After I delivered my first baby, they just let us take her home the next day. We walked out with a new baby daughter and a new life of changing diapers, round the clock feeding, carseats, cribs and colic. Once again, life had changed and the hospital just let us go without a manual, without a clue and without a prayer.
Hospitals change lives, and usually in an unplanned way. My hip replacement surgery was elective, to some extent, but the change in my condition was unforeseeable. What if there had been complications? What if the surgery didn't go well? What if it went perfectly? What does one expect? You can't possibly know until after you are home and can compare what is going on with your everyday life.
St. Vincent's hospital tries to make this transition easier. It's called "Case Management" and they transition a patient from the hospital, a large building full of technology and human resources, to your home, a humble hovel on the side of a hill with the nearest neighbor a half a mile away. Depending on the difference in living situation, this transition can be huge. I do not envy the job of the case management worker, but I am sure glad that hospitals have them.
My husband got us out of Los Angeles just in the nick of time. We were leaving LA at 3pm on a Wednesday which meant that we were right on the cusp of rush hour traffic. I felt exposed sitting the front seat of the Buick Impala with windows to the world. Everything outside of my bubble was happening so fast! Cars were weaving in and out, jockeying for position on LA freeways amidst 18-wheelers, BMW's, Toyota camrys and the occasional Ferrari. After all, this was LA. My husband performed effortlessly and the sharp relief of my condition compared to his was a staunchly apparent. I thought I was such a badass in the hospital because largely, I was comparing myself to other orthopedic patients and was receiving very positive feedback about my recovery. However, being outside the walls of the hospital, I suddenly realized that I was definitely the weak one of the herd. If this were the Serengeti, I would be lion fodder.
I was mostly comfortable, propped up with pillows and taking my pain medication. Once out of Los Angeles and north of the Grapevine, I was overcome with hunger. There's an exit with everything imaginable as you drop in to the Central Valley corridor. I was so excited for non-hospital food. We went to Chipotle, one of my favorite "fast food" stops. When we pulled in to the parking lot, I realized I would have to get out of the car. You forget about the easy things in life like sitting down on toilets, getting in and out of cars, bathtubs, and beds, and walking from point A to point B carrying something in one or both hands. It took me an eternity to get out of the car. I had to keep my foot rotated outward so my poorly supported knee wouldn't dive inward and shred my hip capsule. My stamina was also in the tank, so after first getting both of my legs out of the car, I had to stop and rest. This did nothing for my ego. I grabbed my crutches and headed inside. Again, everything was happening so fast.....
"Hi, Welcome to Chipotle, what can we get started for you today?"
I felt like I was in a time warp. I just looked at the kid in his 20's with the blank stare of a serial killer. My husband stepped in to save me.
"I'll have a carnitas burrito..." and then it was more questions,
"Pinto beans or Black beans? Corn? Rice? Salsa? Lettuce? Tomato? Sour cream? Salsa? "
The word whooshed past my ears like I was in a wind tunnel. Thank goodness I was not operating any heavy machinery. Now it was the Chipotle kid's turn to stare. I was on the spot of indecision.
"Chicken, Black, corn, lots of it, very little rice, no cheese, lettuce, tomato, and salsa, the brown one."
"Flour tortilla okay?"
Not fair, he sabotaged me and went out of order. We were back to the beginning and I felt like I was in a spinning vortex. He was challenging me. Did he not see that I had two crutches that could crack him up side the head at any moment?
"fine," I managed.
The assembly line of my burrito continued faster than I could walk from one end of the counter to the other. My husband was paying for everything before my burrito was even finished
"Anything to drink?"
Seriously? I decided that there were a finite number of questions that people were allowed to ask me my first day in the outside world and this guy's quota was up. My husband, after knowing me for 17 years, sensed that an altercation was on the horizon, that my fuse was short and that I had weapons of mass destruction. He completed our transaction before I could come up with the witty, jolt of sarcasm that was brewing beneath my sharp tongue.
We headed back to the car, which while parked as close as it could be, still seemed like it was in the next state. Upon my arrival, I spent what seemed to be an eternity re-situating myself in a tolerable position that would also lend convenience to eating the massive burrito that we had just provisioned. I dove into it with fervor. It was as if I hadn't eaten anything but gruel for months. It tasted so good, all the flavors just bursting in my mouth. The hidden flavors not on the chipotle choice list, cilantro, lime, chiles, avocado, were all surprising additions to my already perfect meal. I got halfway through and started to feel full, but it was soooooo good! I just had to have one more bite.....and then it was gone. I ate the whole thing. I could feel it just sitting in my gut, which was also about the time I realized that I had not had a bowel movement in three days. I hoped the burrito would push things through. After all, there was little rice and lots of corn. That should do it.
We continued on I-5 north. The I-5 corridor is a vast emptiness of farmland and CAFO's (concentrated animal feeding operations) which have a stench to them that is unique and distinctive. It is also a great precursor to the ejection of a burrito. I wasn't sure if it was the speed at which things were coming at me, the new food, the new smells or the pain medication, but my stomach was sending me a message. "Do that to us again, and I will make you taste it twice."
With my stomach spanking me for my indiscretion, I thought it prudent not to add more pain medication to the mix. However, I-5 was not the smooth, flat pavement I remembered it to be. There were expansion joints, potholes, and a multitude of mini-overpasses that had just enough of a rise to give the contents of the car a slight lift when we hit them. The fluid in my leg responded to this lift and the accompanying discomfort was having a cumulative effect. The novelty of being freed from the hospital had worn off. I closed my eyes and gritted my teeth. 3 more hours of this was going to test my mettle.
I managed to fall asleep to the rhythmic up and down motion despite the pain it was causing. When I woke, my husband asked if I was doing okay. I explained my situation.
"Well, that would explain the groans of agony."
Apparently, I groan in my sleep.
We arrived home around 9pm. My daughters were still awake, of course, because my mother-in-law believes that our established bedtime is really just a "guideline," and I was coming home, so I guess this was a "special" event. They waited so patiently for me to go through my car evacuation ritual and slowly amble into our house. They hugged me gently and welcomed me home with homemade cards and kisses. I was suddenly surrounded in sweetness. I was so happy to see them. Before my surgery, I was so afraid that a complication might change the way we live our lives forever, or that I might not see my children again. Yet here they were, and here I was and aside from a few bruises and some swelling, we were all going to be just fine. It was a comfort and a relief that is impossible to describe other than to say, I exhaled, finally.
Home was comforting. I knew the lay of the land, and which unpredictable obstacles to avoid which included anything associated with the dogs and cats. The peaceful quiet that comes with rural living enveloped me and I realized that this would be the best possible place to heal a new hip. Now, if we could just find that bottle of Coumadin (a derivative of rat poison) that Grandpa seemed to have misplaced........
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