We left the cozy security of Vail and Howard Head and have returned to San Francisco - and I'll be going back to work tomorrow. Tomorrow, I also get to start weight bearing 50% weight on my left leg - still with crutches. A week later, I get to say goodbye to them entirely - assuming I can learn to walk with no extension past neutral, otherwise it'll be another week after that. CPM leaves me tomorrow or Wednesday. Already said goodbye to the gameready - which was sad. Unfortunately, some of my other restrictions ahve been lengthened - I'm still required to limit external rotation and extension - and that's been extended from 3 weeks to 5 weeks - to be sure that my joint capsule/hip heals all nice and tight. So, still have the damn bolster and boots at night, and the hip brace for another 2 weeks. It'll go by fast, no worries. Also stil have the calf pumps for another week. So, that should be manageable I suppose. I can bend over and put that stuff on and off myself at night - so its more just annoying than impossible.
Its been a rough transition - leaving a place where I spent most of my days either in PT or on the couch, and had two loving people around me to help me with everything (i can count on one hand the number of meals i prepared during the 2+ weeks we were in Vail). I now have PT 3 times a week - and I only have 30 minutes with my pt at those sessions. I'm thinking about upping it to 5 times a week (prescription says 3-5), but i'll see how this goes. I'm supposed to do constant passive motion for 20 minutes 1 to 2 times a day for the next 8 weeks. So, this gets done 3 times a week in therapy - the rest of the time, i suppose i'll go to the pool to do it, or beg my brother or some other poor soul to do it. Friends beware, I may show up at your houses asking you to move my leg around in circles... it'll be fun!
Janet - pool therapy was awesome. Basically, a bit of aqua jogging with the aqua jogger belt (totally new for me) and some kicking on my back. some mini squats and some side standing leg lifts, and then some walking, forward, backward, side to side. Today I actually swam a little - with a pool bouy between my legs. My upper body is finally going to get some muscle back (after 8 months of a weak/broken collarbone) - crutches and pool should do the trick.
I'm also supposed to ride a bike with no resistance for 30 minutes a day 2 times a day. My road bike on a trainer isn't working unfortunately (not comfy at all and very hard to get onto with my restrictions), so I'm scrambling to find a spin bike somewhere that I can have at home, rather than having to drive to the gym 2 times a day every day.
In between this will be work and catching up on everything that i've missed.
As for how the hip feels. So far so good. Much harder recovery than last time - I think last time I felt great a few days post op, and would have been happy walking less than a week later. This time, I'm only now starting to think that going to 50% weighbearing sounds like a good idea. Hip is still quite tender some days, other days/times it feels pretty good. I think my adductor is working overtime and sometimes just screams at me - as does the graft site. My IT band and everything that connects with it will need a lot of love in the coming weeks. All in all though, I think I have a more realistic idea of the trajectory of recovery. I don't get all cocky and over confident on good days, and I'm more able to take in stride the bad days. I do also feel like my hip is slowly tightening up (which definitely helps me take things more in stride). I don't care if my hip still still hurts - so long as its not falling out of the socket, i'm happy. I'm hoping that the next week of increasing the work the hip has to do won't cause any major flare ups - but I won't be suprised if I'm in for a bit of pain here and there. I'm very excited to get to walk crutch free again soon - its just a pain in the arse.
Next surgery has been pushed back a couple of weeks - and is now scheduled for April 5. I originally was scheduled for exactly 7 weeks after the first surgery, and now it will be 10 weeks. I think that will make it a bit easier on my recovering hip to deal. Counting down the days!
Thank you thank you thank you for everyone who has been there for me through this time - and the past 8-9 months. It means so much. what's important in life has certainly become more clear to me in this process.
I can see the light at the end of the tunnel. I CANNOT wait to be riding my bike one day and think - my hips don't hurt! doesn't seem too far off now.
Monday, February 14, 2011
Tuesday, February 1, 2011
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
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
Friday, January 28, 2011
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.
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.
Monday, January 24, 2011
Bring It
A little late to start the countdown, but tomorrow is the day! I'm in Vail (well, Avon) and am all set for surgery tomorrow at 12:30. I'm having it done by Dr. Philippon. His best guess is that I will need labral reconstruction (using a graft from my IT band) as well as plication of my joint capsule. He gave me a 90% chance of success - given my age, etc. He thought the biggest concern would be cartilidge damage - which could mean continuing pain - but he was happy with what the MRI showed - good joint space and cartlidge looked better than he had expected, so fingers are crossed on that.
Pre-op day was pretty packed without a lot of waiting around, which was nice. 7:45 am I checked in for MRIs for both hips - since I was still deciding which hip to do. Shortly after, I was brought into the PT for a stress test. Lots of jumping around on one leg with strong elastic attached to my waist. I underestimated this test. I was sweating and breathing hard -especially at 8000 feet. One of the highlights of my day was chatting with a guy next to me on the exercise bike during my little warmup in PT. He was there for a 3 month follow up after having his labrum reconstructed using his IT band. First success story I've seen in the flesh and it could not have come at a better time. He was so happy with the results. It was a revision operation for him too - having had surgery back in 2006 to correct impingement. He said it was like night and day. Only good things to say. Seriously, just what I needed to hear. The Physical Therapist I met with also had positive things to say about the reconstruction, the recovery time, and based on what I told him he thought it seems like the left hip should be done first too. Stars aligning.
After PT. I had some lab tests and then I went out with my parents for a quick lunch in Vail fillage. Then it was back to see Dr. Philippon and his fellow. Lots of great info on what they saw in the MRI and confirmation that it seemed like the left hip should be done first. Then it was off to surgery check in and meeting with nurses. Now 'home' on the couch where I'll be spending quite a bit of the next 10 days.
Last night I was scared and undecided. Tonight I'm scared, but I'm decided and feeling good about the decision. I have high hopes for tomorrow.
Pre-op day was pretty packed without a lot of waiting around, which was nice. 7:45 am I checked in for MRIs for both hips - since I was still deciding which hip to do. Shortly after, I was brought into the PT for a stress test. Lots of jumping around on one leg with strong elastic attached to my waist. I underestimated this test. I was sweating and breathing hard -especially at 8000 feet. One of the highlights of my day was chatting with a guy next to me on the exercise bike during my little warmup in PT. He was there for a 3 month follow up after having his labrum reconstructed using his IT band. First success story I've seen in the flesh and it could not have come at a better time. He was so happy with the results. It was a revision operation for him too - having had surgery back in 2006 to correct impingement. He said it was like night and day. Only good things to say. Seriously, just what I needed to hear. The Physical Therapist I met with also had positive things to say about the reconstruction, the recovery time, and based on what I told him he thought it seems like the left hip should be done first too. Stars aligning.
After PT. I had some lab tests and then I went out with my parents for a quick lunch in Vail fillage. Then it was back to see Dr. Philippon and his fellow. Lots of great info on what they saw in the MRI and confirmation that it seemed like the left hip should be done first. Then it was off to surgery check in and meeting with nurses. Now 'home' on the couch where I'll be spending quite a bit of the next 10 days.
Last night I was scared and undecided. Tonight I'm scared, but I'm decided and feeling good about the decision. I have high hopes for tomorrow.
Friday, November 12, 2010
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!
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!
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