Category Archives: Stabbing pain

Sleepy Saturday

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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

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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.

Hey there freedom!

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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

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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

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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.

Here we go again

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Nuts. I’m anxious. I’m also 9 days away from surgery which makes sense that I would be anxious but last time, I was utterly zen. Totally calm. You’d have thought I didn’t care that I was about to be broken and put back together. Admittedly, before my last surgery I only became zen in the final 2 weeks leading up to my surgery — prior to which time I was a paniced freak. This time, though, I have totally ignored the impending surgery so I never had a chance to panic. Apparently now’s the time.

As I type, I am at HSS in the midst of my surgical pre-clearance, including a physical exam, blood work, EKG, chest x-ray, and a meeting with the hospital GP that is assigned to me for the surgery. The day started at 9am and should be done by 2pm. I’ve been through this before so unlike last time, I knew what to expect (and to bring something to read – there’s a decent amount of down time between appointments).

Most importantly, I already had my appointment with my surgeon. We briefly discussed my impending surgery (the Open SDD) but the majority of the appointment focused on my (still crabby) right hip. I still have pain in the joint and around the greater trochanter but the majority of the pinchy pain is in the area between the hip and my groin – likely caused by the psoas tendon and break in the pubis. So, I am scheduled for an MRI tomorrow, an Active Release Therapy session on my tendon on Thursday, and a follow-up with my surgeon next Monday to see if the pain is caused by a torn labrum, nonunion or seething else. My surgeon has never had to go back in to repair a torn labrum after a PAO so, lucky me, i’d be the first. As of today, we are still moving forward with the left hip but the final decision will be made next Monday – 2 days before my surgery on my left. Apparently it is gonna be a busy week.

Photos from pre-surgical screening – I like to get dressed up for my HSS appointments!

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Thrill Rides

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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!