Saturday, November 18, 2017

4 Months: Massive Roller Coaster Month

Today is four months since the right hip surgery.  I am at the phase of recovery, where there still are weekly gains, but it becomes easier to see progress over a month, rather than a week. This was an interesting month.  Started out super flared, thought it was going end up with flare finally resolved....but nope, ended in worst flare yet. Instead of making gains, I have lost a significant amount of progress/ability. I had started making gains, but progress abruptly ended.

Week 14: Making Progress...

...I think!?!  This week started out in recovery mode after all of the travel to Minnesota and Iowa for surgeon and PT appointments, professional conference, etc. Plus dealing with an annoying issue that had resurfaced inexplicably.

Elliptical is back to pre-op ability.  Walking for exercise is still on hold, but we are using elliptical and walking in the pool to work on gait and help prepare for walking, just as we did last year with my left hip. Pool walking has been iffy since this flare started, so still trying to work back up on that and have gotten from 5 minutes, up to 15 minutes. Swimming has been shifting gradually back toward pre-op ratio of freestyle and breaststroke, but not there yet, as still protecting both hips and both shoulders. I did finally try on a good day swimming pre-op ratio of strokes and that resulted in pre-op pace, too! I was pretty excited.  This has only happened once, is not consistent yet, but offers hope! Next tried swimming a mile (6 more laps than normal), using various ratios of strokes--75/25, then 50/50 the final 6 laps.  (Pre-op was 90/10, or 90% freestyle, 10% breaststroke with no kick). It went well!  Both shoulders and both hips did fine!  Pace was not great, but who cares about pace, when new distance went well in spite of the challenges! Because of that little experiment, then walking in the pool for as long as hips felt OK and only stopping when they started to get tired (30+ minutes!), still did hot tub, and hot shower afterward, I ended up running a tad later for PT than intended, only had time to stop by home, hang up swimming things to dry, grab a snack, head back out for PT.  Thus, was nicely warmed up.  So, he tested me by trying more of the old exercises that had gotten hard--hips handled things fine!  He worked on range of motion--commented it is better and the joint feels better! PT was pleased and I was encouraged. Exciting to be back or nearly so to pre-op ability with a few things.  Shoulders are handling the swimming so far, but noticing left shoulder is getting more tender again with some things.  I see the surgeon for my shoulders again soon, and curious of his thoughts on progress.  We have gotten the last flare with shoulders calmed, we do have shoulders stronger again, but have not regained full range of motion again on left.  Also, the injection for the left shoulder has been losing effect over the past week or so.

Week 15: Back on track?

Elliptical is consistently back to pre-op duration and pace, swimming laps is now back to pre-op duration, pace, frequency as well!  Hip pain seems almost gone again, so flare seems to be calming.  Op hip is regaining ROM quite well after having lost ROM and been really limited.  Still not walking for exercise, but only as needed to get around. However, I can last longer with shopping or other outings. PT is pleased with progress.  Left shoulder is definitely losing injection effects.  Pain keeping me awake at night, pain with some activities during the day.  So far still handling swimming as long as I am very careful of form.  Still waiting to hear when we can get the MRI scheduled. Grateful hips are calming down!  But, it is always something.  It is what it is, move on....

I can sit cross-legged again!  This is new in the past week as we made progress with ROM.  I know I could earlier last time, but was told not to compare.


Week 16: Optimistic and Excited

Still making progress! Chiropractor and PT can tell there is progress.  I am walking better, the joint feels better, etc. All are pleased, I am encouraged. First day of week 16 (15 weeks, 1 day), and I "walked" 2.14 miles on elliptical in 30 minutes, then swam a mile (36 laps), in 35.5 minutes.  That is probably a personal best time.  This was a different gym, but same brand of elliptical, and pretty sure standard length pool.  I must have been on a roll or something? Couple of days later and 2.07 miles in 30 minutes on elliptical and swam 36 laps in 36 minutes! This was the regular gym, elliptical, and pool.

And, right at 16 weeks, sort of starting to flare, not awful, talking things over with PT, explaining I was puzzled with recent compensation issues with left hip and not sure.  He offered to check my form on the exercises I had mentioned being aware of the issues.  He shifted my position slightly at one point to see if it helped, and it put enough more weight through left shoulder (badly flared/painful), that it pretty much quit.  So....we think maybe the gradually worsening shoulder as injection has been slowly wearing off may be the culprit behind the return of old compensation issues.  The next puzzle is what to do......upcoming shoulder MRI will hopefully give more info on shoulder and how far we can push it, or if it needs more rest, etc.  Modified a few hip exercises for now to take pressure/weight off shoulders.  When working on that, it reminded me of old, similar exercises and asked if they were OK to do again, and he said yes, and in fact, they would be very helpful at this stage.

Week 17: The Unexpected

The beginning of this week started with multiple imaging procedures, including shoulder MRI. The initial scan was scheduled well in advance, the final scan was scheduled the day before. The middle scans were scheduled by accident--literally. I had gone to the gym to loosen up and get my body moving after the first scan.  Elliptical (2+ miles in 30 minutes) and swimming (1 mile--36 laps in 38 minutes), plus one lap walking in the pool, all went great and felt amazing!  Headed home, grateful that activity helped so much, feeling so much better, even thinking how grateful to be able to drive normally and without pain.  Then, the rest of the day, rest of the week, and who knows for how long, was changed in a split second.  A pick-up truck came through a red light and hit my car in the intersection, pushing my car into a post.  Both vehicles totaled.  My dad came to get me. Just walking from my car to his car, the right hip was sore, stiff, struggling not to limp.  We went straight from accident scene to take other driver home, then ER. ER did x-rays of right hip, diagnosed various muscle strains, other minor injuries, warned I'd feel worse the next day, instructed to use ice/heat, medications (NSAID, muscle relaxant), see primary care physician in a week if not better. Discharged from ER just in time to get back and changed and get to shoulder MRI appt. Physically, mentally, emotionally exhausted. I was badly shaken by the accident--both physically and mentally/emotionally. The rest of the week was a blur. The right hip was sore, had bruising and swelling. It refused to do much. I was backed down to early post-op (day after surgery) hip rehab exercises, elliptical banned, walking only as truly essential (significant decrease in daily steps, not lasting long with errands, or avoiding entirely), pool still OK as tolerated, but I could barely do anything before pain from the new injuries made me stop.  It is neck, shoulders, back, hips, etc. So, impossible to compensate for one with another as all flared, everything is hard. Crazy how I went from pretty able and making good progress, to pretty limited and dependent again.  Not driving, needing rides, etc. Amazing how new injuries and increased pain can make one grateful for the normal chronic pain levels. Also, interesting to be able to differentiate between acute and chronic pain. The new injuries are a completely different quality of pain. Pathetic that I know and can tell this.

I did let my hip surgeon and team know what had happened, that my right hip was flared, and asked what they thought needed checked--they had me request hip x-rays in the ER. Then, PA called and discussed things. He said not to push through things, to use pain as my guide, let my body rest and recover. Stay in touch and keep them updated after PT and primary care appts.

Start of Week 18 (4 Months): Overwhelmed

The shoulder surgeon called me himself with MRI results--confirming his suspicions he had told me beforehand of labral and/or rotator cuff issues in addition to the os acromiale (failure of bones to fuse during development).  Because I have already been in PT all along, injections have helped, but not lastingly, he is recommending surgery as next step.  However, he is aware of the recent accident, hips flared, so would not consider proceeding until my body has healed/recovered from everything it is currently dealing with. Oh my. I was totally overwhelmed when I got off the phone. I felt like new issues were being piled up on top of me faster than I could keep up with. I was relieved the MRI showed a reason for the ongoing pain and limitations in the shoulder.  However, I had been hoping to be done with surgeries for a while.  Not be facing another when still rehabbing from the last surgery, plus recovering from an accident. Additionally, if possible to imagine, this will be a bigger surgery than the hips were.

Even in the midst of challenge, I am still finding the positive aspects, learning new things.  Grateful! For the accident to be severe enough to total both vehicles, yet both drivers walk away! For the accident to take place at that busy of intersection, yet only involve two vehicles!  For there to be no passengers or pedestrians involved! For family and friends who came to get me, have given rides, etc.  God is good in all!  He gives grace and strength, He is sufficient.  I do not need to understand what happens or know why, but I do need to trust Him.

Here is the post from 4 months post-op left hip last year.

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