Category Archives: Recovery Pains

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.

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.

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!

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