Category Archives: Recovery Pains

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.

The Final Countdown

With approximately 36 hours until I have to be at Hospital for Special Surgery, I am truly in the final stretch leading up to my Open SDD surgery. I will receive final confirmation tomorrow on the time but am anticipating that the surgery will be at 2pm on Wednesday the 8th and I should be in until at the earliest the 10th and more likely the 11th.

I met with my surgeon today to discuss the results of last week’s MRI exam. As I had previously been told, I have tendonitis in my iliopsoas and abductor muscles/tendons and it’s likely a labral tear in my right side. I might eventually need an arthroscopic procedure on my right side to fix the labrum / shave down some more bone if the pain persists at 9-12 months post-op, but again, that’s all hypothetical and not the main attraction of this week.

Ideally, I would be pain free and fully healed before moving onto the left. Honestly, if time were not an issue, I might consider waiting to move forward with the SDD surgery (as was encouraged by my surgeon and his PA to consider doing). As my surgeon pointed out, at less than 5 months following my PAO my right hip is still in pain and although the pubis bone appears to actually be growing together (YEA!!), it’s not fused. While it is safe to do the left side and while it’s not clear what impact the left surgery will have on my right hip (good, bad, or indifferent), waiting would be the ideal course of action.

However, time is an issue because I have to get back to law school (I took the spring semester off expressly to focus on healing). As it stands, I am hopeful (though not totally confident) to be back for the fall semester, though only time — and my healing — will tell. I also believe (and my surgeon thinks it is possible) that my right hip will benefit from all of the rest I will get from sitting on my butt for 8+ weeks. In any event, I am in pain and my mobility is dramatically reduced so it doesn’t make much sense to wait.

One cool thing that did happen at today’s appointment is that my Dr. helped to set me up with a bone growth stimulator! It’s kinda crazy because it’s a little machine about 2/3 the size of an iPhone that you can clip onto your clothes, and that connects through two wires to electrodes that are stuck on either side of my (slowly healing) pubis bone. I wear it 24 hours/day, every day (except while i’m in the hospital), and the wires (though not the machine) stay on even when I take a shower. It feels like NOTHING — no buzzing, no electrical stim feeling. I have basically no idea what it’s doing but I really hope it works.

So that’s it until the big day. Tomorrow will be filled with a liquid diet and final preparations. I’m pleased to report that I am not a bit nervous (a pleasant surprise). I’ll be sure to update from the hospital as much as I can — as always, wish me luck!

Maybe Actually Good News!?!

Quick update.  I had my MRI yesterday at HSS.  If you haven’t had an MRI, imagine laying on a too-narrow super firm bed, having your hips locked into place with a brace, your feet taped together, under a sheet with a light breeze blowing over you, while you slide into giant, thumping, magnetic sardine can.  Some people freak out — I’ve had so many done I literally fell asleep.

So, I got a preliminary “heads-up” from my dr’s office that there are no significant areas of concern in my right hip, that the labrum looks good, but that I have tendonosis in my abductors and iliopsoas muscle.  This may be caused by use or may be related to the fact that I previously had an arthrscopic procedure and my hip may just need extra time and TLC to bounce back.

The reason I am cheerfully optimistic is that 1) the protocol for getting over tendonosis is typically RICE (Rest. Ice. Compression. Elevation) — and once I have my surgery on my left side all I am going to be DOING is resting!, and 2) physical therapy.  Know what’s missing from that list?  Surgery!  I may be able to get away with not having another surgery on my right side!  I didn’t realize how much the fear of another surgery was getting me down until I felt the stress literally float off my body since I got the news.

Again, all of this is preliminary and I still need to meet with my Dr. on Monday to go through the full MRI results.  BUT, it looks like I will be under the knife on my LEFT side come May 8th — and maybe, just maybe, that will be it for a while.  Yea!!!

Here we go again

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!

20130430-111101.jpg

20130430-111116.jpg

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!

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.

20130303-224343.jpg

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!

20130119-151802.jpg         20130119-151824.jpg

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).