Category Archives: Physical Therapy

My Unscrew’d New Years

It’s that time again – time for New Years Champaign and celebrations another hip surgery!  Heck, I would barely know it was the holidays were it not for my annual surgery (in case you’re counting, this is year 3).

The good news is that this one’s supposed to be WAY easier than the last two.  As of 12:30pm tomorrow, New Years Eve, I am having all of the screws in my hips removed.  The procedure, expected to take less than an hour, will be bilateral (on both hips) and will involve my fantastic surgeon removing 5 screws from my right hip and 3 from my left greater trochanter.  Two big incisions to be sure (they will be reopening the incisions that were previously made and healed), but hopefully not TOO much pain.  If all goes perfectly, I could be home in time to see the ball drop.  Otherwise, I’ll see it from my bed at HSS.  I honestly hate New Years Eve so spending the day in the hospital didn’t sound like such a bad option.

The screws have been rubbing the soft tissue and causing a lot of pain and inflammation, especially on my left side where the pain shoots into my knee and all the way down to my ankle.  On the right side, I can feel the heads of the screws through my skin — CREEPY! On a positive note, the screws are no longer needed.  Since they were initially installed (in December 2012 and May 2013), new bone has grown in the spaces that the screws were holding in place and now they are superfluous.  The idea is that once the screws are all removed and I get back to physical therapy, there should be no impediment to my getting better — like all the way, walk without pain or a limp, do things like a normal person, better.

Until tomorrow!

1 Year post-PAO

1 year ago at this hour I was in the PACU (Hospital for Special Surgery’s post-surgical ICU), newly broken hip held together with screws, drugged to the nines and unable to move my right foot (because, as we later learned, the epidural was in a bit too deep). I was just at the beginning of this latest stage in my hip journey. I was hopeful that my right hip would be in pretty good shape by this past May and had not even started to realize how hard my recovery would be.

There’s no new news today but I felt that this is a day I needed to acknowledge, like a birthday for my sorta-new right hip. In less than 3 weeks the 5 screws will be gone – they will be removed along with the 3 screws in my left femur (the remnants of my May surgery). My right hip scar is healed to the point that it’s hard to see, in some places, where the incision was. That will all be reopened soon enough but for now, it seems like such a long time since I really even thought about it.

People ask me if my right hip feels better than before the surgery. The thing is I think it does but I don’t really know. Before the surgery I had pain when I would do certain strenuous activities. Now, I have some level of pain anytime I’m not sitting or lying flat on my back. I don’t do strenuous activities because the pain makes it impossible. I feel confident that once the screws are out and the soft tissue stops getting rubbed the wrong way I will be able to give a better ‘status report’. Like the one year ago version of me I am hopeful.

Before my surgery I had posted a very personal message to those of you who have followed my surgeries and recoveries. I promised to update my site and all of you, to push myself out of my shell and write even when I wanted to hide. And I asked you to stick by me so that I would not have to go through this alone. Please know how incredibly thankful I am for all of you.  It has been a rough year and I cannot thank you enough for sticking by me, and continuing to do so.  I have also been happy to learn that my site has been a resource for other ‘hipsters,’ with over 12,000 views from people in 65 countries.  I am certainly not alone.

As an aside, some holiday carolers we’re wandering down my Brooklyn street and for the first time this year, it felt a little bit like Christmas. Since I likely won’t post again until closer to the New Year and my next surgery, let me wish you all a lovely and joyful holiday season full of love, happiness, and a whole lot of hope.

I’m still here!

It’s nearly 11 months post-PAO and nearly 6 months post SDD and I am still alive and kicking (although, technically, I still can’t kick, with either leg). I know I have been lax in providing updates but honestly, recovery is a SLOW game with small steps forward.  I have been in PT, off-and-on, since February, but recently my improvement, especially on my left side, is mostly stalled and in a holding pattern.  That said, I have a bit of news and some updates to report.  I also know that there are others who are going through similar surgeries and experiences that read my blog and I really want this to be a complete picture of what I have gone through (and continue to go through).

Right hip (PAO) first.  My right hip is doing pretty well with any remaining pain located in either my right greater trochanter or in my psoas at the front of my hip.  I’m hopeful that any remaining pain in these areas will get better with more time, keeping in mind that full recovery from a PAO is up to 2 years.  The only other problem I have with my right hip is that the screws along my iliac crest do give me some discomfort — not sure if they are unscrewing themselves (which is possible) or if the swelling around the incision has finally gone down.  I’ll get back to these screws in a bit.

Left hip (Surgical Dislocation).  Left hip is not doing nearly as well as the right.  I am finally off-crutch (for the most part) because my limp is gone (for the most part).  However, I still have pretty significant pain in my left greater trochanter and psoas.  The pain in the front of my hip seeps into the joint and sometimes I feel like the ball of the femur isn’t solidly in the joint which makes me wonder if I am subluxing my hip joint (click here – Hip Instability – for a bit of information on hip instability and subluxation).  The pain in the trochanter can get pretty severe to the point where I sometimes need to use my cane or crutch, both because of my limp and in an attempt to take the weight off my left hip.  The pain definitely gets worse 1) when it rains and 2) the more I walk.  Which leads me to…

I’m having another surgery!  Yes, that’s right, ANOTHER freaking surgery, and another holiday season sullied.  I am having the screws in my left hip (and possibly the screws in my right hip) removed in late December (exact date tbd).  Good news – it’s an out patient surgery, though I may be in the hospital overnight to ensure the pain is well managed.  Other good news — other people who have had their screws removed bounce back within a few weeks after the surgery and typically move quickly beyond the holding pattern of improvement to actually get better.

I am scheduled to meet with my surgeon on November 18th for my 6 month SDD follow-up and anticipate that my physical therapy benefits will be up around that time.  After my Dr. appointment I will know if any additional procedures (e.g., fluid drainage, scope) are required — I am hoping NO but we will see.

tumblr_mub3moYShU1qhvwbto1_500SO, aside from a new hair color (black and blue streaks), a new semester at law school (my second to last), and a new tattoo (amazing, huge, on my thigh, done by Seth Wood, and appearing at the bottom of the page [you can see the bottom of my PAO scar next to the bee above the flying bee]), that’s what’s new.  Oh, and Happy Halloween!

10+ week status — Open Surgical Dislocation (SDD)

I started this blog with two purposes: 1) to inform the world of how I’m doing, and 2) as a record I can look back on to remind myself how I was doing at certain points in my recovery (really helpful when I’m coming up on a follow-up with my surgeon, as is the case this Wednesday).  This post serves the latter purpose (i.e., it’s probably gonna be boring and you might wanna skip reading it).  I warned you!

I am 10.5 weeks post-op on my left hip SDD (a little more than 7 months post-op RPAO).  I have had several sessions of PT (one/week) and one session of hydrotherapy (PT in the H2O).

PT Exercises — status:  

  • Most of my PT sessions are about determining my current level of ability to perform existing exercises and introducing new exercises into my routine.  The therapists also massage and stretch some of the tendons and muscles that are tight or sore so as to improve range of motion.
  • My limp has definitely improved since my first session, but it is still there and gets worse the more exercises I perform.
  • I continue to perform my PT exercises at home including PT Phase I post-op PT exercises (i.e., seated leg extensions, cow pose to child’s pose, core/glute tightening, and quad stretches) and SOME of Phase II post-op PT exercises (including bridging with red elastic band abduction, bent knee fall-out with red elastic band resistance, standing abduction on the affected side, core stability with hip extension + abduction, balance and proprioception, and upright bicycle).
  • I am unable to perform standing abduction on the unaffected side (where I have to stand on my left leg and extend my right), posterior gluteus medius strengthening (where I have to extend my left leg to the back/side at 45 degrees with a red band) or contralateral elastic band for stability (again, standing on the left [affected] side and extending the rights side with a colored band.
  • Hydrotherapy is great because, when you are in the water, your body doesn’t hurt as bad so you can do more than if you were doing therapy on land.  It’s also terrible because, since you don’t hurt as bad, you don’t realize that you are overexerting yourself until you get out of the water.  That’s what happened with me, and I will be avoiding further hydrotherapy sessions until I am stronger.

Non-PT activities — status:

  • I use one right forearm crutch (Millenial) whenever I walk to off-set the limp and because it’s painful otherwise.
  • To date, the most I have walked in the course of a day is approximately 15 blocks, and I was extremely sore/in pain and exhausted at the end of it.  In average, I walk no more than 2-3 blocks in a day.  I use Access-a-Ride almost exclusively for traveling in the city as my local subway station does not have an elevator and I have a terrible time going up and down stairs.
  • I AM able to ride a bike, which I do on occasion when it’s not a million degrees outside.
  • I am still unable to sleep on my operated side.
  • When sitting my left leg needs to be extended at least 75% of the time.  Otherwise my knee becomes progressively more painful.

Pain levels — status:

  • My pain seems to have increased in the last few weeks, from very little pain at 6 weeks post-op to some level of almost constant pain in my hip, back and knee.
  • I have constant pain in my left side of my left hip.  I would not say it is in the joint itself.  Rather, I would say that that it’s in the trochanter or in the muscles between the trochanter and my lower back (the gluteus muscles).  The pain is relatively mild (around a 2/3 out of 10)  most of the time but can spike to a 7/8 out of 10 depending on my level of activity.  I cannot abduct my left leg at all when lying down (i.e., no “clam shells” — a PT activity for abduction).
  • My Sacroiliac Joint (SI) on my left side has been hurting a lot since my hydrotherapy session.  Note that until recently, I have not had any significant pain in my back and SI joint since prior to my RPAO in December.
  • My left knee started hurting about 2-3 weeks ago, in the area behind and just below my patella.  I am guessing it has something to do with tight tendons / IT band but honestly I have no idea.  It looks swollen — I have tried ice and Voltaren anti-inflammatory ointment on it but without much luck.
  • I manage my pain through a combination of rest, elevation, ice, Tylenol and, on occasion and if needed, stronger pain medication (as was needed as few times in the last week).

Next post will be more interesting — promise!

Hey there freedom!

Tomorrow marks 8 weeks since my left hip Surgical Dislocation but today, for 26 minutes and 13 seconds, I rode a bike, outside, and was totally utterly free.  No crutch, no cane, no limp!  And it was fantastic!  I love to bike ride and lucky for me, biking is one of the few activities I can do with only limited pain.  Since there is a Citibike station around the corner from my apartment, I plan/hope to ride a bunch this summer.

In addition to getting back on a bike, over the last couple of weeks I have slowly been trying to get my life back on line.  I started PT on Monday the 24th — mostly stationary biking, bridging, leg lifts — but it was kinda fun and my therapist was really helpful (which is good since I’ll continue to go 1-2/week for many months).  I rode the subway for the first time since May 7th and was stunned by how exhausted I felt at the end of my trip.  I’ve been using Access-a-Ride to go to the city to work two days a week.  This past Saturday I met a friend for some shopping and brunch in the city and then my husband and I went out for dinner.  I think I am finally, slowly coming out of the hermit’s lair I have resided in for the better part of 6.5 months.

In terms of how I’m feeling, I would say that I am doing OK but not great.  I ache a lot more this time than I did after the PAO.  My left hip hurts, at least mildly, almost all of the time and for the first time, I have had trouble sleeping because of the pain.  I cannot stand on only my affected leg (the leg that had the SDD) or I fall over.  Technically, I can walk without a crutch but not very far and only with a pronounced limp (the limp magically disappears when I use the crutch).  Also, my PT says I’m not supposed to walk unaided until I get rid of the limp (they don’t want me to develop a bad habit) so anticipate I’ll be crutching for several more weeks at least.  My right leg continues to have pain when I perform certain movements and it aches but only when I have been sitting for a long time.

So that’s that – just a quick note.  Happy 4th of July to all!

Long Weekend

I love nights like tonight. When it’s a little drizzly out and seems darker than it should be, and you open the window so that a bit of cool air creeps in while you’re snuggled under the blanket with the cat and the dog and a book and tea. Today is one of those days where I really don’t mind my limited mobility; in fact, were I not immobilized I might feel a little guilty. As it is I feel happily calm.

I am 16 days post-op and had my two week follow-up with my surgeon this past Tuesday.

Two-week follow-ups are less about checking angles or taking x-rays and more about making sure your pain is under control and that you are doing OK. I had all of the Steri-Strips removed from the incision, had the incision cleaned, and had a few placed back on to make sure that the stitches hold permanently. I was happy to learn that I no longer had to wear my DVT compression socks 24/7 (i peeled them off 15 feet from the office door) and could send my CPM machine back as I am mobile enough not to need it anymore (it was picked up earlier today).

This recovery has been going extremely well, my pain managed by Tylenol, and my surgeon was pleasantly surprised at how well I was doing. I mentioned that when I stopped my narcotic medication and switched to OTC meds, I had some unpleasant withdrawal symptoms including extreme irritability, insomnia, and two days of crying for seemingly no reason (must remember for future reference to avoid this medication). I explained how the pain in my left side is more of a deep muscle ache that is always noticeable but not severe or excruciating. The pain on the right side, the side in which I had the PAO surgery in December, is actually where I noticed the more striking and alarming pains. We had previously discussed, before the second surgery, that this would likely be the case . The right side still has problems though the extent is not yet clear. My doctor noted there is always a chance, unfortunately, that once one problem is fixed, another may become unmasked. For example, it’s possible that once the dysplasia in my right side was fixed with the December PAO surgery, impingement may have been unmasked and that may be causing the pain I continue to have in the right side. Similarly, it is possible that, now that the impingement on my left side has been repaired with the SDD surgery, the dysplasia related to my acetabular retroversion may become more prominent.

That said, neither my surgeon nor I are of the opinion that we need to rush to make any decisions, one way or another, on the effectiveness of either of my surgeries to date. These decisions can wait several months, until I am well into my physical therapy and have a better idea of how I’m doing.

As you can imagine, I am hopeful that I am finished with surgeries and that physical therapy will help take me to the finish line in terms of recovery. My next follow-up appointment is scheduled for mid June, at which point my surgeon will take x-rays of my left leg and hip to determine if the trochanter osteotomy he performed is healed and whether I can stop using crutches.

I’m happy to be back working remotely from my home. I like the structure it provides, requiring me to get up at a particular hour and having tasks to complete. I also really enjoy what I do and so it was almost a relief to be able to get back to it. I’ve gone out to a couple meals and to my surprise had no trouble sitting on a booth or on an un-cushioned chair. This is dramatically different than the last surgery and a welcome change. I am hopeful that I’ll be able to get back to law school in the fall, though that will depend on my recovery, any further surgeries I may need, and making sure that I have a safe balance between my work/school/recovery and personal lives. I figure I’ll know more about my Master Plan in a few months.

In the meantime, I hope you all have a lovely long Memorial Day weekend, whether you are enjoying the outdoors or snuggled under a blanket next to a cool breeze

Hey May, whatduyasay?

I canNOT believe that it’s almost May! OK, it’s 9 days until May, but those 9 days plus the following 7 days and suddenly it’s May 8th and my next surgery! Even before we get to May, I have my last sinus surgery follow-up on May 1st (10 days away), surgical pre-clearance day on April 30th (9 days away), and two medical massages.  Add that to all of the fun things that are upcoming — three (3!) Broadway opening nights; pre-surgery highlights + spa necessities; my dad coming to do the 5-Boro Bike Tour; last minute “see you after your surgery” lunches and dinners; bowling (hopefully); and, if the weather is accommodating, bike rides.

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20130421-143109.jpgIncredibly, bike riding is one of the few physical activities that I can do that doesn’t hurt my hip so last week I was able to go to two FANTASTIC 4-year-olds’ birthday party and a brunch (and wear as many patterns as I could find) — all on my coaster bike.

I am pleased to report that the cortisone injection into the psoas and rectus femoris tendons definitely helped a lot, and for the most part, the pain is significantly decreased.  However, it’s not gone.  I still have pain whenever I go up stairs, I cannot lift my right leg more than about 30 degrees without noticing pain in my joint, and the more I walk the more I hurt.  On Friday, I visited fellow Hip Chick Lauren (who just had a total knee replacement at HSS) and decided to really see what my hip could do.  I walked (with a cane) about the distance I used to walk before the surgeries — and since HSS is about a million blocks from the subway, it meant a lot of walking.  Anyway, I was a bit disappointed to realize that by the end of the night, the pain in my right hip (the hip that had the PAO) was definitely worse than the left, yet untreated hip.  I am positive that my right hip will need another surgery but for now, with rest and intensive massages, I am confident that I will make it through the May 8th surgery.

Not much else to report but here are a few cute photos I thought I’d share.  Hope all are well!

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Guy (my husband) and I, post Easter brunch.

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Bagels at the playground — Boris REALLY wants a bite