Our Trip to Nashville

I'm feeling a little better today, but my voice is completely gone. This trip was really hard on me; it was much more tiresome than I had expected.

Dad and Virginia went with us. We arrived in Nashville later than we planned, and had a very late (and yummy!) dinner at Longhorn Steakhouse before collapsing at the hotel. At the restaurant, I could not stop shivering, so I took my temp at the hotel and it was 102.4. I took some ibuprofen and a Zofran (nausea pill), and slept very well.

On Tuesday morning, we made the trip of 6 miles from the hotel to the hospital. We timed everything very well -- we were there and checked in one half-hour before my appointment. In the exam room, they had an adjustable-level table, which meant that I was able to change into a bare butt gown (oh, goody!) and get on the table. The first doctor I saw was a resident/trainee. She was very friendly. She took my history and drew us pictures of a normal femur/hip and then of my circus-worthy one.

When Dr. Holt came in, she was much more blunt about the risks/complications and the trade-off between recovery time and quality of life. (In other words, with metastatic cancer, you have to consider whether you will live long enough to reap the benefits of the long recovery time.) Here's how she answered our questions:

(Q) What exactly needs to be done?
The femur bone needs to removed, at least down to three or four inches above the knee. It will be replaced with a megaprosthesis -- a metal contraption that will include the upper bend of the femur and the ball and then will extend down and be cemented into the remaining femur bone. If any cancer or other damage (possibly from the rod) is found, she will remove the entire femur AND I will need an artificial knee joint. Cadaver bone (allograft) for the hip area will probably not be necessary. Instead, she will reinforce the hip joint with a metal three-layer "cup" that should hold the new femur ball without coming loose.

She says she will bring her "erector set" and be ready for whatever needs to be done once she gets in there. Ha. Ha.

BTW, the new, improved leg will be the same length as my other leg, so no more lift shoes! :-)

(Q) When?
Friday, April 20, 2007 at 8:00 CT.

(Q) Possible complications?
According to Dr. Holt, this will be a major surgery. The incision will be long, there is potential for a lot of blood loss, and there is a risk of infection both now and in the future around the metal prosthesis.

I will have to spend at least one or two nights in the ICU, depending on how well it goes.

(Q) Length of surgery?
5+ hours, depending on the amount of replacement needed and any potential complications.

(Q) Pain?
Well, she says, metal doesn't hurt, so the pain will be caused by the healing of muscles that were cut to access the bone and the hip abductor muscles which will be attached to the prosthesis. Overall, it shouldn't be too bad.

(Q) Hospital stay?
Approximately one week PLUS the time spent in ICU. Probably one to two weeks in all. I might have to go to a rehab center after the hospital stay, depending on how well I am doing, but I could choose one closer to home.

(Q) Rehab?
Believe it or not, she says I can start working on putting weight on the new, improved leg THE DAY AFTER SURGERY! Of course, she said it won't feel very pleasant at first. Apparently, there is an adjustment period to the "wobbliness" of the metal versus real bone.

It will take six to twelve months of intensive rehab to see the full potential of my recovery. She says I *might* be able to walk without assistive devices, or I might need a cane for balance. The fact that I have been on a walker for two years will make it a little more difficult.

BUT, with the troublesome (read: painful) bone gone, I will have more courage. Right?

(Q) Internet access?
Okay, I'm probably the only who cares about this one. For the record, they do have wireless internet access in the hospital, but some parts get better reception than others.

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After the appointment with Dr. Holt, I had some pre-op tests done. At the hospital, I had chest x-rays, x-rays of both legs (forgot to mention earlier that Dr. Holt wants to make sure that my "good" leg is not also diseased), and a test to measure bone lengths. Then I went to an imaging center for CT scans (after a quick sandwich in the cafeteria, the only thing I'd had yesterday except a piece of a muffin and some very watered-down juice at the hotel). At the imaging center, they had me drink water instead of barium. According to them, it is just as effective. What? Then all of the barium I've consumed the past seven years has been for naught? Well, no, I guess not. I *do* glow in the dark now, and that's pretty cool. :-)

While I was at the imaging center, the hospital called and wanted me to come back for MORE pre-operative fun, including an EKG, bone scans, and blood work. I tried to call back, but couldn't get through. By this time, I was physically and emotionally drained, and just wanted to come home. So I will return to Nashville for the rest of the tests, hopefully a day or two before surgery.

We stopped at Cracker Barrel in Cookeville for dinner, and then I slept the rest of the way home. We finally got here about 9:00 p.m.

SO - there's the full report! I'm still "processing" everything, and the fact that I don't feel very well makes everything seem a little overwhelming right now. There's a lot to be done before I go, and I just don't even have the energy to make a list of it all, let alone accomplish it! I'm just going to rest for a day or two, and then I'll be ready to face everything again.

Thanks for caring!