Wednesday, November 14, 2012

Still Broken - 5 months Post-op & CT scan results

5 months ago I woke up with the anxiety, fear and hope that I was beginning the ending of almost a year’s worth pain and extremely limited mobility/quality of life.

I was wheeled in to an operating room and 7 hours later I woke to what I was told was a very successful surgery. My labrum had been detached which was more severe than expected the repair went well. I was told I had good joint space and that the reshaping of my femoral head & neck was smooth. I was also told that my acetabulum was now structurally sound. The periactetabular osteotomy or PAO looked great. I had seven screws holding my “new” hip together as I re-learned how to move it. Initially, things appeared to be going well and the more detailed history can be read below. There were some complications that seemed mild and some typical trip-ups along the way of recovery which was starting to seem slower than some of my new “hippie” friends. I asked questions and I followed my “rules.” After 8 weeks (the typical initial recovery) I went in for a follow-up appt. A set of x-rays determined that my cuts appeared to be healing but “not quite there yet.” And I was told I needed another 2 weeks on crutches. I was cleared after that and started physical therapy.

Which brings me where I am today. Thought the next 2.5 months of PT and beginning to bear weight I continued to have a significant amount of pain.  Which after pushing my me and therapist resulted in the last two blog entries discussing some more imaging results of a MR-Arthrogram (MRI with contrast) and a CT.

As I was driving home two weeks ago, Dr. Prevost called me to give the results of the CT scan. He said that after reading the radiologist’s report and thoroughly reviewing the images himself he agreed with that fact one of the breaks in my pelvis was not healing. This is considered delayed or non-union. He used the term non-union as he talked with me and went on to explain that it is very rare (occurs in about 1% of PAO surgeries), he has never physically seen it and he didn’t know what to do about it (if anything). He wanted to send the images down to Dr. Mayo immediately and talk with him regarding next steps.  “The next decisions will be Dr. Mayo’s,” he said. He also said that it would cause significant pain but he still wasn’t sure what they would do (bone graft, plate & screws), if anything because often they won’t do anything for about a year to be sure the bones are not healing.

There has been several brief conversations emailed back and forth with Kenda, Dr. Mayo’s PA-C and as far as I know, he has the images and is going to be contacting me. I don’t know when.

I am having a hard time dealing this emotionally right now. Other things have been mentioned as possibilities for my pain like, issues with the labral repair or a new tear, the PSOA tendon and just plain old slow recovery. I KNOW something is not right. This pain started from the labral tear – I was told that repairing the labrum would not fix the problem because of the structure of my bones. I was told that they wouldn’t even consider fixing just the labrum and I need the PAO. I went for it, not expecting for a miracle but hoping that in 3-6 months post-op I would be A LOT better than I was at that time. Well I am not. I feel as though I have recovered surgically from one of the most invasive orthopedic surgeries out there but I am still in an amount of daily CONSTANT pain that is comparable (and only slightly different) then pre-op and now the left side is hurting. Leftie was worse off according to imaging a year ago and that scares me too.

So here I am. 5 months post-op and 16 months post-injury. I still struggle with sleeping, walking up stairs, sitting,getting up from a seated position, getting into bed and several other minor moves. I am still in pain that requires pain medication daily. Waiting to hear back from Dr. Mayo and hoping that my next steps… will eventually be pain-free and that my pelvis will no longer be.
X-ray from September Photobucket
3D Image from CT showing Fracture of the Superior Pubic Ramis Photobucket 3D Image from CT showing a small heterotrophic ossification HO (bone forming in the muscle) Photobucket

Friday, October 26, 2012

Almost 5 months - less of an update

This week marked 4.5 months since my surgery (right anterior hip arthrotomy with repair of acetabular labral detachment, osteoplasty of femoral head and neck, and right periacetabular osteotomy). At this point I am completely off crutches and still doing physical therapy but still having more pain and popping than expected or happy with.

I have neglected updating this blog for a bit because I was hoping to have a better update with answers, advice and/or plan of action but I still don’t have it. Last I wrote, Dr. P (my follow-up surgeon) said the bones were healing well but was concerned about the painful popping I had along with my current pain levels. We agreed to continue with PT and see what was going on but a fall and increase in those symptoms looked like I was heading for more imaging.

Well when I met with Dr. P – he agreed that the increase was concerning. He didn’t think I did any real damage (to the bones & screws) but was worried about the labrum either not healing or tearing again. So I was sent off for another MRI or MR-arthrogram (with contrast dye). Dr. P also wanted me to have an inarticular steroid injection. He was hoping that it would help serve a diagnostic purpose (identifying it was actual joint pain) and offering some pain relief. I was worried about the screws but reassured that I wouldn’t have any discomfort with them and they were MRI safe but… they still don’t make it easy to see. What I also wasn’t prepared for was the changes in my hip – physiologically.  As we get started with the injection – the radiologist is asking me about my surgery and current pain and proceeds to tell me about how with chronic pain and/or trauma the body reacts by increasing blood flow to the area. Well after so long… the body actually changes and grows more blood vessels and I have plenty – hypervascular. So hypervascular that he couldn’t get the dye to sit in the hip joint. Several pokes, repositioning and varied injection cocktails were needed to avoid overdosing me with the various meds that they were immediately being pulled away by my blood vessels. This also meant that I couldn’t have the steroid injection because it would not sit in the hip joint long enough to be effective. After he finally found a spot where only half the dye seemed to disappear, I was rushed in the MRI machine and after 20 minutes I was done and there was no more dye left in my joint – just a lot of pain. Another thing that was interesting was when he first turned on the fluoroscope he asked me if I had x-rays taken since my surgery. I said yes but was interested as to why he asked. He pointed to one of the osteotomy cuts and said it didn’t appear to be healed together. He immediately followed it by “well if your hasn’t mentioned it then it is probably just my angle.”

Well when I got the report back it was mentioned.  The overall volume of bone callous at the puboacetabular junction was poorly seen and recommended a CT scan. He also said there was mild bone marrow edema in the femoral neck and over the bursa. I guess this could have something to do with the coxa valga and steep neck angles. He also reported a tear and fraying in the labrum and indicated that my CAM impingement was completely gone (go Dr. Mayo). 

After meeting with Dr. P – he suggested that the labrum findings were inconclusive because of the extensive repair that was done during surgery – this kind of irritated me because I thought that was why we were doing the MR-A. He focused most on the puboacetabular junction and took another set of x-rays. He said it was hard to say definitively that the cut was healing together correctly. We discussed it at length. He said that it could explain the increased pain especially when sitting or weight bearing. Again I was frustrated because I have been complaining about this specifically for months. I understand that I am still not out of the realm of recovery where it would be completely atypical but I feel like I wasn’t listened to really.

So he suggested a CT scan. I asked what that would tell us… He said it would tell us if I had non-union or slow union. I asked what would that change for a “recovery plan” and he said he didn’t know if it would… What?!?! Then why? He said since he was consulting with Dr. Mayo and has never really seen non-union he wants to have the most information to present to Dr. Mayo to decide what to do.  I get that but I am just frustrated that I don’t have any other answers. Tired of waiting for answers. Tired of having the same pain and not knowing why after doing everything my surgeons have said. Sigh. CT is scheduled for tomorrow. We will see how it goes…

PT had been going well and I feel like I am finally starting to gain some muscle back and my therapist feels I am doing great although she is still concerned about what is going on in the joint. I had a little setback with the pain flare from injection and some sicknesses but have an appointment tomorrow before the CT scan… and so it goes on. Hopefully my next update will be better.

4.5 months bilateral hips (note swelling on right side still) Uploaded from the Photobucket Android App Incision 4.5 months Uploaded from the Photobucket Android App Atrohpy & Rebuild at 4.5 months Uploaded from the Photobucket Android App Electrical Stim at PT Uploaded from the Photobucket Android App Therapy Pool at PT - AWESOME Uploaded from the Photobucket Android App

Saturday, September 22, 2012

3.5 months - one step forward, two steps back...

So a couple weeks ago I was able to meet up with two of ladies - hip chicks that I met online at Hip Chicks website. They both had the same surgery and the same surgeon. Tessa - awesome lady with a wealth of knowledge who has helped support me from afar throughout this journey. I "met" Laurie during recovery and found out that she was a couple weeks ahead of me but had also been down to see Dr. Mayo and lived in Anchorage. Tessa came to AK for a visit with her husband and I was able to spend the weekend with her.

I took her out to our cabin and tried to give them a solid Alaska experience. The weather cooperated and I even left the crutches in the cabin most of the weekend!!!! I think I was bound and determined to NOT be walking around on mine while she was walking around not just post PAO but post neck surgery (she has had a number of surgeries in the past year and still has a couple more to go). She is a huge inspiration. We had a great time! I even had a killer cold that came and stole my voice.

My meet-up with Laurie was a happy accident/coincidence. We had our follow-up appointments 30 minutes apart and didn't know it until that morning. She was in and out before my appt started but stayed and sat with me in the waiting room! She has young kids too and hopefully we will be able to schedule more times to hang out in the near future.

I feel very lucky to have met them both! Not everyone understands the enormity of the hip issues and the toll it takes on you emotionally as well as physically. It is great to meet a couple people that truly understand and are great/genuine people on top of that.

I had another follow-up with Dr. P. He doesn't think my progress is typical - well I totally agree and have been saying that for weeks. He took more x-rays and said the bones look good (yay) and I should only be restricted by pain at this point. He did state he thinks I am having more pain than what is typical but that I am not out of the woods yet so he isn't TOO worried.

However, on the physical exam... he could elicit loud painful popping in my hip with passive extension and external rotation. :( He said the likely causes are either a ligament/tendon snapping over boney overgrowth or scar tissue or.... get this... my labrum. I was very upset. The labral tear is what caused my initial pain and started me on this hip journey. It was detached and repaired during my RPAO but he said that the success rate was only about 70-80% because of the blood supply and how they have to try and revive that for the repair (cutting the labrum and the bone to create a vascular bond for the anchors to adhere to for repair). The decision at the end of that appointment was to finish out 5-6 more weeks of PT and see if strengthening all my muscles helps reduce the popping and the pain. I left that appointment upset but also trying to be optimistic.

Well... the weather here is AK has decided it needed a say in my recovery. I posted last time about our crazy windstorm. Well we have had several more since then - most recently the middle of last week. So during Alaska Windstorm #3 (AKA Arctic Hurricane #3) I was trying to keep our trashcan from catapulting itself off the mountain. The Mr. had tied it up to a weighed down wheelbarrow but once empty - it decided to pull away and take flight. I found it at the end of our street. They are fairly spendy cans (I know - we had to replace one over the winter due to winds). So I grabbed the keys to the pick up truck and backed it down the street next to the can so I could lift it in and return it to our garage. As I was getting out of the truck (already a feat in an of itself with the hip) a gust of wind decided to rip down the street. Well it grabbed the truck door and slammed it into me on the back right side as I was turning. It threw me to the ground. I got up angry and wet and had to catch our trash can which was now 10 feet further down the road.

As I was driving I noticed a rather sharp pain that radiated down my entire leg. Then over the course of the day my whole pelvis ached and my hip appeared to be popping on more and more movements. I definitely had have an increase in pain over the last couple days and it is deep in the groin. I called Dr. P's office (he is out for a couple weeks) and they said I could come in to the walk-in if the pain gets too bad. I also emailed Dr. Mayo's office and they said it was unlikely that I did too much damage but to keep an eye on it.

So yesterday, I told my PT about the fall and we had already discussed the popping & pain. She had previously agreed that we could strengthen everything and hope that it was a ligament/tendon. However when I told her about the fall and reiterated the symptoms HAVE increased since the fall. She asked to do a physical exam and "check me out." She got the same painful popping and clicking and did a couple other things that didn't necessarily hurt but then she looked at me and said "girl, this isn't good, I definitely think this has something to do with your labrum." So she called Dr. P's office and they suggested I come in on Monday and see his PA-C (since he still out of town) but she told them no, that she wasn't sure what he could do. She said she recommended new imaging done and that I meet with Dr. P as soon as he comes back.

She said if I need it repaired than I need to do it right away so that I can combine recoveries and maximize insurance benefits for the year. I feel devastated now. I don't want to think about it but I knew the pain was familiar. I hate that I went through all this (PAO) and end up in the same pain. So it looks like I will be getting some more imaging next week - CAN I GET AN MRI WITH THESE SCREWS? Am I seriously looking at another surgery before I have really even started recovering from my last one???????

We'll see I guess.

Thursday, September 6, 2012

12 weeks - 3 Months Post op + caribou hunting, turning 33 and crazy arctic hurricanes...

Labor day weekend was a 3 days weekend from work - it was also pretty busy. So I was dreading it. My husband was going caribou hunting so it was me and kids for 4 days. In that 4 days we had a indoor water park birthday party for my niece (I had to get in since lil guy is only 5) and we had concert tickets to take the kids to see Hot Chelle Rae at the Alaska State Fair. So going into Friday I knew I was going to be hurting. I went to the fair for a couple hours the week and paid for it - ALOT. So much pain I spent 20 minutes crying in my car the next day at work - didn't drive anywhere for lunch just reclined and cried.

Needless to say I was worried about how much I would be hurting after this weekend. Then my dad calls and tells me we are going camping - guilted me into camping. He bought all the food and drink, set up driving (thanks Nancy & JB) and sleeping arrangements and said he/they could make I was back in time for the party. So now, not only did I have spend hours following a 5 year old around a water park & walking around the fair for another couple hours -  I was adding 5 hours in the car and sleeping in the camper. He had camp already set up by the time I got off work Friday. All I had to do was show-up. Mentally I wanted to sooo bad. My PAO pretty much squashed a lot of the camping opportunities this summer and I love camping with my dad/family.

I am so glad I went. Had a great time. My kids and I had soooo much fun. Little man told me that is was the most perfect weekend ever "we got to go camping, swimming, eat ice cream/cake, have a sleepover with Mommy and go see Hot Chelle Rae". If only his words could melt the pain like they did my heart. I am sore and hurting but I got to see/feel more progress and hope then I have in a while.I was able to walk around on one crutch almost the whole time camping - even up a trail. The birthday party was hard but being in the water wasn't so bad - It was walking around in between. The concert and fair was great too. I did take more painkillers than I had been taking in the past couple weeks but I think I was finally able to get over a hump because of it and I can 'see' myself actually getting off crutches now. Hubby even came home with a nice caribou and we have 120 lbs of meat for the freezer! Progressing hope was there, I thought.

Tuesday morning - I woke up hurting and sick - sore throat, head cold, whole body muscle aches and the pain I was expecting with my activites. I didn't have any meetings scheduled and the kids were complaining about the same illness. We decided to stay home and veg-out, watching movies, snuggling and overall recuperating. I stayed on email from work and started getting crazy notices regarding the second windstorm that was moving in - threatening to do some serious damage. We live on the hillside and have experienced our fair share of 100+ mph winds. To me, all it meant was another night of not sleeping and it was my birthday the next day. sigh.

Well I woke up Wednesday morning a 33 year old who just survived the first 3 months (officially) of recovery post PAO+ sugeries and I was finally seeing and able to report progress. I also woke up to another day off of work!!! The wind storm did crazy damage and schools were closed, as well as, many state and city offices. 30k+ people were still without power. Ours had gone out Tuesday night but was back on by the morning. We get lots of wind and lots of snow but this was pretty crazy. It takes some pretty extreme weather to shut down schools here (our kids have outside recess until -10 degrees F and we have to get more than a foot in less than 24 hours). It was an AWESOME birthday wish granted to wake up on a Wednesday and not have to go to work (especially with the overworked body pain and headcold).  Another day of watching movies and snuggling with my kiddos was a blessing. I teased all day that Mother Nature knew I needed another day of rest - and she grants birthday wishes with force & style! My dad's house still has no power and some people are going on 36-48 hours with power and Four of our schools operated today with no power and on back-up generators. Crazy!! We had sustained winds between 70-80mph and reported gusts (near my house) in the 130s! Trees uprooted and blown over - lots of damage all over Anchorage. We lost our trampoline and grill despite well-intentioned tie-down efforts. The trampoline speared itself on a tree between our house and the neighbors, the grill launched itself off our deck (pressed up against the house/almost under the stairs) and into the yard almost into the driveway. But no structural damage to the house and we only lost power for 8-10 hours. Could have been worse.

I realized when I requested my refill of pain medication that I had gone almost twice as long as I have been previously. Part of this is the fact that I am back at work and I can't take it during the day and while that has been incredibly hard on me it has proven I CAN stretch it. I think I have to take an higher dose when I get home and I still haven't found a way to adequately manage the pain during the day but I can tell it is getting better, slowly. I did start taking my Naproxen again. I have another follow-up with Dr. P next week and we will get down to some more details. I have started a list of questions in regards to pain. Did I go back to work too soon? My job involves a lot of sitting up at a desk - what are way to reduce the pain, with medicine or without? Do I need to discuss a modified schedule or alternate work site with my employer, is so, what is recommended and for how long? How long can I realistically expect this sit bone pain? When should I be concerned? I have started, stopped and restarted PT. The week I started was a significant increase in pain - combined with work, how long will this continue? Again - what can I take during the day - naproxen isn't cutting it - oral meds like tramadol or patches??? will patches help joint or bone pain or is that more nerve - I have both but the deep joint pain/bone is what makes a full day & week of work impossible. Nerve & muscle pain is what keeps me awake at night once I get the other pain under control.  My muscles still cramp up during the night? How long is this typical?

So I want to say that my days at work are getting better but I have to be realistic and mention that I have taken several half days - worked with my buildings to go home early (take lunch at the end of the day) and I have taken several sick days. So I am not really working at full capacity yet and that is going to change very quickly. My year is picking up very quickly and thanks to the day off yesterday + a couple days out for training - I will have to reschedule 4 meetings agh. One day at a time right? But I am not coming home in quite as much pain and I have noticed a HUGE increase my abilities. I know I was home for a couple days relaxing (and therefore walking around a small space with lots of things to cruise on and lots of rest) but I haven't used my crutches at home for the last 2.5 days. I was a little too optimistic today (after 5 days off) and decided to only take 1 crutch to work. I realized how big a mistake that was about halfway to my office - walking into the building. Tomorrow both crutches get to go with me and if I leave one in the car or my office while walking around the school - okay, but at least I have them both. It took me a LONG time to get back out to my car at the end of the day. Sleeping is still hard. I still wake up several times and have been cutting and adjusting my ambien trying to find a dose that helps me sleep but doesn't make me feel drunk the next day. I will maybe talk to Dr. P about that as well - of course if I get everything under control - I might actually stay asleep. I am definitely feeling more positive, less hopeless.

There still isn't a light at the end of my tunnel but the darkness isn't as consuming. :) That is enough right now to push me along.

Kids camping! Photobucket trail-walking - 1 crutch Photobucket Happy Kids at the Concert/Fair Photobucket 12 weeks/3 months
12weeks Atrophy
Hubby's hunting trip - 120 lbs of caribou!!!
And some wind damage

Saturday, August 25, 2012

10 Weeks Post Op & Starting PT

I recently found my surgical report and have been slowly and surely trying to understand what the heck is says… This week marked my “right anterior hip arthrotomy with repair of acetabular labral detachment, osteoplasty of femoral head and neck, and RPAO – officially.

I started PT this last week after starting back to work last week - definitely a shock to the system. The day I started work I had a couple stitches pop through and 2 holes opened up in my incision. Well a couple days later another hole opened and a 4th was threatening to but a trip to the Dr., some antibiotic cream and gauze bandaging has allowed them to close back up. Yay! I took it as a sign of doing too much too soon – all at once. My job is not really strenuous but is a lot of sitting upright at a desk though. I am going to start the year off pretty busy and unless I were to give away some of my caseload or one of my schools for awhile – I really can’t take it easy. I have a feeling I am going to love being at both of my schools and am excited to work with both of my teams so it bums me out that I have basically driven home in tears everyday. Before work started I stopped taking pain meds during the night and when I woke up to see if I could make it through the workday. I was making it until about 2-3 before I was super bitchy and really needing to take something. Well…. At work…. I am only making it to about noon before I hit that same pain mark but I am at work so… I told my co-workers to ask for favors and schedule meetings early in the day for the next couple weeks. ;)

I started PT and I already am very unsure of my therapist. After reading some of the posts on here and wanting to be very sure of starting PT I decided to go with my local OS’s suggestion for PT because he refers out most for PAOs and he does the follow-up for Dr. Mayo’s patients in AK and the PT office is affiliated with his same clinic. I had a previous PT that I liked from last year when I injured myself. She was the reason I was sent in the direction that led to my diagnosis. She was the one who suspected the labral tear and requested that they do an MRI. I wrote Dr. Mayo’s office and asked for a copy of the PT protocol so I could pick an office. They stated that Dr. Prevost (my local OS) has been taking care of their patients for years and they would agree with whoever he suggested as they would be aware of their very specific PT protocol.

Well I don’t think the therapist I was paired with is aware. When I walked in… my first introduction to her… She says “soooo, you’re still on crutches??” I said “yeah.” Then she said, “soooo, your surgery was in June right?” “Yes.” “Is there a reason you waited so long to start PT?” ………….. um yes. I was a little taken aback and felt slightly like a errant child. I said – “well when I went in 2.5 weeks ago for my follow-up, the x-rays showed that the bones weren’t quite healed and he told me to wait 2 more weeks.”

I was starting to wonder if this woman even read my file. Then after the initial exam she tells me that we are going to start slowly because she is worried we are going to be competing with pain issues and starts going over the exercises she wants me to start with. I only have three but one of them is a clamshell with a resistance band. I paused and said I wasn’t sure I was supposed to do that. I said that I wasn’t quite sure when the restrictions were lifted on the abductions and straight leg raises. She tells me she is pretty sure it is fine but we can start with the lowest resistance band and she will double check. I did one or two – not to her liking because I didn’t get my leg out as far as she wanted. I didn’t care because I wasn’t sure I should do it anyway. The other exercises are an adduction with a pillow and bridges. I am supposed to do 30 reps once a day.

Well I sent a message to Dr. Mayo’s office and explained that I wasn’t sure when my restrictions (straight leg raises & abduction) were lifted that I didn’t know if it was at the 8-10 week mark or if it was at a couple months. The response I got back this morning was “We prefer that you never do straight leg rises. You may begin active abduction at this time but we prefer you do them standing nor side lying against gravity”… So I am guessing if I shouldn’t do them against gravity then I shouldn’t be doing them again resistance bands, right?

Never?!? Never do straight leg raises. Never run… Suddenly the enormity of all this hit me again. I cried. Driving home hurting like hell on Friday – all I could think about was running. I was listening to a song that I have never ran to but all I could think about how good it would be to run to. I felt like I did very little at PT but still hurt like hell as a result. I can barely make it through my days. I am not sleeping well and my left hip has been starting to ache on a daily basis – that familiar deep achy pain that I am pretending isn’t there… But to be honest… by the end of the day, driving home, I almost can’t tell which side is hurting worse because my entire pelvis aches. Also... sitting on the toilet hurts. This is depressing.

The husband and I were talking about caribou hunting and he said “next year… blah blah blah” and I said – we said that last year and look where I am now – I am not far enough into the tunnel to see the light at the end of yet. And I am so tire of my crutches. I want to throw them away but I am afraid I might even need them again for the other side…. Sigh.

Maybe next week will be better.

Incision - 10 Weeks Uploaded from the Photobucket Android App Close-up of stitch holes looking better Uploaded from the Photobucket Android App Atrophy at 10 weeks Uploaded from the Photobucket Android App Incision 9 weeks Uploaded from the Photobucket Android App Stitch holes Uploaded from the Photobucket Android App Uploaded from the Photobucket Android App

Saturday, August 11, 2012

Some days aren't better

So today I read another blog post. It was called Some Days are Better Than Others. I agree with the author whole-heartedly and completely on any given day. As a working mom I do feel the same way and I thing I am generally good at balancing out the good parenting days with the bad. But that was before the hip stuff.

That was before the days when at any given moment I am THAT close to tears because... I feel lazy, I feel fat, I hurt, the sun is out and I don't want to move, I am feeling ok but it is raining, I want to drive, I want my husband to back off and stop telling me to start driving, I want to say I no longer need pain meds, I want them to give me more cause it still freaking hurts, I want someone to see how I am doing without me reaching out first, I want to not talk about the pain, I want to get OUT OF THE HOUSE, I don't want to start work, I want to go camping, I don't want to admit summer is over, I want to jump on the trampoline with my kids, I want to go for a walk with my kids, I want to be BIGGER than the pain so I can get past it, I don't want to think about dinner places based on how I can sit in their chairs, I want people to stop telling me they will be there "just call", I am tired of not sleeping, I am tired of sleeping in, I am tired of being tired having done nothing for 8 weeks.

Now let's see if I can take any day the author describes above and leave the hip stuff out... I can't. It's not only there, it is smothering. This will be me in a couple days because I go back to work. Only it's going to be worse. Every "mommy, what's for dinner" is going to be dreaded because of the thoughts of "what do we have that I can make without going to the store. I can't drive to the store because I barely made it home to take pain killers. He isn't going to want to go back down to the store because he picked up the kids. I can make this but I don't think the kids will eat it. Oh gawd, I just need to sit until the painkillers kick in." That will be followed by "Mommy, I need help with my homework or I need to bring this to school" which will require a similar set of thought trains that end with needing the pain to stop."

I did this surgery so it wouldn't be like this anymore. When will it not be like this anymore? I want to enjoy my kids. I see little glimpses of these upcoming tweenage and teenage years with my daughter and I want to press pause. She wanted me to play Barbies with her yesterday while it was just me, her and Grandma because the Boys are off hunting. I didn't want to get down on the floor. Pretty soon, not only is she not going to WANT to play with me, she isn't going to want me around in her day and I have lost a year now to hip pain. My son. My little guy. He is starting preschool. He is getting so big. He still likes to snuggle. I know we aren't having anymore kids so I have the pounding reminder to treasure everything now but I struggle to. I feel like I am losing that struggle and I am going to miss it.

So back to the some days are better... Yes, living each day/minute like we might die the next is impossible and exhausting. I get that we need to recognize our not so good days and mix them up with the good and great days and to note that some days are better and be okay with it.
But somedays... sometimes it's just as easy to say... some days aren't better, some days are worse... and leave it there.

Friday, August 10, 2012

8 weeks Post Op

(Saved up two posts for one day)

 So I am now officially through my initial recovery period from my RPAO, labral tear repair & femoral head/neck resurfacing. In my head this was my big milestone. At 8 weeks, I was supposed to be able to start doing everything again (walking, driving etc...)! A newly constructed $100k+ hip (the bills are still trickling in but we are over that amount already - details to come). Well, I made it to 8 weeks but not quite there yet. I have one more week of restrictions based on my last meeting with Dr. P on the 7/31/12 (actually a couple more days at this point). Last week I couldn't imagine being here. It felt like I would never get here. This last week was a long and hard one. I was very busy - doing more than I have at any point during recovery and paying for it. I have definitely felt more pain directly increased with my activity level. Some of the same pain - some new.

For the last couple days I have had a new pain that is rather annoying. It stems from the bottom (literally) of my pelvis, I think. The best way to describe it... if you think about when a kiddo hops on your lap and you say "you have a bony butt" when their little bones dig into your thighs... that, on me, hurts.

My bony butt... aches like heck, on both sides. I can't sit, I can't lay, can't walk, can't ride in a car well because of this pain. Sleeping is hilarious. The only thing that doesn't HURT it - is standing... but I have hardwood floors and my feet are not okay with this arrangement. It is a deep achy bone pain. I have tried muscle relaxers. I have tried laying flat. I have tried laying on my stomach. I have also tried rolling a ball along the back to "rub it out." UGH. This is really interfering with my attitude and my sleep. It isn't super intense but it is definitely enough to wake me up and not let me get a good night's sleep. I have a new prescription for sleeping pills to see if that helps...

Walking - I am still using both crutches but I can tell that I am putting more weight on my op leg. In our  kitchen, I have been using the counters to get around - cruising, the way babies do around furniture when the first learn to balance. I did accidentally take one step the other night (exactly 8 weeks post -op) when I was cleaning up a bit in the living room. It hurt like hell but my leg didn't buckle and I didn't fall. I don't know if it was more than just angry muscle pain but I will wait a couple more days just in case. I also don't see my crutches going too far in the immediate future.

Pain meds - I am still taking them. I was taking a lot again while my sister was here but if was definitely 'as needed.' Since my activities have calmed down a bit I am not taking as many. I have also stopped taking them when I wake in the middle of the night unless I really can't fall back asleep cause of the pain keeping me awake. Sometimes I can get away with tylenol but it is still pretty annoying to not feel rested. I miss my sleep. I miss sleeping on my right side. I really miss it. I don't like my back or left side with a thousand pillows between and around my legs.

Overall - I still have the hospital bed in the living room - it is still more comfortable than my couch for sitting and resting. I have finally branched out from my yoga pants. I wore my fat jeans for the first time since surgery. They fit (yay and boo) and didn't bother my hip too much. My left hip has been bothering me and I am hoping it is just from the overload. Lefty doesn't have the same dysplasia as my right did so it isn't likely to need to the PAO surgery but it had more arthritis and looked worse off on both the MRI and the x-rays. We'll see if a lighter load helps. I still like ice. My nifty cryo-cuff couldn't handle the work and has started leaking. I am going to buy the actual hip attachment for it and see if that helps. I know I will likely still want/need it when I start PT.

I start PT next week. I also go back to work. I am a little worried about this. The first couple days are without students so it will be nice to see how it goes but we also have to jump back into the work routine after having been out of it for a while...

My little girl starts third grade and a new school. My little guy is staying back for another year and trying preschool out. He has only ever been at an at-home daycare and just doesn't seem ready for kindergarten (from a professional view, not just the "mom-and-he-is-my-baby" view). I am really hoping for a great year for everyone.

I have been doing a lot of thinking (again) about Ehler's Danlos Syndrome (EDS). I have suspected for a little while now that I might have this (my little girl too). When I met with Dr. Mayo for my pre-op appt, he brought up my hypermobility again. He stated that he suspected a unknown connective tissue disorder but knew we didn't have a diagnosis of Marfan's syndrome or anything. I have done research on this and if I were a gambling woman - I would almost bet my house on this... I think that with my deductible and out of pocket expenses met - now might be the time to seek out a genetic specialist who might be able to shed some light on this. You can read about it here

Incision - 8 weeks Post-Op (you can still see my drain holes) Uploaded from the Photobucket Android App
Bruising/Redness/Swelling @ 8 weeks - looks a lot better but still there Uploaded from the Photobucket Android App
My "fat" jeans -that fit now & the top of my incision that peaks out Uploaded from the Photobucket Android App

Fun with the Family

So my sister, her husband and my lil stinker of a nephew were here for a week. It was the shortest and longest week of the last couple months. I had a lot of hang out time and it was great. It was short cause, well - a week with my sister... a month would still feel too short. I really wish they would give up and move here because I know they had a good time.

I know this in part because of how freaking sore I was when they left. It took me 4 days to get around to posting about it! I saw the Dr. the day they got here and was given some pain meds. I didn't realize how much we did and/or how bad I was actually hurting until I took note of how many I went through while they were here.  Quite a few - I must have been back on a 4 hour schedule.

We went to our island and stayed a couple nights, we bbq'd, we ate yummy food. I did a lot more with them here than I have done since I saw them in Denver earlier this summer. As much as it hurt (still does - haven't recovered yet) I wish they were still here.

Some of our shenanigans...

Lil Guy actually letting me hold him at dinner Uploaded from the Photobucket Android App
Kiddos on the trampoline Uploaded from the Photobucket Android App
Heading out to the cabin Uploaded from the Photobucket Android App
In the water Uploaded from the Photobucket Android App
Uploaded from the Photobucket Android App
My little girl & little guy kneeboarding (with a loon popping up to say hi) Uploaded from the Photobucket Android App
Uploaded from the Photobucket Android App
Being silly Uploaded from the Photobucket Android App
Uploaded from the Photobucket Android App

Thursday, August 2, 2012

6 & 7 week Post - Op

6 Weeks The day before 6 weeks, I decided I was completely sick of my house. The Mr. had been out of the house for several days: one with the kids playing, 4-wheeling by himself and running our summer fishing business. The kids and I were stir crazy with cabin fever. So I decided that we could continue to get on each others' nerves in our house or we could go to the valley with my in-laws and either stay at their house (where we wouldn't be alone) or in the motor home in their yard one night (to see how well I could stand sleeping in the motor home seconds from a real bed).

The Mr. was already out at the river fishing by the time we woke up to get ready. I was crutching along, helping the kids get packed up and showered, when I slipped in the bathroom on the wet floor (darn those kiddos for getting in and out of the shower, splashing in play). I stepped hard - not actually falling, but definitely breaking my weight bearing restrictions (44 lbs). Pain shot up and down my body from my chest to my toes but I was determined to get out of the house so I continued. We finally got out of the house (with the great help of my mother-in-law). We stopped by the pharmacy to pick up a refill of my pain medication before going out of town. I had been on the phone of with my AK Dr.'s office getting a refill when the "sub" medical assistant (MA) who was filling in for my DR told me that that I was taking "WAY TOO MUCH PAIN MEDICATION" for being over a month post-op and that I needed to "cut back quite a bit." We talked for a few minutes regarding the dose I was taking and how Dr. P had said I would be on that dose for 6 weeks before taking 6 weeks to wean me down (only 3 weeks earlier). I was completely confused but out of pills and knew I would see him the next week for my follow-up appt - plus she didn't really sound willing to negotiate anything. So I took it. So, in less than a day, I went from taking 15-20mg of Norco every 4-6 hours to 10mg every 12 hours. I knew this was drastic when I picked up the meds but again, knew I would see the Dr. the next week to straighten it out. That on top of the slip/fall in the bathroom took me over the edge.

I had a ton of swelling that night and was really concerned. I was also in a lot of pain which I wasn't sure was in response to the fall or the drastic reduction in meds. I couldn't handle the med switch and called the Dr.'s office the next day and told them that. The sub MA told me basically to suck it up and deal with "a couple hard days" even though I told her I couldn't go 6 hours. I also had a lot of bruising and swelling. My great friends on my Hip Chicks website suggested that it was a hematoma that maybe had ruptured in the slip, especially since I had been dealing with increased redness, swelling and bruising for weeks. I agreed but when I called the Dr., the same nasty MA told me "I could go into the walk-in clinic if I was worried but the Dr. wouldn't be in until the next week," well I had an appt the next week, so I didn't go. I went ahead with a family trip in the motor home to camp at the river the hubs fishes at. Here are a couple pictures!!!

6 weeks - After slip in bathroom Uploaded from the Photobucket Android App Laying on Boat with my leg up Uploaded from the Photobucket Android App On the boat Uploaded from the Photobucket Android App Uploaded from the Photobucket Android App Uploaded from the Photobucket Android App Me and the Kiddos Uploaded from the Photobucket Android App Camping Day 3 6w Camping D3, Uploaded from the Photobucket Android App Cankles after being "out & about" for 3 days Uploaded from the Photobucket Android App

7 weeks Post-op 7 weeks since my RPAO, labral repair, and femoral head/neck resurfacing with Dr. Mayo. Yesterday, I had a follow-up appt with my OS here in AK yesterday Dr. P... He thinks the swelling/redness/bruising is either the result of a torn muscle or a ruptured hematoma either of which was a result of my fall. He was pretty impressed with my amount of bruising and gave me a look for not coming in but I said I didn't have a ride, which was only partially true and I left out the camping excursion.

He did x-rays to make sure my anchor screws were still in place - which would indicate tearing off one of the muscles that was moved and anchored during the PAO. They were still in place which he said was good and meant that if it was a tear - it was partial or a completely different muscle. He said that it was also very likely that it was a hematoma, which would help explain some more of the symptoms as well - especially the bruising - which was significant even when I was there. At this point, neither issue would be something they would do A LOT about right now. The torn muscle would have to be addressed slowly when going into PT and the hematoma would likely resolve on its own, with the blood dissolving back into the body. Both of which will be cause for more pain - the hematoma would have been causing more pain all along so that is what it likely is/was.

With regards to the pain meds... It was a misunderstanding and it was because of the sub MA (that was not so nice). A couple weeks ago when I was still trying to get all pain & meds under control - he had authorized more Oxycontin ER (extended release, every 12 hours). I told his assistant I didn't want it - I had weaned myself down to the Norco and didn't want to go back so it was never even called into the pharmacy and never picked up. Well THAT doesn't show up in their computer and he his fill-in MA (who was very judgmental and condescending) informed him that I was taking 20mg of oxycontin and 20mg of Norco for going on 3 weeks now, which is why he wanted me to drastically reduce the Norco. I would have definitely been very "drugged up" if that were true. When I explained that I never took those - he apologized over and over because I was in needless pain. And authorized enough pills that he *would like* to last 6 weeks but if I don't quite make it - then I needed to call him. I also gave him a pain log for the last week and he said thank you and apologized again.

Well the bones aren't quite healed though - almost. The bottom cut was more blurry and almost healed but there was still a distint cut in the top - he said 2 more weeks before I can start weight bearing as tolerated. Same post op restriction for 2 more weeks. This is quite ok with me because I wasn't quite ready - pain wise for sure, mentally either after the last week.

My sister, her husband and my nephew got here the night before last at 4am. We got up to go to my appt at 7am so it was a long day. It was also a nice day and we decided to pack up and head out to our cabin. Between that, fighting with the pharmacy and my insurance deciding that the whole medication dosing change was confusing, and having to go 8 hours without meds - I was in serious pain by the time we got here. I like to describe it as giving birth naturally while being strapped into a medieval horse pulling torture device. I took meds and slept. Hanging out today - perfect!

All in all - I am still feeling okay with recovery at this point. The hematoma explanation makes me feel a little less like a baby. Being on the same page as my OS with regards to starting PT and weaning off meds over the next 6 weeks is relieving. So I was able to enjoy some time out at our cabin/lake with my family before the rain came in and we came home...

Next, I will start PT and work at the same time in about 2 more weeks. EEP, maybe I should have picked up the oxycontin... My nephew and I Uploaded from the Photobucket Android App First boat to the cabin! Uploaded from the Photobucket Android App

Friday, July 20, 2012

5 weeks Post-Op

So... another week further into recovery. I can honestly say - there are more good moments than completely awful ones. When I type that out it seems unreal that 5 weeks have already passed - I am beyond halfway through my initial recovery. I have noticed that some things are a little bit easier. Definitely better than a couple weeks ago but I am still in more pain than I really thought that I would be at this point - which sucks...

I run between a 7/8 (when I wake up and when I push 6 hours on pain meds) and a 3 when icing, using CPM and 30 minutes - 3 hours of taking pain meds. I am still having the severe sunburn pain - skin is still very sensitive to touch, even my clothes hurts sometimes. I am still having the muscle cramping/twitching/locking up. Sometimes I wake up from it (not that I am sleeping great anyway)...

I talked to Dr.'s office today because I still have a lot of swelling/redness/hot to the touch. I don't have a fever, night sweats or chills though. I had sent them a picture of my leg just to see if they still thought it wasn't infected because the incision and drain holes (while not fully healed) still look good. They are concerned it might be contact dermatitis. I was still a little worried that it might be cellulitis but my blood work showed nothing significant and I did have a round of antibiotics... So, tomorrow, I will be trying some hydro-cortisone cream topically and a new med for the nerve pain. Lyrica or gabapentin - we'll see how it goes.

This last week has been super busy. My lil man had his 5th birthday - he is getting so big! I can't believe it. I was up and about  A LOT trying to get things ready (shopping & decorating) and then at his party when we had a bunch of people over! It was lots of fun but I was seriously hurting afterward. My feet were so swollen (both of them) that I put my TED hose back on for a couple days! It was also my mother-in-law's birthday and we (my family and brother/sister in laws family) drove out to the in-laws house with a birthday dinner. The sun came out, the food was good, the kids were playing and I fell asleep on her couch after food for about 5 hours and that was with kids and loud family members around!!!! I was so wiped that even after we drove home I was so ready for bed. I can't believe how sleepy I was. Obviously, my body needs it but it is still crazy how tired I get with so little "hard" activity.

I have been sleeping in my bed again - without the CPM machine but still using the cryo-cuff. I still haven't made it comfortably to 90 degrees on the CPM but I am noticing that I am not AS STIFF when I have been out of it for awhile. I can only sleep on my back or non-operated side. I usually start on my back with a pillow under my operated leg longways and another pillow underneath my knee. After just a couple hours I wake up super sore and stiff. I have to wake the Mr. up in order for him to help me roll sideways onto my non-op side and fold the top pillow in half underneath my knee. I do this over and over because I can't stay in the same position for more than a copule hours...

I can't help but wonder, when does it stop taking SO MUCH out of you to do things  - normal things?? I was really hoping to try some camping before the summer is over. We have access to our in-laws motor home to drive south or stay at the river when the Mr. is busy with fishing. We can also use our cabins at the lake. They are pretty decked out and I have a queen size bed out there, a hammock, my camping chair, the dock and the fire pit. The only issues there are the walk down to the boat landing, getting in the boat, getting out of the bank, getting around the cabins & an outhouse.

Leg at 5 weeks (redness & swelling that got me worried and emailing the Dr.) 5 weeks morning, Uploaded from the Photobucket Android App
Incision @ 5 weeks 5 weeks evening, Uploaded from the Photobucket Android App
Atrophy @ 5 weeks 5 weeks, Uploaded from the Photobucket Android App
Little girl with all her braces off! Uploaded from the Photobucket Android App
Little man at his birthday dinner - Red Robin "yummm" Uploaded from the Photobucket Android App