Tuesday, February 26, 2019

Hip Rehab Progress: 15 to 18 months


15 Months Post-op

My second hip had surgery when my first hip was a little over a year post-op. So, I have never known what the normal course of hip recovery is beyond a year. Well, my shoulder had surgery when my second hip was a little over a year. Thus, I am not sure I will ever know what normal progression is. Besides, my body has never liked to follow normal patterns anyway. I had not really decided if I was going to keep updating on hip recovery or not. Both hips are doing so well. However, a few things are making me think it might be interesting to update. First, it is now five years since my first hip became so severely painful I could barely limp around. Yes, it took two more years to actually figure out it was my hip. Secondly, the back pain is back to higher levels again after being somewhat better. Old compensation patterns are not only resurfacing, but getting stronger again. However, hips are still fine. No hip pain. No indication of giving way. None of the other signs I later learned were blatant hip pain. What is going on now? No one knows. EDS and MCAS both flaring.

Creativity ever to the rescue--wearing both SI joint support belt and the waist strap to my hip brace as a back brace. I have gotten far more use out of my hip brace as a back brace than I ever did as a hip brace. Physical therapist was impressed with my resourcefulness, suggested another option for back brace, but said what I was doing worked well.

18 months post op right hip (2.5 years post-op left hip)

I clearly never got the 15 months post-op post published. So I am just adding to it. 18 months post-op left me rather behind. December had two major surgeries, a lengthy hospitalization, and I ended up losing most of my strength, endurance, having to start over with rehab. I had prepared for surgery as I always do--stayed on top of exercise and rehab, went into surgery strong. However, unanticipated issues arose and second emergency surgery became necessary and much longer hospitalization than planned. Hence, global atrophy in spite of having worked hard to go into surgery strong. (But, it could have been much worse if I had not been strong for surgery.) Hips are still both fine, but lost their supporting muscles, thus not able to do much. The back pain was horrible in the hospital. I hardly needed pain medication for the surgeries, but my back was awful. Physical therapy at the hospital was coming to take me for walks (I was not allowed out of bed on my own because of fall risk, numerous IVs, lines, tubes everywhere). At one point, I asked for tips to help with my back and they were so nice to check postures, how I was getting in/out of bed, with me explaining I was protecting abdominal incision, but also protecting left shoulder. I was told I was moving well, doing all I should. However, I was given tips to try to help lessen back pain. It still took trial and error, but the final days were less miserable. Although, that may be also being less limited, more able to move enough to shift position some on my own.

I am not able to wear most of my compression clothing or braces because I am still swollen and healing from the abdominal GI surgeries. However, a nurse gave me a binder that can be used as an abdominal binder or a back brace, or both! I can also get the SI belt on and it sits low enough not to bother too much, but is uncomfortable as some of my scar goes that low. I also discovered that the elastic/Velcro straps for the cooling pad for my cold therapy machine works well for back support! Because they are narrower than most support belts/braces, I can better position the straps in ways that are less pressure on still swollen abdomen, yet still get some back support. Anyway, it is helpful to have some aid with back support. I may need to try kinesiology tape again, too. I do have my TENS/NMES units back out and using them. Also back to icing, heat for back. A physical therapist helped explain something I have always wondered. This is that my body either loves or hates compression. It either feels amazing, or I cannot stand it and have to get it off. She said when it feels good, it is because my body needs support. When it is uncomfortable, it is because of an inflammation issues. So, my abdomen not liking pressure is because of ongoing inflammation from surgery and infection even though healing. My back needs support.  

Back to hips. My left hip is fine, nothing seems to phase it. Right hip is tight and a bit sore at times. I am doing tummy time again to gently stretch out hip flexors. I discovered I can do TENS at the same time as tummy time so that gets both done without stressing me any further over how much time goes into rehab and recovery.

All rehab is in the pool for the most part. Physical therapist had me focus on pool work after the accident last year when struggling, and he is having me focus on pool work now. The goal is to get me strong enough to do more on land again. My body thrives in water. The water feels good, supports me, lessens pain, gives positive feedback, gives gentle resistance, works my whole body gently. My core is shot from surgeries, trauma. It will not activate on command--isometrics, or trying to engage for abdominal brace just do not happen. But, my core will engage and work in the pool. So we are using swimming and pool walking to help with shoulders, hips, back, and core! I can walk laps in a hallway at home and I have walked outside a couple of times on unusually nice days. Walking distance is pretty normal, but pace is not back to pre-op these last surgeries. Still, grateful for progress!

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