12 weeks post RPAO and 9 months post LPAO

I'm still in PT for the right hip. I don't use crutches anymore. I still haven't done a whole lot of walking distance wise but I will build up to that.
In PT I'm still struggling with straight leg lifts on the right side. It just does not want to do it. My left knee also still hurts, especially on stairs or with a wrong move while turning.

But I am able to lead up steps with my right leg and I can do abduction exercises pretty well, so that is a good thing. I think in my next PT session I'll be getting my ROM measured again so we can see where my hip flexion is at this point.

I am being choosey on jobs as well, trying to find something that isn't as physically demanding, so I am not working yet. Which is ok, since Z said I wouldn't be 100% ready to go just yet anyway. Squatting down and getting back up still bothers my quad on the right and that will be important to get back. Pain is kind of in the background now, like a familiar old ache. It's usually worse after sitting awhile from stiffness or if I'm up doing an activity for too long. But if I rest, it goes away. Icing and heating still do well for me too.

I see Dr. Z again September 12th for my 3 month follow up, so I'm looking forward to hearing good things when I'm there.

10 weeks post op and this thing called patience.

10 weeks seems like a long time when you're analyzing days but it's really not that much time when you look at it in terms of recovery from surgery. I'm starting to get impatient with everything and it's probably because I have technically been recovering since November 30th when I had the LPAO. In a way it's really nice I had the amount of time off (8 months now) but it's also been a little challenging on the lifestyle I am used to.

So at this point in recovery I am no longer using the shower chair (actually wasn't using it since week 8, but kept it in the shower til now). I don't need a chair to sit in to dress now that I can put full weight on my hip. Driving is an independant activity with very little issue and I'm now walking around crutch free, even outside. I have brought a crutch with me if I know I'm going to be walking a lot, but otherwise am doing well enough without it!

As far as pain goes, I've been on Mobic (prescription NSAID) for 3 weeks now and it seems to take the edge off the aches I get in my lower body but it's not the miracle I was hoping for. It does work better than motrin at least. I'm still getting occasional sharp pains in the front of the hip, it gave out once recently, but right now it seems managable. The screws are not bothering me as much either. They will have to come out at some point, but I'm not in a rush like with the left side. The knees to my feet are progressively getting more and more painful. I'm told strengthening is key. I'm really trying and being faithful to my PT workouts.

Speaking of PT, I'm back in the pool. The incision looks good after a week of antibiotics. Pool therapy was nice. I do like it and am thankful for it. My PT measured my hip flexion ROM yesterday and it decreased by 23 degrees. So it went from about 100 degrees to about 77-80 degrees. That's not good and we'll be monitoring that as I progress. Part of the decrease was
pain related but part was also stiffness, as in I could not get it to go any farther no matter what. Hopefully this improves!

Yesterday Z called me to check up on how I was doing regarding the incision and the hips in general. We discussed them briefly and I also explained that I have a procedure coming up soon that will make MRI's no longer an option for me and would this be an issue regarding the right hip? He told me that an MRI would really not be sufficient for me anymore anyway and he would prefer to go in with a scope instead. So, there you have it. Looks like my MRI days are finally over! Thank goodness!

All in all, I think I'm doing relatively well considering the circumstances. It is do-able to have PAO's close together. Other than a little groin pain in the left hip, I'm not having many problems there. And the right hip is still in early stages so we'll just have to be patient and see.

Post op week 9 - incision infection

"You're enjoying your day, everything's going your way, then along comes Debbie Downer!"
This, fellow blog readers, is me, and I apologize because I have yet more bad news to share...
This weekend I began noticing my anterior scope incision to be puffy and way more tender than usual. I also noticed it looked a little red around the incision. I pushed at it and pus and blood came out, followed by a mix of serous (clear, blood tinged) drainage. I called the OS on call for my surgeon's practice and was placed on Keflex 500 mg 4 times a day for a week. I'm also to stop pool PT until next week. Today the site looks much better. Not red, no swelling, and no drainage. The OS thought the drainage might have been a suture that didn't dissolve and acted as a wick.

I did land PT today. We took it easy because Nicky would prefer I stick with water therapy but what can I do? It all worked out well regardless. So I'm a little sore in both hips. I've woken up muscles in the left that must have deactivated and the right hip is struggling with the hip flexor, but doing surprisingly well with the glutes/stabilizers.

I'm starting to try to walk in the house without my crutch and it goes well enough as long as I take my time getting up from sitting awhile. The most I've walked is only a minute or so though. I suppose I should try walking for timed intervals from the front of the house to the back. Work up some stamina. Driving has finally gotten easier! It's back to feeling like an automatic gesture again, although I occasionally still feel like I have to think about moving the foot forward from the thigh. Other things I've noticed is a lot of clicking and popping is going on inside the right hip when I'm in bed and rolling over or changing positions. It isn't painful, just annoying.

What I'm really ready for is going back to work. Not really physically ready, but I need the interaction with people again! Not to mention the checking account could use it too!

First official day of PT/pool therapy

I began PT yesterday actually, with a ROM and strength/overall function evaluation and paperwork. My new PT, Nicky, is also from South Africa, like Liz, my first PT. She's pretty cool! Today marked the start of true PT and it started in the pool and will remain in the pool until the 4th week when I will start land therapy. After a 45 minute workout in the pool the reward is a 15 minute soak in the hot tub!

The water exercises are fairly simple. Forward leg kicks, backward leg kicks, marching in place, the "bicycle" kick, side leg kicks, squats off the wall, and heel raises to name a few. It felt good for the hips although I strained the right side getting too enthusiastic with the false sense of strength of my hip. I think it is great to do water therapy, however first getting out of the pool is hard reality. My right leg felt really weak out of the water. Nicky also suggested taking Tylenol or even something stronger at home and icing to prevent the pain water therapy can initially wreak on the body. I am currently icing. I'll wait on the meds. The plan is to do 3 weeks of pool therapy and 3 weeks of land therapy twice a week. Then I'll have my 3 month follow up with Z the week after I finish PT. There is a chance I could be discharged early depending on progress in therapy.

Right now my left hip feels great, the right hip is throbbing, and both knees are throbbing. And I look like a prune. But I'm definately glad that I went this route. I'm not used to it but I'm sure it won't take long!

8 weeks post RPAO and follow up appointment

I went back to D-town yesterday for my 2nd follow up with Z and this appt was much more promising than the last one! The xrays revealed that the joint space looked good/unchanged and my bones are healing really well. This means I can begin weight bearing full weight now and as soon as I feel able, I can wean completely off my crutches. He looked very pleased that the joint spaced had maintained itself. Me too! I feel much better after this follow up. The screws will need to be removed, although no rush, so we can monitor the hip via MRI to have a good look at the cartilage inside, hopefully stay on top of the degeneration before it's too late. Otherwise, we discussed how I'm feeling right now and I told Z I feel pretty good for having had 2 PAO's close together, the acute pain is gone but I do have a "settled ache" that doesn't go away. He felt it should go away, that it's part of the healing process. Strengthening the muscles is key. Which brings me to PT. I start outpatient PT tomorrow and it is going to be at the new PT place and I am going to do pool therapy. I'm pretty excited!
I asked about approximate timeline back to work and he felt another 4-6 weeks should be about right and probably about 6-8 weeks before I would be unrestricted. So we'll see! I go back to see him for my 3 month follow up September 12th and we'll see how the hip looks then and how I'm feeling.

At this point in recovery, and even last week at 7 weeks, I feel like the left and right hip caught up with each other in terms of how fast they each recovered. It was this same timeframe for the left hip that I was walking and pretty much didn't use my crutches much except outside. I feel pretty confident that the right hip will move along just as quickly. Pain is no longer acute, more just chronic aching now. Every once in awhile I will get a stab in the groin of both hips but I can tolerate it for the time being. My knees are still an issue but we are working on strengthening them. I now have a left knee brace for support.

So today I used only one crutch in the house and I felt pretty good. I have a lot of stamina to build back up but I think the strength is there. I vacuumed a small area of the house and that will probably be the extent of what I do today! Tomorrow is PT and I don't want to go in sore.

There was such relief with this appointment and I could definately get used to hearing my OS say not to worry! He is such a gem!

7 weeks post op and driving

At this point in the recovery I truly don't have a lot to tell. Left hip is holding up pretty well, a bit achy at times, and I occasionally get that anterior "bulging" feeling again. I have only felt minor giving out in the left hip but it's tons better than it used to be. The knee hurts. A lot.
The right hip is still sore around the incisions but thankfully the screws really aren't as bothersome as they were on the left. I'm still not sure how I feel with this hip. I'm really achy. I mean it's a bone deep ache, and it's pretty constant. The right knee also just hurts. My whole lower body hurts!

But aside from complaining, I have been able to do a few things more since last week. I have been cheating on weight bearing a little bit. I'm putting about half or more of my weight down on my right leg when crutching. It isn't too bad. The muscles are sore from non use and I had some issues with pin prickles/tingly feelings in my foot for a bit but it goes away with more use.
I also went in the pool over the weekend for the first time and "walked" in the water! Weightless weightbearing is heavenly! I just wish it was my own pool. I am going to go to a new PT (per my PT's recommendation) at a new place that does pool therapy. I'm very excited for that!
I wasn't sure if I was ready for driving yet but I wanted to try, so with Todd in the jeep with me, I drove to his dad's house, which is about 10 miles away. My practicing in the recliner has helped a little with muscle memory and strength. It felt weird though, like I had to actually think and tell my brain to lift and move my leg to go between the gas and brake pedals. I did just fine but I had Todd drive home. That was enough for me. But now I know I can do it if I need to! And I didn't even need to use my left foot on the brake.
I haven't needed to use the shower bench too much anymore. I still use it for shaving, but thats about it. My strength is getting better.
Today I visited my PCP for a checkup and he gave me a script for Mobic, which is a stronger NSAID than motrin and it only has to be taken once a day vs 4 pills of motrin 3-4 times a day! I started it today and hope to see results soon.

I thought I'd update about my orthotic inserts too. They don't help my knee pain. They do keep my feet from rolling in when I walk but that's about it.

I see Dr. Z next Monday for my 8 week checkup so I'm sure I'll have great things to report! (no word yet on the job I interviewed for).

6 weeks post RPAO

I'm halfway through my recovery! And one great thing to report this week is NO VICODIN has been taken since last Thursday!!! I stopped taking the Tylenol ES too, because it really doesn't do anything for me on it's own, so why damage my liver needlessly? But, I have been bad and started taking my NSAIDs a little more, as in daily, but they do help to just take the edge off...and I still need to ice and heat a lot. My knee and foot still swell ridiculously with activity and standing. My foot also likes to turn dark purple when I'm up and about, but it's not cold or numb. I haven't really felt the tingly, prickly sensations too much more than last entry either, so I am not too worried.

I'm still not able to drive, although I feel like maybe I might be at that point where I could find a place with no traffic to practice. I'm still working on the driving motion with my right leg while I'm sitting in the chair at home. Hopefully that will help make my muscles remember what they're supposed to do. It's still a pretty big effort to get them to respond, but not as bad as a couple weeks ago.

I actually climbed into bed on my knees last night, not even thinking of it! Usually I sit on my butt and swing my legs over, using my hands to help my right leg in. It didn't hurt to do it either, which is good. But the "flash burning" pain I had in my incisional area right after surgery made a reappearance as well. I was lying on my left side and rolled onto my stomach and I must have pulled or contracted my muscles too hard and that burn pain came ripping through, twice with movements. I wonder what that is! Also, a couple nights ago was the first time since before surgery that my husband and I were intimate. It was an experiement to say the least! I think with the LPAO it also took about 5-6 weeks before I felt like doing it.

Since I'm 6 weeks post op, my bones and muscles should be healed well enough that I should be able to use my leg more actively now. 6 weeks generally seems to be the rule of thumb when dealing with broken bones and torn soft tissues. So I tried lifting my leg independently while sitting in my chair. Hardy har har, I can barely make it move. Baby steps. I know it'll get there. But now at least I don't have to consciously try to remember not to use the leg for anything and worry about damaging it!
(I have officially been pardoned from jury duty, thanks to Dr. Z's letter of explanation)

5 weeks post RPAO

In terms of how I'm doing physically for the RPAO compared to the LPAO, I feel like I'm lightyears ahead! That's a major exaggeration, but it certainly feels that way to me. I reviewed my entries for the LPAO at 4, 5, and 6 weeks and I have already achieved everything in those 3 weeks now, at just 4 weeks going into week 5 of my recovery. I'm going to say it definitely helps having gone through 3 open hip surgeries, experience is a plus, but I may attribute some of that success to the awesome skills of my surgeon as well!! : )  Mentally I am still a bit more discouraged on this one compared to the left one and I know that doesn't make any sense considering how well I'm doing with ROM and mobility, but the discomfort I have with this hip is still at a higher level at this point in recovery than I had for the LPAO.

I am managing the pain well enough now with just a half a vicodin in the morning (if needed, otherwise I take 2 extra strength Tylenol) and a half a vicodin at bedtime. I also have to take my Lunesta at night to sleep or I will still have trouble sleeping due to pain. So I have been able to cut down my usage of narcotics since the last entry. It is slow going, but finally making some progress. I sure do miss taking my anti-inflammatories though.
I have tested putting more weight on my right leg lately and I have developed a pins and needles/jabbing feeling in the foot with any weight bearing I do. I noticed twice at night also, that I felt a slightly prickly/falling asleep sensation in the toes. I will be paying more attention to this, although I'm not very worried about it since it's not happening all the time.

I am happy to report I am lying on all sides in bed now! (I couldn't do this until week 6 for the LPAO) I experiemented with lying on my right side just last night and was able to lie that way for at least an hour before I started to feel muscle twinges and had to roll over to my back again. It did feel a little "weird" lying on the right hip directly, so I shifted my weight more to my back side with a pillow behind me to support my body. I'm still needing a pillow between my legs when side lying most of the time, but sometimes find myself having removed the pillow when I wake up. I lie flat when on my back or stomach and only when I put excess pressure on my right side do I feel the pain from the screws or pulling on the incisions. It feels so good to have a new position to sleep in again. I don't know that I'm "allowed" to sleep on the right side yet, so I'll take it slow with this position until I have my follow up in the next few weeks.

I started to "practice driving" recently, while sitting up in my recliner. I failed. I can "push the accelerator" to the floor just fine, but when I tried to move my right leg over to "push the brake", I couldn't move my leg hardly at all, so had I actually been driving, I would have caused an accident. I can always brake with my left foot though, and if that's what I need to do, then that is what I'll do! Once I'm completely off narcs I will have Todd or my mom go with me somewhere that has no traffic and I will actually test drive to see what I can do. It's amazing how little control of the leg I actually have! I thought it was better than that...

The screws are starting to make their acquaintance....my how I missed thee! This is probably the only thing that didn't happen faster for the RPAO than the LPAO. I noticed the screws in the left almost immediately whereas I'm just now this last week becoming aware of them in the right. And the feeling isn't so much as achy like it's been the last 2 times, but more a sharp pulling pain right at the site of the screw heads. If I rest my arms on the top of the hip, I feel pain from the screw heads but not the deep ache I was used to from before. I noticed on xray that Z seems to have countersunk these screws a little more than the left screws were, so that could explain why I wasn't aware of them as soon.

I'm still pretty swollen and tight in between the incision for the PAO and the scope sites. The left hip re-incision is no longer swollen and only feels like a deep bruise now. I'm not really aware of it at all. My knee and foot are still swelling badly after any exertion and often icing will help resolve most of it but I prefer heat which doesn't help the swelling. It just relaxes my joints and muscles more and feels more soothing overall.

I received a summons for jury duty this month and jury duty is required until September 30th. This is my first summons since I turned 18 and I would normally be really excited to do this, but I can't sit for very long and the benches/chairs in the court room are likely to be wooden (ie: hard). I still have to get up and move around a lot and shift positions to avoid putting too much pressure on either buttock. This would not be tolerated during a court case I'm sure. So I'll have to write to the judge to be pardoned. Hopefully Dr. Z will write a letter in my favor.

4 weeks post RPAO / 7 months post LPAO

This is my RPAO incision at 29 days post op. The last steri strip fell off a day ago, so I can finally post the picture in it's full glory! It's still raised but will lay flat in the next month or so. The scope incisions just below the PAO incision are still raised also. The area all around the incisions is still swollen and also a bit on the numb and hypersensitive side at the same time. Very, very sore!

Here is the LPAO re-incision without the steri strips at 29 days post op. The very top of the scar was re-opened and you can't hardly tell! I'm very  happy with this. It seems that it has made my sensation in the thigh a little more decreased since it has been re-opened, but it's not bad.

This is what my bilateral PAO incisions look like. Only the top 2 inches stick out above the bikini bottom when I'm wearing them as I normally would. I think they look great!

7 months post LPAO:

The left hip for the most part feels great! Well, maybe great isn't the word I want, but it does feel like it's doing the job it should do as the supporting hip! The front of my thigh/groin is still sore or achy, like I've done a really extensive work out and pulled a lot of muscles. Thigh fatigue is still much better than it used to be but I challenged it today in the shower. I tried standing for the majority of the shower and had to sit down on the shower bench when I was ready to use my body wash. That was good timing because my left leg was starting to really tire out. My knee is still popping a lot but mostly bothers me when I have to do stairs. My butt pain is improving and I think I'm noticing it to flair up a little bit more right now because I am putting more pressure and weight onto my left butt while sitting. I still somewhat have that feeling of sitting on a golf ball sized rock. But instead of it making me want to sit on a heating pad or ice pack to relieve it, I can shift my weight a little better to make the feeling lessen. The left thigh sensation is a little more decreased than previously since taking the screws out but no where near being numb. I'm so glad for that! I'm still happy I made the decision to go ahead and do the PAO's 6 months apart!

1 month post RPAO:

So the right hip....I don't even know where to begin or what to say. This hip is frustrating me to no end. I am confused as to how it is recovering. It's mobility and ROM is still superior to the LPAO and because I achieved all that so quickly, I feel like I haven't done anything to improve at all since being discharged from the hospital! The pain in the hip however, makes me feel like I'm going backwards and not improving. I have increasing stiffness and "fullness" that seems to be creeping in week by week in the front of the leg and my medial thigh/groin pain at times is downright horrible. Sometimes it feels sharp and stabbing, other times a very deep, dull ache. It is much different than the labral tear pain and I can only wonder if it's due to the capsule being opened and then tightened as it was sewn shut during surgery? I remember having pretty intense pain with the SDD, but that was due to all the muscles and soft tissue trauma from the lateral thigh incision. This incision should not make near that much pain. The pain I have going down steps is still there although because I am protecting the leg so much now by rotating it inward when I step down, I don't know yet if the pain is actually as bad as it was. I will have to try going down steps normally in the next few days. I still can't lift my leg yet, that hurts too much, right below the incision where the leg connects to the hip. So this means no driving until I can control that action. My right knee also gives me trouble. It feels like it's floating in jello right now and is popping and tracking wrong. I'm trying to do my quad strengthening isometrics so it will keep the knee area strong. And the exhaustion! I'm just so tired all the time! I can sleep and sleep and I still feel unrested and some nights are becoming very restless now, so I may have to get back on the lunesta to help me get deeper sleep.
Some positives are that I'm able to sleep on my left side more and more now and also, just last night I was able to sleep on my stomach! I have to be careful turning, otherwise I pull on both incisions too much if I turn too fast. But with a pillow between my knees, it's easier to control the turn. Coughing doesn't  hurt too much, but I found out sneezing is still very painful! Especially right now when the sneezes come on with no warning and there is no time to brace the incision.
I have not been able to stop taking my vicodin. I have been able to take only half a pill in the morning and one at bedtime but if I do any activity during the day, which I've been doing more of lately because of family functions, I find I need more pain meds. Sometimes, extra strength tylenol is enough, but then sometimes it is not and I have to take a half a vicodin still. Since I'm not allowed to take NSAID's at this time (or at least in such limited quantities it doesn't help at all) I find taking the stronger pain meds is necessary for now. This fact about the pain meds frustrates me! I was off pain meds at week 2.5 for the SDD and at week 3 for the LPAO (not including the fall) and right now I'm into week 4 and I cannot go a whole day without narcotic relief. I am going to put in a call to my orthopedic's assistant this week to see if this is a concern and if Z might have any other suggestions.
One thing I did do today and probably shouldn't have is get down on the floor on my belly (PAO leg out behind me and then lowered myself to floor with my arms and left leg only) to retrieve an item I needed, and since I was alone, I had no choice. Getting up was a challenge and I kind of hurt myself, but I did it! I won't be doing it again anytime soon though! I have learned from the last two surgeries not to try to push myself too far too fast. There's a reason our surgeons want us to be on "bed rest" for 6-ish weeks. I really don't want to do anything to this hip that could set it back either, so I'm trying to be good.

I'm discouraged at how this hip feels because I can't help but compare it to the left side and I know that's not a good thing to do, but I am thankful that I'm able to do the things I can do right now. I'm glad that I have pain meds that do take the edge off when I need them. I can ice the hip and can use heat, and those help too. I'm only 4 weeks out, so I know there's a while to go yet and I can allow for myself extra healing time. I just wish I could feel more at ease with the outcome of the right side. I know that weighs heavily on my mind and when the day comes when I can start weight bearing I think I will finally feel better about it all because I'm willing to bet that everything will be just fine!

3 weeks post op and the follow up appointment

Right hip scope: The 4 images shown are from my arthroscopy and they show areas on the acetabulum that are hyperemic (increased blood accumulation to specific area due to an inflammatory response) and also some labral degeneration. There is some yellowing of the cartilage and some of it looks like crab meat. This area Dr. Z debrided away. The first image also shows the swelling and softening of the cartilage. This is chondromalacia and currently I am at grade one, which is the first stage of cartilage breakdown. On images 2 and 3 you can see on the femoral head a lesion of cartilage that is also breaking down. Both these spots on the femoral head and socket are in the lateral space of the joint (outer edge). This is what Z thinks is probably causing my joint space narrowing which will be seen in the following xray images. Image 4 is the thermal ablation of the cartilage to "seal" it back down and clean it up on the socket side. The inside still looks pretty decent actually, but the start of arthritis is there.

Xray progression:

The first xray image is pre-op to any of my open surgeries with Z. The 2nd image is the LPAO and right hip post SDD and screw removal. The 3rd image is the right hip PAO in the "captain morgan" stance. Notice the joint space in the lateral (outside edge) portion. The 4th image is the RPAO and left hip post PAO screw removal. Again, look at the joint space on the right lateral edge compared to the left. The left is ideal joint space, great cartilage and coverage. The right hip joint space is too narrow, meaning a couple of things. The cartilage is thinning (which he said he did not expect going by the MRI arthrogram or previous xrays. He said even the scope findings he would not have expected the outcome he got. He feels the scope findings are really not that significant, but that once he started putting the joint back together is when he realized that the hip is not ideal and may not last.

Post op appt:

My post op follow up appointment went well yesterday, technically speaking. I was taken back for xrays, which would be used for my 6 month LPAO check and the RPAO "2 week" check. The LPAO looks perfect. The bones are healing, right on track, and the fragment is exactly where it needs to be. The screws are out and it looks great!
My right hip is a bit of a different story. On image, Dr. Z is not as optimistic about the right side. He said the fragment is stable and it gives the proper coverage I need but the hip will need to be watched very closely and carefully. The joint space troubles him and it was easy to see when he was talking with me yesterday. He began with pointing out the area of concern to me and said he just didn't expect it to turn out that way. He also then explained that while the scope confirmed degenerative labral tears, the area was cleaned up and even without the scope, he feels the hip would have healed itself once the PAO was done. However, he patched things up and now we know I have chondromalacia (softening of the cartilage) in the hip socket and damage to the femoral head. This knowledge doesn't help or hinder the outcome of the PAO, but it does give him an idea of what could be causing the joint space narrowing.
From my perspective this was the most cautious I have seen him with me. He would not tell me one way or another what the outcome would be, even when I point blank asked him. He said we just need to watch it, give it time. But then he said that there are things we can do to delay a hip replacement and when I asked him what he meant by that, he said that short of cortisone injections he would suggest doing a proximal femoral osteotomy to reposition the head of the femur in the socket better to take the pressure off the area of the joint where the positioning isn't ideal right now. We did not go into this in detail, it's way too soon to be thinking about that right now. But basically, the vibe was now "it's not a matter of if, but a matter of when".

He had me show him my ROM in both hips by lying down on the exam table then and was happy with the left. The active ROM on the left is no where near what it used to be but is definately within good measures. The right hip actively stopped well before 70 degrees and then he asked me to use my hands to get the rest of the ROM and I was able to get it probably to about 95-100 degrees which he was satisfied with. The incisions are all healing very well and there are no issues there. Then we talked a little more about the outcome of the surgery. At one point, it came out that the hip could last 2 months or 20 years, it's just too hard to say. Overall, he doesn't want to upset me because it could be likely that I'll never have anymore issues once I'm healed up. Time truly is the only deciding factor here. I also gave him a list of questions and he answered them accordingly:

-Right hip very painful when I go down steps and use the right leg to step down. If I rotate leg inward, there is no pain, why? It's too soon to really tell what could be causing that right now. It could be inflammation from the surgery, but it might be other things too. Let's just watch that for now.

-Right lateral hip pain, bursitis? Bruising? This is probably bursitis, just keep icing it.

-When will I be able to drive? As soon as you feel like you have good control of your leg muscles and you're off all narcotics.

-Knee problems, popping and pain underneath the knee cap? We'll have to address this once you're healed from your hips. (I asked what he meant, but he said we'd talk about it when it's time. I think he means muscle strengthening/PT).

-Right SI joint still hurts more than usual, is this going to settle down? Yes, the surgical inflammation is probably causing the SI joint irritability.

-Can you suggest a better NSAID for me other than ibuprofen or naproxen? I don't really feel that any other anti-inflammatory is superior to the ones mentioned. The only difference in my opinion is the side effects and you don't want those side effects. It's probably best to just stick with motrin or aleve and in small quantities because of your right hip, so I don't want you taking very much of it right now.

-Please look at my left hand. I've had pain in it since the IV was taken out from surgery (swelling in the hand, bruising, hardened vein that feels like a tendon now, and hard, painful, little blue lumps in the knuckles and below the wrist). Looks like thrombophlebitis. Use a warm, moist compress and I'd usually advise ibuprofen but with you I don't really want you taking a lot of it. It can take a while to heal, up to a year.

So, aside from some joking around and "catching up" conversation, that was the extent of my post op visit. I could tell he wanted to give me better news and say that it went as well as the left hip did, but it just wasn't something he could do at this point. He wants me to come back to see him again "in about a month or so". It doesn't sound like he's really rushing to get me back on my feet and just take our time with this recovery. The full restrictions are still in effect and I'm definately still under keen observation so I don't go doing housework. In fact, he point blank asked Todd, "So is she being a good patient this time?" : )  I jokingly mentioned that I would like to extend this being waited on hands and feet period and he laughed and said, "Don't bring him next time and we'll work it all out!". I set up my next appointment to see him July 25th. Fingers crossed that visit is a much more inspiring one! On the way home at some point in the car, I noticed my hip to knee swelling and I even had it elevated. The knee especially looked puffy and it was warm to touch. Once I got home, I continued to elevate it and ice it and this morning it does look better but still feels "full".

At 3 weeks I again do not have much to add to my list of "can do's" or accomplishments. I did send the CPM back last Wednesday and have slept pretty well without it. I have noticed a slight stiffening and "fullness" in the hip without the CPM but it's not as bad as the left side was. I'm still in enough pain that I'm needing my vicodin daily. However, I mostly take it upon wakening and at bedtime only. This is better than last week when I was still taking a 3rd vicodin in the middle of the day. Sometimes I need it because there is actual joint pain and other times it's for the stiffness of the joint. I'm also noticing more and more clicking in the hip, front and back, as the days go on. It feels like tendons or ligaments shifting. I'm able to sleep on my left side now, with one pillow between my legs and a couple pillows behind my back for support. While I fall asleep like this, I end up waking up on my back, so it's not totally comfortable for me just yet. But it's getting there!
While this hip feels better in mobility (crutching around the house, etc) and passive ROM (achieved weeks before the left hip) it is not feeling as well comfort wise. It's taking longer to feel "good" and doesn't feel the immediate gratification that I felt with the left PAO. I do realize that the left hip may have been extraordinary in healing in that way, and it is too soon to tell how anything really is right now, as I'm only 3 weeks post op. I am trying not to compare the 2 hips too much seeing as the mechanical outcome of the joints are very different, therefore they will have very different stages of healing. No two recoveries are the same. I just need to keep remembering that.
So what is all boils down to is that my right hip will deteriorate at a much faster rate than my left hip. My left hip probably won't need a THR until I'm old, if ever, but the right hip at this point is anybody's guess.