In Training

I am in training. Not for bikini season or a skating event, but for surgery. I've been trying to get in the best shape possible, in particular my arms (the better to crutch with) and my hip flexors/quads (they will be cut/moved/damaged during surgery, so the stronger they are beforehand, the faster they will heal). I've also been getting up from low chairs on one leg. I figure if I can do it now, I might have better luck navigating when I am down to one leg for real. Thank God for all those sit spins I've done in my life!

I am also thankful that we have a home gym, with an elliptical trainer and all-over weight machine. I was working out before I had a surgery date but it was sporadic; now that I have a goal date I can be more focused in my training. I have had to work back up to longer times on the elliptical; at first my hip was throbbing after 15 minutes, and now I'm up to almost 40 minutes before the pain becomes intolerable. I haven't added much resistance but I have increased my step rate, and I just have to keep reminding myself not to bounce!

I trick myself into thinking I'm training for an athletic event and that makes it a bit more fun. If I thought about how much work I'm putting into building up the muscles in my legs, and how those muscles are going to be cut, and then atrophy, in just over 5 weeks, I probably couldn't face the machine each day. Instead I imagine I'm getting ready for ski season, or a cross-country bike tour, or a skating test. So far this trickery has worked.

I've also put together a playlist of music for pre-surgery and, if they'll let me, during surgery. I have picked some of my favorite calming music. I'm hoping that will help my nerves, but perhaps valium would be better. Recently PAO'd hip chicks all comment that the anticipation is the worst part of this surgery, and I'm sure that's the case. A part of me would like to postpone this indefinitely, but the rational part of me says, "let's get this over with."

I'm off to the gym.

Building up “Quad” Strength

I went back to the roller rink last night without Tim, despite a huge blister on my right arch from the rental skates. He is on vacation, so now is my chance to impress him with my newly-acquired roller abilities upon his return. I am intrigued with the quad roller thing, and there happened to be a session after dinner and the roller rink is closer to my house than the ice rink.

It’s not that I like roller skating better, it’s just that it’s a challenge. Plus I am very limited in what I can do on roller skates, so it’s harder to hurt my hips. When I ice skate, I want to do all the things I like to do, which are hard on my hips. When I roller skate, I still get the fun of moving to music (and they have live music at the roller rink too), but I can only do easy things.

I went to a public session hoping to be incognito, but just prior to the session there was a beginning dance class, and most of the class participants stayed for the session. They recognized the fact that I was some sort of a dancer because I was working on dance elements. Then there were some higher level dancers I’d met on Sunday who were there for fun. Everyone was friendly and encouraging and probably wondering why I was there by myself.

My goal was to learn how to hold an edge on those slippery buggers (roller skates don’t dig in to the floor like a blade on ice, so it feels “slipperier” to me). After about an hour I got to the point where I could do all 4 forward edges, although I was pretty slow (um, hello, I would have gone faster but I’m not quite sure how to stop these things yet). I did linked edges and swing rolls, chasses and progressives.

Several people I hadn’t met on Sunday came right up to me and said “ice skater, right?” Was it that obvious? Yes, they said, they could tell by how I do my progressives. We ice people are easy to spot, and not just because we’re dressed for the arctic in a hot roller rink!

I then decided I must learn to turn backward gracefully if Tim was going to make me do dances like the Viennese and Samba with him. Three turns without holding on to him seemed beyond my reach, so I decided to do Mohawks in both directions. My ice technique was wrong, wrong, wrong. They do heel to heel Mohawks. Several people tried to show me how to do this but on ice, heel to heel = veryverybad; not only technically wrong but easy to step on the heel of your blade and go down. I just could not get past my aversion to doing it heel to heel, but I tried repeatedly. By the end of the session I could turn backwards pretty consistently in both directions and it felt sort of like an ice Mohawk, but my new friends shook their heads and told me it was “wrong.” Sigh. I’m going to have to learn it their way, I know, but it’s going to involve reprogramming 10 years of ice technique.

I did do Paso Doble cross rolls and those were pretty easy, although I’m sure I did them “wrong.” A couple passed me and I smiled and said, “Paso Doble!” They nodded and smiled and probably said to each other as soon as out of earshot, “dumbass beginner, stick to the glide waltz.” Yep, I probably should.

One friendly skater told me that I needed to “learn to listen to the music and skate to it.” Now really, my focus was just to start feeling comfortable out there and work on “technique,” such as it were. I was ignoring the music. I guess that’s really bad form at the roller rink. When music is playing (especially live music) then dammit, you should show your appreciation and skate to it.

The only fall I have had so far was when I went to sit down on the bench, but kept “rolling” and missed, falling onto my right wrist and then my butt. It would have been embarrassing, especially if I had ended up in a cast, but as soon as I realized my wrist was only sprained and not broken all was well. So I now have a sprained wrist and a huge throbbing blister but my hips don't hurt at all. Go figure!

Tuesday is for whining

Exercise is important when you are heading into hip surgery. I know I need to keep my weight down as well as strengthen my leg muscles as much as possible. But it’s just gotten so damn depressing lately.

I’ve had to ramp down my eating, to the point where I’m pretty much existing on egg whites and veggies right now. Otherwise I’d balloon up, and then my compromised hips would have to carry around that extra weight, which would just hasten the breakdown of cartilage and hasten the time frame for arthritic changes. I’d rather starve myself than speed up that process.

I am a big eater and have always worked it off with exercise. I’m no good with diets – I just don’t do them. I have cut back drastically on my walking and for all intents and purposes stopped skating. I’ve gone from an activity level of “high” to “sedentary” in a few short months, and I know that my metabolism has changed. My weight has only crept up a couple of pounds but I know my percentage of lean muscle to fat has gone downhill. And there isn’t much I can do about it.

I’ve tried the elliptical machine, and I’m lifting weights a few times per week, but I’ve never been a gym person either. I wasn’t seeing much impact from the machines, and so I started to work out harder, but that means the day after I work out my hips HURT, so I take a couple of days off … and so I’m really not getting anywhere. I’m not sure whether I should continue to work out when things hurt, or not. Then I have to keep cutting back on food, and then I’m always tired.

This is just not a healthy situation. I know that I have to keep it up until July, but by then I won’t be as buff as I had planned. At my advanced age, I know recovery is not going to be as easy as it would be for the younger generation, so the buffer the better. I can’t even ask my doctor about this, because his advice was just “don’t exercise” and “keep your weight down.” I’m finding that next to impossible.

I know I’m going to get at least one comment from a hip sister that urges me to “swim.” I hate swimming. Hate hate hate hate hate swimming. So yes, I know swimming may help me but I just can’t bring myself to take the plunge. I'm saving it for my post-surgical recovery, when I know I won't be able to do anything else.

It's the standing, stupid

While working out last night, I was reminded of my lifelong disgust with myself for never being able to “get fit.” No matter how much I worked out, it seemed my leg muscles would never get used to exercise and my legs always tired quickly and started to ache.

When I lived in Colorado, in my 30’s, I walked 3 to 5 miles every day in my hilly neighborhood. Since I lived on a mountain this was also a way to see wildlife and enjoy the outdoors. I was already athletic so walking seemed easy in some ways – I didn’t get out of breath – but my legs hurt while I was walking and after. So I figured I needed to just keep walking and over time my muscles would build up to the task and the pain would stop.

I walked for 4 years, after buying the latest in cushioned walking shoes, and I walked on dirt trails which I realize now were softer and better for my hips than concrete, but my “muscles” never stopped hurting. The same thing happened if I went to an aerobics class, or did any kind of high impact cardio training. I cursed myself for being such a weenie and just did it anyway. I trained harder, hoping that would do it. I always wondered why everyone else was in better shape (meaning able to walk just fine) without even trying.

When I started skating again I had the same achy leg issues, but put them firmly in the back of my mind. It always bothered me that despite all of that exercise it never got better and I was still “out of shape.” When I tested or competed I had to be very careful not to warm up much so that my legs wouldn’t be “dead” by the time I performed. It was hard for me to reconcile that I just didn’t have any stamina in my legs, although my lungs were fine. I learned how to conserve my energy for when it was needed.

Last night I was doing some standing leg exercises. The leg doing the weight lifting was fine. But the leg I was standing on, putting all my weight on in fact, instantly had that same “muscle” pain and tiredness I used to get. I realize now based on the location of the pain that it wasn’t my muscles that were aching at all. It was my femur bone slamming into my acetabulum that was causing the pain, because my acetabulum doesn’t cover the femur properly. So, all my life, all of my weight has been borne by a very small part of the bone. No amount of training was going to make that pain go away. I just trained myself to ignore it.

I am glad the mystery is solved. It will be nice to some day be able to stand on my leg and have the weight of my body correctly distributed over a larger surface area so I won’t have that aching tired sensation. When both surgeries/recoveries are over I’ll be almost 50 years old, and if all goes well I may just be able to stand and walk normally for the first time in my life.

Pity the runners

I pity anyone who has hip dysplasia and runs. I am not a runner myself - I never liked to run, and never was any good at it, and now with chronic hip issues I will probably never run another step in my life. But I know that runners are just as committed to running as skaters are to skating. It becomes more than a form of exercise, but a way of life. Similar to skaters, runners also socialize with other runners and find it to be great stress relief and escape from the daily grind. So it would be very painful emotionally to give up running.

Skating can be high impact if one does freestyle. The constant jump landings put pressure on the hip joint as well as the knees, ankles and back. I skated freestyle as a kid (heaven knows how I was able to do so with these wonky hips), but now I ice dance. While ice dancing is athletically rigorous in ways that aren't apparent to the casual observer, it has a much lower impact on the hips than freestyle skating or running. So, while I have been told ice dancing is a no-no for me, I justify it as part of my existence because I consider it "low impact" and it hurts me less than walking.

If I were a runner I would not have that option. Recently several posters on the Hipwomen Yahoo Group have talked about how difficult it is to give up running. I can absolutely relate. I am afraid that for those gals, giving up running will be permanent, even after successful surgery. It's just too risky to put an already compromised hip back into a high impact environment. I know that some of them do run again post PAO, but it's rare.

I am prepared to retire from ice dancing post PAO if I'm unable to get my strength, balance, and/or range of motion back. Some or all of these outcomes are possible. I am hopeful that with enough hard work in the gym and a good physical therapist I'll be able to get back on the ice post PAO. I have given it a lot of thought ... what will I do to replace skating if that occurs? What other activity that I could possibly do post PAO combines movement and music and speed and grace and working with a partner? Or even a subset of the above? I don't have an answer yet.

My heart goes out to the poor runners, who almost certainly must find something else to replace their activity of choice. There is nothing I can say, other than that I feel their pain, with every step I take.

New Product Review: AquaBells

I need to remind myself that hip dysplasia is not simply an excuse to buy new gadgets, although the upside to major surgery will be getting my very own "hip kit," sock-putter-onner, raised toilet seat, crutches and metamucil.

A pre-surgery gadget arrived today from Amazon: AquaBells, an exciting concept in hip fitness.

AquaBells are ankle weights which can be filled with varying amounts of water so that they weigh up to 4 pounds. I have started with about a pound of water and have gone through my hip exercise just fine. Once I am less of a wimp, I will be able to add weight slowly by adding more water. As long as they don't leak, I should be fine.

Since I travel, these will be handy to take with me since they only weigh a few ounces when empty. The one drawback is they are a little messy to fill from the faucet, but really not much -- it's a small price to pay for portable equipment which expands as I get stronger.

Lots of fun typos on the packaging ("Exercise quadriceps, hamstrings, inner thighs, and calf's ..."). Humor like this is always appreciated, especially during strenuous workouts. Overall I recommend these.

Mystery Muscles

Last night I did some of the PT exercises I’d read about on another hip chick’s blog. I suppose I should go to physical therapy myself; my insurance allegedly covers it at 80% after I satisfy my $3,000 deductible. But I thought I’d try the hip strengthening exercises and just see what gives.

I am shocked, SHOCKED to find out just how weak some of my muscles are, despite skating. I knew which muscles were overdeveloped, but wasn’t aware until now how many were underdeveloped and underutilized, probably because of compensating for my pain.

Take my hip flexors, for example. Please, take them and give me new ones! I should have known something was up last year at the ice dance seminar with Paul and Sharon, where we were asked to stand on one leg and extend the other in front of us at hip level with skates on, and hold it … and hold it … and hold it. I could not do this! It hurt my hip so much that I could only hold it for about 3 seconds vs. the 45 seconds or so they wanted us to hold it. Isolating those muscles I was subconsciously compensating for was impossible.

At the time I was embarrassed and just thought, OMG, I am so out of shape. But I wasn’t really out of shape. I was skating 6 days a week, 2 hours per day. My skating was strong and my stamina was good, but I, an ICE DANCER, could not extend my free leg in front of me while standing at the boards holding on!! People who appeared far more out of shape then I was could do the exercise, adding to my misery. At the time, I had no idea why this was the case. I was really embarrassed though and figured I was just a wimp.

Last night when I tried to do the leg lifts with 2 pound weights, working those same hip flexors, I could barely do 5 of them. FIVE! The recommendation was for 15. I will have to work up to that, starting perhaps with 1 pound. My skates must weigh at least 5 pounds. Don’t even get me started on the clam shell exercises. I could barely do them either. I believe those work the hip abductors, yet another set of lazy muscles.

So, aren’t these the same muscles I should have been using to skate all these years? Of course they are. What the heck have I been using all this time? I know I can extend my leg forward (in hip speak, this is actually flexion).



See picture, this is my bad hip flexed in the Starlight Waltz last year. (Note that my toe is turned in, where it naturally goes, which is absolutely hideous and which I usually conceal better than this, but still I am able to flex.) What muscles was I using to do all this, my mystery muscles? Or perhaps it’s all being handled by my big huge glutes. That would not shock me. OMG, I am all messed up.

And I'm feeeeeelin' ... good?

Strangely, yes. After several days feeling like someone had beat me up in the parking lot, I woke up this morning feeling almost quite normal. I did my usual routine of sleep for 5 hours and wake up, but I think that was more from habit than pain, and I fell back to sleep.

This morning my hips barely hurt, my back doesn't hurt, and my knees don't hurt. It's amazing. AND, I skated for 45 minutes yesterday, working on Novice Moves since Tim is out of town. I skated at medium intensity and so I figured I'd pay for it today, but somehow I'm not.

The past 3 nights I've had trouble sleeping and it has felt as if someone kicked me in the pelvis by morning. My back has hurt almost as much as my hips but I think that is from standing at my desk all day vs. sitting. And my knees have started to bother me, probably because I walk funny and that puts additional stress on them.

I think that I can attribute this episode of feeling good to stretching last night. I didn't stretch overly hard or long, but I did it. I hate stretching and always have. It has always been painful and I've seen very little progress with it. I've always been inflexible even when I've worked hard at it. This has caused me to hate ballet class where they keep telling me to do things I can't, and to hate stretch class and yoga class where I am the only one who can't touch my toes or bring my knees to my chest.

I even hired a personal trainer once to work on stretching with me. She said I was "the least flexible young person" she had ever seen. Stretching for me has always been a losing battle. Now in middle age I'm only going to get less flexible, so while stretching won't improve me, it may keep me feeling better than I would without it. So I need to make time for it even though it hurts and I hate it.

Other things that I'm learning about myself:

I have very overdeveloped glutes. This is called a "skater's butt," but I have more than the usual amount of it. I have the mega butt, which contrasts enough with my very small waist that I can't find clothes to fit. I always thought the butt was due to skating, even though it persisted during those two decades when I wasn't skating (although I was doing other athletic activities). I wondered why I got so much of it even though as a kid I really wasn't training heavily compared to many and I wasn't an elite skater. I had no body fat either back then so it was just very, very strange and oh, so ugly.

Now I think it's the mechanism my body has used to compensate for the weakness in my hips. I think the muscles around the hip joints have atrophied and the glutes always made up the work load. This is also why I found that I was very weak doing certain exercises that everyone else found easy. I just didn't have the structure for it and the muscles couldn't get strong no matter what. The biggest muscles in my lower body picked up the slack for all the rest.

This is all amateur science and conjecture on my part, but would certainly make sense if it were true. I can't find anything in the medical literature stating that people with acetabular dysplasia develop large glutes, but perhaps it depends on which athletic activities they pursue. My body has been trying to do the things I ask of it, skating-wise, with a structure that is more suited to couch potato-hood, and since I insisted, it compensated.

Well, all this aside, today I am feeling good so I plan to take advantage and paint the closet in the bathroom.

Hurry up, and wait

I am 45 years old, and I'm in pretty good shape. I've always been athletic, I dress fairly "young," and thanks to skating I've stayed out of the sun, mostly. So I look my age and by some accounts much younger (depends on the light level, the distance of the viewer, and the number of alcoholic beverages the viewer has consumed). This information will make sense as this story unfolds.

At work I walk fast, I take the stairs most of the time, and I'm usually walking around the office vs. sitting around. Well, up until recently anyway. Now that I have difficulty walking, I tend to walk much slower than before - noticeably so - and I have a lumbering and unusual gait until I get "warmed up." I can't always sit for long periods of time (I am getting a "sit/stand" workstation shortly).

So based on the fact that I look youngish, healthy and fit, people make certain assumptions about me. Like, if they hold the elevator for me, that I will pick up the pace so they don't have to wait. But I don't pick up the pace any more, and this has caused some people to roll their eyes and give me hostile looks. "Come on, we're waiting for you, the least you could do is hurry up!" "Hey lady, you're wasting my time!" That is what those looks say to me. Now I just wave to them from 20 feet away and say "go ahead, don't hold it for me." Let them think I'm lazy or don't care.

I took the elevator up one flight of stairs the other day, something that I have never done before, but the thought of climbing the stairs was just unnerving at the end of the day. I could almost see people shaking their heads as I got on the elevator on the 10th floor and off on 11, and I imagined what they said after my departure. "What a lazy ass!" "She's the reason our health premiums are so high!" "Wow, she doesn't even look like she feels guilty for wasting energy!"

I realize that I'm projecting my thoughts on other people, and whether the dirty looks are real or perceived, I'm probably imagining some of this. Is this how my own guilt and embarrassment over my new condition is manifesting itself? I'm not really sure.

I am thinking of borrowing a cane. Not that I need it quite yet, although I may need it soon. But with a cane in my hand it will be obvious that I am not just walking slowly because I'm lazy, but because I have a medical need to do so.

It's sad that I feel I need a "prop" in order to walk slowly and stiffly in my office without embarrassment. But I've always prided myself on my athleticism, the fact that I can walk anywhere on my own two feet, my independence. Perhaps I'm dreading the day I lose all of that independence temporarily after surgery, or for good.

I work for a disability insurer. We always tell people in our marketing materials that the risk of disability is higher than they might think. As I wrote those materials, I never thought that I might be one of those who became "disabled" - in my 40's -- after all, I eat right, I exercise, and I wear my seat belt. And here I am, feeling a little bit more disabled every day. I look at the things I've given up over many years and more recently (jumping on ice, which I had just started back to; running for the elevator; hiking; walking unless I have to). I am not truly disabled since I can still work at my desk job with accommodations. But I feel disabled nonetheless. Disabled from my life, the things I enjoy doing and the things I have always taken for granted. It is a sobering experience.