Thursday, January 28, 2010

Ten Weeks

My physical therapist works wonders. I mean that. Even though I spent part of today wallowing in depression because I couldn't lift my left leg high enough to step on the flush handle of a public toilet (oh come on, everybody does it), I know that I am making (slow) progress.

My PT, Kellie, has me working with very low weights and doing many reps. I am amazed at how little weight she uses but if I do the exercises correctly my muscles fatigue quickly. She hooked me up with this genius home pulley system so I can torture myself at home, since the least amount of weight I can use in my home gym is 10 pounds:

You can put whatever kind of weight you want in the bag, down to just a few ounces. She started me at half a pound, for which I used 2 boxes of jello. As I have increased the weight I am using, I have added various items that were readily available next door in the home office. So how much weight am I lifting now? See for yourself what's in that bag:

That's right, I am up to 3 boxes of jello, a deck of cards, an old cell phone, a walkman (a walkman?) and a metal tape measure. Clearly a lot of weight and a good use for a bunch of crap. Genius!

Saturday, January 23, 2010

Nine and a Half Weeks

Note for the curious: thirteen stainless steel screws do not set off the TSA metal detectors. I am coming home from 10 days in Spokane tomorrow. My hip has gotten progressively better and now, at 9.5 weeks, I can say that I barely thought about my hip(s) today or yesterday. Here is the straight skinny:

~Sitting for more than a couple of hours is difficult. I am sore when I get up but feel OK when I start moving.
~Can't wait to sleep in my own (comfortable) bed, although I haven't had much trouble sleeping in the hotel bed.
~I haven't taken any pain meds since the first day when I took two ibuprofen, more for a headache than for hip pain.
~The pain in my buttock is basically gone.
~I have been wearing heels for the past week with no detrimental effects.
~I have been using the cane more to keep crowds away from me than to help me walk.
~I can go up and down stairs OK, but I do generally hold the hand rail. I feel it in my legs, but it's not painful. The muscles are pretty weak (weaker than my right was at this point).
~I can balance on my left leg for about a minute.
~The first day I was here I could barely walk a block without having to stop and rest, and I was pretty slow. Today I can walk about half a mile without much worry, and have trotted a few times to keep up with people. I can probably go farther but haven't tried.
~Getting in and out of cars is still a bit challenging.
~Friends have told me I barely appear to be limping (I can definitely still tell that I am limping, especially if I exert myself).
~Scar looks darn good - almost invisible (although I can still see the two "drain hole" scars.
~I gave up my seat on the arena shuttle because there were so many other people with canes who seemed far more disabled than I am.

Sunday, January 17, 2010

Update from Spokane

Evidently the best way to rehabilitate a broken pelvis is to judge a skating event. I refereed an event at 10 weeks after PAO#1, and here I am in Spokane at 8.5 weeks, spending my days in a huge arena, walking all over the place, going up and down stairs, and sitting on not-so-comfortable chairs for hours at a time.

I keep forgetting my cane (in the hotel room, in restaurants, in the offices we are using for a home base) so obviously my hip is an afterthought right now. It could be that yes, I really am that busy, but I also think I am getting stronger just because of all the activity. The pain in the butt(ock) is still there but diminishing each day, and I rarely think about my hip except at night (the hotel bed is not that comfortable).

Not that I am magically cured. I am still limping quite noticeably, have to rest frequently, and have a lot of muscle weakness. But I feel like I am doing phenomenally well at this point in my recovery compared to where I thought I'd be. I was a little nervous about coming to Spokane at 8 weeks post PAO, but I am relieved that it is not a problem. It is conceivable that I really will be back on the ice around the time of my birthday in March.

Thursday, January 14, 2010

8 Weeks and 1 day (PAO #2)

Talk about one-upmanship. At 8 weeks and 1 day post PAO #1 I actually went skating, which it turns out was foolish since I could have done some damage. For this iteration, 8 weeks and 1 day means I am on an airplane to the U.S. National Figure Skating Championships in Spokane for 10 days, where I will be trial judging singles and pairs for the first half and then just being a spectator for the second half. It has been a long time since I've been able to just be a spectator at a skating competition, so I am looking forward to the second half.

Trial judging is tiring and stressful even for those who are not on crutches. There will be a lot of walking involved (from the arena to the critique room, up and down narrow steps inside the arena, outside in snow/ice) as well as a lot of sitting on not-so-comfortable arena chairs. I sometimes think I might be a fool to be doing this. I know some of my fellow hippies would call me crazy, but I think I am ready for it.

I am taking both crutches and a cane. By this time in the healing process for PAO #1 I was down to just a cane and I hope that is mostly the case, but I want those crutches for backup this time. The hotel has an indoor pool and a fitness room so I am hoping to carve out enough time to exercise. There isn't much time to leave the arena during the day so trial judges often subsist on candy, hot dogs and pretzels - arena food. As a vegetarian, the options are even more limited. I've packed protein bars and trail mix.

In any case, it promises to be an exhausting 10 days, but I am happy to do it. My judging schedule for the rest of the year will all be sans crutches: Adult Sectionals in March, Adult Nationals in April, several non-quals over the summer, and then whichever qualifying competitions I'm assigned to in the fall. It will be nice for my judging peers to finally see me at a competition without a cane or crutches this season!

Wednesday, January 13, 2010

Eight Weeks (LPAO)

After last week's appointment with Dr. Mayo, I have pretty much abandoned the crutches. I am using a cane sometimes, and just walking a lot of the time. I am still doing the Post-PAO "dip-waddle" penguin walk, but I must be walking OK because today, after I parked my car at work (in a handicapped spot) and started walking to the elevator, an irate driver rolled down her window and yelled to me, "You can't park there B#$%@! I hope you get a ticket!!!" Then she gunned her motor and sped on up the parking ramp.

I have a handicapped parking pass (valid through March 1) and I was carrying, but not using, my cane. I am not sure if the irate driver had a handicapped pass as well and was angry because I took one of the last spots on the lot. In any case, I am hoping that my car will not be vandalized when I leave the office this evening.

Saturday, January 9, 2010


Last night I went to a dinner party where I unveiled my new party trick - sitting down on the floor and getting up again all by myself. Everyone thought this was just amazing, especially when they saw me lurching/walking.

As a resource for readers who may not have access to a physical therapist I am publishing some great exercises thanks to fellow PAO patient and blogger Frankenhip. She has some great diagrams on her blog which I will copy here when I have more time (meanwhile you can access them there). I have added a few exercises and additional comments that my PT has given me as well.

My limitations are similar to hers:

o No squats (this is a lifetime restriction)
o No lunges (this is a lifetime restriction)
o No forward leg lifts (my OS waffles on whether this is a lifetime restriction or not)
o No running (this is a lifetime restriction)
o No jumping - anything with both legs off the ground (this is a lifetime restriction)
o No stairmaster (this is a lifetime restriction)
o No incline on the elliptical (this is a lifetime restriction)
o No resistance on the elliptical (this is just until I build up strength, then I can add resistance as tolerated)
o Leg press can only be done to 70 degrees and with low weight/high rep (this is a lifetime restriction)

Do the following at home every day:

1.Bridging – 10 times holding for 10 seconds
2.Isometric Hip Adduction (with pillow or soccer ball as resistance)- 10 times holding for 10 seconds
3.Standing Bilateral Heel Rise (stand on my toes) – 3 sets of 15 reps (progress to doing on one foot at a time)
4.Clam Shells (laying on your side with bent knees and raising the knee to the side) – 3 sets of 15
5.One Foot Balance – Hold for 30 seconds, three sets, both legs. Once I can do 30 seconds, do this with my eyes closed
6. Sliding abduction/adduction - Sit on a floor (not carpet) with both legs out in front of you. Put operated foot on a towel so it slides easily. Slide foot out to the side, then slide back so both legs are together - 3 sets of 15 reps
7. Side leg raises (to activate the gluteus medius) - Lie on your side and raise the upper leg slowly, then lower, with the toe turned slightly in - 3 sets of 15 reps.

Gym Routine (2-3 times per week):

1.Stationary Bike: 10-30 minutes. My OS says that a recumbent bike is better for me than a regular bike. For any bike riding in the future I am not supposed to have a bike that puts me very low on the handlebars, but a more upright position puts less stress on the hip.
2.Pool: forward walk, backward walk, side stepping, total time of 15 minutes. Can do on different days from the bike until endurance builds up.
3.Leg press: < 70 degree hip angle, 50 pounds, 3 sets of fifteen
4.Seated Hip Adbuction: 30 pounds, 3 sets of fifteen (I don't have a seated machine for this so used a pulley while standing but either would work)
5.Seated Hip Adduction: 20 pounds, 3 sets of fifteen (I don't have a seated machine for this so used a pulley while standing but either would work)

It's the piriformis, silly!

PT went well, and we discovered that my buttock pain was sciatic nerve irritation caused by piriformis syndrome. The piriformis muscle can compress the sciatic nerve for many reasons, hip surgery being one of them.

If anyone knows the magic "piriformis syndrome stretches," please comment so I can contact you! My PT and I got sidetracked on other things and she didn't give me anything but I know they exist. I don't see her again until next week.

Update: Here are some stretches I found on the Internet; most are not easy to do with a hip that is 7 weeks post PAO!

1. Stretching the muscle often duplicates the pain. To do the piriformis stretch, lie on your back, and flex the right hip and knee. Now, while grasping the right knee with your left hand, pull the knee towards your left shoulder. This adducts and flexes the hip. In this position, grasp just above the right ankle with the right hand, and rotate the ankle outwards. This applies internal rotation to the hip and completes the stretch.
2. Another way to do this stretch is to stand on your left foot and place the right foot on a chair, such that the right knee and hip are flexed at about 90 degrees. Now, using the right hand, press the right knee across towards the left side of the body while keeping the ball of the right foot on the same spot on the chair.
3. Place the right knee on the ground roughly in line with your left shoulder
The right foot should be just in front of the left knee
Press your hips towards the ground so that your bodyweight is on your right leg.
As you move down the right knee comes closer to the left shoulder.
You should feel a gentle pull deep in the right hip / buttocks. ((Note - this is not possible with a post-PAO hip!!):

4. To stretch your RIGHT Piriformis, start off by lying on your back. Bend your knees and cross your right leg over your left so your right ankle rests on your left knee in a figure four position. Now, bring your left leg towards your chest by bending at the hip. Reach through and grab your left thigh to help pull things towards your chest:

5. Sit with one leg bent. Cross the other leg over the bent leg. Try to press the hip of the crossed leg down to the ground. (Not gonna happen any time soon with my hip!):

6. Sit with one leg straight out in front. Hold onto the ankle of your other leg and pull it directly towards your chest:

7. Lie face down and bend one leg under your stomach, then lean towards the ground:

8. More stretches:

Friday, January 8, 2010

Happy Hipiversary

Today marks exactly 6 months from my RPAO, which was July 8. My right hip is doing very well. If I had not done the LPAO I think I would have scheduled something monumental for this occasion - a five mile hike or a long bike ride was what I originally had in mind. Perhaps even cross-country skiing. Skate skiing looks like a ton of fun.

Since my left hip can't participate, I will be doing none of those things. Instead I will celebrate my right hipiversary by starting physical therapy on my left hip. This is fine with me -- I will save the hike/bike ride (not skiing since it will be mid-May) to celebrate my left hipiversary. Perry and I and my parents are also planning an Alaska cruise to celebrate our fifth anniversary and my parents' 50th anniversary. This will be in July, so can also be used to celebrate the right hip's one-year hipiversary. Lots to celebrate. By then I think both PAOs will be doing quite well.

Since about 4 weeks post LPAO I have been lifting weights in the gym with my arms and right leg. Other than hip flexors, my right leg is coming along well in the weight room. I am not nearly as strong as I once was, but strength and range of motion are both improving.

I just read the LPAO surgical report and discovered that in addition to severe dysplasia I had mild cam acetabular impingement on the left (but not on the right), which was corrected during the surgery. I had no idea, but this is not surprising, and would explain why the left hip was always weaker than the right. However, it was also more flexible, which is a bit odd with impingement. In any case, I am still having more pain on the left than the right but it's mostly my buttock/hamstring. This leg is also weaker and has less ROM than my right did at this point in my recovery. I'm not very concerned at this point - I think it will heal at its own pace and may take longer but eventually it will be fine.

I have been walking with crutches for long distances but have dropped the crutches in the house and for short distances at work. I am doing the dysplasia waddle/lurch, but I can waddle pretty fast. My walking has improved even since Tuesday. I will let y'all know how the PT goes today.

Wednesday, January 6, 2010

Adventures on One Crutch ...

Just a short note to say that I walked across the street from work using just one crutch this morning to get a cup of coffee, which I carried back to the office myself. And I even used the escalator! Ah, the little things in life we sometimes take for granted!

As I was waiting for my beverage I realized that my Tango Original Dance music, which Tim and I used for competition in 2007, was playing over the speakers in the coffee shop. It's a pretty esoteric piece of music (it took us a really long time to find it) so it's not something you hear every day.

Coincidence? A sign from God that I will be able to compete again some day? You be the judge.

Saturday, January 2, 2010

Seven Weeks

The new hardware

Today I went back to Dr. Mayo for my first post-op appointment. My parents accompanied me because even though I can drive, it is a long way and they had nothing else to do today. We stopped for a latte on the way up and had lunch after the appointment at The Hub in Tacoma. I had to take this photo at The Hub (note signage behind me):

"No exceptions!"

Everything looks OK. I've been cleared to start weight bearing (on crutches - first 2 crutches, then 1) and go to physical therapy. Of course I tried walking with no crutches at all; just a few steps to see if I could. Yes, I can, but just like last time it's all very weak and the muscles need time to build back up.

Before seeing the x-rays today I thought I had 14 screws, but it turns out that I have THIRTEEN (13!) screws. It's a good thing I am not superstitious. Thirteen screws in my pelvis for the rest of my life could be unlucky. However, I am hoping that my luck has turned around and that 13 is just a number. I guess it might just be my lucky number now.

Thirteen, count 'em, THIRTEEN!!

I went back to work full-time yesterday and will be back in the office again tomorrow. I feel pretty good after sitting in a chair all day yesterday and the 5-hour car ride today.

I ran into fellow PAO patient and blogger Matt and his wife. Last time I saw them I was there for my pre-op appointments; at the time I was walking with a slight limp and he was 8 weeks post-op and on crutches. This time I was 7 weeks post-op and on crutches and he was walking with just a slight limp. It's good to see the progress we and our fellow hippies make. As long as the general direction is forward, it's all good.