Groundhog Day

Tonight marks the one week anniversary of my hip surgery. In some ways, the past seven days have flown by. In other ways they have crept so slowly by. Every day I feel a little better. My least favorite thing about the recovery time are the restrictions while I sleep - I despise having to sleep flat on my back with my feet strapped in to the foot bolsters - unable to move. I'm counting down the days til that is no longer required.

Every day is somewhat the same. It starts like this: I wake up in bed, flat on my back, feet strapped to a bolster, calf pumps strapped around my calves, game ready machine strapped around my thigh and hip. Stiff, sore, a little sweaty. (nice, yes). I call out, as nicely as i can "help" - and my mom, who usually hears me on the first or second shout, comes in to undo all of the contraptions. I grab the crutches, hobble to the kitchen, and have coffee and enough food to give a little cushion for the pain killers and all the other medications I'm taking to help my hip. I shower - which is tricky and interesting balancing on one foot - and get dressed in some baggy shorts, slip on vans, a tee shirt, and fleece. Then we head out the door and down the elevator into the car, and drive into vail where I crutch into the Howard Head PT and plop myself onto a bike.

I have PT at Howard Head 2 times a day - usually lasting 90 minutes to two hours each session, along with a 20 minute driver there and back. The PT is great. It consists of about 20 minutes no resistance on an exercise bike. Then, I work with a PT for the next 40 minutes to one hour - doing passive circumduction, some soft tissue massage, and some very mellow exercises to get the muscles firing again. So far, both of the PTs I've worked with specialize in hips and are intimately familiar with what was done inside mine. It is reassuring. I wish I could pack one up and take her home with me.

My parents, who are my everything during this time (cook, chauffeur, nurse, psychologist), wait in the lobby for me - chatting with the other 'regulars', writing emails, doing stitchery and reading. After my PT is over, we head back to the condo, eat and I spend whatever time I have in some combination of the cpm machine, game ready, and calf pumps. Then its back to PT to do it all over again.

Evenings usually involve some reading, a movie and food. Luckily I've had a few visitors to mix it up - which as been lovely. Then its off to bed - where I strap into the game ready machine, the calf pumps, and the bolster, take a few pain pills, and drift off to sleep.

I'm still on pain pills - every 4 hours. This surprises me, since last surgery I was off pain killers about one day post op. I'm also still very limited in movements due to pain and restrictions. Also, a new thing compared to last surgery. Each day seems to get a little easier, and the swelling goes down just a little bit. My hips were about 2x as wide as normal for the first 4 days or so - but they are slowly decreasing in size. Along with the decrease in size, there is a decrease in swelling.

In PT I see lots of other hip patients - at all stages of recovery. It does seem like those who had labral reconstruction have a harder the time first few days than the others. I'm told by the PTs that, in time, this all equalizes and recovery time ends up being about the same.

The first few days after surgery, my biggest concern was that my hip still felt loose. I've talked to the surgeon about this, as well as the fellow, the Surgeon's assistant, both of my PTs and a few other patients (yes, I like to talk when I'm worried). One thing I heard from another patient was the most reassuring thing anyone has said. Apparently Dr. Philippon lets people view the surgery - both the fellows and the PTs on occassion. At the end of a labrum reconstruction, he forcibly attempts to distract the femur from the hip socket at various angles in order to make sure the new labrum has created the suction seal he wanted. The femur does not come out. I believe everyone's confidence that my hip is not loose is based on this fact. I think the looseness I'm feeling is a looseness in the joint capsule, and I am hopefull that this will tighten with time and with the reactivation/strengthening of the muscles. In any event, knowing that my femur is secure in the socket is reassuring - I don't have the feeling of the bone clunking around in the socket as I did before. I am so glad I chose to do this surgery with Dr. Philippon. I feel that I'm in very good hands.

Today I could go to the Pool to start aquatic therapy - which they have every tuesday and thursday. Today's conflicts with my PT, so I'm going to go to PT instead. Maybe thursday I'll go to the pool. I have some fear of the pool - only because that was the first place where my hip subluxed after my first surgery - 10 days post op. So, that's a little hurdle I need to make it over.

We originally were planning to go home this Friday - me back to SF and my parents back to LA. But, we've decided to stay another 6 days - mostly because I can't go back to work at this point anyways, and I also wouldn't be able to do most of this on my own. It is so important to me that I comply with all of their instructions as much as possible to do the most I can do to make a full recovery.

Most of the restrictions are lifted at week three - including the despised bolster. At that point, I can sleep however I want! that will be lovely.

Til next time...
Virginia

Time flies

Its Friday, I had surgery on Tuesday, which means this is post op day 3. Seems like it has been forever and at the same time its flown by. This surgery has been much harder than the original hip surgery was. I remember that time, i was off pain killers by day 2 and feeling very mobile and good by day 3. Right now, there is no way i can imagine not being on pain killers - and have been taking them conisistently about every 4 hours. I am guessing this is because they did more work in the joint. I've also been told that revisions are usually harder recoveries than first surgeries.

Dr. Philippon used a graft from my IT band to reconstruct my labrum. It required 7 anchors - which is apparently a large reconstruction - it looked like it was about half of the circumference of my hip socket. Apparently, my joint capsule had scarred to my labrum which is part of what he thinks was causing me pain. He also did bit of cleaning up rough cartilidge and trimmed additional bone off the femur. He also tightened the illiofemoral ligament and did a plication on the joint capsule to try to get rid of the loose feeling I have. He said the cartilidge looked really good and he was pleased - and I didn't need microfracture - so that is good!

I expected to feel an immediate lack of looseness in my hip when I awoke from surgery - but the unfortunate truth is that my joint still feels very loose. It is a terrifying thought that this surgery may not solve that problem, but I'm trying not to worry and to give it time. I know that there is a lot of fluid in my hip and a lot of inflammation, and he did do things to tighten the joint - so hopefully once everything settles down a bit, it will be snug. I hope.

Here's how it went - Tuesday, we showed up at 12:30 pm at the hospital and got checked in for surgery. I got changed into the hospital gear, got the IV going, had blood taken to create PRP than would be re-injected, and got the epidural going to keep me feeling nothing from the hip down (creepy!). I don't even remember being put under by the anesthesiologist, but I woke up around 8:30 pm in recovery - feeling pretty good. No nausea and not much pain because of the epidural. I was already in the cpm maching (constant passive motion machine ) and a version of the game ready ice shorts around my operated hip. My parents came in and said hi and hung out til about 10:00. I had some gingerale and saltines, and texted with people - probably a little incoherently. That night i dozed in and out of sleep - with nurses coming in here and there to adjust this or that. At around 2 am, they took out the epidural and started me on regular oral pain killers - it was a pretty mellow transition. Then, to the bathroom by wheelchair to brush my teeth and rinse my face, and then down to physical therapy where they put me right onto a bike to pedal for 20 minutes. All of the previous day's surgery patients go to PT together early the following morning - so we all got a little class on how to use our own cpm machines, how to operate the game ready, and how to use all of the other random equipment I have to be using for several weeks. Then there was a bit of passive motion with my PT and back to the condo.

At the condo, I showered, got back into the equipment I have to be in (i.e. game ready, CPM, calf pumps) and then headed back to PT for a couple more hours. Craziness. Meanwhile, I should mention that once the epidural faded away completely, my hip began to hurt quite a bit. Worst thing is moving having to use my leg to step forward - it feels horrible. Its getting to be less and less bad though, so that is encouraging.

To give some idea of how labor intensive the equipment is - here is a list of all the equipment I have been instructed to use:

Crutches - with flat foot 20 lb weight bearing for the first 3 weeks and one additional week 50 lb weight bearing. Not a big deal really.

CPM machine for 4-6 hours per day, every day, for the first 3 weeks.

Game ready ice machine - as much as possible for the first 3 weeks. In the photo below, his compression ice pack is for a knee - mine is like a hockey short and fits around the hip. I think I mentioned at my last surgery - the gameready is awesome. Helps deal with pain and swelling - which there is a lot of. I do ususally find myself shivering with teeth chattering by the end, unless I'm in a down jacket, hat, and wool socks and covered with lots of blankets.



Calf pumps - for the first 3 weeks i'm supposed to use these any time i'm sitting around or lying down.

Bolster and foot holders - basically straps feet to this cylinder which prevents external rotation of the operated hip while sleeping. Means that I have to sleep flat on my back. I'm supposed to use this for the first 3 weeks. I couldn't find a picture of this one, but here is a photo of me wearing part of the bolster the morning after surgery. oh joy!

Hip brace - a large black contraption that straps around my waist and left thigh - which is supposed to prevent me from moving my hip in ways it shouldn't go. This I believe is every day all day (except when lying or sitting down) particularly when walking.

The hardest thing about this equipment is that all but the crutches and the brace, i need someone's help getting set up. Its very time consuming, and once you are set up, its an ordeal to get out of the contraptions to go to the bathroom, get something you forgot in the other room, reach the phone, or whatever. Thankfully I have both parents here doing all of this for me - including driving me back and forth to p.t. and various dr appts every day. And, bringing me food and drink while i'm strapped into my various equipment. It is really a 2 person job at this point. Only today did I start being able to do some basic things myself - like getting my operated leg up onto the bed, or off of the bed. Quite a feat.

On top of all that, there are medications to remember - all with their different schedules, the PT i'm supposed to be doing multiple times a day at home, and the 2 hours I'm supposed to be lying on my stomach. gaaah, it is overwhelming! My mom has put together a spreadsheet to keep track of all of that needs to get done. Thankfully I have my parents here to help me - or this whole system would have fallen apart.

Christie, my cousin who lives in Colorado Springs came up for a visit last night - so my entourage got even bigger for a minute! It was so nice to have some distraction and to chat with her in between all of the other stuff. Thanks Christie :)

P.s. my clavicle is holding up nicely, and has really been almost a non-issue. So, that has been a big relief.

Heading back to the clinic for more PT in about an hour and then back to my spot on the couch.


Thanks to everyone who sent me encouraging and thoughtful emails and texts and phone calls over the past few days. It means so much to me!! Made he whole thing a lot less scary too.

I'll update soon.

updates

A lot has happened since my last post, or at least it feels like it. Two days ago I was in Vail - seeing Dr. Philippon. Its a long story, but moral is that I'm leaning towards having my labrum reconstructed with him in January, and then the second hip done in March. I think its just a gut feeling more than finally finding the right answer, since that clearly doesn't exist. I may change my mind in a week, but that's where I'm at now.

I also went to see my clavicle doc yesterday in SF and the xrays show what I thought - the clavicle has indeed started to heal! yay! for now, he doesn't want me pushing it, but to be mellow for another month or so and see where we are at. Ironically, I think (hope) my clavicle will be good to go just about when I'm scheduled for surgery on my first hip - January. So in the meantime, I'm going to just enjoy the holidays and the fall weather we are having, and ride, see family, enjoy the time I have before rehab.

As a side note - I got my first injection of cortisone into my left hip while in Vail. That hip typically just throbs 24/7 and I was hoping for some relief. I'm not sure yet whether its going to work. The first night and following day it definitely hurt more - was tender to even walk on. But, i'm hopeful that it will start to feel better soon...? we'll see.

The best part of going to CO was getting to see Vern and her new (or new to me) house and kitty. Georgeous part of the world. My visit coincided with Denver's first snow fall for the year. The day before I got there was 73 degrees, when I arrived on Tuesday night it was snowing and about 35 degrees. yipes!




The next day was bright blue skies and probably 40. I walked to the gym about a mile and a half away. My fingers and nose froze, but the trees changing color and all the cute houses made it worth it. Yay Colorado. I could live there for sure. Plus I scored some awesome jarred tomatoes and figs from vern. sweet!