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.

Tennis!

On Sunday I played tennis for the first time post-LPAO! It felt great to be back on the court, and both my hips felt great before, during and after.

I played doubles for two whole hours, and while I didn't go for any crazy gets, I didn't hold myself back too much either. Obviously I was a bit rusty, but for the most part I felt really good and like I am ready to start playing regularly again. Yippee!!

I have been doing a lot with my hip lately: walking to and from work (it is only 20 min. each way), Pilates, spinning, and seeing my trainer twice a week. All that work has obviously built up the muscles quite well, and the spinning has been improving my cardio quite a bit.

So fitness-wise, things are going very well. Tomorrow I am going up to Dr. Su's office to get my 12-week post-op xray of the left hip, so we'll see how the progress is going on the inside as well. Dr. Su is a hip specialist at the Hospital for Special Surgery here in New York, and the doctor who first diagnosed my hip dysplasia and referred me to Dr. Millis. I'm having my xray done there so I don't have to drive all the way up to Boston, and so that Dr. Su can see the end result of his initial diagnosis.

Eleven Weeks Post-LPAO

My hip has been doing spectacularly well for the last week or so, with no significant episodes of pain or limitation at all.

Prior to that there was unpredictable, variable pain that seemed unconnected to my activity level. The pain would appear without warning, sometimes in the front of the hip, sometimes in the back, on the ischium, and sometimes, more rarely, on the outside of my hip. It would last for a random amount of time, and then it would disappear, seemingly without cause.

For example, one morning I woke up and had pain with every step I took with my left hip, for no apparent reason. I hadn't pushed the hip the day before, or done anything out of the ordinary. I rested all that day, hoping that would help, but the hip continued to hurt in what felt like the small muscles surrounding the hip, as if I'd overdone it walking or something. Which I hadn't. The pain lasted into the next day and then, as suddenly as it had appeared, it disappeared. For no reason. Frustrating.

The last episode of that inexplicable pain was about a week ago. Since then, my hip hasn't complained at all, despite an increase in my walking, intensification of my workouts with my trainer, and the addition of both swimming and spinning to my regimen. In fact, my hip has taken all these challenges in stride (pun, sorry) and has felt great.

So I don't know how to explain any of it. All I can report is that I've been doing more and more with my hip and it has been feeling good. My right hip, which is now ten months out from its PAO, feels great as well. My fitness level is improving markedly and I'm starting to feel like my old self again.

Next week I will get another x-ray taken and I'll have more to report once Dr. Millis has commented on it.

Nine Weeks Post-LPAO

After my RPAO, I started my nine weeks post-op entry jubilant about finally being allowed to wean myself off crutches. Juxtapose that with today's entry, nine weeks after my LPAO and here I've been walking for three weeks already!

Well, that is a bit of an exaggeration. I only ditched the crutches totally about two weeks ago, but since then I've been walking more and more, trying to get my strength up. I went to Europe right after Christmas and although my hip tired easily, for the most part I felt pretty good through airport transfers, post-holiday sale strolls, and museum visits. I even took a 10 mile bicycle ride one ambitious morning.

I can't say my hip was pain-free -- when it got tired, it definitely got sore, but I was good about making sure I always had an "escape route:" a cafe to rest in, a subway to jump on, a cab to hail, etc. so I never got stuck anywhere having to push my hip past its limits just to get home.

Now I'm all moved back into my apartment in NYC, my office at work, my normal life. Well, almost normal. I still don't think I can make it far enough to walk to work yet. And I definitely need some time before I can play tennis again. But I'm progressing really fast and I'll get there soon enough. Who wants to walk to work in these sub-zero temperatures anyway?

Seven Weeks Post-LPAO

I went up to Boston today for my second post-LPAO appointment -- a little early, at only seven weeks post-op, but that seemed apropos given the quick pace of this hip's recovery.

In the last few weeks, I've been mixing in more and more walking, but still keeping the one crutch with me for longer excursions or (given the current weather conditions on the East Coast) inclement footing. Needless to say, Dr. Millis and the team were pleased with my progress, my range of motion, my strength and my nearly-perfect walking.

I say nearly-perfect because, as physical therapist Jaime pointed out, I need to do some specifically targeted exercises with the thera-band to get back to 100% on the left side. So I've got those movements as an assignment. Other than that, though, I can continue with my bike riding at the gym, and continue to increase my walking as it feels comfortable and as my hip muscles strengthen.

Essentially, I am now where I was at the end of May with my RPAO -- which puts my left hip recovery about a month ahead of where my right hip recovery was at this stage. So there's my Christmas present!

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.