Saturday, January 02, 2016

Othopedic Surgery # 15

Little did I know that 2 weeks after hip replacement I would be back in Northside Hospital for another procedure. Basically a few days after my initial surgery my replacement incision began draining. No big deal at first other than changing dressings several times a day. However, when it continued the doctor saw me and recommended a possible irrigation and debridement procedure; it's the type stuff done to aggressively clean out wounds kinda like what they do when you have severe road rash (which despite all my cycling and occasional crashes I've never experienced). I was scheduled to report to Northside on Thursday morning where the doctor would examine again and decide whether the procedure was needed. Theoretically I could be out in less than an hour if not needed and maybe 2-3 hours if needed. After all aggressively cleaning out a wound shouldn't take to long I thought.

I should have known that "scheduling a surgical procedure" almost always takes a lot longer. Once I'm in a pre-op waiting room the doctor looks at my incision and says we need to "nip this in the bud and move forward." I say OK let's get it done. So then I get the best versus the worst scenarios. Best case: whatever's going on is just on the surface, we clean it out, surgery is over in few minutes, but you'll have to stay overnight until culture samples grow and can be analyzed so we can treat with appropriate antibiotics. Worst case: whatever's going on is deeper and we'll need to replace some parts. Surgery will take longer and you'll stay overnight. I've been through enough surgeries to know that infections especially deep in a joint can turn into a massive long time problem so I didn't debate just signed a bunch of paperwork.

When you wake up in recovery it's hard--at least for me--to get a sense of time. Even when they told me I couldn't remember. Likewise when I asked exactly what they ended up doing about all I heard was "it was a little deeper than normal." The surgeon will go over that with you later. When I wound up in a regular room around 5:30 I figured out they most likely did more than an irrigation & debridement. Also the fact they would not let me out of bed was different from the prior surgery. There was virtually no pain which made me think I must be on something really strong, but turned out to be Tylenol.

Friday morning the doctor visited and let me know they did go into the joint and replaced a portion since there seemed to be something going on well below surface. I'm no othro doctor and can't tell you exactly what he did,but I believe what was done is the best course of action to get me up and about and prevent long term issues. The main reason I'm still in the hospital is waiting for culture results which sometime take longer a day to develop. They have installed a PICC line (central catheter line) in my right upper arm which will be used to deliver antibiotics on a daily basis for 6 weeks. I can most likely be taught how to do this myself so I don't have to go to an infusion center every day. So as of Friday night I have 2 IVs and a Davol closed wound suction evacuator device draining excess fluid from my right thigh. This is how a computer must feel like with input and output devices plugged in, but computers don't have someone coming in constantly monitoring things and also checking vital signs, almost always just after I've manged to fall asleep.

So after a very restless Friday night I wound up feeling pretty dismal about the prospects of possibly spending the weekend waiting for cultures to develop. However, the infectious disease specialist came by to let me know the cultures had not developed any sign of a specific infection which is not so good because it leaves things ambiguous as to what infection I have. However, the good news is they will treat me with an antibiotic called rocephin which should work fine over the course of time. The best news was assuming they could give me the first dose today and arrange for out patient infusions on Sunday and Monday I could go home today. By 2:00 I am getting my infusion, the out patient infusion center is open Sunday and Monday so I should be home by the end of the day All that has to be done now is the discharge paperwork which will probably take longer than surgery. I don't mind; it's like the last few miles of an ultra long ride--the end is near.

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