Sam Pond - 10/28/08, Dr. Vail

My First Week

Hello Fellow Surfers,

This whole things has been such a mystery –  the whole idea of my volunteering to walk into a hospital for surgery! – for me that I thought I’d share my experiences with those who had equal trepidations. For the rest of you, well you’ve been through it all now, haven’t you?

In short, I’m 52 years old, really active, always played soccer twice a week, skied all my life, packed and climbed the High Sierra and fly-fished the great Western rivers. That is until about two years ago when it all got tougher and tougher. After several opinions, I felt like I met the right doc (Vail of San Francisco) and it all fell into place. An October procedure, recuperate during the winter then start fishing and climbing in the spring. It had to start someplace. Here’s my first week. Thanks for reading. And thanks for all of your who have been a part of this voyage. I really appreciate it.

Sam

My First Week

Operation Day: October 28th, 7AM, Checking in
My wife drove me to the UCSF Medical Center, dropped me off at Surgical Check –In, then headed back to get our 10-year old son off to school. My mood? Lightly stoic with an ironic stiff upper lip. It all felt very bizarre. I think my emotional journey in the preceding month was filled with so many twists and turns that I had finally surrendered. This was happening. And that was OK.  Surrender has been the constant theme. Recently I have taken up meditation to help me transcend the rush of the ego mind and to learn to live and accept the moment. (Wow, that’s quite a spiritual drenching so early in the story. Sorry.)

They checked me in astonishingly swiftly, too swiftly really, and before I knew it I was in surgical prep, assigned to a cloth wall cubicle, and got barked at by a check-in nurse straight from central casting. Yah gonna need to use the toilet!? she yelled. I stammered,  Yes, ma’am.  I wanted to get it out of the way now. I definitely didn’t want to wait till later when I had my ass was out of my surgical gown. Yah wanna keep your ass in that thing?! I imagined her yelling.  But I digress.

The first thing I discovered was that I brought way too much stuff to the hospital. What was I thinking? It’s like a packed for a weekend at Stinson Beach! Some shorts, some blowsy pants, a bunch of t-shirts, a few hats! I even brought flip-flops! The emergency-yellow clothes bag they provided (they’ve got to change that color) did not take into account a vacationer such as myself. I’ll tell you now, I wore none of the clothing I brought. I could just as easily have walked out wearing what I walked in with. Which is pretty much what I did.

The first face I see is vaguely familiar. Turns out young Dr. Greenberg – part of my anesthesia team – has lived in the apartment building right next door to us for the past four years. We chat as he sticks tubes in me and assures me that this is the worst part of anesthesia. I believe him. These prep people were amazing. Years ago, I was dragged onstage by a magician-clown. He chatted and waved his arms and the next thing I know he showed me and the audience that he’d stolen my watch with one hand! Pre-surgery was just like this except it wasn’t funny and my date didn’t skip out on me at intermission. (But that’s another story.) People popped in and out, introduced themselves, asked me my name, birthdate and pain level all the whlle I was getting strung up like a marionette. Somewhere in this puppet show my wife showed up looking angelic and calm. My brilliant doctor, Dr. Thomas Vail, dropped by, always calm and assured. I showed him my left hip on which my wife had written in large, black marker –Not this hip! He assured me that the correct hip had already been marked. I felt kind of stupid. Maybe I should have written something more witty.

Now I do not know what they were pouring into my veins but they better not make it available at Safeway. A seamless slip into happiness. I remember kissing my wife, exchanging I love yous, getting wheeled out, down a corridor, and into the operating room. I was like a political candidate getting wheeled into a fundraiser. Hi, guy in blue scrubs! Hi, pretty blonde in the flowered scrubs! They all waved back. Great to be here! I thought. They told me to sit up on my gurney and lean over the table to get some kind of spinal block. Sure! I said. I bet they love the kind of patient I am. They told me to climb up on the operating table (No problem I said. What inner strength!, they must be thinking) and then.

11:45 - The recovery room
This is the place I feared most. When I was ten, I had my tonsils out and the one thing I remember is waking up alone, vomiting and surrounded by screaming. vomiting people. I’m happy to say this recover room was far from that. It was like waking up in a kind of impersonal and technological heaven. I had no desires, no demands. My glorious suspension lasted several hours. I seem to remember someone (my wife?) telling me I had a great corner room with a view of Twin Peaks. That made me happy.

5:00 – Room 1245
This transition was the oddest of all. Rolled out the womb of recovery to the reality room. My wife and son were there and I was stoned and happy to see them. Henry had drawn pictures of our new dog on the white board and he was really looking forward to hospital food. Strange kid. I was in no pain, not hungry and not really anything. Which was fine by me. Then dinner showed up.

The smell of dinner triggered something primal in me, the urge to vomit. For a while there, the nurses and my wife and son couldn’t scramble fast enough to retrieve available receptacles. Then they’d give me something to quell the nausea. And I’d eat a corner of a Saltine and we’d start all over. My thoughts while vomiting? I was thinking, Hey, this is the good kind of vomiting. The kind where it’s all liquid. This kind of vomiting is OK!  I was a little concerned about the presence of my son. But he was OK with it as we had recently reviewed a long list of barfing euphemisms – the technicolor yawn, calling Ralph, etc. – and he’d found some humor in my misery. See what a good parent I am? They left exhausted. It had been a long day for them too.

12PM, 2AM, 4AM, 6AM – My Late Night Friends
A parade of concerned and loud caregivers. I hate to say this but the quality of care at UCSF plummets when the sun goes down. The cast of characters are my roommate’s incredibly chirpy nurse who sounded like a Miss USA contestant jacked up on Up With People sauce, my nurse who spoke loudly in a monotone, a crowd chattin’ it up just outside like three dudes taking a butt break outside a sports bar. Then there was my conspiracy-theorist, night blood taker. At the end of his five-minute long paying federal taxes has never been ratified so we actually don’t have to pay taxes diatribe, he eventually asked me, So ya know about the federal reserve, doncha? To which I mumbled, Not at 4 -f’ing o’clock in the morning. He left astoundingly quietly. Don’t these people understand that it’s the middle of the night? And, oh yeah, my hip doesn’t hurt at all.

Day 1: October 29th, 7AM - Room 1245
Good morning, vomiting impulse! Great to see you again!

I was told by Dr. Vail that the second day was the toughest. So thank goodness my wonderful Welsh-born nurse, Joanne, showed up. Yes, I was still vomitous. Yes, still tired. But I couldn’t pull it together. I managed a bit of post-vomiting breakfast (by the way, this is the last you’ll read the word vomit again) and felt good for an entire half hour. PT showed up when anesthesia and nurse showed up and they had an in-battle as to who gets to poke the zombie. Joanne won because she realized that I was far from getting out of bed. My wife showed up and put up with me feeling really crappy and out of it. But somehow eating.  But definitely not getting out of bed for PT. Although I gallantly managed four foot pumps and seven swivels. Just a lousy day in and out of naps, dealing with low blood pressure and high blood sugar, loathing the night ahead. Thank god for the love of a wonderful family. I can’t imagine I was great company, if any company at all.

The night
Not as bad as the freak show of the night before. As a type 1 diabetic I had been emphatically disappointed in the hospital’s protocols in delivering insulin. I’ve been on a pump for seven years and they kept using their sliding scale to determine how much insulin to give me. The results were blood sugars in the stratosphere! I finally convinced my nurse to track down an expert who eventually showed up and proved herself to be a true advocate. She chucked all the hospital crap, reconnected my pump and got me back involved. The results were nearly normal blood sugars at six in the morning.

Every once in a while I remind myself that I’ve got bionic parts. Hasn’t sunken in.

Day 2: October 30th, 7AM - Room 1245
Today I was nervous that I was not going to be released because I had proven to be a weak and lame-ass patient who couldn’t even sit up without fainting. What happened to that god-like creature that entered the OR with so much jejune c’est quoi?

But certainly a big turnaround today. I ate, I talked, I broke into wild sweats. By this time four different PT’s had shown up and none had been able to get me out of bed. Until Jimmy hit the mother lode. He showed up, got me out of bed, and with the help of my wife, got me shuffling around on a walker, then crutches, then up some stairs. Next thing I know he’s telling me I can go home having passed the stairs test. Good bye, conspiracy theorist night-time blood guy! I was told I could do total weight-bearing on the hip so that’s what I tried and while I’m certain they wouldn’t tell me to do anything I couldn’t do, it scared the crap out of me. I expected reams of PT exercises to take home with me, I was eager for some homework as I wanted to get more actively involved beyond lying in bed. Jimmy told me that my PT was walking, getting off the walker/crutches/cane and walking. Something to do with being an active person before and after and my body will just figure everything out.

In the wee hours of the previous night my nurse discovered that the tube that was delivering meds to block the pain in my lower right quadrant had been pulled out of the catheter and had probably been out for several hours. Again, just like my watch-stealing-clown, the hospital experience had offered me so many distractions I had completely forgot about my pain. But then again, there really wasn’t any. A dull ache and a lot of weakness.

That afternoon I was formally released and I swear the guy pushing me around in the wheelchair not only got lost in his own hospital, he got lost simply trying to find the front door of his hospital.  He had to a new gurney/wheelchair pusher. Not because he got lost. Because he was the only gurney pusher who did not go completely out of his way to regale me with his plans to not be a gurney pusher any more. Each and every one was getting out of that racket and they all had a plan. All great guys, all hated pushing gurneys. I have to say that it sounded like these guys have been trumpeting their I’m-Done-With-Gurney-Pushing dreams for a long time.

Anyway, my wife showed up and we went home. Where I proceeded to become the worst patient in the world.

Initially, Jimmy the PT’s instruction for stair-climbing were excellent and I made it up the 32 stairs to our first floor. (We live on the top two floors of a grand 1891 Victorian just off the Panhandle of Golden Gate Park. Long friggin’ way up.)

But once up, I started wandering aimlessly around our home in my new walker. I was weak, tired, disoriented and my wife watched me mill about. I then proceeded to not tell her what I was thinking, what I was feeling and where I was going. I tried to carry a hot plate while in my walker, lean over and grab a knife just out of my reach and not ask her for anything. Basically, not letting the love of my life in. Oh yeah, I got yelled at.

You see, I basically have spent my life not letting people take care of me. It would be easy to say it was due to the fact that I am a middle child and spent years making sure everybody around me was OK. I created a world where everybody was more important than me. And then I got to play the good guy. But at the heart of it was not needing to be seen as strong or independent, I’m sure it has far more to do with my feeling unworthy of care. I understood my unique foible going in to all of this, swore I wasn’t going to act this way, then promptly started acting that way.

Day 3: October 31th - Home
The bright part of this day was a rapid shift to crutches. Again, my leg didn’t hurt so much but my post-surgery mindset was bad. At times I felt like I was hallucinating. Then exhausted. I did my best to be a good patient, actually asking for things, and was rewarded with love. By the way, a ten-year old makes for an excellent servant.

And so I had in front of me my first day of doing nothing. And not feeling well. My blood sugars were still out of control, I kept breaking out in wild sweats, I couldn’t shuffle down the hall and back without flopping back into the sofa. People were calling, asking if I’d like some company. No, absolutely not. I didn’t have the energy to watch The Price Is Right. I could watch exactly half of The Price Is Right. Then it was time to stare at the ceiling.

That night, the two of them went trick-or-treating and I watched episodes of "The Addam’s Family" on hulu.com, ignoring the occasional doorbell. Let them trick me. I’m tired.

The hospital bed --- I was super intent on not being a burden before all of this (see pathology from previous day) so I took care of everything. Even renting a hospital bed and having it ready in the living room. And while it was convenient the first night, and mildly comfortable the next, it was just so depressing. My family upstairs, me and my bed downstairs. I felt like a dying Italian mama.

Day 4: November 1 – Home
Now I’m thinking this is all backwards. I go in for hip surgery. I come home. My hip doesn’t hurt. But my body is a mess. I watch international soccer on TV and think, How is it athletically possible to perform like that? I couldn’t concentrate on reading, watching TV was marginally less difficult, not even napping was easy. I just floated around in this uncomfortable cloud, trying not to faint whenever I managed to stand up. I immediately snapped to exactly the right conclusion – something had gone horribly wrong. I kept this as my little secret, just in case I was horribly wrong about being horribly wrong. That would be embarrassing. Nonetheless, I had somehow shifted from my walker to crutches.

After a day of watching way too much college football, friends dropped by with their son, a close friend of Henry’s. Only ten-year old boys would spend an hour on a hospital bed attempting to fold themselves in half. I was hoping that they’d break it.

But I was a magnanimous host. For an entire half hour. Then I broke into sweats.

Day 5: November 2nd
My wife’s birthday. Henry and I done good by having already bought her a bike. She was happy. Now the days begin to blur. Football, Oprah, The Price Is Right, election stuff, a paragraph of a book.

I got tired of banging into things with my crutches. So I shifted to a cane and discovered I walked exactly like Vincent D’Onofrio’s character from Men In Black. Lurching, spinning, swaying like my body wasn’t my body.

Still in a fog with sweats and exhaustion, a friend of mine had a theory based on his own experience. He claimed that the body, struggling with coming to grips with surgery and new parts, needed to go through a rebooting process. It wasn’t just the surgery or the titanium or the blood loss or the anesthesia, it was, wait that’s a lot. Once I wrapped my head around rebooting, I started to feel better. I’m just rebooting. Yeah, that’s the ticket.

Oh, I had purchased a hip package before my hospital stay (by the way, I’m sure every hospital will send you home with crutches, a walker, a cane, a hip package so don’t be a maniac like me and buy them weeks beforehand) that came with a leg raiser (to get the ol’ kielbasa up on the bed), a grabber (that my son admired, quite a good one, dad) a stick with a hook to pull your pants up, a sock-putter-oner device, an 18-inch shoe horn and a sponge on a stick.  These were all incredibly handy for a day or two. Then they were disposable.

Day 6: November 3rd
My first day back at work. I’m an independent writer/producer so my office is any cafÈ with an internet connection or whichever studio I happen to be in. Or my home office. Which is upstairs so I haven’t seen it in a while. I managed to work for about an hour, the I broke into a sweat, then I watched TV, then I napped, then I walked the length of our flat, then I flopped onto the sofa exhausted. Thus was my day.

That evening, while my two were off at graduation for our new dog’s Puppy Class, I got up and started heating food up up. I even made a salad. They came back, our dog having graduated with honors and my son said, Hey, dad. You’re not using your cane. And I looked down and I wasn’t. I had just spent a half hour cooking dinner and I had left my cane behind. That made me feel good.

I even found a moment to forgive the conspiracy-theorist blood guy.

Day 7: November 4th
10:00 AM, my official seven day moment since I entered the ER  and waved to all of my doctors. No walker, no crutches, no cane. I keep forgetting about the TED stockings...

I celebrated today by working for three hours, albeit en recluse on sofa, and entertaining both my mother-in-law and mother-mother for two concurrent lunches. Clearly I am a glutton for punishment. After mom #2 left, I was wiped out and by 1:30 began a deep sleep that lasted until 4:00 when the election coverage began.

The three of us took a break to walk the new dog -- my first moment out of the house! You have to understand that it’s 34 steps down to a steep San Francisco street so I’ve been little motivated to go down there. But I did. And we crossed over to the park, we played with the dog and returned and once again collapsed on the sofa sweating. But boy was I happy.

More on my second week to come. So far, it's been a week of miracles and getting better every day.

December 2, 2008

Hello to All Surfers,

Several weeks ago I posted a rather whimsical and bizarre account of my first post-surgical week. Bizarre mostly because there were so many new things occurring. (If you’re curious, search -- "My First Week" sampondsf -- if you want to be horrifyingly entertained or entertainedly horrified.)

I’m afraid my 2^nd through 5^th weeks will not be so horrifying or entertaining. Mostly because things have steadily gotten better. And the fact that there are far fewer midnight conspiracy theorists in my life. I guess that’s the point of this missive. It’s tough at first but it’s far better on the other side.

Hopefully those who are about to head down this road will find my experiences helpful. Or at least mildly diverting.

My Second Week

This was a big transition week for me. Yes, I was ambulatory but my energy levels were on a rollercoaster ride from hell.

My friends would constantly ask me, “How does your hip feel?” My response was, “My hip is the least of my problems.” sMy problem was that my body freaked out after surgery. I think it was the anesthesia. I would walk around, make a little dinner, then suddenly break into a crazy sweat and I’d have to lie down for an hour. Or I’d wake up in the morning then go right back to sleep. Even sitting up would require a nap immediately thereafter. The thing is I love a good nap and now I had an excuse to nap away my days. If only I didn’t sweat so much.

I also discovered hulu.com and caught up on my vintage Addam’s Family re-runs. Great show. Oh, and make sure you rent The Visitor. A perfect little movie.

I’m not sure I mentioned this before but I actually rented a hospital bed to sleep in downstairs. In our house, downstairs is only relative to upstairs because it takes 30 Victorian steps to get up to downstairs. I slept in this stupid bed for four nights and hated it. Just too depressing. My son and wife would walk up to wish me good night. I felt like a dying Italian grandmother. “Bless you,” I’d say which cracked up my son but annoyed my wife. I called the rental place and had them haul it away. The same Russian guy who smelled like cologne and cigarettes. Had to open all the windows.

I’m also the coach of my son’s soccer team and on Saturday we had a game. (We are truly the worst team of 11-year olds on the planet. For example, one kid in the middle of a skirmish for the ball actually stopped to chase a falling leaf! Another kid only kicks the ball in the direction he happens to be facing which means we can only play him on offense because on defense he keeps kicking it back to the goalie!) But I digress. I was worried about my stability so I brought my cane. The boys asked me about it. I told them it was filled with liquor because they were driving me crazy, an announcement that caused them to act even more insane than usual. We lost. I went home and went to bed at four o’clock.

But it was week two and I was getting my life back!

My Third Week

I christened week three with having stitches snipped out. And I finally sucked it up and looked at my incision for the first time. (Until then I had my wife change my dressing. I am such a chicken.) A rather elegant centipede.

My first physical therapy appointment my therapist asked to see my gait. I lurched across the floor, doing my best not to look like Vincent D’Onofrio’s alien character in “Men In Black.” She said, “You’re walking like that guy in “Men In Black.” So we got it all straightened out and for the past three weeks I’ve been thinking about walking while I’m walking. Which is pretty bizarre. But I love PT. No more surrendering. Now I’m taking charge again.

The recovery road is so subtle. One day I can’t imagine going back to my soccer-playing, fly-fishing, even thinking-clearly ways. Then the next I can feel a tiny glimmer of strength, energy and clarity. I celebrate by pushing whatever I’m doing too far. Then I fall asleep. Sleep is a major theme with me these days.

Oh, another milestone. My first whole day without a break. First we sat in a synagogue all morning at my best friend’s son’s bar mitzvah (where my son whispered to me, “Nothing against the Jews, dad, but this is really boring.” Later I told him to be grateful we didn’t go through the sitting/kneeling/standing/kneeling/sitting/kneeling/etc. Episcopalian services I grew up with. You get bored and tired.) Then a double-header soccer game (lost both, too much grass for my players to tear up and throw at each other). Then the bar mitzvah party that evening where I actually danced! Not well, mind you. And not a lot. But you know, they play “Celebrate” by Cool and the Gang and you can’t just sit there.

That night I think I slept for 14 hours. The next day I was hurting. But not the hip!

My Fourth Week

More fleeting moments of feeling like I could just take off running. Every now and then I hop up on a curb. I’ll kick our dog’s rubber ball. I’ll jog four steps. Then I remind myself of my promise to my wife -- the “Don’t Do Anything Stupid” Promise. I am letting time and nature and recovery take its course. Which runs counter to my natural urge to get things moving. (I work for myself mostly because of all the time I used to spend in meetings. Time in meetings is time you’ll never get back for the rest of your life. “So, how was your weekend?” “Good, how was your weekend?” “Good. What did you do?” “We got together with friends!” “You did? We did too!” “Was it fun?” “Sure it was fun.” “Oh, fun!” And on and on and on. Somebody shoot me. I used to work for an ad agency which held Monday morning WIP (Work In Progress) meetings. These were long meetings held to reprimand creative professionals for not getting their work in on time a week before it was due! I pulled my creative staff out of these things as soon as I could. Uh, ten years later I got hip resurfacing. I don’t know what the connection is anymore. Maybe it’s this. Don’t waste your life in meetings (living with a painful arthritic hip) but pull your staff out (make the decision for a BHR) and get some work done (er, get your hip done).

I’m a genius.

My Fifth Week

This was the week that I really started feeling like myself. The physical therapy is making my hip feel much more stable and strong. (Oh, I go twice a week and they work me hard.) I’m back at work, did some volunteering at school, drove the fam down the coast for a family reunion Thanksgiving. Then the big day was Sunday where I spent all day getting the house ready for my son’s birthday. This required frequent trips up and down the 30 Victorian steps and hauling stuff up from the garage. And you know what? I made it through the day without falling into bed exhausted!

So that’s the word for all of you about to go down this road. My advice is to completely surrender at first. Then you’ll find yourself slowly and organically surrendering less. Then you’ll have a lousy day. Then you’ll have a great day. Then you’ll have two great days in a row.

And then you’ll be taking naps because you want to, not because you have to.

Cheers and best of luck to all of you out there.

Sam Pond
Dr. Vail, RBHR, October 28