Today is one month since my LPAO and right hip screw removal. It feels like time has gone so slow and so fast all at the same time. Compared to how I felt last year recovering at 4 weeks, I am certainly not as ambitious to do much of anything. Last year I was satisfied to be out and about (carefully) and trying to do light housework...dreading the 12 weeks to come to an end, lol. This year I have no ambition to do anything and am satisfied to sit and do nothing but read but yet since I CAN'T do anything due to the leg/hip restrictions I WANT to go back to work. It doesn't make sense. But that's how it is. Anyway, I won't go into details about my falling and hurting my hip because that's all I wrote about in my last two posts, but I am moving a lot better. Pain is still an unresolved issue but I'll just have to work through that I guess. I pissed off a lot of muscles/tendons/ligaments.
So, let's talk about the right hip. Since the screws were removed that deep awful ache I got all the way down the leg from trochanter to ankle is gone. I can lie on that side without it having that pulsing ache now, although it still hurts to lie on that side since it's still sore from surgery. Once the surgical pain goes away I think it will be pain free at the trochanter. The surgical report I got said that Z incised the bursa again to get to the screws. So I'm sure that it's very tender because of that as well. I also don't feel the weird popping over the screw heads anymore that grossed me out so much. So having the screws removed was definately the right move. However, the right hip is extremely achy and sore from being the sole weight bearer. It's had sharp pains, it's given out, the lateral muscles are getting fatigued and the groin is getting a slight catching feeling again. I don't know if it'll get better once the left hip can start to bear weight again but I suppose it'll be a watch and see kind of thing. It was a little "crunchy" the other day too. I wonder if that was the cartilage that didn't lay down right after surgery?
The left hip was doing really awesome til I fell. I was doing really well not taking vicodin except at night and just extra strength tylenol during the day. Now I'm back on the vicodin and valium a couple times a day til the spasms and extra pain subsides. So minus the setback of the fall, I would say that I am extremely impressed with how my hip feels. No aching as of before the fall and it still feels nice and stable. Obviously this is all before weight bearing so we shall see. One thing that has started to happen since I fell that wasn't happening before is some anterior clunking. I think it might be the psoas. It's not a good thing to inflame the psoas, but what can I do? Now I'll have to deal with that. But, the good news is I don't feel like I'm fresh post op anymore. Yes, I'm still extremely sore, and yes, I can't hardly do anything at this point now without the hip hurting but I can lift my foot off the ground from a sitting position just an inch or so for a second or two. Just long enough to pull on my underwear, or socks! It hurts the psoas, but I can do it! That's a major accomplishment. I can't wait until Jan 20th when I can get rid of these restrictions and do straight leg lifts and put weight down on the leg and drop a crutch! Another good thing is the muscle atrophy isn't getting any worse and my scar is looking pretty good. I've started using vitamin E oil lotion on it to rub in and try to do scar massage on it. It's so weird because parts of the incision hurts and parts of the incision are completely numb and I can't even tell I'm touching it. It gives me the creeps and makes my stomach roll.
All I do all day for now is sit with an ice pack under my butt with my feet up in the recliner. I have a wheelchair now for when I'm alone during the day when my husband's at work and it's handy for getting food or drinks or whatever when I don't have a free hand. Luckily our house is an open floor plan with wood floors and it's easy navigating.
One thing I have noticed is that my PAO leg from calf to foot is very cool and sometimes icy to touch and then when I'm up crutching my ankle and foot turn a dusky color. But once I sit down and put my feet up it turns a normal color and matches my other foot. The pulses are good, so I don't have a blockage in circulation, but I guess that since I'm not using my leg to weight bear the blood must be pooling in my foot resulting in the dusky color.
I still deal with constipation at times even though I'm still on laxatives and my appetite is still low. I'm drinking plenty of water though and making sure I take my vitamins every day. I guess I've lost a little weight since surgery, because everyone I see tells me I'm looking a little thin. I'll take that! Maybe this isn't the ideal way to lose weight, but hey, whatever:) My appetite is sure to come back though full force at some point and I'm no doubt going to gain back every pound I've lost but oh well. It's nice to be a little thinner for a little while.
I'm still fairly swollen at the incision of the LPAO so I don't know that I can feel the screw heads yet, but I keep feeling for them, waiting for the day I will feel them. They are right there at the edge of the wing of the pelvis. Most of the Z girls have had theirs removed, so I'm no doubt going to be one of them. Today is the first day I wore jeans too! And it doesn't bother my incision much, so that is a good thing. But the jeans are also a loose pair, so I'm not sure how my tighter fitting jeans will feel. I'm not ready to wear those just yet. I think I'll stick to my sweats and yoga pants a little while longer while I still have a great excuse to wear them in public:)
I've learned a valuable lesson over the last few days....don't have the RPAO before Christmas! With my SDD and my PAO both being just within weeks of the Christmas holidays, I have worn myself out more than was necessary and obviously caused me to fall and end up in ER. So, if/when I schedule my RPAO, I will not be doing it during any busy holiday times. I will schedule it for after the Christmas and New Year holidays. Plus it was a bummer not to be able to partake in any active holiday decorating and baking the last two years. I wanted to help and instead was just a burden.
Now the year is coming to an end and I am staring at my 30th birthday on New Years Day and all I can say is, I got a fantastic birthday present....a stable left hip!!! (with a little bling inside, haha!)
Tuesday, December 28, 2010
Sunday, December 26, 2010
The Fall
Well, I did it....I fell, on my PAO hip.
What started out as a great (but exhausting) Christmas with our families, ended up as a night spent in the ER.
To start, on the 23rd I had my mom come over to help me finish wrapping gifts and bake Christmas goodies. We were at this for 5 hours and it's the most I've been up and around since surgery and I actually didn't even do much...she did 90% of the work! I sat and dipped peanut butter balls in chocolate. I sat and opened all the Rolo's to melt on pretzels. I sat and wrapped presents....see a theme...I SAT most of the time, but it was the getting up and moving around to all the different seating positions for 5 hours that tired me out. I also woke up Christmas Eve with feet so swollen that I couldn't wear my tennis shoes to go to our first family Christmas, which was an hour away from home. So factor in at least 2 hours in the car, a Christmas that lasted nearly 12 hours and then getting up very early Christmas morning to do it all over again, only this time we had to go to 2 different houses. We ended the day at my parents house where I did absolutely nothing but sit in the recliner and was waited on hand and foot. But I was uncomfortable and so hot that I was getting almost miserable. I even had to sit next to the door so I could leave it open and let the 20 degree air flow over me to cool me down.
My dad could tell I wasn't feeling the best and was pretty concerned. But I shook it off. I should have listened to my instincts and just told Todd it was time to go at 3 or 4 that afternoon, but we stayed on wanting to visit with my brother and sister-in-law and nephew too. We left there about 8:30 and got home about 8:50 and that's when it happened....
I crutched up onto the platform in our garage and felt a little unsteady but still had another step up into the house. This step however has a deep lip that sticks out and I was just so exhausted that I didn't crutch it properly and my left foot and crutch tip got caught under the lip and I went down hard. Both my knees took the brunt of the fall because I was still holding the crutches with my hands. My husband came running back to the hall and had to lift me up and help me to my chair so I could assess the damage. After about 15 minutes I called the orthopedic on call line and was connected to one of the doctors in Z's practice. He wanted me to come down to Beaumont at first but then realized I live too far away so suggested going to my hospital and getting pain meds, muscle relaxers and xrays.
T drove me to ER and one of my friends/neighbor ended up being my nurse (God bless her) and she took such good care of me. Our wait was not bad at all there! She got the IV going, the meds administered and the xrays going within the hour of getting there. I felt bad for the PA who saw me though as she had never seen or heard of a PAO and didn't know what the xray would look like. She seemed really concerned when the xrays came back because the ischial bone was "displaced". I showed her my 2 week post op xray on my phone and she relaxed saying that the xrays matched and I was ok. Thank God!! The next step was to call the on call doctor again and see what they wanted to do. The consensus is that it could be a torn muscle or ruptured tendon which only a CT scan is going to show. What my instructions were is to call Dr. Z first thing Monday morning, and make an appt to see him as soon as possible, and bring the xrays with me that the ER took so he can see for sure that nothing is wrong.
Today I am moving much better, albeit slowly, much like when I first got home from the hospital. In fact, I feel as if I am just one day post op...my muscles are so very sore/spasmy. I do have new pains though, that come and go, which I hope is just temporary. In my anterior hip and groin I have sharp stabbing spasm pains and in my butt, deep inside is a different kind of pain now that is also a sharp stabbing spasm pain. The hospital sent me home with a new script for vicodin and also a script for valium to help with the pain and spasms. I am hoping these will help settle everything down. I was doing so good at not taking pain meds!!! It looks as though this will be a bit of a set back in recovery. I cannot believe I fell.....I can't believe I could have royally screwed up my surgeon's work. Fingers crossed that there is no permanant or lasting damage from this fall.
(Face palm)
What started out as a great (but exhausting) Christmas with our families, ended up as a night spent in the ER.
To start, on the 23rd I had my mom come over to help me finish wrapping gifts and bake Christmas goodies. We were at this for 5 hours and it's the most I've been up and around since surgery and I actually didn't even do much...she did 90% of the work! I sat and dipped peanut butter balls in chocolate. I sat and opened all the Rolo's to melt on pretzels. I sat and wrapped presents....see a theme...I SAT most of the time, but it was the getting up and moving around to all the different seating positions for 5 hours that tired me out. I also woke up Christmas Eve with feet so swollen that I couldn't wear my tennis shoes to go to our first family Christmas, which was an hour away from home. So factor in at least 2 hours in the car, a Christmas that lasted nearly 12 hours and then getting up very early Christmas morning to do it all over again, only this time we had to go to 2 different houses. We ended the day at my parents house where I did absolutely nothing but sit in the recliner and was waited on hand and foot. But I was uncomfortable and so hot that I was getting almost miserable. I even had to sit next to the door so I could leave it open and let the 20 degree air flow over me to cool me down.
My dad could tell I wasn't feeling the best and was pretty concerned. But I shook it off. I should have listened to my instincts and just told Todd it was time to go at 3 or 4 that afternoon, but we stayed on wanting to visit with my brother and sister-in-law and nephew too. We left there about 8:30 and got home about 8:50 and that's when it happened....
I crutched up onto the platform in our garage and felt a little unsteady but still had another step up into the house. This step however has a deep lip that sticks out and I was just so exhausted that I didn't crutch it properly and my left foot and crutch tip got caught under the lip and I went down hard. Both my knees took the brunt of the fall because I was still holding the crutches with my hands. My husband came running back to the hall and had to lift me up and help me to my chair so I could assess the damage. After about 15 minutes I called the orthopedic on call line and was connected to one of the doctors in Z's practice. He wanted me to come down to Beaumont at first but then realized I live too far away so suggested going to my hospital and getting pain meds, muscle relaxers and xrays.
T drove me to ER and one of my friends/neighbor ended up being my nurse (God bless her) and she took such good care of me. Our wait was not bad at all there! She got the IV going, the meds administered and the xrays going within the hour of getting there. I felt bad for the PA who saw me though as she had never seen or heard of a PAO and didn't know what the xray would look like. She seemed really concerned when the xrays came back because the ischial bone was "displaced". I showed her my 2 week post op xray on my phone and she relaxed saying that the xrays matched and I was ok. Thank God!! The next step was to call the on call doctor again and see what they wanted to do. The consensus is that it could be a torn muscle or ruptured tendon which only a CT scan is going to show. What my instructions were is to call Dr. Z first thing Monday morning, and make an appt to see him as soon as possible, and bring the xrays with me that the ER took so he can see for sure that nothing is wrong.
Today I am moving much better, albeit slowly, much like when I first got home from the hospital. In fact, I feel as if I am just one day post op...my muscles are so very sore/spasmy. I do have new pains though, that come and go, which I hope is just temporary. In my anterior hip and groin I have sharp stabbing spasm pains and in my butt, deep inside is a different kind of pain now that is also a sharp stabbing spasm pain. The hospital sent me home with a new script for vicodin and also a script for valium to help with the pain and spasms. I am hoping these will help settle everything down. I was doing so good at not taking pain meds!!! It looks as though this will be a bit of a set back in recovery. I cannot believe I fell.....I can't believe I could have royally screwed up my surgeon's work. Fingers crossed that there is no permanant or lasting damage from this fall.
(Face palm)
Monday, December 20, 2010
It ain't easy bein' screwed (20 days post op)
I am now one night shy of being 3 weeks post op. The xray on the left is my very first pre op xray with Dr. Z and the one on the right is my latest post op xray obtained at my two week follow up. Look at the difference! On the right, the head is rounder (although the socket is still shallow) and the screws are out. Plus you can't even see where the trochanter was osteotomized anymore! The left hip obviously has the biggest changes and quite a bit more coverage. Z says it is the model of how a perfect PAO should be.
The operative report says that I had a labral tear in the left hip and also an iliac crest bone graft done during surgery. My family and friends that have seen the newest xrays (that are unaware of how a PAO looks) have been absolutely amazed at the size of the screws and the cuts of the bones. Especially for how well I've been handling the pain.
I would say at the 3 week mark the hardest thing for me to handle now is getting up in the morning out of bed due to lying in one position all night. I've just gotten to where I can sort of roll myself into a semi side lying position on my non op side with tons of pillows propped all around me, but that is such a gargantuan effort at 2 am to take on that I just don't feel it's necessarry to carry out. Plus I can only handle lying like that for a very short period of time, so it just doesn't seem worth it. So I stay on my back, which makes for a stiff everything in the morning. I don't wake up at 2 or 4 am anymore for a vicodin, so from 10 pm (usually) til 8 or 9 AM I am without meds. Today I actually went more than 12 hours without meds and am doing alright.
I can do the 500 exercises fairly easily now. I can effortlessly get my left ankle to rest on my right knee and although I feel the stretch in my butt it doesn't hurt to leave it there. Lying down and doing the figure four though is entirely different. It stretches a whole lot more muscles and that does hurt...so much so that my whole leg starts to tremble. I can only hold that position for a couple minutes before I'm dragging the leg by my hands into a straight position.
Using my left leg to lift it off the floor takes a lot of concentration....my brain says "lift!" and my leg says "I'll get to it when I'm good and ready!" Good and ready takes a lot out of me and again I end up using my hands to guide the leg the rest of the way up to complete my knee to chest exercises. Still no straight leg lifts allowed and it's hard to remember that sometimes.
I am still of course dealing with buttock pain and hamstring pain....although I know this will resolve eventually, it feels like it's taking forever to go away. And to top it off, now my calf and ankle are extremely tight and painful too, like I've pulled every muscle in my leg.
I sneezed for the first time last night and although I could feel it coming on and I splinted my incision, it was still agonizing. It was an immediate ripping pain all the way around the hip and tears were leaking out of my eyes as I swore loudly. But then I started to laugh because it was just so ridiculous! That by far was the most painful thing I've gone through since I've been home. I think the only thing more painful was the second time I was taken out of the CPM in the hospital....ah, good times.
The thing that really startled me though, was yesterday morning I realized that "hey, I feel like I could definately do this again if I have to." And you know what? I could. It's not that bad. The first week is one that makes you question everything about yourself but then you see how far you come with each passing day and realize just how strong you are and it becomes apparent that although it ain't easy bein' screwed, it's also not the worst thing that could happen either.
Friday, December 17, 2010
Post op follow up
2 week post op follow up
So, after waiting awhile in the office to be called back, I was sent for xrays. I saw Dr. Z in the hallway on my way to xray and he grinned and said "How's my friend?" I told him I was doing alright, and he looked concerned then, saying "are you sure? You're really doing alright?" I smiled and assured him everything was great. Off to xrays and first set was standing...without crutches....It was a little challenging for the second position the tech wanted, which is the captain Morgan pose, modified. Fortunately there is a block for the foot to rest on while the leg is up in the air. Then I had to do a set lying down. That was really uncomfortable as the table is hard and I'm not used to lying totally flat without cushioning of some sort. The tech did put a pillow under my knees which did help.
I was led back to my room then to wait for Dr. Z to come in and it wasn't long before I saw him. He had a resident with him also, whom I recognized from my hospital stay. He wasn't actually in on the surgery, but did check on me in the hospital. He was very nice then, and had a really nice bedside manner today too.
Z shook my hand with a smile, and we joked around for a few minutes. He pulled up my xrays on the computer first thing while asking how I feel. I coudn't get a good look at the xrays because the resident was in the way of the computer but I got just a glance at the screws. I really wanted to see the coverage though! Z said he would email the xrays to me so I could post them on my blog. He seems really interested in the whole blog/hip support group. I think it's great that he is so supportive of it. So, now I have to wait for my images...hopefully I'll get them soon!
Z had me lie back on the exam table and he looked at the scar, and was pleased with the way it's looking. He said it's healing really well. He asked me to bend up my knee as far as I could get it without using my hands and then use my hands to pull it the rest of the way to my chest to show him how much range of motion I have so far. I wasn't able to get very far yet and he had to help me with grabbing my leg so I could pull it up. Then he had me show him how far out I could externally rotate the leg (like a figure 4) which was "okay" but he said I really needed to work on that particular movement. We discussed my butt pain and he said that would persist for a while. I was given the okay to use a recumbant or upright bike with no resistance to get the back and forward motion with my legs but he warned it would really hurt my butt....
He also asked about my right hip and how it was doing. I told him that it did have some sharp pains going across the joint already and that it did give out on me just a day ago and hurt too much to stand on it. He said that it is shallow too and that I should only walk when necessary (bathroom, etc) until the left hip can start bearing weight and sharing the load. Hopefully then the right hip will settle down and not act up anymore.
What I found really endearing was how proud he was of how well his patients do with this surgery. He is very proud of his stats and he says he'd like to take credit for it all but knows it's all due to us, his patients. He says that Michigan women are a lot stronger than any others!! lol! I thought that was so cute.
~He said I only lost 100 ml of blood during surgery (which is great! no transfusion needed)
~I do not have a numb spot at all
~the hospital stay is typically only 3 nights for us, while most others stay a week
~we talked about how this surgery compared to the SDD; last year I was already asking to drive, going stir
crazy wanting to get out of the house, doing some light house work, pain not so bad at this point, while
this year with this surgery I am not ready for any of that and pain is bigger issue. Only thing "easier" with
PAO is the incision placement. Not as painful as the SDD incision. Z agreed with that point.
I was in trouble though, when T told Z he caught me trying to do laundry a couple days ago and yelled at me. Z told him good job and to keep after me. He then said to me, "don't worry, we have a big list for you in about 6 weeks...we've been working on it" I laughed and promised I'd behave.
So for now it's still full restrictions, which means no weight bearing on the left leg still and no active flexion at the knee (think of kicking the lower leg out) because this could tear or detach the quad muscle that was taken off during surgery and reattached. It needs time to heal and fuse back to the bone before being actively used. I am allowed to do heel slides and use my hands to help the leg up when needed. Then he told me that he'd like to see me again in 4-5 weeks for another check up and we could discuss outpatient PT then and my job til then is to find a PT and have it set up and ready. Good thing I already have Liz, from last year, on board!
So, after waiting awhile in the office to be called back, I was sent for xrays. I saw Dr. Z in the hallway on my way to xray and he grinned and said "How's my friend?" I told him I was doing alright, and he looked concerned then, saying "are you sure? You're really doing alright?" I smiled and assured him everything was great. Off to xrays and first set was standing...without crutches....It was a little challenging for the second position the tech wanted, which is the captain Morgan pose, modified. Fortunately there is a block for the foot to rest on while the leg is up in the air. Then I had to do a set lying down. That was really uncomfortable as the table is hard and I'm not used to lying totally flat without cushioning of some sort. The tech did put a pillow under my knees which did help.
I was led back to my room then to wait for Dr. Z to come in and it wasn't long before I saw him. He had a resident with him also, whom I recognized from my hospital stay. He wasn't actually in on the surgery, but did check on me in the hospital. He was very nice then, and had a really nice bedside manner today too.
Z shook my hand with a smile, and we joked around for a few minutes. He pulled up my xrays on the computer first thing while asking how I feel. I coudn't get a good look at the xrays because the resident was in the way of the computer but I got just a glance at the screws. I really wanted to see the coverage though! Z said he would email the xrays to me so I could post them on my blog. He seems really interested in the whole blog/hip support group. I think it's great that he is so supportive of it. So, now I have to wait for my images...hopefully I'll get them soon!
Z had me lie back on the exam table and he looked at the scar, and was pleased with the way it's looking. He said it's healing really well. He asked me to bend up my knee as far as I could get it without using my hands and then use my hands to pull it the rest of the way to my chest to show him how much range of motion I have so far. I wasn't able to get very far yet and he had to help me with grabbing my leg so I could pull it up. Then he had me show him how far out I could externally rotate the leg (like a figure 4) which was "okay" but he said I really needed to work on that particular movement. We discussed my butt pain and he said that would persist for a while. I was given the okay to use a recumbant or upright bike with no resistance to get the back and forward motion with my legs but he warned it would really hurt my butt....
He also asked about my right hip and how it was doing. I told him that it did have some sharp pains going across the joint already and that it did give out on me just a day ago and hurt too much to stand on it. He said that it is shallow too and that I should only walk when necessary (bathroom, etc) until the left hip can start bearing weight and sharing the load. Hopefully then the right hip will settle down and not act up anymore.
What I found really endearing was how proud he was of how well his patients do with this surgery. He is very proud of his stats and he says he'd like to take credit for it all but knows it's all due to us, his patients. He says that Michigan women are a lot stronger than any others!! lol! I thought that was so cute.
~He said I only lost 100 ml of blood during surgery (which is great! no transfusion needed)
~I do not have a numb spot at all
~the hospital stay is typically only 3 nights for us, while most others stay a week
~we talked about how this surgery compared to the SDD; last year I was already asking to drive, going stir
crazy wanting to get out of the house, doing some light house work, pain not so bad at this point, while
this year with this surgery I am not ready for any of that and pain is bigger issue. Only thing "easier" with
PAO is the incision placement. Not as painful as the SDD incision. Z agreed with that point.
I was in trouble though, when T told Z he caught me trying to do laundry a couple days ago and yelled at me. Z told him good job and to keep after me. He then said to me, "don't worry, we have a big list for you in about 6 weeks...we've been working on it" I laughed and promised I'd behave.
So for now it's still full restrictions, which means no weight bearing on the left leg still and no active flexion at the knee (think of kicking the lower leg out) because this could tear or detach the quad muscle that was taken off during surgery and reattached. It needs time to heal and fuse back to the bone before being actively used. I am allowed to do heel slides and use my hands to help the leg up when needed. Then he told me that he'd like to see me again in 4-5 weeks for another check up and we could discuss outpatient PT then and my job til then is to find a PT and have it set up and ready. Good thing I already have Liz, from last year, on board!
Tuesday, December 14, 2010
2 weeks post op and what happened to my body?!
Today marks 2 weeks since surgery and I know you're all wondering where are my pictures of the scar, the hip xrays and the screws....they'll be coming. I have my post op appt on Thursday so I'll have xrays then (hopefully) and will post pics of everything together. At 2 weeks I am doing a heck of a lot better than I was at 1 week. I am not nauseated anymore, I've pooped like a champ, and I'm eating at least 2 small meals a day and drinking like a fish. I'm a lot stronger too. Emotionally I've calmed down about being so "helpless". It's not forever, it's just a small step in the healing process and I guess I just had to have a pity party or something. I have figured out how to get into the shower by myself (big accomplishment!) with a little tip from a friend, "D" from Hip Endeavors! Thanks D! :) Also, I appreciate the comments on my prior post about how to carry items to and from the kitchen, or wherever. I have taken to using a plastic shopping bag as my transportation device. Pretty handy! Also, sweatshirts with kangaroo pockets are pretty nice too for the smaller items to be carried (cell phones, water bottles, pill bottles...whatever you want to stuff in them).
Pain continues to be minimal at the incision and front of the hip, but my buttock, deep inside is getting to be quite painful. I assume it's the surgical fracture of the ischium (the butt bone). I will be finding out on Thursday what this literal pain in the butt is. Plus my hamstring on my left leg is so tight! Not much helps it in terms of stretching it out, but I'm doing my best keeping up with my 500 exercises...I can now get my ankle to my knee, but not on top of the knee. Soon, I'm sure.
Now, onto the body image portion...
I don't usually have issues with the way my body looks, I'm pretty secure in it. But holy cow, where did my body go!!!??? The left leg atrophy is totally disgusting and the fat I do have on my leg is lumpy and unfortunate. My knee looks deranged since it's still a bit swollen and it's also protruding more and still is twisted inward. My waist on the left is non existant. I used to have beautiful curves. Not anymore...My waist looks higher on the left than the right and I'm sure it's because of the non weight bearing status but it sure looks wonky! I look.....awful. I know, I know, this will go away too, when things start healing and the swelling goes away and I can start using my leg again to strengthen the muscles. It's just kind of shocking because I didn't look this bad after my right hip surgery last year. I had swelling and atrophy, but I still kept my shape. Of course, the doctor didn't rearrange my pelvis on the right side either....
But, onto things I can do at 2 weeks:
I can get in and out of bed and CPM by myself.
I can now (just today) get in and out of shower by myself and take care of myself after.
I can dress myself.
I can get in and out of just about any kind of chair.
I can lie on my stomach (with help) and stay there for about an hour, but need help getting back up.
I can crutch from front of house and back before I tire out.
I can transport small items in a plastic bag with me where I need to go.
I can bend down from standing position with bad leg behind me to get things off the floor.
This is definately more challenging than the SDD recovery. I think the scar placement is the only advantage I have over the SDD. It doesn't hurt or pull at all whereas the SDD scar definately did. I do not feel like going outside at all and don't really want to go out on Thursday either, but have to for my post op appt. This time last year I was going stir crazy and had gotten out of the house a couple times already. I am too tired for one thing, and I do not feel stable enough to go out where it's slippery even though I bought shoe picks for traction outside. I am so scared of slipping and falling. I am a bit clumsy inside and have stumbled a few times already with no obstacles....can't imagine what snow and ice will do for that!
But the good news is, this surgery and recovery so far has not been as bad as what I made it out to be in my mind. Even from day one the pain has been so well managed that I would say it's worth it to anyone who has to go through this and is scared of pain.
Pain continues to be minimal at the incision and front of the hip, but my buttock, deep inside is getting to be quite painful. I assume it's the surgical fracture of the ischium (the butt bone). I will be finding out on Thursday what this literal pain in the butt is. Plus my hamstring on my left leg is so tight! Not much helps it in terms of stretching it out, but I'm doing my best keeping up with my 500 exercises...I can now get my ankle to my knee, but not on top of the knee. Soon, I'm sure.
Now, onto the body image portion...
I don't usually have issues with the way my body looks, I'm pretty secure in it. But holy cow, where did my body go!!!??? The left leg atrophy is totally disgusting and the fat I do have on my leg is lumpy and unfortunate. My knee looks deranged since it's still a bit swollen and it's also protruding more and still is twisted inward. My waist on the left is non existant. I used to have beautiful curves. Not anymore...My waist looks higher on the left than the right and I'm sure it's because of the non weight bearing status but it sure looks wonky! I look.....awful. I know, I know, this will go away too, when things start healing and the swelling goes away and I can start using my leg again to strengthen the muscles. It's just kind of shocking because I didn't look this bad after my right hip surgery last year. I had swelling and atrophy, but I still kept my shape. Of course, the doctor didn't rearrange my pelvis on the right side either....
But, onto things I can do at 2 weeks:
I can get in and out of bed and CPM by myself.
I can now (just today) get in and out of shower by myself and take care of myself after.
I can dress myself.
I can get in and out of just about any kind of chair.
I can lie on my stomach (with help) and stay there for about an hour, but need help getting back up.
I can crutch from front of house and back before I tire out.
I can transport small items in a plastic bag with me where I need to go.
I can bend down from standing position with bad leg behind me to get things off the floor.
This is definately more challenging than the SDD recovery. I think the scar placement is the only advantage I have over the SDD. It doesn't hurt or pull at all whereas the SDD scar definately did. I do not feel like going outside at all and don't really want to go out on Thursday either, but have to for my post op appt. This time last year I was going stir crazy and had gotten out of the house a couple times already. I am too tired for one thing, and I do not feel stable enough to go out where it's slippery even though I bought shoe picks for traction outside. I am so scared of slipping and falling. I am a bit clumsy inside and have stumbled a few times already with no obstacles....can't imagine what snow and ice will do for that!
But the good news is, this surgery and recovery so far has not been as bad as what I made it out to be in my mind. Even from day one the pain has been so well managed that I would say it's worth it to anyone who has to go through this and is scared of pain.
Wednesday, December 8, 2010
LPAO update
Surgery day: November 30th
Todd and I got up early this morning and got everything ready to drop off at his mom's (the pups, who could tell something was brewing) and all their belongings. I was not feeling nervous, actually slept really well. It's amazing what your own bed and surroundings will do for you. We had a timeline to get to the hospital by 12:30 so we could get Todd, his mom, and my parents settled into their condos before I had to check into surgery at 1:30. We made it to Beaumont hospital at 1:00, so a little behind schedule but still able to get everyone settled into their condo units before heading over to the pre-sugery area. Was in pre-op by 1:30, by myself until the IV was started and the surgical history was taken by my RN. IV was absolutely painless and the nurse got it on one try! I told her I had a pretty bad headache (lack of caffeine and stress) and she got some versed on board for me...already the versed begins! She explained that my surgery was already going to be behind because there was still another surgery ahead of me yet. Thank goodness for versed....My family was allowed in and we all sat around and chatted, while being interrupted by various members of the OR team, the most important being anesthesia. The anesthesiologist did have a note that I was extremely anxious about pain upon waking up from surgery and looked at the prior surgical notes and saw that I was really only given pain meds in the beggining of surgery and not at the end. He assured me that I would be well loaded all throughout surgery and not to worry. He said the only drawback would be that I would take a lot longer to wake up. I was A-OK with that! Then Dr. Z came in. Being the ever humerous man that he is, he placed his hands on my legs and patting the right leg, said "PAO" and then the left leg, "screw removal" with a slight smile and gleam in his eyes. I fired right back at him with a smile, "No!" He laughed and said, "oh, your legs are crossed, I got confused". He did a last minute explanation for me and my family about the surgery, how long it should take and recovery. We were still waiting awhile by the time Z came to see me but he assured me that it wouldn't be long before I was next. My circulating nurse saw me right after and she said it was time to go. Then another dose of versed and I was off to surgery! It was a late surgery, about 5:30 or so before it began and it was supposed to go at 3:30 originally. But, being an OR nurse, I completely understand how those things go. I really don't remember much this time about the transfer to the OR or even getting on the bed. I do remember thinking that the amount of surgical instruments didn't seem all that much! It felt like they put me out before I got on the OR table, but I'm sure that's not true.
Recovery and transfer to my inpatient room:
Waking up in recovery was a much smoother process this time around. I was calm, my hip didn't really hurt per se, but it did feel horribly stiff and like it was full of lead. I don't actually know how long it took me to wake up and come around, but I was able to talk to the recovery nurses this time. I asked what time it was (8:30 pm) and how late they stayed open (11:30 pm). I don't know why I had to know that tid bit but it made me feel better. I did notice however that there was a very irritable man in recovery (my anesthestist who took over my case, I think???) who kept angrily yelling at everyone and also wasn't really very kind to me. Not to get into too many details, but he was pretty belligerent with the staff. It was making me a bit nervous.
I was aware for the most part during my awake time in recovery and remember being transferred from recovery (but not the ride itself) and then remember being placed into my room on the children's floor, The Wizard of Oz room. I did have a roommate, a 12 year old CP patient who had broken her leg that day. My transfer was uneventful and I was settled in nicely. I had a dilaudid PCA set up, but no basal rate this time. I can push the button every 6 minutes for meds. My family came in a little bit after that and I was more awake, able to smile, wave and say how I was doing. It's about 9:30 or so now. The staff are "A+" and I am confident they will do a great job with me. At this time my mom starts to complain of feeling hot and just "not right". Sue, my mother in law, is a nurse also and she noticed my mom fading. She told my dad, "let's get her into a chair" at which time I looked at her and saw she wasn't looking right either. I asked her if she was ok but she didn't answer, just had a blank stare at the ceiling and the proceded to pass out right as my dad and Sue got to her. Dad said she stopped breathing for a minute too. I was flat on my back, panicking, crying and begging Todd to get a nurse to help my mom. 3 nurses came rushing in and helped her, and she finally opened her eyes, wondering why everyone was in her face...!! She said she was dreaming right before she passed out but didn't know she had passed out. Vitals all checked out ok on her and she refused treatment. Must have been a vagal vasal reaction we're all thinking. My family stays until about 11 pm, when they know I've calmed down from the scare and mom is ok to get moving.
The CPM (continuous passive motion) machine arrives about 2 am along with the SCD's (sequential compression device). It feels good to have them on. Still loving my nurses:)
Post op day 1: December 1st:
Today is a "chill in bed" day per Dr. Z. I'm not going to be doing much of anything except resting. I saw Dr. Z and 2 residents (seperately) and neither of the residents were in on the surgery, so I couldn't ask them anything about how it went. Z says everything went great and I have 3 screws, can't wait to show me the xrays. I forgot to ask him questions though. It's so early in the morning that all I care about is sleeping!
Only on ice chips at this time (not even water) because I am not passing gas. Until I pass gas, I can't have anything else. I'm actually kind of hungry this time around, so I'm working on getting the gas out:)
My family came in about 8 am and settles in for a long day of visiting and watching me sleep. I feel bad that they were "stuck" there, but they did get up and go out to town a few times. I can't thank them enough for just being there.
Amy (PT) does come see me today (she amazingly remembers me from last year!!!) and shows me some isometric exercises I'm going to do while in bed. This means taking me out of the CPM...I am so comfortable though, I don't wanna move! But Amy is a pro and she removes the CPM and my leg with ease, doesn't even hurt, just a bit of stinging at what I assume to be my incision. I am wrapped in a huge ace bandage compression dressing from stomach all the way down to my left knee. She says this is pretty new and that Z has only just started doing this. She said she would give him a call today to find out his reasons on why he's wrapping his PAO patients now. The isometrics are simple: ankle pumps, butt squeezes and thigh squeezes. I can't get my left thigh to squeeze, but Amy says she can tell it's doing something as she places her hand on my leg. Okay! I notice my whole left leg, from hip to toes, has a weird tingly, pin prick feeling, but not numb. Amy says to mention to Z about that next time I see him. I try to feel for the famous numb patch that all PAOers seem to have, but I don't really feel it, just the tingly feeling. Good sign I hope!
I'm told the goal today is to do the isometric exercises 20 times, twice more today and to be out of the CPM flat on my back 2 more times today. Amy helped get me back in the CPM, reminding me NOT to use my left leg at all. She or someone else would need to lift my leg to guide it where it needed to go while I used my right leg to move my body. It is really hard to not use the leg at all!
My nurses and nurse aides continue to be phenomenal!! I am so pleased with the care. They really know what they are doing. Especially a nurse aide named Michele:) My mom is doing great today by the way.
The second time out of the CPM was not so great. Sue and Michele helped me out of it and I had a breakdown. They didn't do anything wrong but my leg just hurt soooo bad for some reason and I begged Sue "don't drop it, don't drop it!!" I started bawling and hiccuping and it was really awkward b/c everyone was standing around just staring at me, waiting for me to get it together. It really hurt, but was no ones fault. After I calmed down, it was all okay. I laid flat awhile and did my isometrics again. We just have to figure out a good moving pace.
Cierra (Todd's cousin) and her boyfriend stopped by later that night to see me. It was nice to see them again, although we all agreed we had to stop meeting in the hospital:)
My night staff was equally amazing, can't believe my good fortune in care I'm getting. I'm still only on ice chips as I have not passed any gas....getting really hungry now! My pain is still so minimal on the PCA and I can't even tell my right hip had a screw removal done to it. I remain in the CPM and SCD's for the night and sleep pretty peacefully. I do recall my poor little roomie being a bit hysterical at times too, from when the staff had to move her around as well:(
Post op day 2: December 2nd:
It's early in the morning again when the resident stops in to see me, still can't answer any surgical questions b/c he wasn't in there. He pulled my drain, and it didn't hurt at all. Dr. Z doesn't see me today.
Nursing staff, again, is incredible. They help me with whatever it is I need. Listened to my bowel sounds and although they're there, they're sluggish and I'm still not passing gas. Ugh! Still on ice chips. Still in minimal pain. Rumor is I may advance to a clear liquid diet anyway, so that makes me happy! My family stops in again around 8 or so. My mom and dad will be leaving today, later this afternoon, once they know I am comfortable getting up and walking.
Amy stops in about 10 am and says today is the big day. I'm getting up and walking! Yeah! But I'm kinda nervous too. She helps me get up, but has me move all on my own (provided she's handling my left leg) and although it wasn't as bad as yesterday, I still have a bit of a breakdown and cry. It's such a weird and awful feeling from where the muscles were detached and reattached and all that pulling and stretching on them isn't the best feeling. Amy is patient though and says "Take your time, I'm not going anywhere" She's a tough love PT, but it works. Dad has to leave the room because he can't stand seeing me hurt or crying. Standing up felt weird, I was shakey but not dizzy or light headed. Amy told me how to get the left leg going and even had to nudge it with her toe but once I got moving it felt great. It was awkward and my leg felt heavy. I had a difficult time not putting any weight on the leg and Amy said, think of a graham cracker under your foot, you don't want to crush it. I crutched down the hall and back and then sat in the chair to do the dreaded 500 exercises that Dr Z requires. (knee in and out and knee to chest). She also relays that the ace wrap is for swelling and it's something new he's trying to see if it helps. This is the moment I started to pass gas, whoo hoo! I get a regular diet tray and ate a chicken salad sandwich, pretzels, and an ice cream from ben and jerry's.
Todd and Sue leave to go to Trader Joe's and my parents go out to lunch. My friend Sheena visited me at this time because today is her pre-op for her PAO and she wanted to see how I was doing. It was a nice visit and I hope she came away feeling better about everything. I still have little pain, even after walking. The PCA has been discontinued and I am switched over to vicodin and my foley is taken out too. Now I have to get up to use the bathroom, boo! My parents left for home at this time and I was sad to see them go but so happy they were there.
About this time, early evening, I started to get really nauseated and feel like I might throw up. I got IV zofran, but it didn't seem to work, so my nurse gave me a Reiki treatment which was amazing!! It turned out I didn't throw up but I had 2 severe bouts of liquid diarrhea. It was awful. I don't eat again, I actually went back to just water and ice chips. I begin to sleep a lot too, to escape the nausea.
My nurses are super impressed with my pain tolerance as I have not been taking much vicodin and my pain, even with getting up and walking, is remaining any where from 1-3/10. I slept from 10 pm to 7 am and it felt great!
Post op day 3: December 3rd:
I saw the resident again, super early, and he says I am doing great overall but I may need to regress to a liquid diet seeing as what happened yesterday. Boo. Then Dr. Z came in and saw me. He says I can eat whatever I can tolerate (since I pooped yesterday) and that due to how my stomach was feeling I will go home tomorrow instead of today but could go home this evening after PT/OT if I feel good enough. He also explained that the whole leg feeling tingly might have been from the drain, since he punctured a big blood vessel when putting it in, but I tell him the feeling is gone now anyway. He gives me the best news that I can shower today after the dressing is removed by the resident, YAY! I asked him if the quad was detached and he told me it was and also reattached and that my coverage looks great, but to wait to see the xrays. He warned I may feel a bit more sore in the next 10 days but then should get better. No weight bearing but when I asked about a wheelchair for Disney World, he said I'd be getting around good by then, but he'll still write a script for one if I remind him at my follow up.
Nurses are awesome yet again:) I have some of the same nurses, which is nice, day after day. They know how to take care of me.
Todd and Sue get in around 8:30. Amy also arrives around this time and has me walk in the halls. It is a HUGE difference today in how I felt getting up. No tears! I am still at a 3/10 at the most for pain on vicodin alone. Still feeling nauseated though. Amy also had me do stairs, and although not bad, it was kind of scary. I felt unstable on them going down. But I passed her standards:) Amy helped me into my chair and then said "No offense, but I hope I never see you here again!" We said goodbye to each other and then OT came in to show me how to dress and use the toilet and take a shower. All a bit slow and awkward, but with time and practice it will get easier. Always, always pick up the bad leg for everything, don't let it move on it's own til Dr. Z gives the ok.
My Aunt Di and Uncle Gil came to visit me today and brought me flowers. It was so sweet to see them. They didn't stay long as they were only passing through the area, but it was lovely none the less.
I am still not eating, only ice chips as I have not passed gas again since my incident yesterday. I got up in the halls a few times and I guess I wasn't spacing out the vicodin very well, so I had to have IV dilaudid to help with breakthrough pain. Todd and Sue go to Trader Joes again and I get a well deserved nap! I am patiently waiting for my dressing to be removed so I can shower.
Resident comes in around 5 to take the dressing off and I can't believe how good everything looks. You can't even tell where Z took the screws out the incision is so small!! I have glue holdng my LPAO scar together and a bruise where the drain was. Shower time!! It was heavenly. I have never felt so nappy before and to be able to shower was the best. Todd had to help me and did great. Once showered I went back to bed with the CPM and started to feel super queasy again. My nurse offered Zofran but it didn' really work again this time. We opted to try another anti nausea med, phenergan. It knocked me out good!!! The nurses also kept me on a "round the clock" pain regimen with my vicodin and it seemed to help a lot.
Post op day 4: December 4th:
Today is discharge day! I got a new roommate late last night and she was my age and had her 2nd PAO done. We chatted a while and then I saw the resident and Dr. Z. Z says my numb spot should go away quickl because it is not really numb, which is awesome! Todd and Sue came in, and started to pack my things. The nurses came in to get me ready to go as well. I was feeling pretty miserable from nausea and exhaustion and just ready to go! We left around 11 am and getting into the jeep wasn't too bad. Sue had brought 2 king size pillows for me to use. 1 to sit on and 1 to wedge my leg so it wouldn't shake around with the bumpy roads. This seemed to work like a charm. The seat belt didn't even bother me as it didn't lay across the scar.
I will say that going commando with sweats is pretty comfortable, but the sweats should be pretty loose. At least a size larger than what you normally are.
We got to Grand Rapids to drop off Sue and pick up my prescriptions (which took FOREVER) so I napped for the 2 hours it took to fill the scripts. Todd also called the CPM company to deliver the CPM to Sue's house so they wouldn't have to make the trip up north. Once we had everything in order there, we took off for home. Pain is still tolerable but I just feel crappy. We got home about 5 pm and I was settled into the recliner. I slept awhile. But to be honest, I don't really remember the next few days because I would sleep to escape the nausea ALL the time. I think I was literally awake only 3 hours out of a 24 hour period. I couldn't eat and even drinking became a problem. From Saturday til Monday I became weaker and weaker, not passing hardly any gas and sleeping. I could hardly get up by myself. My hubby and family were becoming pretty concerned. Monday night, Sue brought Toby (my Boston terrier) up for my parents to take home with them and when my parents came over they brought with them a script of zofran from my sister in law. I took a dose, not really believing it would work but miraculously, it did. Within a few hours I was perking up and drinking! By Tuesday morning (Dec 7th) I had done a 180 and felt great! I drank several glasses of water and even had a baked potato for dinner, my first solid food since last week.
Now I feel much stronger and better and pain is still about a 3, sometimes 5/10. I remember that Z said the next 10 days could be worse in terms of pain, so I'm not too worried. I am passing gas more regularly now as I have gotten mirilax and colace on board and am moving more. I am staying awake most of the day now, with short cat naps only. The CPM is our only problem now. It's been replaced once already (quitting on me during the night) and now the replacement may need to be replaced because it clunks on extension and flexion and it just hurts my leg for some reason.
All in all, things now couldn't be going better! I still have a hard time believing I had a PAO for the little amount of pain I'm in. Yes, it hurts, but not to what I thought it would. I am most frustrated with not being able to use my leg at all. I am much more needy with this recovery than I was for my SDD. Todd is an angel though!!! I will have to give it a few more days to compare to how I feel with the PAO vs the SDD, although I can already say this is harder. I don't think I will be doing this for the right hip if it's needed...that's what I feel right now.
Todd and I got up early this morning and got everything ready to drop off at his mom's (the pups, who could tell something was brewing) and all their belongings. I was not feeling nervous, actually slept really well. It's amazing what your own bed and surroundings will do for you. We had a timeline to get to the hospital by 12:30 so we could get Todd, his mom, and my parents settled into their condos before I had to check into surgery at 1:30. We made it to Beaumont hospital at 1:00, so a little behind schedule but still able to get everyone settled into their condo units before heading over to the pre-sugery area. Was in pre-op by 1:30, by myself until the IV was started and the surgical history was taken by my RN. IV was absolutely painless and the nurse got it on one try! I told her I had a pretty bad headache (lack of caffeine and stress) and she got some versed on board for me...already the versed begins! She explained that my surgery was already going to be behind because there was still another surgery ahead of me yet. Thank goodness for versed....My family was allowed in and we all sat around and chatted, while being interrupted by various members of the OR team, the most important being anesthesia. The anesthesiologist did have a note that I was extremely anxious about pain upon waking up from surgery and looked at the prior surgical notes and saw that I was really only given pain meds in the beggining of surgery and not at the end. He assured me that I would be well loaded all throughout surgery and not to worry. He said the only drawback would be that I would take a lot longer to wake up. I was A-OK with that! Then Dr. Z came in. Being the ever humerous man that he is, he placed his hands on my legs and patting the right leg, said "PAO" and then the left leg, "screw removal" with a slight smile and gleam in his eyes. I fired right back at him with a smile, "No!" He laughed and said, "oh, your legs are crossed, I got confused". He did a last minute explanation for me and my family about the surgery, how long it should take and recovery. We were still waiting awhile by the time Z came to see me but he assured me that it wouldn't be long before I was next. My circulating nurse saw me right after and she said it was time to go. Then another dose of versed and I was off to surgery! It was a late surgery, about 5:30 or so before it began and it was supposed to go at 3:30 originally. But, being an OR nurse, I completely understand how those things go. I really don't remember much this time about the transfer to the OR or even getting on the bed. I do remember thinking that the amount of surgical instruments didn't seem all that much! It felt like they put me out before I got on the OR table, but I'm sure that's not true.
Recovery and transfer to my inpatient room:
Waking up in recovery was a much smoother process this time around. I was calm, my hip didn't really hurt per se, but it did feel horribly stiff and like it was full of lead. I don't actually know how long it took me to wake up and come around, but I was able to talk to the recovery nurses this time. I asked what time it was (8:30 pm) and how late they stayed open (11:30 pm). I don't know why I had to know that tid bit but it made me feel better. I did notice however that there was a very irritable man in recovery (my anesthestist who took over my case, I think???) who kept angrily yelling at everyone and also wasn't really very kind to me. Not to get into too many details, but he was pretty belligerent with the staff. It was making me a bit nervous.
I was aware for the most part during my awake time in recovery and remember being transferred from recovery (but not the ride itself) and then remember being placed into my room on the children's floor, The Wizard of Oz room. I did have a roommate, a 12 year old CP patient who had broken her leg that day. My transfer was uneventful and I was settled in nicely. I had a dilaudid PCA set up, but no basal rate this time. I can push the button every 6 minutes for meds. My family came in a little bit after that and I was more awake, able to smile, wave and say how I was doing. It's about 9:30 or so now. The staff are "A+" and I am confident they will do a great job with me. At this time my mom starts to complain of feeling hot and just "not right". Sue, my mother in law, is a nurse also and she noticed my mom fading. She told my dad, "let's get her into a chair" at which time I looked at her and saw she wasn't looking right either. I asked her if she was ok but she didn't answer, just had a blank stare at the ceiling and the proceded to pass out right as my dad and Sue got to her. Dad said she stopped breathing for a minute too. I was flat on my back, panicking, crying and begging Todd to get a nurse to help my mom. 3 nurses came rushing in and helped her, and she finally opened her eyes, wondering why everyone was in her face...!! She said she was dreaming right before she passed out but didn't know she had passed out. Vitals all checked out ok on her and she refused treatment. Must have been a vagal vasal reaction we're all thinking. My family stays until about 11 pm, when they know I've calmed down from the scare and mom is ok to get moving.
The CPM (continuous passive motion) machine arrives about 2 am along with the SCD's (sequential compression device). It feels good to have them on. Still loving my nurses:)
Post op day 1: December 1st:
Today is a "chill in bed" day per Dr. Z. I'm not going to be doing much of anything except resting. I saw Dr. Z and 2 residents (seperately) and neither of the residents were in on the surgery, so I couldn't ask them anything about how it went. Z says everything went great and I have 3 screws, can't wait to show me the xrays. I forgot to ask him questions though. It's so early in the morning that all I care about is sleeping!
Only on ice chips at this time (not even water) because I am not passing gas. Until I pass gas, I can't have anything else. I'm actually kind of hungry this time around, so I'm working on getting the gas out:)
My family came in about 8 am and settles in for a long day of visiting and watching me sleep. I feel bad that they were "stuck" there, but they did get up and go out to town a few times. I can't thank them enough for just being there.
Amy (PT) does come see me today (she amazingly remembers me from last year!!!) and shows me some isometric exercises I'm going to do while in bed. This means taking me out of the CPM...I am so comfortable though, I don't wanna move! But Amy is a pro and she removes the CPM and my leg with ease, doesn't even hurt, just a bit of stinging at what I assume to be my incision. I am wrapped in a huge ace bandage compression dressing from stomach all the way down to my left knee. She says this is pretty new and that Z has only just started doing this. She said she would give him a call today to find out his reasons on why he's wrapping his PAO patients now. The isometrics are simple: ankle pumps, butt squeezes and thigh squeezes. I can't get my left thigh to squeeze, but Amy says she can tell it's doing something as she places her hand on my leg. Okay! I notice my whole left leg, from hip to toes, has a weird tingly, pin prick feeling, but not numb. Amy says to mention to Z about that next time I see him. I try to feel for the famous numb patch that all PAOers seem to have, but I don't really feel it, just the tingly feeling. Good sign I hope!
I'm told the goal today is to do the isometric exercises 20 times, twice more today and to be out of the CPM flat on my back 2 more times today. Amy helped get me back in the CPM, reminding me NOT to use my left leg at all. She or someone else would need to lift my leg to guide it where it needed to go while I used my right leg to move my body. It is really hard to not use the leg at all!
My nurses and nurse aides continue to be phenomenal!! I am so pleased with the care. They really know what they are doing. Especially a nurse aide named Michele:) My mom is doing great today by the way.
The second time out of the CPM was not so great. Sue and Michele helped me out of it and I had a breakdown. They didn't do anything wrong but my leg just hurt soooo bad for some reason and I begged Sue "don't drop it, don't drop it!!" I started bawling and hiccuping and it was really awkward b/c everyone was standing around just staring at me, waiting for me to get it together. It really hurt, but was no ones fault. After I calmed down, it was all okay. I laid flat awhile and did my isometrics again. We just have to figure out a good moving pace.
Cierra (Todd's cousin) and her boyfriend stopped by later that night to see me. It was nice to see them again, although we all agreed we had to stop meeting in the hospital:)
My night staff was equally amazing, can't believe my good fortune in care I'm getting. I'm still only on ice chips as I have not passed any gas....getting really hungry now! My pain is still so minimal on the PCA and I can't even tell my right hip had a screw removal done to it. I remain in the CPM and SCD's for the night and sleep pretty peacefully. I do recall my poor little roomie being a bit hysterical at times too, from when the staff had to move her around as well:(
Post op day 2: December 2nd:
It's early in the morning again when the resident stops in to see me, still can't answer any surgical questions b/c he wasn't in there. He pulled my drain, and it didn't hurt at all. Dr. Z doesn't see me today.
Nursing staff, again, is incredible. They help me with whatever it is I need. Listened to my bowel sounds and although they're there, they're sluggish and I'm still not passing gas. Ugh! Still on ice chips. Still in minimal pain. Rumor is I may advance to a clear liquid diet anyway, so that makes me happy! My family stops in again around 8 or so. My mom and dad will be leaving today, later this afternoon, once they know I am comfortable getting up and walking.
Amy stops in about 10 am and says today is the big day. I'm getting up and walking! Yeah! But I'm kinda nervous too. She helps me get up, but has me move all on my own (provided she's handling my left leg) and although it wasn't as bad as yesterday, I still have a bit of a breakdown and cry. It's such a weird and awful feeling from where the muscles were detached and reattached and all that pulling and stretching on them isn't the best feeling. Amy is patient though and says "Take your time, I'm not going anywhere" She's a tough love PT, but it works. Dad has to leave the room because he can't stand seeing me hurt or crying. Standing up felt weird, I was shakey but not dizzy or light headed. Amy told me how to get the left leg going and even had to nudge it with her toe but once I got moving it felt great. It was awkward and my leg felt heavy. I had a difficult time not putting any weight on the leg and Amy said, think of a graham cracker under your foot, you don't want to crush it. I crutched down the hall and back and then sat in the chair to do the dreaded 500 exercises that Dr Z requires. (knee in and out and knee to chest). She also relays that the ace wrap is for swelling and it's something new he's trying to see if it helps. This is the moment I started to pass gas, whoo hoo! I get a regular diet tray and ate a chicken salad sandwich, pretzels, and an ice cream from ben and jerry's.
Todd and Sue leave to go to Trader Joe's and my parents go out to lunch. My friend Sheena visited me at this time because today is her pre-op for her PAO and she wanted to see how I was doing. It was a nice visit and I hope she came away feeling better about everything. I still have little pain, even after walking. The PCA has been discontinued and I am switched over to vicodin and my foley is taken out too. Now I have to get up to use the bathroom, boo! My parents left for home at this time and I was sad to see them go but so happy they were there.
About this time, early evening, I started to get really nauseated and feel like I might throw up. I got IV zofran, but it didn't seem to work, so my nurse gave me a Reiki treatment which was amazing!! It turned out I didn't throw up but I had 2 severe bouts of liquid diarrhea. It was awful. I don't eat again, I actually went back to just water and ice chips. I begin to sleep a lot too, to escape the nausea.
My nurses are super impressed with my pain tolerance as I have not been taking much vicodin and my pain, even with getting up and walking, is remaining any where from 1-3/10. I slept from 10 pm to 7 am and it felt great!
Post op day 3: December 3rd:
I saw the resident again, super early, and he says I am doing great overall but I may need to regress to a liquid diet seeing as what happened yesterday. Boo. Then Dr. Z came in and saw me. He says I can eat whatever I can tolerate (since I pooped yesterday) and that due to how my stomach was feeling I will go home tomorrow instead of today but could go home this evening after PT/OT if I feel good enough. He also explained that the whole leg feeling tingly might have been from the drain, since he punctured a big blood vessel when putting it in, but I tell him the feeling is gone now anyway. He gives me the best news that I can shower today after the dressing is removed by the resident, YAY! I asked him if the quad was detached and he told me it was and also reattached and that my coverage looks great, but to wait to see the xrays. He warned I may feel a bit more sore in the next 10 days but then should get better. No weight bearing but when I asked about a wheelchair for Disney World, he said I'd be getting around good by then, but he'll still write a script for one if I remind him at my follow up.
Nurses are awesome yet again:) I have some of the same nurses, which is nice, day after day. They know how to take care of me.
Todd and Sue get in around 8:30. Amy also arrives around this time and has me walk in the halls. It is a HUGE difference today in how I felt getting up. No tears! I am still at a 3/10 at the most for pain on vicodin alone. Still feeling nauseated though. Amy also had me do stairs, and although not bad, it was kind of scary. I felt unstable on them going down. But I passed her standards:) Amy helped me into my chair and then said "No offense, but I hope I never see you here again!" We said goodbye to each other and then OT came in to show me how to dress and use the toilet and take a shower. All a bit slow and awkward, but with time and practice it will get easier. Always, always pick up the bad leg for everything, don't let it move on it's own til Dr. Z gives the ok.
My Aunt Di and Uncle Gil came to visit me today and brought me flowers. It was so sweet to see them. They didn't stay long as they were only passing through the area, but it was lovely none the less.
I am still not eating, only ice chips as I have not passed gas again since my incident yesterday. I got up in the halls a few times and I guess I wasn't spacing out the vicodin very well, so I had to have IV dilaudid to help with breakthrough pain. Todd and Sue go to Trader Joes again and I get a well deserved nap! I am patiently waiting for my dressing to be removed so I can shower.
Resident comes in around 5 to take the dressing off and I can't believe how good everything looks. You can't even tell where Z took the screws out the incision is so small!! I have glue holdng my LPAO scar together and a bruise where the drain was. Shower time!! It was heavenly. I have never felt so nappy before and to be able to shower was the best. Todd had to help me and did great. Once showered I went back to bed with the CPM and started to feel super queasy again. My nurse offered Zofran but it didn' really work again this time. We opted to try another anti nausea med, phenergan. It knocked me out good!!! The nurses also kept me on a "round the clock" pain regimen with my vicodin and it seemed to help a lot.
Post op day 4: December 4th:
Today is discharge day! I got a new roommate late last night and she was my age and had her 2nd PAO done. We chatted a while and then I saw the resident and Dr. Z. Z says my numb spot should go away quickl because it is not really numb, which is awesome! Todd and Sue came in, and started to pack my things. The nurses came in to get me ready to go as well. I was feeling pretty miserable from nausea and exhaustion and just ready to go! We left around 11 am and getting into the jeep wasn't too bad. Sue had brought 2 king size pillows for me to use. 1 to sit on and 1 to wedge my leg so it wouldn't shake around with the bumpy roads. This seemed to work like a charm. The seat belt didn't even bother me as it didn't lay across the scar.
I will say that going commando with sweats is pretty comfortable, but the sweats should be pretty loose. At least a size larger than what you normally are.
We got to Grand Rapids to drop off Sue and pick up my prescriptions (which took FOREVER) so I napped for the 2 hours it took to fill the scripts. Todd also called the CPM company to deliver the CPM to Sue's house so they wouldn't have to make the trip up north. Once we had everything in order there, we took off for home. Pain is still tolerable but I just feel crappy. We got home about 5 pm and I was settled into the recliner. I slept awhile. But to be honest, I don't really remember the next few days because I would sleep to escape the nausea ALL the time. I think I was literally awake only 3 hours out of a 24 hour period. I couldn't eat and even drinking became a problem. From Saturday til Monday I became weaker and weaker, not passing hardly any gas and sleeping. I could hardly get up by myself. My hubby and family were becoming pretty concerned. Monday night, Sue brought Toby (my Boston terrier) up for my parents to take home with them and when my parents came over they brought with them a script of zofran from my sister in law. I took a dose, not really believing it would work but miraculously, it did. Within a few hours I was perking up and drinking! By Tuesday morning (Dec 7th) I had done a 180 and felt great! I drank several glasses of water and even had a baked potato for dinner, my first solid food since last week.
Now I feel much stronger and better and pain is still about a 3, sometimes 5/10. I remember that Z said the next 10 days could be worse in terms of pain, so I'm not too worried. I am passing gas more regularly now as I have gotten mirilax and colace on board and am moving more. I am staying awake most of the day now, with short cat naps only. The CPM is our only problem now. It's been replaced once already (quitting on me during the night) and now the replacement may need to be replaced because it clunks on extension and flexion and it just hurts my leg for some reason.
All in all, things now couldn't be going better! I still have a hard time believing I had a PAO for the little amount of pain I'm in. Yes, it hurts, but not to what I thought it would. I am most frustrated with not being able to use my leg at all. I am much more needy with this recovery than I was for my SDD. Todd is an angel though!!! I will have to give it a few more days to compare to how I feel with the PAO vs the SDD, although I can already say this is harder. I don't think I will be doing this for the right hip if it's needed...that's what I feel right now.
Thursday, December 2, 2010
PAO done!
I made it thru the PAO pretty well, even with a general only. The anesthesia team took into account what happened last year and made sure to distribute more pain drugs throughtout surgery vs just at the beginning. I made a huge difference.
I have only been in bed using the cpm and eating ice chips since Tuesday. It's now Thursday and I'm supposed to be getting up with PT. Should be interesting.
I'll post more later when I'm more awake and coherent:)
I have only been in bed using the cpm and eating ice chips since Tuesday. It's now Thursday and I'm supposed to be getting up with PT. Should be interesting.
I'll post more later when I'm more awake and coherent:)
Thursday, November 18, 2010
PAO pre-op
MRI-arthrogram #5 did not go so well today. It was pretty painful/uncomfortable compared to the others. And the video goggles were no longer available when I went into the MRI machine. I do think that I can safely say that I will not have to endure another one of those again though!
My pre-op, however, went well. Dr. Z was absolutely wonderful, per his usual self! He met my mother in law (who will be with my hubby and me at the hospital for surgery) and chatted a few moments with her about me and nothing in particular:) He then noticed the t-shirt I was wearing and inquired about it. My t-shirt is the one that was made during my Hippy Union in Chicago and it says "screw-it". It's a Nike shirt and instead of "just do it" we came up with "screw-it"...he got the inside meaning right away and thought it was really great that a bunch of us got together from around the country.
He checked my range of motion in both hips and then felt for the screws on the right hip again and yup, they still hurt! A lot. They are scheduled to come out after the PAO is done. He also explained everything that would happen during the surgery and what to expect afterward.
He and I had a bit of a pow wow regarding pain management since he explained that he doesn't do epidurals for his PAO's anymore. I am really nervous about not having proper pain management after I wake up and I told him this. He said he wants me to be happy, so he will discuss this with anesthesia and see what we can come up with while trying to avoid an epidural altogether. He suggested a caudal block, so I will still have the area numbed, just shorter term and without as much risk as a spinal poses. The reasons he has against epidurals is this: causes prolonged hospital stay, may cause increased bleeding which increases the chance of needing a blood transfusion, they don't always numb everything all the way or the right area, and a patient is unable to start therapy as soon as without an epidural. I am willing to forego the epidural as long as we can come up with a pain block that won't delay recovery. I really need to pray about this since he wants me to strongly consider a general only but will not force me into only a general.
Details of the surgery and hospital stay/recovery:
surgery takes about 2-2.5 hours
I do not need a scope
I do need a femoral osteochondroplasty (reshaping the femoral head and head/neck junction)
I will have 3-4 screws
he may not need to detach the quad muscle, he'll know more when he gets in there. (not sure what determines this....)
MUCH more invasive surgery than SDD
1st day post op I'll just chill in bed, maybe learn some isometric exercises, use CPM
2nd day post op PT will get me out of bed, teach me to use the crutches. This is the day I will wean off of the PCA and start using oral pain meds.
3rd day post op I will continue crutch walking and try stairs. This is the day all drains (hemovac, foley, IV) are removed if they haven't already been on day 2. There is a small chance I could go home this day.
4th day post op I continue with therapy, crutch walking, stairs, etc. Probably go home this day.
5th day post op is possible if pain or bowels are an issue.
I have an ob-gyn yearly physical in early January (have to be in stirrups...) and he feels this should not be an issue.
recommends AT LEAST 3 months off work, possibly 4 for my line of work (nurse).
total recovery time is 6 months to one year.
He explained that he is the only one who does any of the work during surgery and that he talks to the residents to explain the procedure and why he does things the way he does them during the procedure. I really like this about Dr. Z. He said that his PAO pt's tend to recover quicker and are discharged quicker than those of his colleagues (epidurals have a big part in this) and his incision is typically different than most other PAO surgeons. He also discussed the femoral cutaneous nerve being affected during surgery which almost always causes a numb spot on the front of the thigh but eventually may go away over time or it'll be something that will not be so noticable anymore after a few months since most of his patients have told him they don't tend to notice it after a while.
My mother in law asked Z about pregnancy after the PAO and how it would affect the hips, whether it was wise to wait a certain amount of time before getting pregnant (6 months for those who are curious) and he answered that it would depend on how the right hip reacts as he is concerned about the fact that it is still shallow and may need a PAO as well. I am a little surprised to hear this since he had not really mentioned this before, however I do recall the surgeon that did my hip scope saying that the right hip may still need a PAO. I am a bit disappointed by this. I thought that I would be out of the woods once the LPAO was done. I still plan to try for a family once the left hip is healed and see where the road takes us from there. Maybe in a few years the right will have to be done but I don't want to wait any longer than necessary for my family to begin.
Towards the end of the appt my surgery time was brought up and I learned that I am the last surgery of the day....which is good and bad. Good because I don't have to be in Detroit until 2 pm so no hotel stay which saves us money and I can sleep in my own bed and environment but bad because that's a long day of waiting, nerves, and no drinking or eating. I am the oldest patient having surgery that day as they go by chronological order of age. As it was so nicely put, I said "I must be the 'old fart'" and to which Z replied, "you are that day!".
My pre-op, however, went well. Dr. Z was absolutely wonderful, per his usual self! He met my mother in law (who will be with my hubby and me at the hospital for surgery) and chatted a few moments with her about me and nothing in particular:) He then noticed the t-shirt I was wearing and inquired about it. My t-shirt is the one that was made during my Hippy Union in Chicago and it says "screw-it". It's a Nike shirt and instead of "just do it" we came up with "screw-it"...he got the inside meaning right away and thought it was really great that a bunch of us got together from around the country.
He checked my range of motion in both hips and then felt for the screws on the right hip again and yup, they still hurt! A lot. They are scheduled to come out after the PAO is done. He also explained everything that would happen during the surgery and what to expect afterward.
He and I had a bit of a pow wow regarding pain management since he explained that he doesn't do epidurals for his PAO's anymore. I am really nervous about not having proper pain management after I wake up and I told him this. He said he wants me to be happy, so he will discuss this with anesthesia and see what we can come up with while trying to avoid an epidural altogether. He suggested a caudal block, so I will still have the area numbed, just shorter term and without as much risk as a spinal poses. The reasons he has against epidurals is this: causes prolonged hospital stay, may cause increased bleeding which increases the chance of needing a blood transfusion, they don't always numb everything all the way or the right area, and a patient is unable to start therapy as soon as without an epidural. I am willing to forego the epidural as long as we can come up with a pain block that won't delay recovery. I really need to pray about this since he wants me to strongly consider a general only but will not force me into only a general.
Details of the surgery and hospital stay/recovery:
surgery takes about 2-2.5 hours
I do not need a scope
I do need a femoral osteochondroplasty (reshaping the femoral head and head/neck junction)
I will have 3-4 screws
he may not need to detach the quad muscle, he'll know more when he gets in there. (not sure what determines this....)
MUCH more invasive surgery than SDD
1st day post op I'll just chill in bed, maybe learn some isometric exercises, use CPM
2nd day post op PT will get me out of bed, teach me to use the crutches. This is the day I will wean off of the PCA and start using oral pain meds.
3rd day post op I will continue crutch walking and try stairs. This is the day all drains (hemovac, foley, IV) are removed if they haven't already been on day 2. There is a small chance I could go home this day.
4th day post op I continue with therapy, crutch walking, stairs, etc. Probably go home this day.
5th day post op is possible if pain or bowels are an issue.
I have an ob-gyn yearly physical in early January (have to be in stirrups...) and he feels this should not be an issue.
recommends AT LEAST 3 months off work, possibly 4 for my line of work (nurse).
total recovery time is 6 months to one year.
He explained that he is the only one who does any of the work during surgery and that he talks to the residents to explain the procedure and why he does things the way he does them during the procedure. I really like this about Dr. Z. He said that his PAO pt's tend to recover quicker and are discharged quicker than those of his colleagues (epidurals have a big part in this) and his incision is typically different than most other PAO surgeons. He also discussed the femoral cutaneous nerve being affected during surgery which almost always causes a numb spot on the front of the thigh but eventually may go away over time or it'll be something that will not be so noticable anymore after a few months since most of his patients have told him they don't tend to notice it after a while.
My mother in law asked Z about pregnancy after the PAO and how it would affect the hips, whether it was wise to wait a certain amount of time before getting pregnant (6 months for those who are curious) and he answered that it would depend on how the right hip reacts as he is concerned about the fact that it is still shallow and may need a PAO as well. I am a little surprised to hear this since he had not really mentioned this before, however I do recall the surgeon that did my hip scope saying that the right hip may still need a PAO. I am a bit disappointed by this. I thought that I would be out of the woods once the LPAO was done. I still plan to try for a family once the left hip is healed and see where the road takes us from there. Maybe in a few years the right will have to be done but I don't want to wait any longer than necessary for my family to begin.
Towards the end of the appt my surgery time was brought up and I learned that I am the last surgery of the day....which is good and bad. Good because I don't have to be in Detroit until 2 pm so no hotel stay which saves us money and I can sleep in my own bed and environment but bad because that's a long day of waiting, nerves, and no drinking or eating. I am the oldest patient having surgery that day as they go by chronological order of age. As it was so nicely put, I said "I must be the 'old fart'" and to which Z replied, "you are that day!".
Saturday, November 6, 2010
These are good things!
The following is from one year ago:
So, to document what my right hip is feeling like just before surgery (so I have it to compare to for after):
-Creepy clicking/shifting in joint from front to back of hip with walking.
-sharp, pulsing pain in groin/anterior portion of hip that comes and goes in waves.
-dull persistent ache in hip from groin to lateral hip at night while trying to sleep.
-sharp, catching pain with internal rotation whether intentional or not. Stops me in my tracks.
-S.I. Joint pain that is very tight and sharp feeling.
-pain that shoots down my leg from pelvis to knee anteriorly.
-unable to bend leg past 90 degrees without forcing it by hand, if past 90 degrees, very deep pain in hip (this includes when bent down to pick something up).
-cannot put all my weight on my right hip or deep inside the joint it feels like it is going to break or collapse in on itself from pain.
The above list was from a year ago when I was making points to remember what my right hip felt like before the SDD surgery so I could remember and then reflect how I feel a year later. I have to report that only 2 or 3 of the symptoms on the list still exist and not as bad as they used to be! I still get a catching feeling and the SI joint still acts up and I still occasionaly get the dull, aching pain inside the joint. Otherwise, just screw and muscular pain is all I have left and that makes me a very happy person. No more clicking, no more feeling like the joint will collapse in on itself when I stand on it alone, I can bend it past 90 degrees now without forcing it and without pain. Overall, it is a better hip. I suppose I should make a list for lefty. It never did have as many symptoms as the right hip which is why we went ahead with the right hip first. So here we go....
Left hip symptoms pre-surgery:
- lateral thigh pain/aches (probably bursitis related)
- popping of the joint (50/50 being painful vs non painful)
- sharp giving out pains, joint won't support me when it does this. Happens a couple times a month.
- joint feels achey deep inside across from groin to thigh whenever I stand for long periods of time or walk for more than a mile.
- feels "out of place" or loose most of the time, not neccesarily painful, just uncomfortable/weird.
- has been experiencing some clicking and grinding in the last few months.
- sex is awkward and uncomfortable most times b/c I am trying to find a good position where my hip doesn't feel like it's going to "pop out".
That's about it in a nutshell. So most of the symptoms are just annoying vs painful. Even though my left hip is structurally worse and much more unstable than my right, the right hip was so much more painful. I guess I will reflect on this list in a year....or maybe I will be too busy finally having a life that it will become but a memory!
So, to document what my right hip is feeling like just before surgery (so I have it to compare to for after):
-Creepy clicking/shifting in joint from front to back of hip with walking.
-sharp, pulsing pain in groin/anterior portion of hip that comes and goes in waves.
-dull persistent ache in hip from groin to lateral hip at night while trying to sleep.
-sharp, catching pain with internal rotation whether intentional or not. Stops me in my tracks.
-S.I. Joint pain that is very tight and sharp feeling.
-pain that shoots down my leg from pelvis to knee anteriorly.
-unable to bend leg past 90 degrees without forcing it by hand, if past 90 degrees, very deep pain in hip (this includes when bent down to pick something up).
-cannot put all my weight on my right hip or deep inside the joint it feels like it is going to break or collapse in on itself from pain.
The above list was from a year ago when I was making points to remember what my right hip felt like before the SDD surgery so I could remember and then reflect how I feel a year later. I have to report that only 2 or 3 of the symptoms on the list still exist and not as bad as they used to be! I still get a catching feeling and the SI joint still acts up and I still occasionaly get the dull, aching pain inside the joint. Otherwise, just screw and muscular pain is all I have left and that makes me a very happy person. No more clicking, no more feeling like the joint will collapse in on itself when I stand on it alone, I can bend it past 90 degrees now without forcing it and without pain. Overall, it is a better hip. I suppose I should make a list for lefty. It never did have as many symptoms as the right hip which is why we went ahead with the right hip first. So here we go....
Left hip symptoms pre-surgery:
- lateral thigh pain/aches (probably bursitis related)
- popping of the joint (50/50 being painful vs non painful)
- sharp giving out pains, joint won't support me when it does this. Happens a couple times a month.
- joint feels achey deep inside across from groin to thigh whenever I stand for long periods of time or walk for more than a mile.
- feels "out of place" or loose most of the time, not neccesarily painful, just uncomfortable/weird.
- has been experiencing some clicking and grinding in the last few months.
- sex is awkward and uncomfortable most times b/c I am trying to find a good position where my hip doesn't feel like it's going to "pop out".
That's about it in a nutshell. So most of the symptoms are just annoying vs painful. Even though my left hip is structurally worse and much more unstable than my right, the right hip was so much more painful. I guess I will reflect on this list in a year....or maybe I will be too busy finally having a life that it will become but a memory!
Wednesday, October 6, 2010
Miserable screws
If I could chop my right leg off right now, I would gladly do it. My screws have become a miserable malady and have become increasingly more painful over the last few weeks. It has gotten to the point where either I wake up at night and can't get back to sleep for a couple hours or the pain is bad enough to make me take a vicodin during the day (while not at work). I was going to let this new development be, since I knew surgery was on the horizon and I didn't want to bother Dr. Z about this, as we both knew they were a nuisance. Well, they are beyond the nuisance stage and I succumbed to relaying my misery to his nurse, which then she relayed to him. The next day I received a phone call from Z himself, wondering if we shouldn't take the screws out now, and then do the LPAO in November as planned. While this sounds like a great idea, we both agreed that doing 2 surgeries close together (having to go under anesthesia twice so close together) would not be the best of ideas. So, the screw removal is still in conjunction with the PAO. I just wish the next 7 weeks would fast forward themselves. My quality of sleep has gone from a 6/10 to about 4.5/10.
For those who are wondering what the screw pain is like, it's like this:
The area of the greater trochanter is extremely sore all the time and when it is touched or bumped it is extremely painful, enough to make me see stars. The muscles feel like they are stretched way to tight over my outer thigh. Sometimes I feel a popping over the trochanter and I wouldn't say the popping really hurts but it's very uncomfortable/gross.
The pain will start to throb at the trochanter and pulse it's way down the outer portion of my thigh, into my entire knee joint and down my outer calf and into my entire ankle joint. It is a dull but very intense ache that just doesn't go away. It happens when I accidentally lay on my right side (sleeping) or from standing for long periods (kind of hard to avoid at work).
I'm keeping my fingers crossed that the screw removal will be the answer to all this pain that has gradually but suddenly come on!
For those who are wondering what the screw pain is like, it's like this:
The area of the greater trochanter is extremely sore all the time and when it is touched or bumped it is extremely painful, enough to make me see stars. The muscles feel like they are stretched way to tight over my outer thigh. Sometimes I feel a popping over the trochanter and I wouldn't say the popping really hurts but it's very uncomfortable/gross.
The pain will start to throb at the trochanter and pulse it's way down the outer portion of my thigh, into my entire knee joint and down my outer calf and into my entire ankle joint. It is a dull but very intense ache that just doesn't go away. It happens when I accidentally lay on my right side (sleeping) or from standing for long periods (kind of hard to avoid at work).
I'm keeping my fingers crossed that the screw removal will be the answer to all this pain that has gradually but suddenly come on!
Thursday, July 29, 2010
123 days and counting....
I had my appointment with the good doctor today and I feel like I'm repeating history...first off we talked about my post op hip, that had gone through the surgical dislocation. I told Z that the screws really bother me and he smiled and stated "I bet they do". I asked if they could come out and he said "of course". Wonderful! Then he proceded to palpate my right hip around the area of the greater trochanter where the screws are located and I about jumped off the exam table. "That's where the screws are" he says. Thanks, no doubt! He also performed more range of motion on my right hip and it is mostly pain free, which was a big change from last time. Last time the internal rotation and flexion was still as painful as pre-op and I was so disappointed. Today, it was hardly there. I mostly have muscular pain now and we'll continue to watch the hip as the years go on. Then we talked about the left hip. Z went over the issues with the hip and how unstable it is. He worked it through the same range of motion and I have pain with different movements on that hip, but it's different structural issues too. I have since been having new pain issues in the left hip that I described to him, something like a peeling or ripping and popping like bubble wrap in the front of the hip. He thinks I've torn the cartilage now and wants an MRI-arthrogram......again......I asked why the one from last summer wouldn't be adequate for him and he stated that since it's been a year and new symptoms have shown up, he wants a more recent scan to help him decide the best course of action during surgery. He knows for sure the PAO, but has to see if he needs to do the scope along with the PAO. The scope would be done to address the inside of the joint to clean up any labral or cartilage issues. If he does not have to do the scope, which he would prefer due to scopes destabilize joints, then he feels we'd be better off. That's why he wants a new MRI-arthrogram. If the arthrogram shows no tear, then it sounds like no scope. But if there is a tear, then a scope would be advisable, at least that's what I think I got out of the appointment.
I also asked him about my knees turning in so much and if the PAO would address that issue. He asked me to get up and walk down the hall for him. I returned from my walk with his opinion of pretty severe anteversion, but also that he thinks I'm consciously turning my knees in to help deepen the femur into the sockets and make the legs more stable when I walk. He does not advocate doing femoral osteotomies simply because the pelvic osteotomies are very successful with alignment issues. He also said that once you cut the femur and "untwist" it, then you also need to cut the tibia to get it facing in the correct position since my feet would be turned way out to the outside if we did the femoral osteotomy. So he doesn't want to create several surgeries for me if we don't need to. Seeing as he's been pretty spot on with the right hip as yet, I'm willing to go with his view on everything.
I'm not too thrilled about going back for another MRI-arthrogram. It's scheduled for Nov 15, 2 weeks before my surgery, which is the day of my pre-op appointment with Z. I would be happy if I never saw the inside of an MRI machine again, truth be told! This will be my 5th one in 1.5 years. That's 4 too many in my opinion. Overall, the appointment went well. Z warned me that the PAO would be much much harder than the SDD. He said I got away with "the easy surgery" first and not to underestimate the PAO....uggg. I tuned him out shortly after that. I remember this talk from last time but it never sounds good. I got bits and pieces of I really need to make sure I have at least 3 months off work and weight bearing issues were totally different than the SDD. I don't know what else he said beyond that. I am not going to think about how bad it might be. Waking up from the SDD was bad enough! Possibly the worst/most painful moment ever in my! He said we would add the screw removal for the right hip right after the LPAO was done, that it would only take a few extra minutes to do. I'm so happy those things are coming out!
Once my appointment was done I headed over to Beaumont Hospital to visit with H and my brother. She had her SDD done on Tuesday, the 27th and will be going home tomorrow. She seems to be doing pretty well. She was on the pediatric floor so I got a chance to see it finally. It's pretty cute, all decked out with Disney themed rooms and brightly colored walls and decorations. Much more cheerful than the 9th floor where I was:) My brother jokingly warned the nurses that I would be seeing them in a few short months for my next surgery. The nurses were pretty amused and thought it was strange/coincidental how both H and I ended up with major hip problems and not even related. I still try to wrap my head around that!
To end the day, I met up with Niece and her daughter for lunch before I headed back home. It was really nice to see Niece again and her daughter is just the cutest thing! She's a really good girl. Niece and I got a chance to catch up a little and just talk all things hips and otherwise. Then it was back on the road for my 3.5 hour drive home. Bleh. My hips don't like sitting that long, so I always have to stop along the way and get out and move. I can't wait for the day I don't have to consider my hips all the time.
Chicago/Indy Hippie Union is fast approaching and I'm very much looking forward to picking Krystal up at the airport and heading on to Chi-town. It's just a little under 2 weeks away now!
I also asked him about my knees turning in so much and if the PAO would address that issue. He asked me to get up and walk down the hall for him. I returned from my walk with his opinion of pretty severe anteversion, but also that he thinks I'm consciously turning my knees in to help deepen the femur into the sockets and make the legs more stable when I walk. He does not advocate doing femoral osteotomies simply because the pelvic osteotomies are very successful with alignment issues. He also said that once you cut the femur and "untwist" it, then you also need to cut the tibia to get it facing in the correct position since my feet would be turned way out to the outside if we did the femoral osteotomy. So he doesn't want to create several surgeries for me if we don't need to. Seeing as he's been pretty spot on with the right hip as yet, I'm willing to go with his view on everything.
I'm not too thrilled about going back for another MRI-arthrogram. It's scheduled for Nov 15, 2 weeks before my surgery, which is the day of my pre-op appointment with Z. I would be happy if I never saw the inside of an MRI machine again, truth be told! This will be my 5th one in 1.5 years. That's 4 too many in my opinion. Overall, the appointment went well. Z warned me that the PAO would be much much harder than the SDD. He said I got away with "the easy surgery" first and not to underestimate the PAO....uggg. I tuned him out shortly after that. I remember this talk from last time but it never sounds good. I got bits and pieces of I really need to make sure I have at least 3 months off work and weight bearing issues were totally different than the SDD. I don't know what else he said beyond that. I am not going to think about how bad it might be. Waking up from the SDD was bad enough! Possibly the worst/most painful moment ever in my! He said we would add the screw removal for the right hip right after the LPAO was done, that it would only take a few extra minutes to do. I'm so happy those things are coming out!
Once my appointment was done I headed over to Beaumont Hospital to visit with H and my brother. She had her SDD done on Tuesday, the 27th and will be going home tomorrow. She seems to be doing pretty well. She was on the pediatric floor so I got a chance to see it finally. It's pretty cute, all decked out with Disney themed rooms and brightly colored walls and decorations. Much more cheerful than the 9th floor where I was:) My brother jokingly warned the nurses that I would be seeing them in a few short months for my next surgery. The nurses were pretty amused and thought it was strange/coincidental how both H and I ended up with major hip problems and not even related. I still try to wrap my head around that!
To end the day, I met up with Niece and her daughter for lunch before I headed back home. It was really nice to see Niece again and her daughter is just the cutest thing! She's a really good girl. Niece and I got a chance to catch up a little and just talk all things hips and otherwise. Then it was back on the road for my 3.5 hour drive home. Bleh. My hips don't like sitting that long, so I always have to stop along the way and get out and move. I can't wait for the day I don't have to consider my hips all the time.
Chicago/Indy Hippie Union is fast approaching and I'm very much looking forward to picking Krystal up at the airport and heading on to Chi-town. It's just a little under 2 weeks away now!
Friday, April 23, 2010
Spring Renewal!
I am just over 4.5 months post op on the right hip and I am happy to report that the catching is gone...that's correct, gone. Over the last month or so since I've posted, I've been doing my PT home exercises faithfully and I have been using my treadclimber 3-4 times a week after work for 20 minutes at a good hard pace. Well, about 2.5 weeks ago while I was on the treadclimber, my hip had that catching feeling (again) and I externally rotated it to see if I could unstick it and there was a pretty nasty pop and pain but after that the hip felt really good and has no longer been catching with any exercise or movement! In fact, all I really feel now is a chronic pulled muscle feeling along the side of my hip and in my butt. I am very happy with this! I *think* there was scar tissue that built up in the joint and I finally just unstuck the last of it. Let's hope that it's permanant.
I still occasionally get sore at work or have slight swelling. The trochanter is still painful when I lay down on my right side and I'm not sure it's going to get any better...we'll see. It almost feels like a deep ache that spreads from my trochanter throughout the rest of my thigh. Time to get a new mattress!
Well, here's the really interesting thing about my incision. The incision itself looks great. But remember me mentioning there is a round pocket of swelling/squishiness near it at the bottom of it that has not changed since surgery? Well, a fellow hip chick had mentioned in her blog having the same issue and when she saw her OS for a follow up, he told her it was a fat hernia. I spoke with a general surgeon I work with today and showed her mine and she confirmed that mine is most likely a fat hernia as well and that a plastics consult would be the way to go if it bothers me. She also mentioned giving it a full year to let the "remodeling"/healing finish before taking any action against it. Now, I know you're all jealous about my herniated fat, but let me tell ya, it's not so cool walking around in a bikini with a fat hernia sticking out of your thigh....just sayin'. Plastics consult, here I come! (I shall update on that when the time comes...however, it'll be awhile before I go down that road as I will probably wait until after the LPAO).
In other news, I am walking in a 5k in 2 weeks! I tried to train to run for the 5k, but the hip just wasn't quite ready to run and I'm not sure my left hip or my knees would do so well anyway. But I'm excited to say that I can walk that now without too much difficulty. Also, there is only 5 more weeks until my trip to Austria! I plan to do lots of walking then too, so this 5k will be just the beginning:) Spring has sprung here in Michigan (actually has been for the last month, totally unusual!) and I am looking forward to summer very much, which is a big change in heart from a month ago. I wasn't really sure how I felt about summer since my hip wasn't feeling the best, but now that I've turned a corner and seem to have made such major progress with it, I'm very excited for summer.
I still occasionally get sore at work or have slight swelling. The trochanter is still painful when I lay down on my right side and I'm not sure it's going to get any better...we'll see. It almost feels like a deep ache that spreads from my trochanter throughout the rest of my thigh. Time to get a new mattress!
Well, here's the really interesting thing about my incision. The incision itself looks great. But remember me mentioning there is a round pocket of swelling/squishiness near it at the bottom of it that has not changed since surgery? Well, a fellow hip chick had mentioned in her blog having the same issue and when she saw her OS for a follow up, he told her it was a fat hernia. I spoke with a general surgeon I work with today and showed her mine and she confirmed that mine is most likely a fat hernia as well and that a plastics consult would be the way to go if it bothers me. She also mentioned giving it a full year to let the "remodeling"/healing finish before taking any action against it. Now, I know you're all jealous about my herniated fat, but let me tell ya, it's not so cool walking around in a bikini with a fat hernia sticking out of your thigh....just sayin'. Plastics consult, here I come! (I shall update on that when the time comes...however, it'll be awhile before I go down that road as I will probably wait until after the LPAO).
In other news, I am walking in a 5k in 2 weeks! I tried to train to run for the 5k, but the hip just wasn't quite ready to run and I'm not sure my left hip or my knees would do so well anyway. But I'm excited to say that I can walk that now without too much difficulty. Also, there is only 5 more weeks until my trip to Austria! I plan to do lots of walking then too, so this 5k will be just the beginning:) Spring has sprung here in Michigan (actually has been for the last month, totally unusual!) and I am looking forward to summer very much, which is a big change in heart from a month ago. I wasn't really sure how I felt about summer since my hip wasn't feeling the best, but now that I've turned a corner and seem to have made such major progress with it, I'm very excited for summer.
Sunday, April 4, 2010
Acetabular Dysplasia, Henry Ford Hospital, Detroit, MI
Acetabular Dysplasia, Henry Ford Hospital, Detroit, MI
This is a great link to the program directed by my surgeon, Dr. Zaltz. He performs this surgical program at both Henry Ford hospital and Beaumont Royal Oak hospital (where my surgery will take place) in Detroit. It explains dysplasia, PAO, and frequently asked questions regarding the operation and symptoms.
This is a great link to the program directed by my surgeon, Dr. Zaltz. He performs this surgical program at both Henry Ford hospital and Beaumont Royal Oak hospital (where my surgery will take place) in Detroit. It explains dysplasia, PAO, and frequently asked questions regarding the operation and symptoms.
Femoral Acetabular Impingement, Henry Ford Hospital, Detroit, MI
Femoral AcetAcetabular Dysplasia, Henry Ford Hospital, Detroit... Acetabular Dysplasia, Henry Ford Hospital, Detroit, MI
This procedure is done at both Henry Ford hospital and Beaumont hospital in Detroit which is headed by my surgeon, Dr. Zaltz. This link has good information on FAI procedures, and frequently asked questions.
This procedure is done at both Henry Ford hospital and Beaumont hospital in Detroit which is headed by my surgeon, Dr. Zaltz. This link has good information on FAI procedures, and frequently asked questions.
Friday, March 26, 2010
I'm a PT graduate!
Yesterday was a stepping stone day! I was officially discharged from physical therapy as there really is no more that my PT can do for me that I already can't do for myself. She said that technically, I could come back for another 2 weeks if I felt I needed to, but we both agreed that I was to a point that I can continue the exercises at home and gradually build up the weights on my leg reps through the coming weeks. She told me that I could call her or visit her anytime though, if I felt like I was hitting a plateau or just needed a little encouragement. I will miss Liz very much, but we do work in the same hospital and I will be going back to her after the LPAO, so I will get to work with her again. However, she said in order for PT to be a success and help keep me strong for the LPAO, I need to continue my leg/hip exercises every day for the next 6 weeks, and then after that I can take 2 days a week off from the exercises until the LPAO. Also, about 6 weeks before the LPAO, she recommended that I start doing the leg/hip exercises on the left leg (with or without weights) to get it ready for the surgery. So, after 2 months of intense PT, I am done with the outpatient part and it is up to me to continue on my own. I am so happy to have made it to this point and really feel as if PT has made a huge difference in my outcome. I saw leaps and bounds of changes in my strength when I started outpatient PT.
I am still having issues with catching and a painful "something is stuck in the joint" feeling. Just a few days ago, getting into my car this happened pretty severely, and I was trying to maneuver my right hip until it felt like that "stuck" feeling would go away, but it took awhile and when I finally worked out the feeling, there was a very loud crack and bad pain that followed it that lasted for a good 10 minutes afterwards. I was able to walk fine when I got out of the car, thankfully, but something is definately not laying right inside that hip. Whether it's the acetabular cartilage or the femoral cartilage, something still isn't right. It's fortunately not causing any constant, daily pain like it used to, but still. Oh well, in June I'll talk it over with Z and we'll go from there.
I also took my first on-call for work yesterday since I left work on medical leave. I worked my normal shift, went to PT (was d/c'd) then went home and in the middle of dinner, got called in for 2 laparoscopic appendectomies on a 15 year old and a 9 year old. Poor kids! Anyway, worked 5.5 hours and did great! Right hip is holding up beautifully. I have some firm swelling around the incision, it's still sore/tender in the trochanter area. The left hip...well, it's achey, it's throbbing, it's going to get it's dysplastic ass kicked! :) The point is, I'm strong enough to do call now on top of working a normal shift at work too. Good things to report:)
Oh, and I only have 9 weeks until I go to Austria!!!!!
I am still having issues with catching and a painful "something is stuck in the joint" feeling. Just a few days ago, getting into my car this happened pretty severely, and I was trying to maneuver my right hip until it felt like that "stuck" feeling would go away, but it took awhile and when I finally worked out the feeling, there was a very loud crack and bad pain that followed it that lasted for a good 10 minutes afterwards. I was able to walk fine when I got out of the car, thankfully, but something is definately not laying right inside that hip. Whether it's the acetabular cartilage or the femoral cartilage, something still isn't right. It's fortunately not causing any constant, daily pain like it used to, but still. Oh well, in June I'll talk it over with Z and we'll go from there.
I also took my first on-call for work yesterday since I left work on medical leave. I worked my normal shift, went to PT (was d/c'd) then went home and in the middle of dinner, got called in for 2 laparoscopic appendectomies on a 15 year old and a 9 year old. Poor kids! Anyway, worked 5.5 hours and did great! Right hip is holding up beautifully. I have some firm swelling around the incision, it's still sore/tender in the trochanter area. The left hip...well, it's achey, it's throbbing, it's going to get it's dysplastic ass kicked! :) The point is, I'm strong enough to do call now on top of working a normal shift at work too. Good things to report:)
Oh, and I only have 9 weeks until I go to Austria!!!!!
Tuesday, March 16, 2010
Something to think about....
I am in the middle of my third week back at work and am doing really well. I think that my muscles are more sore than the first week, but I'm doing more and using muscles that haven't been used in 3 months. My co-workers are being awesome and easing me into the call schedule slowly. So this means I won't be at the risk of putting in a 12 or 16 hour day which we have been known to do often when on call. I really am lucky when I think about my work:) I have been able to do all my 8 hour shifts though and only had one really, really bad, painful day out of the 2 and a half weeks I've worked, so that's pretty awesome, I think!
The issue I brought up in my 3 month follow up post about my right hip catching still and having pain was revisited with Dr. Z tonight. I called his nurse on Friday, which was the end of the 2 week ibuprofen trial to see if it would calm down any inflammation, to let her know that it did not help. It hasn't gotten worse, but it hasn't gotten better. Dr. Z called me today to discuss with me how I'm currently feeling and I described my symptoms to him that the catching pain happens almost daily and with turning or side stepping, but that I can't really pin point it.
He feels it could be one of two things.
1) It could be that the femoral head scarring didn't lay down right after the hip scope and the open surgery disturbed it causing it to catch
or
2) There was a soft, unstable piece of cartilage in my hip that he cut away and debrided but he said that to the naked eye it is sometimes hard to see if you are able to get it all and the cartilage could have been more unstable than he was able to see at the time and may have loosened again.
If either is the case, then he said a scope would be an option to go in and suture the loose cartilage or debride the scar tissue.
However, he doesn't want to do anything right now. He feels that it will be approximately 6 months before I would "plateau" from healing and he wants to see how I feel at that point. So I have a 6 month follow up with him at the end of June and that's when we'll revisit how the hip feels. He did offer a cortisone injection into the hip if I wanted it and I can arrange that at anytime if need be. He also said I don't have to worry about damaging the joint anymore because he said the femoral head is smooth and round now whereas before it definately was not. I am pleased as punch that he isn't diving into surgery again on that hip! At least not anytime soon. I just want to know that I'm good to go on activity of my choice and that I'm not going to hurt anything. I want to get strong for my other hip surgery without compromising the right hip.
I'm still not able to sleep on my right side totally yet. I can sleep modified on the right, more like on my stomach but the screw heads are way too tender still. This is also something to think about come June when I see Dr. Z again and see if it would be an option to have them removed when I have my LPAO. If I can't sleep on my side (and it does wake me up or keeps me tossing and turning everynight) then I'm going to go crazy!!!!!
The issue I brought up in my 3 month follow up post about my right hip catching still and having pain was revisited with Dr. Z tonight. I called his nurse on Friday, which was the end of the 2 week ibuprofen trial to see if it would calm down any inflammation, to let her know that it did not help. It hasn't gotten worse, but it hasn't gotten better. Dr. Z called me today to discuss with me how I'm currently feeling and I described my symptoms to him that the catching pain happens almost daily and with turning or side stepping, but that I can't really pin point it.
He feels it could be one of two things.
1) It could be that the femoral head scarring didn't lay down right after the hip scope and the open surgery disturbed it causing it to catch
or
2) There was a soft, unstable piece of cartilage in my hip that he cut away and debrided but he said that to the naked eye it is sometimes hard to see if you are able to get it all and the cartilage could have been more unstable than he was able to see at the time and may have loosened again.
If either is the case, then he said a scope would be an option to go in and suture the loose cartilage or debride the scar tissue.
However, he doesn't want to do anything right now. He feels that it will be approximately 6 months before I would "plateau" from healing and he wants to see how I feel at that point. So I have a 6 month follow up with him at the end of June and that's when we'll revisit how the hip feels. He did offer a cortisone injection into the hip if I wanted it and I can arrange that at anytime if need be. He also said I don't have to worry about damaging the joint anymore because he said the femoral head is smooth and round now whereas before it definately was not. I am pleased as punch that he isn't diving into surgery again on that hip! At least not anytime soon. I just want to know that I'm good to go on activity of my choice and that I'm not going to hurt anything. I want to get strong for my other hip surgery without compromising the right hip.
I'm still not able to sleep on my right side totally yet. I can sleep modified on the right, more like on my stomach but the screw heads are way too tender still. This is also something to think about come June when I see Dr. Z again and see if it would be an option to have them removed when I have my LPAO. If I can't sleep on my side (and it does wake me up or keeps me tossing and turning everynight) then I'm going to go crazy!!!!!
Monday, March 1, 2010
Hi ho, hi ho, off to work I go!
I started work today, first time in 11 weeks. I was a little nervous that I would "forget" my job but I did alright! I was given 2 really easy assignments and then I was basically relearning the charting system as it changed right before I left. Best news is I have reduced joint pain! My surgeon did great work. And I survived :)
Sunday, January 31, 2010
2 months post op
These are my xrays from my surgeons office that I was finally able to obtain. The first and second ones are my post op xrays laying down. The third is my pre-op xray. Notice the bone healing in the second post op xray! Pretty cool, huh?
I am almost 2 months post op now (on Tuesday officially). I started PT last Wednesday and will return for 2 more sessions before I go on vacation. I love that I have some more exercises to do now! My PT checked my right quad for strength and we basically both saw that it was very, very weak. I could barely do a straight leg lift. So she modified my strengthening program for the right leg until I see her again on Monday. So far she has me doing 8 exercises, mostly for quad build-up, which I do 10 reps, 3 times a day. I also have some adduction/abduction exercises too and the one where you lay on your side with your knees bent and open up your legs like a clam really gets me!!! It's hard to make my leg do it, sometimes it just doesn't want to fire right away and other times I can do it fine, but it's really sore. I know this is an important one though to help get rid of my limp and I'll be able to walk correctly, so I'm increasing my reps by 1 each time I do a set. I'm really determined to walk without my crutches and my limp within the next 2 weeks! Let's hope I can meet my goal! I can tell I'm getting just a little stronger each day too, so I know the exercises are working. I'm almost to the point where I can get rid of the shower bench and my dressing chair in the closet. I have not used them in the last 3-4 days at all. So, if a week goes by that I don't use them, they're out! It's kind of strange though, as sometimes my leg/hip feels fine and stable and I don't need any assistance with dressing and showering or standing alone on the right leg, but other times it's like I'm back at week 4 where it's just barely strong enough to transfer or pivot on. All in time I guess.
All I care about is that I get it strong enough to not limp and to be able to walk long distances without getting tired or hurting! I've got a couple vacations coming up that I'd definately like to enjoy without thinking about righty:) Lefty is a whole other matter, but I know eventually she'll be taken care of, so I'm going to go with the flow on her!
Tuesday, January 19, 2010
6 weeks down, 6 to go
Today marks the 6 week point since surgery. I have been having more good days than bad now and I feel like my energy levels are just about as they were pre-surgery. I still get tired more easily than before surgery, but I do feel that I can do a lot more now. Even the muscular pain is getting better. I would say right now the scar itself is the most painful thing. My psoas muscle or tendon (groin region) is really irritated and my glutes and adductors (butt and thigh) are definately angry but I am really pleased with how things are progressing. My joint pain is pretty much non existent at this point, I think I still feel some capsule pain now and then, but not the searing pain of the labrum tear or the startling, painful snapping of the joint with certain movements. I still have some disgusting swelling around the outside of the hip. It's nearly twice the size of the other hip at night and I still occasionally get that full, stiff feeling around the area of the trochanter osteotomy. I'm sure it's all due to activity, as I'm increasingly getting more active as the days go by. The exercise bike is helping my muscle strength. I've been able to stand on my operative leg for 5 seconds before it starts to wobble and weaken. Sometimes it hurts to do that and other times it actually feels normal! Just 3 or 4 days ago I couldn't stand on it alone, only with crutches and even then it felt like more of my weight was going through my arms then my leg. So that's a big improvement! I'm hoping by next week when I go back to see Dr. Z that I'll be able to stand on my right leg for maybe 15-30 seconds before it gives out. I'm also hoping for some formal PT. I'm getting restless with the 3 things I can do at home...
I have officially decided I am going to do the LPAO in November or December now. I went to work to talk to my managers about all my possibilities with work and the next surgery and although they have no problem with me being gone for 6-ish months, it's the HR department that would not look favorably on me being absent from work that long. I decided it's not worth it to gamble my position and will return to work in March with my surgeon's approval. I'm really okay with this. I think I need the time to let my right leg heal properly and get strong for the other surgery as it will really take on quite a bit more work and weight than my left leg did. Plus, it'll give me a chance to just take a breather from all this surgery/recovery process. And I am in no way ready to experience the kind of pain I did when waking up from surgery any time soon. Even though I hope to get a spinal next time, it still scares the hell out of me, especially knowing the PAO is quite a bit worse.
But, I'm ready to get it over with and move on!
On Sunday, my dad and I went to a hockey game and sat on the glass which rocked! The thing that did not rock was all the stairs. They're narrow and there are so many! Especially on crutches. What a workout. My left hip finally had it going up the stairs though and gave out painfully on me at the top. The next morning when I woke up was even worse. I could not put any weight at all on my left hip. It was unbelievably painful and unstable! I don't know how I made it from the bedroom to my recliner, but I somehow did. It was some weird shuffle, scooch, lurching thing with my crutches! My husband tried not to laugh because he knew I was hurting but it did look pretty ridiculous. It settled down after a while, but it's still pretty sore. Luckily, I will see Dr. Z next week and be able to discuss some options with him about an injection into the joint to tide me over til surgery. I'm weary about it, but if it would help, then I'd be willing to do it.
As of right now, I'm concentrating on my trip to Mexico, getting tanned and toned (as much as my work outs will allow) and working on only needing one crutch (hopefully none by the time I go!!!). Then it's on to getting strong for work and planning the next trip; Vienna, Austria!
I have officially decided I am going to do the LPAO in November or December now. I went to work to talk to my managers about all my possibilities with work and the next surgery and although they have no problem with me being gone for 6-ish months, it's the HR department that would not look favorably on me being absent from work that long. I decided it's not worth it to gamble my position and will return to work in March with my surgeon's approval. I'm really okay with this. I think I need the time to let my right leg heal properly and get strong for the other surgery as it will really take on quite a bit more work and weight than my left leg did. Plus, it'll give me a chance to just take a breather from all this surgery/recovery process. And I am in no way ready to experience the kind of pain I did when waking up from surgery any time soon. Even though I hope to get a spinal next time, it still scares the hell out of me, especially knowing the PAO is quite a bit worse.
But, I'm ready to get it over with and move on!
On Sunday, my dad and I went to a hockey game and sat on the glass which rocked! The thing that did not rock was all the stairs. They're narrow and there are so many! Especially on crutches. What a workout. My left hip finally had it going up the stairs though and gave out painfully on me at the top. The next morning when I woke up was even worse. I could not put any weight at all on my left hip. It was unbelievably painful and unstable! I don't know how I made it from the bedroom to my recliner, but I somehow did. It was some weird shuffle, scooch, lurching thing with my crutches! My husband tried not to laugh because he knew I was hurting but it did look pretty ridiculous. It settled down after a while, but it's still pretty sore. Luckily, I will see Dr. Z next week and be able to discuss some options with him about an injection into the joint to tide me over til surgery. I'm weary about it, but if it would help, then I'd be willing to do it.
As of right now, I'm concentrating on my trip to Mexico, getting tanned and toned (as much as my work outs will allow) and working on only needing one crutch (hopefully none by the time I go!!!). Then it's on to getting strong for work and planning the next trip; Vienna, Austria!
Monday, January 11, 2010
So, what exactly is a surgical hip dislocation?
I reread all of my blog today (narcissitic and boring, I know!) and I realized there is really nothing in here that explains SDD in detail. I'll do my best now so that anyone who may be needing this surgery knows what to expect, or, if you just have a morbid sense of curiosity, then hey, each to her own:)
Surgical hip dislocation and debridement(SDD) with femoral osteochondroplasty and greater trochanter flip osteotomy is what my procedure was called.
I have femoral acetabular impingement with acetabular dysplasia of my right hip. This surgery addresses the impingement only.
I was given a general anesthesia (just what my surgeon prefers, but I would recommend a spinal! It's what I'll do for my LPAO) and once asleep, a foley catheter was placed. Then I was rolled onto my non-operative side and had blankets stacked between my legs for the operative leg to rest on. The surgeon makes a cut on the lateral thigh (and it's looooong, usually about 10-11 inches) from the top of the buttock to the upper- middle of your thigh. Once that's done, he retracts the muscles and makes his osteotomy cut of the trocanter (with the major muscles still attached to it so that healing is easier and faster) and places it anterior to the hip joint. This is when the surgeon flexes and externally/internally rotates the hip to visualize the impingement. On to the hip capsule. The capsule is accessed by a Z-capsulotomy (cutting open of the joint itself). Then the surgeon uses retractors to pull the femur out of the acetabulum. While he can see inside the socket, he cleans up the damaged areas or tacks the labrum back on with absorbable anchors (my case was debridement, not repair with anchors). The articular cartilage is assessed for any damage and then when satisfactory, he places a wet sponge in the socket. Then the head of the femur is addressed. It is measured with a sizer and extra bone that impinges the joint is removed and the joint is reshaped by a burr and chisel (this is the femoral osteochondroplasty). Once the surgeon is happy with the new shape of the femur he places it back in the socket and does the flexion/external/internal rotation again to make sure there is no more impingement. If all is well, then the surgeon will place a drain close to the hip to collect extra blood and drainage during the hospital stay. He will then begin closure of the hip capsule and pin the trocanter back onto the femur (usually 2 screws). These screws will be permanant unless there is ever a need for an MRI or other surgery. Then the muscle closure/tendon closure begins and the fascia (layer between muscles and skin) is sutured with disolvable stitches. Finally the skin is closed and fortunately for me my surgeon uses glue so it's a nice plastic surgery closure.
Once the dressing was placed I was rolled onto my back, woken from anesthesia and taken to recovery. That's it in a nutshell for the surgery! For pain control, I was given a patient controlled analgesia (PCA) pump that also had a continuos drip in it. This was all the pain meds I needed while on IV meds.
The CPM was started as soon as I was placed in my in-patient room and I had to wear TED compression stockings to prevent blood clots. Also had the sequential compression device (SCD) on my calves which also prevent blood clots.
PT did not begin until the following day and no walker is allowed (apparently my surgeon does not believe in walkers, for PAO's either). So up I went on crutches first thing. The only expectation was to get up and walk to the bathroom and the hallway 4 times that day. Then I just rested and used the CPM. The next day PT showed me how to do stairs, expected me to walk a little farther and showed me my exercises for home. This is also when I was given OT (learned how to dress, shower, sit on toilet, etc, properly). The rest was all up to me after that!
Surgical hip dislocation and debridement(SDD) with femoral osteochondroplasty and greater trochanter flip osteotomy is what my procedure was called.
I have femoral acetabular impingement with acetabular dysplasia of my right hip. This surgery addresses the impingement only.
I was given a general anesthesia (just what my surgeon prefers, but I would recommend a spinal! It's what I'll do for my LPAO) and once asleep, a foley catheter was placed. Then I was rolled onto my non-operative side and had blankets stacked between my legs for the operative leg to rest on. The surgeon makes a cut on the lateral thigh (and it's looooong, usually about 10-11 inches) from the top of the buttock to the upper- middle of your thigh. Once that's done, he retracts the muscles and makes his osteotomy cut of the trocanter (with the major muscles still attached to it so that healing is easier and faster) and places it anterior to the hip joint. This is when the surgeon flexes and externally/internally rotates the hip to visualize the impingement. On to the hip capsule. The capsule is accessed by a Z-capsulotomy (cutting open of the joint itself). Then the surgeon uses retractors to pull the femur out of the acetabulum. While he can see inside the socket, he cleans up the damaged areas or tacks the labrum back on with absorbable anchors (my case was debridement, not repair with anchors). The articular cartilage is assessed for any damage and then when satisfactory, he places a wet sponge in the socket. Then the head of the femur is addressed. It is measured with a sizer and extra bone that impinges the joint is removed and the joint is reshaped by a burr and chisel (this is the femoral osteochondroplasty). Once the surgeon is happy with the new shape of the femur he places it back in the socket and does the flexion/external/internal rotation again to make sure there is no more impingement. If all is well, then the surgeon will place a drain close to the hip to collect extra blood and drainage during the hospital stay. He will then begin closure of the hip capsule and pin the trocanter back onto the femur (usually 2 screws). These screws will be permanant unless there is ever a need for an MRI or other surgery. Then the muscle closure/tendon closure begins and the fascia (layer between muscles and skin) is sutured with disolvable stitches. Finally the skin is closed and fortunately for me my surgeon uses glue so it's a nice plastic surgery closure.
Once the dressing was placed I was rolled onto my back, woken from anesthesia and taken to recovery. That's it in a nutshell for the surgery! For pain control, I was given a patient controlled analgesia (PCA) pump that also had a continuos drip in it. This was all the pain meds I needed while on IV meds.
The CPM was started as soon as I was placed in my in-patient room and I had to wear TED compression stockings to prevent blood clots. Also had the sequential compression device (SCD) on my calves which also prevent blood clots.
PT did not begin until the following day and no walker is allowed (apparently my surgeon does not believe in walkers, for PAO's either). So up I went on crutches first thing. The only expectation was to get up and walk to the bathroom and the hallway 4 times that day. Then I just rested and used the CPM. The next day PT showed me how to do stairs, expected me to walk a little farther and showed me my exercises for home. This is also when I was given OT (learned how to dress, shower, sit on toilet, etc, properly). The rest was all up to me after that!
Saturday, January 9, 2010
Sweet freedom!
I drove today for the first time since surgery. I was waiting until the roads were clear from most of the snow and ice and today is a beautiful winter day; the sun is shining, the snow is melting and not a cloud in the sky! It felt pretty good to drive. The hip itself did fine, it was the muscles that protested afterwards. I don't know what's going on inside my leg, but it is so sore! The incision won't stop hurting either but it looks fine! Just some questions for the doctor I guess.
On another note, slightly related to the hip saga, the hubby and I were offered a free trip to Vienna, Austria in June with some very good friends...near impossible to pass up! Soooo, this along with the fact that I don't think Z wants to do the LPAO in March pushes me to delay the LPAO until December. I'm not going to make any final decisions until my next follow up.
An addendum:
I got a stationary bike yesterday courtesy of my mom (she's so awesome!) And have been using that along with my 1000 leg reps. Gonna get me some strong, sexy legs!
On another note, slightly related to the hip saga, the hubby and I were offered a free trip to Vienna, Austria in June with some very good friends...near impossible to pass up! Soooo, this along with the fact that I don't think Z wants to do the LPAO in March pushes me to delay the LPAO until December. I'm not going to make any final decisions until my next follow up.
An addendum:
I got a stationary bike yesterday courtesy of my mom (she's so awesome!) And have been using that along with my 1000 leg reps. Gonna get me some strong, sexy legs!
Tuesday, January 5, 2010
Holy cow, it's already been a month!
Today is a big day! It's my hubby's birthday and it's been one month since my surgery. I am doing well, besides still being so TIRED. The home exercises I was given continue to get easier and easier and I am still very mentally motivated to be able to have my LPAO in March, but realistically I know it may not happen, as physically I'm not sure I'll be ready. My left hip is starting to become more and more achy and I've noticed that my bursitis on my left hip is becoming a lot more painful. It still hasn't given out on me lately which I am so thankful for, but I have had a few wicked spasms in the left hip/thigh when I've tried to stand up. I've already got myself ready to accept that possibility of delaying my LPAO during my next follow up with Dr. Z.
As for my swelling and my incision, things are still looking ok. The incision is not longer painful at that one spot I mentioned before (I think the triple antibiotic ointment really helped). The swelling is still there, but it hasn't gotten worse, in fact it looks like it may have gotten a little less. Not sure, but the hubby doesn't really think so. I know it goes from feeling like a fluid pocket to firm from time to time, so I really don't know what to make of that. Even though I am a nurse, I am still unsure of my own prognosis/recovery...I think I freak out a little more than I probably should:)
I have "met" a few more hipchicks in the last couple weeks that I am so thankful for getting to know. Hip women yahoo support group and facebook have led me to some wonderful new friendships and I am so glad to be able to use their support and give back support as well. So a shout out to my new hipsters; we are strong, beautiful women!!!!
I have noticed lately that my right quad is really atrophied...uggg. It's gross and I had no idea it would waste away that much for this surgery! I had expected that for the PAO but not really for the SDD. I figured since I was using my leg in the 1000 leg rep exercises that the muscle would still be getting used, but I was wrong. I really hope that PT will be able to sort that out right away!!!! I also hope that I can start PT fairly soon. But I won't be given that go ahead for another month. Arrrrgh. For what was supposed to be a fairly "simple" surgery and recovery it sure does seem to be moving awfully slowly. I am almost getting the feeling that Dr. Z is slowing down my recovery to slow me down from jumping into the LPAO too soon. Not just him telling me "no" but also making it nearly impossible to be able to do it in March due to the physical aspect of it. But who knows? Maybe SDD's are supposed to recover this long? It's hard to say since I don't know of anyone else who really went through one of these surgeries. I just know that for the LPAO I'll be a lot more patient with my recovery (I think) since I've been able to follow up with all the hippies on the support forum about their recovery and what it requires.
I am overall very happy with the outcome of my surgery. That sharp, pulsing pain that was constantly in my groin is gone. The horrible catching pain I had doesn't lock my hip up anymore (hopefully that remains the case forever!) and all I really have left is just a generalized achiness in the hip, but that could just be from the surgery itself. I'm sure I won't really know until all the inflammation and swelling goes away, and I know it could take up to a year before I fully realize how the hip is going to feel for good. For anyone considering this, it's definately worth it. Hopefully the scope option would work vs having the full open surgery like I had, but that was my only option once the imaging scans came back. It worked, so I'm happy! I would liked to have gotten the scope instead of open surgery (scar and more recovery/pain). I completely trust my surgeon though, and am pleased that he is happy overall as well!
As for my swelling and my incision, things are still looking ok. The incision is not longer painful at that one spot I mentioned before (I think the triple antibiotic ointment really helped). The swelling is still there, but it hasn't gotten worse, in fact it looks like it may have gotten a little less. Not sure, but the hubby doesn't really think so. I know it goes from feeling like a fluid pocket to firm from time to time, so I really don't know what to make of that. Even though I am a nurse, I am still unsure of my own prognosis/recovery...I think I freak out a little more than I probably should:)
I have "met" a few more hipchicks in the last couple weeks that I am so thankful for getting to know. Hip women yahoo support group and facebook have led me to some wonderful new friendships and I am so glad to be able to use their support and give back support as well. So a shout out to my new hipsters; we are strong, beautiful women!!!!
I have noticed lately that my right quad is really atrophied...uggg. It's gross and I had no idea it would waste away that much for this surgery! I had expected that for the PAO but not really for the SDD. I figured since I was using my leg in the 1000 leg rep exercises that the muscle would still be getting used, but I was wrong. I really hope that PT will be able to sort that out right away!!!! I also hope that I can start PT fairly soon. But I won't be given that go ahead for another month. Arrrrgh. For what was supposed to be a fairly "simple" surgery and recovery it sure does seem to be moving awfully slowly. I am almost getting the feeling that Dr. Z is slowing down my recovery to slow me down from jumping into the LPAO too soon. Not just him telling me "no" but also making it nearly impossible to be able to do it in March due to the physical aspect of it. But who knows? Maybe SDD's are supposed to recover this long? It's hard to say since I don't know of anyone else who really went through one of these surgeries. I just know that for the LPAO I'll be a lot more patient with my recovery (I think) since I've been able to follow up with all the hippies on the support forum about their recovery and what it requires.
I am overall very happy with the outcome of my surgery. That sharp, pulsing pain that was constantly in my groin is gone. The horrible catching pain I had doesn't lock my hip up anymore (hopefully that remains the case forever!) and all I really have left is just a generalized achiness in the hip, but that could just be from the surgery itself. I'm sure I won't really know until all the inflammation and swelling goes away, and I know it could take up to a year before I fully realize how the hip is going to feel for good. For anyone considering this, it's definately worth it. Hopefully the scope option would work vs having the full open surgery like I had, but that was my only option once the imaging scans came back. It worked, so I'm happy! I would liked to have gotten the scope instead of open surgery (scar and more recovery/pain). I completely trust my surgeon though, and am pleased that he is happy overall as well!
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