Category Archives: Knee pain

Summer 2014

Leave a reply

Holy macaroni has a been a while! 6 months since my last post is inexcusable so I have made a commitment that even if I do not have an impending surgery scheduled, that I will update my blog at least once per season. And this, dear readers, is summer.

Since I last posted, I completed the “plan of attack” I mentioned in my previous post — a combination of 2/week pilates, 1/week physical therapy, daily anti-inflammatories, and monthly meetings with my surgeon.  I still need to lose weight (for health reasons) but am hopeful that the regimented schedule required by part-time law school in the fall will help that along.

I am happy to say that my right hip, the PAO side, is doing really well.  In general, I have no pain unless I walk for a really long time and even then, the pain is mild (though I have to acknowledge that I haven’t pushed my hips beyond basic activities like walking).  Dr. Sink has been very happy with this recovery as well, although he did acknowledge that my recovery from the PAO was about 200% of the average.  I am the turtle of recovery but dammit, I think I pretty crossed the finish line.

The left hip continues to strengthen but unfortunately, the pain caused by activity – specifically any significant distance walking – has steadily increased.  As a result, my left hip is out of line and thus in pain.  Often, after sitting for a period of time, my left hip will ache just from standing up and I limp around for a while like a Weeble-Wobble.  I avoid stairs as much as possible because they cause the greatest pain.  On top of it all, I have maxed out of PT sessions because apparently I am ‘all better.’  All of that said, Dr. Sink and I agree that it seems possible that it will continue to improve, if slowly, so I am going to wait a bit longer see him around Christmas to discuss next steps and to have new MRI and X-Rays taken.  Based on my symptoms and the pain level, my guess is that I will have a total hip replacement within the next 9-15 months.

All of that said, I start back at my last semester in of law school in 2 weeks, followed by the Bar in late February, and then I’m DONE!  While it is unlikely I will ever run again, I’ve wrapped my head around that fact.  However, I continue to take pilates, bowl, golf, ride my bike (on occasion) and even take weekly trapeze classes — strangely, trapeze doesn’t bother my hips a stitch —  and here is video proof from my trapeze show on August 8th.    Onwards to Fall!

(Mostly) Hardware Free 2014

1 Reply

Happy New Year! I hope everyone had a fantastic time celebrating the end of 2013/start of 2014.  I spent last evening at home, recovering from yesterday’s removal of 7 of the 8 screws that were installed during my PAO and Open surgeries. Here’s a (rather long) recap of how surgery went and how recovery has gone so far.

Before surgery...

Excited pre-op

Surgery was initially expected to take about an hour and a half; it ended up taking closer to two and a half hours. Anesthesia consisted of a spinal and sedation. Dr. S started by removing the 3 screws from the left side which had bursitis that he had to clean-up and then removed 4 of the 5 screws from my right side (1 of the screws was positioned too deep to be easily removed).

I woke up in the PACU in a lot of pain in my left side, a burning ache from my left hip down my left side into my knee and cramping my left calf, pain at about a 7 or 8/10. The pain in my right side was not nearly as bad, about 3/10.

...after surgery

Exhausted post-op

The nurse injected liquid Motrin into my IV (which basically had no effect) and then injected Dilauded which worked right away (thank goodness). Dr. S stopped by to check on me (I only vaguely remember that he was there, I was still drugged from surgery) and talked to my husband about how the procedure went. The nurses in pre-op and the PACU were very warm and helpful (another great experience at HSS).

I was in the PACU for 2-3 hours, had 1/2 a cheese sandwich and some ginger ale, and my first dose of Percocet. I got to the point where I felt ok enough (pain at about a 4/10) that I managed to dress myself and was released last evening.

The evening was uneventful and I faithfully took my Percocet every 4 hours, even through the night which was restless and insomnia filled. Unfortunately, this morning I made the mistake I tend to make the day after surgery – I felt so OK, pain wise, that I thought I could wait 5-6 hours to take my pain meds. Bad, bad idea. The pain in my left side, which had been at a steady 3 or 4 out of 10, spiked to 8/10, and I was suddenly in tears. Just then a nurse from HSS called to check-in with me (perfect timing) and reminded me that I MUST take my pain pills every 4 hours on the dot. So I’m on it, the pain’s down to about a 5 or 6/10, and we’ll see how the next few hours go.

Right hip

Screw removal -- Right hip (gauzed) (2)Here are some photos of the surgical coverings (and a peek at a few of my tattoos).  My left hip is on the left side, my right hip on the right.  I can’t take off the gauze or take a shower until Friday so I won’t know how long the incisions are until then. Bathing in the sink until then — Yippee!

My next appointment with Dr. S is Jan 13th when the stitches will be clipped and the steri-strips replaced.  For now and the next few weeks I plan to take my pills and take it very easy.

My Unscrew’d New Years

1 Reply

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!

10+ week status — Open Surgical Dislocation (SDD)

1 Reply

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!

Lurching Into Month 2

Leave a reply

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!

20130608-234156.jpg
My next appointment with my surgeon, my 6 week follow-up, is scheduled for a week from next Monday. Until then, I lurch along.

Flew the coop

Leave a reply

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).

20130512-174125.jpg
Sometimes when I’m not looking, my cat Fawn Adelle uses it as a cat bed.

20130514-143638.jpg

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.

20130514-143425.jpg

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.

20130514-143434.jpg

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.