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