Carole's Recovery Journal
by Carole Woods (Formerly Carole Raymond)
For additional information, please email me at [email protected].
Location of Surgery: Presbyterian Hospital of Plano - Plano, Texas
Doctor: Roger H. Emerson, Jr., M.D., Texas Center for Joint Replacement - Plano, Texas
November 9, 2003 (11:39 pm) - The night before surgery
My surgery is about 9:00 tomorrow morning and they will be putting in a Biomet Metal-on-Metal joint that does not require cement. Instead the bone grows into pores in the metal.
I'm feeling pretty calm tonight. Things I've done on my own to prepare include a lot of isometric exercises in my fused hip. I worked alone and with a physical therapist to make sure I was working all the muscles I could to make them strong so they will be able to support the new joint. We have different problems that regular THR patients in that our muscles haven't worked the way they should in many years. I'm hoping this will make a difference. I'll let you know. Also, I read a book called "Prepare for Surgery, Heal Faster" by Peggy Huddleston. It comes with a tape that teaches you to relax and uses guided imagery where you imagine yourself after you are healed. I think this has helped me remain calm the past week. If you are interested, more information can be found at http://www.healfaster.com. I'll let you know if that helps, too. I also donated 2 units of my own blood to have available for the surgery.
I attended a class at the doctor's office about 10 days ago. I learned what to expect in the hospital and after I return home. I was examined by an internist and they took a chest x-ray at the hospital after I completed the pre-registration. I was given a book that outlines the entire process. I'm more comfortable when I know what to expect, so I feel like I have all the information that's available. The doctor required a low-residue diet for the past two days. Apparently, you handle the anesthesia and post-surgery better if you don't have much in your digestive system. I decided to make sure and I've stuck with yogurt, soup, and protein drinks the past two days. I was also instructed to take a shower with an antibacterial soap (Hibiclens) which I did tonight and will do again in the morning. The anesthesiologist called tonight and we discussed the fact that the hip is fused and that the surgery will be longer and more complicated than a ususal hip replacement. I had been told at the class that I would not be under a general anesthetic but rather an epidural, but he explained it will be necessary due to the length of the surgery, which should last 3-4 hours. He was very nice and I felt comfortable enough to ask him to take care of me tomorrow, which he assured me he would.
I know I will be homebound for a few weeks following surgery, but knowing that makes it easier. Since there is no cement, you must be very careful during the healing process. It will be worth it when I ride a bike and tie my own shoe for the first time in 22 1/2 years.
Well, that's about it. I can't eat or drink after midnight, so I'm staying up and drinking as much as I can until then. I'll update this journal when I return from the hospital and I am able do it.
I'm sorry that I'm just now getting an update written. I can blame a lot of the delay on pain medication that made it tough to have a complete thought there for awhile.
My surgery was a week ago yesterday and lasted about 3 hours. I had used a relaxation tape to prepare for surgery and felt very calm and relaxed when they took me in. The doctor said that he felt the exercises I had done previously made a difference. I'll get more information on that when I see the doctor again.
I was supposed to be on my feet on Tuesday for PT, but the doctor felt I needed another day of bed rest and so I got up for the first time on Wednesday. It had something to do with bone strength due to the fusion. During this time, I still had the epidural they put in place during surgery for pain control. It was great for pain control, but the Morphine in it made me itch really badly. They gave me Benedryl that helped some, but I still have scabs from scratching.
On Wednesday, they removed the epidural and I started taking pain medicine by mouth (Oxycontin and Lortab). They started me on some isometric exercises to do once every hour...and I really tried to keep up with that. Wednesday and Thursday PT came twice a day and got me out of bed to walk a short distance (like to the door of my room). Then they did an additional exercise where they slid my foot to bring my knee up putting my hip at an approximately 60 degree angle. I had to remind myself that I couldn't do that before without bringing my hip off the bed. It's a little surreal when I see my hip joint move in ways it hasn't in so long, but my range is still very limited because of the muscles that haven't stretched in so many years.
The nurse on Thursday morning gave me 2 Lortab pills on an empty stomach about 6 am and I ended up getting very nauseous for most of the day. I didn't take any more Lortab until I felt better, and I thought that since I wasn't having much pain I would just take the Oxycontin every 12 hours and the Lortab as needed.
I felt pretty good on Friday morning and the doctor said I could go home, but my hemoglobin was at 8 (I guess it needed to be around 11) so I had to have an additional unit of blood transfused. I had donated 2 units of my own blood (one was used during surgery and I got one the day after surgery), and they used something during the surgery called a cell saver that recycles the blood you lose, so this last unit would come from the blood bank. The doctor said he was very concerned that with my blood so low that I might blackout and fall. I had been concerned about receiving blood from the blood bank, but the danger of not receiving it was greater so I decided to go ahead.
The trip home was long and I ended up walking (with a walker) more than I had all the times put together at the hospital. By the time I got to my bed, the pain was pretty bad and I had what seemed like a lot of swelling. I realized that cutting back on the pain meds wasn't a good idea yet, so I started taking the Lortab regularly in addition to the Oxycontin (this prescription is for a week and can't be refilled). By Saturday around noon I was back on track and I'm now able to spread out the time between needing the Lortab. This makes it easier to be productive reading, writing, etc. because the pain pills make it tough to concentrate.
Because I had the metal-on-metal THR and there is no cement, my activities are very restricted until the bone starts growing into the metal. My doctor requires that you be under house arrest for 3 weeks post op until your first follow-up appointment to eliminate most chance for accidents. I can't even walk outside, so PT comes to me. Because of the fusion, the doctor made my follow-up appointment for December 17th, which is 4 1/2 weeks rather than 3 from my release from the hospital.
I'm set up in the living room on my fold-down futon sofa (as comfortable as a bed) that my boyfriend and dad used boards to raise it up to 20". This way, I'm in the middle of things rather than a prisoner in the bedroom. It's working out great and with this laptop within reach I'm not bored at all. I'm actually relaxing and enjoying the time off. I think it's as important to get mentally prepared for the recovery as it is for the surgery.
Aside from Friday, the pain hasn't been bad at all, in fact mostly less than what I had before the surgery. I can tell when I get swelling (which as been only a couple of times) because my leg starts getting really heavy when I walk. The doctor says he gave me back the 1/2" leg length I lost with the fusion, and it currently feels longer than the left leg, but he warned me that it would feel that way for a while.
I can be up and around (sitting or walking with the walker) for 20 minutes or so, and then I need to lie down for about an hour. I think this is mostly to control swelling. I understand that I will graduate to crutches eventually, but I'm not sure when yet.
I appreciate all your thoughts, prayers, and good wishes. If you have any questions or just want to correspond while I'm going through this experience, please feel free to write me at [email protected] I'll keep you updated on my progress.
It's now been two weeks since my surgery, and the staples were removed today. I felt a couple of them come out, but for the most part I didn't feel them at all. They were starting to get a little itchy, so it was nice to get rid of them. The physical therapist that visits me at home removed them, and then applied steri-strips across the incision. The incision looks really good and seems to be healed. I'm supposed to leave the strips in place until they flake off themselves in a couple of weeks.
I am still following the rule that if I'm up for 20 minutes I need to rest for an hour, and it seems to be working well. After about 20 minutes, I find I need to rest anyway. As long as I follow the rules, I'm not having much pain at all. If I'm up a little too much and my hip starts aching, I find that if I lie down and relax; I'm able to reduce it a lot.
I don't know what I would do if my parents weren't here to look after me since my activity is so limited.
It's been three weeks now and things are going well. I'm able to be up more and I'm having less and less pain. I'm down to taking one pain pill (Lortab) at night, and 1/2 to 1 pill in the morning. I recently bragged that even though I'm sleeping on my back all the time, I wasn't having back pain. I started having more problems this past week, and it may be due to less pain medication. I only notice it at night about 4 a.m. since I'm moving around more during the day.
It's late and this is when I usually want to write but don't normally have access to the computer. Tonight I'm thinking about how lucky I am, to have a family supporting my recovery and taking care of me, all my friends, and those of you with fused hips that I hope to help with this journal. Three weeks and I'm still glad I went through with it. I'm getting stronger, and with that I'm getting anxious to start moving around more. I guess I'm lucky to have had a fused hip, because I know the moves of doing things without bending more than 60 degrees from the hip...heck, 60 degrees is a lot for me to even imagine. When I lie on the bed and lift my knee up to the allowed limit, it still boggles my mind that the hip is actually doing something now.
I have 17 days now until my first post-op doctor's appointment and one more visit from Eric, my physical therapist. I'm certain I will need more therapy once they let me start moving more and putting weight on my leg, but until after the 17th I will be continuing the exercises I've been doing since I left the hospital.
I called the doctor's office today to request a refill on the Lortab prescription. The nurse asked how I was handling the pain, and when I told her I'm taking 1 1/2 to 2 pills per day--and she was amazed. She said I should still be taking about 8 pills per day to control the pain. I feel strongly that the relaxation methods I learned before the surgery deserve a lot of the credit for this.
Today I discovered why my right leg now seems so much longer. Since I'm not supposed to be putting weight on it when I walk with the walker, I noticed sometimes I'm letting it relax and sort of 'fall'. This was never an issue when it was fused. I realized this is what the doctor was probably talking about when he mentioned it was a possibility that I might need a cane if my hip muscles wouldn't support the hip. I'm now trying to concentrate on holding it up in the correct position when I walk or stand to strengthen the muscles.
You might be bored if the highlight of your day is shopping on eBay. I've actually been doing a lot of online shopping this week...thank heavens for the Internet, especially this year.
Since my back wasn't bothering me when I woke up this morning, I didn't take a pain pill and I haven't needed one all day. When I do have a little ache or pain, it's so much less than what I've been used to for years. I've been thinking about it and I've decided to start taking pain pills only as needed. It will be interesting to see how the night goes when I don't take one before bed.
Today we started decorating for the holidays and wrapping gifts. To be honest, I'm mostly supervising and my parents are having to do most of the work. I can be up for awhile, and then I get tired and need to lie down for a few minutes. Since I can't leave the house for two more weeks, we have plenty of time each day and we can take our time.
I've been having trouble getting to sleep the past few days, which doesn't surprise me since I'm not too physically active and I have a tendency for insomnia. Once I get to sleep, I'm sleeping the rest of the night.
Things are going very well. I haven't had a pain pill in about four days and I haven't needed one.
I think I've found the reason I couldn't get to sleep easily in recent days. My legs were very uncomfortable when I went to bed and it occured to me to do some research on Restless Leg Syndrome. One of the causes I found was a calcium deficiency. As soon as I increased my calcium intake the problem seems to have disappeared and I've had a couple of nights of good sleep.
I still have eight more days of 'house arrest' before my doctor's appointment. I'm feeling stronger every day and I can be up so much more than in the past without getting tired or having pain. If I had just had a usual hip replacement without the complication of the prior fusion, I would have my follow-up appointment this week. Another week will be a challenge, but I'm so confident that the doctor will increase my activity level when I see him that tomorrow I'm making an appointment to get my hair cut as soon as I can after the 17th. It's pretty bad when one of the main reasons I want to get out of the house is to get a haircut, but it's been almost 8 weeks since my last one.
Today we (my parents and I) finished the Christmas decorating. Using a walker really slows things down, but I had a lot of help and the house looks great. It's been 5 years since I've spent Christmas with my parents, so it's nice to have them here for the entire holiday season this year.
Here are the highlights of my progress:
- The incision looks healed and healthy. It no longer itches.
- I can now roll on my left side by myself (with the necessary pillows between my legs).
- I can bend to the floor to pick things up using my old fused hip technique...with my right leg out behind me. My hip is now strong enough to hold my leg up since I'm still not supposed to be trying to bend at that angle. Since I'm constantly dropping everything I touch, this is a helpful skill.
There hasn't been much to report since the last entry. I haven't had a pain pill or any Tylenol, etc. for at least a week. I have 4 more days until my appointment with the doctor and I'm really counting them now. Don't get me wrong, I love spending time at home and that part hasn't been so bad. I am, however, ready to start moving. My leg feels stronger all the time, and I'm ready to start putting weight on it to see what happens. I'm really tired of the walker.
If anything interesting happens before Wednesday, I'll post it here. Otherwise, I'll let you know the outcome of next week's appointment.
Finally, my first post-op doctor visit is tomorrow. The doctor's office called today to remind me, as if I would have forgotten. I'll just be happy to leave the house, even to visit the doctor. I really hope they will say the days of 'house arrest' are over and I can start getting out more, and that they also graduate me from the walker to crutches. I haven't left the house in 32 days, and the 5 days before that I spent in the hospital. It's hard to belive it's almost Christmas...even though it seems like the days are moving so slowly, the past month definitely flew by.
The past week I've been taking an online defensive driving course to earn a discount on my car insurance and I finished it today. It was a 6-hour class and I worked on it on and off for several days. It's the kind of thing I just don't usually have time to do. Besides hand making some Christmas gifts, it's one of the more productive things I've done to keep busy.
I'm still not taking the prescription pain medicine, but I did take some Tylenol on Sunday. I don't know if it was the weather, of if I spent too much time up and around the house on Saturday, but my hip ached and the Tylenol helped.
I'll post a message tomorrow with the results of the doctor visit.
The first post-op appointment today went very well. The car ride was much easier than the last one, which was when I came home from the hospital 32 days ago. The instructions were to ride in the backseat exactly as I had done on that trip, laying with the operative leg against the back of the seat so I could use my good leg to scoot in and out of the car. We arrived about 15 minutes early, and after a short wait I was called in to have 2 x-rays taken. After a little more waiting, I went in to see the Physical Therapist, Cindy. She showed us the before and after x-rays and explained where the bone had been removed from the old fusion to make room for the new joint. To my surprise, there are 3 screws in the socket part going up into the pelvis. I think this is because the pelvic bone was a little soft due to years of not bearing weight. I also learned that they had removed a slice of bone on the side of my femur in order to do the work. There is hardware holding that piece in place, and this is why they are still holding me back on doing abductor exercises (moving my leg to the side) to make sure that bone heals first.
Cindy checked the muscle strength in both legs as well as the range of motion. She was very impressed that I could bring my left leg up to my chest with my right (operative) leg flat on the bed. I can now begin working to increase the hip flexion up to 90 degrees (my former limit was 60 degrees and I had gotten to about 55). I also graduated from the walker to crutches and I can put as much weight on my leg as I can tolerate. In about a week and a half to two weeks, I can start using only one crutch and begin driving. This is about when my parents will be going home, so the timing of additional independence is good.
The documentation I was given said that I wouldn't see the doctor at this visit unless there was a problem, so I wasn't expecting to see Dr. Emerson. I was flattered to learn that he was anxious to see me. He seemed impressed at my progress and discussed the new exercises, etc. with Cindy and me. I talked to him about this journal and the other hip fusion patients I have met online. He said he had mentioned to someone my connection to the "hip fusion community" and laughed that the pressure was on him to do a good job. I honestly feel he has done an excellent job and I am so grateful to have found him.
I also recieved a folder with some color photos from the surgery (which I will scan and provide a link to for anyone willing to take a look), the before and after x-rays, the photo he took of me before the surgery (I'll try to include that, too), and some other information. The x-rays are a a little hard to see, but here are the before and after views:
After the appointment, we made a couple of stops to eat and pick up a few things. Walking doesn't hurt at all, even putting additional weight on my leg. Sitting is pretty uncomfortable. I sat on a wooden chair at the restaurant and 20 minutes was all I could handle.
My next appointment with the physical therapist and the doctor is scheduled for January 14th.
I finally got a haircut today. The haircut felt great, but sitting there was pretty difficult. I sat in the chair about 30 minutes and felt some discomfort, mostly in the muscles/tissues near the incision. Then, we went to a restaurant to have lunch and I had trouble sitting in the chair there, too. When I walk, I'm putting a lot of weight on my leg, and that doesn't seem to cause any problem. I don't notice any pain in the actual joint. When we got back home, I was pretty tired and took a nap. After 5.5 weeks of very little activity, I'm sure this is to be expected. I've been allowed to sit for short periods in a chair up until now, but I've been doing more propped-up-with=pillows-behind-me-on-the-bed sitting than sitting in a chair.
I am also now allowed to lie on either side. If I lay on the left side, I still need a pillow between my legs (I had to sleep this way before the surgery to keep my back from hurting anyway). After about an hour, my hip starts aching and I have to return to my back. I tried laying on the right side last night, and I was surprised that it didn't hurt. After a little while though, it really started hurting. One of the new things the physical therapist told me to do is spend time each day massaging the area around and under the incision to loosen up the tissues and muscles, so I'll keep you posted on that.
I'll be doing more updates now. Tonight, a friend mentioned he had been checking the site and there weren't many updates. I explained that 32 days in the house didn't give a person much to talk about other than what was for breakfast, but now that I can start doing things there will be more news.
Time is moving so quickly now that I can leave the house, and with all the holiday preparations, that I haven't had a chance to write. Now that Christmas is over, I can take a moment to post an update before I go to sleep.
On Sunday, we attended a family dinner with my boyfriend's family. There were 11 people and they asked me to sit where I would be most comfortable. I sat at the end of the table where no one was sitting on my right, in case I needed to stick my leg out to the side. During the meal, I realized I was sitting pretty close to normal in the chair, not on the edge with my leg tucked under the chair or sticking out in front of me. Those of you with fused hips know exactly what I mean. I was sitting in the chair normally. It was almost one of the first real moments I realized the difference. I silently gave thanks for the best gift of all time and vowed it was the only one I needed.
I'm still having some pain in my hip and thigh when I sit for very long...let's say more than 15 minutes, but I can walk with one or two crutches while putting weight on my leg without pain. I'll be trying to drive this weekend. Depending on how the next week goes, I'll probably try going back to work part time the first week of January.
Things have been going very well. I can sit straight with my knees bent (my hip at 90 degrees) for about 15 minutes before I get too uncomfortable. I'm doing my daily exercises and starting to incorporate a couple of yoga stretches to try to stretch out the hamstring on my right leg. It's taking some time after all those years of no stretching, but I am making progress.
I keep thinking that I should be going back to work by now, but the sitting issue is a concern since I have a sit-all-day job. I received a call yesterday from the disability insurance nurse in charge of my case, and she feels I should be off until the first of February. That would be three full months off work, which I don't think I need. I tried to call the Cindy, the physical therapist at Dr. Emerson's office to discuss it with her, but I haven't heard back yet. I figure they are very busy after the holidays and I'll try to call again tomorrow. I'm hoping she can give me some insight about the sitting problems. From the location of the pain, I feel that strange metal piece shown in the x-ray is involved somehow.
Before the surgery I was having pain in my lower back on the right side, and that is acting up. Since it's been a problem since I've been using one crutch, I think it is the way I'm walking. I may go back to both crutches for a few days and see what happens. I've started doing several lower back exercises to strengthen the muscles.
If you're interested in the graphic photos of the surgery, feel free to take a look at your own risk!
I haven't heard back from Cynthia and I've decided to wait until next week's appointment to discuss it with her. I have good days and bad, one day I think I could work easily and the next I want to lie down most of the day. I may not be ready to save the world just yet...
I had my second post-op doctor/physical therapy appointment on Wednesday. I drove myself, which I've been doing for a couple of weeks, but this was the furthest. It's an hour trip from my house to the clinic and I was stiff and exhausted by the time I got there. I also think I'm predicting the weather since every time a front is a day or two from coming through, my right hip and leg start aching. That morning, we had a lot of fog and a front was due on Thursday. I guess I should have taken some Tylenol before I went, because when Cynthia had me walk I didn't do very well at all because of the stiffness. I was much better yesterday.
I am now riding an exercise bike! I rented one from a local company for now and I started out with 2-5 minutes at a time with no resistance. It was delivered yesterday and I rode it for 4 minutes every couple of hours. It felt great and doesn't hurt at all, and I had trouble not riding it a lot more. I also graduated to a cane, and I'm supposed to tap the cane down, not putting much weight on it. I was relying on the crutch more than I thought, as this is more difficult. The joint is still very stiff and it's uncomfortable to put so much weight on it, but not to the point where I can't do it. I do get tired and by Wednesday evening I was back using both crutches before I went to bed. Another thing she has me doing is attempting to walk like Marilyn Monroe with a real exaggerated walk. This is also a challenge because of the stiffness. I'm also working more on abductor exercises. I lie on the bed with a band tied around my thighs and move my right leg to the side. I'm grateful that those muscles are working, even if they hurt!
I find now that hot baths in the evening really help relax my muscles after I've walked a lot. Last week I found that I could touch my big toe in the bath, and while the muscles were still relaxed after the bath I could, while standing, bend over and touch my toe. I took this opportunity to trim my own toenail for the first time in so many years. It was only the hot bath and relaxed muscles that made it possible, but I can see the future! I don't think I'm supposed to be bending like that, but my goals were, as mentioned before, riding a bike and tying my shoe...I'm getting there and I can be patient.
I'm planning to work hard on my exercises and walking for the next week and return to work part time on January 26th. I'm grateful I was able to take this much time off. I'm also grateful for an amazing doctor, and for my family and friends who have been so supportive.
I started back to work on Monday for four hours a day (8-12). It's been going pretty well, but I've been tired. I guess that is to be expected since my activity level was restricted for so long. It's been nice to be able to come home and rest in the afternoon. The pain I was having when I was sitting has improved quite a bit and I'm able to sit for 30 minutes or more now. I'm short, and it helps a lot to sit in a chair where I can have my feet on the ground so there isn't as much pressure on my thighs. The therapist measured my flexion at approximately 87 degrees at my last appointment, and I'm pretty sure I'm at 90 degrees now, two weeks later.
I'm riding the exercise bike now for 20 minutes at a time with no resistence and I feel it's helping a lot. The weather is currently the big problem. We've been having cold fronts move through one after another lately and each one causes discomfort when the barometric pressure changes. I don't like cold weather at all, and when it's in the 20's in the morning I really feel it. The past couple of days has been a challenge, especially in the morning, so today I used the crutches at work instead of the cane. It was the break I needed and I'm back to the cane this afternoon.
I plan to return to work full time next week. I've asked Cindy, the physical therapist, for a release to go to the gym we have at work on my lunch hour. I think it will help to ride the exercise bike and do my exercises and stretching in the middle of the day.
Today was my first full day at work. For my lunch hour, I went to the company fitness center and rode the exercise bike for about 20 minutes. Then I did the exercises I've been doing that were assigned by Cindy, the physical therapist. It was a nice break since I sit most of the day to really move around.
The weekend went very well and yesterday I felt like I could almost walk without the cane and not limp. Last week I had so many days where I was uncomfortable because of the weather that I had nearly forgotten about those really good days. It's funny, too, because we had a big storm come through last evening and I didn't notice it in my hip.
I talked to Cindy this morning about getting a release from her so I could go to the fitness center and I asked her about when I would be able to ride a regular bike. She said I should be able to do that at 3 months post op. That will be next Tuesday, but I'm going to wait until my appointment with her on the 18th to talk more about it. I'm looking at a couple different models and maybe she can give me some input. I can't quite tie my shoe yet, but I've got the bike part down! The groundhog may have seen his shadow, but spring is coming. Riding my bike was one of the first things I always did when the weather got warm. It's been 22 springs since I've been able to do that and I'm going to be ready.
My surgery was three months ago yesterday. My new friend in hip fusion, Jim, has asked me each month if I have any regrets and if I would have the surgery again based on my progress at that time. I can still say at 3 months that I have no regrets and I would absolutely do it again.
Here's what I can do since the surgery that I couldn't do with a fused hip:
- Ride a bike, ride a bike, ride a bike!
- Sit in a chair without sticking my leg in front or in back - this has made a big difference in my lower back problems.
- Since I'm walking and sitting correctly, my knee is no longer causing me problems.
- I used to attach a razor to a wooden handle with rubber bands to shave my legs. I can now reach to shave my legs without the added extension.
- It's even easier to use the bathroom (I'm sure those of you with fused hips can relate to this in some way).
- I don't kick the dog when I bend over. My right leg goes back a little depending on how far I bend, but not nearly as much.
- I can sit on the floor.
- I can almost tie my shoes.
Things I'm still working on since the surgery:
- I still can't lay on my right side for long periods, but I have increased that time to approximately 30 minutes at a time.
- The weather is a problem for me. On warm days I feel great and there's virtually no discomfort, but on cold days or when the barometer is falling, I get pretty uncomfortable and it's more difficult to walk.
There's nothing I could do before that I don't think I will be able to do again, except maybe cruising through metal detectors without being noticed.
I'm still using the cane and working on the strength and flexibility in my hip. The flexibility is improving very well and it's so nice to feel those old muscles working and stretching. If I bend at the waist and let my arms dangle at my sides and slightly bend my knees, I can feel the muscle in my right hip stretch (I guess it's the glutius maximus). I've dreamed of being able to get a good stretch in my hip for ages.
Exciting news! Over last weekend, I bought a bike! I was hoping to be able to get a picture of me riding it for the website, but the weather has not cooperated all week and I haven't been able to ride it. As soon as I can get one, I'll post it here.
We finally had a chance to go bike riding today and rode for 30 minutes or so. It was so fun, just like I remembered. My right (operative) leg is the one that is in the 'up' position. I do have some muscle pain now that I'm increasing the resistance and also riding the real bike, but it works out pretty easily by walking and putting heat on it. I'm sure there are muscles involved that are not used to being called into action.
I had a doctor's appointment on Wednesday. It went very well and both Cindy (the physical therapist) and Dr. Emerson seemed very happy with my progress. My flexion now is at approxmately 95 degrees. I wasn't expecting to see Dr. Emerson on this visit, and when he saw how well I was doing he went to get his video camera to film me walking, etc. He also commented that all the preparation I did with the isometrics I was doing were very beneficial. It makes me feel good to 'make his day' since he has done so much for me.
I haven't been working as hard on the abductor exercises because of the discomfort (the abductors are the ones that move your leg to the outside and they haven't been used since the fusion), but I now need to concentrate on those exercises. Cindy explained that all my other muscles are strong, and I will be able to abandon the cane (in 6-8 weeks) when the abductors are strong enough to make me walk without a limp. The exercises consist of (1) tying a stretchy band around my legs above the knee, and while lying on my back move my right leg to the right using the band as resistence, (2) putting a belt around my legs above my knees with my knees about 12" apart and pushing out against the belt, and (3) the standing leg raise--I lift my right leg out to the right as far as I can keeping my hips even and holding it for a few seconds. I've been working hard the past few days and my abductors are pretty sore. My sister, who does yoga, gave me some tips today for stretching them. I'm wondering if there is a way to work those muscles before the surgery for those of you who are coming behind me.
The bad news is that Cindy asked me to wait until March 10th (4 months from the surgery) to ride my new bike anymore. They know I can ride it, but they are only afraid of me falling and want me to wait until the 4-month mark to take that chance. I can do that.
Here's some good news...on Valentine's Day I became engaged! The wedding, which will be small and simple, is scheduled for Memorial Day (May 31st).
I didn't realize it had been so long since I've made an update to this site! In two days it will be 5 months since the surgery and things have been going pretty well. I've been riding my bike since March 10th, and I still ride the stationary bike several times a week. In fact,on March 28 we rode about 16 miles (we didn't plan to do that, we just got about 8 miles from home and had to ride back). This ride included a couple of pretty big hills and although it was very tough, I rode them. However, I didn't sleep very well that night and ended up taking the next day off. Live and learn!
I've continued having a rough time with the abductor muscles. I was told that getting those muscles in shape would enable me to walk without the cane, so I've been exercising them regularly (but they are a real pain). They are very difficult to stretch, and the more I worked them they developed a real tightness to the point where I felt I was going backward in my recovery. On Friday last week, I sat down and my leg did an involuntary movement (like a spasm) out to the side and back...it was a little unnerving. After that, I felt like I had a 'charlie horse' deep in the joint. A co-worker and I were talking about it and she suggested deep-tissue massage. I have a little trick I do with a tennis ball on the floor...I lay on it and massage my back by moving around on it. Friday evening I used it on the side of my hip. It hurt like crazy and I could tell the muscles were all knotted up. It's been a lot better since then and I'm trying to keep doing that each day to keep the muscles from getting so tight. This turned out to be an important discovery for me and it's made a huge difference.
Otherwise, I don't use the cane as much at home anymore, and depending on how the day is going I need it more some days, less other days. I definitely use it when I have a long way to walk, but for short distances I'm getting along without it most of the time. A new thing I'm doing when I use the cane is to get walking really well with it, and then lift it up for a few steps to make sure I'm walking the same without it. After I've been sitting awhile, it still takes several steps to work out the stiffness, but that is getting less as well. A couple of week's ago, I was taking a pain pill at night because when I tried to relax it would really ache, but since I started the tennis ball therapy I haven't needed to do that. Changes in the weather still bother me, but not as much now that it's not cold.
For those of you with fused hips, I hope I'm not making this all sound too easy. It's taken determination, committment, and a lot of hard work. My fiance calls me 'the energizer bunny' because I'm always in motion and the surgery hasn't changed that. I know that if I wasn't committed to a successful recovery, I wouldn't be making the progress I am. I did everything I could to prepare physically and mentally for the surgery, and I exercise and stretch every day now. I'll be happy to give support in any way I can to those who follow behind me.
My next doctor appointment is May 26th and I plan to make that visit without the cane. Hear that, Dr. Emerson? Get ready with your camera!
It's tax day, the Texas Bluebonnet's are in bloom, and everyone has allergies...it must be spring. It's been a pretty good week. I've taken my cane to work every day this week and only used it once, so I parked it in my cubicle in case I need it. I plan to get one for home this weekend. Everyone at work is commenting on my progress and the lack of the cane, even people I don't know. I bragged to our director (my boss's boss) today and he said he hadn't noticed...and that was a good thing. He said that if he had seen me struggling around without the cane, he would have wondered why I wasn't using it. The weather makes so much difference.
I sent the exercise bike back to the rental company (Aerobic Fitness Rental in Dallas--I highly recommend them) and purchased a trainer for my bike this week. Now I can ride the same bike in the house and outside, and I'm trying to do it for at least 30 minutes a day. It's amazing how much riding a bike has helped strengthen my leg. I'm also still using the tennis ball to massage the abductor muscles and that has helped so much with my walking. The barometric pressure dropped this afternoon and I noticed pressure in my hip. I do know the effects of the weather are less and less as time goes on. I told someone about how Dr. Emerson had said that I might never walk without a cane, but I could prove him wrong...and I already have.
The beginning of May, at about the six-month mark, I noticed a tightness in the back of my thigh. It was a sore muscle and I assumed it was due to bike riding or something else I had done, but couldn't remember anything specific. We were out of town at the time and busy, so I didn't spend much time thinking about it. Over the next couple of days, the soreness increased and I tried stretching it out periodically. I first noticed the soreness on a Saturday, and the next Thursday I was talking to some people at work when suddenly I felt like a big dog had grabbed the back of my right leg...the worst muscle spasm I've ever had. That day, I requested muscle relaxers from the doctor but could only take them at night. That evening, I noticed a large bruise on my right thigh. On Sunday morning I was at the gardening center when the next spasm hit. The bruising got worse. I went to see my primary care doctor a couple of days later and explained that the brusing was developing as the spasms happened. They sent me to physical therapy where they determined it was the medial hamstring. No one had seen anything like it, but it was agreed that the spasms were causing bleeding in the tissue. (Photo of bruises).
I went to Physical Therapy three times a week for the next four weeks (which ended last week). During that time, they treated me with ultrasound, stretching, and myofacial release (myofacial release is where they put pressure on the muscle (or 'knot') until it relaxes). I had one additional spasm during the second week of therapy, but no more since. The massage therapist has had some problems differentiating muscle from bone in some cases, but things are slowly starting to loosen up. They are currently working to get my therapy extended for another month, so I'm not going this week while they contact the doctor and insurance. At my last appointment, I received a list of stretches and exercises to do in the meantime.
I went to see Dr. Emerson for my six-month checkup on May 26, which was nearly seven months post-op by that time. He was very impressed, said my x-rays are perfect and I was walking well without a cane. He actually said I was the best recovery he's seen. I now have no movement restrictions except high impact activities.
During the visit, I showed him the bruise photos and explained about the physical therapy I've been having. Dr. Emerson didn't believe me that the bruises were caused by muscle spasms (why would I lie?). He said he's never seen that happen in his career and they had to be caused by impact. He also doesn't believe that the physical therapy is necessary. Two weeks before I saw him, I couldn't walk without my cane and my leg was black and blue. It was as if I had taken a giant step backward in my recovery. That day and since then, I've walked nearly perfectly without my cane and the bruising is gone. It's easy for him to say the therapy isn't doing any good and that I wasn't having muscle spasms...I wish he had been there when one hit me. I also wish I could have been doing this type of therapy ongoing since the surgery (probably starting at 2-3 months post-op) and I would recommend it to anyone in our situation. I was disappointed that he wasn't more interested in the experiences I'm having as I recover. There isn't any documentation on what to expect from this surgery, and I had high hopes that he could help me change that. It isn't logical to me that you would not experience problems with muscles that had not been used in over 20 years, especially when I was having major problems with them before the replacement.
All in all, things are going well. I'm not using the cane and have very little pain compared to what I'm used to. I can honestly say I am glad I had the surgery and I would make the same decision again. I'll keep posting updates periodically until I feel I've dealt with all the recovery issues. Please feel free to email me any time with questions or comments at [email protected]
Today I updated the site with Denise's recovery journal address. She is having her THR surgery tomorrow.
Also, we now have our wedding photos online if anyone is interested: Wedding photos.
I'm still having shoulder problems that have not improved since the surgery as my knee problem did. I feel the problems are related as the physical therapist feels my spine is slightly twisted from all the years of sitting incorrectly, and also my shoulder slips from the socket. It's my right shoulder...same side as the THR. I've gone to an orthopedic doctor and I'm having an MRI on Thursday. I'll update the site when I know what's going on.
My main challenge right now is not overdoing it. I ended up with stiffness and muscle pain again last week after I increased my workouts. I've been doing a beginning pilates dvd three times a week since right after the wedding, and I've seen the strength and flexibility of my leg increase. I've tried moving up to the intermediate dvd a few times, and last Thursday was the first time I could go all the way through it without pausing the dvd. I did some cardio that day at lunch, and again the next day. Friday night, I thought I was going to need the cane! When I feel good, it's hard not to get carried away with activity. It's a lot better today after days of stretching, but it's still a little stiff.
As for the shoulder, the MRI didn't show anything and the doctor ordered another one for my neck. Initially, it was frustrating because I feel that the problem is caused by the tight muscles in my back and shoulder from the years without a hip. When I requested PT for it, I was going to them for my hip and that's all they could work on. I was hoping that they would do the same for my back/shoulder that they were doing for my tight hip muscles. Well, that's not how it worked out. The physical therapist still thinks there is a problem with my shoulder. She feels the reason the MRI didn't show any shoulder damage is because it was a closed MRI and my shoulder was tight against my body. If there is no damage but the tendons are loose, it probably wouldn't show up under those conditions. I've decided to go ahead with the cervical MRI to rule neck problems out but in the meantime, I'm working on the tight muscles myself with my trusty tennis ball. The MRI is next week and the follow-up doctor appointment is the week after that.
Today is the 10-month anniversary of my surgery. I can't believe it's been that long! I'm doing really well, although I was having a strange problem last week. After my success with the intermediate pilates dvd and needing the cane the next day, I started noticing a popping when I walked. It wasn't all the time, mostly when I was tired, but it worried me. I wondered if it was a problem with the joint, but I thought if it were I would have the problem all the time. I also wondered if all the activity and especially the more difficult pilates dvd might have worked some old, unused muscles deep in the hip or something. I took a week off from extra activity and saw Chad, the P.T. last Friday. He found a lot of deep, tight muscles and worked on them. The popping continued the next day, but I tried to rest as much as possible on Sunday and Monday. The popping has totally stopped and I started riding the bike again last night for 10-15 minutes to loosen it up. I'm planning to go back to the beginning dvd tomorrow, but I'm going to proceed much more slowly this time.
The cervical MRI I had last week showed three bulging disks in my neck, which explains the shoulder and hand problems. I'm scheduled to receive a series of three steriod shots in my neck, two weeks apart, starting on the 20th. This is to relieve the inflammation in the nerves. Once that is better, I will have physical therapy on my neck to help heal the disks (ultrasound, heat, massage, exercise, etc). Unless there is a problem and those treatments don't improve the situation for some reason, no surgery is necessary. It would only be speculation to say that my fused hip caused any of this, but I'm sure it didn't help.
I have been meaning to post an update for six months, but something has always come up. I just received an email update from Jeanette, who had her THR in on March 29 and is doing very well, so I decided to sit here until I get something typed.
I'm doing very well. I have great range of motion and my strength is very good. As always, I have to be careful not to get carried away with activity or I can develop muscle spasms in my IT Band muscles. By over activity, if I work out every day and then go for a long walk on the hills in my neighborhood and don't take time to stretch every time, it eventually catches up with me. I'm always moving and I got used to moving even when it hurt before my surgery, because it hurt all the time. I have to remember to notice the pain now and take it as a sign to slow down. My tolerance for pain became so high that I might not notice it until the pain is what would have other people at the hospital.
Every day I'm grateful that I had the opportunity to have my fused hip replaced. Every time I'm able to tie my shoe, paint my toenails, shave my legs, sit in a chair properly...I could go on and on. The little inconveniences of lingering muscle complaints is nothing and I deal with over-doing without much thought, because my quality of life has improved so much.