Monday, March 28, 2022

 Monday, March 28, 2022

     This was a drama-filled morning. I nearly killed myself twice, and I decided to get hip replacement surgery.

     I had an appointment with an orthopedic surgeon this morning at Kaiser. I made the appointment when I had that problem with my ankle, which started in January. I had excruciating pain in my ankle when I stepped on my left heel. I had completed 337 days straight of 10,000 steps, just 23 days short of my 360-day goal. It was too painful for me to continue. Remembering doctors told me that as the hip got worse, I would experience problems in my lower leg, so I made an appointment with an orthopedic surgeon. If it cleared up, there would be no need to consider THR. I planned to keep the appointment regardless to see if there was additional information. That appointment was today.

    Here's my first attempt at suicide this morning. I missed the turn into the Kaiser parking lot. I was just a nose beyond the entrance. By making a sharp left, I could easily turn in. I started that turn and noticed a dump truck coming down the hill. I aborted my turn and wisely waited till the truck had passed. My decision-making faculties and reflexes were still good enough to make the right choice.

   My appointment was with a woman orthopedic surgeon; the rest have been men. I didn't count on her being much better than the men, but there was a universe of difference. In all fairness, I had information about my body through the PTs I didn't have before. But the doctors did. The doctor was a young woman who spent time talking to me. She addressed my questions and gave me the information I needed. The male doctors said, "Do it! You'll love it!" and "Someday, you will be in terrible pain and have to wait three months for the surgery." Over the years, I made two appointments for surgery and canceled both because I wasn't in pain. I had this strong feeling that it was not right. In both cases, the doctors' nurses said, "If you're not in pain, don't do it!"  

     Dr. Salassa said we usually don't do it if someone is not in pain. I was generally not in pain. I was stiff; I had some movement limitations. Dr. S explained the joint had started to disintegrate and would continue to do so. One day, the femoral head would collapse, and I would be in agony until the surgery. If I lived fifteen more years, it was highly likely to happen. Most predictions for me are another twenty years. That meant I could anticipate trouble. 

   One of my concerns was my apparent uneven 'leg length." Dr. S asked, "Do you think it is caused by a difference in your legs or your back problem?" I thought it came from my back. I asked her if she would take X-rays to precisely determine leg length. No. And then she showed me how she would determine it. She projected a line across the X-ray image of my hips. Then she eye-balled the space between that point and another higher on the hp. She said my legs were even. The difference was created by my back problems.  

   I used a walking stick today during my visit with the doctor. My leg has been problematic. Was this because I was waking with atrophied muscles or because I had pushed the hip as far as it could go? Dr. S asked me a question I wouldn't have thought a doctor would. She asked me if I used the stick to avoid using the left leg or supporting it so I could put more weight on it. The answer was so I could put more weight on it.   

   This is the first doctor to offer an anterior surgical approach. Every other doctor I have spoken to only offered the posterior. This doctor could do both and wasn't invested in one verse the other. I told her a friend popped his new joint several times. He did it in a yoga class, and I want to continue taking yoga classes. With the posterior approach, eagle poses, opening the hip from the rear, are out. With the anterior approach, the warrior poses, opening the hip from the inside is out. However, if I was cautious for six months and allowed the muscles to reattach with vigor and determination, the chances of ever popping the hip out would be negligible.

      Given my anteverted hip alignment (unusual in adults), she said she would prefer the anterior approach for me. She said she could adjust the placement within the joint to make some corrections for my turned-in hip position. My chances of achieving a perfect turnout were off the table.         The doctor said her first available appointments were in May. I have family visiting then. Damon, Cylin, and August are planning for early May. They want Shivani to overlap with them so they can see her and her five-year-old son, Sidney. Shivani had already made flight arrangements for the end of May. I told the doctor June would be great. Now I only have to worry if the world will still be functioning then. 

    The bad news was the problems with my left calf, ankle, and foot were not due to hip problems. Hip problems only affect the muscles of the upper leg. Dr. S thought those problems came from my back and were caused by sciatica. I will have to deal with these even after the surgery. My hanai sister just had back surgery to deal with this problem. OMG! She was in a rehab unit for three weeks. I hope it doesn't come to that for me.

   I headed to the transfer station after Kaiser. It's just one stoplight further down the highway. I had loaded the car with cardboard on Sunday, meaning to drop it off, and forgot because I rushed home from church to nap. 

    I called Judy to give her the news as I headed home from the doctor's appointment. I needed someone to help me return home from Oahu, or the hospital won't release me. I won't 'need' someone to help me on the front end. Once I get to the hospital, the medical staff will do everything until check-out. This all makes me very sad. Several people are willing to come over with me, stay in Honolulu for the night, and then take me home, but it would not be the same as it would have been with Mike. We were glued to each other. If I was in the hospital, he was there; if he was in the hospital, I was there. You have to ask a friend to come. You have to make arrangements. With a spouse, there is no question. It's assumed. If a spouse doesn't come through, it's an ethical breach. This is the greatest loss for me. I am no longer someone's 'must take care of" person, and no one is mine. I can have a bevy of friends come with me, and it won't be the same.

    Here's the story of my second escape from death by my own hand. While I was on the phone with Judy while driving home, someone else called. I arranged to have someone from Kaiser call to interpret my urinalysis results this morning. This could be the call. I hung up with Judy but couldn't switch to the other call. I frantically pushed buttons on the video screen while driving down Queen K at 45 miles an hour. It did occur to me to pull over, but I couldn't coordinate that and argue with the screen. I think I was checking traffic out of the peripheral vision of my left eye. I didn't even wander out of my lane. The call was dropped. I thought, Holy cow! Am I out of my f__king mind?" On the positive side, dying in a car crash would have solved my UTI problem. 

   The phone rang again around 11:30. It was my much-loved primary doctor- not just by me. She is the sweetest person, and she is mighty competent. She was the one who found B's cancer when everyone else missed it. This was the call I was waiting for, only I didn't expect it to be my primary. She said the results of the urinalysis were inconclusive. It looked like the sample was contaminated. I told her of the continuing problems I was facing with urine flow. I had tried everything, and I hadn't seen much progress. She ordered a consultation with a urologist and an ultrasound of my bladder and kidneys to see if there were structural problems. This woman makes it easier to breathe.

   I also told her I agreed to have a THR and about my encounter with Dr. Salassa.  Dr. Reed told me she had heard only the best about this doctor. She has a great 'bedside manner,' and she is an outstanding surgeon. Wow! I will never know if I would have been okay If I had had the surgery sooner. One of my reasons for delaying it was to get my spinal curvature corrected before the surgery. While it was not perfect, the difference between what it had been and what was now was impressive. Both PTs and my chiropractor have commented on it. My PTs said they never expected me to make the progress I had made. I take their advice seriously.

   As I walked out on the driveway to check the mail, I heard a loud male voice coming from a fixed spot. It wasn't someone walking by. I went out on the road to check. Lutz leaned on Mei and Peter's gate, talking their ears off. Peter was clearly uncomfortable. I said, "Lutz. Why don't you walk with me?" He gladly came along. We enjoy each other's company. While Lutz is loud and often bombastic (he describes himself as opinionated), he is open to feedback. Once I learned that I found his company quite enjoyable, I looked forward to walking with him. However, Mei and Peter didn't know him from Adam, and they're Chinese. They had no idea how to deal with this situation. I called them when I got home. They thanked me for freeing them from Lutz's grip. I shared strategies to get them out of that situation. "So sorry. I have to go in now." Etc. Also, I told them he walked between five and six pm every night. They could avoid being in their garden. 

  I called Isaac and proposed he comes over tonight to watch Coda together. I asked him what he was making for dinner. I was so sick and tired of my own cooking. The only things that continue to taste good are roasted chicken and steamed broccoli with butter. (As I remember, Mike once cooked that every night for dinner or a while. I finally objected.)

   He was supposed to come over by 7. He texted he was running late. He arrived at 7:30 with a huge bowl of cooked spaghetti and a small jar of pasta sauce that was more than half empty. I know he loves broccoli. That was my contribution to the dinner. I prepared one of the four bags of frozen broccoli package. 

   Isaac moved around, looking for the TV. While I hadn't gotten rid of the TV in the library, I didn't use it anymore. It was unplugged, and I couldn't find the remotes. We settled into the library. Isaac pulled a small table over to the TV set to rest his computer. He had a subscription to Apple TV; I didn't. He found the control buttons on the TV, which I never could. While he was setting up, Elsa rested next to his food, ignoring it. When he moved the bowl of butter-soaked broccoli over to the chair, Elsa's nose woke up, and she licked it. Something like that doesn't bother me, but it did bother Isaac. I told him to throw away the top broccoli. The rest would be untouched.

      I enjoyed the movie and cried at the main character's success. I might have allowed myself to sob outright had I been alone. I enjoyed the film, but it didn't deserve the Oscar, not when compared to Power of the Dog. No. I hadn't watched that movie. It sounds like an endless nightmare. It was my understanding that's why it didn't win. The Oscar members needed relief from tragedy like the rest of us. However, if the Oscar is awarded for acting skill rather than feeling good, there is no question that the cast of Power of the Dog deserved it. Their roles were challenging.

   Poor Will Smith. He was dysregulated from the high of receiving the award. Then he laughed at Chris Rock's comment until he saw his wife's face. I think he was terrified of her reaction to his behavior. Does she slap him when she takes offense? He was out of control. He sadly confuses fear and love.