Eleven Hours of Tennis

Every part of my body hurts -- except for my hips! This past weekend I went to tennis camp in the Catskills. Ideally, you play 11 hours of tennis over the course of the two-day program, but going into it I wasn't sure how much I would be able to do.

Prior to my screw removal, I was up to playing tennis three times per week, and I'd played two consecutive days in a row, but every time I'd played it had only been for an hour or two total. Tennis camp was a whole new level of intensity.

And it was fantastic. I played every minute of the eleven hours, not holding myself back in any way, and my hips did not hurt for one second. Not the bones, not the small muscles inside, not the incision. My hips felt like there had never been anything wrong with them.

The rest of my body is another story. I am pretty sore! But it is a good feeling of having worked hard and pushed myself, and my tennis definitely got a big boost from all the instruction and practice, so it is all worth it.

New York City tennis season has officially started now that Central Park is open, and I am ready for a great summer of tennis with my new, sensational hips. Thank you Dr. Millis!

Screw Removal

I am now officially hardware-free! Yesterday I had the six screws from my LPAO removed in an outpatient procedure. It was relatively quick (I think it took an hour in OR) but I got general anaesthesia anyway. There was the option to just be heavily sedated but honestly I did not want to hear and feel the vibrations from the drill, no matter how much happy juice they were giving me at the time.

This time when I came out of general anesthesia I was strangely restless and impatient, like I wanted to get out of there, I was bored, I wanted to read, I wanted to move, want want want, I don't know what I wanted but it was everything and nothing. Strange. But better than shaking and freezing like last time.

I came to with several layers of bandages over the incision, and not a lot of pain in the incision area: maybe a 3 on the pain scale, which lowered to a 2 once they gave me some more morphine.

They discharged me relatively quickly; I was only in the PACU for about an hour and then we got on the road on our way home. During the three-and-a-half hour drive home from Boston I was relatively pain-free, but I was very nauseous the whole way and did get sick once on the side of the road. I hadn't even been nauseous after either of my other procedures, so I think this was more the result of a long car drive on top of the general anesthesia and morphine.

Today the incision site is quite painful; more painful than I expected it to be. I'm taking the oxycodone as often and as much as I'm allowed to and it doesn't seem to be making a dent.

Dr. Millis told me I shouldn't play tennis or really do any activity for two weeks after the screw removal, and I'd kind of hoped that was a conservative estimate and I could be back to at least walking to work and working out, if not tennis, by mid-week this week. But at the rate my incision hurts now, there is no way that is going to happen.

That is depressing, because tennis season starts on Thursday, and I've been playing more and more tennis recently to get ready for it. In the last couple of weeks it has been up to three times a week and my hips have been feeling great. So taking two weeks off now is a big setback.

But I suppose I shouldn't complain -- I'm lucky to be on the courts again so soon anyway, and at least now I am 100% done with all my surgeries. One year and five months after my initial diagnosis, both PAOs are done, all the hardware is out, and I know I'm going to be feeling better than I have in years as soon as this incision heals. And that is a good feeling.

Progress Report

Officially five weeks post-LPAO now, and there is more good news to report.

I have been to the gym three times since I got the green light to start last Tuesday. Getting on that bike and moving my blood around feels so good after a month of basically being sedentary. I have fewer restrictions on my movement than I did at this point last time, plus I got started going to the gym the day after I got permission from the doctors, so the mood-enhancing effects have already begun.

At the gym I have been riding the stationary bike for 30 minutes on the "random" setting, with a highest resistance of about 6-8 (out of 25 available on the bike). It may not sound like much but after my RPAO I had to start at zero resistance for 10 minutes, and work up from there. Plus, my cardiovascular endurance totally disappeared during my month of the Couch Workout, so 30 minutes at level 6 has me breathing hard enough already! But I'm looking forward to improving on that front as well.

I've also done some upper body work at the gym (although with all the crutching, I don't think I've lost that much strength) -- lat pulldowns, rows, chest presses, etc., but I've been pretty lackadaisical about it so far; must step it up a bit.

Interestingly, I just realized that I -- completely coincidentally, without having gone back to check my post-RPAO entries -- quit my pain meds at exactly the same time post-LPAO *to the day*. Amazing! So yes, I quit my pain meds today, exactly the same way I did at the five-month mark last time: I woke up with very little pain, and figured, hey, why not give it a shot?

One of the reasons I decided to go off the pain meds now was that I wanted to feel pain as the warning sign it is. Now that I am putting more weight on the left leg, and using one crutch at times, I don't want to push things too fast simply because I've numbed the pain and don't know that I am putting too much strain on the joint. But so far, so good. What pain there has been is minimal and tolerable and subsides if I give my hip a rest for a while.

So now I am pharma-free, except for aspirin (allowed to quit next week), fiber, and calcium. I sleep well on both sides. My incisions look great. My only niggling problem is that tight spot on my spine where the epidural was, although I don't feel it nearly as often now. If it is not gone by next week I'll let the team know.

One Month Post-LPAO

Today was my one month post-op appointment with Dr. Millis and the team. I already had a feeling my left hip was healing faster than my right hip had earlier this year, but my appointment today confirmed this.

I got the standard x-rays before seeing the team: supine AP and false profile. When I went over the films with Erin, she pointed out the areas of bridging -- where the bone had begun knitting to fill the cracks. My bones have done a spectacular amount of knitting in the past month! The cut in the illium was barely visible (except the big gap to fill caused by moving the acetabulum), and the other two cuts were bridging nicely. I'll try to get the films so I can post them. Both Dr. Millis and Erin were impressed.

I reported that I am down to two Percocet a day, one in the morning and one before bed; Valium occasionally as needed. That strange pain (that I thought might be a ligament) is completely gone now. I still take one Atarax at nighttime. I am sleeping much better now, able to sleep comfortably on both sides now, as well as on my back. I still have the strange pulling feeling at my epidural site, so Erin told me to let them know if it got worse or continued much longer.

Erin did my range of motion tests and they were good as well. My hip can bend below 90 degrees towards my chest now and rotation was good. My straight leg raise was high and strong, too, which I think is because I was in good shape going into the surgery. I think if the muscles around your hip are strong going in, it can only help in the recovery.

When it came to movement, I admitted that I'd been putting more weight on the leg this past week. Erin had me walk with one crutch and then a few steps without crutches. One crutch felt OK but without crutches I definitely felt that sinking feeling you get when the leg is not ready to take the weight yet. So I am officially allowed to start using one crutch, but always keep the other around in case I need support or my gait becomes uneven "like a penguin," to quote Erin. Great news, huh?

I am allowed to go to the gym now, with far fewer restrictions than I had post-RPAO. I can do the stationary bicycle at zero resistance to start, as usual, but I can increase duration and resistance faster this time. And I can do any upper body and core exercises I want, provided my hip feels fine when I'm doing them. This is great news because the faster I can start getting back into shape the better; I'd rather not lose as much fitness as I did after the right hip surgery.

It is amazing how much different this recovery has gone compared to my recovery in March. Other women have said that one hip is always worse than the other, but you never know which one will be the bad one. Imagine if this one had been worse than the RPAO! But luckily it is going fantastically so far, and I'm feeling really great. But I doubt I would have appreciated the speed and ease of this recovery as much if I hadn't had such a rough go of it in March.

So good news overall, but there's still a lot of healing to do. I am going to try not to get overexcited about this progress, and continue to take it slow and steady so I can keep knitting away as well as I have been. I return to see Dr. Millis and the team in four weeks (Dec. 29), but I'll update here before then, to report on how the new weight-bearing and gym visits are going.

Two Weeks Post LPAO -- Pain & Itching

Today is two weeks from the date of my LPAO, and I have been home from the hospital for a full week. It has been a bit different than my first week home after my RPAO, which you can read about here and here.

For one thing, my activity level my first week home after this surgery was much higher, and not by choice. After my RPAO, I spent the majority of my first week at home sedentary, reading or sleeping in a couch or bed, moving only when necessary. This past week, I had to work full time the whole week. I was, of course, working remotely from Connecticut, not going into the office. But still, that meant sitting upright in a chair at a desk most of the day, and moving around a lot more than I had done in March. Having to work couldn't be helped, but I do think I could have used a bit more sedentary reclining last week.

My pain has been generally well-managed, except for sometimes sharp pain in two specific places. In March, what pain I had would migrate, popping up in different places every time. This time, the pain is localized in two places: the back of my hip joint (it feels like deep inside where my left buttock meets the top of my thigh, maybe the cut in the ischium?), and above my tailbone, on left side, just above my left buttock.

The former pain has lessened over the course of the week and by now is pretty much resolved. The latter pain is much more common and more severe than the former. That pain above my left buttock is almost constant when I am crutching (each time I take a "step" with my left leg, I feel pain there) and can ache while I am sitting in chairs or lying down, especially if I have just been crutching. I have no idea what it is, it doesn't seem to be located near the surgery site at all. I've got an email in to Dr. Millis asking about it.

My best guess is that there is something going on with the sacrotuberous ligament. That would make sense since one of the hamstring muscles originates from that ligament. Maybe when I step a certain way and activate that muscle, it pulls on the sore ligament? Now why the ligament is sore in the first place is a totally different question. Unless of course it is because that ligament connects the sacrum to the tuberosity of the ischium -- the ischium, of course, being the potential source of my other pain described above and one of the bones cut during a PAO. Gosh, surgeons must love it when patients play doctor using Wikipedia.

Moving on. Unlike on my right side after my RPAO, there is no numb spot on my left thigh after my LPAO. Probably because they didn't have to move the nerves around on the left side.

My incision on the left side is fine. The dressing itches sometimes but not too often. It is not generally tender, although earlier in the week it did feel a bit bruised if I pressed gently on my hip near the top of the incision. We have not changed the dressing on the left side. I imagine it will come off some time this week.

My incision on the right side (where the screws were taken out) does not bother me at all. Obviously it was a much shallower cut than the left side. Its dressing came off on Saturday, but the steri-strips remain.

In the hospital I did have some swelling in the hip area on the left side, and my left foot and lower leg swelled up like the blueberry girl in Willy Wonka for a while. But all that swelling is gone now.

My current pain medication regimen is:

-- 1 Oxycodone every 5 hours during the day
-- 1 Oxycontin twice daily
-- 1 Valium as needed during the day
-- 1 Oxycodone and 1 Valium kept at bedside if needed for pain during the night

It is more pain medication than some other PAO women have taken at this point in their healing, but as I wrote a few days ago, I am not being a sissy; I just seem to need more pain medication than most. I am not worried; I will step it down when I am ready, just as I did in March after my RPAO. But currently, especially with that frequent upper buttock pain, I need pain relief.

As I explained in March, the Oxy painkillers do not make me feel mentally foggy in the slightest. Only the Valium makes me a bit scatterbrained and sleepy, so I never take it when I am working, or trying to concentrate on something important like Gossip Girl.

My horrible skin rash has subsided. Probably primarily because I am not laying in those hospital sheets anymore. Earlier in the week I was applying the prescription steroid rash cream twice daily, but since the rash seems to have been vanquished, I've essentially stopped with them now.

Alas, when one itch dies, another is born. Again I am plagued with the itchy-red-spots problem I had in March, probably a side-effect of the pain medications. I am taking Atarax (thrice daily) to combat the itch, and I also try not to scratch. I carry around Sarna lotion and put that on every time I have an urge to scratch. Needless to say, I am very moisturized. It seems to be working because I feel like I have a few fewer itchy red spots than I did mid-week.

I still take aspirin, but I never wear my TED stockings. No one told me I had to. I wore them on the car ride home from the hospital but that was it.

Recovery Day 2 -- Awakened by Pain and PT

After a calmer-than-usual night of sleep, I was awakened by Dr. LaRue at about 5:30, as he stopped by during his rounds. He took the drain out of my wound. The entire hip/flank area on my left side is hugely swollen and is making me feel enormously fat and distended. I don't recall my corresponding flank being so swollen in March. It almost made me wonder if the drain should stay in a bit longer -- isn't there so much more fluid in there to drain out? But I guess Doctor knows best.

My pain was still at zero this morning, which is even more impressive considering my epidural is set at 8.5 mL/hr this time as opposed to the 12 mL/hr it was at for my right hip in March. So everything is still coming up roses after this second PAO.

With my pain so controlled and my arms so strong, my nurse and I took advantage of the opportunity to give me another sponge bath and change my sheets again. Wow, the hygiene! I will say, though, despite all the prophylactic sheet changing we are doing, my back and flanks are still hot and sticky and pressed into damp sweaty sheets a lot of the time, so I worry that the heat rash may make a reappearance.

Dr. Millis stopped by to remove part of my dressing as well -- the thick ace bandage wrapped around my entire midsection and left thigh. Once he cut that thing off I felt fantastically better. The bandage had been the source of a lot of itching and discomfort so far, and removing it made me far more comfortable. I still had the two bandages over the incisions on either side, but at least the thick itchy girdle covering it all was gone.

After all that activity, I was exhausted, and so I napped from 10 to 12:30, turning away PT's attempts to rouse me into activity in the late morning. I already find PT's in-bed exercises a bit silly, and I am certainly getting tired of the way everyone in the hospital seems to think it is OK to rouse me from my most peaceful slumber for whatever little test (or intern lecture) they have in mind. I thought I read somewhere that adequate sleep (and hydration) were the absolute best medicine?

When I awoke from my healing sleep, I had another headache. (So much for "absolute best medicine, I guess.) I don't usually get headaches, and I don't remember getting any during my hospital stay in March, but this time around I've been having low grade headaches for a lot of the time. Tylenol has only helped about 50% of the time.

I also had another new pain when I woke up from my nap -- my left hip. The hip pain that had been held a zero this entire time had suddenly broken through, and now my left hip ached at about a three or a four -- enough to cause discomfort while lying still, and to cause me to avoid moving the hip if possible.

Nonetheless, I (grudgingly) went through the in-bed exercises with PT when they came back in the afternoon, and I had to postpone my pity party even longer by spending the rest of the day logged on to work (!) taking care of various crises that had popped up in the office since Monday. I was supposed to be able to take time off from work for this surgery, but unfortunately the schedules in my current cases, and the intricacy of my involvement in them, has made my complete absence from work impossible. I can't say that stressing over the projects (and our firm's shoddy remote intranet connection) is helping my healing, but there is not much that can be done about it, so I'm doing what I can, given the circumstances.

Dr. Millis stopped by in the evening to see how I was doing. I told him about today's hip pain and my in-bed PT, he checked my incisions and sensation. He thought all was progressing just fine, but just as a bonus he ordered me to be transfused with a pint of the blood I'd donated autologously pre-surgery.

Five Months Post-Op

At this point, my right (operated) hip is functioning at 100% for all walking-related activities. I no longer have any of the pain I described in my previous entry: no more twinges, no more aches, no more stripes down my thigh.

I can walk for long distances and durations without my right hip causing me to limit myself. Of course, I still get tired and footsore, but that is in a more general sense; I would have gotten tired anyway at some point!

I have now been seeing a trainer for about a month. My first training session was quite light and yet the soreness afterwards was wretched, mostly in my quads. I honestly had trouble walking and supporting myself with my quads for the first few days after the session, and I was in quite a bit of muscular pain. I suppose it was something I was just going to have to go through on the way to getting my quads back in gear, but I have to admit I wasn't aware that my quads were *that* weak!

Since that first session, my trainer has been stepping up the workouts in intensity and pace as my strength and endurance increase. I'd say my fitness is about 75% of what it was last year at this time, when I was playing tennis 5x per week and seeing a trainer regularly. I have some work to do, but obviously it feels good to be back on the path to fitness again.

For the time being, my trainer is being very careful with my (weak) hip flexors and with any impact exercises. So far my hip has not hurt during or after any of the training sessions. During one session my right hip flexor was definitely exhausted, but the joint itself did not hurt and the hip flexor in question was not even sore the following day.

On my own I am working on cardio on the exercise bike and to a lesser extent, introducing the elliptical machine. I am up to 45 minutes at about level 7 or 8 (out of 20) so that is still not hugely impressive on a cardiovascular level.

I am still not swimming. I know it is good for me but I just hate it and so I am still resisting it by making all sorts of excuses.

My numb spot still comes and goes but I never even notice it unless I am purposely paying attention to it.

My scar hasn't really made a ton of progress since the last time I posted a picture, and it still itches sometimes at the top, where that abscess was for a while, although the abscess has closed up and the scar is totally "healed" at this point. But scars do tend to keep that mauve look on me for a long time before they whiten up, so it is not surprising to me that it is essentially unchanged. And it doesn't matter anyway since Dr. Millis is just going to open it back up again in November to take the screws out on that side.

Speaking of November, my left hip (which is scheduled for surgery in three months, on November 2) still hasn't made a single peep of pain all summer.

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.

Six Weeks Post-Op

Springtime has come to Connecticut, so at least now some of my sitting can be done outside in the sunshine, enjoying the slow colorful explosion of my mother's garden.

A week ago I discontinued painkillers entirely; since then pain has been minimal. A few times I have "overdone it," I suppose, but the pain has been manageable with just a few Tylenol rather than the hard stuff.

I still have not exactly mastered the 1/3 weight bearing, so I am contenting myself with an average of 1/3 weight bearing. Sometimes I step too hard, sometimes I don't step enough; so be it. At this point I don't think I'm going to come crashing down in a heap of shattered bones and bent screws if I happen to step on my leg with full weight.

By now I have been to the gym a few times to ride the exercise bike and do some upper body exercises, which has helped my mood considerably. It feels good to get some blood flowing, even if it is only for thirty minutes at zero resistance. That's right, I am up to thirty minutes on the bike. I asked my physical therapist if I can add resistance or some other leg exercises now, but she said I had to wait until I saw the doctor again before I could be cleared for any increases. So that means I am stuck at this level for three more weeks. ::Sigh::

This week I finally removed the shower chair from my shower. I probably could have removed it last week as I hadn't sat on it in a while.

My incision is still plagued by an open wound at the top. Erin (on Dr. Millis' team) said it is called a "suture abcess" and that I should just keep it covered by a Band-Aid until it goes away. Erin didn't seem worried but I can't say I am very pleased about having an open wound for weeks on end.

Last week's malaise hasn't entirely dissipated, but the lovely spring weather and the gym visits have certainly helped. And as always, I have plenty to do.

Work has been very busy these past couple of weeks, in a stressful way more than in a "happy industry" way. I'm very glad to be working from home; I would not be getting nearly as much done if I were in the city struggling to and from the office and trying to handle life alone in my apartment.

The office has kindly let me extend my "work from home" absence past my originally planned return date of May 1. Now I plan to remain in Connecticut with my infinitely helpful and supportive parents until after my next appointment with Dr. Millis, at which I will hopefully be switched down to one crutch or even a cane.

Off The Meds

It has now been five weeks since my surgery.

Today is the first day I have gone without any pain medication at all, and it feels fine so far. I had really been stepping down the dosage slowly prior to that, going by whatever pain level I felt. This morning my hip hardly hurt at all, so I decided to give the day a try without medication.

At this point I can sleep on my right (operated) side for long periods during the night. It feels a bit funny, but it is not painful. I sleep through the night with no problems. I am still clocking about nine or ten hours of sleep every night.

I can move my leg around quite a bit using the muscles near the hip; they are starting to recover nicely. All the exercises I got last week from the physical therapist are going very well; they are almost too easy. Only the hip abduction exercise is still difficult.

I have not been to the gym to do the exercise bike or the weight machines for my upper body -- I'm still trying to work out a membership with the YMCA up here in Connecticut. I really hope to get to the gym soon, as I feel that my sedentary lifestyle is affecting my mood as well as my body.

I am still working on getting my new 1/3 body weight weight-bearing allowance right, but the added weight isn't adding pain in my hip. Even when I've accidentally stepped on it with full weight it has not been painful, just obviously weak.

The numb spot on the side of my thigh is still there. It feels like it might be a little less numb, but it is hard to tell.

My incision has actually regressed and is not looking as good as it was in my last photo. One of the subdermal sutures has poked out at the top of the scar, creating an open wound, so I have to wear a Band-Aid over that part. The rest of the scar looks fine, but it is just redder and more noticeable than it was when I first took the Steri-strips off. I am not sure why. I am allowed to massage the scar with Vitamin E oil now, so maybe that will help.

So basically I am at the point in my recovery where I feel totally healthy, except I am on crutches. It is a very frustrating feeling. Progress was obvious before: less pain, more movement. Now everything just feels stagnant. Before I wasn't frustrated because it was very clear that I was injured and needed to rest and heal. Now it is easy to forget that all I have in those cracks is "fuzzy white stuff" and the bone needs time to heal together into a strong, solid unit again. And so it is easy to fall into the foul mood I have been in for the past three or four days.

I am not bored: I've got plenty to do, especially where work is concerned. But I don't want to do any of it any more. I am tired of this variety of sameness. I move from book to magazine to work task to TV show, I move from bed to armchair to table to couch, but it is all the same. It is all still and slow and seated. And I am really tired of sitting.

Three Weeks Post-Op

It is now three weeks post-op and things have definitely improved. Pain is down (as is pain medication), movement is up, and the incision looks amazing. Next week I go up to Boston for my 1-month-post-op visit and then we'll see how much progress I've made internally as well.

PAIN and its MEDICATION

I have far less pain now than I did a week ago, and I get by on far fewer painkillers per day. This past week I have been taking an Oxycontin twice a day, morning and evening, and filling in with Vicodin three times during the day; yesterday I dropped it down to only two Vicodin during the day. This past week I also stopped taking the Valium all together.

Because of the reduction in medication, I don't have the same skin reactions as I did before, so I have stopped taking the Atarax (although I still use the topical rash cream morning and evening in the relevant areas).

My pain is generally very low. Most of the day I am in little to no pain; towards the afternoon I start to feel an ache and that is when I take the Vicodin. If I am going out to something I usually take a Vicodin beforehand as protection, as Dr. Millis suggested, and then I am able to sit through dinners and events with no problem. I sleep well, not waking up too often, and I don't wake up with too much pain in the mornings.

Overall there has been a huge improvement on the pain front this week. Actually Dr. Millis predicted this would happen. When we spoke a week ago he said that I would probably notice a sudden lifting of pain over the next week or so; a disappearance of the constant aching pain that I'd had since the surgery. And so I did.

MOVEMENT

I have made great strides (sorry) in the movement department as well. With the reduction in pain, and the knowledge that I am not overly numbed with pain medication and am not likely to do anything that will "ruin" the surgery, I feel much less nervous about my right leg in general.

I can bend carefully in more directions and at sharper hip angles without the prior pinching; I can move my right (operated) leg out to the side or in across my other leg a little bit (not talking huge ballet swings here, maybe 20 degrees in each direction?); I can rotate my right foot inwards and outwards when my leg is stretched out before me. I can lift and move my leg more often now (which is still not that often) without using my arms to assist, but I can also tell that many of the muscles around my hip are (not surprisingly) very weak indeed and, once I get the go-ahead, are going to need some rehab work.

One thing I have not noticed with any of my increased movements is popping, grinding, clicking, snapping or any other Rice Krispies sounds or feelings coming from my hip. Perhaps that will come with larger movements, but so far so quiet.

I know that I have put a little more than the allowed weight on the operated leg at times (by accident) in the past week and I haven't had any pain result from those brief occasions. I am still under the hospital-discharge instructions to put no more weight on my operated leg than the weight of the leg itself (i.e. resting my foot on the floor), so that is what I do, but it feels like I am ready to put some more weight on the operated leg.

Honestly, with my pain so low and my movement so improved, sometimes this whole surgery/recovery/crutches thing feels fake. Like I could just throw my crutches aside and walk if I wanted to. I suppose that is a dangerous feeling because it could lead to me acting carelessly with a hip that, while feeling much better, is by no means even close to completely healed.

But it seems my naive pre-surgery superhero feelings have begun to resurface -- the ones that made me think this recovery wouldn't be that bad at all (at least not for *me*) and the ones that are making me think the doctor is going to tell me I can throw away the crutches and walk when I go see him on Tuesday. Thank God my parents never got me a Wonder Woman costume for Halloween as a child; I probably would have jumped off a building expecting to fly.

INCISION

One great reminder that none of this is fake at all is the five-inch scar across my abdomen. All the steri-strips are off and it looks amazing, see for yourself. Dr. Millis must have used skin glue or something because the incision has healed together so smoothly and so quickly. But I can't get too excited about it: he is going to reopen it to get the screws out eventually, and I don't know that it will heal up so nicely the second time around.

MOOD

I am in good spirits most of the time, especially now that the pain and itching have lessened and I've gotten more relaxed about the movement of my hip. I am not bored in the slightest: on the contrary I am relishing the opportunity to read voraciously in various media and keep up with my favorite TV shows and movies. This is the part of me that is hoping that the doctor does *not* tell me to throw away the crutches and walk next week. I'm not done with my pile of books yet!

Nevertheless, the bookworming has slowed down in the last couple of weeks as I'm back to working almost full days now during the week. I feel up to it mentally and so far I think I have been doing as good a job as I would be doing if I were physically in the office. Probably better, since I am comfortable and only have a 13-stair commute.

Venturing Out on the Town

Tuesday's big adventure was going out to dinner at a local restaurant. At the time it was my longest excursion out of the house since I got home from the hospital a week and a half ago.

I was already in a bit more pain than usual before we went, but I thought the pain was more from muscle cramping from sitting in one position all day than from hip ache, so I took a Valium instead of an Oxycodone. Wrong choice. I was irritable, sleepy, uncomfortable in my chair, not very hungry and climbing the pain scale throughout the meal. What a terrible dinner date I was for my poor parents!

When I got home, I got a call from Dr. Millis. He wanted to check up on me at the two-week mark. Obviously he was catching me at a low point pain and mood-wise, but despite how awful I felt during the call, I tried to give him a broader picture of how I have been doing these past weeks and the progresses I have made.

The highlights of what he told me were:

-- if I am to undertake anything adventuresome (ahem, restaurant visit), I should prepare by taking extra pain medication beforehand (in this case one or two Oxycodone instead of one Valium) and not torture myself by going poorly protected, painkiller-wise;

-- he did not seem to be concerned about the amount of pain medication I am still needing (I was concerned because some of my PAO peers seem to reduce and even quit their pain medication so quickly, and I just don't think I can do it that fast, nor do I think I am being wimpy about my pain level);

-- I don't have to worry so much about overdoing the angle or the weight on the operated hip -- it will take more than such small things to do damage to the hip and its healing;

-- any grinding, shifting, popping, or clicking I may have felt are normal the first few weeks (I have felt none of those things.);

-- the dressing can come off any time now, the incision will be healed shut by now;

-- the numb spot will continue to recede.

Today I took the dressing off -- it is still hard to tell what the incision looks like because of the steri-strips. Mostly it looks like a 4.5" long mountain ridge curving down from where the iliac crest sticks out in front. Here is a photo; one of the steri-strips has peeled off already so you can see the actual incision there.

For orientation, the grey fabric is my pants, the top of the incision is where my hip bone would stick out really obviously if I were skinny like a supermodel, and the right side of the photo is the right side of my body. The yellowish tinges are from Betadine solution.

[Note, I've also added a post-surgery x-ray photo here, and going forward photos will be easily accessible in the Quick Links section at left.]

Tonight was another big adventure, attending a three-hour fund-raising event with my parents. Again I was already in a bit more pain than normal beforehand, this time because I'd stepped on the dog while swinging my bad leg off the couch -- the dog obviously jumped up and away, wrenching my leg as she moved. It hurt -- me physically and the dog emotionally.

This time I applied the lessons of Tuesday night and took two Oxycodone beforehand and had extra medication with me. (The fact that the event was a trivia competition and I was able to vigorously compete does prove my point that the Oxycodone does not make me foggy at all.) Although my team did not win, the night turned out well overall. My pain stayed very low until the last hour, when it started to increase and distract me. So clearly I can venture out a bit more, but as Dr. Millis suggested, I should be prepared with extra pain medication to avoid self-torture.

Two Weeks Post-Surgery: Pain & Medication

My pain is generally well-managed but there is a lot of it still lurking below the painkiller block. When the pain does break through, it has usually moved to one or another of its favorite places to surface -- sometimes over the incision, sometimes on the outside of my hip, sometimes deep within the joint, sometimes at the top of my iliac crest (where I think there is a screw head), sometimes in the back of my hip joint (deep inside behind the bottom of my right buttock), sometimes shooting itself like a racing stripe down the outside of my thigh, knee and calf.

There is still a numb spot about the size of my hand on the outside of my thigh, right below where the greater trochanter of the femur sticks out to form the widest part of the hip. The numb spot is normal; Dr. Millis said they have to move a significant nerve aside when they are doing the surgery, and this causes some damage to the nerve that gradually repairs itself over a few months. But there will be a steadily receding numb spot there until the nerve has completely healed.

My incision is usually the least of my problems. It is not generally tender, but it itches sometimes under the dressing, and as I mentioned above, it does sometimes hurt. We changed the dressing two days ago, so I saw the scar (through the steri-strips, which means I didn't see much). Not much to report until I really see it when the dressing and the steri-strips come off. The dressing is set to come off this Thursday.

There does not seem to be much swelling at all in the hip area or the leg on my operated side. I am not even sure there was that much swelling in the hospital.

My current pain medication regimen is:

-- 1 Oxycodone every 5 hours during the day
-- 1 Oxycontin twice daily
-- 1 Valium at bedtime
-- 1 Valium kept at bedside if needed for pain during the night

Some PAO bloggers I have read have been on less medication (or less frequent dosing) by this point in their recoveries, so I'm not sure why I'm still needing such high or frequent amounts of pain medication. I have, on occasion of missing a dose or taking a dose too late, had breakthrough pain, and it is not at all tolerable -- about a 5 on my pain scale if I let it get too far. Since leaving the hospital I have stepped down to one Oxycodone every five hours instead of two every four hours, and have switched to taking Valium at nights instead of Oxycodone.

Unlike others, however, I don't find the painkillers make me feel mentally foggy in the slightest. Only Valium makes me a bit scatterbrained and sleepy, which is why I take it at nights now and leave the Oxys for the daytime. But on the current regimen I have been reading varied, mentally stimulating books and magazines, playing (and winning) fierce games of Trivial Pursuit and staying generally awake and alert all day, save an afternoon nap. So I'm in no rush to get off the pain killers for any philosophical or mental acuity reasons, I just find it interesting that others have weaned off them tolerably so much more quickly than I seem to be doing.

Of course, one must consider that my surgery took seven hours rather than the four and a half hours Dr. Millis had originally predicted, and my bones were, according to him, incredibly strong and difficult to cut. I have five screws rather than the usual number of three most often used in these operations. Also, I came out of surgery with an elbow injury on top of the hip situation (and then there was the heat rash!), so maybe my body's healing department has had a lot a lot of balls in the air and that is why my pain has been persisting longer than that of my PAO peers. Or maybe everyone is different in their healing and it is what it is.

Speaking of heat rash, I've been applying the prescription rash cream twice daily since I left the hospital. The dragonhide that formed after the fiery welts I had in the hospital has completely flaked off by now and the marks of the rash are reportedly looking much better and almost dissipated.

The itchy-red-spots problem (which apparently is a side-effect of the pain medications, although I have not read of similar reactions among any of my PAO peers) persists, but seems to have been lessening steadily. For that I try (usually unsuccessfully) not to scratch at the spots and I apply Gold Bond lotion twice daily. Mostly it feels like I have a mild but chronic case of chicken pox.

I am also still taking the Atarax pills (twice daily) that I was taking when I left the hospital for the itching/spots. I think I will reduce the Atarax as the pain medications are reduced.

I was never given Lovenox or even Coumadin at the hospital, just aspirin, so I keep taking that once daily to keep my blood thin and clot-free as I'm healing. I stopped wearing my TED stockings after a few days at home. Even in the hospital they weren't very tight and didn't seem to be doing anything that a pair of drug-store knee-highs couldn't do. Plus, no one told me I had to wear them when I got home.