Surgery cancelled-rescheduled- completed July 12

[badpenny]

  Glad to hear all is well, remember, rehab is a bugger, this time you are the patient, so two important words to remember would be "yes dear". Wishing you a speedy and safe recovery. 8) 8) 8) 8)

[Patty]

My wife is a saint.  Don't know what I'd do without her.

Every man should memorize these words and repeat them on a daily basis!  :D

So glad to read you are recovering quite nicely, Doc. 

[Norm]

Memorize them...after you made me tattoo it on my butt I don't have too.  :D

[Warbird]

Norm and Patty.  Docb, glad you are recovering well.

[Ernie]

Great news Docb  Jan is a new woman since her hip replacement in spite of not following the surgeon's advice  as accurately as I wanted her to.

[doctorb]

Really wasn't planning to provide constant updates, as I expected things to go smoothly.  Well, everything was fine until Tuesday AM.  I had increasing pain and redness in my left foot and great toe joint.  Couldn't bear weight on the limb. By last night my pain in my left foot was worse than any pain I had experienced in my left hip since the procedure.  I took more pain meds last night than at any time post-op.

There's only one possible diagnosis - acute gout.  By this-afternoon the symptoms have started to subside.  Can't put a shoe on it yet, still can't bear weight.  Saw my doc today and I am the 3rd recent case of this he's seen.  Started on Colchicine.  Well see if that helps.

Why does the post-op period seem to collect cases of gout?  Gout comes from Uric Acid crystal precipitating within your joint, which leads to an incredible acute inflammatory arthritis.  After a big surgery, the patients have some internal blood loss - hematoma formation, which must be resorbed.  Lots of proteins needing to be broken down in the hematomas. The proteins are degraded into uric acids, and, if the concentration is high enough, they can precipitate inside a joint leading to what we call gout.  These things are usually self-limiting.  We'll see.

[beenthere]

Sorry to hear about the setback. Hope it doesn't last too long and the pain subsides.

I can attest to the terrible, unbearable pain that comes from gout. And colchicine was my "friend".
Before that, was Indomethacin, almost continuously.

But for the last 10 years, the discovery of Allopurinol has kept the gout at bay.
What a pleasant relief now that it is over, compared to the previous 25 years.

[Jeff]

O had a bout of gout a few years back after a fall from my tree stand. I didn't know what was going on until I googled sudden and severe pain in the big toe.  Hope your's subsides as fast as mine did once I got the meds. If one has never had it, it's pretty painful.

[doctorb]

I've got to echo Jeff's last statement.  I have examined hundreds of patients with acute gout attacks during my career.  You can work in the pits of the Indy race circuit your entire life, but you'll never truly understand what it's about until you drive that car.  I have never before felt that degree of exquisite pain, so, I fully understand what my patients were going through.  Hopefully, this is a one-time event due to the surgery.  

[SwampDonkey]

My uncle had it quite bad a couple winters ago, could hardly walk. Had it in both feet.  Then with all the hobbling around involved from the pain his knees got bad to. He's had the gout now off and on for 12 years probably. Probably about the worst darn thing to come down with.

[Ernie]

I get it when I eat too many scallops or cashew nuts etc  I was prescribed various anti inflammatories which were marginally effective.  The best thing is an ancient remedy called Colchecine  used by the Romans a couple of thousand years ago.  I take 2 tabs every 2 hours until the symptoms disappear or I get the runs.  The doc (new one) has warned me that this is not a good thing to do but for the last 27 years it has worked a treat.  PS: I rarely need to take enough to get the runs ;D

[Gary_C]

You mean that gout pain is worse than getting up in the night to go to the bathroom and stubbing your toe on the bed post or some other immovable thing that was not supposed to be there?     :D :D :D

[Jeff]

You mean that gout pain is worse than getting up in the night to go to the bathroom and stubbing your toe on the bed post or some other immovable thing that was not supposed to be there?     :D :D :D

You can bet it is.

[Mooseherder]

If gout pain feels like nails going through the bottom of your feet than I have had an attack before.
It happened while I had to run across an Airport terminal to catch my connection.
I was wearing boat shoes and thought that the shoes were defective.  At the time I had to put the pain aside to try and catch the flight.  When I got to the gate and took my shoes off is when I realized there wasn't anything wrong with them.  That was a couple years ago now.  I don't think it has happened since then.  Musta been something I ate. :D

[jim king]

exquisite pain

??? ??? ???

[doctorb]

No Jim,  I am not into pain In a weird way :D. I used the word exquisite because it was so sharp, so intense, and so focused.  Better today.

[jim king]

Doc , that makes me feel better.  I was thinking you guys had a secret fan club of pain types  .

I bet a nice fishing day and a cold beer would help.

[doctorb]

Things are better.  I can put full weight on my foot.  I still have some residual soreness in the ball of my foot at the base of the great toe when I weight bear.  Feels like walking on a badly bruised injury.  Moving from 2 crutches to 1.  Walked 1/2 mile this am.  Yeah, I am gonna make it. ;D

[Gary_C]

Good to hear the recovery is progressing. I recently saw that after some surgeries you should train like an athlete. So crank up that treadmill and push it to the max.  :D :D

I kind of did that after my heart surgery and it sure made the physical therapist nervous. They had to tell me a couple of times to slow down. I was in pretty good shape when they let me loose, but it's been all downhill since. Just too much sitting in an air conditioned cab running joysticks.

[jim king]

Doctorb:

It is quite really quite amazing that a person can be deboned like a quarter of beef and put together again and be walking the same day.

Just the same I am going to walk less and sit more and hope  for the day that they can regrow parts without dissecting me.  I am allergic to pain , even the thought of it.

[doctorb]

Jim. You're right.  We are still using a 40-50 year old mechanical solution when a biological correction would potentially last longer and avoid surgery.  The problem for me was trading a painful day at age 60 versus the hope that something better might be available when I am 70 or 75.  Never know when your time is up!  So I want to be active and pain free between now andthat medical advance.  Not much of a choice ,really, given the degree of pain and disability I've  been experiencing prior to this surgery.

[doctorb]

Boring update - I know 

Down to one crutch.  Important because I can now carry things in my left hand.  One misconception patients have is that they think a single crutch or a cane (my next step) should be held in the hand on the same side of their operation or injury.  Not so.  A single crutch or cane should be used in the opposite side than the weakness.  If you want to see how not to use a cane, watch the TV show "House".  His gait is ridiculous because he uses the cane on the wrong side!

Driving now, as the new replacement is on my left side.

No more pain meds.   

Everything seems to be progressing nicely.

[SwampDonkey]

Nice to see your coming along anyway. Crutch and all.  ;D

[Ernie]

Have you got your entry in for the next marathon.  Great to hear you're on the mend.

[Shotgun]

Glad to see you progressing so well, Doc.  You'll be playing tennis in no time.   ;)

Norm