Saturday, February 20, 2016

A Hip Injection Adventure

During the past year I've started to deal with severe arthritis. On this past Wednesday I had the 2nd injection into my right hip. If one searches the internet there is many mentions of hip injection, but nothing that tells one what to expect, so I thought I would write about this a bit.

For readers in other countries, in the United States if one is over 65 years old, one is eligible for what is called Part A Medicare. This pays for hospital services. Part B Medicare pays for outpatient services. Cost of Part B is subtracted automatically from one's Social Security check. But neither of these insurance programs pay 100% of  costs, and so one needs to buy what is called Supplemental Insurance. I get mine through a large Minnesota system called Health Partners and this is also directly billed towards my Social Security check as well.  And I receive all my health/dental services through Health Partners too.

Health Partners has many, many clinics around the Twin Cities. The one I go to for orthopedic services is less than 2 miles from my apartment. However, for the past 2 years there has been major construction in the freeway I need to use to get there and so I had to do long detours. Most recently I can just get there is less than 5 minutes now.

In the lower part of the photo one may notice a sign that says Gillette Lifetime Services. Gillette Hospital started out as a children's hospital which specialized in care of children with polio. As polio was controlled in the United States, its mission changed. Gillette still cares for children with trauma -- for example, my 2 year old grandson fell down some steps and had brain surgery one night at midnight.

One of the specialties of Gillette is the care of children who for some reason need prostheses. And once a child begins with Gillette for this, they can continue for a long time, if not forever, to have a prosthesis adjusted or changed as the child grows into adulthood. A hospital is not needed for this and so most care is done in a clinic setting.

And yes, I'm aware the word, "Clinic" is used differently in Central Europe at least, than it is in the United States.

A hip injection requires the use of fluoroscope services to ascertain that the needles are entered into the right place. At this clinic, hip injections as well as other services such as shoulder injection, are done in the Same Day Surgery location. I didn't remember that from last time, but then I was in so much pain it is amazing I remembered anything!

I went to a nearby check-in desk to ask where was the Pain Intervention Clinic was. She inquired if I was there for "a shot." I said yes, so then I had to show my ID and insurance card and got checked in for my appointment. Then she said, "Do you need financial assistance?" I replied that I had just showed her all my insurance information, to which she replied she said it was a new question for everyone. This was a change from "Have you been out of the country in the past 21 days?" That all started with the Ebola outbreak in 2014-15.

And since the hip injection is done in Same Day Surgery one is treated as if it is surgery. One can't eat or drink for two hours before the appointment. Since I have more than 40 years experience as a nurse I couldn't help but ask why one couldn't eat or drink before a hip injection because there is no physiological explanation for this direction . There is no general anesthesia. Answer I got back is that "some people throw up."

When one arrives vital signs are checked. One is asked over and over about any allergies to medications. One is asked over and over what is the procedure and on which side. Finally the doctor who does the procedure arrived and asked me to sign a form stating I understood infection is a slight, but possible, outcome of the hip injection. He also placed a mark on my right forearm indicating that was the side for the procedure. Then I sat in a room for about 30 minutes waiting my turn. I was surely glad that I brought a book along to read.

Finally it was my turn. I walked to a procedure room, and hopped up on exam table. I had worn slacks with an elastic band so could just pull them down a bit to expose my right hip bone. The attending staff placed some drapes over my clothing leaving the hip area exposed. Then the skin was cleansed with Betadine or something similar -- I couldn't see. The doctor said "you will feel burning." I did as he injected some anesthesia into the area. Then he said, "you will feel some pressure." That was when the cortisone med was added. Then I was done.

I went back to the room where I left my coat and other possessions. I had to wait for my blood pressure to be taken again. Also I had to wait for the "discharge directions" to be printed and presented to me. I also had to sign a form indicating I had received such directions. These directions speak to what negative outcomes should be reported.

The whole procedure takes about 2 minutes, the paperwork etc takes 30 minutes or more!!!

The final thing to notice about a cortisone injection, including a hip injection, is that is takes 10-14 days to really kick in. I'm waiting for some the radiating pain from my hip joint across my back to disappear.

The staff is always surprised that I'm driving myself to and from. I keep telling them my regular orthopedic doctor said I didn't need a driver for this procedure.

Since my appointment was at 12:30 pm, that meant after 10:30 I couldn't eat or drink anything and now it was 1:45 and I was hungry. So my next stop after this was lunch!! This in itself should convince anyone thinking about a hip injection to understand that it is not at all a traumatic procedure.

After lunch I decided to try a store new to me and see if I could I buy some new luggage for my  Poland trips. I knew the store was having a luggage sale. I've been looking at their website.

Got there and found some lovely new luggage at first a 70% sale and then another 20% on this day. It was a good day to go looking for luggage. First I was shown a black set. I said I wanted something different so I could actually find my luggage when it shows up on the baggage carousel. 95% of the bags are black! So not only did I not have a driver after the procedure, I also went shopping!

Now the final thing to know about a hip injection or any other type of cortisone type injection is that it may cause insomnia. And for me it does. The night of the procedure I slept just fine. In fact, after waking up at 7 or so I went back to bed and slept until about 11 AM I volunteered that afternoon. Then what would be the 2nd night I woke up at 2:40 AM and couldn't go back to sleep. But the good thing is that the insomnia effect wears off in about 48 hours. This is not a bad side effect if one plans for it, and certainly is worth it to get rid of pain -- and I plan ahead for this with a stack of books to read if I can't sleep.

I hope this is a helpful story for anyone who needs a hip injection and wonders what it is all about.

No comments: