Category Archives: SDD (Surgical Dislocation / Open)

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!

Lurching Into Month 2

Today is my one-month anniversary of my left hip SDD surgery. Although I’ve been reluctant to give an update since not much has been going on, I thought that the anniversary warranted a new post.

The first month of this recovery was easier in general than the first month following my PAO. I have been able to sit in a restaurant chair, go to the movies, work on my computer, ride in a car, and generally move myself. My scar looks good, though a bit lumpy – I will try to get a photo soon although it’s placement makes photo taking quite difficult. AbductionThat said, it’s not exactly cotton candy and unicorns. I cannot abduct my left leg AT ALL (see drawing) since even the most minor movement causes a pain that takes my breath away. My pain tends to center around the greater trochanter (the part of my femur [leg bone] that was broken and screwed back together), in my glute muscles, and in the joint where the surgeon repaired the labrum. The inflammation is still pretty bad, even a month out. I have discomfort in my hips legs and knees when lying on my right side and cannot lie on my left at all. I can’t bend over, or sit at a 90 degree angle, or put 50% of my weight on my left side, or cross my legs. I’m tired all the time and I absolutely cannot walk (crutches being my main form of transport).

Lurch Instead, I sort-of lurch around the apartment, hobbling and trying to keep my left leg facing straight ahead. Not an attractive look I can assure you. My physical therapy has consisted mostly of leg extensions, stretches, foot flexes and the like. Something about the pain makes me feel like the more intense PT (that I will likely do at HSS) is going to be a lot more difficult and time consuming on this left side. I’ll have a better idea at my 6 week follow-up in a week and a half.

I’ve been using my bone growth stimulator 24/7 — in the day time it’s attached to electrodes on my right hip, at night to my left. Bone Growth StimulatorIt doesn’t feel like anything is happening, no buzzing or vibrations as I had anticipated; however, it looks like I am permanently wearing an AM/FM radio clipped to my waistband (see photo). Hopefully it is working — I’ll know more at my next appointment.

I continue to use Access-A-Ride (the MTA’s paratransport system for individuals with disabilities) to get to my appointments. I can’t say enough positive things about the program – it is truly a life saver and saves me from having to take a cab every-time I need to leave the house.

In other news, I have been busily working from home (full time for a few weeks) and I started back at law school where I am taking two summer courses (one of which is almost entirely online — an incredible boon with my limited mobility). There is even a chance that I will be able to participate in graduation ceremonies in May 2014 (!!!). I’ve been in school for so long that the idea that I could eventually be done at some point literally never crossed my mind. I have to admit — I’m really excited!

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My next appointment with my surgeon, my 6 week follow-up, is scheduled for a week from next Monday. Until then, I lurch along.

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

Pain

I am 8 days post-op and to my surprise, the severe pain that lasted weeks after my last surgery is already gone. I stopped all narcotic and prescription pain medications today and am only taking Tylenol for the more manageable pains and aches. I don’t have any idea why the pain is so much less severe this time around.

Pain is really kinda great for someone like me because it’s my protection. My natural instinct is to push until I break — either do everything or do nothing. I feel guilty if I don’t throw myself into things 110%. Throughout my hip drama, pain has been a fluctuating roadblock – a limit to my activity and energy that can literally stop me in my tracks and knock me flat on my ass. It’s not always in the same place and can change from day to minute. Pain has stopped me from doing more than I could or should have done; unlike every other barrier I try to artificially manufacture for myself, I have no control over pain. I listen to it and I abide.

This recovery, without the pain I feel rudderless. I know that my body needs to heal A LOT more before I start trying to get back to a normal routine, that I need to rest all the time because I just went through really major surgery. I should be sleeping constantly, taking large doses of meds and yes, I should hurt. But this time my body just doesn’t hurt so much. I’m missing the limit that tells me to stop, so I don’t. I can’t seem to justify a need to sit on the couch and get better, as much as I genuinely wish I could. I sleep a normal amount each night and I wheel myself most of the way to the Target (which was exhausting but didn’t hurt) and I try to tidy up around the house. In other words, I fail to take care of myself because pain isn’t there to remind me.

And so I feel agitated and sad and exhausted and crappy almost all of the things you normally feel like when you’re 8 days post major surgery. But I also feel guilty because I can’t blame the pain for preventing me from getting back to my life. I’m really struggling with this and it’s upsetting me a great deal. I expected to feel terrible – after all, someone sliced me open, broke and shaved bone, took my leg out of the socket, and on and on. I didn’t expect to feel ok (or the feelings that are going along with it).

I don’t know. It’s late and I’m tired. I have no insight or solution. And I don’t have to because this is a blog and I say so. Hey, I’m allowed to be difficult and irrational darn it – I am recovering from surgery, after all.

Flew the coop

I was released from the hospital on Saturday at 2pm and was home in Brooklyn by 3:15. I am allowed to put up to 30% of my body weight on my left leg and the balance on my right / crutches / walker. My stay at HSS was very successful and the pain seldom reached beyond a level 3 or 4 out of 10. However, even with the strong medications I was on, the pain did occasionally spike to an 8 or 9 out of 10.

My left hip and leg muscles feel very achy and sore, while at the incision site (which is approximately 9″ long and runs down the outside of my left thigh) I occasionally feel a stabbing, burning pain. The pain is also noticeable in my gluteus muscles, as spasms in my middle and lower back, and as a slow burn around the top of my knee. Not surprisingly, I continue to have some aches and spasms in my right (previously operated on) leg as it has become responsible for carrying the majority of my weight.

To minimize the pain and to keep my hip joint moving, I use my continuous passive motion (CPM) machine for 2 hour spurts, 4 times a day (I have no idea who the woman in this picture is but it gives you reference as to what a CPM looks like).

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Sometimes when I’m not looking, my cat Fawn Adelle uses it as a cat bed.

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While in the hospital and initially at home I was taking two pills of Hydrocodone and Tylenol every four hours plus Benadryl since the Hydrocodone made my tummy, back and arms very itchy. I also take aspirin (for blood thinning to prevent deep vein thrombosis), Protonx (which help prevents acid reflux as a result of all the medications), Valium (as needed, for muscle spasms), and a variety of other pills that I was taking prior to my surgery. Although many of the medications make me very sleepy I can’t seem to fall asleep and seem like a zombie a lot of the time. I get around 7-8 hours of sleep a night. Boris has been my constant recovery companion.

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I’m happy to report that pain is definitely not as bad as it was after the PAO. I spoke to my surgeon’s office today and told the PA as much. She confirmed that although the initial recovery pains following a PAO are much harder, the length of time and long-term pain associated with a SDD recovery is far more difficult. Fantastic!

One noticeable difference between this surgery and the last is that I have definitely felt more emotional. It may be the change in medication or the fact that this is my third surgery in a short time but I have definitely been more blue. Whatever the cause I am trying to maintain my positive attitude and believe that I may have (hopefully) turned a corner today.

I finally got it together and took a shower yesterday which was a welcome change since it had been 5 days since I’d been permitted to take a shower. Today I even went so far as to shower, put on blush and curl my hair – a look I call ‘recovery chic.’ For comparison, it took me weeks to get to this point following the PAO.

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Starting today I reduced my Hydrocodone/Tylenol to 1 pill every 6 hours as I try to eventually ween myself off the meds. So far so good but I would not be disappointed if I needed to up the dosage a bit if the pain became overwhelming. I seem to be a little less fuzzy-minded but that changes minute to minute.

In general, recovering from surgery in May is a VERY different experience from recovering in December when the weather is dark and gloomy. However, like after my first surgery, my mom and husband have been incredibly helpful and I can’t thank them enough for doing basically everything for me. My first follow-up with my surgeon is scheduled for May 21st. I am hoping my wheelchair is delivered soon so I can get outside and enjoy the beautiful spring day. I hope you are all doing the same.

Heading home mañana

Significant improvements! Since yesterday’s post I have been moved to HSS’s 10th floor, and moved again once on the 10th. The numbness in my left (operated) leg is totally gone and 90% gone from my right leg. I have gotten up and walked down the hall with a walker and then crutches – both times incredibly slowly. I am able to get myself out of bed without too much difficulty and transitioned to a regular solid food diet. Best of all? Baring any traumas I get to go home tomorrow!

Unfortunately not all my news is quite so rosy. My pain continues to be well managed; however the drugs are making it difficult for me to focus and I notice that I’m easily distracted and frustrated (it has seriously taken me about 7 hours to write this little post). My right leg has started to spasm from lack of use. Historically, at about 3 days post-op (relative to when I receive anesthesia) I normally feel pretty depressed. This surgery is no exception and today I’ve been feeling quite blue. You’d think that with everything my body has gone thru in the last few days I would be asleep all the time but instead I can barely sleep an hour at a time and am not sleeping nearly enough – only a few hours a night. Also, I have apparently developed an allergy to the adhesive in medical tape + the oxygen that they put up your nose when you have an epidural makes my nose crazy itchy. Fun!

Guy is renting a car to pick me up at HSS and I hope to be home by 2 or 3pm on Saturday. I took a photo of my wrapped incision (with a pen for size reference) but won’t get to see its full gruesome beauty until they rewrap it tomorrow morning. I’m guessing that its about 10″ long but soon i’ll know for sure. I’m gonna try to get some shuteye. Hasta mañana!

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She’s Alive!!!

20130509-104136.jpgI made it – alive on the 6th floor at Hospital for Special surgery and beginning what will likely be a sloooooowwwww recovery.

Yesterday was a little wacky and pretty exhausting. I arrived at the hospital by 10am as instructed. Once I was admitted I waited about an hour (until 11am) before being taken back to pre-op/holding. I was told that I could expect to be in holding until 1230 as my surgery was scheduled to begin at 1 PM. Unfortunately, my surgery was delayed and I was not taken back to the operating room until around 4 PM. Since I had not eaten since the night before and was sitting in a room lit solely by fluorescent lightbulbs, I had developed a blazing headache/migraine. I was relieved when the anesthesiologist gave me “a little something take the edge off” on my way to the OR.

Unlike with the PAO, this time I was not under general anesthesia but rather had an epidural and regional anesthesia. As a result, I have a vague recollection of them inserting the epidural and leaning against one at the doctors, chatting while they did so. It was very strange. My doctor’s portion of the surgery lasted 2.5 hours but I was in the OR getting prepped and eventually having the incision closed for a total of about 4.5 hours.

When I finally woke up I was in the PACU (think ICU). The pain was well-managed and never reached beyond a 5 out of 10 on the pain scale. Just like last time, I had no feeling in my operated (left) leg but unlike last time, I also no feeling in my unoperated leg. They were both totally numb and as unwieldy as dead fish. The recovery room dr. turned off and eventually repositioned the epidural and I eventually regained about 80% sensation in my legs. I was released from the PACU and taken to my room at 4am.

This recovery already feels a little different from the last. For one thing, I can actually move the leg that was operated on. I can lift it and stretch it and while it hurts, it goes (with the PAO I couldn’t move the operated leg for weeks). Also, this time I feel less groggy – at least right now but that can certainly change. Then there’s the fact that my right leg does not move – I didn’t realize it until just this moment but I can’t move my non-operated leg. I’m assuming that’s just the epidural…hopefully.

Physical Therapist is coming by today, as is my surgeon, my husband and mom. I’m gonna take a nap, but will update tomorrow. Signing off for now, overlooking the East River from the 6th floor at HSS.