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Saturday, February 22, 2014

< 1 Week Pre-Op

I have waited 9 months and now surgery is less than a week away.  It feels surreal.  I think that the majority of this feeling is that I am nearing the ending of school.  THAT is super exciting.  And surgery comes along with a different kind of excitement.  An excitement...erm...rather, hope that comes with the thought that this surgery could be a huge improvement for my quality of life.  The hope that if I can get a stable hip, that I could have a reduction in pain levels and be able to do things on my feet again, like shopping, going out with friends.  When I write it down like that it makes me sound super pathetic and a hermit.  In all honesty though, being on my feet all day hurting so much is so draining, that I barely have the energy to do anything but come home, collapse on the couch with my beloved heating pad, ice packs, and Tramadol.  THIS is the reason I am doing this surgery!  So bring it on!

Anesthesia called yesterday and I think I got my point across on how sick I get after general anesthetic.  The nurse and I had a nice chat about the factors that increase post-operative nausea/vomiting.  Apparently non-smokers, obese, people who get migraines, and people who get motion sickness are the strongest predictors of nausea and vomiting.  Awesome.  I have all of those except the obesity.  The strongest predictor she said was motion sickness...which is so odd that I haven't ever stumbled across this before because I get so car sick that I can't even ride in the back seat of the car around town because I get nauseous.  In the past we have tried scopolamine patches, Zofran, Phenergan, all of which do not help.  The nurse has noted it and I will definitely make the anesthesia team aware of this issue.  This is one of my main concerns about surgery. 

Another thing that is stressing me is that the insurance company has been so kind as to deny my surgery.  I hadn't heard anything from the insurance company or the surgeon's office and I called last week to see if everything was okay.  Apparently the surgeon is doing a peer-to-peer review on Monday to get my surgery covered.  His nurse said that I should really, really NOT worry about it as he WILL get it covered.  All in all, it still makes me very nervous because there is still that possibility that the surgery won't happen if I can't get it covered.  I mean, what else more do you need than subluxed hips on standing to get approved.  So now praying for this as well.  I hope it gets all straightened out.  The insurance makes me so nervous after what we went through in 2012 :/

Sunday, February 16, 2014

Pre-Op Appointment--Check

This past week I had my pre-op appointment with my surgeon.  It went fairly well....all things aside, it made me extremely nervous, but I'll get through.  I am very nervous about this approaching surgery and I obviously came across as a Nervous Nelly because he asked me what I was so nervous about.  In any event, the appointment started with him telling me about how my surgery and hospital stay was going to shake down.  There wasn't anything that I didn't know in his speech.  But he didn't go through everything in detail because I had said that I had a good understanding of what the surgery entails.  Fair enough.  He then went through a very limited list of risks (I know he did this purposefully because both he and I know that I am not the most enthusiastic PAO patient he's ever had and I betcha he didn't want me running for the door!)  While I was asking my questions, I decided that I would ask about my other hip since that side is painful daily as well.  Ultimately, my chances of it settling down after I cease to add the compensatory weight on it are....nil.  Awesome.  So, looks like a PAO on the other side during residency (sooner rather than later). 

We then discussed plan B.  I am extremely thankful for him creating a plan B incase my hip is not good enough for a PAO to be done.  The plan is for him to scope my hip and check my cartilage health and then he will make a decision on whether or not to proceed with the PAO.  He has done 1500 PAOs and has had to abort 3 of them.  My chances are that I will very likely get the PAO.  We are all hoping that it ends up this way as I am too young for a THR.  But, having said this, the PAO will simply be a bridge to get me a couple to several years before needing it replaced.  He can't guarantee that the PAO will remove all of my pain because I have had too many surgeries, but he can guarantee me a stable that is not subluxed out while standing!  I am hoping that the pain from the instability substantially reduces my pain levels.  I know I am making the right decision to go and try the PAO if possible, as then I can know I did everything I could before having the replacement. So if the PAO is a no-go, I will be closed up from the scope and will have a replacement two to three weeks later with his partner.  The risk of infection is too high if we do the replacement the same day.  During my pre-op I also met with the surgeon who will do my replacement if needed.  That is when it really set in that we really don't know how this is going to turn out and that a THR is a very real possibility.  He was very nice about describing it all to me and was straight up that its not a matter of if we will meet for a replacement, it's when.  I got his surgery scheduling lady's contact if it does in fact come to that.  (Please pray it doesn't)

All in all, it was an informative appointment.  I am less than thrilled that I am still on my surgical journey towards functioning hips and have, obviously, become semi-jaded.  I think that my attitude during my appointment came across as being rather fed up and a bit sarcastic.  He knows I am less than excited to have to have surgery again.  I made it VERY clear to him.  Which, isn't exactly how I wanted to come across during our pre-op planning.  He is a very good surgeon, and I think I trust him totally.  My issue with trusting surgeons is that I actually trusted my previous surgeons!  And all they did was make me worse by performing the wrong operations on me.  I think that it is only human nature to be hesitant on the trusting bit once you have been let down so many times in the past.  I hope that my surgeon understands this, because this is one of the hardest things for me at this point in time and I really don't mean to be snarky with him and all of his surgical suggestions.  And my surgeon is such a sharp shooter--whoa!  He doesn't sugar coat anything and just tells you the way it is.  Which is good in a way, but kinda threw me off guard as I have heard from other patients of his how he jokes and has great bedside manners.  With me, it was all business.  Which is fine, I really don't want him to be my bestie, I just want him to fix my hips so that I can start to live a semi-normal life.

I am now in the process of organizing the crap in my life before the big day.  I organized my clothes so that my parents can find things in my closet (I do not keep the most tidy of rooms), started to move my junk into the spare bedroom (since I will be staying down on the main floor post sense in lugging my sore body up 15 narrow stairs post op if I can avoid it).  I also got my pre-admission information all set up with the hospital too--they called yesterday.  So, it is really happening!  We are beginning a major turning point in this hip journey.  In 11 days I will have a better idea of what is in store for my hips.  This is exciting in an oh-my-gosh-I'm-gonna-barf-I'm-so-nervous kinda way.

Sunday, February 2, 2014

T-Minus 25 Days

I seriously can't believe that this dang surgery is coming up so quickly.  It's crazy.  I have waited 9 months to schedule and have this surgery (I could have had a baby in that time for crying out loud!...scary thought).  So now, less than a month and I'll be all fixed up.  And I'm ready!  I am at a point where I know I need something done as I need my life back and if the PAO is what is needed to get it back, then BRING IT ON!

Pre-Op:  February 13th
Last day of school:  February 27th
PAO:  February 28th

February's gonna be a busy month.