About 4 1/2 months post RPAO ... seeing the light

I regularly scan my Daily Digest email from the Hipwomen Yahoo group, and seeing a few questions breeze across the forum about women having some of the same pains I have had during recovery has reminded me I should probably post an update here, as I know some folks from that group visit this blog.

So I'm about 4.5 months post-op now. I'm walking on both legs, unassisted! There is still pain in my hipflexor area (center of the groin area) when I lift my leg up to a Captain Morgan position walking up stairs, or when I try to lift my leg to put pants on, and still cannot cross my right leg over my left by myself. I have to grab my thigh to help it get over with a manageable amount of pain. I have found through Physical Therapy that my hipflexors are still extremely weak. When sitting up and she tries to push my knee down while I try to hold it up, she can push it back down very easily ... and it's painful. One of those things I'm still hoping will fix itself in time.

I haven't walked with a cane in a few weeks now. The pain in my outer hip area that I used to have when putting full weight on it has completely subsided (thanks to my surgeon recommending me to take 800mg of ibuprofen 3x day!)!!! Now, I'm just a little wobbly still when I walk. It's interesting how you really do have to re-train yourself how to walk normally after you don't walk "normally" for 3 months or so. I find myself with tendancies to limp, as if my right leg is shorter than the left, and mentally have to tell myself to walk "tall" and try to NOT walk with a limp. I've found that doing this actually works other muscles in my leg that are still very weak (such as inner thigh, knee, and quads). I kinda thought "walking" on my leg would strengthen it, but I've found that I'm not seeing drastic improvements in a 1-2 week timeframe. I will be patient though - and reassess where I am in a month!! It's so easy to over-analyze daily progress ... it's dangerous!

The low back pain is still pretty bad. When I say "low back pain", I mean lowest lumbar pain. Mobic (anti-inflammatory) doesn't seem to be making a difference. I'm also working to make sure I have as good of posture as I can when walking and standing, but that doesn't seem to help either. I see Dr. Kregor on Monday and will mention this ... perhaps it's time to see someone about it and see if I have any further disk deterioration and if arthritis is setting in. I have lots of stiffening and soreness, which makes me wonder if it's arthritis.

As the holiday season approaches, I keep reminding myself that I am SOOOO thankful for so many things. My family and my husband - for standing by me through the surgery and recovery, and being patient with me. I'm thankful for being able to walk - considering there have been SOOO many times over the past few months where physical discouragement nearly tore me apart at the seams. I'm thankful for Connie Purdue, my physical therapist, who has been with me since day 1 (which was about 2 weeks after surgery) and encouraged me along the way - reminding me how far I've come and continuing to push my abilities. I'm thankful for Dr. Kregor for his passion in orthopaedic surgery (including the hip and osteotomies) and his skilled hand to perform such a tedius and precision-demanding procedure, and to do it so well (oh, and for being LOCAL!!). I'm thankful for all the friends and family who have provided meals, cards, phone calls, help around the house, and words of encouragement along the way ... it has made all the difference in the world.

While I may not physically feel 100%, I am thankful for being alive and being able to walk! Not everyone is this fortunate at this stage of PAO recovery.

Oh, and I'm also thankful for being able to do Christmas shopping online ... :-) My back can't tolerate standing in lines!! (lol)

Someone should have warned me this would not be easy

I should have joined the Yahoo! Hipwomen forum several months ago!

Since my last update, I haven't had much to report. Work has been busy, and the RPAO recovery has been somewhat uneventful. After the injury or whatever happened at PT the day after I got cleared to ditch the crutches, recovery has stalled. I ended up going back to 1 crutch for a week or 2, and last week managed to go with the cane. I'm still on it, and pretty much can't walk pain-free without using it.

Today was my first visit back to PT since the pull/stretch/whatever happened in my hip. She kept my session short as she didn't want to overdo it. Based on how I was explaining the pain I was still having, when it happens, where it happens, etc. she was able to determine that it's probably an issue with my Gluteus Medius muscle (I have a feeling it was was of the muscles which had to be detached/re-attached during the surgery ... not sure though). I was somewhat relieved by her findings and how she explained exactly how it works ... in relation to exactly when/where I have pain. This muscle is basically what keeps your hip stabilized when you put full weight on it. And, unfortunately, that has been my problem. I can't put full weight on that leg while walking because it puts so much painful pressure on this muscle. It doesn't get more frustrating than this - given the "go" to start walking again, but can't!!!

She indicated it may take 4-6 weeks (from when I injured it at PT) for the muscle to heal itself, and she urged me to continue to use the cane and not to walk without it right now. The good part is (if you can call it "good"), is that she recommended I find a local sports facility that has an indoor pool and practice walking in the pool (since you are really only taking about 10% of your body weight in the water). The kids would go NUTS if I told them we were going to a pool, when it's in the 50's outside!! Well of course we would go to an "indoor" pool. :-)

So, I continue to stay on the crutch not knowing for how long. My biggest fear is wondering if I will ever feel somewhat normal again, or be able to walk around the neighborhood with the family successfully. We are considering making our first trip to Disney in Orlando for spring break next year, and I can't even imagine doing it. All the walking and standing ... makes my lower back and my hip hurt just thinking about it!!

I'm doing some web surfing on muscles and trying to better understand various injuries and how long it takes to recover, and what I can do to help it heal. In the meantime, I have to try and remind myself how great it feels to have returned the loaner wheelchair and bed, and to at least be vertical. Things could be a lot worse. Of course, things could be better as well.

Hoping for healing and continued strength ...
-L

What a week!

It has been a roller-coaster of a week, so I'm just now getting around to providing an update!

My 12.5 week check-up went really well on Monday. Here's how it went. My husband and 5 year old son were there with me. First, a younger resident-type doc came in and asked how I was doing, showed me the xrays, etc. He seemed a bit nervous and didn't seem too "schooled" on PAO's, but that was ok because I knew the "real deal" would be talking to me later. :-) This younger doc asked "can I see you walk?". I said, "um, really? Are you sure?". Afterall, I have not even TRIED to walk since my surgery in July. I gave it a whirl ... and though wobbly, I walked around a little in the room! My son was thrilled!! This doc told me the outer edge of my hip (by one of the breaks) had some extra bone healing on the outside that we would have to keep an eye on. Not sure what that means, or what it "could" mean later on ... he didn't explain ...

So then we waited for Dr. Kregor to come in. As to the xrays, all of the load-bearing bones seem to be healing nicely, and there is a non-load bearing bone (inside the pelvic cavity, perhaps by the tailbone) that has not healed but he said I could start weening off my 1 crutch!!! I was ecstatic. I am to continue PT for another 7-8 weeks until I see him again, and was told as to the wobblyness and range of motion that it could take up to a year before I'm 100%. I am still having low back pain and hip flexor/groin pain when lifting my knee or crossing it over to put socks on, but I guess that will just go away with time. It was still good to hear it from Dr. Kregor that there's no huge concern, just takes time. Whew.

So, I had my son carry my 1 crutch out of the building ... and I walked (well, limped). I was holding back the tears (not of pain, of JOY) all the way to the car. What freedom! What elation! My hip area and upper thigh was really sore while I was walking, but it was ok! I realized that while I thought I was doing about 75% weight bearing with 1 crutch, that wasn't the case. I didn't remember what 100% was until I actually started to walk on it ... and then realized I have a long way to go on strengthening those muscles. On the way to the car, my son told me in regards to not using a crutch "Kathryn is going to be SOO surprised!".

When I got to work I was really wishing I had remembered to bring my cane in, but nonetheless decided to just "walk" in. I was turning heads left and right, and my team was very excited for me! They could see the smile on my face as it was beaming with happiness and joined in on the happiness with me. I limped for the rest of the day, but thought all in all this was ok and I would enjoy resting when I got to bed that night!

I went to pick up my 3 year old daughter from school. I walked in, and she immediately stood there and just looked at me for a minute. She got a big smile on her face and said "Mommy? Where's your cwutch?". I told her I didn't need it anymore, and she got real excited ... turned to her teacher and said "My Mommy can walk!". The late-afternoon teacher in the room didn't know what she was talking about, since she doesn't really know me, but I knew. My heart melted. Kathryn and I held hands all the way to the car (which is not something you can do while on crutches). I will never forget that moment.

At home Monday night, I REALLY enjoyed walking around the kitchen helping to get dinner ready. I was amazed at how much faster I could get things ready when I had 2 hands free versus 1! John enjoyed me helping as well, I think. :-) Again, it was nice to be a little more mobile. Going up and down stairs (using the rail, of course) was also surprisingly easy.

I wake up Tuesday morning and head over for PT. I had the cane in the car, knowing I would need it at work ... yet didn't carry it into PT. They were all surprised to see me walk in! It felt really good. I started my 10 minutes on the stationary bike as usual, then proceed to the table to do my leg lift exercises while lying down. I did 20 straight leg lifts from my back. Yeeeah. Then rolled onto my left side, to do the leg lifts with my right leg and was told to do 20. When I got to number 16, I heard 2 quick pops and immediately lowered my leg. Now, I've heard some occasional snap/crackle/pops in my right hip area before since surgery, but since they never hurt ... I figured it was normal. These 2 pops were NOT normal, and were VERY painful. I told my therapist what happened, generally where it was, and we moved on to other exercises to try and isolate what I "could" do versus what I "couldn't" do. We were able to do some other exercises, but I could NOT do anything standing (at least nothing putting weight on my right leg) without huge pain.

She put me in a closed-door room, and tried some negatively charged compound on these electrode pad things to try and calm the muscle down. She put 2 pads on me, one in the groin area and one further up the hip, and zapped me for about 10 minutes. These pads had some sort of anti-inflammatory medication inside it that was supposed to draw itself down into the muscle. Along with that, she wrapped my hip up with ice while that was going on. As the day went on, I found it didn't help the pain. And wouldn't you know, I didn't have a crutch in the car ... just the cane. I was in so much pain walking around even with the cane that I left work early and worked from home ... tail between my legs ... angry that I had done something and set myself back ... and worried that something was horribly wrong.

I emailed Dr. Kregor about this, and he didn't seem too concerned that it was a significant muscle tear, and to take it easy for a week or so and also cut back on PT for a bit. It's now Friday, and I think it's actually feeling better. I have swallowed my pride and have been constantly using the 1 crutch again, and while walking I will allow myself to put a little more weight on the right side. There is still muscle soreness that wraps around from the top of my thigh around to the back of my hip, but I'm being cognizant of the pain and being gradual on putting a little more weight on it. I will probably hold off on PT next week, just to make SURE everything is ok, before we hit it again with weights and strengthening. Once again, it was such a relief to get the email from Dr. Kregor ... as I know nothing about muscles and bones and what is serious and what isn't.

I have had a few friends remind me in the last few days that I have had major surgery and that it takes time to heal. I've never had to take THIS long to heal from ANYTHING (of course, the only other surgeries I've had were 2 c-sections), and my patience is truly being tested. It's hard to be patient with something like recovering from hip surgery when you have a full time job, 2 small children who are active, and when you have other obligations outside of work. It has really been hard to keep my head up and realize how far I've come (thanks, SuSu and Mom for the reminder). I have to keep praying that God will keep me strong (mentally as well as physically) and will give me the patience that I've run out of in order to keep a steady pace of beginning to walk again and not try to rush it. Heaven knows I don't want another setback ...

I'm hoping that perhaps later this weekend ... or early next week ... I'll muster up the courage to try to use the cane again. Just have to make sure I don't damage those muscles. At this point I think I can recognize "bad" muscle pain versus "good" muscle pain! The "good" muscle pain is pain that exudes itself as "I'm weak". "Bad" muscle pain seems to be the kind that is sharp and says "get off me!!!". :-)

Day by day ... gotta "stay the course" ... "slow and steady" ... (in the words of one of my favorite StarTrek captains, Cpt. Jean Luc Picard)

12 weeks and who's counting?

Me! Counting every single day I might be closer to walking and feeling normal again.

Monday, October 19th I see Dr. Kregor for my 12.5 week follow up. At this point I'm probably 75% weight bearing, via one crutch, and hoping Mondays xrays show the bone breaks have finally healed.

It has been amazing to walk with no hip pain or discomfort whatsoever. What was not expected was the continued hip flexor muscle pain I feel when lifting my leg to get it into the car, into bed, or when trying to cross my leg to put a sock on.

I also continue to be plagued with unbearable low back pain after standing for more than 5 minutes, changing positions in bed at night, and sitting up after I've been lying down. I started taking Mobic for a week, an anti-inflammatory friend of mine that I take whenever sciatic nerve pain pops up unexpectedly, but it doesn't seem to be doing any good. I am not having any sciatic nerve pain, just total lumbar pain from left to right and everything inbetween. The mobic I have is a year or two old ... Wonder if that has something to do with the lack of effectiveness. I've been worried ever since I found out I needed surgery if it would aggravate my lower back (have herniation and disk degeration in between the last vertebrae). Throughout most of this recovery and all the sitting and crutching lopsided ... I've had zero back issues. However, the past 4-5 weeks it has been awful. I'm hoping we can get to the bottom of this very soon ... I really need a good, solid nights sleep!!!

Physical therapy continues to progress, except of course those exercises that nearly kill my groin area where the hip flexor is. This past Thursday she took new measurements and tested my strength. Some leg muscles are stronger than others, but it was nice to see that my gluts seem to be the strongest! I was lying on my stomach and doing a straight leg lift upwards while she was trying to push my leg down. She was unsuccessful, and even said "wow! Buns of steel!"! I think I would definately be able to walk unassisted now; moreso than where I was a month ago.

Range of motion is definately an issue. My right knee aches to high heavens when I cross it over my left to put a sock on. I've also noticed I can't bend down as far as I used to (from a sitting position) without feeling some outer/back/side hip pains (like needle sticks). Finally, it seems that the more up and down I'm doing, like on Saturdays like today when I'm trying to take care of the kids, pick up the house, tend to the kids/break up arguments ... My entire right leg was cramping. Is this normal?? Is it just the cold damp weather??

With the cold weather moving into middle TN, so has illness. Almost the entire family has been coughing for a minimum of 2 weeks, my daughter has an ear infection, and we've also had some stomach bug things going on. No fun!

It has been nice driving these past 3 weeks. Mobility has been such a blessing and relief both on me as well as my husband I'm sure. I've also figured out a system whereby I can use my shower! I park the walker right by the shower, back into it, and swivel/pivot on my left foot to get to the middle of the shower stall. It has worked well, except my back is killing me when I sit down at my vanity to finish drying off.

Now if I can just get rid of this last crutch. I'm hoping and praying the bones have finished healing come Monday morning, but everyone heals at different paces and only the xrays will tell for sure.

Let's hope my next post is a more positive one!!

Lori

-- Post From My iPhone

Wow ... over 10 weeks since surgery!

My blogging pace is slowing down! I've been back to work for 2 full weeks now, so I have had NO time for updates! I have 2 major initiatives going on at work, so that on top of just being exhausted and keeping up with the family has kept all my attention lately.

Just a few quick updates. I'm still progressing well with PT (2x week) and am using anywhere from 2-5lb weights on my ankles during most exercises. I am able to do more straight leg lifts each time (even though I'm only up to doing 2 sets of 5 lying down, and can do 2 sets of 10 lying on my side). I'm also progressively putting a little more weight on my right leg as I'm crutching and have NO signs of the same pain I felt prior to surgery!

Now that I have nearly weened my self off pain meds (which was no small feat for me), I'm really feeling the twinges, pangs, muscle soreness, etc. that are going on since they are no longer masked by medication. Most of the time these things are mildly discomforting (such as the twingy pains on the outside of my right thigh as the nerves are healing, the continued mild-to-moderate hip flexor pain in the groin area). After PT though, the muscle soreness and cramping in my leg is most uncomfortable. Of course none of this compares to the blinding pain in my lower back that I have after lying in ANY position for any amount of time, or when standing too long, or sitting in too soft a chair/sofa for any length of time. I wish I knew why ... Either way, I'm not sleeping well and waking up every 1-1.5 hours unless I take a small dose of meds, then I can at least get 2-3 hours of sleep before waking up ... and even then can usually manage to fall back to sleep after that.

I've also started having pain in my right knee. I mentioned this to my PT lady and she thinks if we work on my quads a little more, this may help my knee get used to having weight on it again. With all these various pains/cramps/discomforts ... I'm still thanking my Heavenly Father that my "good" hip is NOT giving me any trouble right now!! I sure hope it stays that way -I honestly could not go through this again.

I haven't been back to church on Sunday morning in probably a month. It was just too hard to orchestrate (and hard on me mentally) to have the family pushing me around in a wheelchair. I went back yesterday, only on crutches, so that was nice. My back (and for the first time, the back of my hip) was telling me perhaps it was too much right now.

Well, I see Dr. Kregor on October 19th and will be roughly 75% weight bearing by then. Sure hope there is light at the end of the tunnel ... I want nothing more than to ditch the wheelchair, walker, hospital bed and crutches!!!! I'm worried about the bones healing though. Only xrays will show, but as of the past several days I've had some stabbing pains right where (what feels like) the screws are. I hope my tossing and turning in bed has not wiggled a screw loose!

Until next time,
Lori

8 1/2 week Follow-Up results

Greetings everyone.

Yesterday I had my check-up with Dr. Kregor. The breaks in the hip bone are healing well, with the exception of one of the major breaks which "still has some healing to be done". He re-checked the swelling in my right leg (and I'm happy to report that the unbelievable swelling in my foot/ankle that I've been fighting with for the last month is 99% gone!), and he noticed I still have swelling around my calf. I went this morning back to Vanderbilt to have another dopplar ultrasound done on my right lower extremity to look for blood clots, and everything was free and clear.

I am allowed to progress from toe-touch weight bearing to 20%, and very gradually increase from there over the next 4 weeks until I see him again. I'm to continue PT 2x week as well, and can drive in 3 weeks.

I have to admit I was not in a good mood yesterday as I went into the office, as I was hoping (prematurely) to be permitted to do 50% PLUS weight bearing and perhaps only use 1 crutch or a cane. I knew deep down that the xrays would be the determining factor of how much weight I would be to bear, so knowing the bones still need to heal ... I have to suck it up and be patient while that happens. The last thing I want is for the healing to not happen the way it should, and possibly have problems later. I definitely don't want to go through that again!! :-)

So I will go back to PT starting this Thursday. I'm also going into the office pretty much every day, granted a little late on PT days, and was given the ok to return to a full work schedule. It's really good to be able to see the team on a daily basis now, and with all the work on my plate it's also been easier than I thought to cut way back on my pain meds (which I'm trying to ween off of). Once I'm down to only taking pain meds before bed, this will help clear me to drive. Pain wise I'm doing really well, just have muscle soreness in the hip flexors from time to time.

I've enjoyed watching the emails fly on the "hipwomen" Yahoo! group I'm now a member of. Lots of women who are just about to go through a PAO, and others who are recovering like I am. I've seen folks asking questions about the same things I'm going through, and I've also seen questions fly by about problems or issues that I (thankfully) am NOT experiencing. I wish I would have found this group earlier on - I think I may have been more emotionally prepared for the recovery ahead than I was.

So when I'm crutching around, I'm letting my foot touch the ground and letting my leg "go through the motions" of walking. I honestly can't tell what percentage of weight I'm putting on it yet, probably 5% or less, but I'm letting it go through the motions and will work with my physical therapist to ensure I'm using more weight, but just not too much to impede the healing of my hip bone. While at home, I will probably still use the wheelchair if I need both hands to do things in the kitchen like clean up. You can't do much of anything when you're on crutches.

John continues to chaperone both kids to school, me to work, and me to all my appointments. I can't wait to be able to drive again so I can help ease some of the load, and can actually feel like there is something I can do on my own ... without help.

Well, that's the latest.

A week from tomorrow - see Dr. Kregor again

One week from tomorrow I have my checkup with Dr. Kregor, whom I haven't really seen since my 2 week checkup. I have been going to PT twice a week, with orders for "making headway" towards a straight leg lift from the back, and a leg lift from the side. The good news is - I can actually do 2 sets of 5 leg lifts from the SIDE, however can barely get air under my heel when lying on my back. If my therapist gives me a little assistance, I can lift my leg farther. As mentioned in a previous post, I am anxious as all get out to begin weight bearing and weaning myself away from the wheelchair and start doing some actual walking with 2 legs.

My most successful exercises are when standing. Doing the "captain morgan" knee lift is going really well (can lift it to 90 degrees with very little discomfort), side/front/rear leg lifts are also pretty good and mobile. Lying on my side, the clam exercises are getting easier and they've even added a thera-band to apply resistance. Each time I go to therapy, I also spend now 8 minutes on a stationary bike (with no resistance) and can pedal in circles with no pain. Last Friday was the first time they increased the timer from 5 to 8 minutes and my legs were a little bit tired, but not too bad.

During the day pain is not bad at all, other than my hands, fingers, etc. who have been compensating for my leg/hip these past 7 weeks. My only complaint is my hip flexor - on the center/inside area of my groin when I do exercises lying down or sitting down. The rest of my muscles (quads, glutts, hamstrings) are still very weak, but improving a little week by week.

I have now joined a Yahoo group for "hipwomen". I for once feel not quite so alone in this journey, but have to admit I'm jealous of many women whose surgeons allow weight bearing right after surgery!! I trust Dr. Kregor though and his direction, but am really hoping for some relief from my lack of independence and isolation next time I see him. My kids really miss me going upstairs to tuck them in, they miss me going to the playground with them, pushing them on the swings, taking them to school ... and I miss most of all not sleeping in my own bed with my husband and having quiet un-interrupted nighttime conversations!!! He has truly been my rock and my stability since the surgery. I don't know how he has kept his sanity as well as he has, but I would be amiss to not mention that he is an absolute miracle and blessing in my life. I don't know WHAT I would do without him. I love you, John.

For those women who have already replied to my posts (either on the forum or on my blog), thank you soooooo much. I want to open up lines of communications in both directions, so I hope my experiences can help someone else who is beginning this journey!

Getting anxious ...

I have begun surfing the web and catching up on other PAO blogs. I'm nearly 2 weeks away from seeing Dr. Kregor again for my 8+ week checkup, so I'm getting anxious and I have a million things running through my head right now. Will he allow at least partial weight bearing? Will he allow me to drive (at least a LITTLE bit)? Will he be pleased with my physical therapy progress? Or, will he say my hip flexor muscles just aren't strong enough, stay as you are for another month??? I have no way of knowing what this appointment will have in store for me.

Just as a recap, here's where I am (and will continue to be for another 2 weeks):

• I still use a wheelchair at home and when I go to church
  
• I use crutches to get into the bathroom (I hope this won't cause controversy. Dr. Kregor never said I could use them, but honestly ... how am I supposed to get down the stairs in the garage in order to get to the car for PT and church??)
  
• I use the walker in the bathroom when I'm bathing/getting ready (it's more stable, if I loose my balance ... and it helps provide me with stability getting in and out of the tub)
  
• I use a shower bench in the tub with a wand to bathe
• Primarily sleep on the hospital bed downstairs (because it's closer to the bathroom, it's easier to get in and out of ... meaning closer to the ground, I can adjust the feet/head to help make me more comfortable, and it doesn't require me to crutch upstairs)
• Still taking Lortab every 4 hours, and HAVE to stay on a 4 hour schedule or I feel the pain setting in (I think the pain is more my hip flexors screaming at me, versus actual hip "joint" pain).
• Have to set the alarm on my iPhone to wake up every 4 hours during the night to take the Lortab. I have been slacking on this lately. I find it pointless to keep myself awake to take 2 huge horse pills only to go back to sleep. Well, if I don't ... I will wake up at 2:30am in writhing pain and won't be able to move to even get to the bathroom. So, I need to get better at this.
• I'm working via laptop (and on the couch) up to 5 hours per day (sometimes less, sometimes more). Good for the brain - I'm so glad I have an IT job and have a great team (and boss) to allow this flexibility.
• Physical Therapy: Still going 2x a week. I'm starting to question my decision to do 2x week versus 3x. Yesterday I started off my therapy on a stationary bike!! No resistance of course. I was able to do an easy 5 minutes of rotation without issue! The bottom line is, I'm still weak. While I'm making progress each time, my hip flexors are still weak and I'm worried sick that this will keep me confined. I should have told them 3x week. Inside I think I was trying to not burden my husband by taking me 3x week, since he has to take both kids to their separate schools, then pick me up, then take me to therapy, then back home, then have him head to work. I'm trying to not burden him more than I already am. I just hope I haven't shot myself in the foot (no pun intended) and delayed my recovery by not pushing my therapy sessions. This means I need to buckle down HARD at home and really stay on top of my exercises to make up for it.
• Incision has healed nicely, though it's big and ugly. I still have swelling in my right foot, ankle, and leg ... but I think it's a little better from where it was a month ago. I think I still have some swelling in my right hip, based on how a pair of jeans felt Wednesday when I went to church for children's choir!
  
• My foot still turns red when I'm standing. I guess this is still normal as everything heals, and the bloodflow returns to normal circulation.

I'm wondering if other PAO women have had the same strange dreams that I have. I've had dreams where I've tried to walk and couldn't. I had another dream that I was out somewhere and someone stole the crutches (that I'm not supposed to have), and I couldn't get home or walk! Then recently I had a dream that I got fed up and got in my car and drove off. Then, down the road, realized I didn't have the leg strength to use the brake pedal! I'm sure I will laugh at this in a year or so ...

My 5 and a half year old son has asked me several times lately when I'll be better again so I can go to the pool with him. I guess it's a good thing that our pool closes after this weekend. My 3 year old daughter also asks when I'm going to be better and walking, though she isn't old enough to articulate why. I get the impression she just doesn't like to see me like this, and doesn't like to see me cry. There were quite a few times over the past 2 weeks where I would break down and cry out of frustration because of the things I can't do, can't reach, or when I've forgotten to do things. One such event I had forgotten about was a banquet at church for those who were leaders in our choirs at church. It totally slipped my mind and when I realized it, John was at my son's school for a parent/teacher thing and even if I could have gotten ready in time, had no way to get downtown to church. I bursted out into tears when someone from church called me asking if I was coming - and I said I forgot - and had NO way of getting there. The kids were very concerned, and I honestly try NEVER to cry in front of them. My son said "will they have a banquet next year?". I said yes, but that this was my first invitation to this banquet since I just started as a leader for our 1st grade choir, and he said "well, then next year will be your 1st year to go then!". I told him that this was my fault and that I was just upset that I had let this slip my mind, and he so sweetly said "but mommy it's nobody's fault". I couldn't believe how sweet he was being and how he was trying to rationalize the situation. I love these kids ...

For anyone reading this, sorry for the long post. Hopefully you're still awake! :-) I'm going to look online for other PAO blogs and see if I can make some contacts with people. I'd love to understand the various ways people are being instructed in their recovery. The one thing I hope Dr. Kregor DOESN'T say in 2 weeks is that I'm clear to use crutches and come back in a month. I will have to politely spill the beans that I HAVE been using crutches a little, and to throw me a bone!!! I'd love NOTHING more than to at least do a little driving ... but I have to watch myself and not get my hopes up.

I just wish I knew what was going to happen ... what he is going to say ... what the rest of this recovery is going to look like ... I guess I can try to be thankful that my left hip is doing great and probably will never need a PAO. I doubt I could go through this again.

5 1/2 weeks post surgery

Well, not much new to report on the recovery front. I am becoming more proficient with crutches (although Dr. Kregor never told me I could use them!), which is good since crutches are the only way I can get down stairs to the car, and I can move more quickly on them than with a walker. I am still going to PT twice a week, and am steadily seeing progress on leg movements (such as raising my leg to a "captain" position, being able to increase my repetitions on original exercises such as the heel slides, etc.). I still have 3 whole weeks until I see Dr. Kregor again to determine what my next steps are.

I have made myself crutch upstairs to spend some time with the kids lately, and to also sleep in my own bed from time to time. The only problem with sleeping in my own bed is the pain. It is a bit difficult to maneuver pillows underneath my foot to raise it (still have some swelling going on), and my back gets very stiff and sore from lying flat. Our bed is also quite a bit higher off the ground than the medical bed downstairs, so it's harder getting in and out. Also, oddly enough, the toilet in our master bathroom is VERY low to the ground, actually lower than any other toilet. It's difficult in the middle of the night to carefully lower myself down with crutches. (probably more information than you readers care to know!) Nonetheless, there is nothing better than having a nice casual conversation with your husband right before you fall asleep. That makes all the pain and discomfort worth it.

I'm still bathing on the stool in the tub downstairs, using a shower wand. I have a system down now, between getting everything (towel, clothes) set up and within reaching distance beforehand, and the whole routine of getting ready. I have managed not to fall or slip, so I guess all this planning is paying off. I can manage to get pants/shorts on by myself now - meaning I can reach (or bend at the waist) much more easily now. I still have trouble getting socks on my right foot. There is intense pain in my hip when I bend forward and then turn my foot outwards. OUCH! I can at least hook the sock over my toe, then put my foot on the floor and pull the sock on while bent at the waist ... ok, nevermind ... it's just really hard!!

This past week there were 2 huge exciting events. Wednesday was the big kickoff for the children's music and missions program at our church, where I'm one of the leaders for our 1st grade choir! It was hectic. We had pictures, a parade inside the church, and I was back and forth between the wheelchair and crutches ... depending on which part of the church I was in. It was so great to meet a new bunch of 1st graders! Then on Friday, I planned on making a trip to the office to see the crew. It was completely and totally awesome to see my co-workers and the new space we moved into a month ago. The team had unpacked my desk and my pictures, had a group card sitting on my monitor, a plate of homemade chocolate brownies that Edwina made, and it was just so great to be there. I had planned on having John pick me up around lunchtime, but decided not to call him for a lift until around 4:30. :-) He had decided to take the day off, so knowing he was having a "recharge" day just doing whatever he wanted to do ... I hated to interrupt! Plus, I was actually having fun being in the office and felt I was more productive than working at home. Since I had gone 100% on crutches, I was totally beat when I left. I was definitely wishing I had brought the wheelchair.

Oh - and also on Friday, we get an email from John's mom who said she would love to keep the kids for a few hours some night this weekend if we wanted to go out. SERIOUSLY!?!?!?!? We took her up on it ... Saturday night we dropped them off, went to Cheesecake Factory, avoided the cheesecake (we were stuffed!), and then decided to try and kill some time by walking around Green Hills mall. Problem ... forgot the wheelchair. I wanted nothing more than to go by the Coldwater Creek store but absolutely could not crutch that far. My stomach was just in knots over this - couldn't believe I didn't bring the wheelchair. I also failed to mention that just before we left the restaurant, I was walking out of the restroom (marble floor) and there was something slippery on the floor. My right crutch (reminder - right hip was operated on) slipped outwards and of course to catch my balance I put weight on my right leg. I don't think it was full weight yet more than I've put on it yet. I did step outwards quite a ways on the right leg ... and it didn't feel good!!

So, PT tomorrow morning, and again on Thursday, then again for the next 2 Monday's and Thursday's. The hardest part is the status quo of this recovery. I have read other blogs where by this point some have been able to do 25% weight bearing, or are doing ankle weights or elliptical machines ... I'm not one who can be patient with the "status quo". Anyone who has worked with me professionally knows I get bored easily if I'm doing the same thing day in and day out with no accomplishments, no goal to work towards, and no challenge. While I'm seeing minor improvements with PT in lifting my leg while standing, I guess I'm wanting something more significant to make me feel like there will be a light at the end of this seemingly loooong tunnel.

4 1/2 weeks since surgery ...

Hello, readers.

I wish I could say that the high's and low's have stabilized since my last post. I have a theory that the "low's" are due to being switched from percoset to lortab 2 weeks ago, combined with just being tired of being disabled. Don't really have an answer ... just try to get by day by day.

Today I had physical therapy. This time last week, the appointment was rough. Really really rough. It was a combination of pain, as well as doing some exercises that truly made me realize my muscular limitations in my quads and hip flexors. Well, today we had some breakthroughs. While doing some new exercises from a "standing" position, I was able to ALMOST lift my knee to a 90 degree angle (like a march)!!! This was huge ... I mean, really huge. I was shocked (as was my therapist) that I was able to lift my leg that high. I'm still not to the point where I'm sure Dr. Kregor wants me to be, but I still have 3 weeks left to make some serious progress before I see him again.

We went to church on Sunday, and that was nice. As always it was good to get out of the house. I'm also starting to make some good traction on some projects at work, which makes the brain feel good. I'm hoping the kids have a good week ... last week my son had a rough first week of Kindergarten. Had several warnings of bad behavior, subsequent time-outs, but then on Thursday and Friday he did really well. Hopefully this is just and adjustment period getting used to a new schedule, new authoritative figures, etc.

Not much new to report on the recovery front. I've found I am sleeping more on my left (non-operated) side which feels good, and less time on my back. The one exception would be if I've been using crutches too much during the day and my ankle swells a great deal, I will sleep downstairs in the mechanical bed so that I can have my legs propped up above my heart so the swelling will go down. Overall the swelling has gotten better, is completely gone in my left leg, but my right ankle is still not cooperating.

Happy Monday, everyone.

Highs and Lows of recovery - will it ever stabilize?

I can now say that I have experienced some highs and some low's at this point with my recovery. At this moment, I am hoping and hanging on for dear life that I am coming out of a "low" that I've fallen into for the past week.

Last week, as mentioned in a previous post, I was feeling pretty down ... somewhat like a depressive state. Highly emotional, short fused. There were 2 factors playing into this though: 1, had just stopped taking one of my medications (a 12-hour time released Oxycontin), and 2, Jonathan (my 5 1/2 year old) was home almost all week due to summer camps being over and he had his first 1/2 day of Kindergarten on Friday. Both of these could have contributed to my nerves and emotions being shot.

After a week like that, I truly look forward to Sunday morning where we all get ready for church, and John and I enjoy the hour kid-less in Sunday School where we can focus on letting the Lord speak to us, without interruption, and enjoy some quality time with the incredibly special people in our class. To my dismay, the one elevator in our church that goes to the 4th floor was OUT OF SERVICE!!! Our only hope was to take another elevator that only goes up to the 3rd floor, and then take the stairs. There's just one problem with that solution ... I can't go up a big flight of stairs like that on crutches (which were in the car) just yet, and my only mode of transportation was a wheelchair. I felt this sinking feeling in my stomach ... I couldn't believe that I couldn't go to Sunday School because of a stupid elevator being broken. After all, I've never had to rely on an elevator before. This was not the way I wanted my Sunday to start off, after we had experienced a rough morning as it was just getting ready, getting the kids dressed and out the door, and listening to arguing and tantrums in the car all the way downtown. John and I sat in the sanctuary during Sunday School and listened to our stand-in pianist and our organist practice, and enjoyed the peace ... for at least 30-45 minutes. There is indeed something special about our sanctuary at First Baptist Nashville ... this room has a grandeur about it with the abundance of stained glass windows and the majesty of the pipes for the organ, and you really can feel God's presence in this place. We decided not to stay for the worship service as we were just exhausted, and picked up the kids after their Sunday School was over.

Leap forward to Monday (yesterday). I am now cleared to get back to work! Granted, it is working from home remotely on the laptop ... and I have a 5 hour max per day restriction ... but at least I can hope to feel some sort of accomplishment and productivity by getting back into the groove. Kids started their new school year as well!

The busy day started with me waking up to my usual stiffness and pain, pain more than usual since I forgot to take my pain meds at 2am. John got the kids ready for their first day of the new school year, and we took pictures of them on the front porch (a tradition I started last year). When pictures were done and last minute items were stuffed in already full bags and backpacks, they loaded up in the car and John dropped them off.

He then came all the way back home to pick me up and take me to my first physical therapy appointment, away from home!! Since I didn't have far to walk, John convinced me to just use crutches and leave the wheelchair in the car. Good move. Therapy went well, and while it did hurt at times ... I didn't mind because I felt comfortable with my therapist and trusted she knew what she was doing. Connie seemed like she had been doing PT for a while, and also knew about hips. My biggest concern with blindly calling up StarPT and telling them I would be a new patient was the potential of getting a therapist who only knew how to heal sports injuries like elbows, shoulders and knees ... And who wouldn't know a hill of beans about a hip procedure like what I had. I really got lucky. Dr. Kregor had advised me to take the printouts of my xrays, and I'm glad I did. It helps to visually explain what was done, the areas affected, and thus how to
build the right plan.

Per Dr. Kregor, there are 2 primary goals with therapy between now and the next 5 weeks. 1 - make good headway towards being able to do a straight leg raise from lying down, unassisted. 2 - while lying on my left (good) side, raise my right leg. Today we sampled some muscle strengthening exercises that gave me an idea of how far I had to go, and which muscles would be needed to accomplish those goals. Needless to say, I have a long way to go and really need to do my homework!!!! (translated - be very diligent with my exercises between sessions)

Once I was home, John headed to the office and I hopped online. I had 2 conference calls, solved some user issues, answered emails, and BOY it felt great. Emotionally I felt the "blues" beginning to lift as I was able to focus on something other than my woes, aches and pains. By the end of the day I was exhausted, from PT as well as work I guess, but it was all good. I am so incredibly thankful for my employer to be so flexible with me during not only my short term leave, but also my restrictions on returning to work. The funny thing is (ok, maybe not so funny), last night I had a dream that they let me go!! I woke up this morning to take my meds and realized it was just a dream, and was so relieved. The dream felt so real - everyone on the team had gotten an email saying I had been let go, but I didn't know about it because my Blackberry was acting up and not receiving emails. I remember feeling sheer PANIC and being mad, disappointed, and broken-hearted because I had thought I was really contributing there! I think I have a small taste of what so many people out there have gone through with loosing their jobs, however am very thankful this was just a dream.

Today was day 2 of working, and it was a good one. There have been various interruptions, such as taking bathroom breaks (it takes a while for me to wheel myself out of the home office, fold up the walker, place it across my legs, and wheel myself to the bathroom), doing my exercises, fixing lunch (again, takes a while to make that happen), etc. But my brain still feels good ... and now I just wish the rest of me did!

Pain-wise, major soreness in my hip and down my leg. I'm hoping this is just my muscles talking to me and saying "hey, it's about time you woke me up!". I still have a good deal of swelling in my right ankle and foot, but not in the "good" ankle anymore. One new thing that has popped up is the fact that when I'm using the walker to get to the restroom, or whenever I'm standing for even just a minute, my right foot turns dark red. I emailed Dr. Kregor's assistant to find out if this is normal or not. Haven't heard back yet.

GOOD NEWS ... I'm no longer on the Lovinox injections!!! Both John and I are very excited about this. :-) Now I switch to taking aspirin daily - no big deal.

All in all, I'm starting to feel optimistic that this will be a good week. Tomorrow at church we have the Children's Ministry Back-to-school Bash which I'm looking forward to! Last year I was asked to be one of the leaders in our 1st grade Music Makers choir, so tomorrow is a big day and I'm soooo looking forward to getting to know our new rising 1st graders! Hoping this is another emotional and spiritual lift that will sustain me through the rest of this recovery period.

Until next time!
Lori

Recovery update - 3 weeks post-op

Wow. Has it only been 3 weeks since surgery??? It has felt like an eternity.

Tuesday I went to Vanderbilt to have a Doppler study (ultrasound) on both legs and my groin to look for blood clots as a reason for the unbelievable swelling I'm having from my incision down to my toes, and now slightly in my good leg. No clots found, and I have good blood flow!! Now I just have to wait and hope my body shapes up and learns how to absorb this extra fluid. I'm increasing my water intake so hopefully that will help.

Since I learned I don't see Dr. Kregor for another 6 weeks, I have had some bouts of serious depression knowing I have to live in these confined conditions for that much longer. I'm tired of this uncomfortable hospital bed that we rented. I'm tired of being confined to the downstairs. I'm tired of the front wheels of my wheelchair pinning me in doorways. I'm tired of the unbelievable pain in the palms of my hands because of the walker. I'm tired of every limitation that keeps me from running errands, helping get the kids ready in the mornings, and everything else domestic that a wife and mother is responsible for. I could go on ...

None of this is a surprise or unexpected. I've been told since day 1 that I would be recovering for 8-10 weeks. One just doesn't really know what that means and feels like in reality until you are in the throws of it.

There are 2 things I can look forward to though. One, my first born starts Kindergarten tomorrow! Two, I get to start work again (granted from home on the laptop, with a 5 hour per day max restriction), so I hope and pray that getting back on my big project I had to step away from will give me the much needed mental distraction and sense of progress that I've been needing lately.

I get to start off-site physical therapy on Monday morning as well. Hopefully it won't be too hard on me.

2 1/2 Week Checkup

Today I went to see Dr. Kregor for my first checkup since surgery. They took new x-rays of my hip to ensure the bone is healing properly, and they took ALL the sutures out!! This part was rather painful, particularly taking out the ones at the far edges of the incision, but I'm glad they are out. In their place, there is dissolvable glue and tape strips that should remain dry for 48 hours, then they are to dissolve on their own. Still feels better than the nylon poky things that were there before!

Here is a summary of the results of my visit:

• Continue toe-touch weight bearing for another 6 weeks when I see him again.
• I can shower (sitting on my bench in the tub) again in 48 hours.
• I can discontinue home PT and progress to off-site therapy which can include bike therapy, with the goal to progress to a straight right leg lift unassisted over the next 6 weeks.
• Continue pain meds as currently prescribed
• Keep our eyes on the middle of my incision which is not healing properly, and hope it heals soon like the rest of the incision.
• At my next checkup in 6 weeks, we will discuss the plan for the rest of my recovery. With any luck, at that point I will be closer to getting clearance to DRIVE!!
• Got release to begin doing work from home (heck, if I'm just sitting on the couch playing on Facebook then why not do some "real" work?) in a week. Stipulation - max 5 hours per day right now.
• Swelling - this is the biggest concern right now. The swelling has progressed to my "good" leg, and is still pretty severe on the right. I am scheduled for a Doppler ultrasound on my lower extremities tomorrow afternoon to see if I have any blood clots. My dear husband is giving me Lovinox injections in my stomach every day (blood thinner), however there is still a chance I guess that there may be a clot that is causing all this swelling. I hope and pray it's not a clot ...

Here is the "before" picture (sorry, I don't have a digital version so this is a picture of a piece of paper) of my hip. You will notice on the left side of the picture (i.e. my right hip) that the femoral head is sticking outside of the socket. The goal of this Peri-Acetabular Osteotomy (PAO) is to use my hip bones to create more coverage on that ball, so that it evenly carries the weight that the upper body creates.


Here is a picture of my post-PAO hip, at 2 1/2 weeks. There's not much change since the picture taken in the OR immediately following surgery, which in my opinion is a good thing. You will notice however that the femoral head on my right hip (left side of picture) now has very nice coverage by the socket!

I'm still trying to figure out what the big black hole is inside my pelvis.

When I got home from my appointment, my Physical Therapist came by for probably my last appointment at home. It went well, and we added some other exercises as well. Yes, I am sore as all get out today! Getting out of the house 2 days in a row, plus PT ... I'm hoping to sleep real well tonight!

It was good to hear that I can double up on my pain meds before I go to bed at night. With my increased desire to drink fluids lately, it of course means I have to go to the bathroom often, and when you really have to "go" in the middle of the night ... I've found I'm extremely stiff and sore when trying to get up out of bed at night. Hopefully a double dose of meds before bed will make it easier, and will also give me some relief when I wake up in the mornings.

Other than that, still dealing with the recovery process pretty well I think. I will admit I'm becoming increasingly frustrated with toys and such lying in the floor that suddenly get caught in the wheels of my wheelchair, and I'm frustrated that I can't help out more around the house and have to carry around my grabber and walker with me at all times while I'm in the wheelchair. Life right now for me is just a big production. I have to plan every move I make, to each room of the downstairs, to make sure I have everything I need and don't have to make multiple trips. Both of the kids now have felt the pain of having their toes squished by a wheel, making me feel absolutely horrible. They just get too close sometimes and I don't see them (or their toes) when I'm wheeling around in the kitchen or den.

I hope and pray there is no news from the ultrasounds tomorrow! Until then ...

First Outing

Well, today I ventured out of the house for the first time since I've been home from the hospital. We all went to church together! The kids were quite excited to see me crutch myself to the car and actually get in. It was very cute how they reacted. Everything went really well, however my legs (yes, both legs now) are swelled up like balloons since I haven't had them propped up whatsoever today. It was still so great to see everyone in Sunday School this morning.

It was especially nice to talk to a special lady in our class who is having eye surgery this Friday. Martha Kirkland, who taught me in children's choir when I was in grade school, has been such a spiritual mentor to me these past few years, will be having this surgery so I wanted to take the chance to let her know in person that I would be praying for her. She is such a wonderful woman and has a heart of gold. I hope and pray the surgery goes well and she can recover very quickly.

Tomorrow is an exciting day for me. I have my first appointment with Dr. Kregor since I last saw him in the recovery room! I was EXTREMELY lucky to nab an 8:30am appointment so that hopefully it's early enough so that they don't have a chance for the appointments to run late and thus cause my appointment to run late. My sister is coming to the house early in the morning to stay with my son Jonathan, since he is done with summer camps now. We will take my daughter Kathryn to school when the doors open at 7, then grab our Starbucks, and head to Vanderbilt. I am hoping they will take my stiches out - it is a royal pain to wrap up my hip and thigh with saran-wrap and electrical tape just so I can bathe, without getting the stitches wet (this is not an easy task). I imagine they will also take x-rays of my hip to make sure everything is healing appropriately and that the screws are doing their job. I am also hoping I can get clearance to start working again (remotely from home) on Monday, August 24th. And, while I'm not expecting much, I'm hoping to get some kind of idea on when I can drive again. Since the surgery was on my right hip, I imagine I will still be another month out from being able to drive, but we will see.

I hope to post a great report tomorrow afternoon after my appointment. For now, I just need to try and get this swelling under control ... which seems to be a loosing battle. The swelling encompasses the left foot/ankle, and the right leg from my toes all the way up through my hip area. I could tell there was quite a bit of swelling when I was sitting in the car and I felt like my hip was hanging off one side. Not pleasant!!

Until tomorrow ...
Lori

13 days Post Op update

I woke up this morning feeling like I had been hit by a Mack truck. I can't figure out why I was in so much pain, considering I was diligent waking up to take my meds at midnight and 3 am, so I can only assume it was because I was stationary for so long. Once I took my oxycontin for the day and my 4 hour percoset (and a couple cups of Starbucks coffee), I feel human again and am ready to start the day!

The pain this morning was not just in the hip, but also my thigh, palms of my hands, forearms, biceps, triceps, and head. The headache was probably because of the pain everywhere else, and the hands/arms were undoubtedly due to increased use of the walker and wheelchair (there is quite a bit of resistance wheeling on carpet).

This picture is my "room" where I only spend the nights in. The bed was rented from a medical supply store, and comes fully equipped with a lifter bar on the top (that I don't use much anymore, but helped give me something to help lift me up out of a lying down position), and a remote-controlled motor to raise the head and feet as needed. The blue noose-looking-thing is my leg leash. This is another "must have" tool that I use to lift my leg into bed, or move it from side to side to get settled. Once my muscles are stronger, I can stop using this but right now my leg feels like it weighs a ton so it's needed. I have a nice TV on a pedestal at the foot of the bed, my laptop/table stand by the window, and of course a potty. In the middle of the night, it would take me too long to maneuver lifting my leg to the floor, getting the walker, and getting to the restroom down the hall ... so unfortunately this is needed for a while as well.

Which one of these is not like the other?

Swelling is becoming a problem right now. It used to be contained just to the hip and thigh area, but has now progressed down my leg and into my ankle. Dang - I thought swollen ankles were a thing of the past once I had my last child!!! I guess I should be thankful it's only confined to the right ankle, versus having swelling in both.

Nonetheless I feel good now, and am able to get up on the walker to brush my teeth and start working on thank you cards. I also need to do my exercises, so that my muscles can get stronger.

John went to the office this morning for an 8:30 meeting so it's pretty exciting and exhilirating to be able to demonstrate my independence skills for a little while!

Let's hope the pain stays in check for the rest of the day!

11 days Post Op, 1 week home

This time last week I was a groggy, pitiful mess who couldn't do a THING. I am continually amazed at how much has changed in this short amount of time. Just a week ago, I was seriously wondering why I decided to go through with this surgery. I was also wondering "what was so bad" with limping before compared to the pain and discomfort I was in when I got home.

I am happy to say (like most other PAO folks) that I am VERY glad I had it done. It will take time to feel like I can reap the full benefits of my newly constructed hip socket and my refreshed femoral head (and hopefully renewed labral tissues over time), however I am already noticing some benefits. The big benefit I have felt is NO LOW BACK PAIN in the mornings!!! For about a month leading up to the surgery, and I may have mentioned this already in my blog, I would wake up with blinding low back pain. I can only assume it was because of my increasing compensation of my left hip to make up for the limping and strain I was experiencing on the right. Well, I haven't had a bit of low back pain since the surgery, despite all the sitting I've been doing! I can only hope and pray the back pain stays away!

I had Physical Therapy at the house today, and it went really well. In case you are wondering what types of exercises one does after hip surgery like this, here is what it focuses on:

• Ankle pumps (Bending ankles up and down alternating feet - good to exercise calf muscles and if my legs are propped up, helps with the swelling.)
• Quad sets (Tightening your thigh muscles, holding it, and releasing - doing this in repetition.)
• Gluteal Squeezes (Need I say more? Exercising those glut muscles.)
• Heel slides (Not my favorite right now. While lying on my back, sliding my right heel up to where my knee is up in the air and my leg is at an upward angle. You need to use all your thigh muscles to do this, and they are not awake as of yet in my case ... but getting better.)
• Hip Rotation (While lying down, rotating my toes inward and outward ... causing some rotation in the hip joint. Again not my favorite, but after I get through a few reps, it actually feels good.)
• Hip Adduction (Basically pretending you are doing snow angels. Sliding your heels outward to the edge of the bed, again moving that hip joint which hurts like the dickens but works those muscles that are still trying to wake up and find their place in life.)

There are a few others, but this is the gist. I'm sure at some point I will be able to move off-site and do more resistance exercises, but right now I'm still just trying to move with my own resistance that I have! PT was pleased nonetheless.

A week from today I go back to see Dr. Kregor for the first time since surgery. I would imagine this visit will involve taking out my 30+ sutures, getting fresh x-rays of his masterpiece, going over what he did during the surgery (now that I'm somewhat more clear-headed now), and talking about where we go from here. I am hoping to get clearance to begin work again, at least from home until I am cleared to drive which may not be for another month or so. We shall see.

Today I received a care package in the mail from work. It was the absolute most thoughtful gift I think I've received yet (and when I say "thoughtful", I mean it - they put a lot of thought into this!). In an effort to de-fuzz my brain which is turning to mush after being at home (and literally in the house) 24/7, there were some books that are favorites of my boss (including "The World is Flat", and couple other books that are Harvard best sellers). There were also some good 'ole convenience store magazines for catching up on celebrities as well as the latest music buzz. Not forgetting about my 2 little ones, there were 2 packages of Putty Bots (little robots with silly putty inside). What is particularly touching about this is, they are exactly the same. We have learned that it doesn't matter if you have a girl and a boy, or 2 girls, or 2 boys ... you have to give them things that are the exact same otherwise there will be an absolute brawl over who gets what! Also for the kids, they have a new Ice Age movie (we had honestly lost the original DVD yet had the 2nd one, so this was uncanny timing), and a book called "The Pigeon Wants a Puppy" so that they can be comforted by Daddy's voice before bed in the absence of Mommy who can't tuck them in upstairs at night.

I was humbled, touched, and simply floored at the thoughtfulness of this "care package" and how it seemed to cover everything we are needing right now. All of the food that our personal and church friends are bringing covers the basic needs of making sure John doesn't have to cook for all of us, and has greatly reduced our grocery bills and trips lately (THANK YOU!!!), and now I have something to share with the family that is a bit more lasting. Thank you Bill, Vic, Christy, Edwina, Mark and Rosanne!!! I am so blessed to work with such a fantastic team.

With my feet propped up, ankle pumps in progress to trying to tackle this annoying swelling, I reckon I will wrap up this post. Until later ...

Lori

10 days Post Op

God must really be smiling on Middle Tennessee this summer. We have had the most unbelievable weather this year, and a good bit of rain too. Usually it's in the mid-upper 90's with horrible humidity and no rain! It has really been nice.

Brief recovery update. I'm feeling fantastic considering it's less than 2 weeks since the surgery. My appetite is getting better (now I can enjoy all the food our friends and family are bringing), my upper body strength is increasing (which is a necessity since I can't put any weight on my right hip and solely rely on a walker and mostly get around via wheelchair), still have swelling and soreness in my right leg, and still need a regular dose of Percoset. Mentally I'm thinking so much more clearly as well; I wasn't expecting it to take so long for the anesthesia to leave my system but I guess after being under for 6 hours this is to be expected. Really pleased with the progress from what I can tell.

The biggest challenge right now is not being able to help with the daily parenting. The kids (particularly my son) are still having a hard time adjusting. We are having problems with obeying, listening, following instructions, and talking back. For example, my husband was trying to get the kids ready for church this morning and it was like pulling teeth to get them to do what they needed to do to get ready. I could hear them bucking back to my husband from downstairs and was absolutely helpless and powerless to do anything whatsoever to help. They finally made it out the door all in one piece, but it just absolutlely broke my heart to not be able to help take some of the stress off my husband who is trying so hard and doing everything he can to keep things rolling. It is so hard being the only functional 2 legged parent keeping the house picked up, laundry going, dishes clean, bags packed, making sure mommy is taking her meds and has what she needs, and getting the kids where they need to be. It's just really friggen hard.

Today I'm thanking God not only for this man who is doing such a great job holding the family together, but also for my mother who came over today to help me bathe and get ready and who made her famous "stained glass dessert" (brightly colored jello squares mixed with cool whip), and for my mother-in-law who is keeping the kids for a few hours so John and do some work at the office (not to mention have some quiet time).

Blessings can sometimes come in the smallest of packages. It's those small packages that can mean so much... God is so good.


-- Post From My iPhone

Ambition can get you in trouble

So I've been feeling amazingly well these past few days. My wonderful mom came over this morning to help me take a bath (using a special bath seat) and wash my hair, shave, blow dry my hair, put on make-up ... the whole 9 yards. I felt LIKE A MILLION BUCKS!!! Until around 1:00 (which was about an hour before I could take my next round of pain killers). It caught up to me big time. The kids have been maniacs all day, not listening, not following rules, hurting each other (like 3 and 5 year old siblings like to do), so I've been pushing myself like mad in the wheelchair all over the downstairs trying to get them in line. I'm thinking this also was pushing my leg muscles a bit further than what they were ready for.

Also, despite my best communication efforts, the kids keep leaving shoes, toys, blankets, just whatever they can find laying in the middle of every hallway and path I use to wheel through. Keep in mind, I can't bend over to pick anything up yet ... and the awesome "grabber" tool I have, well, I don't have it in my hands at all times cause it's sorta cumbersome.

My dear friend Nathalie came over this evening (while John took the kids to the pool) and brought some dinners and offered her wonderful company that she is so good at giving. That was a real treat.

Tomorrow is Sunday and I'm going to miss going to church. It's just too hard to get me to the car right now, with 7-8 steps leading down into the garage, and that's the least number of steps of the 3 doors leading outside and I can't maneuver on crutches at ALL right now much less to go up and down stairs. Maybe next week we can figure out a way to make that happen ... or maybe not. I miss leaving the house.

Well, I presume it will be another restless night of waking up between 3 and 4 a.m. in excruciating pain and having to turn on the TV and wait until it's time for another dose of pain meds before going back to sleep. It does feel good to be a little more mobile, but it's reminders like today (when you do too much) that tell you this is NO joke and there is NO quick path to healing. You HAVE to slow down and let things heal, and it's going to take a loooooooooooooooong time.

I need a "Pain Management for Dummies" book

Seriously - someone should write a "Pain Management for Dummies" book. Actually, once I started typing this in my blog post I hit Google to see if it was actually out there. To my not-so-surprise, there are several. :-) That cracks me up.

My darling husband is fighting a cold, so knowing he needed a break from tending to 3 persons on his own lately, I decided to set myself some alarms across my mobile devices last night for my 4-hour pain med reminders. We had everything layed out so that I could wake up and take the meds, and he could stay upstairs and get some sleep. I ended up staying up late to take my midnight dose of Percaset, then set my reminder for 4am to take more Percaset plus my 12-hour time release Oxycontin. I woke up at 4 in absolute blinding pain. I could hardly push the button on my bed remote to raise the head just enough to take the medicine and wash it down from a cup with a bendy straw in it! I tell you what - I'm starting to think that either I need something stronger, or need to shorten my window from 4 hours to 3. The only problem is, Percaset has a serious dose of Tylenol in it and you can only consume a certain amount in a 24 hour period. Something to talk to my surgeon's nurse about.

I also awoke to notice my right thigh and hip is a bit puffier than the non-operated side. The incision still looks great - no redness or drainage, but nonetheless something I emailed the nurse about. She said it is not uncommon to have more edema around the incision, and reminded me I did have a hematoma at the top of the incision so I guess I don't have anything to worry about. From my perspective though, I can deal with this localized pain MUCH better than that PLUS nausea PLUS heartburn! I feel like a million bucks compared to how I felt just a few days ago. Pain management is such a confusing, scientific balancing act it seems ... I think it also causes you to have really weird dreams. I had some REALLY strange and vivid dreams about work early this morning. I dreamed I went back to work MUCH earlier than prescribed, and had no cane ... no walker ... no wheelchair ... and was hopping around on one leg from meeting to meeting. Very strange. I do miss the work crew though!

Call me Evil Knievel

I was a wheelin fool last night in my wheelchair. I was feeling pretty good and wanted to test my new found independence, so after dinner (I sat at the table with the family, in my ride) I told my husband I would pick up the kitchen while he took the kids upstairs to bathe them. He looked at me like I was crazy, and it took a little convincing, but he reluctantly took them upstairs and I got to work. I threw away all the trash, put dirty dishes in the sink, put a few things in the frig, wiped the counters/island/dinner table down with Clorox wipes, and picked up a few of the piles on the counters ... all from the safe confines of my wheelchair. Later after the kids were nice and squeaky clean ... he said "Wow - the kitchen looks great, babe!". Hee hee ... never underestimate the power of a project manager. :) I will admit it was tricky, and there were some things I really could not do, but it was fun just to put myself to the challenge. I took each of the kids for a ride sitting on my good leg around the kitchen. They had a blast. :-)

In addition to this necessity, PAO patients need a "grabber" (shown here clipped to the right side of the wheelchair). For the things which are not immediately in your reach, this great gadget can usually place things in your reach. I was also provided an "invisible dog leash" sort of thing (will add a picture later) that has a loop on one end (that I loop on my operated leg in the arch of my foot) and is a durable nylon with a handle at the top that helps me lift my somewhat dead leg from the floor into the bed, or wherever I need it to go. My leg muscles are so compromised that I cannot yet lift my leg and place it wherever I please, so I need help.

And then of course is the walker. This is MUCH more stable than crutches at this point, where I still get light-headed after being vertical for any length of time. I will admit it is nearly impossible to fold this up and carry it in my lap when I'm wheeling myself around the house. You can't tell I'm trying to re-gain my independence, can you? Ugh ...

After a busy morning of drinking coffee, changing clothes, brushing my hair, brushing my teeth, and traveling to the den to get myself set up on the couch with my laptop and such, I'm exhausted. My BFF is coming over at lunchtime and bringing our favorite black bean salad from Calypso here in Cool Springs, so hopefully I can stay awake long enough to enjoy a visit with her!

I want to say a special THANK YOU to all my friends and church folk who have brought meals and treats for us. The kids have enjoyed the variety (and so have we!), and it has been much easier on John not having to worry about too much grocery shopping and cooking each night for all of us. I love you all.

And to my husband, who still manages day-in-and-day-out to get both kids up, dressed, and to their respective schools/summer camps, takes care of me, and still manages to get his own work done (remotely at least for this week), he is my hero. He treated himself (with my support, of course) to 2 new 24" Acer monitors for his studio (pics to come as well). Amazon had a sale, so I let him get those and they arrived yesterday. They look awesome!! I love you, John ... and can't thank you enough for your dedication to keeping this family afloat!

Oh - here is my newly constructed right hip with the 7 screws, and a nicely rounded socket where my femoral head fits nicely inside. Yes, very nice. :-) I'm trying to get my hands on digital copies of these, so pardon the red markings from the surgeon - this is a picture of a piece of paper, basically. There is a big white wrinkle going up the page from the bottom, so disregard that. The screws aren't that hard to locate.

More later! Fingers are tired now. :)
-L

1 week Post-Op

Here is my update - 1 week post op! It has been a long and very challenging week. I have already been through what many others have described as depression, day-time-TV blahs, feeling of being cooped up, crawling the walls because you can't do anything, anxious because you can't do anything on your own and have to ask for help ... I've now been there and can understand what they were talking about.

The other day I got really sick, and am thinking it was due to my inability to release the toxins out of my system (trying to choose words carefully here), which is what anesthesia can sometimes prohibit you from being able to do. Once that was taken care of, the nausea and vomiting went away. Then came the acid reflux. I'm not one who has ever had a problem with this in the past, so considering I am not eating much to begin with, still can't figure out why I'm having a problem with this other than I wasn't getting up and moving around. Nonetheless, this is still a pain. Then there is the abdominal pains (for obvious reasons - things are still not back to normal yet). Then there are the chest pains (granted, getting better) caused again from not moving around and taking deep breaths. Trying to do better on that. Then the kids - Jonathan is acting up at summer camp (he's my 5 1/2 year old), and Kathryn (who is 3) has been having accidents in her bed at night (which she hasn't done in nearly a year I might add!) - the kids are starting to not understand what's going on. They see me lying in this rented hospital bed downstairs WAY too much, they never see me up and around. Kathryn asked me on 2 separate occasions last night ... "will you come with me upstairs to get.." and I had to say no, honey - I can't. Then she would say "can you pick me up to get ..." and again my answer was no honey, I'm sorry. Jonathan asked the other day "will our family be like this forever, with mommy downstairs?". Let me tell you - this broke my heart. They can't really grasp the concept of "no, this is just for 2-3 months". They can't understand if that's a long time or not. I broke down into tears last night after they kissed me goodnight and went upstairs to get their jammies on get tucked into bed. Oh the things we take for granted sometimes.

The dressing from the incisions came off yesterday and everything is healing superbly. I was S-H-O-C-K-E-D to see what the damage was. We're talking 12+ inch long incision, because of them having to get full exposure to my hip and dislocate/relocate it as well. Other women have posted pictures of their incision and they don't seem to be quite as far down the thigh as mine, but of course I had some extra special things done in my procedure that others may not have had. Lucky me ...

Last night I think I hit a breaking point, or perhaps a breaking-DOWN point. Everything had come to a head and some pretty big depression and self-pity started coming into play. This depression was turning into anger, which manifested itself today into determination. I stayed awake for my 10pm dose of Percaset, then realized I needed to use the restroom. The one thing I have NOT been able to do this past week (well, other than just about everything) has been to get both feet into bed after I have gotten up. I just don't have the muscle dexterity in my upper thigh to raise it and always needed someone to lift it up for me. Well, I got so pissed off last night that I yanked my leg into bed myself (knowing everyone else was asleep at this point). After I wallowed in tears for a while from the pain, I realized "hey, I did it!". I got a pretty good nights sleep after that.

Today my mom came to visit and helped me take a bath (using the shower seat and shower wand she and her husband installed), wash my hair, brush my teeth, wheeled me in the wheelchair out on the front porch where we enjoyed the breeze, fresh air, and talked about everything ... I felt so refreshed. Oh, have to mention I had a nice cup of Starbucks coffee in my hand. :) That always helps! Home Physical Therapy came by at noon today, and it was also a positive visit.

• Improving my ability to hop with a walker for longer distances (i.e. down a hallway) - still toe-touch weight ONLY on right leg. While vertical, on the walker for example, my right leg feels like it weighs a TON and I feel all that gravity pulling down on my fragile hip being held together by 7 screws. Scares me a bit.
• Able to swing both legs out of bed and stand up to a walker more easily than before
• While sitting on sofa, can lift my right leg to a straight position (equal with my knee/thigh) - This was a HUGE accomplishment that I didn't realize I could do yet!
• With both legs elevated in front of me on a recliner, can slowly move my operated leg from left to right (not without pain though - you are basically moving your hip in it's socket from left to right, so understandably there is pain from the hip down through the thigh and into the knee)

Now that it's nearly 2:30, I think I'm going to enjoy the accomplishments of the day, try to take a little nap, keep my mental state in-check so that I don't dip into that nasty, dark, lonely, fearsome place again, and look forward to seeing the kids reactions this afternoon that mommy is not in her little room - she's actually in the den and looking somewhat normal!

Hip, Hip Hooray ...

Surgery day and hospital stay

Surgery day was this past Thursday. I've been a bit out of it lately, so I will now try to catch up on everything that has happened since then!

First of all, I am extremely thankful to be alive. When someone faces major surgery, there are all sorts of things that cross your mind (in my case, I was thinking worse case scenario) and was scared to death to leave my family.

I had to be at Vanderbilt at 6:00am. My husband had to drop me off then take my daughter to school (they didn't open until 7) and then take my son to summer camp by 7:30. Knowing my OR time started at 8am, I pretty much knew John wouldn't make it back to Vanderbilt to see me before I went in. Once I signed in at the admitting desk, I called my mom (who works in the main OR at VUMC and was just getting off her 7p-7a shift). She met me on the floor when they wheeled me up to the holding area.

Every single person who walked up to me said hello and that they knew my mom, and were very sweet. That was quite comforting. They had me put on a lovely gown - one I had never seen before, then started asking questions while they got an IV started. They then talked to me about anesthesia and the potential of an epidural block to help with pain relief. I let them do it - figuring, if they recommend it ... then I guess I should trust them and do it. I will realize later that I was glad I did!

Questions answered, IV started, block injection complete, now time for some versed (?) in my IV to calm me. Anxiety was running at full force now. To my surprise, Joe Fitzpatrick (our new Minister of Music / Worship and Music Pastor at our church ... my husband and I were active in our church choir before our son was old enough to starting coming to worship this past fall) came by. He had us gather around hand in hand (including me and my mom, and a few nurses who happened to be standing there) and said a wonderful prayer. About 3 minutes after Joe left, my husband walked in. What a HUGE relief to be able to see him right before surgery!! We didn't have long to visit before it was game time. I hugged my mom, told her I loved her, and she stepped aside. John walks up. I stare longingly into my husband's eyes, hoping and praying this is not the last time, and I was off to the OR.

This OR was not too different than any other. Bright lights, cold, no bright colors on anything. I remember hearing clanking of metal instruments and tried to ignore that. :-) The manager of the anesthesia team said "ok, here we go" ... then I saw him walk over to some machine beside me, and that was all I remember.

When I awoke, I asked the nurse who was standing beside my bed what time it was, and she said 4:45 (PM!!!). Surgery took about 6 hours ... I was FLOORED! I think I was more floored to be alive than anything. Surgery was successful - here are some stats.

• Surgery time: ~6 hours
• Tasks performed: PAO with 7 screws, hip dislocated so that abnormal bone on the femoral head could be shaved off
• Sutures: ~30 along a 12" incision
• How I felt: major cotton mouth, but NO pain!
• Good deal of blood loss, but all of my own blood was re-used
• I was informed I had rolly-poly veins. Bruising to come would explain this and the difficulty they had during surgery putting in my additional IV's and arterial lines!

Once a room was ready, they wheeled me over to it. They told me they couldn't let me drink anything (other than sucking on ice chips) until I got to my room, because the bumps along the way to get to the room can sometimes make people nauseous.

I was in the hospital for 4 nights. Had some good nights, others not so good. Initial pain meds were a morphine drip + percaset. Morphine was not doing the trick (c'mon - they say push the button every 8 minutes for pain, but hello ... how are you supposed to do it when you are asleep??), so they switched me to an oral dose regimen of OxiContin (12-hour time released pills) plus 2 Percaset every 4 hours plus a stool softener plus an acid reflux pill (I will realize once home what that was for).

Vitals were checked every hour. On the 2nd day there was some concern with the drop in my red blood cell counts as it may lead to a blood transfusion. Because of my age, they were ok letting it drop to the level it was. It ended up not dropping any further during my stay.

Physical Therapy stopped by on Saturday morning, helped me do a few exercises (couldn't do too much because my pain wasn't under control yet). PT said they would come by later that afternoon, and didn't, and also never came by on Sunday. Monday rolls around, they finally decide it's safe to discharge me, and I make a firm statement that before I leave I need someone to help me figure out how to get up the 7-8 stairs I'll have to tackle from the garage inside the house. Fortunately, we did spend some time on that. Problem was, I was exhausted. With absolutely no appetite for the past 4 days, being on serious pain meds, having no energy, PT wearing me out, and muscles around my right hip now seriously compromised ... I was scared to death about how I was going to make it up those stairs once we got home.

Home journey and where I am today to come. Gotta move around some now - my fanny is getting sore!

My symptoms, and my "so called" options

As you can tell, I'm having a very "reflective" kind of day ...

As friends have found out I'm having hip surgery, I've been floored at the number of people who have reached out and said "oh my gosh - I've been having hip pain too!!". Perhaps something along the lines of hip dysplasia or something of the like is more common than I realized.

I thought I might explain my own symptoms, and what I've been "told" were my options.

Symptoms:

• Started off as hip pain (located in the front, center of your leg in the hip joint area). After sitting for a long period of time (such as at my desk in front of the computer at work), I would stand up and limp for a little while, then the pain would "walk itself off".
• In recent weeks, the hip pain has become constant with any walking, going up stairs, carrying things (such as my youngest child) ... and then radiates to this strange pain down my femur and around my knee

Once I was diagnosed with hip dysplasia, I was told I had a couple of options.

Options:

1. Do nothing - expect a total hip replacement in my 40's
2. Total Hip Replacement (THR) - option not on the table ... I'm too young. Hip replacements (from what I've been told) only last less than 10 years so I would end up having several in my lifetime.
3. With the PAO, prolong (if not eliminate) my need for a THR for 15-20 years if I'm lucky.

Of course, there are several risk factors I learned of the week just prior to the surgery.

Risks:

• If the hip bone doesn't heal (with this procedure they break your hip bone in about 3 places, re-shape the socket to provide total coverage of the femoral head, then screw it back together with a few large, gargantuan sized screws), then a THR will probably be needed.
• If there is degredation of the cartilage in the socket (which it looks like there is "some") and it continues to degenerate for x period of time, then a THR will probably be needed.
• The location of the procedure is dangerously close to the sciatic nerve. Surgeons have to be extremely careful that the nerve isn't damaged.
  

On the bright side, it looks like my left hip is in good shape! There are many folks out there who have issues on both sides, and eventually end up PAO'ing the other one. I'm also thankful that when I went in last week for all my pre-op sticks, pricks, scans, and such ... one of the nurses checking my vitals said "your blood pressure is beautiful". I didn't know that BP could be considered "beautiful" ... I think of "beautiful" as being used when talking about a lovely beach, sunset, or rainbow ... Nonetheless, I take this comment as a good thing.

Ok, enough blogging ... gotta get back to laundry.

My temporary bedroom

I'd like to say a special thanks to my darling husband for allowing me to crash the man cave (also known as Hybernation Music Studio) as my recovery spot! Just need a bed now ... This is the only room downstairs where we could arrange for me to sleep. I bought a laptop stand thing (on the left, beside the sofa) where I can roll my laptop closer to me (and put it together all by myself!) and blog ... actually, probably just play on Facebook and work on my FarmTown farm when I'm not knocked out on pain meds. :-)