It's all a blur. To those who are following my posts, I'm sorry I'm not more diligent about doing regular updates. I will try to do better. But please know that the only reason I'm not blogging is because things are going fine.
Since my first bike ride out on the road, I've relearned how to ride and have found that I bike faster than I did pre-surgery. I've also rebuilt my running endurance and again, I'm faster than I was pre-surgery. My PT said that could be because my range of motion is improved, but is more likely due to the focus on core strength in my therapy regiment. I can vouch for improved core strength! My neck and back don't hurt much any more, and I can do all kinds of things, including elevated planks, where my feet are in straps that are hanging from the ceiling. I even did inverted "jumping jacks" while in plank position.
Unfortunately, all good things must come to an end, and my physical therapy sessions are now over. I've made such good progress that I no longer need assistance in rebuilding my strength and endurance. I've been cleared for all activities, except for squats that go beyond 70 degrees, which is fine with me. I'm gearing up to go back to Tae Kwon Do, and have started stairclimbing again. I am following my triathlon training program, and have found that the more active I am, the less my hip hurts.
My worst days are when I don't have time to get my PT exercises in (still have to do them, even though I'm not going in!). After a couple days of skipping PT, my sciatica comes back full force and I start limping again. This is not the same kind of pain I had pre-surgery - it's nerve and muscle-related, and not in the joint. Plus I know exactly how to make it go away...a single day of jogging and lower-body strength training works like a charm every time.
I had hoped to compete in a triathlon by the end of the year, since I've done one every year for the past 5 years, but given my work/school schedule, I barely have time to get my training in. So I'm not thinking I'll be ready to be competitive. Plus I live in Wisconsin, and I'm not too keen on traveling with my bike to the islands and getting a crash course in ocean swimming just to find a race. But there's no reason I can't do one on my own. So on December 31, you will find me in my gym, swimming 1/2 mile, biking 12.4 miles, and jogging 3.1 miles - in whatever amount of time it takes me.
Thursday, November 11, 2010
Monday, August 23, 2010
Weeks 8-12
The past month or so has been very busy with school, work, and PT, so I haven't had much time to muse about my recovery. But yesterday was a big day, so I wanted to share.
Rehab has been mostly about strength training lately, but some new things are being added it that are making me very happy. I'm starting to feel like a normal person instead of a recovering patient. Jogging is in full force, three times a week - every other session I increase my mileage. I'm doing leg presses with hundreds of pounds of weight, and am getting some really strong abs from the planks, core marches, T-stances, torso twists, and even the straight leg lifts. I'm also doing jump squats, jumping drills, and sprint drills. On non-jogging days, I'm just supposed to get in 45-60 minutes of general cardio, preferably no or low-impact. I usually swim or use the stationary bike. Swimming is building back up slowly - the other day I managed 550 meters, which was exciting for me. Biking was getting boring, but then my therapist told me to get out on the road. He said using clipless pedals would actually be a great workout for my hip. Yay!!
I was so excited to start the next day - it was time to get back on my race bike. I haven't actually been on a bike that required pedaling or balance to stay upright since July of last year. It's hard to believe it's been 13 months since I've seen the bike trail. I ran through my checklist: water, sunglasses, helmet, watch, etc. After I was all ready, it was time to get on the bike. And I froze. After all this time and prep work, I realized I was scared to death.
What if I crash? What if I forgot how to ride? What if it hurts? What if I tear something else? What if I just can't? Wow, at least I wasn't alone. Hubby was right there with me, telling me that everything will be ok. So I clipped my right foot onto the pedal, took a deep breath, and started to go.
Oops. The gear's too hard, and I can't get enough speed to clip my left foot in. Ok, shift and try again. Oh, now I can't find the clip with my left foot and I wobble to a shaky stop. Third time's a charm. Off I go, and turn onto the road leading to the bike trail. But it's uphill, and I'm not conditioned. I quickly change gears to try to the easiest setting so I can make it.
Wow, turns out I forgot how to change gears on my bike and instead quickly made it as hard as humanly possible. There's no way I'm strong enough to push the pedals, and I start to go down. Luckily, my foot snaps out of the pedal just before I topple and I manage to stay upright. I ask my husband to hold the bike up and turn the pedals while I relearn how to shift.
The ride is a slow one. It does not escape my attention that I am decked out in sleek racing gear on my skinny road bike, and I'm being passed by old men on clunkers. But I love life's little ironies, so I just smile. We went four miles out, then turned around and came back. By mile six, I could definitely tell my hip was not too happy, so I slowed down even more. But a couple of downhill sections let me get up to 15+ mph, and I remembered why I loved my fast bike. By the time we got home, I decided that I would dismantle the trainer and ride on the road every time I biked from now until the snow flies. Overall, it was a great ride, and I'm thrilled to be on the road once again!
Rehab has been mostly about strength training lately, but some new things are being added it that are making me very happy. I'm starting to feel like a normal person instead of a recovering patient. Jogging is in full force, three times a week - every other session I increase my mileage. I'm doing leg presses with hundreds of pounds of weight, and am getting some really strong abs from the planks, core marches, T-stances, torso twists, and even the straight leg lifts. I'm also doing jump squats, jumping drills, and sprint drills. On non-jogging days, I'm just supposed to get in 45-60 minutes of general cardio, preferably no or low-impact. I usually swim or use the stationary bike. Swimming is building back up slowly - the other day I managed 550 meters, which was exciting for me. Biking was getting boring, but then my therapist told me to get out on the road. He said using clipless pedals would actually be a great workout for my hip. Yay!!
I was so excited to start the next day - it was time to get back on my race bike. I haven't actually been on a bike that required pedaling or balance to stay upright since July of last year. It's hard to believe it's been 13 months since I've seen the bike trail. I ran through my checklist: water, sunglasses, helmet, watch, etc. After I was all ready, it was time to get on the bike. And I froze. After all this time and prep work, I realized I was scared to death.
What if I crash? What if I forgot how to ride? What if it hurts? What if I tear something else? What if I just can't? Wow, at least I wasn't alone. Hubby was right there with me, telling me that everything will be ok. So I clipped my right foot onto the pedal, took a deep breath, and started to go.
Oops. The gear's too hard, and I can't get enough speed to clip my left foot in. Ok, shift and try again. Oh, now I can't find the clip with my left foot and I wobble to a shaky stop. Third time's a charm. Off I go, and turn onto the road leading to the bike trail. But it's uphill, and I'm not conditioned. I quickly change gears to try to the easiest setting so I can make it.
Wow, turns out I forgot how to change gears on my bike and instead quickly made it as hard as humanly possible. There's no way I'm strong enough to push the pedals, and I start to go down. Luckily, my foot snaps out of the pedal just before I topple and I manage to stay upright. I ask my husband to hold the bike up and turn the pedals while I relearn how to shift.
The ride is a slow one. It does not escape my attention that I am decked out in sleek racing gear on my skinny road bike, and I'm being passed by old men on clunkers. But I love life's little ironies, so I just smile. We went four miles out, then turned around and came back. By mile six, I could definitely tell my hip was not too happy, so I slowed down even more. But a couple of downhill sections let me get up to 15+ mph, and I remembered why I loved my fast bike. By the time we got home, I decided that I would dismantle the trainer and ride on the road every time I biked from now until the snow flies. Overall, it was a great ride, and I'm thrilled to be on the road once again!
Thursday, July 8, 2010
Back to Normal*
Wow, once again it has been awhile. Last time I posted, I was getting ready to head out on a road trip to a game convention with my husband. While fun, these things require lots of sitting, which is a bit of a challenge for a recovering "hipster" (a term I've seen in various places now). The drive took 8 hours, which we expanded to 11 due to frequent walking stops. I felt that I arrived in one piece, but the next day, Thursday, my body told me otherwise. I could barely walk, and sitting was pure torture. But I pushed on (wait - isn't that how I got into this mess?) and made it through a day filled with walking back and forth down a 2-block-long hallway and sitting in uncomfortable chairs for 3-4 hours at a stretch. And I iced. We brought the Game Ready unit, and that saved my butt - literally!
Friday was a little better, so I enjoyed the day a bit more. And, on Saturday, I was reminded once again that I was a work in progress and not a fully recovered being. Out came the crutches so I could actually do more than lay in bed all day. After a day on the crutches, I felt much better, and then it was time to go home. This time, I actually helped drive! Through bad storms that turned out to be thinly veiled tornado threats, and possibly the real deal (found out when we got home). I've seen strong winds and driving rain before, but I've never quite seen such strong winds changing directions so often and truly sideways rain. I was scared, but didn't stop - what was I going to do? Run away from a tornado? Eventually, we got out of it and enjoyed the rest of the trip home. I drove for a total of 1.5 hours. Woo hoo!
The next day, I was back at work. Full-time, with allowances for doctor's appointments and physical therapy. I made it, but it was rough. By Tuesday evening, I was thoroughly exhausted and slept 12 hours. Oops. Sorry, boss! So I missed Wednesday, but went right back Thursday, just in time for a long weekend.
While all this is going on, my therapy has changed a bit to introduce some fun exercises, like deadlifts (which I call T-stances, because you're not really lifting anything). They really work your core! Also added sideways walking on the treadmill at 1.3 mph. For the first time, I started to feel like I was getting back to normal. The stretches for the sciatica worked wonders, and now that only flares up once in a great while.
Fourth of July weekend brought some challenges, but I opted out of most of them and decided to rest instead. Sunday was the only active day (outside of daily PT). We went to a party and decided I could try my hand at playing catch and frisbee. I caught things that were within one step of me and in front. No twisting, and no running! After 15 minutes, I was toast and laid down with three ice packs.
Then yesterday, my world opened up, and I declare normalcy*!! Sam, my ever-enabling therapist, changed everything up on me. I can now swim without the pull buoy (no frog kicking!), increase resistance on my bike as needed, and do up to 20 minutes a day on the elliptical. I can also begin distance walking, up to a mile, with a goal of building up to 3.5 mph. On top of all of this, I have real training exercises - walking lunges, squats, weighted side-stepping, torso twists, deep core exercises, and leg exercises on weight machines. Life is good.
Notes for the 5-7 week range: Scar massage is very important! I have trouble laying on my side because there are little rocks inside my hip. That's scar tissue build up, and I'm struggling to break it down. The trip from crutches to walking goes very fast once you can be weight bearing. Don't overdo it, or the crutches will be back. Try to go back to work part-time to start. Sitting is just too hard. Pull buoys are the best things ever. Get a disabled sticker for your car, if you can - it's great to park closer to the door at big stores, and it's really great for those who live or work in a metro area.
*Normal is a state of mind. There are still things I can't do, and I'm sucking air and gasping in pain more often than I used to. That's because I'm doing more. It will go away eventually, and then I'll be back to "true" normal. But, boy, this feels great!
Friday was a little better, so I enjoyed the day a bit more. And, on Saturday, I was reminded once again that I was a work in progress and not a fully recovered being. Out came the crutches so I could actually do more than lay in bed all day. After a day on the crutches, I felt much better, and then it was time to go home. This time, I actually helped drive! Through bad storms that turned out to be thinly veiled tornado threats, and possibly the real deal (found out when we got home). I've seen strong winds and driving rain before, but I've never quite seen such strong winds changing directions so often and truly sideways rain. I was scared, but didn't stop - what was I going to do? Run away from a tornado? Eventually, we got out of it and enjoyed the rest of the trip home. I drove for a total of 1.5 hours. Woo hoo!
The next day, I was back at work. Full-time, with allowances for doctor's appointments and physical therapy. I made it, but it was rough. By Tuesday evening, I was thoroughly exhausted and slept 12 hours. Oops. Sorry, boss! So I missed Wednesday, but went right back Thursday, just in time for a long weekend.
While all this is going on, my therapy has changed a bit to introduce some fun exercises, like deadlifts (which I call T-stances, because you're not really lifting anything). They really work your core! Also added sideways walking on the treadmill at 1.3 mph. For the first time, I started to feel like I was getting back to normal. The stretches for the sciatica worked wonders, and now that only flares up once in a great while.
Fourth of July weekend brought some challenges, but I opted out of most of them and decided to rest instead. Sunday was the only active day (outside of daily PT). We went to a party and decided I could try my hand at playing catch and frisbee. I caught things that were within one step of me and in front. No twisting, and no running! After 15 minutes, I was toast and laid down with three ice packs.
Then yesterday, my world opened up, and I declare normalcy*!! Sam, my ever-enabling therapist, changed everything up on me. I can now swim without the pull buoy (no frog kicking!), increase resistance on my bike as needed, and do up to 20 minutes a day on the elliptical. I can also begin distance walking, up to a mile, with a goal of building up to 3.5 mph. On top of all of this, I have real training exercises - walking lunges, squats, weighted side-stepping, torso twists, deep core exercises, and leg exercises on weight machines. Life is good.
Notes for the 5-7 week range: Scar massage is very important! I have trouble laying on my side because there are little rocks inside my hip. That's scar tissue build up, and I'm struggling to break it down. The trip from crutches to walking goes very fast once you can be weight bearing. Don't overdo it, or the crutches will be back. Try to go back to work part-time to start. Sitting is just too hard. Pull buoys are the best things ever. Get a disabled sticker for your car, if you can - it's great to park closer to the door at big stores, and it's really great for those who live or work in a metro area.
*Normal is a state of mind. There are still things I can't do, and I'm sucking air and gasping in pain more often than I used to. That's because I'm doing more. It will go away eventually, and then I'll be back to "true" normal. But, boy, this feels great!
Tuesday, June 22, 2010
Sciatica...bummer
Well, Sam ran me through some diagnostics after I told him my hip has been hurting and my butt has been burning. His prognosis: early signs of sciatica. The solution: more time laying down with ice, and gentle stretching. The stretching is new, so that's exciting - plus it feels sooo good! The laying down with ice is not new, so I'm a little bummed about that. It also stalls my progress towards being able to work an entire day (which, admittedly, I'm not too upset about). Turns out I was sitting too much. For reference, I had been sitting about 4 hours a day for work, then 30 minutes on the bike, various time in the car, and a couple hours of random sitting, including meals. Probably 7-8 hours per day in total. Butt time sure adds up fast!! ;-)
Tomorrow hubby and I head out for a road trip we'd been planning since January. We prepaid for everything, so we're going. It should be interesting - at least my seat reclines in the car, so I can alternate between sitting and laying down during drive times. The hotel has a fitness center and a lap pool, so I can do all of my therapy. I can't wait to leave this house! I hope it all works out well.
Tomorrow hubby and I head out for a road trip we'd been planning since January. We prepaid for everything, so we're going. It should be interesting - at least my seat reclines in the car, so I can alternate between sitting and laying down during drive times. The hotel has a fitness center and a lap pool, so I can do all of my therapy. I can't wait to leave this house! I hope it all works out well.
Monday, June 21, 2010
I Can Walk!! (a.k.a., Man, my butt is HOT!!)
Well, I fell behind again, after working so hard to get caught up on my progress. I just got so excited last Wednesday when I was given clearance to walk AND drive! My days quickly filled up with all the things that had been neglected while I was busy laying down and not walking.
So, last Wednesday I met with Sam, who had put me on one crutch the Monday before. He took my one crutch from me and asked me if I wanted it back. I didn't play along, and told him he could keep it. I'm no fun, I know. ;-)
I walked around the gym for a few minutes, and then Sam introduced me to a whole new set of rehab exercises. No more isometrics!!! Woo hoo! I was so tired of counting to ten 360 times a day. We kept the squats, internal/external rotations, leg lifts, quadruped rocking and external leg fall-outs. And we added:
1. weighted leg extensions
2. weighted hamstring curls
3. toe tap-ups (marching in place and tapping each foot on a step)
4. step downs ("bad" leg on step, good leg steps up and down)
5. hip hiking (kinda like belly dancing without the forward rotation)
6. "marching" while laying down (lay on back with bent legs, then contract abs and "march" in place)
7. clamshells
8. aqua walking - normal walking in chest-high water
I also only have to do one session a day, instead of 2-3 each day. That is good, because this all takes about an hour, not including bike and commute to the pool time.
I was so excited that as soon as I got home, I started to clean the house. Nothing major, just walking a glass from the family room to the kitchen, and wiping dust off a tabletop. Nice, easy, movement. That night, I slept for 10 hours. The next day, I did what I could to help my dear husband out around the house. I also focused on improving my sitting times, in preparation for my return to work. I can sit for 1-2 hours at a stretch, but then I have to ice my hip. That should make a 9-hour workday pretty tough. Hoping it gets better! We went out to dinner, which was nice, but the chairs were too uncomfortable to stay long.
Friday brought a bizarre household accident. I was heating up my lunch in the microwave, and when I hit the start button, the cabinet below the microwave opened up and spilled its contents all over the floor. Said contents were serving bowls and platters in a variety of materials. We had two casualties (one a favorite serving dish, the other a 10-pound ceramic chip bowl). The 10-pound bowl landed on my foot, causing lots of pain and cursing. Luckily(?), it was my right foot, which meant I was good if I had to go back on crutches. Life is so fun! After rest, ice, and elevation, I developed a nice knot on the top of my foot that made wearing shoes difficult.
Saturday I went with my husband to run errands and see how long I could last out and about - I drove! I made it 3.5 hours before the couch beckoned. Later that night, we went out for dinner, and about halfway through, my butt starting burning. Just a little at first, then it got really hot. Then a line of fire started going down my hamstring. I have no idea what caused it, but my skin was on fire, too. We left and went home to ice down.
Yesterday was Father's Day. In the morning, we went over to my husband's parent's house and made them breakfast. Then I iced. We then went downtown to a lakefront art festival and walked around for a few hours with my parents. I had to sit a few times, but it all seemed to go ok. At dinner, though, that burning started again. I had no choice but to put up with it, and it eventually passed. I iced as soon as I could, and slept 11 hours last night. Anyone else experience a hot butt and excessive sleeping after they started walking?
I have a session with Sam tonight, so I'll ask him about it. And we'll see if I get any more exercises to get me back in running order!
So, last Wednesday I met with Sam, who had put me on one crutch the Monday before. He took my one crutch from me and asked me if I wanted it back. I didn't play along, and told him he could keep it. I'm no fun, I know. ;-)
I walked around the gym for a few minutes, and then Sam introduced me to a whole new set of rehab exercises. No more isometrics!!! Woo hoo! I was so tired of counting to ten 360 times a day. We kept the squats, internal/external rotations, leg lifts, quadruped rocking and external leg fall-outs. And we added:
1. weighted leg extensions
2. weighted hamstring curls
3. toe tap-ups (marching in place and tapping each foot on a step)
4. step downs ("bad" leg on step, good leg steps up and down)
5. hip hiking (kinda like belly dancing without the forward rotation)
6. "marching" while laying down (lay on back with bent legs, then contract abs and "march" in place)
7. clamshells
8. aqua walking - normal walking in chest-high water
I also only have to do one session a day, instead of 2-3 each day. That is good, because this all takes about an hour, not including bike and commute to the pool time.
I was so excited that as soon as I got home, I started to clean the house. Nothing major, just walking a glass from the family room to the kitchen, and wiping dust off a tabletop. Nice, easy, movement. That night, I slept for 10 hours. The next day, I did what I could to help my dear husband out around the house. I also focused on improving my sitting times, in preparation for my return to work. I can sit for 1-2 hours at a stretch, but then I have to ice my hip. That should make a 9-hour workday pretty tough. Hoping it gets better! We went out to dinner, which was nice, but the chairs were too uncomfortable to stay long.
Friday brought a bizarre household accident. I was heating up my lunch in the microwave, and when I hit the start button, the cabinet below the microwave opened up and spilled its contents all over the floor. Said contents were serving bowls and platters in a variety of materials. We had two casualties (one a favorite serving dish, the other a 10-pound ceramic chip bowl). The 10-pound bowl landed on my foot, causing lots of pain and cursing. Luckily(?), it was my right foot, which meant I was good if I had to go back on crutches. Life is so fun! After rest, ice, and elevation, I developed a nice knot on the top of my foot that made wearing shoes difficult.
Saturday I went with my husband to run errands and see how long I could last out and about - I drove! I made it 3.5 hours before the couch beckoned. Later that night, we went out for dinner, and about halfway through, my butt starting burning. Just a little at first, then it got really hot. Then a line of fire started going down my hamstring. I have no idea what caused it, but my skin was on fire, too. We left and went home to ice down.
Yesterday was Father's Day. In the morning, we went over to my husband's parent's house and made them breakfast. Then I iced. We then went downtown to a lakefront art festival and walked around for a few hours with my parents. I had to sit a few times, but it all seemed to go ok. At dinner, though, that burning started again. I had no choice but to put up with it, and it eventually passed. I iced as soon as I could, and slept 11 hours last night. Anyone else experience a hot butt and excessive sleeping after they started walking?
I have a session with Sam tonight, so I'll ask him about it. And we'll see if I get any more exercises to get me back in running order!
Wednesday, June 16, 2010
Week 3-4
Now we're getting somewhere! On my 4th rehab appointment with Sam, we started doing some weight-bearing exercises. He laid a scale down on the floor next to a phone book. I hopped up on the scale for my baseline weight (it was not a pleasant number, but I'm grateful I haven't gained any more weight since the surgery). Then I stepped onto the phone book with my good leg, leaving my surgery leg on the scale, standing "normally." Sam had me calculate the % weight I was putting on my surgery leg (25%). Then he told me to increase it to 50%. Seriously, I wasn't expecting a math quiz, and it's really early in the morning! But I manage to divide my actual weight by 2 (hey, I figured out 25% easily enough), and start to lean. And lean. And lean some more. I tell Sam I can't possibly reach 50% without falling over, since I'm leaning so far to the right. He just laughed and said I still had a little bit to go before I was simply standing straight up. Wow! My equilibrium is toast.
Once I figure out 50%, we go to 60% (more math!), and then back to 50% for exercises. I now get to add:
1. Mini-squats - same as a regular squat, but not as far down. Full weight-bearing!
2. Calf raises - also full weight-bearing
3. Standing internal/external rotation
4. One more isometric - quad lifting
Sam decides to check and see if I am ready to start driving yet. For this, he places a pen on the ground, just inside my right foot. He instructs me to pick my leg up and place my foot on the other side of the pen, just like moving from the gas pedal to the brake. As has happened so many times before, I will my leg to move and it just sits there. I stare dumbly at my foot, wondering why it won't respond. I stare harder. It twitched. Yay! But the pen has defeated me, and I have one more week to wait before I can try the driving test again. I'd say I'm disappointed, but if I knew there was a driver on the road who couldn't make her leg move just by thinking "hey, leg - move!," I certainly wouldn't want to be on the road with her. I'm content to wait.
I also switch to 2 appointments per week, so now I'm seeing Sam on Mondays and Wednesdays. My first Monday falls within Week 3-4, so I focus on really nailing my new exercises so I can pass the pen test.
The standing leg rotations are done with my good leg on the floor, and my "bad" leg bent at 90% from the knee, with my knee on a stool. These are killing my kneecap. All of a suddon, the squats hurt my knee, as do the leg extensions. Really sharp pain, just under my kneecap. I mention this to Sam on my Monday appointment, and he looks concerned. But as my appointment went on, we started to see a trend - the pain intensified when I put pressure on my right knee. We decided I would either skip the leg rotations or add additional cushioning to see if it was just my weight on my kneecap that was causing the problem.
Also on Monday, I am happy to report that I was given authorization to toss one crutch out the window. I can now mobilize about my house with a free hand! This is an amazing accomplishment, and I spend Monday evening, all day Tuesday, and most of today moving things from one place to another, just because I can.
Sam wants me to build up to 45 minutes on the bike. I can do that by doing 4 10-minute sessions, and running them all together, or just continue adding time onto a single session until I hit 45 minutes. I opt for a combination, and am doing 2 bike sessions per day, adding time until I hit 22.5 minutes each. I'm up to 16 minutes each, and then I can feel my tendon start to twang. Have I mentioned how much I love my Game Ready ice machine? I extended my rental another month because it is so wonderful to just wrap that cuff around my hip and have the ice water course around the entire area. It just feels so good, and no fussing with towels and melty ice packs. Plus it calms twangy tendons down in a hurry! If you can get one of these, I highly recommend it.
My next rehab appointment is today at 5:30. I bet I pass the pen test today. Pedestrians, beware!
Once I figure out 50%, we go to 60% (more math!), and then back to 50% for exercises. I now get to add:
1. Mini-squats - same as a regular squat, but not as far down. Full weight-bearing!
2. Calf raises - also full weight-bearing
3. Standing internal/external rotation
4. One more isometric - quad lifting
Sam decides to check and see if I am ready to start driving yet. For this, he places a pen on the ground, just inside my right foot. He instructs me to pick my leg up and place my foot on the other side of the pen, just like moving from the gas pedal to the brake. As has happened so many times before, I will my leg to move and it just sits there. I stare dumbly at my foot, wondering why it won't respond. I stare harder. It twitched. Yay! But the pen has defeated me, and I have one more week to wait before I can try the driving test again. I'd say I'm disappointed, but if I knew there was a driver on the road who couldn't make her leg move just by thinking "hey, leg - move!," I certainly wouldn't want to be on the road with her. I'm content to wait.
I also switch to 2 appointments per week, so now I'm seeing Sam on Mondays and Wednesdays. My first Monday falls within Week 3-4, so I focus on really nailing my new exercises so I can pass the pen test.
The standing leg rotations are done with my good leg on the floor, and my "bad" leg bent at 90% from the knee, with my knee on a stool. These are killing my kneecap. All of a suddon, the squats hurt my knee, as do the leg extensions. Really sharp pain, just under my kneecap. I mention this to Sam on my Monday appointment, and he looks concerned. But as my appointment went on, we started to see a trend - the pain intensified when I put pressure on my right knee. We decided I would either skip the leg rotations or add additional cushioning to see if it was just my weight on my kneecap that was causing the problem.
Also on Monday, I am happy to report that I was given authorization to toss one crutch out the window. I can now mobilize about my house with a free hand! This is an amazing accomplishment, and I spend Monday evening, all day Tuesday, and most of today moving things from one place to another, just because I can.
Sam wants me to build up to 45 minutes on the bike. I can do that by doing 4 10-minute sessions, and running them all together, or just continue adding time onto a single session until I hit 45 minutes. I opt for a combination, and am doing 2 bike sessions per day, adding time until I hit 22.5 minutes each. I'm up to 16 minutes each, and then I can feel my tendon start to twang. Have I mentioned how much I love my Game Ready ice machine? I extended my rental another month because it is so wonderful to just wrap that cuff around my hip and have the ice water course around the entire area. It just feels so good, and no fussing with towels and melty ice packs. Plus it calms twangy tendons down in a hurry! If you can get one of these, I highly recommend it.
My next rehab appointment is today at 5:30. I bet I pass the pen test today. Pedestrians, beware!
Week 2-3
I'm on my own this week. The parade of visitors, helpers, and well-wishers has finally ended, and it's just me, my books, and my cats. I started working from home part-time, which has been difficult. I hate to admit it, but the thought of going back to work just drains all my energy. The work itself is pretty easy - since I'm not in the office, people don't really know I'm back, so they leave me alone. I'm using the time to get caught up on the backlog of email that came about during last year's project from hell.
From a recovery standpoint, I'm doing well. Still no pain, and the stitches have finally come out. The redness was definitely due to the tape - once I took the tape off and left the incision sites open to the air, things started to calm down quickly.
Time for my third rehab appointment! Sam told me not to get too excited, because even though it's been 3 weeks since my surgery, and the protocol has me doing more weight bearing in week 3, from a rehab perspective, I'm just coming into week 2. What? I really don't get this new-fangled counting scheme. Anyhoo, I get some new exercises.
I can now bike 20 minutes a day, broken into 2 pieces. Woo hoo! Also, I get to remove internal leg rotations on the bed and replace them with standing internal leg rotations. Also added:
1. External leg fall-outs - essentially just letting my operated leg fall outward (controlled falling, anyway) to the point where the hip brace stops it.
2. Quadruped rocking - this one is both fun and embarassing! I get on all fours, and just slowly move back and forth, stick my rear end back as far as I can. Fun because it's a different kind of movement and I'm not laying on my back, and embarassing, because I can only think of one activity that uses this type of movement. (!)
But regardless, things are going well, with one exception. I was given some leg lifts to do while lying on my stomach, but they produced a kind of twangy sensation that left me a bit more nauseous with every rep. Dr. Birmingham told me to knock those off immediately, as that sensation could indicate tendonitis was getting ready to kick in.
I'm able to do more things around the house now, like run into chairs with my hip brace and knock things onto the floor with my crutches. I know how much my husband appreciates the extra work I'm creating for him as I assert my independence. But I seriously can't take much more of this sitting around. My leg wants to walk - it keeps doing it all by itself, with no prodding from me.
From a recovery standpoint, I'm doing well. Still no pain, and the stitches have finally come out. The redness was definitely due to the tape - once I took the tape off and left the incision sites open to the air, things started to calm down quickly.
Time for my third rehab appointment! Sam told me not to get too excited, because even though it's been 3 weeks since my surgery, and the protocol has me doing more weight bearing in week 3, from a rehab perspective, I'm just coming into week 2. What? I really don't get this new-fangled counting scheme. Anyhoo, I get some new exercises.
I can now bike 20 minutes a day, broken into 2 pieces. Woo hoo! Also, I get to remove internal leg rotations on the bed and replace them with standing internal leg rotations. Also added:
1. External leg fall-outs - essentially just letting my operated leg fall outward (controlled falling, anyway) to the point where the hip brace stops it.
2. Quadruped rocking - this one is both fun and embarassing! I get on all fours, and just slowly move back and forth, stick my rear end back as far as I can. Fun because it's a different kind of movement and I'm not laying on my back, and embarassing, because I can only think of one activity that uses this type of movement. (!)
But regardless, things are going well, with one exception. I was given some leg lifts to do while lying on my stomach, but they produced a kind of twangy sensation that left me a bit more nauseous with every rep. Dr. Birmingham told me to knock those off immediately, as that sensation could indicate tendonitis was getting ready to kick in.
I'm able to do more things around the house now, like run into chairs with my hip brace and knock things onto the floor with my crutches. I know how much my husband appreciates the extra work I'm creating for him as I assert my independence. But I seriously can't take much more of this sitting around. My leg wants to walk - it keeps doing it all by itself, with no prodding from me.
Week 1-2
Every day, I get a little stronger. It's so amazing to be in a place where such minute changes are infinitely noticeable. For instance, I can lift my own leg out of the CPM machine (with my hands, of course). I can't do anything with it once it's in the air, but at least that's one more thing I can do!
I went back for my second therapy appointment, and was assured I'm making fantastic progress. I got some new exercises, including that exercise bike that was supposed to start last week.
So now I do 10 minutes on the bike every day (no resistance), plus all of last week's exercises, plus:
1. Internal leg rotations
2. More isometrics - abduction x2 with ball between knees and then between ankles
3. Leg extensions with ball between ankles
All the exercises take about 20 minutes to complete, and I do them 3 times a day. Plus I'm still 8 hours on the CPM, although I can drop one hour for every 10 minutes on the bike. Yay!!
I'm getting stronger with everyday things, like taking a shower, although I still haven't figured out how to keep the prescribed plastic wrap on my leg as water runs over it. Usually I end up with a little water balloon on the back of my thigh, and soaked stitches. I can't wait for the stitches to come out, but there's a problem: the area is very red and inflamed, and it itches like mad. All I want to do is slap my leg silly, trying to make the itching stop! I think it's the tape, because the redness is a perfect extension of the tape pattern. In addition to the anti-inflammatory and the anti-spasmodic, I now get to take antibiotics.
But I'm still completely pain-free, which is amazing. And I'm really enjoying having all of this free time. My job is very high-stress, so I don't get many opportunities to decompress. I've been getting through so many of the books I've been waiting 5+ years to read. Life is good.
I went back for my second therapy appointment, and was assured I'm making fantastic progress. I got some new exercises, including that exercise bike that was supposed to start last week.
So now I do 10 minutes on the bike every day (no resistance), plus all of last week's exercises, plus:
1. Internal leg rotations
2. More isometrics - abduction x2 with ball between knees and then between ankles
3. Leg extensions with ball between ankles
All the exercises take about 20 minutes to complete, and I do them 3 times a day. Plus I'm still 8 hours on the CPM, although I can drop one hour for every 10 minutes on the bike. Yay!!
I'm getting stronger with everyday things, like taking a shower, although I still haven't figured out how to keep the prescribed plastic wrap on my leg as water runs over it. Usually I end up with a little water balloon on the back of my thigh, and soaked stitches. I can't wait for the stitches to come out, but there's a problem: the area is very red and inflamed, and it itches like mad. All I want to do is slap my leg silly, trying to make the itching stop! I think it's the tape, because the redness is a perfect extension of the tape pattern. In addition to the anti-inflammatory and the anti-spasmodic, I now get to take antibiotics.
But I'm still completely pain-free, which is amazing. And I'm really enjoying having all of this free time. My job is very high-stress, so I don't get many opportunities to decompress. I've been getting through so many of the books I've been waiting 5+ years to read. Life is good.
Tuesday, June 15, 2010
Week 0-1
Physical therapy began the morning after surgery. I'm back at the Sports Medicine Clinic, where my first therapist, Chris, identified the potential cartilage tear. But this time I'm with Sam, who is working closely with Dr. Birmingham to refine his rehab protocol.
I was a bit nervous, since my surgery was over less than 24 hours before, but Sam assured me that nothing too strenuous will be done. We talked first. What are my goals? Patients progress faster if they have something concrete to focus on, he said. So I picked getting back to Tae Kwon Do, being able to jog a half marathon, and being able to complete a sprint triathlon in the same amount of time (or better) than I had done beforehand. He thought those were good goals, perfectly within reach, and since they were longer term, I was less likely to push too hard. Sam went on to warn me that women between the ages of 30-45 were most likely to be too aggressive with their rehab, and have the highest risk of developing tendonitis. Duly noted.
For the first week, which oddly is counted as week zero, my rehab consists of the following:
1. 6-8 hours on the Continuous Passive Motion (CPM) machine. This machine moves my leg in a bicycle-type rotation while I lay on my back and study the ceiling. My goal is to increase my range of motion by a few degrees every day until I reach full range of 0-110 degrees.
2. Pelvic tilts
3. Bridges
4. Isometric exercises - squeeze various muscles and hold for 10 seconds, then release. I start with glutes, abductions, and adductions. Range of movement is about a half inch.
5. Game Ready unit icing as needed, but a minimum of 4 sessions a day.
6. Non-weight bearing, wear hip brace whenever not on Game Ready or CPM machine.
7. Sleep with my boots on. These are quite fascinating - very cushy boots that get attached to a large barrel that goes between my ankles by industrial-strength velcro. They prevent external hip rotation during sleep. I have to admit, this is the worst part of the rehab. Having my legs tied together brings me right up to the edge of a panic attack.
Luckily, I was on Hydromorphone, Indomethacin, and an anti-spasmodic since my psoas tendon was cut. These pills knock me right out, so sleeping with restraints is a piece of cake. Even after I gave up the painkiller, the other two kept me in a nice haze so I didn't care.
Amazingly, my post-surgery pain started out at the same level of my pre-op pain, and declined from there. Within two days, I was pain-free. Totally shocked!
Dr. Birmingham called me at home to find out how I was doing. I thought that was very nice, and unexpected. He apologized for the confusion at the hospital and assured me that he was working with them so future patients wouldn't leave in disgust. He asked me how the stationary biking was going. ??? I quickly learned that the hospital was supposed to put me on the bike the day of surgery, and Sam was to put be on the bike during rehab. Since that didn't happen, Dr. Birmingham was disappointed, but assured me that the CPM machine would take the place of the bike, as long as I went for the 8 hours.
Every day, the exercises got easier and easier. I struggled a bit on day 2 or 3 and broke down into tears at my loss of freedom and control. I'm exceptionally independent, and it's very hard to have to ask for the simplest of things, like a glass of water or a blanket. I look forward to getting off the crutchs, and start to understand that I need to be careful, or I will fall into the high-risk category due to aggressive rehab.
I was a bit nervous, since my surgery was over less than 24 hours before, but Sam assured me that nothing too strenuous will be done. We talked first. What are my goals? Patients progress faster if they have something concrete to focus on, he said. So I picked getting back to Tae Kwon Do, being able to jog a half marathon, and being able to complete a sprint triathlon in the same amount of time (or better) than I had done beforehand. He thought those were good goals, perfectly within reach, and since they were longer term, I was less likely to push too hard. Sam went on to warn me that women between the ages of 30-45 were most likely to be too aggressive with their rehab, and have the highest risk of developing tendonitis. Duly noted.
For the first week, which oddly is counted as week zero, my rehab consists of the following:
1. 6-8 hours on the Continuous Passive Motion (CPM) machine. This machine moves my leg in a bicycle-type rotation while I lay on my back and study the ceiling. My goal is to increase my range of motion by a few degrees every day until I reach full range of 0-110 degrees.
2. Pelvic tilts
3. Bridges
4. Isometric exercises - squeeze various muscles and hold for 10 seconds, then release. I start with glutes, abductions, and adductions. Range of movement is about a half inch.
5. Game Ready unit icing as needed, but a minimum of 4 sessions a day.
6. Non-weight bearing, wear hip brace whenever not on Game Ready or CPM machine.
7. Sleep with my boots on. These are quite fascinating - very cushy boots that get attached to a large barrel that goes between my ankles by industrial-strength velcro. They prevent external hip rotation during sleep. I have to admit, this is the worst part of the rehab. Having my legs tied together brings me right up to the edge of a panic attack.
Luckily, I was on Hydromorphone, Indomethacin, and an anti-spasmodic since my psoas tendon was cut. These pills knock me right out, so sleeping with restraints is a piece of cake. Even after I gave up the painkiller, the other two kept me in a nice haze so I didn't care.
Amazingly, my post-surgery pain started out at the same level of my pre-op pain, and declined from there. Within two days, I was pain-free. Totally shocked!
Dr. Birmingham called me at home to find out how I was doing. I thought that was very nice, and unexpected. He apologized for the confusion at the hospital and assured me that he was working with them so future patients wouldn't leave in disgust. He asked me how the stationary biking was going. ??? I quickly learned that the hospital was supposed to put me on the bike the day of surgery, and Sam was to put be on the bike during rehab. Since that didn't happen, Dr. Birmingham was disappointed, but assured me that the CPM machine would take the place of the bike, as long as I went for the 8 hours.
Every day, the exercises got easier and easier. I struggled a bit on day 2 or 3 and broke down into tears at my loss of freedom and control. I'm exceptionally independent, and it's very hard to have to ask for the simplest of things, like a glass of water or a blanket. I look forward to getting off the crutchs, and start to understand that I need to be careful, or I will fall into the high-risk category due to aggressive rehab.
Surgery
My surgery was originally scheduled for March 3. I had my pre-op physical, and was given an action plan to prepare. The surgeon's office filed a preauthorization claim in early February and we waited. My lovely insurance company took the full 30 days to review the claim, and on March 1, declared a denial of coverage.
The reason? FAI surgery is an experimental procedure and there is insufficient evidence that it is beneficial. I was devastated. I had everything in order - caretakers, work schedules, my house - and I had informed everyone I would be off in less than 2 days. Now I didn't know what to do.
I went online and found out this is a fairly common issue in the United States. While the procedure does get approved by some companies, others refuse to consider it. I have Principal Financial, who typically approves it, administered by Aetna, who typically denies it. That was a hard situation. As time went on, I found myself on the phone with my agent, who would say "If it were up to me, your surgery would be approved. But it's up to Aetna." Frustrating!
I found support from another blogger with the same insurance company (UNDERSTANDING FAI (Hip Impingement)), whose well-wishes and positive attitude helped me find the energy to fight my battle. And fight I did. Not a day went by when I wasn't researching, making calls, or talking to friends and colleagues. I'm afraid I became a bit obsessed, as my world fell apart and my pain kept increasing. But I was learning, and eventually I was able to put together a letter to my HR person, pointing out differences between our plan description and the insurance company's behavior. I also indicated I was filing a complaint with the state insurance commissioner. Within 24 hours, I was given a case worker from Principal Financial. Within a week, she had managed to convince Aetna to approve the surgery. I was in business! Also in shock, but in a good way - I had expected a 6-month long battle, and just over a month had passed.
I rescheduled my surgery for May 19. By this time (mid-April), the steroid injection from January was long gone, and I asked for another. Dr. Birmingham indicated that he would do it if I absolutely needed it, but repeated steroid injections can potentially lead to arthritis and he'd rather not increase my risks there. So, for the next 4 weeks, I toughed it out and found my limp was becoming more pronounced, as my capabilities continued to decline. Tick-tock, the clock is slow.
Finally May 19 arrived! Dr. Birmingham met with me before the surgery and reviewed the procedure and what to expect. He was quite supportive, alert, and all smiles. He put me at ease, and I was grateful. My only concern was whether or not my weight would hinder the surgery or my recovery. Dr. Birmingham assured me I would fine - the weight made the surgery a bit more complicated, but not unmanageable. Recovery would be the same.
I had many visitors that morning - nurse, admissions coordinator, anethesiologist, phlebotomist, and physical therapist. The therapist showed me how to walk and take stairs with the crutches. I was surprised to learn prior to the surgery, but my husband thought that was fantastic. He had a knee osteomoty a few years ago, and learning to use the crutches when on pain killers was not so good.
The nurse picked me up and I opted to walk into the operating room. It would be awhile before I could walk again, and I wanted to use my legs as long as I could. I hopped up on the table, and Dr. Cloud (yes, his real name!!) administered the anesthesia. I remember telling him he had a great name for an anesthesiologist, and he replied "thanks, but nobody here calls me Dr. Cloud. They call me doofus." I laughed, and closed me eyes. I woke up about 2 seconds later with a mask over my face.
The surgery had taken ~4 hours. The labral tear was stitched up, not debrided - yay! The goal is to retain as much material as possible, and Dr. Birmingham had retained it all. My acetabular rim was debrided, and possibly the femoral head (I don't have the surgery report, so this is all from foggy memory). There were no issues with the synovial membrane, so he didn't have to do a synovectomy. He did, however, have to release my psoas tendon. It was cut in two places to lengthen it so it wouldn't impair hip movement in the future. Then he started giving me numbers, which quickly washed away in the haze. Something about normal was 30 degrees, and I was 15, or vice-versa. If you know what this means, please let me know! I will get more information when I see him again.
I hung out in the recovery room, fighting the nurses to keep the mask off my face (darn claustrophobia). They agreed, as long as I could breathe deeply enough to keep my oxygen levels up near 100%. If the alarm on the monitoring unit sounded (at 80%, I believe), I got the mask back. I thought that sounded like a fun challenge, so I watched the monitoring unit closely while I tried various breathing techniques. Unfortunately, I kept falling asleep, and the alarm kept going off. They finally said forget it, and put a tube in my nose. Lovely.
Since Dr. Birmingham is new to the area, the hospital staff wasn't familiar with his protocol. They kept contradicting his instructions, and didn't know how to use any of the equipment he had prescribed. I have a Game Ready ice machine, and passive motion leg machine, and a hip brace. I couldn't believe they didn't know how to put on the hip brace, and I was getting frustrated with all the arguments about protocol, so as soon as I was able, I checked out of the hospital to recover in my own home, following Dr. Birmingham's instructions. So good to be home again!
The reason? FAI surgery is an experimental procedure and there is insufficient evidence that it is beneficial. I was devastated. I had everything in order - caretakers, work schedules, my house - and I had informed everyone I would be off in less than 2 days. Now I didn't know what to do.
I went online and found out this is a fairly common issue in the United States. While the procedure does get approved by some companies, others refuse to consider it. I have Principal Financial, who typically approves it, administered by Aetna, who typically denies it. That was a hard situation. As time went on, I found myself on the phone with my agent, who would say "If it were up to me, your surgery would be approved. But it's up to Aetna." Frustrating!
I found support from another blogger with the same insurance company (UNDERSTANDING FAI (Hip Impingement)), whose well-wishes and positive attitude helped me find the energy to fight my battle. And fight I did. Not a day went by when I wasn't researching, making calls, or talking to friends and colleagues. I'm afraid I became a bit obsessed, as my world fell apart and my pain kept increasing. But I was learning, and eventually I was able to put together a letter to my HR person, pointing out differences between our plan description and the insurance company's behavior. I also indicated I was filing a complaint with the state insurance commissioner. Within 24 hours, I was given a case worker from Principal Financial. Within a week, she had managed to convince Aetna to approve the surgery. I was in business! Also in shock, but in a good way - I had expected a 6-month long battle, and just over a month had passed.
I rescheduled my surgery for May 19. By this time (mid-April), the steroid injection from January was long gone, and I asked for another. Dr. Birmingham indicated that he would do it if I absolutely needed it, but repeated steroid injections can potentially lead to arthritis and he'd rather not increase my risks there. So, for the next 4 weeks, I toughed it out and found my limp was becoming more pronounced, as my capabilities continued to decline. Tick-tock, the clock is slow.
Finally May 19 arrived! Dr. Birmingham met with me before the surgery and reviewed the procedure and what to expect. He was quite supportive, alert, and all smiles. He put me at ease, and I was grateful. My only concern was whether or not my weight would hinder the surgery or my recovery. Dr. Birmingham assured me I would fine - the weight made the surgery a bit more complicated, but not unmanageable. Recovery would be the same.
I had many visitors that morning - nurse, admissions coordinator, anethesiologist, phlebotomist, and physical therapist. The therapist showed me how to walk and take stairs with the crutches. I was surprised to learn prior to the surgery, but my husband thought that was fantastic. He had a knee osteomoty a few years ago, and learning to use the crutches when on pain killers was not so good.
The nurse picked me up and I opted to walk into the operating room. It would be awhile before I could walk again, and I wanted to use my legs as long as I could. I hopped up on the table, and Dr. Cloud (yes, his real name!!) administered the anesthesia. I remember telling him he had a great name for an anesthesiologist, and he replied "thanks, but nobody here calls me Dr. Cloud. They call me doofus." I laughed, and closed me eyes. I woke up about 2 seconds later with a mask over my face.
The surgery had taken ~4 hours. The labral tear was stitched up, not debrided - yay! The goal is to retain as much material as possible, and Dr. Birmingham had retained it all. My acetabular rim was debrided, and possibly the femoral head (I don't have the surgery report, so this is all from foggy memory). There were no issues with the synovial membrane, so he didn't have to do a synovectomy. He did, however, have to release my psoas tendon. It was cut in two places to lengthen it so it wouldn't impair hip movement in the future. Then he started giving me numbers, which quickly washed away in the haze. Something about normal was 30 degrees, and I was 15, or vice-versa. If you know what this means, please let me know! I will get more information when I see him again.
I hung out in the recovery room, fighting the nurses to keep the mask off my face (darn claustrophobia). They agreed, as long as I could breathe deeply enough to keep my oxygen levels up near 100%. If the alarm on the monitoring unit sounded (at 80%, I believe), I got the mask back. I thought that sounded like a fun challenge, so I watched the monitoring unit closely while I tried various breathing techniques. Unfortunately, I kept falling asleep, and the alarm kept going off. They finally said forget it, and put a tube in my nose. Lovely.
Since Dr. Birmingham is new to the area, the hospital staff wasn't familiar with his protocol. They kept contradicting his instructions, and didn't know how to use any of the equipment he had prescribed. I have a Game Ready ice machine, and passive motion leg machine, and a hip brace. I couldn't believe they didn't know how to put on the hip brace, and I was getting frustrated with all the arguments about protocol, so as soon as I was able, I checked out of the hospital to recover in my own home, following Dr. Birmingham's instructions. So good to be home again!
Monday, June 14, 2010
The Diagnosis
I consulted with Dr. Birmingham at the end of December. Prior to my first appointment, I was required to get a fair number of hip x-rays. During my diagnostic evaluation, he was careful to confirm the exact locations and type of pain I was experiencing. He took a thorough history, and then spent some time going over my x-rays and his thoughts on what was going on.
The images showed a bony overhang on my hips (both sides). It also showed - to Dr. Birmingham, anyway...I wouldn't know - that my hip sockets are turned forward, leading to a smaller range of motion. He indicated I was born with this, and it was just a matter of time before I ran into trouble. Since I was quite sedentary until 8 years ago, I never had any trouble! It wasn't until I started using my hip that it started giving me pains. He said I had a pincer impingement, and would probably benefit from a removal of the excess bone.
Dr. Birmingham then scheduled me for an MRI and a diagnostic steroid injection in my right hip. The injection was to confirm the pain was indeed coming from the joint, and the MRI to look for a tear in the cartilage. Now, I'm a bit claustrophobic, so I wasn't too keen on the MRI. I had it done at the Center for Diagnostic Imaging, which is a very nice place. They gave me headphones and let me pick any music I wanted. Then they gave me a clicker that will shut down the machine in the event of an emergency. Finally, they gave me funky glasses with mirrors set at right angles to the frames. These allowed me to look at the rest of the room during the test, instead of staring into the tube and freaking out. Wonderful gadget! Unfortunately, they had to tape my feet together to prevent me from rotating my hip. Ugh! It's not bad enough to be shoved into a big white tube with a jackhammer in it, but now my legs are tied together. Big deep breath - the 30-minute test will be over in no time. I managed to get out of that without a panic attack, but the steroid injection wasn't as uneventful.
Since I go to a teaching hospital, there's no shortage of students watching procedures. As I prepared to get my hip injection, I approved it for student viewing, and then watched as 4 new people filed in. Ok, crowded room...not the end of the world. Then the assistant, in an effort to distract me, goes about telling me how she hardly got any sleep last night and just wants to take a nap. She can hardly focus. !!! I get a little nervous but figure she's not playing a critical role so I should be fine. Onto the table I go, and the assistant says "just relax and take a few deep breaths while I mix your drug cocktail." What? Little Miss I'm-so-tired-I-just-want-to-sleep is mixing my painkillers? I'm suddenly afraid I will die on this table. As they do the scan to find the injection site, a doctor comes in. He's soothing, and talks me through the whole injection process. I get to watch it on the screen. I manage to hold it together until they inject fluid to make the final injection easier. The pressure is so intense I start to lose it. On the verge of a panic attack, I manage to blubber out that I'm ok, can someone just please hold my hand? Someone does, and I can breathe again. The injection is over and I'm free to go.
I'm floating as the first round of painkillers take over and I suddenly become invincible. Dr. Birmingham instructed me to behave as if I didn't have pain, meaning I should do things that I had been restricting and measure my performance against pre-injection stats. I kicked butt! I cleaned my house, went for a walk, and did a fantastic job in Tae Kwon Do. I don't recall the last time my hip felt that good...maybe never? Anyway, that did it. The pain was indeed coming from the joint, and the MRI confirmed a tear in the labrum.
Surgery required.
The images showed a bony overhang on my hips (both sides). It also showed - to Dr. Birmingham, anyway...I wouldn't know - that my hip sockets are turned forward, leading to a smaller range of motion. He indicated I was born with this, and it was just a matter of time before I ran into trouble. Since I was quite sedentary until 8 years ago, I never had any trouble! It wasn't until I started using my hip that it started giving me pains. He said I had a pincer impingement, and would probably benefit from a removal of the excess bone.
Dr. Birmingham then scheduled me for an MRI and a diagnostic steroid injection in my right hip. The injection was to confirm the pain was indeed coming from the joint, and the MRI to look for a tear in the cartilage. Now, I'm a bit claustrophobic, so I wasn't too keen on the MRI. I had it done at the Center for Diagnostic Imaging, which is a very nice place. They gave me headphones and let me pick any music I wanted. Then they gave me a clicker that will shut down the machine in the event of an emergency. Finally, they gave me funky glasses with mirrors set at right angles to the frames. These allowed me to look at the rest of the room during the test, instead of staring into the tube and freaking out. Wonderful gadget! Unfortunately, they had to tape my feet together to prevent me from rotating my hip. Ugh! It's not bad enough to be shoved into a big white tube with a jackhammer in it, but now my legs are tied together. Big deep breath - the 30-minute test will be over in no time. I managed to get out of that without a panic attack, but the steroid injection wasn't as uneventful.
Since I go to a teaching hospital, there's no shortage of students watching procedures. As I prepared to get my hip injection, I approved it for student viewing, and then watched as 4 new people filed in. Ok, crowded room...not the end of the world. Then the assistant, in an effort to distract me, goes about telling me how she hardly got any sleep last night and just wants to take a nap. She can hardly focus. !!! I get a little nervous but figure she's not playing a critical role so I should be fine. Onto the table I go, and the assistant says "just relax and take a few deep breaths while I mix your drug cocktail." What? Little Miss I'm-so-tired-I-just-want-to-sleep is mixing my painkillers? I'm suddenly afraid I will die on this table. As they do the scan to find the injection site, a doctor comes in. He's soothing, and talks me through the whole injection process. I get to watch it on the screen. I manage to hold it together until they inject fluid to make the final injection easier. The pressure is so intense I start to lose it. On the verge of a panic attack, I manage to blubber out that I'm ok, can someone just please hold my hand? Someone does, and I can breathe again. The injection is over and I'm free to go.
I'm floating as the first round of painkillers take over and I suddenly become invincible. Dr. Birmingham instructed me to behave as if I didn't have pain, meaning I should do things that I had been restricting and measure my performance against pre-injection stats. I kicked butt! I cleaned my house, went for a walk, and did a fantastic job in Tae Kwon Do. I don't recall the last time my hip felt that good...maybe never? Anyway, that did it. The pain was indeed coming from the joint, and the MRI confirmed a tear in the labrum.
Surgery required.
How I Got Here
Hi there!
I'm starting this blog a bit late (nearly 4 weeks post-op), but thought it might be helpful to others. So a little back-tracking is in order.
A few years ago (2007?), I began having some pain in my hip. Nothing major, just some twinges here and there if I did too much activity, like a 7-hour cleaning session or a full day at a festival. It didn't impact my normal activities, so I ignored it. The pain snuck up on me gradually, coming on sooner and lasting a bit longer. By 2009, I knew I had a problem, but still I pushed on. I was trying to lose weight and get in better shape, and I didn't want anything to stop me.
Previously, my activities included training for triathlons, half-marathons, and half-century bike rides. Six days a week, I was either biking, swimming, or interval jogging. My weight kept me from running, but I was making progress. By June of 2009, I was limping at the end of my jogs. I was also crawling up the stairs after cleaning for an hour. So of course I decided to join Tae Kwon Do to build up my strength and flexibility.
During class, I noticed that my hips would crunch and catch during some of the kicks. I also noticed severe range of motion limitations when comparing my kicks to other students. When asked to do a front kick at head height, try as I might, I could only get to chest level. I started to wonder what was wrong. Just my weight getting in the way? Or something else?
During self-defense training, I popped my knee a good one and took a month off to heal. Went back and popped my other knee, prompting me to go to a doctor for help. I didn't want to be off another month. By this time, I had competed in my first triathlon of the year, with a record finish time and the satisfaction of having run the entire 5k - no stopping! I also competed in a half-marathon, but my hip gave out so quickly that I walked most of it and had to get a massage afterwards to be able to walk.
The doctor prescribed physical therapy at the sports medicine clinic. He was a marathon runner, and knew what it was like to be sidelined. I believe with all my heart that it was this fact that led me to the right place. Would I have received the same treatment at a standard therapist's office? Perhaps, but I personally doubt it.
My therapist found that I had exceptionally weak hips, which could account for the knee pain. I spent the next 3 months strengthening my hips and resolving my IT Band inflammation. At the end of 3 months, we did a post-evaluation. As the therapist moved my leg up and across my chest, I had a sudden burst of intense, sharp pain and yelled out. He immediately told me that the location and severity of that pain was an indication of a cartilage tear and I was to discontinue therapy until I consulted with a surgeon.
I was referred to Dr. Patrick Birmingham, an orthopedic surgeon with a specialty in hips. He completed his fellowship at the Hospital for Special Surgery in Washington, DC, learning his technique from Dr. Kelly. He is also a follower of Dr. Philippon's procedures, and meets with him regularly. He was brought to Wisconsin as an assistant professor at the Wisconsin Medical College, where I happen to go for all my treatment. Lucky me!
I was nervous, but went ahead and consulted with Dr. Birmingham.
I'm starting this blog a bit late (nearly 4 weeks post-op), but thought it might be helpful to others. So a little back-tracking is in order.
A few years ago (2007?), I began having some pain in my hip. Nothing major, just some twinges here and there if I did too much activity, like a 7-hour cleaning session or a full day at a festival. It didn't impact my normal activities, so I ignored it. The pain snuck up on me gradually, coming on sooner and lasting a bit longer. By 2009, I knew I had a problem, but still I pushed on. I was trying to lose weight and get in better shape, and I didn't want anything to stop me.
Previously, my activities included training for triathlons, half-marathons, and half-century bike rides. Six days a week, I was either biking, swimming, or interval jogging. My weight kept me from running, but I was making progress. By June of 2009, I was limping at the end of my jogs. I was also crawling up the stairs after cleaning for an hour. So of course I decided to join Tae Kwon Do to build up my strength and flexibility.
During class, I noticed that my hips would crunch and catch during some of the kicks. I also noticed severe range of motion limitations when comparing my kicks to other students. When asked to do a front kick at head height, try as I might, I could only get to chest level. I started to wonder what was wrong. Just my weight getting in the way? Or something else?
During self-defense training, I popped my knee a good one and took a month off to heal. Went back and popped my other knee, prompting me to go to a doctor for help. I didn't want to be off another month. By this time, I had competed in my first triathlon of the year, with a record finish time and the satisfaction of having run the entire 5k - no stopping! I also competed in a half-marathon, but my hip gave out so quickly that I walked most of it and had to get a massage afterwards to be able to walk.
The doctor prescribed physical therapy at the sports medicine clinic. He was a marathon runner, and knew what it was like to be sidelined. I believe with all my heart that it was this fact that led me to the right place. Would I have received the same treatment at a standard therapist's office? Perhaps, but I personally doubt it.
My therapist found that I had exceptionally weak hips, which could account for the knee pain. I spent the next 3 months strengthening my hips and resolving my IT Band inflammation. At the end of 3 months, we did a post-evaluation. As the therapist moved my leg up and across my chest, I had a sudden burst of intense, sharp pain and yelled out. He immediately told me that the location and severity of that pain was an indication of a cartilage tear and I was to discontinue therapy until I consulted with a surgeon.
I was referred to Dr. Patrick Birmingham, an orthopedic surgeon with a specialty in hips. He completed his fellowship at the Hospital for Special Surgery in Washington, DC, learning his technique from Dr. Kelly. He is also a follower of Dr. Philippon's procedures, and meets with him regularly. He was brought to Wisconsin as an assistant professor at the Wisconsin Medical College, where I happen to go for all my treatment. Lucky me!
I was nervous, but went ahead and consulted with Dr. Birmingham.
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