Here I am ten weeks post op right hip. Definitely being reminded that this is a roller coaster recovery with lots of ups and downs. I am still in a flare, discouraged, tired. I see my hip surgeon in a couple of weeks. Then the shoulder surgeon a couple of weeks after that. I am actually concerned about the travel for both. I am struggling more with driving, sitting, standing again with this flare. We have done a week of pretty much rest, ice, heat, gentle movement as able with the basic early exercises. Every attempt at progress was met with an angry hip, so backed off again. The more advanced rehab exercises have been on hold, elliptical has been on hold, even stationary bike was on hold for a while. We attempted a short trial of pool walking, which has historically been a "safe" activity and that did not go well, even though slow, careful, short duration. So, that got things backed way down and another rest day. Lots of trial and error trying to figure out what the op hip in particular, and my body in general, will tolerate. I stayed home from church again as unable to sit or stand and not wanting to make things worse. I avoid driving other than appointments, and still use left foot to hold down brake at long stoplights to give right hip a break (no pun intended!). I used to drive a 5-speed once upon a time so do not dare even trying to drive or brake with left foot since it is used to a clutch.
It has been really hard to go from steady progress, to no progress, then loss of progress. A week and a half ago I was up to 25 minutes on elliptical, 30-45 minutes of pool walking, 30 minutes stationary bike with resistance and it was going well. Rehab exercises included mini squats, single leg bridges, various other more advanced exercises. Went to no elliptical, no bike, no pool walking, very little rehab--pretty much just the day-after-surgery exercises. Still swimming some, but no kicking, and even backed off of the swimming.
Another cold front and series of storms went through this weekend, so another flare, on top of the already unresolved flare. So, still doing some days of total rest. However, also starting to figure out what the hips will handle--not much, but more than nothing. Left hip is really just irritated from compensating for the right hip--I think. Anyway, discovered over the weekend that both hips will handle a few minutes of stationary bike without any resistance; yesterday, that as long as super careful, I can do a few minutes of elliptical. Today, both hips handled a few minutes of careful pool walking. So, I can get them moving some. All of this was OK'd by PT. He did a ton of soft tissue work on both hips last Friday and we talked through how to try to approach this as not wanting to lose what strength we had gained, but not wanting to further irritate things either. He had suggested the pool walking earlier last week and it did not go well. I mentioned when pool walking did not go well with left hip last spring, elliptical was still OK for some reason, but I had been afraid to try again this time since this is earlier post op and we had been still advancing elliptical, as it was a newer activity. He said to go ahead and try, but start out slowly and keep it short. Then, basically proceed as tolerated. PT today went well. He thinks we are making progress in that at least the hip is not still getting worse and we are figuring out some things it will handle. It has become very selective about range of motion, and type of exercises it will tolerate. As a result, there are some things I am becoming afraid of even trying anymore. My limit pushing side is definitely being overridden by my cautious side at present with respect to hips. The limit pusher is dominant with shoulders. Since shoulders have been calming down since the injection, and even in spite of current flare, we are working on strengthening more again. So, today I tried swimming laps again even though I swam laps yesterday. This is the first attempt at swimming consecutive days since before surgery. It went well! Grateful for progress somewhere!
Choosing to remember my theme for recovery. This is not a race to see how fast I can recover but a journey to see how well I can recover. It is worth taking the time my body needs to heal well.
Ten weeks post op left hip last year. Apparently flares about now are normal. However, this time, not the same triggers. Last year was a full-blown crash as tapering prednisone, working through a stressful project, etc. This is only a flare, though if it does not get calmed, may turn into a crash depending on what direction things go. I am employing what tactics I know and that I can implement. In the meantime, I am grateful it is not worse than it is.
Copyright © 2017 by Stef. All rights reserved.
Tuesday, September 26, 2017
Tuesday, September 19, 2017
Week 9: Flare
Nine weeks (two months) post op right hip!
I still remain susceptible to flare triggers and suspect I will for the rest of my life--sobering thought. The combination of travel, sitting early in the week made me more sensitive to being in the car the rest of the week even just driving to PT. It was not bad, just a bit sore. Then, massive cold front went through and my body does not like even mild weather pressure changes at all, so I definitely felt that one.
I seem to have encountered the first flare-up with right hip since surgery. Both hips handled the drive to and from Omaha (from Lincoln) early in the week, plus lots of sitting between waiting and exam rooms. This was huge as driving, sitting, standing were incredibly difficult pre-op both hips. I was pretty excited at how well things went. However, right hip was more sore that evening and the next couple of days. I noticed it did not like being in the car, and found myself using left foot to hold down the brake at stoplights again as I used to do pre-op. There was a major weather change shift over the weekend and that flared entire body, including both hips. Sunday, I stayed home from church as too uncomfortable to be able to sit. The right hip was still pretty sore Monday, so called PT to see if this was something to work through and continue rehab exercises, or back off. I was told to take a break and he'd check it next day at my appt. He did check and could tell it is irritated, but not too concerned and figured it should be calming down in the next day or so. He said to go ahead and try pool walking, then elliptical, but back off duration and pace, then start adding back more rehab exercises by Thursday. Tried pool walking this evening, and I did not last as long as usual, but being in the water felt great!
The Omaha trip earlier last week was seeing a new orthopedic surgeon for my shoulders, and to check hip incisions. Incisions were not concerning. This surgeon was clearly familiar with Ehlers-Danlos syndrome and among other things checked what degree of laxity my shoulders have--some, but not too bad. He confirmed the os acromiale in both shoulders and that it can cause pain itself, though my worst symptoms are coming more from rotator cuff--especially left shoulder. I ended up with cortisone injection in the left (worse) shoulder, plan to follow-up in several weeks, discussed MRI at that point depending on how things are going. He was more thorough than when I have had shoulders checked in the past, but he also took more time. Injection calmed shoulder nicely! Normal injection response--amazing relief first few hours, then more sore.achy, then couple of days later, better! Right shoulder is calming as well--I was not sure, but really hoped it would without an injection as it had done so in the past once we got left calmed some. We have already increased shoulder exercises in PT with injection in effect. This is a relief. After the appointment, I was second guessing both injection for the left shoulder and not getting an injection for the right shoulder. However, I was basing my observations and preferences on how both shoulders felt and what I knew from past. We had talked about waiting on injections completely. However, when I explained what has been done, is being done, what happened last time, we decided on injection for left shoulder that day. I was asked about right and said I did not think it needed it. Afterward, half wished I had waited on left as several more weeks is really not going to be that big of deal but then remembered the difficulties falling asleep at night from painful shoulders. So, then wondered if I should have asked to go ahead with right as well, but do not want more injections than actually needed. My body seems to be following previous patterns and confirming right decisions.
Week 9/2 months left hip last year.
Copyright © 2017 by Stef. All rights reserved.
I still remain susceptible to flare triggers and suspect I will for the rest of my life--sobering thought. The combination of travel, sitting early in the week made me more sensitive to being in the car the rest of the week even just driving to PT. It was not bad, just a bit sore. Then, massive cold front went through and my body does not like even mild weather pressure changes at all, so I definitely felt that one.
I seem to have encountered the first flare-up with right hip since surgery. Both hips handled the drive to and from Omaha (from Lincoln) early in the week, plus lots of sitting between waiting and exam rooms. This was huge as driving, sitting, standing were incredibly difficult pre-op both hips. I was pretty excited at how well things went. However, right hip was more sore that evening and the next couple of days. I noticed it did not like being in the car, and found myself using left foot to hold down the brake at stoplights again as I used to do pre-op. There was a major weather change shift over the weekend and that flared entire body, including both hips. Sunday, I stayed home from church as too uncomfortable to be able to sit. The right hip was still pretty sore Monday, so called PT to see if this was something to work through and continue rehab exercises, or back off. I was told to take a break and he'd check it next day at my appt. He did check and could tell it is irritated, but not too concerned and figured it should be calming down in the next day or so. He said to go ahead and try pool walking, then elliptical, but back off duration and pace, then start adding back more rehab exercises by Thursday. Tried pool walking this evening, and I did not last as long as usual, but being in the water felt great!
The Omaha trip earlier last week was seeing a new orthopedic surgeon for my shoulders, and to check hip incisions. Incisions were not concerning. This surgeon was clearly familiar with Ehlers-Danlos syndrome and among other things checked what degree of laxity my shoulders have--some, but not too bad. He confirmed the os acromiale in both shoulders and that it can cause pain itself, though my worst symptoms are coming more from rotator cuff--especially left shoulder. I ended up with cortisone injection in the left (worse) shoulder, plan to follow-up in several weeks, discussed MRI at that point depending on how things are going. He was more thorough than when I have had shoulders checked in the past, but he also took more time. Injection calmed shoulder nicely! Normal injection response--amazing relief first few hours, then more sore.achy, then couple of days later, better! Right shoulder is calming as well--I was not sure, but really hoped it would without an injection as it had done so in the past once we got left calmed some. We have already increased shoulder exercises in PT with injection in effect. This is a relief. After the appointment, I was second guessing both injection for the left shoulder and not getting an injection for the right shoulder. However, I was basing my observations and preferences on how both shoulders felt and what I knew from past. We had talked about waiting on injections completely. However, when I explained what has been done, is being done, what happened last time, we decided on injection for left shoulder that day. I was asked about right and said I did not think it needed it. Afterward, half wished I had waited on left as several more weeks is really not going to be that big of deal but then remembered the difficulties falling asleep at night from painful shoulders. So, then wondered if I should have asked to go ahead with right as well, but do not want more injections than actually needed. My body seems to be following previous patterns and confirming right decisions.
Week 9/2 months left hip last year.
Copyright © 2017 by Stef. All rights reserved.
Tuesday, September 12, 2017
Week Eight: Optimism
Eight weeks post-op right hip, 14 months post-op left hip.
I am finally getting back into more normal routines. I am doing pre-op exercise routine as far as able, and I am back to taking a day off a week from exercise. That has helped immensely. Instead of merely getting through each day, I am starting to look ahead again.
I do still get tired out/worn out easily and if I do more one day, need to take the next more slowly. I am sleeping 10-12 hours a night, 8-hour nights just are not enough.
PT says my op leg is getting stronger, walking is getting better! Yay for progress! Still advancing time on elliptical and it is going well. I am up to 15 minutes and nearly a mile at a time and it feels great to be moving! More lap swimming again, and that also still feels great! I am kicking with left leg for freestyle, no kicking at all for breaststroke. I am working a little at a time on increasing flutter kick with freestyle with right leg, but not pushing it yet. I am swimming full number of laps I was swimming before surgery! I have to be super careful of shoulders, but as long as I am careful and am not swimming consecutive days, shoulders are handling being back to more swimming again. Pace is slower than before surgery, but between not kicking as much/strongly, and shoulders being irritated, not worried about pace at this point and working more on form and grateful for being able to swim at all. I am still walking in the pool to work on gait and endurance. I can walk up to 45 minutes in the pool (maxing out here).
I was given an activity monitor a couple of weeks after surgery. (I sort of wish I'd had it pre-op first hip as it would have been fascinating to watch as ability decreased pre-op first hip, became nearly non-existent after surgery, the slow increase with rehab, the decrease as second hip got worse, now slow increase again. It also would have been interesting to compare between recoveries.) Anyway, when on crutches, to protect my shoulders in particular, I was intentionally trying to limit to less than 1,000 steps per day (pathetic goal, I know). I was mostly successful, exceptions being PT days and pool days. Once off crutches, not really trying to manipulate things, so much as let my body move more as able and tolerated. Steps have been averaging around 5,000-6,000 a day. However, I have reached over 10,000 steps in a day in the last week! For someone who is goal-oriented, it can be hard not to try to reach certain goals and an activity monitor can make it even more tempting to push toward goals. However, the clinical researcher part of me finds it interesting to just observe what happens without trying to manipulate outcomes.
I did get in for dry needling early in the week. Opted to target low back and left hip based on observed referral patterns and what I know of my body. Sure enough, she found numerous tight areas to work on and left hip had more tension than right. She said she can also dry needle shoulders. I see the orthopedic surgeon for my shoulders, so will see what he says about shoulders, if injection(s) or not, then go from there regarding needling or not.
Not sure how many are aware I am sensitive to latex but PTs are aware as regular therapy bands contain latex. I had latex-free bands from a clinic several years ago but these were wearing out and the next clinic I had been at did not have latex-free bands. The new clinic I am at now has latex-free bands! It is the little things. All bands shown below are latex-free. The orange ones are the ones from several years ago. The others are the new ones.
There are, of course, other things going on, but choosing to focus on what is going well.
Week 8 left hip last year.
Copyright © 2017 by Stef. All rights reserved.
I am finally getting back into more normal routines. I am doing pre-op exercise routine as far as able, and I am back to taking a day off a week from exercise. That has helped immensely. Instead of merely getting through each day, I am starting to look ahead again.
I do still get tired out/worn out easily and if I do more one day, need to take the next more slowly. I am sleeping 10-12 hours a night, 8-hour nights just are not enough.
PT says my op leg is getting stronger, walking is getting better! Yay for progress! Still advancing time on elliptical and it is going well. I am up to 15 minutes and nearly a mile at a time and it feels great to be moving! More lap swimming again, and that also still feels great! I am kicking with left leg for freestyle, no kicking at all for breaststroke. I am working a little at a time on increasing flutter kick with freestyle with right leg, but not pushing it yet. I am swimming full number of laps I was swimming before surgery! I have to be super careful of shoulders, but as long as I am careful and am not swimming consecutive days, shoulders are handling being back to more swimming again. Pace is slower than before surgery, but between not kicking as much/strongly, and shoulders being irritated, not worried about pace at this point and working more on form and grateful for being able to swim at all. I am still walking in the pool to work on gait and endurance. I can walk up to 45 minutes in the pool (maxing out here).
I was given an activity monitor a couple of weeks after surgery. (I sort of wish I'd had it pre-op first hip as it would have been fascinating to watch as ability decreased pre-op first hip, became nearly non-existent after surgery, the slow increase with rehab, the decrease as second hip got worse, now slow increase again. It also would have been interesting to compare between recoveries.) Anyway, when on crutches, to protect my shoulders in particular, I was intentionally trying to limit to less than 1,000 steps per day (pathetic goal, I know). I was mostly successful, exceptions being PT days and pool days. Once off crutches, not really trying to manipulate things, so much as let my body move more as able and tolerated. Steps have been averaging around 5,000-6,000 a day. However, I have reached over 10,000 steps in a day in the last week! For someone who is goal-oriented, it can be hard not to try to reach certain goals and an activity monitor can make it even more tempting to push toward goals. However, the clinical researcher part of me finds it interesting to just observe what happens without trying to manipulate outcomes.
I did get in for dry needling early in the week. Opted to target low back and left hip based on observed referral patterns and what I know of my body. Sure enough, she found numerous tight areas to work on and left hip had more tension than right. She said she can also dry needle shoulders. I see the orthopedic surgeon for my shoulders, so will see what he says about shoulders, if injection(s) or not, then go from there regarding needling or not.
Not sure how many are aware I am sensitive to latex but PTs are aware as regular therapy bands contain latex. I had latex-free bands from a clinic several years ago but these were wearing out and the next clinic I had been at did not have latex-free bands. The new clinic I am at now has latex-free bands! It is the little things. All bands shown below are latex-free. The orange ones are the ones from several years ago. The others are the new ones.
New latex-free bands! No more rashes/reactions, no more worn-out bands breaking on me!
There are, of course, other things going on, but choosing to focus on what is going well.
Week 8 left hip last year.
Copyright © 2017 by Stef. All rights reserved.
Wednesday, September 6, 2017
Week Seven: Regaining Independence
Seven weeks post-op right hip, 14 months post-op left hip.
I have been incredibly independent from the start this time, so not much to complain about. However, with this surgery being right hip that was operated on this time, driving has taken longer. I had started to feel stuck even though I have sisters who have been very willing to give me rides when they are available. But, as the flare progressed, I needed more medical care, which translated into more appointments, which in turn meant more rides. Also, their schedules started to fill as they returned to normal school and work tasks. It was hard to try to schedule things when not knowing availability for rides. I have also been more or less stuck by myself at home during the day. I have not really had time to feel lonely or anything because rehab exercises, ice, rest take pretty much the entire day. However, I had projects I wanted to be working on and have not been able to get to them. I do still get a lot of reading done and some crocheting as ways to fill the time when on the exercise bike, or icing, or in waiting rooms.
Well, I can drive again! I started about a week ago. I was told to start out just trying in a parking lot, or non-busy residential area. That went well, so drove myself to PT a couple of days later and that also went well. Drove myself to church. Drove myself to run errands, etc. Yay! I am also cleared for elliptical! First attempt felt great and went well. It was hard to hold back to the duration and pace I was told to start out with as trial. It felt amazing to be able to move more again! I then swam consecutive laps in a lap pool for the first time since surgery. I had done up to ten laps at a time here and there or had done consecutive laps for 35 minutes at a small pool, but that was different. This was 35 minutes of non stop laps in a normal length pool. My pace is not what it was pre-op, but since this is the first I have tried to this extent since surgery and since I am not kicking, I was impressed with how well it went and how many laps I got done. I am kicking with left leg for freestyle, no kicking at all for breaststroke. I can do a tiny bit of gentle flutter kick with right leg for freestyle, but it does not amount to much yet (have only done a couple of partial laps and there is no power in it--really just working on getting it used to the movement again).
PT went well yesterday--he told me I am walking well, gait is looking pretty good, he can tell I am getting stronger. The op hip is doing well. It is the rest of my body that has been the set back. I was given the OK to back off on how many times a day I am doing exercises since we are advancing with more strengthening. Hopefully, this means things will be and feel less time-consuming and tedious. It has been exciting to advance in rehab and to get stronger, but has been hard when it feels like my entire day is taken up with rehab. He also said it is fine to go back to taking one or two days off a week from intentional exercise! Yay for another shift back to more normal routine.
Aha moment! This article explains some of why I felt like I was always hungry in spite of always eating and eating well those early week after surgery. I knew healing from surgery itself placed higher energy demands on the body and I suspected crutches also did, but was not sure what effect crutches had, especially when limiting how much I was up and around. (I was finally weighed recently and I did lose weight after surgery in spite of trying to hold weight stable. Of course, there was also muscle atrophy from being partial weight bearing as well.)
Overall, still doing really well with respect to recovery. Some of the massive flare is starting to calm down. I am more optimistic again. There are still challenges to work through, but they seem less insurmountable.
Week 7 left hip last summer.
Copyright © 2017 by Stef. All rights reserved.
I have been incredibly independent from the start this time, so not much to complain about. However, with this surgery being right hip that was operated on this time, driving has taken longer. I had started to feel stuck even though I have sisters who have been very willing to give me rides when they are available. But, as the flare progressed, I needed more medical care, which translated into more appointments, which in turn meant more rides. Also, their schedules started to fill as they returned to normal school and work tasks. It was hard to try to schedule things when not knowing availability for rides. I have also been more or less stuck by myself at home during the day. I have not really had time to feel lonely or anything because rehab exercises, ice, rest take pretty much the entire day. However, I had projects I wanted to be working on and have not been able to get to them. I do still get a lot of reading done and some crocheting as ways to fill the time when on the exercise bike, or icing, or in waiting rooms.
Well, I can drive again! I started about a week ago. I was told to start out just trying in a parking lot, or non-busy residential area. That went well, so drove myself to PT a couple of days later and that also went well. Drove myself to church. Drove myself to run errands, etc. Yay! I am also cleared for elliptical! First attempt felt great and went well. It was hard to hold back to the duration and pace I was told to start out with as trial. It felt amazing to be able to move more again! I then swam consecutive laps in a lap pool for the first time since surgery. I had done up to ten laps at a time here and there or had done consecutive laps for 35 minutes at a small pool, but that was different. This was 35 minutes of non stop laps in a normal length pool. My pace is not what it was pre-op, but since this is the first I have tried to this extent since surgery and since I am not kicking, I was impressed with how well it went and how many laps I got done. I am kicking with left leg for freestyle, no kicking at all for breaststroke. I can do a tiny bit of gentle flutter kick with right leg for freestyle, but it does not amount to much yet (have only done a couple of partial laps and there is no power in it--really just working on getting it used to the movement again).
PT went well yesterday--he told me I am walking well, gait is looking pretty good, he can tell I am getting stronger. The op hip is doing well. It is the rest of my body that has been the set back. I was given the OK to back off on how many times a day I am doing exercises since we are advancing with more strengthening. Hopefully, this means things will be and feel less time-consuming and tedious. It has been exciting to advance in rehab and to get stronger, but has been hard when it feels like my entire day is taken up with rehab. He also said it is fine to go back to taking one or two days off a week from intentional exercise! Yay for another shift back to more normal routine.
Aha moment! This article explains some of why I felt like I was always hungry in spite of always eating and eating well those early week after surgery. I knew healing from surgery itself placed higher energy demands on the body and I suspected crutches also did, but was not sure what effect crutches had, especially when limiting how much I was up and around. (I was finally weighed recently and I did lose weight after surgery in spite of trying to hold weight stable. Of course, there was also muscle atrophy from being partial weight bearing as well.)
Overall, still doing really well with respect to recovery. Some of the massive flare is starting to calm down. I am more optimistic again. There are still challenges to work through, but they seem less insurmountable.
Week 7 left hip last summer.
Copyright © 2017 by Stef. All rights reserved.
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