12 Weeks Post Op - Is That a Light I See At The End Of The Tunnel?

Monday February 24th. Finally I have made it, 12 weeks post op today, and I do believe I am seeing the light. If I had written this post on Friday, I would be saying something completely different. If there is one thing I have learned through this it is how  just a few hours can make a difference in how you feel.

This last 3 weeks (So week 9-12) have been pretty dark. I lost my positivity that I had during my initial post op period and spent a fair old time crying and feeling sorry for myself. I think I had a right to feel sorry for myself though so I wont be to hard myself.

 

It has all been such hard work, getting off the 2 crutches and learning to walk again has pretty much been one of the toughest things I have ever done. I have ached all over, I have been so mentally and physically tired that I almost fell asleep waiting at a set of traffic lights in my car last week. I have really had to push myself with every inch of determination I could find. From getting up the morning to going to bed at night.  The last two weeks I have been trying to get back to normality (still on one crutch) by starting back work (I run a pet care franchise), looking after our elderly pony, going food shopping and doing the house work. I found I was planning my days down to the minute almost, setting out what I would do in a day in relation to the amount of mental and physical energy required. Any deviation in my plans would throw me. I wasn't enjoying anything I was doing.

 

By Friday just gone I was pretty much at my lowest ever, not helped by a visit to my disinterested GP, but I shall post separately about that. My back was killing me, my op hip was pinching, my non op hip was burning and quite honestly I was beginning to think I had made a big mistake. I was starting doubt my surgeon even, whom up until then I had hailed as my hero! I had pretty much decided that all this was a waste of time and money, a wild goose chase and that  I was never going to be pain free, that fixing my hip would never fix my back.

 

But enough of my woe

 

Throughout last  week I have been doing my Physio home work and forcing my body to walk correctly, 20 steps at a time, whilst I was walking a dog or walking about at home. It really hurt my hip flexors and hamstrings, and I was back to codeine and ice at night.

 

Then, when I woke up on Saturday morning, I got up, walked across the bedroom to look out of the window before realising I had just done that without a limp! I walked around the bedroom some more, yup. No limp, and not that slow either!!

 

So on Saturday we had family to visit and we all caught the coastal rider bus into Weston Super Mare, I even got up stairs with my one crutch.  We walked though town to what I do believe to be one of the best fish & chip restaurant  in the UK. I sat on the most uncomfortable wooden chair throughout, then we walked along the pier and back before catching the bus home. Now it wasn't easy, but It did not hurt. My back felt good, my op hip was not painful, just very tired by the end of it all.

 

Sunday morning came and I expected to be very stiff and sore from all the walking yesterday but I wasn't, I got up, went downstairs, walked around the kitchen and living room with no crutch all without a limp! It felt so good to be walking "level" again, not twisted or bent over, and my back really appreciated it. Now my limp did return, as after even short time walking with no limp, my leg muscles obviously got tired, but I still think it is fantastic progress and I can actually begin to imagine that this week I might even manage to walk outside, in public with no crutch and not look like cripple.

 

I rode my horse on Sunday again, for the first time since the head spinning escapade at 7 weeks. This time it was much easier to get on, my leg can now swing up a lot higher, but I am still grateful I have such a placid horse who doesn't mind me scrambling around on him! Once in the saddle, I felt more comfortable than last time but still pretty ineffective. I could not get my op leg in the right position to put my foot in the stirrup. My horse is western trained and so very sensitive to even the lightest cue. Whilst my husband still had us on the lead rein, I was able to  ask Charlie to walk on, turn left and right and stop through almost invisible squeezes of my lower leg, shift in weight, neck rein  and voice commands. I rode for a total  of 5 minutes. Any longer than that and I think my hip flexors would have started to spasm. So whilst I think I am long way off from a proper ride, I can now see that will be able to do this again. I have arranged that my lady who is currently exercising Charlie for me will continue to do so for the next 2 weeks, and then I shall take over his exercise sessions again. To begin with it will all be about me and my confidence I know, but Charlie and I have a good bond and I know he will look after me. I don't expect I will ride much to start with but we do a lot of stuff in hand on the ground so we have plenty to do. Afterwards, I had the tightness back in my groin, but that is something anyone that hasn't ridden for a while will get. My op hip felt a lot better that my non op hip, which benefited from ice and codeine that evening.

 

No hydrotherapy tonight as the pool has a leak, and I cannot make the session next Monday due my Nans funeral, so I will need to rearrange that. With hydro, I want to get the point where I can swim again, and then I shall stop going there and start going to our local swimming pool. I want to start swimming lengths to burn of the stone and a half of weight I have gained since last yea, when the only calorie burning exercise I could do was walking.  I have land physio with Donna this Wednesday, I am looking forward to that this time as hopefully I will be able to show her my normal walking!

 

So there we go, finally a positive post from me. I have no doubt I am going to have my fair share of down times in the coming weeks, but for now, I am going to try and enjoy this positive feeling whilst it lasts. Thanks for reading.

 

 

11 weeks Post op

Last week I started back to a bit more work. I run a Pet care Franchise, and part of my service is dog walking (although I only have one daily one and 3 or four "irregular" ones now, most of my work comes from feeding cats and pet transport). I have employed someone to do the dog walks whilst I was off and it is my plan to phase back in by the end of the month. I started with Henry, my 5 days a week dog, just doing Tuesday and Thursday last week. It went ok, I am still on one crutch so wasn't easy but, feels like a step in the right direction, I think that walking is deffinatly something I need to get back too, to build up my stamina.

 

I went to Land-physio with Donna on Friday 14th . She loosened my back off again and we went and did 2  mins warm up on the static bike then the leg press machine! - no weight, so only pushing my own body weight, I did 15 reps and that was enough. She says next week we start single leg pushes. The she analysed my gait walking up and down the gym without the crutch, She got me to slow right down to the point at which we could spot when it is I fall to the right, it is just as my right foot needs to push off from the back. So she got me concentrating on that point and engaging my core and hip flexors to prevent the listing. It was good, I managed to walk back to her clinic room with no limp, but VERY slowly. So that's my home work for the week.

 

The day after physio I felt really sore in my hip and hip flexors so rested as much as I could. I also felt the familiar shooting pain in my spine when I twisted funny in my desk chair. But I am trying to ignore that . The day after that (Sunday) I was struck down by a migraine, so another day resting on the sofa between trying to do physio and get some jobs done. So overall I am feeling pleased with my hip, but the rest if me just feels fatigued and achy.

 

I AM doing more. Dog walking feeding cats, house work, laundry even going to feed and turn our old pony out in the morning. But everything seems to take so much effort. I have to plan everything. It may appear to some people that I am pain free because I can walk around the house with out the crutch and am driving and doing jobs and errands etc, But when my mother in law asked me to pick up some bacon and milk "while you are out" - that completely threw my plan for the day, both in terms of logistics and energy. I have to plan  where to park at the supermarket, hoping to a find a free space where I can get out with my crutch and yet not walk to far to the shop. Then once in the shop, it is surprising how far you have to walk. And with a crutch it is not easy to manoeuvre, avoid, or pre-empt the rest of the worlds movements. Because I find most people are in a world of their own and oblivious to the young person on one crutch trying not to have to make any sudden movements. Also there is the issue of hands. I cant push a trolley yet so its hand basket only, so then I have no hands! I have to make sure I don't buy to much as I can only carry in one hand back to the car. So much to think about! anyway, I did it. And got soaked in the process as it was pouring with rain.

 

Monday night was hydro night and I was so tired, I didn't feel like going. But I made it through the dreary dark rain and it was nice to get into the pool and get warm and relax a bit. Here is a break down of the exercises I am doing in the pool:

 

Pool walking, normal, lifting kneed, lifting heels and side stepping

standing leg lifts (still can do them on land)

Standing abduction

Standing swinging leg back

lying on back flexing knees, flexing spine, cycling with legs

Step ups

Squats (very slight)

Lying on a support and doing front kick with legs (under water)

 

Chris, my therapist said my waddle is improving, and was looking much safer so I didn't need to use the walker frame around the pool, So that is another step forward.

 

So there you go. To sum up 11 weeks post op: Op hip feels ok, some pinching on occasions. other hip aches, Back aches, basically all of my body aches and I am very tired in my head. Hopefully my energy levels will pick up soon.

10 weeks POst op

In many ways, things are great. I am down to 1 crutch now at last. I spent last week flipping between one and two as I getting all sorts of aches and pains in my other hip and back. Went to first physio with Donna on Friday. She is really pleased with me but I can tell she thinks I should be off the crutch by now. Things is,  I list to the right side and waddle a bit when I go “Free style”. Last Wednesday I strained a rib in my back which I have done a few times in the past. It is very painful, like a pinching pain and hurts to breath. I also had pins in needles in my right arm/hand because of this. Donna sorted that out with some massage and two acupuncture needles. She then got me on the Swiss ball which was very hard to start with as I couldn’t balance myself. She said this was an important exercise to so as it will teach my muscles to balance my body again. So I have 5 exercises to do on that every day now. She also got me holding a rail and trying to do knee lifts. I could lift my op leg no problem, although not to 90 degrees. But I could not lift my left leg at all (because this involves standing on my op leg). The muscles for  doing that are obviously still asleep, though I can do it in the pool. So that is another exercise to work on. I also have to do the abduction and backwards swinging of my op leg whilst holding the back of a chair, 15 times each as well as the knee lifts (or attempted knee lifts). I am to continue with the exercise bike at no resistance, increasing the time.

By Thursday last week I found that I could climb the stairs one after another fashion by holding the hand rail in my left hand and carrying my crutch. And I could come down one after the other so long as my crutch accompanied my op leg, holding the hand rail with my right hand. So I am glad I can do the stairs quicker, one at a time was becoming VERY boring!

My new walking stick arrived in preparation for not needing the crutch. It is lilac. I had a go with it, but my hand wobbled about on it as I am obviously still needing to bare more weight than a walking stick can cope with. Hopefully I will transition to it soon. Something I never realised before my op was that if you use a stick or crutch, you should use it on the opposite side to your bad leg and move it forward at the same time as you bad one. Try to do it any other way and you will fall over!

I had a busy weekend at home. Because I can do the penguin walk with no crutches, I found myself doing the vacuuming and mopping and few other odd jobs with no cructhes. I also went to see my horse on my own for the first time. I took one crutch and someone had already brought him into the stable for me, so I just groomed him. It was nice to spend sometime on my own with him after so long.

I  really felt like I had overdone it when I woke up on Monday morning and spent most of the day resting on the sofa. I went out a 3pm to do a couple of jobs and then to hydro, first time driving myself there, and first time in the group session. I coped Ok, we all just get on with our exercises and the therapist comes and round help you if you have any problems. My hip and back felt quite tight and pinchy in the pool and I didn’t feel I could cope with the new lunge exercise so we have saved that one for next week. I didn’t get home until 8pm so had been out for 5hrs, the longest since my op, so I was really tired.

9 weeks Post Op

Today I feel ok, I have taken very few pain killers and I seem to be doing well getting about on one crutch now. I am finding I can do a “penguin walk” with no crutches, which is handy around the bedroom/bathroom/kitchen. I am aware that doing to much of this might mean I start doing more things in general and must make sure I don’t overdo things.  I have some achey/restriction pain, but no groin or leg pain at all, unless I push beyond my ROM limit. The incision has been  giving me some sharp nerve type pain over the last few days, but nothing really bad, I think it just a process of it healing. The area around the incision also feels rather numb. Again, I am not worried about this, I am sure it is just nerves healing.
 

Hydro tonight was good, I did go on two crutches but only because it was late (8:30pm!), rainy and it is a fair walk through the hospital to the pool, my  leg does tire quickly of I walk far on one crutch.  I had to use the walking frame around the poolside again. I felt a lot more confident in the pool, a lot more balanced. I mentioned to  my therapist about the reduced ROM in the leg raise and he said it was nothing to worry about, it would improve again. We did a lot of different exercises today, including a step that was put on the floor of the pool and I practiced going up and down like a normal person would! Next week I am joining the group, so there will be six of us but we all have own exercise plans to work to. Bit worried about that, as I tend to be a self conscious in a group environment. I hope I don’t over do it as it is a 45min session instead of 30min and obviously I won’t be supervised as much. I shall have to remind myself to take things slowly and not rush!

I go to see my physiotherapist Donna on Friday so I am looking forward to that. I want to go through the exercises I am doing at the moment and see of there is anything I change or add to it.

The day before 9 weeks post op

 Taken from my post on the FaceBook Hip FAI group:

It's Sunday the 2nd February 2014,  and I realise that one year ago today I was feeling completely bummed out, depressed and lost after the appointment with my 1st hip specialist who told me I did not have enough FAI to benefit from surgery, and that the scope surgery he could do on my "slight cam" would probably make me worse.

He said all my pain must be coming from my back (or in my head),and that I should pursue the spinal route next. He said a hip block injection would be of no benefit and also that I should give up riding my  horse.  "not a realistic expectation" were his words, and he even put that bit in writing. Well now I am sitting here on the eve that marks 9 weeks post from my open dislocation & debridement surgery  from my wonderful 2nd opinion surgeon who addressed cam, pincer & calcified labrum. Last weekend I sat on my horse, at my surgeons recommendation. Recovery is not an easy ride but I am getting there. For all you FAI sufferers reading this, I cant lie, it is a tough journey, stick at it, don't let doctors tell you are wrong when you know are right. Find one that will listen to you. Stay strong.

Calculated & Educated Risks

When I went to my first hydrotherapy session, 8 weeks post op, and told my therapist that I had sat on my horse at 7 weeks post op, he did a very good job of not looking completely aghast. I wondered if  I hadn't have said that it was actually my surgeon that suggested it, if he might have said I shouldn't have done it. But we kind of got to talking about how such things are both a calculated and educated risk.

 

Part of the reason I got on my horse was because of what my first opinion surgeon said about me doing it. "Not a realistic expectation with your back" he had said, back in 2012. Also, my current surgeon that had done the op had had scope surgery for FAI himself, and he had got back to his cycling and skiing pretty quick, so he knew how I was feeling mentally about getting back on my horse as soon as I could.

 

My therapist referred to the show jumper Nick Skelton. He won Gold at London Olympics 2012. He has 2 knee replacements and a hip replacement, as well as a near fatal neck injury in 2000. Nick Skelton must know that to fall from a horse now,  with these replacements and neck lesions, gives him a higher chance of severe injury. But he does it anyway, because he loves it, and because he is taking a calculated, educated  risk. He knows what he is doing, he knows the horse, and yes, he also knows the consequences of falling off. But a lot of variables need to come together for a catastrophic fall, and he has control of many of those variables through knowing his horses training, and his own abilities.

 

I loved this thought process coming from my therapist. It made absolute sense! I was taking a calculated, educated risk getting on my horse, because I love it and  because I know he was well trained, that he is a calm relaxed horse, that I do know what I am doing. It would be a different thing entirely if I was getting on a rodeo bucking horse, the variables there certainly suggest I would  hit the dirt!

 

And anyway. We all take calculated educated risks every day. From driving our cars to getting on an a train on airplane.

Exercises - up to 8 weeks and after 8 weeks

As a reminder, here are the only exercises I was allowed to do for the first 8 weeks post op:

Exercises up to 8 weeks

Ankle pumps and ankle rotation as often as possible during the day.

Glute sets as often as possible during the day

Twice a day:

·       Passive abduction to max 30 degrees x 10

·       Passive flex ion to max 90 degrees x 10

From 3 weeks added  a raised passive flexion to 90 degrees max x 10

·       Quad sets – 2 lots of 10

·       Glute sets – 2 lots of 10

·       Non op leg – leg lift/extension, 2 lots of 10

·       Prone lying (when able to get there) for 30mins, with some knee raised to stretch quads

My Planned exercises from 8 Weeks

Active heel slides – 2 lots of 10

Active abduction to 45d, x5, build as tolerated

Active leg left, angle as hip will allow, 5, build up as tolerated

Leg lift & flexing for non op leg as before

Prone lying and flexion as before

20+ “sit ups” for core - literally just lifting my head and shoulders off the bed but ensuring core is "engaged"

Pelvic rocking

Standing abduction as far as leg will allow, startat 5. Build up to 20

10 minute walk if weather allows

Static bike, no resistance, start at 3mins and increase by 1 minute per day.

1st Hydrotherapy Session - 8 weeks post op

First Hydrotherapy session tonight (Tuesday) at the Avon orthopaedic Centre at Southmead Hospital, Bristol. Paul drove me. It was a long way from the main entrance into the hospital so I was glad I went on 2 crutches. First of all I had to answer loads of general questions about what I had had done and what I doing physio wise and what my goal of Hydro was “To be able to walk with out the crutches”. Then he checked my leg lifting and abduction on op leg. I could lift my leg to about 60/70 degrees!

I had to use the walking frame around the pool as  went down into the pool, I left the frame behind and used the hand rail to walk up, round and down. As I went down into the water if felt wonderful, lovely and warm. The water came up to my chest in the shallow end. I Spent a few minutes standing getting  used to the feeling of being held up in the water. Then I was given two woggle floats to old onto in front of me to use to balance on and walked across the pool.

It was a very odd feeling as I felt as though I might fall but the water would not allow me. During the session we did walking, high stepping, side stepping and holding on to the side to do abducting and moving leg backwards. It all felt ok. The we  did floating in the corner using the woggle and flexed knees alternately which felt good as my knees are feeling creaky! I had a rubber blow up ring put onto my op ankle when I was not flexing that one to support it a little.

The weirdest thing was getting back out of the water as I could feel myself getting heavier and less able to walk. So then it was back to the walking frame and back to reality of needing crutches to walk.

I really enjoyed the hydro and the plan is for to go for another solo session and then join a group.

The following few days I felt achy and my ROM reduced, I could only do a leg lift for a  few inches, and even if Paul helped me passively ,my leg was shaking at the top. I am sure this is all due to using the leg more and some Delayed Onset Muscle fatigue  from the hydro, but it is difficult to not feel down when things start to go backwards.

On the Thursday  after Hydro I tried a side lying leg lift. Big mistake NOTHING HAPPENED!! So perhaps this is another of those things that require me to just start by sending the message to the muscles and will eventually get the idea? I am guessing it is because my abductors have been asleep for 8 weeks due to the non weight baring? I try again in the Friday morning and still no movement. So I email my surgeon just to check this is OK. This was his reply:

“yes… its the hardest thing to do at the moment… don’t bother trying. do the same movement whilst standing, and continue until you can do it 30 times easily, then start to hold your leg out 18” for as long as you can. When you can do that for 30 seconds, start doing the same thing on your side.
On your side, try keeping your one bent initially (to make you leg shorter, reducing the lever arm) and then progressively straighten your leg as you get stronger”

-         Thats ok then, I shall go back to standing abduction then for a while!

8 Weeks Post op

At 8 weeks I feel like have come so far yet have so far to go. I have been fully weight baring on my op leg for a week, and it feels great. I am down to  1 crutch around the house most  of the time but I switch to two if my back or other hip starts to hurt. Outside I am still on 2 crutches .

I can officially start doing my extra physio exercises now so shall add in some active abduction and leg lifts. I can also use the static bike so I will start at 3 mins and build up by 1 minute each day, no resistance. I am pretty much of pain killers in the day now, I still have some groin pain at night so I am taking 20mg amitryptalline and 60mg codeine at night so that I can get to sleep. Sleep is much easier now that I can roll over on both sides, though the op side is still a bit sore so I don’t spend long on that side, I think I am mostly sleeping on my front.

Today I needed to run a few errands in town so I kitted up with two crutches, and a rucksack instead of hand bag & shopping bag. Drove to town and parked across two bays so I could get our of the car with my crutches. Went on two crutches across Zebra crossing to vets to get cats tablets then back across to the chemists, then back to car and home, pretty tired but felt like had accomplished something on my own at last

Week 7 Post FAI Surgery

Week 7 feels like a VERY long week.  I feel ok, my hip feels good and I just want to get on do things! I carried on full weight baring on two crutches for a few days. It is nice to get out walking on the sea wall as fully weight baring means I can walk normally without straining my shoulders. So I go for 5 minute walks every day. By the Wednesday I am really bored of 2 crutches so start switching down to 1 in the house – only for carrying things when I need to. It feels good to be able to make my breakfast and carry it, even if it does take 3 trips (1^st to take cup of tea in, 2^nd to take toast, 3^rd to fetch crutch number 2!) But using one crutch makes things ache a bit, all the muscles on my non op side between my ribs are really sore and my lower back aches as I feel I am a bit twisted, so I carry on with two wherever possible.

On the Friday I had couple of things on. I had to feed some clients cats, collect my friends little dog that stays with us when she is on night shifts  and go the beauty spa to have my legs & feet done in prep for hydro - I have no hope of doing such things! So I take 1 crutch, it goes ok but it is really tiring and by the time I get back home I am really tired and achy and a bit bummed out thinking I am not going to be able witch to one crutch when he said I could.

I spend Saturday feeling very sorry for myself and using 2 crutches around the house. Pretty much the same on the Sunday but Paul talks me into going to see my horse, maybe to have a ride. Paul saddles him up and off they go to the indoor school and I follow on one  crutch. Paul lunges him a little first and CB seems in a very relaxed state of mind. I really didn’t want to get on as I was just feeling sorry for myself but with  the determined voice in my head and Paul's encouragement I do it: I get up onto the mounting block like I do stairs and pass the crutch to Paul. Then I put my non op leg in the stirrup and realise I can't push up off my right leg like I would normally. SO I have to haul myself with my hands on the front and back of the saddle. IT REALLY hurts, Not sharp pain but that tight feeling from the muscles all being to tight. Three attempts of me saying “I can’t do it” and Paul saying “you can” (he told me later that if I said it a 4^th time he would have let me stop) And on the 4^th attempt I manage to get my leg up onto CB’s bum. My leg just feels like a big lump of lead that doesn’t want to do anything! “My leg's stuck1" the two options available of carrying on or getting off now look both as impossible as each other so I opt for carrying on. Paul comes round to my side and helps move my leg a bit further on then he goes back round the other side “Right, you are going to have to lie forwards and let your leg drop down this side, I’ll control it” OK. There was no going back “This just seems like such a stupid thing to be doing, why am doing this”? and then, my leg is down on the right side of CB and and I am sitting up. It feels VERY weird. Like I can't  get on my seat bones in the saddle  as I would normally. I am perched there, on top of my horse, my head is spinning and I have no hope of getting either of my legs to a position where I can get my feet in the stirrups. My non op leg feels just as tight as my op leg. “ok?” says Paul “yeah”, says I.

And so we go for a walk, only 5mins, around the school. And my head the spins the whole time. “what a stupid position to be in, sat on a horse, 7 weeks post open hip surgery, I cant even get my feet in the stirrups never mind actually ride him! If he does something silly now, I will fall straight off” But then I think “No don’t be stupid. Trust your husband, trust your  horse, trust the training he has on him, trust what you did with him last year, Trust the fact he is your horse and he knows you need him to be good” So I did I relaxed a bit but my head still span. And then it was time to get off. Paul tied CB up to the tie ring and told him to be still. And he was. He stood like a gentle lamb whilst Paul first helped lift my leg up onto his bum then ran round to the other side and helped lower my leg down as I slid off and he caught me. DONE I had ridden my horse and wonderful clever horse he is, I gave him a big hug and a kiss. I was more proud of him being so gentle and kind and understanding than I was of what I had managed to do.

 

Me and My Horse, after our first ride,
7 weeks post op

 

Week 5 & 6 Post FAI Open Hip Surgical Discloation & Debridement Surgery Recovery

During the 5^th week post op, I seemed to improve quite a bit. I had cut down a lot of the pain medication and so was a bit more “with it” I was moving about more on my two crutches without pain. The swelling in my leg was a lot less  and  I started to feel like my leg actually belonged to me again! I was getting very tired of the crutches as everything ached and everything was hard work with only toe touch weight baring.  When I woke up on the morning of 6 weeks post op I felt great. I took hardly any pain killers that week and actually started to bare some more  weight through my op leg as it felt fine and my shoulders really appreciated it.

We went down to Truro for my post op check on the 17^th Jan and the Xray showed that my osteomy had healed, Mr F said he could barely see the fracture line. I must be a super healer or something because my scar looked great to! He said he was pleased with my "new angles". He said that I could fully weight bare on it from that moment and from the following Friday I could drop to one crutch. Then from the  Monday after that (8 weeks post op) I could start my hydrotherapy and begin to get back to normal. He even said I could do a Zumba class form 12 weeks if I fancied - I didn't fancy, thank you very much. Not my sort of thing! What about horse riding? "When ever you feel like it from next weekend, just for a few minutes at a time"  Brillo!  My post op x-ray is below and it kind of freaks me out how different my hip sockets look now. My operated one is so much smaller!

I asked him if there is now a risk that my op hip may dislocate now that it is all so much smaller? He says not a chance. I ask if him if I will need to hip replacement, He says it very unlikely because now, as if it wasn’t for the hardware, my hip looks a very good, healthy hip. 

He says I will need number 2 doing, as soon as the number one is recovered at the Tonnis angle in that is is in the negatives and the CE angle is to big. There is also posterior overcovergae so basically the same as number 1 was. So there is no question of whether my other hip needs doing, its more a matter of when. They say it takes at least a year to heal from this op, as the current op leg needs to take on the role of the main leg when the other is done. But realistically, I don't want it done this year. Autumn 2015 would suit me, so long as it can hang in that long!

So overall I feel very happy with my post op verdict. It is just sad they have to go through all this again with hip 2. It seems like I am half walk through my battle and the end is still a long way off.

7 Weeks 5 days post op!

 

 

Photos Taken During Surgery - Do not Look if you are squeemish

Ok, so for the brave ones amongst you, here are 3 pictures taken during my surgery, when my hip was dislocated!



Pic 1. Following dislocation this is the top of my femur
You can see the damage done by the pincer impingement and the
large CAM deformity

pic 2. Close up of the CAM lesion, and damage.



Pic 3. Following Mr F's femoral osteoplasty (re shaping)
Here he using a template to check for spherety

Weeks 2 to 5 Post Op

Really week 2 to week 5 were pretty much of a muchness. I find it difficult to think back and separate them. For week 2 and 3 I stayed on 500mg paracetomol and 60mg codeine 4 times a day. The pain was ok, no more than a 3 or 4 out of 10. My back felt great, sitting around for 5 weeks  in the past would surely have sent it into spasm. There was the expected post op surgical pain, but my pain killers kept it pretty well under control. My hand hurt the most, from using the crutches! I ended up a padding them out with soffban dressings and tennis racket grip over the top.

There was a set of rules to follow for weeks 1 - 6:

 

1) Toe Touch Weight Baring only on op leg

2) Hip movements allowed.
Hip flex passively to 70 deg.
Hip abduction to 30 deg
Hip extension to neutral (ie. Lying supine or prone)

3) Hip movements to be avoided
Hip Adduction beyond neutral so no crossing ankles
Any active hip flexion or abduction.
Avoid powering up hip abductors.

My husband did the following passive exercises for me twice day.

1) Passive adduction, not more that 30degrees - 10 times

2) passive flexion, not more that 70 degrss - 10 times

These two exercises are important to maintain motion between the hip capsule and labrum (well, what bit I have left!) and to avoid adhesions forming 

I did the following exercise 3 times a day:

1) static quad sets x 10

2) static glute sets x 10

3) ankle pumps

4) ankle rotations

5) Some Pilates exercises for my other leg, like single leg raise, flexion , adduction

The first 6 weeks after this surgery there are a lot of restrictions. You are not allowed to flex your hip beyond 90degrees at all, so it's important that all chairs you use allow you to stick to this rule. It also means a raised toilet seat is required. I was glad of mine, and I also had a shower stool and perching stool for sitting at the sink. I wasn't able to get in out shower for the first 3 weeks. I just felt unsafe getting in, even with my husband there to help, so I stuck to washing at the sink sitting on my perching stool. Washing my hair wasn't easy and was a right old rigmarole, so I only washed it once a week, leaning back over the sink as far as I could for my husband to wash it for me. I used dry shampoo in between.

Daily life 

I spent the days alternating between sitting in my armchair with either with my feet up on the foot stool or flat on floor, lying on the downstairs bed or sitting at the table doing a jigsaw puzzle. obviously following surgery like this there is a risk of Deep Vein Thrombosis. My surgeons protocol for avoiding this is 150mg aspirin once day, TED stockings and doing the ankle pump exercises regularly. I was glad that the DVT injections I had in my tummy in hospital didn't have to carry on, they were quite sore, like a bee sting.

Getting about at home

It was really a pretty boring 5 weeks, I could do very little for myself. I mean, I could wash and dress myself - with the use of a grabber/helping hand and the a long handled shoe horn with a hook on the end. But beyond that, the fact that I was on two crutches meant I had no free hands  to do anything!(a back pack came in handy for carrying things between rooms, even flasks of tea or noodles/soup for lunch!) Also, with the toe touch weight baring only, getting around was really hard work. My non op hip would burn if I was on it to long, especially standing still making lunch or standing at the sink, I would almost feel like it would give way if I didn't get  to a chair quickly. The stairs were really hard work, going up was the worst and seemed to take for ever going one at a time and taking a break after 2 or 3! to start with I only came down in the morning and up at night, I couldn't have gone up and down more times than that. By week 4 though, I could do a it a couple of extra times during the day but it was still hard work.

Going to bed

Going to bed seemed to take ages, I would generally go and get myself into my PJ's in the downstairs bathroom at 8pm. At 9pm I would collect together my ipad, phone, book, pills etc in my backpack then climb the stairs one by one to bed. Then my husband would do my passive exercises and change my TED stockings. Then I would do my active exercises. whilst Paul came back downstairs and let the dog out, gave her her super, locked the house up and washed my TED stockings by hand ready for the next night (I only had 2 pairs). It doesn't sound like that much, but the same thing night after night seemed like ground hog day and Paul was knackered by the time he got into bed.  

I was  not allowed to actively abduct or lift my leg, so if I needed to move my leg onto the sofa, foot stool or into the car, I had to have someone do it for me or use a dog lead to hook around my foot and lift it.

Going Out

I didn't go out much in the first 5 weeks, we had borrowed a wheel chair as walking far on 2 crutches was just to painful on my non op hip and shoulders. So my husband wheeled me along the sea wall a couple of times, and down to the farm where we keep our elderly pony. We also went up to see my horse 3 times, taking the chair so I could sit and watch him groom him. Charlie was very good with me in the  wheel chair, he wasn't to keen on my crutches. There was a brief trip out to the GP practice to the see the nurse  at 2 weeks post op and have my dressing removed. The wound looked great, it had been sealed only with glue and looked no more than a nasty cat scratch really.

My Scar 12 days post op (Dressing removal)

 

Sleep

From weeks 1-6 I was only allowed (and able) to sleep on my back and this was one of things I found hardest about recovery. I found it very hard to sleep on my back and often be awake until 3am watching TV or reading. The first 2 nights were  very sore on my lower back and my nurse friend suggested sleeping on the sheepskin rug that we have. It was fantastic. It eased the pressure of my lower back and slept on it every night for 5 weeks. I also had a back rest on its lowest setting angle and my leg on a pillow. And that's how I slept for 5 weeks. 5 very  long weeks! The one thing that made it bearable was my Pie Cat sleeping on my chest/tummy EVERY night without fail. She was good company, and of course, you cant beat the healing power of being sat upon by a cat!

The Healing Power of Being sat upon by the cat!
 

 

Physio

At the start of week 4 I went to see my physiotherapist Donna. She was very excited to so me and it was lovely to see her. 18 moths after hse first suspected FAI we finally at the post op stage! My husband came in and we all had a good chat about things and then showed she him a couple more passive exercise that he could do for and also about massaging around the scar area. The area around the scar was rock solid, it felt like solid tea-plate was under the skin. She said that we needed get this tissue moving to stop adhereing together and forming to much sacr tissue.

So weeks 4-5 we added in the extra passive exercises as well as my static quads & glute sets and also the bio oil massage, along with the continued TED socks changes, this made the task of going to bed even longer. It felt like those weeks were never ending. During week 5 I emailed my surgeon to ak if I  could stop wearing the TED socks and said yes. So that was a bit a relief for me and Paul, one less thing to fight!

 

Week One Post Op

I spent the whole of week one in  hospital. It was supposed to be a 3-4 night stay but unfortunately I had some non-hip related complications.

 

I wont bore you with a day by day account of my stay in hospital suffice to say I stayed  the 4 extra days due to a low haemoglobin count (7) which meant I could not walk very far with out feeling faint. Even going to the toilet on the walking frame meant I had to be followed by the oxygen trolley - just in case - and it exhausted me so much that I was a dithering wreck by the time I got back to bed. It is quiet a shock to go from being able to walk 3 miles  a day one week to being like that. I can remember spending a lot of time sitting on the toilet clinging  to the grab handle on the wall, resting my head on the tissue paper dispenser, my head spinning, whilst the nurse waited outside!!

My catheter was removed on the 2nd morning after surgery (so Wednesday) and the pain buster removed later the same day. It was running up to Christmas, so and I could see the Christmas decorations on the nurses station outside my room, that was nice. And from my window I could watch everyone coming and going from the main entrance and also see the Cornwall Search and Rescue helicopter landing on the helipad for Treliske hospital.

Helicopter from my window!

 

My temperature control was all out of sync I seemed to get very hot all of a sudden, I spent most of the week with the window open and a fan. Crazy in the middle of December.

 

I stayed very itchy all over for about 4 days, That was the worse part really. The pain was managed well with 1000mg paracetomol, 400mg ibuprofen and 60mg codeine  4 times a day, with the occasional oral morphine and also diazepam at night as I was having spasms in my groin. I used the CPM machine a lot, I really liked it. It gave my leg something to do instead of trying to fidget! for the most part, the CPM did not cause pain, but there was a certain point every now and  again, when the flattest moment of the CPM coincided with the air pump cuffs around my legs being deflated, so my leg was at its straightest. That pulled quite a lot on my hip. 

My CPM machine (continuous passive motion) this
prevents the hip joint stiffening up prevents
 the build-up of adhesions

I made slow progress with physio due to my low haemoglobin/fainting tendency. So on the 3rd day post op I had a blood transfusion. This seemed to take for ever to organise and it ended up starting at 11pm and took until 2pm for the 2 units to go in. The two nurses were great  fun though and kept bringing me tea & custard cream biscuits, .

The blood transfusion going in!

 

The next day (day 4 post op) I felt a bit better and was able to progress a bit further with physio, finally mastering the crutches. The day after that I did the stairs and also had a shower which was marvellous. My can of dry shampoo could do no more for my hair after 6 days!

I went home on the Sunday. The trip was 2.5 hrs and I loaded myself with relief beforehand, I still wasn’t really in much pain, my lower back felt the best it had for years.  We had to stop at Cullompton service Station but we managed to get the disabled space right outside the door. I felt very unsteady and self conscious on my crutches but made it through the door and saw that the toilets were all the way across the costa coffee shop, it seemed like miles away. But I made it and used the disabled loo ok.

When we got home, I went to bed in the downstairs spare room and slept until dinner time. Are my dinner then went back to sleep. Rock and Roll!

My cat Pie came to see me as soon as I got home

And my other cat Tooie slept on my bed all night!

 

Op Day and Day 1 Post op

1^st  December 2013 We travelled down to Truro the night before and stayed in a B&B. We went out to a local pub and had a lovely steak & chips dinner, which went down OK. I had no idea when I would be eating next and hoped the anaesthetic wouldn’t make me sick, as I really like food! I didn’t sleep very well that night but I guess that was to be expected. It felt like I was the eve of a great leap into to unknown, which I guess I was

2^nd December. Checked in to hospital bedroom at 10:30. The anaesthetist came to tell me I would be having a full anaesthetic which I was glad about, along with spinal pain relief. Mr F came to see me and drew an arrow on my leg. He said he would try  to get away without doing the trochantic osteotomy by going beneath one of the muscles to reach the impingements. That got me a bit worried as I felt like even though no osteotomy would mean less time on crutches, the thought of the full open surgery made me feel like everything would be sorted as he would get full visualization of my joint. I didn't mention that worry to him, as I felt sure he would to the right thing and do the osteotomy if needed.

I got changed into my gown and into bed and got pushed down to the theatre pre-op room at about 12noon. I could see Mr F in the theatre through the round windows in the doors.  I can remember I had to sit on the edge of the trolley with my feet on a stool whilst the anaesthetist  put the cannula in my right hand. There was a younger man standing in front me with both hands holding onto my shoulders. I can remember talking to the Scottish anaesthetist about Gin, Bombay Sapphire on the rocks to be more precise . He said I best have some of his injectable  gin before I had the spinal injection as that would mean I wouldn’t know anything about it. I can remember saying to the young man “Holding” me up that I was glad he was there or else I would fall off the bed. And that was it. Next thing I knew it was 4pm and I was in recovery room and my nose was REALLY itchy!!

The recovery nurse said I had been very naughty trying to remove the oxygen prongs from my nostrils and rubbing my nose. But they were so annoying!!!!. He asked if I was in pain and I said no but my nose is really itchy! And that is about all I can remember really, apart from realising I didn't have that horrid sore throat or lip thing going on that I had with a previous and anaesthetic and  the  feeling of relief to think it was all over. Mr F had finally been in and sorted my hip out. I spent the next half an hour rubbing my nose and trying to pull the oxygen prongs away whilst the nurse kept telling me off for it!

I got back to the room about 5pm I think there was a lot of hustle and bustle whilst they set up blood pressure machine and organised my fluids stand and then the physios came in and put the CPM (continuous passive motion) machine on my leg , which didn’t really bother me, it felt good to get my hip moving as it was stiff.  Then they fetched my husband and we were left in peace. I had a peek under the covers to look at my leg. There was a pain booster tube going in, and  a wound drain tube coming out, with a small bruise around it.  There were 3 big plaster type dressings and my leg was a red colour. The nurse said that was due to the dye in the sterile wash they use.  

After the op
 

after the op, the blue thing is the CPM machine

 

Half an hour later my Mom & Dad arrived. I can't really remember much about that evening. I was really relieved to have a catheter in place, I didn't feel like I could move an inch never mind as far as the loo! I felt quite comfy pain wise, it was just a heavy/stiff feeling in my leg. The thing that really bothered me was how itchy I was all over and the fact I really wanted a cup of tea something to eat. The cup of tea arrived along with a ham & tomato sandwich. It was great! Mr F came to see me, but I cant remember what he said, apart from  the fact he HAD had to do the trochantic osteotomy in the end and "at least you know you are not bonkers now" What a great term! Yes, I now knew non of this was in my head, there was something wrong and that it had been fixed.

Best cup of tea and ham sandwich in the world!

 

That night was one of the longest nights of my life. I was right out side the nurses station so it was quite busy. I could not sleep I was so itchy!! I just wanted to scratch everywhere all the same time and I couldn’t. They said it was to do with the anaesthetic meds. I had piriton and some oral morphine in the hopes I would settle and go to sleep but it didn’t work. I just lay there, trying to fidget and scratching my arms and legs mostly!  About 2am I had fidgeted so much that I manage to undo a connection on my catheter and so now I had a bed full of wee. Great.  The nurse came and reconnected it then set about changing my bed sheets. I had thought this would involve me having to get out of bed, not something that filled me the sense of fun, but honestly its like magic how they can change a bottom sheet of the bed with someone still in it!! She had to take my CPM machine off to do this and didn't put in back on.

I didn’t sleep at all that night. Paul came about 8:30am and was a bit cross that my CPM machine had been taken off. The physio came at 9am and put it back on, and when she doing that,  I realised just how much my hip had stiffened up and it quite painful. I had to have some more morphine to take the edge off. I didn't do much that day. Just stayed in bed, watched TV and tried to dose, unsuccessfully. Usually just as I dosed off, a nurse would come crashing in to do my observations. I made it my challenge to eat all food and drink all tea put in front of me. The food was really nice. I was still quite miserable with the itchiness, which was still persisting. I really needed one of the back scratcher things with a hand on!

Mr F came and told me a bit more about what he had done. He said he had addressed the cam and pincer impingement and that my labrum was calcified, which was why he had ended up doing the osteotomy, so that he could remove the calcified labrum. He said I should do just fine without a labrum, better to have non than the calcified one that was damaging the head of my femur. He showed me two pictures that he had taken during the op. He had them on his iPhone! The brief glimpse of the inside of my hip was a bit shocking and made my head spin! He said the physios would get me up on walking frame the next day, and to make sure I kept up with the pain relief, that there are no medals for trying to be a hero coping with pain. He said the morphine is very good at taking the edge off but only lasts an hour so, so to try and keep on top of the pain by asking for it before I felt I needed it. Throughout that day I also taking paracetomol 1000mg and codeine 60mg, four times. In terms of pain, it was mainly just a very sharp, achy feeling in my groin.

That 2nd night was the next worst of my life. I cant really remember much of it as I was completely whacked out. The night nurse decided I should try some of my amitryptaline that I had bought with me as a repeat GP prescription. She thought it would help me sleep. I had it at the same time as some oral morphine. Big mistake. I was convinced I was freezing cold. I was dithering so the nurse bought an electric heater in and a duvet and left me to it, closing my door behind her. I think I probably spent 4 hours with a sky high temperature, which fuelled my amitryptaline and morphine induced  nightmares, as well as still being VERY itchy. I really wanted my husband - or my Mom. I know was talking to myself and I can remember thinking there was a man standing by the door. I woke at some point pouring with sweat and pressed the nurse buzzer. She came and turned the heater off and removed the duvet and left the door open. I spent the rest of the night drifting in out and of bizarre sleep & nightmares, I thought daylight was never going to come! But it did.

Further Information on FAI and Open Hip Debdridement Surgery

I wanted to include a few bits of information before finally getting into my op story:

 

In case you haven't read my earlier posts or need a refresher, this is a really good information document on FAI ( but you really must replace the grey head models with younger, more active types!

http://www.eorthopod.com/Booklet?ClinicID=6138752e01d21f68baaa5b7b82751802&TopicID=0a0773151e66b80b97aa3f0f9ca765a9

This is a really helpful document produced by the Cornwall Hip Foundation team which outlines pretty much everything to with Open Surgical Dislocation and Debridement for FAI:

http://cornwallhipclinic.com/resources/Documents/Open-FAI-info-sheet-11Jan2009---MRN.pdf

The Cornwall Hip Clinic Website:

http://cornwallhipclinic.com/index.html

There are  couple of You Tube videos showing the open dislocation/debridement surgery.... I wont post them here as they are rather graphic, I will leave you to search You Tube for "Open hip debridement surgery" if you wish!

 

 

2013

2013 was not unlucky for us, though it was probably one of the most stressful years of my life. As well as battling with my continued chronic back and hip pain, we also moved house. We exchanged contracts on the 31^st May 2013 and so began the mammoth task of moving out of our rented house and into our new home by the end of June. They say moving house is on life's most stressful activities. When you also have 3 cats, a dog, chickens, rabbits and small pony to move, whilst doing it all through the fog of chronic pain, the stress if magnified. I think the only thing that got us through it was the fact we were moving to pretty much our dream home , right on the beach front. It is our forever home.

Although we did use a removals company for the house contents, we move all our outside things ourselves. That included the contents  of my husbands workshop, a wooden double stable, 2 sheds, a green house and their contents. It was exhausting. I was unable to help my husband with any heavy lifting and so he was more exhausted than I was. My back held out until mid June. I was redecorating our bedroom and  had managed OK with the help from my friend. Then, when I was sat in an awkward position on the floor painting the skirting board, it went into a major spasm. I managed to get down stairs into the garden where Paul was working before it locked up completely. I  took some codeine & diazepam  and lay there on my front in the garden for about an hour, until my back relaxed a bit and I could stand up. That  put an end to any painting or decorating and after a few days “rest” – which also meant cancelling my dog walk jobs, I was relegated to cups of tea making only. It was completely and utterly depressing. This  was before I had been to see Mr F to get my proper diagnosis and if nothing else, it cemented my decision that I couldn't go on with life like that and had to go and see him at the end of the summer, when we would actually have time and mental capacity to tackle it.

After I had been to Mr W in February and he had told me stop horse riding, I decided that I would do quite the opposite. I felt like My life was ticking away not doing the things I loved. I had put a pause on horse riding because Paul was worried that if I did have labral tear in my hip, I could be making it worse. We had placed my horse into full livery in January because we knew I could no longer care for him. It was either that or sell him. And selling  my Charlie Brown was not something that would make me happy. After Mr W dismissed my hip symptoms as bieng related to my back, I decided to ignore his advice and get back to riding my horse whether it hurt on not.  Through 2013, depending on my pain levels,  I alternated between ground  work with Charlie, going for a walk with him like a dog on the end of a lead rope and gentle riding, walk and trot only. This proved beneficial to both of us and we actually developed a better bond, We began to understand each other better because we were doing things slower I believe he knew I was in pain and looked after me. We went out on a few rides on our local bridle paths (once we had conquered crossing the very high bridge over the M5 motorwar!) . It was fabulous to get out into what felt like the middle of nowhere on our own and forget about all the stress of work, trying to get a diagnosis and house moving. I would be in a fair amount of pain when we got back to the stables, but I really didn’t care. My horse and I were having fun at last and it a great anti depressant for me.  

View from a top my horse at the top of a nearby hill.

 

My last ride on him was 4 days before surgery and I felt both really pleased with how far we had come that year, and sad because I didn't know when I would be able to ride again. A part of me was scared that  I would never be able to ride again. The yard owner was all set to ride Charlie for me for the next 3 months or so. So I said good bye to him the day before my surgery not knowing when I see him again.

My physio would have liked me to have undergone an extensive “pre hab” regime prior to surgery to get my leg muscles and core as strong as possible to help with post op rehab. But it was never going to happen. My back and hip were intolerant to any repetitive exercise other than a handful of gentle Pilate's exercises or walking. I had a few regular dog walks at work. I walked a poodle 5 days a week for half an hour, a labradoodle 3 days a week for an hour, a Golden Retriever twice a week for 45 minutes and  a German shepherd cross once a week for 45 minutes. These dog walks became my exercise and were the thing that kept me going through 2013. There were many times when I struggled on these walks, I was careful to choose only flat walking locations, and new all the benches on the routes. Some days I would walk really slow. The poodle in particular was very knowing. He was a big powerful dog but I could see him modifying his pace to walk at my slow speed. Four weeks before surgery I started to use a walking pole, It really helped and I wished I had started using it earlier.  I had managed to organise a someome to take my dog walks on for me whilst I was on crutches, and hoped I would be able to start back walking them in March. I spent a lot of time with all 4 of the dogs, walking miles with them. Sitting on bench's with them whilst I rested. They were a very good alternative to any other pre- hab I could have done.

 

Here some picture of the 3 dogs I spent a lot time with walking in 2013, on thour last walks before my op

 

At the start of November I made a giant to do list in preparation for life after surgery, so much needed organising. There were 3 titles: Home, work, Animals. If it wasn’t on the list, it didn’t get done. Everything was on there, from stocking up on animal feed to arranging the mobility equipment I would need after surgery. It was quite a relief to finally tick the last item off the day before surgery: “Pack bag for hospital”