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.

 

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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!

 

Day 2 & 3

Day 2

Day 2 was much like Day 1.  I sat in the recliner with my ice packs and watched tv/movies.   I did get to take a shower around noon.  It was glorious, but a lot of effort.  I started playing some games on my tablet just to keep my brain occupied.  I still fell asleep off and on throughout the day.

This recovery has been very different than my past surgeries.  I typically can start walking around without a crutch after a few days, but I still can’t put any weight on my leg without any pain.  I also started trying to do my post-op exercises and found that they brought significant pain.  I emailed my surgeons PT last evening:

Good morning Dave,
Sorry to bother you…
I am trying to keep up with my post op exercises,  but I am unable to do pendulum or log rolls without significant pain.  I am very hesitant to do anything that causes more pain.  Should I still do them or is there something else I could do instead? I haven’t tried the bike yet, but I could attempt that.  This surgery feels way different post op than my others so I’m being more cautious.

He replied and asked how far post-op I was and what Dr. Ellis ended up finding and doing.  Below are his recommendations:

Don’t worry about the pendulums until 5-7 days post op (wed or thur of this week).  Once the swelling comes down you’ll be able to do those.  We’ll need to modify your rehab slightly.  Before you start with Orion let me know and we’ll touch base with them.  Basically no hip extension beyond 0 deg and no ER beyond 20 deg for the first 4 weeks.  You’ll feel stiffer than last time at the front of the hip until you are about 6 weeks out.

I am lucky to have a great therapy team and surgeon who reply to messages quickly to reassure their patients!

Day 3

I spent last night in my bed.  It was better than the recliner.  I did wake up a few times and struggled to get comfortable, but it was better than trying to get comfortable in the recliner.

Today was my first day alone….my parents both went back to work.  I have 3 golden retrievers taking care of me!  I got up around 8am and made coffee and oatmeal.  I carefully brought them down with both crutches.  I started icing and watched a few hallmark movies I recorded yesterday.  Lunch was a little challenging.  I continue to ice….and I’m attempting to try and start watching Game of Thrones, but I don’t know if I’m smart enough to follow it!

I have gotten the hang of our anti-rotation boot hack (so I can do it alone)….

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Day 1 w/ velcro
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Day 3 w/ exercise band and grabber!

The other side!

Pre-op

I haven’t written in a while so I wanted to bring you up to speed.  I had a very crazy week at work last week.  We had a regulatory body at work and I had to run around a lot more than usual.  I was counting down the minutes until surgery!  I was so ready.

I procrastinated on getting my stuff packed.  I was super ready for the surgery, but because work had been so crazy all I wanted to do when I got home was to sleep.  The night before surgery ended up being a long night for me to get everything packed and ready to bring to my parents.

About 1:30pm on Thursday the surgery center called to let me know that my surgery time was at 11:30am and they’d like me to arrive at 10:15am.

Day of surgery

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I got up at 6:30am on Friday to shower (with CHG soap) and pack up my car.  We needed to leave by 8:45am to give us time to get to Columbus and give us a little buffer in case we hit any Columbus traffic.  We made it to the surgery center at 10am.  We hung out in the car for a few minutes and then headed in to check in.  I signed a bunch of paperwork and then we sat down in the waiting room for a few minutes before they called me back. I wore my “so hip, it hurts!” t-shirt, it was a big hit! I had an absolutely wonderful pre-op nurse (Marilyn).  We went over my meds, consent, got my wrist bands, and then I got to pee in a cup.  Then she took me to Dr. Ellis’ pre-op bay.  She had me change into my gown and then she needed to start an IV.  My veins are very hard to find (especially when I’m dehydrated from not being able to drink since midnight).  She tried for a few minutes to find the best option, it only took one try!  She was a good stick.  She then started my pre-op meds and washed my leg with CHG.  After she finished getting all the pre-op stuff completed it was just time to wait.  She brought my mom back around 11:10am.  It was close to 12pm when Dr. Ellis came in.  Dr. Ellis moved my leg into flexion to see how far he could move my leg before pain.  My leg stops at about 90 degrees, but if he moved my leg out to the right and then did flexion, I had no problems.  I told him I had a few questions.  My major question was, if it was bad enough in my hip joint would he please just do a hip replacement?  I thought he would be very against it, but he completely understood my reasoning and agreed with me!  H assured me that if he felt a hip replacement was a better route he would change courses.  I also asked if I would need anti-rotation boots, he said that he would know once he got in there and if I did I would wake up with them on.  Lastly, I asked about PT.  His post-op protocol has changed each of my surgeries, so I wanted to make sure I needed to wait until 3 weeks to start PT.  He has a great way of reassuring me.  He left and said he’d see me in surgery (although he came right back in because he forgot to sign my leg).  The OR Nurse and Nurse Anesthetist came in to wheel me back to the OR.  They both asked if I had any questions and then they gave me some Versed (after that my memory gets fuzzy).  I remember getting on the table and people grabbing my feet to wrap them in the booties for the traction table.  The Nurse Anesthetist told me to take a few deep breaths and then I was out.

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Next thing I remember is trying to wake up in Recovery.  I woke up in pain.  The nurse ended up needing to give me 5 doses of pain meds before I felt good enough to stand up and change into my clothes to go home.  At some point while I was trying to wake up Tiffany came by and talked to me for a few minutes, but I don’t remember anything she said.  The nurse helped me change and offered me something to eat and drink.  While she went out to get my GF crackers from my mom, Dr. Ellis came by and talked to me.  He told me that my joint cartilage looked great, no labral tear, but my capsule was crushed.  So, he shaved off more bone off of my AIIS and cleaned up the capsule.  That was the first time after surgery that he stopped by to talk to me.  I think he knew how anxious I was regarding this surgery and wanting it to be my last!

The rest of the day was mostly a blur. I spent the rest of my day in my ice machines.  I was in and out of sleep.  I had to rewatch a few shows because I fell asleep during them.  My hip is super painful.  Way more than any of my other 3 hip surgeries.  I am in anti-rotation boots for 4 weeks because of the damage to my capsule.  They emailed the pics from my surgery (see below)- I’m not sure what I’m looking at…..I’ll ask at my 2 week appointment.

My Physical Therapist called me around 8pm that evening to check on me.  She was on a trip in Las Vegas, so I really didn’t expect to hear from her.  I had sent her a text earlier in the day with what Dr. Ellis found and what he did.  We texted for a few minutes, but I was very surprised she called.  She has been through this long journey with me and knew how anxious I was to have this surgery and hopefully get back to my previous quality of life and activity level.  I love her!!!

Day 1

I’m still on regular pain meds and ice.  The day was kinda boring.  Nothing on Netflix or TV.  I fell asleep on the couch for awhile and then my sister and nephews came over for dinner and to watch a movie with me.

I am sensitive to the tape that holds on the bandage.  I waited until 24 hours (like my post-op instructions said), but it still ripped off some skin.  I took the bandage off and it was quite saturated with blood.  I had 3 portals for this surgery (and I don’t think he used my previous ones) with a total of 5 stitches.  I could’ve taken a shower today, but I didn’t think I could make it.  Hopefully tomorrow!

Overall, I’m glad he found what he thought he would find, but I have a feeling this recovery is going to harder than my previous ones.

Getting close

Countdown to surgery: 12 days

I know I haven’t written anything in awhile, but I haven’t really had much to write.  I’ve just been trying to maintain.  I have received approval for my time off work!  I have also received the approval from my insurance company for my surgery.  Those are both huge!  So, I’m very thankful that that has gone smoothly.

I had to stop all my OTC meds and NSAIDS.  I have warned my staff that I may be more cranky than usual because of my pain levels!  My PT worked her  magic Thursday to try and prepare me for weaning off my meds.  She is the best!

I am down to less than 2 weeks!  I’m so ready, but I’m procrastinating this time trying to get everything done/ready.  I need to start organizing my stuff, finish a few projects, etc….work has me stressed an overwhelmed.  I’ve been working a ton of hours and then coming home to work on more stuff.  We are anticipating our tri-annual survey anytime and it has everyone on edge!  I’ve been super exhausted when I get home and have NO motivation to get anything done!

I guess I should pull my old post out of what I need to pack!!!

The countdown is officially on………!

Over it all

The last week has been incredibly difficult.  It started mid-week when I had to run all over the hospital to do audits on my staff.  It ended up rolling over into two days of audits and lots of lots of steps.  On Friday we had 4 call-offs….I ended up being in the kitchen running around working numerous positions throughout the day.  I barely made it to my car.

Saturday I had to go with my mom to help watch my nephews while my sister/brother-in-law went to a viewing/funeral.  The boys were wild and I was in a significant amount of pain.  I ended up napping while the 2.5 year old napped and my mom watched the 5 year old.

Sunday I did nothing, except go to the grocery and do some meal prep for the week.  I ended up having to take multiple breaks throughout the day to rest.

I had warned my PT that I was an absolute MESS.  By Wednesday I was slightly better, BUT I was still pretty messed up!  My quad was super grumpy!  My PT dry needled and I had reactions like I never had.  Long twitches and burning from the needles.  My swelling had moved from just a ring around my thigh with a lateral pocket to all the way down my thigh and around to my back.  We continued to cupping to try and work it all out.  This all caused me to feel pretty sick….nauseous and blah!

I ended up emailing my surgeon and surgeon’s PT because I was/am in panic mode.  I am really afraid I will be back on crutches in the next few days to weeks.  His PT had many similar recommendations to what I’ve already done (including the brace) and crutches prn.  I don’t know if I’m going to make it 5 more weeks!  My hip is a MESS!!!  I am so over this and ready to be done talking about my hips!