Tuesday, July 31, 2007

MRI #3...over

I am going to start this post like yesterday's...I DID IT!! ITS OVER!! IT SUCKED but its OVER!!! I feel accomplished!
I had a lot of apprehension leading up to this MRI, and I am not a nervous person, but since my last MRI sucked so much, I was pretty anxious about having to do it again. I was anxious all day, I could barely eat at lunch, and it was just an MRI. I am less apprehensive about huge needles going into my hip and even surgery, I don't get it!
I decided to bring my own music this time, at my first MRI, I was given an array of choices, classical, rock, pop, country... I chose pop and ended up enduring 45 minutes of rap music. At my second MRI, I explained to the technician what had happened with my music choice, so he put in a Billy Joel CD for me, it was better than the rap!! But everything else went wrong with that MRI (see earlier post).

So needless to say, I was scared of having another bad experience, I would not say I am claustrophobic, I hate labels, but confined spaces don't thrill me. I was mostly afraid of swallowing, and having the swallowed contents get stuck in my throat and block my airway, as in MRI #2. So I have been practicing in my bed every night, swallowing while lying down, while taking slow deep breaths. I discovered that if I tilt my head back a little, it is easier.

As I was waiting for the technician to come for me, he brought back a lady who had just had her MRI, she said he was wonderful, but I didn't think it mattered how wonderful he was, unless he was having the exam instead of me! But boy was I wrong. I told him upfront that I was scared, and explained what had happened last time. He joked around with me and just made me feel at ease. He joked a lot, it took a few minutes to set me up, with the pads in the right spot, the coil on my hip, my legs taped together...Just as I lay down, my heart started racing, shit, I couldn't swallow, so I sat up and asked him for some water, and apologetically explained that I am not normally such a pain in the ass! He was fine with my request and jokingly asked if I wanted scotch instead..YES!!!

I finally settled in, he gave me cool glasses with a mirror so I could see behind me, and see him in the little room behind the glass. I really liked him, he promised to keep talking to me and letting me know what he was doing. He showed me how to adjust the glasses, and asked if I could see the man in the room, he said "in 15 minutes I am leaving and he's taking over", "Yeah right!!", "No, I'm serious, my shift is over and I go home, you'll be fine, I'll tell him you're scared and he will continue to walk you through". OK, I can handle this, I made it this far already!!

So we began! 3 seconds in, I started to have a panicky feeling, shit, I am going to have to stop this, and reschedule with Valium. No, I am here, lets do this. So some deep breathing, happy thoughts and Green Day playing in the background got me through the worst!

He kept me informed of how long each scan would be, finally, he said, "OK, last one, 4 minutes", phew! I am doing great, only 4 more minutes, I can do this! It ended, and I am getting really hot, and the panickiness is returning, I need to get out, I know the end is near. He announces "I am just checking the pictures", in my head, I was saying, they better be perfect because that will be as good as they get! They were, and he came to take me out!!

For me, the keys to a successful MRI were: A good, encouraging technician, my own music, and keeping my eyes closed the entire time. I have added this to Learn From My Experience/ Mistakes. I hope I never have to go through this again!!! Now the waiting game begins for the results!!!

Monday, July 30, 2007

All in a Day's work

I made it. I am exhausted. But I did it!! Yay!!! I feel so accomplished. Did it hurt? Yes, but it was sooooo worth it!! I am back to work! Luckily, I had a light schedule today. There were a few "issues" involving my work performance, that I had not anticipated. First, I was working with a lady who preferred to be on a low table, so in order to stretch her, I was kneeling, sitting back on my heels, I suddenly developed that deep, gnawing groin pain, and had to find another position to work in. The other issue came from left field. I work in an outpatient orthopaedics facility, with mostly surgical and orthopaedic conditions. We also have a pool. I had a new patient, wheelchair bound, who wanted to use the pool, and needed to be transferred from her wheelchair to the table. This almost never happens, my patients are usually higher level functioning. There was no way in hell I could pull this off, probably even on a good day!!! After some discussion and shuffling, I got the situation under control!!!

Besides for that, everything was going pretty well, until my SI joint decided to give me trouble. Yes, again, when it rains it pours. Interestingly, my dysfunction was a posterior inominate on the right, normally, I get an anterior inominate, I assume it is from the hip flexors tightening up and pulling it forwards. Today it was posterior. P hypothesized that maybe it went that way bc the hip flexors are weak? I muscle tested a 4,4+/5 on that side.....so who knows. He corrected it with a MET, he said I was "stuck" on that side. He also released (sigh, again) my iliacus and psoas, which REALLY hurt. I stood up and felt great, walked to my computer, sat down, and had groin pain (sigh). I am beyond frustarted at this point, I don't even know what to think anymore.

The rest of the day was uneventful,, the kiddies slept late, until almost 5:00, so we did not do anything this afternoon, other than a short trip around the block, L on her bike and Jk in the stroller. What a sight it was, since L is not great at riding, me pulling her with one hand and pushing Jk with the other! As I sit here and blog, my hip pain is back with a veangence, and just in time for my Target excursion!!

If you have gotten this far in my post, I want to try something. One of the hardest things I found when my hip journey began was finding a list of symptoms correlated to a labral tear and FAI. If you would like to help, I want to compile a list of people's sympotms in the "comments" of this post, and in a week or so, publish it as a posting, so others have a place to compare notes.

Here were my pre-op symptoms: Groin pain, deep deep groin pain, not always excruciating, but so annoying I felt like cutting off my leg, tight hip flexors, pain with sitting, pain with walking uphill, pain with pushing my stroller. I did not have radiating pain down my legs, all the hip pain was anterior medial.

Chapter 2

I feel like I am starting a whole new phase of this surgical experience today, I AM GOING TO WORK TODAY!!!!!!!!!!!!!! Can you tell I'm excited!!! I have this nervous anxiety going on, but I am thrilled to finally be going back! wanted to go back last week, but they didn't believe me that I could spend 4-5 hours at a time on my feet (ok, I lied when I told them I could, but this staying home business is making me crazy). I decided to schedule PT on days I am not working, just for this week, I think it would be too much to work out, then see patients, next week I will change things around. Going to work should also help my super-bitch counterpart tone down a bit, hopefully!!

I have spent a good portion of the last few days/ weeks online, researching hips, again. I did this for the whole month of December, before my diagnosis, I feel like I am back there, but nothing has chnaged out there in 7 months. Tommorrow is my MRI, I am so nervous, I don't know what they will find, and if they will be able to see anything. I don't even know what I am looking for online, all I know is that I have a sore neck from having my laptop in bed with me, and I have not come across a single new piece of information, but again, I am not too sure what to look for!

Yesterday we spent a great day out with the kids, we went to the Wiggles show (for those of you who don't have kids yet, once you have kids, you will know exactly who the Wiggles are!). My hips did fine for the show and walking around the arena, the only issue I had was after the show, it was pouring rain. Of course we did not have umbrellas, J carried Jk to the car, and L and I walked together, I say walked because I am not able to run on my left hip, it just doesn't go. So we got a little wet, but no big deal. While we were in the car, I had to turn around to give Jk a blanket, I was on my knees and turned, and heard/ felt a little click in the right hip, and then my pain came back, it was weird.

Today is Monday, my MRI is Tuesday, I hope to have an answer by Thursday at the latest, in case I need an injection, since the following week we are going on vacation, I would like to have it done before then!

Friday, July 27, 2007

Ignorance is Bliss...or is it???

Let me start by saying that I scheduled my MRI, but like everythig else in my life these days, it could have gone smoother.

I called Dr. Kelly's office this morning to have them set it up, which is already annoying, I could just as easily called myslef! So the receptionist asks me when is good, I said Mon. afternoon, or Tues. or thurs. all day, but the sooner the better. She leaves me on hold for about 5 minutes, comes back and says they are not answering. I remind her I need it at HSS, whoops, she is trying to schedule me somewhere else. I need HSS bc they have my prior scans to compare. Oh. So she calls HSS. How is Thursday, after 2? Fine I say, she says ok, so I said what time exactly, bc after 2 is not very specific, so she puts me on hold again, 1:00. Fine, sigh, nothing earlier in the week? No. Fine, I take it.

Later in the day, I am not pleased with a Thurs. appointment. This means I won't have results until the following week, the suspense is killing me! So I decide to take matters into my own hands and I call HSS myself, they can do Mon. at 4:30 (too late in the day for me) or Tues at 2:30. Perfect! Sometimes you just have to speak up and do things yourself!

I have been trying to imagine that all of this is synovitis, or the psoas. I go into my old MRI reports, to see what they had shown. Did I have synovitis the first time? No, both reports specifically say no synovitis. I know this doesn't mean much, since he did find it with the scope, but I want to make sure all grounds are covered, and there are no unexpected surprises. My husband would say stop being neurotic, you know too much, but I think this helps keep me more sane than not!

Thursday, July 26, 2007

Uncertainty

I have had a day of indecisiveness!! If I had had time, I would have posted my question to all of you and maybe had some help, but I ended up coming to my own decision. So...what the heck am I talking about???
As you know, my right hip has been pretty bad, it is at the point I was before surgery, sex hurts too, so when I am ready to actually go to sleep at night, I am in so much pain, it is hard for me to fall asleep. I really don't know what to do, I was afraid that if I called Dr. Kelly, he would blow me off, tell me it is compensation, and leave me even more annoyed and frustrated, which I cannot handle now. But I was getting so frustrated with the pain as well...I didn't know what to do. My friend Amy, who has been through a lot of hip shit told me to call him, she didn't understand why I wouldn't, P, my PT said not to bc he knew I would be pissed. So after much deliberation....I called!

My message went like this: Please tell Dr. Kelly that I am having a lot of issues with my right hip, and it is not from compensation!

He called me about 4 hours later, in the past, I have waited 4 days for a call back! I am highly impressed!
I explained that I am having a ton of pain in the right, very much like I had pre-op, pain in the joint, non-palpable. He said it could be the muscles acting up, maybe we should inject the psoas...I repeated that the muscles are fine, my PT worked on them ART'd them...they are not the issue. He said it could be synovitis, the joint is inflammed from the added stress. I reminded him of the twisting episode, and how I am not sure what to think of it, especially since I went on crutches 3 days later, and I really don't know what to do, thats why I called! He said I could get the joint injected if I wanted to. Again, I don't know what I want! So he read the chart over for a few minutes, he said he is confident that I did not re-tear the labrum, this is why he likes to debride, bc there is nothing left to tear. Sometimes, the mechanics of the joint change, causing the muscles to act up. I could get an MRI if I want, but sometimes it is hard to read in the area of the old tear, so it may show nothing. Ok, I really didn't know what to do. He said continue working on it in PT, have somene work on it, modalities of my choice.... still looking through my chart...ok, get an MRI, then we can decide on the injection!!

So, now I am glad I called, at least it is all out in the open, not just on my blog! So, he thinks it is synovitis, I think his first thought is the psoas, possible tendonitis, but the joint hurt first, the psoas does occassionally flare, but it is in response to the joint flaring. So now I am nervous. First of all, my last MRI was awful, I almost panicked. I had a really bad cold and was really congested, also had a cough. Midway through, I needed to cough, alot, but I was afraid to move. But I really had to, I pressed my button, I informed the technician of my needs, he said I could under so circumstances get up bc the machine takes a picture of the hip angles in the beginning and uses them to compare all the images. So I stayed there, and began having a coughing fit, then all this gunk got stuck in my throat and I felt like I couldn't breathe, it was such an awful feeling. I have had awful flashbacks of it, and have been petrified to have to ever have another MRI, I never thought I would! Then comes the issue, what if he finds something bad? I don't want more surgery? Or, what if he finds nothing? Where does that leave me? Crazy????

Wednesday, July 25, 2007

Normalization

Today has been the most normal day I have had since my surgery. I am 3 weeks, 3 days out. Here is how the day went: I took L to camp, went to the dentist (see post below), went to the mall (I don't go to the mall as often as you think, but it is an "activity" for me since I am so bored), took the kids for a walk in the stroller for the first time, fed the kids dinner, bathed the kids, put Jk to bed (L is watching a dvd in my bed).

It feels great to be resuming my normal life again, it is like I am free! I hate depending on others for everything, as much as I hate giving baths, I have never appreciated my ability to actually give a bath before. Yes, I am totally exhausted and ready for bed, I feel like I ran a marathon today, but I completed it!

Things are definetely going so much better this time, I hope it is a sign of how things will be in the future. At this point last time, I was on one crutch, not going to the mall, definetely not pushing my monster truck of a stroller, and not even thinking about giving a bath.

I did develop a slight limp at the mall, a painfree limp though, my hip flexors are still pretty weak and it is a little bit painful to lift my leg, especially when getting into the car, but it will soon resolve. I needed a day like this to lift my spirits and make a add a more positive post to my blog.

When I decided to create a blog, it was with the intention that I would be able to portray a very positive experience with my surgery and rehab...I didn't mean for it to become a place for me to whine and complain all the time, so I apologize. I do hope that in the end, I will have a positive outcome on both sides and can move on with my life and live relatively pain free, it will just be a little longer because of my latest developments. Thank you all for your support and encouragement, it is really helping me get through this.
To those of you who actually have to live with me (if you are reading this), I apologize for turning into super-bitch. I will try to not let me pain and frustrations get the best of me, I will try to stop losing my patience, snapping and yelling. I love you!

Follow your Instinct

I have been having a lot of doubt over my decisions of the past few months, but after today, I am happy I went with my instincts. Yes, I may not be having the "happiest ending" but hopefully I will, and maybe it will take one more surgery to correct all of my problems, but I think I went the correct route. So where is all of this coming from?
About 1 month ago, I went to the dentist, I had been to him a year prior as well, for my first visit. He was a dentist of convenience as his office was located in the lobby of my building. At my first visit, he informed me that one of my old fillings needed to be redone, either with the same stuff in it now, or he could make me a crown. The tooth was not bothering me, so I ignored his advice and returned a year later for a cleaning (I was busy during that year with hip stuff so put off the cleaning!). At this appointment, he again, told me to redo the filling, but this time he said I needed a crown. I asked if he thought the problem had worsened over the last year, to which he answered he could not tell. So why do a crown? He didn't give me a straight answer, or one I was pleased with. The crown was also pretty pricey. My uncle is a dentist, his practice is a little over an hour away, so I decided to get his opinion, and let him do the work. After many x-rays and inspection of the teeth, he found absolutely nothing wrong. I am so pissed off at the first dentist. The point of this story is that when something does not feel right, or if you have questions that are not being answered, it is ok to seek a second opinion. Had I not followed my gut instinct this time, I would have spent a fortune of money on something I did not need and had to endure painful dental work that would have been totally unneccessary. I feel like calling the first dentist and telling him off!!!

Tuesday, July 24, 2007

Ups and Downs

This is really a crazy, unstable recovery! This is a warning to those undergoing it or who will undergo it! Each day can be so different. With my first surgery, I tracked my progress in terms of weeks, I used Saturdays, how much more was able to do each Saturday, and it was usually measured in terms of walking distance and assistive device.

I really spent a good part of the day in bed today, I needed a break, both physically and emotionally. My left hip feels better today, the psoas is sore as is the joint itself, but better than yesterday. The right side hurt, even while in bed. The muscles hurt as does the joint, I don't think there was much benefit to the ART yesterday. But on a more positive note, my life is definitely getting back to normal, I walked L to her tap/ballet class today (yes,I did eventually get out of bed), and tomorrow I plan on going to the pool with both kids. Once I can do that, everything will be more or less back to normal, on the outside. Of course there is still a lot of healing to do on the inside.

Because things have been so crazy lately, I have been a bit neglectful with household things. This is how L came home from camp today.

Her teacher taped a note to her dress to remind me to send something in!!! How embarrassing!
I think taking today as an "off day" will really help me to continue to progress on the left, I need to be more disciplined with strengthening on PT off days!! But one thing at a time!!!

Monday, July 23, 2007

3 Weeks post-op

I went the whole day without crutches, I think I am in the clear, but my SI joint hurts, probably because I still need a crutch, or maybe a cane, but I am so not doing a cane!! If the SI doesn't resolve, I will have P fix it on Thursday, it is not too bad though, I have taught J how to fix it for me in the past! I tend to get awful SI issues at 3 months post-partum, it happenned both times, but I have trained J well!

I had PT today, I almost broke down, but the look on P's face when he saw that I might cry was enough to make me hold back my tears, and boy did I have to fight to hold them back. He had that look that men get when a girl is aout to cry and they really don't know what to do! I am laughing now thinking about it! My office was pretty busy today, so we didn't have a room, so I really didn't want to cry in the gym, so I held back. I finally just came out and said I think my first surgery failed (then fought really hard again to hold back the tears). What??? Are you sure? I thought it was just compensation??? So he looked at it, again, and all of my symptoms were back, my original November symptoms, decreased ROM (I have practically lost all IR), sitting pain, pain with ambulation during the stance phase of gait. So he worked on that side today, TFL, psoas, both super tight. He also did some mulligan belt mobs, to try to increase my ROM, and some anterior hip glides. For the other side, he stretched/ ART'd my psoas and worked on my scope sites. Originally, I had decided to not let anyone work on the scope sites and see what would happen, and compare to the other side since they had been worked on extensively after my first surgery, but they really looked and felt awful today, so I gave in, so my trial is over!

I had to cut back on the single leg stance exercises today bc my operated leg was beginning to get irriated, probably from all the stair climbing this weekend, and lack of crutches. The (sort of) good news is that I am having anterior tightness now, I didn't develop this until much later on last time, so hopefully it is a good sign, that things are progressing quickly. I need to take an "off day" tommorrow and let things calm down in the operated hip a little, it has definetly been abused the past couple of days. I have some pain in it, it is similar to my pre-op/ post-injection pain, it is tolerable!

I added a link today in Learn From My Experience/ Mistakes, it is called Orthopaedic Considerations for Intercourse. It is not made specifically for hips, there are some positions approved for total hip replacements, these are labeled THA. What I think will work best is if you know what positions are painful for you, and use the pictures to help guide you in choosing a position that would work for you, like most things, sex after a hipscope does not come with cookbook instructions. What is helpful are the "tidbits of information" on the bottom about each position. But you may need to trouble shoot in the beginning until you find what works for you. The 7th position works best for us early on. We have been having intercourse since 2 weeks, 2 days post-op, without too much of an issue.

Sunday, July 22, 2007

A Pain in the Butt continued

I am home (sigh of relief)! The carride home was uneventful, L and Jk slept for most of the time. Now I can vent about the weekend without fear of things being left behind on other's computers!
So the whole issue with the stairs, it sucked. It is hard for me to ask for help, so I don't. I also don't always get the help I need from my IL's. I found it hard to keep asking for other's to go get my things, a diaper, wipes, a book... and bedime came, so the kids wanted me, so up and down the friggin steps again and again. As i mentioned in the first half of this post, my right hip was pretty bad all weekend, left was ok, and when I was putting Jk to bed, I had my first meltdown, tears and all, more on my numerous meltdowns soon.

Its not that I don't get along with my IL's, it is just an uncomfortable tension that exists, and has always existed between us. To make matters worse, J's grandparents were there as well, they can add tension to any situation. I just did so much walking, stair climbing and standing there, I am exhausted.

So now, at 12:40 am, I am in my own bed with my laptop. My operated hip is stiff and tight, but I just sat in a car for 3 hours. I am developing the anterior tightness I had last time, but much earlier,I remember bringing it up to Dr Kelly at my 8 week appointment, so things are moving quicker this time.

I had a few other "tearful" moments this weekend, I think I am accepting the fact that I retore the labrum on the right. I know, I said no jumping to conclusions and its too early to tell, but this pain is not compesation pain, once you experience the torn labrum pain, you don't forget. And I have no imaging to back me up, which is fine, this way it is not really reality, at least not yet. I have been upset and angry about it. I really thought I did everything right, I went to a top hip guy, we found the impingement and thought it was addressed, rehab went great, but somewhere along the line, something went awry. I keep saying that I feel like I wasted so much time, 4 months of PT, 4 weeks of crutches, and all for nothing,I am back where I started. Looking back, I don't know what I could have done differently, but I feel like I failed at this. I hope I am wrong, I hope I am having an emotional/ hormonal day and completely overreacting about it, and in 2 weeks I will wake up and have no pain!

Ok, I feel better now! Got that off my chest! So I ended up leaving my crutches behind this afternoon,Jk and I went to the mall, I got a pair of ballet flats http://www.gap.com/browse/product.do?cid=34759&pid=514975 (very cute if I do say so myself), walked around a little but then had to go home. I can't expect to be able to walk for hours on my first day of of crutches! My gait was not perfect, but it is improving each day, and I used my excursion as personal gait training,I tried to focus and swinging my leg straight through, and not around!

After the mall, Jk and I picked L and J up from the basebal game, she had a blast, as did he! We got home, I was trying to unload the car and help L run in to use the bathroom, and the nxt thing I knew I was on the ground.I tripped on some water thing on my IL's sidewalk. It was so scary, luckily, I landed on my knees/ hands and spared the hips, but I just sat on the ground, stunned, with J asking if I am ok, and if I hurt my hip. I was fine, the only damage as the grass stain on my white leggings!

So now i am home! It is such a great feeling! I can focus on my rehab and returning to work, no later than a week from tommorrow!

Looking for Advice

I am looking for advice from you, my trusty readers (I will post A Pain in the Butt...part 2 tonight).
I woke up this morning and feel a lot better. I haven't left the house though, J and my FIL took the kids to a duck pond to feed them. L and J are going to a baseball game later and I want to go to the mall to buy a new pair of ballet flats (being that my right hip hurts a lot, I figure it will be a good investment for the future, plus Gap has a few cute, cheap pairs right now).
Do you think I should take my crutch? I know, I am the PT, but I am so sick of it, and I will look stupid pushing the stroller and holding a crutch, I can do it though, if I need to, but really don't want to!!!
I am afraiud of a setback, but want to move on!!
What do you think? My gait is better today, but not perfect!

Saturday, July 21, 2007

A Pain in the Butt...in every possible way

Being that my mom left, and I was in no hurry to cook and deal with the kids on my own, I thought maybe coming to my in-laws for the weekend would be a good idea. Let me remind you, I live in New York (in a suburb right outside NYC), in an apartment, with an elevator and doorman. My in-laws live in Boston, about a 3 hour car ride, in a house, with 3 floors, and lots of steps.

Everything was going well yesterday, I walked L to and from camp, walked to the bank, to the nail salon, to the drugstore, all with one crutch, but I was on top of the world, for sure by tomorrow, I thought to myself, I can lose the crutch.

So we began our drive, we were doing great, the kids were behaving, about 30 miles before we got here, traffic came to a standstill, and practically stayed like that for 2 1/2 hours. We were on the highway with nowhere to go, my biggest fear was that L would have to use the bathroom, but she did great!


So our 3 hour car trip turned into a 5 1/2 hour car trip, needless to say, I did not practice what I preach, and remained sitting the whole time. When we arrived, I was STIFF!

Next came the exploration! Jk was running circles around us, he was just so happy to be out of the car, then he found the steps. This is when things got ugly for me. I really never have any need to do steps, I live on a high floor so never consider walking, my office has no steps and Target has an escalator (this is why America has such a high obesity rate, but I digress!) Stairs are really hard for me. And up and down numerous times was awful. I dumped my crutch when we got in the house, but desperately needed it for going up the stairs. By the time we sat down for dinner, I was in excruciating pain, but more on the right side (first hip). I was panicking, the pain was so intense, like pre-injection intense. I wanted to cry, out of pain but as well as fear. By the time I put Jk to bed, I had real tears, but kept them to myself, as I only express my "hip emotions" here!

By bedtime, both sides hurt, my gait was awful, I really needed to be using the crutch, but it is so annoying in the house, especially with kids (I know, again, not practicing what I preach), so my back started hurting because of the way I was walking/ compensating/ twisting.

This morning, I felt better, but soon all my bad habits came out, no crutch, up and down the steps... right hip pain, left hip pain, low back pain, piriformis pain. That one is new. I think my SI joint became a little rotated, which for me, causes my piriformis to spasm, you can tell that so far, the trip has been lovely. I will get into more details about why I was up and down the steps when I get home.

I have also been exhausted since I got here! I napped this morning for 2 hours while Jk did, then dozed off again in the afternoon. I have been tired since surgery, and early on had a scheduled nap each day! By late afternoon, I couldn't take the pain anymore and took Tylenol, this is big for me, I am not into pills, I prefer pain, as long as I am not in tears, like today. I find that in my case, I take something (these days nothing other than Tylenol), I feel better, I overdo it, and end up with more pain later so it is not worth it. Pain is your body sending you a signal that you are overdoing it.

I know I need to be on that crutch, I actually feel so good in comparison when I am on it, then when I am not. We walked to the park today, I took the crutch, and did great. I was not able to walk and chase the kids at the park since I had been having such a crappy 24 hours. I also end up doing a lot of standing here, the kids sit at the breakfast bar when they eat, so I am up and down getting everything, feeding them, cleaning up after them...

I am finally sitting now, at 11:30 pm, I am being rude, the whole family is downstairs eating ice cream, but I needed to get everything off my chest, and more will come when I get home! I am evaluating the day, the damage possible done and pray that I did not have setback from this mini-not-so-vacation! Live and learn!!

Thursday, July 19, 2007

One Darn Crutch

Stupid crutch. I need to get rid of it, I can't deal with it anymore. The sad thing is that it doesn't hurt when I don't use it, I just look ridiculous! It is a terrible thing to ambulate with an antalgic gait pattern, especially when it can be corrected by using a crutch. I know it is only for a few more days, but I don't know how much longer I can take, I have run out of patience. I know last time, at this point, I was still on 2 crutches, but I feel so much better this time. And I keep saying to myself, ok, this is the last day with the crutch, and then I wake up and still need it.

I saw J for PT today, I didn't tolerate a traditional ITB stretch (Ober position) so she decided to do some manual release stuff, it killed, except for over my numb patch, see, something good came of it! I was able to do some more modified single leg bridges. Later in the day, I tried some of P's "custom for me" exercises, a psoas strengthener, sitting on the edge of a low treament table and holding my knee to my chest, without my hands. I was able to do it. Last time, this would have caused a terrible tendonitis flare up of the psoas, this time, no problem. I had a lot of psoas issues last time, we decided it was tightening so much bc it was so weak, that exercise helped target it and strengthen it.

I asked P for his blessing in not doing aqua therapy this time, since it was such a pain to chnage and be wet and smell like bleach all day.... he said no problem, as long as the gait issue resolves soon. I think we are all just so impressed with the change in recovery time from one side to the other. P watched me walk like a hundred times so we could figure out the problem with the gait. At first, he wasn't too convinced with my description, I said "I feel like I am circumducting my pelvis as I weight bear on the left". Huh??? He gave me a puzzled look, then watched, and watched again, and then a few more times, hmmmmm, what the heck are you doing while you walk?? See, I told you! "You're right" he said!! But why??? So I walked more. We decided that my hip extensors are weak, and I am having trouble eccentrically contracting my hip flexors, so I can't pull my body over my leg when it is on the ground while I am walking, so I thrust my pelvis out to the side to get over the leg. It is not as bad as it sounds, but not good for you, nonetheless. It is amazing how one crutch can instantly fix this.

On a more positive note, I went food shopping alone today. I had to limit my purchases to what would fit in my basket since I can't push the shopping cart yet, but it felt like a good accomplishment.

Later in the day, I needed to go to Target. For those of you not familiar with Target, it is the greatest place on earth, you can buy EVERYTHING there, seriously, you name, they have it. To illustrate my point, I will name a few items in my cart: Diapers, ball, milk, laundry detergent, floor cleaner, crayons, t-shirts, bathing suit, spray bottle. Target I couldn't do alone, so my nanny came + L and Jk, before their nap! It was quite a site, me on one crutch, and my nanny pushing my cart with both kids in it. I got them to behave by promising them we would go to Starbucks when we were done, which by the way, is inside of Target!

Being that I am sick of the whole crutch business, I needed to prove to myself, again, that I am capable of doing things on my own. So I cooked dinner, fed the kids and cleaned up (didn't do all the dishes yet, maybe J can pitch in). I also got sick of the kid's toys being in disarray all over the living room, my nanny thinks that if she piles them all in the corner, they are cleaned up. So I collected all the stray pieces from all the toys and matched them up with their respective owners. Lots of bending and standing and back and forth from room to room. I did fine with that.

This is a long post, but I need to get everything off my chest. I am having those "am I crazy" feelings again. Since I am not sure what is going on with my first hip, and the pain comes and goes, I start to wonder if I am imagining it, or what!!! After PT, it became painful, it was that awful, deep in the joint, squishy pain-like feeling that is so annoying you want to cut off your leg. Oh, just like before the first surgery, and just like then, exercise aggravates it. Shit. I hope I am just crazy!

Wednesday, July 18, 2007

Are you reading my blog???

Hi guys! I just added a site sounter to my blog, and it is recording hits! Is someone really reading this? Then why no comments? Let me know what you think, is this helpful? Are you laughing with me or at me? Are you in the same situation? pre-op? post-op? not sure? Are you stil trying to find a diagnosis? Are you rehabbing?
Thanks
-Susie

Operative Report 7/2/07

Second Surgery
*these reports are dictated, therefore, some words are missing and or incorrect

After the patient was correctly identified in the holding area, she was brought to the operating room. Spinal anesthesia with combined epidural was administered. The left hip was prepped and draped in the usual sterile fashion.

The lateral portal was established under fluroscopic guidance and then a distal lateral accessory portal was established.

Arthroscopic examination demonstrated a large anterior superior labral tear with associated___________ lesion also evidence of a Cam delamination effect and associated synovitis.

At this point, a labral tear debridement was performed at the level of the affected tissue. A smooth contour was achieved to the anterior, inferior, and posterior superior labrum.

Then, the acetabular rim lesion was clearly identified and a rim decompression was performed to reestablish the normal contour of the femoral head and neck junction. At the completion of the rim decompression, a wide synovectomy was then performed using the Tac-S radiofrequency probe.

The cartilage on the femoral head and acetabulum within the joint were in good condition. the ligamentum teres was in good condition, as well. At this point, the scope was brought into the peripheral compartment and a Cam bump identified with clear synovial herniation and pitting.

The junction between the normal articular cartilage and the area where the impingement was occurring was clearly demarcated and a Cam decompression was performed using a 5.5 mm high speed bur. Re-contouring of the affected region was established with good reestablishment of the normal articular cartilage. At the completion of the Cam decompression, all bony debris was evacuated from the joint. No further pathology was identified.

The instruments were removed from the hip and the arthroscopy portals were closed with 3-0 nylon sutures. A "morphine" (should say marcaine) cocktail was placed into the joint. The wounds were cleaned and dried. Sterile dressings were applied. The patient was awakened from anesthesia and brought to the PACU having tolerated the procedures well.

Operative Report 3/5/07

First Surgery
*these reports are dictated, therefore, some words are missing and or incorrect

After the patient was correctly identified in the holding area, she was brought to the operating room. Spinal Anesthesia was administered. She was placed in supine position on the traction table and approximately 10mm of traction was achieved across the femeroacetabular joint.

The right hip was then prepped and draped in the standard, sterile fashion. A lateral portal was established under fluroscopic guidance using the Seldinger technique, distal lateral accessory portal was then established.

Arthroscopic examination demonstrated some cartilaginous loose bodies within the joint and demonstrated a large anterior superior labral tear with an acetabular rim lesion and associated synovitis.

The tissue of the labral tear was of nonviable quality. At this point, a labral debridement was performed . Labrum was recontoured to a normal anterior inferior and posterior superior labrum. Acetabular rim lesion was clearly identified and then, using a 5.5mm high speed bur, the acetabular rim lesion was shaved down to remove the rim osteophyte.

At the completion of the acetabuloplasty and labral debridement, a wide synovectomy was performed using the TAC-S radiofrequency probe. All cartilagenous loose bodies were then removed from the joint. Remaining cartilage surfaces on the femoral head and acetabulum were in good condition. the ligamentum teres demonstrated no significant fraying.

At this point, traction was released. Suction was re-established. No further pathology was identified. The arthroscopy portals were closed with 3-0 nylon sutures and the wounds were cleaned, dried.
The bottom of the page says continued, but I do not have more!

16 day post-op appointment

This morning I saw Dr. Kelly for my first post-op appointment. I actually didn't have to wait too long and was out the door in less than hour. The visit was short and to the point. He showed me the scope pics, pretty ugly stuff inside my joint, he showed me where the tear was, again, it was a large tear, then he showed he the acetabulum and where he shaved down, and the femur, all with before and after shots. I look at the pics and wonder how I didn't have more pain than I did, and how I was able to function.
The newly done hip looks great, the ROM is good, pretty pain free, I am walking with one crutch, he would like for me to lose the crutch soon. He is happy with the progress. As far as the other side, I didn't make a big deal about it, no matter what the issue, there is nothing to do for it right now. He did say that it is common for the other side to flare up like this, but would like me to try anti-inflammatories if possible (see previous post from June, When it Rains it Pours).

As he was checking my hip, he said "we did the femoral side on this hip, what did we do on the other side?" "not the femoral side, just acetabular", I think I momentarily saw a look of worry on his face, but time will tell what the real issue is. He didn't say much about the numbness, although his research assistant was concerned about it. She stayed back after he had gone to get more info on it. There is nothing to be done, I know that, and luckily he didn't bring up taking Lyrica as his PA suggested he may want.
I am going to post the findings on my 1st and 2nd operative report in the following post, as well as add a link to them on the side bars.

Tuesday, July 17, 2007

Tonights Accomplishments

Need I say more! My mom left today, so this left me responsible for feeding my 2 monsters! By the looks of things, everything went smoothly! Yes! I can do this, alone!! Things are beginning to return to normal!!!

Making Progress

Another PT session down, and boy am I tired of it. things went great today, so great that I asked P if he thought I could cut down from 12 weeks to 6 weeks of PT, he said he thought it would be ok, we'll see how things go.

I started off on my trusty, upright bike, and proceeded to single leg stance on the floor, not too shabby! No hip drop today! P added some contralateral hip hiking while doing the single leg stance, it was hard, but I got 10 in! I did squats, on the ground, with a theraband around my knees, isometric hip abduction/ adduction against the wall while standing on one leg, walking side squats with a theraband. Then my usual table exercises, with the addition of 9 modified single leg bridges. While I waited for P to finish with his other patients, I did some quad stretching, adductor stretching, hamstring stretching and hip flexor stretching. I had him work on my ITB and hip flexors today. I walked out pretty much painfree!!!

We discussed when I could return to work. I am on one crutch now, he said when I can walk around for 4-5 hours with no crutches, then I can come back! If you read my blog often, you'll notice some changes and additions I made, I am bored. I am beyond bored actually, I need to work or else I go crazy and start to lose it!

We skipped hi-volt today, I decided it was pointless, if the sensation is going to ever come back, then it will, on its own, no machine or drug is going to change it. It is not that awful for me, I do have feeling on the side of my leg, it just feels weird, on a positive note, P can work the heck out of that portion of my ITB and it doesn't bother me!!!

Monday, July 16, 2007

Learn From My Experiences/ Mistakes


-Listen to your body, if you think something is wrong, seek help
-Find a hip specialist, not one who performs hip replacements, but one who can address labral tears and FAI
-Nexcare waterproof bandages will keep your stitches dry in the shower for the few days you are not supposed to get them wet
-If you are using a GameReady, do not keep filling it up with ice and water, this is annoying, and difficult for the person in charge of doing it. Freeze 5-6 mini water bottles and put them in the GameReady with 2" of water, keep another 5-6 bottles in the freezer and keep switching them
-Ladies, accept the fact that you will not be able to shave your legs for several days
-Accept the fact that you will not be able to wash the bottom of your feet in the shower for several days
-Save your hands, get Millenial crutches
-Find a PT who can help you, will listen to you, and can provide you with "hands-on" treatment
-Find another person who has gone through a hipscope already, and milk them for info/ help (I can be reached via email at suzq613 at aol dot com)
-Don't let anyone tell you "its just a 'scope'", this is serious surgery, and a much longer recovery than your basic knee scope
-It is normal to feel like you are on an out of control roller coaster ride, physically and emotionally, no one will understand what you are going through, I hope you listened to my previous advice and found a "hip friend"
-If you are at all apprehensive about having an MRI, bring your own music, keep your eyes closed the entire time, and take slow deep breaths
-this list will be continuously updated as I inadvertently make more mistakes!
-Take Colace with your narcs, and if all else fails, ex-lax or dulcolax works like a charm!

2 Weeks post-op

It has been 8 days since I have taken a Percocet, 6 days since I have used my cpm, and 4 days since I have used my Gameready. Do not rely on my blog in order to follow the protocol! I really wanted to spend the whole day on 1 crutch, but ended up at the mall (again) and was doing a lot of walking so I took 2. I also walked tot he pool today, with 2 crutches as well. I have PT tomorrow and nothing else planned so I will hopefully spend the day on 1 crutch.

My mom is going home tomorrow, it is bittersweet, she has been awesome and there is no way I could have done it without her, but I need my independence. If you are thinking about having this surgery done and have kids, you need help, there is no way around it. My mom drove me everywhere the first week, cooked, bathed the kids, cleaned up after them...she was really busy, and I have a full time nanny as well. L cried when I told her "Ma" was leaving. Luckily we see my parents very often, we all have a wedding in early August in Costa Rica, and they will be back in NY for a wedding in late August.

I have been trying one crutch in the house for most of the time, but I know I have been overdoing it since I did experience some pain today, after my painfree day yesterday. I actually woke up with pain, and knew I had done too much yesterday, it is so hard to back down once you have accomplished something. Maybe after PT I will spend the afternoon in bed until my nanny leaves. My day in bed last week made such a huge difference.

But I already knew that this would be a roller-coaster ride...again! My hips are so temperamental, I still can't figure them out! The right hip has been a disaster, it is begging me to lose the crutches for good, and give it the day off!! I will give a full report on PT tomorrow!!

Sunday, July 15, 2007

I'm Walking on Sunshine

Really, I am so happy with the way things are going for the new hip! I went to the pool today with the family, and walked all day on 1 crutch, no trendelmberg (at least not noticeable to me). No swimming though, one stubborn incision still is kind of open. I used those waterproof band aids to shower the first couple of days when your not supposed to, but swimming with them is different than a quick shower. Then, at home, I have been walking with no crutches, visible trendelmberg, but nothing beats the use of both hands when you have kids!

Since I was feeling so ambitious, I cooked, nothing fancy, but cooking is a big thing for me, I barely got back into cooking after my first surgery. I need to feel independent and useful. It was a great feeling to carry ingredients in the kitchen and stand at the stove and prepare a dish. I honestly think I could go back to work this week, but I have coverage for 4 weeks, so I won't do anything stupid, and allow my body to really recover well. I even tried a mini-squat in the bathroom, if J saw me trying to exercise now, he would flip out. I was able to do the squat. Tuesday is my next PT appointment, if P agrees, we will add standing squats with a theraband around my knees, to work on the glut med. I'm sure he will agree, this time I have been dictating more or less how things will go. I also will start single leg stance activities this week. I haven't been compliant with my home exercise program, and have done nothing since I left my office on Thursday, but who cares, I feel awesome!!!

I wonder if I feel this way in comparison to how I felt last time, or it is real! Last time, I was still taking pain meds at this point, still on 2 crutches, not driving, and feeling rather pathetic! I need my life back and going for at full speed!

Saturday, July 14, 2007

12 days post-op

I got my stitches out yesterday, and in the process decided I needed a new internist. Since Dr. Kelly was away yesterday, my first post-op appointment is for next week, at 16 days post-op, but my stitches really had to come out already. So after speaking to his assistant, we decided that it wasn't worth going into the city for her to do it (see previous post) and that my regular doctor could just take them out. Just to add to my frustration from yesterday, when I made my post-op appointment, the receptionist said that if the stitches became a problem, "any nurse could take them out".

So I made an appointment and the doctor says that she doesn't feel comfortable touching another surgeon's work. Seriously. They are 3 tiny incisions, with 3 stitches in each, and it is not like it is plastic surgery or anything, no one sees them....but I digress! I explained that the surgeon is out of town and said anyone can remove them "well they should have called me as a courtesy, this is really unconventional", I was ready to leave, but she decided to go against her better judgement and remove them. I could tell that she doesn't do that too often as she had a hard time with the middle stitch each time, one of the incisions was still open, but it didn't hurt. I left pissed off and feeling queasy for the rest of the day! (surprise)

I am now down to using one crutch in my apartment most of the time, I can even walk a little without the crutches, but it is not pretty! Even one crutch is not so pretty, I have a little trendelemberg, not too bad, but it is there, so I am not ready to come down to one crutch permanently, and there are times I need the second crutch to come rescue me.

I walked about 1/2 mile today to a friend's house and back, I did well, on the operated side. 1st hip still sucks, I am trying not to think about it, I will give it 4 more weeks until I pass full judgement, that gives me 2-3 weeks off of crutches (assuming I get off of them in the next week or 2). I hope I make it 4 weeks without losing it though, I haven't decided if I will bring it up at my appointment this week, I know he will piss me off but just saying it is compensation....I know it may be, but what if it is not????? Ahhhhhhhh

Thursday, July 12, 2007

More doubt/ bordering fear

I spent the day in bed today, I needed a break, mentally and physically. I sent everyone out of the house and stayed in bed with my gameready and laptop. I have been doing a lot, way too much for being 10 days out of surgery. So I took the day off! While I was in bed, doing nothing, my right hip started hurting. A lot. Shit. Resting pain scares me. I have pinching, decreased ROM, pain with closed chain internal rotation. Shit. This sounds very familiar. Why is this happening? I can't have a new problem every time I go on crutches. I need to lose them ASAP.

Tomorrow I get my stitches out. What a relief, I hate stitches, and they are really bothering me. I have so much trouble sleeping at night because I can't sleep on my stomach. I actually have an aversion to stitches and skin staples, I'm not sure which one more. I can't stand to look at them, much less touch them. the worst part of my c-section was having to decide between the 2. Its not like my OB gave me the option up front, but I expressed my opinion about my aversions to her, she told me I would be happier with the staples. Was I? I guess so, she took them out 36 hours later, and my waxing lady told me recently that my c-section incision is impeccable!!

I won't see Dr. Kelly for the stitches though, I have an appointment next week. I spoke to his PA, she is awesome. I was going to go in to the city and have her do it, but she told me that honestly, it wasn't worth a trip in, even though she would be more than happy to do it, but she knows that I know to wean off of the crutches (already started), I can stop wearing the brace (oops, did that already too), and if I have an infection, she will call in an antibiotic for me, but that is pretty rare. So I will see my GP for the big event!

We spoke about the numbness too. She said he may put me on Lyrica for it, I am not thrilled about that. I have to do my homework on it before I go in, I don't know too much about it, other than that people take it for nerve pain, and I have no pain.

Wednesday, July 11, 2007

Self Doubt

I went shopping again yesterday. Not for very long though. As I was hobbling around, I complained to my mom that my right hip was hurting more than my left. "Don't worry", she said, "Last time you said the same thing". Yeah, and look where I ended up!!! Oops! Wrong thing to say.

Today in PT, I expressed my fears to P, who referred to them as paranoia, but then checked himself, and responded with a "hmmm". I told him that I feared that the femoral side had been missed on my first surgery, since it was addressed the second time, and that hip is awesome. He said that I know too much and should stop asking questions!! I know I am not making this up though. He knows too because he decided to mobilize that hip and see if he could make the pinching go away using some Mulligan belt mobs, with the mobs, my ROM is better and I get further without pinching. I am going to keep my fears/ suspicions to myself for a while, at least until I am done with the crutch business.

I am soooooo bored with PT, I have been doing steady PT since March 6th, as well as not so regularly since November. I have had enough. I have had enough pain, crutches, weakness, lack of working, lack of self sufficiency. I need this all to be over and the negative thoughts to go with it.

Things I wish I could do/ do differently

Go into starbucks, alone, and have a cup of coffee
Can someone recomend a crutch cup holder?
Sleep on my stomach
Carry my coffee to the table in the morning
Have sex
(funny how sex comes after coffee and sleeping)
Take my stitches out myself, they are starting to really annoy me
Walk faster
Walk farther
Stop getting asked if I've had a hip replacement because "I am way too young for hip surgery"
Stop getting horrified looks when people see my hip brace (I stopped wearing it)
Go back to work
Push my stroller(s)
Stop doubting if this was the right decision

I will continue to update this list as more things pop into me head!!

Tuesday, July 10, 2007

Happy Birthday To Me

If you have been reading my posts, you know things have not been going great for me lately, yes, things could be a lot worse, but things could be better too! On the eve of my 27th birthday, I reflect on 26, boy did it suck!
Ok, I have my 2 gorgeous kids, my husband, my family and my career, all of that is great, healthwise I have been a mess. Can you believe that before 26, I was never sick, never had any medical condition, the most serious thing that ever happened was my planned c-section with L. The first time I ever called a doctor was when I was pregnant with her, about 7 or 8 weeks along, it was around lunchtime, and I had thrown up 5 times already. I was on the bathroom floor at school, crying, not knowing how I was going to make it through the next 32 weeks! But I digress!

So before 26, things were peachy. Then came 26, with 26 came my first mortgage and down-payment, so a lot of what happened early on was attributed to stress. Luckily, nothing was too serious, but the shear amount of non-serious things was enough for me to will 27 to come sooner!

26 started with what I thought was a splinter in my foot, turned out to be a (gross) wart, so I had my first podiatrist appointment. Then came my Crohn's diagnosis, a week later I broke my toe (first broken bone ever), a UTI (first ever), hip pain right, hip scope right, hip pain left, Crohn's flare-up, diagnosis of gallstone, hip scope left, right hip pain.

So tomorrow 27 will start, and hopefully all of this will go away. I have lately become obsessed with checking my insurance explanation of benefits, which basically tells me what a doctor billed, and how much was paid, would you believe that in the last 6 months there have been 59 claims submitted under my name, and my most recent surgery has not been submitted yet! I know 80 year olds with less medical issues!!! May 27 be a better and brighter year!!!

Family Matters

Being that I have 2 children under 2, crutches do not help my situation. I need my hands, I need to be able to sit on the floor, I need to be able to chase them, I need to be able to push my stroller. That is the hardest part about this for me. Luckily, my mom is awesome, she is staying here and doing practically everything around the house. My husband could be more helpful, but chooses not to be, leaving the bulk of the work to her. This puts me in a very uncomfortable situation, she is not here for him to take a vacation, and sit back and relax. I need him to realize that he needs to pull his weight around the house more.

This situation has added stress to my home, as much as I love my mom, and love her being here, I think that until she goes home my husband will feel like that. The hard thing is that once she does go home, I will not be able to go out and do things with the kids. For example, we have been going to the pool, L plays nicely with her friends, Jk runs around like a baby maniac, and needs to be chased. I will not be able to do any chasing for a while, and definitely not while on crutches.
I am now driving again, since I stopped the Percocet, so I have a lot of my freedom back, so I feel guilty making her stay longer, but I know the kids will suffer once she leaves since our outings will be cut.

On the other hand, I can drive, but I can't exactly do the grocery shopping on crutches. I feel torn, I don't want to make her stay here and feel used, but I don't want the kids to suffer, and I need J to step up and start doing more around here.

Monday, July 9, 2007

Week 2 Begins

Ahhhh...the numbness persists, plus additional negative thoughts. Ok, this is my blog, and I can publish all my negativity/ doubts here!
Since my "twisting/ popping" episode the Thurs. before my surgery on the right hip, things have been kind of funky. Now, in my compulsive state, I notice that there are positive impingement signs in that hip (gulp). So what is going through my head....was cam impingement missed on that side? My left hip (most recently done) is doing awesome, and there is no pinching at end range, there is pain and discomfort at endrange, but it is a different quality of pain. The right hip pinches (omg, tons of freaking out), but now is not a good time to judge the outcome of the first surgery.But still...

Why does my left hip feel so much better than the right one did? I had pinching for so long, I was told it may never go away because the area was worked on, bone was shaved, so there may be some residual pain for life, I am OK with that, but as long as that is what I am feeling. I know my hips will never be the same as they were before this happened, but I want them better than pre-op. So my doubts continue to exist in my mind...at the same time,I don't know if I want to know if here is still some issue going on in there...my personal recovery is going well, but it is so hard not being able to do things on my own, more on that later!

On a more positive note, I had my 3rd PT session today. P, my other PT was in today, he is not sure what to make of the numbness, on another positive note, he worked the hell out of my ITB and it didn't bother me. He did ART on my psoas, iliacus, TFL and ITB. I rode the bike for 15 minutes (I had pain after 10 pre-op), isometric hip ab/dduction (blue band today), bridges, stool IR/ER/extension, and we decided it would be ok to add the wobble board. Yes, I am only supposed to be 20 lbs weight bearing, I am doing more (see disclaimer below), but I am doing more and want to ditch my crutches ASAP. Oh, I ditched my hip brace today too, it was too cumbersome and my ROM is great, and beyond what the brace allows. My hip flexes way beyond 90', ER is almost full, IR exists this time!!!

To address the swelling (and hopefully the numbness), I set the e-stim machine to Hi-volt, 1-10mhz, for a muscle pump action. It didn't feel good, but I am willing to do it if here is even a remote possibility it will help.

I have been off of Percocet since Saturday. I take a lot of Tylenol, and could probably use the percocet at times, especially at night, but I am desperate to feel "normal" again!

Saturday, July 7, 2007

Chugging Along

I am learning to time my Percocet to coincide with activities I want to do. Today for example, I knew I wanted to walk to the park, about 1/3 mile, so I took a Percocet 2 hours before going. For me, it is at its best 2-4 hours after taking it, and I can increase its effect with Tylenol 3-4 hours later. So I walked to the park, I didn't do that until 2 1/2 weeks post-op last time.

I would really like to be off of painkillers in the next few days. My mom is staying with us, doing practically everything, she is amazing. The hard thing is that despite how amazing she is, I really would prefer if I didn't need this "amazingness" and could function on my own. She is my chauffeur, nanny, cook, waiter etc. I also feel bad that she is so bored here because I can't really do to many fun things right now.

Everything seems to be going well except for the persistent numbness, I am still really hopeful that it is a swelling issue, so all this excessive walking is not helpful. I am not capable of staying home, it makes me crazy. I have always been like this, just to give you an idea, one week after my c-section, I was walking around the mall, yes, I was in pain, and exhausted, but I was bored at home, and I needed a diaper bag!

I plan on continuing to ice aggressively, plus I will try ultrasound on a swelling setting on Monday at PT. I am not at all into modalities, I rarely use ultrasound, it is usually a last resort, when nothing else is working, but that is how I feel in this instance. Maybe some retrograde massage will help too, anything to decrease the size of my leg and increase the amount of sensation to it. If anyone has any ideas, please let me know!!!

Friday, July 6, 2007

Overdoing it

I went to the Mall today, the real, actual mall, not a little strip mall, but the mall, department stores and all. Yes, I did a lot of sitting, but I ventured out for a real trip that was not PT. I did it under the influence of 1 Percocet, followed a little later by 2 Tylenols. I have been in bed since I got home.

I am exhausted, it is so hard for me to realize what my limits are, and I am continuously learning the hard way. I did buy a cute skirt, it fit really nicely on the right side, but was amazingly tight on the left. A few more days of icing should improve the fit!

I am now able to do a heel slide on my own, and have not needed pain meds since I have been home, only tons of ice. The skirt-trying-on adventure really showed me how much swelling there is, so I am back to being an ice queen!

Thursday, July 5, 2007

What a Difference a Day Makes

I have almost no pain today, I am in shock, my muscles are sore, and very weak, but my pain is almost non-existent. I know this is a change from last time. I don't even know what to attribute it to, more work was done this time, unless, a tiny thought lingers in the back of my mind, not enough work was done the first time. I quickly brush this aside, it is highly unlikely.

My numbness is definitely there. I spoke with Dr Kelly's office today, there is a tiny possibility of nerve damage, but they are really careful with portal placement, so also, unlikely. Hopefully it is due to swelling, and will resolve in time as the swelling does. I have been icing like crazy, this may also attribute to my lack of pain.

I took one Percocet this morning, had PT and took a 4 block walk, then took 2 Tylenol, I really want to be off of narcotic painkillers.
Pt went like this. First, I had J check my sensation, she agreed that it was parasthesia most likely due to swelling, since there is a lot, but agreed that I should call Dr.Kelly about it. I wanted to try some active assisted ROM, so we did hip flexion, abduction, and active assisted heel slides. I rode the bike again, for some reason, it is still difficult for me. I did isometric abduction with a green theraband, and isometric adduction with the "kegel ball". J worked on my ROM, very gentle, emphasizing flexion at this point, but I am past 90', like last time, IR is coming back the slowest, but it will be back soon! I also did stool IR/ER and extension.
Disclaimer: A lot of what I did is a little accelerated for Dr. Kelly's protocol, but I made my own call on this and felt ready. My surgery was just a debridement, probably (even though I hate to admit it) best for my lifestyle, since I need a quick recovery, and don't want to constantly have a fear of retearing the repair. Don't get me wrong, I really did want him to repair it, but I am happy this way as well.
I am also putting more than 20lbs of pressure on my foot, again, I am calling the shots and feel like this is ok, for me, at this point. I tried walking with one crutch but was unable to do it well due to weakness.

Hmm, maybe it was my prehab that helped? I will never know, but I wasn't doing a ton on that side in my workouts, isometrics hurt, bridging hurt, single leg stance hurt....who knows!! I will continue trying to figure it out. Or, maybe it is just too numb for me to process the pain!!

Wednesday, July 4, 2007

My newfound love

Pre-op, I loved cortisone, it gave me back my life! Post-op, I am having a love affair with Percocet! Yay, I finally have found a painkiller that isn't killing me. Ok, it isn't perfect, but so far, what a difference! I took one at midnight, 6Am, 12PM and around 5:30pm. I am trying to stay ahead of the pain. I am a drop nauseous, it makes me dizzy and lightheaded, but hey, I am not lying in my bed, curled up in a fetal position, garbage can ready, so to me, this is a HUGE improvement. I am not pain free with it either, but I don't think I could handle 2 pills at a time. Finding a comfortable medium is very important!

I am also icing a lot, it definitely helps too! My Gameready is being put to use often! I still have numbness, swelling and bruising, and need this to go away ASAP!

I ventured out of the house today! I drove to the park to be with L and Jk, then we went to get pizza for lunch! I did fine, thanks to my new found love! Percocet got me through my c-section pain with little side effects too, I don't know why I didn't think of this earlier.
My hope is that in a few days I can wean down from it and try the Darvocet again, or even the Ultram!

Oh, I just woke up from a Percocet induced sleep to find that I am able to do a mini heelslide!!!

Post Op Day 1 Cont.

So you already know that yesterday sucked, but after I posted, things got worse. Let me start at the beginning. After my first surgery, I went to bed at a reasonable hour that night and slept through until the morning, no pain meds throughout the night. I woke up in horrific pain. I was not letting that happen this time. SO...this time I took vicodin at 12 and then at 6, I felt fine nausea-wise. Of course I had to go to PT that day, which in my opinion is barbaric. My PROM was better this time but AROM was not, all active movements hurt, a lot. All I did was (attempt to) ride the bike, that hurt too, at first I couldn't make it all the way around with the pedals, but soon I was able to. My PT then just did some PROM on my hip, everything went well.
Since things were going well, I decided we should go out for lunch. I took a Vicodin on the way there, and then a Zofran during lunch. Just as we were finishing, I felt this all too familiar feeling, and I knew I had to go home, NOW. So I did. I collapsed into my bed, garbage can nearby, but luckily the zofran kicked in, It didn't do a lot for the nausea, but I did not throw up. I ended up falling asleep, on the operated side (note to self- don't do that). I spent the rest of the afternoon in bed.

Later in the day, Dr. Kelly's office called to see how I was doing, we decided to change the painkillers (yet again), this time to percocet. Since no one could go pick it up at that moment, I took an Ultram because the pain was coming back and I was petrified of Vicodin. Ultram took the edge off of the pain and didn't make me sick.

Later that night, I had had enough of feeling "hospital dirty" and wearing the huge bandage on my leg, so even though the post-op instructions say no showering until post-op day 4, I could not wait. I have these waterproof bandages by nexcare, they work great. So off came the bandage, to reveal a mess of a leg underneath. 3 scope sites this time, as opposed to 2 last time, bruising, swelling and.....numbness. Shit, this is not good. When I spoke with Dr. Kelly on Mon. night he asked about numbness, I didn't think I had any, his assistant asked me as well, and I told her no, but now with the bandage off, I can feel it (do you feel numbness? that sounds weird, but I know it is there). What worries me is that it is in the distribution of the lateral femoral cutaneous nerve, I really really hope it is from the swelling and will go away really soon. Today is a holiday but I plan on calling Dr. Kelly tomorrow about it.

My shower felt refreshing, and before I went to bed, I took a percocet, hopefully percocet and I can become friends and have a nice and pleasurable experience

Oh, my kids did eventually get out of the CPM and let me use it, I like to use it while I am icing, my GameReady is on the floor next to the bed with a hose leading to the attatchment on my hip!

Tuesday, July 3, 2007

Post-op Day 1


Today sucked!!!! I am not in a writing mood right now, I will try and post more later. In a nutshell, my pain is too intense for Darvocet, so I took my old Vicodin, which of course made me sick, so I just took an Ultram, and had Percocet called in to the pharmacy!
I have been too nauseous to ice/ cpm, but the cpm is being put to good use as a jungle gym!

Nitty Gritty II

Since I am stranded in bed with no one else awake, I will continue with my detailed story!

I left off when I kissed J and was taken to the OR. With my first surgery, I arrived in the OR and it was bustling with action, there must have been 15 people in there, all of who ignored me!

This time, I arrived, and it was just the anesthesiologist, the room didn't look like it was ready either. She had me lie on the operating table and immediately gave me sedation, last time, the sedation immediately knocked me out, this time it just made me foggy. For some reason, I have some recollection of her inserting the the needle in my back, but it didn't hurt, I just felt pressure, and that was all I remember!

I woke up 3 hours later, to someone saying "its over"! I opened my eyes and said "is Dr.Kelly here?" "no", "they said, "he is speaking to your husband". Now remember, I am a control freak, despite the fact that I was sedated and had just woken up from surgery, and was still in the OR, I needed to know what he had done and what he had found. "Is his fellow here"? "yes" they answered. So I asked him what they did (he must have thought I was crazy...but I am, so that's ok!). I think he said something about shaving the acetabulum and the femur....but then I fell asleep again.

I woke up in the PACU, shaking like crazy. They plugged me back into the gown heater, and covered me with about 7 heated blankets, but I kept shaking. They explained that the OR was cold, they use cold IV fluids, I was exposed....so it all adds up to this crazy shaking. I then asked for my CPM (J says I'm a pain in the ass....being that I work in the health field, I know you need to speak up to be heard). It finally came, I was still shaking. That lasted about 2 hours (by this point, all the other 8am surgeries had gone home). I still could not move my feet and was picturing another lovely day wasted in the PACU.

A little while later, the nurse came to see how the anesthesia was wearing off, she said it was down to T10 since I had some feeling near the top of my leg/ bottom of my stomach. Then I had a burning sensation near (where I think) the incisions were, but really, awful burning. So I had her turn off the heater. She asked me if I wanted pain meds...YES, but I had to eat first. At this point, I did not want think about food, look at food, and much less eat food! My choices were tuna sandwich, turkey sandwich or cheese sandwich....under normal circumstances, I would not have gagged at this, "how about some crackers" I said.
So they sat me up, and I got REALLY dizzy and lightheaded, so they brought the bed down a little. A lovely volunteer brought me 10 crackers, what a joke! I ate 1/4 of one, and she said I had to eat more if I wanted the meds. She also brought me my all time favorite hospital drink, apple juice, this I drank!

Finally,I called the nurse, I NEED pain meds, so she brought me darvocet, but warned me to take them every 4 hours round the clock for the next few days because they are not that strong. I took 1, and it didn't make a dent in my pain, then I took another, 15 minutes later, I still had pain. It was so bad that I was on the verge of tears, I think she noticed and gave me a shot of dilaudid in my IV. A little later I had this again! The Dilaudid made me a little sleepy, but I really wanted to go home, and at this point, I REALLY had to pee, I had gone through one huge IV bag, and part of another, plus a cup of apple juice. I needed to go now!!
The only problem was that this required getting out of bed, into a wheelchair and then into the bathroom, and I still had pain, despite everything I had already taken. I also had no idea that the epidural catheter was still in my back, so this had to come out as well. It didn't hurt,other than when she had to remove all the tape it had been attached with, it felt like a bad waxing job!
I finally peed, and was taken to phase 2 of recovery. At this point, they disconnect your from your IV bag, but keep it in place, just in case you need more fluids, they help you get dressed and you have PT.

I had my own crutches from my first surgery, they are Millennial crutches, I highly recommend them, they are spring loaded and really comfortable on your hands. The PT in recovery tried them out and she really liked them as well. I stood up, she put on my lovely hip brace, and I walked with the crutches.I don't think I did a great job, but well enough to be sent home!

First morning

I made it through the night! I really hurt, not as much as I did the morning after my first scope, but again, live and learn. I took vicodin at midnight, and now another one at 6am, this is not darvocet pain, this pain requires something stronger!!! I am only taking one at a time though, and I have my zofran handy, I may just take one now as a precaution. Of course, most importantly,I am popping colace like they are candy! No one ever mentions the side effects of narcotics, so it isn't until you have a bad experience one time that you know!

I went to sleep on my good side, with a pillow in between my knees, but woke up on my back, pillow still there! I would normally get up and go have my first cup of coffee, but being that everyone is in asleep, I will have to wait!

Monday, July 2, 2007

The Nitty Griity

Ok, I am in bed, but I don't feel like falling asleep, probably out of fear of pain.If I keep my leg completely still,I feel ok, once I start to move it......I am not so happy!

Usually, when I want information on a topic, I want to know EVERYTHING, so I will tell my tale of surgery day the way I would want to know it!! With some of my own antics stuck in, of course! So here is the story of hip arthroscopy!

I had to be at the hospital at 6am, for an 8am surgery, I requested first case of the day! So 4:30, my alarm went off, I was in a deep sleep! Yay!!! I got sleep the night before surgery! By 5:15, I was blow dried and had applied my makeup (yes, I am still a control freak).

We got to the hospital and the questions began in admissions, I must have answered this 100 times today: "What body part? Which side, right or left?" They are very careful!!! I was speaking to the man at the desk, going over all the info, he asked "who is the doctor?", I answered "Dr.Kelly", "Good Choice" he replied! I know he must say that to everyone, but it made me feel good!

Then I was called back, I had my own room, with a TV!!! I had to take a pregnancy test, the thought of having to find out you are pregnant the morning of surgery is scary! I knew I was not, but my heart beat a little faster until it was confirmed negative!!!!

Next, I changed into a cool blue hospital gown, and they gave me "disposable underwear", which are not underwear, rather shorts, I don't know at what point they came off, but they were not on me when I woke up!!! The nice thing about HSS is that the hospital gowns really are cool, I was not being sarcastic! They attach to a unit on the wall through a hose which blows hot air. I am always cold, this is a huge plus for me!!! During my first surgery, a PA came into my room to plug me in when he walked by and saw that I was turning blue!!! I had him again today, and he remembered, so he plugged me in right away!

Next came the pre-op physical. Lots of questions about my medical history, medications, and hip pain! I passed! So I got my IV. Luckily, my IV nurse the first time was awesome, and I had her again!!! I have had awful experiences with IV's, this was a cinch!!!
Next, a nurses aide came to "wash my hip", I kid you not. She had me roll onto my side and gave my hip and butt a sponge bath!!
I assume you now understand why I had to be there 2 hours in advance!!!
Next Dr. Kelly came to "sign"my hip, yet another safeguard that they are doing the correct side! Oh, they also put your hospital bracelet on the opposite side, as well as your IV (I wonder what they do for people getting both sides done!).
I needed to find out what his "plan" was, since I had not seen him since we took X-rays. He said he planned on doing the same hing as he had done on the first side, he was very reassuring, he also mentioned that he had been noticing that people were still making progress past 12 months, which is nice to know, but I told him I was not yet done making progress on the right side!
He walked out to write some notes, then I remembered something important, NO RESIDENTS! so I called him back to remind him! Its not that I have a problem with people learning, hey, I was a student once too, and I never had anyone tell me they didn't want me because I was a student, but it is July 2nd, they all started yesterday!!!

Finally, my anesthesiologist came.I requested her because I had really liked her last time. I have 2 children, L was a c-section, I still have vivid memories of receiving the spinal, and I never want to experience that again. Jk was a VBAC, it was different than the c-section, I requested an epidural bc I was in pain, it still hurt like hell though! In fact, it is the only part of childbirth I clearly remember! During my first hip scope, she sedated me then inserted the spinal, I woke up and didn't have a drop of pain from it!! I loved her! So clearly I wanted her again! I did have some issues though last time, the spinal took a very long time to wear off, as did the sedation. She decided to do a combined spinal epidural, to avoid potential problems, as well as use lighter sedation. I just wanted to make sure I would not feel her putting it in, she said I would not!!!
My final "visitor" was the OR nurse, she came and whisked me off to the OR, I gave J a hug and kiss and off I went!

Home at Last

I am home! I will try to keep this short bc I don't know how much is me talking and how much is meds! Hopefully tomorrow I will post all the details of the day, now I will give a quick rundown!
My biggest concern for this surgery was throwing up post-op and anesthesia, since last time I was in recovery forever.
So.....surgery was at 8AM, it ended at 11AM, that is a long time for a hip scope! I just found out that I had a bone spur on the acetabulum, a bone spur on the femoral head-neck junction, and a labral tear, as well as loose bodies in the joint. I didn't get to speak to my surgeon afterwards. He did speak to my husband but J does not know the right questions to ask!!!
My surgeon is Bryan Kelly in NYC, he s awesome!!! I highly recommend him to anyone with similar problems.
I had a combined spinal epidural (I have to google this later), the anesthesiologist thought I would recover quicker this way, she also kept the sedation lighter than last time. It's a good thing we went this route since the surgery lasted so long, she said the spinal would not have lasted that long.
Most people who had 8am surgeries went home around 12 or 1pm, I went at 3:30, better than last time!!!!
I took 2 darvocet in the hospital and was given dilaudid in my IV, I threw up twice already!
I am hoping it was the anesthesia, I cannot handle more puking, I prefer pain, which is why I am without pain meds at this time, if I lie perfectly still, I am ok!
I will post all the gory details later or tomorrow, hopefully I will be more lucid! I also have PT at 9:30 tomorrow morning so tomorrow I will have a lot to talk about!