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Wednesday, March 9, 2011

They Said It's Time To Go To Rehab. I Say 'Yay, yay, yay!'

Intial Recovery - The First 14 Days

Day 1 - Surgery Day
Thursday - I am not going to lie.  I did everything I could to keep cool prior to.  I got a massage, I got a mani-pedi, I worked out.  But the morning I walked in, keeping my cool was all I could do.  The young, beautifiul anesthesiologist gave me anti-nausea drugs, but made two attempts at the veins in my hand - not exactly confidence building.   They marked my hips and on schedule, at 7am, they rolled me into surgery. 

I woke up and was a little bleary eyed.  I spent most of the time trying to focus and then came another 2 percocet.  So much for focus.  I felt really good considering, but what did I know, I was drugged up.  My husband managed to help me get my clothes on, down to the car, and up the stairs of death (no railings on the outdoor stairs).  I collapsed on the pre-arranged chaise and commenced to pretend that I was altert and capable of carrying on a conversation.  I nodded in and out throughout the day and night.  Went into the office, where we had the CPM setup, did two hours as I fell asleep.  That was day 1.  A blur.

I do remember the doctor calling to check on me and my being elated at the pain being gone.  Not sure if it was the results of the surgery or the powerful good drugs, but either way, I was grateful!

Day 2
Friday - Still a little opaque.  Took Vicodin, antibiotics and anti-inflammatories.  Feeling good.  Groin pain gone.  Now doing CPM 4 hours per day (2 in the morning and 2 at night).  Nothing extraordinary to report here. 

Went in for intial post-op with doctor's assistant to change bandage and get further instructions.  20% weight applied to surgical leg (toe tap) and continue with drugs, CPM and Game Ready icing (30 on/30 off).  A bit of numbness in the leg, but as to be expected.

Day 3
Saturday - More of the same routine.  Plus the endearing notes, emails and food deliveries from friends.  A party we had been on planning attending for a while has now arrived - Top Chef.  My husband concocts a delicious halibut with mango sauce for the party, but prepares a pre-dinner for me.  It's a winner!!!! 

Some good friends come over in his absence to sit with me and bring me a wonderful Thai dinner.  It's pretty much a haze, but very memorable.

Day 4
Sunday - Still.on antibiotics and anti-inflammatories, but the Vicodin needs have subsided.  Moving about pretty well, albeit on crutches.  Some good friends visit while hubby takes a well-deserved break.   They bring me Thai food and wine.  What more could you ask for?

Day 5
Monday - Don goes back to work today and I'm on my own.  What to do. 

Just a note:  One of our cats has been sleeping on my legs almost everynight, almost as a way of saying, don't you dare turn over.  How does she know?

Day 6
Tuesday - .Home alone again!!!!  Aaaaahhhhh!!! Luckily it's the maid's day, so they showed up to do the cleaning while I sit inside the office and do my CPM machine, work, watch TV, etc.  Really non-eventful today.  Pain lessens and mobility increases a bit daily.

Day 7
Wednesday - Don is really got the cold bad, so he has stayed home.  I've lured him back into the web.  But now, who's taking care of who.  Luckily, my friend came by with lunch and stayed to watch a movie with me while hubby slept.

Day 8
Thursday - Got stitches out!!!!  And, my first day back out into the new world.  It's pretty out there.  Don needed to get back to work, so I suggested he drop me off at a local restaurant nearby his office so my friend could meet me for lunch and then drop me off at home.  Problem with being a shut-in for a week, you forget essentials like rings, watches . . . housekeys.  So, my friend drops me off at home and I go to look for the hide-a-key.  Yeah, the maids who had been there two days ago left it on the bar upstairs.  Luckily, I did have my cell phone and a neighbor who worked nearby with a key to the house.  The irony.  The shut-in got shut-out.

I am now convinced the surgery was the right thing to do, but now my right leg/hip is now killling me because of all the pressure and compensation now impacting my right leg.  My left knee is aching.  New plan.  Left knee, 3 months from now; right hip, 3 months from left knee.

Day 9
Friday - IT band is really sore near the knee.  Don took me to the Farmer's Market and I think I overdid it.  It was nice though.  Got to go out and actually enjoy the neighborhood, if only for a little while. 

Day 10
Saturday.  The guys are here to put the railings on to our Stairs of Death.  It's like a dream come true.   I'm closing my eyes today until it's all over.

The cat is still sleeping on my legs at night.
Day 11
Sunday - The guys thought they would rap it up yesterday, but there's a bit more work to be done.  My friend came over to visit.  We drank wine and then she walked with me to a couple of Open Houses on our street to pass the time.  I like when people visit.

The railing is done and it is spectacular.  I can now make it safely up and down the stairs with no fear of falling.

Day 12
Monday - Worked more than expected and just hung out and watched movies.  I did, however, manage to clean up and bit and fix the man a nice pasta dinner with a bruschetta appetizer. 

Day 13
Tuesday - Woke up with the cat on my legs.

My first day driving.  Getting into and out of the car, I discovered was going to be the most challenging part.  I have also discovered that if you go to stores, buying things can be really challenging while you're using crutches.  However, you will be amazed at the kindness of strangers who are willing to help you out: open doors, carry items to your car, etc.  Then you notice those who won't even cast a glance in your direction.

Picked up some herb plantings (basil, oregano, rosemary, etc).  I was going to call it my Simon & Garfunkle herb garden (just parsley, sage, rosemary & thyme) but I got carried away.  I was surprised that I was able to bend as well as I did.  I did ice afterwards, just as a precaution.

Day 14
Wednesday - I rode a stationary bike today for 30 minutes at a slow pace.  So slow, the machine kept thinking I was pausing.  Burned all of 70 calories - but hey, movement is movement.  No real pain.  A little discomfort but very minimal.

Laying here watching 'I Shouldn't Be Alive'.  Truly, puts things in prespective.  I wrote thank you cards to all of those who had visited me or extended themselves in some way.  Appreciate it while you have it.  Tomorrow, I will bake cookies.

The Initial Diagnosis and Actual Work Done

  1. Left hip femoroacetabular impingement (CAM type).
  2. Labral tear anterolateral zone.
  1. Left hip femoroacetabular impingement (CAM type).
  2. Anterolateral labral tear
  3. Grade III articular cartilage defects of anterolateral watershed are of acetabulum (OA)
  4. Synovitis
  5. Osteophytes fovea
  6. Ligamentum teres tear
  1. Left hip arthroscopy and labral debridement
  2. Synovectomy
  3. Femoroplasty
  4. Ligamentum teres debridement

Saturday, March 5, 2011

Choosing Your Doctor and Physical Therapist

I went through three doctors and two PT Clinics. 

Doctor 1
Was recommended by a friend, who had recently had a hip resurfacing, and swore by him.  In a great deal of pain, I made an appointment.  A week later, I headed to the doctor's office for an initial consulation.  In spite of his not advanced age, he was making a name for himself in the hip world.  He wanted MRIs run and gave me a phone number to schedule the tests and a follow-up appointment.  Long story short, he told me I had a degenerative hip condition and that I should not hesitate to take care of it.  I was not overwhelmed by this doctor as he left me in a treatment room for over 2 hours and then chastized me for being impatient.  He did, subsequently apologize, and did recommend me to . . .

Doctor 2
Or as I like to call him, 'The One'.  He too was making strides in the hip world, he was developing new methods to make arthroscopic surgery as uninvasive as possible.  It was with him I went through three years of cortisone shots until we both reached the conclusion that we couldn't keep doing it.  But, just to be safe, I felt I needed to consult with just one more who was at the top of their game and the doctor of a friend who had undergone a hip replacement.  And, so, I made an appointment with . . .

Doctor 3 
He wrote the book on it.  The 'should I, shouldn't I' handbook and guide on hip healing.  Not only had I read the book, I had practiced all of the pool therapy exercises in the book for the last three months.  He reviewed all of Doctor 1 & 2 notes, x-rays, MRIs.  He very cooly stated that, in his opinion, he would not recommend surgery based on my dysplasia.  That he would only take on a situation like mine, if, and only if, there were labral tears.  So, he sent me to . . .

Physical Therapist 2 
What happened, to Physical Therapist 1, we'll save them for last.  PT 2 helped Doctor 3 write the pool therapy portion of his book.  So exciting - I get to work with the person who developed the very exercises I had been practicing.  I will say, that the few times I went, I felt a marked difference.  Why did I stop going?  When Doctor 3 told me they were disorganized and that they would try to pawn me off on the less trained PTs, I should have been a bit suspect.  Not only was that true, but the PTs were training two people at a time, different fitness levels and . . .  different sides of the pool? how do you do that effectively?

Physical Therapist 1
My go to guy who worked on my shoulder.  They do stim, massage and ice.  They don't have a pool with a deep end, which makes doing the exercises from PT2, virtually impossible.  They were ruled out because of this.

The Final Decision
The more I did therapy and felt that stabbing pain in my groin, the more I realized my anatomy was not likely going to change no matter how much PT I did.  Most likely, I would just make it worse.  And then there was that nagging comment that Doctor 2 made.  He said that he would only perform surgery if there were labral tears, otherwise, I'd be trading one problem for another - hip instability due to my dysplasia.  The notes clearly indicated that there was a high probability of labral tears and the dysplasia was mild to moderate.  It all pointed me back to my only option.  Surgery.

Introduction: The Road to Deciding on Hip Arthroscopy

I am a 44-year old female who, a little over 3 years ago, was diagnosed with a degenerative hip condition.  Problem was, I just wasn't quite sure what that meant and what the long term implications would be.  Not to mention, how did I get here in the first place?

In August of 2008, I was going to compete (participate) in my first half-ironman triathlon.  The day before, I thought it would be a good idea to be as loose as possible, so I took a yoga class.  The teacher was not one I normally took practice with, but I had taken one or two before.  At one point in the class, as we sat in bakhasana, he came up behind me and pressed by chest towards my knees.  Instantly, I had suspected that was not the best move on his part - for either of us. 

The next day, we left for the triathlon.  The race would be the following day.  I made it out of the river (a body of water I am not accustomed) in good time and embarked on the bike.  I just was not getting my rythym and was having a hard time adjusting.  Powering on, as I made it to mile 20, I felt a pull in my groin.  I shook it off to a cramp and kept going.  As I rolled into mile 30, the pain became unbearable.  I got off of my bike to stretch.  Got back on the bike and stopped again at mile 35.  When I asked one of the volunteers what would happen if I couldn't go on, I was told to pull over on the side of the road and wait for the meat wagon for pick up.  Not wanting to quit, I continued on.  Then I saw it.  Chalk Hill.  My groin was telling me, 'not today'.  I sat on the side of the road and waited. 

The next day, there was a dime-sized bump on my inner thigh.  I figured I had a groin pull, nothing less, and figured it would heal with time.  But, it didn't.  The next three years consisted of cortisone shots and physical therapy.  PT and a third opinion made me realize that it wasn't getting better.  So I chose surgery. 

I won't go into extreme detail here but will detail it in subsequent blogs.  I will say, before you decide on surgery make sure you do all of the following:
  1. Choose  your doctor carefully.  And get at least three opinions, but don't let the doctor choose for you.  Do your research, take all opinions into consideration, but let the decision be yours;
  2. Try all options before you decide.  If PT doesn't work, make sure you are in the best possible shape before you succomb to surgical options;
  3. Listen to your body.  Give yourself a good two weeks to heal.  Your body has gone through trauma, no matter how minor the hip condition.  Let your body heal.
This is my story.  Hope it helps you along the way.