Sunday, January 27, 2013

The Patient

Greg has taken to referring to me as "The Patient" ever since my hip surgery on January 15th. And, it's true, I have needed a full time caregiver for the first two weeks post op. I'm slowly regaining my independence now, but there are still plenty of things I can't do and that I won't be able to do for several more weeks and, in some cases, months.
Post Op Day 9 - going to PT by myself for the first time
Greg only took the day of my surgery off work. Thankfully, he is able to work from home and that is how he has been able to take care of me without burning all of his vacation days (he hasn't been with this employer long enough to be eligible for FMLA). He also took a few hours off to accompany me to my first two PT appointments.

My last post covered the day of the surgery in excruciating detail. Now I'm going to bring you up to speed on the new version of my daily life.

When Greg gets up in the morning, usually around 6am, I make sure to carefully roll onto my stomach to spend my last hour in bed as "tummy time." I have to do two hours of tummy time every day as part of my physical therapy regimen. This strengthens the back & abdominal muscles and is essentially a lazy version of the locust pose in yoga.
As soon as I get up, typically around 7am, I start popping pills. Thankfully, I have only been taking 5mg oxycodone (pain medication) at night to help me sleep, and have gotten through the rest of the day by frequently applying ice to the surgical area - my right hip. Even when the femoral nerve block wore off after 36 hours, the pain was very tolerable. I do have to take two other pills (to encourage proper healing) and two more (to offset the side effects of the other medications). I also take several vitamins (B-12 & D-3 which were prescribed by my general practitioner due to low levels in blood tests) and other drugs (niacin & L-arginine for Raynaud's disease).
Post Op Day 10
In the past few days I have regained enough flexibility to bend over far enough to put on my underwear, pants, socks & shoes by myself. Before that, it was Greg's job! Once I'm dressed, we begin the at-home exercises that currently make up a large part of my physical therapy regimen. Greg helps me with 40 minutes of passive stretching & range-of-motion exercises, then I do another 20 minutes of exercises on my own. We have to do all of these exercises twice daily.
my week-by-week physical therapy schedule
I then move over to the couch and place my right leg in the CPM machine. It continuously flexes my leg at the knee from 0-90 degrees (relative to my hip). I have to spend 6-8 hours every day in this machine for the first two weeks post-op. I typically break it up into three 2-hour sessions, and get up at the halfway mark of each session to encourage more blood flow to my feet.
Post Op Day 5 - quality reading time in the CPM machine
Due to my Raynaud's disease, I've been having an especially tough time of keeping my feet warm since the surgery. The tips of my big toes are deep red to blue and very sensitive, alternating from burning to tingling to almost completely numb throughout the day. This is in spite of taking all the prescribed medications, wearing Heat Holders socks & a warm hat (even indoors), and covering up with two blankets any time I'm sitting/lying down. This is about the extent of what can be done to alleviate the symptoms of this disease and it sure is frustrating (and painful)!
Raynaud's flare up on my left great toe
Between the tummy time, exercises, and CPM machine, I am occupied for 10 hours every day. While I'm in the CPM machine I usually read, or, at night, stream videos on Hulu. It was too painful to sit upright for any length of time for the first week after surgery, so I also ate most of my meals while reclined on the couch. This week I am able to tolerate 30 minutes of sitting in a chair so I am eating with Greg at our dining room table. We even went out to eat at a neighborhood Thai restaurant last night!

There's not much I can do to help out around the house while I'm on crutches, but at least I'm able to stand up by myself. For the first few days, Greg had to lift me up from any sitting position plus he had to move my right leg when I changed positions. Now I've learned to hook my good leg under, and use it and my right arm to control the right leg so no additional stress is put on my hip. This also helps for taking showers, which is particularly difficult because we have a deep claw-foot tub.
Post Op Day 4 - I have a visitor!
I am supposed to be on crutches for two weeks post-op so hopefully will start to wean off them this week. But I'm very lucky because even though Dr. Herzka did microfracture the top of my femur, the damaged area (where the cartilage was completely worn down) was small enough that they only drilled two holes in the bone. Anything more and I would have been on crutches for six weeks!
Post Op Day 2 - first trip to physical therapy
In addition to all of our daily rehab activities at home, twice weekly I travel to OHSU for physical therapy. I go via public transportation, and depending on what time I leave, that requires two buses, or two buses plus the streetcar (and a lot of extra time for getting to & from the bus stop on crutches). Unfortunately, the first day I went to physical therapy, January 17th (two days after surgery), the streetcar we were riding on broke down. We were instructed to get off and board the next streetcar, which arrived within five minutes. However, the "broken" streetcar had not been able to get far enough ahead to not block the tracks, so we had to get off the second streetcar, as they were now going to use it to tow the broken one back to the garage. We ended up having to walk a few blocks and then Greg picked up a Car2Go to drive me the rest of the way to PT. Thankfully, the other two times I've been to physical therapy since, I've not had any transportation-related issues.
Post Op Day 7 - I'm riding a bike (kind of)!
As I mentioned in my previous post, I have also been to one post-op doctor's appointment. I received a printed summary of the surgery and got to see photos that were taken with the endoscope. The doctor did a basic exam, checking my range of motion and the appearance of the surgical site. She also removed the sutures and replaced them with a few pieces of surgical tape. She was very happy with my overall condition. My next follow-up appointment is on February 28th with the surgeon, Dr. Herzka.
Post Op Day 9 - sutures removed, rash & bruises starting to subside
As I mentioned before (in reference to not taking oxycodone), the pain has been pretty manageable. Yes, I am in constant discomfort, but, on a scale of 1 to 10, it's typically around 2 or 3. Initially it seemed to arise from the swelling around the surgical site and the sutures pulling on my skin. Now I am experiencing more muscular aches as I progress in physical therapy with some occasional acute pain associated with the areas that were repaired during surgery. I'm also having an issue with the second nerve block not wearing off completely and thus I have numbness in part of my upper thigh. Hopefully this will go away within the next week and should not be permanent.
pre-op CPM machine practice
The only other real negatives to speak of are that I had a reaction to the adhesive they used to cover the surgical site and broke out in a rash that still hasn't completely disappeared; and I've had a sinus infection for the better part of this past week and have gone through a box of Kleenex.
Post Op Day 6 - bad rash, sutures, bruising
So that's my life for the past two weeks. It will evolve as I continue to heal and progress through six months of physical therapy. I particularly want to say thank you to my sweet husband, Greg, who has played many roles in the days since my surgery including cook, waiter, dresser, bather, lifter, physical therapist, cleaning/laundry man, escort, and general "fetcher" of things. I can't imagine going through this without you and I love you very much!
Post Op Day 10

3 comments:

  1. Amazing story! Physical therapy is a good treatment for us. We can reduce our pain through it and I hope that you will have recovered properly now.

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  2. Hi There!
    I know this is a blog post from 3 years ago but I was wondering how you are doing now? Sounds like surgery went really well for you. I found your blog researching my upcoming arthroscopy. I have femoral acetabular impingement with labral tear. I will be having surgery at OHSU with Dr. Herzka the first week of August. Very nervous. Thanks for documenting your pre and post op!!
    Take Care,
    Tonie

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    Replies
    1. Hi Tonie,
      I did write a few follow-up posts after this one. Just search here on my blog for "hip surgery." In general, I continue to be 99% better than I was pre-op. I followed the strict physical therapy regimen to the letter, which is critical for a successful recovery. To this day, I still do exercises that help strengthen the muscles around my hip to prevent re-injury. I have no pain, just occasional flare-ups that feel like a slight pinching when I overdo it working out or just standing/walking/biking around too much (i.e. for 4+ hours at a time). Just so you know, I would definitely have the surgery again and I wouldn't hesitate to recommend Dr Herzka. The more you educate yourself and can ask her detailed questions, the more you will get from her in terms of an open dialogue on a clinical level. Not sure where you plan to have PT, but know that Dr Herzka's preferred therapist at OHSU, Christy Allwein, had the surgery about a year after I did so she can totally relate to what you are going through. Good luck and don't hesitate to email me or contact me through Facebook if you have any other questions.
      Alethea

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