#thr — Public Fediverse posts

So You’re Having Major Surgery

Before I had my hip replaced, I read a lot of online accounts from other people. A lot. They were all helpful in their own ways, so I’m adding to the canon. CW for surgical stuff, OCD, mental health, and cautious optimism.

Introduction

On May 20th, I had my right hip replaced.

This had been coming for a while–longer than I’d thought. I’d been suffering from what I assumed was an unhealed stress fracture for over a decade. When I was finally diagnosed with osteoarthritis, you could have knocked me over with a feather. A cortisone shot helped for about six weeks, but it was too late for more than that. My right hip was entirely without cartilege, and it let me know every single moment of the day.

By the time I booked the surgery, I felt like I had no choice. Getting in and out of a car was agony. Stairs were mildly terrifying. I couldn’t walk across a room without hanging on to something. Small tasks–feeding the cats, putting on socks–were elaborate productions.

I did not like the idea of surgery. When I was a kid I went under a general for something little; I threw up afterward, and for an entire day I had crying jags while my body purged the anesthetic.

A THR (total hip replacement) sounded like a much better deal. For one thing, most of them (I was told) are done without a general anesthetic–just a spinal and a sedative. When they’re done anteriorly, you go home the same day. The hospital told me I could expect it to take about 6 hours from checkin to heading back out to the parking lot–on my feet, albeit with crutches.

One person’s online account asserted that they’d been out running not three days after their surgery. This seemed miraculous. This seemed like not major surgery at all.

I saw video of Misty Copeland performing at the Oscars (she comes in at about 3:30), three months after she’d had a THR herself. I’m not an athlete, and I don’t have the same access she does–but I figured I was relatively young for the procedure, and maybe that would help me recover fairly quickly.

But when I clicked into her Instagram and saw videos of her early recovery, they gave me pause. This woman was not pulling on her running shoes and tearing down the street. This woman was using a walker, and being extremely cautious on her feet. This woman–twenty years younger than me, and a professional athlete–was considerably slowed down.

I’m not sure what I really believed at that point. I wanted to be optimistic going in to the surgery. I wanted to be realistic coming out of it. Misty Copeland’s three months from surgery to performing (in toe shoes, no less!) suggested I would, in fact, recover and be far more mobile than I’d been before.

And I am.

But it was not what I expected.

Part I: Before Surgery

The weekend before my surgery, The Kid graduated from college. I was walking with a cane.

We’d checked out the handicapped parking situation, and found a lot close to the graduation venue. On the day of, though, we found out the people directing traffic had no idea what we were talking about. We were directed to the general parking lot, and pointed at shuttle buses.

I could walk to a bus stop. I could get on and off a bus. But I was very slow, and not at all steady. I was in constant pain and easily fatigued. I couldn’t rush to catch a bus, or easily get out of anyone’s way. Even stepping up on a curb required several seconds of planning.

The space where her graduation was being held had an elevator–but you had to climb a flight of stairs to reach it. Seating was folding chairs, which meant people with walking devices ended up on the aisles. I was not the only person there needing an assistive device–I saw everything from canes to walkers to scooters. The venue was not prepared for those at all.

But everyone was very nice, and people did their best to give me room as I did my best to stay out of the way. It was a lovely ceremony, and by the end of it–making my way back down those stone steps, back onto the shuttle bus, back to the giant parking lot–I was absolutely exhausted. Surgery seemed like a miracle at that point. I didn’t care how long it would take me to heal, as long as I could eventually walk again.

It’s possibly worth mentioning at this point that I’m an extremely impatient person, and I’m least patient with myself. Reminding myself recovery would take time was not the same as understanding what I was in for. I told myself I couldn’t know how it would go, but on some level, I believed it’d be easy.

And then came the prescriptions.

I was prescribed nine separate medications before the surgery. They ended up lined up by the sink, waiting for me: anti-inflamatories, a blood thinner, multiple painkillers, an antacid, an anti-nausea med. Those little bottles gave me a serious wobble. What was I doing? I’d been suriving on Tylenol and Advil. What kind of trade was I making? What was I thinking, having an entire body part removed?

I was scared. But every time I took a step, I knew I’d made the only real choice I could. It’d be over soon, and I’d recover, and everything would be the way it was.

Part II: Under The Knife

Both Spouse and The Kid came to the hospital with me.

A lot of what happened before the surgery is a blur. I checked in, and was given a bag for my clothes and shoes. Eventually someone came in to shoot lidocane into my back to prepare for the spinal. Someone put a port in my right arm for the sedative. I’m not clear in what order all this happened.

I remember the surgeon stopping in to say hello. I remember meeting multiple anesthesia guys. I remember saying goodbye to Spouse and The Kid, and being wheeled into the operating room. I remember the big iconic lights hovering over me. All the modernization we’ve had, and surgery is still done under those big theatrical lights.

The wakeup was equally fuzzy. They let Spouse and The Kid in fairly quickly. I got my glasses back–giving up my glasses is possibly the worst part of any medical procedure; I feel completely helpless–and the grogginess started falling away. I sent a text message to a friend of mine about four hours after I was knocked out. About five hours after, they’d fitted me with crutches (a walker didn’t really work, which was good because it would have been difficult to wrangle in our house), and we were sent upon our merry way.

I don’t remember much about the rest of that day. Once home, I went up the stairs to get into bed. Spouse and The Kid took excellent care of me, bringing me my computer, my tablet, and everything I needed. The hardest part was the cats, who didn’t really understand why they couldn’t curl up on my right hip, or why I couldn’t lie on that side.

But I was home, it was over, and I could get down to the Super Fast and Totally Linear process of healing.

Part III: Recovery, or What The Actual Fuck?

I am a terrible patient.

I feel like most of us are, really. We have in our heads a baseline for how our bodies behave, and if we have a setback, we’re ready to just shake it off and get back to where we were. What’s all this time needed for healing? What’s all this physical therapy nonsense? It’s my body; I’ve known it a long time. Can’t it just toughen up and get with the program?

So I don’t think I was some sort of Special Snowflake of the post-operative crowd. I was just another person who’d undergone a fairly common procedure wondering WTF was going on.

And then, of course, there’s OCD.

Everyone is different, but my OCD brain goes one of two ways:

1. Everything will be fine if you just ignore it and pretend nothing is wrong.
2. You are going to die, very soon and very horribly.

On top of this, I react rather strangely to a wide variety of meds, and I hit some new ones this time. I reacted oddly to the antacid (really messed up my appetite). And I think the antibiotic just made me weird. There’s already a whole family of antibiotics I can’t take because they strongly influence my mood. This was not of that family, but I think it’s one I need to add to the list of “drugs to avoid if at all possible.”

Or maybe it was just the surgery.

Depression after surgery is extremely common. It’s especially common in people who’ve had depression before.

The physical therapist who came to the house was telling me how well I was doing. I could clearly move better and further every day. But I felt constantly upset and disoriented. I felt like I’d made a horrible mistake, and had to constantly remind myself how hard it had been to walk.

I had the oddest sensation that I was speedrunning death, that the surgery had unlocked some malevolent cheat code and I was shooting down a waterslide toward The End. I had, sporadically, the absolute conviction that I was not the same person I’d been before the surgery. Like I was some sort of transporter copy.

Day 5 was the worst. The Monday after surgery I felt awful. Just a general miasma of I Feel Crappy And Something’s Wrong. No fever, no other issues, but I couldn’t shake the feeling.

After that, though, I began climbing out of the abyss. Slowly. It was difficult. I was emotional, volatile. I was so easily exhausted, so impatient with the things I couldn’t do. Hating that I needed help.

I couldn’t write. I couldn’t read. I surfed social media and tried to play games. Now and then I’d go downstairs for dinner and spend time with my family, but I couldn’t make it more than a few hours.

Every day was a little better, but at the time? It felt like disaster.

Part IV: Approaching Normal, Maybe

About 2-1/2 weeks after surgery, I started walking without crutches. The following week, the surgeon approved me to drive.

I started reading again around the time I got off the crutches. Writing took longer–until June 16, nearly four full weeks after surgery. Both of those activities contributed to improving my mental health.

At this point I get around pretty well. I still keep a death grip on the banister going up and down the stairs, but stairs are actually less painful than regular walking. I’m doing outpatient physical therapy at this point, with an eye toward getting back on the treadmill. I’d love to be able to run again, but for now I’ll take my old walking regimen. That’s what started all this: my doctor telling me the surgery would get me back to regular exercise, which would be good for so many reasons.

I still struggle with OCD and depression. I still catastrophize when I shouldn’t. It’s dramatically better than it was. I have hopes that our little weekend vacation next month will be fun–and that I’ll be able to keep up with everyone. But the feeling of dread still comes for me, still threatens to drag me under. It’s not as strong, or as frequent, but when it’s present it still feels like it’ll never leave me.

The cats, bless them, don’t care about my mood. They care that I can now sleep on my right side (their preference), that they can curl up against me any way they’d like, that their food appears at the appropriate times. Animals are so good at reminding us what’s important, aren’t they? Sustenance and comfort. Curling up with the ones we love. A decent night’s sleep.

I am not yet myself. I am getting there.

Epilogue: So, Liz, would you do it again?

This is a very different question than “are you glad you did it?”

Because I’m not glad I did it. And I’d absolutely do it again.

Even with Misty Copeland’s videos, I had an overly optimistic picture of what recovery would be like. (I mentioned to the physical therapist the person who’d claimed they’d gone for a run two days after surgery. She smiled, and said, “I’ve been doing this for seventeen years. That never happened.” So don’t believe what you read on line, I guess!) That I wouldn’t be under general anesthesia and could expect to go home the same day also made me feel like this would all be a minimal disruption.

To anyone who might be thinking the way I was thinking, I’ll remind you: it is major surgery. They cut you open (my scar is about 6″ long) pull your muscles and ligaments out of the way, saw off a chunk of bone, put a plate on your hip bone, and insert a spike with ceramic a ball on the end into your femur.

The incision will hurt for a while. (Mine still does, somewhat, when I move.) Your muscles will hurt worse. You’ll have numbness, thanks to your nerves being jerked around; one physical therapist volunteered that’s usually the bit that lasts the longest. Small activities will wipe you out.

Your insulted muscles will retaliate. They’ll be stiff and sore, especially around the new joint. They won’t hold your weight without help. They’ll want to let you sink into the new hip–which will be just about the only thing that doesn’t hurt–and make you wonder if your legs are now different lengths. (They might be. This isn’t unusual. Still working with the physical therapist to see if that’s the case with me, or if it’s only lingering weakness.) The exercises you’re given will hurt like hell, and that’ll weird you out, because we’ve evolved to avoid pain.

But the physical recovery will come. It won’t be fast enough or easy enough to make you happy, but it’ll come.

It’s the mental stuff that has the potential to really trip you up.

Maybe you won’t be like me, and you’ll feel like yourself, just cranky about not being able to do laundry without help.

But if you are like me…you may feel frightened. Helpless. Depressed. Out of place in your own body. You may feel unable to do the non-physical things you want to do, or at least to enjoy them. You may feel like you have to perform normalcy for your loved ones while you’re convinced you’ll never feel normal again, not ever.

I didn’t talk a lot about it at the worst points (although my primary care doctor got to see a full-on OCD meltdown for the first time, bless his heart). Knowing it was coming wouldn’t have changed my mind about having the surgery. But it made some of those post-operative days pretty actively miserable.

Was it the meds? Those contributed, I think. I’m on OTC-only at this point. Maybe it’s just a coincidence. Maybe being able to control the pain with plain ol’ Tylenol means whatever-it-was about the surgery is finally clearing my system.

But all of this has been an ordeal, in ways I hadn’t anticipated, even with my research. I’m still riding waves of instability, although I’m finally at the point where I don’t think they’ll last forever.

I cannot be glad I did this to myself, but I am very clear it was still, with all these side effects, a better option than trying to live with what I had. I feel lucky the technology exists to replace a hip joint as easily as they did mine. I feel lucky my surgeon was skilled and conscientious. I feel lucky my primary care doctor is a good and compassionate listener. I feel astonishingly lucky that my family is so kind and patient.

It was still terrible, I expect all major surgery is terrible. Even if it’s exactly what you need.

So You’re Having Major Surgery

Before I had my hip replaced, I read a lot of online accounts from other people. A lot. They were all helpful in their own ways, so I’m adding to the canon. CW for surgical stuff, OCD, mental health, and cautious optimism.

Introduction

On May 20th, I had my right hip replaced.

This had been coming for a while–longer than I’d thought. I’d been suffering from what I assumed was an unhealed stress fracture for over a decade. When I was finally diagnosed with osteoarthritis, you could have knocked me over with a feather. A cortisone shot helped for about six weeks, but it was too late for more than that. My right hip was entirely without cartilege, and it let me know every single moment of the day.

By the time I booked the surgery, I felt like I had no choice. Getting in and out of a car was agony. Stairs were mildly terrifying. I couldn’t walk across a room without hanging on to something. Small tasks–feeding the cats, putting on socks–were elaborate productions.

I did not like the idea of surgery. When I was a kid I went under a general for something little; I threw up afterward, and for an entire day I had crying jags while my body purged the anesthetic.

A THR (total hip replacement) sounded like a much better deal. For one thing, most of them (I was told) are done without a general anesthetic–just a spinal and a sedative. When they’re done anteriorly, you go home the same day. The hospital told me I could expect it to take about 6 hours from checkin to heading back out to the parking lot–on my feet, albeit with crutches.

One person’s online account asserted that they’d been out running not three days after their surgery. This seemed miraculous. This seemed like not major surgery at all.

I saw video of Misty Copeland performing at the Oscars (she comes in at about 3:30), three months after she’d had a THR herself. I’m not an athlete, and I don’t have the same access she does–but I figured I was relatively young for the procedure, and maybe that would help me recover fairly quickly.

But when I clicked into her Instagram and saw videos of her early recovery, they gave me pause. This woman was not pulling on her running shoes and tearing down the street. This woman was using a walker, and being extremely cautious on her feet. This woman–twenty years younger than me, and a professional athlete–was considerably slowed down.

I’m not sure what I really believed at that point. I wanted to be optimistic going in to the surgery. I wanted to be realistic coming out of it. Misty Copeland’s three months from surgery to performing (in toe shoes, no less!) suggested I would, in fact, recover and be far more mobile than I’d been before.

And I am.

But it was not what I expected.

Part I: Before Surgery

The weekend before my surgery, The Kid graduated from college. I was walking with a cane.

We’d checked out the handicapped parking situation, and found a lot close to the graduation venue. On the day of, though, we found out the people directing traffic had no idea what we were talking about. We were directed to the general parking lot, and pointed at shuttle buses.

I could walk to a bus stop. I could get on and off a bus. But I was very slow, and not at all steady. I was in constant pain and easily fatigued. I couldn’t rush to catch a bus, or easily get out of anyone’s way. Even stepping up on a curb required several seconds of planning.

The space where her graduation was being held had an elevator–but you had to climb a flight of stairs to reach it. Seating was folding chairs, which meant people with walking devices ended up on the aisles. I was not the only person there needing an assistive device–I saw everything from canes to walkers to scooters. The venue was not prepared for those at all.

But everyone was very nice, and people did their best to give me room as I did my best to stay out of the way. It was a lovely ceremony, and by the end of it–making my way back down those stone steps, back onto the shuttle bus, back to the giant parking lot–I was absolutely exhausted. Surgery seemed like a miracle at that point. I didn’t care how long it would take me to heal, as long as I could eventually walk again.

It’s possibly worth mentioning at this point that I’m an extremely impatient person, and I’m least patient with myself. Reminding myself recovery would take time was not the same as understanding what I was in for. I told myself I couldn’t know how it would go, but on some level, I believed it’d be easy.

And then came the prescriptions.

I was prescribed nine separate medications before the surgery. They ended up lined up by the sink, waiting for me: anti-inflamatories, a blood thinner, multiple painkillers, an antacid, an anti-nausea med. Those little bottles gave me a serious wobble. What was I doing? I’d been suriving on Tylenol and Advil. What kind of trade was I making? What was I thinking, having an entire body part removed?

I was scared. But every time I took a step, I knew I’d made the only real choice I could. It’d be over soon, and I’d recover, and everything would be the way it was.

Part II: Under The Knife

Both Spouse and The Kid came to the hospital with me.

A lot of what happened before the surgery is a blur. I checked in, and was given a bag for my clothes and shoes. Eventually someone came in to shoot lidocane into my back to prepare for the spinal. Someone put a port in my right arm for the sedative. I’m not clear in what order all this happened.

I remember the surgeon stopping in to say hello. I remember meeting multiple anesthesia guys. I remember saying goodbye to Spouse and The Kid, and being wheeled into the operating room. I remember the big iconic lights hovering over me. All the modernization we’ve had, and surgery is still done under those big theatrical lights.

The wakeup was equally fuzzy. They let Spouse and The Kid in fairly quickly. I got my glasses back–giving up my glasses is possibly the worst part of any medical procedure; I feel completely helpless–and the grogginess started falling away. I sent a text message to a friend of mine about four hours after I was knocked out. About five hours after, they’d fitted me with crutches (a walker didn’t really work, which was good because it would have been difficult to wrangle in our house), and we were sent upon our merry way.

I don’t remember much about the rest of that day. Once home, I went up the stairs to get into bed. Spouse and The Kid took excellent care of me, bringing me my computer, my tablet, and everything I needed. The hardest part was the cats, who didn’t really understand why they couldn’t curl up on my right hip, or why I couldn’t lie on that side.

But I was home, it was over, and I could get down to the Super Fast and Totally Linear process of healing.

Part III: Recovery, or What The Actual Fuck?

I am a terrible patient.

I feel like most of us are, really. We have in our heads a baseline for how our bodies behave, and if we have a setback, we’re ready to just shake it off and get back to where we were. What’s all this time needed for healing? What’s all this physical therapy nonsense? It’s my body; I’ve known it a long time. Can’t it just toughen up and get with the program?

So I don’t think I was some sort of Special Snowflake of the post-operative crowd. I was just another person who’d undergone a fairly common procedure wondering WTF was going on.

And then, of course, there’s OCD.

Everyone is different, but my OCD brain goes one of two ways:

1. Everything will be fine if you just ignore it and pretend nothing is wrong.
2. You are going to die, very soon and very horribly.

On top of this, I react rather strangely to a wide variety of meds, and I hit some new ones this time. I reacted oddly to the antacid (really messed up my appetite). And I think the antibiotic just made me weird. There’s already a whole family of antibiotics I can’t take because they strongly influence my mood. This was not of that family, but I think it’s one I need to add to the list of “drugs to avoid if at all possible.”

Or maybe it was just the surgery.

Depression after surgery is extremely common. It’s especially common in people who’ve had depression before.

The physical therapist who came to the house was telling me how well I was doing. I could clearly move better and further every day. But I felt constantly upset and disoriented. I felt like I’d made a horrible mistake, and had to constantly remind myself how hard it had been to walk.

I had the oddest sensation that I was speedrunning death, that the surgery had unlocked some malevolent cheat code and I was shooting down a waterslide toward The End. I had, sporadically, the absolute conviction that I was not the same person I’d been before the surgery. Like I was some sort of transporter copy.

Day 5 was the worst. The Monday after surgery I felt awful. Just a general miasma of I Feel Crappy And Something’s Wrong. No fever, no other issues, but I couldn’t shake the feeling.

After that, though, I began climbing out of the abyss. Slowly. It was difficult. I was emotional, volatile. I was so easily exhausted, so impatient with the things I couldn’t do. Hating that I needed help.

I couldn’t write. I couldn’t read. I surfed social media and tried to play games. Now and then I’d go downstairs for dinner and spend time with my family, but I couldn’t make it more than a few hours.

Every day was a little better, but at the time? It felt like disaster.

Part IV: Approaching Normal, Maybe

About 2-1/2 weeks after surgery, I started walking without crutches. The following week, the surgeon approved me to drive.

I started reading again around the time I got off the crutches. Writing took longer–until June 16, nearly four full weeks after surgery. Both of those activities contributed to improving my mental health.

At this point I get around pretty well. I still keep a death grip on the banister going up and down the stairs, but stairs are actually less painful than regular walking. I’m doing outpatient physical therapy at this point, with an eye toward getting back on the treadmill. I’d love to be able to run again, but for now I’ll take my old walking regimen. That’s what started all this: my doctor telling me the surgery would get me back to regular exercise, which would be good for so many reasons.

I still struggle with OCD and depression. I still catastrophize when I shouldn’t. It’s dramatically better than it was. I have hopes that our little weekend vacation next month will be fun–and that I’ll be able to keep up with everyone. But the feeling of dread still comes for me, still threatens to drag me under. It’s not as strong, or as frequent, but when it’s present it still feels like it’ll never leave me.

The cats, bless them, don’t care about my mood. They care that I can now sleep on my right side (their preference), that they can curl up against me any way they’d like, that their food appears at the appropriate times. Animals are so good at reminding us what’s important, aren’t they? Sustenance and comfort. Curling up with the ones we love. A decent night’s sleep.

I am not yet myself. I am getting there.

Epilogue: So, Liz, would you do it again?

This is a very different question than “are you glad you did it?”

Because I’m not glad I did it. And I’d absolutely do it again.

Even with Misty Copeland’s videos, I had an overly optimistic picture of what recovery would be like. (I mentioned to the physical therapist the person who’d claimed they’d gone for a run two days after surgery. She smiled, and said, “I’ve been doing this for seventeen years. That never happened.” So don’t believe what you read on line, I guess!) That I wouldn’t be under general anesthesia and could expect to go home the same day also made me feel like this would all be a minimal disruption.

To anyone who might be thinking the way I was thinking, I’ll remind you: it is major surgery. They cut you open (my scar is about 6″ long) pull your muscles and ligaments out of the way, saw off a chunk of bone, put a plate on your hip bone, and insert a spike with ceramic a ball on the end into your femur.

The incision will hurt for a while. (Mine still does, somewhat, when I move.) Your muscles will hurt worse. You’ll have numbness, thanks to your nerves being jerked around; one physical therapist volunteered that’s usually the bit that lasts the longest. Small activities will wipe you out.

Your insulted muscles will retaliate. They’ll be stiff and sore, especially around the new joint. They won’t hold your weight without help. They’ll want to let you sink into the new hip–which will be just about the only thing that doesn’t hurt–and make you wonder if your legs are now different lengths. (They might be. This isn’t unusual. Still working with the physical therapist to see if that’s the case with me, or if it’s only lingering weakness.) The exercises you’re given will hurt like hell, and that’ll weird you out, because we’ve evolved to avoid pain.

But the physical recovery will come. It won’t be fast enough or easy enough to make you happy, but it’ll come.

It’s the mental stuff that has the potential to really trip you up.

Maybe you won’t be like me, and you’ll feel like yourself, just cranky about not being able to do laundry without help.

But if you are like me…you may feel frightened. Helpless. Depressed. Out of place in your own body. You may feel unable to do the non-physical things you want to do, or at least to enjoy them. You may feel like you have to perform normalcy for your loved ones while you’re convinced you’ll never feel normal again, not ever.

I didn’t talk a lot about it at the worst points (although my primary care doctor got to see a full-on OCD meltdown for the first time, bless his heart). Knowing it was coming wouldn’t have changed my mind about having the surgery. But it made some of those post-operative days pretty actively miserable.

Was it the meds? Those contributed, I think. I’m on OTC-only at this point. Maybe it’s just a coincidence. Maybe being able to control the pain with plain ol’ Tylenol means whatever-it-was about the surgery is finally clearing my system.

But all of this has been an ordeal, in ways I hadn’t anticipated, even with my research. I’m still riding waves of instability, although I’m finally at the point where I don’t think they’ll last forever.

I cannot be glad I did this to myself, but I am very clear it was still, with all these side effects, a better option than trying to live with what I had. I feel lucky the technology exists to replace a hip joint as easily as they did mine. I feel lucky my surgeon was skilled and conscientious. I feel lucky my primary care doctor is a good and compassionate listener. I feel astonishingly lucky that my family is so kind and patient.

It was still terrible, I expect all major surgery is terrible. Even if it’s exactly what you need.