Three Weeks

Has it been three weeks? Has it ONLY been three weeks?

Time seems to be moving slowly; I'm focused on my 8-week "bye bye crutches" appointment and I’m not even halfway there.

As I write this, it is 105 degrees in Portland; we’ve had record high temperatures the past few days. I still have trouble regulating my body temperature, and coupled with the heat this has been difficult. We don’t have air conditioning because our house is up on a hill and surrounded by trees; it never gets hot enough for us to need air conditioning (until now). We do have a basement which is cool, but I'm at the point in my recovery where I want to get out of the house and be more active. I can’t really do much outside without dissolving into a sweaty tired mess.

Today my parents took me out to lunch at a nice air conditioned restaurant. Then we went to the grocery store (also cool) and pharmacy (not bad). I did a lot of walking in the stores and felt pretty strong on the crutches. I didn’t realize how tired I was until I got home and took a two-hour nap!

So here is my three week update:

~Scar looks good and I’ve started massaging Vitamin E oil into it. I’ve heard that Bio Oil works well but also heard that any oil is fine, and since the scar already looks so good I see no reason to buy the Bio Oil because I have some Vitamin E.
~I try to sleep in my regular bed but still bail out in the middle of the night to the hospital bed. The mattress on the hospital bed is horrible, but I can change the settings and get more comfortable. Plus I hate waking Perry up with all my tossing and turning. I did spend one night early on sleeping in the recliner but did not repeat it because the hospital bed is better. I can usually sleep on my non-op side with a pillow between my legs but sometimes that just hurts. It’s hard to move the pillow and my leg around to find the sweet spot but when I do, it's great.
~My pain level is usually a 1 and I’m not taking any pain killers. The pain I do get feels muscular and not like it’s inside the joint or in my bones. It’s hard to tell for sure, but I don’t think I feel anything where the bones were cut. I feel sharp pain if I move my leg too abruptly. I am trying not to actively lift the leg as I was told not to, but occasionally I do by accident. I’m able to do it, but I feel sore in my hip flexors and my inner thigh when this happens. I’m trying to be more aware so as not to do it accidentally.
~I’m trying to do things around the house like laundry, cleaning, etc. I carry things around the house in a tote bag around my neck, in my teeth, in a backpack, tucked into my waistband … whatever is handy. It takes a while to bring all the clean laundry in to the bedroom and put it away – several trips with the tote bag – but I feel productive. My house is a mess – we have a long-haired cat shedding everywhere and the vacuum cleaner is just not going to happen with crutches – but I have learned to live with it. Laundry, of course, is not optional.
~Thanks to the CPM machine, my range of motion seems excellent. I can bend over to pick things up from the floor, reach forward and touch my toes, tie my shoes, paint my toenails, bring my leg in to my chest (not all the way by any means, but darn close), sit on the floor, and pull my operated leg up over my head with my hands a la Biellmann. OK, OK, I can’t do the last thing, I was just seeing if anyone was still reading.
~I have gently tried external rotation (e.g., sitting cross legged). My external rotation (turnout) has always been limited and it’s exttremely limited now because of post-surgical stiffness. This surgery did not correct my anteversion (my femurs are rotated inward) since that would be an additional surgery (femoral osteotomy) and my surgeon did not want to do it. (I didn't really either, although the thought of better turnout almost made it worth it.) I don’t know how much my external rotation will improve once I am able to stretch and work on it. I hope to have external rotation that is no worse (and if the stars align, better) than before. Otherwise returning to ice dancing, with its requirement for turnout in order to do even the easiest turns, may be challenging or impossible. This was my biggest outcome fear going in, and it’s too early yet to know how this will turn out (pun intended) in the long run, because I’m not allowed to do any real stretching or rotating yet.
~I’ve lost 12 pounds. I’ve been eating very healthily and I’m definitely not starving myself or dieting. Everyone says my formerly muscular legs are looking wimpy. So we can safely assume that’s 12 pounds of muscle gone to hell.
~Sneezing and coughing aren’t as excruciating as they were earlier in my recovery, but I still feel them in the joint/incision.
~My hands still hurt when crutching but I’m getting used to it and it rarely bothers me.
~I can still see the bruise from my first Fragmin injection, given to me in the hospital by Nurse Ratched. I can still see the bump where the IV needle was inserted. I can just barely still see the bruise from my autologous blood donation! Needles and I just don't get along.
~I am going to have a glass of wine before bedtime. I haven’t had an adult beverage since before my surgery. I have a feeling I will sleep quite well tonight.

Daily Routine

I picked a great time to have surgery. It had been really hot here in Portland with beautiful sunny days. Our house is in a forest and very well insulated, so it stays cool. I love sitting in the living room watching the hummingbirds and squirrels. I can wear shorts and tank tops around the house and don't have to worry about trying to stay warm. Best of all, I don't have to put socks on (something which I don't think I can do on my right side by myself yet).

I have been waking up at 5:30 AM to have breakfast with Perry and sit in a chair for a couple of hours. Our new recliner is being delivered today and I can't wait for that as the chair I'm sitting in is a bit uncomfortable. I usually check e-mail and read the news in the morning. I am a bit obsessed with checking other hip chicks' blogs to see what they are up to, especially those that are a few weeks ahead of me in the recovery process. We all heal differently, but it's good to know what to look forward to.

I've been leaving comments on other hip chicks' blogs with more regularity because I can empathize about both pre- and post-surgical issues. I am trying not to make a career of reading and commenting on blogs, but it's hard not to be obsessive about it since it's what I am living every day.

I have noticed that most peoples' blog entries tend to taper off or stop just about the time they are allowed to ditch the crutches and start walking. This makes sense because at that point people pretty much go back to their normal lives. I would like to hear more about the physical therapy experiences people have at that point, but I'm sure I'll have the experience myself soon enough.

The only "complication" I've had is that my hands are sore. I'm using padded bike gloves, but they aren't helping much. The crutches are a bit more cushy than the walker so I'm using those more, but it's easier to carry things with the walker. I put a bike basket on the front -- the same kind of bike basket that used to go on my pink Schwinn when I was 10 years old -- only this one doesn't have plastic flowers on it. My Mom's friend had it hanging in her garage and donated it to the cause, and it has been invaluable.

I am allowed to walk as far as I'm comfortable with the crutches as long as I don't put any weight on my right leg, which means most of my weight will be on my hands. The doctor made it clear that it's a good thing to walk and exercise but I haven't ventured out very far yet. I think my hip could go miles without a problem but my hands might not make it that far. Since we live on a steep hill, I think I'll try going to a flat neighborhood to see if I can crutch a block. Someone can follow me in the car in case I poop out.

(Speaking of, yes I did, on Wednesday. My sister Linda won the betting pool.)

Most days, after sitting in a chair for a couple of hours I go take my meds and inject myself with Fragmin, the worst part of my day. Then I usually get tired and take a nap. When I wake up I work for a few hours each day on my laptop. I don't want work to think they can survive without me for too long! Usually I read a book in the CPM machine in the afternoon. When Perry gets home he helps me take a shower. A shower chair is invaluable and Perry installed a hand-held shower head as well. I strongly advise everyone to have those things to make your life easier.

I got a bedside commode because my surgeon told me to, but I've never used it. I don't have a raised toilet seat either. I know those things can be helpful but I haven't found the need. I would advise people to buy the raised toilet seat and have it available. Try the toilet without it. If you find you don't need it, return it.

The only other assistive devices I have are a grabber (invaluable - things fall on the floor all the time and I can also use it to help get my pants on my "bad" leg). I have a sock putter onner but haven't tried it yet as it has been too hot for socks. Usually people buy a "hip kit" which has a long shoe horn, a sponge on a stick for washing, a grabber, and a dressing assistant device. I didn't think I needed all of that and the grabber was on sale, so it was cheaper to buy just what I needed. However, usually it's cheaper to buy everything as a kit and some people may want the other items. I can reach my lower legs to wash them and can put my shoes on without a shoe horn so I didn't need all of the items.

I try to do my isometric exercises about 5 times a day, 20 reps each time. Those consist of the following exercises done lying on my back:
~Glute squeezes
~Pointing and flexing my feet
~Hamstring exercises in which I pull my heels down and toward my butt
~Quad exercises in which I tighten my quads and push them down into the bed

I try to get up 5 or 6 times per day just to stroll around. I'd do this more often if my hands hurt less.

I spend 20 or more hours per day in the CPM machine and I'm up to 75 degrees. I need to get to 90 degrees before I can stop using it.

My IV site is still sore and tender. Obviously anything having to do with putting a needle in one of my veins is a problem. Not intolerable, but something I've learned about myself.

The Big Betrayal

I sometimes feel betrayed by my body. All these years I’ve taken pretty good care of it. I’ve been lucky to have had very good health all my life. I don’t smoke, rarely drink, don’t overdo the caffeine even though I live in Starbucks Land, eat right, and exercise. I am the type of person my insurance company loves – no claims, just the yearly wellness stuff, and meanwhile I subsidize everyone else’s bad health habits. Until now, when we find out that hey, I’m all broken! I have to be taken apart and put back together again in order to work right!

I did pilates a couple of years ago to become more flexible. My back was pretty flexible and my upper body can do interesting things, but no matter how much stretching or strengthening I did, my bones wouldn’t change their shape, and so my lower body was as inflexible as a piece of wood. It was so totally frustrating. My pilates teacher, Angela, is a skater and I had private lessons with her. I stretched at home every night. She was patient and tried everything with me. I eventually just gave up in frustration.

I’ve started using the cane more and more, and will soon get crutches. Not that I really need crutches yet (although the cane has been helpful). But I want to learn how to use assistive devices now, while I’m still pretty mobile, and not in the hospital the morning after surgery when I’m wandering around in a drug-induced fog with my butt cheeks hanging out of my gown. It also may help to keep some pressure off the joints before I go under the knife.

I wrote an e-mail to my co-workers explaining what was going on so they wouldn’t be appalled to see me with a cane at work on a regular basis. I showed up at the rink with the cane for the first time just so everyone could stare at me without feeling badly about it and get used to the idea.

People ask questions once they get over the shock. I know they all mean well, but after a while I just want to wear a t-shirt or carry a sign, or maybe just hand everyone an FAQ sheet:

~No, I didn’t fall down and hurt myself. Boy, do I wish that’s all it was!
~No, I’m not “injured” – my body was put together wrong.
~What happened? Well, actually, nothing “happened,” I was born this way.
~Thank you for saying you hope I get better soon, but I won’t get better, I’ll only get worse until surgery fixes me.

Carrying things while using a cane is difficult. I have a purse which is really a backpack and I dug it out and it works great! I think crutches will be really, really super-specially fun. Being on them may cure me of my daily latte habit since I see no way to carry a hot cup of espresso in the backpack while on crutches. My husband, who is very handy, will probably rig something up to make this possible. Although I suppose I don’t really need the crutches to cross the street and get coffee. After all, I can still walk on my own for now.

I wrote this in an e-mail today to Angela:
"It has been an enlightening journey to find out just how badly put together my body is, but it explains so many things about my inabilities and physical challenges throughout my life. It's good to know it's not just that I'm lazy, or that my muscles are tight, or that it's all in my head. It's a relief to have a reason now."

Speak softly and carry a big stick

My new sidekick: A wooden cane that my grandparents brought back from Mexico 30 years ago. It was in my parents' basement so I borrowed it for a test run.

Some problems with carrying a cane:
1. It's hard to carry other things since you only have one hand free! I must get a backpack since I carry a lot of stuff most days.
2. It's unwieldy. I have already wacked two people with it and not on purpose. It falls down when I lean it up against things. It's easy to trip over if I leave it lying around.
3. It's heavy.
4. It attracts attention. OK, look, I know I could mitigate this issue by getting something plainer; my cane has intricate carvings painted in bright colors. But my grandfather used this cane for years and it has sentimental value. Plus I'm cheap. Why buy a cane when I already have one?

I now have some level of pain pretty much all the time. If I sit for long periods of time my hips start to ache. When I first get up, I'm too stiff to move for a few moments. I can still sleep but only on my back. This doesn't hurt my hips but it does hurt my back. I figure eventually it will hurt my hips too, it's just a matter of time. I can't lie on either of my sides.

Walking hurts, although after I get going it hurts less.

Skating hurts.

Standing, sitting and lying down all hurt most of the time.

It's a tolerable hurt right now -- a dull ache and not a sharp pain. I am not taking pain medications until I have to. I'm not big on meds. NSAIDS can cause kidney damage and I'd rather have some pain now than kidney disease later. If I have to start popping an Advil now and then I will, but I want to delay that as long as possible. I want to know how bad it is, not mask it.

I am hoping that the pain will be tolerable through this skating season. I can then do something about it. I have an appointment with the periacetabular osteotomy guy Oct. 30 (I still can't believe the lead times for doctors). PAO does not sound promising, however. It sounds horribly painful with a long recovery time. A week in the hospital, and no weight bearing for months. The pain is akin to a broken pelvis, because that's what they do, break your pelvis. Hip replacement/resurfacing sounds less painful with a much shorter recovery time. However, the life span of those methods is limited (10 years? 20? who knows really) and the PAO may postpone the need for them -- or eliminate the need for them altogether.

When I read about the limitations post-surgery, PAO also sounds worse. I can't skate if I'm constantly thinking about what I can't do. I don't want to skate if my toes turn in and my extensions look like shit. I have worked all of my skating life to fight my lack of turnout and now I am at the point where my legline looks decent. To give all that up now just because I'm in some pain sounds silly. But if the pain increases it probably won't be so silly any more.

That's PAO though. Hip resurfacing will allow me some turnout; perhaps more than I have now. It's just the limited lifespan that worries me. I plan to live a long time and don't like the sound of 2 revisions in my future. But it seems multiple surgeries of some sort are inevitable. It's just a question of what. And when.