Arx Hereticus

Welcome to the ramblings of a merry heretic, an ex-pat (Tex-pat?) American living in Maryland after having spent six years in Germany. Arx Hereticus is part travelogue, part cooking, part budo, part socio-political commentary and mostly just me BSing.

Sunday, July 22, 2007

Post Surgery - The Heretic gets Hip

Saturday, July 21 -- 3rd post-op day

Morning brought the typical start to the day, but a little extra: With breakfast, I got a full pot of coffee rather then just a cup! For the first time in days, I feel adequately caffed-up.

If y'all don't know about typical German fruhstuck, their normal breakfast consists of a couple of broetchen (known as semmelen in Bavaria), a slice or two of some kind of wurst – think cold cuts – with cheese, and honey or jam with butter. Better than the French equivalent (a bowl of coffee and dry bread) or the Greek ( a cigarette and a cup of coffee). I actually rather enjoy the German b'fast, being a huge honey fan, I am.

Overall, feeling better, not as much pain, though some movements are still distinctly tender and must be undertaken quite carefully. Very tired today though. Learned with some (somewhat surprising) relief that I'd not see the physical therapist today or tomorrow, and felt grateful for the rest. The doc will make it in sometime today, but not on the usual early-morning schedule.

The nurse had to remove my (I've forgotten what to call an in-dwelling IV catheter) from the back of my left hand this morning, it'd stopped working. Another Pfleger came by to try to start one in the right, but it blew out and he had to remove it. They were using the shunt to give me a drip of antibiotics, and I'm taking capsules until they can consult the doc for options. Me, I'm fine taking pills rather than dealing with the tubes.

Somehow or other, the day flew past and it was suddenly lunchtime.

I'd watched some TV (love German TV -- wish I could understand more so I could enjoy the weirdness of it all in the native tongue. I can make out the gist of most spiels, but detail eludes me sometimes, especially if they're talking fast or about technical matters.

There's a Saturday morning show about talk shows (Talk Talk Talk), with a very pneumatic, Barbie-doll hostess who changes outfits and hairstyles for EVERY segment,
and has maybe 10 seconds of dialogue, draped or perched provocatively in front of a flat-screen by means of introducing each segment.

They go so far as to translate foreign shows (Spanish and English anyway) into Deutsch, complete with trying to match the voice to the characters. Very strange.

Some interesting history and culture shows, and a couple of familiar (Canadian or American) shows voiced over in German. I always try to catch the news, and can generally suss out most of what they're talking about.

Anyhow, talked to HW a couple times and she's getting ready to head this way. Probably the last night she'll be able to spend here with me. After tomorrow, they may want to plop in a roommate and I'm going to be thinking einzelzimmer (single-room) thoughts most likely. My insurance pays for a double, and we're paying extra for HW to stay over (50 Euro a night, including 3 meals a day), but if the single's not too horribly expensive, I'd be willing to pay extra for peace and quiet and not having the distraction of a roomie right now.

Unless she were a very cute Czech girl, of course (with a big wave at John in Old Blighty).

HW has to go back to work next week. As an independent contractor, she gets no leave or bennies and a week out of the shop is a week with no pay.

I'm very proud of her work and her progress. We haven't bought Euros in several weeks, due to her practice on in town on the German side, and she continues to ply her trade on broken and achy bodies on-post as well. As long as the dollar's in the sewage pit (0.71 Euro cent to the dollar last I looked), HW's Euro income is a Damn Good Thing.

Lunch today more than made up for dinner yesterday – Jaegerschnitzel (pork steak with mushroom gravy) and Spaetzle (a sort of noodley dumpling)! Yum.

I'll drop all this on a thumb drive and hand it off the HW to take home with her tomorrow to update the blog, feel free to comment or query, she's got access and will try to keep posts from herself running, too.

One of the surgeon's assistants showed up in his stead, and we chatted a bit about my progress. He changed my nighttime meds, as I'd been having a lot of trouble sleeping, changed my dressings and said all looked good. He decided to leave the butterfly IV out and give me oral antibiotics, something for which I was greatful. The butterfly was annoying at the best of times.

(HW: for the nonsurgical among you, a butterfly is a shunt inserted into a vein in the hand. It looks like it would hurt, and my supersensitive hands winced every time I saw those tubes inserted in the back of my mate's leathery-skinned paw. It beats a new needle every time, but his body simply got tired of it and shut it off. The last nurse got it to work by stroking the vein, which makes sense, as CG can be made to do darn near anything by petting, and absolutely nothing by striking.. his body threw out the butterfly, it threw out the drain, and is currently draining itself very nicely thank you.. I had to use stain remover on a pair of pants he decided to wear, despite bandages, tape etc. I keep telling him he's just getting in touch with his Feminine side, having to wear stockings and bleeding all over the place involuntarily.. )

HW showed up just before dinner and we had good cuddles, then she showed off all the treats she'd brought, fresh peaches, grapes, watermelon chunks ... tasty!

We spent the evening chatting, playing Scrabble (we were 1 and 1, she took the seven-tile game easily and I swept the nine-tile round away), occasionally seeing what weirdness German TV was up to, and nibbling fruity goodies. We took a walk around the station, debated going down to the cafe, but decided it was a bit much, though we might try to go tomorrow afternoon.

(HW: We did, with a dear German friend who visited that afternoon, make it down to the cafe on Sunday. CG did great, we used a prop pillow stolen from the waiting room on a cafe chair. Funny now it's doc's orders that CG takes his usual comfortable long-legged slump)

I was pretty chipper and alert until after 10 pm, unusual for me since the OP, but after I took the new nighttime meds at about 1030, I was out like a light. Slept pretty much like a log, though I did have one weird dream about HW, P!nk (!?) and myself wandering around this little town drinking beer and raising hell.

(HW: Hmm. Must have had to do with me observing MoPed punks putting on helmets and then punching each other, and wondering how much fun it would be to walk up and knock one over without really hitting the helmet... )

Woke up twice, once to crutch to the WC and once to wave at the night nurse peeking in, then suddenly, it was daylight.


Friday, July 20 -- 2nd post-op day

Morning routine. Poke, prod, "How ya doin'?" then breakfast.

Surgeon came in and removed the second (and last)drain from the wound. Says all looks good.

(HW: Post-op patients wander around with a kind of movable "blood bucket" which looks like they have a bottle of beet juice attached to *wherever*)

HW has to go back to Pressath to deal with some business and chores today and tomorrow, so she loaded up and headed out just a bit ago but she'll be back tomorrow around lunchtime.

(HW: The hospital presented me with a "pre-bill" of about 12,500 Euro for the hospitalization and rehabilitation. They want it by the time they discharge him. I told him they would get it when the insurance company sent it, because we didn't have that kind of money, but that they would get it. The lovely young lady I spoke with [in broken Denglish] seemed resigned.. I used my age and presence to just make things "as they were" and the Germans, bless them, understand bloody bureaucracy all too well. I think they invented it, and are very sorry. )

She helped me get up and make my first trip of the day to the WC (I have a piss-bottle for that, but the WC calls, especially after coffee.), which was challenging, but not as exhausting as yesterday. Staff has bustled about, but I haven't seen the PT yet, and am anticipating her arrival with mixed feelings ...

I'm not in a whole lot of pain right now, but have recently discovered that my right butt cheek is numb. Weird, but not a real problem. That sort of thing happens after you get chopped upon.

Morning went fine, but the afternoon and evening sucked. More pain, more restlessness, and the staff here was running around like they had their hair on fire. I was basically on my own for the most of the evening, when usually the nurses or helpers are poking their heads in every hour or so. They were apparently having a Bad Day yesterday eve.

(HW: It was the first night I was gone, and I was furious when I called and found out about it. My guard dog hackles went up, my teeth itched and I wanted a piece of whomever threatened my mate's health Real Bad... fortunately I wasn't there, and CG's equanamity prevailed. He worked in a hospital for years, and knew that sometimes, things just go tits-up. It's something I try to learn from my mate, this centered empathy and some truly legendary listening skills... the art of siddown, shaddup and LISTEN. One of the best lessons anyone can ever learn. I'm studying hard. )

I was annoyed, too, because supper basically sucked big green eggs. Smoked herring. Holy shit, that stuff is horrible. Fortunately, I also got a big brezel stangl (pretzel stick), bread and butter and cheese. That was all fine, but I was Jonesing for a bottle of red wine to go with and wash away the taste of the herring.

(HW: I have a bottle of St Emilion Grand Cru from the Alsace I am saving, for when we can enjoy it outside with the duckies and the bunnies and the excellent sunshine south of Regensburg)

Dear friend Miguel promised some of his wife's excellent Cuban cooking should the next Friday menu threaten similar poor fare!

Evening finally came (along with a crashing thunderstorm and, believe it or not, a 30-minute firework show and blaring music from a fest going on this weekend – all in all, I'd rather have been at the fest drinking beer ...), and things settled down a bit after shift change, but I had a bad night. Lots of pain, restlessness, and nothing seemed to help. I had extra pain meds and sleepy drugs. I went to sleep pretty fast, but still woke up sometime after midnight and only slept intermittently from then on, waking up about every hour or so and thrashing about trying to get comfy. I'd sit up on the bedside, watch some of the truly bizarre German late-night TV, lie back down, try to sleep.

Amused the night nurse (who's a real sweetie with excellent English and a good touch) by waving at her every time she peeked in the room.

Thursday, July 19 -- 1st day post-op

The mornings start early here, and I was awake and being poked, prodded and queried by about 5 am. "How are you feeling, having any pain?" Etc. Got to take a nice little spit bath and got my back rubbed with some soothing cooling gel stuff, too.

(HW: He was on super drugs and has always been able to get in and out of sleep effortlessly -- I, on the other hand am a deep and slightly fanatic sleeper... Nurses would come in, do things, and then I would get out of my bed, go over and check on him myself with cuddles and kisses. Touch is nothing when you really need morphine, but touch is great on top of excellent medical care.)

The staff are very attentive and responsive and very tolerant of my attempts to speak the language, and many of them speak quite excellent English, though some are quite shy about it.

I saw the surgeon before lunch. His assistant removed the bandages and took my leg out of the brace and MAN did that feel good.

They removed the first of two drains from the wound, and we got to see the actual incision. It's about 10 inches long, sutured up with bright blue nylon. Sort of festive, if it weren't for all the, um, pain. HW, of course, took a photo.

(HW: I'm not sure yet where to put that or what kind of cautions to put on it. Surgical scars aren't pretty to look at, but our friends are exceedingly tough-minded and, well, kinda morbidly curious.)

After lunch, I got my first physical therapy session.

Wow. I've never been so ragged out after doing so (apparently) little. Frau Winter is an intense compact woman with a brisk manner but a very caring touch. She taught me a handful of exercises I must do every hour, isometric contractions of the feet and legs, toe wiggling and deep breathing routines designed to keep circulation flowing and prevent bedsores.

She also did some assisted flexion and extension exercises that, truly felt wonderful

And, I got up and walked the first time. I was given crutches, helped to my feet and pointed at the door. I walked out of the room, made a circle in the hallway outside my door and walked back to bed.

I felt like I'd just run 5 miles. It was the first of three times, I'd be up on my new crutches that day,

Apparently, the implant I have is a titanium shaft in the thighbone, roughened to let the bone adhere to it. The more it's used, the stronger the bond is.

The rest of the days went pretty much like: Get up and crutch to the WC and back, take pain meds, nap. Get up and crutch to the WC and back, take pain meds and nap.

By 8 pm, I was exhausted. I had taken some meds, and the Pfleger came by with more. He said he wanted to be sure I slept well. I took the extras and was out like a light. Despite waking up to get temp taken, a small dose of antibiotics and such, I slept fairly well, though I'd kill to be able to curl up on my side.

Won't be able to do that for several weeks, I fear. I've got to 'sleep politely', as the Japanese say, on my back, feet and hands arranged just so. No crossing of feet, no rolling on the side.

It's a little frustrating, but almost do-able.

(HW: it's amazing how much a guy who's not supposed to be able to move around can thrash, flip blankets and drop things... )

Wednesday, July 18 -- Day of surgery

Early morning started out with a sleepy pill, surgical prep (shaving the thigh and hip and my pubes), and waiting. Kinda like the Army -- hurry up and wait.

Finally, a couple of Schwestern wheeled me briskly into anesthesia where I got and IV, a shot of something else sleepy-making and a muscle relaxer, and the anesthesiologist did the spinal. Two or three shots in the lower back, and immediately my feet got very warm and within minutes, were gone. Weird feeling, but not unpleasant.

By the time they wheeled me into the surgical suite, I was barely awake and the soothing bustle and chatter faded into black.

I awoke on the operating table when they were done, likely due to the anesthesiologist administering an anti-narcoleptic, and felt nothing at all from my waist down. It was weird, being mostly awake and watching the surgical assistants wave my legs around as they applied bandages from toe to waist on the operated leg.

They noticed I was awake and there was some soothing chatter and shoulder patting. The surgical assistant told me all had gone very well.

I think I fell asleep again and awoke en route to the recovery room/pain management center where I was given some very, very, very good drugs. Repeatedly. And was once scolded for not asking for them frequently enough. I was ber' ber' happy for a while there.

However, as the spinal wore off and feeling started coming back, I was less and less ver' happy and was decidedly not bashful in requesting more good drugs.

My OP-leg was encased in elastic bandages from toe to waist, and was further supported and stabilized in a foam form that kept me from moving it around at all.

Most of the rest of that day passed in pain management. I was in and out, napping after the drugs, awake and chatting with the nurses and HW off and on, and got to see the surgeon again. He commented that he hadn't expected so much muscle in my thigh, and we reminded him that I'd been doing martial arts for 30+ years. He evidently had to rethink the situation in the OR and adjust for the more robust structure he encountered. Folks, I got thighs, and they ain't decorative, but they're damn strong. He's commented about how much and the quality of my thigh musculature every time he's been in to see me. He said, "70-year-old women are MUCH easier to operate on."

(HW: yep, he's got legs like a cuttin' horse, and I LIKE 'em! ;-) )

I had a (very) light supper in the recovery area, then they took me back to my room where I spent the rest of the evening in wrapped in druggy fuzzy goodness, but started hurting about bedtime.

Fortunately, the nurses kept me supplied with pain relievers (though not as tasty as the opiates they'd given me in recovery), and I slept most of the night.

I mustn't neglect mentioning the excellent company HW had during the day. Two dear friends came down from Graf and spent the day with her here, keeping her in very good company whilst I was getting cut upon and later while I was heavily doped up.

Once they knew I was out of danger, and HW was hovering at my bedside, I sent them off to have a good lunch. She popped back in after and I told them to go to the local swimming pool for the afternoon. I was mostly conked out anyway, and the nurses knew how to reach her cel phone if she were needed.

I can't thank those two enough. They were an immense comfort to HW and made the day much less stressful, and probably a great deal more fun for her.

(YES! TW and JP, you guys are sanity savers.. thanks for making one of the harder days in my life fun. You are both so sweet, kind, smart and beautiful, you should both get Miz Universe and the No-Bell Peas Prize all on the same day!!)


Tuesday, July 17 -- To the hospital.

Spent the morning sending a few last minute e-mails, having a nice pancake breakfast with HW and apologizing to the cat for the suitcases. We were still shunned.

Got on the road and made pretty good time, all considered, and arrived at the hospital right on time. Check-in and orientation were, as typical for Germany, efficient and complex.

In between all else, last minute blood work and consultations with the surgeon's assistant and anesthesiologist (we decided on a spinal rather than general and some good sleepy-making drugs that wouldn't take me completely out, but would relax me to the point of not caring. took up most of the morning.

We were finally shown to the room about noon, and found lunch waiting. Roast pork with gravy and knoedel, typically German fare. After lunch, I answered a ton of questions (that had been covered at least three times already in various interviews -- information sharing anyone?) for the floor nurse (a male nurse is a Pfleger, a female is a Schwester -- Caregiver and Sister respectively, despite the female nurses NOT being nuns).

My marginally conversational Deutsch got a real workout, and HW's super translation powers helped muchly. By the time all the wandering about and interviews and finally meeting with the actual surgeon was done, it was almost suppertime. HW went for a walk to acquaint herself with the area while I awaited a couple of shots and more chatter with nurses.

We're doing the Lucy and Ricky thing here, separate single beds, but despite that, it's very cool for HW to be able to actually stay in the room with me. In the coming days, she'd prove to be a great help and a real trooper.

(HW: I threatened to set up a tent on the grounds if they didn't let me stay. It's evidently rare for a family member to want to be around for surgery, but there's no way I could be kept away. The power of touch is the best medicine in the world, and CG and I have a very touch-oriented relationship.)

She's infinitely curious about how things will get, what will happen and how I will be affected. I'm just ready to get this done and move forward.