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Friday, June 20, 2014

16 Weeks Post Op

I am amazed that I have kept this weekly update thing up for so long.  I guess I'm just not busy enough.  That will come starting next week.  I start orientation in 6 days and then start working July 1st.  I'm extremely nervous for this on so many different levels.  I'm worried I don't know enough Internal Medicine to actually function as an intern physician (I hope I have an understanding team), and then physically I am also worried (my right hip hurts and I have yet to use my left hip for any significant period of time). 

On the hip front, things are going well.  I resumed physical therapy this week and have been working on the adductors.  They just don't want to work in the middle of the muscles (distally and proximally they are ok, but middle, they don't contract).  We've been the using muscle stimulator during my ball squeezes and leg slides to try and get it contracting properly.  This is something I need to ask my surgeon about at my upcoming appointment.  I have also been able to use the elliptical in addition to the bike at PT.  The left hip held up nicely, so I am thrilled about that since before the LPAO, there is no way that I would have been able to do the elliptical due to pain.  I'm hoping this LPAO was a success, without having used my hip all day, it's hard to tell, but it looks promising.

The right side is, well.....the right side.  It's yet to be fixed properly, so I will be eager to hear how soon my surgeon will want to operate.  I'm game for anytime, so long as my residency is cooperative with my surgical plans (they said they would be, but I've learned to not take anybody's word until I actually see it happen).  I know that the surgical scheduling lady at my surgeon's office said that due to my situation, they could have me in an OR within two weeks of the surgeon deciding to operate.  Last appointment my surgeon said that there was a 50% chance he would do it in July, and my PT thinks I'm ready for it.  Needless to say, I do have my hopes up to get this surgery done and out of my life.  But, ultimately, my surgeon makes the call, he is the expert and knows when it is safe to do the other PAO. 

Sunday, June 15, 2014

15 Weeks Post Op

Even though I'm a few days past, I'll still consider this my 15 week update.  It's almost four months!!! I can't believe has flown by yet dragged at the same time.  Generally speaking my PAO'd side is doing well.  It definitely gets tired, but it holds its own.  I had over done it on the PT exercises this past week and took a few days to recover from that.  But, at 14.5 weeks post op I tried: walking for 20 min, biking with resistance for 20 min, then 1.5 hours of exercises.  Not brilliant.  So after three days of recovery, I then had my graduation party which involved me standing and walking around for several hours.  I sat when I could, but with the number of people at my party, I had to socialize and walk around my yard from 4:30 until 10:00pm (which was after helping with decorating, cooking, etc).  So I now need to recover from that. 

Overall, my right side is not doing well.  It hurts a lot and I don't see how I'll be able to work disgusting hours with a right hip that is as sore as it currently is.  D-day is next Monday.  My surgeon will see if he feels I am ready for my next PAO.  What gets me is that my general energy is still not normal.  I realize I had my pelvis broken, but I also feel like any form of physical stamina has been sucked out of my body.  And this is still at almost four months out.  I can't imagine how long it will take to get my umph back if I go back to the OR in July.  Ha.  And I can't believe that I'm begging to do it again.  Call me crazy, but desperate times call for desperate measures. 

My work authorization should be here tomorrow, which will be awesome because then I'll be able to head back to PT hopefully this week, get my medications (I've completely stopped my Neurontin and birth control pills bc I can't get to the US to pick my scripts up).  So, if my card arrives tomorrow, I'll be heading over to CVS ASAP to pick my meds up and hopefully get a PT appointment in.

Saturday, June 7, 2014

Milestones for LPAO

Surgery:  February 28, 2014
Post Op Day 1:  walk few steps, sit up in bed
Post Op Day 2:  walk 15 feet
Post Op Day 3:  walk 30 feet, 5 stairs, discharged from hospital
2.5 Weeks Post Op: Decrease pain meds from Norco 10mg to Norco 7.4
2.5 Weeks Post Op:  Begin riding upright stationary bike 10 minutes, no resistance
3.5 Weeks Post Op: Stop taking narcotics around the clock, only at night
7.5 Weeks Post Op: Cleared to walk without crutches, instructed one week full weight bearing two crutches, then one week full weight bearing one crutch, then completely off as tolerated
8 Weeks Post Op:  Begin formal physical therapy
11 Weeks Post Op:  Completely off two crutches, no limping
12 Weeks Post Op:  Move to my bedroom upstairs
13 Weeks Post Op:  Can appreciate the stability in the joint, pain better than pre-op

Friday, June 6, 2014

14 Weeks Post Op

This last week has been relatively plateaued.  I can't say I've made any significant gains or losses.  So, I guess that is good.  Everybody keeps asking me how it feels, did the surgery work.  And I know it did, but as far as the amount of pain relief I am actually going to get, that will be determined when I am back on my feet all day working in the hospital.  Right now I am not doing much of anything on my feet.  I know my surgeon isn't telling me exactly how much pain relief I can expect, he is very cautious in giving me any sort of promise, especially since he operated and saw the inside of my hip.  The best we can do is hope and pray that the left hip survives the next couple years.  It would be amazing to get through residency with my own two hips!!

I see my surgeon in two weeks (hopefully, as long as my immigration stuff to work in the US comes through in time....long story of major stress).  It will be interesting to see what he thinks of my healing and when he thinks I could handle another PAO on the opposite side.  I truly think that my left side could hold me up, even if it was tomorrow.  I don't think that the left hip would be happy, but it quite possibly could be possible in another month or so.  I'm keeping my fingers and toes crossed.  Having said this, if he didn't feel that I was strong enough, I most definitely won't go ahead with something that is unsafe.  But leaving the surgery until December (the timing my residency wants me to have surgery) is seeming more and more unrealistic.  Unrealistic in the fact that it would be unrealistic to work until then without being completely miserable.  I did the entirety of my fourth year of medical school with one (which turned into two) very sore hips, I was, in fact, horribly miserable, and if July isn't going to work, then we have to swing something sooner because life is too short to limp around and miss out on activities because of hip pain. All of these scheduling possibilities are simply ramblings of my thoughts, what it actually comes down to is when my surgeon feels I am ready to have the surgery, which will be determined next appointment.

So I've been doing some reading on femoral/acetabular version since receiving my MRA report.  I have 6 degrees of femoral anteversion which means that I am actually retroverted.  Now, femoral version issues have never come up in any conversation with any surgeon in the past, nor with my present surgeon.  After some reading, I have learned that my measurements put me into the severe category.  Mind you, my acetabular version could offset the femoral version abnormality, so that it may not have stability ramifications, but this is definitely something that I need to bring up my next appointment, because if this needs to be fixed, I want it fixed during my PAO.  We haven't discussed what my right hip is doing other than the fact that we have established that it is painful, it won't get better without surgery, and it has dysplasia.  Again, next appointment will hopefully clarify what the surgical plan is for this right hip.


I have had quite a bit of free time lately and had a look back at my old blog posts.  All of my previous surgeries have been documented here (not my first one, though I wish I had that one on here).  It made my heart sink.  Every single surgery I was so optimistic that that surgery was going to work, it was going to take away my pain and be my last surgery.  I refuse to now say that this one is going to be the last surgery.  Not only has it been false in the past, I don't believe that it will actually ever end, there will always be the possibility of another surgery until my hips are replaced.  My hips are essentially THR ticking time bombs.  And the day I get my new hips, then will be able to relax and stop worrying about surgeries.  It sounds pessimistic, but I can't help myself, after 7 hip surgeries, one becomes jaded and skeptical to believe that they could actually be done with regular surgeries.