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. 

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 it...it 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.

9 Weeks Post Op

Yesterday marked my nine week post op from my left periacetabular osteotomy.  I can't say that I'm so thankful that I have done it yet as I am still too fresh out of surgery to be able to consider it a success.  I do know that my good ol' hip pain, deep ache, and catching is less pronounced than it was prior to surgery.  But this has been replaced with generalized achiness all over the pelvis.  My pubic symphysis has gone mad on me as it still hurts to touch lightly.  All this said, the hip is definitely more stable and I don't have the fear of it sliding/clunking around (although this only happened occasionally pre-op). 

The nerve pain continues.  I am still completely numb laterally but this doesn't hurt, its the medial/proximal thigh up into my crotch that really hurts.  I'm still taking Neurontin 200mg QHS but it might as well be a sleep aid and nothing else as it does help me fall asleep but it does not help with the nerve pain.  I intend on calling the surgeon in a week or so to increase my dosage.  You know what I really need is a primary care doctor!  That way I could eliminate the need for my orthopedic surgeon to write me scripts.  I will definitely do this, but the timing isn't great as I need to find one close to my hospital and I don't know that area very well, nor do I know who is good out there. 

As far as my function goes these days, it is slowly (SLOWLY) getting better.  I am still on one crutch almost all of the time inside the house.  Although I do manage to hobble around to cook myself my meals and when I need to carry light things I am able to do so without any crutches - it is just very trendelenburg in nature.  I can't say that it is only weakness nor only pain that requires me to use the one crutch because sometimes it doesn't hurt to place weight on my hip and it is just muscle weakness, while other times it downright hurts to put weight on my hip.  When I wake up in the morning, it hurts to put any weight on it for approximately an hour and then things settle down.  I am also showering without a shower chair (started last week!) and basically am completely independent.  I am still sleeping in the spare bedroom because my room is up 14 steep stairs and the fact that I am so sleepy due to meds in the middle of the night and still on crutches, it is just safer to remain in the spare bedroom.  It's a comfy bed and I don't mind it at all.  We still have yet to remove my own bed from the living room.  That was a Godsend post op, the bed in the living room, but I don't need it anymore and I've just been using it at night to watch TV, but only because it is there, not because I need it--the couch will do perfectly fine.

I can't wait to get back to a routine.  I have nothing to do all day and basically lounge around, watch Dexter, make earrings, answer emails, do paperwork.  Fairly boring, but this will all change once I start work July 1st.  Things will start to pick up starting next week. I received a lovely script in the mail yesterday for an arthrogram and MRI on my right hip, so I have that scheduled for Friday of this upcoming week.  Then on Monday have another doctor's appointment, followed by a physical/drug test/TB test at the hospital on Tuesday.  All of this plus PT on Monday and Wednesdays. 

Speaking of PT, I had another therapist on Thursday.  Well, actually, I just worked with the ATC.  It was helpful but I didn't feel as comfortable with her knowledge (she didn't realize the surgery I had nor had no idea that I actually kinda knew what I was talking about).  So, I will remain with the PT/ATC that I originally began with last week and go just two times.  I can totally do the home exercises and plus, I'll save some money!!

First Physical Therapy Sesh

Yesterday was my first session with my physical therapist (and her athletic therapist).  It was, overall, painful.  I really think that they got muscles that haven't been used in like two months.  We worked mostly on the hip flexors, adductors, glutes, quads.  Although I could only do three separate exercises because I got one of those amazing (not) sympathetic responses from a) trying so hard and b) pain.  It just kinda hit me and I got all sweaty, clammy, lightheaded, etc.  It was not fun.  So we decided that three exercises would be enough.  The PT adjusted my pelvis a bit as well since my pubic symphysis is like super tender to touch and crooked. 

I showed her my xrays on my phone and she said that it's no wonder my pubic symphysis hurts bc it's all arthritic.  Well...I knew it was sore to touch and it looks all jacked up on the xray....so, yeah...obviously it's gonna be crappy.  But she is going to work on leveling the pelvis out a bit too.  I appreciate her outlook:  she isn't focused on just my hips, but also my pelvis, and core.

I haven't worked with an athletic therapist in conjunction with my physical therapist on a regular basis, but it seems as if the ATC helps with the exercises and the physical therapist helps with the manual stuff.  I'm not sure how I feel about this, as I can do the exercises at home (once they show me what to do).  We will see how this works out.  I am going three days a week for the first couple of weeks, and then we will see how much I need.  I have unlimited PT visits with 10% co-insurance for a medically necessary condition.  So that is in my favour! :)

Me having such a response yesterday to the few exercises we did, they told me to anticipate being really sore.  Last night after therapy, I was beat!  I had to have a bath to wash all the sweat off since I was so scuzzy.  And then did end up taking a Norco (first one in weeks).  It helped things and I actually slept all night without waking up hurting (yay for pain pills when you need them)  I have PT today, but was told that if I woke up hurting a lot that I could call and cancel if going to PT was not going to be worth it.  So today, I am not too terribly sore.  The hip flexors and adductors feel like they've run a marathon, and my other hip hurts a lot, but overall, it's not too bad.  So I guess I should go to PT today.  Maybe they can stretch me out and release some muscles?! That would be amazing!

PT Assessment

Yesterday I had my first PT sesh.  It really wasn't a full treatment or anything since she did an assessment.  She seemed like she kinda knew what she was talking about.  I'll have a better idea after we start working together.  We are planning to do three times a week in order to maximize my recovery and get strong enough to have a fighting chance to be strong enough to get the right hip done end of July.

I have a lot of work to do:  my adductor and hip flexor strength is only 1/5 and my extension is zero degrees.  A lot of this is expected since they did essentially break my pelvis, inserted four screws, and I've been walking with crutches for two months. 

Speaking of crutches, I want off of them!  I can do one crutch alright, but very slowly, and when I'm tired it hurts too much.  If I could have one wish right now, it would be to not need crutches to walk :)

8 Weeks Post Op

Two whole months!  Dang.  I want this recovery to keep a rolling on :)

I am feeling pretty well these days.  I had my second post op appointment this week.  Things look good.  I had an xray of my left hip and there is enough bone there to begin to weight bear but my muscles are not strong enough to walk properly.  My surgeon had me take a few steps without the crutches to prove his point that I need to get my muscles back.  After my appointment I was allowed to put full weight on my hip with two crutches.  I am to do this for a week and then graduate to one crutch for as long as it takes me to walk without a limp.  I can easily do one crutch already, so I do that in the house, but when I am out, I still use two crutches at the moment.  Monday, I plan on not needing two anymore, but I am to just listen to my body and go from there.

The remainder of my appointment went well.  He started me on Neurontin for the nerve pain.  Albeit, a VERY small dosage, so I am not sure that I will see any benefits from it, but I'll keep taking it and see.  The burning proximal, medial thigh is less than cool!  Speaking of nerves, my LFCN is still dead.  Absolutely no feeling.  No change or improvement either.  Ok, back to the appointment.  He tested my muscle strength and it seems it is all good except my adductors are almost non-existent.  He asked me if I had been doing my adductor squeezes (uh, yeah, I have been, too bad it doesn't show).  We then discussed my right hip and agreed that it must be done.  I explained how I wanted to do it before August first as it would save me a lot of money in insurance, but he said that it would be cutting it pretty close and that there would be like a 50/50 chance I could do it at the end of July.  The other option is doing it in December since it would be slower in the hospital and my absence would be less of a burden on my resident team.  I really hope that it can be done in July.  Hobbling around for another half year would suck.  He said that we would decide when I see him next near the end of June.  If he decides that I am strong enough, we can do surgery near the end of July, if not, then I must wait until December. Fingers and toes crossed I get my muscles into gear and get strong enough by end of June!!!!!

I am now cleared to do PT as well.  I had to call up several places to see if they were familiar with hips and PAOs.  I called two places and one place seemed confused on what I wanted and didn't make me feel like they knew what they were talking about, so I ended up going with the second place I called.  I made a huge ordeal about needing somebody who knew what they were doing.  So I got the head PT at this place.  I start on Monday with an evaluation.  And then will schedule appointments from there.  The script says 2-3 times per week for 4-6 weeks.  I will do whatever it takes to get strong enough to have my other hip done so that these major surgeries are out of my life!! I am actually excited to begin physical therapy!  Until I get my butt in to see the PT on Monday, I have been trying to slowly start strengthening my hip, butt, and core muscles.  But having a professional opinion and guidance will be helpful as well. 

As far as mobility goes, I am doing alright.  I am able to easily use one crutch and can hobble along without anything as well.  The first day cleared to weight bear, I was able to walk fairly well with just a small limp, but since I have been trying to activate more muscles, they have become very sore, and I now have a sweet Trendeleburg gait going on.  It's kinda pulling on my SI joints and lower back when I do walk without assistance, so I best be careful. 

And, last but not least, I definitely forgot to ask my surgeon during my appointment if I needed an MRI/arthrogram for my right hip.  I only wanted to know now because I would prefer to have it done prior to beginning work.  So I emailed his nurse and asked to see if she could find out anything.  I feel bad for bugging them so much, but I really do want to know.  It would make life so much easier to get it over and done with when I am off, instead of trying to schedule it when I am working at my new job. 

Patience, Patience

I try, I really do, to be patient.  The surgeon says I need time...so here's to time healing all wounds!  I continue to plug through this hip journey.  Regardless how I feel, I am trying to remain positive and have things to look forward to that are not, in any way, shape, or form, related to hips.  Although I basically detail my hip journey on these posts, I really try not to let my hips dictate my every thought and activity.  This is definitely easier said than done.  I truly believe that keeping a level head and forcing myself to do things that are not related to my health is extremely important.  I feel like it is so easy for a journey like this, chronic in nature, to become who we are, dictate everything we talk about and everything we think about.  We are more than our hips.  We are more than our pain.   I'm not minimizing the fact that bad hips (or any other chronic illness or that matter) really does dictate how we live our lives, but keeping things in perspective and remember that I am not completely my hips; they are only a part of who I am is essential.  I am a daughter, sister, friend, medical student.  I have been surviving my chronic pain for six years now, and over this time I have been in contact with some amazing people.  Having seen many perspectives on similar situations, it amazes me as to how people cope differently.  I know that everybody has to do what works for themselves, it is just interesting to me how people respond to health challenges.

I am currently trying to put the pieces together to return to school.  I am scheduled for rotations to start Feb. 18th and I am ecstatic about this.  I still have two required rotations:  Emergency Medicine and General Surgery in addition to two electives (of my choosing).  Since I have to do General Surgery before I do Emergency Medicine and because I cannot just hop back into rotations in my current stage of healing, I have asked to begin with an office rotation (most likely Family Medicine).  Although the details are still being worked out, I am pumped to start having a schedule and be moving forward with life.  Deep down inside, I am scared to see how my body will hold up because my left hip still throbs the majority of the day (especially if I do any sort of physical activity--cleaning, swimming).  God know what is in store for me and I completely trust what He is doing with my life.  Even when I am scared and sore, He is there for comfort and courage.  For that I am thankful.

Since I have been hurting more lately, I have been in contact with the head PT dude in Vail.  We have been talking, on average, once a week.  I am truly impressed because I feel that he truly cares about me feeling better.  We are adjusting exercises according to pain levels.  This and keeping in regular contact really help me feel like I am trying what I can to get this pain under control while gaining strength bilaterally.  I have been instructed to reduce my Naprosyn to only 220mg BID.  Ugh.  But, I have began something that I had read on Facebook:  Golden Milk created with turmeric paste.  At first I was leary:  turmeric paste, almond milk, sesame seed oil and honey.  I could barely gag it down for the first few days.  When I removed the honey and added a dash of cinnamon, it was muuuuuuch better.  So I drink a cup of milk with a heaping teaspoon of the paste.  It really isn't that bad and it is supposed to be anti-inflammatory in nature.  I'm not sure how much different I feel while drinking this every day.  But it is inexpensive and I am willing to try anything at this point in the game.  While speaking of foods, I am trying to eat more healthy too.  Not necessarily starving myself, but counting my calories so that I remain at my current weight.  Having a visual representation of the foods I eat really is an eye opening thing.  I must have been eating SO MUCH before I was recording my food/calories!  I'm surprised I'm not 200 pounds.

4 Weeks Before Surgery

Wow, time is flying by, and I want it to since I am extremely sick of staying at home with no real schedule.  I basically do nothing all day and attempt to study for a couple of hours each day (which may or may not actually happen).  Otherwise, I am simply putting in time to heal before the next surgery.  I dislike the fact that I am living surgery to surgery these days, but it is what needs to be done.

I am getting stronger on my left side and now feel confident that it will be able to hold me up after my right hip surgery.  I am actually really looking forward to getting my right side fixed up so that I can move on with life.  Having said this, I am worried too as I am physically and mentally exhausted and the thought of having another surgery makes my stomach flip.  This upcoming one will make it 4 surgeries in 14 months.  Something I wouldn't wish upon anybody.  I now have the peace of mind to know that I have an extremely reputable surgeon and have all my trust in him to fix these stupid hips!!!

At the moment I am trying to figure out my PCP pre-op appointment.  Apparently he is booked solid and they are having to 'slip me in' sometime next week.  All I need is for him to fill out three papers and order some labs.  Nothing much.  In fact, before the last surgery we didn't even fill any of this out because it happened so quickly!  All I had was blood work the day before surgery.  Having looked back on the past surgery and that experience, I am still amazed at the whirlwind it was.  One day I was attending medical school rotations and the next I was canceling everything have planning surgery for the next week.  Craziness!

The left hip is feeling pretty good, the flexion and extension pinch is still there but my ROM is not decreasing.  I am thankful for that.  I still bike everyday and do exercises every day and PT twice a week.  The left is still a bit finicky as far as the soft tissue goes, but, that is improving slowly.  My right side as the distinct groin ache and then, intermittent lateral troch pain and butt pain.  It sometimes catches when doing my exercises for my opposite hip and while rolling over/stretching in bed.  I definitely know that it having this surgery is needed, although it is not nearly as bad as my left was prior to the last two surgeries on it.  I hope that Dr. Philippon is pleased with the results of this surgery and the small little kinks can be worked out with time and, maybe, injections.  We will see in about a month.

I had a big weekend!  I went out of town with my family to visit my brother where we were outside for 6 hours sitting on picnic tables (which are very hard if you haven't ever thought about it) while we watched my mum skydive, then we walked around a Peach Fest and the next day we walked around Niagara Falls.  It was so incredibly tiring.  I mean, I am very glad I did it, but I am so exhausted I can barely do anything.  I haven't slept very well these past two nights either.  Which is due to me doing too much and then not being able to get comfortable in bed.  Totally my fault since I probably shouldn't have been walking around like that, but sometimes I feel like you just have to live. Go out and do things regardless on how much it hurts.  Because if you don't, you could be stuck in the house staring at walls all day living an extremely boring existence.  Speaking of doing things, I have a fellow hip friend coming to visit me for a week.  In fact, she is en route right now.  Her flight gets in later on today.  It will be fun to hang out with somebody who actually understands what life is like, especially having limited mobility.  I look forward to great times with her!!!

As far as insurance goes, we are still waiting on pre-authorization.  I pray that we get it or else that $10K down payment will have to be made, and I'd rather spare this if possible.  I am still trying to raise money for my medical bills.  As of now I have raised ~$600 (give or take a bit).  I am still praying to get a bit more as these medical bills are gonna be HUGE coming up.

Pre Op Day 52 & Pre Op Day 48

Sleeping is horrible.  Literally horrible.  I tend to lie there awake and then when I finally do fall asleep, I wake up every time I move.  This is partially due to my left but mostly due to my right, it is probably a good idea to continue to take my pain meds despite not wanting to keep taking them.  I am utterly exhausted.  My hamstring attachment and psoas are no better than they were on Saturday and it's really aggravating.  I am sure they will settle down, but it is so uncool as my right is so sore.

Walking has been pretty good.  The latest muscle strains make the left hurt to weight bear, but nothing that I can't handle.  And overall the joint feels good.  I have some groin pinching upon full extension still, but otherwise the left is managing.  My right is quite aggravated and feel that it won't get any better until Dr. P fixes the joint.

Today was the first time I didn't use a shower chair!  I was thoroughly proud of myself.  I even shaved my legs. Shaving the left leg is easier in that I can bend forward but...standing on the right leg for that long made the joint throbbing increase in intensity for an hour or so after the shower.  I'll have to focus on the positive aspect that I don't have to contort myself to shave the left leg as before I had to do so in order to prevent myself from getting hairy manly legs because the joint wouldn't move very much at all (the left hip was so tight that Dr. P said it was the tightest hip he's ever felt...I remember thinking...no kidding! It HURTS!)  I digress.

I am trucking along these days doing waaay more home PT exercises than I can handle.  I am wondering if I am doing too much?  I am going to speak with my PT today as we may be able to tailor the program to cut back on the number of things I do each day to reduce my pain levels.  We will see later on today.

Surgery #5: 7 Days Post-Op

So much has happened since I have posted last.  I had surgery on 6/16/2012 on my left hip.  It was a rollercoaster and a half trying to organize surgery in a week.  But it was done.  Here's the scoop:

We left Friday, the 15th, at 4:00am, and we arrived in Vail, CO around 11:00am and had an appointment for pre-op at noon.  I ended up seeing Dr. P's PA.  I did not have a problem with this since I had seen Dr. P the week before.  All we did was fill out paper work and sign consent forms and pick up prescriptions.  It was fairly harmless.  We then went to Wal-Mart and picked up food for the week.  We planned out so that we could eat in every single day so as to eat better and save money.  This worked out nicely.  Friday evening was fairly low key, we ate dinner outside on the patio with a fantastic view of the mountain.  I was truly able to take this time and enjoy the beautiful scenery which surrounded us.  Surprisingly, I was not very nervous.

View from our condo

We got up at 8:00am on Saturday and was to check in to Vail Valley Surgical Center at 9:30am. We did this and then had to wait for hours and hours.  I was scheduled to be in surgery at noon, but it didn't end up being until 2:00pm when I got rolled into the operating room.  My mum and myself simply watched I Love Lucy reruns.  It was stupid but definitely passed the time.  Nobody operates on Saturdays there, but apparently Dr. P had another case before myself.  Everybody was confused as to why he was operating on a weekend.  So we had three nurses helping me out pre-op, very personalized care!!  I had my hip scrubbed with chlorhexidine, which did NOT go over well when it made me itchy and they had to wash it off.  I hated making a big deal about it, but it had to come off or else I'd scratch myself raw.  I also had to have them find the smallest blood pressure cuff they could find since my pipes aren't exactly standard size.  No biggie though.  The fellow then came in and signed my hip and we were off.  They gave me some, as the anesthesiologist called "anti-crying medication" aka Versed prior to be entering the OR.  Then they made me sit up and get an epidural.  This was the most easiest epidural I've ever had.  The OR nurse, Penny, did an amazing job of distracting me by talking with me, plus the surgeon popped his head in during the epidural placement and chatted a bit.  I literally didn't feel the needle even go in.  I was extremely worried about it working as last time the epidural didn't work.  The sensation was checked all over and they said it was good to go.  Next thing I knew I was groggy and trying to wake up, somebody was asking me to wiggle my toes.  It was over.  And I was numb from the belly button down.  Woohoo!

 Me before surgery showing off my pipes.  They were so big they had to go and find the smallest blood pressure cuff 

After the surgery.  Snoozing away after the dry heaves and shakes wore off.  Gosh I hate those.

I have a terrible time waking up from anesthetic.  I had the dry heaves and terrible shakes for about three hours.  I always make a scene.  I thought of apologizing to the PACU nurse prior to me having surgery!  After the nausea and shakes were under control with vast amounts of Zofran, Phennergan, and Toradol, I snoozed for the majority of the night.  I had to be woken up to have my vitals checked, H&H checked, and then at 3am the epidural turned off, and pain medication administration.  The standard order is Percocet, but I did not want this and wanted Vicodin, but the nurse couldn't give me less powerful pain pills until she called the fellow.  I felt bad bc nobody wants to be woke up in the middle of the night to ask for Vicodin vs. Percocet!  Ah well, got my meds. The night was relatively painless.  I had to be taken out of my CPM at midnight and had lovely blue shorts placed sometime in the middle of the night as well.  This was an ordeal since I was completely numb.  They had to roll me over one way, slip on the shorts, and then roll over on the other side and repeat the same procedure.  Overall the night was fine, no major upsets.

7:00am came, and I was pulled out of bed, epidural removed, and then put into a wheelchair and brought down to PT.  I was put on a table in the back and then basically snoozed there.  The athletic therapist and the fellow came in and changed my dressing and explained to me what they did.  I was fairly drugged, but I do remember them saying that my hip was a very angry hip.  And that practicing flexion was key:  before surgery I could do 85* voluntarily, they did 110* under anesthesia and then, after the surgery, could do 130* of flexion.  I will go into exactly what they did during my surgery, what they found, and the prognosis, but this post is detailing my experience.

After my first PT session, I was allowed to go home, where I slept until my next PT session.  We are required to do two PT sessions each day.  It was pretty intense since you have to ride the stationary bike twice a day for 20 minutes each time.  The first PT session I couldn't get to the bike due to nausea and the room tending to spin on me.  But the second time I go there without much hassle.  The therapists are all so encouraging and upbeat, it sure isn't a place where one can feel sorry for yourself.  I really loved my therapist too.  We got along well and worked out perfectly.

Basically I was there for  5 days post-op and then came home.  Each day I had two PT sessions with many hours on the CPM.  It was a full time job.  The first two days were kinda rough.  They are always not very much fun, but by the third day, I thought that I could feel a difference and by the fourth day, I could already flex my hip past 115*  Everybody was so excited.  The athletic therapist always happened to come down to PT just as I was there; he was checking up on me and how my flexion was.  I am sure that Dr. P sent him down to see how I was.  Anywho, that is about it.  I did have a follow-up with Dr. prior to leaving town, but that is another post completely.  Glad I got caught up, and will promise to give updates much more regularly.