13 days Post op

The last two weeks have been interesting. First off, i think that the initial recovery from surgery was a lot easier than I expected. After the first day or two the pain in my hip was minimal (probably a 2 on a scale of 1-10) and once I was off pain meds (2 days after surgery) my head cleared and the rest of my body started to feel better. It hurt to do certain movements, and I was non-weighbearing, but still - I was hopeful that recovery was going to be a breeze. I think its been hard adjusting from the initial few days of feeling like everything was going well, to the following several days of not much progress. The fact is I had surgery in my hip - bone was removed, cartilidge was removed, and muscles and tissue was moved around quite a bit - so things are going to hurt for a while.

I went back in for my 10 day post op visit with the surgeon this past monday and he was all smiles and happy with how it went and how well I appeared to be doing. He cleared me to shower (yay!!!!!!!!) , swim (with kicking!), stop using the cpm maching, and start weaning off crutches. I was thrilled and left the office with a huge smile on my face - thinking how fun it would be to be walking around without crutches and suprise jon that night. I think maybe I was too pleased, and momentarily forgot that I'd had surgery - thinking those rules of slow recovery don't apply to me. Bad move. Well, I did what the surgeon said and started "weaning" off the crutches - which is a really vague instruction. I did some walkiing without crutches (VERY gimpy/lurchy) and did some crutching with one crutch and some crutching with two crutches with more weight on the left leg. I went on a cleaning/organizing spree around the house - moving things around and clearing out some of the stuff from post-surgery.

The next day I went down to the pool - I did a lap with gentle kicking and breaststroke - and the kicking hurt, so I stopped. I then used the pool bouey and it was fine, but a few times my hip felt like it slipped out of the socket - not a good feeling and it made me a little worried. I was also doing some walking in in the water - thinking this would be a good way to transition into using those muscles again - and it felt fine until hip just slipped and gave out. It was painful and scary and left me a bit shaken. After my hip slipped again with the bouey, i decided to get out of the pool and go home. Plus I had to race back for a work conference call before going to PT (balancing working from home with being a gimp - when everything takes 3 times as long, doctors appointments, and physicial therapy really sucks. I wish I could focus just on recovery. but i guess that is not the way its going to be). Anyway, I did go to physical therapy and asked about the hip slipping issue and she suggested that maybe it was a ligament slipping over bone which feels like the hip slipping out of the socket. I don't know. PT went ok (very mellow), but after leaving, i was using both crutches, and it happened again - left leg had the feeling that it was loose/slippery and then my leg went out. Had I not been on crutches, i woudl have fallen. Scary. So, I'm not giving up the crutches yet. Hopefully that will happen naturally in the next few days. And, I'm trying to look at the recovery in terms of weeks, not days - since progress day to day sometimes goes backwards and definitely doesn't go forward as fast as I'd like.

My worst fear is that surgery to correct too much bone coverage has left me with too little bone coverage - and a form of surgical dysplasia. I hope this is just me being crazy. My hope is that this is just part of recovery - and due to the fact that with the new greater range of motion in my joint I will have to activate and use muscles that have never had to work before - so maybe they just don't know yet how to work - and lead to the slipping feeling. I don't know. For now, I'm riding a stationary bike with no resistance around 40 minutes a day and doing a series of isometric exercises to remind my glutes, hammies, quads and core that its supposed to fire when I move.

Yesterday I also had an MRI with arthogram on the right hip. I have the same structural issue on that hip - though I've had less pain on the right than on the left. I had hoped to have the MRI before surgery on the left hip - since I was still riding my bike a lot and my right hip was aching/hurting. But now, since I've been inactive for 2 weeks, my right hip feels awesome. So, the diagnostic aspect of the MRI is lost - I don't know if the numbing injection in the hip made the pain go away since I wasn't feeling pain at the time. Hopefully the MRI will give an idea of what is going on and how much damage is there. Right now, with the scary stuff on the left hip, I'm starting to feel less certain abotu going ahead with the right hip. But, I want to move forward with the expectation that in a few weeks my left hip will be feeling good and I'll be more confident about the success of the surgery. Funnily, after the injection in my hip (5 inch needle into the joint capsule, with injection of contrast dye and numbing stuff), my right hip feels more painful at times than the left! i guess that is a good sign :)

Today I'm in LA with my parents - I got here last night. It is georgeous here - clear, blue, warm, beachy. I wish i could go walk on the beach. I will at least stick my toes in the sand :) Melodie and Mike get married on Sunday. Mel and I were teammates on Proman and Vanderkitten - here's a photo from our first race together in '08. Totally cracks me up. No brainer that we became very good friends.



I'm looking forward to catching up with my LA girlfriends tonight and tomorrow - I don't get down here enough! Steve and Lynn and the boys are in town too for a little while - so I get to see them and maybe get a little cute overload tomorrow afternoon. Meanwhile, doc review and work emails continue - but trying not to stress about that too much - and to enjoy a little mini break after all the bod's been through.

On my way

I'm writing this from my couch - partially reclined - left leg in a gameready machine - being pressurized and iced simultaneously, and in a cpm machine - which is moving it in a nice little up and down flex motion. I'm supposed to be icing with the game ready machine 24 hours a day for the first few days, and in the cpm maching 6-8 hours a day. Luckily, I'm still kinda drowsy and drugged up and not itching to do much more than this.

Surgery was on Friday morning. Jon was still in NYC - so my parents drove up Thursday afternoon and we got everything situated with their bedroom, and all of my christmas goodies - such as a raised toilet seat, a few different kinds of crutches, shower chair, walker, and reacher. My goodness! such good stuff. We then went down to sakae and ate some delicious sushi and i drank a bit too much sake. And then off to bed.

Alarm set for 4:45 am, so I could shower with the special soap as instructed, and get to the surgery center in Redwood city by 5:45. I was regretting the sushi and sake and the fact that i couldn't have anything to drink - as i was feeling a bit queasy - hoping that i'd hold it down until surgery. Once there, we checked in and i met with both the nurse - to get ready for surgery and get my IV in place and with the sales rep to get fitted and instructions for the various equipment I might be taking home. I was told that if I had a labral repair I'd wake up in a hip brace which would stay on, night and day, 24 hours a day for 2 weeks. That hip brace was huge and would have been not so fun. In addition, i'd be in the cpm machine. The CPM machine would be required for 8 weeks if I had a microfracture done. I was hoping for the best case scenario - just the game ready and cpm for 2 weeks. thats what I got :) Now, i say best case scenario, but I gather that the reason they didn't repair the labrun is because it was too far gone to save. So, while I like not being in the brace, I do wish I'd still have a labrum. can't win em all. But, I did not need microfracture - which means that I had enough cartilidge still intact to not need to create any more artifically. This is a very good thing in my book.

Before surgery I also met with the anesthesiologist, the medical student fellow working with my surgeon (who I had met at the pre-op) and the assistant. All were friendly and made me feel at ease. When I was wheeled into surgery - i saw Dr. Safran briefly and was in awe of the massive amounts of modern equipment. Then I said good night :)

My mom and dad talked to my surgeon after the surgery and he explained waht he had found and what he had done. My dad figured out how to use his computer to record the report so I got to hear it later which was really helpful.

When I woke up from surgery I was in a fair amount of pain, and was really foggy/groggy - i just wanted to doze off. I think the pain level was around a 4 or 5. They kept giving me more pain medication by IV but it wasn't helping the pain and was just making me sleepy and wonky. I also started to get really nauseaus, and had some medicine to help with that - along with some saltines and sprite. Once the nausea was under control and the grogginess faded away, we decided it was time for me to get dressed and leave. so, the nurse helped me into my shirt and pants, and i was rolled out the door. The drive home was not so fun. I felt like i'd been hit by a truck and every jolt in the road and every car that came too close felt painful. finally, we arrived at home, and my parents helped me down the 9 steps from the car to the house. Once i got all set up on the couch with my new gear, I was feeling much better. I slept through the night pretty well - waking to take pain meds at about 3, to make sure that any pain was kept in check. I stayed on full meds all day yesterday - which means i was napping a lot :) Last night was fine, except for a bout of nausea and feeling chilled by the ice machine. Today i've cut the dose in half, and so far so good. I'd like to be off the pain meds by tomorrow - I don't like the grogginess/spaciness and I feel like they mess with my body.

It feels weird crutching around - like my hip is loose in its socket. Jon thinks this is because i was in traction - where they pulled the hip out a bit. who knows - i guess that whole area has a lot to relearn. I had a lot of bone shaved off - and have more range of motion now than i ever have - so lots of muscles to strengthen. I'm looking forward to starting P.T. I'm also looking forward to getting this massive bandage off of my leg - whcih happens tomorrow at my first follow up.

I'd say that so far, this is an easier post-surgery situation than when i broke my collarbone. That is probably because with the clavicle there was a lot more damage and trauma with the collar bone surgery - with broken ribs, lots of drilling into bone, and lots of broken clavicle bits. Also, i think having one leg and two arms is easier than two legs and one arm. Except that I can't seem to get my coffee from one place to another - hands are full with the crutches. Thank goodness I've had a full support staff - Mom, Dad and Jon - alll generously helping out as I shout out commands. I'd better not get used to this :)

One last thing - I am feeling very good about my choice of having surgery with Dr. Safran. He and his team were all very professional and everything went flawlessly as far as I could tell. It is confidence inspiring when you are part of a well oiled machine. The Stanford outpatient surgical center was also very nice - felt sort of like a nice hotel. I'm happy to go back and have the second hip operated on there. Maybe i'll have my clavicle plates removed there as well.

signing off,
v

Surgery and Patience

After a lot of back and forth and information gathering, I've finally scheduled surgery on my left hip for April 13. That's 2 weeks from tomorrow!

I am so glad to be finally getting started on this whole hip recovery process. I had been hoping to have both hips operated on (and fixed) at the same time. Unfortunately, the surgeon who is willing to do that doesn't take insurance. While the hospital and anesthesiologist would be covered, I'd be out several thousand dollars - on top of my out of pocket maximum for covered services. It was going to be too much. So, I've come to terms with having one surgery at a time. Dr. Safran is very experienced doing surgery for FAI, and seems very knowledgable and meticulous - two things I appreciate very much in someone who will be operating on me. Here is a link to my surgeon:

http://med.stanford.edu/profiles/ortho/researcher/Marc_Safran/

This is going to be a major test of patience for me. Not only will my surgeon only operate on one at a time, he also has a pretty lengthy (and conservative?) post-op protocol. The other surgeon apparently lets you fully weight-bear within a week or so of the bi-lateral surgery (he said i could be off crutches in 3 days!). My surgeon, on the other hand, will have me on crutches for 2-8 weeks - with a maximum of 20 lbs weight bearing on the operated leg. I also will be hooked up to some large machines for several hours a day for up to 8 weeks and going to p.t. 3 times a week. So, its a more involved process. Once i'm off of crutches for the first hip, a month later I can have the other hip operated on - and then the whole process begins again. But, I'm feeling ok about it - I'm hopeful i don't lose my mind during the process and that the conservative route will pay off in the end. Why rush it. I have (hopefully) a lifetime on these hips. If 6-12 months of patience means that I can run again, can compete, train and push myself without pain - then its worth it.

I've already navigated the mental and emotional hurdles of not being able to train and being forced to re-define who I am (am I still an athlete if I can't train or race?) with the various injuries and issues I've had over the past 18 months. I think that was the hardest part. This is the less hard part. My biggest struggle will be fitting in all of the p.t., work, and strength stuff and trying not to gain a ton of weight. I have a tendency to eat more when I do less - and when I'm bummed out. Not a good thing. Hopefully i'll get to swim pretty soon and start doing some core and strength traning to keep me sane and keep the endorphins coming.

Preparing for surgery (and post-surgery) is kind of funny. My mom and dad are coming up from LA to help out - with my mom staying for a week +. This will be absolutely invaluable. We have done this before. Last June when I broke my collarbone in Tulsa and had to have surgery - my mom flew up from LA to meet me at the airport in oakland and stayed with me for a week. It made recovery so much better - not only practically speaking - someone to help me feed myself, put on clothes, grocery shop, pick up pain meds, drive me around - but also mentally. It was nice to have a caring person around to chat with, watch tv with, and keep my mind off of what was happening. So, this time around I'll have my mom and dad for a while, my mom for even longer, and Jon - while he's not working or riding. I think it will be fun :) Work's been stressful and busy lately - so it will be nice to have the break from that as well - to focus solely on healing and taking care of myself.

I'm told I'll be in this lovely contraption for 2-8 weeks for 2-8 hours a day. Jon is already jealous.

Success!

Yesterday's commute was a success! Instead of riding my fancy carbon bike to work and risking it being stolen, I rebuilt my Klein with some decent parts and am using that as my commuter bike. It is riding reallllly nicely (thanks Dmitri!). It is probably a few pounds heavier than my normal bike, and slightly different geometry. Funnily, the bike's stem isn't adjustable at all - its old school - and all one piece. So, the only thing that is adjustable really is my saddle. I'm lucky it fits as well as it does! I scored on this bike on craigslist back in 2002 or 2003. It was my first road bike and I loved the Klein. She had a triple chain ring and some random parts, but totally functional. I raced my first year on that bike - and upgraded to a cat 3 all on the Klein. Pretty cool. I then went out and splurged on a cervelo and that was so amazing - I felt like i was cheating... anyway, i digress.

So, riding the Klein is a bit different, as is riding with a bag. I'm hoping I can figure out how to make the bag a bunch lighter as I go forward. I think leaving the big lock at work and toiletries at the gym is a start.

The commute was a success. The views were beautiful. I went up and over San Bruno to Skyline, down to great ocean road...

Up along the cliff house and lands end, through the legion of honor...

past baker beach to the bridge. Since I had time and it was beautiful, I decided to add on the Marin headlands loop. It was sloooow going up that hill, but so worth it for the georgeous views going down the back side.

I'll be sad when that road is closed - which I hear is from April through October. I'm hoping that will coincide with surgery/recovery - so its there when I'm back. Selfish, yes. After the loop, I rode back across the GG bridge, dodging tourists, and down along the marina green to downtown. It went very smoothly, and I was showered and in the office by noon. Sometimes i forget how lucky I am (for so many reasons) to get to have all of that riding, fresh air, views, endorphins, before work. It is so rad.

New Commute

Today I am finally breaking in my new plan of riding to work. Its been raining here alot lately and I'm finally getting over this lingering cold, so I decided today is the day. I'm meeting Jon in Burlingame for dinner tonight, so I get to try out caltrain on the way home for the first time too... should be quite a learning experience. I'm excited.

How fitting that google maps now has directions by bike!!
http://airbornecombatengineer.typepad.com/in_decatur/2010/03/google-maps-now-providing-bike-directions.html

Unfolding

The past 18 months have been quite a ride. In summer 2008 I was racing my bike like a fiend. Loving the sport, the training, the competition, the possibilities. Then, I overtrained, crashed hard, and apparently dug myself into a hole. The end of the 2008 season was disappointing, mind bending, and hard. Priorities changed along with my perspective, but I continued to want to train, compete, succeed. Winter of 2008/2009 brought a strange and undefined health problem that took me to many doctors without a solution. In retrospect, I think i was overtrained, exhausted, and beaten down. My body needed to rest and recover and when I refused to listen, I got slapped around a little. Unable to train, unable to breathe. It was rough. But, February 2009 came and I started to ride, to train, hoping to get fit enough to race again at the level of the year before. The training was hard, the racing disappointing. Finally, I had clawed my way back into shape enough to feel like I could be a factor in races, and then BAM - Taken out at 30mph in a crit in Tulsa in May 2009. Shattered collarbone, broken ribs. Surgery required. 2 plates and 16 screws later, I had no more mojo to get back on my bike for the rest of the season. I couldn't bring myself to fight back into shape on what little base I'd accumulated during the spring. So, I rested, reevaluated. Adjusted priorities and goals.

It was then that I started dreaming of running again. I had stopped running in 2005 after years of injuries had repeatedly sidelined me from training. I was never a fast runner. But i loved it. The endorphins, the trails, the solitude, the views, the air. I had been so sad to give it up when I tossed the running shoes for the bike in 2005, but it seemed the only choice at the time. In Fall of 2009 I started to think, if I took it slow, kept up core strength, did cross training - maybe I could run without pain and injury. Maybe I could compete in a trail run. Maybe I could even do a triathlon again. So, i bought some running shoes, bought a book on chi running, and started to run.

I didn't get very far. In June of 2009, on a few rides after my injury, I started to have what I thought was a groin pull. It hurt getting on and off my bike and sometimes while riding. I had no trouble on a backpacking trip in September, but by October, it was hurting pretty badly. My little runs had become impossible - sore and achy from the waist down, but particularly my hips. The hip flexor tendonitis of 2002/2003 came back with just a few minutes of jogging.

Then I went to my surgeon for a follow up on my clavicle surgery in October 2009 and asked her if she knew any good hip doctors - I thought I needed some P.T. and once again, that I was just destined not to run. She asked some questions and took some xrays and told me that I had "FAI" - short for femoral acetabular impingement. That I could try physical therapy, could try a steroid injection, but if those didn't work, I'd need surgery.

So, here I am, March 2010. PT didn't solve the problem. I've decided to have surgery to fix dem hips. Right now, I'm planning on surgery in early April. Surgery on the second hip would be a few months later.

I'm not expecting surgery or recovery to be easy. Knowing myself, it is going to be incredibly hard to be laid up on crutches and inactive for months at a time. But, I am hopeful that afterwards I'll get back not only to biking pain free, but that I may be able to run again. I have set a goal in my mind that I'll do a triathlon in 2011. Maybe sooner. We shall see.

This is my story.

My First Year

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