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.

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.

Three Weeks Post LPAO

It is now three weeks post-LPAO. At this point last time I had a giant leap in progress. This time, progress on the left hip is just steady and slow. I think the difference (again) is that Dr. Millis didn't have to go into the joint capsule on this left side. The first three weeks of horrendousness after my RPAO probably had a lot to do with the joint capsule having to heal up and stabilize. So while my first three weeks post-LPAO felt better than my first three weeks post-RPAO, I think the recoveries are pulling even now.

PAIN and its MEDICATION

My pain is generally very low. Most of the day I am in little to no pain. I usually wake up with pain around 4 or 5 in the morning, but once I take a Percocet I can make it quite a while until the next one. That ligament (or whatever it is) is still bugging me from time to time, but not nearly as much as it was last week, when it hurt at every step. Now it is just an occasional pinch from time to time.

Sleeping is still not fantastic, but is getting better. I still wake up a few times a night when I have to roll over. I can comfortably sleep on my right (non-op) side for long stretches at a time. The pain gets worse towards the morning when the previous night's bedtime Percocet has worn off. Last night, in a fit of madness, I tried to roll onto my left side. Ouch. I'm not quite ready for that yet.

I am gradually stepping down on the painkillers. This past week I discontinued the Oxycontin altogether and I have been averaging 4 Percocet/day (day being 24-hour period, in this case). I am still taking the Valium as needed.

I haven't stopped Atarax but I think I will this coming week. My hospital rash is long gone and the itchy-red-spots are pretty much gone as well. Just some residual itching here and there.

MOVEMENT

Movement is generally the same as last week. Now that the ligament pain (or whatever it was) has let up, I am less reluctant to crutch around. I have even left the house for dinner at a restaurant and other adventures. I am good on my crutches (after much practice!) and I am strong from my pre-surgery fitness level, so moving around is not a problem when the ligament is not bothering me. Some chairs are still uncomfortable, but I can find ways to sit to minimize the pain.

Because I seem to be healing so fast, I have been entertaining delusions of perhaps getting off crutches earlier this time. But I think that is probably not going to happen. I have been ahead in the healing game with this PAO because of the joint capsule -- but cut bones are still cut bones and they are going to take as long to heal on the left side as they did on the right. So I'm just going to be in this I-feel-fine-I-just-can't-walk limbo phase for longer this time. Great.

INCISIONS

Both my incisions look great: click the links for the pictures. The one that really matters is the right side, since that will be my permanent scar on that side. On the left side they will open the scar back up again to get the screws out in a few months anyway, so who cares what it looks like now.

MOOD

My mood is good; mostly stressed. I have had to work a lot during this recovery and it is leaving me with less time to read and relax than I had during my recovery this spring. It is also draining. In the evening I feel like I am going to collapse from exhaustion once I log off work. Another reason I am not getting as much reading done this time around. Happily there's the holiday weekend coming up so maybe I can get through a book.

Next week is my 1 month post-op in Boston. How the time flies as I limp along behind it.

Autodonations

Today was my second autodonation prior to my LPAO. This time my blood pressure was 120/80 and my hemoglobin (iron) level was 13.8. At my first autodonation (September 25) my blood pressure was 104/80 and my hemoglobin was 15.9. (Normal hemoglobin for women is 12-15 gm/dL of blood.) I'm taking iron supplements, of course, and trying to be as healthy and rested and hydrated as possible so my body can make more blood, but it can only work so fast. Luckily I have two full weeks until my next autodonation.

It is harder to stay healthy this time around, though. Maybe it is the season, but I have been a bit sick recently. The day of my first autodonation I felt fine, but my throat had been a little rough when I'd first woken up and I knew that I was on the verge of getting sick. And I did get a mild cold after the autodonation.

I hope the blood will be OK. When I woke up with a raspy throat the morning of the autodonation, I did some research; it seems the reason you can't give blood when you are sick is because you need that blood yourself to fight off the sickness -- not because your blood will be tainted with sickness. All I care about is that the blood I get post-surgery is not going to hurt me.

This morning I could tell that I was again on the verge of something -- this time it felt like I might have the stirrings of something in my left sinus (under the cheekbone). But again I felt fine going into the autodonation: no fatigue, aches or other signs of sickness. So we'll see. I will definitely ask Dr. Millis about this during my pre-op later this month.

It is hard to believe that I have less than a month left until my second surgery. I'm almost seven months post my RPAO and I've recovered so well -- I'm playing tennis twice a week, seeing my trainer twice a week, and I even did Pilates for the first time last week. I feel strong and relatively fit again (cardiovascular endurance is still not what it was). My left hip doesn't hurt at all, ever, and my already-PAO'd right hip is pain-free most* of the time. It is possible I've been pushing it a little too hard, though.

In a way, it is depressing that I have come this far and recovered so well, only to bring it all back to zero and have to start recovery all over again. But on the other hand, it is helpful that I now know the process of recovery, and the timing, and I know that if all goes as well as it did after my RPAO, I should be at this level of strength and recovery again by May. But then again, if I've learned anything from this process it is that recovery is impossible to predict, so really, anything could happen.

I am glad that I am having the second surgery in the winter. It is supposed to be a record-breaking cold and snowy winter this year, and now I have an excuse to sit inside by the fire for most of the winter. My parents' house in Connecticut, nestled in the snowy woods, is a great place to spend a winter.

I'm not there yet, though. I still have a month left. A month to tie up loose ends in NYC and at work, stay (get?) healthy and strong, and enjoy all the walking and tennis and Pilates that I'm lucky enough to be able to do in this brief interlude.

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*My right hip does hurt sometimes, and it is very confusing. I can't predict it or make sense of it at all. The pain is usually in the front, (which is where the labral pain was before), but the pain is not on impact like it was with the labrum. Instead it hurts when I lift my leg to step a certain way, or in a deep squat. I think it must be the muscles (especially the hip flexor) getting fatigued and sore. But what is taking it so long!? I have been working on my strength for months; all my other muscles are back in business. Why would the hip flexor keep hurting on and off for so long?

The other strange thing is that it doesn't seem to be correlated to my activity (as least as far as I can tell). Some days I step on the tennis court and am sore after 5 minutes of play. And some days (like tonight) I can play an hour and a half and not feel sore until the end. Why is that? Some days I walk to work and it is pain-free; some days I start to walk and it is sore as soon as I get out the door. Another question for Dr. Millis.

One reason might be that I am constantly pushing the envelope with my hip -- if I were not walking to work every day and playing tennis twice a week, it might feel totally pain free all the time. We'll see what Dr. Millis says later this month. Whatever it is, it can't matter that much, since I'm about to slow way down on the activity level for a couple of months.

Six Months Post-Op -- Tennis Again!

Six months after my RPAO I am feeling good and enjoying an active summer. At this point I feel pretty much 100%, except that my fitness level is still not as high as it was pre-surgery, especially my cardiovascular endurance.

The biggest news I have is that at 5.5 months post-op I was cleared by Dr. Millis to begin playing tennis again! Finally! I have only played a few times since then but I am looking forward to getting a little more regular with the tennis this month. Very exciting indeed.

Meanwhile, I've continued to work with my trainer and increase my overall strength and endurance. I've also stepped up the cycling cardio (on a real bike this time!) over the past two weeks. All of that has been going well and the only limitations I've felt have been my fitness level, not my hips.

My left hip is still completely pain-free; I wonder if it will stay that way all the way up to its surgery date?

Speaking of LPAO, it is only two months away! Sad. It will be such a bummer to have to do all this again starting from zero again. But I am glad I took the summer off and didn't have the LPAO in July or August. It has been really great to have an active summer and enjoy the weather and my vacations. I think it would have been really tough to go through recovery in the summer when all I would want to do is run around outside. Plus those hot flashes I got from the pain killers would NOT have been welcome on a hot summer day!

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.

Four Months Post-Op

In my last entry six weeks ago, I was just starting to walk again; now I am getting close to 100% with walking. Right now, I'd say I'm at 80% of my pre-dysplasia-pain ability to walk, and probably 100% of my ability to walk just prior to surgery.

As I wrote six weeks ago, at first even going on a half mile walk was exhausting. My leg muscles were in various states of soreness for several weeks, and my cardiovascular endurance needed work after two and a half months of limited activity.

My gait stabilized soon after I began walking. Once I got steady on my feet, I tried to increase my walking bit by bit -- at first just starting with the basic walk to and from the subway on the way to work (a few blocks each way), then little lunch-hour walks that I stretched longer and longer.

Eventually I was able to walk from my apartment in the Financial District across the Brooklyn Bridge to DUMBO, one of my favorite walks and one I was very glad to get back to! My longest walk so far has been a five-mile walk through London the weekend before last -- but I did pay for that with exhaustion and soreness for the rest of the day afterwards, so I haven't repeated the feat since.

I have had pain as I've been increasing my walking. It is hard to explain -- a lot of the time it is clearly muscle pain -- in the quads, glutes, calves, hip muscles -- but once or twice it has felt disturbingly like the old pain: twinges when my hip hit a certain way; that old "blister" feeling. The twinging/shooting only happens when I am *really* spent, like after that 5 mile walk for example. In London, my hip felt great during the whole walk (I would have stopped immediately had it started hurting), but after I came home and had rested on the couch for a while, I got up and felt really stiff with twingy pain in the operated hip on each step. I don't know what that means.

At times I admit I've been concerned that the surgery "didn't work" and the pain was the same old pain I had pre-surgery. But unlike the pre-surgery pain, the twingy pain I have now goes away quickly. The old pain would linger for several days until I'd stayed off my hip long enough for it to fade away.

Other times when my hip has been tired I've sometimes felt an ache, sometimes with the ache reaching down in a stripe down the outside front of my thigh. Of course that stripe could be some inner quad muscle complaining. In fact, I am not sure that the twingy pain isn't muscle related, too. I just don't know. But no matter what the pain, it has usually not lasted more than a few hours and it has always been gone the next morning. I figure it is just all part of building up the strength and endurance of my hip, and to stick with the rule to ease up if it hurts.

Jaime (physical therapist) did give me some exercises and stretches during my May visit, which I was to do daily. I tried to do them every morning and evening but I definitely did not do them that often. The stretching was, and still is, the worst -- my hamstrings were tight anyway before the surgery and now they are just ridiculously tight. It is hard to tell if there is even any progress with the stretching, but I suppose it is good for me no matter what.

I have also ridden the exercise bike sometimes during the past weeks. I haven't swum and I haven't done any anaerobic exercise, but that is just because I am lazy. I have resolved to remedy those deficits in the coming weeks.

As it stands now, I am back to being able to get around in the city at least as well as I did just prior to surgery. I can walk to subways, around the office at work, to errands at lunch hour, in parks on weekends, etc., all without pain (for the most part). I can walk briskly and bustle up and down stairs at typical New York pace. The last couple of nagging range-of-motion problems (not being able to really bend freely over my operated leg to put on a sock, for example) have finally fallen away.

I still have the numb spot on the outside of my thigh, but it comes and goes. Sometimes it feels like it is almost totally gone and then sometimes it comes back a little bit. I guess it is possible there will be some sort of strangeness there for the rest of my life, but no matter; I rarely notice it and am never bothered by it when I do.

I went up to Boston yesterday to see Dr. Millis and the team. (My last visit was back in May, right before my last entry in here.) I got x-rays that looked (to me) exactly like the x-rays from six weeks ago. Screws straight, cracks filled in, etc. Dr. Millis was pleased with my gait, flexion and strength and all seems to be improving according to plan. Weakest links are the right hip flexor and hip abductor muscles. (They probably would have been stronger if I'd been more religious with my PT exercises, hmm?)

I asked Dr. Millis and Jessica (physical therapist) about adding back some activities. Sadly I'm not allowed to start up tennis again, but I'm now allowed to hit against a wall or against a ball machine, so that's a start. Jessica said I needed a month or so before I could start adding any impact on my hip, so "real" tennis is still on hold.

No horseback riding still because it is "too jarring." (I'm surprised they didn't also say "and you could fall off!")

Thankfully I am allowed to start back up with a personal trainer again, so that should help with my motivation to get back in the weight room. I've already set up my first session for this Friday.

Another bit of good news is that I don't have to go back up to Boston until my LPAO pre-op appointment in October! I will communicate with the physical therapists and Dr. Millis via email to give updates on how I'm doing, but basically I'm free to enjoy my summer and fall.

Speaking of LPAO, my left hip is still pain-free despite the increased activity. I haven't had even a twinge from it even during the longer walks. That doesn't affect my decision to put it on the chopping block in November, but it is definitely good news for the enjoyment of my summer.

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.

Staying Healthy

Now, in last few weeks before surgery, the most important thing for me to do is remain healthy. I have heard too many horror stories of girls who have gotten a cold right before their surgery date and have had to have the whole thing postponed. Best to avoid that if at all possible.

DIET

Of course I am eating a healthy diet. Lots of fruit, vegetables and lean protein, very little sugar and starch. I have completely cut out alcohol. I am also focusing on iron-rich foods, to help my blood bounce back between autologous donations. So that means dark green leafy vegetables, red meat, beans, etc. A quick Google search can bring up a more comprehensive list. Liver anyone?

I am also taking iron supplements in addition to my usual multivitamin, omega 3 and calcium. There is a lot of information out there about what supplement to take (or avoid taking) with what food to increase absorption, but I just can't be bothered with taking it all in and regulating myself so much. So I'm just eating as healthily and ferrously as possible, taking the supplements, and hoping it all comes out in the wash. Or absorbs in the wash, as it were.

I have to mention that iron supplements will unpleasantly affect your digestive system. And I will leave it to you to look up why that is and what you can do to ameliorate some of the problem.

EXERCISE

Since my hip has significantly been increasing in pain over the past six months or so, I have been decreasing my activity level to compensate. I can no longer walk for long periods around the city (like to and from work) or play tennis at the frequency I used to. I can eke out a match here and there, but I will pay for it the next day (or even towards the end of the match).

For the most part, I am not usually in much pain on a daily basis, but that is because I have curtailed my activity level so much to avoid aggravating my hips. I don't take (and have never taken) painkillers when my hips begin to hurt -- not because I have anything against painkillers, but because I just figured the pain was a signal that I should stop. This kind of hip pain is not pain you can "work through" like having sore muscles that warm up and loosen up; this is pain that gets worse the more you do. So I figured if I mask the pain to allow myself to do more, I am just going to pay for it in the end (or cause so much damage that I would need painkillers to do even routine things in life). So basically my "painkiller" is to stop moving around until my hips stop hurting. Which has meant I don't move around much anymore.

So with that backdrop comes the challenge of getting myself into surgery shape without causing myself pain.

For cardio I have been doing the bikes (seated and stationary). Elliptical hurts my hip. I also swim, since I am lucky enough to have a pool in my building. I usually hate swimming laps, but since I got a swimming armband and earphones for my iPod, the boredom is gone!

For strength training I have been doing weights (both general circuit training and a specific focus on the crutching muscles: lats, pecs and triceps) and some Pilates mat exercises that focus on the muscles around the hip. I also do some of the hip muscle exercises in the pool after swimming my laps.

To be honest, I've only really gotten serious about this pre-surgery health-nuttery since last week -- most of the PAO women whose blogs I have read started much earlier. But I was already in decent shape, with good muscle tone from regular visits to the gym prior to this pre-surgery frenzy. So I'm not starting from zero. I'll just have to do my best for the remaining 2.5 weeks!

Pre-Op Scheduling

Now that I have a surgery date, I have had to schedule all my pre-operative appointments. Before surgery I need a complete physical with blood panel, kidney function and liver function tests; autologous blood donations (giving my own blood for use during/after my surgery); and pre-operative appointments at the hospital.

The challenge is not only in coordinating schedules, but in planning dates that allow for proper hemoglobin replacement between blood draws and prior to surgery. My first blood donation cannot be earlier than six weeks before the surgery (February 2) and my last donation cannot be later than two weeks before the surgery (March 2). Moreover, one must allow seven to ten days between blood donations to allow the body to replace the missing pint of blood each time.

Two of my blood donations will be in New York at the New York Blood Center, which will ship my blood up to Boston. One of my donations must be on-site in Boston, as they need a very fresh on-site sample to separate into plasma and platelets for concentrated infusions during surgery. A shot of platelets in various areas can boost clotting during a bloody surgery (which any surgery involving bone-sawing necessarily is).

The schedule I have finalized is as follows:

February 3, 2009 -- Complete physical, including blood/liver/kidney levels, just to check everything and know my baselines. I'm getting this from a regular internist here in Manhattan and having the records sent up to Dr. Millis' office.

February 9, 2009 -- First autologous blood donation, at the New York Blood Center. After this appointment I am to ensure my diet has iron-rich foods and am to take iron supplements for five days.

February 19, 2009 -- Pre-operative appointments at Children's Hospital. During this full day in Boston I will meet with Dr. Millis, the anaesthesiology team, and admitting. I will also have my second autologous blood donation while I am there.

March 2, 2009 -- My third autologous donation, at the New York Blood Center, with the blood subsequently shipped up to Boston.

March 16, 2009 -- Surgery date.

Meanwhile, I have a more general goal of getting myself as strong and healthy as possible prior to the surgery. I have read that other women have experienced faster recoveries when they have gone into the surgery strong and fit. I also must try to eat a nutritious, iron-rich diet during this period of blood donations, as well as keep myself generally free of colds and other sickness. If one is sick one cannot donate blood; if one is sick in the days approaching surgery, the surgery will be postponed.

I've arranged my absence with work. I plan to be completely off the grid for two weeks after the surgery: one week in the hospital in Boston and one week sleeping and healing at my parents' house in Connecticut. During the third week (week of April 6), I plan to begin working remotely from Connecticut, although start day and hours per day are going to be contingent on how my recovery is progressing at that point.

I plan to stay in Connecticut for at least five weeks after returning from Boston, so I can have the help and supervision I would not have if I returned alone to my apartment in the city. Manhattan is NOT a friendly place for people on crutches, so ideally I would like to be almost off them before I leave Connecticut. Right now I anticipate physically returning to the office the week of April 27, but again that is contingent on my recovery speed.