Category Archives: Leg Cramps

Sleepy Saturday

It’s been 4 days since bilateral hardware removal and today I was finally allowed to remove my bandages and take a proper shower. I saw the new incisions on each hip for the first time and truthfully, they’re not as bad as I’d anticipated. At about 4″ long, they’re each approximately half the length of the incisions from the original surgeries. They are healing nicely (although they look a little gory with dried blood and steri-strips) – I decided not to post pictures of them until they look a little bit better (you’re welcome). I can’t yet tell if surgery fixed my remaining issues – it’s just too soon to tell. I probably won’t know for certain until the inflammation goes down which might take a while. That said, I am cautiously optimistic.

Earlier today I made the exact same mistake I’ve made after pretty much every surgery – I acted like I had not just had surgery and tried to do a couple things around the house. I paid for it with a serious bout of nausea and exhaustion. I know this was a “minor” surgery but it still involved somebody cutting into me and my body feels the need to remind me of that fact. In general I’m worn out most of the time and get so sleepy that I can doze off at the drop of a hat. I’m sure it’ll take me several weeks or even a month or two to really get back to feeling normal.

I’ve started to pull back on my pain meds since the pain has lightened a bit. I haven’t had leg cramps in the last day (a huge relief) and the itchiness has gone now that I’m off the Percs (a definite downside to opiate medication). That said, I wouldn’t be surprised if I have to kick them up for a period of time since recovery is all ups and downs.

I’m hoping to try some PT exercises at home once I feel up to it, starting with mild things like bridges, clamshells, squats and the like. My next appointment with my surgeon is January 13 when he will clip the ends of the dissolvable sutures and will likely discuss formal PT and steps moving forward. For now, I’m falling asleep. Goodnight and sweet dreams.

(Mostly) Hardware Free 2014

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.

10+ week status — Open Surgical Dislocation (SDD)

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!

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!

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

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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