37 weeks post-op

Has it really been that long? Mind-boggling, truly.

Yesterday I walked all the way home. I was definitely feeling it on the way but kept it up. I'm a bit sore today but not as bad as I thought I would be, v. happy about that.

I haven't had a chance to go to the pool yet, but am thinking that I will do that tomorrow. I really want to get in some exercise before I have to have the next surgery on the 20th. I know the doctor said I can go in the water afterwards but I'm not sure how I will feel so would like to get some pool time in now, just in case.

I had to change my appointment with Dr. Kelly that was on the 27th June back to the 18 July. It was the first appointment he had available in a time I could manage. I didn't think going to his office a week after I have the surgery would be good, since he likes bending my legs and hips all over the place. Trying to put off as much pain inducing actions as possible :-)

My bum is still not happy but I'm trying to get through the next 2+ weeks as the doctor had said it would be better to wait a bit. Hopefully (touch wood) I will be able to manage it.

Did get a letter regarding the insurance appeal, and it's in the works. Fingers crossed that I can at least go back to PT for a bit to see what my real strength is and what I should and shouldn't be doing. I know bike riding is not in the near future, but that's not because of my hip!

Insurance companies

On Friday I heard from my PT office that they received a letter denying me future PT for my hip. It was sent to them, it's 5 days later and I still haven't received anything directly. They claim my strength is 4/5 (I'd love to know where they got that one from) and that I've "plateaued" so PT is not something I should do, it's "not medically necessary". I was a bit peeved at my PT's office as they just left a message telling me about the letter, and that I should contact them about fees for the future, and as an afterthought mentioned appealing, as if that was something I shouldn't even consider. Not quite. I'll be appealing any which way I can. I suppose I can understand how some pencil pusher in a building with no medical experience can assume that I've not been progressing because he looks at his list he's been given and doesn't take into consideration the actual person and all of their medical issues. But it's still not right or justified.

My PT said he'd submit an appeal and that I should get a note from the rheumatologist (sent her a fax and am awaiting a reply). I asked Dr. Kelly's office but was told that their letters for this do not apply (???) and they can't do anything "legal". Other ideas were mentioned but I won't even consider them except as a last resort. This is so bloody frustrating!

I've been going to the pool three times a week and since I didn't go to PT yesterday, I went home and did some with my exercise ball and weights. I will have to go to the gym for the bike and leg press. I was meant to go the pool today but was invited to an event at the New York Public Library. Very excited as I love libraries, books, anything like that really.

Other than all this stress, the weather is making me pretty achy, as well as my erratic sleep habits. I have been taking the Mobic since Saturday. One pill (7.5mg) once a day. I haven't felt any difference at all yet, but it's still early. I have an appointment next week to see my internist about the acid-reflux meds. So not happy about that but I don't have a choice, at least for the moment.

Overdosing on doctors...

I saw Dr. Kelly this am. The short of what he said is that "there's no solution for what is wrong with you". Kinda knew that already, but I'm just looking for some sort of relief. Well, relief in a more natural way than just popping narcotics. He gave me another prescription for PT b/c the insurance company is getting cranky - I really hope that helps. And he said the pool is the best thing for me, so will keep up with that. He also mentioned prolotherapy. I've researched that in the past, but it involves lots of stuff being injected into you. I HATE needles. But even so he said I should research it though he wouldn't feel comfortable going that route until we're sure the surgery didn't work, which would be about a year out. I will wait a bit to do more research on it as I don't even want to think about all those needles! He also wants me to see another rheumatologist. I definitely didn't want to return to my original one - see v. early posts - as she has NO CLUE about ANYTHING! I've just made an appointment for the 27th. Dr. Kelly feels that we have to try to control the general inflammation I have so we can focus on strengthening my hips, both of which are v. v. weak. I think he was surprised just HOW weak - though I wasn't.
So that's where things stand at the moment.
At least it's Friday! :-)

21 Weeks post op

This weekend my body felt like it went through the ringer. Friday night I started feeling pretty crappy because of the weather, so just went home and reacquainted myself with my couch. Did not have a good nights sleep which never helps matters and on Saturday I was worse. I had theatre tickets on Saturday to see "Is He Dead?" and didn't want to miss that (good thing too it was quite amusing) so I schlepped to the theatre district. Not sure how I got there without crying, but the stairs to the mezzanine were the worst! Afterwards I had an early dinner with my theater date and then headed home, straight back to the couch! Unfortunately I had another rough night and sleep was not good.

I started to feel a bit better yesterday as the weather was much improved, but last night again sleep eluded me and so I'm still pretty achy today. This does not forebode well for me as I have PT after work and am having major muscle spasms especially in my back.

As for my right hip, yesterday I walked two block and was fine and then all of a sudden the front of my hip tightened up and I was limping again. That's been coming and going now. I haven't been to the pool since Thursday. I believe S will be back at PT tonight so I will have to discuss this with him. Perhaps some sort of stretching will help in that area? We shall see. I will only be going tonight as I have a do to go to on Wednesday. Friday is my appointment with Dr. Kelly - I'm thinking he's not going to be too pleased to see me when I tell him what's been going on.

Good & Bad

Yesterday I was doing really well. PT on Wednesday was good, we didn't over do anything, just took it slow and steady. I wasn't even limping yesterday! It was such a nice thing. Then I had to go to the pool last night. I am going to have to talk to Dr. Kelly about this next week when I see him. S at PT said I should be doing it and A agreed. I was only in for 25 minutes, but am I feeling it today! So much that I'm limping with my right leg. The front of my hip feel v. tight and a it is a bit painful as well. This is v. frustrating as I really need to strengthen up. We'll see what the doc says.

Pool time continued...

Friday I came out to the island. I had a heavy bag with some laundry, so that didn't help but to irritate the body a bit. I was definitely still achy and in pain in my hips. The weather went off in the evening and my knees especially were feeling it, took me a while to finally fall asleep. I had also put half a lidocaine patch on the back of my right shoulder as it was killing me. It was a little touch and go so didn't get a "good nights sleep" as I was a zombie when I woke up on Saturday.

Yesterday I couldn't decide whether to go to the pool or not, but eventually did in the afternoon. Thanks to my mother driving me, as I had no capacity for driving at that moment! I was in the pool for about 25 minutes, did my leg exercises and walking back and forth and then side to side. I am still cutting out the squats as I think that might have been irritating by hips, but not sure. My right hip was NOT happy in the least when I got out of the pool, and I made sure to ice when I got home, which definitely helped.

In the evening we went to my brothers house for my nephew's birthday. I took it easy and was still just so tired. When we got home last night I went straight to bed and was just watching telly. All of a sudden the groin area on both my left and right sides started a stabbing pain, first on the left, then the right. I was crying from the pain it was so bad. My mother came in and then got me some ice packs and that seemed to calm it down. It was the strangest thing, totally out of nowhere. Eventually I fell asleep and slept relatively well.

I think I am going to pass on the pool today though. I am not sure if that is what triggered that groin pain, so will have to ask my PT guys tomorrow. I am also pretty achy all over. Unfortunately I think he is away so it will just be the new understudy. I don't think she has enough experience with this. I see Dr. Kelly in two weeks and right now I am ready to yell at him. It's been almost 6 months and I don't feel that much better, on my right side. I hope he has some better ideas, and not including surgery, because I know I don't have the strength for that with either leg at the moment.

I am sorry to say it but I'm having a hard time keeping the faith at the moment. Hopefully we'll come up with a resolution or plan of attack soon and it will work. I guess it doesn't help that my right index finger has been barely usable for the last two weeks and my jaw/mouth pain has been non-stop. I would love to hop on a plane and disappear, but as we know, running away from problems or displacing them never helped anyone.

12 weeks post op

It's never a dull moment in Tricia's world, that's for sure. I came down with a lovely cold or something last week, and it has decided it is so fond of me it doesn't want to move on. We are now trying antibiotics as a form of eviction. I hope they work.

As for my hips. The right one is good, I haven't been moving around too much since I've not been feeling well so it's hard to tell. The left hip has been touch and go and last week we didn't do any leg lifts with it. I've started to do them the last couple of days at home and so far so good. But again, I've not been walking much so it's hard to suss out exactly what triggers what pain.

The good news is that Dr. Kelly said I can get an injection into my left hip! I am going on the 21st, with the hope (and a prayer) that it will work like last time and keep me pain free for at least 3-4 weeks so I can enjoy my trip to London. I'm not looking forward to the process again as it hurt a lot last time, but I've got to try something.

Fingers crossed it works!!!

11 week post op update

Yes I am late again, but that's because I didn't go to PT on Monday. To be honest, I did not go Wednesday last either. I was letting some semblance to a social life start to creep in again.

So, last week, after PT on Monday, where we did leg lifts with NO weights, I still ended up in agony for a few days after. This is really getting old. And boring.
For the most part when I walk around I am okay on my right side. The right can get a little unhappy if I do much walking, but I am starting to think that is because I am leaning on it more than my left because my left is hurting so much. I try to ice when this occurs.

Yesterday am I woke up with horrible pain in my left hip. I was so uncomfortable that I rang Dr. Kelly's office and left a message. I have been thinking that since PT is so difficult on that side, and my leg is clearly getting weaker (it's weaker than my right now), some sort of evasive action needs to be taken. Other than this inhibiting me from walking more and seeing how I do without the crutches, and making my right side get irritated, it's most importantly going to ruin my trip to London in a few weeks! I can't have that. I discussed with my PT guy all of this last night and he agreed with everything I was saying, and said that (the dreaded) injection may be a good idea. For those of you that do not know me well, I absolutely dread the thought of putting that poisonous rubbish in my body. But...(there's always a but) it did work from 3-4 weeks on my right hip over the summer, and if I can somehow be fortunate enough to have it done and it works whilst I'm in London, I'll be a much happier person. Also it will help me take the pressure on my not-to-be-abused right hip.
I heard back from Dr. Kelly's office today. Arianne went on holiday so it was some person I don't know which meant going through the whole song and dance about what has been going on. (It's been short of a few days from a year since I first saw Dr. Kelly). I filled her in on all of my left legs loveliness (ie my IT band pops constantly and pain is more so on the outside of the hip), and she said that she thinks an injection might be something Dr. Kelly would want to do, even though I've not had an MRI yet on the leg. She was going to speak to him and would ring me back either tonight or tomorrow.

So, there we are. Oh, and to add to the fun, I think I've caught either a very bad cold or the flu. Ain't life grand? Still, off to see Tom Stoppard's "Rock n Roll" tonight, so perhaps that will cure me???

Happy Hanukkah!!!

8 Weeks Post op

Sorry, these have become more like weekly updates.

Last Friday I went to see Dr. Kelly for a post op check up. He seemed happy with the way I am progressing, definitely a good thing. He said that I still should not try too much in PT, just focus on strengthening the muscles to help stabilise the joint. He thinks that around 4 or 5 months post op is when I can start pushing it up a notch.

I told him how my left hip has been bothering me a lot more. He still thinks part of it is compensatory, but I did remind him it was bad when I first came to see him about my right hip (just that the right was a hell of a lot worse at the time). He said to tell the PT guys to work on my left and stretch it out, as the IT band is popping a lot and it hurts on the outside of the joint.

Sunday I spent a long time on my feet shopping with my mum. I have not really tried that yet as Dr. Kelly kept saying to keep taking things very slowly. I was sore and achy and my left hip and left wrist (from the crutch) hurt like hell, but my right one held up pretty well. I iced as soon as I returned home and was just a bit stiff that night and yesterday. Not a bad test run at all I'd say. Once I get rid of this last crutch I hope it will be much better for my other body parts.

On the root canal front, I've just returned from the "final" visit with the endodontist. Fingers crossed that once the novocaine wears off I will be okay.

L O N G recovery ahead

Yesterday I had a lovely outing sitting outside across the street at Starbuck's. It was the first time I've really gone out for anything other than to and from a place. We sat out there for a little over two hours which was huge for me as I have not been able to sit in a chair that long since surgery. Unfortunately the fresh air didn't help me sleep any better though. I would kill for a good 8 hours in-a-row of sleep. Again, not so much for the pain, which is getting better on the operated side (unlike the rest of my body which is getting worse), but lack of comfort. I was even desperate enough to try to sleep on my stomach, which didn't last very long.

Today I went for my post-op today and the sutures were removed. They told me that I couldn't shower for a day or two as when they remove the sutures they put a tape with some sort of sticky glue stuff on top and want that to stay put for a while. I wish I had known that as I had thought I would be able to take a shower after the visit, so neglected getting up early to take one before. Oh well.

Dr. Kelly came in afterwards and asked how I was doing and moved my right leg around. He said that I could cut the CPM down to one hour a day, but I asked if I needed to keep it because I would have to pay another $350 for two additional weeks. Thankfully he said that was fine to return it and I've seen the last of that machine - they are coming to pick it up today! He then showed me the pictures they took when they were doing the surgery. I cannot believe how red it was inside, really bright, bright red! He showed where I had a bone spur and where they shaved that off and the other bone that was shaved down as well, and also my psoas before and as they were cutting it. All very amazing to look at. Unfortunately the post op report was not typed up yet, but I was told I could ring them next week and they would fax it over. We went over my PT and he said he actually wants me to go very slow, and that my recovery would take about six months. I was not too surprised from this, but it was still not thrilled about it. The key thing is he wants my psoas to stay slightly tight since I have the laxity issue, but at the same time not scar up completely. It is a very fine line and my rehab is going to be very specific because of my multiple issues. He already told me to change one of the exercises I was told to do as he does not want me to externally rotate the leg too much. He said internal rotation is fine for now. I asked if he could reaffirm this with the PT guys as they were having a hard time believing me about having to do only two hours on the CPM and four. I also asked him why he had to make four incisions and he said that was because they had to get to the other side of the bone to cut it down. Fair enough I suppose. He said also to use the brace as long as I want because he doesn't want me to hurt at all. I am to try to put more weight on the leg but only as I can tolerate, it's very important to not inflame the hip. Regarding the crutches I will most likely be on them for a few more weeks. I kept laughing in my head when everyone kept saying I'd be on them only two to three weeks. I knew this was going to take a long time to be able to walk again without pain. But I don't want to mess up everything that was done so I will do exactly as I am told. The last thing I could deal with is having to go through this all again (poo poo, touch wood, etc.).

After I had been home for a couple of hours I noticed that one of the incision site tapes had liquidy stuff seeping through it. I just rang the office and spoke to Arianna. She said that sometimes the incisions open up after the sutures are taken up and that is should heal by itself, and to keep and eye on it and make sure it stays dry. Hopefully it will do this quickly.

I think that's it for now. I'm tired so going to have a bit of a kip if possible.

Questions to ask regarding surgery

Surgery Questions
*Is there an advantage to doing this procedure/surgery sooner vs. later or not at all?
*Arthroscopic surgery? Outpatient?
*How long does the surgery take?
*What specifically will you do in surgery (what is/are the specific procedure(s) you’ll be doing on me)?
*How would the labral tear be fixed?
*If there is arthritis and cartilage damage - is there anything you can do? If there is more damage than the labral tear, will you fix everything then?
*Success rate - What percentage of patients improve following the procedure? After full recovery - what are the restrictions?
*Will you be the one doing the surgery?
*Will students/residents be assisting in my surgery? -Is there a way for me to request or be assured that only you will do the surgery (no students)?
*What are the benefits of the procedure in terms of pain relief, functioning/mobility? How long will the benefits last?
*What are the risks involved with this surgery? Complications specific to me?
*What if I have had bad experiences in the past with general anesthesia, what other options do I have? What anesthetic will be used? What are the risks? Do I have a choice about the type of anesthesia that will be used on me? What are the pros and cons of my choices? I react v. badly to general and would prefer to not have this. Will I meet with the anesthesiologist in advance? Will he or she know my needs/allergies? (Allergic to: Sulfa, Indocin, ) Can I request Dr. Jules? What is “combines spinal epidural w/ sedation?)?
*What amount of pain relief can I expect from the surgery?
*Will I need any tests or medical evaluations prior to the surgery?
*Will the surgery need to be repeated after a certain amount of time? Increase chance of needing hip replacement in future?
*What type of complications have you experienced with other patients? Both in surgery and after? What are the risks of this surgery, both short and long term? (i.e. - Blood clot, infection, failure to heal, vascular necrosis, nerve palsy, damage to the femoral neck, etc.) And what can we do to reduce these risks?
*Are all various dr’s and hospital services covered by Oxford? If not, what would cost be out of pocket?
*Need pre-approval, who takes care of this?
*Do I need to stop any medications before surgery? How long prior to / after?


Post Op Questions
*What equipment will I need during recovery? (Crutches (how long) ((Millennial Crutches))? Brace? Wheelchair? Walker? CPM machine? Toilet seat riser? Shower bench/transfer? Etc.)
* Will it be provided by the hospital/surgery center? If not, where do you suggest I get the items?
*Will you prescribe crutches for me ahead of time – what type considering my shoulder and hand issues?
*What are my limitations during recovery?
*How long till I can shower?
*How long until return to FULL activity in sports? (Gym? Swimming? Walking distances? Stairs? Sitting for length of time, ie theatre, work, etc.)
*How long will the recovery take?
*Will I need assistance at home afterwards? For how long? /Will I need 24-hour help? For how long?
*What will discharge instructions be?
*When can I realistically return to work?
*Will I have any disability following surgery?
*Will I have pain following the procedure? What pain relief or pain control measures will I be given? (I have bad reactions to vicadin and that sort. Have used Ultram and Ultracet with some success. V. sensitive to medications.)
*Any other medications you prescribe post surgery? Anything for nausea or a laxative b/c of the pain killers?
*How many post-op visits required?
*How long do stitches/staples stay in? Which do you use?
*How long will I be in PT for?

Discovery Questions
*Do I have arthritis or no arthritis? If so, how much?
*Is the underlying femoral neck misshapen and also causing the impingement or a result of the impingement? if so would that be reshaped as well? how about the socket?
*Do I have FAI (femeroacetabular impingement)? (Untreated FAI can lead to repeat labral tears.)
*How was the bursa?
*Any signs of: Hip dysplasia? Hip instability? Degenerative disease in joint? Osteoarthritis? If so, how severe?
*Are ligaments and tendons intact and supporting the joint?
*Any sign of ligamentum teres syndrome (what does thickening of it mean/imply)?
*Any chondral damages?
*Any implications of bone marrow swelling (edema)?