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I was told to show up at the Surgical Day Care Unit at 10:45 am, which was 2 hours before my surgery was scheduled. We live about two and a half hours from MGH, so we got up at 5:30 am, got ready, and drove into Boston. We arrived one half hour early at 10:15 since there were no traffic delays.

My bag was tagged. I don't think I used anything in it during my stay. I changed into pajama bottoms, a jonnie, and a bath robe. My clothes were put in a bag and tagged. My vitals were taken. Then I waited. And waited.

When my scheduled surgery time came and went, I inquired at the desk and found out the person scheduled into the operating room before me had just entered it. So it would be at least a two hour delay. It was more like a three hour delay. But finally I was put on a gurney and said goodbye to my wife. I was wheeled up to the entrance of OR 23. I could hear the staple gun in the OR so I figured they were still closing up my predecessor.

While they were cleaning up and disinfecting the OR, the anesthesiologist came by and we discussed how they would put me under. I asked for a spinal. I had been told that patients with a spinal are usually given a drug that causes short-term amnesia so even though the patient is awake and aware during the surgery, afterwards, they remember nothing. I asked if that drug could be left out of my cocktail. I wanted to remember what happened after it was all over. The anesthesiologist said he could do that. Dr. Tomford also talked to me for a while and he concurred. Otherwise I would not have been able to give you this fairly detailed report.

Sometime during my stay outside the OR, an IV was inserted into my hand. I think it was the anesthesiologist that did that, but it may have been a nurse.

Finally I was rolled into the operating room. I'm not sure exactly what time it was but it was probably well after 4:00 pm. The first thing I notice is blood on the ceiling! I'm on my back and I guess I'm the only one looking at the ceiling. I mentioned that I didn't think that was very appetizing.

They transferred me to the operating table. I was given the spinal. It places the nerve deadening agent in the sac containing the spinal cord. They do it at the bottom of the spinal cord where it has split up into many individual nerves. They don't want to puncture the spinal cord itself. They sometimes hit one of the nerves with the needle, however, and that happened to me. I had what felt like an electric shock in my left shin. The anesthesiologist used this information to help him know where his needle was, I guess, since he was interested that the shock was on the left side of my body.

It is pretty weird to have the feeling of your lower body disappear over the period of a few minutes. It was followed by a wave of nausea, a cold sweat, and then feeling very hot. While the anesthesiologist was dealing with that, the nurse inserted a catheter into my bladder. I'm glad I didn't feel that.

They turned me onto my right side and rested me on a beanbag. They removed the air from the beanbag which more or less clamped me into that position. I was covered with a sheet so I couldn't see any of the surgeon's activity. I could hear low murmurs so I know Dr. Tomford was talking to his assistant, Dr. Stewart.

I have what are called Premature Ventricular Contractions, PVCs for short. It is essentially a skipped heartbeat. For some reason they were occurring at every other heartbeat at this point. Dr. Tomford was not happy seeing all those PVCs. I moved my arm a little and they quieted down a bit. They are most unpredictable.

I heard Dr. Tomford call for a razor, so I assume they were shaving the hair off my leg.

There was no movement that I could feel for about 10 minutes. I assume they were cutting.

They must have dislocated my hip about this time but I couldn't discern that.

I heard what sounded exactly like a SawsAll. I asked the anesthesiologist if the ball at the top of my femur was being sawed off. He stood up, looked over the edge of the sheet, and verified that the ball was being sawed off. There's no going back now!

There was lots of movement. I can't actually feel what they are doing to my leg, but there is a lot of movement that is transmitted up to my trunk. They were rockin' and rollin' down there.

Then I heard what sounded like a Black and Decker electric drill. I guessed they were reaming out the socket in my hip bone. The anesthesiologist confirmed that. I kept hearing what I knew were sizes of the sockets. Dr. Tomford had said before that he likes to ream out a hole smaller than the socket that will be inserted so it will be a nice tight fit. I heard all of the following sizes, but don't know which were for the hole and which were for the socket that was going to be placed in the hole: 58, 59, 59-1/2, 60, 61, 62.

They insert the socket with a mallet. And they really whack away! Then I heard Dr. Tomford say he doesn't think that is quite right. He wants a pair of pliers. I'm guessing he is pulling out the socket he had just pounded in. Then more reaming. Then more whacking.

About this time it is the end of the anesthesiologist's shift, so he is replaced by another anesthesiologist.

I heard the drill again but it didn't sound like it had the rasp on it. It sounded like it was drilling a hole for a screw. But it must have been something else, because there were no screws used.

I think the last of the whacking was to pound the ball into the end of my femur.

The spinal is starting to wear off at this point. It feels like lots of little fingertips are tapping on my thigh. So a very slight sensation is coming through. After a while, I start to feel movement in the bones. Not pain, really, because it was attenuated so much. But I knew they were working on my bones. The anesthesiologist fixed that with a little pain killer in the IV.

Finally there seemed to be a struggle and I assume they were trying to get the new ball into the new socket. I was pretty glad I couldn't see what was going on in real time. But I would have liked to see it on video sometime in the future.

It's quiet now so I assume they are doing the internal sutures. Then the staple gun. It sounds just like an electric Bostitch stapler.

All of a sudden I'm exhausted. Maybe they were giving me some kind of a stimulant and they stopped it. I don't know. But boy was I tired!

The surgery is finally done. The beanbag is removed and I'm rolled onto my back. A foam V is strapped between my legs to keep the operated hip from dislocating. I'm transferred to a hospital bed. I look up at the ceiling and notice that there is more blood on the ceiling than there was when I entered the OR. Some of that blood was mine. More about that later. I was too tired to inquire.

I was rolled into the recovery room and an x-ray was taken with a portable x-ray machine. More blood was drawn for tests. They took my vitals quite often. I guess my blood oxygen must have been low because I was put on oxygen. They kept asking me to try and move my toes. My right toes moved before my left ones. That is weird, too, asking your toes to move and not having them obey. I'm so tired.

Finally I can move my toes and I'm wheeled out of the recovery room into a hospital room in the vascular ward. There were no beds available in the orthopedic ward. I arrived in the room about 9:30 pm and my devoted wife was there to greet me. We were both tired. I can't remember if I fell asleep before she left or a few seconds after.

 

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