6 month check-up – all good!

On 1st Feb 2013, it was 6 months and 1 day since Mr Witt sawed and chiselled his expert way through my pelvis and pinned me back together during my RPAO.  And of course, the only way to celebrate this is with an X-ray at UCLH (apparently my second home).  One of the most exciting parts of this adventure was travelling on the London Underground – I haven’t been mobile enough to do that for years! Now I can cope with just one crutch, to support my left (unoperated) hip.

And the good news is, everything on the surface is healed (see below for non-gruesome scar pic) and on the X-ray everything looks fine!  One of Mr Witt’s registrars showed me just how much more coverage my hip socket has following the operation – no wonder I’m getting less pain on that side when I walk these days!  There is one fracture which had to be shifted so far that it’s unlikely the two sides will unite fully – and apparently this is quite common and not a problem as it’s a non-weight-bearing part of the pelvis.  But the hip is officially fixed.  Woop!

We discussed one niggle that has been frustrating me for the last few weeks – when I try to do certain yoga poses (bridges, clamshell exercises), I get an intense pain low down in my pelvis, kind of between my butt and my pubic bone (nice).  It’s impossible to point out without looking extremely rude, so that was kind of embarassing.  Anyway, it’s so sore that I have to stop whatever I’m doing, and it takes several days to recover again – during which time it hurts when I walk, go up stairs, do my physiotherapy, turn over in bed  – well, during everything.

Mr Witt and his team told me that this is reasonably common and can be caused by a tiny stress fracture in the pelvis – but on a non-weight-bearing part which is why I can’t feel it when I walk around (unless it’s after I attempt said bridges, clamshells etc). They inspected my X-rays thoroughly and found no evidence of a fracture, and so they’ve put it down to a muscle (probably hamstring) which is rubbing or catching on one of the fractured sites.    They gave me more hamstring stretches to do, and told me that if it doesn’t improve in 6-8 weeks, they can give me a cortisone injection under sedation, to ease it.  This is something that happens quite often post-PAO, and apparently cortisone tends to sort it out for good.

So, that leaves Hip Number 2 – the left one!  Mr Witt put me on the waiting list for my LPAO at the same appointment, so I just have to cross my fingers I won’t have to wait too long.  I suspect August will be an interesting month for the second year running.

In the meantime, here is a picture of my scar, on its 6-month birthday.

IMG_1443

Stripes – I’ve earned a few..

I’m quite proud of it – it’s fading to a pretty silvery colour, and sits right along the natural crease in my hip joint.  It’s invisible under my knickers or a bikini.  And it’s only about 4 inches long.  The little screw bumps above the incision are not really visible in this picture, but I’m rather fond of them too.  It’s nice to have a reminder of the operation that is helping me walk again.  Almost like people get tattoos to mark important times in their life.  Tattoos aren’t my thing, but I like to think I’ve earned this particular stripe!

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Back in the saddle…

Hooray!  Just don't make any sudden movements

Hooray! Just don’t make any sudden movements

Well, it’s been 4.5 months since my PAO, and I seem to have let the blog go a little bit. I am sorry – but unsurprisingly, the drop in posts coincided with my return to work – and something had to give! I found going back to work quite tough at first, but I’m properly back in the swing now. Luckily, my employers have been tremendously supportive and during my first few weeks, I worked reduced hours until I’d got my energy back.

Since my last PAO post, my recovery has been pretty smooth and steady. I no longer have to attend hyrotherapy but have kept up with the physiotherapy, attending a series of gym classes at my local hospital for people with lower limb problems. This has really helped with my strength and as a result, I can now:

Walk without a limp for a lot longer (but I still need a crutch or a stick because of my other hip)

Do several wobbly lunges (this does hurt), dips, squats, and bridges

Do about 20 minutes on a stationary bike and 3 or so minutes on a rower.

I’ve been cleared by Mr Witt to do some low impact weight-bearing exercises now, but of course, there’ll always be a limit to my mobility until I get my left hip done. Most of the time, though, it’s the left (unoperated) hip, that is giving me more trouble now. I am amazed and delighted with the difference to how my right hip feels. I don’t feel so unsteady on my right hand side, although there are times when I still feel real, acute pain low down in my butt and in my groin from the pelvic breaks, and that makes me really wince.

One of the best milestones in my recovery was my first riding lesson – check out my smile in the photo above! I spent 15 minutes walking and trotting around in circles on a very safe, lovely pony, and my instructor was amazed at the difference in position and strength of my operated leg. When I ride these days, I’m a bit lop-sided because my left leg (which previously was always the stronger one) is now holding me back. Woop (although I do feel sorry for the poor pony)!

Trot on! Riding again at last.

Trot on! Riding again at last.

For the past year or so (pre-op), riding was a life-saver for me. I missed my mobility, I missed running around the hills of Devon, and discovering a riding stables where the instructors were willing to let me have a go was such a blessing. I adore borrowing my ‘spare legs’ and I’ve turned out to be quite good at it (with limits – getting on and off is always a challenge). Doing so much core stability in my physio seems to have been a big help. I also seem to be ‘liked’ by horses, and the instructors say ‘oh look, they recognise that you are lame’. Sure enough, the first time I returned to the stables, the horses and ponies took a massive interest in my operated leg, sniffing it, nickering at me, trying to ‘groom’ my hip through my clothes.

I’m not the only horsey addict in the family – the two girls are also having lessons, which has led to lots of imaginative play. And Irish and I are rather happy about that – riding is an expensive hobby, but preferable to an interest in boys at this age!

Playing horses - a lot cheaper than boys (potentially)

Playing horses – a lot cheaper than boys (potentially)

Irish has promised (rashly, I believe) we can look into loaning a horse/pony once all my PAOs are out of the way. Hmmm – I wonder..?

PAO Recovery Week 10: A Setback.

Dammit – things were going so well!  Until a week or so ago, I was making great progress.  As I wrote in my previous PAO update, I was beginning to do some weight bearing physiotherapy , trying to move away from crutches, and generally enjoying being in much less pain and much more mobile.  So much so, that I think I got too confident and…oops.

*Sniff*

I was trying to do some one legged bridges (raising myself up on my operated leg) and it felt sore.  Well, I thought to myself, physiotherapy exercises do hurt.  Every physiotherapy exercise I’ve ever been given has hurt when I first tried it.  So I did a few more.  And that night, when I went to bed, I noticed a soreness down the side / back of my right thigh.  It hurt when I bear weight through my leg, when I squat, when I sit down, when I stand up – and over the next few days, it didn’t get any better.

After an uncomfortable hydrotherapy session I decided to take it up with my GP, who sent me to the Accident and Emergency Department for an urgent X-Ray.  Three different orthopaedic doctors compared the X-ray with the previous ones taken at my 6-week checkup, and decided that there were no changes between the two.  This is good news, because it means my adventurousness hasn’t resulted in a fracture.  Blood tests revealed nothing unusual so infection is also ruled out – hooray.   Unfortuately though, it has left me with a series of guesses as to what is causing the problem.  Sciatica?  Bursitis?  Iliotibial band?  I’m not sure.

Ouch…what have I done?

But still – meh.  In terms of pain and mobility levels I have regressed weeks.  I am back on two crutches, need serious amounts of codeine to help me sleep through the pain, and can’t sit, stand, walk or sleep for long. And I’m still at a loss as to what is causing the pain.  It isn’t localised to my joint – in fact the mobility in my hip joint is continuing to improve.   This pain radiates down the back and outside of my thigh, even as far as the outside of my knee.   And because I don’t know what the matter is, I don’t know how to try and fix it.  I’ve been told to lay off the physio and wait to see if things improve without any weight bearing or other kind of aggravation.  Grrrrrr!

Thankfully I have another physio appointment in two days, so I am really hoping for a) some answers and b) some exercises that can help me reduce the pain.  I feel like I’ve retreated back to a codeine-induced zombified haze, and I just don’t want it to be like this any more. Last week, I was getting excited about  returning to work soon, and now I’ve been signed off for at least another four weeks.

Are there any PAO-ers or ‘hip women’ out there who can give me some advice?  Does this sound like anything you experienced or have heard of?  I’d be so grateful if you could help me get rid of this pain and put me back on the track to becoming the bionic woman (minus one-legged bridges, which I may very well never attempt again.  Ever).

Week 9 post-PAO – hydrotherapy rules

9 weeks into my PAO recovery and things are definitely looking up!  I have been working hard at the physio and am now happily doing exercises that I found impossible in week 6 – and more besides.  My physio has been really helpful at finding me new exercises that challenge me (for which read: that hurt like hell). For the first day or two, they are beyond difficult, but gradually I am finding myself getting stronger and stronger.  It’s a small difference which I can’t notice day by day, but when I look back each week, the improvement is undeniable.

My scar is continuing to heal and my mum bought me this stuff:

I am bio-oiling the hell out of myself.

I have no idea if it works, but it smells innocuous and feels nice when I smooth it into the incision and surrounding area.  My GP friend suggested I try it, so I will continue to report back on the healing process.

Some things I can now do:

  1. Stand on my operated leg for  about 5 wobbly seconds
  2. Do a few dips on my operated leg whilst holding onto a chair or whilst using my crutch for balance
  3. Lift my operated leg until it’s perpendicular to my body (when lying down) and hold it there quite happily
  4. Walk around inside the house without a crutch – albeit with a significant limp, and very slowly.  The more I walk, the more noticeable the limp is.  And in the morning and evening it hurts because it all feels so stiff.
  5. Bring my operated leg up and cross my ankle over my other knee so my legs are in a ‘number four ‘position.
  6. Sleep on my operated side for several hours
  7. I had a teeny little practice driving again yesterday – hooray!  I wouldn’t want to drive more than a few miles yet, but it felt good to get behind the wheel and to practice some emergency stops / harsh braking to reassure myself I could do it if necessary.

These are small triumphs that please me every day.  I am less reliant on painkillers but still take paracetomol (and sometimes codeine) before heading off to physio or hydrotherapy.  This week at physio I spent 5 minutes on a bike and discovered that if I worked at it, the limp I have when using one crutch will go away.  At hydrotherapy I was given some very tailored exercises that will help me with the things I still find difficult (reaching to put shoes, socks, jeans, underwear on, lifting my knee up in front of my hip, pushing down with my heel).

The issue with hydro is that people assume it’s a lovely spa treatment and offer up comments like ‘ooh, lucky you!’.  Unfortunately, this isn’t the case – at my hydro session, it feels more like getting into a warm bath with your physio and perhaps one other patient, and splashing about doing exercises that hurt you but which you are assured will aid your recovery.  That said, it is blissful to let the warm water take the strain off my body for a while – and so freeing to be able to walk in chest deep water with no limp and no significant pain.  I am always a bit reluctant to come out of the pool after my time is up, but it is exhausting work!

In general, the tiredness is where I feel I am getting stuck at the moment.  If I go out and I’m out of my comfort zone, I get tired after a couple of hours.  The pain creeps up on me and my brain gets all foggy with tiredness and soreness.  It’s this which makes me feel I’m not ready to go back to work yet.

I’ve also noticed that I’m continuing to have some very mild hair loss.  It started during week 2 post-op.  Every time I brush or wash my hair, I lose about a handful’s worth (scrunched up) of strands from the root.  I also shed strands of hair over the carpets, etc (nice).  I’m not too worried about this – I have a lot of hair, and I’ve heard this can happen after major surgery or a physical trauma.    To be honest, there are so many people who lose all their hair through chemotherapy, etc, that I can’t really get upset about this.

On the plus side, I’m getting quite fond of my new ‘dinosaur spines’, as I’m calling the screw bumps just above the incision.  They are starting to become more obvious – you can see in this picture.  They do press into tight clothing like jeans, but wearing dresses is proving to be an easy alternative for now.

‘Dinosaur spines’ – I actually quite like them. I am weird.

The screws will be taken out with the ones from next year’s LPAO, probably in 2014.  That seems like a looong time away, so perhaps it’s a good thing I’m happy with them.  They make me feel like a bionic woman!  Watch this space for future feats of athleticism…I’ll just have a quite nap first!

What a difference three weeks make – PAO recovery weeks 5 – 7

After week 4, the rehabilitation work begins. My time is now increasingly taken up with physiotherapy exercises and attending hospital appointments.

Week 5 sees the first of my physiotherapy appointments.  Having seen all the amazing feats of athleticism that other PAO-ers are able to achieve after 5 weeks, I’m rather nervous that my physiotherapist will be disappointed with me.  But no – in fact, she’s really impressed!  This is a big relief to me, as I was starting to wonder if my pain levels at this stage were rather high.   She suggests I add in an abdominal exercise to the exercises I was given when I left the hospital, and books me in for hydrotherapy in week 7 (of which more later).

Pleasingly, she also marvelled at the rate at which my scar is healing, and at how neat it is.  You can judge for yourself here!

I did not pick the glue off this scar at ALL. Definitely not. No.

This photograph was taken in week 4.  I think it looks a lot worse in the photo than it does in real life, actually. You can see that the glue covering the incision is starting to peel off, and it’s very difficult to refrain from helping it along.  The peeling increases after I discover that I can wangle myself into the bathtub at last.  This is heaven.  I spend a long time in the bath every morning.   It really seems to help with the achey feelings I get when I wake up.   There is still some weird numbness along the incision site and radiating down my thigh – but the area affected by this is decreasing every week.

Week 6 sees me head up to London for my check-up at UCLH – and the surgeon also seems really pleased with my progress.  ‘I did that!’ he says with a rather endearing level of smugness, as he checks over my incision.  He’s also happy with the new X-rays, which show that my pelvis is starting to heal.

So, now I’m expected to put full weight through my operated leg – although still using two crutches.  ‘Let’s give you a test’, says the surgeon.  ‘Stand on your left leg.  Lift up your operated leg.  Good’, he says, as I wobble about.  ‘Now, try the same on your right leg’.  I attempt to lift my good leg off the floor and put all my weight through my operated leg.  Ouuch – but I manage it for about, ooh, half a second.  The surgeon actually chuckles.

He gives me some new physiotherapy exercises which, at first, I find really tough.  I wonder if he’s overestimated my recovery level, even though my mobility and energy are continuing to improve.

The new exercises I have to do are:

1) Lying on back, keep operated leg straight and raise it into the air.  Repeat 20 times

2) Lying on back, bend the knee on your operated side and lift your leg towards your chest.  Hold your knee and pull your leg towards your chest.  Hold for 20 seconds, repeat 15 times.

3) Lying on your side (operated leg upwards), keep your operated leg straight and raise your leg, keeping it parallel to the lower leg.  Repeat 25 times.

25 reps?  Oh please! The first time I tried this, I could barely do one.  After a week or so, however, it gets easier.  My hip starts to feel more stable, and I feel as if the movements are more controlled.

By week 7,  I’m used to the pain of carrying out the exercises and reassured that the hurt is not making my hips worse.   Of course, I’m still not improving as fast as I’d like, but my physiotherapist rolls her eyes at this.  ‘What do you want?’ she says.  ‘I’m amazed you can do those exercises and that number of reps.  Your pelvis was broken in 3 places!’.   She tells me that the pain is due to the inflammation still present and to the fact that the muscles and ligaments are being pulled and stretched differently now that my pelvis is screwed into a different position. She seems genuinely impressed with how I’m getting along, and tells me not to overdo it.  Nonetheless, I persuade her to let me try a few minutes on a stationary bike, and she gives me a new set of exercises that I can do at home with a gym ball.  So I have plenty to work on!  I also start hydrotherapy this week – and in chest-deep, warm water I discover I can walk without pain and without a limp.  It feels heavenly.

And finally – all the lounging in the bath and hydrotherapy sees off the last of the glue surrounding my incision.  Here it is – again, I think it looks rather more graphic in this photo than in real life, but what a difference from the photo above!  The ridge above the incision line is partly caused by the heads of the three screws holding my pelvis together – they do stick out a little, but that’s probably more to do with the fact that I’m quite slim.  I’ve been told that all the screws will be removed one my second PAO is done.  In the meantime, I’m starting to feel that I’m getting my life back!

Incision at 7 weeks.

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