Yesterday was a full month after the right hip surgery. It seems hard to believe it has been a month since surgery. In some ways, it feels like it has been forever. The tedious stage continues. My body is exhausted from crutches and I wake stiff/sore every morning. I am cleared to use only one crutch around home as long as it feels alright and not too long of distance. I can put full weight through with both crutches, but again, only as long as it feels alright. So far it all feels fine. I know I posted at one month post-op last time as it was a memorable date--the day I was first allowed to start weaning crutches and try walking both with one crutch and with no crutches. The no crutches did not go well and I had to keep a crutch. This time, I was allowed to try walking with one crutch in PT at four weeks, and since it went well, told it was fine to walk short distances at home with one crutch. Well, the PT appt at one month (4.5 weeks) was pretty much just repeat--walking with one crutch still looks fine, so still fine to do so at home. Otherwise, two crutches. Because I had already been cleared to do this, this was sort of an anti-climax to be just maintaining the status quo. We have still not even tried seeing how I do without either crutch. We know I can stand with full weight on surgical side. I think I am more puzzled than discouraged, but have to admit to being somewhat discouraged. This hip is doing better, tolerating adding weight on better than first one did, etc. Thus, I am uncertain why I am being held back. However, I know from last time that weaning off of crutches is a crucial step, needs to be done in such a way as to make sure there is no pain and no limping. We are still working on gait. The rest of my body gets ever more tired of crutches. I wake every morning with everything stiff and sore--neck, back, shoulders, wrists, hands, both hips. Left hip has been sore the last few days--enough that when icing right hip first thing in the morning, I have iced left as well the last few days and that has calmed it nicely. So, hoping to avoid full blown flare, but being cautious. I had been limiting how much I am on my feet/crutches/walker anyway, but starting to do so even more and starting to become afraid of consequences of being on crutches/walker this long based on what happened last time and what is happening now. I still go nowhere non-essential. I have been wanting to get to church, but trying to wait until off crutches. I had been hoping to make it this weekend, but with still being on two crutches, this is now unlikely. Besides, it is still hard to sit very long. (Family movie night here at home started out with me fully reclined in my zero gravity chair, but halfway through I moved to lying prone on the floor propped with a pillow.) The other hard part of recovering from right hip surgery, is still not being able to drive. I could drive pretty early with left hip. I am very grateful for sisters who are willing to make themselves available to give me rides. However, I really want to be able to drive myself again.
I am still not on any pain medications or sleep medications, but things are stiff and sore enough to be considering restarting pain medication(s), and sleep quality is starting to worsen enough to contemplate adding back sleep medication(s). I know this is just an awkward, tedious, challenging phase of recovery, so I am trying to be patient and proactive versus reactive in my approaches. However, coming off crutches with hips flared is not going to help the next stage of rehab, either. Uncertain what it best. Hoping to get through the weekend alright and see how PT goes next week.
Copyright © 2017 by Stef. All rights reserved.
Saturday, August 19, 2017
Tuesday, August 15, 2017
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.
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.
Copyright © 2017 by Stef. All rights reserved.
Tuesday, August 8, 2017
Three Weeks: Tedious and Tiring
I am now three weeks post-op and I have been in the tedious phase of recovery. Overall, things are still going really well, but everything takes longer. It often feels like all I do is rehab exercises, rest, ice, self-care. But, this is laying the foundation to build on as my body heals and we start working on strengthening and advancing exercises. It is worth taking this stage seriously and supporting my body as it heals. I am intentionally not comparing recoveries between hips, but once I have gotten through each week and written the update, it has been interesting to look back and read my thoughts on things at the same stage last time. Here is three-week update last surgery.
I posted the two-week update early enough that I missed being able to mention that I went to a picnic that evening. It was so good to get out for something other than medical appointments, moving, or even the swimming, which is partly rehab oriented. This was fresh air, seeing people, an actual social function. I still do not do well with lots of sitting, so we (my sister, not me), hauled my zero gravity chair along. I still wore out--too much sitting--even with my own chair. But, overall, it was worth it.
There is much that is going well. I am sleeping through the night for the most part, most of the time. Both hips are totally pain-free! This has been amazing! After surgery a year ago, I was so excited when first hip was pain-free, but second was not....and when it hurt would remind myself at least the first did not hurt. So, now the novelty is neither hip hurts! I am also still adding in new things I can do.
Crutches. I think it took longer this time, but still ran into issues with the crutches flaring up shoulders, neck, back, wrists, hands, etc. All are tired by evening and all stiff/sore when I wake the next morning. I knew this was a possibility and tried to be careful and avoid it. I am still doing PT exercises for neck and shoulders, plus have already seen chiropractor to get things addressed. For now, choosing to rest and stay off crutches/feet as much as possible. This means going nowhere non-essential, doing nothing non-essential, hence things getting even more boring. PT and pool are considered essential as the outcomes are worth being up and on crutches to get there and back. I do have and use a walker as well, but the walker is harder to maintain as normal of gait, just as stressful to shoulders, wrists, hands, etc. It is also more awkward to maneuver. Lots of reading and crocheting are happening during this enforced downtime.
Brace. It has still never yet restricted my movement. It does throw off my walking with crutches and wear me out faster. I was supposed to wear it 2-3 weeks per discharge info, but surgeon had told me pre-op 2 weeks or until sick of it. It is not that bad, so not sick of it. However, not convinced it is actually helpful in my case and may actually be contributing to some issues. Not sure. Initially, I thought the more tiring days were from being up more; however, it seems both hips, but especially surgical side, are more tired/sore on days I wear the brace whether up more or not. I think it is the extra weight from the brace and that I have to be careful to avoid catching crutches on it, so gait is off even more than from just restrictions and crutches themselves. Anyway, I am now three weeks post-op, so can officially be done with it based on discharge info. I have not been wearing it the past few days already anyway and quite a bit of the stiffness/soreness calmed down again. Thoughts: I suspect the brace would have been more helpful if I had not already known how to stay within restrictions. I recall last time thinking early on maybe a brace would have been nice to prevent going outside of restrictions. However, I decided with time it was better not to have a brace as it forced me to be continually mindful of how I moved. Between that experience and that most of the restrictions are things that were painful pre-op, thus had been avoiding already anyway, I know how to stay within restrictions without a brace to remind me.
I have still not tried driving this time. I am a really weird mix of super cautious, with definite limit pusher. However, multiple surgeries and other experiences have helped teach me patience and when to be cautious versus when to push limits. Right after surgeries I tend to be more cautious, almost afraid to do anything. As I recover, curiosity starts to take over and I start testing things out of curiosity to see how I do. Being in the pool is something relatively safe to test and push. Driving is not. I had enough trouble driving pre-op that I am in no hurry to try too soon and risk a set back. I also still do not like sitting up fully, so prefer being reclined. I can sit better than pre-op, but still not really comfortable. I do not want to undermine recovery, so sort of waiting until sitting is more comfortable and hip feels stronger, less sensitive to little things.
Being in water remains my best help. It helps relieve the issues from crutches--neck, shoulders, back. I can swim full laps even though it is all only arms, no kicking yet. I can stand in neck deep water, do simple PT exercises in neck deep water. It feels so good to be in the water and able to move better. Came back from the pool at 2.5 weeks post-op after not wearing the brace or compression sock for the first time when out and both hips felt so good I stood at the bottom of the stairs trying to remember which hip I was supposed to be protecting.
PT with new therapist here is going well. I had been really apprehensive about this, but also really optimistic. I had been with my Iowa PT for 4.5 years and through multiple surgeries and other tough issues. I credit her as well as my surgeon with how well my left hip has done. It is scary starting over with someone new who does not know me or my body and whom I do not know. But, so far, going well. He seems to really know rehab, is open to what I know of my recovery last time as well as the input of both the MN and IA PTs, but also giving me new suggestions that are helping. Sort of funny incident during second appointment, I mentioned how tight my thigh on operative side was. He did some manual soft tissue work, commented I had some knots and that since I was not squirming at all with the pressure he was using, he was going to try something else, so then got out Astym tools telling me what they were. I'd had Astym and Graston before and they worked well. Anyway, hip and leg felt so much better after he worked on them!!!! Grateful and more hopeful again.
Today marks three weeks post-op and is a next step in rehab. I get to start adding more weight onto the surgical side, get to relax some of the restrictions, as mentioned above I get to be done with the brace, etc. I have already walked in the pool in neck deep water, but am now cleared to walk in chest deep water and to do PT exercises in chest deep water. I got to try the AlterG (anti gravity treadmill) at PT this afternoon and that was fascinating to experience and gave valuable feedback as there were cameras so I could watch and adjust my gait. More soft tissue work again, too. PT could tell things were less tense than last time, but still had knots that needed worked out. He is hoping that more weight bearing will help with that. He also agreed that my observation about the brace possibly having contributed to issues made sense and was probably part of what had been going on. Anyway, I am ending week three and entering week four far more optimistically than even just a few days ago.
So grateful for how well things are going overall, trying to keep my focus on the positive aspects, but it has been challenging and discouraging at times as well. My theme for recovery needs to be kept in mind: 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 needed to let my body heal at its own pace. I need to stay focused on the end goal--full recovery.
Therefore, since we are surrounded by such a great cloud of witnesses, let us throw off everything that hinders and the sin that so easily entangles. And let us run with perseverance the race marked out for us, fixing our eyes on Jesus, the pioneer and perfecter of faith. For the joy set before him he endured the cross, scorning its shame, and sat down at the right hand of the throne of God. Consider him who endured such opposition from sinners, so that you will not grow weary and lose heart. Hebrews 12:1-3 (NIV)
Copyright © 2017 by Steph. All rights reserved.
I posted the two-week update early enough that I missed being able to mention that I went to a picnic that evening. It was so good to get out for something other than medical appointments, moving, or even the swimming, which is partly rehab oriented. This was fresh air, seeing people, an actual social function. I still do not do well with lots of sitting, so we (my sister, not me), hauled my zero gravity chair along. I still wore out--too much sitting--even with my own chair. But, overall, it was worth it.
There is much that is going well. I am sleeping through the night for the most part, most of the time. Both hips are totally pain-free! This has been amazing! After surgery a year ago, I was so excited when first hip was pain-free, but second was not....and when it hurt would remind myself at least the first did not hurt. So, now the novelty is neither hip hurts! I am also still adding in new things I can do.
Crutches. I think it took longer this time, but still ran into issues with the crutches flaring up shoulders, neck, back, wrists, hands, etc. All are tired by evening and all stiff/sore when I wake the next morning. I knew this was a possibility and tried to be careful and avoid it. I am still doing PT exercises for neck and shoulders, plus have already seen chiropractor to get things addressed. For now, choosing to rest and stay off crutches/feet as much as possible. This means going nowhere non-essential, doing nothing non-essential, hence things getting even more boring. PT and pool are considered essential as the outcomes are worth being up and on crutches to get there and back. I do have and use a walker as well, but the walker is harder to maintain as normal of gait, just as stressful to shoulders, wrists, hands, etc. It is also more awkward to maneuver. Lots of reading and crocheting are happening during this enforced downtime.
Brace. It has still never yet restricted my movement. It does throw off my walking with crutches and wear me out faster. I was supposed to wear it 2-3 weeks per discharge info, but surgeon had told me pre-op 2 weeks or until sick of it. It is not that bad, so not sick of it. However, not convinced it is actually helpful in my case and may actually be contributing to some issues. Not sure. Initially, I thought the more tiring days were from being up more; however, it seems both hips, but especially surgical side, are more tired/sore on days I wear the brace whether up more or not. I think it is the extra weight from the brace and that I have to be careful to avoid catching crutches on it, so gait is off even more than from just restrictions and crutches themselves. Anyway, I am now three weeks post-op, so can officially be done with it based on discharge info. I have not been wearing it the past few days already anyway and quite a bit of the stiffness/soreness calmed down again. Thoughts: I suspect the brace would have been more helpful if I had not already known how to stay within restrictions. I recall last time thinking early on maybe a brace would have been nice to prevent going outside of restrictions. However, I decided with time it was better not to have a brace as it forced me to be continually mindful of how I moved. Between that experience and that most of the restrictions are things that were painful pre-op, thus had been avoiding already anyway, I know how to stay within restrictions without a brace to remind me.
I have still not tried driving this time. I am a really weird mix of super cautious, with definite limit pusher. However, multiple surgeries and other experiences have helped teach me patience and when to be cautious versus when to push limits. Right after surgeries I tend to be more cautious, almost afraid to do anything. As I recover, curiosity starts to take over and I start testing things out of curiosity to see how I do. Being in the pool is something relatively safe to test and push. Driving is not. I had enough trouble driving pre-op that I am in no hurry to try too soon and risk a set back. I also still do not like sitting up fully, so prefer being reclined. I can sit better than pre-op, but still not really comfortable. I do not want to undermine recovery, so sort of waiting until sitting is more comfortable and hip feels stronger, less sensitive to little things.
Being in water remains my best help. It helps relieve the issues from crutches--neck, shoulders, back. I can swim full laps even though it is all only arms, no kicking yet. I can stand in neck deep water, do simple PT exercises in neck deep water. It feels so good to be in the water and able to move better. Came back from the pool at 2.5 weeks post-op after not wearing the brace or compression sock for the first time when out and both hips felt so good I stood at the bottom of the stairs trying to remember which hip I was supposed to be protecting.
PT with new therapist here is going well. I had been really apprehensive about this, but also really optimistic. I had been with my Iowa PT for 4.5 years and through multiple surgeries and other tough issues. I credit her as well as my surgeon with how well my left hip has done. It is scary starting over with someone new who does not know me or my body and whom I do not know. But, so far, going well. He seems to really know rehab, is open to what I know of my recovery last time as well as the input of both the MN and IA PTs, but also giving me new suggestions that are helping. Sort of funny incident during second appointment, I mentioned how tight my thigh on operative side was. He did some manual soft tissue work, commented I had some knots and that since I was not squirming at all with the pressure he was using, he was going to try something else, so then got out Astym tools telling me what they were. I'd had Astym and Graston before and they worked well. Anyway, hip and leg felt so much better after he worked on them!!!! Grateful and more hopeful again.
Today marks three weeks post-op and is a next step in rehab. I get to start adding more weight onto the surgical side, get to relax some of the restrictions, as mentioned above I get to be done with the brace, etc. I have already walked in the pool in neck deep water, but am now cleared to walk in chest deep water and to do PT exercises in chest deep water. I got to try the AlterG (anti gravity treadmill) at PT this afternoon and that was fascinating to experience and gave valuable feedback as there were cameras so I could watch and adjust my gait. More soft tissue work again, too. PT could tell things were less tense than last time, but still had knots that needed worked out. He is hoping that more weight bearing will help with that. He also agreed that my observation about the brace possibly having contributed to issues made sense and was probably part of what had been going on. Anyway, I am ending week three and entering week four far more optimistically than even just a few days ago.
So grateful for how well things are going overall, trying to keep my focus on the positive aspects, but it has been challenging and discouraging at times as well. My theme for recovery needs to be kept in mind: 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 needed to let my body heal at its own pace. I need to stay focused on the end goal--full recovery.
Therefore, since we are surrounded by such a great cloud of witnesses, let us throw off everything that hinders and the sin that so easily entangles. And let us run with perseverance the race marked out for us, fixing our eyes on Jesus, the pioneer and perfecter of faith. For the joy set before him he endured the cross, scorning its shame, and sat down at the right hand of the throne of God. Consider him who endured such opposition from sinners, so that you will not grow weary and lose heart. Hebrews 12:1-3 (NIV)
Copyright © 2017 by Steph. All rights reserved.
Tuesday, August 1, 2017
Two Weeks: Regrouping
August 1 marks two weeks post-op right hip and 13 months post-op left hip. The focus has been mostly on the rigth hip, but the left hip is still rehabbing as well. Left hip is doing great! It is handling doing most of the work with crutches. My shoulders are also so far handling the crutches. Both shoulders and left hip are usually pretty tired by evening and sometimes getting sore, but OK again the next morning. I am trying to be cautious with how I move and how much I am up and around to avoid the issues I ran into last year from crutches. I should be about halfway through the time on crutches. The right hip is still doing very well! I am still off pain killers, no actual pain. It will get a bit sore if I have been up sitting more with appointments, but nothing concerning--just uncomfortable. It is interesting to look back and see how things were going at two weeks post op last time, as well as a year ago. I'd say overall, recovery and rehab are still going better this time, but I am being cautious as I know how easy it is to overdo it and how easy it is for flares to strike. I also know weaning off crutches can have some uncomfortable times. A lot has happened over the past week. This includes moving out of state, so final packing, cleaning, transition first to a hotel, then travel. My sister was staying with me for the move and she did her best not to let me help, but I insisted with tasks I knew from last year that I was capable of doing. Thus, I did help with both packing and cleaning. I am none the worse for doing so, and it decreased both our stress levels those final days.
In spite of all going on, rehab and recovery are still going well! I can do most things on my own, am independent for nearly everything. Because of surgery on right hip, I am still not driving--I have not even tried. The hip may be ready to try, but I do not want to risk a set back and currently have drivers available. Once again, I am finding all of the work pre-op making sure I was strong has been incredibly helpful with early recovery and rehab. We think I was even stronger prior to this surgery, than last surgery. At any rate, I am handling crutches better, stairs are easier--not just knowing how to navigate them with crutches, but actually less exhausting, less work. With an injection several months ago anf treating MCAS and other issues, we had gotten shoulder pain calmed down, and that allowed us (PT and me) to work more on strengthening. I was able to go from restricted to only swimming non-consecutive days to give shoulders a break, to gradually working up to swimming every single day (6 days in a row) the week before surgery. This further strengthened shoulders, plus increased overall endurance and I think has really helped. I think both hips were also stronger going into this surgery, than last time. I know core strength was better Last time, I was 7 months post-op abdominal surgery when I had the hip surgery and we had my core strength back really well and even better than prior to the abdominal surgery, but this time had even more time to continue to build my core strength.
Moving necessitates finding a new medical team. As a decidedly medically complicated patient, seeing new providers for the first time can be interesting (aka intimidating/nerve-wracking). I go into appointments with new providers hoping for the best but keeping expectations minimal. I know things are challenging--not just for me to live with, but for providers to help me manage. I do not expect answers, solutions, etc. I am only looking for help and support with learning to manage everything the best possible. I have been surprised over the past year with some actual answers, diagnoses, etc. But, was not expecting them, so they actually caught me off guard. However, it has been incredibly helpful to have those answers when transitioning care--better explanations for what is going on, less questions as to what exactly we are trying to treat, etc.
I got to meet my new PT and the appointment went well. I am optimistic. I also saw the physician who I have been looking to transition primary care to and had the sutures removed and replaced with Steri strips. Incisions look fine, the Steri strips are a precaution due to EDS. He was not at all concerned with my medical complexity, knew what EDS is, was open to info on MCAS. He is willing to support me with what is needed to manage things. So grateful things went well! More hopeful.
I saw my surgeon the day before surgery on right hip for 1-year post-op appointment on left hip. He checked both hips, which did not surprise me, and we also discussed both hips. Left hip is doing really well, no concerns. We discussed expectations long term for left, rehab for right. My surgeon told me my persepctive on things was healthy and encouraged me to do what I did last time as it clearly worked for me. This was a huge boost of confidence just as I was going into surgery the next day. I was trusting him as he operated, and he trusting me with rehab. He told me he would support me with whatever is needed, but I need to let him know what I need. I already knew he would support me as he did so with the first hip even through some flares and rough times. I was nervous as knew I would be changing PTs and I credit my Iowa PT with helping me rehab as well as I did with the left hip and really wished I could have stayed with her to rehab the right hip--at least the first few months. The PT I saw this time in MN further supported me. She commented she could tell I'd been through this rehab before and clearly had a good PT working with me in Iowa. She trusted me to walk without the brace to get on the bike and commented she had watched and I never once broke restrictions. This was another boost of confidence that I and my body know what to do. This confidence and trust in me and my body is so helpful when trying to navigate working with new medical providers.
Speaking of medical complexity, here are some of the Facebook memories for this date over the years. This is the third time in 4 years I have been recently post-op on this date.
4 YEARS AGO TODAY
In the past week, I once again traveled out of state, this time moving from Iowa to Nebraska, rather than returning to Iowa from Minnesota after surgery. The trips are the same distance (~215 miles Ames to Minneapolis, ~215 miles Ames to Lincoln, both take ~3.5 hours, but I usually take 4 ish hours from frequent stops). The trip home to Iowa after surgery took 4 hours. The trip to Nebraska went OK, but uncomfortable and the normally 3.5-hour drive took 5 hours. I was so tired of sitting, even reclined, but too tired to stand/walk much, so ended up lying down on a bench at a rest stop for a while for a break.
Officially back in Lincoln, Nebraska. I have no idea how temporary or permanent this move is. For now, grateful to be here, but missing Iowa and Iowa people. I am still in transition as staying with my sister until off crutches and can better handle all of the stairs at my dad's place. Then, still in transition even there until rehabbed well enough to find work and my own place again.
God has gone before, faithfully brought me safely here, sufficiently providing needs. I need to keep trusting.
Copyright © 2017 by Steph. All rights reserved.
In spite of all going on, rehab and recovery are still going well! I can do most things on my own, am independent for nearly everything. Because of surgery on right hip, I am still not driving--I have not even tried. The hip may be ready to try, but I do not want to risk a set back and currently have drivers available. Once again, I am finding all of the work pre-op making sure I was strong has been incredibly helpful with early recovery and rehab. We think I was even stronger prior to this surgery, than last surgery. At any rate, I am handling crutches better, stairs are easier--not just knowing how to navigate them with crutches, but actually less exhausting, less work. With an injection several months ago anf treating MCAS and other issues, we had gotten shoulder pain calmed down, and that allowed us (PT and me) to work more on strengthening. I was able to go from restricted to only swimming non-consecutive days to give shoulders a break, to gradually working up to swimming every single day (6 days in a row) the week before surgery. This further strengthened shoulders, plus increased overall endurance and I think has really helped. I think both hips were also stronger going into this surgery, than last time. I know core strength was better Last time, I was 7 months post-op abdominal surgery when I had the hip surgery and we had my core strength back really well and even better than prior to the abdominal surgery, but this time had even more time to continue to build my core strength.
Moving necessitates finding a new medical team. As a decidedly medically complicated patient, seeing new providers for the first time can be interesting (aka intimidating/nerve-wracking). I go into appointments with new providers hoping for the best but keeping expectations minimal. I know things are challenging--not just for me to live with, but for providers to help me manage. I do not expect answers, solutions, etc. I am only looking for help and support with learning to manage everything the best possible. I have been surprised over the past year with some actual answers, diagnoses, etc. But, was not expecting them, so they actually caught me off guard. However, it has been incredibly helpful to have those answers when transitioning care--better explanations for what is going on, less questions as to what exactly we are trying to treat, etc.
I got to meet my new PT and the appointment went well. I am optimistic. I also saw the physician who I have been looking to transition primary care to and had the sutures removed and replaced with Steri strips. Incisions look fine, the Steri strips are a precaution due to EDS. He was not at all concerned with my medical complexity, knew what EDS is, was open to info on MCAS. He is willing to support me with what is needed to manage things. So grateful things went well! More hopeful.
I saw my surgeon the day before surgery on right hip for 1-year post-op appointment on left hip. He checked both hips, which did not surprise me, and we also discussed both hips. Left hip is doing really well, no concerns. We discussed expectations long term for left, rehab for right. My surgeon told me my persepctive on things was healthy and encouraged me to do what I did last time as it clearly worked for me. This was a huge boost of confidence just as I was going into surgery the next day. I was trusting him as he operated, and he trusting me with rehab. He told me he would support me with whatever is needed, but I need to let him know what I need. I already knew he would support me as he did so with the first hip even through some flares and rough times. I was nervous as knew I would be changing PTs and I credit my Iowa PT with helping me rehab as well as I did with the left hip and really wished I could have stayed with her to rehab the right hip--at least the first few months. The PT I saw this time in MN further supported me. She commented she could tell I'd been through this rehab before and clearly had a good PT working with me in Iowa. She trusted me to walk without the brace to get on the bike and commented she had watched and I never once broke restrictions. This was another boost of confidence that I and my body know what to do. This confidence and trust in me and my body is so helpful when trying to navigate working with new medical providers.
Speaking of medical complexity, here are some of the Facebook memories for this date over the years. This is the third time in 4 years I have been recently post-op on this date.
1 YEAR AGO TODAY
In the past week, I once again traveled out of state, this time moving from Iowa to Nebraska, rather than returning to Iowa from Minnesota after surgery. The trips are the same distance (~215 miles Ames to Minneapolis, ~215 miles Ames to Lincoln, both take ~3.5 hours, but I usually take 4 ish hours from frequent stops). The trip home to Iowa after surgery took 4 hours. The trip to Nebraska went OK, but uncomfortable and the normally 3.5-hour drive took 5 hours. I was so tired of sitting, even reclined, but too tired to stand/walk much, so ended up lying down on a bench at a rest stop for a while for a break.
Officially back in Lincoln, Nebraska. I have no idea how temporary or permanent this move is. For now, grateful to be here, but missing Iowa and Iowa people. I am still in transition as staying with my sister until off crutches and can better handle all of the stairs at my dad's place. Then, still in transition even there until rehabbed well enough to find work and my own place again.
God has gone before, faithfully brought me safely here, sufficiently providing needs. I need to keep trusting.
Copyright © 2017 by Steph. All rights reserved.
Friday, July 28, 2017
One Week: Off to a Great Start
I had hip arthroscopy a little over a week ago on my right hip to address impingement and repair a labral tear. My left hip was surgically repaired a year ago. I posted weekly, then monthly after the surgery on my left hip a year ago and found it helped me track progress over time, so am hoping to post how things are going with recovery from surgery on my right hip this year. Surgery was July 18, so I am a little over a week post-op, but things have been crazy and in transition, no time for anything except essentials, and often no internet access, so this post is late.
I am doing incredibly well--much better than I expected! I was pretty independent from the start this time. I was off the narcotic pain medication just a couple of days post op, started PT and stationary bike the day after surgery. Rehab exercises are going well, and already maxed out on limits for the bike for this early. I was in the pool at 5 days post-op (mostly just hanging out in deep water, but a little gentle range of motion work in the safe ranges PT already had me doing, a tiny bit of breaststroke no kick at all. It went well and gave my entire body a break from crutches. Tried again a couple of days later at one week post-op and did more swimming, but still arms only--this time both breaststroke and freestyle. It felt amazing to be able to move, to unweight my body, give my left hip a break, both shoulders a break. Water gives me a reprieve from all of the usual chronic pain as well, so it was nice even to just hang out in deep water. (Surgeon and PT cleared me to be in water this early and I have waterproof bandages.)
I am so grateful and relieved to be doing so well. I am not getting overly confident, but still being careful and cautious. I know last time that flares happened, so no matter how well I feel, I am choosing to rest, take things slowly, not push limits. With everything else going on right now, I sort of needed this recovery to go well, but those other issues also make it easier to undermine recovery if not careful. There have been a few nights of less thane optimal amount of sleep, I also did help with some of the tasks needing done. Then more travel on top of that. But, still doing well.
I am still using the theme from last year for this year. 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 it to give my body the time and support it needs to heal and recover well.
Copyright © 2017 by Steph. All rights reserved.
I am doing incredibly well--much better than I expected! I was pretty independent from the start this time. I was off the narcotic pain medication just a couple of days post op, started PT and stationary bike the day after surgery. Rehab exercises are going well, and already maxed out on limits for the bike for this early. I was in the pool at 5 days post-op (mostly just hanging out in deep water, but a little gentle range of motion work in the safe ranges PT already had me doing, a tiny bit of breaststroke no kick at all. It went well and gave my entire body a break from crutches. Tried again a couple of days later at one week post-op and did more swimming, but still arms only--this time both breaststroke and freestyle. It felt amazing to be able to move, to unweight my body, give my left hip a break, both shoulders a break. Water gives me a reprieve from all of the usual chronic pain as well, so it was nice even to just hang out in deep water. (Surgeon and PT cleared me to be in water this early and I have waterproof bandages.)
One week post-op: preparing to go swimming again!
I am still using the theme from last year for this year. 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 it to give my body the time and support it needs to heal and recover well.
Copyright © 2017 by Steph. All rights reserved.
Hip Surgery Update: Transitions
After years of debilitating hip pain, I had surgery on my left hip July 1, 2016, and then surgery on my right hip July 18, 2017.
So far, I am doing incredibly well and this recovery going even better than last time! I am choosing to be careful and rest even if I feel well.
The surgery itself was nearly identical to surgery on my left hip as my surgeon said both hips were pretty much the same. Thus far, this recovery has been going even better than the recovery from the first hip surgery. This is partly because I know more of what to expect and had already figured out tricks to make things easier. However, we also think I was even stronger prior to this surgery, so early recovery and rehab are going even better than last time. I thought I was independent quickly last time, but this time I started out even more so.
The anesthesiologist had discussed with me some of my complicating factors a few weeks prior to surgery, then again morning right before surgery. I trusted the anesthesiologist so followed his preferences regarding how to address the precautions for EDS and MCAS, even though different from what had been initially recommended. The way he managed things worked very well for me, as I have felt really well since pretty early after surgery. However, I was apprehensive about the scopolamine patch used to prevent nausea. I had the patch last time for the first time ever and although I had no nausea, I also had such badly blurred vision for so long that I could not read, email, text, message on Facebook, or much of anything for days. We ended up deciding to forego the patch completely this time. I knew this meant higher risk of post-op nausea. I have been pleasantly surprised that there was no nausea at all even without the patch and also vision has been fine! I have so much enjoyed being able to see to read, type, crochet, etc.
The brace is really not that bad. I usually wear it over a tank top but under t-shirt or dress. I have not noticed it restricting my movement, but I was also told by the PT I saw day after surgery that I obviously had been through this recovery/rehab before and had a good local PT working with me as I was moving well, maintaining restrictions, knew what I was doing, and had good questions. She told me she trusted me to walk without the brace to the bike, and afterward told me she had watched me walk and I never once went into extension. My surgeon had already told me I only need to wear it when up and around, not when resting or sitting still. So, early on, some days, I never wore it as resting all day. With the move, I was wearing it majority of days where there was more going on and I was up and down more, or actually helping. The brace is heavy (relatively, not awful) and gets hot with all-day wear. My biggest issue with it, is it gets in the way of the crutches and afraid of catching myself up.
Transitions--the secondary title of this post. I am transitioning from rehabbing left hip and "prehabbing" right hip, to maintaining left hip (some ongoing rehab) and rehabbing right hip. However, it also has to do with moving from Iowa back to Nebraska, plus other changes. Timing of both surgery and moving were not ideal and things have been challenging. I was so restricted pre-op that I was overwhelmed with how to possibly get packed to move and prepare for surgery when I could not sit or stand long. Friends from church willingly offered to help me and took turns coming to my place, helping me sort things, pack, clean. We had most of the packing done prior to surgery. The actual move took place four days post-op. My brother coordinated guys to help in Iowa and my dad coordinated help in Nebraska. We had my boxes and furniture loaded in an hour! Last minute the night before after an honest conversation between PT, my sister, and I, we decided to keep my bed after all, but sent all else, except folding card table, folding chairs, my folding zero-gravity chair, my "bike" (folding pedals, and bar stool), a few other small items. A couple of days later, some of the ladies from church came and deep cleaned my apartment! Then, my aunt and uncle came over and finished off final details. My sister who had traded places with another of my sisters to stay with me the weekend of the move, helped with the very final packing and touching up the cleaning right before we left at eight days post-op to move to a hotel, then drive to Nebraska the next day at nine days post-op. I maybe helped with the final packing and cleaning. My sister tried not to let me, but I insisted and knew it was things I really could do based on what I was doing at this stage last time. For as overwhelmed as I started out with how impossible the surgery and moving appeared, but ended up overwhelmed with how many pitched in to help me.
So grateful and relieved! I honestly was not sure what to expect. I hoped this surgery and recovery would go even better than last time, but did not expect it to do so. Also, my surgeon had told me pre-op that although surgery should be similar, that recovery may be similar, but may be either harder or easier. Thus, I went into this surgery as I go into most surgeries--hoping for the best, but preparing for the worst. Because I saw my surgeon for post-op appt on left hip the day before surgery on right hip, we discussed again expectations for surgery and I told him my mindset/persepctive going into surgeries, and he encouraged me that it is a healthy perspective.
I am also retaining my recovery theme from last year to use for this year. This is not a race to see how fast I can recover, but a journey to see how well I can recover. Thus, it is worth giving my body the time and support it needs to heal and recover well.
There are so many praying for me, for surgery, for recovery, for the move, so many helping in other ways. I am so, so grateful to all! God has gone before in so many ways.
Something my dad put together years ago seems fitting in this setting:
Copyright © 2017 by Steph. All rights reserved.
So far, I am doing incredibly well and this recovery going even better than last time! I am choosing to be careful and rest even if I feel well.
This photo is just a couple of days post-op right hip surgery, next to the sign made for me after my left hip surgery a year ago.
The surgery itself was nearly identical to surgery on my left hip as my surgeon said both hips were pretty much the same. Thus far, this recovery has been going even better than the recovery from the first hip surgery. This is partly because I know more of what to expect and had already figured out tricks to make things easier. However, we also think I was even stronger prior to this surgery, so early recovery and rehab are going even better than last time. I thought I was independent quickly last time, but this time I started out even more so.
Pre-op and post-op. Yes, I really felt that well just hours after surgery and barely back at the hotel!
Being silly waiting to be taken back for surgery. Modeling the latest in fashion. 😉
The anesthesiologist had discussed with me some of my complicating factors a few weeks prior to surgery, then again morning right before surgery. I trusted the anesthesiologist so followed his preferences regarding how to address the precautions for EDS and MCAS, even though different from what had been initially recommended. The way he managed things worked very well for me, as I have felt really well since pretty early after surgery. However, I was apprehensive about the scopolamine patch used to prevent nausea. I had the patch last time for the first time ever and although I had no nausea, I also had such badly blurred vision for so long that I could not read, email, text, message on Facebook, or much of anything for days. We ended up deciding to forego the patch completely this time. I knew this meant higher risk of post-op nausea. I have been pleasantly surprised that there was no nausea at all even without the patch and also vision has been fine! I have so much enjoyed being able to see to read, type, crochet, etc.
The brace is really not that bad. I usually wear it over a tank top but under t-shirt or dress. I have not noticed it restricting my movement, but I was also told by the PT I saw day after surgery that I obviously had been through this recovery/rehab before and had a good local PT working with me as I was moving well, maintaining restrictions, knew what I was doing, and had good questions. She told me she trusted me to walk without the brace to the bike, and afterward told me she had watched me walk and I never once went into extension. My surgeon had already told me I only need to wear it when up and around, not when resting or sitting still. So, early on, some days, I never wore it as resting all day. With the move, I was wearing it majority of days where there was more going on and I was up and down more, or actually helping. The brace is heavy (relatively, not awful) and gets hot with all-day wear. My biggest issue with it, is it gets in the way of the crutches and afraid of catching myself up.
Brace. The smile is because we were getting ready to go swimming again!
Transitions--the secondary title of this post. I am transitioning from rehabbing left hip and "prehabbing" right hip, to maintaining left hip (some ongoing rehab) and rehabbing right hip. However, it also has to do with moving from Iowa back to Nebraska, plus other changes. Timing of both surgery and moving were not ideal and things have been challenging. I was so restricted pre-op that I was overwhelmed with how to possibly get packed to move and prepare for surgery when I could not sit or stand long. Friends from church willingly offered to help me and took turns coming to my place, helping me sort things, pack, clean. We had most of the packing done prior to surgery. The actual move took place four days post-op. My brother coordinated guys to help in Iowa and my dad coordinated help in Nebraska. We had my boxes and furniture loaded in an hour! Last minute the night before after an honest conversation between PT, my sister, and I, we decided to keep my bed after all, but sent all else, except folding card table, folding chairs, my folding zero-gravity chair, my "bike" (folding pedals, and bar stool), a few other small items. A couple of days later, some of the ladies from church came and deep cleaned my apartment! Then, my aunt and uncle came over and finished off final details. My sister who had traded places with another of my sisters to stay with me the weekend of the move, helped with the very final packing and touching up the cleaning right before we left at eight days post-op to move to a hotel, then drive to Nebraska the next day at nine days post-op. I maybe helped with the final packing and cleaning. My sister tried not to let me, but I insisted and knew it was things I really could do based on what I was doing at this stage last time. For as overwhelmed as I started out with how impossible the surgery and moving appeared, but ended up overwhelmed with how many pitched in to help me.
So grateful and relieved! I honestly was not sure what to expect. I hoped this surgery and recovery would go even better than last time, but did not expect it to do so. Also, my surgeon had told me pre-op that although surgery should be similar, that recovery may be similar, but may be either harder or easier. Thus, I went into this surgery as I go into most surgeries--hoping for the best, but preparing for the worst. Because I saw my surgeon for post-op appt on left hip the day before surgery on right hip, we discussed again expectations for surgery and I told him my mindset/persepctive going into surgeries, and he encouraged me that it is a healthy perspective.
I am also retaining my recovery theme from last year to use for this year. This is not a race to see how fast I can recover, but a journey to see how well I can recover. Thus, it is worth giving my body the time and support it needs to heal and recover well.
There are so many praying for me, for surgery, for recovery, for the move, so many helping in other ways. I am so, so grateful to all! God has gone before in so many ways.
Something my dad put together years ago seems fitting in this setting:
God is With Us!!!
August 25, 2008 at 10:07pm
Here's some thoughts that I've been putting together over the last few years:
GOD IS WITH US [Joshua 1.9] Have not I commanded thee? Be strong and of a good courage; be not afraid, neither be thou dismayed: for the LORD thy God is with thee whithersoever thou goest.
HE GOES BEFORE US [Deuteronomy 31.8] And the LORD, He it is who doth go before thee. He will be with thee, He will not fail thee, neither forsake thee. Fear not, neither be dismayed.
HE IS OUR REAR GUARD [Isaiah 52.12 (NIV)] But you will not leave in haste or go in flight; for the Lord will go before you, the God of Israel will be your rear guard.
HE SURROUNDS US WITH SONGS OF DELIVERANCE [Psalm 32.7 (NIV)] You are my hiding place; you will protect me from trouble and surround me with songs of deliverance.
COVERED UNDER HIS WINGS [Psalm 91.4] He shall cover thee with his feathers, and under his wings shalt thou find refuge...
UNDERNEATH ARE THE EVERLASTING ARMS [Deuteronomy 33.27] The eternal God is your refuge, and underneath are the everlasting arms...
WE ARE IN CHRIST'S HANDS [John 10.28] And I give to them eternal life; and they shall never perish, neither shall any man pluck them out of my hand.
WE ARE IN THE FATHER'S HANDS [John 10.29] My Father, which gave them me, is greater than all; and no man is able to pluck them out of my Father’s hand.
HE IS IN US [1 Corinthians 6.19] What? know ye not that your body is the temple of the Holy Ghost which is in you, which ye have of God, and ye are not your own?
WE ARE IN HIM [Ephesians 2.13] But now in Christ Jesus ye who sometimes were far off are made nigh by the blood of Christ.
IF GOD IS FOR US WHO CAN BE AGAINST US? [Romans 8.31] What shall we say then to these things? If God be for us, who can be against us?
Safety is NOT the absence of danger; but, rather the Presence of the Lord... and as you can see - HE IS WITH US!!!
Here's some thoughts that I've been putting together over the last few years:
GOD IS WITH US [Joshua 1.9] Have not I commanded thee? Be strong and of a good courage; be not afraid, neither be thou dismayed: for the LORD thy God is with thee whithersoever thou goest.
HE GOES BEFORE US [Deuteronomy 31.8] And the LORD, He it is who doth go before thee. He will be with thee, He will not fail thee, neither forsake thee. Fear not, neither be dismayed.
HE IS OUR REAR GUARD [Isaiah 52.12 (NIV)] But you will not leave in haste or go in flight; for the Lord will go before you, the God of Israel will be your rear guard.
HE SURROUNDS US WITH SONGS OF DELIVERANCE [Psalm 32.7 (NIV)] You are my hiding place; you will protect me from trouble and surround me with songs of deliverance.
COVERED UNDER HIS WINGS [Psalm 91.4] He shall cover thee with his feathers, and under his wings shalt thou find refuge...
UNDERNEATH ARE THE EVERLASTING ARMS [Deuteronomy 33.27] The eternal God is your refuge, and underneath are the everlasting arms...
WE ARE IN CHRIST'S HANDS [John 10.28] And I give to them eternal life; and they shall never perish, neither shall any man pluck them out of my hand.
WE ARE IN THE FATHER'S HANDS [John 10.29] My Father, which gave them me, is greater than all; and no man is able to pluck them out of my Father’s hand.
HE IS IN US [1 Corinthians 6.19] What? know ye not that your body is the temple of the Holy Ghost which is in you, which ye have of God, and ye are not your own?
WE ARE IN HIM [Ephesians 2.13] But now in Christ Jesus ye who sometimes were far off are made nigh by the blood of Christ.
IF GOD IS FOR US WHO CAN BE AGAINST US? [Romans 8.31] What shall we say then to these things? If God be for us, who can be against us?
Safety is NOT the absence of danger; but, rather the Presence of the Lord... and as you can see - HE IS WITH US!!!
Copyright © 2017 by Steph. All rights reserved.
Saturday, July 15, 2017
Preparing for Surgery
Once again I find myself preparing for an upcoming surgery. This is another hip surgery, I had the other hip surgically repaired last year so better know what to expect this time. I am not really afraid of the surgery itself this time. I also already have most of what I will need for recovery. In some ways I was both over-prepared and under-prepared last time. There will be some changes this time.
I wrote previously on tips for recovery from surgery (some overlap of information presented here), and that it is as much mental and emotional as physical and the same applies to preparing for surgery. I do not get too nervous until the day or night before. Even if it is a repeat procedure, I usually still do get a little nervous the day before. I also usually do not sleep at all the night before surgery. I am struggling more with the mental preparation this time. This is not because of surgery--almost looking forward to it at this point with how challenging the hip has become. It is because of being in transition--with lots of things. I prefer things stable during recovery, but this time facing lots of major changes. Working on finding a way to create stability in the midst of the craziness. This is a mental/perspective exercise.
Post-op aids. This time, I already have crutches, walker, shower seat. I did not have a shower seat last time until over a week post op. But, having had surgery on one arm a few years ago, had learned how to shower only using one arm, so after the hip surgery, stood on good leg, supported myself with one hand on wall of shower, leaving one arm/hand free. It worked, but not ideal, and the shower seat was a welcome aid once I got it. I am most definitely not looking forward to being back on crutches. I recall counting down days until I could be done with crutches last time, and I am closer to being back on them now than when I was counting down getting off then. At least this time, I know how to use crutches already, unlike last time. I found this helpful video by the Nebraska Medical Center, but not until after I had been shown things by PT. Currently, I am choosing to enjoy my final days of "freedom." This time, I will need a hip brace after surgery, thus need to be fitted for the brace. I did not need a brace last time. So, this should be interesting. Curious to see how the process goes, curious to see how I feel about the brace. There were times last time, I thought something to prevent wrong or excessive movement might have been nice, but not having a brace meant being more mindful of how I moved, which in the long run I think was better. So, not sure how this will go. The surgeon told me I'd need the brace ~2 weeks or until I was "sick of it." I thought about asking what happened if I got sick of the brace the first hour, but decided that was probably not a good question to ask. I was told the reason for a brace this time is the EDS--the brace provides extra stability during the early healing stage.
Other supplies. I have a stock pile of waterproof bandages (to allow me to be in the pool early!), my regular "safe" band-aids (I have adhesive sensitivities, these usually work, but last time reacting to these as well by the time I no longer needed to cover incisions), all of my ice packs in the freezer, the water bottles used in the ice machine all in the freezer, jugs of chilled water for the ice machine in the fridge, have the ice machine drained and ready to go (have gotten way more than my money worth out of it as used it post-op several months last time, then for other hip, both shoulders, neck, back, etc. Incredibly helpful for icing at night to save getting up to get ice pack(s) from the freezer, which then more fully wakes me.
Zero gravity chair. I know I mentioned this in the post on recovery. But, I found the chair helpful pre-op both times, plus immediately post-op and it is one of the back-up options for bed depending on how things go with the move. A body pillow fits nicely and makes it really comfortable.
Rehab aids. I have a fair amount of basic items already from being in PT so long and doing exercises at home. I am latex sensitive so have to have latex-free therapy bands. I also have a thick exercise mat, yoga ball, small weights, etc. I knew in advance last time that stationary bike would be part of rehab. For bike, I had to be creative. Initially, I'd only need it a few minutes at a time 2-3 times a day. Not worth trying to get up and down two flights of stairs with crutches to get to the gym, so really needed something at home. Discussed options with PT. What I came up with, and PT OK'd, has worked well for me and my situation with small apartment, small budget. I ended up with folding bike pedals that just sit on the floor. Then, because of trying to avoid too much flexion at the hips, I sit on a tall bar stool (~30") rather than a chair.
Medications. With surgeries, the surgeon prescribes what is needed for after surgery However, I have enough other issues that require medications, that I also make sure that I have refilled any prescription medications, have enough over the counter medications and supplements to last until able to run errands again. Additionally, over the counter pain killers can be used along with narcotic to aid in needing less narcotic, or assisting with managing earlier without narcotic. A caution with over the counter pain medications and narcotic pain killers--if the narcotic contains acetaminophen, it is best not to take any additional acetaminophen. I have managed chronic pain long enough that I know how to stay within the daily maximal dosing for acetaminophen with extra over the counter acetaminophen with acetaminophen-containing narcotic, but this is something that has been discussed with prescribing physicians in the past and they are aware I know the limits for acetaminophen and how to stay within them. I was off narcotic really early with both of the last two surgeries, hoping to be able to be off pretty early again, but will have to see how things go as prior surgeries it took weeks.
Meal preparation in advance. I have done this with every surgery. It looks a little different every surgery. However, with each surgery, I do emphasize protein and lots of vegetables both pre-op and post-op. I did make granola bars again. I also did some crock pot cooking, but less this time. I find I am not hungry the first few days--presumably due to anesthesia effects? Thereafter, feel as if always hungry. Thus, I tend to make sure I have nutrient dense snack options available for the early days. Then, once hungry again, back to normal meals plus snacks as needed. Surgery and recovery are not a time to try to lose weight Ideally, weight should be kept stable a month prior to surgery and at least a month post-op. Even if someone has excess weight, losing weight close to surgery is not a good idea as the body needs to have the resources for healing. After surgery, the body is using so much energy for healing, that even though not moving much, I still was always hungry even though eating well. Another aspect of food/nutrition for post-op is countering effects of anesthesia and/or narcotic pain medication in terms of constipation. Narcotics do not affect me at all, anesthesia does and to the extent that I have yet to figure out a strictly dietary approach and need stool softeners at first. However, plenty of water, fiber (veggies, whole grains, legumes, etc.), probiotics in some cases, etc. can help. I am on probiotics already in anticipation of being put back on antibiotics for surgery.
Finishing projects and getting things to a good stopping place. This applies to work, school, moving, or whatever happens to be going on. I like to have things either completely finished up, or at a stable point. This take pressure off of me to try to get back to tasks right away. This then lets me take the time to rest and focus on recovery initially.
Someone to help after surgery. Help is essential at first. My sister has offered to come be with me for surgery and stay the initial days afterward to help me. She helped after my last hip surgery and I am so grateful she is willing to help again! We (mostly she) figured out systems to help things go more smoothly and help me be independent earlier last time and we have decided practice makes perfect (we hope!), so hoping this time goes even better. This time, I have arranged to have help the entire time after surgery until the move out-of-state. Last time, I was on my own earlier, but with the move, want to make sure I am not trying to do things I should not be doing. (Such as climbing up and changing the battery in the ceiling mounted smoke detector by myself at one week post op last time....)
Comfy, easy clothing. I suspect this varies person to person and by season. I lived in shorter tank top dresses after surgery last summer except for PT, then shorts and t-shirt. I also had supportive, slip-on shoes for early on when getting socks on or shoes tied were challenging. (The brace is sort of throwing me for a loop as not certain of what clothes will work best with it. However, I figured things out last time, so can figure things out again.)
Surgery planning. This is not referring to the details of the procedure itself, but managing medications, other conditions, etc. in context of surgery. Conversations with surgeon and team, anesthesiologist, primary care physician, physical therapist, etc. This is the same surgery, but other hip, same surgeon, same surgery center, etc. So, we all have been through this and know I did well last time. Clarifying some of my unusual (complicating) factors and how is best to address them or work around them during surgery. The recent diagnoses of Ehlers-Danlos Syndrome and Mast Cell Activation Syndrome have ramifications for surgery. These have been discussed and plans are in place. Grateful for a team familiar with these conditions and how to address them! My bigger concern going into this surgery is that I am not on prednisone, as we are pretty sure in hindsight the prednisone is why my past two surgeries/recoveries went really well when none of the prior ones did (suspecting MCAS related). The recommendation/plan is high dose steroid burst prior to surgery. Hoping this works as well as chronic low dose prednisone did the last two surgeries. Choosing not to worry about if it does not--will deal with that as it happens if it does.
Safety issues. "Crutch-proofing" prior to surgery--making sure rugs are picked up to avoid tripping from a crutch catching, making sure plenty of space to maneuver with crutches and even more space for a walker, etc. Any cords out of the way to avoid tripping. Funny thing, is some of the rearranging I did last time never got put back to how it was before. I am not one to do a lot of rearranging or reorganizing. Once I have a system that works, I keep using it--if it is not broken, do not fix it. Surgery necessitated rearranging, but then got used to that system, so did not go back--at least not fully.
Physical preparation: aka "prehab." Last time, PT helped me work on core strength (I was just months post op another abdominal surgery), glute and hip strength, shoulder/arm/upper body strength in preparation for being on crutches and not able to move normally for a while. This helped me go into surgery really strong, which in turn helped with early rehab. So, we are currently still rehabbing first hip, but also again working on making sure I go into surgery as strong as possible. With the uncertainty of timing of when my my bed gets moved or what options after it gets moved, we have worked on how to get to/from the floor early after surgery. This is something I was told last time not to even attempt at first, and took me 2-3 weeks to manage. With PT's direction/assistance, I am surprisingly strong for as many physical limitations as I have. I laughingly consider it as training for surgery. I know others who are training for marathons, or various other races, and I train for surgeries. This is only a temporary shift in perspective. Normally, I am training to survive life. Goal is to get back to thriving again versus just surviving. Life with chronic illness is essentially a marathon--journey, not a race, though.
Back to concept of mental/emotional/physical preparation--each surgery I try to cerebrate what I can still do before surgery, knowing I will lose it after surgery, but can regain that ability again in time and with work. I prefer to do pretty much everything I can the day before surgery for one last time before letting it go. However, with local pools being closed, the timing of travel for surgery, uncertainty of how hotel pool will work for swimming, etc. not sure if that will work this time. So, I considered yesterday my final day just in case nothing else works out. I am still planning to stay as active as I can these final days of relative ability.
It has been overwhelming at times, and I am sure will still be so for a while. However, it has been exciting to see God going before in so many ways. He has been providing help and encouragement along the way. Prayers for the surgery and recovery are greatly appreciated!
Copyright © 2017 by Steph. All rights reserved.
I wrote previously on tips for recovery from surgery (some overlap of information presented here), and that it is as much mental and emotional as physical and the same applies to preparing for surgery. I do not get too nervous until the day or night before. Even if it is a repeat procedure, I usually still do get a little nervous the day before. I also usually do not sleep at all the night before surgery. I am struggling more with the mental preparation this time. This is not because of surgery--almost looking forward to it at this point with how challenging the hip has become. It is because of being in transition--with lots of things. I prefer things stable during recovery, but this time facing lots of major changes. Working on finding a way to create stability in the midst of the craziness. This is a mental/perspective exercise.
One of my favorite photos.
Post-op aids. This time, I already have crutches, walker, shower seat. I did not have a shower seat last time until over a week post op. But, having had surgery on one arm a few years ago, had learned how to shower only using one arm, so after the hip surgery, stood on good leg, supported myself with one hand on wall of shower, leaving one arm/hand free. It worked, but not ideal, and the shower seat was a welcome aid once I got it. I am most definitely not looking forward to being back on crutches. I recall counting down days until I could be done with crutches last time, and I am closer to being back on them now than when I was counting down getting off then. At least this time, I know how to use crutches already, unlike last time. I found this helpful video by the Nebraska Medical Center, but not until after I had been shown things by PT. Currently, I am choosing to enjoy my final days of "freedom." This time, I will need a hip brace after surgery, thus need to be fitted for the brace. I did not need a brace last time. So, this should be interesting. Curious to see how the process goes, curious to see how I feel about the brace. There were times last time, I thought something to prevent wrong or excessive movement might have been nice, but not having a brace meant being more mindful of how I moved, which in the long run I think was better. So, not sure how this will go. The surgeon told me I'd need the brace ~2 weeks or until I was "sick of it." I thought about asking what happened if I got sick of the brace the first hour, but decided that was probably not a good question to ask. I was told the reason for a brace this time is the EDS--the brace provides extra stability during the early healing stage.
Other supplies. I have a stock pile of waterproof bandages (to allow me to be in the pool early!), my regular "safe" band-aids (I have adhesive sensitivities, these usually work, but last time reacting to these as well by the time I no longer needed to cover incisions), all of my ice packs in the freezer, the water bottles used in the ice machine all in the freezer, jugs of chilled water for the ice machine in the fridge, have the ice machine drained and ready to go (have gotten way more than my money worth out of it as used it post-op several months last time, then for other hip, both shoulders, neck, back, etc. Incredibly helpful for icing at night to save getting up to get ice pack(s) from the freezer, which then more fully wakes me.
Zero gravity chair. I know I mentioned this in the post on recovery. But, I found the chair helpful pre-op both times, plus immediately post-op and it is one of the back-up options for bed depending on how things go with the move. A body pillow fits nicely and makes it really comfortable.
Rehab aids. I have a fair amount of basic items already from being in PT so long and doing exercises at home. I am latex sensitive so have to have latex-free therapy bands. I also have a thick exercise mat, yoga ball, small weights, etc. I knew in advance last time that stationary bike would be part of rehab. For bike, I had to be creative. Initially, I'd only need it a few minutes at a time 2-3 times a day. Not worth trying to get up and down two flights of stairs with crutches to get to the gym, so really needed something at home. Discussed options with PT. What I came up with, and PT OK'd, has worked well for me and my situation with small apartment, small budget. I ended up with folding bike pedals that just sit on the floor. Then, because of trying to avoid too much flexion at the hips, I sit on a tall bar stool (~30") rather than a chair.
My "bike" set-up
Medications. With surgeries, the surgeon prescribes what is needed for after surgery However, I have enough other issues that require medications, that I also make sure that I have refilled any prescription medications, have enough over the counter medications and supplements to last until able to run errands again. Additionally, over the counter pain killers can be used along with narcotic to aid in needing less narcotic, or assisting with managing earlier without narcotic. A caution with over the counter pain medications and narcotic pain killers--if the narcotic contains acetaminophen, it is best not to take any additional acetaminophen. I have managed chronic pain long enough that I know how to stay within the daily maximal dosing for acetaminophen with extra over the counter acetaminophen with acetaminophen-containing narcotic, but this is something that has been discussed with prescribing physicians in the past and they are aware I know the limits for acetaminophen and how to stay within them. I was off narcotic really early with both of the last two surgeries, hoping to be able to be off pretty early again, but will have to see how things go as prior surgeries it took weeks.
Meal preparation in advance. I have done this with every surgery. It looks a little different every surgery. However, with each surgery, I do emphasize protein and lots of vegetables both pre-op and post-op. I did make granola bars again. I also did some crock pot cooking, but less this time. I find I am not hungry the first few days--presumably due to anesthesia effects? Thereafter, feel as if always hungry. Thus, I tend to make sure I have nutrient dense snack options available for the early days. Then, once hungry again, back to normal meals plus snacks as needed. Surgery and recovery are not a time to try to lose weight Ideally, weight should be kept stable a month prior to surgery and at least a month post-op. Even if someone has excess weight, losing weight close to surgery is not a good idea as the body needs to have the resources for healing. After surgery, the body is using so much energy for healing, that even though not moving much, I still was always hungry even though eating well. Another aspect of food/nutrition for post-op is countering effects of anesthesia and/or narcotic pain medication in terms of constipation. Narcotics do not affect me at all, anesthesia does and to the extent that I have yet to figure out a strictly dietary approach and need stool softeners at first. However, plenty of water, fiber (veggies, whole grains, legumes, etc.), probiotics in some cases, etc. can help. I am on probiotics already in anticipation of being put back on antibiotics for surgery.
Finishing projects and getting things to a good stopping place. This applies to work, school, moving, or whatever happens to be going on. I like to have things either completely finished up, or at a stable point. This take pressure off of me to try to get back to tasks right away. This then lets me take the time to rest and focus on recovery initially.
Someone to help after surgery. Help is essential at first. My sister has offered to come be with me for surgery and stay the initial days afterward to help me. She helped after my last hip surgery and I am so grateful she is willing to help again! We (mostly she) figured out systems to help things go more smoothly and help me be independent earlier last time and we have decided practice makes perfect (we hope!), so hoping this time goes even better. This time, I have arranged to have help the entire time after surgery until the move out-of-state. Last time, I was on my own earlier, but with the move, want to make sure I am not trying to do things I should not be doing. (Such as climbing up and changing the battery in the ceiling mounted smoke detector by myself at one week post op last time....)
Comfy, easy clothing. I suspect this varies person to person and by season. I lived in shorter tank top dresses after surgery last summer except for PT, then shorts and t-shirt. I also had supportive, slip-on shoes for early on when getting socks on or shoes tied were challenging. (The brace is sort of throwing me for a loop as not certain of what clothes will work best with it. However, I figured things out last time, so can figure things out again.)
Surgery planning. This is not referring to the details of the procedure itself, but managing medications, other conditions, etc. in context of surgery. Conversations with surgeon and team, anesthesiologist, primary care physician, physical therapist, etc. This is the same surgery, but other hip, same surgeon, same surgery center, etc. So, we all have been through this and know I did well last time. Clarifying some of my unusual (complicating) factors and how is best to address them or work around them during surgery. The recent diagnoses of Ehlers-Danlos Syndrome and Mast Cell Activation Syndrome have ramifications for surgery. These have been discussed and plans are in place. Grateful for a team familiar with these conditions and how to address them! My bigger concern going into this surgery is that I am not on prednisone, as we are pretty sure in hindsight the prednisone is why my past two surgeries/recoveries went really well when none of the prior ones did (suspecting MCAS related). The recommendation/plan is high dose steroid burst prior to surgery. Hoping this works as well as chronic low dose prednisone did the last two surgeries. Choosing not to worry about if it does not--will deal with that as it happens if it does.
Safety issues. "Crutch-proofing" prior to surgery--making sure rugs are picked up to avoid tripping from a crutch catching, making sure plenty of space to maneuver with crutches and even more space for a walker, etc. Any cords out of the way to avoid tripping. Funny thing, is some of the rearranging I did last time never got put back to how it was before. I am not one to do a lot of rearranging or reorganizing. Once I have a system that works, I keep using it--if it is not broken, do not fix it. Surgery necessitated rearranging, but then got used to that system, so did not go back--at least not fully.
Physical preparation: aka "prehab." Last time, PT helped me work on core strength (I was just months post op another abdominal surgery), glute and hip strength, shoulder/arm/upper body strength in preparation for being on crutches and not able to move normally for a while. This helped me go into surgery really strong, which in turn helped with early rehab. So, we are currently still rehabbing first hip, but also again working on making sure I go into surgery as strong as possible. With the uncertainty of timing of when my my bed gets moved or what options after it gets moved, we have worked on how to get to/from the floor early after surgery. This is something I was told last time not to even attempt at first, and took me 2-3 weeks to manage. With PT's direction/assistance, I am surprisingly strong for as many physical limitations as I have. I laughingly consider it as training for surgery. I know others who are training for marathons, or various other races, and I train for surgeries. This is only a temporary shift in perspective. Normally, I am training to survive life. Goal is to get back to thriving again versus just surviving. Life with chronic illness is essentially a marathon--journey, not a race, though.
Back to concept of mental/emotional/physical preparation--each surgery I try to cerebrate what I can still do before surgery, knowing I will lose it after surgery, but can regain that ability again in time and with work. I prefer to do pretty much everything I can the day before surgery for one last time before letting it go. However, with local pools being closed, the timing of travel for surgery, uncertainty of how hotel pool will work for swimming, etc. not sure if that will work this time. So, I considered yesterday my final day just in case nothing else works out. I am still planning to stay as active as I can these final days of relative ability.
It has been overwhelming at times, and I am sure will still be so for a while. However, it has been exciting to see God going before in so many ways. He has been providing help and encouragement along the way. Prayers for the surgery and recovery are greatly appreciated!
Copyright © 2017 by Steph. All rights reserved.
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