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Read about the complications from surgery.

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My Hand, My Hip: Going Under the Knife, Part I
October 18-November 13, 2001

In August 2001, I broke my finger while walking my dog. When I went to the urgent care, I found out that the xray showed an enchondroma, or a bone tumor inside my finger. It had rendered it the thickness of an eggshell and this is why it snapped so easily.

I was told to go to the orthopedic hand specialist at Duke, James Nunley. He told me I had to let the bone break heal first, then I would have to schedule surgery to have a bone from my hip taken out and placed in the finger, after they remove the tumor. I told him that I wanted to go to my 20th HS reunion in NYC before surgery (October 13), so he scheduled it for the week following.

So, those couple of months went by, my bone healed, but my range of motion in that finger never came back, but it was ready for surgery.

Thursday, October 18, 2001

I am having surgery on my left index finger today. Tim came down to stay with me through Monday. The surgery is at the new Duke Ambulatory Surgery Center.

The hip surgery, they say, is more difficult to recuperate from than the finger surgery. Since I am diabetic, I am prone to infection, so I expect it may be a long haul. I am off work for 3 weeks to recuperate from this.

There are several kinds of complications that can arise from the hip graft (iliac crest surgery, I am having it taken from the anterior portion "A", on the graphic below):

Iliac crest harvesting is associated with significant morbidity
Donor-site complication rates as high as 49%
• Infection
• Prolonged wound drainage
• Hematoma formation
• Neurologic and vascular damage
• Herniation of muscle and abdominal contents
• Transient pain or pain lasting longer than 6 months
• Subluxation, sacroiliac joint destabilization
• Gait disturbances
• Pelvic or iliac fracture
Source: http://207.103.3.25/products/vitoss/autograft.html

So anyway, I figure I'll have one or more of these. That's just the way it goes.

***

5PM -- i'm home from surgery, really sore, but made it to my desk to do this letter before taking my next dose of oxycodone which will put me out. sorry for the lack of caps, but i can only type with one hand. this is slow going as it is.

surgery went as planned; dr. nunley, the orthopedic surgeon, said the tumor in the finger was quite large, filling the whole cavity of the lower portion of the left index finger. it was the consistency of toothpaste, he said. the graft was taken from my left hip, so my left side is pretty much useless. sitting and getting up are the worst on it.

i ended up with regional anesthesia for the hip and the arm. apparently something didn't work on the arm, I think they had to gas me some too. I woke up with no pain in my hip because of the block, but my arm felt like it was on fire. i received good basic care in recovery, they had to give me a good bit of morphine several times before the pain in my arm went down to a 5 out of 10.

total time: went there at 10 a.m., they operated at 11:30, got home at 5 p.m. the surgery itself was 90 minutes, so the rest of the time was recovery. i wasn't ready to go when they released me; i soo wanted to sleep more. but today's health care system wheels you out asap. tim drove me home and i managed to get in the house, i don't know how i did this in the condition i was in. i got in bed and slept only a couple of hours and then i needed my meds (oxycontin). they said the nerve blocks can last up to 24 hours on some people, or as little as 8. i guess i am on the low range, dammit.

Monday, October 22

it hurts less to stand, shifting my weight to my right leg, or to be in bed. sitting sucks. my hip doesn't like this position at all. getting up or out of bed is miserable, even on the drugs. i am "walking" better, now. it's slow motion getting around, but at least i can. tim left today; he changed my hip dressing on sunday and said the stitches looked good, no sign of infection.

i have to go back to the dr on the 29th for recasting of my arm, which goes up the length of my forearm. It will take up to 6 months for the graft to take, and my hip to heal, he says. the hip may be a bit longer. i can take the hip dressing off in 5 days and either put a gauze patch on it or leave it free, it depends on if it gets irritated or infected.

***

October 29

As you can see, I am back to caps typing again! Went for followup ortho surgeon appt yesterday and Dr. Nunley took off my arm cast and said the stitches (looks to be about 8) in my left index finger looked good. It's swollen, but not discolored or infected. It itches and hurts some, but it's bearable. He didn't recast (thank God) but put a large regular bandage on it and told me to try bending my finger to unstiffen it as I can over the next week, but to keep it dry and covered for now. So now I can do 9-finger typing again, albeit slowly.

Of course the downside of no cast is that I have to be careful about whacking my finger and dislodging the graft. As when I originally broke the damn thing, the break/graft is in a weird place that makes local splinting painful and not particularly effective. At least I have become somewhat used to avoiding whacking that finger from waiting for the break to heal prior to surgery. I don't think I need to put my arm in the foam block during the night as I have been for the past week.

As far as the left hip goes (where the graft was taken from), those stitches are still in. They may come out next Monday as well. The pain still sucks big time when sitting and getting up from sitting and lying down. It's bad enough that Nunley wrote me another script for painkillers, but I take half the dose with ibuprofen only when it hurts. Standing and walking for short periods are the least painful positions. Stairs suck, but are do-able if I go slowly.

I was bad and I folded myself into my car and drove to the store myself a couple of days ago (2 blocks to grocery store, and about 1 mile to my appt yesterday). It did hurt like hell carrying things and getting in and out of the car, though. Believe me, I popped the painkillers and went to bed after those excursions. It was about all I could stand. I will go to the grave stubborn.

I have about enough energy to do one "project" each day before the hip pain makes me quit -- like laundry or vacuuming the tumbleweeds. I still cannot seem to stay awake long enough to concentrate on puzzles, movies or read the pile of magazines I have here. I slept all day on the weekend in order to stay up to see the ^%&*$ Yankees drop those 2 games to Arizona. Those games were painful (in another way) to watch, lol.

***

November 5

Yankees lost in game 7 in AZ, after they swept the NY leg of the series.

So today went to the dr and the stitches are out in both places. My hip is a little raw and even bled, so they had to put a different kind of dressing on, but the stitches are gone. The surgeon (Nunley), while brilliant at surgery, is pretty rough on the bedside manner. He tried to yank my left index finger into a fully straight position and that sent me howling through the roof, enough to make me forget about the awful hip pain, so it was bad. My range of motion is still pitiful, the tendons in there are very tense.

So I hobbled over to physical therapy right after the appt. I am now in a special splint to exercise it (worn all day and even to wear to bed, dammit). I can do my 9 finger typing, but it's a bit of a pain with this thing on. I have to go to PT once a week "for a good long while", the therapist said. I am not getting therapy for the hip unless there are complications. I just have to take it very slow for a while. Hopefully if I do my exercises enough, by the time I go back to Nunley on the 26th it won't send searing pain when he jerks the finger. Oh well. I'll take some meds and then take a nap. That was enough action for today, I am very weak and tired, and nauseous.

I really still shouldn't be driving, or walking/sitting/standing for too long. I just need to do my physical therapy and sleep. I don't have energy for much else these days. I definitely won't be able to work full days when I go back to work on Monday.

November 9

My hip is still oozing, but it has slowed. Looks ok, no infection.

Today I took a lounge chair outside in my backyard and just reclined and enjoyed watching the leaves gently fall from the giant pin oaks in my back yard, twirling in the breeze. The doggies rested out on the leaf covered yard in the sun and snoozed. It was so peaceful and quiet...blue skies, 75 degrees, no humidity. It was blissful. It was the first day I've done this since surgery so I drank it all in and took not one moment of the beautiful fall day in my world for granted.

Monday, November 12.

I actually went in on Sunday to put my Eudora emailboxes back on my work computer. I had zipped them up and took them home on 10/17 (day before surgery) so I could do email work at home during my leave and not have to reconcile the mailboxes when I got back to work. This turned out to be a good idea, because it made my first day back less problematic. No time wasted having to sort through hundreds of messages. Good thing I had the foresight to do this...

My first day back to work -- all kinds of chaos happened -- the fulfillment system went down, so I ended up there most of the day instead of half-days as I was planning to do to ease into work. I was pretty wasted when I got home. My hip hurt, and I was very tired. I went to bed around 8:30. My hip is still oozing. The bandage is soaked by morning. I had to get up once in the night to clean out the wound and put on a dry bandage. It might be infected.

Today an American Airlines plane crashed in NYC in Rockaway, Queens killing all on board and several people on the ground.

About a dozen homes were destroyed. My aunts Judi and Sandra were safe, they are a few miles away from the incident, but still -- NYC is just had enough to deal with since 9/11! I couldn't get through on the phone to find out since the lines were jammed. Within a half-hour, the FAA people were floating with some certainty "it looks like an accident, not terrorism". That seems, on its face, irresponsible to say that without facts.

No, there was no time for it to be hijacked (it crashed less than 4 minutes after takeoff), but the damn tail and 2 engines fell off in that time, sending the plane nose diving into a house! The pilot had no time to even get it into the ocean, which is right there. Sabotage should at least be on the table. If it is structural failure/maintenance negligence, I wouldn't advise getting on an Airbus A300 any time soon.

Tuesday, November 13.

Got up, showered and was to work by 7:45. I did get several purchases and reconciled bills. Returned phone calls. I got a lot done, but I was tired again by around noontime. I think it must be infected; the discharge looks nasty, so I called the nurse to set up an appt at Nunley's office for the next day at 12PM, convenient since that clinic is right next to the Physical Therapy clinic for my hand so it kills two birds with one stone. I still had work to do, so I stayed until 1:30 or so and went home.

I had made chili in the crock pot that morning, so I had a nice hot lunch waiting for me when I arrived home. Took some ibuprofen, cleaned out the wound again, then went to sleep for a few hours. I got up and fed the dogs, then went out and washed my windshield, as it had some kind of tree sap on it that wouldn't wash off normally, and it was making it hard to see when driving. That tired me so I went inside again, watched some news, then went to bed. I wasn't hungry, so I didn't eat dinner before bed.

I had heinous abdominal pain overnight. It was stabbing pain at first, then just throbbing. It went away, but the abdominal area around my wound was much harder than it seemed in the prior AM, and was more tender. Something in there is festering.

But wait, there's more. I wasn't out of the woods yet. Read here.

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