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Sunday, January 29, 2012

Welp, I think I overdid it

Yupp, I definitely have overdone things. I always do this post op and always pay for it. Yesterday and the day before I felt pretty good. I did all of my exercises and made great progress. Now today, every time I move my hip angrily protests. Ah well, this is a normal occurence post op, although it stinks to have to do it.

My body is desperatly protesting being on crutches. My shoulders are not happy. They are all clicky and painful. I know that my shoulders can dislocate very easily and I have to be careful, but I am pretty sure that I have some sort of rotator cuff tear on both sides. I test positive with the physical diagnostic tests. Normally my shoulders don't interfere with my daily life, but now that I use my arms to help walk they are very angry. I have troubles combing my hair and grabbing things out to the side. It is a bit worrisome since they are so sore, but I assume they will settle down once I get off these crutches.

Saturday, January 28, 2012

Impressive Efficiency

Yesterday was an extremely busy day. I am not complaining about that either as it was welcomed after being cooped up in my living room, only leaving for physiotherapy. Mentioning physiotherapy, I had a session yesterday and he was very adament that I let the doctor know that I still had an infection in my incision. Yes, I don't seem to be able to shake this thing, although it is getting better. So, I called to see if I could still do all of the exercises I had been doing since it was infected. This started a rapid cascade of events which ultimately led to a trip to the clinic and new antibiotics. I digress though. After I called and left a message, it was 15 minutes before they had called back, I had emailed them a picture of my hip, they showed the picture to the doctor, called back and made sure that either I go to a clinic that day and get some Bactrim or they would call in a script to a pharmacy near me.

I still can't get over this efficiency. In a quarter of an hour I had had my hip looked at by a doctor more than 2000 km away from me and figured out what to do about it. Impressive to say this least. This is in stark contrast to what would happen here at home. Basically, after surgery you are left hanging. Literally, after my previous surgeries I was told, weight bear as tolerated and good luck, see you in 6 weeks (where they always told me that is was too early to tell anything regarding the surgery). Not that the surgeons didn't care, but they simply are too over-worked and too busy to go the extra mile to ensure that every single concern of my was met. To email a picture of my hip to the surgeon to have him take a look at it is unfathomable, let alone to do it within 15 minutes! It is just not heard of here. Having this prompt care ultimately enhances my trust in my current surgeon and helps me believe that this may be the end of my hip struggles for several years.

Thursday, January 26, 2012

Lacking all stitches!!!!

Today I got the remaining stitches out of my hip. I am thrilled to have those whiskers removed. Now I can wear tighter pants (provided my pooch of swelling in hip/buttocks fits). There will be no jeans yet, but I am thinking that maybe yoga pants that can stretch to accomodate the swelling may work.

I am convinced that I hate getting stitches removed. I almost passed out from the pain today! I tried to play it cool, but when I started to profusely sweat from the pain, we decided that it would be better if I lie down (I was originally seated while the doctor took the stitches out). I hated being like this, but my goodness it hurt. He had a very difficult time getting the stitches out since they went so deep. He said that he had never seen stitches on the skin go that deeply. I guess it is good that they kept so much tissue in place post-op, but, compared to all of my previous surgeries, these hurt the most. I now have stabbing pains into my hip every time I move. Not cool. I'll prolly have to re-take some more Tylenol.

I have checked into going to a pool to get some aqua rehab into my schedule since both the PT in CO and my PT at home both are on my case. I really don't like swimming at all, but I am going to do it since it will be good for my hip. I need to do everything correct and follow my surgeon's protocol to a T since I am tired of having surgery after surgery. I was going to go this evening, but now that the doctor had to literally cut my skin to get the stitches out, I don't think that it would be smart to go swiming with small cuts all over my hip. So, it will have to wait until tomorrow or the next day. Also given the fact that things are pretty painful now, the extra movement probably won't be well tolerated.

As of now, no more stitches. No more narcotics. And...I am now 50% weight bearing (I increase to full weight bearing next week...I have a loooooong way to come before I'll be able to weight bear on this hip, but slow and steady wins the race).

Happy hip thoughts to all!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Monday, January 23, 2012

No Narcotics

These past two nights are the first consecutive nights during which I did not take any pain killers. I am happy since this means that things are slowly but surely improving. Although I did take a muscle relaxant both nights, I still didn't have to take the heavy stuff. Come to think of it though, the muscle relaxants are probably not the best thing for me to take since everything is so loose to begin with. hmm...

There are certainly many ups and downs when it comes to recovering from surgery. It is incredible how one day I can do my exercises and feel great and the next day I don't feel so great and I have trouble doing anything. I think it is so important to be patient and not get discouraged. I've been battling this over the last week. Some days are great and I think 'wow, I am going to get better' while other days (well, most days right now) I feel much worse than pre-op and can't really feel any difference. To say that I can't feel any difference is a lie since I do believe the deep aching groin pain is gone (which has nicely been showing up on my other side, I know just due to compensation, but this also worries me since I have also had it debrided). But it really is too early to tell at just over two weeks. I just can't help being paranoid about the success of the surgery though. Being that this is the third surgery on this side I hope it is understandable.

As far as physiotherapy goes, I am trying to do everything in the protocol given to me. It is pretty intense and I do manage to do almost all of it every single day. The thing is that it is very difficult for me to keep up with the progression as outlined in the protocol. I know that this doc really knows what he is doing, but I find it hard to imagine that I could keep up and rehab the same as somebody with a surgery that included substantially less work done in and around the hip and I am expected to follow the same protocol; exhausting. I certainly am doing everything as of this point in the protocol. I just have to find a pool because apparently the aqua-rehab program is also very beneficial in rehabilitation. Problem is, I dislike swimming. But, as per my physiotherapist here (and in CO), I will look into gaining access to a pool where I can get my swim on and rehab even more. I swear this PT is becoming my full-time job!

Thursday, January 19, 2012

I don't do puss

Really. I don't. Purulent discharge is one of the most stomach-churning things for me. I just don't do it. Today I had to get the one stitch removed from where the graft was taken from my IT band and, unfortunately, it is horrendously infected. I had no idea. I had steri-strips on the incision and there was no oozing whatsoever. As the doctor took off the steri-strips my incision area ripped open, and, it was green. I really thought that I could have taken this stitch out myself since I am a medical student, but there was just no way. She initially thought that she couldn't even get the one reinforcing stitch out because of the infection. But, she managed to wiggle the stitch loose and pull it out. Getting stitches out really doesn't bother me, but this was horrendous. In any event, she cleaned it out, and put a dressing on it and sent me on my merry way. I have to keep an eye on it, if it doesn't start to granulate in or if it is still oozing in a couple of days, I have to go back. I just so happen to start my doxycycline tomorrow (for cartilage formation); so we'll be using the antibiotic effects as well now.

I haven't ridden the bike yet today and I am very hesitant as I am afraid that the open wound on my hip will rip open. I am extra afraid since the entire area is numb and there would be no way for me to know that I had done so. Maybe I'll take it easy today? I dunno. This stinks (not literally, thank goodness). I have a picture, but I'll spare the gruesomeness.

Also, I can't sleep! I sit around worrying about my future and just lie awake. I think it is a combination of that the fact that I am researching for programs in which to do residency as well as the fact that I simply can't get comfortable. This coupled with the fact that I really want to completely eliminate my narcotics sends me into an insomniac state. Not cool.

So, I have four more stitches left in my hip which will be there for 1 more week and then I'll officially be stitchless! woot woot.

Tuesday, January 17, 2012

What has my body done?

I was riding the bike today during my routine ride when I thought to myself, 'holy cow! how have things changed for me.' Seriously. Today I was trying to do this:

But I could not put that much weight through my hip. I realize that I am shy of two weeks post op, but it is terribly sad to think that 5.5 years ago I was doing triple jumps on the ice and running 5 km road races under 25 minutes. Absolutely insane what a couple of years full of surgeries can do to one's body. I know that I will never get to skate or run again. But one thing I do know, is that I am going to make the best of the body I am given. I will get my hips feeling the best they can and deal with the other aches and pains as best I can.

I now have a LOT more time on my hands since I am off school for a while, and I have really noticed my hypermobility. I really notice this as I have to scoot on the bed/couch with my upper body while somebody moves my leg to get situated in place (only a couple more days of complete hip flexor rest for me!). I fear that I am going to dislocate both shoulders and clavicle every time I move. Also, when I get help to go from sitting to standing I fear my wrist is going to pop out. UGH. Frankly, it scares me. I hope that everything holds up considering how much abnormal movement I have in my knees, shoulders, wrists, etc. etc. ;(

Monday, January 16, 2012

Nerve Pain

My swelling and bruising are dissipating nicely. I am extremely happy at how the bruising is decreasing. I have been going to PT every single day and we have been taping it up in a web-like pattern and it really has cleared up the bruising well. =)

I could, though, do without the nerve pain. My femoral nerve and lateral femoral cutaneous nerve (LFCN) are EXTREMELY irritated. The LFCN's area of hypersensitivity and pain has quadrupled to what it was pre-op. Since my last surgery I have had an area about the size of a deck of cards on my lateral thigh that was hypersensitive and paresthesias. Sometimes I used to think that my cell phone was buzzing in my front pocket! But now it is a huge area that is so sensitive, anything that touches it makes me cringe. Even light touch with fingertips (during effleurage sessions) makes me have to hold my breath. Also, the femoral nerve irritation has led to an empty-end pain in my rectus femoris. I can't wait for the nerve to heal up (fingers crossed this occurs sooner rather than later)

I am feeling much better than this past weekend though. Saturday was a wreck. (I even had a meltdown) But today, I rode the bike for 40 min and only had minimal pain at the beginning of my cycling session. My knee flexion doubled from Saturday! (both the PT and I are ecstatic about this). Overall, I am heading in the right direction. I can't wait to test out my hip once my ROM restrictions are lifted.

Friday, January 13, 2012

1 full week post-op

**Note: I have included a pic of my hip @ 1 week PO. It may be a bit much for some, so only scroll down all the way if you wish

Today is POD7 and I am still chuggin' along. I am still doing PT a lot. Although I am not having two sessions of formal PT each day, I am doing as much as I was in Vail. My PT has been absolutely amazing. I love him! He hasn't been charging me and has been spending massive amounts of time with me. In fact, today, he came in on his day off just to treat me. He is doing everything exactly as it was at the PT in the hospital/clinic. I worked with him after my last surgery this past summer and we really bonded, but it was different than it is now. I feel like he gets me and my body, he knows when to push me, even when writhing in pain, and he knows when to stop and when I need a break. I am truly blessed to have found him and look forward to rehabbing this hip properly with him during these next several weeks. It looks like I keep doing these same exercises for the next 2 weeks; which is fine by me (I can't imagine pushing myself more than I currently am).

My pain levels are pretty controlled. I take narcotics/muscle relaxants at night and just an anti-inflammatory during the day. I took off my scopolamine patch last night and I can now see straight! Oh brilliant! The patch really helped with the nausea, but it made my memory fuzzy and gave me blurry vision. The vision thing was crazy weird; I could barely read my iPhone at all. But it has resolved so, now I can text properly. lol I my whole leg has now decided to turn blue every time I stand up due to pooling of blood. I kinda figured this was going to happen as it did my previous surgery, but it still isn't something I wish I had right now. Plus, from the traction, my calf/foot are freezing all of the time. It should return to normal soon. The only real painful this is my femoral nerve has decided to ultimately freak out. My rectus femoris is insanely sore, not stiff, but sore. It feels like my quads are ripping in half with the slightest bend of my knee. It makes my eyes sweat when getting in and out of the car for PT. I have it taped now and it has helped maybe 3%, but I really would appreciate it if it would calm down. The lateral femoral cutaneous nerve (not completely healed from the last surgery) also has my lateral thigh super hypersenstive. I think that my swelling has decreased a little bit, but as the blood rushes to the area as I stand up, it still feels like my hip is going to explode. But, I plan on all of these symptoms to last for only a little while longer as I plan on forcing myself to heal quickly :P

Also, my insurance company has informed me that they denied my request to have my CPM machine covered. Ugh! One more headache with which to deal. I now have a letter from my surgeon stating the medical necessity of this machine and the physiological mechanism by which the machine induces healing and reduces fibroarthrosis, plus I have a sheet to fill out for the appeal. It wouldn't be the end of the world if I didn't get it covered, but still, it is extremely common to use post-hip arthroscopy and my insurance company is now stating that it is only useful in knee surgeries. Frustrating. So a few prayers for this appeal to go in my favour would be appreciated.

Thursday, January 12, 2012

Pre-Op / Surgery

So I thought that it would be appropriate to detail my pre-op experience. It was, for lack of a better term, taxing. My goodness. It all started off with an MRI (not an arthrogram) at 8:45am, then I went to the clinic and saw Dr. P's fellow. He was extremely thorough. He moved my hip into various positions and commented on how unstable my hip was. To be honest, I didn't think that it was that unstable since my ROM was so limited, but it was moving all over (hence the rapid decline in function/ROM and increase in pain since the summer). The fellow also asked me to show him the movement of my fingers, elbows, knees, shoulders. As he did these things he asked me about symptoms of my other joints and he said that I most definitely have hypermobility syndrome. Although I kinda figured that, it was almost freaky how everything he asked, I had.

I then had my strength/ROM/functional testing performed by various physical therapists and athletic therapists. As expected, I was weak on my left side, very limited ROM, and the functional testing....well, I def failed that test since I couldn't do have of the exercises due to pain/lack of ROM.

We then had to get the prescriptions filled, register at admissions, get a pregnancy test, and then was allowed to have a little snack. Then we went back to the clinic to meet the man himself. Well, in all reality, it was a 4 minute encounter with the doc, during which we only talked about my figure skating. Although he did to a hip exam (not as thorough as the fellow) and asked me to walk up and down the hallway a couple of times to assess my sweet antalgic gait! He then proceeded to say that I was going to have a reconstruction. I didn't have any questions since the fellow had explained everything so well (even with pictures). I think that if I knew that was going to be the last encounter with Dr. P for the entirety of my trip to Vail, I think I would have asked more questions. Well, that statement isn't entirely true as he came in at 2am as my pain was not controlled since the epidural decided not to work. As well, I saw him the morning after, but both times I was a high as a kite and literally don't remember anything he said except that he wished my Mum was there (during the morning encounter). Sigh. I suppose I went there for his surgical skills and not a cuddly personality.

We then went to Walmart to gather up some fruits and veggies, and other healthier snacks for the remainder of our trip. We also decided to drive up a mountain towards the highest car pass in North America. Although we didn't make it all the way up because the sun was setting, but, my goodness, MAGNIFICENT is the only word to describe how beautiful it was. We drove up the side of the mountain where, right next to the road was thousands of feet immediate drop. It was amazing and was the highlight of the entire trip (minus the little surgery I It was breathtaking to look at God's creation and see something so beautiful that only He could have made; I am very thankful that I had the opportunity to see such beautiful landscape. After, we headed to the hotel room to eat and then head to bed for the big day.

Surgery Day:
I was to check in at 8:00 am. I was then immediately hooked up to IV and put into those lovely gowns, then I proceeded to wait for hours and hours. Apparently the case before me turned into a very complicated. I later found out that the graft that they took from the IT band on the patient wasn't large enough to cover the deficient labrum, poor guy/ When my turn finally came the anesthesiologist gave me some Versed and they then proceeded to bring me back to the OR. There, they gave me more Versed as they did the epidural. They used a C-arm and set the epidural fluoroscopically. It wasn't horrible at all and they all were very nice at explaining everything that was going on. After the epidural was in place, they laid me back and then gave me some Propofol and then, whooosh, asleep.

The surgery took 6.5 hours and they did a number of procedures. It ended up I had CAM/Pincer impingement removal, synovectomy, labral repair, labral debridement, labral graft from my IT band, psoas release, ligamentum teres debridement, capsular plication. I think that is everything, but I'll have to double check later on (still on some drugs to help with the muscle cramping and they make me mentally dull). Total I was in traction for just under 3 hours (which is a lot compared to all of my previous surgeries were about 50-60 min of traction). The team was very happy how the surgery went and believe that I'll have a good outcome.

I really don't remember much after the surgery. In fact, I don't remember even trying to wake up! All I remember is somebody telling me that I still needed the oxygen on (apparently I was NOT happy to have the O2 on). After the PACU, I was brought up to my room. This is when the fun started. They asked me about pain, and I was in horrible pain. After a bit, they tested my sensation to see if my epidural was in tact, well, I had sensation everywhere on my body. The nurses kept testing all over my body and I could feel everything. Apparently the epidural did not work at all. At this point they decided to switch to IV pain meds. They kept up with giving me the IV pain meds, but they were concerned since I was supposed to have pain control from the epidural. This hullabaloo ended up with the fellow in my room about 1:00am, Dr. P in my room about 2:00 am, and then anesthesia in my room shortly after trying to decide what to do with the epidural (or lack there of). To make matters worse, apparently the hospital had a shortage of valium (which would have helped me sleep). Apparently they gave me something to finally settle down the pain and I slept in a drug-induced state for a couple of hours until the fellow and Dr. P rounded on me in the morning. I remember them coming in in the morning but I have no idea what they said :( This makes me sad since this is when they talked about my surgery and how it went. And my Mum wasn't there to hear the details either. So basically nobody told us how the surgery actually went since I was incoherent at the time. I assume that I would have heard if there were some issues pertaining to the success of the surgery.

After I was all dressed and 'awake' I was brought down to PT where I rode the bike for 20 min, had a session, slept on the PT bed for a couple of hours, rode the bike for another 20 min, then had another session of PT. Funny thing, I don't remember 95% of this day either. After the long day, I headed back to my hotel room where I slept again.

So that concludes my surgery/hospital adventure. The remainder of my trip was focused on PT and CPM machine.

Monday, January 9, 2012

I now have a labrum woot woot!

So I am finally done my time here in Vail and will be flying home tomorrow morning to convalesce in the comfort of my own home instead of a hotel room. I can now say that I have a labrum on my right hip, along with many other fixes. I plan on giving more thorough updates with more details from pre-op through, surgery, and immediate post-op days, but I will do this once I get home and a little more coherent.

I will say that the surgery was a success though. It ended up taking 6.5 hours to do everything that needed to be done, but I got: CAM and pincer impingement removal, femoral chondroplasty, femoral osteoplasty, labral repair/debridement, labral graft from IT band, psoas release, ligamentum teres debridement, synovectomy. I feel pretty good considering I had all of this done, I just can't tell much difference yet since I am still pretty swollen .

Well, I will update again in more detail later. But I am alive and I have a new labrum and very cleaned up hip!! :)

Monday, January 2, 2012

Let's GO!!!

I am all packed and ready to go to the land where mountains grow and hips are fixed. Everything has fallen into place very nicely and am thrilled to get the chance to be fixed by one of the best surgeons in the world. Although very expensive, it will be worth it if it is the last hip surgery I'll have to have for a very long time; maybe even forever! It will be absolutely wonderful to be given the chance to live life with less pain. Even if I am not totally pain free, if I can manage it and be better than I currently am, it will have been a success.

I go through waves of nervousness but, in the end, I am so thankful that this is happening. And happening so quickly too. I know that most people have to wait months and months to get in, and I only had to wait 2 months for surgery. I thank the Lord for this opportunity.

My brother and Mum are coming with me out to Vail. It should be good company to have them both there, plus it will be a great help. I am fairly useless after surgery, so the help will be much appreciated. We are staying in a hotel that is 6 minutes away from the hospital; nice and close/convenient.

Despite being nervous, I am excited. Excited to get fixed, plus...I get to see a mountain for the first time EVER! :)