Going Under

It actually snowed in Portland the day before my surgery. I got out to run a few last minute errands (pick up prescriptions, buy a few groceries, get a haircut) and enjoy total freedom & mobility one last time. I even cooked steaks (it's a rarity for us to eat red meat at home) for dinner knowing that I wouldn't be able to eat again for almost 24 hours.

The hospital had called at the end of the previous week to let me know they were pushing my surgery back from first thing in the morning to midday due to some necessary equipment not being available. So we left our apartment around 9am on January 15th to catch a bus & then a streetcar to the OHSU Center for Health & Healing. We checked in on the 4th floor, paid a deposit, signed several consent forms, and were escorted to an exam room by 10:30am.

the first tall building to the right of the bridge is the OHSU Center for Health & Healing

I was immediately issued a wrist band (name, date of birth, drug allergies) and changed into a lovely purple hospital gown & socks. I got onto the gurney and the nurses covered me with blankets and connected a hose to a hole in my gown which then inflated with warm air.

Next, they began a battery of tests (temperature, pulse, blood pressure) while answering multiple questions about my medical history and confirming my identity and the surgery I was there for. We also reviewed post-op instructions & medications. They gave me an IV (I convinced the nurse to put it in my arm versus the back of my hand) and then the anesthesiologist came in to discuss general anesthesia.

Greg was allowed to stay with me until they wheeled me to a pre/post-op room just before noon. There I was greeted by multiple doctors who continued the prep work by adding some drugs to my IV, prepping the skin (I had also showered with Hibiclens the night before and that morning), marking the surgical site on my leg/hip, and using an ultrasound-guided needle to administer a femoral nerve block.

Sometime around 12:30 I was wheeled to the OR and transferred to the operating table. I remember saying hi to my surgeon, Dr. Herzka, and then the anesthesiologist put a mask over my nose & mouth and told me to take seven deep breaths. I made it to three...

I woke up a few hours later in the recovery room and immediately felt intense pain in my hip. The nurse gave me some opioids through my IV which quickly made me feel nauseous. So they decided to give me another ultrasound-guided nerve block, but in a different location than the first one (which was still working). My throat was also very sore & dry from the breathing tube so I started sipping some water. Eventually I was stable enough to be wheeled back to the exam room where Greg was allowed to join me around 3:30-4pm.

I was still nauseous from the pain meds so the nurse brought me some apple juice. Within an hour I was feeling well enough to get dressed and transfer to a wheelchair. Greg went outside to pick up a Car2Go while a nurse wheeled me down to the lobby. We met Greg at the building entrance and barely squeezed my leg (which was encased in a full leg brace to immobilize my knee since I couldn't feel anything due to the nerve blocks) into the tiny Smart car along with a giant bag of ice.

Luckily, even though it was rush hour, the traffic coming home over the Hawthorne Bridge wasn't too bad and we made the just-under-four-mile drive in about 20 minutes. It also helped that it wasn't raining. I took my time getting up the eight steps to our apartment (on crutches, which I had practiced prior to surgery) and quickly settled in on the couch.

more crutches + steps practice just before we left for surgery

Once he was sure I was okay, Greg walked to Safeway to pick up my post-op pain medicine (5mg oxycodone) as it was out of stock when I dropped off the prescription on Friday. The nurse had told us my femoral nerve block would probably wear off in 10-12 hours and that I would need to pre-medicate to avoid feeling any severe pain. When Greg got back home he heated up some soup for me (my first food in 24 hours). I was still suffering from a sore throat and could barely speak so I was also drinking lots of water and sucking on cough drops. I took one oxycodone and went to bed around 9pm (over the previous weekend we rearranged furniture and inflated the Aerobed so Greg could still sleep in the same room and help me if I needed anything during the night).

on the couch with full leg brace & ice bag after we got home from surgery

I will write about my first two weeks post-op in my next post, but I did want to include the information from the surgeon's report (which I received at my first follow-up appointment on January 24th) in this post.

These are the procedures that were performed with my "translations" in parentheses:

• Diagnostic hip arthroscopy (get in there with a camera to see the extent of the damage)
• Acetabular chondroplasty (trimmed the loose cartilage around the hip socket)
• Labral repair (used three suture anchors to secure the torn labrum back to the acetabular rim)
• Femoral neck osteoplasty (used a burr - a tool that looks like a long drill bit - to recontour my pelvic bone & the top of my leg bone to increase range of motion)
• Focal acetabular microfracture (drilled two small holes in the bone to encourage new faux-cartilage growth in an area where the entire thickness of the original cartilage was worn down to nothing)
• Capsular repair (sewed up areas they cut to allow movement of surgical instruments)

Credit: OHSU

Click on the Credit link under the above illustration to read more about hip arthroscopy and my surgeon, Dr. Andrea Herzka. They did take photos with the scope during my surgery (I saw them during my follow-up visit on the 24th) and I have requested a copy which should be delivered sometime next week. Fascinating! ;)