Friday, October 13, 2006

Dislocated Hip!

I dislocated my (prosthetic) left hip [1] in the wee hours last night. . .by far the most painful thing I've ever experienced. . .by orders of magnitude. My stainless steel hip bone popped right out of the socket. My leg no longer worked, and I could do nothing but slide to the floor, where I remained for about the next hour, trying to find the least painful position (a position that didn't exist), and hoping I could somehow pop the hip back in. My leg was almost turned backwards.

Moving even 1/4" was excruciating. One position that hurt the least, but it started hurting and I had to find another. And every move was complete and total agony. Breathing could hurt. Muscle twitches felt like fire. And the muscles were twitching. I got a Charlie horse and couldn't stop it. It hurt too much to straighten my leg out. I woke Keelin up and she and Colum called 911 (!). The fire department and an ambulance arrived and after fifteen minutes of butt-scratching, carted me out of the basement on a papoose, up the steep back stairs and into the meat-wagon for the drive down the street to Ballard Hospital. They started me on Dilaudid (and gave me a good plungerful in the I.V. whenever I asked).

Since I'd drunk a glass of orange juice at 12:00, they had to wait eight hours to perform the surgery. Not surgery, really, but sticking the hip back in the socket. The Doctor said it was more like carpentry than surgery ("we use the same tools...chisels, saws, screws, cement, hammers"). They had to knock me out to perform the hip "reduction" as it's called. Dr. Wexler was a very personable guy. I tried to talk him into just banging the hip in without anesthetic (Lethal Weapon style). We wouldn't have to wait for my stomach to empty. Alas, he seemed almost game, but didn't want to do it. He'd done a shoulder w/o anesthesia, but he didn't know if he could pull off a hip. So, we waited on three babies about to emerge.

They put me under and wrestled my hip back to its rightful home. I woke up three minutes after they knocked me out, and my hip was back in place. I'm still hurting, but they gave me plenty of Vicoden, which helps a little. I am wearing a "knee immobilizer" to prevent my hip from twisting, andto protect me from myself.

One minute after they finished with the hip, I woke up. It was a shimmering moment of joy. . .in these three minutes I was asleep they had changed my life! I went under at 9:30--I was facing a big clock--and when I snapped to it was 9:34! How did they do that??!! That is maybe the most amazing part of this story. They can put you under for three minutes, perform their maneuvers, and bring you concscious instantly! Keelin said I made a joke when I woke up. And for a second, I thought maybe they didn't fix it...but I wiggled my leg...it was attached and it was no longer on fire. My hip was home and I was sore all over, but I could move my leg under my own volition. The absence of pain was a joy. I feel a lot of other pains at the moment, but in perspective, they are infinitesimal. I am going to be OK, I'm sure. But I am always an optimist about these things. My knee immobilizer prevents me from doing anything too crazy. I'll admit, 'though, I am the last person in the world who would do anything risky right now. The pain is way too fresh. I'm not ready for that again. OK. . .enough. . .how are you feeling?!


[1] From Dynomed.com: In a posterior dislocation, there is usually a great deal of power brought to bear to a flexed knee and to the hip.

Dislocations of a prosthetic hip can happen without any trauma since the ligaments that support the hip joint are no longer working properly. However, nationwide, only about 1 percent of all hip replacement patients will suffer a dislocation. The dislocation can occur when the leg is put in positions that can manually pop the ball from the hip socket, like crossing your legs at your knees or squatting. Additionally, for preventive reasons, physicians advise against bringing your knees to your chest if you have a prosthesis.

Two common techniques for performing a posterior hip reduction (the most common kind of hip dislocation) are the Allis Maneuver and the Stimson Maneuver. In addition to those two techniques, there are several other options available to an orthopedic surgeon depending on the individual case. Both maneuvers require the use of physical force to push the hip back into place and are performed with the patient sedated. The hip and knee are flexed to a 90-degree angle when a surgeon applies the Allis Maneuver. The Stimson Maneuver has the dislocated leg hanging over the edge of the bed with the hip and knee also flexed at a 90-degree angle.

---o0o---


2 comments:

Pete said...

Geez Jack. I hope this Friday the 13th story is your version of an April Fool's joke. If it's not, get better soon and have a Darvocet on me.

They ever catch the bastards that shot the two lady hikers on Pilchuck? Being an avid hiker I'd like to hang the bastards by their sensitive bits...

Jack Brummet said...

I wish it was a joke! But I'm totally on the mend. . .a little spooked, but according to my hip Doc, everything is OK.

And no, they never caught the guy(s) Pete. In fact there was a recent report that they brought in profilers--a sure sign they're at a total dead end.