Monday, July 28, 2008

Look Ma, No Hands!

No, it's not me.  I'm still using 2 hands tightly on everything I touch.  It's my son who has found a new use for the CPM machine--weeee!  Hey, I'm just glad that someone is having fun with this thing that will cost us about $500 for two weeks.  Insurance doesn't see the necessity for hips, but has ok'd it for knees.  What exactly is a CPM machine?  It stands for Continuous Passive Motion, and it automatically moves my leg through a range starting at 0 (straight leg) to 80 degrees bent knee to prevent stiffness.  This has become an extension of my leg while sleeping, and believe me it's not very comfortable!  So far we spend about an hour before going to bed making adjustments to get it comfortable, and then I'm waking up around 2:30 am needing more adjustments--UGH!

If you look closely at the bottom picture you can check out my Millenial Crutches in the background.  They're a bit bulky for what I've been shown to do so far, but I know they'll be useful as I become more mobile.  You can also see my lovely TED tights on my feet to prevent clots.  I think I have another week of these things, nothing like wearing opaque tights in 80+ degree weather!!

Sunday, July 27, 2008

Cha'robics, the next big informercial?

So I'm getting a little antsy just sitting around and feel the urge to start working out again.  For some reason I really want to find a way to do push-ups, but there's no way that can happen just yet.  Then I realize that I can use my recliner as an incline bench--brilliant!  I order up some old 5 pound weights from the basement storage, and viola I'm in business.  I can do everything--chest press, flys, back, bicep curls, tris, shoulder--this makes me SO happy.  I think it's best to start off with light weight seeing how surgery can take more out of one than may be realized.

So now I can put some kind of routine together.  I have 1000 leg reps that I must do everyday, so I try to aim for 100 at the top of each hour.  I'm suppose to manually lift my knee up & down with my hands, and push my knee in & out.  The goal being to eventually cross my ankle over my knee (something I haven't been able to do since my scope in February.)

This is so cool, I now have another activity to help pass the time!

Saturday, July 26, 2008

PAO & the first week

So I've come to terms that this PAO thing is inevitable.  I decide to tackle it head on and look for some lessons to take away from this experience along the way.  So far:

1)  My husband is an absolute Saint!  I've always known he's a good guy, and I never doubted his abilities, but he has come through for me at an unimaginable level.  I will be forever grateful (and fortunately I also have the power of the delete key ;p)
2) It is okay for me to give up some control.  Actually I've had to give up all control, and things are still good.
3)  There are many, many good people in this world and I'm grateful for all the wonderful people who have taken the time to send me an email or to tell me they're thinking of me.  I was amazed at the number of people who wanted to know the exact time of my surgery so they can send out positive vibes.  Purely humbling.
4)  I already knew, but am more than ever grateful for the fabulous team of family and friends around me.
5) A negative thought can not exist at the same time of a positive thought.  So if I have feelings of uncertainty or fear, I just think of a happy moment in my life to over-ride the negative.  This tool has worked very well for me throughout this whole process.

Here's a re-cap of one very long week:

D-Day, July 19: 
Surgery is on a Saturday, which is very cool since I'm the only one at the hospital needing to be prepped.  I decide to conquer my fear of needles, having a picture of my son in hand with every poke & prick helps get me through (I fainted during my scope when they put the IV in.)  Surgery lasts about 4 hours, I have both a scope & PAO.  Things are fuzzy, but ultimately I'm taken to my room on the Peds floor (where my doc sends his patients), I have a PCA machine with morphine, a catheter, and am connected to a CPM machine to prevenet stiffness.  I stayed in this state for 48 hours.

2 days Post Op:
Now the hard part starts.  I'm awaken to have my dressing changed, catheter removed, PCA taken away, and PT is to show me how to get out of bed--BIG DAY!  Problem is that the oral meds make me itch something fierce, so we spend the next couple days trying to manage the nurses to help me with my medication.  This is one of the biggest lessons, frustrations, and surprises:  You must take control of your own pain regime.  The staff clearly did not know, in some cases didn't care, what meds I was taking or when I should have them.  Fortunately my husband was a great record keeper and a bit of a bull dog.

This day also brought me the greatest pain I have ever felt in my entire life, which was completely avoidable.  PT came in and as she was holding my leg with one hand and trying to put the CPM machine under the bed with the other hand, she dropped my leg.  I'm talking hyperventilating, passing out kind of pain where you're not crying but your eyes are streaming tears and you're in shock over what just happened.  In the end she was able to show me how to make it to the bathroom, but we cut it short and she vowed to be back the next day.  I vowed to be out of bed before she had a chance to touch my leg again.

I also got to eat my first meal in 3 days, and was able to get up 4 times on my own.

 As for getting around, I'll be using crutches (not a walker as I had thought.)  I'm only to put the weight of my operated leg on the floor.  So one step goes:  R crutch, L crutch, schooch R foot forward, step through with L; repeat until I get where I need to be.

4 days Post-op:
Received my discharge papers.  "Walked" from the car to the bedroom, and slept in my own bed for the 1st time in 4 nights.  I have a nice set up with a recliner in between my bed & bathroom, that allows me to change positions and to keep from getting too sore.  Also, have hourly exercises to work on.

5 days Post-op:
Got to SHOWER!  What a relief, and a bit of a challenge but totally worth it!  I also find that I'm schooching less with my operated leg and able to start taking something that looks more like a step.

6 days Post-op:
Pain meds are lasting longer.  Had to venture out to have blood drawn since I'm on Coumadin, so that means I had to get dressed, and walk to the car.  Was able to get myself out of the CPM machine and out of bed on my own.

7 days Post-op:
Still taking it slow, but pain is being managed.  Was able to get myself back into bed & into the CPM machine on my own at 3am.  For now I need to rest, take my meds & vitamins, do my exercises, and continue to ice--I can handle that.  I just realized I haven't changed a diaper or had to decide what's for dinner in a whole week!?!

Over all my week has gone much better than expected.  My husband missed his calling as a nurse.  He's great at tracking my meds, making sure I'm doing my exercises, and feeding me. My mom & mother-in-law have been absolute angels helping with my son.  At this point for my husband it's kind of been like bringing a new baby home, even though I'm trying to be as cooperative as possible and I can get myself to & from the bathroom =)

Hip Scope Blues

Feb 08, hip scope complete.  Unfortunately the outcome is not as we had hoped.  2 tears were actually found and arthritis has set in as the joint has continued to deteriorate over the years.  

Arthritis=Huge Bummer!  To hear your doctor say "It' not good."  Is very devastating.  I'm told to give up all the forms of exercise I love so dearly.  No more kickboxing, no more multi-joint moves, no more jumping, no high reps, pretty much I'm limited to biking and water.  At the time it was like a death sentence.  

So I decide to buy a stationary bike and get use to the idea of riding.  I also dig in for 6 weeks of PT.  Now mind you, I was told this was going to be a minor surgery and I'd be able to get back to things 'at my own pace.'  Of course my own pace is usually break-neck speed, so I'm thinking piece of cake.  I never planned to be on crutches for 4 weeks, or to really struggle with some of the PT exercises.  What do you mean I have zero range of motion and am unable to lift my leg straight back?!

Week 4 post-scope, I ditch the crutches.  Life is good.  I have a whole new appreciation for my health and am just happy being able to take care of my family.  

Week 6 post-scope, I re-tear.  Up to this point, 2nd worst pain I've ever felt (child birth & being hit in the head with a softball=#1.)  And all I was doing was sitting on the couch.

Ultimately, Dr. Z becomes very concern that I may lose my hip.  He wants to do the PAO asap.  I try to fight him to wait until after summer. I'm determined to win.  2 weeks later of hobbling around and constant pain, I give.  In the end, Dr. Z squeezes me into his busy summer schedule and I have surgery on Saturday, July 19th.

Torn Labrum. Dysplasia. Now What?

Ok it's October 2007.  Dr. Z says the MRI- with dye injection confirms the larbum tear.  I'm also told the cartilage looks good, that there is not evidence of arthritis, and that my joint space is great. 

 Basically there are 2 options at this time:

1)  Hip Arthroscopy, aka Scope.  More conservative, less invasive approach that will allow Dr. Z to clean up the tear and further evaluate the joint.  This is recommended given that my pain is mainly in the groin and I have the symptoms associated with a torn labrum.  I'm told this will more than likely cure everything, but there I will be carefully evaluated for years to ensure the dysplasia has not been made more problematic from the scope.  What happens during a scope is that the torn cartilage is removed, creating joint instability that can lead to more problems.

2) PAO.  The mother of all hip surgeries.  Involves cutting the hip socket out of the pelvis and then screwing it back together in a way that better aligns the socket & femur, making movement fluid between the ball & socket and conserving the cartilage.  It's meant to preserve the hip joint.  It is not a hip replacement, which are not ideal for younger people as replacements only last a short time before needing revisions.  Someone my age could face 10+ hip revisions, each depleting the bone.

Well of course I choose option #1!  I have my hip scope on 2/5/08, and plan on taking 6 weeks off work.

The Endeavor Begins

This hip endeavor goes way back to January 1995 when I was rear-ended by an Explorer doing about 50 that never stopped.  Unfortunately I saw her coming, and there was nothing I could do but brace myself for impact.  I held onto that brake something fierce, trying not to be smashed into the car in front of me.  Maybe I would have been better off staying limp?  At any rate, I was able to walk away from the wreckage, but with a whole list of orthopedic issues:

Bulging disks--check.
Torn Labrum--check.

What the heck is a labrum?!  It's a thick, whitish band of cartilage that surrounds the hip socket.  Think of a Thanksgiving turkey, it's that really tough white thing that you have to break apart to set the leg free.  And when it's tore, it often causes catching, locking, and popping--which was exactly what was happening to me.  Sitting was the worst.  I'd go to stand up and wouldn't be able to move.  I'd have to do this 'pirate walk' for it to unlock.  Basically I'd schooch forward on my left and drag the right leg behind until I could walk again.

The thing is that back then not much was done for hips, with the exception of replacements for old people.  In the end I was told to live with it and not to pick an active profession like a street  cop and hopefully I'd be okay.

As I found myself getting squishier from lack of activity, I decided I needed to start exercising and fell in love with kickboxing to the point I started teaching fitness classes.  In the end the exercise would prove to be a catch-22, it would strengthen the muscles enough to allow them to compensate for the faulty labrum so pain would be minimized, but it may have also accelerated the condition.   

Everything really came to surface after quitting my day job to stay home with my son.   I decided to pick up more classes, and soon after was in so much pain that I was having a hard time making it through the days.  Limping was now a daily occurrence, and pain was coming from the groin and deep in the hip.  Weird thing was that I would limp into a class, teach a great class, then limp out of a class.  I think adrenaline, overcompensation, & pride have a lot to do with it, as it's the same way when I'm sick as a dog and have to teach.

It was time to seek out a doctor, yet again.  Fortunately I was able to locate my original doctor, and I was eventually referred to my surgeon--Dr. Zaltz. I am so grateful to have met Dr. Z, I think he's an absolute genius, and if there's one person you want in your corner, it's this guy.   Upon meeting Dr. Z, I was also introduced to the words 'hip dysplasia.'  Ok, so I knew that dogs get that, but I never heard it associated with people.  My hips were very mildly dysplastic, and I could have probably gone my whole life never knowing of this abnormality, but having the car accident was kind of like the perfect storm.

To Blog or Not to Blog

So I've been toying with the idea of blogging my hip experience for quite some time.  I've benefited greatly from reading other fellow 'hip chicks' experiences, but still I've hesitated. Something about posting all my personal experiences and thoughts out on the Internet makes me uneasy.  But at last, boredom has won.  So you are invited to venture into my hip endeavors.