Yoga=FAIL

Happy Sunday Everyone!

I must say that I thoroughly enjoyed my Thanksgiving weekend with amazing family and friends.  I hope you all did as well.

I have some bad news; a "bump" in the road to recovery if you will.

I received the green light from my surgeon's physicians assistant to try a hot yoga class again.  I went last Sunday (11/17) and felt great!  When I saw my physical therapist two days later, he even commended me for being the most open and flexible in my hips since surgery!

Since I was feeling so open and great, I decided to try another hot yoga class on Thanksgiving morning (11/22).  During and after the class, I continued to feel great!

**PLEASE NOTE**
During BOTH of these hot yoga practices, I was extremely careful by taking many breaks, sitting out on many poses and not going as deep into poses as normal.

Ever since Friday morning, I have been dealing with AWFUL pain in my lower right back, right groin and the pain is shooting down my right leg.  I have not felt these sensations since BEFORE my surgery.

I am very worried that I damaged or re-injured something... :/

I emailed my surgeon's physicians assistant, Kira, letting her know what happened.  I also have an appointment already scheduled with Dr. Coleman this coming Wednesday....

I reallllyyyyyy hope everything turns out alright...

XOXO,
Ashley Girl

12.5 Weeks Since Surgery!

Hi Everyone!

Wow, I can't believe it's almost 2 months since I last updated everyone on my recovery. Time really has flown by!

UPDATES:
Physical Therapy: This week started 1xWeek of PT and acupuncture!  I can not believe I am almost done with my entire PT protocol.  Crazy.  However, Dr. Jim O'Rourke says that I almost have COMPLETE range of motion back, but that it takes up to a full year for a body to recover from a major surgery.

Elliptical:  Back to normal.

Pilates:  Back to normal with slightly less range of motion.  However, with my awesome Pilates instructor and friend, Elly Mandarakas, I know that will all come back with time!

Hot Yoga:  I was just cleared to SLOWLY and CAREFULLY try my first practice in 13 weeks!  I signed up for a class at Garden State Yoga in Bloomfield, NJ.  I can't wait to start practicing again, although I'm pretty nervous...

Running:  Not happening yet.

I see Dr. Coleman, my surgeon, for my second follow-up on Wednesday 11/28.  I'll let everyone know how that goes!

Overall, I am 200% happy that I repaired my labral tears in my hips and I am so thankful that my recovery has been going so smoothly.

Best,
A

Five Weeks Post Op

So who is absolutely LOVING this crisp, sunny, cool Fall weather?!  I hope everyone in my NJ area is, because it is GORGEOUS!  I am so thankful to live in a place that gets to experience all 4 seasons and Fall is my FAVORITE.

In other news, I can not believe that 5 weeks have passed since my hip arthroscopic surgery!  I am still on the road to recovery and it has definitely been a journey.  I am still going to physical therapy with Dr. Jim O'Rourke at Focus Physical Therapy in Montclair, NJ.

Some updates:
1) This is my last week of tons of PT, starting next week I will be dropping down to 2x per week!

2) I tried a different elliptical machine (with arms and a wider stride), that simulates the motion of running way more than the one I've been using.  I did it for 30 minutes this past Saturday and I was SUPER SORE Sunday and Monday.  I'm still feeling the effects today.  I think I need to apply my "less is more" mantra the next time I attempt this machine.

3) My incisions are all pink and healing.  I hope in the next few weeks I can start using scar cream to reduce them.

4) Due to the antibiotic I was on for my infected incision, I developed TWO "lady" infections, which I have been on medicine for.  Luckily, today is the last day for those, and boy am I thankful.  I have been dealing with such bad side effects from all the medication and I can't wait to get my body back on track.

Until next time,
The School Psychologist Intern with Recovering Hips

Four Weeks Post Op

Happy Tuesday Everyone!

It is rainy, cloudy, humid and dreary in North Jersey today and I am completely unmotivated to be doing anything!  However, it has been 4 weeks (wow, I can't believe 4 weeks has passed) since my hip surgery, so I wanted to provide some updates on my recovery!

1) I have been on the elliptical a few more times and I no longer get super sore!

2) I went for my first "leisure" walk with my Golden Doodle Bentley Boyd and walked almost 4 miles!  I was surprisingly not sore at all, but I definitely do not have my speed or full stride back yet.

3) I had a deep tissue massage this past weekend and BOY WAS I TIGHT!  All of my glute, thigh, low back and hip muscles have never felt that tight before!  The massage really helped and I decided to schedule one more on 10/1.  Hopefully that keeps things moving.

4) I went back to my Pilates class last night!!!!  I was nervous of how I would feel this morning, but I have awesome news: I AM NOT SORE AT ALL!  However, during the class, my right hip joint kept popping and making clicking noises.  I thought that this surgery was supposed to fix that?  I developed some anxiety and began thinking that something may have went wrong in there... I have decided to try one more class on Wednesday.  If it's not better, I'll email Dr. Coleman and Kira!

5) I am still progressing wonderfully in physical therapy and I will be starting some new strengthening exercises tonight (i.e. small lunges).

Until next time,
The Girl in Need of Starbucks!

Three Weeks Post Op

Hi All!

Today marks the 3 week anniversary since my double hip arthroscopic surgery at Hospital for Special Surgery with Dr. Struan Coleman, the most awesome hip surgeon around! ;)

Here are my updates:

1) I have been going to physical therapy 3 days a week at Focus Physical Therapy (Montclair, NJ) with the best PT around (Dr. James O'Rourke)!  I HIGHLY recommend this facility and doctor to anyone who needs physical therapy work.  They are the most kind, intelligent and supportive experts around.

2) I tried the elliptical machine for the first time on 9/7 for 35 minutes.  I rotated between levels 6, 7, 8 on a 0% incline.  The next day I was SUPER sore in my hip joint, so I took the day off to rest.  I was back at it with Sunday morning Spin class for 45 minutes though and felt fine!

I attempted the elliptical again, yesterday, on 9/10.  I rotated between levels 6, 7, 8 and between 0, 1, 2, 3% inclines.  I stayed on for 35 minutes and was NOT sore this morning!

I have decided that I will do the elliptical on days that I do NOT have physical therapy.   The days I do?  The bike it is!

3) Dr. Jimbo told me that I could try Pilates class starting next week.  I am going to see if he will let me go tomorrow!!  Fingers crossed!

4) I am on my last day of antibiotics for my infected incision.  The redness has gone away, the puss has cleared up and I hope that this dose of medication will keep me infection clear!

That's it for now folks!

Keeping 9/11 and everything about it in my thoughts and prayers today,

Ashley

Day 16: Infected Incision

Hi All,

I was planning on only updating you once per week, but I have some unfortunate recovery news.

As I was in physical therapy yesterday, Dr. Jim O' Rourke (Focus Physical Therapy, Montclair, NJ) noticed that only one of my sterile strips was still covering one left leg incision.  He noticed that there was some discoloration on the strip and asked if he could remove it.  Obviously, I agreed and this is what we saw:

Sorry for all of my readers with sensitive stomachs!  However, this incision clearly appeared INFECTED.  I guess I caught it early, since the surrounding skin was not swollen, red or hot.  As you can see in this photograph, it appears that the incision is only infected on the surface, however, I wanted to be safe.

I emailed Dr. Coleman and his physician's assistant (Kira) a picture.  Long story short?  They thought it looked "funky" and diagnosed an infection. They prescribed me the antibiotic Cephalexin for 5 days.  I take 4 pills a day at 500mg.  Let's hope this doesn't get worse!

In lighter news, I'm still championing through my biking and physical therapy, but I am itching to get on the elliptical and back to Pilates class.

Happy Friday!

XX,
The Infected One

Two Weeks Post Op

Hi Everyone!

I'm sorry I did not get to update you all yesterday, being that it was my TWO WEEK POST OP anniversary.  It was my first day back at my school psychology internship and it was a crazy and hectic day.  Today the students have arrived, so I am even more exhausted.

Just to let you know:

My sterile strips have come off my incision sites and they are completely closed up!  They still appear red, but at least they are healed.  The scars are so small it's crazy!!! :)  It amazes me how Dr. Coleman made two TINY incisions and was able to do all of the bone resurfacing and cartilage repair.  I am still so thankful that everything went well that day.

I had my second physical therapy appointment with Dr. Jim O'Rouke at Focus Physical Therapy in Montclair, NJ yesterday.  I started doing heel slides, balancing acts, quad stretching and small bridges.  He told me that at 4 weeks I can go back to Pilates class... FINALLY!  Only 10 more days to wait ;) And that I can try the elliptical machine a few days after that!!! :)  He is happy with my progress.

I am really sore this morning, since I did 40... yes FORTY minutes on the stationary bike after PT and burned a total of 400 calories!!! (My most yet!).

I must get back to interning now... I only have a few more weeks of being an intern before I need to find a full-time position.  I can't believe graduation is in 3 months and I only have 6 more graduate class meetings left!

Respectfully Yours,
Ashley

OH!!  Want to know what the best part of yesterday was?  Coming home from a crazy and hectic first day to the most gorgeous bouquet of get-well flowers I have ever received.

They were from my very best friend Lauren Totoris, her Mama Vivv and Papa Jack.  I could literally feel them hugging me through the flowers and I can't thank them enough!  I am so lucky to have people in my life who genuinely care about me, as much as I do about them!  By the way... this is Lauren...

Recovery Day 11 and 12

Happy Labor Day Weekend Everyone!

I'm sorry that I did not post yesterday, it proved to be a very discouraging day in my "hip recovery" world and I just did not have the mental energy to write about it.  However, today is going MUCH better! :)

After wining and dining myself on Friday night at Stamna with some great friends, falling asleep at the table and getting AWFUL stomach pains... I realized that I still need to be taking it easy and that alcohol just needs to stay away until I'm more recovered.  It may sound ridiculous, but the few glasses of wine that I had really made my entire body swell, especially my hips/thighs.  So listen up people, NO MORE ALCHY for a while!

I woke up on Saturday morning and enjoyed a delicious North Jersey diner breakfast with my friend James.  We had great conversation about life goals, education and fitness.  I had two eggs over easy with a side of melon AND allowed myself to eat ONE whole wheat pancake ;)

After, my stomach seemed to be in much better shape and my headache was wearing off, so I decided to go to LA Fitness and ride the spin bike.  However, I only lasted 10 minutes due to feeling faint and my muscles shaking uncontrollably.  I was really annoyed with myself, since I wanted to get a work out in and it took some time for me to self-talk myself back into a positive mood.  However, one of my best friend's Jaci came to the rescue.  It was her birthday and she invited me to have a birthday lunch with her on the patio at The Cheesecake Factory!  I enjoyed a delicious vegetable salad, with a side of Tramadol (pain medication) and had wonderful conversation!

I spent the rest of my afternoon icing and got to bed early.  However, I developed ANOTHER allergic reaction to my pain medication (the same type I had to the antiinflammatory drug) and had to take more Benedryl.  Luckily, the Benedryl eliminated my symptoms and I was able to get a good night's sleep.

So, I'm learning that I really need to embrace the phrase "less is more" at the moment, but it is so HARD!

This morning I woke up and told myself that I would have a much better day, NO MATTER WHAT.  I went to 8:15 spin class, told the instructor my situation and had the RIDE OF MY LIFE.  Well, the best cardio workout I've had in almost two weeks anyway.  I lasted 35 minutes, sprinted on a level 8, reached a level 14 and burned 300 calories!  I finished with some light arm work, pushups and topped it off with very few crunches.  I even downed some Motrin, since I knew I'd be sore.

The best part of my morning was attending church!  I went to my congregation of the New Apostolic Church in Wayne, NJ and had a LOVELY spiritual hour with minister Jeff Harmon!  He held a thrilling and uplifting service about not worrying and fearing your life away.  He spoke about striving to be more like Jesus Christ, letting go and allowing God to be in control of our lives.  It was wonderful!

I'm on the couch icing now, since I feel swollen from spin... IN A GOOD WAY THOUGH ;)  I'm getting excited for the afternoon BBQ at my friends Kevin and Emilee Orlofski's.  They just bought their first home a few months ago and invited a bunch of people over to celebrate the last weekend of summer!  I made my Grandmother's famous chocolate chip cookies and I'm excited to eat some great grilled food before going back to internship on Tuesday!

Learning that less really might be more,
Ashley

Recovery Day 10

Hi Everyone!  I feel that I have so much to update you on since yesterday morning when my stitches were FINALLY removed...

My mom, Anna and I piled into the car around 9:15 and headed off to Dr. Coleman's office on the Upper East Side.  I arrived to my appointment right on time for 10:30 and was immediately brought into the room.  A very kind nurse cleaned the incision areas, used a tool to pull up on the stitches and then cut them with scissors.  After snipping, she pulled them right out and covered all 4 incisions with sterile tape (that will eventually fall off on their own).  I must say, getting my stitches out on the left side sort of... HURT!  Again, the left side is still more swollen, stiff and sore... and clearly WAY MORE TENDER.  Removing the right side stitches was a breeze!

After removing my stitches, I got to see Dr. Coleman's physician's assistant, Kira.  She quickly examined my incision sites, yelled at me for never using my crutches and cringed when I said I was already up to a level 4 on the bike.  HOWEVER, she said I am on a great road to recovery and to stop being so stubborn with my exercise routine ;)  She then handed me my physical therapy protocol and told me to schedule my next appointment in 6 weeks.  I won't see her or Dr. Coleman again until Monday, October 8th at 9:45.

I won't bore you all with mundane PT jargon, but I will give you some of my information:

Physical Therapy: 3 times per week

Stationary Bike/Spin Class:  Keep working up intensity, resistance and frequency until I can handle a complete spin class.

Pilates: When my body allows and does not feel sore.  However, some movements in Pilates I won't be able to do for another 2-3 weeks or so.

Walking: As much as I can handle.  If I fatigue or become SUPER sore, back off.

Elliptical:  As soon as my hips can handle the motion without becoming super sore OR at 6 weeks.

Running: Not until 3 months (Thanksgiving time) NO MATTER WHAT.

Yoga: Not until 3 months (Thanksgiving time) NO MATTER WHAT.

After receiving all my information and scheduling my appointment, we were off to walk a few blocks to the Atlantic Grill for some delicious lunch!  We sat outside and I really got to enjoy some time with my mom and little sister.

After lunch, I arrived back home in NJ around 2:30.  I immediately packed an overnight bag and drove down the shore to Lavallette, NJ.  I spent the night with some of my Dad's side of the family at my Aunt's shore house.  We attended a fundraiser at a local restaurant for the Lavallette police and hung out with each other all night!  I got to spend time with: Aunt Fran, Uncle Frank and Kristin; Auntie Steph and Jamie; and my Dad and sister Melissa!  I am so thankful to have had that family time.  However, I was EXHAUSTED.  It was the most I've done in one day since my surgery and I definitely felt mentally AND physically fatigued.  Luckily, I got into bed early and had a really great night's sleep.  Here are some pics:

 I woke up this morning and immediately drove back up north to do my daily stationary 30 minute recovery ride, upper body and core workout and had lunch with my grandfather.

Today at 2:00 was my very first physical therapy appointment with Dr. Jim at Focus Physical Therapy. We went over my protocol, did some heating and light stretching, some stabilizing isometric exercises for my quads and glutes and then he massaged my incision areas.  WOWWWWW was the left side tender!!!!  There is a lot of scar tissue and swelling in the left side (when compared to the right), so he spent a little more time massaging there.  It felt AWFUL during, but as I am sitting home now, it feels so much better!

I plan on spending my Friday afternoon icing my hips and letting some Motrin work itself into my sore muscles.  But tonight, I am going out for a DELICIOUS dinner at a local Greek restaurant with 3 awesome friends... followed by a night of wino.

I am so thankful to report that I am still recovering well.  However, I think I am still getting over the anesthesia, since I am ALWAYS tired.

Respectfully Yours,
The Stubborn with Exercise Routine Patient

What Happened During Surgery

HAPPY I GET MY STITCHES OUT DAY!  I'm rushing to get ready for my first appointment with Dr. Coleman to hear about my progress and get my stitches out.  I am praying for good news!

Here is a decent example of wear my stitches are on my upper thighs:

Until then... I'll leave you with some interesting information about what went on DURING my surgery.  Happy reading!

Surgical Procedure: What happens during hip arthroscopy?

Before surgery you will be placed under either a general anesthesia or a type of spinal anesthesia. A special operating room table called a traction table will be used.  The hip joint is very tight with little space between the ball and the socket. By applying traction, the surgeon is able to increase this space and allow the arthroscope to be inserted into that space. The end of the arthroscope will be moved about in this space to look throughout the joint. Sterile drapes will be placed to create a sterile environment for the surgeon to work. There is a great deal of equipment that surrounds the operating table including the TV screens, cameras, light sources, and surgical instruments.

The surgeon begins the operation by making two or three small openings into the hip, called portals. These portals are where the arthroscope and surgical instruments are placed inside the hip. Care is taken to protect the nearby nerves and blood vessels. A small metal or plastic tube (or cannula) will be placed through one of the portals to inflate the hip with sterile saline.

The arthroscope is a small metal fiber-optic tube.  It is about 1/4 inch in diameter (slightly smaller than a pencil) and about seven inches in length. The fiber-optics inside the metal tube of the arthroscope allow a bright light and TV camera to be connected to the outer end of the arthroscope. The light shines through the fiber-optic tube and into the hip joint. A TV camera is attached to the lens on the outer end of the arthroscope. The TV camera projects the image from inside the hip joint onto a TV screen next to the surgeon. The surgeon actually watches the TV screen (not the hip) while moving the arthroscope to different places inside the hip joint and bursa.

Over the years since the invention of the arthroscope, many very specialized instruments have been developed to perform different types of surgery using the arthroscope and to see what is going on while the instruments are being used. Today, many surgical procedures that once required large incisions for the surgeon to see and fix the problem can be done arthroscopically  with much smaller incisions. For example, simple removal of a torn labrum or a loose body can be done using two or three small 1/4 inch incisions. More extensive surgical procedures may require larger incisions. Your surgeon may decide during the procedure that the problem requires a more traditional open type operation. If this has been discussed before the operation the surgery may be performed immediately; if it has not been discussed, the arthroscopic procedure will be concluded and another operation at a later date will be planned once your surgeon has discussed with you the details of what was found at the time of the arthroscopy and what more needs to be done.

Once the surgical procedure is complete, the arthroscopic portals and surgical incisions are closed with sutures or surgical staples and covered with surgical strips. A large bandage will be applied to your hip. Hip arthroscopy is usually done on an outpatient basis meaning that patients go home the same day as the surgery.

Crutches are commonly used after hip arthroscopy and the Physical Therapist will show you how to use your crutches on both level ground and also while doing stairs. You will need to follow your surgeon's instructions about how much weight to place on your foot while standing or walking.  How much weight your surgeon would like you to put on your surgical side depends on what your surgeon has done inside your joint. Every surgery is different. Crutches may only be needed for one to two days after simple procedures, but should be used until your surgeon says you can fully weight bear, and until you can walk virtually without a limp.  Even one crutch, used on the opposite side to your injury, can be used to provide some support and allow you to avoid walking with a compensatory gait post-surgically. It is important to avoid doing too much, too quickly.

Recovery Day 8

UPDATED

I find it hard to believe, in a very positive and awesome way, that just about a week post op and I am feeling so great.  I am off all medication (even Motrin) and most of the symptoms I was dealing with are gone!

List of symptoms since the surgery:

1) Dry mouth (from anti-nausea patch that Dr. King gave me).
UPDATE: GONE!

2) Dry nose (from the oxygen that I had during the surgery).
UPDATE: GONE!

3) Upset stomach (from all the drugs I've been taking and the epidural)
UPDATE: GONE!

4) Random times of nausea and dizzy spells
UPDATE: GONE!

5) Random body temperature changes (probably due to the ice machine and 90 degree weather)
UPDATE: GONE!

6) Numb upper left thigh (from the surgery)
UPDATE:  Still dealing, but it is SO MUCH BETTER!

7) Shaking thigh muscles (from fatiguing on the stationary bike)
UPDATE: GONE!

8) Stiffness in the hip, pelvic and upper thigh area (from the surgery)
UPDATE: Getting better!

9) Irritated skin on the upper thigh (from the waterproof bandage tape).
UPDATE: Still irritated, this will not go away until my stitches come out and I can stop wearing band-aids.

10) Anxiety about gaining weight (from not being able to do my normal cardio routine)
UPDATE: This comes and goes.

...I must say that I am so thankful for the friends that I have.  My afternoon with Amber was really, really nice.  We had a delicious NJ diner lunch and then enjoyed pedicures and back massages in Montclair, NJ!  Amber was so sweet, she paid for my pedicure as my "get well" present and I could not have been happier!

I am also happy to report that yesterday, I rode the bike on a resistance level FOUR!  Yes, four!  That is my typical level!!! I broke a big sweat and lasted for 30 minutes with absolutely no pain.  I was dealing with a bit of soreness in my pelvic area last night, but I think it's alright.  I'm just proud of myself at this point and thankful that my hips are such CHAMPS!

Last night, I kept waking up.  For some reason, I am dealing with a bit of "restless legs" for the first time in my life.  I feel like I have to move in order for my pelvic area, thighs and lower legs to feel comfortable.  I really hope this wears off, because it is rather annoying.  :/  I mean, I tried EVERYTHING.  I put pillows under my legs, I put my foam roller under my knees, I laid on my side with my knees bent...

...YES!!! I FINALLY LAID ON MY SIDE WITH MY KNEES BENT!!!!  When I realized I was in that position, I smiled to myself!  It may have been a tiring 4am smile, but I have been waiting a week to finally be able to do this again!  Further, I am thrilled to report that getting in/out of bed and cars has become much easier and is ALMOST back to normal.

Tomorrow is a big day everyone... My first appointment is at 10:30 with Dr. Coleman to get my stitches out and to see how my recovery is REALLY going... AHH!  I'm nervous, so prayers are greatly appreciated!

Love you all,
Ashley

One Week Post Op

Hi Everyone!

Last night seemed to prove quite interesting and solidified the fact that I can't be left alone during this recovery process! ;)

Julia had to go to work for just an hour last night and in that time I decided to take my FIRST drive back to Focus Physical Therapy and stretch out in Pilates class!

Yes, I know what you all must be thinking ("is this girl nuts?!"), but the drive was fantastic.  While I took it VERY slow, nothing hurt or felt uncomfortable.  However, I did feel slightly shaky at the wheel, so I think I will be sticking with neighborhood driving as of now... no highways or long distances yet!

Pilates class proved to be interesting.  I could barely do any of the moves, except hold table top and do some roll-ups.  But it honestly felt good to stretch everything out!  The second I got home I was SO SORE in my pelvic area, hamstrings, hip flexors and quads that I could have died.  However, I iced and when I woke up this morning, I was fine!! :)  But don't worry... no Pilates for another 2 weeks or so.

I'm getting pretty excited for Thursday when I see Dr. Coleman for the first time to get my stitches out.  I hope he gives me good news about my recovery process.  Prayers would be greatly appreciated for that!

Today will be a very fun Tuesday.  Jackie is coming over to study for a few hours, then I get to see Amber for lunch and pedicures and then my afternoon will be back on the bike with some arm work.  Tonight I get to relax, which is always very nice.

I don't have very many updates today.  I am getting antsy to get back to some decent cardio exercise, but I know I have to take a deep breath and keep moving slowly.

Peace out,
A

Recovery Day 6

It's that dreadful day again... MONDAY! ;)  However,  I still have another week of summer vacation and Julia had off today,  so that means I have company all day!

UPDATE:  I took a ton of Benedryl last night, threw out the bottle of Meloxicam antiinflammatories and woke up with no more itching!  Apparently, my body had an allergic reaction, so I can't take that medication anymore.  Dr. Coleman's PA instructed me to take Motrin throughout the day instead.

I spent a lovely morning organizing my room, grabbing lunch with Julia and my friend Matt and then headed to Focus Physical Therapy for my daily recovery bike ride.  Today was exciting though!  I rode on a level 3 resistance :) and it felt WONDERFUL on my thighs and legs.

I am now parked on my couch for the rest of the afternoon/evening icing away with my trusted Game Ready machine!  I was so sick of icing, that I took the morning off.  However, I think that was a bad idea.  It was a bit humid in North, NJ and my msucles definitely felt/appeared more swollen than usual.

I think my sister Melissa is coming by tonight to see me, so I'm really excited for that!

UPDATED: List of symptoms since the surgery:

1) Dry mouth (from anti-nausea patch that Dr. King gave me).
UPDATE: GONE!

2) Dry nose (from the oxygen that I had during the surgery).
UPDATE: GONE!

3) Upset stomach (from all the drugs I've been taking and the epidural)
UPDATE: Steal dealing with some...

4) Random times of nausea and dizzy spells
UPDATE: Still dealing with this.

5) Random body temperature changes (probably due to the ice machine and 90 degree weather)
UPDATE: GONE!

6) Numb upper left thigh (from the surgery)
UPDATE:  Still dealing...

7) Shaking thigh muscles (from fatiguing on the stationary bike)
UPDATE: GONE!

8) Stiffness in the hip, pelvic and upper thigh area (from the surgery)
UPDATE: Getting better!

9) Irritated skin on the upper thigh (from the waterproof bandage tape).
UPDATE: Still irritated, but going away.

10) Anxiety about gaining weight (from not being able to do my normal cardio routine)
UPDATE: This comes and goes.

Signing out,
A

Pictures from Day 5

Recovery Day 5

What a beautiful Sunday morning to wake up too!  I have to say that even though I only slept 3 hours last night, I woke up feeling refreshed, energetic and pretty damn thankful.

Yesterday afternoon, my best man Doug came over to take care of me all afternoon.  I even left the house on my first "outing" since the surgery to Oksana's backyard birthday BBQ.  It felt great to get dressed in real clothes, blow dry my hair and spend time with people in a normal setting!

Then my friend Matt Brody came over around 5:30 and cooked a DELICIOUS steak with grilled veggies and awesome red potatoes.  I can't thank him enough!

After dinner, I was surprised by a bunch of my best friends in the world.  They came to spend time with me on my outside deck.  We listened to music, looked at my stitches, changed my bandages and laughed a lot.  I really have to say that I have the best friends in the world.

My friend Ksenia (who is from Russia, but now living in Queens) even brought me a beautiful angel statue and worked with my roommate Julia to make awesome t-shirts!!!

Anyway, I woke up this morning and decided to stay home from my usual Sunday morning church service in order to ice my hips with my loyal Game Ready machine ;)  I was also pleasantly surprised that I was MUCH LESS swollen today and that I could actually SQUEEZE my legs into my jeans for the first time!!!  I also woke up and realized I really am not even sore or stiff anymore... I am just left with a funny burning/pulling/crawling sensation in my left-mid thigh.  Hmmm... It's honestly AMAZING to me that I had DOUBLE HIP SURGERY on Tuesday afternoon and I already have regained strength and awesome range of motion!  Is this a joke?! Am I dreaming?!  Or am I really this lucky?  Geez, God really has taken care of me through this one ;)

Only problem today?  I am SUPER SUPER SUPER SUPER SUPER itchy from the inside out!  I can't control it!  I emailed Kira and she thinks I may be allergic to the anti-inflammatory pill I'm taking.  She advised me to take a Benedryl tonight, skip the pill tomorrow and see if the itching subsides... here is hoping it does!

Anyway, after a delicious dinner date with my Grandpa and Julia at Lombardi's in Cedar Grove, I'm off to splurge on chocolate chip Teddy Grahams and relax on the couch.

Respectfully Yours,

The Itching Patient

Recovery Day 4

It's Saturday!!! And I've got a funny feeling that tonight.. "tonight's gonna be a good, good night!"

...I'm in a really good mood because a ton of my closest friends are coming over to spend time with me tonight.  It will be awesome to get to hang out and "forget" what my hips are currently going through.

So, let me go back to yesterday afternoon when the numbness developed all down my left leg.  A few hours later, just as I was forgetting about the numbness, all the muscles in my thigh started convulsing and shaking... and I could NOT stop it! However, just as the new "shaking" sensation developed, my Aunt Fran and cousin Kristin arrived... so I just forgot about it for a while.

Aunt Fran and Kristin were nice to enough to bring me a huge bottle of Moscato wine and sat with me for about an hour.  We had great conversation and I'm so happy I got to see Kristin before she heads back to BC on Friday.

After my visitors left, I called the lovely Kira Levykh (Dr. Coleman's PA).  She explained that since my muscles in the area surrounding my incision completely shut down during surgery, they are learning how to "move" again. From getting on the stationary bike for 30 minutes, my muscles fired up and swelled (as they should).  She believes they hit a nerve ending and the sensation traveled down my leg.  Well, you'll be glad to know, when I woke up this morning, only my thigh was numb! ....PROGRESS! :)

As for the "shaking" sensation, Kira explained that even though I'm in "super shape" (as she called it), yesterday was the most activity my thigh muscles have done since completely shutting down.  Kira believes they started shaking because they reached fatigue level.  She also thinks this is a completely normal sensation.  Well, after another icing session, you'll be happy to know that the shaking subsided.

Let me move on to the good stuff of yesterday afternoon... my SHOWER!  I was very nervous to get in the shower, in fear that the water would somehow get under my secured waterproof band-aids and ruin my stitches.  However, with the help of my mom, I was able to lift my legs over the bathtub and took a quick, but SUCCESSFUL first shower!  I think today will be even better, as I won't be as nervous to spend some more time under the running water.

After my shower, I ate a healthy dinner and did some more studying for my upcoming licensing exam while icing.   I'm telling you... this Game Ready ice machine has definitely become my best friend! I even got a card in the mail last night from my Aunt Stephanie and cousin Jamie... with SCRATCH OFFS in it!  Here's to hoping I'm lucky when I decide to "scratch" them off today.  I better use a lucky penny or something... ;)

My mom and Anna Banana left for the beach last night, so Julia is now in charge of me all weekend.  She was nice enough to sleep in my room again, in fear that I might fall out of bed ;)  I must tell all my readers:  One of the key components to this recovery process is to have a GREAT support system.  My mom and Julia have been ANGELS... literal angels and I'm so happy I have them to help me.  So thank you guys!

Here is a list of symptoms I have and am still having since the surgery:

1) Dry mouth (from anti-nausea patch that Dr. King gave me).
UPDATE: I took the patch off yesterday, hopefully the dry mouth will subside shortly.

2) Dry nose (from the oxygen that I had during the surgery).
UPDATE: I used Saline Solution nose spray yesterday and that seemed to help.  I'll use it again today and it should clear up.

3) Upset stomach (from all the drugs I've been taking and the epidural)
UPDATE: Still dealing with stomach issues.  For the first 3 days I even had to take a stool softener to help me "regulate."  Luckily, they worked, but my stomach is still out of sorts.

4) Random times of nausea and dizzy spells
UPDATE: Still dealing with this.

5) Random body temperature changes (probably due to the ice machine and 90 degree weather)
UPDATE: Yesterday was a LITTLE better.  Hopefully this subsides soon as well.

6) Numb upper left thigh (from the surgery)
UPDATE:  Still dealing...

7) Shaking thigh muscles (from fatiguing on the stationary bike)
UPDATE: This will probably continue after exercise until I regain all my strength.

8) Stiffness in the hip, pelvic and upper thigh area (from the surgery)
UPDATE: Still really bad.  This is also impacting my range of motion greatly.  I hope this will start to improve when I start physical therapy next Friday.

9) Irritated skin on the upper thigh (from the big pillow-like bandage tape).
UPDATE: Still irritated, but going away.  I think I'm also starting to develop this irritation under the 4 waterproof band-aids I have covering my 4 stitches.  I'm not really sure what to do about this one...

10) Anxiety about gaining weight (from not being able to do my normal cardio routine)
UPDATE: Starting today, I am going to cut down on portion sizes until I am up and moving around more.  I'll let you know how this goes, as changing an already extremely healthy eating plan can't be too easy...

Well, that is all I can think of so far.  I'll let you know if any more symptoms arise!

I'm signing off now to get some icing and study time in before heading off to the stationary bike and chiropractor (for my neck!).  And then my best friend, Doug Hollinger, will be here all day to babysit me until Julia gets home from work!

I love you all!

XX,
A

Recovery Day 3

Happy Friday everyone! (Today is an even more special Friday, since it is my best friend Oksana's birthday).

With last night's events being a bit brutal, I did not have high expectations for this morning.  However, I woke up a little less stiff than yesterday!  I spent my morning icing and studying with Jackie for our exam and enjoyed a delicious lunch at home.

I just got back from Focus Physical Therapy and actually completed 30 slow minutes on the stationary bike.  I found out today that riding the bike decreases scar tissue and gets blood circulation flowing to the healing muscles.  I felt awesome on the bike!  However, I just got home and now have a weird numbness sensation going from my left hip incision all the way down to my left foot.  Hmmm... I hope this goes away.  I'm back on the couch icing and compressing the hell out of the left thigh.

I am going to spend the rest of my day taking it easy and visiting with my Aunt Fran and cousin Kristin as soon as they get here.

Most exciting news of today:  I can SHOWER!!! :)

Updates:  Still taking Tramodal once or twice a day for pain, 1 anti-inflammatory per day and still don't' feel the need to use my crutches.  I was able to walk up and down the stairs more normally today as well.

I'm starting to really learn that I am going to need a lot of patience over the next couple weeks.

Recovery Day 2

Thursday 8/23/12 I still woke up VERY stiff, swollen and sore once again.  But this morning I was able to take off the pillow-like bandages and cover my 4 little stitches with waterproof band aids!  My mom assisted me in the bathroom.  And what a GOOD thing that was, since I blacked out when I saw my stitches!

My right hip is definitely doing a lot better.  There is no numbness or pain and the swelling has gone down quite a bit.  I even have decent range of motion.  The left side?!  Well, that's a different story.   My left thigh is still numb and so stiff I can barely put pants on.

I'm still dealing with a sensitive stomach, nausea and weird body temperature changes.  Not too mention, I'm always tired!! However, I am finding that my crutches just make walking more uncomfortable.  I will call the doctor tomorrow to find out if it's ok that I ditch the crutches.

I rested almost the entire day, except when I went out to the supermarket for some food. My good friend Jackie came to visit me as well, and we were able to get some good studying done for an upcoming exam that we have.

Unfortunately, I was only able to ride the bike for 17 minutes today, since I developed a sharp pinching pain in my groin.  However, I was able to do some arm work with light dumbbells and hold plank for 60 seconds!

Trying to sleep this night was brutal.  I could not get comfortable in bed and when I got up to use the bathroom, I moved too quickly.  A sharp, pinching pain developed in my left groin and it hasn't gone away. I'm tired... hopefully tomorrow will be better.  I'll even get to take a shower!  I just hope I didn't damage the results of the left side of my hip!!

Recovery Day 1

On Wednesday 8/22/12, I woke up extremely stiff, sore and swollen.  My thighs were puffy and taught... even when I gently touched them, they felt like leather.  The big puffy pillow-like gauze bandages that were covering my thighs did not really help this feeling either.  However, I was told that the bandages couldn't come off until Thursday, so I stuck it out.

My Dad surprised me this morning and took some VERY unflattering pictures of myself while using the ice machine.  If you're friends with him on Facebook, promise you won't laugh! ;)

I iced both sides of my hips all through out the day.  I even got a ride to CVS for waterproof band aids, Sports Authority for a foam roller to put under my knees for circulation AND had a family lunch at Toast! I must say, getting in and out of cars presents QUITE the challenge!

Today was the first day that I got on a stationary bike and rode for 20 minutes (VERY SLOWLY and with no resistance).  It honestly felt GREAT!  And I felt that I could have rode longer.

Oksana, my stepmother and sister Megan came to visit today after work today.  It was really nice to see some friendly faces and I even received some beautiful flowers to put in my room!

I ended the night at church, came home for icing, and slept very soundly once I got hoisted up in bed! ;)

Updates: I never have taken the Oxycodone.  That medication makes me too hyper and loopy, not too mention the withdrawal effects are awful.  I have taken Tramodal for pain and Meloxicam for inflammation.  I am still not using my crutches.  They make walking more uncomfortable.  I need to check with my doctor if that is OK.

"One day at a time... one day at a time... one day at a time..."

Surgery Day!

After being extremely nervous for a few months to the anticipation of the surgery and the anxiety of the unknown recovery process, Tuesday 8/21/12 finally arrived.

My mom and I left for HSS at 10:15.  Here is the surgical timeline of the day:

11:30: Arrive at hospital for registration and check-in

12:00: Met with staff to collect appropriate crutches and my Game Ready ice/compression machine

12:30: Greeted by Dr. Coleman

1:15: Taken into prep waiting room

2:00: Blood pressure taken, hips washed, IV plugged into hand

2:30: Greeted by Dr. Coleman's Physician's Assistant, Kira

2:45: Hips autographed by Dr. Coleman

3:00: Greeted by Dr. King, the anesthesiologist

3:15: Walk to operating room with Dr. King and the O.R. nurse

3:30: Introduced to surgical team, placed onto operating table, held hands with Dr. Coleman as Dr. King sedated me and then administered an epidural into my spine....

Surgery on both hips lasted 3 hours and ended at 6:30

7:00: Wake up for the first time.  Visited by nurses, my mom and Dr. Coleman.  I fall back to sleep and don't remember this.

7:45: Fully awake in the recovery room with complete feeling in all lower extremities.

8:00: Delicious turkey sandwich to eat

8:30: Dressed in street clothes and sent home!

10:00: Arrive home for diner soup, hard-boiled eggs, Teddy Grahams and diet ginger ale thanks to Julia!! :)

What my surgery was all about...

Anatomy of the Hip Joint

The hip joint is a “ball and socket” joint located where the thigh bone (femur) meets the pelvic bone. The upper segment (“head”) of the femur is a round ball that fits inside the cavity in the pelvic bone that forms the socket, also known as the acetabulum. The ball is normally held in the socket by very powerful ligaments that form a complete sleeve around the joint capsule.

Both the ball and socket are covered with a layer of smooth cartilage, each about 1/8 inches thick. The cartilage acts as a sponge to cushion the joint, allowing the bones to slide against each other with very little friction. Additionally, the depth of the acetabulum (socket) is increased by a fibrocartilaginous rim called a labrum that lines the rim of the socket and grips the head of the femur, securing it in the joint. The labrum acts as an “o-ring” or a gasket to ensure the ball fits into the socket.

Anatomy of the hip

Femoroacetabular Impingement and Hip Mobility

What is femoroacetabular impingement?

Femoroacetabular impingement occurs when the ball (head of the femur) does not have its full range of motion within the socket (acetabulum of the pelvis).

Impingement itself is the premature and improper collision or impact between the head and/or neck of the femur and the acetabulum. This causes a decreased range of hip joint motion, in addition to pain. Most commonly, Femoroacetabular impingement is a result of excess bone that has formed around the head and/or neck of the femur, otherwise known as “cam”-type impingement. Femoroacetabular impingement also commonly occurs due to overgrowth of the acetabular (socket) rim, otherwise known as “pincer”-type impingement, or when the socket is angled in such a way that abnormal impact occurs between the femur and the rim of the acetabulum.

A)	Normal Hip
B)	Cam impingement
C)	Pincer impingement
D)	Combination of cam and pincer impingement

Source: Femoroacetabular Impingement Forms - Lavigne, et al.

What happens inside a hip joint that has impingement?

When the extra bone on the femoral head and/or neck hits the rim of the acetabulum, the cartilage and labrum that line the acetabulum can be damaged.

The extra bone can appear on x-rays as a seemingly very small “bump.” However, when the bump repeatedly rubs against the cartilage and labrum (which serve to cushion the impact between the ball and socket), the cartilage and labrum can fray or tear, resulting in pain. As more cartilage and labrum is lost, the bone of the femur will impact with the bone of the pelvis. This “bone on bone” notion is most commonly known as arthritis.

Tears of the labrum can also fold into the joint space, further restricting motion of the hip and causing additional pain. This is similar to what occurs in the knee of someone with atorn meniscus.

How does femoroacetabular impingement occur?

The extra bone that leads to impingement is often the result of normal bone growth and development. Cam-type impingement is when such development leads to the bump of bone on the femoral head and/or neck.

Normal development can also result in the overgrowth of the acetabular rim, or pincer-type impingement. Hip trauma (falling on one’s hip) can also lead to impingement. The tears of the labrum and/or cartilage are often the result of athletic activities that involve repetitive pivoting movements or repetitive hip flexion.

MRI of a normal hip with an intact labrum

MRI of a hip with a torn labrum

What are the common symptoms associated with impingement?

Impingement can present at any time between the teenage years and middle age. Many people first realize a pain in the front of their hip (groin) after prolonged sitting or walking. Walking uphill is also found to be difficult.

The pain can be a consistent dull ache or a catching and/or sharp, popping sensation. Pain can also be felt along the side of the thigh and in the buttocks.

How is impingement diagnosed?

Medical imagery in the form of x-ray and magnetic resonance imaging (MRI) are crucial for diagnosing femoroacetabular impingement. X-ray can reveal an excess of bone on the femoral head or neck, and on the acetabular rim. An MRI can reveal fraying or tears of the cartilage and labrum.

Hip Arthroscopy in Treating Femoroacetabular Impingement

What happens during a hip arthroscopy?

Hip arthroscopy, or a “hip scope,” is a minimally-invasive procedure. The use of an arthroscope means that the procedure is done using 2-3 small incisions (approximately 1/4-1/2 inch long) rather than a more invasive “open” surgery that would require a much larger incision. These small incisions, or “portals", are used to insert the surgical instruments into the joint.

Aiding other advances in arthroscope technology, the flow of saline through the joint during the procedure provides the surgeon with excellent visualization. The surgeon is also aided by fluoroscopy, a portable x-ray apparatus that is used during the surgery to ensure that the instruments and arthroscope are inserted properly.

A patient being set up for traction

The location of the incisions and instruments for the procedure

The instruments include an arthroscope, which is a long thin camera that allows the surgeon to view the inside of the joint, and a variety of “shavers” that allow the surgeon to cut away (debride) the frayed cartilage or labrum that is causing the pain. The shaver is also used to shave away the bump(s) of bone that are responsible for the cartilage or labral damage.

In addition to removing frayed tissue and loose bodies within the joint, occasionally holes may be drilled into patches of bare bone where the cartilage has been lost. This technique is called "microfracture" and promotes the formation of new cartilage where it has been lost.

The procedure is normally done as an “outpatient” surgery, which means the patient has the surgery in the morning and can go home that same day. Normally, the patient is underregional anesthesia. Under regional anesthesia, the patient is numbed only from the waist down and does not require a breathing tube.

What is the recovery time associated with hip arthroscopy?

Following the procedure, patients are normally given crutches to use for the first 1-2 weeks to minimize weight-bearing. A post-operative appointment is normally held a week after the surgery to remove sutures. Following this appointment, the patient normally begins a physical therapy regimen that improves strength and flexibility in the hip.

After six weeks of physical therapy, many patients can resume normal activities, but it may take 3-6 months for one to experience no soreness or pain following physical activity. As no two patients are the same, regular post-operative appointments with one’s surgeon is necessary to formulate the best possible recovery plan.

Who will benefit from hip arthroscopy and what are the possible complications?

Following a combination of physical and diagnostic exams, patients are deemed suitable for hip arthroscopy on a case-by-case basis. Patients who respond best to hip arthroscopy are active individuals with hip pain, where there exists an opportunity to preserve the amount of cartilage they still have. Patients who have already suffered significant cartilage loss in the joint may be better suited to have a more extensive operation, which may include a hip replacement.

Studies have shown that 85-90% of hip arthroscopy patients return to sports and other physical activities at the level they were at before their onset of hip pain and impingement. The majority of patients clearly get better, but it is not yet clear to what extent the procedure stops the course of arthritis. Patients who have underlying skeletal deformities or degenerative conditions may not experience as much relief from the procedure as would a patient with simple impingement.

As with all surgical procedures, there remains a small likelihood of complications associated with hip arthroscopy. Some of the risks are related to the use of traction. Traction is required to distract and open up the hip joint to allow for the insertion of surgical instruments. This can lead to post-surgery muscle and soft tissue pain, particularly around the hip and thigh. Temporary numbness in the groin and/or thigh can also result from prolonged traction. Additionally, there are certain neurovascular structures around the hip joint that can be injured during surgery, as well as a chance of a poor reaction to the anesthesia.