Monday, May 25, 2009

Ten Weeks Post-Op -- Walking Again

So now, ten weeks after my surgery, I am back in NYC and walking without crutches, two big steps towards getting back to "normal!"

Last Wednesday I packed up my things and moved from my parents' house in Connecticut back to my apartment in the city. On Thursday and Friday I worked in the office for the first time in over two months.

Thursday I used one crutch for pretty much any walking I did around the office, as well as to and from the office. I took a cab to work in the morning but I took the subway on the way home. On Friday I only used the crutch for getting to and from the office; all day long I walked around in the office without crutches. And on Saturday I went crutch-free all day!

At first I was not very steady walking without the crutch. I don't mean that my balance was off, I mean that my gait was strange and halting. It was as if I'd forgotten how to walk normally. I was overly conscious of my posture and my stride, and I had a sort of limp. I was not in pain -- my hip would get tired and uncomfortable, but it did not hurt in the way it did before the surgery. Mostly it was difficult to get my leg to move properly for the walking stride.

Interestingly, climbing stairs was one of the first things I was able to do "normally". Even a few weeks ago when I still used crutches for everything else, I could climb (not descend) stairs fluidly and without pain or discomfort of any kind. I wonder if this is because stepping up with the operated leg doesn't put the same kind of pressure on the joint as taking a step on flat ground -- and the stair-climbing muscles (hamstring and buttock) were already getting back in shape from my exercise bike riding.

As for the occasional discomfort I've felt these past few days as I have been weaning off crutches, it is the muscles -- not just near my right hip, but throughout both my legs -- that are hurting most as they build back up. Physical therapist Jaime told me to expect this.

Today, for example, my right soleus muscle is quite sore. That makes sense since that muscle is critical for walking and standing, two things which I have not done with that leg in a while. If I am going to be really whiny, my entire right leg is pretty sore, but the soleus is the worst.

I should also mention that as I'm relearning to walk, my right knee is almost as jerky and confused as my right hip. I suppose it is because the right knee fell into just as much disuse as my right hip while I was on crutches and so all it's surrounding muscles need to shape up too. Now when I get up from sitting for a while, my knee is often stiffer than my hip! I can walk it off in a few steps, and it is not painful.

Unsurprisingly, I am exhausted by what used to be standard NYC walking. On Saturday I walked to the Seaport from my apartment (about a half mile each way) and felt like I'd walked a 10K. It gives me a new appreciation for what good walking shape I must have been in before!

My left leg has been quiet through all of this increased activity. I am just waiting for it to start hurting (but hoping it doesn't). Dr. Millis said I can get the left hip done in as soon as a month's time, but I am not anxious to leap back onto the gurney just yet. I'm hoping my left hip can behave itself until October, so I can do all the fun summer activities on my calendar without having to coordinate my outfit with a pair of crutches.

Finally, I should note that the numb spot on the outer thigh of my operated leg is almost entirely gone now. It still feels a little bit strange when I rub it, but much improved from immediately post-surgery. For the most part it is almost back to normal sensation.

Tuesday, May 19, 2009

Nine Weeks Post-Op -- Lose the Crutches!

Hallelujah! I am now officially allowed to wean myself off the crutches!

Today I went up to see Dr. Millis for my two-month post-op visit (although it really was 9 weeks post-op). He took another x-ray (I'll post it as soon as I get the image from the hospital) and I met with Jaime, the physical therapist, again.

I'm sad to say that it is hard for me to see any difference between today's x-ray and my last x-ray, or even the x-ray taken 5 days post-surgery. But the doctor was very pleased with all the new fuzzy white stuff I have apparently added in the last month, and he said that according to the x-ray there was no skeletal reason I couldn't walk right away.

Dr. Millis had me "try" walking without crutches, and both he and Jaime were impressed that I was walking so well my "first time" without crutches. I didn't tell them I'd already been using one crutch a little bit and even doing some minor walking. Hey, they didn't ask, OK? I would have told them if they'd asked.

Even though I've now gotten permission to walk, I can't just toss the crutches aside like a Christmas miracle; my hip and leg muscles, after two months of general atrophy, need a little time to get up off the couch, dust the Doritos crumbs off their bellies, and get in shape. I am allowed to walk as much as is comfortable, but Dr. Millis and Jaime warned that I should always have a crutch with me for when (not "if") my hip gets tired or sore.

Weaning off the crutches means sometimes I'll be walking, sometimes I'll be on one crutch, and sometimes I may even need to go back to two crutches for a day or so, depending on what my hip feels like. But as my joint strengthens I should find myself needing support less and less.

Jaime tested the range of motion in my right (operated) hip, as well as my current ability to use various muscles around the joint to lift my knee up, abduct my leg, and bring my leg out behind me. She also had me stand on my right (operated) leg and lift my left leg off the floor, which felt unstable and a bit scary. But apparently having 100% of my body weight on my right hip is not a problem at this point -- everything is healed enough that I'm not going to damage anything. What I really need to avoid is impact. Standing with 100% of weight on operated leg = OK; jumping up and down on operated leg = not OK.

Jaime then had me stand on my right (operated) leg, with a hand on the table for balance, and do all the same movements with my left leg: lift knee up, abduct the leg, bring leg out behind me. Initially I thought this was to strengthen the muscles around my left hip, but it turned out that having to support my entire body weight on my right leg while bracing myself against the movement of my left leg was the actual point of the exercise. And it was hard. The same muscles that are used for leg abduction are used to support the leg when standing on one foot, so I felt the burn on the outside of my right hip/thigh rather than in the muscles around my left hip. I am to practice these leg movements bilaterally, adding the resistance of a thera-band as my strength increases.

In addition to the leg movement exercises, Jaime also gave me some more stretches (hamstring and hip flexor) to add to the quad stretch I was already doing. She cleared me to begin doing crunches, increase my resistance on the exercise bike and swim laps in the pool (gently). She said I could try the elliptical machine when I felt my balance was good enough. I am not allowed to work with a personal trainer or do Pilates until after she's assessed my progress at my next visit.

So all of this is fantastic news. I have a lot of new movements to work on now, so I finally feel like progress can occur again! I am very excited to get started.

My next visit with Dr. Millis will be at 16 weeks (four months) post-op.

Wednesday, May 13, 2009

Two Months Post-Op

I was supposed to see Dr. Millis yesterday for my two-month visit, but I couldn't because of scheduling conflicts (mine, not his). So I was supposed to know by now whether I could ditch these wretched crutches.

I've unofficially been mixing one-crutch and cane usage (and even some walking) into my days for the past week and a half, even though I'm technically supposed to be on two crutches until I next see the doctor. My hip has been feeling OK with the increased burden: sometimes it feels a bit tired and achy but most of the time it feels just fine. Even when it does hurt after being on it too much, it is not very painful at all. Maybe a 2, at the maximum. Any time I've felt discomfort I've gone back to two crutches until it has subsided.

As I write this I am starting to feel more and more guilty about cheating with the crutches. Erin told me expressly not to cheat and to stay on crutches until I saw the doctor again, and even the physical therapist wouldn't let me increase the resistance on the bike. If I find out next week that there are negative consequences to my cheating, i.e. my x-rays show some setback due to my impatience, I will be really upset with myself.

This is just taking too long, though! Two months is too long to be limited like this, especially in the springtime. It is one thing when I am just sitting at home at my parents' house, but the instant I do anything remotely social or adventurous, I want so desperately to be off the crutches that I cheat (now that I can). For that reason it is good that I have kept myself up here in Connecticut and not returned to the city. I knew the sequestration would protect me from temptation.

Another cause of my impatience with crutches is shame. I've felt a bit ashamed about this whole diagnosis since the beginning. It is not like I had some glorious sports injury; I was born defective with a deformity commonly associated with DOGS. That alone is cringe-worthy, but in addition I am not a person who likes to be seen as weak, helpless, pitiable or needy. I don't like attracting attention such that people feel sorry for me. I don't like having to ask for help. And so I absolutely hate being in this condition. Another reason for hiding up in Connecticut is so people don't see me in this pathetic state.

The closer I get to walking, the more impatient I am get rid of these symbols of weakness and deficiency. And sometimes that impatience overrules the cautious part of my brain that says I should follow my doctors' orders.

None of this is offered as an excuse for my cheating, just as an explanation. I have a week to go until I find out how everything looks on the inside. You know what would be the most karmically appropriate result? If my imprudence has set back my healing and so I have to stay on crutches for another month. That would be just what I deserve, wouldn't it.

Wednesday, May 6, 2009

Seven (and a Half) Weeks Post-Op

The healing proceeds apace. Pain is negligible, movement is good, abscess is on the mend.

I've been going to the gym several times a week (the goal being every day but sometimes it just gets away from me). I know my physical therapist told me I couldn't do more than resistance level 1 until I see the doctor again May 19, but... machines are different, right? Some go 1-10, but the one at my gym goes 1-20. So I have been squidging my way up on the resistance and am now up to 30 minutes at level 3, with no obvious ill effects. I have also been doing some upper body exercises and ab work.

Last month Erin warned me to stay on two crutches and 1/3 body weight until May 19, but it is hard to do that when I am feeling so much better and stronger. I have to admit that I sometimes put the crutches down when I am in the kitchen and just taking small steps around carrying a bowl from counter to counter or something. So technically that is the verboten full weight sans crutches. I know I shouldn't but it is so tempting, and there's no pain to tell me "no."

It turns out Erin was right about the abscess: it has been clearing up. It is still scabby but I don't wear a Band-Aid anymore. The rest of the scar is pretty much the same as it was -- like someone drew a line on me with a mauve-colored marker.

I am pleased with my range of motion, and I can feel that the muscles around my hip are getting stronger. I can lift my leg onto the couch now, or into the car, without using my hand under the knee to help it up. One thing I still can't do is put my socks on right (operated) foot, or tie my shoelaces on that foot. The angle when I bend over the right hip is too acute. I can do the left, but not the right.

Not really much else to report this week. I guess this is the long boring part of recovery.