Wednesday, January 23, 2013

7 1/2 weeks post op

I saw my OS last week and he is very happy w my bone healing. He wants me to slowly wean off of crutches but not before 4 weeks. I have been having a tough time but the last few days seem to finally show me there is hope! I have actually gotten dressed (skirt and tights!) 2 days in a row for a few hours. The pain is less as well. I keep thinking of what a fellow hip friend told me- recovery is not linear! I keep reminding myself of that. 
My PT keeps telling me how strong I am and how mobile I am. Yes, I can get on and off the bed, on and off the floor, all around the kitchen. I guess you can say I am seasoned!!
I am so happy that things are turning around. I am going to drive tmrw morning. I've driven a teeny bit but it is painful. I have the added problem now that there is a bus strike in nyc so I am relying on friends to transport my kids. Z walks to school and my neighbor has been taking him but we are in the middle of a deep freeze and walking to school is just not an option. I will drive him the 2 blocks tmrw and hopefully the pain won't be too bad. It has been 7+ weeks and not driving is becoming a burden. 

Wednesday, January 16, 2013

Monday, January 14, 2013

It's been 6 weeks

I have been thinking about the past 6 weeks and boy have they been hard. I recently found these pics and was thinking that I haven't smiled like that since!


and a before and after shot of my feet!

Thursday, January 10, 2013

5 1/2 weeks post op

Sigh! It's been 5 1/2 weeks, you would think that by now I could manage my pain effectively and cope with this situation. I really dislike having to take pain meds so I wind up in a mess of a situation some days. I try to avoid narcotics so I'll start to have pain, I'll try taking 3 extra strength Tylenols, sometimes it helps, sometimes it doesn't. What happens next is the pain will get worse and I'll start asking myself if I really need pain meds..... This will continue until I realize that I can barely walk and I have tears in my eyes from pain....and then I realize that I am being ridiculous about the meds. But because I let the pain get so out of control its hard to get it back under control. At 5 1/2 weeks postop I can say that now I have left the house 3 more times- once for Z's birthday party, once for a manicure and once for a quick lunch with a friend. Each outing is exhausting both physically and mentally. Additionally, the motivation to go out is not there. I look so worn out, I have no energy or desire to stand in the bathroom and put on makeup or do my hair. I haven't attempted to put on anything other than sweatpants or yoga pants for fear of anything touching my greater trochanter. If I am lying close to the edge of my bed and my kids sit next to me, it hurts if they touch my leg there. Needless to say I am still not driving. I keep saying "maybe next week". So at 51/2 weeks I don't spend the day in bed but I am home. I work from home which is a godsend. If I get busy and sit too long I get pretty bad pain. I try to rest ad ice during the day but it doesn't always happen. I am trying to be patient....

Tuesday, January 1, 2013

Op report #6 (open surgical dislocation)

The patient suffered from persistent right hip pain, sense of instability. She failed non-operative measures and had clinical, radiographic and diagnostic studies consistent w given pathology. Given the persistent pain, she was indicated for a revision allograft labral reconstruction, capsular repair and revision arthroplasty. Spinal epidural anesthesia was administered. She was placed in the lateral decubitus position. Right leg was prepped and draped in standard surgical fashion. A lateral portal was made down to the iliotibial band. A modified Gibson approach was performed and the gluteus Maximus was retracted posteriorly. The trochanteric flip osteotomy was then performed with a 15mm trochanteric wedge. The minimums was dissected off the anterior capsule and dissected anteriorly. A T- capaulotomy was then performed allowing for good visualization of the labrum. Hip was dislocated after ligamentum teres was cut. Labral reconstruction from prior semitendinosis allograft appeared to be well incorporated but was not providing a suction seal, probably due to the thin tissue quality. As a result, augmentation of the labral allograft reconstruction was performed. The edge of the acetabular rim was prepared and a total of six 1.4 mm anchors were placed and labral allograft reconstruction was performed with good anatomic restoration of the labrum. Dynamic arthroscopy was performed and demonstrated no evidence of any impingement in any direction at all. There was no subluxation of the joint. The iliopsoas was very tight so some additional bony decompression was performed with a psoas across the front of the femoral head to minimize any underlying pain that may have been related to the iliopsoas. Subsequent to this, the capsule was repaired anatomically and tightened to improve capsular stability as well. Trochanteric osteotomy was then prepared with three 3.5mm screws and the wound was copiously irrigated. Then the wound was closed in layered with 0 vicryl to close the fascia, 2-0 vicryl followed by running monocotyledons suture and steri strips. No drain was necessary as there was no bleeding. The wounds were cleaned, dried, sterile dressings were applied and the patient was awakened from anesthesia and brought to the PACU, having tolerated the procedure without complications.