September 13, 2019

Confusion Runs Amok

Sorry, no photos today.

This confusion on my Physical Therapy started with myself as soon as a few hours after surgery. I was told by my surgeon pre-op that they would have me up and out of bed walking a few steps with support within HOURS AFTER my operation. I came back to reality around 9:30am Sunday feeling better than I thought I would. A few hours passed and I asked one of the nurses either taking blood, my vitals or lab work ... when are we going to start the PT ??

The first time I got was 6pm Sunday night because someone was coming in that needed to be here. The nursing staff changed shifts at 6:30pm and starting officially at 7:00pm for the next 12 hours. I repeated that same question a couple of times up until midnight then said screw it when I wasn't getting an answer.

So unlike I was suppose to ... I didn't walk one step, did not get out of bed, did nothing but lay in bed adjusting the back and legs to get the most comfortable.

Monday morning I was told I was being moved up to the orthopedics where I would start a little PT and they would evaluate what I could do and not do, then recommend to the doctor whether I go home or stay with them a minimum of 3 more nights because insurance companies did not like less than 3 nights. Once again ... times not met with no explanation. I am beginning to think this GREAT DEPT I heard about was beginning to really disappoint me and confuse me.

Finally around 9am a PT comes in, introduces himself and told me to get up and out of bed then sit in the chair nearby. I did that with no support except the walker and felt no pain of any kind. When I asked him about the lack of walking 24 hours earlier like the surgeon told me I would have he explained no one is here on Sundays to do any PT work. Hmmmmm.

We head out to the hallway after I showed him I could use the walker, get into the bathroom, pee, turn around and walk out ... walking out to the hallway with him every step of the way. He kept telling me I was doing great and I had no problem walking slowly to the end of the hallway with the walker and the PT next to me ready to catch me if I collapsed.

Then I didn't hear anything from anyone as I waited for the surgeon and hospital doctor to come in and evaluate me for departure that afternoon. I talked to a couple of case workers and a different nurse ... all surprised I was not already taking any kind of medication before I was admitted. Isn't that what all people 67 years old do? Why not me? What ... you don't have a walker at home you can use?? "Why would I need a walker before now?"

Let's just say my confidence level in this operation was in a nose dive and I was planning my escape from this building no later than 4pm.

It was time for lunch so I ordered a few things still waiting for the surgeon and doctor to show up. Now at this time I am guessing that I will need to get up out of this chair, walk to the hallway ... do something for them to approve my discharge. ... No, they only based it on the PT's recommendations. Yet even with everything signed I wasn't going anywhere unless I had a walker.

The Case Worker told me even though she had ordered the walker and the service was in town, 5-10 minutes away ... the walker might not show up until tomorrow !!!! Really? This was going to be easy. I called the Case Worker back in and "sweet talked her" to the point she gave me the phone number of the hospital supply service. Once she left I called that number, giving them my date of birth ... and promptly told them I had being discharged at 1pm and needed my walker today.  They had 50 minutes to get this done.

Just like clock work ... at 10 minutes till 1pm ... that happy smiling Case Worker was walking in my room with my new $121 walker saying "look here" .... well no shit. Get off your ass and call someone to make it happen. I was having flashbacks to my working days where more and more people were turning into slackers with no concerns for deadlines ... I knew once again I was not mentally stable to work in todays workforce .... since retired I have turned myself into  a professional slacker.

Doc comes in ... What about my PT schedule. "The PT has given you two exercises to do and explained what those are for. Your PT is to learn how to walk again and then walk."  That is a no shit answer from the surgeon. When I asked the admitting doctor the same question he told me "The PT will cover all of that with you at the time of discharge."

Nothing was said and by 3:45pm I was picked up by the neighbor and was heading home.

- Three friends living in Sacramento, Chicago and Atlanta are confused ... "your PT??"
- I am confused and a little scared ... "only two exercises to do ... but for how long"
- Neighbor and his sister in-law confused ... "I've never heard of anyone having a hip replacement and not in a PT program immediately after their surgery."
- My friend, fellow bicyclist and is a PT, in fact works with patients from this hospital in a different town ... asked me last night how I was doing then replies .... "You're doing well. I'm still surprised they don't have you in PT though ... that confuses me a little"

Lights go off in my head once I heard a PT say that. One that is familiar with the hospital and surgeon.

When I told her the PT told me their PT program was only for Knee Replacements .... she replied.

"That's false. I treat hip replacements every day. But maybe because you're so active they felt you didn't need it. I'm not sure what their thought process was."

THEY told me to do the Ankle Push but not how often. I decided to lift my lower leg to the same level as my knee because it makes my right leg feel much better. I do that sitting on the edge of the bed or sitting in a chair. I know from cycling that simple exercise will strengthen my thighs and the tendons wrapped around my hip. It's like pulling the pedal UP on a bicycle while pedaling.

So I am a little concerned. It's Thursday night when she tells me this. I lay in bed since I have been sleeping since 6:45pm and start doing a few more exercise that make my right leg feel better. It is my RIGHT hip that was replaced.

I do a heel slide until it hurts because it makes my right knee feel better. I do the Abduction, sliding the right leg outward, back and forth slowly ... it's the same move I have to do getting out or in bed. That makes my hip feel better.

But WTF ??? Why didn't THEY tell me to do those two exercises ????

Another I found today that is legit after searching on the internet. Standing with the walker to support me ... I left my lower right leg, bending it back toward the leg and that looses my knee and quads up ... makes them feel much better.

I called the surgeon's office and told them I was having some memory lapses and wanted to go over again the exact exercises I was to be doing but also for how long. I wanted to ask him again when do I start this PT program. I have a follow-up appointment with the surgeon in two weeks. They told me the doctor could not answer those questions over the phone and I would have to set up an appoint to come and talk to him about those questions.

I calmly declined and told her I'd see him in two weeks, disconnected from the call I asked Stella who was staring at me a few feet way ... "Stella WTF is going on?" She wags her tail and slides out a new long piece of drool ... maybe in anticipation of a walk ... isn't that PT ??  LOL

I can only come up with this idea on why I don't follow the protocol of other fellow Total Hip Replacement rehabbers. I am in a lot better shape than most 67 year old men or women. I always thought I was younger than my age said I was, activity, diet, etc of those younger in most cases.

Maybe I really am in that good of shape and that moves me away from a PT way that my friends, neighbor and PT friend thinks I should be doing. Although my neighbor told his sister in-law I was doing all of this alone and he personally thought I was doing an amazing job. My PT friend thinks I am doing great based on the exercises I tell her I am doing and all the other stuff. My dog feeder that shows up twice per day told me this morning she is amazed how good I am walking with the walker only 5 days after surgery.

So maybe the confusion of all of us is not needed. Honestly I have no idea anymore.

My neighbor told me he parked the Mini back in my garage to keep it out of the sunshine and away from the eyes of car thieves. No, that is not a problem in this area and my neighborhood is loaded with new Tacoma and Tundra 4x4 OR's. He said I haven't known you long but I know well enough to keep the keys to the Mini so there is no chance I decide to take it out for a joy ride.

"If you are doing that ankle exercise, it might be for blood circulation but that is the accelerator foot also" ... as he laughed walking out the door. The car is nice to look at though. I'm glad it's back inside.

You are welcome to comment or email me with your thoughts or experiences on hip replacement physical therapy ... The wagon is pretty large for all of us confused people so jump on if you want.

Stella and Heidi really get excited when MaryJane walks in to feed them.

Up at 6am officially and it was the best I felt. It's only 12:40pm now and seems like 6pm. I'm a little tired, a little sore and am going to go lay down for a while.

Another beautiful day in the Wild West.

10 comments:

  1. This lack of PT appointments sounds like the right hand doesn't know what the left is doing. It seems that there is miscommunication or lack thereof to get the PT ball rolling. Good luck, stay strong and remember you are your own best advocate.

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    1. I am told in today's medical environment being "my own advocate" is the best thing I can be. I called a local PT in sports injury management and will call my doctor on Monday to send that PT office a script to come to my house and start some serious PT although what I am doing under their direction when I left the hospital is working out well.

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    1. It's already in work with a PT facility just a couple of miles from my house. Of course they are not open on weekends and I called a few minutes before they closed. I have a good range of motion. When I "march" down the hallway I can take each step and raise my knee on BOTH legs as high as the horizontal bar on the walker. I can do leg lifts on the bad leg, ankle rotation is normal and I can lay in bed and raise the bad leg to where I bend my knee making everything feel better.

      The is the reason I am calling for a PT on Monday, because they can tell how I am doing plus stretch those muscle just a little bit more knowing what is good and bad. I will do everything they say to get back to full range motion and normal activity. That's my new workout now, not riding.

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    2. Sounds good. Save the splits and full lotus for another day. Just kidding... They might have you work on the scar too at some point. Helps to flatten it out and reduce the build up.

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  3. Just wanted to add that in quite a few states, you can self refer or get direct access to physical therapy, but I don't know how the insurance would work for that.

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