Rewind: Appointment Before Leaving Vail

I was reading my previous post and noticed that I had mentioned that I would detail my appointment with Dr. P that I had prior to leaving Vail.  And, although out of order, I thought I'd do it here.  

So my Mum and I hobbled up to the clinic on the Thursday morning of the day we were to leave to come home.  I was to be seen at 8:30 am.  I was brought back to the examination room by the PA.  I really like him (not his notes, but whatevs, we'll get that sorted out soon).  I had x-rays done of the left hip.  To be honest, I don't know how useful they would be as I barely had any bone work done.  I mean, I know they have to check for HO, but still, $40, poof!  Not to mention the cumulative amount of radiation from the x-rays I've had on my hips is enough to last a person a lifetime.  That's besides the point.  I then had my hip ROM measured:  120* of flexion baby!!!!!!!!  (on the left side).  Still only 90* on the right side.  The PA couldn't believe it.  I then proceeded to wait for the surgeon to come in. 

After 45 minutes of waiting he finally came in, along with his peanut gallery too: the fellow, athletic therapist were also close behind him.  He came in, did a hip exam and was beaming.  He said that he has never seen a hip so bad get so great ROM so early; it seems encouraging.  He said that he absolutely knows why I hurt so much before surgery.  Now to figure out whether or not to inject.  See, we have a problem that recurs, every time I have surgery I develop scar tissue.  Over the last 5 months I completely scarred down my hip and Dr. P was figuring out if he wanted to inject my left hip (we were already going to inject the right one at this appointment.)  He decided that he had to think about whether or not he wanted to inject.  So he sat down on the chair and we all just stared at him.  I feel like every appointment I have with him makes him 'sit down and think' while everybody in the room stares at him.  He didn't necessarily want to inject the hip since it was doing so well and didn't want to upset the area since the allograft was so newly placed (and wanted it to attach).  When he asked me if I could come back in two weeks, he said he would inject it then.  I said I would if I had to, but I have no money, so it is extremely difficult.  He said I didn't have to and he would inject both sides right then and there since to not do something to reduce inflammation would be too risky given that I form adhesions like its going out of style.

Injections....

Okay, so I've had three arthrograms and two diagnostic injections prior to meeting Dr. P.  And yes, they suck, but these previous injections were nothing compared to the injections Dr. P does.  Ugh.  Last time I saw Dr. P three months ago, he decided to inject my left hip, he had just whipped out an injection, and poof, I was being injected, no guidance or anything.  And when we decided that both hips needed injections, I just knew what was coming.  He did my right hip first as he was still thinking about what to do with the left hip.  He placed a plastic pen lid-like contraption on the skin for 10 seconds or so, and then took a way-too-large gauged needle (I swear it's so large you can see through it!) and just jabs it into my hip.  I don't think he'd describe it as 'jabbing' but that is what it feels like.  All the while he keeps saying 'excuse me, excuse me'.  He and his French-Canadian accent are too cute. I think he knows it hurts (or at least I hope he knows it hurts!)  Then he did my other side.  Now that hurt a lot more since I was still all swollen and tender.  Heck, more than a week later and I still have a nice bruise on the injection site.  The injection proceeded the same as the other hip.  The needle was placed 2.5 cm away from each of my scope sites.  I'm happy I didn't call Dr. P a jerk while he injected me....it really did hurt.  I really don't ever get much relief from the injections, but as long as it reduces inflammation on the left side, I'm cool with it.  The right side was injected just to appease the insurance company.

The Plan....

Since the surgery went so well and I had so much ROM and pain relief, Dr. P expects a positive outcome.  At this point, I should mention something that is a bit concerning, although he hasn't said anything to me directly, but rather my Mum (kinda uncool, but I don't even want to discuss this at this time anyway).  But after surgery, Dr. P spoke with my Mum for several minutes.  He said the surgery went well, but I have shallow anterior hip sockets and that he couldn't guarantee that I wouldn't need a PAO in the future.  This is something that I can't even let into my head right now, there is no room for me to think of this.  I just won't entertain the idea currently as I can't imagine more surgery.  I think I'll crawl to a hip replacement rather than to have more hip preservation surgery after we get the right side scoped this summer.  I digress.  

So the plan as of now is to have the right side done at the 6 week mark. When I questioned him about the left side being strong enough, he said that it shouldn't be a problem.  I then spoke with the PA when everybody left the room and he said that we could probably get it done prior to August 1st, but ultimately when I have surgery is up to me.  

Here we go, the (hopefully) last round of hip surgery for a very long time.  (So long as I can actually schedule the darn surgery).

14 Days Post Op

It is hard to believe that two weeks ago today I was in surgery getting my left fixed up. I must say I'm doing quite well and am very happy with the progress I've made. Today I spent a significant amount of time in the pool. Half of the time doing exercises and half of the time just floating with my legs dangling in the pool. It felt amazing doing both the exercises as well as floating. I did backward kicking and deep water jogging for ten minutes each. In addition, I did standing abduction. The hip muscles felt great and the right hip didn't catch too many times. All in all it was a good day in the water. It was also wonderful weather. I don't mind rehabbing and getting a tan all at once.

 My home PT exercises are going well too. I can do all of them that have been prescribed to me thus far and feel like I could do more. Today marks the last Voltaren that I have to take. Now I go on extended release aspirin and doxycycline. I hate taking doxy with a passion as it really does a number on my stomach. The tablets just make me nauseated, which I can handle, but the capsules make me barf. Thank goodness I have the tablets right now, but who knows if I'll get the tablets in the refill.

13 Days Post Op

Nothing much is new on the hip front.  My left hip is still awesome and my right hip is miserable. I can't stand for any length of time....like brushing my teeth requires too much standing, so I sit on the counter.  Stupid little things like that are pretty annoying.  I can though, shower without any help.  Although I still use the shower chair, I can fully wash myself without the aid of any brushes/sponges on the end of a stick.  This is something I haven't done in a very long time, and, as you can tell, I am very excited.

My left hip has extremely acceptable flexion, although it does hurt at the very end point of the flexion.  PT says that if I kept this amount of flexion, it would be considered normal.  Internal rotation is still improving.  I am not allowed to extend or externally rotate my hip until day 21, so I am unable to comment on these ROM at this point.  I am still 20 pounds weight bearing (basically the weight of my leg while touching flat foot on the ground), I am still wearing the Philippon-Bedsloe hip brace while ambulating, I am still using SCDs and the CPM at night.  I am only able to sleep on my back which is sometimes quite difficult to remain asleep.  And when I am not in the CPM and relaxing, I must be bolstered into the bolster (anti-rotational boots). Ah well, I am getting by on a decent amount of sleep these days, even if it is drug-induced!

Monday may actually yield some answers regarding trying to get my right hip surgery scheduled.  The PA is in the office on Monday and the surgery scheduling lady will be speaking with him as my right hip is not mentioned in the clinic note he dictated.  Lovely, eh?  This really shouldn't have happened as, in a note, one should include everything that occurred during that appointment.  I have called the PA asking him to call me.  As well, the surgery scheduling lady will be talking with him.  So hopefully something comes out of this as I am no further along in scheduling the right hip surgery than I left the clinic from my appointment 8 days ago.  I mean, 8 days isn't a long time, but time is of the essence as a) I would like this done prior to August first, and b) Dr. P's schedule is really super packed and he books months and months out in advance.  I am going to play up the fact that I cannot stand on my right and it hurts like the dickens, plus I was told that I am a priority case.  All this said though, if they do not think that I am going to be strong enough on the left side or if they feel like my left side needs more time to prevent inflammation which will prevent scar tissue, then, by all means, I will wait.  Although this would be less than ideal financially, I will do whatever I am told by the doctors and physical therapists as I want this next surgery to be my LAST surgery for a very long time.

Where I Stand Now

Right now, things on the left side are going amazingly well.  The right side, horrible.  I am feeling absolutely wonderful on the left, most recently operated hip.  It feels so free and smooth.  I am in love with it.  Yes, I still have surgical pain and inflammation, but the horrible, deep pain that was there before surgery is gone.  In fact, this evening was the first time I have washed my own feet with my hands in many, many moons.  Small, but important thing to note.  I would say that I have no groin pain and 2-3 out of 10 pain on the left, which is surgical and nothing too concerning.  Although, I must say that I am severely paranoid about scar tissue formation or an anchor falling out.  I've never been worried like this before, but then again, I've never had anything to lose.  The anchor worry stems from the fact that I now have 9 new anchors in my hip, making that a total of 16 anchors in the left acetabulum.  Let's hope they are all nice and tight....forever! My one incision has stopping draining, but the other one has not, hence it is still taped up.  I will prolly add pictures to these blog posts one afternoon.

My right side is another story. Having it be the sole weight bearer is not cool.  I sometimes hurt so badly that I can't stand on the right leg.  Hopefully this will be able to get fixed soon.  I have some ironing out to do.  When I emailed the surgical scheduling lady at the surgeon's office she said that there was nothing mentioned about my right side in the note dictated and that we wouldn't be able to schedule surgery until my 6 week follow up.  Ha.  This is NOT what we had planned.  She is going to speak with the PA about his note as we had all agreed on doing the right hip at the six week mark, and before August first.  She is also saying that the schedule may not allow for this either.  Blah.  I swear these people need to get their act in order because this hip is going downhill fast being the 'good' weight bearing leg and my insurance changes August 1st, meaning being able to get the right side done before this date could save me thousands of dollars!

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.

 

AWOL: My life has been turned upside down!

I apologize for not posting, I was going to after my appointment with Dr. P, but then it turned out to be such an emotional time that I had to give it a couple of days before I could post, then everything started happening so quickly that I just haven't had the time.

Story goes as follows...

I saw Dr. P last Wednesday and after examining me, looking at my MRIs and radiographs, he said that nobody should have to live like this and things are obviously very wrong with both hips. I kinda figured this as I can't stand nor do my clerkships anymore without significant pain.  It is significantly affecting my life and school.  So, he said that he wouldn't want me to wait and he could come in on Saturday June 16 to operate on my left hip.  He said he wouldn't wait any longer since my ROM is decreasing rapidly.  As far as the right goes, as soon as the left side is strong enough to support my weight (prolly 8-12 weeks) we have to have surgery on the right.  And so, the saga continues.

I will go into details on what is planned for each hip, but I do not have time right now.  Currently though, everything is in place for this weekend.  I have flights, condo, car, pre-op appointments all set up.  I will be in Vail from Friday June 15th until Thursday June 21st.  I have pre-op all afternoon on Friday and they will figure out when the surgery will be planned for the Saturday.

As far as school goes, I have taken an emergent leave of absence and will be returning back to clerkships in February of 2013.  This gives me ample time to recuperate from two surgeries and get my health all straightened out so that I can at least function, if not feel all better.

No time to get nervous or scared now.  When Dr. P says jump, everybody says how high????!!!!!!

Friends

I always thought that friends are there for you, through thick and thin.  There to support and encourage.  Not necessarily to just socialize when times are going smoothly, but for a shoulder to cry on and a word of support when the going gets though.  I am pretty sure this is what a friend is supposed to do.

I was utterly let down this past week.  I won't get into the specifics, but, I have a friend who I would consider one of my best friends.  We have been 'best friends' for like 15 years.  This past week I received a Facebook message telling me that she is mad at me because I wouldn't go out shopping with her and that she felt I didn't want to see her.  Excuse me, but she has no idea how much I would have loved to go out with her shopping.  But I can't do that, I can't stand at the moment.  I haven't responded to her message, but I really don't think she knows how much she hurt my feelings.  I have hip chick friends with whom I have never had any direct physical contact, known for only a couple of months, and they are more concerned about my feelings than my long time friend of more than a decade.  It is heart breaking.  I am pretty emotional these days leading up to my appointment with my surgeon as I could very well be off to surgery in the near future and have to take a year out from school.  Meanwhile, I have a friend who is definitely not supporting me through this difficult time.  I'm not asking for much.  I don't expect her to ever understand what I am going through, and I don't want others to have to go through what I am dealing with currently.  All I ask is a little bit of empathy and consideration for my current health situation.  It breaks my heart that she feels this way.  I would bend over backward for anybody who needed help, and my friends' response: you aren't spending enough time with me.  I am crying as I am typing this because I thought that my friend would have been there for me and all she cares about is herself.  I guess going through difficult times really brings out peoples' true colours.  And I want to tell everybody out there who has given me support and encouragement: thank you!

xoxo