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.