Category Archives: Procedures

Thrill Rides

Spring is officially sprung and in the spirit of renewed activity, my hips have been busy little bees the last week!

As I previously noted, I had been having an increased amount of pain in my right hip (really, the space between my right hip and groin) in the last few weeks. I was able to walk short distances but longer walks and lifting my leg definitely made things worse. Climbing stairs was mildly painful and I had been using my cane everyday for support but in general, the pain never exceeded a loud grumble…until this past Tuesday.

I felt fine at lunch but as I walked up several flights of stairs and out of the subway the pain in m right hip (the hip that had the PAO surgery) became utterly excruciating, like the most awful ache with moments of stabbing pain like mini ice picks! I only had my cane with me and nearly sat down on the sidewalk since I could barely drag myself the 1 block down the street to my office. I leaned on my cane, pain shooting into my hip with every step, and dragged myself back. By the time I made it I was in tears (this is only the third time I have cried since the PAO in December). I frantically called and e-mailed Dr. Sink who was able to get me in the next day (which I was so incredibly thankful for – he fit be in between surgeries). Luckily the pain mostly went away when I sat so I either sat or reclined the rest of the day. I started using crutches again that night, for the first time in 6 weeks. I started to worry that I would never actually get better, that I would always be in pain, that my next surgery would have to be postponed indefinitely.

At my appointment the following day, they took 4 x-rays and determined I did not have an new stress fractures. They also determined that the non-union of the pubis bone had not repaired itself (although a tiny bridge of bone, maybe 1/8th the width of the break, appeared to be growing). The pain was thought to be caused by one of the tendons (the rectus femoris or iliopsoas) — either that it was aggravated or that it had become stuck in the osteotomy site (basically, that the tendon rolled into the space where the bone was supposed to have grown and got stuck there). I was prescribed anti-inflammatories + the anti-inflammatory patch I have been wearing on my hip. I was sent for an ultrasound (with contrast) and injection of lidocaine and cortisone (into the sheath of both tendons). The ultrasound showed that although the tendons were not in the break that moment, they were each sitting right on either side of the break (and the pain could have been caused by the tendons rubbing on the edge of the break or they could have been stuck for a bit of time).

The cortisone injection took several hours to kick-in but by 10pm I noticed that my hip was feeling better. The next morning it was WAY better — honestly, it hadn’t felt so good since my surgery. For the first time in months I could put on my socks without pain. And walk? Back to normal – if not better! The pain had decreased about 90% and has since settled to a decrease of about 80%. I slept a ton and took it very easy the rest of the weekend – even let my sweet husband GK push me around in a wheelchair at the auto show. I was feeling so ‘normal’ today, though, that I let myself take a short bike ride today (bike riding is one of the few activities that doesn’t hurt if you have hip problems).

I have to be evaluated by Physical Therapy at HSS before I can get back to working with my physical therapist again. I may also need another cortisone injection before or after the surgery. It’s also possible/likely I will need another surgery on the right hip to fix the torn labrum (another pain) and non-union but not until the Open SDD is healed.

Oh! And on that note – the Open SDD is set for May 8th (1 month from today). My sinuses are healing wonderfully (follow-up with ENT this Wednesday) and my BIRTHDAY (my 36th) is this Thursday, April 11! Time to start revving up — it’s gonna be a busy busy spring!

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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I think it’s working!

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!

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!

Five Fantastic (F)weeks

It’s been FIVE weeks (and two days) since the big PAO and I am doin’ pre-tty darn well. Gaining strength in my operated leg and have been able to start putting a little bit of weight on it.  Yea!

Life is gaining a bit more normalcy.  I had brunch (at Aita, the restaurant across the streetand one of the few reasons I get out of the house) with some friends who sweetly came to visit me and thereafter I crutched my way to the nail salon for a mani/pedi combo. Blue and green sparkles!

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Sure, I admit, I am pretty much exhausted now and am going to have to take a nap but it was nice to start to feel like myself again, even if only for a few hours.

On the recovery front, one thing that’s been happening that I hadn’t expected is that I’m getting a lot of cramping and Charley Horse sort-of sensations/pain in the muscle of my right thigh. From what I understand, it’s caused by my body trying to activate the muscles and tendons that have been out of commission for the last several weeks. I think that the fact that I’m feeling this is actually good thing because it means that I’m continuing to recover but at the same time, they can be super uncomfortable and last for a while. Yuck!

I also decided to create another video (a guide to putting on your socks when you have hip surgery) for what i am calling my “Mobility Series.”  Yea, pretty much it just gives me an opportunity to make a video about the inane things that I do and have to deal with in the course of the day but I’m really having fun doing them I gives me an excuse to brush my hair and put on a little lip gloss so I figure it certainly doesn’t hurt (note that if you receive this as an e-mail and the video is not available, please check it out on my site because it took me, like, a whole 75 seconds to make and is totally worth your time).

Cabin Fever!

Yep, totally starting to lose my mind. Cabin fever is taking over. I’m allowed to start putting a little weight on my leg starting tomorrow (at the 5 week mark) but it my next follow-up is not for almost 3 more weeks. So until then, I am pretty much a homebody.
Cabin Fever

I did a search for “cabin fever” photographs but kept ending up with a sorta creepy movie poster but then, after searching for “cabin thermometer” I found this rare gem.  Log cabin syrup…digital thermometer.  It is just about as absurd as staying inside, almost constantly, for 5 weeks to date.

Over lunch I made a video of my mobility skills.  Yep, almost 60 seconds of me showing off my walker and how I can stand on 1 foot and shimmey side to side.  It seemed lika a really good idea at the time but, honestly, who is the target audience for this video?  I have seriously got to get out of the house from time to time!

I

Access-an-Adventure!

The six weeks following surgery when you are prohibited from putting basically any weight on your operated leg presents a special set of circumstances. On the one hand, you are tired and recovering and need a lot of sleep and are happy to hang out at home. On the other hand, you have basically been in the house for six weeks straight (in my case, almost four weeks to date) and you are starting to go stir crazy. As a result, I decided to venture beyond my apartment door a few times in the last couple of days to see, what the kids these days call, the outside.

Yesterday I went for my disability evaluation with the MTA Access-a-Ride paratransit program (http://www.mta.info/nyct/paratran/guide.htm). Basically, its an on-demand alternative to standard public transportation which, if I am deemed eligible, I could use to get to my appointments and even to work since wheelchair accessible public transit is not really an option where I live.

The evaluation required that I use an Access-a-Ride bus to visit the evaluation center.20130108-184503.jpg20130108-184531.jpg

In the wheelchair and used the lift to get into the bus.  Once onboard, I was SHOCKED (see shocked face) by how many cables and belts they used to make sure I did not roll around.

20130108-184511.jpgMy friend Dave helped push me around in the wheelchair.  I am really bad with the wheelchair, like bad enough that the nice lady at the evaluation center suggested I take lessons.  I get stuck in corners, a lot.  I always think of that scene in Austin Powers where he tries to do a three point turn and gets stuck in the hallway.  At least I can laugh — otherwise it would be tragic.

I’ll hear within 21 days whether I’m eligible for service. Fingers crossed!

My husband and I realized that it had been a long time since we’d taken our dog to the park to run around so on Saturday we bundled up like crazy and Guy wheeled all the way to Fort Greene Park so that Boris could play with his buddies.

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After all of that activity, it was nice to have a visit from my husband’s Aunt Margaret and cousin Elaine.

20130108-184632.jpgThey were so kind and brought pastries, bagels and a cake.  We relaxed for a while — it has been so nice to have visitors.  Since my energy is still FAR lower than it used to be and since my mobility is basically non-existent, I have appreciated that people have been willing to stop by.

 

Next big adventure?  I am weening myself off of Tramadol and onto only Tylenol and Aleve.  Oh, my life is full…

Recovery Lacks Pizzaz

It has been exactly one month since my PAO. I continue to gain strength in my operated leg.  Unfortunately, my not-yet-operated leg is deteriorating under the stress of bearing all of my weight.  I’m more tired than I thought I would be at this point and sleep around 10 hours a night. I seldom have any significant pain in my right hip joint. However, the muscles in my right thigh and around my right knee often ache, either from the surgery, the atrophy, or the fact that they are all stretched out because of the placement of the bone. I wake up every night because of the ache. My house is filled with equipment — multiple sets of crutches, a wheelchair, a walker, the list goes on. It’s more than three weeks until my next follow-up, more than three weeks until any of this changes. I live in pajamas, I have noticeable roots and I really need a haircut.

Now don’t get me wrong — I knew what I had signed up for. Recovery is a slow process and I need to let my body heal. But like so many things, knowing how things will be is a lot different than experiencing it. And now I know, and it has become ABUNDANTLY clear, that recovering from surgery is really freaking hard for me.

This may sound insane but surgery was exciting!  Pre-op appointments, learning where the cuts would be made, talking to the surgeon, blood draws, getting my bag packed, waking up early to make it to the hospital on time, checking in, getting myIV, being wheeled into the operating room?!? These adventures were WAY cool! And then I woke up and there are people everywhere and alarms going off and I realized I was stuck to 4 cables and, oh by the way, the surgery just happenend and possible complications and then there’s the days in the hospital and visitors and therapy and going home and being on drugs and follow-up appointments.  Novel! Excitement!!

Then, slowly, the excitement faded and there’s not much new and novel going on.  Life is getting back to normal, although slower and less shiny than before the surgery because, well, I’m recovering.  I’m back to work (from home, for which I am really thankful thankful since it permits me to have some interaction with the outside world, plus, it exercises my brain). I leave the apartment a few times a week with my husband but doing something as simple as going to dinner wears me out. I watch tv or draw. I am TOTALLY ready for my tax appointment. And I’m starting to research what my next surgery will be like, because even if it’s another PAO, it will be new and novel and a little bit exciting.

I know who I am, that I thrive when I am busy, that the busier I am the more I can get done and the happier I feel.  I grasp on to exciting new things, always looking for something I can do next.  Recovery has forced me to slow down, a lot, to stay in the moment and to let my body heal. There is no glitz, no glitter or sequins. Nothing new to target my sites on, nothing special, just more of the same but less… It is me, slowly getting better, without the shine or sparkle, the new or the novel. In this way, for me, recovery is way harder than the surgery was.