Hip Surgery is On

After much going back and forth, the anesthesiologist at Stanford has agreed to clear Adrienne for surgery on December 19 and do her preop the Friday before. He seemed quite anxious about taking on an oncology and cardiac patient from the children's hospital but both her doctors there agreed that she is perfectly healthy for the procedure and the long anesthesia, 3.5 hours. Adrienne will probably spend two days in the hospital and will be discharged with a walker, after her pain is under control and she learns how to move properly to avoid fractures.

The surgery is called a core decompression. The top of Adrienne's femoral bone, which is the large bone in the upper part of the leg going into the pocket in the pelvis, is necrotic, dead. The doctor will drill at 4.5 mm hole from the outer part of the leg up into the necrotic area to relieve the pressure and hopefully cause new blood vessels to grow. The surgery is effective 80 to 90% of the time in regenerating new bone and avoiding total hip replacement surgery.

The PA over in surgery had asked for a copy of Adrienne's last echo, essentially an ultrasound of the heart, done in October. You may recall that she has mild cardiomyopathy resulting from one of her chemos, specifically adriamycin, in 1997. This was diagnosed in 2004 and she sees a cardiologist twice a year to moniter her condition. Her most recent echos have been very similar actually showing quite good numbers. I asked that a copy of the echo report be faxed here when they sent it over to surgery. I was quite surprised to see quite a significant drop in Adrienne's shortening fraction. Her ejection fraction, the more important measurement, is essentially unchanged. I understand that a drop in the shortening fraction precedes a drop in the ejection fraction. Up until now, she's been able to avoid medications for the problem, but it may be necessary in the next year. Adrienne isn't worried however since she had a new technician and she's sure she did something wrong. Adrienne's next cardiology checkup is in March.