Two Years Post-RPAO

It has been a long time since I last wrote here, and an even longer time since I visited Dr. Millis. But today I made the old familiar drive up to Boston again.

The main purpose of my visit was to get a contrast MRI of my right hip now that it has been over two years since my March 16, 2009 RPAO. I am part of a study Dr. Millis is doing on cartilage regeneration post-PAO surgery -- the study will compare the MRI taken pre-RPAO with MRIs taken one year and two years post-PAO. Ideally, the MRIs will show that cartilage damaged by the poor alignment of the dysplastic hip will repair itself once the joint alignment has been corrected by the PAO.

One of my favorite qualities about Dr. Millis is that he will sit down and geek out with patients about the science of the surgery -- this time he sat with my mother and I and took us through all my MRIs, explaining how the contrast material indicates cartilage damage in the pre-surgery image, and then tracking the cartilage repair across the two post-surgery MRIs. Today's MRI showed no cartilage damage at all, indicating that my body has repaired all of the painful damage my hip had suffered prior to the surgery. It is an amazing result -- two-and-a-half years after my diagnosis, I am truly "cured" of hip dysplasia as well as the damage it caused.

Of course, today's MRI merely confirmed on a medical level what I already knew to be true from my own experience. For the last year I have been active with tennis and horseback riding and long walks around New York City, limited only by stamina and blisters. Most of the time I don't even think about my hips, but from time to time I am still struck with wonder and gratitude at the amount I can do, and the pain I don't feel.

No News is Good News

No news really is good news. I haven't written here since April because I basically have not thought about my hips for months.

The entire summer I have been playing amazing amounts of tennis -- four times a week at my peak -- as well as walking up to five miles across the city at times. Through all of this, my hips have been completely pain-free.

I'd say my hips were "as good as new," except they actually are better than new. I never could have done this amount of activity with them pre-surgery. In the months before my first surgery I could barely play tennis once a week, let alone walk long distances.

My hips have now healed so well that in the midst of a tennis match I've actually forgotten that I even had surgery on them, or that they ever even pained me. Which is exactly how someone my age should feel about their hips while doing athletic activity, actually.

So thank you to Dr. Millis for re-aligning my chassis so that my hips can now carry me as smoothly as they should have from the beginning. My tennis opponents wish you'd left me as I was. :)

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.

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?