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Saturday, February 25, 2012

Survival of the Fittest

I have survived my first week back to my rotations. To say the least, it was difficult. I hated having to explain why I was using crutches to everybody I saw. Ah well, at least I am spreading the word that even young people can have bad hips!

Each day this past week I basically collapsed on the couch wh
en I got home from work and didn't move until I went to bed at 9:30pm, only to do it again the next day. I managed to get through it though. I tend to fade after noon hour lecture, but I try my best to keep up. We never take the stairs, and I sometimes am allowed to sit and look up lab values while the fellow and the other medical student go see patients. It is quite tiring and not fun at all. But, a sight to behold:

On another note, I realized that I hadn't posted pictures from inside my hip during surgery, I got 5 pages of them. It is difficult to determine what is what since they look like planets, but nonetheless, they are cool to look at.

Ligamentum teres hypertrophy

Top left shows my hip capusle directly attached to the acetabulum; no labrum

No labrum --> labral graft

Checking bone shaving
Bottom right: PRP injection into graft site

Tuesday, February 21, 2012

Returning to School is NOT Fun @ All!!!

Phew. That is all I have to say. Today I suffered through a 10 hours of crutching around the hospital. This was after crutching for 7 hours yesterday. Horrible is all I have to say. Nobody should ever have to do this and I wouldn't wish this upon anybody. It is not fun and leaves me sore and tired. I left the hospital today and cried in my car from pure exhaustion.

I was fine, both yesterday and today, until about 2:00 pm, then things just went downhill; especially today. I was rounding with the GI fellow and had almost zoned out completely. I tried so hard to concentrate, but it was just not possible. I found my mind wandering. In fact, I sat there wondering why the heck I chose to study medicine! A thought that had never crossed my mind while out on a rotation. I wondered how the heck I was ever going to get through this, how will I ever have enough energy to give to the profession, to my patients? I hated being there today. To be completely honest though, what I hated more was that these thoughts had crossed my mind.

It was around 5:00pm, I had presented my patients to my attending, and the fellow asked me how I was doing. I almost burst into tears (clearly I was struggling). She told me that I could go home, she felt sorry for me sitting there trying to keep up with everything. I hate having to leave early all of the time! It makes me feel like a slacker and doesn't exactly give the attending a great impression of my work ethic. I have no choice these days, I must leave so that I can move the next day to come in and do it all again. Luckily (or unluckily) I have to leave at 3:30pm tomorrow since I have a dentist appointment to get a filling fixed (yes, my teeth are falling apart too!).

Frankly, I don't know how I am going to do this. This is definitely a low point during this recovery process. I know I'll get stronger and be able to last longer, but it doesn't make crutching around all day any easier.

Sunday, February 19, 2012

45 Days Post Op and Returning Back

Today is my last day of my medical leave of absence and tomorrow marks the day that I return back to school and continue on with my medical education. I am surprisingly excited to get learning again and start to assimilate myself back into society. It will be mentally and emotionally good for me to get out of the house and function in a social situation again. I also happy that I am able to return back to something I love.

The only problem I have is physical. Will I be able to function? I plan on returning on crutches as I will be putting in very long days. My friend just finished the rotation that I am about to start and she was doing 12 hour days. I will simply not be able to handle that. I am praying that the attending doctor will be understanding and perhaps will allow me to leave a little bit early so as to build my strength up. I will have to feel him out and see how much I can ask for. I haven't had any trouble up to now as each time my attending saw I was limping before my surgery he/she told me to go home. At the time the pain was manageable if I sat a lot. But, I assume crutches will be more tiring and I am still much more sore than pre-op.

I am beginning to worry about the rest of my body too. My other hip has a nagging deep groin ache that is all too familiar to me. I hope and pray that it is simply compensation and will shortly go away once I have rehabbed my left side. Also, my back has been really hurting me. I am stiff in the morning and really hurt at night. It hurts to flex and extend now. Yesterday I swore that I was going to ask for an injection or something since it hurt so much. I hope this too settles down. In addition to be low back pain, my epidural site is still quite sore. It didn't hurt me until 4 weeks post op and now it hurts to touch and extend. Very weird. So, the list of questions to ask at my follow up in three weeks keeps growing.

Well, that's be update. Here goes nothing!!! I'll certainly be quite the sight: scrubs, white coat, and crutches. Sigh.

Thursday, February 16, 2012

3 Days Left

I only have 3 days left of my medical leave. I got a letter from my surgeon's office stating that I am medically clear to take care of patients and resume my medical education (little do they know I am still on crutches!) I have no choice but to work up to being back on my rotations for school. I return to a service that is expecting me to do 12 hours! This is next to impossible for me at this time. To be quite honest, I don't even know how I am going to do a couple of hours. Crutching around all day is going to be exhausting and I'll need a couple of prayers to help me make it through. I hope that the doctor with whom I am working is understanding of my situation and will allow me to sit when I can, perhaps leave when I absolutely need to, etc., etc. Thinking about having to work all day and see patients is a bit worrisome, my stomach hurts thinking about having to crutch around the hospital all day.

I wonder how my body will hold up. Not only is my surgical leg sore, I have developed groin pain on the opposite side (which I am praying is simply compensatory pain), as well, my back is sore and I tend to dislocate my shoulders and clavicles while on my crutches. This has lead to extreme shoulder pain as of late. How will they hold up to the rigors of being on crutches all day?! My back hurts to just breathe right now, so I am hoping this settles in the next couple of days as well. Having everything hurt will not be entirely conducive to learning much while on my rotation. I wish there was a pill to take that would remove my pain and allow me to keep a clear head. Unfortunately, I can't take narcotics while taking care of people in the hospital, so I'll be limited to Aleve and Tylenol. If anybody has any advice or extra hints on what might help me to survive please let me know. Thx!

Tuesday, February 14, 2012

Some Pictures


Even though I don't have a Valentine, making these cookies made
for a delightful afternoon of fun. Even though you can't really tell on the left side,
but the icing colour graduated from white to pink to red.


Gracie always keeping me company despite the constant motion of the CPM machine


My beloved CPM machine, I wMas sad to see you go and miss you desperately.


Still the only way to get a decent night sleep: to strap my feet and knees together. I still wake up every time I move, but at least this prevents me from moving every 5 minutes all night long.


More pictures to come ;)

Wednesday, February 8, 2012

34 Days Post-Op

I am 34 days post-op, not that I am counting or anything! hehehe.

I am really learning a lot about myself during this recovery. The greatest thing that I have learned is patience. I have been dealing with hip pain since 2006 and, although I've been through many surgeries, this time around is much different. I need to patiently await for my hip to heal on its own schedule; not mine. I had several procedures done during the 6.5 hour operation, I need to allow my body time to heal from the insult, even if it means remaining on crutches for a more lengthy period of time. Even if it means crutching around the hospital once I return to school. Even if it means hours and hours of physiotherapy. Even if it means not going out with friends. Patience in all of these facets of life will, hopefully, provide me with some success in reducing my pain.

Even a happy life cannot be without a measure of darkness, and the word happy would lose its meaning if it were not balanced by sadness. It is far better take things as they come along with patience and equanimity.
Carl Jung

Trust. I have, well, to be more accurate, I am trying at the moment to trust. Lately I have been battling trust. I need to trust my surgeon and the team helping me through this last surgery. I frequently find myself doubting the success of the surgery. Even at this early stages. In sane? It might sound as if I am paranoid. Here's the thing though, I have been through three previous surgeries with all of them leading to less than ideal results. I trusted these surgeons, and I didn't have success. Now, I am supposed to trust this surgeon? Not so easy. I keep telling myself that he is one of the best in the field, but it is still difficult for me to truly believe that success is highly likely.

If we really want to be full and generous in spirit, we have no choice but to trust at some level. -Rita Dove

Support. I have always loved my family from the bottom of my heart, but going through this has really brought out the steadfast love we have in my immediate family. Both my brothers and my parents have been absolutely amazing. Helping me in every way possible. Supporting me, encouraging me. It is incredible. God has given me a great support network. In addition, my fellow hip chicks have been great too. In fact, I have got more texts asking how I was after my surgery from these fellow hipsters than from my closest (non-hip) friends. It is incredible the love that is felt and the connection made between people who understand what it is like to do this. For everybody who texted, messaged, or even read this blog once, thank you!

"Let me tell you something you already know. The world ain't all sunshine and rainbows. It is a very mean and nasty place and it will beat you to your knees and keep you there permanently if you let it. You, me, or nobody is gonna hit as hard as life. But it ain't how hard you hit; it's about how hard you can get hit, and keep moving forward. How much you can take, and keep moving forward. That's how winning is done. Now, if you know what you're worth, then go out and get what you're worth. But you gotta be willing to take the hit, and not pointing fingers saying you ain't where you are because of him, or her, or anybody. Cowards do that and that ain't you. You're better than that!"
- Movie Quote from 'Rocky Balboa'

Saturday, February 4, 2012

4 weeks Post Op

I actually missed the date, but two days ago, I was four weeks post of from my fourth, and hopefully final, hip scope. This scope has been much harder to get my feet underneath me, so to speak, compared to all of the others. I had expected for this recovery to be tougher though, my hip was in worse condition and I had a lot more done. Previously I had only had impingement removal, debridement, or attempted repair of the labrum, as well, I have never been in traction for more than an hour. This time, I was in traction for just shy of 3 hours. This has made a big difference on the nerves; they are still very angry but slowly improving.

Right now I feel like I can pretty much take care of myself. I am still on crutches and should be almost done with them. I am 100% weight bearing but I have a limp and Trendelenburg gait, so I am on two crutches until I can get rid of them. I can get dressed all alone now, with the exception of my left sock (but I have needed help to put it on for the last several months, so no surprise there). I am finishing up my CPM machine and SCD usage and return them to the area rep on Monday. I certainly am goingt to miss my CPM machine; I sleep in it every night and it feels soooooo good to move the hip!!!!!!! My hip is all closed up now and I just have scabs on my incision and scope sites. Swelling is still a major issue, especially since I have been able to begin to put weight on it. This is also what I expected; I just got rid of my pooch of swelling from my previous surgery and it is back with a vengence. Hence, I continue to ice.

I don't take anything put Aleve during the day and at night I take a muscle relaxant as the muscle spasms are rearing their evil face these days. But, on a more positive note, I am definitely getting stronger and look forward to starting to walk unaided. My ROM is still quite limited and my flexion is still about 90* at which point I get a groin pinch. I emailed the surgeon and his athletic therapist said that if we strengthen the glutes and once they get firing it should alleviate the pinch.

All in all, things are slowly getting better. I am getting stronger and hopefully this surgery will be a success!

Wednesday, February 1, 2012

Stir Crazy

I suppose that it is a good thing that I have become stir crazy as it definitely means that things are getting better and I am having enough energy to become stir crazy. This although, does not mean that I have to like being cooped up in my living room all day. I don't leave the house except to go to PT three times a week. This is in stark contrast to my overly busy days working in the hospital and never being home except to eat supper and sleep.

Yesterday I got so annoyed at just everything. I still need help getting into the shower on my shower chair. The darn hip flexors are still half sleeping! I still can't carry anything because I am on two crutches. So, I basically had to wait until my Mum was done work at 3:00pm before I could shower, get changed into real clothes, and eat a full meal. My Dad leaves breakfast out for me in the morning, but waiting until 3:00pm is a bit long.

My parents have been absolute saints in helping me after this (and every other) surgery. They never complain or make me feel bad; they are wonderful. Although, me being home all of the time and not getting a lot of visitors means that the only people I see in a day is my parents. Please don't get me wrong, I absolutely love my parents, in fact my Mum is my best friend, but I do feel a bit smothered and annoyed with them at times. I shouldn't feel like this, but I am just not used to being around them all of the time. It isn't healthy.

So tomorrow marks the month mark for my surgery. Pretty in sane how quickly it came and went! I've been emailing my surgeon's assistant pictures of my hip for the past couple of days since I had an infection. They said that it is looking great! The only thing is that the incision scar is quite open. They asked when the steri strips came off. They were removed at two weeks just prior to my reinforcing stitch removal. At this time though, the incision did split open, so now my scar is going to be huge. It is about 10cm long and maybe 5 mm wide. It has some depth to it too. I don't mind having a larger scar though, I enjoy my battle wounds. I just don't want the area to be exceptionally weak. We've been exchanging emails though, so I would assume that they would be getting back to me as I had to explain to them about my steri strip removal.