What's a girl to write on the eve of the New Year when not much exciting has happened? I guess a blip on recovery will suffice and we'll see where that takes us.
I went back to work on Dec. 20th, just shy of 2 weeks ago. Because of the holidays, I've not worked a full week and that has really come in handy. Next week will begin the full work weeks and, sigh, I am ready, whether I like it or not. Sitting in my office chair doesn't feel great, but I get up and move/stretch a lot and have my heating pad on all the time. While at home I reclined any time I was sitting, which is hip friendly.
I still haven't made my PT appt yet, 1) because of my ear restrictions, which are now lifted and 2) because my PT saw me at work and told me that they are extremely busy right now but would squeeze me in. I will hold off til next week. I've been doing most of my own PT at home from the exercises I was given last time and that seems to be helping. My goal is to get back into running form. Little by little I've thought to myself, "screw it, I'm gonna run, even if it kills me". Ok, it won't kill me but it might "kill" my hip. I'm ok with that...I think. First though I have to feel it out and see if I can even tolerate running anymore, which will start with speed walking on an incline on the treadmill to a slow jog to a fast jog to running. I worry I won't tolerate it because I stopped taking my pain medicine altogether a month ago. It was a personal decision even though my doctor felt I should remain on it. As I've said in the past, only time will tell.
Among other "exciting" tidbits, I enrolled in school for the spring to finish my Bachelors in Nursing (way long over due) and will decide from there which direction I want to go with my Masters. I initially thought Nurse Practitioner, but am considering Research Clinician as well.
I have a 3 month follow up for my right hip on Jan 28th with Dr. Z. I imagine that appt will be the "turning point" in how often I see him. I think he will want a 6 month check, and then yearly from then on. If that's the case, that will really throw me off, but in a good way. I've been so used to going to Detroit every few months for the last 3.5 yrs that it's going to be a little hard honestly to not think about the next trip down there.
So my hip? It doesn't always hurt, at least not enough to count, but when it does, it hurts A LOT. How to describe it...the deep dull ache with some throbbing, like an ear ache. It started catching a lot again. It catches when I turn/pivot, when I vacuum, when I come to a hard stop and try to push off (this actually causes a sticking, almost locking sensation).
When I have my leg abducted and flexed, I feel a snapping/clicking in the medial groin/hip area when I move my leg from flexion to straight. I didn't notice this before the scope.
My left hip has a symptom that I noticed starting in late summer/early fall and seems to come and go. Everytime I notice it though, it's worse than the time before. I'm feeling a clicking internally and by palpation when I walk on the outside lower edge of my hip (sort of where the butt and thigh meet but closer to the back of the greater trochanter). This leads to an apprehesion feeling and a need to "pop" my hip, which I do on the lateral side. I believe this to be my IT band. I often need to "unstick" my knee as well, and can very forcibly pop the knee cap by twisting my femur away from my tibia. It feels better once popped. The ITB isn't tender to touch but my bursa is tender on the greater trochanter. My left side still just feels wobbly. No aching in the hip just occasional sharp catches, which also happens in the knee but the knee also aches.
2012 brought a close to my hip preservation surgeries. It was the year I found peace and meditation through running. It was the year I was told my right hip is done and full of arthritis, consequently putting an end to running, my form of stress release. 2012 brought about a change in my nursing career, one I didn't anticipate I would not enjoy as much as I'd hoped. But it also led me down another path to furthering my education and hopefully getting me back to where I thrive, in the surgical setting, transitioning patients from pre-op to post-op and during surgery.
I don't have a clue what 2013 will have in store. But I do know I'm surrounded by the most encouraging and loving family and friends to get me through. And if it means a THR sooner than later, well, Bring It!! I'm prepared, and I'm going to have fun doing what I want to do in the meantime.
Monday, December 31, 2012
Monday, December 10, 2012
Return to work set
I will be 6 weeks post op coming this Friday and things are going relatively well. I've been going without crutches for a week now and although short distances are ok, walking in the mall or for any extended period of time is not working out so well. I still feel a catch in the front of my hip. My limp comes back and my whole leg fatigues.
I have started home PT though to try to help strengthen the hip. Due to the recent ear surgery I had to remove adhesions from my inner ear, I'm on certain restrictions that prevent me from doing formal outpatient PT for another 2 weeks.
I'm released to go back to work with no restrictions on Thursday Dec 20, 2012. One and a half weeks left to get a little more strength and rest in before resuming everything as before.
Overall, I'm able to do just about anything, just have to modify a little if it's uncomfortable. Exhaustion and back pain are the biggest things I'm dealing with right now.
**I have 100 degrees hip flexion according to my office visit notes
I have started home PT though to try to help strengthen the hip. Due to the recent ear surgery I had to remove adhesions from my inner ear, I'm on certain restrictions that prevent me from doing formal outpatient PT for another 2 weeks.
I'm released to go back to work with no restrictions on Thursday Dec 20, 2012. One and a half weeks left to get a little more strength and rest in before resuming everything as before.
Overall, I'm able to do just about anything, just have to modify a little if it's uncomfortable. Exhaustion and back pain are the biggest things I'm dealing with right now.
**I have 100 degrees hip flexion according to my office visit notes
Friday, November 30, 2012
2 year celebration
Today is my 2 year LPAO anniversary, (and 4 weeks post right hip scope). What a fast and wild ride! I am very happy with my left hip and the outcome. Dr. Z has gotten it stable enough to withstand running, so I'd call that a success in itself. As far as pain goes, the hip joint itself doesn't bother me much. The surrounding areas do in different ways though. And it's all attributed to the femoral malalignment. Dr. Z and Dr. T are well aware and have told me that muscle strength is key but it will never be perfect. Derotation is always an option, but only I can make that decision. Right now I'm happy enough with things and trying to recover from my right hip, so this will remain on the back burner.
Left hip progress at 2 years:
No more giving out in front of hip, but there is occassional posterior giving out.
No more shocking sharp, stabbing pains with weight bearing.
I can spread my leg without feeling like the hip is going to pop off like Barbie's leg might.
Can withstand running.
Things that still need improvement:
Hip still pops/snaps painfully.
Still feels like a wobbly pogo stick at times, but it's the whole leg and I assume this must be the miserable malalignment throughout entire leg.
Still fatigues easily no matter how much strengthening I do.
Still can't comfortably sit Indian style although it doesn't really hurt.
Happy Two Years to me!
Left hip progress at 2 years:
No more giving out in front of hip, but there is occassional posterior giving out.
No more shocking sharp, stabbing pains with weight bearing.
I can spread my leg without feeling like the hip is going to pop off like Barbie's leg might.
Can withstand running.
Things that still need improvement:
Hip still pops/snaps painfully.
Still feels like a wobbly pogo stick at times, but it's the whole leg and I assume this must be the miserable malalignment throughout entire leg.
Still fatigues easily no matter how much strengthening I do.
Still can't comfortably sit Indian style although it doesn't really hurt.
Happy Two Years to me!
Tuesday, November 20, 2012
Post op news
So there's good news and bad news with this post. I had my two week follow up yesterday with Dr. Z and it both surprised me yet confirmed what I really already knew.
Good news:
The FAI portion of the surgery went really well. He showed me the areas he shaved down and showed me how much ROM I have now which is about 105 degrees, which we were both ecstatic about. It might even improve more beyond that! My incisions are healing nicely, no issues there. My lateral thigh/bursa area are extremely tender to touch but it should resolve in the next few months.
Bad news:
He showed me my scope images and what he saw in the hip did not make him happy. My acetabulum (socket) is ok cartilage wise, no further softening since a year and a half ago, just some labral degeneration which he debrided. But my femoral head is looking awful. The cartilage was shredded to pieces. It looked like floating crab meat or parmasean cheese flakes. My femur also had bone spurs on it that reminded me of looking at the knobby part of a dog's chew bone that has the nubs all over it. He ground all the spurs down and smoothed all the cartilage down but overall he was really dissatisfied. He said that I have an arthritic hip and I have to be careful now. Total hip replacement came up a few times. As in, this is the next logical step. It doesn't sound like there's anything left to do to help save it. I asked about the intertrochanteric osteotomy to shift the bad part off the weight bearing zone and he said it'd be a last ditch "hail mary" effort. That didn't sound promising. It's not off the table, but it doesn't sound likely it would be beneficial. My guess is he's thinking it wouldn't delay the THR at this point and it'd be awful to put me through that to only go right into the THR, but we'll see.
It's definately more real now. Last year when the PAO healing was so touch and go, it seemed scary when he said it could be 2 months it could be 20 years before THR, but now after this scope, it's inevitable it's going to happen soon. He's telling me to avoid running and find another avenue of exercise, like swimming. He asked if I was ok with that and I told him no. He conceded to say gentle and very short jogging for 1 or 2 days a week would be "ok" but would really prefer me not to do it at all. So this means 5k's are out. I still plan to ask him if I can run one or two 5k's a year when I see him again in January, so I'll update on that.
Basically right now it's too hard for us to conclude how things are going to turn out because I'm only 2 weeks and a couple days post op. It's to irritated and fresh to know what's happening. He'll have a better handle on it when I come back again and I should know more about the condition of my hip.
At this time, 2 more weeks of crutches then wean. Start PT at 4 weeks post op. I'm cleared to start driving again (yay!) and go back to work at around 6 week mark unless I feel I can go back sooner. Right now I'm not ready for going to work yet. I'm still pretty tired and my leg still hurts alot when I use it more than 5 min.
I can shower without my bench though and I'm able to get dressed standing for the most part. I need a chair if I'm tired and the muscles are fatigued. I'm also capable of light house work (loading/unloading dishwasher and washer and dryer). No vacuuming yet, no bending over to clean bathroom yet.
PT instructions say no squatting or lunges so I won't be doing any type of exercise that requires those motions. I'm still just extremely upset about the no running thing. I really need to reflect on this and decide what is best for me and if I'm willing to give it up for the sake of saving my hip.
Good news:
The FAI portion of the surgery went really well. He showed me the areas he shaved down and showed me how much ROM I have now which is about 105 degrees, which we were both ecstatic about. It might even improve more beyond that! My incisions are healing nicely, no issues there. My lateral thigh/bursa area are extremely tender to touch but it should resolve in the next few months.
Bad news:
He showed me my scope images and what he saw in the hip did not make him happy. My acetabulum (socket) is ok cartilage wise, no further softening since a year and a half ago, just some labral degeneration which he debrided. But my femoral head is looking awful. The cartilage was shredded to pieces. It looked like floating crab meat or parmasean cheese flakes. My femur also had bone spurs on it that reminded me of looking at the knobby part of a dog's chew bone that has the nubs all over it. He ground all the spurs down and smoothed all the cartilage down but overall he was really dissatisfied. He said that I have an arthritic hip and I have to be careful now. Total hip replacement came up a few times. As in, this is the next logical step. It doesn't sound like there's anything left to do to help save it. I asked about the intertrochanteric osteotomy to shift the bad part off the weight bearing zone and he said it'd be a last ditch "hail mary" effort. That didn't sound promising. It's not off the table, but it doesn't sound likely it would be beneficial. My guess is he's thinking it wouldn't delay the THR at this point and it'd be awful to put me through that to only go right into the THR, but we'll see.
It's definately more real now. Last year when the PAO healing was so touch and go, it seemed scary when he said it could be 2 months it could be 20 years before THR, but now after this scope, it's inevitable it's going to happen soon. He's telling me to avoid running and find another avenue of exercise, like swimming. He asked if I was ok with that and I told him no. He conceded to say gentle and very short jogging for 1 or 2 days a week would be "ok" but would really prefer me not to do it at all. So this means 5k's are out. I still plan to ask him if I can run one or two 5k's a year when I see him again in January, so I'll update on that.
Basically right now it's too hard for us to conclude how things are going to turn out because I'm only 2 weeks and a couple days post op. It's to irritated and fresh to know what's happening. He'll have a better handle on it when I come back again and I should know more about the condition of my hip.
At this time, 2 more weeks of crutches then wean. Start PT at 4 weeks post op. I'm cleared to start driving again (yay!) and go back to work at around 6 week mark unless I feel I can go back sooner. Right now I'm not ready for going to work yet. I'm still pretty tired and my leg still hurts alot when I use it more than 5 min.
I can shower without my bench though and I'm able to get dressed standing for the most part. I need a chair if I'm tired and the muscles are fatigued. I'm also capable of light house work (loading/unloading dishwasher and washer and dryer). No vacuuming yet, no bending over to clean bathroom yet.
PT instructions say no squatting or lunges so I won't be doing any type of exercise that requires those motions. I'm still just extremely upset about the no running thing. I really need to reflect on this and decide what is best for me and if I'm willing to give it up for the sake of saving my hip.
Thursday, November 15, 2012
Unrestricted
I can flex my hip freely to a little over 100 degrees! This is truly wonderful! This is the outcome I was hoping to achieve and thankfully it happened. I know my husband and family have been grimacing at the thought of "what if this didn't work". Well the hip is definately not a "good" hip anymore but now that I have free, unrestricted movement (which I've never experienced on this side) it is amazing. More so than what my left hip felt like after being stabilized with the PAO! I will report the exact amount of degree of flexion after my follow up appointment. I'm sure it's better than anything I've achieved before. But more than numbers is just truly NO blockage or a hard end point feeling. It's great!
My pain has improved too. It's not bad at all now. When I'm resting (laying down) it aches to the point of distraction, so I'm not sleeping well. Plus if I stand more than a couple minutes I get pretty achy. Moving helps ward it off. I still feel like something catches if I'm bending the hip, so I'm resigned to the fact that feeling will probably always be there.
I got my surgical report back and among the things Dr. Z found were chondrocalcinosis, bone spurs, frayed cartilage and labrum, softening of the cartilage and cartilage fissuring, synovitis, dense adhesions of the capsul and near the bursa and glute muscles, and of course the acetabular impingement. He burred down 7 mm of the impingement and what a difference! Among all the other work he did in my hip, this is what made the most impact, although he feels it's going to be the release of the adhesions. Time will tell. He's usually right.
I'm unusually atrophied in the thigh in my opinion. I think it might be because of all the other surgeries on this hip. But it has made walking unassisted really difficult. I can't go more than two steps without a pronounced limp, pain, and my knee locking up. But I am getting better at walking more "correctly", that is, with my foot pointed straight and not outward. I'm glad that the instructions say to use the crutches for 4 weeks. Even straight leg lifts and knee extensions are too painful and hard right now. My thigh shakes and there is a sharp pain initially with a dull ache afterward. It is only 2 weeks post op tomorrow, but I still have the mentality that I should be up and running by now. Not very realistic, I know. The majority of my discomfort right now is laterally and at the knee, except at night, then it's all the hip joint.
Mostly what excites me is that the feeling I have with this unrestricted hip flexion is that I feel as good about it as my left hip!! Dare I say it will last?? I can hope, what else do I have? 2 week follow up with Dr. Z is on Monday.
My pain has improved too. It's not bad at all now. When I'm resting (laying down) it aches to the point of distraction, so I'm not sleeping well. Plus if I stand more than a couple minutes I get pretty achy. Moving helps ward it off. I still feel like something catches if I'm bending the hip, so I'm resigned to the fact that feeling will probably always be there.
I got my surgical report back and among the things Dr. Z found were chondrocalcinosis, bone spurs, frayed cartilage and labrum, softening of the cartilage and cartilage fissuring, synovitis, dense adhesions of the capsul and near the bursa and glute muscles, and of course the acetabular impingement. He burred down 7 mm of the impingement and what a difference! Among all the other work he did in my hip, this is what made the most impact, although he feels it's going to be the release of the adhesions. Time will tell. He's usually right.
I'm unusually atrophied in the thigh in my opinion. I think it might be because of all the other surgeries on this hip. But it has made walking unassisted really difficult. I can't go more than two steps without a pronounced limp, pain, and my knee locking up. But I am getting better at walking more "correctly", that is, with my foot pointed straight and not outward. I'm glad that the instructions say to use the crutches for 4 weeks. Even straight leg lifts and knee extensions are too painful and hard right now. My thigh shakes and there is a sharp pain initially with a dull ache afterward. It is only 2 weeks post op tomorrow, but I still have the mentality that I should be up and running by now. Not very realistic, I know. The majority of my discomfort right now is laterally and at the knee, except at night, then it's all the hip joint.
Mostly what excites me is that the feeling I have with this unrestricted hip flexion is that I feel as good about it as my left hip!! Dare I say it will last?? I can hope, what else do I have? 2 week follow up with Dr. Z is on Monday.
Thursday, November 8, 2012
This recovery is out of control!
I'm 6 days post scope and already have more to share:
Just some interesting observations I've had in the last couple days:
1) my pain suddenly (not gradually) has become what I think is "out of proportion" with the surgery I had. It is intense and not letting up. It is from buttock wrapped around to almost the groin and down thigh to knee (in front only, butt and just below butt in back). Everything hurts it, movement, weight bearing, touch, thought....ok not thought but then when I do think about it it does hurt more! It's ridiculous. Pains meds don't touch it, ice doesn't work (I've found sitting on ice is the best at this point but it doesn't really do much or last), and heat is pointless. The quality of the pain stays the same. There's an underlying element of soreness, like an extremely bad sprain/strain, but throughout the whole thing is this piercing, throbbing, ache that becomes sharp enough to induce tears if I move too much or just the wrong way.
2) Interestingly enough, I've found that weight bearing flat footed aggravates the pain (I can walk with the crutches, slowly) but I started going back to old habits and placing all my weight on the outer edge of my foot (so pinkie toe down to the floor, big toe up to the ceiling) and standing or walking this way. It really helps relieve a lot of the weight bearing/walking pain. This position also aligns my leg nearly perfectly straight, which I have pointed out to both Dr's Z and T before and they had said it was because of the twist in my bones.
I guess I'll be walking on the outside of my foot til it stops hurting otherwise. I don't know what else to do or think.
The intensity of the pain, being "out of proportion" with what I had done, worries me slightly, but the nurse in me says that I don't have a fever, the area is not red or overly swollen or overly warm to touch, so I doubt it's an infection. The only thing I can plausibly come up with right now is a hematoma and the pressure it would cause and that might make this pain I'm having seem reasonable. Otherwise, I'm at loss. A scope recovery shouldn't hurt about as much as my SDD recovery.
Just some interesting observations I've had in the last couple days:
1) my pain suddenly (not gradually) has become what I think is "out of proportion" with the surgery I had. It is intense and not letting up. It is from buttock wrapped around to almost the groin and down thigh to knee (in front only, butt and just below butt in back). Everything hurts it, movement, weight bearing, touch, thought....ok not thought but then when I do think about it it does hurt more! It's ridiculous. Pains meds don't touch it, ice doesn't work (I've found sitting on ice is the best at this point but it doesn't really do much or last), and heat is pointless. The quality of the pain stays the same. There's an underlying element of soreness, like an extremely bad sprain/strain, but throughout the whole thing is this piercing, throbbing, ache that becomes sharp enough to induce tears if I move too much or just the wrong way.
2) Interestingly enough, I've found that weight bearing flat footed aggravates the pain (I can walk with the crutches, slowly) but I started going back to old habits and placing all my weight on the outer edge of my foot (so pinkie toe down to the floor, big toe up to the ceiling) and standing or walking this way. It really helps relieve a lot of the weight bearing/walking pain. This position also aligns my leg nearly perfectly straight, which I have pointed out to both Dr's Z and T before and they had said it was because of the twist in my bones.
I guess I'll be walking on the outside of my foot til it stops hurting otherwise. I don't know what else to do or think.
The intensity of the pain, being "out of proportion" with what I had done, worries me slightly, but the nurse in me says that I don't have a fever, the area is not red or overly swollen or overly warm to touch, so I doubt it's an infection. The only thing I can plausibly come up with right now is a hematoma and the pressure it would cause and that might make this pain I'm having seem reasonable. Otherwise, I'm at loss. A scope recovery shouldn't hurt about as much as my SDD recovery.
Tuesday, November 6, 2012
Post op hip scope recovery
It's day 4 post op and things are well. I'm allowed to weight bear as tolerated, no real restrictions, can use the stationary bike without resistance, and just need crutches for 4 weeks. I've cheated already and gone to 1 crutch short distances but I'm not ready to go without crutches yet. I have a limp. It doesn't hurt much to put weight down, but lifting my leg hurts. Sitting too long hurts. Actually sitting on my butt is what hurts. I think there's just a big bruise there though.
What's been most painful though is my back. I can't lay on my back or sit for long without it beginning to give me a piercing ache. I can't say what it's from, but I would imagine the traction while in the scope may have aggravated it. The pain is in the right SI to across my mid upper back. It really kind of overshadows the hip pain.
Besides that, a run down of how much easier this recovery has been for me over the SDD/PAOs:
Post op day 1: in hospital, d/c'd by 12-1 pm, home and able to stay awake til normal bedtime, not feeling horribly emotional. Pain is controlled.
Post op day 2: had mom stay the day with me since hubby had to go to work. I literally slept the entire day, didn't really do anything. Took dressings off and showered in the evening, and didn't need any help showering (getting in or out). Used the shower bench to reach lower extremeties but was able to stand majority of time. Hubby helped put on pants and socks because right hip/knee still so swollen from scope fluids.
Post op day 3: on my own majority of the day, taking care of the dogs myself (1 lab, 1 boston terrier). Hubby pre-planned day and made sure everything was out of my way so I could crutch safely and also set up my table with everything I'd need next to my chair. I did really well, tired and sore from more movement, but was able to go on first outing later in the afternoon too and then I came home and crashed.
Sleeping on back in CPM sooo uncomfortable that I finally gave it up at 4 am and turned on my side with pillows. Way better sleep.
Post op day 4 (today): again, alone, phone calls from mom to make sure I'm ok and I am. Really reflecting on things my husband discussed with me that Dr. Z brought up after surgery. I'll elaborate more after my 2 week check up, when I can understand it better.
Crutching is easy, showering is easy and the shower bench is just a comfort measure if I need it. I'm able to bend my leg easier now (still hurts) to put pants and socks on, but do need to sit to do that. My appetite is still poor, but the nauseated feeling has gone away, a lot faster than other times.
All in all I'm much more independent with this recovery. It helps that I'm experienced too, because I remember 3.5 years ago when I had my first surgery ever, a hip scope, which wasn't near as involved as this one, I was slow and cautious to a fault with recovery. Now it's second nature, and things are coming along so much better.
Plan is to send the CPM back this weekend and wait for the post op follow up to talk about the results and how I'm progressing. I also have my ear implant revision surgery coming up in 3.5 weeks to get ready for. I do need to set up my classes for my BSN as well while I'm off work. The great thing about this type of recovery is that I feel stronger both mentally and physically than I did with the SDD/PAOs and feel like I can probably accomplish this, and in a shorter time frame.
This week is about resting though and watching the presidential election unfold.
On a scale of 1-10 for discomfort for a hip scope over an open hip surgery, I'd say I'm at a 3-4, whereas I'd have been about a 6 with the opens. I think the only reason I'm even rating it as high as a 3 is because there is arthritis in my hip and because of my back.
What's been most painful though is my back. I can't lay on my back or sit for long without it beginning to give me a piercing ache. I can't say what it's from, but I would imagine the traction while in the scope may have aggravated it. The pain is in the right SI to across my mid upper back. It really kind of overshadows the hip pain.
Besides that, a run down of how much easier this recovery has been for me over the SDD/PAOs:
Post op day 1: in hospital, d/c'd by 12-1 pm, home and able to stay awake til normal bedtime, not feeling horribly emotional. Pain is controlled.
Post op day 2: had mom stay the day with me since hubby had to go to work. I literally slept the entire day, didn't really do anything. Took dressings off and showered in the evening, and didn't need any help showering (getting in or out). Used the shower bench to reach lower extremeties but was able to stand majority of time. Hubby helped put on pants and socks because right hip/knee still so swollen from scope fluids.
Post op day 3: on my own majority of the day, taking care of the dogs myself (1 lab, 1 boston terrier). Hubby pre-planned day and made sure everything was out of my way so I could crutch safely and also set up my table with everything I'd need next to my chair. I did really well, tired and sore from more movement, but was able to go on first outing later in the afternoon too and then I came home and crashed.
Sleeping on back in CPM sooo uncomfortable that I finally gave it up at 4 am and turned on my side with pillows. Way better sleep.
Post op day 4 (today): again, alone, phone calls from mom to make sure I'm ok and I am. Really reflecting on things my husband discussed with me that Dr. Z brought up after surgery. I'll elaborate more after my 2 week check up, when I can understand it better.
Crutching is easy, showering is easy and the shower bench is just a comfort measure if I need it. I'm able to bend my leg easier now (still hurts) to put pants and socks on, but do need to sit to do that. My appetite is still poor, but the nauseated feeling has gone away, a lot faster than other times.
All in all I'm much more independent with this recovery. It helps that I'm experienced too, because I remember 3.5 years ago when I had my first surgery ever, a hip scope, which wasn't near as involved as this one, I was slow and cautious to a fault with recovery. Now it's second nature, and things are coming along so much better.
Plan is to send the CPM back this weekend and wait for the post op follow up to talk about the results and how I'm progressing. I also have my ear implant revision surgery coming up in 3.5 weeks to get ready for. I do need to set up my classes for my BSN as well while I'm off work. The great thing about this type of recovery is that I feel stronger both mentally and physically than I did with the SDD/PAOs and feel like I can probably accomplish this, and in a shorter time frame.
This week is about resting though and watching the presidential election unfold.
On a scale of 1-10 for discomfort for a hip scope over an open hip surgery, I'd say I'm at a 3-4, whereas I'd have been about a 6 with the opens. I think the only reason I'm even rating it as high as a 3 is because there is arthritis in my hip and because of my back.
Sunday, November 4, 2012
3rd hip scope (has to be) the charm
Surgery went as planned on Friday, and I finally wasn't the last case of the day as I usually happen to be, but it was still a late case. I was admitted at 3 pm and went back to OR sometime between 5-6 pm. The admitting nurse told me I'd be getting a block for this surgery along with general anesthesia. A block is a nerve block in the hip region, so it's much different than a spinal. The anesthetist numbs the front of the hip before finding the nerve to numb after the nurse gives you versed and fentanyl to sedate you and keep the block from hurting. In all the experience was fine, and I remember everything which is cool. The block took effect in my knee and I thought maybe it would get to my hip in time for surgery but it didn't. I woke up in extreme pain, a lot like the SDD because the block did not work. I also couldn't pee again and was straight cathed twice (once in recovery and once in my room on the floor). This bought me a guaranteed overnight stay since urine that is obstructed leads to kidney damage. My recovery nurse was amazing though and I'll be sending in a letter of gratitude to her soon. All nurses should get recognition when they give good care, it's never mentioned enough!
Dr. Z explained to my family that he removed some impingement on the socket and removed a lot of scar tissue around the bursa and underneath the SDD incision, which he thinks will really help. But what my husband felt like he focused on most was the arthritis he found in the hip. He described it as being much more than what would be expected in a hip of someone my age, even with the dysplasia and FAI. He wasn't sure if this scope would help me but also said that some people can have a large amount of arthritis and hardly know it, while others have a small amount and have terrible pain. Basically at this point he told my husband he wasn't going to stop me from running or enjoying other activities that are hard on the hips unless it starts to hurt, then he'd advise to back off whatever hurts. Pain is to be my guide. I will be asking him at my 2 week follow up a bit more on this point. I also need to ask him about the degree of flexion in my hip that he obtained while I was under anesthesia. He saw me the day I was discharged and asked me to flex my hip and see if it hurt. I tried and it was so tight with swelling from the arthroscopy fluid that it was hard to do but I think it did feel less restricted. He had said he couldn't get it to go past 90 degrees when I was under but I don't know if he meant before or after the scope. Being that I only had about 80 degrees before it could be either way.
This scope is easier on my hip in the fact that I'm allowed full weight bearing as tolerated on crutches and have no restrictions to movement. I can use a stationary bike with no resistance right away. I need to use the CPM for 2 weeks, be on crutches for 4 weeks, and originally we had planned 6 weeks off work but after I see him on the 19th for my post op, we may decide I'm ready for work sooner!
It doesn't really hurt much to put weight down on my hip but moving it forward and to the side hurts a lot. I have 3 key holes to make a total of 7 now. I am surprised at the amount of pain it caused initially but now things are way better, at just two days out.
I'm still experiencing the stomach issue where I have no appetite and don't feel well after I do eat or drink anything. Best thing I've found that works is the BRAT diet (bananas, rice, apples, toast). It's bland and easy on the tummy. I've managed a few bites of rice and toast.
I also took my dressings off today and even as a nurse, it disgusted me. It was very bloody, which Dr. Z had said it would be. I'm still pretty swollen from waist to knee. I have a sausage leg! But I got to shower and that made up for it. My husband and parents have been truly amazing again, and I'll never be able to make up for it, but I do love them so much!
I'm going to end this with a running photo. Although I didn't end up running in the fun run in Plymouth the weekend before my surgery (work conflict) I did happen to run a 5k distance (actually just a little further than 3.1 miles!) on the treadmill at home the Wednesday before surgery...and here's the proof!
Dr. Z explained to my family that he removed some impingement on the socket and removed a lot of scar tissue around the bursa and underneath the SDD incision, which he thinks will really help. But what my husband felt like he focused on most was the arthritis he found in the hip. He described it as being much more than what would be expected in a hip of someone my age, even with the dysplasia and FAI. He wasn't sure if this scope would help me but also said that some people can have a large amount of arthritis and hardly know it, while others have a small amount and have terrible pain. Basically at this point he told my husband he wasn't going to stop me from running or enjoying other activities that are hard on the hips unless it starts to hurt, then he'd advise to back off whatever hurts. Pain is to be my guide. I will be asking him at my 2 week follow up a bit more on this point. I also need to ask him about the degree of flexion in my hip that he obtained while I was under anesthesia. He saw me the day I was discharged and asked me to flex my hip and see if it hurt. I tried and it was so tight with swelling from the arthroscopy fluid that it was hard to do but I think it did feel less restricted. He had said he couldn't get it to go past 90 degrees when I was under but I don't know if he meant before or after the scope. Being that I only had about 80 degrees before it could be either way.
This scope is easier on my hip in the fact that I'm allowed full weight bearing as tolerated on crutches and have no restrictions to movement. I can use a stationary bike with no resistance right away. I need to use the CPM for 2 weeks, be on crutches for 4 weeks, and originally we had planned 6 weeks off work but after I see him on the 19th for my post op, we may decide I'm ready for work sooner!
It doesn't really hurt much to put weight down on my hip but moving it forward and to the side hurts a lot. I have 3 key holes to make a total of 7 now. I am surprised at the amount of pain it caused initially but now things are way better, at just two days out.
I'm still experiencing the stomach issue where I have no appetite and don't feel well after I do eat or drink anything. Best thing I've found that works is the BRAT diet (bananas, rice, apples, toast). It's bland and easy on the tummy. I've managed a few bites of rice and toast.
I also took my dressings off today and even as a nurse, it disgusted me. It was very bloody, which Dr. Z had said it would be. I'm still pretty swollen from waist to knee. I have a sausage leg! But I got to shower and that made up for it. My husband and parents have been truly amazing again, and I'll never be able to make up for it, but I do love them so much!
I'm going to end this with a running photo. Although I didn't end up running in the fun run in Plymouth the weekend before my surgery (work conflict) I did happen to run a 5k distance (actually just a little further than 3.1 miles!) on the treadmill at home the Wednesday before surgery...and here's the proof!
Monday, October 15, 2012
Ultrasounds are hip!
Of all the imaging tests I've had done these last few years, the ultrasound is the easiest, least invasive, least expensive, and least radiation exposure....and the most diagnostic. For me at least! The radiologist Dr. Z wanted specifically is amazing. We deduced I do not have hernias, tears in my muscles, or pubic symphysis inflammation. But I do have an enlarged labrum ("huge!" as the radiologist put it), and a good bit of soft tissue being impinged in the front of the hip. My problem is too much bone now in the AIIS, or anterior inferior iliac spine. I *think* this is what Dr. Z was telling me anyway. Without a diagram or model to look at, it was hard for him to explain over the phone. Basically I'll need bone work. He's going to decompress the hip, or shave back some extra bone. He'll also take a look inside, and look at the bursa. He explained there would not be a risk for morbidity (making the hip worse), but the recovery will be more involved than what I'd been told before. Also he did say I have definate arthritic changes, so I won't have complete relief, but should have enough for now. I'm great with that. I am fully aware this hip is not as good as my left but it does have some room for improvement. I'll take anything at this point.
I'm coming up on my 2 year LPAO anniversary next month, and a week following that will be my 3 year RSDD anniversary. It really has just flown by. My left hip feels terrific compared to how it felt before! I do have popping and snapping that hurts but no more giving out. What's weird about the left leg though is that it is still the leg that fatigues much faster than my right, even with my right having a ton of work on it. All in all, worth every moment, good and bad.
I'm coming up on my 2 year LPAO anniversary next month, and a week following that will be my 3 year RSDD anniversary. It really has just flown by. My left hip feels terrific compared to how it felt before! I do have popping and snapping that hurts but no more giving out. What's weird about the left leg though is that it is still the leg that fatigues much faster than my right, even with my right having a ton of work on it. All in all, worth every moment, good and bad.
Wednesday, September 26, 2012
Plot twist
Things have taken another interesting turn for me and have shaken and stirred everything up. But now the dust is settling and I can breathe easy again, I hope! To summarize, I am still running but am unable to get past 1-1.3 miles. My legs simply quit at that point. It isn't the pain that is stopping me (I can mentally block that for a good while) but just purely muscle fatigue. It isn't the same thing as they're "weak" because my muscles are now nice and toned and can harden right up, but plain and simple they just quit working. Then the aches and pains really start. So, besides that I'm still planning to do the Fun Run in October.
A few weeks ago I had a really bad sharp pain in my symphysis pubis when my cat pushed off my lap. It happened a few times with that and a few times with twisting movements. My right SI joint also felt/feels awfully painful, like I need to shift it or pop it, and the pain feels like it's ripping apart sometimes. So since the pubic pain was new, I called Dr. Z about it. He was curious about this and said it's enough to prompt him to order inflammatory blood tests on me. If it's not an inflammatory condition then it's definately malalignment. Blood work was done right away, and a few days later, I got the call that a test called HLA B27 is positive. This is a genetic marker for a rheumatoid disease called ankylosing spondylitis, or AS. Basically it is an inflammatory arthritis that eventually fuses the spine and SI joints, while also affecting the shoulders, hips, knees and ankles. I then had to see my rheumatologist to determine if I really do have AS, and if so, can I still have surgery on my hip?
The rheumatologist is the same who diagnosed my EDS and hypermobility. He eased my worries by telling me that although I have the symptoms of AS, the signs are not there yet (no sacroiliitis on xray, nor spurring or bambooing of the spine). But, if my back/SI pain persists or worsens, then we need to get a CT and/or bone scan because these are more sensitive than xrays, and usually damage takes a long time to show up. Once that happens, then we talk about treatment. But that's another blog, another time.
He said that even if I had active AS, he would/will still clear me for surgery. So the hip scope is still a go.
Dr. Z is fine with it but does want me to come down before surgery to have a pelvic ultrasound. At first it sounded like we would be doing a pubic symphysis injection and rectus femoris and SI joint injection too. But now I'm not sure. This new twist in events has got all of us with our panties in a bunch. I had a pretty long and serious heart to heart with Dr. Z. Beyond him being unhappy that AS could be in the picture, he is worried what he's going to find in the hip and he's worried he's going to make it worse.
Last, I finally confessed I saw Dr. T about my miserable malalignment and the recommendation was for the derotation of the femur and tibias. I wanted to mention this to him because the rheumy felt most of my pain really is from my malalignment. Dr. Z was actually very cool about it. He is glad I saw Dr. T since he is one of the best in the country for derotations. As he put it, two heads are better than one and getting second opinions is a good thing. I mentioned wanting to stick with him (Dr. Z) for the derotations if I ultimately decide to go that route, but....Dr. Z deferred and told me I really should have Dr. T perform that surgery. He told me that if he or his wife were going to have that done that he'd want Dr. T to do it over anyone else.
But, as for now, I've got 4 weeks left before my run and 5 weeks before my scope. I'm very busy, busy, busy in the coming weeks! Lots of changes, lots of news, and lots of self reflection to decide what's going to be best for me in the long run.
A few weeks ago I had a really bad sharp pain in my symphysis pubis when my cat pushed off my lap. It happened a few times with that and a few times with twisting movements. My right SI joint also felt/feels awfully painful, like I need to shift it or pop it, and the pain feels like it's ripping apart sometimes. So since the pubic pain was new, I called Dr. Z about it. He was curious about this and said it's enough to prompt him to order inflammatory blood tests on me. If it's not an inflammatory condition then it's definately malalignment. Blood work was done right away, and a few days later, I got the call that a test called HLA B27 is positive. This is a genetic marker for a rheumatoid disease called ankylosing spondylitis, or AS. Basically it is an inflammatory arthritis that eventually fuses the spine and SI joints, while also affecting the shoulders, hips, knees and ankles. I then had to see my rheumatologist to determine if I really do have AS, and if so, can I still have surgery on my hip?
The rheumatologist is the same who diagnosed my EDS and hypermobility. He eased my worries by telling me that although I have the symptoms of AS, the signs are not there yet (no sacroiliitis on xray, nor spurring or bambooing of the spine). But, if my back/SI pain persists or worsens, then we need to get a CT and/or bone scan because these are more sensitive than xrays, and usually damage takes a long time to show up. Once that happens, then we talk about treatment. But that's another blog, another time.
He said that even if I had active AS, he would/will still clear me for surgery. So the hip scope is still a go.
Dr. Z is fine with it but does want me to come down before surgery to have a pelvic ultrasound. At first it sounded like we would be doing a pubic symphysis injection and rectus femoris and SI joint injection too. But now I'm not sure. This new twist in events has got all of us with our panties in a bunch. I had a pretty long and serious heart to heart with Dr. Z. Beyond him being unhappy that AS could be in the picture, he is worried what he's going to find in the hip and he's worried he's going to make it worse.
Last, I finally confessed I saw Dr. T about my miserable malalignment and the recommendation was for the derotation of the femur and tibias. I wanted to mention this to him because the rheumy felt most of my pain really is from my malalignment. Dr. Z was actually very cool about it. He is glad I saw Dr. T since he is one of the best in the country for derotations. As he put it, two heads are better than one and getting second opinions is a good thing. I mentioned wanting to stick with him (Dr. Z) for the derotations if I ultimately decide to go that route, but....Dr. Z deferred and told me I really should have Dr. T perform that surgery. He told me that if he or his wife were going to have that done that he'd want Dr. T to do it over anyone else.
But, as for now, I've got 4 weeks left before my run and 5 weeks before my scope. I'm very busy, busy, busy in the coming weeks! Lots of changes, lots of news, and lots of self reflection to decide what's going to be best for me in the long run.
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