Category Archives: Physical Therapy

6 week follow-up – NEWS!

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!

Rockin’ the Follow-up

I just want to start by saying that I had very good last couple of days.

On Wednesday afternoon, my husband Guy came home from visiting his family in Toronto over Christmas. It was really great to see him as he’d been for six days. It also meant my mom was going to be leaving the following day and that Guy would need to take over all of the responsibilities of caring for me that my mother had been dealing with since I’d come home from the hospital. As one might imagine, my mom had done a lot to help because of my limited mobility but I was sure Guy was up for the task.

On Thursday, my mom packed her bags, put on her babushka, and headed for the airport and home.

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We realized there were a couple things needed around the house and decided to take a track out to Target. At somewhere around 15 blocks from our house, the trip took quite a while and was the farthest that I have been out of the house since my surgery. My hip was quite sore because of all the bumps in the sidewalk and I iced for a while once I got home. Although it was windy and cold, it was sunny outside outside and Guy and I had lots of laughs.

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Today was my two-week follow-up from my surgery so we rented a car and made our way to HSS for my 10 AM appointment. At the appointment, the PA removed my stitches and all of the icky Steri-Strips. My incision is mostly healed though they put a few more strips on to make sure that it is set. Here I am, hanging out on the exam table.

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My surgeon, Dr. S., came in and reviewed my x-rays with me and talked about what would happen over the next month as well as what to expect at my six-week follow-up. He felt things were going really well so far but said he would have a better idea of where things stood once they do x-rays late in January. I genuinely cannot say enough wonderful things about my surgeon in terms of his expertise and his demeanor, both at the hospital and at every appointment i’ve had with him. He is so professional yet incredibly kind and I feel very lucky.

We stopped at Whole Foods on the way home from the appointment. I’m surprised how tired I was, having been out only for a couple hours — I’m probably heading to bed early tonight. Guy’s been really amazing in helping me out and cooking my food and taking care of the animals and just about everything. I do wonder though if Fawn (our kitty) may be taking advantage of his kindness…

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In any event, it’s been a really nice couple of days. I have mostly minor aches which is far better than I expected. We may go to out to dinner tomorrow and see a movie on Sunday and I’m actually looking forward to getting back to work (from home) next week. With all the TV I’ve watched its a surprise my mind has not turned to mush! Boris doesn’t seem to mind either way.

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Maybe I Overestimated

I has been 1 week since my surgery and a little over 1 week until my first follow-up appointment (December 28th).

I’m starting to think that how I was feeling on Tuesday was just a tease, a day when I didn’t feel so bad that I was lulled into believing the worst was over and I was on the way to getting back to normal. It may have been the fact that I was finally allowed to take a shower or that the hospital meds were still in my system. In any event, I cannot emphasize enough how wrong I was.

Wednesday was a rough day that made me believe that I haven’t even experienced the worst of the pain less than the idea that am recovering. My hip, hip joint, incision site, my thigh, my lower back, core muscles, backside, and un-operated leg are so incredibly tight and sore. It aches to simply lay down and can be frightening when I move about the apartment on my walker because I feel genuinely afraid of falling down when my left leg starts to shake. Falling down would be a disaster because it could mean that the screws which are holding my acetabulum in place could break or bend — and would therefore require more surgery. Today is a little better but I am shockingly exhausted and my legs seem to shake all the time.

I have been doing my PT exercises, as much as I can. They are really basic — flex/extend ankles; press thigh into the bed, raise a can over my head while lying over my back — and from what I understand these will be the basic exercises I will be doing for several weeks. This part of the process is less about strengthening than rebuilding, letting my pelvic bones grow mesh back together into one cohesive unit.The hope is that meshing will be done by the 6 week follow-up (late January) at which time I can I can start weight-bearing on both legs and eventually be off crutches in February or March 2013.

By way of a reminder and as I previously noted (and as is probably evinced by my bizzaro writing), I am on a lot of pain and focusing is not my greatest skill. Sometimes I just start writing and get distracted but keep writing and then look down and it’s like my fingers have a mind of their own. I have also taken to falling asleep while people are talking to me on the phone or in person, like i blink and in that single second I fall asleep and start dreaming and simply forget to reopen my eyes. Also, as I try to type late and night I repeatedly just about drop my iPad or iPhone when I start to drift off to sleep. I thought that was a late night problem but I am revising my note this morning and the problem is just as bad.

One note of thanks to those who kindly sent flowers and treats from Zabars They are really beautiful and yummy — here is post them.

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Home

I am happy to report that I made it home from the hospital yesterday and arrived at our apartment around 2pm. The house was super walker/crutch sound effects, I have a recliner I sit in during the day (and a rolling overbed table), and for night i sleep on a chaise (I would sleep in our bedroom with the dog and cat except for my severe allergies.

Things started off really good – not a lot of pain and a lot of people around to support me. My husband set-up an app on my iPhone called PILBOXIE which reminds me exactly what pills to take, how many of each, what they look like, dosage etc. It’s also great because it keeps track of the pills you have taken in the past so that when I go to my 2 week follow-up appointment I can say exactly what I had been taking.

Things continued on a good track through part of today, to the point where i thought that I would be ready to get back to work sooner than anticipated. I quickly realized that rushing back to work too soon would probably mean that my recovery overall will take far longer. That realization, coupled with an increased amount pain on both my operated and yet-to-be-operated-on plus the fact that the back of my throat is red/swollen/with possible strep blisters implies that rushing back and wearing down my immune system is not a good plan,

On the red sore throat (strep?), I called my physicians office to ask what to do and am waiting
hear back. Otherwise I’m ok aside from totally lacking coordination and the fact the drugs really make me loopy to the point that i don’t know where i am and I literally fall asleep if I close my eyes for 3 seconds.

On a surgical note, the incision is 8″ and the SteriStrips are starting to come off – creepy incision photos coming soon I hope!

Fading fast – more details tomorrow!!

Ex post long screws

Not much new to report from hospital land. My hip and the incision site ache and burn. My right leg basically does not work – it is incredibly heavy and like a dead muscular fish. Therefore, my left leg is having to bear the burden of walking and pretty much any activity I try. Unfortunately the left leg quickly becomes very weak and unstable and I feel like I could easily collapse (i have a similar problem with my left leg as the right and am having surgery in May.

It looks like i will be released tomorrow to recuperate at home for several months. Dressing over the incision comes off tomorrow too! For the meantime, here is an x-ray of my right hip post-PAO (the doctor takes numerous X-rays during the procedure to be sure that the placement is correct and he kindly gave me a copy). More photos coming soon!

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Baby steps

Day two post surgery is still going pretty well. I have not slept much in the hospital, even since I got out of the ICU. Someone still comes in at least once/hour to check something and my sleep cycles are really screwed up from the massive amount of medications I am taking (Percocet, dilaudid, oxy to name a few). So while I’m a little loopy, I’m not really all that sleepy. And on the subject of loopy, some of these pain meds make it practically impossible to even write a sentence (so apologies if this post is confusing).

20121215-211455.jpg (the ginormous stuffed bunny that Guy got me to sleep with while i am at the hospital)

My epidural and Fowley catheters were removed this morning so I have had to get out of bed several times to use the restroom – my walker is my new BFF (at least until I can walk on my own).
My pain feels like it is in either the incision site or deep in the right hip joint. I haven’t seen the incision yet but believe it is between 8″ – 10″ long. There is also this crazy level of itchiness on my torso that is frustrating – caused by the dilaudid – so I have a different drug to take care of this. It feels a little bonkers.

Here is a photo of my incision, covered by its dressing and in no way inappropriate (I promise).

20121215-211621.jpgThe incision dressing runs down the front of my leg starting from just below my waist to about half way up my thigh.

I figure that once I can remove the dressing, around the 18th or 19th, I’ll take a photo if the actual scar. I also have an X-ray that the Dr took during the procedure – ill scan it and add it to the site once I’m home.

Falling asleep…g’night