John 15

John 15
‘I am the vine, you are the branches'

Monday, December 29, 2014

Week 7 - The Rehab Ride - "What is your drug of choice?"

Did I catch your attention? Good - because post surgery rehab is like teetering on an uncontrollable see-saw .....
From no pain to pain to no pain.
From weak to strong and then weak again.
From mentally unbreakable to the black abyss.
Another layer of paint expunged from the meticulous self painted image.

This is the rehab ride.  What is your "drug" of choice?
Is it to loath in self pity?
Is it to look fear into the eye and extinguish it?
Is it to be afraid of what may never come?
Will anger boil over burning everyone and everything?
Or will you be emotionless - void of feeling?

And here's where I am going to let you in on a little secret.  All of the above emotions will be your drug of choice and then some. There will be days that you sit in the blackness of the night convinced that you are bipolar ready to self commit and on other days you will feel as if you never had surgery.

The rehab ride can be scary. No matter how much you try to mentally prepare yourself for the up and downs, it will be mentally hard when you hit the down slope of pain post surgery. Fear starts to creep in, the mind taunting you....

At times, it's easier to have a pity party than it is to shine through the clouds. While it would be great for this recovery to be as easy as a hip or knee replacement, we all knew that it wouldn't be.

Therefore, it's important to remember...

1. During this stage, it's not about how fast you get there, but that you keep moving forward.
2. No matter how small each step may seem, it's still a step forward.
3. Every day of pain also means that the next day another muscle grows stronger.
4. Don't make grandiose assumptions of what you will be doing by when. The key to surviving this is by staying flexible and adapting to any shifts in the sand.
5. Accept your emotions, but don't let them manage you. You were born with emotions, you had them before the pain set in, and before diagnosis. Expecting to bury them will only make them surface stronger and more frequently.
6. Open your bible.... have faith....
7. Meditate. If you don't know how, learn how to. If you live in a larger city, look into meditation groups. Also experiment with different styles. I prefer mindful meditation over the clear you mind and don't think of anything style...
8. Don't isolate yourself. Like I mentioned in my  "Elephant in the Closet" blog, you may have to reach out to your friends. Don't expect them to reach out to you. Likewise, utilize the boards to connect with others going through this.
9. Find a surgery buddy... there are over 1,000 people on the PAO board. You will likely have surgery +/- a few days from someone else. For me, I was +/- a week from 4 other people. We kept in contact supporting each other along the way.
10. Do something you are passionate about. Change the neurons in your brain to fire in a more positive manner. Neurons that fire together wire together. If you are constantly trying to trump eor with the "woo is me syndrome", then you are enabling a negative vicious cycle possibly promoting depression.  Joe Dispenza is a great author who has written 3 books on this subject.

If you are what you eat, then in same cases you also are what you think. Buckle in, fasten the see-saw, but don't give up because one day you will get there.

Wednesday, December 24, 2014

Must Have POST PAO Items

Okay people, I am going to give you the skinny straight on what items have best helped me post PAO.  I am cheap, I don't like to spend money, so if I have it listed- then it's probably a pretty important items to at least think about.

1.  Mobilegs Ultra - Amazon
These crutches are hands down the best crutches I have ever used.  To start off with, I am a klutz... but on these I can glide on.  The Ultra's are a must since the top crutch pad is more mesh like providing ventilation. Also because they are mesh, they do not dig into your armpits. The handles also adjust to your liking.  Don't bother trying another crutch... these are the way to go...

2. Rollator Walker with Seat & Basket
This was not my favorite walker the first 3 weeks. However, once my glute and lower SI joint pain subsided it became my best friend at home.  I was able to zoom around the house, carry stuff in the basket and on the seat, sit down when I needed to, cook meals and put them on my seat for transport. It folds easily if you choose to take it out of the house. Indoors, this is my go to!

3.  TED Compression Stockings
Also loved having these in the hospital and home. It helped to reduce post surgery swelling and pain. I highly suggest you buy more than 1 pair, I bought 2 since they will have to be washed. I wore them for about 2 weeks, but some people have to wear up to 5.

4. Arnica Tablets
With the recommendation of my natropath, I took arnica tablets a week before surgery and then continued until the swelling and pain went down. These tablets naturally help reduce inflammation without slowing bone growth like anti-inflammatories would.  Post surgery, I had no bruising and the post surgery swelling I had went down within a week.  Of course, before taking these please check with your doctor.

5.  Indoor Bike Trainer
LOVE- LOVE - LOVE THIS!  I was able to start riding with no resistance 10 days post op. This helped to keep the hip joint fluid. Trainer was easy to put together and as for the resistance will get back to you on that. Husband didn't hook it up knowing I would push my limit.

6.  Yoga Non Slip Socks
These are also a must... after being sawed open, screws inserted, and drugged up the last thing you want to do is slip and fall on the shiny hospital floor. Do yourself a favor and buy some. I also wore them at home to avoid slipping in the kitchen/bathrooms, etc. They are also comfortable.

7.  Grip N Grab
Please, buy yourself 3 of these if not more. You WILL need them. I only have 2, but could really use 1 more. I drop stuff all the time and for the first 4 weeks was unable to bend down to pick stuff back up.  I've picked up everything from my pesky phone to my travel cup of coffee with these things.

8. Hip Ice Pack
I did not get an ice machine- I kept it simple. Heat was more my friend than ice. However, this ice pack is definitely one of the better ones.  I am able to use it on the outside of my waste, inner adductor muscle, back and buttox region.  Highly recommended. The outer covering is also nice and the straps are long so you can adjust to location.

9. CoCo Care Vitamin E Oil
This stuff is the real deal... it is thick, goes on strong, and has visibly reduced the appearance of my scar.  I have also started using it around my eyes and forehead to reduce fine lines and wrinkles.

10. Recliner (sorry no link- picked mine up at an estate sale)
Any recliner that you find, get.  You will be flopping around like a fish the first few weeks. Some of my best naps were in the recliner.

11. Bed Rest Pillow
LOVE! LOVE! LOVE! Just get one... you will be so finicky after surgery that you will require 40 different pillows to get comfortable.

12. 4 position support pillow
Another must have.  I used this for under my legs post surgery to reduce pressure on my lower back. I also use it as a pillow for my head. This is also great if you are able to sleep on your non-operated side, I throw this between my legs and am able to nod off for a bit. Really... it's 4 in 1... so worth it and it has held up really well!

13. Carex Round Cervical Pillow
I literally brought this pillow to the hospital to use instead of those flat things that they give you.  At home, it also helps to provide support with my lower back or neck.. told you you will become a pillow feen.

14. Long Handle Razer
You can make your own, but this is rather cool. I did not think about how I would shave my legs... epic fail- but hey that's what amazon prime is for!

15. Shower Bench
You will NOT be able to stand and take a shower. You will be on drugs, tipsy and just need to sit your but down. Get you a shower bench so you're not putting your newly formed hip at risk of falling and damaging what has been done and honestly, you will be too darn tired to stand.

16. Long Shoe Horn
You may get this in the hospital... but this tool is awesome! If you don't get one, buy one! Must have if you want to wear something other than slip ons which might bunch up on you anyway.

17. Sock Aid
For the first few weeks, it will be VERY hard for you to put your own shoes and socks on... therefore, I also suggest this!

Below are a few suggestions for the hospital, which I have already blogged about here:

1. 2 night gowns
2. Don't bother with underwear- your incision will take precedence
3. Something 2 sizes larger for you to go home in because of swelling
4. Long cables for your phone and computer.
5. Starbucks Insta Coffee
Don't leave home without it... you NEVER can guess what kind of coffee they will serve you.
6. In addition to that, you will want Chamomile and Peppermint tea to deal with the upset stomach
7. Peppermint Candy and throw away tooth brushes
8. For your nice nurses, 5 dollar gift cards

Monday, December 22, 2014

Week 6 - Leave Expectations at the Door - Post-Op Follow Up

Prior to my 6 week follow up, 2 out of the 4 girls who had surgery +/- a day from mine were allowed to ditch the crutches. And this is where my list of mistakes starts. Mistake #1, setting the expectation that the same would be true for me. Clearly we are all the same people (NOT), who have the same surgeon (NOT), with the same degree of dysplasia (NOT), and all bone cuts are alike (NOT).  There is nothing black and white about this surgery; even the scar location is different from person to person. Some people have it in their hip line, some people have it straight down there thigh, others have it on the outside of their thigh...

Let's continue with my list of mistakes

Mistake #2 Having my x-rays loaded for me to view in the exam room. Usually I dig this because I then have a chance to take pictures to spam the entire world. Instead I freaked and spammed them to all the PAO Warriors that have been through this frantically asking them for their thoughts.
Mistake #3 LOOKING at them.
Mistake #4 Almost passing out on the nurse when I saw big gaping holes. I can be daft at times and was expecting everything to be fused together.
Mistake #5 Expecting my husband to join my freak out session. After 11 years of marriage, I know that is not his style, but yet still expect him to hop on my bandwagon. Brilliant wife moment...

Doctors and REALITY

As the resident entered the room, I put on my "fake it until I make it smile" hoping that I appear calm while every cell in my brain was screaming WTF in four different languages. We then proceeded to play the question and answer game rating pain, movement, etc.

All the while I want to know about my X-RAYS... because what I am seeing is no change from my surgery day. Images of bone simulator machines are entering my mind along with future surgeries to help the bones fuse together. The fancy term for all of this is non union.

Let me be clear, I really like this resident.  We go way back to my first appointment day when I busted out crying explaining that I am 37 living like a 70 year old. Any doctor that manages not to get the "another woman crying look" wins the total confidence award with me.

Finally, X-RAY time... he affirms that bone growth is right on track and takes the time to show me that the very, very light haze is a sign that the bones are fusing together.  This light haze is similar to someone putting a few drops of glue into a water bottle and expecting you to notice it right away. Got it Sherlock.

Finally, the SURGEON comes in...  not only is he a great surgeon, but he has a great personality.
Strength checked out on track
Flexibility checked out on track
Bone growth checked out on track
But..... drum roll, I will still need to use crutches for the next 6 weeks. However, I can increase weight bearing to 50% of my weight for the next 2 weeks and then if tolerated, bump up to 70% of my weight for another 2 weeks, and then 80% for the last 2 weeks prior to my appointment.

After my husband reexplained that concept to me in the car, I calmed down. Essentially, by the time I go back to see him end of January, I should be done with crutches.

In hindsight, this is good. Considering how bad my hip and muscles were, this will allow time for PT to strengthen my leg while I slowly build back up. If I were to ditch the crutches now, I would repeat the vicious trigger point cycle since the strong muscles would become overworked compensating for the weaker muscles.

Lessons Learned:
1. Leave Expectations at the door... you are not like anyone else, nor will your recovery be like anyone elses.
2. Be happy with what progress you have made. We all heal at different rates.  Along with that, each surgery requires a different level of healing.
3. Just calm down. Don't try to read ahead and play doctor. You likely didn't go to school for 20 years (J/J... 7+) so let them read the x-rays.
4. Keep pushing on. Recovery will come.  If it wasn't for this surgery, most of us would live in pain until our joint eroded enough for a THR (Total Hip Replacement). Because we are all active people (yes, this is true- I have not found one inactive person on the PAO board), this surgery IS our ONLY options. It's not like we have 20 options lined up...
5. Smile on...

Below are my 6 week x-rays.  The areas circled in red are what still need to heal.

Wednesday, December 17, 2014

The Elephant in the Closet

In the wake of the holiday season, this surgery couldn't have come at a more timely time. Not only will it push you physically and mentally to your max, but it will also identify -- wait -- "friendships"???

And here's where the truthful sailor girl in me comes out... the elephant in the closet no one like to talk about--  look at your friends as ships passing in the night.

The hardest part on you will be your kids. You will have to reach out for play dates. For some odd reason people assume because you can't walk, that your kids can't play either - GASP... I could of sworn in my drug induced haze they were still running around stealing my crutches and using my rolling walker as an indoor surf board.

Assumptions! I love them. They get you so far in life... because assumptions always lead to your next promotion, right? The biggest after surgery assumption that people make for you is to to never bother you again. For the love of honey loaves, that might have been true the first 2 weeks, but 5 weeks out most of us are able to get around with crutches and in most cases a good percentage of us PAO (ers) start part time work at +/- the 8 week mark.

The bottom line is YOU make people 40 and under uncomfortable whether they are conscious of it or not. Perhaps it's an unsettling reminder of how earth shattering life can be. Perhaps its a reminder of how quickly they could loose everything they have worked so hard for. Perhaps they just have a fear of illness and injury. And let's not forget that people are just plain busy- it's the American way to live life to the max.

While I realize this post may be ill humored to some, it's by no means meant to be facetious. As mentioned in my previous blog "The awkward silence of chronic pain", not everyone is natural at empathy. Try and have sympathy as it's an adjustment on their part too. People are doing the best with what God has given them through their experiences in life.

Why hold back on this "elephant in the closet" when almost EVERY SINGLE PERSON on the PAO board has gone through this as well. This isn't just an isolated 1% incident... it has affected 99% of us. So, if you're not wanting to be normal, sadly enough, if the ghost of friendships past happen to you - you are the NORM.

Now that I have busted down the elephant and closet doors, what does one do?

1. Expectations- don't expect or define how a person may respond. This is just the same as "expecting" your husband to do something? The ultimate fail.... communicate your needs.

2. Pick up the phone- technology is great isn't it? Well, use it to reach out to schedule play dates, lunches, or a quick trip for coffee. Everyone has an electronic leash.

3. Self- DON'T expect people to fill in your free time. Find a way to creatively pass your time. Learn something new, blog, reach out to others, join groups. You are in charge of your life and your time. Fill it with productive things and in turn you will feel productive.

4. Set boundaries. We do it at work all the time. It needs to be done at home also. Hold yourself accountable to something. You won't feel as lost and/or isolated.

5. Kids. If you have kids, don't make a big deal out of it. You are the parent- come up with things to do with your kids. Kids watch our reactions closely. This is a great time to also teach them about empathy and compassion.

6. You are in charge of your happiness. Set Your path, RAISE the sail, and DEFINE your course. You won't be like this forever. Healing will occur and before you know it, life will go back to normal for you and your family.  Until then, use this extra time as a way to reflect, relax, and recharge.

7. Grudges. Don't hold grudges. That is so high school.... accept a persons reaction for what it is, put your grown up panties on, and CRUTCH ON.

Sunday, December 14, 2014

Week 5 - The Lopsided Honey Loaf

Week 5 and I am just now noticing my butt is lopsided???

GASP.......  HORROR..... SHOCK..... 

I have been wearing yoga pants since week 2 (insert > MORTIFICATION)

How did I not notice? Maybe because it felt like someone slammed me with a shovel the first 2 weeks leaving me as stiff as a dead animal in winter for weeks 3 and 4 rendering me with the slightest displeasure of turning. 

This would also explain why I had to upgrade the seat on my indoor bike training to one of those gel comfort wide seats.

My new friend-enemy  this week is PT. Love to hate; hate to love.  Love the push, dislike the ache. One of my PT's brought up a really good point that part of my positive recovery can be attributed to all the Pre-PT I had prior to surgery.

     * 50 dry needle visits, another 40 additional PT visits, and a break up letter from my insurance    
     company later; it was all worth it.

     > Dry needle to save my muscle from atrophy
     > PT to strengthen the surrounding muscles
        and if I have to explain a break up letter to you go back to high school

After my rehab I really should send my husband on a hunting retreat. He has become the "default parent. Not the best post retirement present. The truth be known, my husband bedazzles me.

Our ongoing joke has always been that he would be the "better" homemaker once retired. I think this little escaped has just proven he could do it.

1. The cub scout patches I would have taken to the cleaners, I found him sewing on with a real sewing machine (insert Grinch type jealousy that he even knows how to use one)
2. The cakes for cubs scouts that needed to be made, he made. Mine would have been un-frosted cakes from the bakery with a tub of frosting on the side.
3. Dinner has not once been burnt in the last 5 weeks.

As I turn in my home-maker card- need I say more? I obviously belong at the office... and that's exactly where I will be end of December.

Five weeks later, my appetite is STILL that of a pregnant lady... The article,  How to Speed Fracture Healing is a really good article that explains the art of bone healing, nutrition, and supplementation. Post PAO surgery is not the time to think about your next figure competition... Put that skimpy little bikini away and focus on what it takes to regrow your bone and strengthen those muscles!

Take Them a Meal is an amazing website that can be used for coordinating meal preparation between friends, family, co-workers, and church groups. Regardless of how many meals are frozen in advance, or the number of willing cooks in your house, this is a nice way to give your primary care giver a break. I know it has made a difference with us.

Saturday, November 29, 2014

Surviving the hospital stay

My hospital stay was the pitts because the nurses couldn't seem to get me my pain medication on time. This really floored me as it would seem that would be their number one concern.  Anyhow, below are a few tips  for all you upcoming PAO Warriors:

(1) Walker: I bought a roller walker off of amazon. Although this has worked out great in week 4, this was not suitable for me in week 1 since the body needs to be placed between the bars for full weight bearing.

(2) Crutch pads: if you have carpal tunnel let your surgeon know. The hospital  can provide crutch pads for the walker to avoid aggravating CP.

(3) The hospital also provided a long shoe horn, a lolly pop looking bath tub scrubby with an extra long handle.  You can likely get better quality for a lower cost from Target or Walmart.

(4) If you buy your own non-traditional crutches, bring them to the hospital.  Otherwise, they will teach you off of what they have.

(5) Don't be afraid to ask for Benadryl or another pain medicine if you are having a reaction.  For that matter, don't be afraid to speak up if your pain medication is not working. It's the hospital's job to keep you comfortable so you can leave.

(6) Pack lots of snacks and instant coffee. Hospital food sucks and is high in sodium.  If you are a coffee or tea person, having a few to go packs on hand may brighten your day :)

(7) Start a stool softener early on and pack suppositories.  They are not joking when they say pain medication slows your systems down.

(8) Pack chamomile and peppermint tea.  It will help with after surgery stomach pains.

(9) Check your narcotic prescription before you leave to ensure you have enough to last. I was only given a weeks worth of pain meds which left me in a bad spot one week post surgery.  If you find you have an insufficient amount of medicine to get you through, make sure to discuss your options with your doctor or pain management team before you leave.

(10) Pack mints and disposable toothbrushes. Getting out of bed the first 2 to 3 days may not happen and there is nothing worse than stinky teeth.

(11) Along with #10, packing disposable face wipes and body wash clothes are a must.  Makes the after surgery funk seem a tad more pleasant.

(12) Bring a bag of candy or a few 5 dollar Starbucks gift cards to thank any excellent nurses that you may have. If you have a crappy one, then you will really appreciate the good ones. 

Post PAO - Week 4 "Breaking Out"

Holy fizzle sticks. Four weeks ago I was coming out of the recovery room at Duke Regional. My husband had to remind me a few times in week 3 that I was not yet in week 4 since I had very little pain. Thankfully, I am getting used to crutchen' around and am seeing great progress with strength and recovery. I am so thankful to God to have the chance to get back into live without having to live in chronic pain.

With that being said, I am ready to break out of this house like an old lady with a motorized scooter. Staring at the same walls for the last four weeks is akin to being underway on a ship. Confined spaces are not my friend. I forget that I just had surgery and and try to use my operated hip. Sudden images then rush into my mind of a crumpled me on the floor with screws laying all around. Clearly, someone else has noticed this too since a stool now proudly sits in my bathroom.

Along with feeling closed in, week 4 has brought an increase in energy levels.  My mental clarity is coming back with a vengeance. I am leaning more towards reading vice watching TV and geeking out on books about neuroplacisticy.  I must forewarn you though, increased energy levels also brings an increased level of frustration.  You will want to do or go, but still have to keep it simple. Family members likely will want you to start using pain medication again as the passed out version of you is much easier to deal with than the snippy version.

Week 4 also brings the good fortune of out-patient PT. I am excited to start the rehab process with people that I trust. This week, I have been working on Range of Motion (ROM).  Just like locked shoulder syndrome, my surgeon does not want me to get a locked hip. To combat this, my husband made me a band out of webbing which I use to gently move my leg in different ROM positions. Being hyper mobile, I am stymied at how non-flexible I am post surgery.

And as I predicted in week 3, the lolly pop scrubby did not make it.  I had to put it to rest after 4 uses. Extreme sadness washed over me as I saw dollars signs go down the drain.

The kitchen is still my enemy.  I am so grateful that my husband helps me prep all my meals. I can get around on my own if I need to, but it is a pain and really tires out the right leg. When I do have to be in the kitchen, I have found using my walker in the kitchen is the better alternative to crutches. I am able to sit and push myself around and then stand when I need to.

For longer trips out of the house, I use the wheelchair. Let me rephrase that, my husband pushes me around the in the wheelchair. During our most recent trip, I braved my first solo "wheelchair" bathroom mission in Walmart. I felt like a bad ping pong ball as I rounded the corners. As if getting into the bathroom was not hard enough, I then had to figure out how to push myself far enough into the stall, but still close enough to the stall door for me to close.

Weight.. I was really concerned that my weight would balloon up post surgery especially since I already have a few extra lbs from the pre-surgery slow down.  At least with this type of surgery, it seems that my body burns calories in overtime mode. Up until week 3, my diet has not been the best. So, imagine my surprise when the scale showed I was down 3 lbs from my pre-surgery weight. Talk about total motivation to get back to clean eating.

I have been pretty diligent with my supplements.  In addition to my multi-vitamin, I have added a probiotic, vitamin c, calcium, magnesium, and amino acids.  Now that I am in week four, I have add fish oil, vitamin E, and Dr. Williams Joint Advantage back in. This will all help naturally fight inflammation without the use of more drugs. I avoided those specific supplements the first 4 weeks due to either blooding thinning or anti-inflammation issues.  The body needs a certain amount of inflammation to heal. Therefore, preventing inflammation early on would slow the healing process down.

Overall, I really am impressed at the transformation each week brings. Having that "all-star" person to help take care of you may definitely make or break the recovery process. If I had to do this recovery on my own, or with very little support, I have no doubt in my mind that I would be in much more pain.

Monday, November 24, 2014

Post PAO Week 3

The arrival of week 3 has been the most difficult for me.  I am no longer crashed out on pain medicine like week one or trying to acclimate like in week two.  Instead, week 3 brings a whole new set of challenges, mostly emotional. Now that I am 95% pain medicine free, I am thinking more clearly.  I also have slight bursts of energy where I want to get up and go.  Although I try to get up and crutch around, I still become easily fatigued since my body is trying to recover which leads to many naps.  Even in pain, sitting for 90% of your day is hard.  Netflix has become my BFF, along with bible study material, and reading. However, when your body just starts itchen' to move and you can't that can be mentality tough; especially with going into the holidays.  It will require a whole new level of effort for me to keep my mind in check focusing on the purpose of this surgery.  Everything comes to and end including rehab from surgery. I also firmly believe the mind plays an integral part in recovery and the more positive mindset you are in, the more likely healing will occur.

On a positive note, I have started becoming more independent.  I was able to take my first solo shower this week.  Thankfully we have a large enough shower where I can walk in with my crutches and put them off to the side without them getting wet.  It is getting easier to move with my crutches and backpack.  I don't feel so wobbly.  I am also figuring out how to get my own stuff in the kitchen. There is a whole lot of sliding objects down the counter and I have to plan 30 minutes in advance for my meals, but it works.

My strength is increasing every day.  I still have trouble sliding my leg out while laying down, but am able to do that while standing up. For those planning to go through this surgery, I highly recommend an indoor bike trainer. The bike helps to break up the stiffness prior to exercises.  My surgeon recommended that the prescribed exercises are done 3 times a day without pain, but I am only able to get at least 2 sets in before it becomes uncomfortable.  Progress is progress. The first week, I wasn't able to move my leg at all.

As for tools, the hospital sent me home with this cool 3 in 1 chair that I mainly use for the shower. It's also great to use for putting my makeup on and doing my hair.  The hospital also provided me this Lolly Pop looking scrub brush which I had to laugh at.  The way it's connected is so weak. A few more showers and the yellow lolly pop will be on the bottom of my shower floor and will likely stay there since I can't bend over to pick it up. Shaving has been a struggle.  I am still trying to figure out a creative way to do that. I could always buy a long handle razor, but after all the other pre-surgery purchases, I would like to not buy anything else.

The next round of tools in the below photo are quite creative. The far object on the right is used to help you put your socks on independently.  I have not been able to successfully to that yet.  I take the 3 year old approach and whine until my husband and kids  comes around and puts my socks on.  I find that method to be much easier. The object on the left is a long handle shoe horn. I actually love this thing. It has helped me to put no-lace slip on shoes on. 

And last, but not least, my favorite tool is the grip and grab.  This is a must.  I actually recommended getting more than 1 for each main area of your home.  I don't know how many times I've dropped my cell phone, clothes, or crutches and used it to pick those items back up.  

Overall, week 3 is a blessing.  As for emotions, it's going to happen sometime so I guess the earlier the better.  Mobility gets better as pain decreases.  However, it's easy to over do it. Because of this it's important to watch your activity level. Being tired is a given. Nap when you're tired and it will help the healing process. Up until this week I haven't been in the mood to see many friends or socialize.  I find between the pain meds and trying to heal, I am too exhausted to hold adult conversation. Just trying to work through insurance and my PT sessions turns me into an adult human blob. That's where the lack of expectations comes in.  Not having any helps to avoid comparing myself against some loosely written time table.  

Sunday, November 23, 2014

Week 2 Post Op PAO Appointment

My 2 week Post Op appointment was my first real chance to leave the house.  This was also my first time out since surgery with my crutches.  I eagerly set my alarm for 5 am only to find out how naive I was.  Therefore, below are a few lessons I learned.

Lesson #1: Use the handicap bathroom for the first few weeks.  I found this out the hard way. Halfway through our trip, we stopped for breakfast.  So, silly me goes into a regular stall not thinking much and found myself not being able to get up.  The stall had nothing for me to grab on to and the seat was too low for me to lift myself up.  Because I was unable to get up, I debated calling my husband asking him for help, but was finally able to maneuver my crutches and and lift myself up.  

Lesson #2: Illogical design of some bathrooms.  After my appointment at the clinic, I had to use the bathroom again.  Yes, a lot of bathroom stuff going on, but remember, I try my best to drink lots of water to push all the toxins out of me acquired through all the prescribed medication.  So, back to the clinic bathroom. First off, the door was heavy.  This pissed me off quite a bit.  Here I am young and struggling to get the door open with crutches and the clinic population is mostly full of elderly people. I am the minority. If I can't get the door open, how is someone twice my age going to do it without assistance? As for the illogical bathroom design, the paper towels were at the far end of the bathroom instead of instead of on the wall closest to the exit. I realize these are small things that one would not normally think of if not injured, but when injured these designs make a huge difference.

Lesson #3:  Get used to STARES.  People stare wherever you go.  Some are kind and helpful, some just stare and watch while you try to maneuver.  I would like to think the ones "just staring" are too busy trying to figure out why you are on crutches. That is why PAO Hip Dysplasia gear is GREAT! You can wear it when going out and if people have the sense to look they may be able to put 2 and 2 together. 

Lesson #4: Crutches.  If you have mobilegs or another form of unique crutches, people will stop and want to talk to you about your crutches.  Heck, I would ask... regular design crutches are the pits, but yet they are highly marketed? Because my crutches are cool, I was more than happy to explain why mobileg crutches are awesome. I think a few people wanted to try them, but that wasn't happening. I am a klutz and held on to those puppies to keep me upright.

Lesson #5: Don't forget you had surgery.  A few times during our drive, I almost got out of the car forgetting I needed crutches.  I had little pain to remind me of the surgery and I felt so normal. Well, that is until it was time to get out of the car.  Thankfully, my husband caught  me each time reminding me to stay put until he got my crutches for me. 

Lesson #6: It takes twice as long to do everything so plan accordingly. Although I set my alarm for 5 to get out of the house for 6:10, I was behind. My husband had to step in and finish what I had yet not done.  I know before I go back to work I will likely still be on 1 crutch, possibly 2 depending on bone growth,  Because of this, I will have a few drills the week before making sure I can get ready in a reasonable amount of time. 

As for my Pre-Op appointment, we had to drive 3.25 hours to get there. I highly recommend bringing a small pillow to provide cushion between your wound and the seat belt.

Upon check in, the very kind nurse ensured I was appropriately tagged.  Her klutz radar was dead on.

I then had the privileged of putting on some luxurious x-ray shorts.  I found this picture to be interesting as it really shows how quickly atrophy can occur.  I should note, I did have some atrophy before surgery, but not to this extent. 

As for my appointment, with Dr. Olson, all is healing well. I was able to get my outpatient PT scripts early to include dry needle.  Home PT has been good, but I would receive more of a benefit from seeing out patient PT.  I don't have "surgery-pain" persay, but muscle pain that could be better controlled by out-patient PT.

I especially like the below 2 week x-ray since it clearly shows the bones that have to graph back together where the screws are.  Although there are no screws in the lower pelvic area, those bones also have to graph back together.  That cut had to be made to allow Dr. Olson to adequately move the puzzle pieces around to create better coverage over my femoral head.  Remember, he had to make at least 3 cuts into my pelvic region to get that coverage.

The goal with this surgery is to persevere my natural joint, increase coverage over my femoral head, retrain my muscles to fire correctly alleviating the stress on my quads and abductors, and reduce pain in my hip joint.  My follow up appointment is Dec 18th where another set of x-rays will be taken to assess bone growth and if I can go down to 1 crutch. 

Wednesday, November 19, 2014

Post PAO Week 2

I have made it past the drug induced state of week one phasing into week 2.  While I still have pain and limited mobility, I am starting to see improvements.  I have been able to reduce my pain medicine to just before PT and at night.  Because of the reduced pain, I am also able to push the limits a bit with my crutches trying to learn how to do things on my own. I have found a cross over backpack to be my best friend.  I can throw small items in it and sling it over my back when I move locations.  I am still sleeping a lot, but with short bursts of energy in-between.  Mornings are really rough as I wake up super stiff and it hurts to move. I tend to lay on my BioMat for a good 30 minutes before getting out of bed.

PT is going well.  She introduced some new exercises this week that likely attributed to my increased pain.  However, it feels really good to get on my bike with the resistance level set to zero. There I am cheesing super big below!  

My mental outlook throughout all this has been positive thus far.  Perhaps being faced with living a life of chronic pain and doctors become your new social calendar has helped me to see this surgery in a more positive light. I realize the next six to nine months will have it's ups and downs, but at least I know I'm on the other side.  I really am looking forward to the day when my appointments decrease and I can slowly put my personal and professional life back together.  However, until then, I will be thankful for all that I have.  I have become humbled. God has graced not only me, but my family with so much. Yes, we might have less than we did a year ago and yes, I might be less mobile, but the future is so bright and optimistic. 

As for Post PAO week 2 tips and tricks. Take the pain medication if you are in pain. It allows your body to rest and grown stronger.  Continue to try and move every hour and do what you can with your post op exercises. Expect to be tired in week two.  This is a major surgery and the body needs time to rest and heal.  On your good days, figure out ways that you can gain independence.  Eat healthy meals with lots of protein.  Your body needs the nutrition to heal. Oh and drink lots of water, it will help push the toxins out of the body and force you to get up and move.  I highly recommend listening to meditation CD's.  Meditating does help to reduce the pain.  For further information on how meditation can affect your brain, check out this article from Scientific America  Meditation.  I have also picked a few independent bible studies I can do on my own. Staying in God's word is important and for me, I find that being able to study the bible through self picked bible studies has helped to keep my mind positively focused. Proverbs 31 ministries is also a great page to like on FB. You can sign up for daily devotional emails as well as join one of the many on-line bible studies that are offered there.  

Overall, my expectations are still low.  Recovery from this type of surgery really varies from person to person.  Because of this, I refuse to put myself on any timeline of what I should and shouldn't be able to do. I will be concerned at the six month mark if I can't move my leg.  Until then, progress will happen when my body is ready for it to happen.  

Tuesday, November 18, 2014

Pre Surgery Tips

For all your PAO Warriors nearing your surgery date, my best advice is to focus on your family first.  If you have children, there are many, many, areas that need to be covered in your absence.  Below are some pre-surgery tips.  I didn't go crazy, but instead tried to go the minimalist route making sure all the major items were covered:

1. FOCUS ON FAMILY:  For starters, if you have children you will need someone to watch them.  After caretakers have been secured, then you will need to focus on medical authorization paperwork, forms allowing your primary and secondary caretakers to pick up your kids from school and after care should they go to after care. A household survival guide may also need to be made in the event the caretakers are not family members, but people you trust.  This will help them understand the family rules, who is available to call in an emergency, all medical information, and so forth. All important documents were placed in a single folder to include a copy of the emails that were sent to the school and after care. Also, pulling a copy of your will out is important. I know it's something we don't like to talk about, but it's best to cover all basis.

1a. Also, if you are nearing a season change, make sure the appropriate clothing is available to the caregiver or child.  You don't want to be in surgery and the temperature suddenly drops and the kids have no jackets or mittens.

1b. As for the medical authorization, you can type up a basic document stating x person has permission to provide x,y.z care for our child in our absence.  You can google medical authorization form on the internet for a base example.

1c. Centralize all the medical items in your house that your fill-in caregivers may need while gone.  In addition, I created a list of what medications should be given based on the symptoms.

2. HONESTY: While we are on the subject of kids and family, if you have kids be honest with them at their age level.  Kids have an amazing propensity to understand early on what's going on. They see you walking around in pain so don't try and hide the obvious from them. They will fair much better when you come home on crutches knowing that you will be coming home on crutches. I'm not saying to divulge all the gory details, they just need to know that Mommy's hip is bad and the doctor is going to fix it.

3. FOOD: Depending on your arrangement with whomever will be watching your kids, plan ahead and make sure there is enough food in the house while you are at the hospital. If you also like to cook, and can manage with you hip, then it might be helpful to your husband and care giver to prepare some meals in advance.

4. YOUR HOSPITAL BAG: The last thing I focused on was my hospital bag. It took me less than an hour to get together.  The only items that I actually used out of my bag was my phone, computer, snacks., tea, and go home clothes.  I did however bring 2 extra pajama dresses, 2 boxer shorts, 3 different types of pants to go home in along with a shirt.  I opted for no underwear. Why spend the extra money when it will likely hurt to have on anyway.  Make sure whatever you bring to go home in you buy 2+ sizes bigger. I ended up bloating up 3 sizes and had to wear my PJ pants home.  I also brought mints, which were a life saver since I wasn't able to get out of bed for 2 days.  As for my beauty bag, I had deodorant, dry hair shampoo, face and body wipes.  I actually brought much more than that, but didn't use it. The hospital provided me with a walker which I did use the first week because of how loopy I was with all the drugs.

5.  MEDITATION/BIBLE/DEVOTIONALS: It is inevitable, you will get nervous the night before.  Whether you are able to stay home or have to travel, make sure you have something with you that can help focus you in a spiritual way.  I had a list of my favorite scriptures saved on my phone along with my meditation CD's which helped calm me throughout the night because let's be honest, you're not going to sleep much before the big day. I know I didn't.  The CD's helped to keep my mind off the looming surgery. I have stuff downloaded both on my IPOD and phone.  You can find many great apps in the store for just a few dollars.  I focused on healing, relaxation, and pain apps.

6. DINNER: If possible, try and have a nice dinner with your family and our spouse/significant other or friends depending on your relationship status.  Because we had to travel, we went to our favorite restaurant down at Duke.  It was a nice chance to have dinner alone with my husband along with a beer. Yes, I had one beer before surgery.  It won't kill you.

7. FACEBOOK GROUPS: If you are on any board that discusses the surgery you are about to have, it may be essential for you to not check into that group for awhile.  I found the group to be supportive prior to my surgery, but that's because there were 4 of us going during that time frame. However for some, these groups can heighten your anxiety making the pre-surgery days that much worse.  Again, this is where it's important to surround yourself with motivational material that keeps your outlook positive.

8. PRE-PAO YOUR HOME: What I mean by that, is when you come home from surgery, your mobility will be limited.  Try and think ahead, move items higher if they are too low, test your walker to make sure it can fit through couches and doorways.  If not, re-arrange your furniture and practice using your walker or crutches through tight spaces. Move your make-up, hair items, toiletries to a higher draw. Perhaps put a chair in your bedroom if you don't have anywhere to sit so that you may have an extra place to sit and put clothes on with the tools the hospital gives you. If you are on routine medication, refill anything you can before hand. Spend a day pretending that your hip/leg is immobile and adjust your house from there.

10. MEDICATION: Check with your surgeon what medication is safe to take before surgery. I know for myself I had to stop anything ibuprofen based 10 days before surgery.  This all is usually covered at the pre-op appointment, but some medication may need to be stopped sooner than 10 days prior. Also, if you are a supplement freak like me, some supplements like turmeric will also have to be stopped since they act like an anti-inflammatory as well.

Like I said, I kept it simple  I normally over-prepare for everything in my life and tried to dial it down a notch this time and guess what- it worked out just fine. I will be creating additional blogs that break down what items to buy, what brands I prefer, specific lists for the hospital, etc.  I wanted to keep this one general.  Stay positive, block the negative out, and remember- those who choose this surgery do so to have their active lifestyle and mobility back!

Sunday, November 16, 2014

The First Week Home

I wanted to write about this while it was still fresh in my mind.  Let's me just say that the first week sucked.  You no longer have the IV pain medication when you need it and for me the pain pills didn't always work.  Before leaving the hospital, I had 2 PT lessons. One was learning how to walk the other was learning how to master the stairs and 1 OT lesson that showed me how to put my socks on with the grabber and sock glove.  Honestly, I could of used a few more OT lessons teaching me how to live life without going over the 100 degree angle.  For those not familiar, after a PAO surgery, you can not go over the 100 degree angle so that the area can heal correctly.  It's not really as easy as it sounds.  Things like bending over, getting up from a chair, sofa, or toilet can all put you over the 100 degree angle.

I knew moving would be painful, so I moved as little as possible, but made sure I walked and did my exercises every hour.  I also knew that I would be fully dependent on my husband to take care of me so patience for us both was needed.  Him, to figure out what made me most comfortable and for me to  understand that there is no manual on how to take care of your wife.  Actually, I think we managed fairly well the first week.  I was fed, when I moved locations, my belongings followed me, and I got lots of hugs and kisses.

The little, little people in my home were also super helpful. They were great at grabbing ice packs or throwing trash away or picking up things that I dropped.  Having the grip and grab was also a life saver. I have 2 and they stay in the rooms that I am mostly in.  I really should have 3, one for my bedroom, kitchen, and living room.

I also slept a lot the first week.  This wasn't the get comfortable and maybe fall asleep kind of sleep.  This was nod off where ever I was at, drooling on the couch kind of sleep.  I would just topple over in the middle of talking. I could sleep through anything which I actually did.  Kids were home on Veterans day and there I was, fast asleep on the couch with 3 boys and 1 girl screaming through the house. Thanks to Super Dad, he kept everything under control while Mommy was passed out on the couch from surgery and pain pills. Here's to a new look at suburb Mom's.

What surprised me the first week was the area of my pain. It was more in my glutes and lower back than the top of my thigh area.  I tried to get in to see my dry needle therapist, but unfortunately I needed a new script due to surgery.  I tried to get my home PT to send a copy of my script to his office, but because of insurance reasons they were not able to.  Thankfully, I was able to see my PT Hip Specialist since I was seeing him under a different script.  He was able to gently manipulate my lower back and hips. He did say that I would continue to have problems with this until my muscles gain strength due to the weight of the screws and my immobility to move or stretch in certain positions due to the 100 degree rule. Bonus, he gave me some extra exercises that I can do to help decrease the pain that does not effect my range of motion

Because of this, I will be asking my surgeon for a new script to that will cover both my PT Hip Specialist and Dry Needle Therapist.  They want me off of pain pills and the sure fire way for me to do that is to receive PT that works.  This I know because that's how I managed to get by with minimal pain medication prior to surgery. As for home PT, I don't know if I will keep them.  They are following the surgeons guidelines to a tea and I believe I would receive more of a benefit seeing the specialist that kept me moving with their . With the help of my husband, I can do the assigned exercises at home.

The after surgery swelling has gone down immensely.  Although I brought clothes that were one size big for after surgery, I ended up having to wear my super stretchy pajama pants because I swelled up to almost a size 14.  I thank my decreased swelling to my BioMat, which is a full size FAR infra red heating pad that helps to stimulate the body in many ways. Another blog on that to come, but in the meantime here is the link to the companies web page Richway BioMat Professional.  I also took Arnica pills daily to help with swelling.

So, to recap week one, I slept a lot, tried to manage pain.  I used both heat and ice to increase comfort.  I was able to sleep in bed with lots of pillows.  My recliners were a definite bonus during the day.  Learning how to move without going over 100 degrees was one of my major challenges along with learning how to move with crutches/walker.  Sorry no pics... unless the hubbi took a Mommy passed out on pain pills picture that I don't know about.

Saturday, November 15, 2014

Left Hip Before and After

Here's a preview of my left hip before and after PAO.  The after picture is not the best as my husband took a picture of this image from the hospital computer on his phone. In the before picture you can see the my left hip is more jagged around the joint as well as the femoral head does not sit tightly in the hip socket leaving it more exposed.

This is the after picture.  The hip socket looks much cleaner after he fixed the labral tear and the hip socket also covers the femoral head providing a tighter fit.  As for the bone that looks broken, not sure but plan to ask the Dr. about that during my follow up.

The Hospital Stay

To start, I would like to say that I had a really great surgeon.  He had to do some unique moves to fix my labral tear and then the PAO. However, the hospital stay was horrendous. Perhaps it was a case of unfortunate events, but I will start with the epidural.

For most PAO surgeries, the surgeon uses an epidural along with pain medication to help manage pain. Unfortunately for me, my epidural decided to numb the wrong leg.  This caused much back and forth with the pain management team because they had to put me on higher doses of oral pain medicine sooner than the normal.  The on call anesthesiologist also had to come up later that night to check on my epidural as the numbness started rising past my lower rib cage on the right side.   Looking back, that should have been a sign for them to just remove the epidural, but I kept it in hoping that it would somehow start numbing my left leg.  Hope and reality are two different thing and the reality was that it never did start working on my left leg.  This fact became obvious once the epidural was removed and my pain medication did not have to be raised.

The epidural also delayed my PT.  Because my right leg was overly numb, I was unable to stand on it to learn how to walk putting me behind by a day.

Having stayed in the hospital for roughly 3 days, I went through 6 different nurses half of which were great.  My biggest frustration while in the hospital was pain management. I had some really great nurses that were on the ball with my pain medication, but the other half of nurses were not.  By Friday, I had lost trust that the nurses would give me my pain medication on time after having my pain go from a 3 to an 8 twice due to late medication.

Actually, the best care that I had was from a student nurse that was so grateful that I let her take care of me.  Are you kidding me?  It was  my lucky day letting her take care of me.  She was on time, made sure I had what I needed, and was more than happy to move me around in my bed since moving was so painful.  Best of all, during her 12 hour shift, I had no fluctuations in pain.  I stayed right around a 3. That student nurse rocked!

Other small things happened during my stay that frustrated me. I noticed that my bladder bag was about to bust.  It took the day nurse 25 minutes to arrive after pressing the nurse "help me" button. Of course she was then floored saying she's never never seen a bladder bag that full.  By that point I was done with the less than stellar nursing care and had to bite my tongue.  There were a few other issues that I had that took over 7 hours to get resolved which left me in immense pain.

I will admit that I was a needy patient. My pelvic bone was just broken in 3 different sections, my pain was not controlled, I was unable to walk or get out of bed, I needed ice about every 2 hours to keep swelling and inflammation down.  I was essentially an adult newborn.  I ended up having to set a timer on my phone to go off every 3 hours to remind me to remind the nurses it was time for my pain medication.

However, had my pain been better controlled by timely medication, my stay would have been awesome.  A patient in pain is a miserable patient, especially when the pain can be controlled easily by receiving medication on time.  Saturday was my discharge day and I couldn't wait to leave even with a three and a half hour car ride looming over us. I have since received the hospital survey which I will fill out.

At the end of the day, people choose surgeons based off of their skill. The hospital that they practice at is part of the deal.  I would still rather have a top notch surgeon fixing my hip with a less than stellar stay than a less skilled surgeon fixing my hip with top notch service.  The long term goal is a fixed hip that allows me to live an active lifestyle.   This is me on Friday... not much of a difference minus the eye patch missing.

Post PAO Recovery Eye Lash Dilemma

I've had a few surgeries in my life and through all of them have also recovered very well with the exception of this one.  This was also the first surgery that I actually remember being put to sleep in the OR.  Perhaps that was a sign?  Anyhow, as the nurses are standing over me while in recovery reminding me of who I am and where I am at, I naturally try to open my eyes.  My right eye opens without a hitch, but immediately I knew there was something wrong with my left eye.  It felt as if I had an eyelash stuck under the top lid.  Of course the nurses are patient with me for a little bit while checking and flushing my eye. I am however getting pissed off because I want to check my own eye by myself. I  know how blond my eyelashes are and in my state I was convinced the nurses were missing the very blond eye lash.  So, of course, I start crying.  I want to see out of my left eye and I can't, the nurses can't find the missing eye lash, and I can't look for myself so crying seemed like the next best choice.  This did not make the recovery nurses happy.  I wasn't happy either so I figured that made us even.  The nurses however had the last laugh... below picture explains it all.
A few more doctors came by and put in an order for an ophthalmologist to check in on me to ensure there was no scratch. Later that night, the nicest ophthalmologist came by to see me.  He put some special numbing drops in my eye that took the blinking pain away and from initial glance he was not able to detect a scratch.  He surmised that in some people who have especially long surgeries, the top layer of the eye can become dry causing the eye lash or sandpaper feeling while blinking.  He then put  some salve like stuff in my eye before properly patching it up and said he would check on me in the morning.

Thankfully, next day by mid morning I was able to blink pain free and took the eye patch off.  The ophthalmologist, true to his word, swung by the next day to see me.  It's the little things that people say or do while you are in the hospital that make the stay that much better.  He was definitely one of those people that made my stay less stressful.

Wednesday, November 5, 2014

PAO Day!

This post will be quick and to the point as blogging fron the phone is difficult.  The drive down last night was quite amazing. Thankfully the Lord blessed me with a calm heart. However my mind was still racing; the fear of missing ships movement ie surgery time. Very glad I uploaded all my meditation CD to my IPOD as I listened to them all night. Best part of my night was skyping with my precious kids. They are all so strong and amazing for such young kids. Dinner with my husband was excellent. Any date night, regardless of circumstances, is special.  I am now here in my cattle bin (pre surgery waiting area) at Duke. My husband was given one of those buzzing devices signaling he is allowed back.

Thank you to everyone has been there and prayed for me. I feel amazingly calm and at peace this morning.  Ready to get this faulty bridge shored back up!  I see forsee spits in the park with my boys.

Monday, November 3, 2014

The 36 Hour Countdown

It's 10:15 PM and the 36 hour countdown has started.  I know I should be in bed sleeping, but as I watch these beautiful sleeping angels of mine, I can't seem to tear myself away.  These last 2 weeks has been long and trying.  First, to come down with my first cold in over a year that turned into a sinus infection definitely blew my mind. I've had minor aliments here and there; mostly allergies. But something to render myself sick enough requiring an antibiotic definitely jacked up my anxiety a few notches. I didn't envision spending my last 2 weeks holed up in my house (a) recover and (b) hiding away from human population to avoid any further germs.  I wanted to spend my time playing with my kids and seeing family and friends prior to my upcoming mandatory downtime.  Life beats to it's own drum and I am merely a follower of it. This I am learning the hard way. Some brick walls are meant to be knocked down; others will knock you down if you don't slow down.

The last needed item for my surgery was delivered today; a wheelchair with off roading wheels.  My Mobileg crutches are set and adjusted and my walker is put together. We only have a minor problem in that the walker doesn't fit between our couch and fireplace.  Like I said, minor problem that can be addressed when I am stuck screaming HELP at the top of my lungs.  I am sure the couch will be moved to accommodate the walker then. Or perhaps it can be a game with the kids- who's turn is it to lift Mommy's walker up and run with it.....

As these last few hours tick by, I have the same itch as I had with all my previous military moves. This is the limbo stage where nothing really happens because you are between point A and point B. You're not quite here nor are you quite there. All the necessary stuff that had to get done before surgery is complete, now it's down to the last minute items and nice to haves.

So, with that being said, one last glance at my precious sweet peas and off to relax with one of my favorite meditations CD's I go... tomorrow will fly by and before I realize it, it will be Wednesday morning and me patiently waiting for the anthologist to give me the happy drug in preop.

Pre-Surgery Nesting

I have accepted in my current state that my house is a disaster.  My steps have to be used for important stuff like walking through the gym giving everyone who can work out the stink eye-- listening to size 0 Mom complain about the imaginary fat on her cankle.

No really, who would have thought that this thing called "Pre-Surgery Nesting" could or would occur to me.  Well, Mother Nature is cruel...  Instead I have a desire to move all the furniture away from my walls and vacuum every nook and cranny in my house, dump all the drawers out and reorganize them, make my kids try on all their clothes and get rid of ones too small, organize my pantry by content and size, open the windows and chunk junk through them--- you get the point. Is it really necessary to go through the attic and reorganize it before surgery?

These are the rapid thoughts running through my mind because clearly when I come home from surgery my brain is going to be sharp as a tact on copious amounts of pain medicine. The likelihood is, I'm not going to give 2 dead flies about the state of the house.  The only thing I am going to care about is the amount of hours between medication and getting into my newly scored rocker/recliner that was 25% off.

To amuse me though, the 4 men in my life dutifully followed my barking orders all day Sunday.  I was like a badly programmed robot with a twitch about to short out. Laundry baskets were flying, kids trying to wash each other, contents of drawers were being dumped straight into trash bags, one kid skate mopping across the floor, and the vaccum was turned into a sibling attacking lite saber.  By the time all was said and done, we were like hungry wolves ready to attack each other.

Therefore, if you have a kids, let me give you a heads  up.  Pre-surgery nesting with kids can be a lot of fun.  On the flip side, nothing really gets done to your standards.  It's not the whimsical pre-labor nesting that makes you feel at peace prior to the birth of some amazing tiny little human being. Instead, pre-surgery nesting may turn you into Cruella De Villa with little kids snickering behind your back that Mommy has lost it.

What I have learned from the aftermath of pre-surgery nesting; make sure the kids have enough clean clothes while you are gone, food in the fridge, and any important paperwork needed to cover your them is complete. As for the rest, grab a large bottle of wine and consume it until the "nesting" phase "phases" away because in the course of a few hours your house won't look like anything was done anyway.

Friday, October 31, 2014

Hip Dysplasia Awareness Gear

I have been actively trying to blog my experience to educate others about hip dysplasia. People that have finally received the diagnosis of hip dysplasia often have endured pain for well over a decade. Symptoms of dysplasia evade many medical professionals in the community to include hip orthopedics. Those of us with this diagnosis have very similar symptoms and pain patters.  It mystifies me how this diagnosis can go undetected in so many of us for so long. 

I have meet some amazing ladies on the Facebook PAO board.  Each person has their own unique story and trials.  Amongst this very inspirational group are a few that have decided to use their talent to help increase Hip Dysplasia Awareness.  Below are the links to their page.  A percentage of their profits goes towards hip dysplasia research. 

PAO Tough - PAO Chick Handmade Jewlery on etsy

Hip Dysplasia Bracelets on Brava

Why the PAO Surgery is Necessary

I am not going to rehash my story here... I have about 40 blog postings that already do that.  What I do want to focus on is why this surgery is necessary.  After diagnosis, I was connected with a highly knowledgeable hip PT specialist.  What this guy is able to do with hips is hands down genius. Even better, he takes the time to verbally explain and visually show you how this situation is structural.

In hip dysplasia, the femoral head does not sit in the hip socket correctly. This prevents certain neurotransmitters in the brain from firing because our femoral head connection to hip socket is not flush. Instead, of the glutes muscles firing to hold our hips in place, other muscles in our body fire to compensate. This is why the majority of people with hip pain also experience muscle pain in different locations of their body.

The day this concept really hit home for me was when my PT placed a band in the crease of my upper thigh and torso area.  He then pulled on this band from the back and had me do a squat.  After about my 4th squat, the light bulb went off, I actually felt that squat in my glutes instead of my quads.  He also did other moves through manual therapy that reinforced all the muscle problems I am now having is truly because of my dysplastic hips.

Having dysplastic hips is similar to driving your car across a poorly designed bridge.  One day that bridge is just going to give out from the poor design and wear and tear.  Dysplastic hips are essentially the same concept. One day, they are going to give out from repeated stress.

You can try and train your muscles to force fire, but at some point, the joint itself is going to wear down and osteoarthritis may set in.  Likewise, tired muscles become angry and create trigger points. These trigger points can cause a slew of problems; pain, atrophy, additional weakness, etc. This is why the PAO surgery is recommended for people that have hip dysplasia. It structurally sets the hips in the right position, as close as possible, preventing any further damage to the joint and structurally aligning our body thus relieving those overworked muscles.  Once the bone grafts back together, pain subsides by correct alignment and muscle firing.

Tuesday, October 28, 2014

Pre-PAO Surgery Mind Games

I really do love my mind, on most days that is.  I consider myself to be a pretty happy, systematic, drive person.  Naturally, when it comes to such a big surgery as this, I want to execute it as streamlined as possible. Let me say here and now, last laugh on me.  Remember, God is in control and all my perfect plans are really his plans?  Sometimes I forget that and he ever so gently reminds me.  I have to step aside and trust him.  Each day that passes, I become more and more humbles as I learn this.

Therefore, I think it's natural for anyone to second guess a surgery as big as this.  As I draw closer to my surgery date, my mind definitely started playing tricks on me.  The first trick, that I am normal. My mind decides to reason with my brain that my drastically alternated life is really normal.  That excessive sitting is the new in, modifying your every move has become cool and that my bones are really normal.  I don't need this.... I can get better without surgery, I can do this, I can outsmart my body...

About 3 weeks from my surgery date I start to do some serious 2nd guessing.  This isn't a simple put down, cut, tweak and out procedure.  There will be some major muscle de/reattachment, nerve protection, bone cutting going on.  Caveman like tools will be used by my surgeon to make these cuts into my skin and bone.  Any surgery that needs an epidural in addition to anesthesia has to rate pretty high on the major surgery list; especially when during your Pre-OP you get the tone inflection PAO surgery 10 octect raise from the nurse. I am not an idiot... I just heard that in your voice. Anyway, a portable x-ray machine will be placed over me so as the surgeon breaks my pelvic bone in 3 sections and takes my hip apart like a bad puzzle he can reassemble it correctly with screws.  That brings a whole new definition to being "screwed".  Don't worry- I will post pre and post PAO pictures and the screw part will make more sense; that is unless you care to watch the video "Explaining PAO Surgery" under helpful links.

Ironically, the day I was seriously thinking that I could rehab without this surgery, my hip gave out. This is after being in PT twice a week with a hip specialist, dry needle twice a week, and trigger point injections once a week to manage my muscles and pain. To put this even in more perspective, I have hit my 50th dry needle visit, used all 98 allowable PT appointments through my insurance, charge Trigger Point Injections to my insurance company like a rich girl going on a shopping spree without batting an eye lash, and have sunk at least 3,000 dollars of my own money in alternative care to not do this.  As I've told every doctor and PT person before, I just moved.  That's the thing with hip dysplasia. There is no rhyme or reason when the pain comes. You can't beat it or outsmart it.. I HAVE TRIED.

Bless my dear friends heart, her name I will leave out, but she knows who she is.  That very day she called right after it happened and immediately could tell something was wrong. So, what do super friends do, they barge in your house unannounced.  Awkward moment, she finds me on the living room floor in tears with a crayola marker in my hand dotting my leg with just underwear and my shirt on. Too bad they weren't superwoman undies... I think I will get some of those. Superwoman got bolted ... I was in such pain that I didn't care.   The marker was pink by the way... have to have some cuteness while in pain.

Now, this is the type of girl that has an answer for everything... You don't mess with her. She is country and smart.. Not that us city folk aren't, but there is something different about country girls. They have a way of setting everything straight. They are doers... Her husband has sworn her off from fixen' her own car, funny part- she could do it.  Yet, she had no answer for this situation.  All's she could do is look beyond the fact that I was sitting in my underwear with a crayola marker in tears and emotionally pick me back up.

Luck was on my side that day as I had Trigger Point Injections with my physiastrist.  I have been very open to his PA doing the injections so that she can learn, as I have plenty of them to practice on. So, that day when I told his nurse no, he has to do the injections he new something was wrong; I am all about training the next generation.

In he walks with 3 large syringes and with tears streaming down my face he starts injecting my leg. That day, my left leg took all 3 syringes.  Normally he has some left for my right and upper neck area.  Well, because of my body weight, he can only give me a certain amount of lidoacane.  I thought about begging for a 4th needle to take home; insurance just in case.  I really do think with all the hours of injections I've had, I could be an honorary member to inject myself.  Diabetics do...

My point with all this is, even with all the PT and personal therapies I invested in I could not out-run this surgery.  I could not make my muscles compensate for dysplastic hips.  So, I write this because one day, another person facing this surgery will feel the exact same way... 2nd guess the surgery when they are feeling good, thinking they have outsmarted it... but it's only a matter of time...

Pre OP Jitters

After coming down with a pretty nasty cold/sinus infection, I made it to my PRE OP day and passed initial screening.  Seven hours of driving for a one hour appointment... EPIC.  What I do have to say is Duke has it together.  I am not normally a germ-a-phone, but I have become ONE OF THOSE before surgery.  Three kids, all in school, cold and flu season and a 3 month waiting list to get this surgery done... I was not looking forward to setting foot into a hospital.  All this technology, can't this be done over skype? Traveling lab techs? I am down with that.  

So back to why Duke has their act together.  From the moment I checked in until I was called back, I only had to wait 5 minutes in the waiting area. From that point on, I was given my own room and all necessary personnel came to me; anesthesiologist, nurse, lab tech. I couldn't have been more thankful that I didn't have to walk all over the hospital passing potentially sick people.  I think it makes sense... more hospital should do this, maybe they do?  

I didn't picture myself being holed up in my house like a prisoner until surgery date.  I kind of envisioned myself going about my normal life until then... but given the circumstances I am willing to self isolate.  Dr Olson doesn't have the best of availability and it would be another 3+ months before I can slide back in.  I would like to be on the end of rehab, not just getting surgery. So, inside and away from people I will stay. Now just to heal stay health until November 5th... 

Sunday, October 26, 2014

Hip Dysplasia and the Pelvic Floor

Right around the time my symptoms of hip dysplasia set in, I also started to have pelvic floor issues. I did not see these events as related, just a series of unfortunate events as I aged.  In September of 2012, I had one really bad UTI. After that initial UTI, the symptoms never fully went away.  I circled between urgent care, my OBGYN, and PCM.  Finally my PCM sent me a to a urology clinic for further testing as my test results continued to come back negative but I still had symptoms.

At the urology clinic, a brilliant PA concluded that my pelvic floor was not working correctly.  This could be attributed to chilbirth.  In my case, my pelvic floor muscles were tightening up to protect the hip joint due to the dysplasia.

A month later, I saw a very compassionate Pelvic Floor Specialist PT.  She explained that the medical community is not aware of Pelvic Floor Dysfunction and many women deal with this pain needlessly for years before seeking treatment.  Of course, this angered me.  How could OBGYN's not be aware of Pelvic Floor issues when the female reproductive system is their specialty?  I know for a fact I am not the other female to deal with this and I wouldn't doubt that they see routine patients in their office for the very same thing on a monthly basis. 

Because of this, I wanted to share my experience to educate others. To drive my point further home, this article in Science Daily states that 1 in 3 women suffer from some kind of pelvic floor issue  Further information regarding Pelvic Floor Dysfunction can be read 

Thursday, October 9, 2014

Become YOUR OWN Health Advocate

Let me save just a sliver of your sanity now.  BECOME YOUR OWN HEALTH ADVOCATE. The medical community truly does want to help you. However, they are bound to practice within the guidelines of the insurance company.  Below are some suggestions to better help you become your own "Health Advocate".


Understand your insurance.  I can't emphasize how important that is.  Doctors treat based off of potential diagnosis defined by the insurance company.  Understand how your insurance reimburses for medical supplies in advance or purchasing.  Familiarize yourself with their website.  Know what your co-pays are, learn who's in network and who's not, and what your maximum yearly medical expense is.


Ensure your doctor(s) document all your symptoms. Once a diagnosis is found, that documentation may be needed to prove the need for treatment.  Likewise, circle back and ask for the doctors notes.  I found that there was additional information that the doctors wrote in my notes that wasn't presented to me at my appointment.  Make copies, bring X-Ray's, MRI's, reports, and notes with to appointments.  This will save you and your insurance company money by not having redundant testing or imaging done. And, if your journey is like the rest of ours, you will more than likely see more doctors than what you can remember.  It's far easier to collect the data along the way vice trying to backtrack.


Create one main timeline of your illness and or injury and add to it outlining all previous testing, diagnosis, current symptoms, courses of treatment, etc.  This will help prevent you from forgetting pertinent information assisting your doctor to determine next course of treatment.


EDUCATE, EDUCATE, EDUCATE yourself.  As potential diagnosis were suggested, I researched them and writing down any questions I had.  Don't be afraid to ask questions or be respectfully aggressive when trying to understand a diagnosis. You would be amazed at what you can come to understand when determined. 

My hip dysplasia evaded went un-diagnosed for 18 months at the onset of symptoms.  As we worked our way through various specialist, my husband suggested that we create an exclusion list of what I don't have.  This helped me to stay positive as some pretty serious testing came back negative.  

Likewise, once you have a diagnosis and settle on a course of treatment, don't be afraid to connect with other through professional forums, FB Boards, or other venues. People are more than willing to share their experience with previous doctors; the good, the bad, and the ugly.  By conversing with previous patients, I was able to educate myself on the pro's and con's of each surgeon, what to expect at my first appointment, and the hospital environment.  As nice as it is to get a referral from your main doctor, the wait would have been longer.  Instead, I was able to communicate with over 1,000 people over the weekend and had my surgeon picked out 4 days later.

Most important of all, keep trying even if there seems to be no hope.....

“Most of the important things in the world have been accomplished by people who have kept on trying when there seemed to be no hope at all.”—Dale Carnegie