered to myself, Chicken Korma. T-bone steak. Sierra Nevada Pale Ale. And with each ten yards I managed to hobble on the walker (Jesus Christ, was there ever a more humiliating device?) I essayed images of Afghan flat-bread straight from the Tandoori oven, of basil-rich lasagna with a rough Chianti, a loaf of San Francisco sourdough bread... So crusty.... Soooo crusty....

My stratagem seems to have worked. I got out 24 hours early.


I'm back at home, "resting comfortably," as the kids say nowadays. I spent all day today luxuriating on my bed, desultorily answering emails, catching up on the blogs, deliriously lifting my leg and letting it fall again. I have a home-care nurse who comes in and checks for those death-fevers and unripped sutures, and another who gently leads me through PT exercises meant for someone twenty-five years my senior. I am, in short, a pig in shit.

I've weathered it, baby! Officious nurses, burst bladders, being poked at with a stick when I try to sleep, and food that would have been scorned on an eighteenth-century whaler two years from port.

And most gloriously of all, I have a future. I can contemplate anything again. I'm planning this summer's garden. I'm talking up a ski vacation next spring, a walking tour of Europe, a bicycle trip across the Andes, kite-surfing from Jedda to Calcutta and back again. No, most of these won't happen, here's the important part: I can pretend that they will!


Zeke said...

Cheers, Ned! I'm glad to hear you're out and on the mend. Best wishes for a fast and complete recovery, and much faithful service from the new wheel.

mikeinseattle said...

Neddie, I sure am glad you're back home and feeling better, if not quite in the pink. I'm drinking a Sierra Nevada in your honor as we speak.

Lots of people out here, most of us lurkers, of which I am one, know you only through your writing, but are able to see what kind of a good man you are. I appreciate you and always get a kick out of your writing. And may I say, was a little worried from your description of the procedure. So I'm damn glad you're back. The world can sure use more like you.

If you're in the mood for a tune, courtesy of tbogg, here's a terrific little performance on Letterman from last summer by composer/guitarist M. Ward whose music I'm really starting to enjoy, and I hope you do, too.

Ol' Pal D said...

Nice f'n goin', big guy - *now* you're cookin'.

I wish you huge wild blueberry pancakes w' the real stuff (and powdered sugar), sausages 'n fresh-squeezed and fresh-roasted Guatemalan "La Provincia" to wash it all down. In Bed.


Mdm DeFarges said...

By Neddie Jingo--welcome back to the world of possibilities. I went through what you described twice. There is a sameness to these situations apparently. Like what's with the catheter reluctance thing? I had to beg to get one. I was slipping into a drug facilitated hysteria before they deigned to "do no harm." Sheese! Your world will expand now...not continually contract to an area the size of couch. Great good luck to you.

Blue Wren said...

Welcome home Neddie! Glad you're back with your mischief and mayhem muscles intact and growing stronger once again. You'll be back to your swashbucklin' ways in no time. Ask me for my recipe for pozole ...
(raising a mug o'mead) Here's to you!

Donna said...

I told you to tell your doctor don't do the morphine pump! It sounds good but is a torture device! I forgot all about the leg massage thing though. Mine wasn't loud but it made my legs so hot and sweaty, just add some more discomfort why don't ya, doc?

Glad to hear you were able to make a break for it and are recovering at home.

Kevin Wolf said...

There's no place like home.

My hospital stay was extended; there was no way around that, but I did indeed get out as fast as I could manage it. I know the feeling - the pull as if from outside the building. It was like being in the Big House. (Luckily, they put no cap on my morphine and the food was okay.)

I had one misconception completely erased from my mind: that a hospital is where one goes to rest and recuperate. I know know it is impossible to do so in a hospital.

Glad to hear that you're mending, Neddie. I am, very sincerely. Looking forward to more posts on, say, what it's like to bungy jump off a cliff. Welcome back.

(P.S. My lame joke in a comment I left here pre-op, in which I refer to "tripping," was meant in the druggy sense, not in laughter at your temporary disability.)

QRED said...

you'd have thought I'd asked for a tracheotomy kit to play with

Didn't they market those back in the '50s?

To your health, Neddie, and your future.

Carl said...

Good to hear you're home, Neddie. Rest up.

robin andrea said...

Your pre-op state of mind was exactly what I fear mine would be. I would do too much research, see too much. So, it is a relief to read that you made it through the other side of that terror. Hospitals always sound like places that are to be avoided. I hope your recovery goes very well. Some chicken korma and homemade naan might do the trick.

Matt said...

So glad to hear that you're on the mend, Neddie. Cheers!

Neddie said...

Thanks to everybody for your kind words, it really helps me heal knowing I've got nice folks like you reading along...


Awww, now you're just trying to make me cry, aren'tcha...

I liked that M. Ward song very much. He's got some very subtle, jazzy chord work going on that adds nicely to the emotional effect. I'm wondering what you'd call that weird-looking percussion rig that bald guy's playing. The cymbal looks like a cross between a Van de Graaf Generator and a Tiffany lamp...

Also, in light of my latest post, the one about last night's dream, I have to admit I laughed real hard at the "Severe Weather Alert" crawl at the bottom of the screen during the first half of the performace... It just doesn't let up, does it?

Donna: You were absolutely right about that morphine-drip fraud. One hunnert-percent. Everything was exactly as you said it would be. Fortuna willing, I won't have to decide whether to use one again, but if I do, it'll be an emphatic NO!


Hospitals always sound like places that are to be avoided.

If ever a Moral Lesson were to be drawn from this experience, you have stated it as clearly as any human could.

Anonymous said...

Three cheers for our Neddie! Your experience should be a lesson to all those who see a "moral hazard" in free access to medical care. I'm sure you'd do it again, if only for the endorphin release from your mighty micturition.

Mark Smeraldi said...

Glad to hear all went well.It turns out that "the waiting is the hardest part" is NOT just a figure of speech after all. Sounds as if you've got your own private Sweden going on down there, although Nurse Diesel is a somewhat jarring note. Mine were sweethearts, yet I ran exactly the same escape routine. Instinct, I guess.Enjoy your Coleridge phase, you'll be back in the cubicle sooner'n you think.

The Viscount LaCarte said...

Welcome back.

snedyynn - What this blog is.

JD said...

Surprised at your nurse's reluctance regarding the straight cath--in my experience writing a straight cath q 6-8 hrs PRN order is de rigeur if only to prevent a UTI which, if left to rage unchecked, could endanger your new hip. Still, all seems to have turned out well. Welcome back to the fray!

Dragon Laugh said...

Welcome back!

Breadbox said...

Welcome back to the land of the gloriously-happy-to-be-alive!!!
Have fun on the new joints: you've given me renewed hope that in a year or two when my knees go the way of all flesh that I can survive a similar ordeal....

Gin and tonic in hand, I salute you!
Bake a loaf,

Jeremy Cherfas said...

Dear Ned

Any time you feel like hiking the Appenines, give me a shout.

blue girl said...

Wow, Jeddie. You can really write about post-op stuff well. I'd love you to write *my* version of having a baby!

It would put Stephen King to shame!

It would be a bestseller! Talk about population control.

I'm so glad you're on the mend and that you can imagine all kinds of fun things again.

You *are* one of the best.


Tom said...

Tuning in late - congrats to have it over with. Boy, your post makes me want to "reminisce":

I'd forgotten about the annoying leg thing - like having your blood pressure taken over and over and over again. I don't understand the catheter business - mine was installed by default. On that morphine drip - the timer thing is supposed to tell you it's OK to push it, but I reacted like Pavlov's dog and pressed it every time it went off! (Big Nurse bitched me out, but it's not like they read you the manual.) And the food - they seem to have a talent for putting the worst combinations in front of you - who in their right mind would eat a hamburger with a side of beets?

Anyway, dream on! You're going to have a great summer.

Travis & Erika said...

My dad just found out that he has stage two AVN. He'll be 50 July 1st, and has been a "closet" alcoholic for years.

Really, I guess my question for you, seeing as you have already gone through all of this, is do you have any pointers, questions, ideas about what needs to be asked?

It's just they have effed around with him for the past year, stating that it's this and that and this and that and Xray here and MRI here, but not of where they needed to be, and now, because he demanded they do an MRI on his hip, our DUMB doctor has discovered this.

Any input that you have would be greatly appreciated. You can email me at if you like.

Thank you in advance, and I am glad to see you are doing better!