Thursday, December 31, 2009

Thoughts as 2009 comes to a close

For me, 2009 has been "the year of the hips." I am happy to see it go, because I am confident that 2010 will be a more mobile - and productive - year for me. However, 2009 has not been a total waste of time.

What I've learned:
~How to do the one-footed twist walk in order to carry things a short distance without bearing weight on my operated leg or using crutches.
~Resourcefulness (see above)
~Patience
~Just because you have crutches or a cane, don't think that people are going to move out of your way, open doors for you, or not run you over.
~However, some people are very helpful.

What I've lost:
~Most of my flexibility
~A lot of leg strength
~Any muscle tone I ever had in my legs
~Several thousand dollars in co-pays/deductibles
~I am no longer a "hospital virgin"
~I am not allowed to run, jump, or do "impact sports" for the rest of my life.
~I am not allowed to do stairmaster, lunges or squats for the rest of my life.

What I've gained:
~Two groovy new hip sockets. My hips are not and will never be normal, because the hip sockets are manufactured from my pelvis and not God-given, but they are "normal-er" than they were before.
~Two 7" scars
~14 stainless steel screws in my pelvis
~The ability to walk without pain (don't have this ability yet, but once I am off crutches and rehabbed, I hope this is the case).
~A new appreciation for those who are Disabled.
~Bunches of new friends from the Hipwomen group who have gone through this same dysplastic journey.
~Bulging arm muscles from more than 4 months spent on crutches.
~A closet full of mobility and other aids (walker, crutches, grabber, toilet seat riser, shower chair, bedside commode). I hope not to use these again until I need my hips replaced which will be, if all goes well, at least 10 years hence.

********************************************

Happy new year everyone.

Tuesday, December 29, 2009

Six Weeks

Snowy Day ...



Spent by the fire ...



I am counting the hours until I return to Dr. Mayo a week from today for my first follow-up appointment. I must get off these crutches! I had a couple of weeks of interesting pain, in particular at night, which seemed to be related to either hamstring or abductor weakness. The pain is still there when I move around at night, but much improved. Everything else is feeling good and normal and I am more than ready to start walking again.

I am still more tired than normal, but capable of getting through the day without a nap. Sitting in an office chair all day is difficult, but I am returning to work full-time on Monday. It has been difficult to be home longer this time, but I didn't feel ready to go in to the office until now. Being home and seeing so many projects which need to be done, but being unable to tackle them because I am on crutches and can't lift or carry anything, has been frustrating.

Not much more to report until Tuesday.

Tuesday, December 22, 2009

Five Weeks/Happy Holidays



There are only a few weeks per year that you can wear a sweater like this with a straight face ... as you can see, the butt bone is still firmly connected to the recliner.

Saturday, December 19, 2009

Out and about ...




At 4 weeks and a few days I went out to Perry's company holiday party, wearing (small) heels.

I got away with the heels because I only had to walk from the car to the restaurant and up a few stairs to the table. It can be done on crutches.

Thursday, December 17, 2009

Four Weeks/Scar Pic

Today is week 4 + 1 day, and I drove myself to the pool. I was driving at 4 weeks last time, and that was when my right leg was operated upon, so I figured there was no reason not to drive as long as I am no longer under the influence of narcotics. I have been off the oxycodone for 2 weeks and only take an occasional Tylenol PM to sleep, so I know that I can drive safely.

Stayed in the pool for about 30 minutes and mostly bobbed around in the deep end with a flotation belt. I can't say I "walked" or "ran" in the water. I used my arms and right leg to ambulate, but didn't use the left leg much since I'm not supposed to. It feels good to get the right leg moving in the water again. I'll start "walking" with the left leg in a couple of weeks when I'm allowed to do so.

Not even 3 weeks to go until I see Dr. Mayo for my follow-up appointment. The time has gone by really fast, although at the time it seemed like an eternity.

My scar is so well done this time ... you really can barely see it after 4 weeks. I mean, you really have to know it's there. It can be covered by my swim suit if I pull it down. Scar shown below. There are two lines; the one on the left is the scar, and the one just to the right of that is the residual line from my swim suit. The fact that the two lines look similar shows how faint the scar is:



My left hip is not swollen like the right one was either. So I look pretty normal. People at the pool or who see me on crutches keep asking me what's wrong with my foot. I tell them that my foot is fine but my pelvis was broken in 3 places. The look on their face is interesting. They are expecting to hear about a sprained ankle or broken toe. It's not that I enjoy shocking people, but hey, they asked the question and I'm not going to sugar coat the answer!

I still have a bit more pain on this side despite less swelling and a prettier scar. My range of motion appears to be more limited as well, and this was historically my more flexible leg. So it remains to be seen how I'll recover long-term.

Monday, December 14, 2009

Swimmingly ...

Went to the pool today and "walked" in the deep end for 20 whole minutes. I feel like I actually did something other than sit on my butt for the first time since surgery. No need to let Dr. Mayo know that I went in the pool so early since he wants me to wait until 6 weeks. For crying out loud, people in the UK get in the pool the day after surgery!

I love Dr. Mayo and think he is a great surgeon, but ... but ... well, I am not going to hurt myself in the pool. My incision is healed and it's easy to get in and out of the therapy pool without putting any weight on my leg. I'm barely moving once I'm in there. And damn it, it feels good to be in the water! So there.

(Oh yeah, now that I've done this PAO thing twice I think I know more than my surgeon ...)

Friday, December 11, 2009

The butt bone's connected to ... the recliner



It has occurred to me that I have been on crutches for more time than I have been off them for the last half of 2009. Add in the time I used a cane, and this has not been a stellar year.

I am having more pain in my ischium ("butt bone"), where one of the three PAO cuts through the pelvis was made, than last time. I think this is due to a lack of butt muscle to cushion the bone. When I had the first PAO I still had some muscle, but now it has mostly atrophied so there is less padding there. It hurts to sit and to lie down on my back, although sleeping on my right side takes the pressure off.

I am off all pain meds but still having some moderate pain, which is totally manageable. It's better than all of the nastiness that accompanies Oxycodone use. I am really tired most of the time, more so than PAO #1, and don't feel like doing much of anything most days. Hoping that will change soon.

I allowed myself to think for the first time about what my body has been through this past half year, and it's pretty scary. I chose to do both surgeries just 4 months apart, and looking back I really can't believe that I went through with that plan (when it comes to all things medical I am the great procrastinator), but I am glad I did.

Two major surgeries, 10 days in the hospital, unquantifiable amounts of strong drugs in my body, countless needle sticks to take blood from my non-cooperative veins, 28 days of self-administered heparin shots in the stomach, 4 months on crutches, and countless sleepless nights. For a control freak who breaks out in a cold sweat at the mere sight of doctors, needles, and medical equipment, the fact that I survived mentally and emotionally, not to mention physically, is indeed close to a miracle.

As the holidays and new year approach, I am thankful for my friends and family who have supported me through this challenging time, for my loving husband Perry who puts up with occasional tears (from his wife who "doesn't ever cry") and much crabbiness, my parents who are there at the drop of a hat to help me, my co-workers who have picked up the slack, and my fellow hippies who have been there unfailingly with words of advice and encouragement. I am grateful to have all of you in my life and wish you holidays filled with peace, love and joy.

Tuesday, December 8, 2009

Three Weeks/Five Months

I am at three weeks for LPAO and just past 5 months for RPAO.

Good news all around: CPM is gone! Fragmin is gone! TEDS are gone!

I'll give a brief status report on the RPAO so that hip doesn't feel neglected. I am happy to say that my right hip is holding up very well bearing all my weight only 5 months after RPAO surgery. I give lots of credit to my PT, Kellie, who really helped me heal quickly. That hip is actually getting a rest, despite bearing all my weight, because I'm not going to the gym right now, or skating, or doing yoga. It is hard to work the right leg much when I can't stand on my left. But I think some rest is good for it. The hip flexors are still weak but snapping less, and all of the muscles will need work in the gym to come back to normal, but I am optimistic. It will just take time.

LPAO required a bit more time on the pain meds than RPAO did. While my pain level is the same on this side, it is lasting longer. I was taking one Oxy 5 mg before bed until Sunday, then switched to Tylenol PM. The tradeoff for narcotic pain relief is itching, and right now I'd rather have a bit of pain than an all-night scratchfest. Oh yeah, not to mention the night sweating that accompanies narcotic use. Yuck.

I can now sleep on my right side, although my left hip starts to hurt after several hours. Sleeping on my back had become difficult since both heels were starting to get sore and my lower back is complaining. I have padded my heels to avoid bedsores and so far, so good (just a small sore on the right), but I know that this is not something to mess with. I alternate between back and right side through the night. Can't sleep on my left side quite yet.

I can take a shower by myself without the shower chair and can dress myself, including shoes and socks. I can shave my legs. I painted my toe nails on Sunday. I can make myself something to eat but can't carry it to the table. All similar to recovery #1.

I am very much looking forward to the pool in a week.

Sunday, December 6, 2009

Farewell Forever Fragmin ...

Already ditched the TEDs ...

So much for ...

...my ability to predict the weather. The sun is shining, although it is really cold!

Friday, December 4, 2009

Crap, it's going to rain again

Hip hurts. Enough said.

Sunday, November 29, 2009

Two Weeks (PAO #2)

It has been two weeks since PAO#2. In a nutshell:
~The incision looks great
~CPM has been at 90 degrees for several days so I'll be sending it back soon
~The left hip doesn't feel much different than the right hip did at this stage, except the numb patch is much larger. The numb patch goes from the incision down to my knee along the outside of my leg, whereas on the right it was just around and to the outside of the incision in a patch the size of my hand.
~I am able to shower and dress unassisted, with occasional help needed getting my left sock on (sometimes I can do it, sometimes I can't).
~I am able to work from home and have been doing so a few hours per day as needed. Luckily it's rather slow at work right now.
~I can do some very light housework. Two thumbs up for the roomba.

Here are my upcoming milestones:
~Finish Fragmin shots and lose the TEDs - 4 more days
~Able to get in the therapy pool - 2 more weeks
~Allowed to drive - 4 more weeks
~Follow-up appointment with Dr. Mayo - 5 more weeks

So it's really 5 more weeks of healing, not doing much, and looking forward to the follow-up appointment where if all goes well I'll be told that I can bear weight, lose the crutches, and start PT. That's when the rehabilitation really begins.

Thursday, November 26, 2009

One Week (PAO#2)

I haven't felt much like blogging; it just seems too repetitive from last time and I am busy with other projects. I'll focus in these updates just on things different from last time.

~I had some pretty major issues in the hospital. Dr. Mayo was appalled when I told him the story. I have made a formal complaint to the floor supervisor and I sent a letter to the CEO of the hospital per Dr. Mayo's request. I don't want to alarm anyone going to Tacoma General. I don't think it's any worse then any other public hospital. But I will reiterate that you MUST be your own healthcare advocate. Best if you have friends/family with you at all times in any hospital setting to watch out for you. Bottom line: hospital wards are understaffed and therefore nurses, as caring as they might be, have a workload that is too large to put your health first. That's the way it is folks. (For details, please contact me directly and I will send you the letter.)
~Because of what happened in the hospital I had to be able to get my own leg out of the CPM more quickly than last time. Using a folded sheet I was able to do this on the 4th day after surgery.
~Since having the epidural removed, I have been taking one Oxycodone 20 mg every 12 hours for pain. Unlike last time, I am taking nothing else. My pain level is about a 1 most of the time which is the same as the last time with the short-acting meds, so I don't miss them. I would like to wean off the pain meds over the next week.
~I was able to shower and dress myself yesterday and only needed help getting my left TED on.
~Speaking of TEDs, this time they itch. I have some other itching which I don't remember from last time so I am taking hydroxizine for that every 12 hours. It could also be the time of year - it is winter vs. summer and my skin is drier due to central heating.
~I am up to 75 degrees on the CPM. This CPM is ancient and makes a loud metal-on-metal screeching noise about every 5 minutes, so I have been wearing ear plugs and noise canceling earphones in order to sleep.
~My right leg is holding up well and I am crutching around fine. Only used the walker in the hospital but when I got home switched to crutches.
~I've done a lot of sleeping.

Thursday, November 19, 2009

I'm Bilaterally Undysplastic


Nobody over the age of 40 should have to wear knee highs!


Surgery #2 done. Just a brief note to say I am feeling pretty good, as good or better than last time. Epidural again numbed both legs so couldn't walk today; will try again tomorrow.

Same thing happened with dinner post op as last time. I told everyone that I was vegetarian. At least 4 people. So, of course they brought me meat. I asked for something different and said "no pasta with marinara, too spicy." So that is exactly what they brought me.

It made me a bit nauseous just to smell it so I skipped dinner but had a good appetite this AM.

The vampires came at 2 AM to draw blood and had to stick me 4 times ... the blood clotted before they could get it to the lab ... and they finally took it from my fingertip. Sigh, they didn't believe me when I said hard stick. They never do.

Photo is of me with Valerie, PT, sitting on the edge of the bed today. Notice my green leg and very puffy self from all the IV fluids. Lovely picture but I'm on enough drugs to post it publically!

Tuesday, November 17, 2009

Another night before

This is getting a bit boring as I retrace my steps toward PAO#2.

First the good things -- I got to meet fellow hipster and blogger Matt, who was having a follow-up appointment right before my pre-op appointment. He has now been cleared to bear weight and start physical therapy. I remember that day well, and hope that he is out celebrating!

Everyone at Dr. Mayo's office was nice and happy to see me, and Keri and Sara both remarked that they think I am the fastest second surgery they know of. Usually it's a 6-month wait, and I am at 4 months and 10 days. Sara said I appear to be farther along healing-wise than many people at 6 months. She also cautioned me that the second recovery may be more difficult, and my right hip might hurt when it has to bear all of my weight for the next 8 weeks. Something I knew, but good to hear it validated.

The hospital pre-op was ho-hum since I'd been through it only 4 months before. The anesthesiologist actually asked me why I was there, since there was no need to meet if I had no questions. I requested Dr. Swineheart (my wonderful anesthesiologist from PAO#1) for tomorrow but there are no guarantees.

Perry and I ate at the Hub (restaurant tip for Dr. Mayo's patients from out of town, we recommend the Hub in Tacoma). We are now back at the hotel room, I've had my hibiclens shower, washed my hair for the last time in a week, shaved my legs for the last time in who knows how long, and set the alarm for 4:30 AM.

I am much more relaxed than last time. Not looking forward to it, but ready to get this over with and start my new 100% non-dysplastic life.

Monday, November 16, 2009

Last Skate Revisited

The Monday before my prior Wednesday hip surgery Tim and I skated for a couple of hours. Even though he was not available today, I figured it couldn't hurt for me to go alone because I'm a bit superstitious and figure if I repeat what I did last time it might make this time go well too.

I have skated several times now since being cleared by Dr. Mayo. Today was definitely better than the others. That may be because I had a "what the hell" attitude. After all, if I fall or pull a muscle it doesn't really matter because I'll be able to lie around and recuperate for 8 weeks.

So I attempted a lot of new things today. I wanted to see which limitations were in my head and which were physical. Turns out a lot of them really are physical. My quad and hip flexors usually start hurting within 5 minutes of taking the ice. It's not horrible pain but it is enough to notice, and worsens to the point where I really can't do much with my right leg by about 30 minutes. This pain is accompanied by weakness, meaning that I can only have my weight on my right leg alone for a certain amount of time before I can't hold it any more, and I can't hold a good extension at any angle.

I started with FO and FI eights (figures) and FO and FI loops. Not bad really. I did choctaws (blues and rhumba) and rockers (FO, FI, BO, BI). Slowly, I might add. The first rhumba choctaw I can do, but don't have the strength in my right leg to hold the BO edge long enough to step forward on the second choctaw in the sequence, so I had to put my foot down in between. I skipped counters because twisting while bending was difficult and I was experiencing pain in the flexors by then. I bit the bullet and did FO and FI twizzles with some speed on both feet and they weren't too bad. I did a BI upright spin (on my right leg).

Finally, I tried to do a hydroblade just to prove the absolute limits of my limitations, because I was darn sure it would be impossible and I was right. As I started to bend down (I didn't get very far) my right leg muscles all instantly rebelled with screaming pain. OK, that is going to take more time. A LOT more time ... in the gym.

Right now I feel like I have one good leg and one bad. Next time I skate they will both be "post-op," meaning "bad." Most of the confidence I have right now is based on my left leg still feeling about the same as before. Next time I won't have my strong left leg to bail me out if I get into trouble. Next time it will be a brave new world of learning to deal with new balance points on both sides and a new reality of weakness and pain until I am able to build those muscles back up.

I figure I'll be cleared to skate again 4 months after PAO#2, which lands me squarely on March 18th, my 47th birthday. It's on my calendar.

Friday, November 13, 2009

Good things come in threes

Since this blog is about me I do talk about myself a lot. Sometimes even I tire of it and think I should blog about something else for a change, but then I realize how infinitely entertaining the minutiae of my life must be to everyone else.

Well hey, you all do read this, right?

In any case, the following good things have happened in my life this month:

~I am about to be promoted at work (a significant promotion which should have happened a long time ago, but better late than never).
~I received my National ice dance judging appointment, which means fans can boo and criticize my matronly fashion choices and blame me in online chat groups for all that is wrong in figure skating. This I will choose to ignore.

What will be the third good thing? I am hopeful that it will be a successful outcome of my surgery on Wednesday.

And yes, world peace would also be a nice bonus but I am not holding my breath.

Wednesday, November 11, 2009

My dream: hangin' out in the lutz corner

This will be more hilarious to my skating friends than to my hippy friends, but I just had to memorialize it here. Last night I had a dream that I was in a kitchen (not my kitchen, but someone else's, I'm not sure whose) practicing off-ice double lutzes in the "lutz corner" (aka just a corner between the cabinets and the kitchen island). They were good too; extremely high and landed cleanly.

So I haven't done a double lutz in probably 30 years and I haven't done off-ice jumps for almost as long. Why the dream, especially when I am now an ice dancer and don't jump? Until I was about 40 I used to do an axel every year on my birthday just to prove I still could, but otherwise not a whole lotta jumping going on until the summer when Tim was injured and I started practicing freestyle, including jumps, just for something to do. Not soon after I started jumping again I was diagnosed with hip dysplasia and that was the end of that. I am not so foolish to compromise my newly reconstructed acetabula by jumping again, so it's not something I plan to do ever again.

But those double lutzes in the dream, even though they were on linoleum and not on ice, sure felt damn good.

So today I did go back to the rink, this time on a public session. I didn't try to do actual ice dances but just worked on basics and did much better. Doing dances is difficult because so much is going on. Basics are not as challenging right now. I found that back crossovers were much easier than forward crossovers. It's hard to lift my operated leg to stroke when going forward but I do OK going backward. I did double 3's (FO/BI and FI/BO) and those were OK. I did lots of 3 turns and mohawks.

Just very basic, basic skating but I had my head up and a bit more extension this time. I still started to have hip flexor pain after about 20 minutes. I know, I know. It is still healing. Perhaps after the next surgery and another 8 weeks on crutches not doing much of anything the hip flexors will heal enough to allow better skating when I am ready to try again.

Monday, November 9, 2009

It's a long, long haul

On my 4 month hippiversary (yesterday), I went to the social dance session and skated for an hour. My right hip flexor was sore by about the halfway mark, and still hurts today, so an hour was probably too much but I keep thinking ... when can I start pushing myself?

Since I look pretty good just walking around -- I walk pretty fast, with an occasional slight limp -- most people wouldn't guess I have 7 screws in my pelvis.

But when I get on the ice it's apparent to all who know me that I am not myself. It's going to be a long, long haul.

Of course I'm really just getting on the ice for rehab benefits and not trying to re-learn how to skate just yet. That would be silly since I'm facing PAO #2 a week from Wednesday. But my skills have deteriorated to the point where the old me would have been embarrassed to even show my face at a dance session filled with very skilled skaters and with a large audience of mall shoppers. I used to love that audience because I am a performer, and I was a decent skater, so it was fun.

One of my wise hip sisters pointed out to me that I need to Dance As Though Nobody is Watching. But people ARE watching, and I am aware of them and basically I suck. Before surgery I skated like an adult who skated as a kid. Now I skate like a brand new adult skater and that's a very different story. I'm not trying to offend anyone out there, but for those of us who skated as kids, "skating like an adult" is not a compliment.

I can do three turns, but my free leg has to bend, I have to jerk my arms, and I have to wide step. Mohawks with a bit of speed are jerky and hurt my hip. My head is always down looking for the rut I'm going to trip in. My hands and shoulders are up and my arms are stiff. My knees are locked. My toes are not pointed. My extensions are non-existent. I am going about half speed, if that. My edges are flat. Expression? What's that? For someone who has passed standard gold and international dance tests this is almost too much to bear.

We sometimes catch snippets of audience conversation as we skate by, and since I am traveling so slowly I heard a long snippet yesterday. "The one with the big butt pads can't skate." Well, enough said.

One of my skating buddies asked me if it is "hard to start over." They might as well have said, "God, you look like shit!" but I don't want to put words in their mouth and of course I am taking it hard because that's what I think too. I pointed out that I could either be at the rink trying or be home not trying, and I'll never get any better with the latter approach. Despite being able to walk with just a bit of a limp, my skating muscles are just not strong enough to bend and push enough to make me look like a competent ice dancer.

Despite all the above, I did the following dances (all solo as I don't feel competent to partner yet, although I did do a Canasta Tango with Doug who is not only brave but extremely qualified to hold me up):

~All preliminaries
~All pre-bronzes except only parts of the Fiesta (can't do the step forward at the end)
~All bronzes
~European Waltz (not too bad),
~American Waltz
~Viennese
~Silver Samba

So keep in mind that when I say I "did" the dances, they were at slow speed, off time, not pushing, on flats, no extensions, etc. I could do most of the steps and turns, sometimes on two feet, but not well.

And let's not have a party just because I listed the Viennese and Samba. The Viennese was basically a walkthrough of the steps -- no speed, no edges, on two feet when needed, and tiny pattern. The Samba is an easy dance to solo and hey, I was barely pushing so it was barely recognizeable as the dance I passed a year ago. Sigh. I am the proudest of it because when the music started I was going to go stand at the barrier but instead I just grit my teeth and did two sucky patterns and tried to actually skate it as best I could. I stayed mostly off two feet and kind of on time, bouncing along on flats.

I am not sure whether to be happy about all I can do or sad about all I can't do, and I realize I am expressing both in this post. I have gone from depressed to happy to depressed again ever since I got off the ice yesterday. Any of you who are getting ready to lecture me please think about how hard it would be for you to lose all of your hard-won skills (skills fought for over a lifetime, in fact, because I've always been fighting my dysplasia). I'm also facing 4 more months of rehab on the other side before, if I am lucky, getting to this point again, and then the real work of learning to skate again will start.

This is why it's a long road. Some days I'm happy just to be walking again. I know some people who are 4-months post PAO are barely off crutches, so I should be happy with my progress. Other days I stress out at what I'm facing if I want to some day test another international dance (Cha Cha Congelado, which probably could have been tested last year if I had taken the time to work on it instead of stressing about my upcoming surgery), which may or may not be possible but sounds like a good goal to me.

And of course, it all pales by comparison to what's going on in the world. I remind myself that it's only skating and not world peace, and I am just one person, and maybe my time could be better spent pursuing non-athletic endeavors when this is all over.

Tuesday, November 3, 2009

Four Month Update


In Las Vegas with Perry for Halloween

The four month mark is still a few days away, but I don't think much will change between now and then. This is also the "seventeen-week update," but that doesn't have the same cachet.

I just spent 4 days in sunny Las Vegas for a friend's 50th birthday party. Perry and I walked at least two miles every day. The first day we walked three miles. We did not walk particularly fast since we were on the strip and it was halloween, thus crowded, but I certainly felt like I was working my hips.

So at 4 months I am feeling pretty normal in many ways, even though I still have a long way to go. I almost never have what I would call pain, although the muscles still get stiff on exertion. My hip never swelled a huge amount, but it is still swollen - noticeably larger than my other hip. Dr. Mayo did not seem concerned. I guess in two weeks when I do the other hip they will match, but I would like them both to go back to normal size at some point.

Vegas was a good test of normal everyday hip function. I did a lot of walking, standing and sitting. Most people couldn't tell I was limping. I still am nervous in crowds.

I still haven't done any heavy-duty strength training (waiting until after PAO#2). I feel flabby all over my body. Strength and stamina are way below normal. Flexibility is way, way below normal. But on a typical day doing typical non-athletic things, I am fine and dandy and rarely think about my hip.

Friday, October 30, 2009

W Pose

Fool that I am, I went to yoga class last night after skating yesterday, thinking the stretching would be helpful. The instructor decided to focus on "hip flexibility" (gag!) so there were certain things I did not do. However, for the first time ever in a yoga class, we did ... drumroll please ... W POSE!!

That's right, the only yoga pose designed specifically for anteverted dysplastics. I had no idea it existed, although I did say in a prior post, "let them all try to sit in 'W'!" and now my wish has come true. I smugly looked around the room and saw that none of my super flexible classmates, including the instructor, could do the pose very well so I flaunted my superior ability to get those knees down while everyone else made faces and looked supremely uncomfortable. Finally a yoga pose at which I can excel! Finally they know what it feels like to be me during all of the external rotation poses! Of course I'm sure nobody noticed that I could do the pose, just like I'm sure they don't notice all the stuff I can't do. Yoga class isn't all about me, after all.

After all of that exercise, this morning I feel pretty sore in my glutes (likely from the skating), but it's a good pain showing that I worked out. My hip flexors are just a bit sore. My hip joint itself has no pain at all. This is what makes it all worthwhile.

Thursday, October 29, 2009

First Legal Sk8

Today I went to the rink during my lunch break and skated for about 45 minutes. This was the first Dr-Mayo-Approved skate and per his request I was careful, but pushed myself harder than my two prior illegal and unauthorized skates.

It is interesting to note the difference between my "good" (unoperated) and "bad" leg. Stamina in the right hip is terrible. My leg gets tired after about a lap of stroking and I have to stop and rest, but not for long. I can put my full weight on my good leg and it feels normal, but if I put my full weight on my right on a good edge with knee bend I can't hold it for long. I can hold an edge, just not with good knee bend and pressure through the leg.

Overall I felt a bit wobbly but another skater who was watching said he couldn't tell and that I looked strong. I spent most of the time doing forward and backward stroking (last time going backward scared me, but I spent a long time doing back crossovers today since that works the right muscles). I did forward outside and inside eights to warm up, and forward outside loops. I did forward swing and cross rolls. I tried to do a few more turns than last time; since my balance is off turns are a bit scary. I did 3 turns and mohawks, cross roll 3s, then double forward outside twizzles on both feet (those are the easiest twizzles for me), Blues choctaws, and careful Kilian choctaws (those were the hardest turns I tried). I did back pivots and long back outside edge glides (could do them fairly well on my left leg but just barely on my right).

Knowing where I am at almost 4 months is a good barometer for where I'll be after surgery #2. Adult Nationals is in mid-April and while I will NOT be competing (ha - the very thought!), I hope to be selected to judge. If that happens my goal is to skate the social dance session afterwards. That will be about 5 months after PAO#2 and I now think I might be able to handle it. That's not saying I will be doing high-level dances, but at least I'll bring my skates and try the easier dances.

Several hip sisters have said that 5 months is a good time to try to meet a goal. I don't have a 5-month goal for the RPAO since the LPAO is happening before 5 months, but now I have a 5-month goal for the LPAO.

Wednesday, October 28, 2009

Sixteen Week Update

I’m just back from judging the Southwest Pacific Regional figure skating competition in Scottsdale. Now, just because it’s hot in Scottsdale does not mean you should assume that the rink isn’t a freezing hellhole. Putting a good spin on things (no pun intended), it was cold enough to be a really good test of my almost-4-months-post-RPAO hip. There’s nothing quite like sitting for a couple of hours at a time on an uncomfortable folding chair in arctic cold to test the mettle of the metal in your body.

I did OK. When I first stood up from judging long events I sometimes had to take a couple of steps to get going again. I limped some days worse than others. I had some interesting pins and needles sensations in my hip here and there (nerves regenerating?) which felt like someone was pinging me with a rubber band from inside my leg. This usually occurred in the middle of an event.

When traversing the lobby to get outside or to the restroom I dodged a lot of kids and their preoccupied parents who were determined to run into me. I felt naked and vulnerable without a cane to warn them away. It is truly amazing how few people look where they are going nowadays thanks to cell phones and other distractions. People don’t apologize when they run into you either. They also pee all over the toilet seat in the women’s bathroom, but that’s another matter.

The final event ran late and I had to get from the rink to the airport quickly to catch a flight. I grabbed my luggage and met the volunteer driver in front of the rink, only to see her pull up in the hugest truck I had ever seen. I am not a tall person, and my ability to step up is compromised, so when I opened the door I just looked up in horror at the humongous step I was going to have to take with my right leg to get into the vehicle (the way the seat was positioned, I couldn't step in with my left leg). There was nothing to grab onto, nothing to step up on, just what appeared like a 4-foot hurdle in front of me. Since we were late I vaulted as best I could and grabbed onto the seat for dear life, pulling myself up with my arms so I was pretty much laying on the seat, then pulling myself up and inside. It was certainly not a pretty sight for anyone standing behind me, but at least I made it in without falling down. That would have been ugly indeed.

Speaking of falling down, in preparation for my LPAO I am trying to practice sleeping the entire night on my back (I fall asleep that way but I usually wake up on my left side). I practice getting up from chairs with my weight only on the right foot. I think it’s time to start practicing using crutches on the other side. I am so used to favoring my right side that it will be difficult to be non-weight bearing on my left! I fear I will accidentally put all my weight on it because I’m trained to think of my left leg as my “good” leg.

So much for that, because in just a few weeks I won’t really have a good leg any more. Both of them will be “in recovery.” It’s nice to have at least one good (pre-op) leg so I can compare my operated leg with it to see how far from normal the operated leg is. I dread losing that point of reference. What will I compare my right leg to once the left leg is post-PAO? How will I know when I’ve fully rehabbed the right leg? For this reason the left PAO scares me more. I will be past the point of no return. No more knowing what my hips have always felt like which, while sub-optimal, is comforting because it is familiar.

I feel myself starting to get all mushy and philosophical about this, so I ‘m going to put the kibosh on the pity party right now. Lefty has to be done and I know that I will be better off in the end, even though I will never be the same. As Dr. Mayo says, I will always have pain and my hips will never be normal, but if all goes well a year from now I will be as close to normal as I’ve ever been. Well, my hips will be anyway.

Thursday, October 22, 2009

Halloween is coming ...

...watch out for those who want your blood!

Because of the short turnaround time between the day Dr. Mayo confirmed my surgery date and the actual date, donating blood for myself is not a good idea. I would have to donate two pints within 3 weeks, and that doesn't leave my body much time to replenish its blood supply before surgery. This could lead to weakness and slow healing.

(Plus, as longtime readers know, my veins suck. Giving blood, for me, was the worst part of the PAO surgery process.)

So thank you once again to my mom and also to my Auntie Evie, who are each going to donate a pint of blood on my behalf. I promise to take good care of it! XOXO Terri

Tuesday, October 20, 2009

Fifteen Weeks and my chat with Dr. Mayo

First, to avoid any unnecessary suspense, my left PAO is now confirmed for November 18th. My right leg is healing well. I am walking OK ("gets better as I get going" says Dr. Mayo), my strength and ROM are good, and the x-rays look OK.

I am also cleared to skate. If I fall on my hip it will hurt. A lot. More than before. But I won't do any damage to his work. He just said to take it easy and build up my muscles over time.

Dr. Mayo is very quotable. Below is what he said about my left hip. Note that my left hip's dysplasia is just as bad as that of my right hip, but it doesn't hurt as much. This isn't a direct quote, just a paraphrase:

"Normally I would not operate on a hip that isn't fully symptomatic. We'd just watch it and see. However, your dysplasia is so severe that it's only a matter of time. Studies have shown that the best long-term PAO success happens for people who had the least arthritis to begin with. So it's best to do it as early as you can."

Sign me up.

Sunday, October 18, 2009

A hip skate ...

I had to be at the rink today for a meeting and so I decided to skate even though I am not cleared to do so yet. I realize I am not a model patient but ... oh come on, people. I know hip chicks who have skied, ridden horses and ridden bikes at this point in their recovery. The only issue is falling down, and I am capable of doing that without ice and blades, not that I have yet. I was ready with an alibi, OK, a lie, to tell Dr. Mayo about how I received my injuries if I did fall ("damn cat ran right in front of me and I couldn't avoid her ... tripped and fell right down the stairs!") Yes, I am justifying my stupidity and I know none of you are buying it. I just could not go to the rink, yet again, and not skate.

I felt much stronger than the last time I skated at about 8 weeks (when I could barely walk). I skated for about 45 minutes and spent much of the time talking to people who were clearly jealous of my svelte and hip-looking butt pads. I actually enjoyed seeing friends but really wanted to skate more. Probably best that I did not since I am sure I overdid it. My hip flexors are screaming at me right now and I will be in more pain tomorrow, no doubt.

Skaters may be curious to know what I could and could not do. Forward stroking was OK at about 30% of normal power. Compared to last time, my hip abductors are actually working now and I can push to the side vs. just toe pushing. FI edges were OK. FO swing rolls were definitely stronger on my left than my right, but much better than at 8 weeks. Very cautious turns: RFO and LFO 3 turns, RFI and LFI mohawks, a couple of Blues choctaws (painful), one pathetic Kilian choctaw (painful), FO loops on both feet (two footed at the top of the loop) and one very slow and cautious set of LBO double twizzles (not painful at all). Note that my left leg is my "good" (unoperated) leg; I didn't try any twizzles on my right leg, I'm not totally insane! I was, however, spotted doing the forward samba steps from the Silver Samba at very slow speed.

FO mohawk a la rocker foxtrot was the most difficult turn I tried but my compromised ability to externally rotate was always a problem for me on those turns, and continues to be an issue. I could barely do one holding on to the rail. It's almost impossible. FO mohawks a la fourteenstep were a bit better, but forced and painful. I did 2 off the rail at very slow speed.

As mentioned, I had been concerned about turnout. It's not as good as I would like it to be, and it is worse than pre-PAO but may improve as I heal. I think if I were doing all these turns at speed I would have problems rotating. It will take some time to re-learn how to fake them consistently with my new alignment and worse turnout than before, but I think that it's all do-able with a lot of work, other than the FO mohawks. I may have to kiss the foxtrot, rocker foxtrot, and starlight waltz good-bye. Thank God I took Tim through the rocker and starlight tests before the PAO!

Overall I'd say right now, compared to pre-PAO, I am at about 30% stamina, 35% leg strength, and 25% flexibility. My posture is terrible but then again those muscles are weak. I am also in the bad habit of looking down right now - a bit scared to hit a rut or something on the ice like a french fry (the food court is directly above us in the mall rink) and go down on my hip. The fear of falling is something I am going to have to work through. I know how much a direct hit to the hip is going to hurt me and it's mentally limiting. I don't have much ability to bend my knees; this is not so much a knee or quad strength issue but I can't flex much at the hip and that prevents everything else from bending including knees and ankles. It's not surprising that I am stiff but that will take time to work through.

I now know some of the challenges and what I need to work on off the ice before next time. I do promise that next time won't be before I see Dr. Mayo and ask him for his blessing.

Luckily enough, I have an appointment with Dr. Mayo on Tuesday to find out how I'm doing and verify my upcoming surgery date in November. Perhaps he'll tell me to stay off the ice until 4 months (Nov. 8) but I'm hoping he'll let me out of the penalty box sooner.

Wednesday, October 14, 2009

14 Weeks Down, 5 Weeks to Go

The countdown to PAO#2 has now begun, even as I count the weeks since my first PAO. Here's the weekly status report.

~After feeling like crap a week ago, today my hip feels the best it has since surgery. That may be due to the body work my PT did yesterday (she is the best), or to the pilates class I took last night, or to the fact that the sun came out briefly yesterday. All I know is, I got up this morning and was able to walk immediately with no pain and no hitching. Usually I am stiff and sore when I first get up; it's a given. This morning I felt almost normal from the first step.
~One thing I do know is that recovery from PAO is not linear. You make progress, you regress, you make more progress ... as long as the general direction is forward, it's all good.
~My scar has healed beautifully - it's a thin pink line that I hardly notice. It is covered by my swimsuit, except when I hike it up a bit to show off in my Seniors' Pool Exercise class, where everyone has a scar of some sort and mine is the newest and I dare say the prettiest.
~My cane has been unused for weeks. In fact, I'm not really sure where it is right now.
~I can walk a mile, but haven't tried to walk farther. It's rainy here and so I've been doing indoor exercises instead. My goal was to walk the Fairmount Loop (3.5 miles) by Thanksgiving. However, I will be one week post PAO#2 on Thanksgiving so I may have to try it the weekend before.
~I can do 30 minutes on the elliptical with no incline and no resistance.
~I am doing a lot of pulley work per my PT's orders, still swimming some, and going to the occasional yoga or pilates class (more on that later).
~My left (unoperated) hip sometimes hurts more than my right, but in a different way.
~Daily hazards still exist: I'm suspicious of revolving doors after a mishap around 10 weeks when someone got in behind me and gave the door a huge shove. I almost fell down. I don't like people to walk too close to me, and when they are coming at me fast in the opposite direction I get a little nervous. I don't want anyone to knock me over or bump my hip. I am also nervous in elevators. The other day someone banged my hip with a backpack in a crowded elevator and I doubled over and cried out in pain. I'm sure he thought I was overreacting, but I pretty much couldn't walk for 24 hours after that. I now stand with my purse way out in front of me to block people from getting near me. Paranoid is better than hurting.
~I guess that's what it will feel like when I start skating again and fall on my hip. Something to look forward to for sure.
~Carrying heavy loads still makes my hip hurt. I have tried to carry less except when I have no choice. I still think it's great to be able to carry a cup of coffee across the street and still have a hand free to open the door. Can't wait to be back on crutches ...
~ ...Not.
~Yes, I can tell when it's going to rain. It's autumn in Oregon so that's pretty much every day.
~I have gone to yoga and pilates classes. There are moves I can't do at all, and others I modify. Some of them I do pretty well unmodified. As someone asked on HipWomen, why does it seem every yoga move starts with, "rotate your hips outward"? I do a lot of the strength and balance moves with my hips square and no rotation, and they work fine for me that way. I see no reason to try to work on external rotation because let's face it folks, my femurs turn in. It is what it is and will always be. Let them all try sitting in "W"!
~I will admit, however, that it is disheartening to look around the class and see the people who have little core strength or balance but who can all sit smugly cross legged with their knees on the floor, or in lotus position ... everyone in the class can do it except me. I do a great plank ... and I can balance on one foot longer than anyone else (my knee is forward in tree pose, not out to the side, thank you very much) ... and I am the only one in the class who can roll up to standing from my back ... but I am not going to do those turnout moves. It's just not gonna happen.
~Note to self: Yoga is not about competition. Do not compare yourself to anyone else. Let it go. Breathe. Just be.
~Yeah, right.

Monday, October 12, 2009

Reminiscing

This brings back so many memories ... working on choreography early in the morning in an almost empty rink. Notice that Tim and I have different ideas about when the lift should end, but it all works out because really, what choice did I have? It was either hit the position again or get dropped on my head.

Ah, I do miss getting dropped on my head.

Thursday, October 8, 2009

Fashion Week for Post-PAO'ers

I have a few more weeks before I am allowed to skate. November 8th is the date, but unfortunately I will be out of town judging a competition on that date, which means I will probably cheat and go skating a few days earlier before I leave on my trip. November 18th I go under the knife for PAO#2 so I need to make the most of those ten days on the ice. In anticipation, I ordered these:



I know all you female ice dancers are turning green with jealousy. Perhaps I'll start a new fashion trend at our Sunday social sessions. Trade in your sleek Seku tights for huge lumpy butt pads, woo hoo!

Post-PAO fashionistas who ski, snowboard, roller blade, bike, or skate may be interested in these and I'll give you my unbiased opinion on how they work as soon as I have a chance to try them out. Stay tuned for my product analysis in a few weeks. Meanwhile you can order your own here:

http://www.rei.com/product/777181

Three Months

I’ve never paid much attention to people who claim they can tell when the weather is about to change based on their aches and pains, any more than I pay attention to people who claim they communicate with aliens through the fillings in their teeth. But now, thanks to the 7 stainless steel screws holding my broken pelvic bones together, I too have joined the amateur meteorologist club.

A few days ago a cold front blew in; the night before that I couldn’t figure out why I was suddenly limping again. Ever since the weather changed, my upper thigh has been both achy and numb. Well, it’s always numb, but the achiness is new. I’ve been stiffer in the morning, and it has been harder for me to get moving after sitting for a period of time at work. Evidently this is my post-PAO body’s crappy way of welcoming fall.

This is the first status report in a long time where I can’t say that anything positive has happened over the past week. I’ve had to work harder to make less progress. My PT exercises are no longer energizing, but exhausting. My limited flexibility is not responding to my efforts, and in fact I seem to be regressing in that area. Overall I am starting to feel uninspired about this whole recovery thing.

I wouldn’t be normal if I never had a bad day, so please, no lectures about how a positive attitude is the key to my successful recovery. Pessimist though I am, I’ve posted mostly cheery and upbeat blog messages here over the past 3 months. Now, in the name of honest reporting, it’s time to wallow in my misery a bit.

Tuesday, October 6, 2009

Thirteen Weeks

I received a letter from Dr. Mayo's office today telling me that my second surgery has been officially scheduled for November 18th. That's right, it's time to break out the iron and vitamin C pills again.

For those who want to do the math, that's just over 6 weeks away. I am much calmer now than I was at the same point in the countdown to PAO#1. I know what needs to be done, and I know what's important and what isn't. I'm not freaking out or picking fights with my husband. I know that my pain won't be nearly as bad as I imagined it would be at the beginning of this journey. I know how long rehab will take. I know how to go up and down stairs on crutches. I know not to take any crap from nurses who are having a bad day. I know who to call, and where to go, and what not to wear.

I'm still nervous because this is major surgery; it's not fun, and things can go wrong. However, this time I see the light at the end of the tunnel. I am eager to put this hip journey behind me.

Wednesday, September 30, 2009

Twelve Weeks

Pretty soon I'll be looking at monthly, vs. weekly updates. The three month RPAO anniversary is coming up soon!

Right now there isn't much new to report. Progress comes, but more slowly. I am working with my physical therapist twice per week to build up strength. She says I am doing phenomenally well. I feel like my leg strength is coming back nicely. Unless I am tired I barely limp any more. I can get up out of a chair using only my right leg (something I'll need to do with PAO#2). I can do 20 minutes on the elliptical (I could do more but she won't let me yet).

Flexibility is and will always be compromised, although I am doing what I can to work on it. Things that used to be easy on the ice like spirals, sit spins, lunges, and hydroblades are now out of my repertoire forever. Those were things we used in our free dance choreography. Nice high turned out extensions which I learned to fake in the past are probably not even fake-able any more. I am not sure I will have enough turnout to do choctaws or even mohawks, but that is something I'll explore when I am able to get out on the ice in about a month. I learned to cheat them before, so now I may be able to ultra-cheat them. Probably not enough to fool judges in a test.

I am going back to see Dr. Mayo October 20th to discuss timing for PAO#2. I would like to do it this year so that I don't have to pay the out-of-pocket co-pays and deductible again next year; that adds up to several thousands of dollars. I am also interested in getting PAO#2 over with as soon as possible so I can go on with my life.

Keri, the scheduler at Dr. Mayo's office, informed me there are two open surgery dates in 2009: November 18th and December 21st. The November date is only 19 weeks after the first PAO (and 7 weeks from today). Doctors usually won't do the second PAO until 6 months after the first, to allow the first side to heal enough to bear all the weight during the 8 weeks of recovery for the second. I am skeptical that Dr. Mayo will actually allow me to go forward on November 18th, but Keri has me penciled in.

Am I psychologically ready to go through this again so soon? That is the question. Having both PAOs behind me so quickly is certainly a bonus. Recovering during the end-of-year holidays doesn't really bother me; we were going to have thanksgiving at our house but that can easily be changed. Work is slower than normal in November and December and the weather is lousy, so staying in the house on the couch by the fireplace actually sounds OK by me.

The one thing that keeps bothering me is that I have had such an easy recovery with PAO#1. Will PAO#2 be as easy? Will I have complications with my left leg, which has always been somewhat weaker than my right leg and where the dysplasia is worse? Will my expecations be too high and will I be disappointed? Will my flexibility be even worse when both hips are done? I can only hope for the best.

Wednesday, September 23, 2009

Eleven Weeks

For all you Spinal Tap fans ... mine goes to Eleven, so of course it's louder!

(That makes no sense really so now back to our regularly scheduled program.)

I did 10 minutes on the Elliptical today (first time). No resistance. No incline. No pain!

Also today one of the hip dudes (the rare man with hip dysplasia) is having surgery with Dr. Mayo; I wish him the very best. I took the liberty of stealing a couple of very good pictures showing how PAO works from his blog and I am posting them here for your edification. A picture is worth a thousand words:



Saturday, September 19, 2009

I am not all better, but sometimes I act like I am ...

I am at 10.5 weeks and just traveled to a nearby state (2-hour plane trip) to referee a skating competition. I carried my own luggage, only used my cane to skip the long security line, and spent 14-hour+ days in a cold ice rink sitting, standing, walking, climbing stairs, carrying things, and (gulp) running. The latter happened when I had an issue during an event and had to get quickly from one side of the arena to the other, and I'll be damned if I was going to let something minor like a little hip surgery blow my event schedule out of the water. No sirree!

When I realized I had broken into a run I sort of toned it down into a race-walking type of thing. It didn't cause any pain although I was stiff at the end of the day but probably would have been anyway. I brought my cane each day and it sat in the corner while I ran the competition. I wore (low) heels the entire time, I might add. I didn't take any pharmaceuticals for pain.

On the last day when I was tired I did use the cane for the last hour, and at least one person said, "is that yours, what is wrong?" When I told them I'd had hip surgery in July I found that most people had not even noticed that I was limping. That did depend on what time of day they saw me of course. A couple of people had noticed and asked what was wrong - and they were people who didn't know me.

I still can't even bend over to touch my toes, and I still can't do very many leg lifts, but I can referee a competition. Hang in there all of you in the early days post PAO. It gets better!

Thursday, September 17, 2009

TSA

Because enquiring minds want to know: seven stainless steel screws, some the size of ball point pens, do not set off the airport security machine when they are inside of your pelvic bones. At least they did not do so today at Portland International. Yes, I was ready to bare it all and show them my scar if necessary!

Wednesday, September 16, 2009

Ten Weeks

At ten weeks I am no longer lurching, but I am still limping. On the limp severity scale of 1 - 10 I am somewhere between a 2 and a 5, depending on tiredness. I was able to walk 2 miles consecutively over the weekend, with about half of that on the beach. As expected, my hip flexors were sore two days later, but I felt good during.

I wore mid-heel shoes the other day with no ill effects.

I am functional for most common activities at work (sitting, standing, walking) and at home (cooking, cleaning, light gardening, errands, chores).

I really don't need the cane but it's tough to give it up. I am afraid of people bumping into me. With the cane I don't feel I need to explain why I take the elevator up and down one flight, walk slowly in the crosswalk, and don't run for the elevator. I work in a busy, fast-paced downtown office area and I have found that people are usually impatient. When I have a cane I am less likely to be pushed, jostled, or frowned upon, and sometimes people even hold doors for me. I didn't want anyone holding doors when I first got the cane but now that I am used to it, I realize that it's no fun to have the door slammed in my face.

Sometimes my left (unoperated) hip will catch and feel worse than my right. I will be having left PAO in December if all goes well.

Athletically I still have a long way to go. I can't bend my right knee very far. I can't touch my toes. I have almost no flexibility or strength in my right leg other than enough to walk and function at a basic level. I still occasionally use my hands to lift my right leg into the car or into bed. I know this is an area I need to work on, and my physical therapist is forcing me to go slowly so I don't overdo and risk a stress fracture, muscle trauma, or other injury.

Tomorrow I am going on a short plane trip for the first time post-surgery. I've been told that the 7 stainless steel screws in my pelvis will not set off the alarms. I'll let you know whether or not I have to drop trou and show my scar to the TSA agent!

Saturday, September 12, 2009

What I did for my end-of-summer vacation

I am at the coast today before the end of summer. Last time I was here was the weekend before my PAO. Now I'm closing in on 10 weeks post PAO. Last time I was nervous and scared, trying hard to have fun and forget the surgery coming up. This time I am cautiously trying to see how much I can do, exploring my new post-PAO world, and feeling pretty darn independent.

I walked for a total of a mile today (1/2 a mile on the beach and later 1/2 a mile on pavement), which isn't very much empirically but seems like a good distance for me at this point. I had my cane to avoid limping but didn't really feel I needed it. I went up a flight of stairs several times. I did all of my PT exercises which are still pretty simple and using only my body weight and gravity (worked glutes, hip abductors and hip flexors - 3 sets of 20 reps).

I did toe raises. I pushed myself up out of a chair using only my right leg 5 times. (Remember, I have to be able to use only my operated right leg to support my weight for 8 weeks, starting in December, if my second PAO occurs as planned.) We'll see how I feel tomorrow, but despite all of today's activity I don't have any pain this evening.

Pre-PAO if I walked a mile (or less), my back and hip would be stiff and ache. Today after I walked I did not have those old pains and complaints. Granted, I walked slowly. I did have muscle soreness afterward and a bit of ache that felt like it was coming from where my pelvic bone was cut, but I had no intra-articular pain and none of the agonizing pre-PAO stiffness.

I am still taking it easy and doing pretty basic exercises, but I am happy with my progress.

Wednesday, September 9, 2009

9 Weeks

I have been so busy living life that I've almost forgotten about this blog. That is certainly the desired outcome!

I've had two PT sessions and I am swimming several times per week. I feel "normal" most of the time. I do limp; I have weakness and limited ROM in my right leg, dull achiness with activity, and occasional odd sensations, but I don't have pain. I am walking without any assistive devices except for the cane for moral support during medium to long distances. (It's best used to scare away dogs and small children who come too close for comfort.) I haven't tried walking a really long distance, like a mile, yet, but I will probably start walking more just to find out what I can do. I mostly walk a few blocks here and there downtown while at work. I do a lot of short walking trips throughout the day without problems.

After all the hoopla surrounding my skating last week I decided to do the intelligent thing and ask Dr. Mayo when I could get back on the ice. He said that I had to wait 4 months from my surgery date, which means November 8th is circled in red on my calendar. That will give me a few weeks to skate before PAO #2!

The issue is falling of course. My bones aren't fully healed and a fall could do some major damage right now. I have skated for many years and don't fall often, but it is certainly bound to happen at some point. Not that I'm a model patient, but I will comply with the 4-month rule because Dr. Mayo is the boss. Plus I really don't want to show up in the ER with a shattered pelvis and have him find out about it. I don't need that kind of humiliation, not to mention the pain and possible permanent disability.

So while I'm really glad I got on the ice last week, I'm hanging up the skates again for a while to concentrate on my physical therapy and rehabilitation per doctor's orders. See you at the gym!

Sunday, September 6, 2009

Dance Camp: Goals

"Australian Waltz" at the HDC Today (It's interesting to note my lack of turnout on the right leg. You can actually see in this photo that my right femur is twisted inward, preventing my toe from turning out naturally. This is particularly obvious since Doug has great turnout. See how his right thigh naturally turns out at the hip, creating a much more pleasing leg line than mine):


"Tangle Romantica":


My goal was to skate on the social session at the High Dance Camp. Sincere thanks to Doug for making that a reality, and to Patti who has been so encouraging.

Thanks to Bob R. for the photos!
Terri

Thursday, September 3, 2009

8 Weeks and 1 Day: Ice Ice Baby

I was walking around the house in my skates last night because I had them rebuilt and I’m trying to soften them up. I realized that I was limping less while wearing the skates than I had been just walking around, and that my balance was fine. So it occurred to me that getting out on the ice might just be possible.

Even though I had planned to go to a public session in the middle of the day where nobody would know me so as to keep this little experiment under wraps, another ice dancer happened to be at the mall, so I had a witness. It turned out this was a good thing since he encouraged me (thanks Doug) and reminded me to be careful.

I spent the first lap or two holding on to the rail, then ventured out into the flow of traffic. I found that I had more pain in my abductors than anywhere else, although both legs were generally weak, right more than left. Bending my knees hurt, so I was pretty stiff. I did a lap of forward swizzles and a lap of forward slaloms before trying to do anything on one foot. I then did forward outside and inside edges on half circles. They were slow, stiff and barely recognizable as edges, but I think I had a silly grin on my face just the same.

Then the true test – I did the steps to the Dutch Waltz. Even in the tiny mall rink my pattern was miniscule. There was no way I could get any push with my right leg because my abductors hurt too much, and pushing onto my right leg was also difficult. I did a lot of toe pushing. I was on flats. My knees were stiff. My posture was terrible. Had music been playing I would have been off time. My pattern barely filled half the rink. I would have absolutely failed the easiest dance if I had been testing. But I did a full pattern and I was ecstatic.

8 weeks and one day ago I was in surgery having my most valuable skating muscles cut and reattached while my pelvis was sawed into pieces and screwed back together. Just a week ago I had not put any weight on my right leg for 7 weeks, and at that time I could not even balance on my right leg. Considering the timeline, what I did today was damn good. But as skating goes this shows me just how far I have to go in order to do even the easiest dances socially. Getting myself onto the ice does not indicate that I’m all healed and better, it just indicates that I’m a little bit crazy. And very, very determined.

Tuesday, September 1, 2009

8 Weeks - Physical Therapy and Bye Bye Crutches

Well let's start with the most important part first, shall we? At my first physical therapy session (today) my therapist told me I did not need crutches at all. I've been using 2 for long trips and 1 for short, and nothing for really short/around the house. She said a cane was probably just fine and to let pain be my guide.

Woohoo! That's a recommendation I am happy to take to heart.

She measured a whole bunch of things, like strength and range of motion. I heard her say "normal" a couple of times. Normal! I've never been normal in my life, and now I'm becoming normal. Or normal'er.

That doesn't mean there isn't a lot to work on, and I have home exercises to do, but not overdo, as she was quick to warn me. I think these people are all on to me ... they realize that I will do as much as they will let me as soon as they will let me and that patience is not one of my virtues.

I am clearly limping but my gait isn't as bad as she would have expected. I walked up the stairs like a normal person (right foot up then left foot up) without crutches. She finally got a little scared and asked me to please hold the handrail, but I didn't feel I needed it. She said she would have expected my right thigh to be more atrophied (well hey, it was huge to begin with). My right calf is very atrophied.

We talked about flexibility, turnout or lack thereof, my ticklishness problem (caused perhaps by all the "guarding" my muscles automatically do, perhaps due to dysplasia), the limitations given by my surgeon, and how right now I am compensating all over the place just to be able to walk, which is normal. She does think I will see fast improvement and that this is going to be "fun."

Well, fun for HER.

Friday, August 28, 2009

7 Weeks - First Steps

Dr. Mayo said on Tuesday that the gaps in my pelvis have filled in with enough healthy bone to support my weight while walking. He suggested that I start bearing my full weight on the right side but continue to use two crutches for balance and because my muscles are weak. He told me that after I build up my muscles I'll be able to drop down to one crutch, then a cane, then walk unassisted in a few weeks.

Never known for my patience, I have been trying to walk without crutches whenever possible since I got home from the appointment on Tuesday. My balance is just fine. Due to muscle fatigue I still use two crutches for long distances and one crutch for medium distances. Oh the joy of one crutch; I can go to the corner coffee shop at work and carry a latte back to my desk all by myself! My caffeine addiction, which has been dormant for 7 weeks, is now back in full swing.

When I got home Tuesday night I took a few steps without crutches, figuring it would be a disaster. I made it across the room lurching like a drunken sailor. After that I couldn't help myself; I started walking without crutches whenever I was going a short distance. Yesterday I left the crutches in the car when I got home from work, and I've been walking totally unassisted in the house for two days. I've been going up and down stairs normally (just 2 steps to get in and out of the house, and 14 if I want to go down to the basement). My right quad is a bit sore, but I can't even call it pain. I am limping due to weakness, but it's getting better each day. I can lurch really fast when necessary, although I do prefer to go slowly and concentrate on NOT lurching.

The first couple of days I could not stand on my right leg without support - it was just too weak. Starting today I can balance on just the right leg for about 10 seconds with no other support. I did this several times throughout the day - in the shower and while waiting for the elevator at work. I also tried toe raises. I could do just one the first day and now I'm up to three on my right leg with no assistance from crutches or the left leg.

I've noticed that my lordosis (swayback) appears to be much improved. Since diagnosis I've thought the mysterious swayback was my body's way of providing a little extra femoral coverage where none naturally existed. Now that I have normal coverage, my body appears to be realigning itself. I'm shocked at how much realignment has occurred in such a short period of time. My lower back, which has almost always hurt throughout my life, doesn't hurt any more and feels more stable than ever. My clothes hang differently -- almost normally! -- straight down my back, something that has not been the case since I was a teenager, when I started recognizing that I had a deformity but did not know the cause.

I can't wait to get some real strengthening and stretching exercises from PT on Tuesday. Meanwhile I will continue these first steps. Of course walking through the house with hands free means I have no more excuses for not cleaning, so it looks like tomorrow I'll be spending some quality time with the vacuum.

Tuesday, August 25, 2009

7 weeks ... 7 screws



"Damn, screwed again!"

Today was my 7 week follow-up appointment with Dr. Mayo -- the first time I've seen him since I left the hospital. X-rays look good with not 3,not 4 or 5, but SEVEN screws holding my right leg on. In this view it's hard to see more than 6, but believe me, there are 7 in there. I had no idea there was that much screwage in my pelvis. (Everyone insert their best rude/lewd comment here.)

Dr. Mayo says I am free to drive now, which is a good thing since I drove myself to and from the appointment (6 hours roundtrip). My coverage angle has gone from 5 to 30 (anything >25 is normal). The pelvic bones that were cut apart are now fused together enough that I can put all my weight on my right leg without damaging anything. However, he doesn't really want me walking unassisted yet; he wants me to wait until I see the physical therapist next week because otherwise I'll have more difficulty getting rid of my limp. My PT appointment is Tuesday and I am looking forward to learning how to walk again.

I have a long list of things I am not supposed to do for a month or two or three, and other things that I am never ever ever supposed to do for the rest of my life. The never evers include stairmaster, lunges, squats, and running. Dr. Mayo also frowns on yoga, and doesn't want me to ever do it, a bummer. Using extrapolation to ice, the never evers means I won't be doing sitspins (one of the few things I do/did well, oh well), lunges, hydroblades (ah, another thing I did well) or jumps of any kind for the rest of my life. There are a lot of dance spin and lift positions that will also now be out of the question. While I am allowed to bend my knees, anything that gets down very low and stays there would be considered a squat. I am not really sure how this will play out. This is likely to impact choctaws and my ability to generate power, not to mention how I look. I may be able to technically do the steps, but they won't look good (and they will be more difficult) if I can't fully bend my knees.

But now back to reality: walking. Must walk before I can skate. I did try walking with just one crutch and even took some steps with no crutches just to see how bad it would be. Well ... it's bad. It's beyond a limp; it's a lurch, and there is no strength at all in my right leg. It is going to be fun times in physical therapy, that's for sure.

Dr. Mayo thinks I'm doing very well so I must agree that I am. I am not discouraged, just realizing yet again what a long uphill climb this will be. Today we discussed timing for my left PAO. He thinks we may be able to do it in December, which is sooner than I thought (I was thinking February). December is great because I'd like to get it over with. I am going back in 2 months so they can evaluate my progress toward PAO#2 and then we can decide on a date in December. Oh boy, surgery just in time for the holidays!

Sunday, August 23, 2009

Cost Cutting

I am looking over the bills I've received for my PAO. I thought you'd all be amused and/or appalled by some of these numbers. Note that I have not yet received a bill from the surgeon yet!

These numbers all represent pretend money in many ways. For example, I pay 20% co-pays on pretty much everything, but my "out of pocket maximum" is $1,500 per year, meaning that most covered, in-network charges I incur over $1,500 are paid by Aetna. I also have to pay a $350 deductible. Prescriptions have their own deductible. And, if I go "out of network," there are additional maximums and deductibles. All of my care to date has been "in network" with a few things just not covered by insurance at all, such as $600 for autologous and directed blood donations.

So far I've actually paid about $2,000 for out of pocket maximum, medical deductibles, and prescription deductibles. I have also paid about $3,200 for non-insured but necessary expenses that I would not have incurred without having a PAO (blood donations, assistive devices, vitamins, pool membership, hotel in Tacoma for family members, gas to and from Tacoma, meals in Tacoma.)

The total hospital bill (5 night stay in a private room which was billed as "semi-private" and a huge list of undisclosed "incidentals") is a whopping $109,000. The negotiated rate that Aetna paid is just over $30,000. The hospital had to make some margin of profit on the deal just to stay in business. That leads me to ask, what was the true cost? Had I paid this out of pocket with my 50% cash discount the hospital would have realized an additional $25,000 profit over what Aetna paid. Luckily I did NOT have to pay out of pocket, and really, how many people would have actually paid a bill like that despite signing a payment guarantee? I was prepared to pay if necessary but I realize most people could not afford to.

In addition to the hospital bill, the charge for the anesthesiologist was in the neighborhood of $3,000 (my cost = zero since insurance covered in full). Prescriptions were billed out at about $600; my co-pay was just under $200 ($150 of that just for Fragmin which is considered by my insurance plan to be a "specialized" drug). A huge supply of narcotics only cost me $20; that's a bargain considering what each pill sells for down at the bus mall on 82nd Street. Medical equipment was billed at $600 but this does not include the CPM machine since I have not yet seen that bill (my cost for equipment will be zero because insurance will cover it all). Various x-rays and lab tests were billed at a couple hundred dollars (again, my cost = zero).

I will probably go out of network for physical therapy (see my prior post), which means I'll be paying for much of that out of pocket, about $50 per visit. Aetna may add my PT to their network but I'm not holding my breath.

The bills keep rolling in. I'll publish a grand total in a future post.

Saturday, August 22, 2009

They're Back


Blue is annoyed by the smelly new cat toys.

My skates came back from Harlick yesterday with new tongues and other refurbishments. I put the laces in and put the sharpened runners on and then tried them on (on crutches, with no weight on the right of course).



Now the skates are propped up against the wall next to the bed. I see them when I wake up. Probably a stupid idea because I won't be using them any time soon. I had hoped Harlick would keep them longer because then I couldn't even fantasize about doing the Austrian Waltz over Labor Day weekend. Now I ponder when I'll really be able to skate.

Seems like as soon as I can walk, I should be able to skate, but I don't think that will really be true. Walking will be an iterative process; first bearing progressively more weight with one crutch, then bearing all my weight with one crutch or a cane, then lurching along without crutches or a cane, and finally walking with a limp that should diminish over time. I am not sure at which point I might want to venture onto the ice. But at least now I'm fully equipped when the time comes.

Wednesday, August 19, 2009

Moving Stairs

Today I went to the mall next door to work on my lunch hour to get a sandwich at the food court. I walked in the door and was confronted by ... an escalator!! I pondered this for a bit. Would I be capable of getting on and off the thing? Hmmm. Stairs are tricky enough with crutches, but moving stairs? I opted for the elevator, which I had never even noticed before. I had not noticed the handicapped buttons that automatically open the doors either, but let's just say my consciousness has been raised.

On a totally different subject, I read the following in a study discussing how to diagnose DDH in babies and young children. The following applies to children who are already walking:

"Dislocation of both hips may present with increased lumbar lordosis ["swayback"], prominent buttocks, and a waddling gait. Physical findings may include a stable "clicking" hip."

Describes me to a "T" before my PAO. It may just be my imagination, but I think my lordosis has resolved significantly since the surgery. As for the big butt -- well, I am a skater. I think that's here to stay.

[Link to the entire article]

Monday, August 17, 2009

Six Weeks: Swim, Swam, Swum

I know that I am blogging way too much lately, but so much exciting stuff is going down. Today was my first pool outing since surgery.

I am lucky to have a warm water therapy pool just a short drive from my house. They also have an olympic-sized pool right there for when I graduate from the baby pool. For now though I'm happy as a clam floating around in the 98 degree bathwater.

I wasn't really sure what to do when I got there. Not only was I the youngest person by at least 30 years, but Dr. Mayo did not give me any pool exercises and he actually seemed reluctant to even let me go in the pool when I asked him. He said I could go at six weeks (yeah, that's Wednesday, but come on ...) but didn't tell me what I could and could not do. So I stayed with my usual restrictions. No straight leg raises or abduction or weight bearing ...

Wait a minute. Weight bearing? If I walk in the pool am I really weight bearing? In theory I am allowed to put up to 44 pounds on my operated leg. How they came up with 44 pounds is beyond me, and it's not like I am able to tell accurately how much weight I'm bearing anyway. I have just stuck with the concept of "toe touch" until now. But in the water I did some actual walking in the shallow end.

It was very odd. My body is so used to NOT walking that every time I stepped on my right leg my torso would scrunch up in a futile attempt to not bear weight. Even in the pool I had a pronounced waddling limp. It got better over time, but boy, if this is any indication, real walking on land is going to be, um, rather challenging. I had hoped walking, which I've been doing for almost half a century, would be a skill I might easily reacquire. Now I'm thinking not so much.

Over the course of an hour I did lots of floating, some range of motion exercises, a little walking, more floating, and some paddling with just my arms in a feeble attempt to get my heart rate up (kicking my legs did not seem like a very bright idea even though it's not on my restriction list).

Today was the first time in almost six weeks that I've done any activity which resembles exercise. I am sure that I overdid it. Based on the pain that's just starting to become apparent in my right groin and buttock, I'm sure I will find out in the next 24 hours just how much.

Let's get physical

I have been in search of a physical therapist who is conveniently located, takes my insurance, has worked with dancers/skaters, and has worked with PAO patients. The first three things are easy to find, but it seems none of the in-network PTs have ever worked with a PAO patient. This is not insurmountable, but I'd really prefer someone who has been there and done that. After all, this is NOT your grandmother's hip replacement, yadda yadda yadda, and I don't want the person responsible for my rehab to treat me just like the resurf and THR hippies (no offense to y'all).

I know there are many surgeons out there who don't even prescribe PT, but mine does and I think there are many things a good PT can do for me. It's not that I'm lacking in the motivation department, or that I don't know how to go to the gym and sweat. I just want some guidance. For example, they can point out that I'm limping and teach me how not to. Or, they can evaluate where my body parts might be out of alignment or unbalanced and show me how to fix it. These are all things that I might notice through trial and error, but I'd rather leave their diagnosis and cure to a trained professional. I know my body pretty well, but I don't claim to know how to fix it when it's broken.

I finally found someone out of network who has worked with not one, but TWO post-PAO patients. She clearly has a good understanding of the challenges I will face, and she said that her PAO patients both did remarkably well. I've made an appointment with her and will ask if I can contact the PAO patients as references. She is working on getting Aetna to add her to their network. Now all I need is clearance from Dr. Mayo to start PT at my follow-up appointment on the 25th. Bones, heal thyselves!

Sunday, August 16, 2009

Journey back to Tacoma

I judged a skating test session yesterday, which is significant in many ways. It required a 5-hour car trip (I did not drive, although I did drive to and from my ride's house, about 10 miles total, with no problems). It required me to crutch around an ice rink, which is not exactly even footing. And, it required me to sit in the cold in an uncomfortable chair for 2 hours. Ironically the skating took place in Tacoma, which is where I had my PAO surgery just 5 and a half weeks ago. Those 5 and a half weeks feel like a lifetime!

I was a little nervous about this expedition, but I know that finding judges, especially dance judges, who aren't on vacation or at a competition and are willing to travel to Tacoma in mid-August is not an easy task. Of course I agreed to do it for the free food. (Just kidding, although the chocolate dipped strawberries were wonderful.)

Everything went just fine. I was a bit tired when I got home, and a tiny bit sore, but all in all I'm none the worse for wear. This was a good trial run since I have a lot of judging gigs coming up: a local test session August 30; refereeing a competition in Utah in mid-September (which will include my first plane ride post PAO); and judging Southwest Pacific Regionals, Pacific Coast Sectionals, and Junior Nationals (in October, November and December respectively, and all requiring plane travel).

I am now confident that my hip can handle all of this travel and judging, and I hope to do most of it without crutches or cane. Then at the end of the qualifying competition season it will be time for PAO number two (right now I am thinking early February, after Nationals). I hope to be recovered enough from that to judge Adult Nationals in April.

Tuesday, August 11, 2009

Five Weeks

Here's a quick update on my hip status at five weeks post right PAO:

~The scar itself looks amazing; it's just a pink line. There are itchy red dots around it though - probably some kind of rash, definitely not an infection. I'm putting on neosporin/cortisone and will call the doctor if it doesn't go away soon.
~I have very little pain and have not even taken Tylenol in weeks. I still don't have anything that feels like bone or internal joint pain. It just feels like soft tissues adapting, and I have tightness in the muscles and near the scar, especially first thing in the morning or if I move suddenly or if I'm on my feet (well, foot) for too long. I hear an occasional click when I externally rotate. No other hip noises though.
~I wore fitted jeans and low-heeled boots to go out with friends on Saturday night. My scar did not hurt from the waistband and I did not have an issue walking in "real" shoes. I am not going to wear high heels any time soon though.
~I made zucchini bread this evening all by myself, thanks to the bar stool in the kitchen and my handy backpack for carrying stuff.
~I went in to the office Monday for 4 hours. My butt hurt from sitting in a real chair for that length of time, and when I got home I was tired and took a nap. I am going back in tomorrow and Thursday and will try to work longer hours as tolerated.
~I am sleeping a bit better but still not back to normal. I can sleep on my back and on my left side. I rolled over onto my right side just to see what would happen and it didn't hurt. I am not really supposed to do this so I have not made a habit of it.

Range of Motion Illustrated:
Range of motion is much better than I thought it would be at five weeks, although I have no real basis of comparison. I can bring my right knee toward my chest (I can get it closer than shown in this photo, but not while taking a picture of myself!):



My external rotation has improved since my four week report; however, it's still not very good, as expected:



While lying on my stomach, I can grab my right foot with my hand and touch my butt with it. I can cross my right leg over my left. I haven't figured out a good way to stretch my hamstrings, which have been historically tight; I have a feeling they will be very tight when I'm able to really try.

I am very pleased with my progress, excited to get in the pool in a week, and anxious to start bearing weight and doing real exercises. I am curious how much my pain level will increase with additional activity and weight bearing since it feels like I'm doing a lot of nothing right now.