Tag Archives: Periacetabular Osteotomy

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.

I’m still here!

It’s nearly 11 months post-PAO and nearly 6 months post SDD and I am still alive and kicking (although, technically, I still can’t kick, with either leg). I know I have been lax in providing updates but honestly, recovery is a SLOW game with small steps forward.  I have been in PT, off-and-on, since February, but recently my improvement, especially on my left side, is mostly stalled and in a holding pattern.  That said, I have a bit of news and some updates to report.  I also know that there are others who are going through similar surgeries and experiences that read my blog and I really want this to be a complete picture of what I have gone through (and continue to go through).

Right hip (PAO) first.  My right hip is doing pretty well with any remaining pain located in either my right greater trochanter or in my psoas at the front of my hip.  I’m hopeful that any remaining pain in these areas will get better with more time, keeping in mind that full recovery from a PAO is up to 2 years.  The only other problem I have with my right hip is that the screws along my iliac crest do give me some discomfort — not sure if they are unscrewing themselves (which is possible) or if the swelling around the incision has finally gone down.  I’ll get back to these screws in a bit.

Left hip (Surgical Dislocation).  Left hip is not doing nearly as well as the right.  I am finally off-crutch (for the most part) because my limp is gone (for the most part).  However, I still have pretty significant pain in my left greater trochanter and psoas.  The pain in the front of my hip seeps into the joint and sometimes I feel like the ball of the femur isn’t solidly in the joint which makes me wonder if I am subluxing my hip joint (click here – Hip Instability – for a bit of information on hip instability and subluxation).  The pain in the trochanter can get pretty severe to the point where I sometimes need to use my cane or crutch, both because of my limp and in an attempt to take the weight off my left hip.  The pain definitely gets worse 1) when it rains and 2) the more I walk.  Which leads me to…

I’m having another surgery!  Yes, that’s right, ANOTHER freaking surgery, and another holiday season sullied.  I am having the screws in my left hip (and possibly the screws in my right hip) removed in late December (exact date tbd).  Good news – it’s an out patient surgery, though I may be in the hospital overnight to ensure the pain is well managed.  Other good news — other people who have had their screws removed bounce back within a few weeks after the surgery and typically move quickly beyond the holding pattern of improvement to actually get better.

I am scheduled to meet with my surgeon on November 18th for my 6 month SDD follow-up and anticipate that my physical therapy benefits will be up around that time.  After my Dr. appointment I will know if any additional procedures (e.g., fluid drainage, scope) are required — I am hoping NO but we will see.

tumblr_mub3moYShU1qhvwbto1_500SO, aside from a new hair color (black and blue streaks), a new semester at law school (my second to last), and a new tattoo (amazing, huge, on my thigh, done by Seth Wood, and appearing at the bottom of the page [you can see the bottom of my PAO scar next to the bee above the flying bee]), that’s what’s new.  Oh, and Happy Halloween!

6 week follow-up – NEWS!

So much to report! This is going to be fact / text heavy but I want to make sure I get thru all the details.

On Thursday, I met with Dr. Sink at HSS (full disclosure, I asked – he was cool using his last name on the blog) for my 6 week follow-up, although it had been exactly 7 weeks since my surgery. I took a cab to the appointment since I was not yet comfortable with the idea of taking the subway (and would have been exhausted since HSS is about the length of 7 avenue blocks from the subway).

When I first got there, I had 2 x-rays taken and was immediately whisked into an exam room. Dr. S’s nurse and PA came in to talk to me initially, to see how I was feeling and how recovery had been going. I was in a really good mood — in fact, I’ve been in a really good mood for most of my recovery (which likely has more to do with not being as hyper-stressed [from trying to juggle school / work / social life] than with recovering from an invasive operation). In any event, we had a good chat and they seemed pleased with how I was doing.

Dr. S. came in a few minutes later and we started talking about how my healing was going. I told him that I felt really good, that I was using the crutches when I went short distances and a wheelchair for long distances (walker when at home). He looked at the x-rays and confirmed that 1) the bone was filling in really nicely along all of the breaks, 2) that the head of my right femur is now sufficiently covered by my right acetabulum, and 3) that the angles (between the center of the head of the femur / hip) created the perfect 90% angle that he was looking for. He seemed really psyched about that and I was pleased to know that the surgery appears to have turned out really well. He also confirmed that I have 5 screws (I had only noted 4) and that I was ready to move onto physical therapy 1/2 x week x 8 weeks. More on that later.

We then started talking about my left hip, what type of surgery we would be looking at, especially since the surgery is scheduled for May 8th. As a reminder, although my right hip had dysplasia (which can only really be solved by a PAO), my left hip has acetabular retroversion, mild femoral retroversion, cam and pincer impingement, the neck of my femur (between the ball and trochanter) is too short, multiple labral tears, a hairline fracture of the acetabulum and what appears to be a hypertrophic (overdeveloped) labrum. We had always discussed an SDD for the left hip but at my last few appointments, Dr. S suggested that the left hip might need a reverse PAO so I was curious what he would say, having now reconfigured my right hip. After some discussion about the coverage of my femur (which looks good, side to side), he feels that an SDD is the best way to go. What this will mean is that the incision will be on the rear side of my left thigh, 8″-10″ long, and during the procedure Dr. S. will literally remove my femur from the socket, shave down the impingements on the femur and acetabulum, repair the labrum, break the trochanter and either move or remove a part of it, remove and reattach muscles, and I don’t know what else, but not necessarily in that order. As much of an invasive procedure the PAO was, this actually sounds worse. But strangely, I am totally not concerned.

The plan is that I will meet him in 6 weeks, after my PT, to see how I’m doing. Things may change and the surgical plan is fluid but at this point, an SDD is the plan. Dr. S was great, explaining all of the reasonings for doing this procedure and showing me the x-rays and MRI scans. I was at his office for about and hour and fifteen minutes and he was in the room talking to me and my husband for the majority of the time.

After my appointment I met with a physical therapist who gave me some initial exercises to perform at home. I was shocked to be told I could be full weight bearing on my crutches (and am permitted to use only 1 crutch or a cane when at home). Some of my exercises require that I stand on only one leg – the operated leg – and I was really surprised that I was able to do all of it with no pain (although my muscles are way weak). I’ll start PT in Brooklyn next week.

Finally and un-hip related, I went and had a CT scan of my sinuses / maxillofacial bones to see if there is any reason I am permanently congested / have terrible allergies in spite of allergy shots + major pills. My ENT thinks it might have more to do with the fact that I have a very small nose and that the sinuses are so small that there’s simply no space to move around. There has been suggestion of sinus surgery to see if there is some space to be opened up. I seriously need a break from surgery, not more! We’ll see what shows up those reports.

I feel like you seriously deserve a prize if you got all the way to this point in the post. I hope my honest to goodness gratitude is prize enough, but seriously, thanks so much for reading. Onward and upward (or, actually, downward since I need to do my PT exercises before bed). G’night!

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!

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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).

Steri-Strip Free Me

Life is moving along quite well over the last few days and my recovery progresses.

On Saturday night, Guy and I went out to dinner for the first time since surgery. The restaurant, Aita, is really good and, lucky for us, located about 1/3 block from our apartment. Based on how long it took me to get there though, you might have assumed it was quite a distance away. Crutching is exhausting and slow, whether or not I use my snazzy Millenial crutches.

Dinner was tasty, although sitting was sorta rough. The whole structure of my pelvis is a little different and the muscles in my right side have atrophied a bit due to lack of use. As a result, sitting on seats that have insufficient padding causes soreness and general discomfort. By the end of our hour long dinner I was looking forward to my cushy recliner.

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Sunday we headed out for another wheelchair adventure and though I thought that the sidewalks in my neighborhood were already a wheelchair nightmare, ice managed to make it that much more unpleasant. Aside from my transport frustration, it was ice cold waiting outside for our sandwiches but Boris helped to make sure I was toasty warm (and I returned the favor by cuddling him under my coat and hood).

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New Years found Guy and I performing our annual tradition of scrambling to make our year-end charitable contributions. What once started as an error in timing has turned into an actual tradition. As you can tell, we would rather hide in our apartment than venture out on New Years (and my limited mobility would have made it impossible either way). I had a few visitors on New Years day which was LOVELY. I absolutely enjoy the company and appreciate their willingness to come over to the house.

I’m also back to work, starting today. I’m working from home but I anticipate that it will go pretty well. I have a good set-up at home and am able to focus without any problems. The key is to take enough breaks throughout the day so that my hip doesnt’ get too sore. I also started to teach myself a tiny bit of HTML, to hopefully make the site a bit snazzier (for example, the photos have colored frames and some of the words are colored). Like my recovery, my learning curve will undoubtedly be slow.

Heads Up – Scar Photo Ahead

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Finally, I am very pleased to report that the steri-strips on my scar have all gone away and I can now see it in its full gory glory. It’s actually not that bad looking and at 8″ is on the shorter side of what I had anticipated. I am sure it will continue to fade over time but since it has been less than 3 weeks since my surgery (3 weeks as of January 3rd) I am really totally OK.

Oh, and Happy Belated New Year!!

Rockin’ the Follow-up

I just want to start by saying that I had very good last couple of days.

On Wednesday afternoon, my husband Guy came home from visiting his family in Toronto over Christmas. It was really great to see him as he’d been for six days. It also meant my mom was going to be leaving the following day and that Guy would need to take over all of the responsibilities of caring for me that my mother had been dealing with since I’d come home from the hospital. As one might imagine, my mom had done a lot to help because of my limited mobility but I was sure Guy was up for the task.

On Thursday, my mom packed her bags, put on her babushka, and headed for the airport and home.

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We realized there were a couple things needed around the house and decided to take a track out to Target. At somewhere around 15 blocks from our house, the trip took quite a while and was the farthest that I have been out of the house since my surgery. My hip was quite sore because of all the bumps in the sidewalk and I iced for a while once I got home. Although it was windy and cold, it was sunny outside outside and Guy and I had lots of laughs.

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Today was my two-week follow-up from my surgery so we rented a car and made our way to HSS for my 10 AM appointment. At the appointment, the PA removed my stitches and all of the icky Steri-Strips. My incision is mostly healed though they put a few more strips on to make sure that it is set. Here I am, hanging out on the exam table.

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My surgeon, Dr. S., came in and reviewed my x-rays with me and talked about what would happen over the next month as well as what to expect at my six-week follow-up. He felt things were going really well so far but said he would have a better idea of where things stood once they do x-rays late in January. I genuinely cannot say enough wonderful things about my surgeon in terms of his expertise and his demeanor, both at the hospital and at every appointment i’ve had with him. He is so professional yet incredibly kind and I feel very lucky.

We stopped at Whole Foods on the way home from the appointment. I’m surprised how tired I was, having been out only for a couple hours — I’m probably heading to bed early tonight. Guy’s been really amazing in helping me out and cooking my food and taking care of the animals and just about everything. I do wonder though if Fawn (our kitty) may be taking advantage of his kindness…

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In any event, it’s been a really nice couple of days. I have mostly minor aches which is far better than I expected. We may go to out to dinner tomorrow and see a movie on Sunday and I’m actually looking forward to getting back to work (from home) next week. With all the TV I’ve watched its a surprise my mind has not turned to mush! Boris doesn’t seem to mind either way.

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