Category Archives: Physical Therapy

Living Life on Hold

I am very pleased to report that sinus surgery this past Thursday seems to have been a success. At the very least, I haven’t had any significant pain or discomfort following the surgery and I was able to work from home the day after the procedure. The nasal stints are scheduled to be removed tomorrow – those puppies are BIG!  I feel sorta stuffed up and sleepy but apparently it’s normal and resolves itself within a few days. I can’t do any lifting or bending for the time being but should be 100% within a few weeks. Yea!

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I’ve been thinking more about the nonunion of my pubis bone and the pain in my hip and front of my right leg that seems not to be getting any better, even though I can walk. As  I understand, nonunion is normally asymptomatic but in my case, it may be causing the pain and may be the reason my recovery is stalling (even though I am able to walk). I learned from other ‘hip women’ that I could request copies of my x-rays from the hospital, which I did. I figured I’d post the x-ray of the nonunion so that everyone can understand what I’m talking about.  For perspective, imagine that the camera is facing me and I am turned 90 degrees to the left.  My left leg is placed facing forward, in front my body, and my right leg is turned out 90 degrees and placed back and to the right.  That’s why it looks like my pelvis is torqued.

I’ve also learned that as part of my May Open SDD surgery on my left hip (which is 6 weeks and 2 days away and which will require more recovery time than my PAO), the surgeon breaks off a small portion of the greater trochanter bone from the femur to gain access to the joint and later reattaches that section of bone at the end of the procedure with two or three screws. Sometimes (I’ve heard up to 40% of the time) the screw heads catch on muscles or tendons in the leg and the screws have to be removed in yet another surgery.

So, if you’re counting, which I am, I had a right hip scope surgery (January 2012); right PAO (December 2012); sinus surgery (March 2013); and will have Open SDD on the left side (May 2013). Add to that the possibility of a surgery to fix the nonunion of the right side AND, if I’m lucky (said sarcastically), screw removal. Between all these surgeries, there is recovery and pain and holding patterns. I know that I can’t expect to have all the answers but COME ON!!! I just want to take my life off hold and start living again! Ride my bike, take a walk, NOT watch TV like an obsessive, go back to school, lose some of the weight I have gained from sitting around all the time.  I have tripped down the rabbit hole and I would like to find a way to climb back out.

I don’t wanna be whiny but man, it’s spring, almost April, the days are getting longer and soon the weather’s gonna be nice.  Let’s get this show on the road!

Surgeries and Surprises

First, Happy slightly belated St. Patrick’s Day! Hope you were out drinking green beer and eating corned beef and cabbage!

It’s been a little while since my last post and I have lots to report. For those who don’t want to / have time to read the full post, here are the bullet points:

1. One of the bones in my right pelvis that was broken during the PAO surgery (the pubis bone) did not grow back together. Dr has prescribed a bone stimulator / increase protein to make it grow. If it doesn’t work I may have to have ANOTHER hip surgery on my right side to bridge the gap.
2. We are a go for my Open SDD surgery on my Left Hip on May 8th (pre-op April 30th).
3. Sinus surgery is set for THIS week (Thursday, March 21st). Basically, Dr is creating a straight shot out of my sinuses / removing bone and tissue / fixing my deviated septum. Same day surgery, home Thursday evening, around a week of recovery.

THE LONG VERSION
I met my hip surgeon for my 3 month RPAO follow-up / 2 month pre- Left hip Open SDD appointment on March 15th. The appointment started with x-rays. I met with my Dr. and mentioned that although PT (physical therapy) was going well and even though I am able to walk unaided, I was concerned about a new sort of pinchy/burning feeling that I’ve been noticing in the front of my hip. It also sometimes feels like the tendon is rolling over the joint, almost like it’s catching.

During my hip evaluation, my Dr. had me sit at the end of the table and try to lift my leg up off the table (really hard to do) while he pushed down. It was excruciating and I squealed in pain, not a normal reaction at 12 weeks post surgery. The Dr. then pulled up my x-rays. The x-ray showed that one my the bones had not grown together, possibly at all. The two sections of bone appeared to be about a centimeter apart, not even touching. This is called nonunion (when the bone does not grow back together following the surgical break) or slow union. It is one of the complications that can result from PAO surgery, normally only in about 1% of cases. Oh, lucky me. Even when it does happen, is typically asymptomatic and therefore does not require further medical intervention. Unfortunately for me, it may be the reason that I’m having pain in the front of my hip and, it’s possible that the tendon is getting stuck in the break. Gruesome.

The Dr prescribed me a bone stimulator which is a machine I will have to wear every day at home and will hopefully stimulate the bone to regrow. His staff also recommended I increase my daily intake of protein and calcium as much as possible so unfortunately for the animals, my efforts toward vegetarianism are taking a break. Hopefully the bone stimulator + increase in protein works. If it doesn’t, and if I continue to have problems, I may have to have a further surgery on my right hip after my SDD surgery in May. I should know more after my next appointment. In any event, it doesn’t sound like it will prevent me from moving forward on my left hip surgery which is good.

My next appointment on April 30 is my pre-op for my Open SDD surgery scheduled for May 8. It’s so strange to think of going through all of this again when I feel like I’m not even through the first surgery but I have to just keep moving forward, partly because I don’t really have any other choice.

In other news, my sinus surgery is scheduled for this Thursday, March 21. It’s a same-day surgery so assuming that the surgery requires that I get there at 7am, I expect to be home by 3pm or 4pm. The doctor is performing a septoplasty, turbinectomy, balloon sinuplasty and I don’t even know what else. The goal is to create more space in my sinuses so that when I have allergy problems, my sinuses don’t get so inflamed that they completely block and get infected. I also started back to allergy shots, 4 shots 1-2x week.

This year is already wearing me out and it’s only March. It feels absurd to me that my hip problems have so taken over my life. I am really looking forward to getting though the next 9 months and getting back to my life (surgery free!). Until then, the saga continues.

(Mostly) Crutch Free + 12 week Status Update

It’s been 11.5 weeks since my PAO and I am crutch free (mostly)! I say mostly because I am not willing to put away the crutches quite yet, and will definitely have them with me for longer trips (and I will absolutely continue to use the motorized scooter when I shop at Target). But this weekend, when I went out to dinner with my husband and when I walked 23 (23!) blocks over Sunday afternoon I did it only with a cane. I admit, by the end of the walk both of my legs were aching something fierce but I surprised myself by going as far as I did. I don’t seem to have a limp (as far as I can tell) and my surgery’d side hurts less than my yet-to-be-surgery’d side so I am really pleased.

Recovery was tough for the last week or two – I was doing more because of PT and my hips were not happy about it, very sore and achy and my muscles always quivering. But something seemed to turn a corner this Thursday because when I went to PT it was as if my muscles all decided to start trying to work again and I felt stronger and more capable. My therapist even approved my not using crutches. I’m know that the rest of PT will not be a cake walk and that I have a ways to go to be ‘normal’ but it was nice to feel like I was improving.

For reference, here are some answers about the status of my recovery to date (as of March 9th — 12 weeks and 1 day post-op):

  • When did I feel significantly better?  My pain was well managed but I was exhausted for the first 2 months. It literally took until 11 weeks until I felt significantly better.
  • How long was I on pain meds?  Narcotics (oxy) – 11 days following surgery; non-narcotic but strong – thru Jan 10th (about 1 month following surgery); Tylenol/Aleve – consistently thru 2 months post surgery; still occasionally
  • When was I able to completely take care of myself? My mom and husband were willing to help a lot so I let them. It was until mid Jan (about 1month post surgery) that I started to really take care of myself completely. If I had needed to I could have taken care of myself completely at between 2-3 weeks.
  • How long was I on crutches/walker? Non weight bearing crutches or walker – thru 5 weeks; weight bearing crutches – thru 10 weeks.  I continue to use a cane.
  • When was I able to wear anything but sweatpants? 2-3 weeks
  • When was I pain free? Too early to answer – still have some pain and lots of soreness
  • When was I able to lay on the operated side? 4 weeks
  • When was I able to drive? Don’t drive (live in NYC)
  • How long before I had a day that I didn’t need to lay in bed most of the day? I started working from home at 3 weeks – that was when I stopped laying in my recliner as much but I continue to rest and sleep a lot more than I used to.

I passed the half-way point between my 2 hip surgeries on February 24th and I am 9.5 weeks out from the SDD surgery. The 24th was an emotionally difficult day because I realized that I am actually going to have to go through this (or something like this) again and although I have handled the physical components of recovery well, the emotional has been harder than anticipated. I am scheduled for my next follow-up with my surgeon on March 15th so we will have lots to discuss. I’m really curious to hear if he thinks that I will need another scope on my right side (please, I really hope not). Also, following my unsuccessful balloon surgery attempt, I am scheduled for full sinus surgery (fix the deviated septum, turbinectomy, balloon sinuplasty, who knows what else but ALL performed under general anesthesia) on March 21st. Good news is that recovery for that should just be the weekend, plenty of time for the May 8th SDD.

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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!!