Wednesday, March 31, 2010

19 Weeks; Skating Lesson

Had my first post-PAO session with a coach. This is more to document my progress and probably not going to be interesting to very many of you. Hippies will laugh when they hear that the first thing she commented about was "lack of psoas (hip flexor) involvement." Isn't that just the way it is with us? Hip flexors are always a problem. When I explained what was cut during surgery her face went white. "I can't even believe you're out here," she said. I told her not to go easy on me; if there's anything that hurts I'll tell her. I need someone to push me and give me confidence.

We did FO, FI, BI, and BO edges on half circles. Back edges were easier than forward edges - despite surgery, I have always spent more time skating backward than forward in my many years of skating. Once I got over the fear of not being able to see people coming, backward was easier. Need to remember to lift up the upper body when I push (not collapse forward) and bend skating knee for the push before rocking over. Swing free leg through turned out and straight (yeah, right ... but I'll try). On FI push, rock back to the heel.

Two-foot slaloms forward and backward. Need to bend knees and get a good upper body twist. This hurt my left hip flexor going forward, but not intolerable. It will be sore later.

Double 3s on two feet, both directions. On the left I tend to stick the skating hip out. Need to get up and over it. Twist and check with the arms. Down, up, down with the knees.

Coach R was impressed with how much I could do, and actually I was too. This all seems so remedial but of course I have to crawl before I can walk, and walk before I can run. Watching Barb do beautiful Westminster Waltz patterns this morning inspires me to try harder.

Saturday, March 27, 2010

Not all PAOs are created equal, part 2 ...

A skater at the rink asked me to do a high-level dance on Sunday. I told him that (obviously) I couldn't do it, and that I might never recover enough to do it. He was partly joking, but then he said that I should be able to do it some day, because he knew another ice dancer who had the same surgery I had who could now skate just as well as she could before.

This shouldn't bother me, but it did. To compare two people's recovery is really unfair. I am only 4 months out from my second PAO, and while I have never met the other skater, I understand hers was many years ago. I don't know if she had bilateral PAOs or just one. I don't know if her skating muscles were cut or not. I don't know her age or fitness level.

The person who asked me to dance seemed to think that I was pretty full of shit and that I was making a big deal out of nothing - and that I should be just fine soon. I certainly hope he is right, because I would really like to be just fine some day. But realistically, I know my body. It is going to take a long time, and a lot of work, to make progress in my flexibility, which is greatly limited despite yoga twice a week and daily stretching. Strengh I am more optimistic about, but after hearing other PAO patients' experiences I know that our muscles still tend to fatigue more quickly than pre-surgery, even many years post PAO.

The goal of the PAO was to give me everyday functionality, not to make me a great athlete. The likelihood of getting back to my prior level of function is between slim and none. I am 47 years old, and I don't have hours to spend working out every day. This is a reality I accept. I wish others would accept it too.

Thursday, March 25, 2010

Not all PAOs are created equal

I recently compared my x-ray with another hip chick's x-ray. Granted, all bodies are different and all surgeries are different too. People recover at different rates and have different reactions to medications and procedures. Surgeons use different protocols and techniques.

Her x-rays looked really different from mine. She only had 3 screws, and by the angle it looked like they were all holding the acetabular bone fragment in place and none were holding detached muscles. Her three small screws were all lined up neatly in a row, all pointing the same way. My 13 screws are much larger, in different places, and at various angles.

When she told me her surgery only lasted an hour, and that she was going to be off crutches and back in spinning class 4 weeks after surgery and back to work in less than 2, I started to wonder, did we have the same surgery? If I'm healing so darn fast (by all accounts), and I'm at 8 and 4 months respectively for dumb and dumber, then why does the thought of a spinning class even now make me shudder, knowing I wouldn't be able to walk at all the next day? And why did my surgeries, performed by an equally competent and well-regarded surgeon, take OVER SEVEN HOURS??

Why such a difference? In a relatively simple PAO, the acetabular bone is cut and reoriented and then screwed back in place. The quad muscles are not cut, and the hip capsule is not opened. In a not-so simple PAO like mine, the quad muscles are cut to access the hip capsule; the hip capsule is opened; and various things are done in there (from shaving impinging bone to re-shaping the femur to repairing a damaged labrum, all of which happened to me). All of this additional trauma makes for a longer recovery.

Broken bones usually heal much faster than traumatized muscles and soft tissues, so this all makes sense. It explains why, all other things being equal, some people heal much faster from their PAOs and are able to regain more function. Mystery solved!

Wednesday, March 24, 2010


In compulsory figures, a wobble was also known as a subcurve. In skating, all movements (with a few exceptions such as the slides on the Paso Doble) are done on curves, or edges. Skaters are judged on how well they skate these curves, meaning they should be continuous, deep and round. If the edges contain subcurves, the skater is not securely balanced over the blade, causing it to wobble.

I don't yet have the leg strength or control to push down through my hip, knee and ankle to make the blade contact the ice securely. This means that my blade does not grip the ice well, I don't get "into" the ice, and I skate on insecure edges. In other words, I wobble all over the place.

Remember Weebles? They were toys from my childhood, and as the jingle goes, "Weebles wobble but they don't fall down."

Well, so far, I am a Weeble ... I'm wobbling but I haven't fallen down yet. Which is a good thing because, as another famous slogan goes ... "I've fallen, and I can't get up." It's only a matter of time.

But back to today's skating saga. I went to the group moves in the field class taught by coach R., who used to work with me privately. She knows me and is also very motivating, so I figured this was a good place to start.

We started doing swizzles. I was way behind the rest of the class speedwise, but did two laps eventually and these didn't hurt my hips too much. We then did 3 turns. I started on two feet, but eventually was able to do them on one foot. I am still not into the ice so they aren't secure. I actually wish I could use more speed since that would help, but I am not there yet.

I did alternating 3s to the center on half circles. I had to put my foot down on the BI edge back to center most of the time, but did manage a few where I didn't. And doing the choctaw step forward from BI edge to FO edge was next to impossible due to my lack of turnout. I was able to force a couple from my better hip ("dumb") but none from my less better hip ("dumber").

Speaking of dumb and dumber, I could really tell the difference between my 8 month old right hip and my 4 month old left hip in strength, balance and flexibility.

So tonight there was incremental progress - a good thing.

Sunday, March 21, 2010

Not so much

I went to the Sunday social dance session today. Perhaps due to my heavy workout on the elliptical trainer yesterday, my legs just wouldn't move today. It was a rather depressing skate, made even more depressing by the ugly butt pads I am sporting. Even though I've lost weight, they make me look huge and feel fat and ungainly.

It's totally normal post PAO to work out one day and be totally knackered the next, so this is not unexpected. That doesn't make me like it any better.

Again, I did just the forward dances, but could barely pick up my feet or hold an edge on one leg. Knees did not bend. The thought of 3 turns is depressing, although I tried a few, using my upper body and free foot to force the turn. I can not stop. I can't get out of the way. I can't push. Worst, I critiqued the local solo dancers who are competing at Adult Nationals next month. They will be skating Westminster Waltz and Kilian. Those dances look so difficult and impossible to me right now. I can't even imagine skating like that again. The solo dancers are so carefree and light on the ice. I am so ponderous and plodding.

Lots of self pity going on here today, but again, that's expected. I don't need cheering up, or to be told it will get better, or to be told I'm doing as well as anyone could expect. I just need to say how much this sucks.

Wednesday, March 17, 2010

Sk8 Post 1: APBM

I think this blog is about to change from a hip surgery blog to a skating blog. It may only be valuable to me, as a record of my skating progress, since I am starting over with zero ability. In that regard, it could be a private journal. But making it public keeps me honest and perhaps inspires (or annoys) others. It means I have to follow through. Right now motivation is a problem, so that's a good thing. Knowing someone may be reading this might mean the difference between going to the rink or sleeping in.

I didn't have any realistic skating goals until today, which meant I wasn't motivated to go to the rink. My pre-PAO goals were to pass my Novice moves and a few more international dance tests, but those goals are plain impossible right now. So my new, post-PAO goal is to pass my adult pre-bronze moves. Now, granted, I have already passed that test, along with all of the other adult moves tests. I have my adult moves-in-the-field gold medal and in fact was the first person in the country to earn it. But that was a couple of surgeries ago. After looking at the patterns I realized that going through all of the adult moves tests really will give me a good fundamental grasp of the skills I've lost.

Today was day 1 of my "training." I ran through the APBM test and, let's just say, I would not have passed the test even with a drunken panel of judges. I put my free foot down several times, and just plain couldn't do a lot of things. For example, a Waltz 8, something I passed when it was a preliminary figure back in 1976, is scary and impossible right now. The FI three turns on the last move are impossible, not to mention the FO three turns that are only slightly less impossible. Oh yeah, and backward crossovers? Give me a break! Working on these things until I master them will be a true test of what I can accomplish.

My goal is to test the APBM May 24th at Sherwood. That gives me just over two months to master them. It should be a nice quiet test session where nobody knows me so when I fail the test I can slink out the back door quietly. Or, more likely, take off my skates and judge the rest of the test session.

The plan really is perfect ... a timeline which may culminate in total embarrassment if I don't get my butt out there. Instant motivation!

Thursday, March 11, 2010

Adventures in Yoga

I suck at post-PAO yoga as previously mentioned on this blog. But there are a few things I can do. Revenge of the anteverted: today our instructor had us try Crane Pose

Note - this is not me!

for the first time, and I was able to do it. Nobody else could do it, despite all their fancy shmancy open-hipped abilities. Nyah nyah nyah.

(I know, I am missing the entire point of yoga class but it sure felt good to finally be able to do something!)

I held the pose for a full 10 seconds and then ... thunk ... fell forward right onto my forehead which made a loud noise on the wooden floor. I didn't care at the time as I was just so proud of doing the pose. I have certainly learned to be sure my head is over the mat before doing crane pose in the future.

Just to prove it wasn't a fluke, I did the pose again when I got home. Nobody is home to take a photo of this amazing event but eventually I'll replace the stock photo.

Monday, March 8, 2010

8 Months RPAO

Why we chase the zamboni ... from a distance!

My RPAO is 8 months old today. It's easy to assume that 8 months after an orthopedic surgery the patient should be all better and have nothing left to say. Not so with periacetabular osteotomy, which my physical therapist is quick to let me know takes a full two years to recover from, and even then I will never be as strong or flexible as I was before. So chronologically I am really only one-third recovered from the first PAO. Plus the fact that the right side wasn't anywhere near recovered when I had the left side done, and the recovery has been more challenging.

Despite all that, I am happy with my right PAO. Compared to pre-surgery, I no longer get the crippling stiffness and pain after walking. I no longer have the stabbing groin pain or difficulty sleeping on my right side. I don't have lower back pain unless I really exert myself. I don't have knee pain.

In fact, I rarely have pain at all, except in the hip flexors which get sore. I do have weakness though. I still have some stiffness after exertion or sitting for a long period of time. It takes me a few steps to hit my stride when I start walking (and since I'm still limping on the left side, it's hard to tell how good the right side really is). I can do most housework, although I do get sore or tired if I do too much vacuuming or kneeling to clean or garden. Getting up from the floor is not as easy as it used to be, but I can do it. I still have to use my hands. (I think this is more a limitation on my left side than my right.)

For most of my day-to-day existence I don't think about my right hip because it functions just fine. For that matter I rarely think about my left hip because it functions close enough to fine not to limit me. It's only in the gym, in the yoga studio, or on the ice that I feel as if I am living inside someone else's body.

My hip flexors are weak despite working out like a mad dog in the gym. Every PAO patient is probably in the same boat. They tell me to be patient and this gets better. My other leg muscles are still weak, but less noticeably so than the hip flexors.

Some flexibility has returned, but despite regular stretching and yoga class I seem to have hit a plateau. I hope this is not as good as it gets. I can no longer do a nice leg extension or attitude position even with assistance. I have some turnout, but not as much as what I had before (which was less than normal). I know there has been improvement because my right is much better than my left and again I must be patient. Ah, my lovely spirals on the ice -- wish I had those on video!

I am religious about doing my PT exercises, hitting the gym, and stretching and yet progress is very slow. This is the reality of what a very slow recovery is like.

Just tellin' it like it is!

Thursday, March 4, 2010

Finally, butt pad fashion photo shoot

Due to high demand for photos of the now infamous butt pads, I had my rink friends memorialize today's skating session in the photos below. I am sorry to say that you really can't see the pads that well because I am wearing all black and they just sort of blend in. However, I think you can tell by the shape -- that is not my real butt! (Click on photos for higher resolution images if you want better detail on what is me and what is pad ...)

As for today's skating - I skated only 30 minutes but didn't stop much to rest. I actually broke a sweat. Worked on forward and backward stroking and turning from front to back (3 turns and mohawks only). Amazing how something I've done since I was 10 can be so very foreign to me.

They're sleek ... they're chic ... and they're only $49.95!

I know, I know, everyone wants their own pair.

Wednesday, March 3, 2010

The World is Full of Morons

I keep hearing on the Yahoo HipWomen group that well-meaning friends of newly-diagnosed dysplastics, upon hearing their diagnosis, tell them things like "it's impossible for adult humans to have hip dysplasia," or "it's impossible that bilateral hip dysplasia would not be caught at birth."

These same "friends" then question the diagnosis and treatment plan, making the poor recently-diagnosed patient question everything themselves. Believe me, the diagnosis is confusing and upsetting enough without the "well-meaning" buttinski commentary.

Now, I realize that I have been living in hip-dysplasia fantasyland for about a year and a half. Based on the blogs I follow and the online Yahoo groups to which I belong, it would seem the world is amply populated with adults diagnosed with hip dysplasia. They are everywhere -- soon to take over the world!

But of course, the reality is that we are a very tiny population in a world that hears the term hip dysplasia and says, "woof."

The truly unfortunate part of this is that some of these "friends" are also professionals who are entrusted with people's health issues: Physical therapists, sports trainers, and (gulp) I am sure some physicians. It's scary how much misinformation exists.

Granted, PAOs are a fairly new invention and in 20 years there will probably be a much better way to correct this problem. Or perhaps screening methods will improve so that all cases actually WILL be caught at birth and corrected. Meanwhile, I'm here to say that we adult dysplastics exist and our dysplasia didn't come about due to poor nutrition, sitting in "W" position, or child abuse; we were born with it. The evidence is overwhelming - it runs in my family and I am a first-born female. Can you say, "the genes were stacked against me?"

We veteran hip chicks (and dudes) can only continue to educate and encourage the newly-diagnosed, steering them to expert surgeons who understand the condition and away from those who don't. I guess that is why I continue this blog, despite being at the point where people probably think I should move on and get a life!

Monday, March 1, 2010

Next day ...

Pretty sore today, but not unhappy about it. I could not even get my shoes on today and finally switched from a shoe with buckle to a slip on after trying unsucessfully to reach the buckle for 5 minutes!

On the way in to work I was limping worse than usual and when I went up the ramp from the parking lot I slowed down and put my hand on my right hip. A well-dressed woman behind me said a bit sarcastically, "what's the matter, do you have a hip problem?" She looked really sheepish when I replied, "Yes, I have had two recent surgeries to correct congenital hip deformities. My pelvis was broken and screwed back together in November and July." I mean really, why do people ask these questions? Did she think I was just faking it? Puhleeeeze.