Hip Replacement Part 4–A Day at the Hospital

On January 3, 2012 I spent most of the day at Parkwest Hospital getting pre-admission tasks out of the way.  I had appointments for Pre-admission, Pre-admission Testing, a Joint Class and then a Pre-op meeting with Physical Therapy.

Parkwest is very well organized.  My first appointment was at 9:45 am.  Marie dropped me off and I checked in at the Admissions desk.  I settled in for what I assumed to be a long wait, but was called back within about 10 minutes.  The lady who checked me in was pleasant and efficient.  She gathered all of my insurance information, printed two patient bracelets… one I wore during my visit that day and one attached to my file for when I report for surgery.

After finishing my pre-admission process, I was escorted to the surgical ward where I did have to wait… about thirty minutes or more.  Turns out my RN case manager was delayed in returning form Paducah, KY due to wrecks caused by the snow and ice we received the night before.  She did not get home until three am and was late for work.  She verified my medical history and asked questions about allergies and prior operations.  Did I smoke, did I use recreational drugs, did I use alcohol and so forth.  After that I was swabbed to test for MRSA. (Methicillin-resistant Staphylococcus aureus (MRSA) is a type (strain) of staph bacteria that does not respond to some antibiotics that are commonly used to treat staph infections.)  If I am a carrier the doctors will have to take extra precautions during surgery and recovery.  When that was finished, the Nurse Anesthetist came and asked me a series of questions pertaining to medical history as well.  She informed me I would receive a General Anesthesia for the surgery.  Once the Q&A was over the Case Manager gave me an orientation as to where I would report on the day of surgery, what would happen when I arrived, what to wear.  After the orientation she pointed me to my next appointment… the Joint Class.

At 11:30 am Marie joined me for the Joint Class in the Grubb Room adjacent to the cafeteria in Parkwest Hospital.  The Joint Class was a review of the Joint Handbook given to me after my appointment with Dr. Cates.  The instructor also covered what would happen after surgery.  Up at 5 am every day… twice a day physical or occupational therapy… pain management issues, move as much as possible, etc.  She also covered what to expect and do after release from the hospital.  More on that in a later post.

At 2:30 pm I went across the street to the Parkwest Tower for my Pre-op Physical Therapy appointment.  It was short and covered the post-op exercises they want me to do twice a day after I get home.

One note, while I was in Pre-admission, Marie took the car to get the tires rotated and when they finished they ran into something and bent the bumper and right front fender.  Bummer!

Next up is my pre-treatment measurements for my Bone Rad treatment at Thompson Cancer Treatment Center on January 11, 2012.

Hip Replacement Part 3 - Pre Op Physical Exam, Most of It Anyway

On December 27, 2011 Dr. Cates requested that I get a pre-operative physical exam.  I usually do this in August but I had not made my annual trek to Dr. Bingham’s office, so this was a good time to kill two birds with one stone so so speak. 
My appointment was at 10:00 am, but I arrived at 9:30 am and was immediately ushered to the dreaded scales.  When I first started visiting Dr. Bingham some years ago, they still used the old fashioned standard with the double sliding bars.  The Army used them the entire time I was on active duty… they were supposed to be calibrated, but I suspected they were part of a communist plot to make everyone think they were heavier than they were.  Why else was I always 4-5 pounds heavier in the office than at home.  Anyway, I was pleasantly surprised to see they have installed new digital scales… no improvement on the weigh-in.  Still heavier in the office than at home.  There’s basis for a new years resolution.
After weigh-in I was placed in the “private” waiting room… they call it an exam room, but actually it is just another place to wait for the doctor so you have the illusion of something happening.  The nurse (I assume) took my BP, which was slightly elevated and my pulse… she did not say I had one.
From there we went to X-Ray… I sure wish they could figure out how to warm those machines… was rather chilly  for a chest X-Ray.  After we finished it was back to the waiting room for an EKG.  Another surprise… no more messy cream and suction bulbs.  New technology again… tiny little stick-on electrodes and then just clip the leads, run the machine and we were done.  After that I was back to waiting on the doctor.  In between I was asked to leave a sample which required a visit to the bathroom. 
Dr. Bingham came in, read the EKG and said that there had been no changes in 10 years.  I think that is good.  He listened to my heard, my neck, ears, nose and throat.  The last exam involved a pair of rubber gloves on which I will not elaborate.
From there I was asked to donate blood.  I am not fond of this, but 20 years in the Army and flight physicals every year have helped me build a tolerance to the practice.  There must be a lot of test to run, instead of the usual two vials, they took six.  A quick swipe of antiseptic and a Band-Aid and I was done.
My next big day is January 3, 2012.  All day at Parkwest and Tennessee Orthopedic Clinic.  

Hip Replacement Part 2 - Getting Ready

There is a lot to do to get ready for hip replacement surgery. My initial thought was visit the doctor and show up for surgery... not so. Here is the list of things that must be accomplished before my surgery on the 17^th of January.

The first thing was, much to my surprise, a visit to the Thompson Cancer Treatment Center for a consultation on radiation treatment prior to surgery.  Turns out that radiation treatment (called a Heterotypic Bone Rad) can prevent the formation and growth of bone spurs.  That visit occurred shortly after my visit with Dr. Cates on October 31, 2012.  For Halloween, Dr. McDonald’s staff was dressed as barn yard animals… first time I have ever had my vital signs taken by a pink pig.

The next requirement on my to-do list was to donate blood to hold for use during surgery if needed.  This took place December 8, 2012.  It was relatively painless and took only ten minutes to drain me of a “unit” of blood… what every that is.  I was no worse for the experience.  While waiting my mandatory 20 minutes to ensure I was not going to pass out I decided to make one of my rare posts to Facebook about giving blood and the snacks Medic provided.  My cell phone decided that instead of snacks I really meant that I was having juice and “snakes.”  This caused a bit of a flurry for those who actually read the post.

The next thing upcoming after Christmas, is my pre-operative lab work with my family physician, Dr. Bingham.  I am to be poked and prodded, x-rayed and ekg’d to make sure I am fit for surgery.

Following that, the big day is January 3, 2012.  This day starts at 9:45 am with my pre-operative registration at Parkwest Hospital.  At 11:30 I undergo pre-admission testing.  (No study guide provided.)  At noon, I have a Joint class to go over my new joint and how to manage things post-surgery.  Finally, at 2:30 pm I have a pre-operative meeting or session with the Tennessee Orthopedic Clinic Physical Therapy staff.  This will be a really long day.

On January 10^th I have to stop taking aspirin, nsaids or any medication which causes blood thinning.  This will lessen the chance of bleeding during surgery.

The next day, the 11^th, I have an appointment back at the Thompson Cancer Center to have all the measurements taken in preparation for the radiation treatment scheduled the day before surgery.

Beginning January 15^th I have to take three showers a day using Chlorhexidene scrub… I think this is to mitigate the possibility of transferring MRSA (Methicillin-resistant Staphylococcus aureus… whew!) or other bacteria.

On January 16^th, it is back to the Thompson Cancer Treatment Center for a quick zap of radiation… or officially a Heterotypic Bone Rad treatment.  This has to be done within 24 hours of surgery to be effective.  It is best to have this the day before surgery not the day after for obvious reasons.

The big day… January 17, 2012.  Surgery is scheduled for Tuesday… no time set yet… but I am sure I will have to be there early.  Dr. Cates says the surgery will take about an hour and that they will get me up shortly afterwards and start physical torture… I mean therapy.  I expect to be in the hospital for up to three days depending on progress.  Walking and navigating stairs are the criteria for release according to Dr. Cates.

Following my release I will have outpatient physical therapy.  I will not be permitted to drive for four weeks.  I have a follow-up post-operative appointment with Dr. Cates’ Physician’s Assistant, Kim Sanders on February 17^th.  I expect to be released to return to work at that time.

I do not know what to expect after surgery.  After recovery, I hope to be relatively pain free and mobile.  I do have some concerns about complications as a result of surgery, but I am trusting God to protect me and grant me peace during and after surgery.

Tim's Hip Replacement Journey - The Beginning

With my hip surgery pending in January, I thought I would try my hand at blogging about my experience, if for nothing else but to document the journey for myself.

First, my surgery is scheduled for January 17, 2012 at Parkwest Hospital's Joint Center. Dr. Harold Cates, Tennessee Orthopedic Clinic, will perform the surgery.

How did I get to the point of needing to completely replace my hip? About five years ago I was assisting my mom down the short flight of stairs in my garage. As I turned to close the door my foot slipped on the stairs and I fell about two and a half feet to the concrete floor on my left hip. I also hit my head on the bumper of our car parked in the garage at the time. Dazed and sore I recovered enough to continue to church and did not think much about the fall. Several days later I discovered deep bruising on my thigh and down to my knee. Eventually everything healed. Some of you, who know me, know that I play basketball with a group of faculty and staff at Roane State. We call ourselves the NBA or Noontime Basketball Association. We play every Monday, Wednesday and Friday. I have been doing this since my arrival at Roane State over eighteen years ago. After my fall I experienced pain in my groin and thought I had pulled a muscle playing basketball.

During an annual physical I asked the doctor about the injury and he made an x-ray. After seeing the x-ray, he recommended I see an orthopedic surgeon. I made the appointment and the doctor said that I had what is known as an “arthritic event.” In short, the fall had triggered arthritis in my hip. His advice was, “when it get to the point you cannot stand the pain, then come back.”  After some weeks of physical therapy, I was back on the basketball court.  I have now reached the point where I think the hip needs to be replaced. I can feel the joint pop and move around. I experience pain all the time... not unbearable... but all the time.

I have several friends who have had hip replacements... one with both. The common theme is that they wish they had the surgery earlier because of the relief they received. I am not looking forward to the surgery, but I hope to get relief. The primary reason I waited is because my first doctor told me I would not be able to run and play basketball. Dr. Cates said that was a possibility after six months. I hope so.


About a month ago I made an appointment with Dr. Cates who verified that there were no other alternatives or remedies, the hip needed to be replaced.  I made the decision to move forward and that is how I arrived at this point.



Next, what I have to do to get ready.