Four Weeks: Stay the Course

In some ways it is hard to believe I am already four weeks post-op, and in other ways, it seems like it has been much longer. This week started out much more optimistically than the previous week proved to be.  However, in reality has not really been much different. I can put more weight on the surgical side hip/leg now, but am still on crutches, still partial weight bearing--even if there is a higher percentage of weight on the leg, it is still not full weight. My shoulders, hands, wrists all appreciate this change in weight bearing ability, but are still stiff and sore from still having to aid with partial weight bearing. My body is getting ever more tired of crutches. Also, the additional weight bearing is as tolerated, so there are times I am still at the initial 20 pounds max restriction on surgical side.

I am still loving being in water--pool walking, PT exercises in the pool, swimming no kick, just hanging out in deep water, etc. Being in the pool is a break from crutches but being in water also provides counter pressure and lowers all pain. Both hips are pretty much pain-free, but the rest of my body is not and crutches have flared the normal problem areas.  Last time, I ended up needing injections in the other hip and one shoulder once off crutches.  Hoping to get by without needing injections this time.  So far, other hip is holding out great!  Both shoulders are not so happy, but not awful.  So, I am remaining optimistic.

Positive observations:  I was off pain medications very early after surgery, used some over the counter acetaminophen as needed with the move and travel, but then was off of that as well by 1.5 weeks post op.  I was prescribed non-optional NSAID (anti-inflammatory) for the first three weeks after surgery, but even that is done now and so far still doing well without any pain medications at all! I have also been off of all sleep aids since surgery, though used them a few nights here and there around the time of the move because of the general upheaval of routines and environment. Since then, I am sleeping through the night for the most part even without sleep aids!  This is huge!  I have been on some form (usually multiple forms) of pain medications and sleep aid medications for many, many years.  I did have a reprieve after surgery last summer, but was still on prednisone at that point. This time, not even on prednisone.  However, I am on super high doses of antihistamines to manage the MCAS (mast cell activation syndrome), and this is strongly suspected to be aiding with symptom control--both pain and sleep issues, along with numerous other symptoms. The antihistamines were what aided the final weaning fully off prednisone last spring. I have noticed a little stiffness at times in the surgical hip since stopping the NSAID, but it seems to be intermittent, not persistent. No increase in swelling though.

I had noticed at two weeks post-op that op side leg was already getting smaller from atrophy from being on crutches.  A little after three weeks, my sister commented my leg felt noticeably lighter when she was doing the circumduction "exercises" with it.  Yep, sigh.  I had asked PT the day after surgery if there was anyway to minimize the atrophy after surgery while on crutches and she said there was not.  So, it is what it is.  It is interesting how fast muscle is lost and how long it takes to regain it. Last time I had lost an inch circumference entire length of leg on op side by the time I was off crutches.  It took months to regain it.

Last time I had incision issues at 2.5 weeks post-op.  Things resolved fine.  However, it led to a discussion pre-op this time in context of recommendations to leave sutures twice as long due to the Ehlers-Danlos Syndrome.  Last time, I had been reacting to the stitches themselves by the time they were removed, so I was nervous about leaving them even longer. Thankfully, surgeon's PA said to still get them removed at the same timing as last time, but this time suggested steri strips.  So, that was what we did and so far, so good. Just recently pulled off steri strips (as directed) and things look good--at least as good as surgical incisions can look. Certainly looking better than the mirror image ones on opposite hip, which are wide, though fading nicely.

PT appointment at four weeks went well.  There has been some muscle tension/soreness, so lots of soft tissue work and less exercise work.  No AlterG today.  He said the hip is doing really well overall and he did let me try walking with only one crutch.  Since it felt OK, he said it is OK to use one crutch for short distances at home from time to time.  But, otherwise, still on crutches. Sigh. This hip is handling increased weight bearing better than I remember the first hip doing, but this is still a long process.  I am not nearly as wiped out after PT appointments this recovery as I recall from last time, but I do find those days more tiring overall and that it does not take much to wear me out. My body is siltl doing a lot of healing. I clearly recall some aspects of last recovery quite well even without going back and looking. However, it is still interesting to look at last year  Here is the 4-week post from last year. That week was challenging and taught me a lot of caution and has definitely impacted some of my choices this recovery. Experience teaches wisdom.

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