Pool Workout

Today was my first pool workout.  Going to the YMCA was actually more of a challenge than I anticipated.  We have numerous YMCA’s in the surrounding area, but I have always gone to the older Downtown Y because it is the closest to work.  There is one closer to my house, but my locker and all my swimming stuff is Downtown.  The problem with the downtown Y is that it is in an older building and has lots of stairs.  Crutches and my brace up lots of stairs is not fun.  Then getting getting into the pool with my brace and crutches was a challenge!  Lastly getting out of the pool weight and putting my brace back on and not falling on my way out of the pool was a workout of it’s own!

Dave recommended 10-15 minutes of forward walking and 2 minutes small side steps.  I decided to do 3 sets of 5 minutes forward walking, 2 minutes side steps, and 250 yards freestyle (no kicking).  The walking and side steps were wicked boring, but I tolerated it with no problems.  The lap swimming went well too, but my arms were jello!  I am so out of shape and have no endurance!  It’s going to take awhile to get me back to my “norm”.  I was absolutely exhausted when I got home!  I fell asleep for at least an hour!  I need to charge my waterproof ipod to help with the boringness of aqua walking!  Otherwise I excited to finally be able to move!

PS- My incision looks much better since he removed the stitch (other than being blue and bruised from him pulling the stitch out)!

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6 weeks

I haven’t written in a few weeks because I had been doing pretty well.  Life has been pretty low key since moving home 2 weeks ago!  Late last week my hip started hurting more.  I sent my PT a panicked text on Friday night because something didn’t feel right.  By Saturday I was miserable.  I had promised to make cookies with my 5 year nephew and it took everything in me to make them.  Luckily he also wanted to watch Cars 3, so we chilled in the recliner after making cookies!  Monday I sent a warning text to my PT that she needed to mentally prepare for me to be in full on panic mood at my appointment Tuesday.  I honestly think I am just sick of being in pain and bored that I have nothing else to do but to think about my pain and compare it to my past surgeries.  I had PT yesterday and I was an emotional mess!  I was at my limit (and almost broke down completely).  My PT assured me that it wasn’t time to panic yet.  She said I have major muscle imbalances and instability.  She needled a lot and I had a lot of massive reactions.  I think the headaches I’ve had for the last 5 days had to do with the tension in my shoulders from the stress (holy trigger point Batman).  My glutes, QL, hip flexor, and adductors were ridiculous.  To quote my PT, “holy smokes your trigger points were insane today.”  So, I wasn’t as panicked going into my 6 week appointment with my surgeon and surgeon’s PT.

Dr. Ellis’ MA, Sharon has a smiley face system to give the team a heads-up how ones’ hip is doing.  I have a pretty good track record for sad faces.  I have gotten 2 or 3 smiley faces over the last 2.5 years!  Today I was unsure how to explain my hip.  Wendy had talked me out of freaking out, but my hip is still not “happy.”  I told Sharon that I was unsure….she said it’s ok….I have a face for that.  So, today I got the “I don’t know” face…which should’ve probably been a sad face!

Dave came in first to see what was going on.  I explained my symptoms of groin and lateral pain, pain with weight bearing, still on crutches, inability to progress with PT, swelling, etc.  He had me get on the table and he examined my left (good) hip first, then he compared it to my left hip.  He said my hip is super tight.  It is definitely angry.  After lots of examination and my side, back, stomach and checking strength.  We talked about a plan for progression (which he said could change based on Dr. Ellis’ thoughts).  He really wanted me to start pool walking and limit my “land” PT.

Dr. Ellis came in and talked to Dave briefly.  Dave left to go get some basic exercises together for me.  Dr. Ellis was frustrated with the state of my hip!  He just hung his head…he’s like this isn’t supposed to happen!  He understands my frustration with everything.  First I had him look at my unhealed incision.  I have a stitch that hasn’t been allowing the incision to heal.  He looked at it and pulled the knotted stitch out and cut it out.  He said it should heal now!  After that, he moved my hip around and told me that my hip is “tight as shit.”  He asked me what has worked in the past.  I said steroid taper.  He said, let’s try that and then he wants to see me back in 4 weeks.

Dave wants me to take it easy over the next two weeks while on the steroid taper.  He said that the only thing he really wants me to do it walk in the pool.  If I feel up to it I can do the following exercises (but the pool is the most important):
-Quadruped w/ leg extension
-Standing Terminal Knee Extension
-Bridges (toes up)
-Angry Cat (if my hip feels like it needs to pop)
-Prone bent knee fall in
-Supine bent knee fall out

I did ask about my anticipated progression and when they think I “might” be able to return to work.  Dave said probably 2 more months.  That puts me closer to 14ish weeks rather than 12 weeks.  He said it typically takes 4-6 weeks after someone is off crutches to feel up to returning to an active job.  I am still on crutches and he doesn’t anticipate me being off of them completely for 3-4 weeks….and I’m advancing slower than most….so he told me to anticipate closer to 2 months from now!

Week 4

This week has been pretty uneventful.  Overall I am wicked bored!  I had two PT appointments this week.  On Tuesday, I went to PT at 2pm.  I spent the time before my appointment at my house.

My appointment went well.  I am progressing, slowly, but I am progressing.  Tuesday I was actually feeling pretty good, so we advanced some exercises.  My PT’s previous patient was one of her DPT students, she asked if she could sit in on my appointment because she had similar symptoms and my PT thought she had both FAI/labral tear and a hernia and wanted me to talk about it with her.  My PT worked on my neck, dry needled and lymphatic massaged my hip/quad, needled my calf, circumduction, and worked on my back.  She added new exercises: short arc quad, prone hamstring curl, and a few i’m not sure what to call them.  We did discuss 4 week progressions…I was told I could start driving and weaning off the crutches at 4 weeks.  She was fine with me driving, weaning of the crutches, and moving back home this weekend.  The added movement fared up that evening and into Wednesday.  I took it easy until my next appointment.

Thursday was my 34th birthday.  I was able to drive to PT by myself!  Yay for progress.  I was swollen (and red) on the outside of my leg.  We started off with needling and she hit a huge trigger point which was referring to my lateral hip pain.  After she finished needling she used a ice cup on my hip because she was afraid it would bruise.  She looked at my back which was a mess.  She tried to fix it without manual manipulation because she didn’t want to twist me too much, but we ended up having to anyway.  Once she twisted me my SI joint popped, it was the best feeling!  So much relief.  After that I rode the bike for the first time post-op with this hip.  I only rode it for 5 minutes and I struggled to pedal fast enough to keep the timer going, but I made it!  After that I ran though my exercises and iced!

I went and grabbed a salad at Piada and went to my house to hang out until my mom got off work so we could go out to dinner.  Prime Rib and Baked Potato!  Yum!  Then we came back to my parents.  My wonderful team at work sent me beautiful flowers to wish me a Happy Birthday.  They are absolutely amazing!

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I am going to move back to my house on Sunday.  I just don’t like that my house has been vacant for a month!

3 Week PT appointment

Today was my first post-op PT appointment.  Technically it was supposed to be at 3 weeks….but my PT doesn’t work Friday’s….so my appointment was today (19 days post-op).

My PT and I have been in touch almost daily.  She had done a tone of research a few days a go in preparation of my appointment….below are two of the articles she sent me.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4739034/

http://www.benjamindombmd.com/pdf/arthroscopic-capsulotomy-capsular-repair-capsular-plication-hip.pdf

Basically- too many hip surgeries = microinstability

Her plan is to:

Restrict hip extension and ER for 4 weeks.
So goal is: light holding of leg and wanna be a pendulum. Myofascial release of iliacus and QL. DN front of quad….

Today’s appointment was very low key.  We started with my neck.  She needled both shoulders due to crutches!  Next she assessed my hip. She compared both hips and took notes for my starting point.  I was very swollen so she spent a lot of time lymphatically massaging to try and move the swelling out of the area.  I did heel slides and quad sets.  That is the extent of the exercises she wants at this point.  She needed my quad and calf.  Lastly, she looked at my back to make sure everything was in place.

I spent 20 minutes on ice….overall I was there 1.5 hours.  It was nice to see everyone and catch up…next week I see her twice!

2 week post-op appointment

Yesterday was my 2 week post-op visit.  It was only my second outing since surgery.  I didn’t end up going to church on Sunday because I was sore and thought it would be better to take it easy!  I’ll start with the operation report and what it said (what Dr. Ellis did):

Post-operative diagnosis: Right hip subspine impingement
Procedure: Arthroscopic acetabular rim trimming
Findings/Procedure: Significant erythema underneath the inferior spine.  Minimal articular    cartilage damage.  Mild residual cam lesion, medially.  Capsular tear superiorly with synovitic changes underneath the inferior spine. 
Procedure: AIIS resection, mild osteoplasty medially/laterally, capsular plication

I had appointments with both my surgeon’s PA and PT.  My appointment with the PA was supposed to be at 3pm and 3:30pm with the PT.  At 3:15pm Dave, my surgeon’s PT, came out to the waiting room and got me.  He took me back and asked how things were going.  I told him I was having groin time, sharp at times.  He asked if Dr. Ellis plicated the capsule…I didn’t know.  He told me to go ahead and take my brace off and lay on my back on the table while he went and pulled up my op-report.  While I was laying on the table waiting on Dave to come back in, the PA, Tiffany, came in the room to remove my stitches.  I was very excited to get my stitches out, they were quite tight this time (Tiffany even commented on how tight they were).  While she removed my stitches, Dave came back in.  The three of us discussed my symptoms/questions.  We discussed my pain levels and decided to change my anti-inflammatory to Duexis rather than Mobic.  Both Tiffany and Dave said it is much more effective in pain control.  It’s 3x/day alternating with Tylenol.  Dave wanted to move my leg around, so Tiffany left and said that Dave was going to do what she would do, so Dave could grab her if I had any further questions.

As Dave moved my leg around we discussed my other questions.  Dave was happy with how my joint felt.  We discussed how my my deep, sharp, groin pain could be related to my hernia repair.  When Dr. Leff repaired my hernia he told me that it was tight….so with the swelling and changes from my surgery it could be pulling the mesh, etc.  Both Dave and Tiffany told me that they don’t expect anyone to be pain free at 2 weeks.  I know that it is early in my recovery, so I am not panicking, just trying to be cautious.

They have changed some on their protocols since my last surgery….formal PT doesn’t start until 3 weeks (only 1 more week until I get to see my wonderful PT).  Also, they have changed their crutches restrictions….still WBAT, but they’d like you to stay on both crutches for 4 weeks (maybe 6 weeks for me per Dave).  In the past I had transitioned to one crutch by this point.  So, I am to continue anti-rotation boots for 4 weeks.  Brace for 4 weeks at home (I rarely wear it at home because I am not doing much of anything) and 6 weeks outside the home.  I did ask if I could do any pool therapy (I am antsy and want to get back to the gym), Dave was hesitant, but said I could start walking forward at 4 weeks.  Other than that, my home exercises/restrictions are below:

Exercises are the same for the most part although I am on Capsular restrictions…
-No hyperextension x 4 weeks
-No external rotation in prone
-No FABER x 6 weeks
-No single knee fall-outs x 4 weeks
-No kneeling hip flexor stretch until ~6 weeks

Home Exercise Program:
-Hooklying reverse butterfly (2-3 min, 2-3x/day, pain free)
-Short arc quad (10 times, 3 sets)
-Prone hamstring curls (10 times, hold 10 seconds, 1 set)
-Bridges (10 times, 3 sets)
-Posterior Pelvic tilt (10 times, 3 sets)

Side note:  No more pendulums because they have been causing pain….instead I am to have my PT do passive circumduction.

 

First Outing

Post-op day: 8

I decided to take my band-aids off this morning prior to my shower and one of my portal incisions looked funny.  One of the stitches looked like it had come undone.  I decided to pull on the knotted side gently to see if it would move.  It slid right out.  Luckily the incision looks healed and I see the PA to remove my stitches on Wednesday.  If it wouldn’t have been healed I would’ve called my surgeon’s office.

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It’s the middle of October and it was anything but a fall day.  It was a nice summer-ish day for my first outing since my surgery.  It was actually hot out.  The sun hasn’t been out since last week (and I haven’t been out), so the sun seemed extra bright.

My mom asked me where i’d like to go for my outing….I am very exciting and chose to go to the grocery.  We decided that we are going to start a Whole30 tomorrow and we needed to get groceries.  I have gained weight over my last 5 surgeries and I need to get my eating under control until I can start swimming again.

We started at Fresh Thyme and then went to Meijer.  My mom told me I had to ride in an electric scooter….I told her I’d made it 5 surgeries without riding in one and I wasn’t going to start now!  After Meijer we made quick stop at Sam’s.  I wanted to stay in the car, but I needed to make a return so I had to go in.  Our last stop was to grab lunch to take home.  It was almost 4pm and I was hungry and tired.  So I stayed in the car!  Once home I hit the recliner and mom brought my lunch down and ice for my ice machines.  I made it through one episode of Supergirl and then I fell asleep.  I spent the rest of the evening in the recliner with my ice.  I’m not in too much pain, luckily….but I am swollen….we’ll see how I feel tomorrow.

We are going to try and go to church in the morning…we’ll see how I feel!

 

1 week

Not a lot of change to report.

My view for the last week has been from my parents recliner with my ice machines on.  My routine is pretty similar….wake up, shower, make coffee/oatmeal, head down to recliner, watch tv, go upstairs and make lunch, back to recliner until my parents come home.  More ice, recliner, tv…..then bed!  I know….sounds very exciting!  My current TV binge is Supergirl.  When I originally saw the advertisements for the show I thought it looked really cheesy, but I binged on an entire series over the last 2 days.

I am feeling much better and my pain is better, but I know I could easily overdo it if I do anything.  By the end of the night my pain is back.  During most days I can manage with ice and Tylenol.  I’m still in anti-rotation boots and they require help.  I can’t put on a sock or my boot on my surgical leg.  Once the boots are on I can get into the anti-rotation band.  Weight-bearing  is getting less painful and easier.  I am still using two crutches to distribute my weight and allow my hip the maximum healing time!

My mom has been wonderful and has been making me meals and checking on my house/getting my mail.  I couldn’t have gone through all my surgeries without them!

I had a surprise phone call from my PT yesterday!  We have become very close over the last 2+ years that I’ve been seeing her (I had seen her husband for my back for 6 years before I switched)….she had a cancellation and decided to video chat me from clinic.  She was very careful to protect all the patients privacy (HIPAA) by only allowing me to see her face and her colleagues.  It was nice to catch up with her and see all my “PT family”.   I don’t resume PT for another week and a half.  I see my surgeon’s PT next Wednesday and then my PT the following Wednesday!

I also called and checked on my supervisor team during our typical huddle time.  Only 3 of the 5 of my supervisor team were there, but it was really nice to catch up!  We have a good time together!

Now back to my recliner, ice machines, and tv shows!