Friday, January 31, 2014

PAO Surgery Day Has Arrived

January 31, 2014

TODAY IS THE DAY!

 My alarm is set for 4:00 am, although I have to shower again with the special soap, David said that even if we leave by 4:30 we will for sure get there by 5:00 am check in. Not likely to have traffic at that time. My mom is setting her alarm for 3:00, she says because she wants to do her hair and makeup, but I am sure it is for nerves also. I slept fairly well, but i get up at about 3:45 to shower and dress. My nerves are okay.

I hear my mother upstairs getting ready. my husband is the last to awaken. They have a small breakfast and coffee. They also make cups to go. We grab our items, books, iPads, and head out.

4:45AM We arrive at the James Street Garage. It is a cold morning. But thankfully it isn't the sub-zero temperatures we have been experiencing. Going up to the elevator, we get a little mixed up, but finally get to the main lobby and find our way to the main elevators and to the 3rd Floor to Ambulatory Surgery, check in and wait to be called.

5:34 They call my name and I am brought back to a bed where a nurse gives me a bracelet and a gown. They take my first set of vitals, ask me the obligatory questions to confirm my name, birthdate, and why I am here. they also ask me other hospital questions required by law. My nurse is very nice and at this point, it is a waiting game. i am my Surgeon's first case (not sure about the only case-but I think I am) of the day.


Sitting and waiting for surgery is never a "good time". But for some reason, I was extremely calm. I knew that it would all be fine. I have every confidence in the procedure, the surgeons, the hospital, the fact that it is known for its orthopedic surgery unit all came into play. I was also pretty tired too. There was a TV on in the waiting area, and that helped to keep things calm.

Shortly I was given my IV, and prepped with yet another scrub down. No infections here! They also came in and took some preliminary blood tests and checked the red bracelet that I had been wearing.






My mother and husband, were brought back and then my Anesthesiologist, a young man who introduced himself in the most friendly and upbeat way. I was really impressed at his level of respect and care in his demeanor. I also really liked how he said "I am going to take excellent care of you today Jennifer". After that we went over the procedure, the process, and were just waiting for blood work to come back. 

About 20 minutes or so later, my surgeon, Dr. Timothy J Sauber came in and marked my leg. Said hello and in about two minutes later I was given my first shot of a cocktail of relaxation juice. I said my goodbyes and was wheeled away. From there I cannot tell you anything else but the foggy recollections of the recover room. 

My family tells me that the surgery was about 7 1/2 hours in total. Complication free. They did the PAO and also did some work to resurface the femoral head of my leg bone (the femur). they said that they got a call at 4 hours and that they got a good signal. It was just going to be a bit longer.

In recovery, I can remember seeing my Anesthesiologist again, hearing my name being called to me, and that is about it. I know that they were giving me pain level tests and pain medicines. In addition my left hand was experiencing a feeling of extreme numbness. My thumb, index and middle fingers were stiff feeling and felt-to me- numb and waxy. My only complaint was the Recovery Room Nurse who kept passing off my telling her about my hand and then telling my doctors and Nurse in my room that i was "Complaining for no reason" 

I was NOT complaining for no reason! I just came out of a 7 1/2 hour surgery and I was experiencing something that wasn't normal. Parts or my body felt abnormal and I was reporting this to medical professionals. There was a reason. Thankfully my nurse in my first room on the tenth floor, Mary called for a Consult and that Jerk Nurse got the stink eye and sent away. 

I began to drink ginger ale. My mother and husband visited for a while. I wasn't really able to speak to well since my throat was sore from the breathing tube. I still had a Foley Catheter and would for at least a day or two. I was completely immobile from the waist down. Since I seemed to be somewhat awake, David decided to drive my mother home to her house and was going to come back. While he was gone they brought me a tiny plate of macaroni and cheese with tomatoes and I tolerated it very well. I hadn't eaten since Thursday at 5PM

My first Day/Night after surgery was spent receiving pain medicines, answering pain scale questions (at this point is was 9 or 10). I saw a few doctors, the resident who was in surgery with me, who was super sweet and checked on me a few times. 

David stayed with me. And in Godfather style I was moved to another room like Vito Corleone late at night, Since there wasn't enough staff to take care of all of the patients i was being moved from the much nicer rooms to an older section of the Orthopedic floor. It was okay, at that point, it was the care that was important. 

Instead of a pull out couch for David they left the extra bed and that is where David slept.



My nighttime nurse was Karen, a very very kind lady who even brought covers for David and would talk to me about the show the First 48 on A&E. It was the only thing I could find that was on that I could watch while I was in and out of sleep. I spent my first night calling for medicines as they began to wear off, or calling for water.  I can say it wasn't bad, it was what I expected. I was in a controlled pain state. I would give the day a good grade. The worst was over, the surgery was over and the healing was the next chapter.



~DriveSlow~

Thursday, January 30, 2014

The Day/Night Before PAO Surgery

January 30, 2014
THE DAY BEFORE SURGERY

After a the disappointment of not being able to have the day off from work, I decided to fore go my bus ride and suck it up and pay for parking. We woke up to sub-freezing temperatures and below zero wind chills. Thankful for my remote starter, I put on my layers and headed out the door. I made it to the office by 7:00AM. I was feeling anxious, but also knew that I could only do what I could in my work day and the rest would have to fall into the hands of my very capable coworkers and a very eager, caring Temp. I wasn't planning on slacking, but I wasn't going to add to the stress that was naturally occurring.  I had my NutriBullet smoothie ready for lunch and the day was off to a good start.


The day progressed, however I was anxiously awaiting my call from the hospital for my arrival time. Apparently in recent years it has become protocol to call a patient the day before a procedure for their official arrival time. I guess to account for cancellations, or to just make us crazy. I am sure there is a lot that goes into Operating Room Logistics that we would never see, nor want to know about. Things like procurement of equipment, tools, staff, etc. It has to be a huge undertaking in and of itself. I keep my phone with me, with the ringer on, AT ALL TIMES.

1:14PM RING RING RING   A-ha! I get my call from Colleen at Allegheny General Hospital (AGH) Surgery Scheduling. One of THE nicest and most helpful schedule callers I have ever had the pleasure to speak with in my life. So, if anyone knows Colleen, please pass this along to her!


Speaking with Miss Colleen, I was instructed to arrive at the hospital at 5:00AM, Park in the James Street Garage, go to the third floor to the Ambulatory Surgical Center and check in at the Desk. I was also given last minute pre surgery instructions which are as follows:


  • No makeup
  • No nail polish
  • No contact lenses (wear your glasses)
  • No jewelry of any kind
  • No eating or drinking after 11:30 pm
  • Use Hibicleanse tonight and again on the morning of surgery from the neck down as an anti-bacterial body wash.
  • Wear loose clothing
  • Do not bring valuables
  • If I was staying overnight have my family member keep the bag in the car.
So, I thanked her and got on with my day. Googled Hibicleanse and texted my mother who kindly said that she would go out to WalMart and get it. She would be coming to our house and spending the night and coming with us to the hospital. I was told that the parking voucher was only one per family per patient. Which, in all honesty, seemed pretty fair.


After having a conversation with my boss, who somehow thought my surgery was a SATURDAY and not the day I had told him about a few months earlier  He asked me if I was getting ready  Ummm, yes, my surgery is tomorrow..... So after telling me I could leave early, I was already at work well over half the day. this conversation came after he declined my request for the day off, going through the proper channels, I could have just called off and left everyone hanging.  What surgeon does a planned surgery on a SATURDAY??? NONE-ZERO  That is reserved for emergency cases. But whatever, I guess some people don't listen.

 After I got my daily deposit of checks of course, today, the day before the end of the month, was the day that the check scanner decides not to work. I decided that the best thing to do was to put in a ticket for the help desk, tell my boss that I would take the stack to the bank, post the deposit and go the heck home!
He agreed-wished me well and I was done for the day. I gave a few hugs. Had a few people come by throughout the day, but in order to keep myself calm I didn't want any big to-do.

My friend Donna did pray with me as I left the building-She was in the lunchroom and we hugged. 
There is a bank in my way home so i stopped at that one rather than walk in the freezing cold weather Downtown

The evening was pretty calm-I went to dinner with my mom, just a short trip to "Fancy Wendy's"




Watching Jeopardy-



I did my shower and we watched a little tv then went to bed. David had a Basketball game and he returned home later. I made sure my few items were packed and I was ready to go.



It was going to happen!


~DRIVE SLOW~

Wednesday, January 29, 2014

Polar Vortex Continues, no I am NOT having a hip replacement-I am having HIP PRESERVATION (POA SURGERY)

January 29, 2014

The "Polar Vortex Continues". Pittsburgh, and much of the country remains under the frosty veil of the Polar Vortex. Upon waking the temperature read -8 F. with a wind chill of -21 F. Today was supposed to be the "warmer day". HA! I don't think the day really got above 14 degrees on the actual temperature and the wind chill might have made it to zero degrees Farenheit.


As time is ticking away and tomorrow is my last day at work people are coming up to me and wishing me well.  In addition to this, many of those same people asked me about the surgery. Was I getting a hip replacement? Aren't you too young for that?  

The short answer to the second to the second question- YES In most cases hip replacement is NOT done in someone of my age group because they are not known to last that long. Especially in an already active person, the replacement would have to be replaced at least twice within my lifetime. I would actually end up wearing them out. Hip relpacement requires full joint replacement and there for the ball and socket is replaced and the femur is also cut and the surgeons use implants. The fact that my acetabulum (the socket itself) is so shallow would never change. 

My hip dysplasia is bilateral and congenital. Meaning is is on both sides and I was born with it. My hip sockets are too shallow and therefore do not properly cushion and protect the ball in the ball and socket part of the hip joint. This causes a few different issues besides just pain. It causes tears in the spongy tissue called labrum, instability, uneven distribution of weight and shock when walking and doing other activities, and can also cause back problems because the rest of your body will try to overcompensate to make up for the underachieving parts.

After seeing a few doctors, my most recent was Dr. John Christoforetti. He is a known hip specialist. he actually referred me to my current surgeon and told me to explore a newer surgery that was just for patients like me. Patients with my type of dysplasia, my age group, and it was very effective and it was called PAO.

At least I felt like I had hope. I wasn't leaving the doctor's office after being told that I had to wait until I was older to get a hip replacement. I have already spent years doing several rounds of physical therapy, cortisone shots, and anti-inflammatory treatments. While most of the time I know I just live with my situation, make my modifications and go forward and be as active as I can, I wouldn't be human if I didn't have days thinking that there has to be a solution, that all of these futile attempts really aren't changing the core issue. So I decided that i am going to go for it and look into PAO. 

I called immediately, and amazingly was able to get an appointment the next week! NOT what I had expected. In that week in between, I did my research. I am very thankful to live in the time of the internet. The information and blogs of past patients was so helpful. I took all of this into consideration and took it home and discussed it with David. Even he had been noticing that there were just some evenings and days that I avoided stairs, seemed too sore to do anything and was resting more than I was doing. He also noticed that I was even having problems being on my feet while in stores shopping. I was using carts for stability and not just to hold my purchases.

PAO SURGERY
Periacetabular Osteotomy (PAO) is a surgical treatment for acetabular dysplasia that preserves and enhances the patient's own hip joint rather than replacing it with an artificial part. The goal is to alleviate the patient's pain, restore function, and maximize the functional life of their dysplastic hip.  PAO is a procedure that was developed and first performed in 1984 in Bern, Switzerland by Professor Reinhold Ganz with the assistance of Jeffrey Mast, M.D. (an American surgeon from Sparks, Nevada who was spending a year's sabbatical leave with Prof. Ganz). 
Peri-Acetabular Osteotomy series 1Peri-Acetabular Osteotomy series 2


Peri-Acetabular Osteotomy series 3Peri-Acetabular Osteotomy series 4

This surgery involves cutting the pelvis around the hip joint and shifting it into a better position to support the stresses of walking. After the hip is re-positioned, it is held in place with screws until the bone heals. After the bone heals, the screws can be removed, but this is not usually necessary.  http://hipdysplasia.org

This surgery is considered hip preservation as it involves using the patient's native hip.As you might imagine, this operation is complex and is usually performed in specialized centers that do this procedure on a frequent basis. After the operation, patients should not put full weight on their leg for up to three months, so crutches or walkers are often recommended along with a wheel chair for longer distances until the bone has healed in its new position. - See more at: http://hipdysplasia.org

My appointment as we know, from this blog, was a success, and I will be having PAO surgery on my left hip. It is the more pronounces of the bilateral dysplastic hips. I will be having the labrum repaired as well. It will only be after i have fully recovered on the left that assessment and a treatment plan for the right can commence.

Getting ready for surgery is never easy-I am quite the veteran of medical issues and doctors have never been a big deal for me. It has been a while since I have gone in for such a complex surgery. The Silver Lining to all of this is that it is to make me better-It is to correct an anatomical issue and not a disease or ailment that is going to come back. Any pain I shall experience going forward will all be in the name of healing and on the road to recovery.

~DRIVE SLOW~




Tuesday, January 28, 2014

Braving the Weather for a Dinner and a Movie Before Surgery

January 28, 2014:
At 4:45 am the temperature was -7 F degrees with a wind chill of -15 F degrees. Braving the weather again with two (2) pairs of socks, Cuddle Duds pants, Footless tights, lined slacks, Cuddle Duds Base layer shit, another long sleeved knit top and a sweater. WHEW! And that does not even count my thermal boots and Columbia Omni-Heat jacket, wool scarf, and furry hat with ear flaps! 

The Temperature dropped some more and the bus I normally take DID NOT SHOW UP! I am grateful that I am at a Park N Ride because I can at least get back into my car, My silver Kia Soul I have named Tiffany, and wait for the next ten minutes or so and listen to my Satellite radio .[ I am a Stern Super Fan of over 20 years. ]

  

As a result of the unbelievably frigid temperatures all schools were closed again. My husband, a teacher was off and as a coach, the game that was scheduled for this evening was also cancelled. We decided that tonight would be the night for a Dinner & Movie before surgery. After surgery it will be pretty much impossible to go anywhere or do anything non-essential for quite a while. Also it will be quite the production taking into account the time of year and any weather situations we may be dealing with in the next few weeks.

We are usually very big proponents of healthy and clean eating. however, like I have stated in prior posts, everything in moderation. If you deny yourself everything you like or desire all of the time, it will usually backfire. A person will most likely end up eating everything else trying to satisfy a craving instead of eating that one thing that one time. So GO AHEAD & ENJOY IN MODERATION.  We decided to go to Steak N Shake (I had coupons too, of course ).  and then to see the movie Dallas Buyers Club. 





The movie was phenomenal and definitely worthy of all Oscar buzz and accolades. This will be the first year that I will not be able to see all of the Oscar nominated movies. I still need to see four (4) of the nine (9) Best Picture Nominees. But, I am okay with that.

I have been a little more anxious as time is getting closer to the actual day. Nothing bad, just normal, natural feelings. I have my little bag packed with a few essentials that I will be taking to the hospital. I don't think that I will really need a whole lot in terms of pajamas or toiletries. I have a short list below:

Flannel drawstring pajama pants
Flannel drawstring shorts
cozy socks
contacts/travel solution
travel toothbrush/toothpaste
dry shampoo
moisturizer
chapstick
hair ties
hair brush
drawstring sweatpants
slip on sneakers
socks
underwear / cotton
zip up hoodie
Fuzzy blanket
I will bring with me on the day of surgery:
Kindle w/ charger
iPhone w/charger



Periacetabular Osteotomy (PAO) is a surgical treatment for acetabular dysplasia that preserves and enhances the patient's own hip joint rather than replacing it with an artificial part.

Days Until Surgery: 3






Saturday, January 25, 2014

My last solo shopping trip - Stocking up, extreme couponing and braving the snowy roads.

January 25:
As predicted the snow was coming down at a record pace and not letting up. With less than a week left before surgery, I was hoping to attend a few more yoga classes. However upon waking I  logged into Facebook to see that all classes had been cancelled for the day!  The snow was not going to be an ally today.

David braved the nasty road conditions to go coach his basketball team. In the meantime, we watched the snow continue to fall at an amazing pace and I decided to bake. I have always enjoyed baking. This will be the last weekend that I will be able to bake for a while. Orange Pound Cake sounds good for a day like today!  After my two helpers cracked the eggs and mixed the batter, we watched a movie and occasionally I was given an update of how many minutes was left on the oven timer.

"Twenty-seven Minutes!"-Running back into the living room and getting ready to watch a Snoopy Movie



We spent the day doing our coupon cutting and organizing. Even though it was snowing a lot today and it was in the forecast to snow again tomorrow. I was determined to go out.  I have been using coupons for several years. However lately, I have been using them A LOT more often and taking cues from the "extreme couponing shows. I have even begun a small stockpile of my own. It is all items that we use, we need, and items that are non perishable. It isn't out of control, nor is it a hoard . The bulk of the purchasing has been focused on HBA items (Health Beauty Aids) and personal items. 

I have managed to use my coupons to have a cache of personal care products large enough that we will not need to buy the following products for at least 6 months:

Toothpaste
Feminine Hygiene Products (various types)
Deoderant (men/woman)
Shampoo/conditioner
Bodywash
Cold/flu remedies
Body lotion
Soup
Pasta/Pasta Sauces
Frozen Veggies
Frozen Pizzas
Frozen Meals(Organic)
Dry Soup Mix
Coffee/K-Cups
Lightbulbs
Laundry Detergent

**Couponing Tip #1: Whenever possible, the key they to getting the most out of your coupon is to get the smallest size allowable with the coupon. 

**Couponing Tip #2: Use Your Weekly Circulars to make the most out of your coupons to get the specials and any available coupon doubling opportunities. Places like WalMart DO NOT DOUBLE. 

**Couponing Tip #3: If you have a coupon that requires a purchase of multiple items, save it to use with a sale in an advertised sale at a local grocery store or Sunday Circular. 

**Couponing Tip #4: Coupons Often have varying expiration dates and require constant organization and monitoring. It is imperative to go through your coupons weekly, as you are putting new ones into your binder, pull out expired ones and those which will be expiring soon. 


I enjoy the "thrill" of saving money and seeing the final tally of how much I have saved. But, my main motivation for doing the purchasing in such volume was to help alleviate the burden on David. He will taking only a few days off of work. In the mean time he will still be working, coaching and coming home to take care of me. After my hospital stay, my mother will be staying with us. So this will also help her. I have a friend, Dawnelle, who just had a PAO surgery and she has confirmed that the first few weeks post-surgery are quite intense and being left alone isn't really recommended. 

It is going to be hard not to have control and to be dependent on others to help me for almost every aspect of my care. So by doing this, by providing a pantry of items and supplies it is helping me to feel better about becoming the receiver of my much needed help. 



~DRIVE SLOW~

DAYS UNTIL SURGERY: 5




Friday, January 24, 2014

Nutrition+Clean Eating = Less Infflamation

January 24, 2014: The Return of the POLAR VORTEX ! The night before the wind chills were well into the negatives and the forecast of "maybe one inch of snow" in our area turns out to be more like three (3) inches of icy and cold treachery.

Again my husband's school was running on a two-hour delay. At 4:46 am this was the current state of the outdoors.



January is a month of resolutions. The time when "The Resolvers", as my brother and I have named them, are making their best efforts to lose weight, go to the gym more, join a gym, and make other health conscious decisions. However, it is usually by this time in the month that reality, and old habits tend to creep back into practice. The willingness to do and wanting to make a change loses out over to complacency and making excuses. even though the weather is COLD-BEYOND COLD outside that doesn't mean it is my opportunity to not eat well, not treat my body the way it should be treated. I should and do find a way everyday to move and be active. Especially when dealing with joint issues or health issues. 

Making life changes is not easy and is best achieved when done in steps. Making and taking those steps isn't going to always be fun glamorous, or as fabulous as many of those 90 day challenge infomercials would make it seem. But, I assure you that once you start to make positive changes and the toxins are being removed from your body, it will thank you. The thank you will be seen by you and others, felt at first by a little soreness and later in an improved mental state and also it can greatly help to alleviate symptoms of inflammation.  

During this time I would highly recommend that anyone consult with their physicians and nutritionists. Make sure that you are going to embark on a program that will work with your current treatment plan. 

Our bodies are our vehicles, we have them for our whole lives and we need to keep them in the best possible condition. We provide routine maintenance by going for check ups at our physicians, dentitsts getting cleanings and x-rays, getting yearly flu shots and making sure our Rx for eyeglasses is up to date. Food is the fuel for our machines. Bad fuel, just like in a car or engine, will result in an unwanted or an unwelcome outcome. Our bodies immediately respond to the fuel that we feed them. They respond in visible ways and also in ways that we cannot see. 


As illustrated in the graphic above there are also longer term effects that are a direct result of what we put into our bodies. When dealing with joint issues and conditions like arthritis, bursitis, and even in some cases (not me personally) gout, the main underlying symptom to be addressed is inflammation.

The following graphics show foods that are known to cause inflammation and those that can be introduced into a diet to help reduce or eliminate inflammation. *PLEASE NOTE* This does in no way mean that you will be cured of all that ails you and be pain free by eating multiple servings of nuts and other listed foods. You must adhere to the serving guidelines and any that your healthcare providers recommend if you are managing any health conditions such as high blood pressure, high cholesterol, and diabetes.

I will say that you CAN and WILL be healthier by eliminating fast foods, foods fried in heavy animal fats and oils from your diet. I have been hard pressed to find data that says that there will be any negative repercussions for eliminating that immediately from your diet.  

Being a healthy and clean eater doesn't mean that you can never go out, be social or enjoy the occasional indulgence. Restaraunts and fast food chains are making changes in their menus and offering alternatives so that you can go out and enjoy a meal along side friends who want to have that triple decker 1800 calorie 50 fat gram burger and large fries.Every one of them offers bottled water instead of soda. Even traditionally junk food only chains like Dunkin Donuts has been offering item after item for their healthier patrons.   The key to everything is MODERATION. 








I am married to a Type II Diabetic. He is a very active person and we both share the same ideals and philosphies about food and eating. That helps a lot. Having support at home helps. We also don't really buy or have "temptation items" on hand so it is very easy to not become a person who sits and eats chips. If we do have treats or chips and things in the house I try to exercise portion control and use a small bowl. I fill my bowl or put my portion into a paper towel and when it is gone, I am done. 

Mental Exercises are just as important when changing eating habits and taking on a healthy lifestyle change. Learning about yourself and the reasons why we eat is HUGE! I tell myself A LOT-I am not hungry I am just BORED. That is a trigger for me to drink a glass of water and engage my brain in another way.

                                               

As of Christmas 2013, thanks to my mother I have been using my NutriNBullet faithfully to create delicious raw and dairy free food extraction smoothies. The NutriBullet is not a juicer because it uses the whole food and pulverizes it into a smooth drinkable concoction.  I use my NutriBullet for breakfast , and I have a cup of coffee. I make a "NutriBlast" for my lunch and take it to work. I have found that since I am using a whole organic banana, lots of organic spinach,and  frozen wild blueberries as my base i am always full and very satisfied with the taste. 

I have made a few other "Blasts" using apples, pears, some strictly all green, added protein powders. I am enjoying them a lot and finding that this little machine is very easy to use, clean and lives up to the claims on the infomercials and those demonstrations on the home shopping cable networks. I also like the fact that using this machine means I am getting extra servings of vegetables and fruits very easily and getting the whole food. 




Starting slow and starting with what you already like is the best first step to take. Do your research and consider all of the facts. Ask Questions-Keep asking and engage in conversations with people in the business of health, nutrition, and fitness. I would also suggest utilizing social media to "meet up" or "chat" with people in similar situations to create a support system and more importantly an accountability system. Having a time and a place where you can share your achievements, challenges, and ask questions about one another's experiences.

COUNTDOWN TO SURGERY: 1 WEEK

~DRIVE SLOW~





**Disclaimer: Information included in this post is based on my findings and experiences. Before starting any new diet or exercise routine consult with your physician or health professionals.**