Alan Ray Handball 12/15/04 Dr. Koen De Smet

Yo, Hippy Kids...

Today marks three years of remarkable, painfree, unrestricted life after a resurfacing on 15Dec04. In my case, for you who are new here, I was crippled after a handball mishap in May of 1996. I had to stand, leaning on crutches, to check into the hospital, because it finally hurt too much to sit down again. We had a fine band of friends in Gent...Deborah Page, Gordon Jackson, Jean from BC, Jay Brand. At last reports, all were living completely unrestricted lives. To mark the anniversary, I have, in the past reprised my first post-op posting from Gent. I do it one more time. This the post: from Dec. 18, 2004.

(Still Walkin' in Straight Lines)

Alan RayHello from a cybercafe' in Gent. Four days since the good Dr. de Smet gave me life back. And he has put my life firmly back in my hands.

The operation was quick and clean. I took my last Codeine fizzy at 6:00 yesterday (Friday) morning. It's now 3:15 pm Sat. in Gent. Apologies for having been out of touch so long, but the pre-paid internet machine at the Holiday Inn was out of order before we arrived on Monday and it's still not fixed; as any of you who have been to Jan Palfijn Hosp can attest, it is not wired for the Internet. So this is the first time I've been able to check in:

Over time, especially after I get back, I'll compose a journal. For now, Dr. de Smet assures me, I will be able do whatever I want: handball; weight work withouth load restrictions.

I still must learn to walk again, and re-learning began the first day after surgery. Today it continued with Marc, the gifted physical therapist. It seems to get better almost by the hour, though I know, nothing goes in a straight line:

Last night, as I lay in bed, on my back; a silly grin came unbidden to my face and tears welled up. I DID NOT HURT. It was the first time in more than 5 years that I have been able to lie in bed in any possibition without hurting.

(I'm sorry if this missive is a bit slow to develop and disjointed, but I'm using a Belgian/European keyboard and I have to correct about every third keystroke. The pace is about I might have imagine if I were trying to chisel a note in stone.)

There's still quite a recovery road ahead. As I see the course: Dr. de Smet helped me trade life of pain increasing limitation for life of no pain and expanding possiblities. But he has only really given me the possibility: The story now will be told not in the gift he has given, but in how much I'm willing to work to realize its possibilities.

Updates on the other Brothers and Sisters in The 12/15 Band of Hippies: Deborah is at the hotel,though she had a bout of hypotension; and good deal of nausea; surgery went well. Gordon Jackson's surgery went well; Jean from BC also had low BP and nausea, and had to stay at Jan P. an extra day, though her surgery was a success. A previously unheard-from hippy, Jay Brand from Oklahoma and I shared adjoining beds in a truly nightmarish four-bed room (more about that in the journal in a  few days), he came through surgery just fine, though.

As for me, despite repeated requests, hospital attendant said she could not provide a raised commode seat when I asked the evening after surgery. Having no choice, I tried it the old fashioned way, in space barely bigger than your standard issue Paris water closet. The astonishing KATHUNK as I tried to stand left me feeling as if I'd simply pulled the thing apart and, after that, every step hurt like hell. At 6:30 I was on the phone to the cell phone of Hugo in Dr. de Smet's group; at 7:10 I was back in Radiologie for x-rays of what I was sure would be an irreparable medical disaster. The x-rays rode back with me to the room, and by 7:30, the inestimable Hugo was in the scene The x-rays showed nothing out of place or out of order. (Ten minutes after Hugo left, Jay asked for — and got — a raised commode seat.) I apologized to Hugo before he left, but he assured me I had done the right thing in calling.

(I did see the x-rays: beautiful. The bone stock in the femoral neck looks really solid and the BHR looked to me as if the doc had implanted one of those rolling furniture casters where part of my hip used to be. Even the doc told me the morning's a very big piece.)

Today, when Dr. de Smet came by the hotel for my check-up, I apoligized again for the false alarm. I explained that I just hadn't known what 'normal' felt like. He also said the call had been the right thing. He said seen the condition of my hip when he got in there, and there'd be no way I could know what a 'normal' hip is supposed to feel like.

I'm learning. I had expected to be more excited. I will be, I think. But at the moment, I'm learning a whole physical vocabulary, and as I  write this; I'm getting a bit misty again. The gift that has been given me is almost overwhelming. Other's have written of post-op depression. I'm not depressed. I just have to learn to deal with a quarter of my body that's mostly been a stranger for eight years.

Thank you, my hippy family: I could not have imagined this without you. Thank you for helping me find the possibility of a full life again.

12/15/04 Dr. de Smet

P.S.—(And thanks to Al and Paula for a wonderful welcome to Brussels: About which much more as we go)


Opening notes: Yo, hippy kids, as promised, this is the diary of my trip to a new life in Belgium. Al from Brussels, and Dr. Tom Simpson of San Francisco, among others, have provided useful, practical reference diaries. Dr. Tom’s details quite better than I could the medical issues, considerations and procedures. I will avoid telling the stories or details of the trips of others in the 12/15/04 Belgium Band, because I have only truly my piece of the puzzle. Bear in mind, please, that every fool has a piece of the truth, and I the only piece I can claim is my own. In our ways, each of us is like the blind man trying to describe the elephant only by the part he feels. Some qualifying notes, references and details will be included as end notes.

Dec. 11, Departure. My wife Chris and I had arranged a cab shuttle to take us from the East Bay to San Francisco International Airport. He was on time, picked us up at 5:00 in the morning. As we drove across the Bay Bridge, he seemed to be fading a bit, losing the string. I don’t want to die in a crash when the cabby falls asleep at the wheel on my way to a new life. Turns out we were his last trip in a day of about 300 miles that had started the morning before. He admitted he was having a hard time staying awake. I asked him if he’d seen the movie “Collateral”. He asked what I did for a living. I said… ”You don’t really want to know.” He stayed awake and we talked for the rest of the trip. The SFO to Newark flight was long, but uneventful. In Newark, we met up for the flight to Brussels with the soon-to-be resurfed Deborah Page and her heroic helper Linden O’Ryan. From there we four flew on to Brussels.

Dec. 12, Brussels. I’d taken to using two crutches full time in the last week before the trip to resurfing. When the people at Brussels Airport saw it, they volunteered a wheelchair (although I’d only arranged officially for wheel chair service on the return trip), and given the long distances from the Brussels arrival terminal to the baggage area, this was a godsend. The owner of the Welcome Hotel in Brussels, where we would spend this Sunday night, was the “driver” who picked us up at the airport. At 8:00 on Sunday morning. The Welcome is a funky, fun, clean, happy hotel. I would recommend it to any one planning a Brussels stopover on the way to or from resurfacing in Gent. You can find them on the Internet, and the manager, Vanessa is a pleasure to deal with.

We spent Sunday midday eating a light breakfast at the hotel, and resting. In the evening we were picked up at the hotel by Al from Brussels, who, with his wonderful wife Paula, spirited the four of us off to a delightful evening meal at an excellent restaurant. There were toasts aplenty.

Dec. 13, Brussels-to-Gent, We four hippies and helpers took the day to wander around Brussels, and meet friends for lunch. We picked up the train to Gent at 4:00 in the afternoon. It was a dark trip. Personally, I’d recommend leaving earlier in winter, so you can see where you are, and where you’re going… but we found Gent without incident. We taxied to the Holiday Inn U-Z, where Dr. de Smet has a lodging arrangement for resurfacing patients. The price when we were there for the de Smet package was $86 Euros a night, and that included free breakfast buffet… which was actually quite good and nicely rounded. Chris and I learned with the evening meal that room service food is quite good, and considerably cheaper than a trip to the restaurant outside of breakfast buffet hours (6:30 to 10:00 am).
Dec. 14, off to Jan Palfijn. As we arrived in the lobby for the cab to the hospital for 2:00 check-in, we met Jean from BC and Gordon from Wisconsin, who were the two others of the 12/15/04 North American Hippy band (we would learn later that there were others from the US who had made the trip for surgery in that week unannounced, and not previously known to us.)
The arrival at Jan Palfijn Hospital was not auspicious for some of us. We’d been told that Gordon and I would share a two-bed room. But, when I checked in, they had a record of my name and date… but no room. It took them ten uncomfortable minutes to find me a room, and then it was a room for four… on the 4th Floor, not on the 2nd, where most surface hippies go. I was barely consoled when the woman at the desk told me there was an American in the room, so I’d have somebody to talk to. Gordon had money clearance and room issues that complicated his life, though he did finally find better accommodations.*

Chris and I went up to Room 436 and in the bed next to mine was a guy lying quietly on his side, looking a bit lost… as we all seemed to be. We introduced ourselves. He was Jay Brand from Oklahoma. He was there alone for a right hip resurf. He’d checked in on the Surface Hippy site a couple of times, but had not posted nor stayed, nor read much. We made small talk… the nurses came in… shuffled us off to Radiologie for hip and chest x-rays. Then the trainee came to draw blood. I know the effort was her first. I’d have preferred she be better prepared for it, but I credit her for feeling badly that she was hurting me. It didn’t last long.

A cardiologist comes in… takes my blood pressure, says it’s 160/104. Which, he warns, is a bit high. Great bit of detective work, Sherlock… wanna guess why? Long flight to a foreign country, wrong room deal, waiting for a guy I’ve never met to put a large slice in my left butt cheek. Yeah, the BP might be slightly elevated, don’tcha think? That’s what I thought. I didn’t say anything… except to assure him that it has never been that high before. And I’ll get it checked when I get home. He pronounces me cardiologically fit for surgery.

Another barely-English speaking young thing arrived to ask what we’d like for meals. This is a fool’s venture. Tell them you don’t care, because you won’t get what you tell them you want anyway.

When Jay and I arrived, there was space for a fourth bed in the room, but there was no bed there. A barely-English speaking man in the third bed seemed to be trying to tell us something alarming about the guy in the fourth bed, but we didn’t understand.

Then they wheeled the fourth bed in, and parked it in its corner. Nice enough looking older man, quite nicely gray, and seemingly in good shape.

Then dinner arrived. Two slices of what seemed to be warmed-with-steam white bread… and some dreadful attempt at coffee. Not what I was sure I had ordered. But, it was too late to change it. I passed on dinner.

The leg-shaving (at least for a furry-legged guy like me) was something of a revelation. Just a blade in what looked like a standard Gillette-style safety razor… no crème, no water… no nothing. But, not a knick and no razor burn when it was bare. I still wonder how he did that.

Jay, not having spent anytime with the Surface Hippies didn’t know some things: He didn’t know you had to provide your own towels… I had brought extras, and lent him one. (Other than the gown they give you for surgery and the first few hours post-op, the hospital also doesn’t provide sleepware. Take your own jammies… or nightshirt/gown… and, in winter, you’ll probably want to take some slippers, too.) Jay and I traded books to read.

The night was not-uneventful. The guy in the fourth bed spent the entire night ranting and trying to get out. We didn’t sleep much.

Dec. 15, Day Zero… I’m second on the surgery schedule… on the table about 9:00. Jay was to go after me, as I recall. Tom Simpson and others (their diaries are linked with the SurfaceHippy main page) have talked about the surgery itself, so I’ll pass on that. Except to note that I remember absolutely nothing… until I was back in Room 436, after the Post Anesthesia Recovery room. I’m told I asked Dr. de Smet to play handball. Don’t remember it. The first thing I do remember was… No Pain. Dr. de Smet was in the room with Chris and me shortly after I came out of recovery. He said I was big boned. Said he put “much metal” in me. I hadn’t the presence of mind to ask ‘til sometime later what that meant.

When I was wheeled back into the room, they hooked me up to an IV drip and a morphine pump. (If you feel pain, you just push this little button three times, and get a dribble of friendly fell good juice) Jay wasn’t so lucky. The hospital had only 12 pumps. His was to have been the 12th, but it was broken. They had no replacements, and Jay got no morphine pump. They apparently tried to treat his pain with oral meds. They didn’t work much, if at all. Jay had a very hard day. And it got worse. His left-arm IV needle came out late in the day, when he moved (because of the pain)… and they just took the IV away… didn’t replace it.

I was catheterized twice, over the next few hours. They want you to pee, but I was trained not to urinate lying down so I couldn’t produce for the bed pan. The nurse came in to do it a third time… I said… let me stand up, and everything will be fine. We had a walker, for trips to the commode, which were frequent. Once I could stand up, and used the walker to the water closet everything came out alright. But, truth be told, unpleasant as it is, catheterization is not end of the world.

I hazed-out most of the day… and into the night. Morphine will do that, you know. But I was in and out of awareness enough to know that the guy in bed four was loud, and not mentally connected.

Dec. 16… Day 1: The first day (Thursday) post-op was interesting… and not in all the best ways. There was breakfast. More plain bread… and dreadful coffee. A physical therapist came through and put us through the first session. There was no pain. Still.

Lunch was… unidentifiable. It looked like some kind of ham (paper thin, with lots of fat), wrapped around what I later learned was a piece of overboiled Belgian endive… all of it covered with some kind of paste/sauce/mucilage. It went back untouched. Even hunger has its limits.**

Through the day, Captain Dementia dozed and slept quietly, uneventfully.

Dinner was more dreadful stuff… but Chris was kind enough to order a couple or room service ham sandwiches, which she smuggled in from the Holiday Inn… so we did have something to eat for the day.

Late in the day, I had the need to use the john. I asked one of the nurse’s aides – twice – if they had an elevated seat She looked at me and left the room. And she didn’t come back. So I tried using the facilities the old fashioned way. But the gripping bars were badly placed… and the room was no bigger than a Paris water closet, so there was no way to get up, other than to push off on the just-operated leg. The action was greeted with a solid sound/feeling of kathunk in the hip. And pain. This did not feel good, and scared the hell out of me. A half-hour later, the pain was still present, so I used the cell-phone number they had provided to call Dr. de Smet’s aide Hugo at 6:30 in the evening. Hugo dialed up the hospital, and ordered x-rays immediately. Twenty minutes later, the x-rays were done and I was back in the room. Five minutes later, Hugo was there… assuring me that the x-rays showed everything just where Dr. de Smet had intended it to be.

About ten minutes later, Jay asked for a raised toilet seat… and got one.

But that was the end of satisfaction at Jan Palfijn for us. The nurses came through with the night’s medications, then left us. The guy in the third bed turned down his hearing aid and turned up the TV (he had sole possession of the remote control), apparently to drown out the endless rantings of Capt. Dementia in Bed Four. When the guy in Bed Three started snoring, we called the night nurse to turn off the TV, and she seemed miffed that we couldn’t deal with it.***

Then Captain Dementia really took off, playing with himself, soiling himself, ranting, trying to get out of the railed bed (he only apparently failed to escape because he had a broken hip). At one point, we called the night nurse because the poor guy was half in bed and half out, and in danger of strangling himself. She tried to put him back. He punched her… three or four times. She put him in restraints. He still got half out of bed. We called the night nurse… she came back and added rope to the restraints. And he ranted though the night. Jay and I did not sleep. Though at one point we asked that they find another place for Capt. Dementia… and we were told… there was no other room for him in the hospital. Jay and I got a few rueful, wry laughs about the night… but no satisfaction. And no sleep.

Dec. 17, Day 2: Jay was fed up, angry, hungry and exhausted. He checked out of the hospital for the hotel before 8:00 in the morning, just to find some quiet and some sanity.

By the time I got out at noon Friday, after a mid-morning physical therapy session, I had eaten a half a ham sandwich in 36 hours, and hadn’t slept in nearly 24 hours. In the cab on the way to the Holiday Inn… we stopped for a bottle of Scotch. It was a better day. Laphraoig single malt, and a room service steak. I think I’ll live now. And I have no pain.

We had called the Holiday Inn from the hospital, and asked them for an extra mattress to raise my bed, and one of the elevated toilet seats. Both were there when we arrived from the hospital.

I took a shower, but the tub was hard to step into. It had a very high edge, and working the operated leg around it was a trick. With the towel racks and bars around the bath area, some purchase is possible… but entry eventually requires bending the operated leg at the knee, and rolling it over the edge of the tub. The reward is a very nice shower.

Dec. 18, Day 3: Chris had to be at work in SF early on Monday morning, so she left this morning… cab to Brussels, then the flight home. Later in the day, came the first visit to the hotel by de Smet’s nurse Jan. He’s a trip, drives a Porsche Boxter… and is a very good nurse. He changed the dressings, putting on one he assured me I could swim in. Marc the physical therapist arrived not long after. Later I ventured down to the front desk of the hotel, to ask about using the pre-paid internet service. It was out of order. So, I found a cab, to take me to an internet café… where I managed my first post-op post. It used a Flemish keyboard… and a couple of simple notes took more than two hours.

Cab back to the hotel… and for dinner… a bit of an adventure. I crutched my way alone to the Capanile Restaurant, which is down the drive… and attached to its own hotel. I had the duck breast fillet with fresh cranberry sauce, and a side of lightly fried apples. It was the best duck I’ve ever eaten. Time to sleep. Not well, but better, since I’m measuring any night’s sleep against the last night at Jan Palfijn. It was a good night.

Dec. 19, Day 4: Marc arrives for another PT session. His exercises seem so simple and so basic… but they really do work. And he’s good about helping me to learn to walk again. The last exercise of every day is a groin-stretch… in which I sit at the end corner of the bed, butt on the corner, legs splayed with feet flat on the floor… then I lie back on the bed ‘til my back is flat. I feel groin muscles stretching… muscles that haven’t done anything but hurt me for eight years. When Marc says I can get up… I sit up straight… then I stand straight up in a continuous motion, rising with only the strength of my legs… no pushing off the bed, no assisting push off the thighs. It’s giddy-making. I haven’t been able to stand from a lying or sitting position without pushing off for at least five years. I’m grinning. Marc seems pleased. Nice guy.

I headed down to the breakfast buffet… and, as I get back, my daughter Krista has arrived from Seattle to help for the rest of my time in Gent. She’s fresh from Grad School fall quarter finals… and surprisingly ready to help when needed. Jan arrives to change my dressing again. How can anybody be that happy all the time? The day is mostly quiet. That night (Sunday) with Krista’s help, I venture into the Holiday Inn swimming pool for some therapy. The water is not real warm. But it’s a good place to be, and I learn that, even now, I have more range of motion in the hip than I can remember.

Have I mentioned that the hip now looks like Dr. de Smet removed the joint and installed an egg plant? Big, fat, purple, ugly, lumpy… and I don’t like egg plant.

Dec. 20, Day 5: Start out with 600 paces on two crutches, up and down the Holiday Inn hallway. Dr. de Smet comes to the hotel, to visit, answer questions about the surgery and leave paperwork for insurance, x-rays and a laminated one-sheet describing the surgery, including a picture of the x-ray with prosthesis in place. I took a 64 mm acetabular cup. Geeze. That’s a big one. No wonder the incision is almost long enough to give you white line fever.

Later, Jay, Gordon, Linden, Deborah, Krista and I take a taxi-van in to Gent for some walking, shopping and eating. Krista and I found a Moroccan Bistro called “Sarabande” right across the bridge from the cybercafe’. Outstanding food and service. I recommend the clay-pot of lamb’s leg with prunes, pears, apples, sesame’ and spices. It is to die for.

As it got dark, the main market area of Gent started to look more and more like Disneyland’s Mainstreet USA, lights strung everywhere, impressive (but real) old building facades… and smiling, laughing, happy people everywhere. They ddn’t seem to notice that it was 28 degrees. But we hippies stood in the cold for 40 minutes waiting for a cab.

Dec. 21, Day 6: Watching the spread of the big purple ugly… from the hip around the hamstring to the inner thigh… and down, to the knee… and then to the ankle. But even now, near the incision the flesh that once looked purple with bruising has started to turn a bit lighter… to yellow.

The TED’s (thrombo-embolitic defense, or something like that), are a trial. They fit tight low on the leg, but I can’t keep them over the meaty part of the thighs. Fortunately, these days I’m wearing those snap-up-the-side warm-up pants… so I can reach in between the snaps and hike my knickers up when they start to droop to the knee. (You’ll want to try to avoid doing this when people are watching.) Making the TED’s even less agreeable: As they slip, they ruffle the ample hair on my legs… and it feels like something is crawling around down there. Alan is not happy with TED’s.

In the evening, about 8:00, nurse Jan comes by. After a full day of walking and standing on the leg, there is no drainage from the incision… so, he says, unless something unexpected happens, I’ll only see him for one more dressing change before I leave.

Dec. 22, Day 7: One week from the great dividing line of my adult life. Today, a big step in reverse. I hadn’t noticed anything amiss after last night’s long stand waiting for a cab. I woke up early this morning (about 5:30) and the breakfast buffet doesn’t open for an hour, so I figured I’d practice walking. One crutch, 1,000 steps up and down the hall. Seemed like no big deal.

Went down to breakfast with Krista and Hippies. I went back to the room to take a shower… and when I looked down… I could have sworn that, somewhere in Africa, an elephant was missing a leg… because it was attached to my left hip. Purple and quite swollen… apparently from the combination of the long stand waiting for a cab the night before… and too many practice steps in the morning. Jan looks… agrees the swelling is not good, but says the dressing is fine. Marc cuts the day’s PT session in half, because of the swelling.

Dec. 23, Day 8… Jay leaves. Krista helps him put his TED’s on, and we walk him with his bags out to the meet the cab. The hotel internet service is still out of order. (This will be the case for the rest of the time we’re here.) Only today, they finally put on ‘out of order’ sign on it.****

There’s a short trip in to town. To the internet café, and to the chocolateer, who sees me and points and says “Dr. de Smet?” I say yes. He says his 40 year old aunt was resurfed by de Smet last summer, and is going wonderfully well.

Dec. 24, Day 9… Still there’s swelling (though not as much) in the operated leg, so now… a concession to reality, and an acceptance of vulnerability:

My plan to leave from Brussels on Christmas Day with Deborah and Linden is now scrubbed. I’ll be staying in Gent until my flight day on the 27th. No Brussels stop, no Midnight Xmas Mass at St. Bavos Cathedral, and no Xmas eve dinner in town with the other hippies. Instead, I spend my Christmas eve in the pool doing water rehab… then Krista and I have a room service dinner. The swelling is going down. And faced with 22 hours of international transit time in a few days, I don’t want it to come back. Rest is my new best friend. Early in the evening, we gather in Deborah and Linden ’s room, a half dozen hippies and helpers… for a Bailey’s toast to all, as Deborah and Linden will be leaving early in the morning.

Dec. 25, Day 10… The 12/15 Hippy Band disbands a bit more… Deborah and super hippy helper Linden take the train to Brussels for a day stop-over before heading home to Maine.

My swelling is almost completely subsided now. But much of my body looks like a poorly used punching bag. There’s still bruising at the elbow site of the IV drip; there’s a mass of purple from my left hip to ankle, and now… the subcutaneous anticoagulant injections in my belly are leaving a purple track on either side of my navel.

Christmas or not, Marc and Jan both show up… as scheduled… for PT and dressing changes. Marc is teaching me the finer points of walking. After eight years, the muscles have forgotten how to do it on their own, and I’ve forgotten how to tell them what to do. This will take some time. But… now that it doesn’t hurt to take a step, I can handle the practice.

Advice also from Marc: Yes, go back to the weightroom as soon as I can at home, but don’t try too much. And, he says, if I go to a physical therapist, don’t go to one who specializes in sports therapy. He says they’re too intense. Judging by the ones I know that’s a wise caution and an astute observation.

Dec. 26, Day 11… Next-to-last day in Gent. Jan removes the last of the stitches, and applies a new watertight dressing. He pronounces the wound “beautiful”. He says the dressing can stay on a week, if I need it… but the wound is so well healed, I really could get on quite well without it.

Marc arrives for our last PT session. It is an uneventful session. His last words to me as the hotel room door closed behind him: “Don’t fall.” And he said it most solemnly.

In the afternoon, it’s back to Gent ’s Korenmarkt for the briefest of shopping stops, and one last check at the cybercafe’.

Since I’ll be taxiing out to Brussels airport at 6:00 the next morning, the remaining members of the hippy band… Gordon, Jean, Diane and Krista and I… gather in the hotel restaurant for good-bye dinner.

Dec. 27, Day 12: Out the door of the Holiday Inn… into a cab for Brussels Airport at 6:00 in the morning. (My flight doesn’t leave ‘til 9:30, but nobody’s quite sure how heavy or light the traffic might be on this first business morning after Christmas. So I leave early to avoid problems. ) Arrive at the airport at 7:00. The driver helps me with my bag to check-in. (The Holiday Inn webpage says the trip to Brussels is supposed by cost 95 Euros. They’re charging 104 for every trip. I paid it.) When I bought the tickets for the trip, I’d arranged for wheel chair service from gate to plane to gate… all the way back to SFO. Given the distances, and the physical drain of a total transit time of 22 hours, it was about the smartest thing I did. The dumbest thing, in reflection… not taking enough boxer shorts. Briefs are impossible in the first swollen days post-op. Boxer shorts, I believe now, are God’s special gift to hippies.

Arrive at SFO… to a wheel chair at about 8:30 pm PST on Tuesday. Not sure I’ve ever been this tired in my life. Coach is not a good way to fly, if you can avoid it. Especially if you’re tall (as I am) or weigh 200 pounds (as I do) I thought I could upgrade to business class in Brussels, since that’s what Continental Air had told me on the phone when I called three days before departure. They said I had to make such changes at check-in. But the people at check-in said such upgrades had to be made 72 hours before flight time. So, I sat hunched, scrunched and bunched in coach for flights of nine and six hours… with a four-hour stopover in Newark. The coach seat scrunch was more than enough incentive for me to stand and walk every half hour or so… but that meant no sleeping, which is what usually gets me through long flights.

Dec. 28, Day 13: The day is lost in my life. There’s a fog of jet lag, time change, fatigue and pain that blots the day out. This is my first night sleeping in a recliner. It won’t be the last. The bed is too low, and too flat on my back. The recliner makes it easier to sleep with the leg elevated. In bed I couldn’t get enough elevation to reduce the post-flight swelling. What I remember most about the day was the chance to make my own pot of Starbuck’s French roast… for my first really drinkable cup of coffee in 17 days. Not sure how I lived through such deprivation.

Dec. 29, Day 14: A much better day. I’m comfortably down to one crutch. I get behind the wheel of my fast, red car. By pushing the seat all the way back, I can get in without undue discomfort or hazard… and I can operate the clutch. (Mine is an Acura, with the low-release, heel-to-and-toe clutch… and a very gentle spring. Not sure how the driver of a higher-release, heavier spring manual, like a Mustang, would fare trying to shift so soon after surgery.)
In Belgium, my blood pressure had always seemed a bit elevated (though never again at the levels of the night before surgery). Today, I drive the short distance to the gym. Lower body work only, exercises I’d specifically asked Marc about before I left. Three minutes with no resistance on the stationary bike… three minutes on the StairMaster at level 2. Ten minutes after the light work out, my BP was back to its normal range, 118/68. But now, there’s some pinkness and tenderness on the upper end of the incision. I decide to wait ‘til the next day to call my GP. This is the first day I’ve tried to wear jeans, and I thought I did feel a bit of rubbing.

Dec. 30, Day 15: Another night in the recliner, and I’m still not really sleeping well. The incision is still tender, so I call my GP… just because I don’t want to try to get help if an infection develops over the holiday week-end. He sees me before lunch… says there’s no infection, but a bit of friction… and, he says, the incision is “beautiful”. Says there’s just a bit of scar tissue forming, and that’s probably the cause of discomfort, too. He’s intrigued by the surgery. I’d taken my laminated one-sheet with me. He made one copy for reference to keep in my chart… and one copy for himself. He asked if I’d talk to any of his patients who might have hip problems. I told him I’d be happy to. The hippies will lead, and the leaders (eventually) will follow.

In the afternoon, back to the weightroom… but now, I feel some cramping in the groin. Well, duh… I realize that, for all the time I’m spending in the weightroom, I’d forgotten to do the end-of-bed groin stretch Marc used. I won’t forget it again.

Still can’t walk without a crutch. The resurfed joint feels solid and stable, but the outside muscles and the IT band just won’t hold the weight yet for a solid step.

Dec. 31, Day 16: The end of the year seems a good time to end this journal. There’s no telling how soon I’ll be able to let go of the last crutch. But, if I need it even for another couple of weeks, I’m still ahead of the game. I have no pain. And I know eventually I’ll be crutch-free. After nearly 9 years of pain and limited mobility, Dr. de Smet has given me back a life of possibilities. I’m up to two sessions a day at the gym now, morning and afternoon. I’m tempted to push the workout envelope – probably more than I should. Whenever the temptation arises, I remember Dr. de Smet’s wisest words to me… ”Listen to your body.” And I go more gently.


* In the matter of reservations at Jan Palfijn: It turns out the hospital only has three two-bed rooms, and three three-bed rooms. In the case of my reservation, they apparently promised more than they could deliver. I know of no hippies in two-bed rooms (and that was all the others from the 12/15/04 Belgian Band), who endured the kind of demented nights Jay and I did. I would suggest you contact them perhaps a week before you leave for Gent, to assure you do have one of the two-bed rooms.

** As regards the food, if you go with a helper, they can bring food to you at mealtimes. The hospital provides all the bottled water you’ll need. After Jay went ballistic over his inedible meal, Dr. de Smet came by, and offered to provide fruits, vegetables, or whatever Jay wanted. Jay had lost his appetite. We’ve been told that Dr. de Smet’s highest priority at the hospital at the moment is the food, and he’s hoping to have the situation remedied by early in the New Year. The biggest problem seems to be money. I was told by one nurse at the hospital that the budgeted allowance for meal spending is 2.30 Euros per patient per day. Another nurse told me 3 Euros per patient per day. In any case, it’s not enough to provide edible food. Also remember, the total stay at Jan Palfijn without complications will be barely 70 hours, and almost 24 of those will be hours pre-op and post-op, when you won’t be thinking much about food. No one will die of starvation. And you can order beer with lunch or dinner.

*** The story of Captain Dementia is a sad one in all particulars. The man had been diagnosed with dementia a couple of years earlier. Then he broke his hip. Jan Palfijn has no special ward or facility for Alzheimer’s, dementia or psych patients, so they are sprinkled into the four-bed rooms among the general patient population, as the need arises. Despite repeated protests and demands by Jay and me, the night nurse insisted they had no other place to put either Captain Dementia… or us. Just damned bad luck in the draw.

**** The Internet. Others at other times have found the Holiday Inn pre-paid Internet service to be workable, if a bit pricey (45 minutes for 10 Euros, when it works). We were in the hotel for 13 days. In that time, it was operating for no more than 90 minutes, total. The cybercafe’ near Korenmarkt amounts to a single PC, with a Flemish keyboard, which is exceptionally difficult and time-consuming to use. Other internet café’s or centers also use the Flemish keyboard, and they charge up to 3 Euros per hour to use. My advice, if you need the net… take your laptop, and pay the price of a hook-up provided in-room at the hotel. Pricey, but dependable.

***** A last thought. There were a few difficult and unpleasant moments in Gent. But what day in life doesn’t bring some? When you cut to the medical part, I learned everything I needed to know about why I belonged in Gent on my first night post-op, when I thought I had sprung the implant trying to rise from the low commode. Hugo’s response was immediate, efficient and unquestioning. I got new x-rays almost instantly, and he was there within minutes. When everything turned out to be fine, I apologized for calling him after hours, and he said… I had done exactly the right thing. Two days later, I offered the same apology to Dr. de Smet for what now seemed like a silly call for help. He also said… I had done exactly the right thing. Knowing all I know, I’d make the trip to Gent again, and will, if the other hip ever needs to be resurfaced.

One last time… and never again, I say: Hobble on, Hippies…

LBHR 12/15/04 Dr. de Smet