I left off talking about my first closed reduction procedure following my first experience with a complete hip dislocation. The procedure went well and I honestly thought I was as good as new and was eagerly awaiting the “all clear” from the doc to start the physical therapy that would put me on the road to training for the sport of triathlon. Also by this time, Gail was becoming quite accomplished at the sprint distance and was beginning to talk about moving up to the olympic distance races. I was getting around without the aid of crutches and making sure that I was not doing anything to jeopardize my physical progress. I followed the doc’s orders to the T.
We had been invited to the wedding of our dear friend’s daughter that was to take place in Flagstaff, Arizona on Aug 4. It was a trip that we were looking forward to and we were definitely planning on enjoying the weekend in the higher, cooler climate of northern Arizona. Our daughter and her husband were going as well as all our close friends from the old neighborhood. The drive up was uneventful and as we got into town, we contacted our daughter and made plans to have lunch together before getting dressed for the wedding. The ceremony was to take place out doors in a wooded location that was to offer great scenery as well as fresh air and a lot of sunshine. Since the wedding was planned to be held in an open field and an estimated 100 yards from the parking lot to the ceremony “site”, I had thought it best to throw my crutches in the car just in case I needed “four wheel drive”. Our daughter had attended Northern Arizona University her freshman year and she still knew a lot of the great places to eat. Lunch was great and as we were getting ready to leave the restaurant I turned in my chair to be able to stand up and leave. I turned to the left and my left leg hung up in the carpet and did not turn with the rest of my body. The pop and immediate pain in my hip told be that I was not going to go very far and in fact would be headed to the hospital and not the wedding. My daughter went to the car and got my crutches and once I had them, everyone helped me out of the restaurant and into the car. I could only lay across the back seat and hope the ride was not going to be too long. As soon as we got to the hospital, I helped myself slide out of the car and onto an awaiting gurney and my next stop was the emergency room. A quick x-ray confirmed what I already knew and the medical attendants began preparations for a second closed reduction procedure. As soon as they were able to send up my medical records from Phoenix and get the final necessary medical clearances, I was taken in to the surgical room and put to sleep. I woke up in the recovery room and I could tell by look on Gail’s face that something was not right. As it turns out, they were not able to get the hip back into the proper alignment and opted to make some changes to the procedure that would for sure work the “next time”. They set up a second attempt to complete the closed reduction. It didn’t work. While in recovery for the second time, the attending staff came in and explained that the hip dislocation was like none other that they had every dealt with and they were recommending that I stay in the hospital till the following Tuesday when the orthopedic surgeon would be able to perform an open reduction. For sure that would work. I said that that was not going to happen. Sunday morning I asked Gail to contact Dr. Wilmink in Phoenix and let him know what was going on and what he wanted me to do. I was not going to stay in Flagstaff any longer than necessary. Gail worked with the people at the hospital in Phoenix and we set an estimated arrival time at the hospital for about 4:00 Sunday afternoon. I had my daughter buy a baby crib mattress and some cheap pillows that would fit in back of our car and we got ready for the two hour drive south. I was taken to the car on a gurney and I had them slip a back board under my back and bridge the space between the gurney and the back door of the car. I reached up and grabbed the top of the door opening and pulled myself into the car. I was as comfortable as I was going to get and Gail started the drive. I can’t say here a whole lot about what I was thinking during the trip. I didn’t want to think about pain or consequences of what lay in store for me. I did know that I was going to a place where I was confident that all was going to be OK. Gail called ahead to the hospital and when we got to the emergency room entrance, the hospital staff was waiting. I am sure they were waiting to help and also waiting to find out what kind of idiot was coming into the hospital with a dislocated hip in a car and not an ambulance and who just completed a two hour trip on basically over the counter pain killers to get there. Again, they had no idea on how to get me out of the car so I asked for the backboard. We bridged the space between the car door and the gurney. I reached up and pulled myself out of the car and once halfway on the gurney, they slide me the rest of the way and we went straight into the surgery room. I finally got what I will call some good drugs. They contacted the doc and began working on getting me ready for the closed reduction that I needed to have done. All went well and I walked out of the hospital after waking in the recovery room and getting some final instructions again. Thankfully we got home late Sunday evening.
Thursday, four days later. I was home and not planning on doing a lot of activity. I also found out it didn’t take a lot to dislocate my hip for the third time. My hip was talking back to me. It was telling me that we needed a new plan. Dr. Wilmink had the plan. Gail came home from work and once in the car we went back to the hospital. They were all waiting for me. They were in total disbelief that after what had happened I was in pretty good spirits and ready to go again. I was confident that doc’s plan was going to work and that all we needed to do was to get it done. We were going to open up the hip for the fourth time in 2012 and we were going to take out the parts that weren’t working right and I was going to get a new heavy duty ball and socket system. The spike did not have to be replaced. The spike had become well embedded in the bone like before and we knew that there would be no problems with it. A special ball joint was used to replace the standard one. This one was slightly out of round. Once it was put in place, and the socket that was matched to it was installed, the doc had to move my leg in a series of motions to snap the ball into the socket and lock it in once and for all. Guaranteed not to ever come apart again. The only down side was that the doc said I would loose about 10-12% articulation in the hip joint. That didn’t seem to me to be a whole lot at the time. Withing two weeks I was up and ready for therapy.
By now it was the first of September and I was keeping two thoughts alive and well in the back of my head. With all the surgery that I had gone through so far in 2012, I knew that our medical insurance was taken care of till the end of the year. 2013 was going to be a wait and see time to find out what the health insurance situation was going to be given the political/economic atmosphere that was prevalent at the time. I don’t need to go into that much further only to say thatI did not like what was going on. I did not trust that what was going on was a good thing and I did not trust that those “back east” knew what in the hell they were doing. My instincts were telling me that whatever they were trying to do was not good, not going to work, and everything was headed “south” for sure. During a followup visit with Dr. Wilmink, we talked about the above subject and I asked what he thought about my right hip. Fifteen minutes later and a quick x-ray confirmed what we already new. The right hip was as banged up as the left, if not worse than the left one was prior to the first replacement. I didn’t have to ask. Doc knew what I wanted to do. He agreed with me and we scheduled to have the right hip replaced as soon as possible. This would be an anterior procedure and there was no reason to believe that there would be any complications. After all, infection was the problem in the first place and I was under medical care to keep that in check. And it was in check. The following week I was in and out. Home by the weekend and walking around with the help of my crutches. Before long, I was back in therapy and looking forward to moving on.
I mentioned two thoughts that I had that were alive and well in the back of my head. One, my right hip, was over and done with. The other one was the hiatal hernia that Dr. Tim Byrne had found as an incidental discovery during a CAT scan that I had after my third heart ablation. With all that had been going on earlier in the year, the somewhat discomfort that I was having in my chest was causing some concern. I figured that with everything else going on a little stress was expected. It was time for my heart check up with Dr. Byrne anyway, so while in his office, I asked him about this situation . It was not a heart problem. He recommended that I go ahead and have the hernia thing checked out. He sent me back to the doctor that originally looked at the CAT scan. He had determined like everyone else that if I did not have the major symptoms of the hernia then lets leave well enough alone. During this appointment and one quick x-ray later revealed a horse of a different color. Without hesitation, he contacted Dr. Byrne and they both sent me to another amazing doctor. This one was an internal specialist and one of the finest internal surgeons around. Dr. Richard Perry. He saw me immediately. After a quick look at the x-ray, he said that if I were not on blood thinners due to the latest hip surgery, he would have me in the hospital. Evidently, the mass that showed up on the original CAT scan and all assumed was a hiatal hernia was really not a hiatal hernia. This time the x-ray revealed that in fact the mass was my stomach. Evidently over time, my stomach had slipped through a hole in my diaphragm and ended up on the top and the back side of my heart. The x-ray showed that it was twisted as well. If I were a horse they would have taken me out behind the barn and shot me. He could not believe that in this condition I was eating, drinking, and having thoughts about swim, bike, run or anything else involving physical activity. He had never really seen anything like it and he immediately set the wheels in motion to get me in a physical condition that would allow me to have surgery as soon as possible. On December 6, they installed some filters to help prevent potential blood clots that might form from moving throughout my blood system. This would allow them to get me off the blood thinner medication that I was on. The surgery date was set for December 14, 2012. The surgery that they were going to “start” with is called a nissen fundoplication surgery. I cannot tell you what that means. I do know that what was supposed to take in 1 1/2 hours went well into the 5 hour time limit of the anesthesia. I also found out that at the last moment in time and just as the doc was getting ready to cut me in half, he was able to do whatever he needed to do to make the repairs. It was by far the most painful and complicated surgery I had ever experienced. The doc said that if had he needed to perform the radical incision surgery that was avoided, it would have been the most traumatic surgery of its kind that he had ever performed. After 10 days in ICU and another compete heart exam, I got to go home. I now had a stomach that was 1/3 the size of what I started out with and a whole lot of instructions on what I could and couldn’t eat, how to eat, when to eat and even more information about how my life was going to be different with my “new” stomach. It was right before Christmas 2012. After eight (maybe 10) weeks on a liquid diet, a lot of pain medication for someone who thought he could handle pain, and about 40 lbs lighter, I got an all clear from the doc to start living the new life. As it turns out, the hole in my diaphragm was the result of years of working out and lifting weights that were way to heavy for a person to be lifting to be of any physical value anyway. The doc was a power lifter himself and over time developed a condition similar to mine but obviously not as radical. In fact, he had the nissen fundoplication surgery as well.
So I now try to live a much healthier lifestyle and I feel awesome. With my stomach much smaller, I don’t have to eat as much food and by eating the right foods, I have continued to loose weight and have lost close to a total of 75-80 lbs. As of April 1, 2012, all of my doctors have given me the go ahead to continue my physical activity and they all know that swim, bike, run is my physical activity of preference and they know that the Ironman is my goal. I began swimming again with the master’s swim team. I am definitely starting from day one in the pool. The last entry on my garmin account documented the ride I spoke about in November of 2010. That was my last bike ride. Getting on and off the bike has been a bigger challenge than riding it and I am farther along in my cycling abilities than the other two triathlon disciplines. Hills are not fun but a necessary must to my overall strength and ability to compete. Running is the main challenge that I face and I know up front that in order to complete the Ironman, I will have to understand that walking is going to play a big part in my ability to finish. Training for the marathon will require the incorporation of a run/ walk interval from the start. I have been able to begin a full base/prep training program that will eventually lead to the full training it will take to be ready for IMAZ 2014. Once I achieve the levels of ability that have been set in the base/prep program, I will move on to an organized training regime set up by my coaches. That time is near.
I have officially registered as a participant in the 2014 Ironman Arizona.
tomstriptoimaz 