Monthly Archives: February 2013

The Nose kNows

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My immune system decided that my hips have been getting WAY too much attention in the last several months and that another body part should receive above the title billing once in a while. Apparently it was my sinuses’ time to shine, to take center stage so to speak.

For this reason, I found myself at the ENT doctor today at 8 AM, ready and raring to go for my balloon sinuplasty, a “simple” in office procedure that takes no more than an hour and with “minimal” pain or discomfort. Seasonal AllergiesThe idea was that the procedure would help alleviate my persistent sinus infections as well as calm my extraordinarily severe level of allergies for which I had taken shots weekly prior to my recent surgery (and for which I continue to take 5 different medications daily). I wanted to get it out of the way before the spring allergy season kicked into full force since I am already having frighteningly bad allergy symptoms even in the absence of all of the normal seasonal triggers. I hadn’t thought too much about the ballon sinuplasty in terms of pain – after all, I had my hip broken four times in December and bounced back pretty well so how bad could a balloon be? Also, everything I had read online indicated that it might be a bit uncomfortable but certainly not painful. So I assumed that today’s procedure would be a simple one. I should realize by now that no medical procedure in my world is ever simple.

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Some of the tools. No fun at all.

The doctor started by placing cotton balls coated with numbing agent in my nose. After my nose was sufficiently numb came the two syringes and eight+ mini shots in each nostril. it sucked but was over pretty fast. I figured that once they’d injected the anesthesia into my nose the pain would be pretty much done and anything that happened after might feel like a little bit of pressure but certainly not painful. After a few minutes of waiting for the anesthesia to take hold I was taken to another room and they started the procedure. I got as far as having the camera placed in my nose and up to the point where my sinuses began when I started to think that my head was actually going to explode.

Puppy wave
I want to be born, THROUGH YOUR FACE!!!

I have never given birth but I imagine that if I tried to give birth to a puppy through my sinuses and out my nose having a balloon sinuplasty is what it would feel like. Also, because there are sinuses near your teeth, it was like when that little puppy realized he wasn’t getting out through my nose, he was would literally have to push my teeth of my mouth and escape through the empty cavities. I literally thought I was going to cry – oh wait, I did.

Popped balloon

After the doctor removed to the scope I asked her if that was as bad as it would be and she said that she’d only gotten into my nose, that she hadn’t gotten into my sinuses yet nor inserted the balloon yet nor inflated the balloon yet. So yeah, it was going to get worse. The doctor was very kind and took her time but after two tries it was apparent that this was never going to work. I asked her and she said that only about 1 in 50 patients are unable to complete the procedure and that it’s likely that I just have hypersensitivity in my sinuses. I want to meet somebody that’s gone through this procedure and shake their hand.

So now I am stuck. My only option to get rid of this persistent and really awful sinus/allergy problem is to have a full endoscopic sinus surgery which involves general anesthesia and outpatient trip to the hospital. I have a email into my hip surgeon’s office to find out if it’s even viable to have the surgery performed before my SDD in May. I’m actually afraid of going through the spring allergy season where I’m trapped inside, recovering from my surgery and having constant allergy attacks. At this point I don’t even of its possible to do the endoscopic procedure and I am too raw, literally and figuratively at this point, to make a decision one way or the other. I figure I’ll get more information and decide in the next week.

Bravo sinuses! You really stole the show today but for now you are relegated to be an understudy and my hips the star of the show.

PT, DEN, BSP – OMG!

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Holy guacamole – so much has gone on since my last post. Physical therapy started, I flew for the first time since my surgery, I met with my Ear Nose and Throat doctor about my persistent sinus infections – and these were just the highlights.

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Until we meet again…

Its been 10.5 weeks since my PAO surgery and I’ve been doing well – I’m able to walk unassisted when inside and use my crutches to get around outside. Oh, and the wheelchair went back to the rental shop, not to be seen for another 3 months (until the next surgery!).

So, I figured that if I could walk, I was pretty much back to normal. I figured wrong. I have a lot of pain and difficulty doing things other than walking. For example, if I am sitting and my legs are extended in front of me, it’s really hardand pretty painful to lift my leg, even a few inches. The muscles in the front of my thigh are super weak. I have noticed increased in the joint, expecially when I sit with my hip at greater than 90 degrees for more than a few minutes. Also, the muscles in my backside are super weak and shake when I do many of my exercises. I still have trouble putting on socks or buckling shoes and I have a really hard time falling asleep because I can’t get comfortable. My left hip aches ALL the time, near the greater trochanter on the femur and in the areas of my labral tears. One thing that’s freaking me out is that I still notice the sharp ice-pick like pain in my right hip when I do certain movements. While it is only 10.5 weeks since the surgery, I am a little concerned about how this is going to affect my next surgery (which is 12.5 weeks away). I need my right hip to be strong because I will be depend on it exclusively while my left hip recovers.

Physical Therapy. Started PT on the 7th and had 3 sessions so far. The focus of PT is to strengthen my core, my glute and thigh muscles, and to stretch the joint. On my off days I do my exercises at home. I feel really strong at the PT offices but when I try to do the same exercises at home, it’s like my strength evaporates. I am also super sore because of the increased exercise. I know that it’s helping but it still feels like a setback to be sore and in pain now when I felt so pain-free at 6 weeks (although at 6 weeks I was not weight bearing and almost totally inactive).

20130218-195402.jpg20130218-195410.jpgDenver – There I went I flew to Denver to attend my cousin’s wedding this past week and had a great time and was truly happy to spend time with my family. I was able to sit in a bulkhead seat on the airplane (which permitted me to extend my legs and avoid joint stiffness) and got the added benefit of sitting next to two French Mastiffs from the Westminster dog show! I used wheelchairs to get me through the airports (BEST choice ever) my family drove me get around once in Colorado.

20130218-195442.jpgDragging luggage through the airport (like carrying a shopping basket at the grocery store or walking the dog) is incredibly difficult when on crutches. In general, travel was harder than I’d anticipated, both physically and mentally, even at this point in my recovery.  I am sore and still worn out a few days after getting back.  That said, I wouldn’t have missed it for the world.

Balloon Sinuplasty. Aside from all the hip drama, I suffer from severe allergies and persistent sinus infections. After having met with an ENT and having a CT scan I am scheduled for a balloon sinuplasty this Friday. It was either that or a traditional surgery and since balloon sinuplasty is less invasive we decided to try that first. Click the link to learn what a Balloon Sinuplasty is and what it does — What is Balloon Sinuplasty? — there’s also a useful animation. At this point, my head is so full with hip related anatomy and physiology that I don’t have the mental capacity to learn the intricacies of sinus surgery. I’m not looking for a miracle, just to be able to make it through the Spring allergy season without having a meltdown.

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Wheels on the bus go round ‘n round!

In other news, February 24th will be the half-way point between my two surgeries — time to start getting ready for May 8th and my SDD surgery. Yikes!?!

Finally, I am happy to report that I got approved by Access-a-Ride, the MTA’s paratransit system.  I used the service for the first time to get to my ENT appointment and will use it again on Friday for my BSP.

Tiny fall, big reminder

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I have been both surprised by and proud of how positive an attitude I have had leading up to and following my surgery. I’ve honestly been really upbeat and feeling really good in general, hitting recovery milestones with flying colors. I believe that my positive attitude has gone a long way toward my recovery.

Unfortunately, a positive attitude can only get me so far. I also have to be careful to not overdo it and not forget that my hips are still really unstable. And when I do forget? Well I fall down, just a little.

I was putting some things away in a lower drawer in my apartment this evening and was in a squat position. It’s never been painful for me to get into this position but standing up from it, unaided, has been a practical impossibility even before I had surgery. Couple that with a terrible sinus / allergy problem that has made me dizzy several times today. So I tried to get back up today and basically fell backward, landing on my left (non-surgical) hip and cutting up my hands on a drawer. I was really surprised by how much I was shaken by it and had to take a few minutes of sitting before I could climb my way to standing. Both hips have been sore and aching a little extra as a result but I’m sure it’s just from being jarred – no long term damage.

Big small

Thank you, dear Matroyshka dolls, for helping to explain the difference between something tiny and something big.

It made me think though about how uncareful I have been when I am home. When I leave the house I am super cautious, use my crutches, wear sensible shoes with good traction, and never go too fast. When I am home I wear slippery socks and seldom use my crutches or walker and I find myself forgetting that I absolutely should be doing so. I forget that I’m not truly better, even if I can get around my little Brooklyn apartment.

So I’ve learned from my tiny fall — I still have a super positive attitude but it will be tempered by care.

Next up? Physical therapy starts on Thursday followed by early morning appointments with my ENT and allergist on Friday to get this evil sinus / allergy problem figured out. Onward and upward!

I think it’s working!

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Quick little report of positivity.

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This is the non-actually-waving cat family that came home with us and is currently staring out my front window.

My husband and I took a cab into the city and found ourselves with 3 hours of unanticipated free time between events in Chinatown — not enough time to really go to another neighborhood and find something to do but too much time to hang out in a tea house sipping bubble tea (almond milk with tapioca, my fave).

We decided to wander the streets, searching for glasses and waving cats. I was on crutches and since this was my first time to really walk around on the crutches for any long period of time, I was worried my right hip would start to really hurt or give out on me.

Whoa was I wrong! My right hip held up like a champ!! Pretty much no pain, and really no pain within the joint (a bit of muscle pain but that was just from my hip actually working). My right hip felt stable and I realized that I could not remember the last time my right hip did not hurt or ache after walking more than a block or two (probably years). Here was evidence that my reconfigured hip is really working!

My left hip, however, was a different story. The joint ached and felt weak and unstable, just as it always had. The more I walked, the worse the pain and instability. It was a significant and noticeable difference between the hip that was operated on and my left ‘virgin’ hip. It’s just as bad as before my right hip was operated on, possibly worse because the pain in my left hip started faster than before. In any event, I am really excited at the prospect of someday soon having 2 hips that feel good enough that I can wander hours through Chinatown, pain free.

Here are a few candid shots from the yummy dinner with my husband’s wonderful family!

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6 week follow-up – NEWS!

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So much to report! This is going to be fact / text heavy but I want to make sure I get thru all the details.

On Thursday, I met with Dr. Sink at HSS (full disclosure, I asked – he was cool using his last name on the blog) for my 6 week follow-up, although it had been exactly 7 weeks since my surgery. I took a cab to the appointment since I was not yet comfortable with the idea of taking the subway (and would have been exhausted since HSS is about the length of 7 avenue blocks from the subway).

When I first got there, I had 2 x-rays taken and was immediately whisked into an exam room. Dr. S’s nurse and PA came in to talk to me initially, to see how I was feeling and how recovery had been going. I was in a really good mood — in fact, I’ve been in a really good mood for most of my recovery (which likely has more to do with not being as hyper-stressed [from trying to juggle school / work / social life] than with recovering from an invasive operation). In any event, we had a good chat and they seemed pleased with how I was doing.

Dr. S. came in a few minutes later and we started talking about how my healing was going. I told him that I felt really good, that I was using the crutches when I went short distances and a wheelchair for long distances (walker when at home). He looked at the x-rays and confirmed that 1) the bone was filling in really nicely along all of the breaks, 2) that the head of my right femur is now sufficiently covered by my right acetabulum, and 3) that the angles (between the center of the head of the femur / hip) created the perfect 90% angle that he was looking for. He seemed really psyched about that and I was pleased to know that the surgery appears to have turned out really well. He also confirmed that I have 5 screws (I had only noted 4) and that I was ready to move onto physical therapy 1/2 x week x 8 weeks. More on that later.

We then started talking about my left hip, what type of surgery we would be looking at, especially since the surgery is scheduled for May 8th. As a reminder, although my right hip had dysplasia (which can only really be solved by a PAO), my left hip has acetabular retroversion, mild femoral retroversion, cam and pincer impingement, the neck of my femur (between the ball and trochanter) is too short, multiple labral tears, a hairline fracture of the acetabulum and what appears to be a hypertrophic (overdeveloped) labrum. We had always discussed an SDD for the left hip but at my last few appointments, Dr. S suggested that the left hip might need a reverse PAO so I was curious what he would say, having now reconfigured my right hip. After some discussion about the coverage of my femur (which looks good, side to side), he feels that an SDD is the best way to go. What this will mean is that the incision will be on the rear side of my left thigh, 8″-10″ long, and during the procedure Dr. S. will literally remove my femur from the socket, shave down the impingements on the femur and acetabulum, repair the labrum, break the trochanter and either move or remove a part of it, remove and reattach muscles, and I don’t know what else, but not necessarily in that order. As much of an invasive procedure the PAO was, this actually sounds worse. But strangely, I am totally not concerned.

The plan is that I will meet him in 6 weeks, after my PT, to see how I’m doing. Things may change and the surgical plan is fluid but at this point, an SDD is the plan. Dr. S was great, explaining all of the reasonings for doing this procedure and showing me the x-rays and MRI scans. I was at his office for about and hour and fifteen minutes and he was in the room talking to me and my husband for the majority of the time.

After my appointment I met with a physical therapist who gave me some initial exercises to perform at home. I was shocked to be told I could be full weight bearing on my crutches (and am permitted to use only 1 crutch or a cane when at home). Some of my exercises require that I stand on only one leg – the operated leg – and I was really surprised that I was able to do all of it with no pain (although my muscles are way weak). I’ll start PT in Brooklyn next week.

Finally and un-hip related, I went and had a CT scan of my sinuses / maxillofacial bones to see if there is any reason I am permanently congested / have terrible allergies in spite of allergy shots + major pills. My ENT thinks it might have more to do with the fact that I have a very small nose and that the sinuses are so small that there’s simply no space to move around. There has been suggestion of sinus surgery to see if there is some space to be opened up. I seriously need a break from surgery, not more! We’ll see what shows up those reports.

I feel like you seriously deserve a prize if you got all the way to this point in the post. I hope my honest to goodness gratitude is prize enough, but seriously, thanks so much for reading. Onward and upward (or, actually, downward since I need to do my PT exercises before bed). G’night!